I Bill, therefore I Am

These two articles, one from The New York Times and the other from
the London Sunday Times (see below) were forwarded by John Young to the
phil-counsel list server (http://www.freelance.com).
Both of these articles are problematic in that philosophical
practitioners are depicted as therapists, while philosophical
practitioners themselves do not present their skills as those of the
therapist.
For details about the bill on philosophical practice read the
topic *Controversial Legislation* on the Philosophical Counseling Website.



The New York Times, March 8, 1998, pp. 4-1, 4-4.

I Bill, Therefore I Am

Philosophers Ponder a Therapy Gold Mine

By Joe Sharkey

When he was starting out as a standup comedian in the
1960's, Woody Allen joked about being expelled from college
for cheating on a philosophy exam: "I looked within the
soul of the boy sitting next to me," he said.

Three decades (and 30 years of personal psychotherapy)
later, Mr. Allen still sprinkles his movie scripts with
references to philosophers like Kierkegaard and Kant, as
well as to psychoanalysts like Freud.

There may be a lesson here -- at least if you're a
philosopher. Taking note of psychotherapy's mixed record
during its century-long domination of the effort to address
people's practical problems of living, some philosophers
have begun to scamper back down from the ivory tower to
conduct business the way Socrates did -- by returning,
literally, to the marketplace.

They are hanging out their shingles. Springing from a
movement that began in Germany in the 1980's, a small but
growing number of American philosophers have opened private
practices as "philosopher practitioners," offering a
therapy based on the idea that solutions to many personal,
moral and ethical problems can be found not in
psychotherapy or Prozac but deep within the 2,500-year-old
body of philosophical discourse.

"Psychiatry and psychology ultimately have failed people,"
said Lou Marinoff, a professor of philosophy at City
College in New York who has been seeing private clients --
at $100 a session, about what psychologists get -- since
1991. Dr. Marinoff, who estimates that there are several
dozen philosophers in private practice in the United
States, wants to lead like-minded colleagues back to their
ancient place at the center of the emotional tumult of
daily life.

Typical clients, he said, are "refugees from
psychotherapy," some seeking deeper truths and others just
looking for a better way to deal with depression and
anxiety.

"What we're suggesting is, if you can be referred by your
H.M.O. to a psychologist or a psychiatrist, you should be
able to be referred to a philosopher, too," said Dr.
Marinoff, who is the president of the American
Philosophical Practitioners Association, which has several
hundred members. The group has drafted licensing criteria
and is leading a state-by-state drive for certification.
The most notable success so far is a bill making its way
through the New York State Assembly that would establish a
board to license philosopher practitioners, and thus propel
their campaign to qualify for insurance reimbursement.

Anxious Psychiatrists

With health maintenance organizations already cutting back
on coverage for traditional mental health care, some
psychiatrists and psychologists naturally react with a
mixture of anxiety and denial to any suggestion of sharing
the market.

Dorothy Cantor, a clinical psychologist and former
president of the American Psychological Association,
dismissed the idea that "philosophical counseling, or
whatever the heck they're calling it," has a legitimate
claim on dealing with "something as delicate as a person's
mental health." Philosophers who consider themselves
mental-health therapists, she said, suffer from a "naive
assumption" that purely intellectual discourse can address
personal problems that are intractably emotional and
sometimes severely debilitating.

"They totally ignore the role of the unconscious," said Dr.
Cantor. For patients who need psychological help, she
added, "Plato isn't going to solve their problems."

Psychologists, she said, need to make a better effort "to
educate the public as to what they should be looking for --
well-trained doctoral-level providers" who are licensed in
therapies subject to stringent professional review.
"Imagine peer review by philosophers," she said.

Dr. Marinoff conceded that his more scientifically grounded
colleagues chuckle at the idea of philosopher therapists.

"People think of a philosopher as someone you wouldn't send
out for a loaf of bread," he said. "In fact, a lot of my
colleagues, if I sent them out for a loaf of bread, might
come back with a quart of milk or with an essay about why
they spent the afternoon walking around aimlessly." But he
said philosopher practitioners have adopted uniform
standards and peer review procedures. In New York, State
Assemblyman Ruben Diaz Jr., a Bronx Democrat who has an
interest in philosophy, is sponsoring the bill pushed by
the philosophers to authorize state certification.

Philosopher practitioners usually have academic doctorates,
Dr. Marinoff said, and are trained to refer people with
serious mental disorders to the appropriate professionals.
"You don't want to try to treat severe personality
disorders with Sartre," he said. But he added, "If somebody
comes to me trying to reinvent Nietzschean morality,
struggling to transcend good and evil, we can have a
dialogue and I can say, 'Hey, that's very interesting. This
is something Nietzsche thought an awful lot about.'
Ultimately, they won't feel lost or isolated. They can
explore and address their dilemma through the long history
of thought, rather than through Prozac, for example."

Harriet Chamberlain, a philosopher practitioner in
Berkeley, Calif., suggested that clients may find it
appealing that there is no stigma attached to counseling on
philosophy. Clients are driven, she said, by "normal
weaknesses" over job-related stresses, concerns over
long-range goals, relationships and general "existential
anxieties" that are intensifying in an increasingly complex
world.

White Coats and Sandals

Dr. Marinoff said that philosophical counseling rejects
psychotherapy's "medical" approach, which considers
emotional distress to be a disease, in favor of a
humanistic approach that stresses dialogue and self-
reflection. "We are not like the guys in white coats," he
said.

"What do they wear, sandals?" asked Deborah Chollet, vice
president of a health care group called Alpha Center, which
does medical insurance research. She said employers and
legislators can be overwhelmed by wide public support that
marketing-savvy proponents of alternative therapies can
muster.

Philosophers are not the only alternative therapists lining
up for a piece of the healthcare spending dollar. Some
chiropractors want to expand their uses of alternative
therapies and are lobbying hard to expand coverage for
chiropractic treatment to include a variety of ailments,
like depression. Another initiative is coming from a
movement called personal coaching, which includes thousands
of therapists licensed only by the movement. They use New
Age motivational and self-help techniques to counsel
clients, who pay as much as $500 a session.

It is crucial to require proponents for an alternate
therapy to "prove that it is a demonstrably cost-effective
treatment," Dr. Chollet said. In states that have put those
kinds of requirements in place, she added, there has been
a dramatic reduction in new mandates requiring health
insurers to cover alternate treatments.

The philosopher practitioner movement is working to
"accommodate itself to the realities of insurance" in the
American healthcare market, said Keith Burkum, the chairman
of the philosophy department at Felician College, a small
Catholic liberal arts college in New Jersey that recruited
Dr. Marinoff to teach a course to train philosopher
practitioners who sought certification by his organization.
So far, Dr. Burkum added, "The track record for the
profession is primarily in Europe, but it's coming on
strong here. I don't want to pick a fight with
psychologists, but in this society psychoanalysis is in
deep trouble." Several hundred philosophers practice full
time in Holland and in Germany, and a smaller number
practice in Israel.

But maybe accommodations can be made, said Donald K.
Freedheim, a professor of psychology at Case Western
Reserve University in Cleveland and the author of "The
History of Psychotherapy: A Century of Change," published
by the American Psychological Association in 1992.

Given the tightening of insurance spending on
psychotherapy, philosophers might be able to come into the
mental health industry tent as certified "gate-keepers,"
under the strict supervision of psychologists or
psychiatrists, he suggested. They could refer cases that
need "a more sophisticated, comprehensive approach" to
psychologists while handling the simpler counseling cases
themselves at a lower cost, he said.

"Actually, 80 percent of the counseling that is done now
could be done by them," said Professor Freedheim.

[End]

--------------------------

London Sunday Times
March 15, 1998

UNITED STATES

Socrates and Plato sink the shrink

by Matthew Campbell
Washington


TIRED of Freudian "psycho-babble" and
new age fads, Americans are turning to
philosophy in their pursuit of happiness. In
a trend that has worried conventional
psychologists, philosophers are setting up
shop as therapists offering Plato, not
Prozac, in the fight against depression.

Following the example of Socrates, who
conducted his business in the streets of
Athens, dozens of philosophers have
entered America's healthcare marketplace
as "philosophical practitioners". They are
campaigning for recognition by the
authorities that would allow patients to be
referred to them by family doctors.

"Psychology has failed," said Lou
Marinoff, a philosophy professor at the
forefront of the trend. His Manhattan
practice is a magnet for "refugees from
psychology" who pay $100 (=A360) an hour -
the same fee charged by psychoanalysts - in
exchange for philosophical insights into
their personal problems.

It does not work for everyone. "If they're in
need of medical attention, of course I'll
refer them to someone else. But a
philosophical dialogue can often calm
them down," said Marinoff, whose
association of practitioners has drawn up
licensing criteria in the drive for
government approval. "If you can be
referred by your doctor to a psychologist
or a psychiatrist, you should be able to be
referred to a philosopher, too."

It might seem tailor-made for Woody
Allen, the angst-ridden actor and devotee
of the analyst's couch whose films are
peppered with references to Freud - the
father of modern psychoanalysis - as well
as philosophers such as Kierkegaard and
Kant. But the traditional "shrinks" are
appalled at the intrusion of what they see
as unqualified, underemployed academics
into their domain.

"These people have PhDs, but their
doctorates are not in anything relating to
mental health," said Dorothy Cantor, a
leading clinical psychologist. She
dismissed the notion that "philosophical
counselling or whatever the heck they're
calling it" could help people suffering
psychological difficulties. "Plato isn't
going to solve their problems."

One reason for anxiety and denial on the
part of the men and women in white coats
is the cutbacks that health insurers are
already making on coverage for
conventional mental health care.
Psychologists are naturally concerned
about any suggestion of sharing the market
with a bunch of bearded Aristotelians.

Marinoff, a Canadian, is used to being
laughed at by more scientifically oriented
colleagues, but he and other philosopher
therapists, who claim philosophy is the
"parent discipline" of psychology, are
equally critical of their clinical
counterparts. "Psychiatry is in crisis and
psychologists are on the defensive," he
said, echoing a widespread disenchantment
with the discipline's tendency to see all
mental disorders as a product of childhood
conflicts and traumas.

The biggest blow to psychotherapy's
century-long dominance of efforts to solve
the practical problems of living was the
arrival in 1987 of Prozac, the
antidepressant drug that can alleviate
misery with scarcely a Freudian word
being spoken.

However, Marinoff's tool is the
2,500-year-old history of philosophical
discourse. For example, he said, "a
breakdown in marriage can be seen as a
breakdown in issues about obligation or
duty or responsibility. But it can also be
viewed in terms of power struggles and so
one could bring Kantian or Hobbesian
systems to bear".

As part of a campaign to win state
certification for the discipline, Marinoff is
teaching a degree course for philosopher
therapists at a small university in New
Jersey. Students are taught to refer people
with serious mental disorders to the
appropriate professionals.

"You don't want to try to treat severe
personality disorders with Sartre," he said.
But "if somebody comes to me trying to
reinvent Nietzschean morality, struggling
to transcend good and evil, we can have a
dialogue and I can say this is something
Nietzsche thought an awful lot about.
Ultimately, they won't feel lost or isolated.
They can explore and address their
dilemma through the long history of
thought, rather than through Prozac".

The purists might laugh. But in New York
a state assemblyman with an interest in
philosophy is sponsoring a bill to
authorise state certification of
"philosopher practitioners", allowing them
reimbursement by health insurance
companies. If the bill is passed in New
York, other states are likely to follow suit.

Philosophers are not the only alternative
therapists vying for a slice of healthcare
spending. Chiropractors are lobbying hard
to expand insurance coverage for their
treatment to include a variety of ailments,
including depression. A "personal
coaching" movement has also emerged
using "motivational" techniques to
counsel clients, who pay up to $500
(=A3301) a session.

Critics say legislators can be easily swayed
by the public support that proponents of
alternative therapies with marketing savvy
can muster. Some states require
proponents of an alternative therapy to
"prove that it is demonstrably
cost-effective treatment". In the field of
mental health this is hard to gauge.

The philosopher therapists see their role as
a fitting return to their ancient place at the
centre of life's daily tumult. "Socrates used
to sit in the marketplace engaging people
in conversation," said Marinoff. "The
Greeks searched for a way of putting one's
insights into practice. This is what
philosophical practitioners endeavour to
do, firstly for themselves and, if they
manage that, perhaps they can help others."

If not, the men in white coats will be
waiting.

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