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In the relatively young movement known to most as philosophical counseling, there have already been some deep disagreements among its enthusiasts. One of the central issues is the relation between philosophical counseling and counseling and therapy aimed at curing mental disorders. Schuster is deeply opposed to the mental health profession and therefore she opposes any use of philosophy as a form of psychotherapy. She uses the term "philosophy practice" to refer to the use of philosophy to help people solve their problems in the way she approves of.
It might seem that the disagreements between different groups of philosophical counselors are clear. She opposes certification of philosophical counselors or any attempt to bring philosophical counseling into the house of mental health. She thinks that philosophers should work independently of insurance companies, HMOs and national health schemes. Indeed, that is how she works: people simply pay her for her services in a one-on-one interaction. I think, however, that in fact the differences between philosophical counselors are far from clear.
It is her antipsychiatric stance that motivates Schuster's conception of philosophical practice as she describes it in Part I of her book, especially the first chapter, "Philosophy as an Alternative Practice." Elsewhere she has endorsed the criticisms of the mental health profession as self-serving and oppressive. So it is important to her that philosophical counseling bear no resemblance to mainstream psychotherapy. Thus she denies parallels between philosophical counseling on the one hand and, on the other, rational emotive therapy, cognitive behavioral therapy, and existential psychotherapy.
This raises a question. To what extent can a theory dictate or describe what actually happens in an extended interaction between two people sitting together in a room? One person has a problem, the other is trying to help by asking questions, listening, waiting, and giving advice. One point that philosophical counselors seem to agree on is that there is no specific method behind their approach. What they do cannot be broken down into simple steps. There can be no manual of philosophical counseling that tells you to how to do it. (Louis S. Berger makes this point concerning psychoanalysis, for example, in Psychoanalytic Theory and Clinical Relevance: What Makes a Theory Consequential for Practice.)
So no matter how much one sets out theoretical differences between philosophical counseling and other approaches, this will not tell one how what philosophical counselors do is different from what psychotherapists do. Nevertheless, Schuster tries hard to give the reader some sense of how she goes about talking to her clients. The remaining three chapters of Part I are "Classic Instances of Philosophy as Practice, " "Philosophical Care," and "Philosophical Narratives of Lives." Part II consists of eight chapters describing Schuster's sessions with clients.
Schuster argues for philosophy as a "grass-roots" movement rather than as an "ivory tower" activity. She says that what is known as "applied ethics" has failed. "Business ethics," "environmental ethics," and "medical ethics" are far removed from real life, she says. Not only is she against professionalized mental health, but she is also against professionalized philosophy. She summarizes the ideas of thinkers with whom she is sympathetic, and these people are mostly unknown to American philosophers, let alone the general public -- Gerd Achenbach, Alexander Dill, Petra van Morstein, and Eite Veening, for instance. She also approvingly discusses the existentialist ideas of Martin Buber and R.D. Laing. So her book probably has something to teach most people, although I have to say that I was not very convinced or impressed by the ideas of the philosophers she summarized.
The accounts of the sessions with clients are probably the most enlightening part of the book as a way of understanding what her approach is about. She encourages her clients to talk about their views of life, and she often recommends that they read some philosophy. Here's a snippet from her account of her sessions with "David."
Since I thought that the problems with his children were based on a kind of distrust--I talked to David about Buber's idea of existential trust and Nietzsche's amor fati. I thought it helpful in his situation to think about our planet as a place where "all is well, and all will be well," although this cannot be proven, and there seems to be more evidence to justify the opposite conclusion. However, it might be helpful to think with a confident attitude, with an accepting "Yes," about all the events of existence.
While the aim of philosophical counseling is not to get to client to adopt the counselor's views, it is inevitable the counselor will tend to discuss views with which he or she is more familiar. If I were a philosophical counselor, I dont think I'd be encouraging my clients to read Martin Buber or Friedrich Nietzsche. I might recommend the work of the eighteenth century Scottish philosopher David Hume, who doesn't even make it into Schuster's index. Schuster does not make any claim to provide total neutrality, and so it's fine that she gives preference to the kinds of philosophers she finds helpful. Clearly, different counselors will have different approaches.
But we are left with many questions. What makes a good philosophical counselor? Can one be trained to be good at it? How does the counselor know what to say and when to say it? Is it the philosophy that helps, when the client is helped, or is it simply having a sympathetic person to talk with? Since I'm neither a philosophical counselor nor a psychotherapist, the closest experience I have that helps me think about these questions is from teaching undergraduate philosophy classes. I was never taught to teach--I just picked it up as I went along. In my classes I try to stay neutral rather than indoctrinating my students with my personal views. I try to make philosophy useful to my students. But apart from their ability to do philosophy tests and write philosophy papers, I have no independent evidence that suggests that my students have gained from taking my classes. Occasionally I get testimonials from past students, but we know very well that testimonials are unreliable as evidence of what works. While there are rules of thumb to follow in being a good teacher, there is no recipe book to tell me how to teach. Yet I continue to teach and I even like to think of myself as a good teacher. I certainly hope that my classes are useful, although I know that the ways that studying philosophy can affect people's lives is somewhat unpredictable. In a similar way, philosophical counselors do their work, and their clients may well be happy with the results. Even if we don't have proof that it is effective, it could still be as worth trying as taking a philosophy class.
What is notable about Schuster's account, and what she does not note, is that it her criticism of psychiatry and the mental health profession is independent from her account of how she does philosophical counseling. She could do philosophical practice in the same way, even if she changed her views about psychiatry. Indeed, I don't see any great differences between her methods and those of rival philosophical counselor Lou Marinoff, as described in Plato Not Prozac! (reviewed in Metapsychology, August 1999), with whom Schuster is not inclined to agree on most issues.
This separability of theory and practice is probably for the best, since most people, including myself, do not agree with her criticism of the mental health profession. Of course there are plenty of problems with psychiatry today, and many people have legitimate complaints about their experiences with psychiatrists, therapists, groups, and medication. Other people, even if having no axe to grind concerning mental health treatment, may simply want or need other forms of treatment. Philosophical counseling may therefore be attractive to many. Schuster's book can serve as a helpful introduction both to potential clients and also those who might want to try becoming philosophical counselors themselves.