As if on cue, vis a vis the last post, a post at Shrink Rap considers the ethics of physicians enjoining their patients to lose weight (when, after all, lasting weight loss is uncommonly successful and the health effects of less-than-morbid obesity remain debatable). There is a fine line always between encouragement and scolding, and this is clearly a case in which moral disapproval is an attempt to motivate. The problem is that when the hoped for motivation does not happen, and yet the disapproval persists, shaming is the likely result. The widespread phenomenon of obesity perfectly illustrates our excessive faith in simplistic free will; physicians nagging patients to lose weight is a moral "treatment" that has a low (but non-zero) success rate, and that can cause significant emotional side effects.
A couple of posts ago I alluded to Orwell's comment that change can only occur through education, politics, or violence--but I didn't comment on politics. Politics is essentially moral debate in which contending parties posit or repudiate, as the case may be, particular visions of value and the good life (if education is about cognitive and conceptual means, then politics is about ends, and religion is a metaphysical form of politics). Psychotherapy is largely about education ("know thyself"), but inasmuch as questions of value are intrinsic to the endeavor, interpersonal politics play a role--a psychotherapist doing meaningful work must stand for particular views of what the good life ought to be, above and beyond mere symptom reduction.
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