MY THERAPY JOURNEY – Page 4 – Critical Research Journal

While both Abraham Maslow and Carl Rogers use the term “self-actualisation” in their respective theories of human development and psychology, there are subtle differences in how they conceptualise and emphasise this concept.

Maslow’s Self-Actualisation:

Hierarchical Framework: Maslow’s theory of self-actualisation is part of his broader hierarchy of needs, which posits that individuals must fulfil (at least in part) their basic physiological, safety, love/belonging, and esteem needs before striving for self-actualisation.
Goal-Oriented: Self-actualisation, in Maslow’s framework, is often portrayed as a pinnacle or endpoint of personal development, representing the fulfilment of one’s potential and the realisation of one’s highest aspirations and talents.
Innate Drive: Maslow suggests that self-actualisation is an innate drive or tendency present in all individuals, although it may be more or less pronounced depending on various factors such as upbringing, environment, and life experiences.
Characteristics: Maslow describes self-actualised individuals as creative, spontaneous, autonomous, and focused on personal growth and fulfilment. They exhibit qualities such as authenticity, acceptance of themselves and others, and a deep sense of purpose and meaning in life.

Rogers’ Self-Actualisation (Self-Realisation):

Process-Oriented: Rogers’ concept of self-actualisation, often referred to as “self-realisation,” emphasises the ongoing process of becoming one’s true self rather than a static endpoint or achievement. It is viewed as a continual journey of self-discovery and growth.
Client-Centred Approach: In Rogers’ client-centred therapy, self-actualisation is seen as the primary goal of therapy, where individuals strive to align their thoughts, feelings, and actions with their innermost experiences and values.
Unconditional Positive Regard: Rogers emphasises the importance of unconditional positive regard, empathy, and congruence in fostering self-actualisation. He believes that individuals can fully actualise themselves when they experience genuine acceptance and understanding from others.
Emphasis on the Present Moment: Rogers focuses on the present moment and the individual’s subjective experience of themselves and their environment. Self-actualisation involves being fully present and engaged in the here and now, rather than striving for some distant ideal or goal.

Subtle Difference:

The subtle difference between Maslow’s and Rogers’ use of the term “self-actualisation” lies in their emphasis on hierarchy and goal orientation (Maslow) versus process orientation and present-centredness (Rogers). Maslow’s conception of self-actualisation is often portrayed as a culmination of individual development, achieved through the fulfilment of lower-level needs and the expression of one’s unique potential. In contrast, Rogers’ view of self-actualisation is more fluid and dynamic, emphasising the ongoing process of self-discovery, authenticity, and alignment with one’s inner truth in the present moment. While both theorists highlight the importance of personal growth and fulfilment, they differ in their theoretical frameworks and emphases, reflecting their distinct perspectives on human nature and development.

Medical courses generally dedicate a significant amount of time to teaching about ethical dilemmas. The reasons for this are usually covered by these labels:

Patient Care and Safety: Healthcare professionals make decisions that directly impact patients’ well-being and safety. Ethical dilemmas in medicine often involve complex situations where choices must be made that balance the best interests of the patient, informed consent, and potential risks. Teaching ethics helps medical professionals develop the skills to navigate these situations while prioritizing patient care.
Informed Decision-Making: Medical decisions are rarely black and white. Ethical dilemmas frequently arise when multiple valid options exist, and the best choice depends on the specific context. Training in medical ethics helps practitioners consider various perspectives, weigh pros and cons, and make informed decisions that align with their patients’ values and best interests.
Autonomy, Agency, and Consent: Respecting patient autonomy is a fundamental principle in healthcare. Ethical training helps healthcare professionals understand the importance of obtaining informed consent, involving patients in decisions about their care, and respecting their preferences, even in challenging situations. There’s strong evidence that having a sense of personal ‘agency’ (aka control) leads patients to pursue treatment to its natural conclusion rather than stopping when immediate symptoms disappear.
Complex Cases: Modern medicine often involves intricate cases that pose moral and ethical challenges. These might include end-of-life decisions, organ transplantation, genetic testing, experimental treatments, and more. Properly addressing these cases requires a deep understanding of ethical principles and frameworks. Psychotherapy too embraces decisions that will affect an individual for the rest of their life.
Legal and Regulatory Compliance: Many ethical principles are intertwined with legal and regulatory requirements in healthcare. Teaching about ethical dilemmas helps medical professionals understand the legal implications of their actions and avoid potential legal pitfalls.
Interprofessional Collaboration: Ethical dilemmas often require collaboration among healthcare professionals from various disciplines. Teaching medical ethics fosters the ability to communicate effectively, share perspectives, and reach consensus in complex situations.
Professionalism: Medical ethics education is integral to shaping a strong sense of professionalism among healthcare providers. It instills values such as integrity, empathy, and honesty, which are vital for maintaining patient trust and a high standard of care. For disciplines like counselling which is on the threshold of professionalisation a focus on ethics affirms its status.
Public Trust: Related to ‘professionalism’, the medical field relies heavily on public trust. Demonstrating a commitment to ethical practices helps uphold the reputation of healthcare professionals and institutions, fostering trust within the community.
Ethical Changes in Medicine: As medical technology and practices evolve, new ethical challenges arise. Teaching medical ethics equips future healthcare professionals to adapt to these changes and make ethically sound decisions in rapidly changing environments.
Reflective Practice: Ethical training encourages healthcare professionals to engage in self-reflection and critical thinking about their actions and decisions. This ongoing process helps them continuously improve their ethical decision-making skills.

Medical courses, therefore, invest considerable time in teaching about ethical dilemmas because ethical considerations are inherent to patient-centred care, informed decision-making, and maintaining the integrity of the profession. Ethical training equips healthcare professionals to navigate the complexities of their field while upholding the highest standards of patient care and professional conduct.

Aren’t ethical dilemmas really just common sense?

Ethical dilemmas are often resolved by a combination of rational thinking, moral principles, and practical judgment. Common sense can play a role in tackling ethical dilemmas, but it might not be the sole or primary factor. Whether common sense can effectively resolve an ethical dilemma depends on several factors:

Clarity of Values: If the ethical dilemma involves choices that align with widely accepted values and moral principles, common sense might provide a straightforward resolution. For example, a dilemma involving honesty and truthfulness might be resolved through common sense if honesty is considered a fundamental value.
Simplicity: When an ethical dilemma is relatively simple and doesn’t involve complex or conflicting principles, common sense might be sufficient to guide a decision. For instance, deciding whether to help someone in immediate danger is often resolved by an intuitive sense of empathy and compassion.
Cultural and Societal Norms: Common sense is often influenced by cultural and societal norms. Ethical dilemmas that are consistent with prevailing norms may find resolution through common sense, as individuals draw on their understanding of what is socially acceptable.
Personal Experience: Past experiences and personal values can contribute to a common-sense approach to ethical dilemmas. If someone has encountered a similar situation before, they might rely on their intuition to determine an appropriate course of action.
Immediate Practicality: In some situations, common sense might prioritize immediate practicality and safety. For instance, if an ethical dilemma involves potential harm to oneself or others, common sense might lean towards minimizing harm as quickly as possible.
Clear Hierarchy of Values: If the ethical dilemma involves conflicting values but there’s a clear hierarchy among them, common sense might guide individuals to prioritize the more important value.

However, there are instances where ethical dilemmas are more complex and involve conflicting principles, grey areas, and potential unintended consequences. In these cases, relying solely on common sense might not be enough. A deeper analysis of ethical theories, discussion with others (such as peers and supervisors), consultation with experts, and careful consideration of long-term consequences might be necessary to make an informed and ethically justifiable decision.

So, common sense can provide a useful starting point for resolving many ethical dilemmas, however, more complex situations often require a more comprehensive and nuanced approach that takes into account various moral considerations.