The Virtues in Psychiatric Practice John

R. Peteet
Visit to download the full and correct content document:
https://ebookmass.com/product/the-virtues-in-psychiatric-practice-john-r-peteet/
The Virtues in Psychiatric Practice
 The Virtues
in Psychiatric
Practice
Edited by
JOHN R. PETEET

1
 3
Oxford University Press is a department of the University of Oxford. It furthers
the University’s objective of excellence in research, scholarship, and education
by publishing worldwide. Oxford is a registered trade mark of Oxford University
Press in the UK and certain other countries.

Published in the United States of America by Oxford University Press

198 Madison Avenue, New York, NY 10016, United States of America.

© Oxford University Press 2022

All rights reserved. No part of this publication may be reproduced, stored in

a retrieval system, or transmitted, in any form or by any means, without the
prior permission in writing of Oxford University Press, or as expressly permitted
by law, by license, or under terms agreed with the appropriate reproduction
rights organization. Inquiries concerning reproduction outside the scope of the
above should be sent to the Rights Department, Oxford University Press, at the
address above.

You must not circulate this work in any other form

and you must impose this same condition on any acquirer.

Library of Congress Cataloging-​in-​Publication Data

Names: Peteet, John R., 1947–​editor.
Title: The virtues in psychiatric practice /​[edited by] John R. Peteet.
Description: New York, NY : Oxford University Press, [2022] |
Includes bibliographical references and index. | Identifiers: LCCN 2021034905 (print) |
LCCN 2021034906 (ebook) | ISBN 9780197524480 (paperback) |
ISBN 9780197524503 (epub) | ISBN 9780197524510 (online)
Subjects: MESH: Virtues | Psychiatry | Social Responsibility |
Interpersonal Relations | Psychotherapy
Classification: LCC RC 480 . 5 (print) | LCC RC 480 . 5 (ebook) |
NLM WM 21 | DDC 616 . 89/​14—​dc23
LC record available at https://​lccn.loc.gov/​2021034905
LC ebook record available at https://​lccn.loc.gov/​2021034906

DOI: 10.1093/​med/​9780197524480.001.0001

This material is not intended to be, and should not be considered, a substitute for medical or
other professional advice. Treatment for the conditions described in this material is highly
dependent on the individual circumstances. And, while this material is designed to offer
accurate information with respect to the subject matter covered and to be current as of the
time it was written, research and knowledge about medical and health issues is constantly
evolving and dose schedules for medications are being revised continually, with new side
effects recognized and accounted for regularly. Readers must therefore always check the
product information and clinical procedures with the most up-​to-​date published product
information and data sheets provided by the manufacturers and the most recent codes of
conduct and safety regulation. The publisher and the authors make no representations or
warranties to readers, express or implied, as to the accuracy or completeness of this material.
Without limiting the foregoing, the publisher and the authors make no representations or
warranties as to the accuracy or efficacy of the drug dosages mentioned in the material. The
authors and the publisher do not accept, and expressly disclaim, any responsibility for any
liability, loss, or risk that may be claimed or incurred as a consequence of the use and/​or
application of any of the contents of this material.

1 3 5 7 9 8 6 4 2
Printed by Marquis, Canada
 Contents

Preface  vii
Contributors  ix
Introduction  1
John R. Peteet

V I RT U E S O F SE L F- C
​ ONTROL

1. Accountability  17
Charlotte V. O. Witvliet and John R. Peteet
2. Humility  33
Nicholas D. Covaleski
3. Equanimity  61
Michael R. Tom and David R. Vago

V I RT U E S O F B E N EVO L E N C E

4. Forgiveness  87
Everett L. Worthington Jr.
5. Compassion  109
Paul Gilbert
6. Love  129
John R. Peteet

V I RT U E S O F P O SI T I V I T Y

7. Defiance  147
Nancy Nyquist Potter
vi Contents

8. Phronesis (Practical Wisdom)  165

Jerome Kroll and Perry C. Mason
9. Gratitude  185
Lilian Jans-​Beken
10. Self-​Transcendence  205
C. Robert Cloninger and Kevin M. Cloninger
11. Hope (Optimism, Resilience)  231
Warren Kinghorn

F U T U R E D I R E C T IO N S

12. The Science of Human Flourishing  255

Tyler J. VanderWeele

Index  273
 Preface

There is growing recognition of the value dimension of psychiatric

practice [1]‌, the contributions of positive psychology in documenting
the role of virtues in human flourishing [2], and the relevance to pro-
fessionalism of virtue ethics [3]. Books by Pellegrino and Thomasma
[4], and Sadler and Radden [5] have articulated virtues important
for medical practice and the psychiatric clinician, respectively. Duff
Waring [6] and others [7,8] have gone further to describe a place for
therapeutic virtues in psychotherapy understood as the cultivation of
character. A number of authors [9–​12] have suggested that one’s pref-
erence for particular virtues depends on one’s worldview.
Even so, the place of virtues in psychiatric treatment remains largely
unexplored. How does a need for virtues fit into the processes of diag-
nosis, formulation, and treatment? What patient problems and other
factors should influence the therapist to promote forgiveness, grati-
tude, humility, or accountability? What is the relationship between the
therapist’s and the patient’s virtues? What is the relevance of religious
or spiritual resources to the formation of virtue? How does the culti-
vation of a particular virtue relate to psychodynamic, behavioral, ex-
istential, or spiritual approaches? What ethical questions does it raise,
and what are its implications for psychiatric education?
Following an Introduction containing a general framework for
approaching these questions, the chapter authors consider them in
relation to the theoretical and empirical literature, and discuss the
practical clinical implications of specific virtues, using case examples.
Building on a growing literature relating the Big Five personality traits
to character strengths and human functioning, the book considers
four basic capacities—​self-​control, benevolence, intelligence, and pos-
itivity—​roughly corresponding to the four cardinal virtues of Plato
and Aquinas (temperance, justice, prudence, and courage), based on
neurobiological evidence of potential for moral enhancement and
viii Preface

psychotherapeutic relevance [13]. The virtues highlighted include

those of self-​control (accountability, humility, and equanimity), be-
nevolence (forgiveness, compassion, and love), intelligence (defi-
ance and phronesis, or practical wisdom), and positivity (gratitude,
self-​transcendence, and hope). A concluding chapter considers the
implications for psychiatry of the emerging science of human flour-
ishing. Our aim is to give readers a fuller appreciation of the impor-
tance of virtue in the therapeutic encounter, a clearer understanding
of clinical indications for focusing on particular virtues, and enhanced
practical ways of promoting human growth.

References
1. Michel AA. Psychiatry after virtue: A modern practice in the ruins. J Med
Philos. 2011;36:170–​186.
2. Peterson C, Seligman MEP. Character Strengths and Virtues: A Handbook
and Classification. New York: Oxford University Press; 2004.
3. Robertson M, Walter G. Overview of psychiatric ethics II: virtue ethics
and the ethics of care. Australas Psychiatry. 2007;15:201–​206.
4. Pellegrino ED, Thomasma CD. The Virtues in Medical Practice.
New York: Oxford University Press; 1993.
5. Radden J, Sadler J. The Virtuous Psychiatrist: Character Ethics in Psychiatric
Practice. New York: Oxford University Press; 2010.
6. Waring D. The Healing Virtues: Character Ethics in Psychotherapy.
New York: Oxford University Press; 2016.
7. Woolfolk RL. Virtue and psychotherapy. Philos Psychiatry Psychol.
2012;19:41–​43.
8. Martin MW. Psychotherapy as cultivating character. PPP. 2012;19:37–​39.
9. Bergin AE. Psychotherapy and religious values. J Consult Clin Psychol.
1980;48:95–​105.
10. Kinghorn W. The politics of virtue: An Aristotelian-​Thomistic engage-
ment with the VIA classification of character strengths. J Pos Psychol.
2017;12:436–​446.
11. Roberts RC. Virtues and belief in God. J Pos Psychol. 2017;12:480–​488.
12. Peteet JR. What is the place of clinicians’ religious or spiritual
commitments in psychotherapy? A virtues based perspective. J Relig
Health. 2014;53:1190–​1198.
13. Hughes JJ. Moral enhancement requires multiple virtues: Toward a
posthuman model of character development. Cambridge Q Healthc Ethics.
2015;24:86–​95.
 Contributors

C. Robert Cloninger Warren Kinghorn

Professor Emeritus of Psychiatry Associate Professor of Psychiatry
Washington University School of Department of Psychiatry and
Medicine Behavioral Sciences
Department of Psychiatry Duke University
St. Louis, MO, USA Durham, NC, USA
Director of Institute for Research
Anthropedia Foundation Jerome Kroll
St. Louis, MO, USA Professor of Psychiatry Emeritus
Department of Psychiatry
Kevien M. Cloninger University of Minnesota
Executive Director Medical School
Anthropedia Foundation Minneapolis, MN, USA
St. Louis, MO, USA
Perry C. Mason
Nicholas D. Covaleski Professor Emeritus
PhD Student Department of Philosophy
Department of Religion Carleton College
Boston University Northfield, MN, USA
Boston, MA, USA
John R. Peteet
Paul Gilbert Associate Professor
Professor of Clinical Psychology Department of Psychiatry
Centre for Compassion Research and Harvard Medical School
Training Boston, MA, USA
University of Derby
Derby, UK Nancy Nyquist Potter
Professor of Philosophy emerita and
Lilian Jans-​Beken Adjunct
Senior Researcher Department of Psychiatry and
The Thriving Human Behavioral Sciences
Science Center University of Louisville
Venray, The Netherlands Louisville, KY, USA
Senior Editor of Philosophy,
Psychiatry, and Psychology
x Contributors

Michael R. Tom Charlotte V. O. Witvliet

Resident Lavern ’39 and Betty DePree ’41
Department of Psychiatry VanKley Professor of Psychology
Beth Israel Medical Center, Harvard Department of Psychology
Medical School Hope College
Boston, MA, USA Holland, MI, USA

David R. Vago Everett L. Worthington Jr.

Research Associate Professor Commonwealth Professor Emeritus
Department of Psychology Department of Psychology
Vanderbilt University Virginia Commonwealth University
Nashville, TN, USA Richmond, VA, USA

Tyler J. VanderWeele
John L. Loeb and Frances Lehman
Loeb Professor of Epidemiology
Department of Epidemiology
Harvard T. H. Chan School of
Public Health
Boston, MA, USA
 Introduction
John R. Peteet

Virtues originally defined human flourishing, but they have been his-
torically neglected within psychiatry. In this chapter I consider some
reasons for this neglect and suggest how attention to virtues can play
a critical role in promoting growth in patients, as well as in sustaining
the clinician in providing care.
Virtues are generally understood as admirable character traits or stable
dispositions to do the right thing for the right reasons, at the right time,
in ways that are appropriate to the situation. They involve both thinking
and emotion, free will as well as habit, and emerge from and are intelli-
gible within a cultural context and a community. The term virtue recalls
the early Greeks, especially Aristotle’s notion of cardinal excellences of
character—​practical wisdom, self-​control, courage, and justice—​that are
important to living well. But beginning even before the Greeks, religious
texts such as the Koran, the Bhagavad Gita, as well as Buddhist, Hebrew,
and, later, Christian scriptures laid out paths toward virtue.
For centuries, priests functioned as virtuous healers, and physicians
into recent times have been admired for their selfless dedication to the
sick. However, in the wake of the Enlightenment and the rise of scien-
tific medicine, Freud and many of his followers framed treatment pri-
marily as an objective search for truth and greater individual autonomy,
achieved through the exercise of therapeutic neutrality. Unfortunately,
in psychiatry, the technical neutrality of the analyst in evenly hovering
over the patient’s conflicts has often been confused with the myth of
value neutrality—​mandating that the psychiatrist should be value free.
And autonomy understood as freedom from influence has often been
confused with autonomy understood as mastery, a more appropriate
goal of therapy [1]‌. One reason for this confusion is what the philos-
opher Charles Taylor has called the self-​sufficient “immanent frame”
2 Introduction

of the modern age—​“an order that requires nothing transcendent in

order to function—​in which values are defined by rights to be free of
constraining influences” [2]. This perspective contrasts with the clas-
sical view found in Aristotle and the Judeo-​Christian scriptures that
freedom depends not on the absence of obstacles, but on the attributes
necessary to overcome obstacles and achieve fulfillment—​in other
words, on character or virtue.
Freud also raised another objection to talk of virtues; he maintained
that it is unrealistic: “The commandment, ‘Love thy neighbor as thy-
self,’ is the strongest defense against human aggressiveness and an
excellent example of the unpsychological [expectations] of the cul-
tural super-​ego. The commandment is impossible to fulfil; such an
enormous inflation of love can only lower its value, not get rid of the
difficulty” [3]‌. There is of course considerable empirical support for
recognizing that human beings are not as virtuous as we like to think
we are but at best we are a mixed bag [4], with the potential for virtue as
well as for vice. But of course the solution is not to lower our standards,
as Freud suggests; rather, it is to incorporate moral goals into care-
giving as appropriate.
In both Europe and then in the United States during the 17th
and 18th centuries, reformers such as the founder of the American
Psychological Association, Benjamin Rush (1745–​1813) [5]‌, favored
humane ways to encourage rationality and moral strength in asylums
(the so-​called moral treatment period). But conditions in asylums
deteriorated with time, and the model came into criticism from Michel
Foucault (1926–​1984) in the 20th century in his famous book Madness
and Civilization, where he argued that the “moral” asylum is “not a
free realm of observation, diagnosis, and therapeutics; it is a jurid-
ical space where one is accused, judged, and condemned” [6]. Here
Foucault echoed a third objection to giving virtues a place in psychi-
atry—​that they are moralistic and judgmental. But the objection that
virtue talk is judgmental is itself a judgment, and militant neutrality is
itself a strict norm. So we cannot escape moral evaluation. We can only
agree to settle on more or less adequate or appropriate moral concepts.
As Curlin and Hall have argued [7], moral discourse is often essential
to the patient–​physician relationship, and rather than shrinking from
such discourse, physicians can best engage patients regarding these
 Introduction 3

concerns not as strangers imposing a technique guided by neutrality,

but guided by an ethic of moral friendship that seeks the patient’s good
through wisdom, candor, and respect.
A fourth source of criticism is the doubt sown by Freud and other
materialists that virtue, especially virtue inspired by religious faith,
could have a place in a scientific field such as psychiatry. Although a
number of thinkers [8]‌and researchers [9] have challenged this as-
sumption, influential scientists such as Eric Kandel and Joseph Le
Doux continue to encourage the reductionistic perspective that psy-
chotherapy works only insofar as it effects changes in gene expression
and altered neuronal pathways.
Despite these four historical reasons for questioning their rel-
evance—​ as undermining therapeutic neutrality and being un-
feasible, moralistic, or incompatible with science—​ a number of
developments—​ including the fragmented, at times dehumanizing
experience of modern medical care—​have led to renewed interest in
the virtues within psychiatry. For example, the Dutch philosopher and
psychiatrist Gerrit Glas in his recent book, Person-​Centered Care in
Psychiatry: Self-​relational, Contextual, and Normative Perspectives [10],
describes a normative practice approach (similar in some respects to
values-​based practice, better known in the United Kingdom as values-​
based health care, recovery and narrative-​based approaches), which
recognizes that value-​laden assumptions and norms are central in
shaping the patient–​psychiatrist relationship. Glas also refers to the
field of positive psychology, pioneered by Martin Seligman, which
now comprises a voluminous literature on the positive mental health
outcomes of virtues such as forgiveness, gratitude, and hope [11]. To
cite just one example, gratitude interventions are now being shown to
improve mental health outcomes through the use of randomized clin-
ical trials, and their effects rival those of some of our pharmacolog-
ical interventions in effect sizes [12]. Dilip Jeste has promoted a similar
movement for positive psychiatry [13]. And Tyler VanderWeele has
described an emerging science of human flourishing, pointing out that
much empirical work in the social and biomedical sciences focuses
on narrow outcomes such as a single socioeconomic measure, disease
state, or mood state. He argues that human well-​being or flourishing
consists in a much broader range of states and outcomes, including
4 Introduction

mental and physical health and financial and material security, but also
happiness and life satisfaction, meaning and purpose, character and
virtue, and close social relationships [14].
Positive psychology has helped to inform a fourth wave of thera-
pies that have moved away from focusing only on psychopathology
toward conceptualizing a more positive vision of human flourishing
and health [15]. To briefly review: First-​wave therapies, which in-
clude psychodynamic therapy, aim at enhancing autonomy and mas-
tery through insight and rely on the therapist as expert. A second
wave of therapies, including cognitive-​ behavioral therapy (CBT),
gestalt, and family systems theory, are more present and problem fo-
cused. They are also more theory driven than third-​wave therapies,
which focus more on solutions and conscious action, and are heter-
ogeneous in technique. Third-​wave approaches include acceptance
and commitment therapy (ACT), dialectical behavior therapy (DBT),
behavioral activation, schema therapy, and mindfulness-​based CBT.
(Incidentally, the popularity of mindfulness as nonjudgmental aware-
ness may continue to reflect suspicion of the notion of morality and
virtue—​that virtue meant moralism and judgment.) By comparison
with these three waves of psychotherapy which are primarily directed
at correcting deficits responsible for dysfunction, many of the newest
and most novel mental health interventions can productively be char-
acterized as a fourth wave [15], which, built on the legacy of existen-
tial psychotherapy and related humanistic approaches, aims beyond
insight, mastery, and problem solving toward achieving positive well-​
being. These value-​and virtue-​oriented approaches include positive
psychology interventions (PPI), loving kindness and compassion
meditation, dignity and gratitude promotion, and meaning-​centered,
forgiveness-​oriented, and spiritually informed therapies. They overlap
with traditional religious/​spiritual (R/​S) practices that utilize prayer,
scripture study, the sacraments, and supportive communities to help
individuals achieve valued ideals and to flourish. Put another way, they
call attention, in an increasingly evidence based way, to the place of
virtues in our work to help patients live lives that are worth living.
In recent years, two philosophers—​ Eric Matthews and Duff
Waring—​have also helped to clarify the relationship of mental illness
to education in virtue. Matthews, at the University of Aberdeen, refers
 Introduction 5

to the large number of conditions which lack a clear biological origin,

that in these cases,

“mental illness” seems to deviate significantly from the medicalized

concept of bodily illness. Deviation from a moral vision of human
life seems in these cases to be essential to the definition of what
makes a person’s mental condition “disordered”: He or she is not
simply thinking, feeling, desiring, etc., in ways that differ from what
is normal in human beings, but in ways that significantly affect his or
her chances of achieving a satisfactory human life. . . . Medical treat-
ment in the form of drugs or even surgery may help to alleviate the
effects of such a person’s condition, for example, by making it easier
for the person to fit in with conventional society, but the most appro-
priate treatment for the condition itself . . . involves a certain vision of
what a satisfactory human life ought to be like, a way of interpreting
what is “wrong” with clients as deviation from that “moral vi-
sion,” and a way of treating clients aimed at showing them ways of
achieving that moral vision in their own lives. [16]

The philosopher Duff Waring has described in a more granular

way a place for therapeutic virtues in psychotherapy understood as
the cultivation of character. As Waring states: “Virtues are revealed in
therapeutic goals that stress the desirable and stable traits of character
that mentally healthy persons have and that patients who want to re-
store lost selves ought to strive for. Hence the idea that mental health
amounts to a virtuous state” [17]. He argues that the realization of cer-
tain virtues, for example, self-​love, self-​respect, and empathic concern
and respect for others, are plausible psychotherapeutic goals for some
patients, given the problems they present. Their cultivation and attain-
ment as sufficiently stable states amount to positive mental health.
The virtues instrumental to Waring’s healing project include hope-
fulness, perseverance, courage, healing curiosity, respect for the
healing project, and the virtues of focus and dialogue. He illustrates the
therapist’s role in cultivating these virtues in the case of a “Demoralized
Woman” and an “Angry Man.” “The Demoralized Woman lacks a
loving bond with herself by which she knows, feels, and lives by her
identity—​conferring values and commitments.” The psychotherapist
6 Introduction

can offer a supportive and respectful alliance and “reinforce three

ideas: (1) that she is worthy of an ethical identity; (2) that she will dis-
cover herself through creative, identity-​conferring efforts; and (3) that
she can and ought to attend to herself with love and respect.”
The Angry Man, who had been abused by his father as a child,
was helped by psychodynamic therapy to recognize the origins of his
“simmering antipathy,” but it was when he began to take responsibility
for changing it that he experienced the healing virtues of dialogue, em-
pathy, and self-​control. Reminiscent of Matthews, he quotes the psycho-
therapist Peter Lomas: “Therapists cannot confront the ‘whole being’ of
their patients without asking how they might help that person lead a
better life and what that better life might be.” Given his belief that “there
are ways of living that are better than others,” Lomas felt that it was
better for his patients not to be crippled by unrealistic fears, consumed
by hate, or to engage in persistent lying. Their daily encounters with
patients force therapists “to enter personal dilemmas of a moral nature,”
thus making them “continuously embroiled in questions of morality”
and the kind of life that is worth living” [18]. Waring writes: “This ap-
proach to treatment is like a mode of education that requires the active
involvement of the patient. At some point, the patient has to accept re-
sponsibility for working with, on, and for herself. The working through
can involve cultivating affective, cognitive, and behavioral inclinations
in the effort to effect morally desirable changes in the way the patient
treats other people. It can also involve strenuous efforts at improving
oneself by cultivating an appropriate measure of self-​love” [19].
Waring’s list of virtues that he considers worth pursuing to achieve
treatment goals could be expanded to include the virtues—​many now
evidence-​based—​of equanimity (mindfulness), forgiveness, gratitude,
self-​transcendence, defiance, humility, compassion, love, hope (opti-
mism, resilience) and phronesis, or practical wisdom. Examples are to
be found in the chapters of this book.

Virtues in Clinical Practice

Personality disorders are perhaps the most obvious example of a clin-

ical need for virtues—​for example, compassion in antisocial personali-
ties or humility in narcissistic individuals.
 Introduction 7

Depression is often marked by guilt, inhibition, and impaired

self-​love, reflecting a need for the virtues of forgiveness, love, and
compassion.
Anxiety is often accompanied by fear and distractibility, reflecting a
need for equanimity, courage/​defiance, and phronesis.
Substance use disorders are often accompanied by impulsivity, irre-
sponsibility, and guilt over damage done to self and others, reflecting a
need for accountability, gratitude, and self-​forgiveness (as encouraged
by the Twelve Steps of Alcoholics Anonymous).
Repair of moral injury often entails self-​awareness, moral integra-
tion, and connection to community.
Consider five clinical contexts in which a focus on needed virtue is
especially relevant:

1. When life events challenge a person to change and to ask, “What

do I need to do differently, and better?” I work in a cancer center,
with individuals who often respond to a life-​threatening illness with
questions about the kind of person they are and most want to be. I also
work with physicians who have been forced to step back from practice
because of a substance use diagnosis. Clinicians can have an important
role as midwives to this process of reassessing their moral identity.
A 50-​year-​old businessman became increasingly frustrated 1.5 years
after chemoradiation for head and neck cancer as his several treatment
side effects persisted. He became verbally abusive to his wife, who then
took their two young sons to live with her parents. Guilt over his beha-
vior led him to take responsibility for this conduct, to consider in therapy
how his own abusive childhood contributed, and to explore how he could
change his behavior.
This patient was forced to confront how he fell short of his ideals
of what a father should be, to address the issues causing his behavior,
and to change course. Similarly, many individuals facing the need to
change as a result of addiction find a structure for character change in
the Twelve Steps, the fourth of which involves a “searching and fearless
moral inventory.”

2. When the patient presents with guilt or shame, reflecting a sense

of personal failure, and the clinician sees what is good, highlighting
the patient’s existing strengths even as they function as defenses or
8 Introduction

characteristic ways of coping [20]. A psychiatric resident I supervised

reframed a patient’s shameful thumb sucking as an effort to comfort
himself when his parents had not been able to do so.
Unconditional acceptance of the patient—​an important element of the
virtue of love—​can undo negativity and shame in character-​transforming
ways, consistent with Irving Yalom’s observation that the act of revealing
oneself fully to another and still being accepted may be the major vehicle
of therapeutic help. Outside of therapy, we see this in Victor Hugo’s Les
Miserables, when we witness Jean Valjean’s transformation following the
priest’s act of grace in giving him the silver Valjean had stolen. We also see
this in Marsha Linehan’s experience of the love of God, which led her to
love herself and marked the end of her cutting [21].

3. When the patient’s core difficulties reflect the critical lack of a needed
virtue—​a situation most obvious in the case of personality disorders,
but as we have seen in the case of Waring’s Depressed Woman, not
limited to these. Every patient must decide to engage in treatment and
therefore enacts the most basic moral norm in psychiatry, of caring for
the self or not.
Consider this example:

A 22-​year-​old college student came for treatment after dropping

classes and withdrawing from his semester for the third time. His
parents had become increasingly frustrated that he was wasting
their tuition money and risked losing a scholarship due to smoking
marijuana and enjoying time with his friends rather than attending
classes. A family meeting led to a plan whereby further financial
support would be contingent on his regular attendance at class and
therapy sessions, and on monitoring of his drug use. These meas-
ures led him to reexamine his life and priorities; after being forced
to show he could do acceptable work at a local community college,
he was able to reenroll at his university, later taking pride in doing
well academically.

In this case, there was a clear need to help the patient develop the
virtue of accountability—​welcoming responsibility for himself and to
others.
 Introduction 9

4. When a patient, not being forced by either life events or the ther-
apist, feels internally drawn to live a fuller, more meaningful life. For
example, an anxious patient may feel he is not living up to the expec-
tations he has for himself, or a depressed patient may realize he is
not experiencing the promise of his religious faith. In exploring this
patient’s anxiety, a therapist can ask both “What do you want to be
like?” and “What resources can help you?,” listening for ways that faith
or other value-​oriented communities can help to inform the basis of
this search and to sustain it. Virtues as identity-​forming dispositional
frameworks and regulatory processes are often shaped by spiritual
practices in striving toward one’s ultimate end, a process of integrating
one’s personal identity and narrative self in the world. As such, they
have an important transcendent dimension—​gratitude implies a giver,
forgiveness a forgiver, accountability an authority, and love an ultimate
lover. All major religious traditions, including nontheistic ones, em-
phasize the cultivation of virtue. In Buddhist psychology, for instance,
there are numerous diagnostic categories for personality flaws, such
as sexual desires or pride, and compensatory meditation exercises
are prescribed to address them. It may be that the cultivation of pos-
itive emotion and habits of right living is an important mechanism by
which religiousness is so often associated with positive mental health
outcomes.
But whether an individual identifies as Religious/​Spiritual (R/​S) or
is religious with a small “r” [22], their core commitments shape the di-
rection they want to take their life and need to be understood by any
clinician hoping to treat them as a whole, relational, and moral person.
This of course involves going beyond the use of symptom checklists
to listening for what the patient cares most about and why—​perhaps
beginning with a simple question, “What do you love to do outside of
work?” Christian Miller in his book The Character Gap [5]‌, discusses
the existing evidence for practical strategies to cultivate virtue; these
strategies include looking to role models, being more self-​aware, and
engaging in spiritual/​religious practices reinforced by a community of
faith (in this case, Christianity).
Recognizing all this can help clinicians think about where they want
to be on the continuum of providing spiritually sensitive, integrated, or
oriented care [23].
10 Introduction

5. Very often, patients identify with and model themselves after their
therapists in changing their approach to life; this raises the following
question for therapists: “What virtues do I need to model?” This pro-
cess is similar to the way residents emulate their supervisors and med-
ical students learn the “hidden curriculum.” Gandhi highlighted the
power of example when he said “my life is my message.”
To summarize, the virtues are intrinsic to three basic clinical tasks
aimed at helping a patient live well in the context of their whole life:

1. Goal setting: Imagining what flourishing or doing well would

look like for a patient—​for example, caring for themselves or reg-
ulating their emotions well.
2, Strategic planning: Recognizing what particular virtues need
to develop for the patient to flourish—​for example, equanimity,
gratitude, or forgiveness.
3. Implementation: Identifying what resources can be recruited for
recovery and flourishing—​for example, in their experiences of
faith, with an inspiring mentor, or in the therapeutic relationship.

Of course, promoting therapeutic virtues has ethical implications,

especially since, in addition to S/​ R-​
related countertransference,
therapists have differing moral visions and related preferences for
encouraging particular virtues. Is their ultimate aim for patients
improved function, less distress, greater adaptability, enhanced flour-
ishing, greater freedom, or deeper relatedness to others? If individuals
are seen to flourish by pursuing the Good, which is understood as what
is important beyond the self, relational virtues such as compassion,
love, and forgiveness will carry more weight than if morality centers on
individual rights and the achievement of autonomy. Spiritual traditions
may play an important role in shaping moral visions and preferences
for virtues. For example, for Jews, these include communal responsi-
bility and critical thought; for Christians, love and grace; for Muslims,
reverence and obedience; for Buddhists, equanimity and compassion;
for Hindus, appreciation of Dharma and Karma; and for secularists,
respect for scientific evidence, autonomy, and intelligibility [24]. These
have differing implications for treatment, as illustrated through the
use of a hypothetical case. In his classic paper, “Hidden Conceptual
 Introduction 11

Models in Clinical Psychiatry,” Lazare [25] framed a sample case using

medical, behavioral, psychological, and social perspectives. A subse-
quent letter suggested a possible existential frame. Lazare’s description
of the case using a psychological frame offers an opportunity to appre-
ciate the role of differing religious virtues in treatment.
Mrs. J., a 53-​year-​old widow, had been depressed for a few months
after the death of her husband. Although the marriage seemed happy at
times, there were many stormy periods during their relation. There had
been no visible signs of grief since his death. Since the funeral, she had
been depressed and had lost interest in her surroundings. For no apparent
reason she blamed herself for minor events of the past. Sometimes she
criticized herself for traits that characterized her husband more than her-
self. She had had a similar reaction after the death of her mother 23 years
previously, when she and her mother had lived together. From the his-
tory, it could be inferred that the relation was characterized by hostile
dependency. Six months after the mother’s death, the patient married.
She seemed intelligent and motivated for treatment, and had considered
psychotherapy in the past to gain a better understanding of herself.
Christians believe that the experience of God’s unconditional love
empowers people to love both others and themselves. A Christian ther-
apist might help Mrs. J. by understanding her well enough for her to
feel loved and to find in that experience enough acceptance of herself
to go even more deeply into the ways she needed to change. He might
also help her to look for sources of love and forgiveness beyond her-
self and the therapy, and with time for ways to love herself and others
more effectively. A Jewish or Muslim or atheist therapist might empha-
size different virtues. Nevertheless, a growing literature relating the Big
Five personality traits to character strengths and human functioning
does seem to provide a growing consensus on four basic capacities re-
flective of the virtues highlighted by Plato and Aquinas: capacities or
virtues of self-​control (reflected, for example, in humility, accounta-
bility, and equanimity); benevolence (for example, in forgiveness, com-
passion, and love); intelligence (in defiance or courage, and phronesis
or practical wisdom); and positivity (for example, in gratitude, self-​
transcendence, and hope). This is by no means an exhaustive list, but
it has both psychotherapeutic relevance and neurobiological potential
for fostering moral enhancement.
12 Introduction

Yet another reason for the resurgence of interest in the virtues in

psychiatry is the growing focus on professionalism and burnout, and
its relationship to moral injury [26]. When psychiatrists and other
physicians experience moral distress or injury by finding themselves
compromised in acquiescing (for example) to productivity demands at
the expense of time spent with a patient or family member, they need
to cultivate patterns of behavior consistent with their higher values—​
in other words, character—​which in turn reduces future moral injury.
Books by Pellegrino and Thomasma and others [27] have discussed
virtues inherent in medical practice, and Radden and Sadler [28] have
argued for a virtues-​based framework as the most appropriate for
thinking about psychiatric ethics. They highlight virtues that are par-
ticularly important for the psychiatrist: trustworthiness, respect for the
patient and for the healing project, empathy and compassion, gender-​
sensitive virtues, warmth and genuine warmth, self-​knowledge, self-​
unity, integrity, emotional intelligence, unselfing, realism, authenticity,
sincerity, wholeheartedness, and the meta-​virtue of phronesis, or prac-
tical wisdom. Sustaining the professional virtues of hope and mean-
ingful engagement can be challenging, but evidence is growing that the
clinician’s R/​S and ability to nurture the virtue of equanimity and an
inner life can be important and protective in this process [29,30].
Finally, a number of questions continue to surround the place of
virtues in psychiatric practice: How exactly does a need for virtues fit
into the processes of diagnosis and clinical formulation? How does
the cultivation of a particular virtue such as forgiveness, gratitude, hu-
mility, or accountability relate to psychodynamic, behavioral, existen-
tial, or spiritual approaches? What are the neurobiological aspects of
moral enhancement (mindfulness has been best studied, but also more
recently others such as compassion)? What is the relationship between
the therapist’s and the patient’s virtues? What are the implications of a
virtues-​based framework for psychiatric education?
The underlying question, which I have tried to address in this
Introduction, is: “What does a focus on virtue add to the scientif-
ically oriented practice of psychiatry?” Rather than return us to a
pre-​Enlightenment moralization of mental illness, which we now un-
derstand as being biopsychosocial in nature, a virtues-​oriented frame
makes the movement toward health understood as “a state of complete
physical, mental and social well-​being and not merely the absence of
 Introduction 13

disease or infirmity” [31], intelligible by engaging the moral, relational,

and existential dimensions of human well-​being. It offers language and a
growing evidence base for discussing how our work is inherently moral
and how psychiatric practice and education involve the cultivation of a
mature and ethical character. As the subsequent chapters show, virtues
are not simply the ethical base on which the psychiatry rests, or simply
optional considerations, but are intrinsic to psychiatric practice itself.

References
1. Bishop L, Josephson A, Thielman S, Peteet J. Neutrality, autonomy and
mental health: a closer look. Bull Menninger Clin. 2007;71(2):164–​178.
2. Taylor C. A Secular Age. Cambridge, MA: Harvard University Press; 2007,
pp. 542–​543.
3. Freud S. Civilization and Its Discontents. S.E. In Strachey J (ed).
New York: Macmillan Press; 1930, p. 51.
4. Miller CB. The Character Gap: How Good Are We? New York: Oxford
University Press; 2018.
5. Borthwick A, Holman C, Kennard D, McFetridge M, Messruther K,
Wilkes J. The relevance of moral treatment to contemporary mental health
care. J Ment Health. 2001;10(4):427–​439. doi: 10.1080/​09638230124277
6. Foucault M. Madness and Civilization: A History of Insanity in the Age of
Reason. New York: Random House; 1965.
7. Curlin FA, Hall DE. Strangers or friends? A proposal for a new spirituality-​
in-​medicine ethic. J Gen Intern Med. 2005;20(4):370–​374.
8. Bergin AE. Psychotherapy and religious values. J Consult Clin Psychol.
1980;48:95–​105.
9. Koenig H, Al-​Zaben F, VanderWeele T. Religion and psychiatry: Recent
developments in research. BJPsych Advances. 2020;26:262–​272.
10. Glas G. Person-​Centered Care in Psychiatry: Self-​relational, Contextual,
and Normative Perspectives. New York: Routledge; 2019.
11. Peterson C, Seligman MEP. Character Strengths and Virtues: A Handbook
and Classification. Oxford: Oxford University Press; 2004.
12. Emmons RA, Stern R. Gratitude as a psychotherapeutic intervention. J
Clin Psychol. 2013;69(8):846–​855. doi:10.1002/​jclp.22020
13. Jeste DV, Palmer BW, Rettew DC, Boardman S. Positive psychiatry: Its time
has come. J Clin Psychiatry. 2015;76(6):675–​683. doi:10.4088/​JCP.14nr09599
14. VanderWeele TJ. On the promotion of human flourishing. PNAS.
2017;14(31):8148–​8156.
15. Peteet JR. A fourth wave of psychotherapies: Moving beyond recovery
toward well-​being. Harv Rev Psychiatry. 2018;26(2):90–​95. doi:10.1097/​
HRP.000000000000015
14 Introduction

16. Matthews E. Moral vision and the idea of mental illness. PPP.
1999;6:299–​310.
17. Waring DR. The Healing Virtues: Character Ethics in Psychotherapy.
Oxford: Oxford University Press; 2016, p. 81.
18. Lomas P. Doing Good? Psychotherapy Out of Its Depth. Oxford: Oxford
University Press; 1999.
19. Waring DR. The Healing Virtues: Character Ethics in Psychotherapy.
Oxford: Oxford University Press; 2016, p. 98.
20. Wong JY. Strength-​centered therapy: A social constructivist, virtues-​
based psychotherapy. Psychotherapy: Theory, Research, Practice, Training.
2006;13:133–​146.
21. The power of rescuing others. The New York Times. https://​www.nyti​mes.
com/​video/​hea​lth/​1000​0000​0877​082/​t he-​p ower-​of-​rescu​ing-​oth​ers.
html. Accessed August 3, 2021
22. Zahl D. Seculosity: How Career, Parenting, Technology, Food, Politics, and
Romance Became Our New Religion and What to Do about It. Minneapolis,
MN: Fortress Press; 2019.
23. Sperry L. Spiritual and religious concerns in psychiatric treatment.
In Peteet JR, Dell ML, Fung WLA (eds). Ethical Considerations at the
Intersection of Psychiatry and Religion. New York: Oxford University Press;
2018, pp. 60–​73.
24. Peteet, JR. What is the place of clinicians’ religious or spiritual
commitments in psychotherapy? A virtues based perspective. J Relig
Health. 2014;53:1190–​1198.
25. Lazare A. Hidden conceptual models in clinical psychiatry. N Engl J Med.
1973;288(7):345–​351. doi:10.1056/​NEJM197302152880705
26. Dean W, Talbot S, Dean A. Reframing clinician distress: moral injury not
burnout [published correction appears in Fed Pract. 2019 Oct;36(10):447].
Fed Pract. 2019;36(9):400–​402.
27. Pellegrino ED, Thomasma DC. The Virtues in Medical Practice.
New York: Oxford University Press; 1993.
28. Radden J, Sadler JZ. The Virtuous Psychiatrist: Character Ethics in
Psychiatric Practice. New York: Oxford University Press; 2010.
29. Wicks RJ. The Resilient Clinician. New York: Oxford University Press; 2008.
30. Yin-​Ling Tsui E, Hoi-​Yan Chan C, Fong Tin A. Beyond professional com-
petence: effect of equanimity on the professional quality of life among
health-​ care professionals working in perinatal bereavement support.
Illness, Crisis & Loss. 2016;24(2):88–​102.
31. Preamble to the Constitution of WHO as adopted by the International
Health Conference, New York, 19 June–​2 July 1946; signed on July
22, 1946.
V IRT UE S OF SE L F- C
​ ONT ROL
 1
Accountability
Charlotte V. O. Witvliet and John R. Peteet

Introduction

While not traditionally named as a virtue, accountability plays a vital

part in healthy relationships and in a morally integrated life. The idea
that one is answerable to others besides oneself—​to give others what
they are due—​places relational accountability within a frame of jus-
tice and serves to counterbalance the prevalent emphasis on individu-
alistic autonomy in mental health and human flourishing. Welcoming
responsibility to others and caring about one’s impact on others is basic
to making healthy personal relationships work over time. Without ac-
countability, people can neglect their relational commitments, which
fractures relational bonds. Accountability is also critical to the trust
and cooperation needed for effective work with others. Moreover,
accountability serves as a critical support for the integrity and flour-
ishing of morally virtuous persons in relationships. Actively knowing
to whom and for what one is accountable is clarifying in terms of con-
necting one’s relational responsibilities with one’s identity, direction,
and sense of purpose.
In brief, people with the virtue of accountability:

(a) welcome being accountable to others across relationships with

others to whom they rightly owe a response—​both receiving ca-
pable, good input of trustworthy persons and providing trans-
parent explanations of their own decisions and actions; and
(b) are willingly accountable for their own attitudes, thoughts,
emotions, and actions—​working to improve or correct their own
responses so that they have a positive impact.
18 Virtues of Self-Control

In this chapter, we review the existing literature on accountability; con-

sider its neurobiological, personality, and developmental aspects; and
then explore its implications for clinical practice and professionalism.

Literature Review

Many professional fields recognize the value and relevance of ac-

countability. Prominent calls for accountability in society (e.g., in gov-
erning and policing) draw attention to deficiencies in the virtue. Yet
despite a large literature in diverse fields—​organizational behavior,
public administration, political science, international relations, med-
ical decision making, criminology, social work, theology, and nursing
practice—​surprisingly little work exists on accountability in mental
health [1–​9].
The reasons to value welcoming accountability to others are ev-
ident across life domains. Timely, independent, and transparent
answerability is essential to the just and effective functioning of fam-
ilies, organizations, communities, and societies. Sociologists such
as Michael Lindsay further describe the way that elite leaders main-
tain relationships involving accountability [10]. When leaders fail
to be appropriately accountable across spheres (e.g., business, polit-
ical, religious, law enforcement), the adverse impact on others can
reach beyond those immediately involved to also affect stakeholders,
constituents, and the larger community.
Societally, lack of accountability can be a strain contributing to
conflicts and crime [11]. Criminologists are increasingly recognizing
the importance of social and transformative identity factors in the ces-
sation of criminal behavior, and the valuable contribution of restor-
ative justice—​which involves taking responsibility to repair damage
to individual people [12–​14]. Accountability is crucial to facilitate the
transition of offenders reentering society (using Circles of Support
and Accountability, or COSAs) [15]. Religious communities, when
they fully embody accountability, may contribute to such transfor-
mation by bringing together both a social and a spiritual summons
to responsibility [16]. The Angola prison population is one of the best
studied examples of cognitive and identity transformation through
 Accountability 19

restorative justice, with religious and spiritual calls to relational re-

sponsibility [17].
Accountability is also tied to professionalism in the health and
helping professions. For example, accountability is much discussed
in the nursing literature, where it refers to being responsible and an-
swerable to those affected by one’s actions and omissions; lifelong
learning; quality patient care; and upholding the standards of the pro-
fession [9]‌. Physicians such as Lionel Green-​Thompson have charac-
terized professional accountability as also having an important social
dimension, reflected in the responsibility to respond to a community’s
health priorities [18]. Accountability is a core value of physical therapy
professionals [19]. Further, social workers such as Sarah Banks have
pointed out the need for clinicians to negotiate the potential tensions
between professional accountability (e.g., the duty to meet ethical
standards, obligations imposed by regulation, standardization, and
productivity) on the one hand and one’s personal, political, or religious
values and commitments on the other [7].
Some mental health professionals have noted that accountable
relationships can be transformative for individuals recovering from
addiction and problematic behaviors, even in the case of aggressive in-
timate partners [20]. Psychotherapists generally help patients to face
the reality that they live within relational contexts requiring respon-
sibility and to hold themselves to fulfill their commitments [21]. For
example, a leading principle of acceptance and commitment therapy
(ACT) is to set goals according to values and carry them out respon-
sibly, in the service of a meaningful life [22]. Similarly, Twelve Step
programs (notably steps 5–​10) involve systematically increasing ac-
countability to others for the adverse impact of one’s addictive beha-
vior [23].

Neurobiological and Personality Aspects

Accountability involves fulfilling one’s relational responsibilities.

The relational orientation involved in receiving and responding to
input from others suggests that agreeableness would be associated
with accountability. The responsibility involved in carrying out one’s
20 Virtues of Self-Control

commitments suggests that conscientiousness would be associated

with the virtue. Indeed, accountability has been found to correlate pos-
itively with the Big Five personality traits of agreeableness and con-
scientiousness; further, accountability scores have gone beyond these
personality traits to predict flourishing as both feeling good and func-
tioning well in relationships and with purpose [24, 25, 26]. We also an-
ticipate that accountability will be functionally connected to four core
dimensions of personality functioning as measured by the Level of
Personality Functioning Scale (LPFS): intimacy, identity, empathy, and
self-​directedness [27]. Each of these dimensions has proposed neuro-
biological correlates.
First, the World Health Organization [28] and contemporary psy-
chiatry recognize that mental health involves relationality, rather
than being simply a matter of self-​realization. The LPFS denotes op-
timal functioning in this area of intimacy as the capacity to sustain en-
during and satisfying relationships with mutuality and responsiveness
to others across personal and communal areas of life [27]. Individuals
described by Josefsson, Jokela, Cloninger, and colleagues as having
the trait of reward dependence temperamentally tend to make close
attachments and to be sentimental, sensitive to social cues, and de-
pendent on social acceptance [29]. Social connection has been corre-
lated with the function of the medial prefrontal cortex (mPFC), which
has strong connectivity with the amygdala, a structure responsible for
processing emotional valence [30,31].
Second, to fulfill one’s responsibilities to others involves the ca-
pacity to receive their input and feedback, while self-​regulating one’s
responses in order to make corrections or improvements. The LPFS
denotes optimal functioning in this area of identity as living with self-​
awareness and appropriate relational boundaries, having an accurate
appraisal of oneself, with the capacity to experience a wide array of
emotions, while able to regulate one’s emotions and responses [27].
The capacity for self-​aware reflection can, for some people, be asso-
ciated with self-​transcendence, and can involve greater positive emo-
tion and more spiritual sensibilities [29]. The precuneus in the medial
superior parietal lobe has been associated with introspection and has
increased connections with other default network regions (including
the mPFC and temporoparietal junction [TPJ]) during higher-​order
 Accountability 21

social cognition tasks, including emotion perception, empathy, and

theory of mind (ToM) [31].
Third, responsiveness to others includes being concerned for them,
which entails empathy, perspective-​taking, ToM, compassion, and ser-
vice. The LPFS denotes optimal functioning in this area of empathy as
the capacity to understand the motives, perspectives, and experiences
of others across contexts, while also understanding how one’s own
actions impact others [27]. Individuals who are empathetic and sym-
pathetic, accept and help others, and are guided by explicit prosocial
values show the character trait Cloninger and colleagues describe as
cooperativeness [29]. Higher-​order social tasks, including empathy,
theory of mind, and morality, have been correlated with activity of the
TPJ [32–​34].
Fourth, accountability involves being able to fulfill one’s responsi-
bilities with effectiveness and integrity, which often relies on self-​reg-
ulation of one’s impulses in order to meet goals. The neurovisceral
integration model posits that flexible and adaptive cognitive and emo-
tional self-​regulation are supported by neural networks connecting
the brain and heart connections via the vagus nerve [35]. The LPFS
denotes optimal functioning in this area of self-​directedness by the
ability to determine and pursue appropriate goals that are well-​suited
to one’s capacities while meeting appropriate behavioral standards
with meaningful reflection [27]. The temperament trait of persistence
is marked by the characteristics of being hardworking, committed to
excellence, and not easily frustrated in working toward a goal [29].
Studies attempting to localize compulsivity and perfectionistic traits
have found their neural substrates to be complex.

Developmental Aspects

Developing moral emotion, empathy, and self-​ regulation is key

to the relational virtue of accountability. Building on the work of
psychoanalysts and theorists such as Lawrence Kohlberg (1927–​1987),
Stillwell et al. [36] propose that individuals become morally capable as
they develop perspective-​taking, acquire impulse control, and incorpo-
rate input from admired exemplars—​key capacities for accountability
22 Virtues of Self-Control

in relationships. Five domains of conscience functioning are important

in Stillwell and colleagues’ model: attachment, emotion, cognition, vo-
lition, and moral meaning making. The anchor domain is conscience,
which connects to moralization of attachment, moral-​emotional re-
sponsiveness, moral valuation, and moral volition. These capacities
emerge through stages of moral development: external conscience,
brain–​heart, personified, confused, and integrated. We posit that al-
though Stillwell et al. do not overtly name virtue or accountability in
describing mature moral functioning, their frame for knowing when
one is responsible to others and welcoming this responsibility fits with
the view that accountability as a virtue is important for healthy and
morally developed personal and professional relationships.
As these considerations make clear, both interpersonal and intra-
personal dimensions are important to the growth and cultivation of
the virtue of accountability. We turn next to its relevance for psychi-
atric assessment, diagnosis, formulation, and treatment.

Clinical Implications: Assessment, Case

Conceptualization, and the Therapeutic Process

In recent decades, psychiatry has extended its scope beyond pathology

and its neurobiological correlates to the health and flourishing of the
whole person [37]. Positive psychology has provided evidence for the
importance of character strengths, including relational virtues such as
forgiveness and gratitude. However, relatively little attention has been
devoted to the relevance of accountability to others or transcendent ac-
countability in the area of human flourishing, including mental health.
As discussed elsewhere [38], clinicians garner valuable information
from listening for ways that a patient has or has not been accountable
in life and in previous treatment contexts, as well as for how they have
suffered from the failures of others to be accountable. We suggest sev-
eral questions: What are the patient’s most valued relationships—​and
to whom are they most attached and why? Which relationships are
thriving—​and languishing? What exemplary experiences or failures of
accountability stand out as significant for the patient? How have their
attitudes and actions in relationships been influenced by key authority
 Accountability 23

figures? Does the patient/​client have an accountability partner? Does

the patient experience belonging, mattering, and growth in communi-
ties of support (e.g., a Twelve Step program, support group, commu-
nity organization, congregation, or religious or spiritual body)? Does
the patient have transcendent ideals, connection to a higher power, or
a relationship with God that has implications for living accountably?
How does the individual interpret relational disappointments or a
strained relationship with God—​or, conversely, is the individual flour-
ishing in relationships with others and God or a higher power?
We posit that two key capacities—​empathy and self-​regulation—​
play an important role in accountability across relationships. What
are the patient’s or client’s strengths and weaknesses in empathic
perspective-​taking and regard for others? What are their strengths
and struggles with self-​regulation—​adaptably enacting appropriate
responses at the appropriate time? These capacities also relate to how
people respond to feedback from people in their lives who have the
practical standing or roles to provide evaluative feedback. How open
is the patient/​client to such feedback—​do they tend to receive input as
an opportunity to learn and improve, or as a threat and indication of
inadequacy? How does the patient respond to invitations to engage in
perspective-​taking and the possibility of learning from feedback? How
does the patient respond to invitations to see their own ability to make
beneficial corrections or improvements?
Within the frame of therapy, what behavioral evidence does the pa-
tient give of succeeding or struggling with accountability? Are they
able to talk rather than act out, respect professional boundaries in the
relationship, appropriately call as needed, keep appointments, and
manage fees (not to be confused with economic barriers due to sys-
temic reasons for which they are not accountable)? Does the patient
show discernment and trust within the relationship with the mental
health professional? Does the patient show perspective-​taking with re-
gard for the professional’s input? Does the patient follow through with
implementing changes? Do they persist even when the work of therapy
becomes difficult?
The relevance of accountability to the clinical formulation is most
clearly seen when individuals lack features that support accounta-
bility and contribute to mental health: connectedness, proportionality,
24 Virtues of Self-Control

responsiveness to others, and persistence. For example, schizoid or

depressed individuals often lack the ability to respond both propor-
tionally and through connection, which disrupts the relational aspects
of fulfilling responsibilities accountably. Those with perfectionistic
or obsessional features may lack the proportionality required to re-
spond appropriately, which primarily distorts the responsibility as-
pect of accountability. Narcissistic or psychopathic individuals lack the
ability to empathetically respond, thereby impeding the relationality
of accountability. Impulsive or undisciplined individuals lack the per-
sistence needed to fulfill the responsibilities that are so essential to
accountability.
Fostering capacities that support the virtue may be an appropriate
aim in the treatment of individuals with deficient or distorted account-
ability. Consider the following examples:

Depression
Severely depressed individuals often lack both proportionality and
openness to others due to negative preoccupations. Treatment may
need to focus not just on these cognitive distortions and behavioral
activation, but also on the patient’s valuing of their own dignity and
efforts, scaling their contributions in terms of responsibilities that are
realistically appropriate, and seeing the worth of their relationships
[39], as a means of regaining proportionality and connection.
A 60-​year-​old teacher developed anxious depression that required hos-
pitalization and ECT (electroconvulsive therapy), followed by an inten-
sive outpatient program and individual therapy. Although her condition
improved, she continued to ruminate about how she did not measure up
to her siblings, whom she saw as more accomplished. Treatment focused
on helping her adopt the acceptance and valuing perspective that her
husband and others offered her. With this support and validation of her
worth, therapy supported her in clarifying her priorities and in seeing her
own capacities to realistically fulfill responsibilities in the relationships she
valued.

Narcissism with Psychopathic Features

A 40-​year-​old married father of two elementary-​aged children came
for treatment at his wife’s insistence because of his loud, accusatory
 Accountability 25

outbursts directed at her. Together, they had briefly attended couples

therapy, but rather than acknowledging the pain his abusive beha-
vior was causing her, he emphasized the ways that she provoked him,
giving him “no choice” but to respond so that the kids would respect him.
Individual treatment involved clarifying his hopes for the relationship
and helping him to envision a mutually responsive marriage—​rather
than one that was a zero sum game. Therapy focused on connecting his
goals—​keeping his marriage and family together—​with his capacity to
own responsibility for his attitudes and actions, to fulfill his valued duty
to live out the vows he had made to his wife, and to provide a good future
for their children.

Perfectionism/​Obsessive Compulsive Features

A 21-​year-​old college student presented with perfectionistic tenden-
cies and obsessional worries about conducting cleaning rituals to
avoid infection by Covid-​19. Going beyond the health guidance of the
Centers for Disease Control (CDC) and the strict mask and distancing
guidelines of the university, this bright, previously high-​achieving stu-
dent focused on handwashing rituals. They became increasingly iso-
lated, angry that others did not observe the same high standards for
cleanliness, and frustrated with their own failings. Treatment aimed
at improving proportionality and connection, so that they could
better understand where others were coming from, take others’ input
less personally, focus on more likely and proximal transmission risks
(e.g., airborne respiratory transmission) rather than remote and less
likely possibilities (e.g., contaminated toothpaste), and reengage
relationships and activities with more appropriate action to fulfill rea-
sonable responsibilities.

Impulsivity
A 35-​year-​old single woman came for treatment looking for greater con-
sistency in her life and more satisfying relationships after having moved
from one career interest to another, periodically abusing substances
and becoming sexually promiscuous. She found it helpful to have sup-
port group “accountability partners” and to work in therapy focused on
developing her capacity to follow through with responsibilities in other
relationships. By persisting through challenges to pursue goals in these
26 Virtues of Self-Control

therapeutic relationships, she developed more stable patterns in her work

and personal relationships that connected with her values.

Trauma
A 42-​year old single mother felt overwhelmed raising her daughter, who
had now reached the age she had been when a family friend raped her.
Central to establishing a trusting treatment relationship was acknow-
ledging the impact she experienced when her own family and their
friends had failed to prevent this violating trauma and failed to respond
appropriately to both her and the offender. Within therapy, she worked
to develop her accountability as a parent to her daughter. This involved
seeing beyond her daughter’s vulnerability to foster her agency, nurture
a relationship marked by unconditional acceptance, and openly discuss
appropriate behavioral expectations.
All of these individuals benefited from clarity and support in be-
coming more responsive and responsible in relationships in order to
function more fully in the world. Beyond a traditional emphasis on au-
tonomous functioning, a focus on accountability added constructive
cultivation of interpersonal perspective-​taking, receptivity to learning
from input and feedback, regulation of responses, and prioritization
to fulfill responsibilities in real-​world relationships relevant to their
presenting problems.
Accountability as a virtue can also be central to the broader process
of treating individuals. For example, expecting the patient to honor the
frame (coming on time and paying the fee) can convey regard for both
the patient and the work [40]. Encouraging self-​reflection and open-
ness to input is basic to both insight-​oriented and skills-​based therapy,
and may need to include confrontation of specific resistance to wel-
come and act constructively on feedback—​rather than taking it per-
sonally, distorting its essence, disavowing its importance, or blaming
circumstances.
The therapist’s accountability to the patient entails prioritizing the
patient’s needs over their own in matters such as recognizing when ter-
mination—​rather than comfortable but stagnant treatment—​is indi-
cated. The therapist’s demonstrated accountability to the patient can
provide a caring, responsible form of attention that the patient has
lacked and, as suggested above, often needs in order to feel heard.
 Accountability 27

Ideally, treatment is a mutual process of perspective-​taking with

openness to learn from one another and self-​regulation to adapt to
what is being learned.

Accountability and Professionalism

As professionalism has become a focus of increasing attention, Radden

and Sadler [41] have called attention to the virtues a psychiatrist or
clinician should embody. We have noted elsewhere [38] the larger set
of these important virtues and those that are particularly important
for accountability: respect for the patient and for the healing project,
empathy, self-​knowledge, and the meta-​virtue of phronesis—​practical
wisdom to do what is right at an appropriate time and in a good way
for the right reasons [41]. Explicit recognition of accountability as a
relevant and related virtue emphasizes the nature of the psychiatrist’s
interpersonal responsibilities and the value of being able to adapt
in light of new information in order to carry out these relational
commitments. Accordingly, therapists will consider the context of
their own supervision, learning, colleague relationships, responsibil-
ities to the professional organization, and the culture of which they are
a part. Importantly, a forward-​looking rather than a defensive posture
in response to feedback from supervisors can help maintain a positive
focus on the shared aims of the supervisor and trainee, while buffering
against burnout. Similarly, at all stages of professional development,
clinicians and work units can benefit from the capacity to receive
and incorporate feedback with the goals of continued improvement.
Scandals, or other failures of systems to maintain quality care, often
reflect a previously unrecognized breakdown of healthy accountability
within a professional’s particular relationships or broader systemic
relationships affecting the professional organization.

Accountability and Growth

As noted earlier, a fourth wave of therapies now aims beyond treat-

ment of disorders to promote growth, including the fostering of
28 Virtues of Self-Control

virtues toward human flourishing [37]. Although research into ac-

countability as a virtue is only beginning to emerge, other relational
virtues such as forgiveness and gratitude cluster with measures of
accountability [25, 42, 43]. Those who show accountability may also
pursue other dimensions of human flourishing such as meaning
and a sense of purpose [25, 44]. Individuals who find meaning in
a spiritual identity are likely to find vertical or transcendent ac-
countability particularly relevant in lending a frame of purpose and
relational spirituality that intersects with human accountability
relationships [45].
Despite these findings, it seems clear that one’s values and
assumptions—​for example, an individualistic versus communal em-
phasis, or immanent versus transcendent frame—​can shape the prac-
tical importance that one grants to accountability [46]. Future work
will need to address issues associated with overcoming obstacles to
accepting feedback well, enhancing empathy and self-​regulation, de-
veloping mindsets that facilitate accountable change, and examining
dynamics of accountability in relationships across cultural contexts
and over the developmental lifespan.

Conclusion

Greater attention to what constitutes and promotes human flour-

ishing has shown the limitations of maximizing individual autonomy
as the goal of mental health treatment. Accountability to fulfill one’s
relational responsibilities complements a vision of autonomy to act
in healthy congruence with deeply held and meaningful values [47].
This is consistent with Ryan and Deci’s view of self-​determination as
reflective of capacities for relatedness, competence, and autonomous
(rather than controlled) motivation [48]. For mental health treat-
ment, welcoming accountability—​of clinician toward patient, of pa-
tient toward clinician, and of both toward the aim of the patient living
accountably—​is often crucial to fulfilling mental health goals in light
of relational roles. The virtue of accountability is indispensable to a
flourishing life.
 Accountability 29

Acknowledgment

This project/​publication was made possible through the support of a

grant from the Templeton Religion Trust. The opinions expressed in
this publication are those of the authors and do not necessarily reflect
the views of the Templeton Religion Trust.

References
1. Hall AT, Frink DD, Buckley MR. An accountability account: A review and
synthesis of the theoretical and empirical research on felt accountability. J
Org Behav. 2017;38(2):204–​224.
2. Bovens M, Goodin RE, Schillemans T (eds). The Oxford Handbook of
Public Accountability. Oxford: Oxford University Press; 2014.
3. Stokes SC. Perverse accountability: A formal model of machine politics
with evidence from Argentina. Am Pol Sci Rev. 2005;99(3):315–​326.
4. Mulgan R. Holding Power to Account: Accountability in Modern
Democracies. London: Palgrave Macmillan, 2003.
5. Han S, Lerner JS. Accountability. In: Kattan MW, Cowen ME, Encyclopedia
of Medical Decision Making. Thousand Oaks, CA: Sage; 2009:7–​9.
6. Roche D. Accountability in Restorative Justice. New York: Oxford
University Press; 2003.
7. Banks S. Negotiating personal engagement and professional accounta-
bility: Professional wisdom and ethics work. J Soc Work. 2013;16:587–​604.
8. Gates DK, Steane P. The theology of accountability and biblical, historical
and political implications for social justice. Int J Knowl Cult Chang Manag.
2008;8:43–​52.
9. Krautscheid LC. Defining professional nursing accountability: A literature
review. J Prof Nurs. 2014;30:43–​47.
10. Lindsay DM. A View from the Top: An Inside Look at How People in Power
See and Shape the World. Hoboken, NJ: John Wiley; 2014.
11. Agnew R. Pressured into Crime: An Overview of General Strain Theory. Los
Angeles, CA: Roxbury; 2006.
12. Giordano PC, Cernkovich SA, Rudolph JL. Gender, crime, and
desistance: Toward a theory of cognitive transformation. Am J Soc.
2007;107:990–​1064.
13. Braithwaite J. Accountability and responsibility through restorative jus-
tice. In Dowdle MD, ed., Public Accountability: Designs, Dilemmas and
Experiences, Cambridge: Cambridge University Press; 2006,33–​51.
14. Zehr H. The Little Book of Restorative Justice: Revised and Updated.
New York: Skyhorse Publishing; 2015.
30 Virtues of Self-Control

15. Bohmert MN, Duwe G, Hipple NK. Evaluating restorative justice circles
of support and accountability: Can social support overcome structural
barriers? Int J Offender Ther Comp Crim. 2018;62:739–​758.
16. VanderWeele T. Religious communities and human flourishing. Curr Dir
Psychol Sci. 2017;26:476–​481.
17. Hallett M, Hays J, Johnson BR, Jang SJ, Duwe G. The Angola Prison
Seminary: Effects of Faith-​Based Ministry on Identity Transformation,
Resistance, and Rehabilitation. New York: Routledge; 2017.
18. Green-​Thompson LP, McInerney P, Woollard B. The social accountability
of doctors: A relationship based framework for understanding emergent
community concepts of caring. BMC Health Serv Res. 2017;17:269.
19. American Physical Therapy Association. (2019, September 20).
Professionalism in Physical Therapy: Core Values. Retrieved July 12, 2020,
from http://​www.apta.org/​upload​edFi​les/​APTA​org/​About​_​Us/​Polic​ies/​
BOD/​Judic​ial/​Prof​essi​onal​ismi​nPT.pdf. Alexandria, VA: APTA.
20. Jory B, Anderson D, Greer C. Intimate justice: Issues of accounta-
bility, respect and freedom in treatment for abuse and violence. JMFT.
1997;23:399–​419.
21. Klein A. What men say about #MeToo in therapy. New York Times, July
1, 2018, Section SR, Page 10. https://​www.nytimes.com/​2018/​06/​30/​
opinion/​sunday/​men-​metoo-​therapy-​masculinity.html
22. Harris R. Embracing your demons: An overview of acceptance and com-
mitment therapy. Psychother Austr. 2006;12:2–​8.
23. Alcoholics Anonymous. Alcoholics Anonymous (4th ed.). New York: World
Services; 2001.
24. John OP, Naumann LP, Soto CJ. Paradigm shift to the integrative Big Five
trait taxonomy: History, measurement, and conceptual issues. In: John
OP, Robins RW, Pervin LA (eds), Handbook of Personality: Theory and
Research. New York: Guilford Press; 2008;114–​158.
25. Witvliet CVO, Jang SJ, Berry JW, Evans CS, et al. (August 2019).
Accountability to people: A new frontier in positive psychology. Presented
at the American Psychological Association (APA) Annual Convention,
Chicago, IL, 2019.
26. Keyes CLM. The mental health continuum: From languishing to flour-
ishing in life. Journal of Health and Social Research. 2002;43:207–​222.
27. American Psychiatric Association. Diagnostic and Statistical Manual of
Mental Disorders (5th ed.). 2013. Arlington, VA: Author.
28. World Health Organization. Mental Health: Strengthening Our Response.
https://​www.who.int/​news-​room/​fact-​she​ets/​det​ail/​men​tal-​hea​lth-​streng​
then​ing-​our-​respo​nse. Accessed September 8, 2021.
29. Josefsson K, Jokela M, Cloninger CR, et al. Maturity and change in person-
ality: Developmental trends of temperament and character in adulthood.
Dev Psychopath. 2013;25:713–​727.
 Accountability 31

30. Kim MJ, Gee DG, Loucks RA, Davis FC, Whalen PJ. Anxiety dissociates
dorsal and ventral medial prefrontal cortex functional connectivity with
the amygdala at rest. Cereb Cortex. 2001;21:1667–​1673.
31. Li W, Mai X, Liu C. The default mode network and social understanding
of others: What do brain connectivity studies tell us? Front Hum Neurosci.
2014;8:74.
32. Eres R, Louis WR, Molenberghs P. Common and distinct neural networks
involved in fMRI studies investigating morality: An ALE meta-​analysis.
Soc Neurosci. 2008;13:384–​398.
33. Bzdok D, Schilbach L, Vogeley K, Schneideret K, et al. Parsing the neural
correlates of moral cognition: ALE meta-​analysis on morality, theory of
mind, and empathy. Brain Struc Func. 2012;217:783–​796.
34. Decety J, Lamm C. The role of the right temporoparietal junction in social
interaction: How low-​level computational processes contribute to meta-​
cognition. The Neuroscientist. 2007;13:580–​593.
35. Kemp AH, Koenig J, Thayer JF. From psychological moments to mor-
tality: A multidisciplinary synthesis on heart rate variability spanning the
continuum of time. NeurosciBiobehav Rev. 2017;83:547–​567.
36. Stillwell BM, Galvin MR, Gaffney MM. Progress in conscience-​sensitive
psychiatry: Assessment, diagnosis and treatment planning. Conscience
Works, An On-​line Periodical: Theory, Research and Clinical Applications.
2006;2:5–​30.
37. Peteet JR. A fourth wave of psychotherapies: Moving beyond recovery to-
ward well-​being. Harvard Rev Psychiatry. 2018;26(2):90–​95. https://​doi.
org/​10.1097/​HRP.0000000000000155
38. Peteet JR, Witvliet CVO, Evans CS. Accountability as a key virtue in
mental health and human flourishing. PPP. In Press.
39. Waring DR. The Healing Virtues: Character Ethics in Psychotherapy.
New York: Oxford University Press; 2016.
40. Gutheil TG. On the therapy in clinical administration: III. Psychiatric Q.
1982;54(1):18–​25.
41. Radden J, Sadler JZ. The Virtuous Psychiatrist: Character Ethics in
Psychiatric Practice. New York: Oxford University Press; 2010.
42. Witvliet CVO. Forgiveness, embodiment, and relational account-
ability: Victim and transgressor psychophysiology research.
In: Worthington EL Jr., Wade N (eds), Handbook of Forgiveness. 2nd ed.
New York: Brunner-​Routledge; 2020:167–​177.
43. Witvliet CVO, Root Luna LM. Forgiveness and well-​ being.
In: Dunn D (ed), Positive Psychology: Established and Emerging Issues.
New York: Routledge/​Taylor & Francis Group; 2018:131–​152.
44. VanderWeele TJ. On the promotion of human flourishing. Proc. Natl.
Acad. Sci. U.S.A. 2017;114(31):8148–​8156. https://​doi.org/​10.1073/​
pnas.1702996114
32 Virtues of Self-Control

45. Witvliet CVO, Jang SJ, Berry JW, et al. (June 2019). Accountability to the
transcendent: A new frontier in psychology. Presented at the Association
for Research in Personality (ARP) Annual Convention, Grand Rapids, MI.
46. Taylor C. A Secular Age. Cambridge, MA: Harvard University Press; 2007.
47. Weinstein N, Przybylski AK, Ryan RM. The index of autonomous func-
tioning: Development of a scale of human autonomy. J Res Person.
2012;46:397–​413.
48. Deci EL, Ryan RM. Self-​determination theory: A macrotheory of human
motivation, development, and health. Can Psychol. 2008;49:182–​185.
 2
Humility
Nicholas D. Covaleski

Introduction

Early in my Master’s program, I attended a career panel to hear three

medical professionals talk about bioethics. The panelists came from
different areas of healthcare and therefore had different stories to
tell, yet one theme continued to resurface: humility is key. I found
this theme particularly intriguing since, having come from a reli-
gious studies background, I was well aware that the centrality of hu-
mility resonates with several religious and spiritual traditions [1]‌.
Combined with a strong interest in mental health, I decided to inves-
tigate humility’s role in the therapeutic context. To do so, I conducted
a literature review on PubMed using the keywords “humility” and
“mental health,” selecting peer-​reviewed articles published in the last
10 years. To supplement the literature, I reached out to a handful of
mental health professionals to learn more about how humility informs
their approaches, as well as to gather case examples that illuminate the
relevance of humility for mental health practice. The results revealed
that there are at least three “types” of humility: cultural, epistemic, and
existential. The presence of each type in various mental health settings
has reliably been shown to be a positive contributor to mental health
outcomes. Several religious and spiritual traditions, moreover, boast
long histories of thought on humility. Taken together, in this chapter
I show that humility is a key part of the therapeutic context and that
religion can enrich our understanding of how this virtue is formulated,
cultivated, and studied. Thus humility in general, and its relationship
with religion in particular, warrant future research not only within the
arena of mental health, but also within the broader arena of human
flourishing.
34 Virtues of Self-Control

A (Humble) History of Humility

Virtue ethics, a branch of moral philosophy that focuses on those char-

acteristics that dispose one to act in accordance with moral principles,
obligations, or ideals [2]‌, has experienced a bit of a renaissance within
North American intellectual thought [3].1 Thinkers from a range of
related fields—​political philosophy, theology, and bioethics—​have in-
creasingly turned toward the virtues in an effort to advance those qual-
ities that promote the good life [4]. Until recently, however, the virtue
of humility remained largely neglected, for several reasons. First, hu-
mility is almost entirely absent from the material that usually serves
as the entry point into virtue ethics—​namely, Greek and Roman ac-
counts of virtue [3]. To be humble in the Ancient world was “to be born
a nobody” and thus had no bearing on the cultivation of excellence
[3]. Another immediate explanation for humility’s neglect is that, vir-
tuous or not, it is a difficult thing to define and measure [5], arguably
even more so than other qualities such as forgiveness [6] and grati-
tude [7,8]. Lastly, according to a number of mainstream and scholarly
definitions, humility frustrates a liberal democratic ethos [4]. For in-
stance, if one defines humility as having a low view of one’s importance
or worth [9], then humility seems inconsistent with several core values
of the professed American creed, including autonomy, freedom, and
self-​respect. In the context of American healthcare, moreover, such
definitions of humility conflict with characteristics typically conferred
on the doctor: confident, skilled, and assertive [10]. Thus humility, at
least in the United States, has often been excluded from conversations
on the virtues and human flourishing within healthcare and beyond.
Recent work in positive psychology, however, has shown that
those definitions of humility that emphasize self-​abasement are mis-
leading at worst and lacking at best. And a number of contemporary
philosophers—​in no small part because of the work being done in
positive psychology—​have made the case that humility is a valuable
moral virtue [9]‌. Still, the “general notion of humility”—​what James

1 For a much more thorough discussion on defining virtue ethics, see Christine

Swanton, “The definition of virtue ethics.” In: Russell DC (ed). The Cambridge
Companion to Virtue Ethics. Cambridge: Cambridge University Press; 2013;315–​338.
Another random document with
no related content on Scribd:
 in South Africa, and to produce what, thank God! he had failed
in producing—a racial war." Mr. Chamberlain retorted that Sir
William Harcourt's attitude was unpatriotic and injurious to
the cause of peace. He denied aggressiveness in the policy of
the government, asserting that the South African Republic had
been spending millions on armaments imported from abroad, in
view of which the strengthening of the British garrison at the
Cape by an additional regiment and three batteries was no
unreasonable measure. Mr. Balfour, also, begged the House and
the country to believe that the troops were sent only as a
measure of precaution, to maintain admitted rights.

{478}

SOUTH AFRICA: The Transvaal: A. D. 1897 (May-October).

The British assertion of suzerainty and declination of
proposal to arbitrate disagreements.

On the 7th of May, 1897, the Acting State Secretary of the

South African Republic addressed to the British Agent at
Pretoria a communication of great length, reviewing the
positions taken by Mr. Chamberlain in his several arraignments
of the government of the Republic for alleged violation of the
London Convention of 1884, and proposing an arbitration of the
questions involved. "The complaint," he wrote, "which Her
British Majesty's Government has advanced in an unmistakably
pronounced manner over an actual or possible breach of the
Convention has deeply grieved this Government, as it thinks
that it has fulfilled its obligations. It sees in the
fulfilment of the mutual obligations under the Convention one
of the best guarantees for the maintenance of a mutual good
understanding and for the promotion of reciprocal confidence.
To this good understanding and that confidence, however,
severe shocks have been given by events which cannot be
lightly forgotten. And if it were not that this Government
wishes to guard itself against adopting a recriminating tone,
it might put the question whether, for example, the incursion
of Dr. Jameson, whether considered as a breach of the
Convention or a grievance, is not of immeasurably greater
importance than the various matters adduced by Her British
Majesty's Government would be, even if the contention that
they constitute breaches of the Convention could be accepted.
There should, in the view of this Government, be a strong
mutual endeavour to restore the shocked confidence and to calm
the excited spirit which this Government with sincere regret
sees reigning throughout almost the whole of South Africa.
This Government is anxious to co-operate for this end, for the
desire of the Republic, with the maintenance of its
independence and rights, is for peace, and where for the
reasons given it has been unable to entertain the proposal of
Her British Majesty's Government in the matter of the Aliens
Law,—and it appears very difficult to arrive at a solution of
the question by means of correspondence,—it wishes to come to
a permanent good understanding along a peaceful course, not
only with respect to its undisturbed right to make an alien
law, but also with regard to all points touching the
Convention which are referred to in the two Despatches under
reply by Her British Majesty's Government. While it respects
the opinion of Her British Majesty's Government, it takes the
liberty, with full confidence in the correctness of its own
views, to propose to Her British Majesty's Government the
principle of arbitration with which the honourable the First
Volksraad agrees, in the hope that it will be taken in the
conciliatory spirit in which it is made. …

"Although this Government is firmly convinced that a just and

impartial decision might be obtained even better in South
Africa than anywhere else, it wishes, in view of the
conflicting elements, interests, and aspirations, which are
now apparent in South Africa, and in order to avoid even the
appearance that it would be able or desire to exercise
influence in order to obtain a decision favourable to it, to
propose that the President of the Swiss Bondstate, who may be
reckoned upon as standing altogether outside the question, and
to feel sympathy or antipathy neither for the one party nor
for the other, be requested to point out a competent jurist,
as has already oftener been done in respect of international
disputes. The Government would have no objection that the
arbitrator be subject to a limitation of time, and gives the
assurance now already that it will willingly subject itself to
any decision if such should, contrary to its expectation, be
given against it. The Government repeats the well-meant wish
that this proposal may find favour with Her British Majesty's
Government, and inasmuch as the allegations of breaches of the
Convention find entrance now even in South Africa, and bring
and keep the feelings more and more in a state of suspense,
this Government will be pleased if it can learn the decision
of Her Majesty's Government as soon as possible."

Mr. Chamberlain's reply to this proposal was not written until

the 16th of the following October, when he, in turn, reviewed,
point by point, the matters dealt with, in the despatch of Mr.
Van Boeschoten. With reference to the Jameson raid he said: "Her
Majesty's Government note with satisfaction that the
Government of the South African Republic see in the fulfilment
of the mutual obligations under the London Convention one of
the best guarantees for the maintenance of a mutual
understanding and for the promotion of reciprocal confidence.
Her Majesty's Government have uniformly fulfilled these
obligations on their part, and they must strongly protest
against what appears to be an implication in the Note under
consideration that the incursion of Dr. Jameson can be
considered as either a breach of the Convention by Her
Majesty's Government or a grievance against them. That
incursion was the act of private individuals unauthorised by
Her Majesty's Government, and was repudiated by them
immediately it became known. The immense importance to the
Government of the South African Republic of that repudiation,
and of the proclamation issued by the High Commissioner under
instructions from Her Majesty's Government, is recognised
throughout South Africa. Her Majesty's Government maintain
 strongly that since the Convention of 1881 there has never
been any breach or even any allegation of a breach on their
part of that or the subsequent Convention, and, as the subject
has been raised by the implied accusation contained in the
Note under consideration, Her Majesty's Government feel
constrained to contrast their loyal action in the case of the
Jameson raid with the cases in which they have had cause to
complain that the Government of the South African Republic
failed to interfere with, if they did not countenance,
invasions of the adjacent territories by its burghers in
violation of the Convention, and they feel bound to remind the
Government of the Republic that in one of these cases Her
Majesty's Government were compelled to maintain their rights
by an armed expedition at the cost of about one million
sterling, for which no compensation has ever been received by
them."

Concerning the proposal of arbitration, the reply of the

British colonial secretary was as follows: "In making this
proposal the Government of the South African Republic appears
to have overlooked the distinction between the Conventions of
1881 and 1884 and an ordinary treaty between two independent
Powers, questions arising upon which may properly be the
subject of arbitration.
{479}
By the Pretoria Convention of 1881 Her Majesty, as Sovereign
of the Transvaal Territory, accorded to the inhabitants of
that territory complete self-government subject to the
suzerainty of Her Majesty, her heirs and successors, upon
certain terms and conditions and subject to certain
reservations and limitations set forth in 33 articles, and by
the London Convention of 1884 Her Majesty, while maintaining
the preamble of the earlier instrument, directed and declared
that certain other articles embodied therein should be
substituted for the articles embodied in the Convention of
1881. The articles of the Convention of 1881 were accepted by
the Volksraad of the Transvaal State, and those of the
 Convention of 1884 by the Volksraad of the South African
Republic. Under these Conventions, therefore, Her Majesty
holds towards the South African Republic the relation of a
suzerain who has accorded to the people of that Republic
self-government upon certain conditions, and it would be
incompatible with that position to submit to arbitration the
construction of the conditions on which she accorded
self-government to the Republic. One of the main objects which
Her Majesty's Government had in view was the prevention of the
interference of any foreign Power between Her Majesty and the
South African Republic, a matter which they then held, and
which Her Majesty's present Government hold, to be essential
to British interests, and this object would be defeated by the
course now proposed. The clear intention of Her Majesty's
Government at the time of the London Convention, that
questions in relation to it should not be submitted to
arbitration, is shown by the fact that when the delegates of
the South African Republic, in the negotiations which preceded
that Convention, submitted to Her Majesty's Government in the
first instance (in a letter of the 26th of November, 1883,
which will be found on page 9 of the Parliamentary Paper C.
3947 of 1884) the draft of a treaty or convention containing
an arbitration clause, they were informed by the Earl of Derby
that it was neither in form nor in substance such as Her
Majesty's Government could adopt."

Great Britain, Papers by Command.

C.—8721, 1898.

SOUTH AFRICA: Natal: A. D. 1897 (December).

Annexation of Zululand.

See (in this volume)

AFRICA: A. D. 1897 (ZULULAND).

SOUTH AFRICA: Cape Colony: A. D. 1898.

The position of political parties.
The Progressives and the Afrikander Bund.

"The present position of parties at the Cape is as unfortunate

and as unwarranted as any that the severest critic of
Parliamentary institutions could have conjured up. … The Cape
has always had the curse of race prejudice to contend with.
Time might have done much to soften, if not to expunge it, if
home-made stupidities had not always been forthcoming to goad
to fresh rancour. The facts are too well known to need
repetition. It is true not only of the Transvaalers that 'the
trek has eaten into their souls,' and up to the time of
emancipation and since, every conceivable mistake has been
committed by those in authority. Thus, when the breach was, to
all appearances, partly healed, the fatal winter of 1895 put
back the hands of the clock to the old point of departure. As
Englishmen, our sympathies are naturally with the party that
is prevalently English, and against the party that is
prevalently Dutch; but to find a real line of political
difference between them other than national sentiment requires
fine drawing. … According to our lines of cleavage both
Bondsmen [Afrikander Bund] and Progressives are Conservatives
of a decided type. Practically they are agreed in advocating
protective duties on sea-borne trade, although in degree they
differ, for whilst the Bond would have imposts as they are,
the Progressives wish to reduce the duties on food stuffs to
meet the grievance of the urban constituencies, and might be
induced to accord preferential treatment to British goods. On
the native question neither party adopts what would in England
be considered an 'advanced' programme, for education is not
made a cardinal point, and they would equally like, if
possible, to extend the application of the Glen Grey Act,
which, by levying a tax on the young Kaffirs who have not a
labour certificate, forces them to do some service to the
community before exercising their right of 'putting the
spoon,' as the phrase is, 'into the family pot.' Neither party
wishes to interfere with the rights of property or the
absolute tenure of land under the Roman-Dutch law. A tax on
the output of diamonds at Kimberley has been advocated by some
members of the Bond as a financial expedient, but it is
understood to have been put forward rather as a threat against
Mr. Rhodes personally than as a measure of practical politics.
Questions of franchise are tacitly left as they are, for no
responsible politicians wish to go back upon the enactment
which restricted the Kaffir vote to safe and inconsiderable
limits. The redistribution of seats was the subject of a Bill
upon which the last House was dissolved, after the rebuff that
the Ministry received upon a crucial division, but it has been
dealt with rather for practical than theoretical reasons. Two
schemes of redistribution have been formulated, and each has
been proposed and opposed with arguments directed to show the
party advantage to be derived. For political reform, in the
abstract, with or without an extension of the suffrage, there
is no sort of enthusiasm in any quarter. Railway
administration furnishes, no doubt, an occasional battle-field
for the two sides of the House. Roughly, the Progressives
favour the northern extension, and are willing to make
concessions in rates and charges to help on the new trade with
Rhodesia; whilst the Bond declare themselves against special
treatment of the new interests, and would spend all the money
that could be devoted to railway construction in the farming
districts of the colony itself. Mr. Rhodes, however, has
warned the Cape that any hostile action will be counteracted
by a diversion of traffic to the East, and it is unlikely that
any line of policy will be pursued that is likely to injure
the carrying trade of the southern ports. Between the
followers of Mr. Rhodes and the followers of Mr. Hofmeyr there
is no wide divergence of principle on public affairs of the
near future, so far as they have been or are to be the subject
of legislation; where the difference comes in is in the
attitude they severally assume towards the two republics and
the territories of the north, but when talk has to yield to
action it is improbable that there will be much in their
disagreement."
 N. L. W. Lawson,
Cape Politics and Colonial Policy
(Fortnightly Review, November 1898).

{480}

SOUTH AFRICA: The Transvaal: A. D. 1898 (January-February).

Re-election of President Kruger.

Renewed conflict of the Executive with the Judiciary.
Dismissal of Chief-Justice Kotze.

The Presidential election in the South African Republic was

held in January and February, the polls being open from the 3d
of the former month until the 4th of the latter. President
Kruger was re-elected for a fourth term of five years, by
nearly 13,000 votes against less than 6,000 divided between
Mr. Schalk Burger and General Joubert, who were opposing
candidates. Soon afterwards, the conflict of 1897 between the
Judiciary and the Executive (see above: A. D. 1897,
JANUARY-MARCH), was reopened by a communication in which
Chief-Justice Kotze, of the High Court, called the attention
of the President to the fact that nothing had been done in
fulfilment of the agreement that the independence of the Court
and the stability of the Grondwet should both be protected by
law against arbitrary interference, and giving notice that he
considered the compromise then arranged to be ended. Thereupon
(February 16) President Kruger removed the judge from his
office and placed the State Attorney in his seat. Justice
Kotze denied the legality of the removal, and adjourned his
court sine die. In a speech at Johannesburg, some weeks
afterwards, he denounced the action of President Kruger with
great severity, saying: "I charge the President, as head of
the State, with having violated both the constitution and the
ordinary laws of the land; with having interfered with the
independence of the High Court; and invaded and imperilled the
rights and liberties of everyone in the country. The
 guarantees provided by the constitution for the protection of
real and personal rights have disappeared, and these are now
dependent on the 'arbitrium' of President Kruger."

SOUTH AFRICA: Rhodesia and the British South Africa Company:

A. D. 1898 (February).
Reorganization.

In February, the British government announced the adoption of

plans for a reorganization of the British South Africa Company
and of the administration of its territories. The Company,
already deprived of military powers, was to give up, in great
part, but not wholly, its political functions. It was still to
appoint an Administrator for Rhodesia south of the Zambesi,
and to name the majority of members in a council assisting
him, so long as it remained responsible for the expenses of
administration; but, by the side of the Administrator was to
be placed a Resident Commissioner, appointed by the Crown, and
over both was the authority of the High Commissioner for South
Africa, to whom the Resident Commissioner made reports. At
home the status of the Board of Directors was to be
considerably altered. The life directorships were to be
abolished, and the whole Board of Directors in future to be
elected by the shareholders,—any official or director removed
by the Secretary of State not being eligible without his
consent. The Board of Directors was to communicate all
minutes, etc., to the Secretary of State, and he to have the
power of veto or suspension. Finally, the Secretary of State
was to have full powers to inspect and examine all documents;
Colonial Office officials named by him were, in effect, to
exercise powers like those of the old Indian Board of Control.

SOUTH AFRICA: Cape Colony: A. D. 1898 (March-October).

Election in favor of the Afrikander Bund.

Change in the government.
 Elections to the Upper House of the Cape Parliament, in March,
gave the party called the Progressives, headed by Mr. Rhodes, a
small majority over the Afrikander Bund—more commonly called
the Bond. The Parliament opened in May, and the Progressive
Ministry, under Sir Gordon Sprigg, was defeated in the Lower
House in the following month, on a bill to create new
electoral divisions. The Ministry dissolved Parliament and
appealed to the constituencies, with the result of a defeat on
that appeal. The Bond party won in the elections by a majority
of two, which barely enabled it to carry a resolution of want
of confidence in the government when Parliament was
reassembled, in October. The Ministry of Sir Gordon Sprigg
resigned, and a new one was formed with Mr. Schreiner at its
head.

SOUTH AFRICA: The Transvaal: A. D. 1898-1899.

Continued dispute with the British Government
concerning Suzerainty.

During 1898 and half of 1899, a new dispute, raised by Mr.

Chamberlain's emphatic assertion of the suzerainty of Great
Britain over the South African Republic, went on between the
British Colonial Office and the government at Pretoria.
Essentially, the question at issue seemed to lie between a
word and a fact and the difference between the disputants was
the difference between the meanings they had severally drawn
from the omission of the word "suzerainty" from the London
Convention of 1884. On one side could be quoted the report
which the Transvaal deputation to London, in 1884, had made to
their Volksraad, when they brought the treaty back, and
recommended that it be approved. The treaty, they reported,
"is entirely bilateral [meaning that there were two sides in
the making of it] whereby your representatives were not placed
in the humiliating position of merely having to accept from a
Suzerain Government a one-sided document as rule and
regulation, but whereby they were recognized as a free
contracting party. It makes, then, also an end of the British
 suzerainty, and, with the official recognition of her name,
also restores her full self-government to the South African
Republic, excepting one single limitation regarding the
conclusion of treaties with foreign powers (Article 4). With
the suzerainty the various provisions and limitations of the
Pretoria Convention which Her Majesty's Government as suzerain
had retained have also, of course, lapsed."

On the other side, Mr. Chamberlain could quote with effect

from a speech which Lord Derby, then the British Colonial
Secretary, who negotiated the Convention of 1884 with the Boer
envoys, made on the 17th of March, that year, in the House of
Lords. As reported in Hansard, Lord Derby had then dealt with
the very question of suzerainty, as involved in the new
convention, and had set forth his own understanding of the
effect of the latter in the following words: "Then the noble
Earl (Earl Cadogan) said that the object of the Convention had
been to abolish the suzerainty of the British Crown. The word
'suzerainty' is a very vague word, and I do not think it is
capable of any precise legal definition.
{481}
Whatever we may understand by it, I think it is not very easy
to define. But I apprehend, whether you call it a
protectorate, or a suzerainty, or the recognition of England
as a paramount Power, the fact is that a certain controlling
power is retained when the State which exercises this
suzerainty has a right to veto any negotiations into which the
dependent State may enter with foreign Powers. Whatever
suzerainty meant in the Convention of Pretoria, the condition
of things which it implied still remains; although the word is
not actually employed, we have kept the substance. We have
abstained from using the word because it was not capable of
legal definition, and because it seemed to be a word which was
likely to lead to misconception and misunderstanding."

Great Britain,
Papers by Command: C. 9507, 1899, pages 24 and 34.
SOUTH AFRICA: The Transvaal: A. D. 1899 (March).
Petition of British subjects to the Queen.

A fresh excitement of discontent in the Rand, due especially

to the shooting of an Englishman by a Boer policeman, whom the
Boer authorities seemed disposed to punish lightly or not at
all, led to the preparation of a petition to the British
Queen, from her subjects in the South African Republic,
purporting to be signed in the first instance by 21,684, and
finally by 23,000. The genuineness of many of the signatures
was disputed by the Boers, but strenuously affirmed by those
who conducted the circulation of the petition. It set forth
the grievances of the memorialists at length, and prayed Her
Majesty to cause them to be investigated, and to direct her
representative in South Africa to take measures for securing
from the South African Republic a recognition of their rights.
The petition was forwarded to the Colonial Office on the 28th
of March.

Great Britain, Papers by Command: 1899, C. 9345.

SOUTH AFRICA: The Transvaal: A. D. 1899 (May-June).

The Bloemfontein Conference between President Kruger and
the British High Commissioner, Sir Alfred Milner.

There seems to be no mode in which the questions at issue

between the British and the Boers, and the attitude of the two
parties, respectively, in their contention with each other,
can be represented more accurately than by quoting essential
parts of the official report of a formal conference between
President Kruger and the British High Commissioner in South
Africa, Sir Alfred Milner, which was held at Bloemfontein, the
capital of the Orange Free State, during five days, May
31-June 5, 1899. The meeting was arranged by President Steyn,
of the Orange Free State, with a view to bringing about an
adjustment of differences by a free and full discussion of
them, face to face. In the official report of the
conversations that occurred, from which we shall quote, the
remarks of President Kruger are given as being made by the
"President," and those of the High Commissioner as by "His
Excellency." The latter, invited by the President to speak
first, said:

"There are a considerable number of open questions between Her

Majesty's Government and the Government of the South African
Republic on which there is at present no sign of agreement. On
the contrary, disagreements seem to increase as time goes on.
… In my personal opinion the cause of many of the points of
difference, and the most serious ones, arises out of the
policy pursued by the Government of the South African Republic
towards the Uitlander population of that Republic among whom
many thousands are British subjects. This policy, the bitter
feeling it engenders between the Government and a section of
Uitlanders, and the effect of the resulting tension in South
Africa, and the feeling of sympathy in Great Britain, and even
throughout the British Empire generally, with the Uitlander
population, creates an irritated state of public opinion on
both sides, which renders it much more difficult for the two
Governments to settle their differences amicably. It is my
strong conviction that if the Government of the South African
Republic could now, before things get worse, of its own motion
change its policy towards the Uitlanders, and take measures
calculated to content the reasonable people among them, who,
after all, are a great majority, such a course would not only
strengthen the independence of the Republic but it would make
such a better state of feeling all round that it would become
far easier to settle outstanding questions between the two
Governments. … The President, in coming here, has made a
reservation as to the independence of the Republic. I cannot
see that it is in any way impairing the independence of the
Republic for Her Majesty's Government to support the cause of
the Uitlanders as far as it is reasonable. A vast number of
them are British subjects. If we had an equal number of
British subjects and equally large interests in any part of
the world, even in a country which was not under any
conventional obligations to Her Majesty's Government we should
be bound to make representations to the Government in the
interests of Her Majesty's subjects, and to point out that the
intense discontent of those subjects stood in the way of the
cordial relations which we desire to exist between us. I know
that the citizens of the South African Republic are intensely
jealous of British interference in their internal affairs.
What I want to impress upon the President is that if the
Government of the South African Republic of its own accord,
from its own sense of policy and justice, would afford a more
liberal treatment to the Uitlander population, this would not
increase British interference, but enormously diminish it. If
the Uitlanders were in a position to help themselves they
would not always be appealing to us under the Convention. …

"President.—I shall be brief. I have come with my commission,

in the trust that Your Excellency is a man capable of
conviction, to go into all points of difference. … I should
like His Excellency to go point by point in this discussion,
so that we can discuss each point that he thinks requires
attention, not with a view to at once coming to a decision,
but to hear each side, and we can go back on any point if
necessary, and see if we can arrive at an understanding. I
would like to give concessions as far as is possible and
practicable, but I want to speak openly, so that His
Excellency may be able to understand. I should like to say
that the memorials placed before Her Majesty's Government came
from those who do not speak the truth. I mean to convey that
we do give concessions wherever we think it practicable to do
so, and after we have discussed it in a friendly way Your
Excellency will be able to judge whether I or the memorialists
are right. I have said that if there are any mistakes on our
side, we are willing to discuss them. Even in any matter
concerning internal affairs I would be willing to listen to
his advice if he said it could be removed in this way or that
 way. But when I show him that by the point we may be
discussing our independence may be touched, I trust he will be
open to conviction on that subject. …

{482}

"His Excellency.—I think the point which it would be best to

take first, if the President agrees, … would be the Franchise.
… There are a number of questions more or less resting upon
that. … I should like to know a little more about the
President's views. I want to know more because if I were to
begin and say I want this, that, and the other, I know I
should be told this was dictation. I do not want to formulate
a scheme of my own, but I can, if necessary.

"President.—As long as I understand that it is meant in a

friendly manner, and you mean to give hints, I won't take it
that they are commands. It has already been arranged that you
give me friendly hints and advice, and I will not take it as
dictation, even though it should be on points on which I
should consider you have no right to interfere. … I would like
you to bear one point in view, namely, that all kinds of
nations and languages, of nearly all powers, have rushed in at
the point where the gold is to be found. In other countries …
there are millions of old burghers, and the few that come in
cannot out-vote the old burghers, but with us, those who
rushed in to the gold fields are in large numbers and of all
kinds, and the number of old burghers is still insignificant;
therefore we are compelled to make the franchise so that they
cannot all rush into it at once, and as soon as we can assure
ourselves by a gradual increase of our burghers that we can
safely do it, our plan was to reduce the time for anyone there
to take up the franchise, and that is also my plan. … As His
Excellency doubtless knows, I have proposed to the Volksraad
that the time should be reduced by five years, and gradually
as more trusted burghers join our numbers, we can, perhaps, go
further. There are a number who really do not want the
franchise, but they use it as pretext to egg on people with
Her Majesty. … You must remember, also, on this subject, that
the burghers in our Republic are our soldiers, who must
protect the land, and that we have told these men to come and
fight when we have had difficulties with the Kaffirs. They
wanted the vote, but they would not come and fight. Those who
were willing to help obtained the franchise, but it appears
that many do not want to have it.

"His Excellency.—They did not want to take the obligations

without the rights of citizenship, and in that I sympathize
with them. If they should obtain that right, then naturally
they would have to take those burdens upon them.

"President.—Those who want the franchise should bear the

burdens.

"His Excellency.—Yes. Immediately they get the franchise they

take upon themselves the obligations connected therewith."

[From this the talk wandered to the subject of commandeering,

until the High Commissioner brought it back to the franchise
question.]

"His Excellency.—If I made a proposal to admit strangers under

such conditions as to swamp the old burghers it would be
unreasonable. But the newcomers have, at present, no influence
on the legislation of the Republic, which makes an enormous
difference. They haven't got a single representative. The
First Volksraad consists of 28 members, and not one member
represents the feelings of the large Uitlander population.

"President.—Men from any country could after two years vote

for the Second Volksraad, and after two years more sit in the
Second Raad. There are Englishmen who have obtained the full
franchise in that way, and are eligible for the Volksraad. And
now I have proposed to shorten the last ten years of the
period required for the full franchise and make it five years.

"His Excellency.—There are a great many objections of the

gravest kind to the process by which men may now obtain
burgher rights. First of all, before he can begin the process
of gradually securing burgher rights—which will be completed
in 14 years at present, and in 9 years according to the
President—he has to forswear his own allegiance. Take the case
of a British subject, which interests me most. He takes the
oath, and ceases to be a British subject by the mere fact of
taking that oath; he loses all the rights of a British
subject, and he would still have to wait for 12 years, and
under the new plan 7 years, before he can become a full
citizen of the Republic. British subjects are discouraged by
such a law from attempting to get the franchise. Even if they
wanted to become citizens, they would not give up their
British citizenship on the chance of becoming in 12 years
citizens of the Republic.

"President.—The people are the cause of that themselves. In

1870 anyone being in the land for one year had the full
franchise.

"His Excellency.—That was very liberal.

"President.—In 1881, after the war of independence, some of

our officials and even members of our Raad then said that they
were still British subjects, although they had taken the oath
of allegiance, and I had to pay back, out of the £250,000,
what I had commandeered from them. That was the reason the
oath had to be altered. …

"His Excellency.—In 1882, after all this had happened, there

was a franchise law in the Transvaal, which demanded five
years' residence, but it did not require the oath that is now
taken. It required a simple declaration of allegiance to the
State, though all this that the President refers to happened
 before. Why was not it necessary to introduce this alteration
then?

"President.—The people who, before the annexation, had taken

that oath, but had not forsworn their nationality, 1887, sent
a lying memorial, as they are sending lying memorials now, to
say that everybody was satisfied, as they now say that
everybody is dissatisfied.

"His Excellency.—I think I must just explain a little more

clearly my views on the point we are now discussing. … I think
it is unreasonable to ask a man to forswear one citizenship
unless in the very act of giving up one he gets another, and I
think it is also unnecessary to ask him to do more than take
an oath of fealty to the new State, of willingness to obey its
laws and to defend its independence, when it is known and
certain that the taking of that oath deprives him of his
existing citizenship. I think the oath should be a simple oath
of allegiance, and that it should not be required of a man
until the moment he can get full rights in a new State. Now
that was the position under the law of 1882, and all these
reasons which the President has been giving are based on what
happened before that.
{483}
Why were they not considered and acted upon when the law of
1882 was made? … As for the period required to qualify for the
full franchise, I do not see why the length of time should be
longer in the South African Republic than in any other South
African State. They are all new countries. In the new country
which is springing up in the north, and which is getting a new
Constitution this year, the period is one year. The people who
have conquered that country for the white race may find that
the newcomers are more numerous than they are. But I do not
expect that anything like that will be done in the South
African Republic; something far short of that would be
reasonable. What I do think and desire, and that is the object
of my suggestion, is this: that the numerous foreign population
engaged in commerce and industry—to which the country, after
all, owes its present great position in wealth and influence—
should have a real share in the government of the Republic,
not to over-rule the old burghers—not at all—but to share the
work of Government with them, to give them the benefit of
their knowledge and experience, which is in many cases greater
than that of the old burghers, so that through their gradual
co-operation a time may come when, instead of being divided
into two separate communities they will all be burghers of the
same State. It is not enough that a few people should be let
in. It is obvious, however, that you could not let in the
whole crowd, without character or anything—I do not ask
it—but you want such a substantial measure that in elections
of members of the Volksraad the desires of the new industrial
population should have reasonable consideration. They have not
got it now, and when the questions that interest them come
before the Volksraad it is too evident that they are discussed
from an outside point of view. The industrial population are
regarded as strangers. … I do not want to swamp the old
population, but it is perfectly possible to give the new
population an immediate voice in the legislation, and yet to
leave the old burghers in such a position that they cannot
possibly be swamped.

"President.—I hope you will be open to conviction on that

point. I would like to convince you on the subject, and to
show you that it would be virtually to give up the
independence of my burghers. In the Republic the majority of
the enfranchised burghers consider they are the masters. Our
enfranchised burghers are probably about 30,000, and the
newcomers may be from 60,000 to 70,000, and if we give them
the franchise to-morrow we may as well give up the Republic. I
hope you will clearly see that I shall not get it through with
my people. We can still consult about the form of oath, but we
cannot make the time too short, because we would never get it
through with the people—they have had bitter experience. I
hope His Excellency will think about what I have said, and
weigh it well.

"His Excellency.—I see your point, and want to meet it.

"President.—I will think over what has been said, and will try
and meet every difficulty.

At the opening of the Conference on the second day the

President spoke of reports of an increase of British forces in
South Africa, which the High Commissioner assured him were
untrue. The latter in turn referred to accounts that had
appeared of an extensive purchase of arms in the Transvaal;
and was assured by the President that the armament of the
burghers was only for their proper preparation to deal with
the surrounding natives. The President then produced a
memorial purporting to be signed by 21,000 Uitlanders,
contradictory of the representations contained in the memorial
sent to the Queen in March (see above). After discussion upon
this, the conversation returned to the question of the
franchise.

"His Excellency.—What makes this whole discussion so difficult

is the intense prejudice on the side of the present burghers,
and their intense suspicion of us. They think Her Majesty's
Government wants to get their country back in one way or
another. Her Majesty's Government does not; but what it does
desire is that it should have such a state of rest in the
country as will remove causes of friction and difficulty
between the Republic and Her Majesty's possessions in South
Africa, and the whole of the British Empire, and my
suggestions here are directed to that end. I do not want to
say it over and over again, I say it once for all. …

"President.—I should like to make a slight explanation to His

Excellency. His Excellency yesterday mentioned that in some
States those going in from outside speedily got burgher
rights, but he must not forget, as I said before, they are