Round 2B: Facing Human Suffering -- A Response to Held

Abstract

Held’s (2006) “Does Case Study Knowledge Need a New Epistemology?” suggests that clinical psychology might honor clinical knowledge and the case study method recommended by the author (Miller, 2004) and Fishman (1999) without abandoning an objectivist epistemology. Held’s argument suggests that there is an implicit objectivism in both authors’ adopting Bromley’s quasi-judicial method, as well as within other comments made concerning the way a case study database could be used to build inductive rules of practice. In response to Held, there is a need to further explicate the meta-ethical sense in which psychotherapy is a moral enterprise and a form of phronesis. Particularly important is the unusual feature of practical wisdom wherein the ends are intrinsic to the means, and so means and ends of clinical interventions (techniques and values) cannot be separated. Therefore all psychological diagnoses and treatments are infused with moral judgments that cannot be separated from the substantive psychological propositions indicating the nature of the problem, treatment, or outcome. One is hard pressed then to see how clinical knowledge or case study research can qualify as “objective knowledge” given the incommensurate nature of many moral disagreements, though it is knowledge nonetheless.