Confessions of an Incrementalist

By Joel A. Dvoskin, Ph.D., A.B.P.P.
From the Spring 1999 edition of Public Service Psychology,
the newsletter for Division 18 of the American Psychological Association

In my travels across the country, my work as a consultant or expert witness has often let me into conditions that were not only unconstitutional, but horrifying. And yet, in those same systems, I have seen seemingly decent and hard-working psychologists, working tirelessly to provide solace and hope to people in very difficult straits.

Some ethicists argue that participating in unacceptable systems is wrong. They argue that the participation of credentialed professionals legitimizes and thus perpetuates these systems. They admonish such professionals to simply walk away, to refuse to play in such a filthy sandbox. And these arguments seem reasonable.

But when I meet the people who have stayed, I do not find them less ethical or less moral for it. To the contrary, many of these psychologists, nurses, psychiatrists, social workers, correctional officers, and psychiatric technicians have become heroes to me. To maintain one's standards of decency and professionalism in the face of an apparently uncaring political system takes courage and tenacity and goodness of heart.

These observations lead to several important questions. How then does one makes sense of this dilemma? How bad can the system be before it is time to walk away? And how does one walk away from people in such dire need?

I'm not sure why any of you should care where I think about these issues, but it's my column, so here is one person's opinion.

I have learned over the years that I am not a perfectionist. (I mean, I am really, really, really not a perfectionist.) It's way too depressing to me; perfectionists of course never succeeded at anything. Their lives are spent climbing a ladder that has no top rung. (No offense to those of you who are; in fact, my heart goes out to you.) And since I actually enjoy making creative mistakes, for me, perfectionism is especially uninviting.

No, my friends, I am, to the core of my being, an incrementalist. I believe in trying to leave everything just a little better than I found it. I believe in the hokey "star fish" story with all of my heart. I believe that if everyone who visited a park would take just one extra piece of trash out with them when they leave, the park would be spotless in less than a week.

Granted, to many of you, it will not seem like much of an assignment. But it is my assignment, and I have accepted it.

But what about perpetuating evil? Nonsense. Watch what happens when a psychologist quits in moral indignation. See if the place closes down. It won't, and no matter how good the quitter feels about themselves, if they were any good, it will be their clients who have been hurt, not the system.

To me, the moral thing, the ethical thing, is not to cut and run. It is to maintain one's dignity and professionalism in the face of bad circumstances. It is to understand the difference between reasonable flexibility and selling out. It is speaking with honor and humility (even in court) about how it ought to be, and resisting the understandable temptation to sink into self righteous and angry denunciations. It is protecting your own hope against all assaults, because hope is the most precious gift you share with your clients.

So, to those of you who do good work in bad settings, I have something to say. Not only are you behaving in a morally and ethically acceptable manner; to me you are heroes. Your jail or prison or hospital or free clinic is a little better each day because you are there. You leave each of your clients a little better than you find them, and occasionally foster hope in people for whom hope is but a distant memory.

The time to quit? That's an easy one. Quit when you run out of gas. Quit when it hurts you more than it helps them. Quit when the system won't let you help, even a little bit. Quit when you become an instrument of harm. Until then, Godspeed to you, and thanks.

Copyright © 2000 by Division 18 of APA. Reprinted with permission.

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