At one time seeing a therapist was a subject of embarrassment if not outright shame. It was tantamount to an acknowledgement that one was unable to cope, needed help and was inherently unstable. Pride and social convention at the time combined to dissuade people from seeking it and to conceal it if accessed. Having a stiff upper lip was perceived at the time as an important part of dignity and self-respect. Real men didn’t cry. Much has changed since then and as always, the pendulum seems to have swung from one extreme to another. Today seeing a therapist is fashionable to the extent that “My therapist says” as a preface to discussion at a cocktail party has become a badge of honor. It is now often not so much a matter of needing to see a therapist as it is perhaps a matter of being able to afford one.
This is not in any way to dismiss the value of therapy, or the increasing need of people perceived or otherwise to access it. However, with the increasing demand has come a diversity of approaches and schools of practice. Some of the more popular offerings are along the lines of CBT or Cognitive Behavioral Therapy and more recently DBT or Dialectical Behavioral Therapy, the latter being generally regarded as a subsection of the former. Whereas CBT stresses rethinking outcomes relative to intentions to ‘correct’ cognition, DBT places emphasis upon the regulation of emotions through certain exercises intended to help realign actions to intended consequences. None of these approaches can be regarded strictly speaking as scientific. In my opinion, they more properly fall under the category of an art by which I mean that the personality of the therapist is a signifiant factor in both the practice and outcome of the process. The interaction between the client and the therapist involves a certain intuitive flow wherein the therapeutic model provides a defining environment within which this takes place.
Having said that, all talk therapies involve encouraging the client to examine their own thoughts, feelings and actions with a view to making changes that will lead to solutions or improvements to whatever situations have led them to seek help. Insofar as this involves self-examination and a certain level of detached objectivity, the relationship between CBT and philosophy has often been noted by CBT theorists. Parallels have been consistently drawn between early Greek philosophy and CBT practice. The difference being primarily that therapists are now generally regarded as being appropriately designated as ‘health care’ professionals rather than mere mentors. Any personal ‘dysfunctions’ are now systemically embraced within the realm of mental illness.
As Marinoff points out in his book, the medicalization of issues around individual human experiences has had a tendency to level the diversity and depth of human experience to templated categories designated as sicknesses, diseases or dysfunctions ( I have dealt with this topic in some depth in my review of the book Saving Normal). These categories are then reified, which is to say that a complex of behaviors is given a name i.e. a noun and therefore becomes a thing. As an example, a diagnosis of ADHD or Attention Deficit Hyperactivity Disorder is based upon a grouping of observed behaviors. The ranking of those behaviors in terms of degree is ultimately subjective as are the sufficient and necessary conditions in place for an individual to qualify for the diagnosis. This fact can be proven by virtue of the progressive relaxation of the criteria in place for the diagnosis that has taken place over the past two decades. Moreover, the precise borderline between having or not having the diagnosis becomes a matter of conjecture as the assessment of behaviors approaches the lower end of the qualifying scale. For persons on the edge of being just under the qualifications, they are arguably still a weaker instance of the same diagnosis and on this basis the introduction of ‘spectrums’ for disorders has further complicated matters. The spectrum diagnosis allows even the slightest degree of off white to be seen as a pale grey. Ultimately, the person’s behaviors become externalized as a ‘thing’ (i.e. ADHD) that a person ‘has’. Linguistically, verbs heaped together that require a subject are transformed magically into nouns and thus removed from requiring a subject. Hector has ADHD removes the behaviors from Hector and they become not his behaviors but rather behaviors that have him. In this manner he becomes the object and recipient of those behaviors and not their author.
Part of the problem of dealing with the issue of ADHD is therefore to understand that regardless of the language employed, behaviors belong to a subject and are therefore ultimately subject to his or her control and responsibility. As such, the author’s point is that philosophy in its original sense was equatable with self-examination and the desire to make sense of oneself, others and the world around us. The Greek pronouncement that the unexamined life is not worth living gives way to the other dictum of know thyself. This, Marinoff argues, is the core essence of philosophy and only in comparatively recent times has philosophy given rise to the view that philosophers must deal with and write about esoteric matters that the general reader will find unfathomable. The philosophy of Plato and Socrates involves dialogue and questioning with others as well as the inculcation of a certain level of receptiveness to re-examine ideas and beliefs in light of reason and evidence. Plato’s dialogues depict conversations and interactions and are thus social and interactive. They may be read in an ivory tower but do not take place in one.
“…philosophy doesn’t have to be intimidating, boring, or incomprehensible. Much of what’s been written on the subject over the years certainly falls into one or more of those categories, but at its heart, philosophy examines the questions we all ask: What is the good life? What is good? What is life all about? Why am I here? Why should I do the right thing? What is the right thing? These are not easy easy questions, and there are no easy answers, or we wouldn’t still be mulling over them. No two people will automatically arrive at the same answers. But we all have a set of operating principles we work from, whether or not we are conscious of them and can enumerate them.”
To this end, he advocates philosophical counselling, not necessarily as a substitute to psychological and psychiatric counselling but rather as an additional alternative. Rather than seeing all problems through the lens of sickness, the point is to normalize the emotional conflicts and struggles experienced by all of us as part of the human experience. These core issues of human experience are fundamental to our humanity and have been so for thousands of years. The realization of this fact goes some distance in helping to gain a perspective on our own plight. It is all too easy to fall into the pit of self-pity by feeling that nobody has ever gone through this before. The very fact that other people have and are going through similar experiences and have survived or are surviving can do much to support the belief that you too can overcome this challenge. Perhaps misery loves company because company reduces misery.
It is also true to state the fact that modern life has substituted some past issues of concern and stress with new ones. In the past, strict hierarchical social orders and correspondingly fixed religious beliefs provided defined social roles and answers. Whereas it could be argued that these met pre-existing human needs, their ability to do has always varied from individual to individual and time to time. With so many traditional means of meeting these needs now under attack or abandoned, the stress is increasingly upon individuals to define their own reality if they refuse to accept traditional answers. Therefore, as existentialists such as Jean Paul Sartre have argued, modern life brings with it the freedom for the individual to define their meaning within an apparently meaningless universe. It is well enough to not believe or share values with others, but ultimately the questions remain as to what you do believe in and what your values are. It is impossible to act without belief and impossible to avoid internal conflict without some consistency in those beliefs. In this sense, philosophical counselling becomes an entry point into viewing life from a philosophical point of view, which is to say from a questioning and analytical perspective. From analysis can come a synthesis. This, however, requires effort and a willingness to do so.
Philosophical counselling as Marinoff advocates it, consists of five stages which he summarizes as PEACE or Problem, Emotions, Analysis, Contemplation and Equilibrium. The first two stages are simple in that they involve identifying what the problem is as presented to them as well as identifying their emotional reaction. The next two steps may require outside assistance or counselling but involve progressively analyzing the problem whereas the final stage involves incorporating into your life what you have learned from the previous four stages.
As a working example, he uses an instance where a parent is dying who has left instructions to not extend their life through extraordinary measures. In this case the identification of the problem is straight-forward. However, the resultant emotional reaction may be complicated by a combination of different emotions such as grief, anger or guilt. Working through this will require analysis to separate out those feelings. In the third step you will use analysis to set out options in terms of how to deal with the problem. Ideally this analysis will sort out both the practical external issues as well as the internal emotional ones. However, it is important to realize that often a perfect solution is not obtainable and so it is a case of settling on the best possible solution or solutions among those available. In the fourth stage you are contemplating your entire situation as outlined in the previous three stages with a view towards integrating those stages into a unified philosophical view of the overall situation. In the final stage, the philosophical position that you have achieved is integrated into an overall synthesis of thought and action. For example, prioritizing a parent’s wish to have life support terminated may come as the result of placing the wishes of a dying parent and their views as to their quality of life over your own. This involves coming to peace with that decision regardless of the grief that it may cause you or whether that is a choice that you yourself would have made. It may come as a result of accepting the importance of the ultimate right of others to make decisions that affect them. As such, there is no conflict between your belief as to how you would wish to deal with the situation if it were you and the parents’ wishes. Acknowledging the right of others to make decisions with which you do not agree does not threaten and indeed could be said to reinforce your similar right.
There are other examples given and then some specific examples of cases of individual clients and how this approach helped them. But for those I refer the reader should they be interested to further explore the book in detail.
The important features of philosophy as an orientation towards life can I think be summarized in a few key points. The first of these is the process of analysis to compartmentalize a problem (a) in terms of identifying possible courses of action and (b) in terms of separating emotions and emotional reactions as component parts of a problem or as hinderances towards an objective analysis of (a). Far too often, we are driven by emotions and unable to see things clearly as a result. The ability to detach even temporarily the world as we want to see it from the world as it objectively presents itself is an important one to cultivate. Reason cannot replace emotions, but it can divert them or find ways to offset some with others. An arrow may not be able to be stopped, but it can be deflected.
Whereas each of us carries within ourselves our own narrative, our views of the world form a perspective colored and determined by our own experience. Despite the fact that as a limitation this cannot be entirely avoided, varying degrees of ability to transcend this still present themselves. In many instances this ability could be said to define intelligence. At the very least, it is the defining characteristic of adaptability and therefore the necessary prerequisite of survival itself. Largely, that ability rests in the acknowledgement of the fact of our subjectivity. Once that is established much else can follow through intelligence and empathy. However, devoid of the recognition of this fact, mental life becomes its own self-imposed prison or solipsism. The ability to define boundaries starts with the acknowledgement that they exist. Once acknowledged and defined we can begin to see where the world as we want to see it ends and the world as it is begins.
Similarly, knowledge based upon intensity of belief as its sole arbitrator should always be suspect for it is not infrequently the case that the more we desire something to be true the less likely it is to be so. The emphasis upon faith or strongly held beliefs over reason is the core basis for the conflict between religion and science as it is the fundamental basis of conflict elsewhere. Arguably, it is also the primary cause underlying the relative ability of individual minds to grow in richness and diversity of experience. Growth, after all, necessitates change.
It is entirely possible to believe in something as a reasonable explanation or the best explanation available without also refusing to acknowledge other possibilities or excluding information that can not be accounted for in your belief system. Many of the personal problems that occasion people to seek help, counselling and therapies involve their inability to see their own situation objectively and gain some distancing from the emotions relative to their beliefs. Intensity of feeling is often equated with a how true a belief must be when in many cases the opposite is true. We believe in the truth of our own feelings because of the investment that we have in them, and that investment is invariably in direct proportion to how much we want something to be true.
Bertrand Russell (1872-1970) the eminent philosopher and mathematician, dealt with personal depression during difficult periods of his life with what he referred to as the Doctrine of Cosmic Piety. This consisted in him regarding himself as an insignificant speck on an insignificant planet in a vastly larger universe. This was not to belittle human emotions or feelings as much as it was to gain perspective. Many daily problems fade into insignificance when greater problems come along. Much of human experience consists exactly in this kind of regret. Focusing on what life is denying us often obscures acknowledging what is granted to us.
It should give us pause for reflection that in an era with an unprecedented standard of living and material comfort, so much unhappiness exists. This in itself should be a cause for philosophical reflection for it becomes apparent that human happiness requires other elements that are clearly lacking in our present society. Perhaps if people were to think more and feel less, the quality of what they feel would be enhanced. Emotions, after all, should not be measured by their intensity but by their depth. As an adolescent I can vividly remember going through periodical bouts of depression during which everything around me was a reason to be miserable. On one such occasion when I was doing homework, I received a phone call from a friend. After a twenty-minute conversation, I found that my mood had completely changed, and I was now feeling happy and positive looking forward to the weekend. Suddenly, I came to the realization that my world had not changed, merely my reaction to it. All of the external reasons that I had identified as justifying my misery were still there, but the misery was not. At that point, I grew to distrust my emotions and that distrust has never left me. Emotions do indeed form the richness of human life, but emotions need direction. Like the horses on a chariot, the energy of the horses need not be diminished but their direction requires the control of a skilled charioteer.