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 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 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.
