Accountability as a Virtue in Mental Health and Human Flourishing
John Peteet, MD, Associate Professor of Psychiatry, Harvard Medical School
In recent decades, psychiatry has extended its scope beyond pathology and its neurobiological correlates to the health and flourishing of the whole person. Positive psychology has provided evidence for the importance of character strengths such as self transcendence and persistence, as well as of relational virtues such as forgiveness and gratitude. Relatively little attention has been devoted to the relevance of human or transcendent accountability to human flourishing, including mental health.
People with the virtue of accountability (a) welcome being accountable to others across relationships with others to whom they rightly owe a response--receiving their capable, good input and providing transparent explanations of their decisions and actions; and (b) are willingly accountable for their attitudes, thoughts, emotions, and actions--working to improve or correct their responses so that they have a positive impact. Recently Witvliet et al. have used a representative sample of the U.S population to establish construct validity for measures of human and transcendent accountability.
Accountability as a virtue reflects the coming together in a functionally important way of four aspects of mental health: connectedness, proportionality, responsiveness to others and persistence.
The clinical relevance of accountability is most clearly seen when individuals are lacking in one or more of these core aspects of mental health. For example, schizoid or depressed individuals often lack the ability to respond through connection; those with self-absorbed, narcissistic, or obsessional features may lack the proportionality required to respond appropriately; psychopathic individuals lack the ability to empathetically respond; and undisciplined individuals lack the persistence needed to remain responsive. An example of the therapeutic relevance of accountability can be found in the problem of scrupulosity and OCD, both reflective of an overly severe conscience. Consistent with classical virtue schemata, the virtue of accountability inhabits a mean between a vice of deficiency and a vice of excess. When the object is God, the vice of deficiency can take the form of apathy or neglect (to pray, to confess, etc.); when the object is others in community, this vice might take the form of sociopathy or general lack of regard for rules. On the other hand, the vice of excess is an overly severe conscience. When the object is God, this manifests as scrupulosity, a condition which receives significant attention in the writings on religious melancholy by 17th- and 18th-century “divines” like Robert Burton, Bishop Jeremy Taylor, Bishop John Moore, and Richard Baxter. Given that individuals with scrupulosity and OCD judge others more severely than they judge themselves, they also show a failure of empathy for themselves. Whereas religious scrupulosity may respond somewhat to faith based interventions, OCD is best treated as a clinical disorder. What is needed in addressing both conditions is a vision of proportionate accountability including proper empathy for oneself toward which struggling individuals can be helped to move.
The wisdom of theocentric religious traditions regarding transcendent accountability and its implications for human accountability are an important resource for clinicians and patients in developing and maintaining this vision.
People with the virtue of accountability (a) welcome being accountable to others across relationships with others to whom they rightly owe a response--receiving their capable, good input and providing transparent explanations of their decisions and actions; and (b) are willingly accountable for their attitudes, thoughts, emotions, and actions--working to improve or correct their responses so that they have a positive impact. Recently Witvliet et al. have used a representative sample of the U.S population to establish construct validity for measures of human and transcendent accountability.
Accountability as a virtue reflects the coming together in a functionally important way of four aspects of mental health: connectedness, proportionality, responsiveness to others and persistence.
The clinical relevance of accountability is most clearly seen when individuals are lacking in one or more of these core aspects of mental health. For example, schizoid or depressed individuals often lack the ability to respond through connection; those with self-absorbed, narcissistic, or obsessional features may lack the proportionality required to respond appropriately; psychopathic individuals lack the ability to empathetically respond; and undisciplined individuals lack the persistence needed to remain responsive. An example of the therapeutic relevance of accountability can be found in the problem of scrupulosity and OCD, both reflective of an overly severe conscience. Consistent with classical virtue schemata, the virtue of accountability inhabits a mean between a vice of deficiency and a vice of excess. When the object is God, the vice of deficiency can take the form of apathy or neglect (to pray, to confess, etc.); when the object is others in community, this vice might take the form of sociopathy or general lack of regard for rules. On the other hand, the vice of excess is an overly severe conscience. When the object is God, this manifests as scrupulosity, a condition which receives significant attention in the writings on religious melancholy by 17th- and 18th-century “divines” like Robert Burton, Bishop Jeremy Taylor, Bishop John Moore, and Richard Baxter. Given that individuals with scrupulosity and OCD judge others more severely than they judge themselves, they also show a failure of empathy for themselves. Whereas religious scrupulosity may respond somewhat to faith based interventions, OCD is best treated as a clinical disorder. What is needed in addressing both conditions is a vision of proportionate accountability including proper empathy for oneself toward which struggling individuals can be helped to move.
The wisdom of theocentric religious traditions regarding transcendent accountability and its implications for human accountability are an important resource for clinicians and patients in developing and maintaining this vision.