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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