email page print pageAll Topic Reviews
Maximizing Effectiveness in Dynamic Psychotherapy Self-Compassion in Psychotherapy101 Healing StoriesA Clinician's Guide to Legal Issues in PsychotherapyA Map of the MindA Primer for Beginning PsychotherapyACT With LoveActive Treatment of DepressionAffect Regulation, Mentalization, and the Development of SelfAlready FreeBad TherapyBecoming an Effective PsychotherapistBecoming MyselfBefore ForgivingBeing a Brain-Wise TherapistBetrayed as BoysBeyond Evidence-Based PsychotherapyBeyond MadnessBeyond PostmodernismBinge No MoreBiofeedback for the BrainBipolar DisorderBody PsychotherapyBoundaries and Boundary Violations in PsychoanalysisBrain Change TherapyBrain Science and Psychological DisordersBrain-Based Therapy with AdultsBrain-Based Therapy with Children and AdolescentsBrief Adolescent Therapy Homework PlannerBrief Child Therapy Homework PlannerBrief Therapy Homework PlannerBuffy the Vampire Slayer and PhilosophyBuilding on BionCare of the PsycheCase Studies in DepressionCaught in the NetChild and Adolescent Treatment for Social Work PracticeChoosing an Online TherapistChronic DepressionClinical Dilemmas in PsychotherapyClinical Handbook of Psychological DisordersClinical Intuition in PsychotherapyClinical Pearls of WisdomCo-Creating ChangeCognitive Therapy for Challenging ProblemsCompassionConfessions of a Former ChildConfidential RelationshipsConfidentiality and Mental HealthConfidingContemplative Psychotherapy EssentialsControlConversations About Psychology and Sexual OrientationCoping with BPDCouch FictionCounseling in GenderlandCounseling with Choice TheoryCouple SkillsCrazy for YouCreating a Life of Meaning and CompassionCreating HysteriaCritical Issues in PsychotherapyCrucial Choices, Crucial ChangesDeafness In MindDecoding the Ethics CodeDeconstructing PsychotherapyDeep Brain StimulationDemystifying TherapyDepression 101Depression in ContextDialogues on DifferenceDissociative ChildrenDo-It-Yourself Eye Movement Techniques for Emotional HealingDoing CBTE-TherapyEarly WarningEncountering the Sacred in PsychotherapyEnergy Psychology InteractiveErrant SelvesEssays on Philosophical CounselingEssentials of Wais-III AssessmentEthically Challenged ProfessionsEthics and Values in PsychotherapyEthics in Plain EnglishEthics in Psychotherapy and CounselingExercise-Based Interventions for Mental IllnessExistential PsychotherapyExpectationExploring the Self through PhotographyExpressing EmotionFacing Human SufferingFairbairn's Object Relations Theory in the Clinical SettingFamily TherapyFavorite Counseling and Therapy Homework AssignmentsFear of IntimacyFlourishingFolie a DeuxForms of Intersubjectivity in Infant Reasearch and Adult TreatmentFoundations of Ethical Practice, Research, and Teaching in PsychologyFreud and the Question of PseudoscienceFrom Morality to Mental HealthFundamentals of Psychoanalytic TechniqueGenes on the CouchGod & TherapyHalf Empty, Half FullHandbook of Clinical Psychopharmacology for TherapistsHandbook of Counseling and Psychotherapy with Lesbian, Gay, and Bisexual ClientsHandbook of Evidence-Based Therapies for Children and AdolescentsHealing the Heart and Mind with MindfulnessHeinz KohutHelping Children Cope With Disasters and TerrorismHigh RiskHistory of PsychotherapyHow and Why Are Some Therapists Better Than Others?How Clients Make Therapy WorkHow People ChangeHow Psychotherapists DevelopHow to Fail As a TherapistHow to Go to TherapyHypnosis for Inner Conflict ResolutionHypnosis for Smoking CessationI Never Promised You a Rose GardenIf Only I Had KnownIn Others' EyesIn SessionIn Therapy We TrustIn Treatment: Season 1Incorporating Spirituality in Counseling and PsychotherapyInside the SessionInside TherapyIs Long-Term Therapy Unethical?Issues in Philosophical CounselingIt's Not as Bad as It SeemsItís Your HourLearning ACTLearning from Our MistakesLearning Supportive PsychotherapyLetters to a Young TherapistLife CoachingLogotherapy and Existential AnalysisLove's ExecutionerMadness and DemocracyMaking the Big LeapMan's Search for MeaningMetaphoria: Metaphor and Guided Metaphor for Psychotherapy and HealingMind GamesMindfulnessMindfulness and AcceptanceMindfulness-Based Cognitive Therapy for DepressionMindworks: An Introduction to NLPMockingbird YearsMoments of EngagementMomma and the Meaning of LifeMotivational Interviewing: Preparing People For ChangeMulticulturalism and the Therapeutic ProcessMultifamily Groups in the Treatment of Severe Psychiatric DisordersNarrative PracticeOn the CouchOne Nation Under TherapyOur Inner WorldOur Last Great IllusionOutsider ArtOutsider Art and Art TherapyOvercoming Destructive Beliefs, Feelings, and BehaviorsOverexposedPathways to SpiritualityPersonality and PsychotherapyPhilosophical CounselingPhilosophical Counselling and the UnconsciousPhilosophical Issues in Counseling and PsychotherapyPhilosophical PracticePhilosophy and PsychotherapyPhilosophy for Counselling and PsychotherapyPhilosophy PracticePhilosophy's Role in Counseling and PsychotherapyPillar of SaltPlan BPlato, Not Prozac!Polarities of ExperiencesPower GamesPractical Psychoanalysis for Therapists and PatientsPrinciples and Practice of Sex TherapyProcess-Based CBTPsychologists Defying the CrowdPsychology, Psychotherapy, Psychoanalysis, and the Politics of Human RelationshipsPsychosis in the FamilyPsychotherapyPsychotherapyPsychotherapy and ConfidentialityPsychotherapy As PraxisPsychotherapy East and WestPsychotherapy for Children and AdolescentsPsychotherapy for Personality DisordersPsychotherapy Is Worth ItPsychotherapy Isn't What You ThinkPsychotherapy with Adolescent Girls and Young WomenPsychotherapy with Children and AdolescentsPsychotherapy without the SelfPsychotherapy, American Culture, and Social PolicyRapid Cognitive TherapyRational Emotive Behavior TherapyRational Emotive Behavior TherapyRationality and the Pursuit of HappinessRebuilding Shattered LivesReclaiming Our ChildrenRecovery OptionsRelationalityRent Two Films and Let's Talk in the MorningSaving the Modern SoulScience and Pseudoscience in Clinical PsychologySecond-order Change in PsychotherapySelf-Compassion in PsychotherapySelf-Determination Theory in the ClinicSelf-Disclosure in Psychotherapy and RecoverySerious ShoppingSex, Therapy, and KidsSexual Orientation and Psychodynamic PsychotherapySigns of SafetySoul Murder RevisitedStaring at the SunStraight to JesusStrangers to OurselvesSubjective Experience and the Logic of the OtherTaking America Off DrugsTales of PsychotherapyTales of UnknowingTalk is Not EnoughTalking Cures and Placebo EffectsTelling SecretsThe Behavioral Medicine Treatment PlannerThe Body in PsychotherapyThe Brief Couples Therapy Homework Planner with DiskThe Case Formulation Approach to Cognitive-Behavior TherapyThe Challenge for Psychoanalysis and PsychotherapyThe Child and Adolescent Psychotherapy Treatment PlannerThe Clinical Child Documentation SourcebookThe Clinical Documentation SourcebookThe Complete Adult Psychotherapy Treatment PlannerThe Couch and the TreeThe Couples Psychotherapy Treatment PlannerThe Crucible of ExperienceThe Cure of SoulsThe Death of PsychotherapyThe Education of Mrs. BemisThe Ethical Treatment of DepressionThe Ethics of PsychoanalysisThe Gay and Lesbian Psychotherapy Treatment PlannerThe Gift of TherapyThe Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work The Healing JourneyThe Heart & Soul of ChangeThe Heroic ClientThe Husbands and Wives ClubThe Love CureThe Making of a TherapistThe Mindful TherapistThe Mirror Crack'dThe Mummy at the Dining Room TableThe Neuroscience of PsychotherapyThe Neuroscience of Psychotherapy: Healing the Social BrainThe New Rational TherapyThe Older Adult Psychotherapy Treatment PlannerThe Other Side of DesireThe Pastoral Counseling Treatment PlannerThe Philosopher's Autobiography The Pornographer's GriefThe Portable CoachThe Portable Ethicist for Mental Health Professionals The Present Moment in Psychotherapy and Everyday LifeThe Problem of EvilThe Problem with Cognitive Behavioural TherapyThe Psychodynamics of Gender and Gender RoleThe Psychotherapy Documentation PrimerThe Psychotherapy Documentation PrimerThe Psychotherapy of HopeThe Real World Guide to Psychotherapy PracticeThe Schopenhauer CureThe Sex Lives of TeenagersThe Talking CureThe Therapeutic "Aha!"The Therapist's Guide to PsychopharmacologyThe Therapist's Guide to Psychopharmacology, Revised EditionThe Therapist's Ultimate Solution BookThe Trauma of Everyday LifeThe Trouble with IllnessThe UnsayableThe Way of the JournalTheory and Practice of Brief TherapyTherapy with ChildrenTherapy's DelusionsTheraScribe 3.0 for WindowsTheraScribe 4.0Thinking about ThinkingThinking for CliniciansThinking for CliniciansThoughts Without a ThinkerThriveToward a Psychology of AwakeningTracking Mental Health OutcomesTrauma, Truth and ReconciliationTreating Attachment DisordersTreatment for Chronic DepressionTreatment Plans and Interventions for Depression and Anxiety DisordersUnderstanding Child MolestersUnspeakable Truths and Happy EndingsWhat the Buddha FeltWhat Works for Whom?What Works for Whom? Second EditionWhen the Body SpeaksWhispers from the EastWise TherapyWittgenstein and PsychotherapyWorking MindsWoulda, Coulda, ShouldaWriting About PatientsYoga Skills for Therapists:Yoga Therapy
Can Philosophy Help?
In David Lodge's 1995 novel, Therapy, TV sitcom writer Laurence 'Tubby' Passmore goes through a mid-life crisis, so he goes to a psychotherapist once a week. She is a cognitive behavioral therapist, specializing in rational emotive therapy, who gives him writing exercises. These and entries from Passmore's personal journal constitute the chapters of the book. Passmore's girlfriend has been seeing a psychiatrist five times a week for years, for full-blown psychoanalysis. Passmore is skeptical whether this is helping her, but she eventually comes to a resolution in her life and ends both her analysis and her relationship with Passmore. This of course doesn't make him any happier, and it is not clear that his own therapy is helping him either. What does seem to help is his almost obsessional absorption in the life and work of Soren Kierkegaard. Passmore's progress provides one model for how philosophy might help people.
As someone who has taught introductory courses to philosophy to at least 500 students in the last five years, I am curious whether my teaching had a beneficial effect on them. What many experienced faculty say is that it is very hard to predict what parts of teaching turn out to be remembered by students. My hope is that my students end up with a greater ability to reason and understand ideas about the world around them. But I really don't have any strong evidence either way concerning the beneficial effects of their philosophical experience.
So I am very curious about the claims of some philosophers that they can help people in solving their personal problems. A growing number of people describe themselves as "philosophical counselors." This movement started in Europe and Israel, and is now spreading to the US. It aims to be an alternative or supplement to psychological therapy. Last month I attended the Third International Conference on Philosophical Practice, and I even gave a paper, with the cumbersome title of "The Role of Philosophy and Philosophers Outside the Academic World: A Comparison of Bioethics and Philosophical Counseling." The conference varied greatly in the quality of its papers, although there was only one session I actually walked out of. Those who describe themselves as philosophical counselors certainly have a heterogeneous set of approaches, some of which were quite far from traditional philosophizing. It was, for instance, the first (and I hope the last) time I've attended a conference where the audience was asked to participate in guided imagery. In preparation for the conference, I read the articles collected in Essays on Philosophical Counseling. The book, which claims to be the first in English on philosophical counseling, consists of an introduction and fourteen papers by philosophical practitioners from across the world. The papers present a diverse set of views of what philosophical counseling is and how to go about it. They are on the whole readable and competently written. After all of this, though, I am still unsure whether philosophy can be emotionally helpful.
You don't have to spend a long time reading articles and listening to talks by philosophical counselors before you realize that there is little consensus about what makes philosophical counseling distinctively philosophical, and distinguishes it from psychotherapy or teaching. Indeed, some deny that there is a distinction between philosophical counseling and psychotherapy, and are particularly attracted to rational emotive therapy (RET) because the therapy takes the form of clarifying the client's reasoning. One such is Elliot Cohen, author of Caution: Faulty Thinking Can Be Harmful to Your Happiness and Philosophers at Work: An Introduction to the Issues and Practical Uses of Philosophy. In his paper, "Some Roles of Critical Thinking", he says that Albert Ellis, the originator of RET, "held that if people acquired a sane philosophy of life they would rarely be 'emotionally disturbed'" (122). The goal of psychotherapy, on this view, is largely to clear up confusions in people's thinking.
Cohen gives an example of one of his successes. A man experienced anxiety about shopping for a new car. This anxiety stemmed from his worry that car dealers would cheat him. Cohen showed the client that his worry was based on a negative stereotype of all car dealers as "slimeballs."
In the next weekly session, this hypothesis was corroborated when the counselee reported positive experiences and much less anxiety in car shopping after having relinquished the stereotype. Subsequently, he was able to satisfactorily purchase a car (127).
Skeptics may wonder whether the anxiety here wasn't perfectly rational. While not all car dealers are slimeballs, some might say that a large proportion are, and it can be very hard to distinguish the slimeballs from more honest dealers. Did Cohen adequately address the danger of his client getting ripped off, and in what ways was the car-purchase "satisfactory"? This example highlights the difficulty of assessing when reasoning is reasonable. More generally, I suspect that clear thinking is just as liable to make people unhappy, because it can show how little knowledge we have. I find that in teaching students I am often taking away their comfortable frames of thought and replacing them with uncertainty, which can be unnerving for them.
Another worry about this form of counseling is that there are so many kinds of emotional problems it cannot help. Often there is a divide between emotion and reason, and no matter how much cognitive information and clarity a person has, her emotions refuse to change. Phobias are a good example. Telling a person afraid of spiders that there is no rational reason to be afraid of spiders will do nothing to reduce her fear. Similarly an obsessive-compulsive can be quite aware of the absurdity of her rituals, but she still feels a need to perform them. Furthermore, if clear thinking were a secret to happiness, wouldn't philosophers be a happier bunch? But, I'm sorry to say, they seem just as unhappy as everyone else.
What might be at issue is what kind of intelligence philosophers have. My father was visiting me recently, and he has his own opinion of philosophers. He is tremendously proud of my academic successes, even though academic life is rather alien to him, since his high school education was interrupted by the World War II. He describes himself as a "business animal," and has learned to survive largely through the "university of life." So he explained to me that while I have a huge brain, I basically have no common sense. (Don't misunderstand his intention: we British use insult as a way of expressing affection.) Of course, I dispute his evaluation of me, but I can see what he means when I look at some other philosophers. While we are very smart in some ways, we might be lacking in other forms of intelligence. Maybe we lack what Daniel Goleman calls Emotional Intelligence. It is safe to say that our interpersonal skills are rather underdeveloped, and we can be socially awkward. And of course, we have an unfortunately fondness for tweed jackets. If you ever go to a meeting of the American Philosophical Association, you will encounter a sea of tweed. (I'm told that those at Modern Languages Association meetings are far more fashionably dressed. I'm blissfully ignorant of the sartorial sense of mental health professionals at conferences.)
One might acknowledge the limitations of philosophers as counselors, yet still allow them a place in the counseling world. One way is suggested by Louis Marinoff in "On the Emergence of Ethical Counseling: Considerations and Two Case Studies". Rather than concentrate on the emotional issues of the client, a philosopher could help a person facing an ethical quandary. Marinoff sets out one case of a man who has to decide whether or not to hospitalize his mother, who had suffered from a degenerative neurological disorder. This difficult decision, which he had so far been unable to make, was causing the man to feel troubled and anxious. Through philosophical analysis of the situation, Marinoff helped straighten out what was at issue in making this decision, and relieved the client's sense of uncertainty and anxiety.
This case calls to attention a worry that is pervasive in biomedical ethics. Does the philosopher here have a genuine claim to be an ethical expert by virtue of his or her knowledge of the relevant literature and possession of skills of reasoning? Philosophers are certainly experts at arguing about morality, but that in itself doesn't make them ethical experts, because being morally sensitive may not be closely connected with technical philosophical expertise. We certainly should not expect moral philosophers and ethicists to be especially good people. Knowing about morality does not make one a good person any more than knowing about fluid dynamics makes one a good swimmer. Philosophers might even make problems worse by overintellectualizing what are basically simple issues.
I do in fact think that philosophers have a valuable contribution to make in helping people to understand and settle moral quandaries. But if I had a difficult moral decision to make, I think I would first seek out other people who had gone through similar problems to get their perspectives. What one needs most in such circumstances is a good listener who can understand one's situation: philosophers might have those qualities, but they don't seem to be especially philosophical qualities.
One of the best papers at this year's conference on Philosophical Practice was David Jopling's "First Do No Harm: Over-Philosophizing and Pseudo-Philosophizing in Philosophical Counseling." (I didn't have the monopoly on cumbersome titles at this conference.) In it, he emphasized the possibility that even if a philosopher helps a client, it could be through being an authority figure or simply being someone to talk to, rather than any specially philosophical aspect of the counseling (i.e., the benefit of philosophy would basically be a placebo effect.) There are some people for whom psychotherapy does not work, and these people might be more comfortable with someone who does not say "tell me how you feel about that," but instead says "how do you see this situation?" Some people are almost hypnotized by great (and not-so-great) philosophers, and will treat them as sources of truth as much as fundamentalist psychoanalysts treat the words of Freud. This may indeed be therapeutic, but there are associated dangers. Clients entranced by a philosophical outlook at one time may come to change their minds later on and regret their actions, and they may hold their counselor responsible. They may also make bad decisions while under the temporary influence of an extreme philosophical theory.
It is often noted that different nationalities have characteristic philosophical tendencies. The British are said to be empiricists, wanting evidence for any assertion, and preferring terse expressions of ideas rather than long, flowery, obscure paragraphs. I can think of several British philosophers who don't fit that model, but nevertheless, speaking as a British citizen, I think there is some truth to it. Australian philosophy is famed for its blunt no-nonsense approach with a strong preference for a scientific view of the world. France and Germany, on the other hand, have long traditions of philosophers who rejoice in obscure terminology and ideas. They have a fondness for elaborate philosophical systems, such as rationalism, phenomenology, existentialism and post-structuralism. The general public in those countries also tend to have much greater reverence for philosophers than English-speaking countries. That's not shared by most English speaking countries. I'm pretty sure that most people in Britain and the US, for instance, could not name one living philosopher.
These national differences might well play out in the kinds of philosophical counseling that would work in different countries. It might be possible to set out worldviews of some philosophers as possible ways of dealing with a situation. A French person might be interested in how Jean Paul Sartre would view a difficult choice. But I suspect that any appeal to the authority of a particular philosopher, even Aristotle or Plato, with a British person would meet with considerable resistance. Indeed, I suspect that the general public in the US will be quite suspicious of the idea of a philosopher helping them to solve their personal problems. Similarly, in my classroom, students at the introductory level often start out thinking that philosophy is bound to irrelevant to their own lives. It can take a few weeks to convince them otherwise, and many may still end the term thinking that we've over philosophized some of the issues. Of course, from my perspective, we've only just scratched the surface of the issues we've discussed.
The Goals Of Counseling
Comparing philosophical counseling with psychotherapy helps to focus the issue of what therapy is aiming to achieve. There is, of course, a large literature on measuring the effectiveness of psychotherapy. I have never heard of any empirical studies of the effects of philosophy on people, and fortunately none of my students has ever confronted me with a demand for proof that my classes are effective. Possibly the reason for this is that it is all too obvious to my students that philosophy is useful and asking for proof of this would be like asking for proof that the sun warms the earth. But I don't think so. They do acknowledge that it helps their reasoning powers and opens them up to views they had never previously seriously considered, but the value of philosophy can't be reduced to these factors. We might be able to describe some of the useful effects of studying philosophy, but it there is also an ineffable element that defies description, let alone measurement. My students realize how silly it would be to try to measure the unmeasurable. If psychotherapy has a kinship with philosophical counseling, then it too should provide something unmeasurable, an improvement in the quality of life that cannot be included in cost-effectiveness studies.
Of course, these lofty thoughts are all very well, but if we can't measure the benefit of philosophical counseling, then there is a real danger that it will present a field day for philosophically-inclined slimeballs, ready to rip off clients with mention of a few things they learned in their own introductory philosophy classes. Philosophical counseling still has to face the challenge of how to regulate itself. Right now there is no regulation process whatever in the US.
The figure of Tubby Passmore, the narrator of David Lodge's novel Therapy, is a useful one for philosophical counselors to contemplate. Passmore is a happily married writer of a successful sitcom, but he is unhappy. He comes by chance on the existentialist thought of Kierkegaard. Initially it is the titles of his books that attracts Passmore: Fear and Trembling, The Sickness Unto Death, The Concept of Dread, and even Either/Or and Repetition. After ploughing through some of Kierkegaard's turgid prose, he finds some parts that speak directly to his condition. For example, the unhappy man is "always absent to himself, never present to himself," always living in the past or the future. Simply finding a description of his condition which has previously so perplexed him makes Passmore grin all over his face. He also becomes interested in Kierkegaard's life, and he immerses himself in pursuing the connections between his biography and the philosophy. It's rare for a modern novel to devote a whole seven pages to setting out of a philosophical exploration, concluding with an explanation of the role of repetition in a good marriage. But this also serves a dramatic purpose, since it is after this passage that Passmore writes in his journal that his wife just came into his study telling him she wants a separation from him. Lodge pricks the philosophical balloon, illustrating how easy it is to for real people to get lost in the consideration of abstract ideas.
Yet it seems that Lodge is not simply lampooning philosophy and its use as therapy. Passmore goes on to consider his first teenage romance and realizes that he had callously broken the girl's heart. It is his reading of Kierkegaard that enables him to come to this self-realization. He decides to seek her out, and finding her somehow helps him achieve some resolution to his life. But the end of the novel, he is much more content with his life. It is far from clear, however, what it was that helped him. It could have been the writing exercises he was given by his cognitive-behavioral therapist that were designed to help him see himself as others saw him, or the changes in his life that force him to make a new start. Or it could be his encounter with philosophy. Lodge's novel illustrates the potential benefits and pitfalls of philosophical counseling, and how it can be difficult to tell which are which are the benefits and which are the pitfalls.