Exploring virtue ethics in psychodynamic psychotherapy: latent changes in humility, affect regulation, symptoms and well‐being

Abstract

A virtue ethics premise is that flourishing cannot be achieved solely through symptom reduction, but, rather, is inextricably connected with the development of 'qualities of human character and excellence which enhance the capacity to live well' (Sandage & Hill, 2001, p. 243). Sometimes also described as character strengths, virtues are grounded in motivational, affective, cognitive, relational, behavioural and contextual dimensions of human functioning, and thus hold important implications for therapists' clinical formulation and treatment approaches. Virtues orient clients to reflect on who they are and are becoming in relation to others (McMinn et al., 2016). While numerous virtue-based interventions exist (e.g. keeping a gratitude journal), considerably less attention has been given to understanding the complex and often implicit psychotherapeutic processes that promote or impede virtue development (Jankowski et al., 2020). Rowden and colleagues (2014) described a shift from 'focusing exclusively on what people do in relationships (action oriented or skills training approaches) to addressing who people are (character, affective, and motivational domains)' (p. 380). It is this focus on who people are in relation to others that is consistent with a psychodynamic understanding of virtue development (Akhtar, 2019; Summers & Barber, 2010), and frames our current study.Recent psychotherapy research suggests the importance of dual-factor models that attend to both mental health symptoms

Religious leaders’ well-being: Protective influences for humility and differentiation against narcissism.

“…Our findings addressed the need for further empirical research on humility and well-being in outpatient mental health contexts (Jankowski, Captari, et al, 2021;Paine et al, 2018), and we offer two primary implications for the assessment and potential treatment of religious leaders. First, emotion regulation appears to be a key construct in recent empirical research on virtue and well-being (Jankowski, Captari, et al, 2021), and emotion has played a prominent role in many moral philosophies related to virtue (Kristjansson, 2018). In addition, Sandage et al (2015) surmised that grandiosity can function as a defense mechanism or coping strategy against emotional dysregulation, indicative of an instrumental or utilitarian approach to relationships.…”

“…We tested our proposed moderated mediation model with a sample of clergy candidates receiving a psychological evaluation at a community mental health center as part of their vocational discernment process. We therefore draw attention to client humility, and address the neglect of research on client humility, relative to the growing literature on clinician humility and the effectiveness of mental health treatment (Jankowski, Captari, et al, 2021).…”

“…These findings are consistent with a virtue ethics framework that posits virtues as facilitative of greater well-being and lower mental health problems, which together constitute flourishing. This virtue ethics framework has recently emerged as a proposed foundation for future research examining salutary influences for virtues (Jankowski et al, 2020; Jankowski, Captari, et al, 2021).…”

Humble with God? How Education and Race Shape the Association between God-Mediated Control and Humility in Later Life

“…Humility lies at the heart of religion, as Christian scholars St. Augustine and St. Thomas Aquinas have advocated, and has also been linked to several favorable outcomes, including health (Krause 2010 ; Jankowski and Sandage 2014 ), better social relationships (Davis et al 2013 ; Van Tongeren et al 2014 ) and more effective job performance and organizational leadership (Johnson et al 2011 ; Lee et al 2019 ; Howard and Van Zandt 2020 ). Given both theological and social scientific interest in humility, we sought to expand on a growing base of empirical evidence linking religion/spirituality and humility (see Davis et al 2014 , 2017 ; Jankowski et al 2021 , 2022 ; Rowatt et al 2014 ; Van Tongeren et al 2016 , 2018). In the current study, we considered how one aspect of religion/spirituality, perceptions of God-mediated control, may be an additional precursor to humility.…”

Integrating Positive Psychology, Religion/Spirituality, and a Virtue Focus Within Culturally Responsive Mental Healthcare

“…Interweaving a virtue and well-being focus-contextualized to a client's SERT context-within clinical formulation and treatment has significant potential, but it is much more difficult to study and thus is less empirically developed. As one example, a recent practice-based study found that clients in psychodynamic therapy evidenced growth in humility, which predicted changes both in symptoms and well-being (Jankowski et al, 2021). For some clients, virtues may be a relevant explicit focus (e.g., integrating the REACH Forgiveness model into therapy); for others, virtues may emerge within the treatment process (e.g., the therapist embodies humility amidst an alliance rupture).…”