An important part of my work is to combine mainstream therapy with philosophy. Therapy is a broad term, and it includes counselling and psychotherapy, both of which I am educated in, and they are what I am combining with philosophy, as well as other disciplines such as the clinical therapies: psychiatry, and much of psychology and social work. The difference between counselling and psychotherapy is that, whereas counselling is defined above as conversational skills, a way of being, and a set of knowledge, a psychotherapy is the expression of some specific psychological theory. There are different psychotherapies because there are different psychological theories. These include the various psychoanalytic, cognitive-behavioural, and humanistic therapies. Each is an umbrella term for various schools of therapy, for example among the humanistic therapies we have the various Rogerian, Gestalt, and Existential therapies and others. All the approaches mentioned in this paragraph have important virtues and have contributed greatly to people's lives. However, they have some significant vices, which have a real impact on therapy, on clients, and on our culture. I want to address the core problem, and how Philosophical Counselling can overcome that.
The central problem with mainstream therapy is its tendency to reductivism. What is reductivism? It is to divide the whole into parts, and then favour one part and claim that it is the essence of the rest, when in fact it is not. Another way of understanding reductivism: it is to take a narrow lens, focused on just some part of the thing, or on only one way of knowing, and to reduce the whole to what can be seen in through that lens. You wear a set of glasses which colour everything green, and then because you cannot blue you claim that it does not exist, or at least is not important in reality. Perhaps you add also that anybody who thinks otherwise is a fool. That is reductivism. There is a whole backstory here about Descartes and modern philosophy, and the whole Enlightenment era in which we still live: the age of science, reason, and technology. Whereas classical philosophy focuses on the whole, on form and meaning, these "modern" ideologies proceed by reducing things, and that quickly becomes dogmatic reductivism. It becomes the age of scientism, rationalism, technocracy. This is the context in which therapy arose, and therapy is an expression of the ideology of its age. The two main paradigms of therapy are the clinical and the humanistic. The clinical paradigm is a straighforward expression of Enlightenment values and practices, and unfortunately of its vices: scientism, rationalism, technocracy. The history of clinical therapy is the history of theories which reduce us to psychological structures, or defense mechanisms, or cognition, or behaviour, or neuro-chemicals and disease, or so on and so forth. This lens is not capable of seeing meaning and value, and so they don't exist. They are mere expression of defenses of neuro-chemicals. To think otherwise is to be foolish and dogmatic. The model of clinical therapy is applied science. The client is the passive object of the science, which is to say the client as defenses, or chemical, or disorders. The active one, the "scientist-practitioner" (to use the phrase favoured in psychology today) engages in an objective assessment and diagnosis, based upon the apparently scientific schema set down in their manual (typically psychiatry's Diagnostic and Statistical Manual of Mental Disorders or DSM). With an accurate diagnose, a technology can be applied to fix the disorder: that is, a therapeutic treatment. As an example, according to the DSM if your child dies and, despite three weeks having passed, you are still grieving, then you are still grieving, then you may be diagnosed with clinical depression or disordered grief. You may then be treated with psychiatric medication, as well as cognitive-behavioural therapy which is designed to correct irrational thinking. Some people claim that this clinical-scientific approach is cold, objectifying, and alienating, and at precisely the moment when a person may be feeling most vulnerable, and in need of human connection and wisdom. Some people also suggest that this clinical view of people and of their problems can be blind, superficial, foolish, and even a little mad. Please remember while reading all this, that I am describing therapy's vices, while ignoring its virtues. In response to the Enlightenment and its reduction of life to mechanisms, another movement arose, called Romanticism. Romanticism asserts the reality and value of the inner life. Likewise, in response to clinical therapy, a movement arose called humanistic therapy. Humanistic therapy asserts the irreducible and central importance of the inner life of human beings. Humanistic therapy is Romanticism. Classical philosophy does not have this divide, or at least not in this extreme way, because it focuses on unity. At the heart of good intellect is feeling, and at the heart of good feeling is intellect. Modern philosophy cannot see the irreducible reality of the whole. It assumes wholes are always reducibe to the parts, which are what is real. What follows is a perpetual war between the parts: head versus heart, science versus feeling, other versus self, left versus right, Enlightenment versus Romanticism, clinical versus humanistic therapy. As a form of Romanticism, humanistic therapy is poetic. It speak of wholism. Yet, as just suggested, it plays the same game as that to which it reacts: it unwittingly assumes reductivism, and enacts its own form of reductivism. Whereas Enlightenment and clinical ideology has been boastful about its reductivism, gleeful in claiming that we are "nothing but...", Romanticism and humanistic therapy have more taste. More warmth. When they assume the same basic worldview of the Enlightenment--that is, when they reduce us to the body--it is not as mechanisms, but as feeling, embodiment, breath. This is reductivism dressed up in hippy linen. Humanistic therapy shows its reductivism most of all through its anti-intellectualism. To think, to question the ideology, is to be "in your head." Stop thinking, just feel. After all, we are reducible to the parts, and the parts are in theoretical competition: which is the true part? Of course, none of this is clearly recognise, it is implicit, and hard to see given the saturation of our culture by the dogma of Enlightenment ideology. That anti-intellectualism means that humanistic therapy can be quite silly, quite faddish, forever adopting the latest therauetic fashion. Of course, who cares about this therapy? Well, it teaches us to see ourselves in a certain way, and to value certain things. If its ideology is misled, it is nonetheless correct that how we see ourselves, and what we value, will shape us and our lives. As the philosopher Iris Murdoch famously wrote: "Man is a creature who makes pictures of himself, and then comes to resemble the picture." Indeed, we live in what Philip Reiff called the triumph of the therapeutic: therapy operates as a kind of secular theology for us. Such an ideology, which denies genuine value and meaning, and claims that what is most real is my individualism and my feelings, has significant effects on the development of one's own character and happiness, and significant consequences for the kind of society that emerges. I have dedicated my life to such therapy, I am a therapist, but I believe that therapy has been very much a double-edged sword. If clinical therapy invites us to see ourselves as meaningless mechanisms, with all the consequences not only for how we feel, but for how we treat one another, and if humanistic therapy invites us to deny value and meaning as anything more than psychological preferences, and to see ourselves fundamentally as individuals, whose individual desires and feelings matter most of all, the obvious if unintentional product of all this is nihilism. Nihilism is not only a consequence, it is of its essence, it flows from it. Classical philosophy and so my Philosophical Counselling is predicated on the power and centrality of the human spirit, of the power of your head and heart above all, however when that is denied, as it is by both paradigms of therapy--at least logically, if not rhetorically--then we are left with techniques. Instead of the cultivation of your wisdom and virtue, there is the application of therapeutic techniques from without, whether by the expert clinician to you the patient, or by the guidance of the humanistic therapist, or by you applying it to yourself as though from the outside (which is how a technique works). In clinical therapy this might include cognitive reprogramming or psychiatric drugs. In humanistic therapy it might be breath work, the felt sense, or embodied processing, and now perhaps psychotropic drugs. There is an ideology and performance of personal passivity here. Sure, outwardly you may become more active, even manic, in the application of techniques and life hacks and the disciplines of health and wellbeing. But what is happening inwardly? Where the heart of problems are, where the source of real change lies? The therapeutic age is the age of the passive indidivual. Outwardly manic, perhaps, but inwardly passive when it comes to the striving for wisdom and virtue and so for a true and more full human life. Instead of the triumph of the human spirit, we have the triumph of the technique, the triumph of the therapeutic as a benign form of scientism and technocracy. When I taught philosophy, I would encourage my students to imagine the philosophy, the theory, as a person, and to assess it from that perspective. We can do the same with these therapeutic paradigms. If you had problems in your life and desired guidance from somebody, would you approach a person who reduces us to mechanisms and neuro-chemicals? Remember to imagine a person who not only believes that, but who lives it out, whose morality and emotions and behaviour consistently express that belief. What would it be like to be with such a person? What would it be like for them to have power over you? Alternatively, would you seek out somebody who treats their feelings and desires as the final authority in everything, and who dismisses critical reflection as "being in your head"? We need therapy which is much more wise. Let us not make the same error and be reductive and so unjust: I am discussing the vices of therapy, and their significant impacts, while ignoring the considerable virtues of these therapies, and their significant impacts. However, those vices are real, and we need to do better. What if therapy maintained its psychological and practical insights, but avoided the follies of Enlightenment and Romantic ideologies, with all their implicit reductivism, passivity, and nihilism? What if we took the best of mainstream therapy and combined it with the best of philosophy, to develop a therapy which is not only psychologically and practically helpful, but which is also also the cultivation of wisdom and all the virtues, which fulfill our human nature and lead to a good life? Indeed, what if that cultivation of all that is best in us was treated as the primary way of approaching our challenges and of making life better? This is what Philosophical Counselling is about.
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"Beware, lest in your anxiety to avoid war, you obtain a master."
-Demosthenes, 2500 years ago. Life is dangerous. And trying to live in a richer, fuller way, whether it be through achievement, love, or simply drenching oneself in experience, makes life even more dangerous. To be alive, to exist as a human being, provokes anxiety. Philosophers call this existential anxiety. Psychological techniques cannot solve existential anxiety, because life is not a problem to be solved. It is a challenge to be faced. But does this mean we must be mere slaves of our anxiety, unable to do anything more than tolerate it? “Nothing happens while you live. The scenery changes, people come in and go out, that's all. There are no beginnings. Days are tacked on to days without rhyme or reason, an interminable, monotonous addition.”
-Jean-Paul Sartre, Nausea “The most glorious moments in your life are not the so-called days of success, but rather those days when out of dejection and despair you feel rise in you a challenge to life.” -Flaubert Here is a memory that will never leave me. One morning during a very bad time in my early 20s, I looked into the mirror while shaving and was suddenly overcome. I seemed to stare into an endless repetition of that moment, stretched out as a meaningless series, my whole life nothing more than this. The weight of facing such monotony was agonising. I wanted to kill myself. Grief is more than bereavement after a death. It is about significant loss, of any kind. And not only the loud losses, but also the subtle shadows that are cast over our lives. These shadows shape who we are. It is tempting to push our griefs away because, of course, they are discomforting or painful, and because they can be addictive and we rightly fear that. However in pushing them away we are pushing away parts of ourselves, which need attention if we are to bring in more light than shadow. Furthermore we lose sight of what grief is teaching us.
This article is so important that I have simply copied and pasted it as a blog post, in the event that it should ever disappear from the net. I will follow up soon with my own reflection. The research reported in this article shows that suicide risk assessments are unreliable, and that they can even increase the risk of suicide. I worked for five years in suicide crisis intervention, talking people back from bridges and so on, and then a further five years in bereavement-after-suicide, and my experience not only aligns with the research, but with my own sense that typical suicide risk assessments often alienate people, which increases their risk of suicide. What is needed is connection, and frank honesty, and the stuff of good therapy. Here is the orginal article. What follows is the text of that article. NB that the scenario and initial guidelines that it describes, refers to the American context.
This essay sets out the framework for an original and yet very simple model of philosophical counselling. This form of philosophical counselling has the benefit of being evidence-based: of being proven to work. I build my picture of this model through a response to the assumption that counselling is, and must be, psychological. Hence, I start by defining psychology, and then counselling, and then I explore how the core of effective counselling is not psychological. By contrast, I define the core of effective counselling as "the common factors," with reference to the research which uses that term. By reducing counselling to these common factors, I make the case that they can be blended with philosophy. If you have not read my previous post on common factors theory then I suggest you do so first. In other essays I will unpack philosophical counselling in more detail.
There are many approaches to - or models of - counselling and psychotherapy, and many tribal wars about which is superior. This can be confusing for the public as they sift through the many offerings. The assumption throughout the history of counselling and psychotherapy is that it is the models, and the techniques based on them, which make theray effective. This assumption makes sense, given the emergence of therapy from medicine, wherein there is a disease with a cause, and technologies which assess and treat the disease. However, most of our personal struggles in life are not diseases, and this technocratic model is proving increasingly wrong for our needs. Meta-analytical research has now shown that most approaches to therapy are equally effective, but that what makes them effective is not the approach - the model and its techniques - but rather certain "common factors." This post is a summary of these factors. My goal in this essay is to report on the common factors theory, on how counselling in its effective essence is not the application of a medical or scientific model, but rather is a very honed way of doing something which is age-old. This will clear the ground for my next essay, in which I will argue that counselling is not inherently psychological, but rather that it is these common factors which do not rise to the specificity of any such discipline, which I will suggest can be blended with philosophical reflection to create philosophical counselling.
At first glance Stoicism and bereavement might seem to be strange bedfellows. Stoicism may be one of the wisest philosophies of the ancient world, but it is precisely with regard to grief that it seems most un-wise. The love of rationality and suppression of emotions renders the philosophy tone-deaf and callous in the face of such loss. However, grief is not all flooding emotions, even if it often feels like that. I spent five years providing bereavement counselling after suicide, three days a week. I witness how grief goes to extremes, from a kind of emotional madness, to a need to quietly reflect on existential questions, and everything in between. There are aspects that are out of people's control, which at best can be simply accepted (rather than fought against). There are also aspects that are in people's control, especially over time as the madness wanes. Below are some stoic principles, with a discussion of how they can guide us in bereavement over the long term.
The existential philosophy of the 20th century is rooted in the lebensphilosophie or life philosophy of the 19th century. It is philosophy as "thinking which comes out of living." Accordingly, an existential therapy focuses on challenges in living. This is in contrast to, say, a clinical therapy which focuses on problems as mental disorders. Existential therapy helps people deal with their challenges using the resources contained within their own humanity: their intellect, their will, their loves and desires, their values and motivations, their context and relatonships, and so forth. It is not surprise, then, that an existential therapeutic understanding and response to depression is quite different that of a clinical mental health service. This essay gives expression to just a few aspects of how depression is conceptualised and responded to in existential therapy.
Following on from my last reflection, Ernesto Spinelli is a British existential therapist and philosopher whose work provides an interesting contrast to that of Emmy van Deurzen. The title for Existential Therapy is almost short-hand: more fully, it is Existential-Phenomenological Therapy. While drawing very much on both, most existential therapists work in a way that is either somehwhat more existential (overtly philosophical) than phenomenological, or more phenomenological than existential. To me, van Deurzen represents the former, while Spinelli represents the latter. I too am somewhat more existential than phenomenological, however phenomenology forms the basis of my approach as it does for most existential therapists. In my view Spinelli is the leader in thinking about phenomenology in Existential Therapy.
If I had to list my greatest influences as a therapist, they would include Emmy van Deurzen, Viktor Frankl, Irvin Yalom, Ernesto Spinelli and Carl Rogers, among others. Van Deurzen has probably helped me most when it comes to developing the details of my therapeutic approach, especially in terms of her discussions of polarities. Van Deurzen is a key founder of "the British School" of Existential Therapy, and has developed her own very pragmatic approach to a philosophical form of counselling, which is primarily focused on helping clients face the challenges of everyday life. Van Deurzen argues that life is often hard and unfair, and we are constantly caught up in irresolvable dilemmas, tensions, and paradoxes. She believes that individuals experience anxiety in the face of these challenges, and in an attempt to dispel this anxiety they resort to self-deception about themselves and the possibility of an easy life. The aim of Existential Therapy according to van Deurzen is to help clients face up to the reality of their situation and wake up from self-deception. Clients are encouraged to creatively grapple with life's problems and come to terms with its contradictions. In the reflection which follows I will summarise some key themes regarding Emmy van Deurzen's Existential Therapy
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