Do Clients Want What They Want? Understanding Preferences Through the Directional Framework
Mick Cooper, Professor of Counselling Psychology, University of Roehampton
‘The problem with pluralistic therapy is that clients do not know what they want.’ This criticism of pluralism, levelled even by advocates of a person-centred approach, has many parallels in the field of social and political theory. Here, ‘preference utilitarianism’, articulated by such authors as John Harsanyi, has been challenged for not recognising the malleability and adaptability of people’s desires. ‘How can you base a society on maximising wants’, the critique goes, ‘If people’s wants can consistently change, can be influence by others, and may not reflect the person’s true interests?’ There is also the intersubjective perspective of such philosophers as Habermas: that our view of what is right emerges through dialogue and between communities, and is not something that resides ‘within’ the person.
Empirically, such critiques have much validity (see here). There is evidence, for instance, that people’s self-reported motivations do not tend to be matched with their motivations as assessed by an external judge (for instance, using a psychometric test). Furthermore, the external assessment tends to be a better predictor of actual behaviour. We also know from cognitive psychology just how easily people’s stated preferences can be changed–for instance, through simple changes in the wording or ordering of a question. And, in counselling and psychotherapy, many of us have worked with clients who do not feel able to express their preferences, or express preferences that later change in therapy (though our research suggests that, as well, many preferences do stay constant).
Over the last few years, I have been developing the concept of directionality and a directional framework, and I think it helps to cut through some of these challenges. The basis for this thinking is a simple one and by no means original. It holds that we have higher-order wants (or what I can higher-order ‘directions’) and lower-order wants, and that the latter are the specific means by which we strive to attain the former. So the highest-order directions are the things that we most fundamentally want–like closeness with others, meaning, or self-worth–and people strive to fulfil these highest-order wants in a multiplicity of ways. In this framework, highest-order directions may vary across people, and can also include fundamental values: like ‘authenticity’, ‘goodness’, or ‘faith’.
In this framework, lower-order directions are always, ultimately, aimed at fulfilling higher-order directions. So, for instance, a person may strive for money or Facebook friends because they believe it will bring them happiness. But although that might be veridical within the person’s own subjective worldview, it does not mean that that will actually be effective. So a person’s striving for money may, actually, make them less happy rather than more. This means that, although people’s preferences–from the highest- to the lowest-order–are always intelligible, they are not always ‘right’: in the sense that they will not always help people get to where they ultimately want to be. Indeed, much of the work of therapy, from the standpoint of the directional framework, is helping people to find more effective–and more synergetic–ways of getting to what they actually, genuinely want: actualising their highest-order directions.
So the preferences that a client states at the start of therapy may, or may not, be the things that are genuinely most helpful to them. From a pluralistic ethic, it is essential that we listen to them and respect them, but that does not mean we take them as the final word on what will genuinely help. It’s complicated, and the best that we can do is to engage in dialogue and keep the conversation open. That way, over time, the client can come to a closer approximation and understanding of what it is that is genuinely going to get them to where they want to be.
And while clients may be aware of their concrete, lower-order directions, they may not be so aware of those things that they most fundamentally want in their lives–or the things that can most genuinely get them there. Clients may know, for instance, that they want to feel good about themselves, but does that come through talking about their problems, or distraction techniques, or creative practices? As the therapeutic process evolves, so they can come to a closer grasp of what that is.
Not all preferences are created equal: in some of our earlier writings on pluralistic therapy, I think we failed to always understand that. It was through challenges from colleagues in therapeutic fields like psychodynamics that helped me, I think, recognise the complexities and nuances here. Of course, the directional framework is just one means of trying to address this issue–there are, undoubtedly, many other ways of conceptualising preferences that can bring out some of the subtleties here. What we have learnt, perhaps most importantly, is that it is not ‘either/or’–clients’ expressed wants add something, but exactly what they add, and how they can be best brought into the mix, is a subject for ongoing discovery. And, of course, from a pluralistic perspective we need to be open to the possibility that this will vary by clients and by cultural backgrounds at different times. For sure, there is still much to learn.