Our guest
Lou Marinoff joins us to discuss philosophical counseling, a recent trend to use philosophy as a type of talk therapy. Now, despite the provocative title of his best-selling book, “Plato, Not Prozac!: Applying Eternal Wisdom to Everyday Problems,” the idea is actually not to replace psychiatric medications with chats about the ancient Greeks. Rather, as he puts it in the introduction to the volume, you should take your medications if you really need them, but once your brain is back to a normal functionality you will likely still be faced with the same existential problems that plague most human beings. And that’s where philosophy might help.
Lou Marinoff is the Chair of the Department of Philosophy at The City College of New York and a founder of the American Philosophical Practitioners Association. His other books include "The Middle Way: Finding Happiness in a World of Extremes" and "Therapy for the Sane."
I listened to the episode and I must say that I am a little concern about the lack of the scientific evidence in favor of this type of treatment. It sounds great but how do we actually know that is working? Moreover, Marinoff at one point admit that this is not scientific but and art. This sounds suspiciously similar to many sham treatments including psychoanalysis. While I admit that it doesn't sound very harmful, and is usually short-termed, how can the public knows if it's valid or not, and what separate this treatment from other pseudo treatments?
ReplyDeletegil,
ReplyDeleteit really depends on why one seeks counseling, right? If it is meant to be analogous to psychotherapy, then yes we need evidence that it works (though the reason we don't have it is because it is a relatively new and small phenomenon). But if professional philosophers get paid to talk about how philosophy applies to real life, in what sense would one check if it "works"?
One should be careful to hire only licensed professional philosophers.
ReplyDeleteOf course not. I think there is a clear distinction between public speak that is intended to the general audiences and individual counseling. How is it exactly different from an astrologer that gives advice? I am not comparing the field of astrology to philosophy but how can we justify banning astro9logy and cold readers and support this type of counseling?
ReplyDeletegil,
ReplyDeletethat's not quite a fair analogy. Take the fact that I teach philosophy, not astrology. I think I can make a darn good argument that the first one belongs in serious academic discourse, the latter doesn't. In the case of counseling, you can think of it as one-on-one teaching of practical philosophy. Hardly the stuff of astrology, no?
I agree, but we are not arguing about the academic side of both thing. We are talking strictly about counsling. Philosopgy indeed could be potentially helpful but when people go to therpay they need to know it can also work. Psychoanalysis doesn't really work even though it looked good on paper. Since people can be wasting their time and money going to the wrong therapist I just think there should be more regulations.
ReplyDeleteI recall rejecting the (what I would now call) ontological claims of Christian monotheism at a relatively early age -- I believe I was 15 -- due primarily to the influence of A.J. Ayer's 'Language, Truth, and Logic' (lifted from my father's library) and the general physics and geoscience books from local libraries.
ReplyDeleteBut I still had difficulties with the existential problems that Christian monotheism at first blush could provide satisfying answers for: How does one ground values? How ought one to live? etc. It was not until I read Nietzsche (The Birth of Tragedy and then Twilight of Idols and The Antichrist) and the Greek myths that I was able to come to terms with my difficulties.
I have since largely rejected as unimportant the existential problems that vexed my youth and that occupy the time of too many contemporary philosophers, which reveals how important Ayer, Carnap, Reichenbach, Hempel, Quine, et al. have been to me.
gil,
ReplyDeletesee Eamon's comment above. I think part of the problem is the use of the word "counseling," which is immediately equated with psychotherapy. This ain't it, the goal is closer to what Eamon was referring to above. I don't think we need to regulate this sort of things (even though the APPA actually favors regulation) more than we need to regulate, say tutorship for academic purposes.
I also have a problem with the lack of evidence here, particularly from someone who has written a book called "Plato not Prozac." His comments about the title of the book were excuses, so its a bit disingenuous to imply evidence is not as important. Then he goes off on a Big Pharma rant during the podcast (which seems clear that he was holding back a bit)..at least there are requirements of evidence for medications, but this person doesn't feel compelled to demonstrate evidence before promoting this "counseling."
ReplyDeleteI have no problem with the basic concept of apply concepts in philosophy to one's life, but the promotion of this as a discipline as he describes it sounds problematic, particularly without any evidence that it does anyone any good. Its also obvious that this type of practice is not immune to the potential for abuse found in approaches of "counseling"...it doesn't take much imagination to see how someone could use this to take advantage of others.
The Big Pharma rant and the claim that we are medicalizing people concerned me a lot. I'll grant that there are problems with Pharma, but it smacked of the same non-sequitor pleadings made by supporters of CAM.
ReplyDeleteI'm also curious is Julia had a chance to catch JT Eberhard's presentation at the end of Skepticon. I think some of what he talked about bears on this topic.
The preamble from the ASPCP's standards of ethical practice should have been one of the first things you talked about Massimo. No wonder people are confused--even Julia it seems. Your guest didn't help that confusion with his cagey answers, either.
ReplyDeleteReading the preamble, it's obvious that philosophical counseling isn't meant to be a treatment, but more like a Q&A session for someone with philosophical questions.
Still, Julia's "other problem" hasn't been knocked down.
Massimo, you and others seem to suggest that this is just a philosopher talking with people about life in general and sometimes the person feel better or get a good advice. This seems different in the way it's portrayed in the podcast where people come to the sessions with specific problems and need help. I don't see how this is different that what therapists offer. In addition, he clearly states at the end that people without philosophical background join the movement because they know how to help people. How would non-philosopher help with very little background? With no regulations or specific guidelines I see such ocunseling or advices could be misused.
ReplyDeleteAt least at first blush, this type of relationship (whether we call it "counseling" or something else) makes sense to me - perhaps because it evokes (mostly fond) memories of consulting with rabbis about various crises - whether they revolved around halakhic (Jewish legal/customary), ethical, doctrinal, or more personal matters (e.g. "What do you think of the name that we picked out for the baby?"). But I also understand that nostalgia for pastoral advice is no substitute for efficacy, however that's defined in this case.
ReplyDeleteAnyhow, I suppose that I already use various media (e.g. books, articles, and blogs - including this one) to fill that void. The idea of meeting face-to-face with a professional philosopher to discuss such matters might only enhance that experience - if I felt that the benefits (however subjective) exceeded the costs.
Eid,
ReplyDelete> Still, Julia's "other problem" hasn't been knocked down. <
That's because Julia persists in treating philosophy as it if were science, where one theory (at best) is true, all the other wrongs. But in many cases philosophy can offer a variety of points of view and ways of looking at things. So for example one person may find a stoic perspective more useful than a deontological one for a given problem. No, it's not "anything goes," because while there are multiple solutions to a problem in logical space, there are also many wrong answers.
gil,
> he clearly states at the end that people without philosophical background join the movement because they know how to help people. <
Yes, but help people with problems of a philosophical / existential nature. Hence his clarification (which is also right in the introduction of the book) that if you need Prozac you should take it. But after that, it may still be good to read Plato.
Massimo,
ReplyDeleteFrom what I've seen, Julia treats philosophy like a Bayesian: one theory is more likely to be true than another. Maybe there are multiple solutions for X philosophical problem, but do you have any examples where each solution is as likely to be correct as others?
Eid,
ReplyDeleteagain, Bayesianism is good when it comes to assessing empirical evidence, but in terms of logical spaces I'm not sure what would count as "evidence" (think of multiple solutions to logical problems, like chess positions).
As an example, consider different ethical theories. I really don't think there is any sense in which one can say that, for instance, utilitarianism is more true than virtue ethics. They work by different assumptions, each has its advantages and problems, and one can rationally adopt one or the other without thereby going for something that is "wrong."
As someone with degrees in philosophy who has theorized about, and on occasion practiced, philosophical counseling (PC) since 1997, I think it is important to say that Dr. Marinoff's approach to PC is only one, and not one I favor, though I admire Dr. Marinoff's efforts. My problem with his approach--which I call the wisdom-brokerage approach because it is about connecting clients with relevant wise texts--is similar to Julia's. How does one know which text to recommend, and how can one be sure the choice is not based on a pre-determined desired outcome? Dr. Marinoff hand-waved this, I thought, but it is a real concern, I think. Personally, I think a better approach is simply to let the client talk about their problem and discuss, in a commonsense philosophy way, issues of reasoning / philosophy as they arise. Where I disagree with Julia is on the idea that counseling based on psychology of reasoning error would be an apt replacement for philosophical counseling. Reasoning error is a small part of what PC is about, though probably an area where PC and psychological counseling overlap. Philosophical counseling comes into its own in being able to engage with clients on the substantive philosophical questions of life-- the meaning of life, love, marriage, friendship, death, work, etc. In my view, PC does not give answers but only helps the client work out their own answers as it relates to their problem. Approaching a counselee with only psychological research about bad reasoning (and commonsense) would be like approaching carpentry with only a sword. Philosophical counseling is not just about sound reasoning; it's about the philosophical content of life. In my view, psychology, and science generally, is at grave risk of colosal arrogance in thinking it has much to say about philosophical counseling. Though this may offend the totalizing scientistic mind, PC has little to do with science and science has little to say about it. Personally, I think PC has greater kinship with literature than with psychology.
ReplyDelete"Philosophical counseling is not just about sound reasoning; it's about the philosophical content of life."
ReplyDeleteThere is tremendous overlap here that you are glossing over. Cognitive behavioral therapy does not just pertain to sound reasoning in a vacuum, but must do so in regards to life questions. I agree that PC may have other things to offer in that it is broader in scope, but more comparable that you are describing.
"In my view, psychology, and science generally, is at grave risk of colosal arrogance in thinking it has much to say about philosophical counseling."
Sounds a bit too much like special pleading to me (more than arrogance on the other side). I'm not sure looking for evidence can be viewed as arrogant. To the extent that philosphical counseling has an objective of a benefit to clients, it should be approachable by evidence of this benefit.
I agree that what you (Paul) are describing is a bit different than what Lou was discussing (and more reasonable I think). Given your description of PC, the title "Plato not Prozac" is nonsensical since Prozac is used to treat depression and anxiety and that is beyond the scope of PC. Philosophical counseling sounds more like a mentoring relationship, rather than counseling in the traditional sense.
cc,
ReplyDeleteI'm all in favor of evidence-based approaches, but one needs to consider what one would be seeking evidence of. If philosophical counseling is, as you put it, "more like a mentoring relationship, rather than counseling in the traditional sense" (and I agree) than what are we going to do, make people take philosophy exams?
Imagine someone, you did not like, made the following claims:
ReplyDelete1) I have a 3 day certification program.
2) I have no evidence to back up my claims.
3) I'm practicing an art and there is no way to measure my performance.
4) Big pharma is holding me down.
I think you would view the claims as nonsense (possibly on stilts).
cc - I appreciate your comment. To clarify what I meant by "arrogance," some science-oriented people (btw, the critique here and above is not directed at Julia) in commenting on PC seem to assume that the philosophical component of PC is either frivolous or equivalent to something that science-based counseling is already doing. The intellectual worldview behind this assumption is one that really has no room for philosophy. While the classic example of this attitude is the psychotherapist who hears about philosophical counseling and immediately reacts with, "we're already doing that," it can also take the form of a "concern to protect the public" and a "concern with whether PC works." In my view, both of these concerns are off-base and result from 1) assuming that PC is a kind of medical practice, and 2) not understanding what PC, and philosophy generally, are about. While such concerns are often innocent enough, they are arrogant when they are based more or less consciously on the view that PC is necessarily a kind of medical practice and that any supposed special nature of philosophy is besides the point.
ReplyDeleteWhy are these concerns off-base? Regarding danger to the public, PC is in form simply conversation between consenting adults. While there may be some risk that PC will attract people that PCers are not competent to deal with, 1) this is not a risk special to PC--when a mentally-ill person appears in a PCer's office, the situation is not significantly different from when one appears in a classroom, a church, a legal office, a supermarket, a yoga studio, and anywhere else where the scope of service offered is not what the person needs--2) it would be over-reactive and paternalistic to regulate the PCer/client relationship as though it were a practice of medicine due simply to the supposed risk to mentally-ill people. PC is not a practice of medicine, and, personally, I think such a broad definition of 'practice of medicine' is scientism. The PCer should be prepared to refer mentally-ill people to appropriate help, but so should a teacher and a lawyer. Though some PCers favor it, I think the conception of PC as part of the mental health field should be resisted. The reason is that seeing PC as about mental health misses the point; it's like seeing philosophy generally as about mental health.
Regarding the question of whether PC "works," there are at least two ways in which the idea of testing PC for effectiveness is misguided. Massimo suggested one of them in mentioning the difficulty of any such test. I would expand this by noting that generally whether a practice is effective is a matter of whether the practice does what it *aims* to do. Well, a hopeless problem for testing "the effectiveness of PC" is that what PC aims to do in detail varies with practitioner. PC is not a distinct therapeutic modality but rather a practice that is intrinsically related to the general philosophical outlook of the practitioner. To complicate things further, the PCer may collaboratively develop different goals with each counselee, and in fact may have no "result" goals at all.
While the idea of testing PC for effectiveness is off-base, there are reasons for believing PC is a valid practice. Not understanding these reasons is a second way in which thinking that PC can be tested for effectiveness is misguided. The value PC may generally be said to offer is precisely the value of thinking critically about one's life--the examined life. So the question of whether PC "works" is largely the same question as whether the examined life "works." The mistake in asking this question is that "works" requires a means/end relation and the examined life can be an end in itself. PC is not necessarily about results; the value provided might simply be the help with examination.
"If philosophical counseling is, as you put it, "more like a mentoring relationship, rather than counseling in the traditional sense" (and I agree) than what are we going to do, make people take philosophy exams?"
ReplyDeleteMassimo: The confusion regarding my comments have to do with my perception that there is some debate about the scope of PC. If taken as the mentoring-type relationship, then the evidence question is less applicable. However, the way it was sometimes described in the podcast (perhaps I am reading between the lines of the guest), evidence may be possible and needed. In the situations that PC is used as a intervention that overlaps in scope with other interventions, a comparison can (and should) be made.
Paul:
"So the question of whether PC "works" is largely the same question as whether the examined life "works."
I partially agree except that PC is not the only way to examine life (unless you are calling any such activity PC). So it is not just a question of whether it "works," but in situations in which there are alternatives, how does it compare?
"PC is not necessarily about results; the value provided might simply be the help with examination."
I certainly agree with this perspective, but I never said that there would be no value to the process. PC certainly can have value in and of itself in the intellectual insight and life examination. That doesn't mean that in the situations in which results are important, PC cannot be compared to alternative interventions.
"The mistake in asking this question is that 'works' requires a means/end relation and the examined life can be an end in itself. PC is not necessarily about results; the value provided might simply be the help with examination."
ReplyDeletePerhaps an analogy may help with why I think asking the question is not a mistake, but quite the opposite. Although massage therapy may feel good during the treatment, that does not mean that it is off-base to wonder if there is a sustained benefit after the treatment session. It also not a mistake to wonder how massage compares to physical therapy for example for certain situations. One may decide that the short term effects are good enough, but there is value to exploring further.
The same can be said of PC in certain situations... there may be value in the process, but perhaps we could question whether there is sustained improvement in a person's life. Perhaps we can see that not only does the person gain insight in a session, but that the insight gain improves ones life... that PC becomes applicable outside of a "session."
Its a bit tough to talk in generalities about such topics since we may be thinking of different scenarios, but I was hoping to show that the questions raised are not necessarily off-base.
Chris,
ReplyDelete> I think you would view the claims as nonsense (possibly on stilts) <
I would have to look at what those claims were and in what context they were made. As I said above, I don't see philosophical counseling as counseling, but more like mentoring, in which case one can still collect data, but it isn't clear to me about what and for what purpose.
I should add that the APPA does advocate studies on the efficacy of their approach, it's just that so far nobody has taken them up. Studies cost money and require time, and the philosophical counseling movement is too small to justify them at the moment.