Philosophy says that life must be understood backwards. But . . . it must be lived forward. . , , It is more and more evident that life can never be really understood in Time. It was a pleasure to read Jason Thompson’s serious and thought-provoking piece, and I am grateful to the editors for giving me a chance to comment. The idea that the self is revealed in narrative is a popular one among different schools of psychotherapy, both in (...) terms of technique and theory; and my response addresses both these issues in turn. As a clinician, I have always liked people’s stories. As a junior psychiatrist, I used to love the moment when I first met someone and could say to them, ‘You were born; and then what .. (shrink)

According to insight-oriented psychotherapies, the change clients undergo during therapy results from insights gained into the “true” nature of the self, which entail greater self-knowledge and self-understanding. In this paper, I question such claims through a critical examination of the epistemological and metaphysical values underlying such forms of therapy. I claim that such psychotherapeutic practices are engaged in a process that subtly “absorbs” clients into the therapist’s philosophical framework which is characterized by a certain problematic conception of subjectivity, knowledge, and (...) reality. Through mechanisms which are intrinsic to the therapeutic encounter, such as suggestion and power, such therapies construct and reconfigure clients along the lines of socially accepted norms and values. Consequently, insight-oriented psychotherapy results in a deceptive form of social control. (shrink)

Basics of awareness : knowing yourself -- Basics of awareness : privilege and social responsibility -- The process of acculturation : developing your professional ethical identity -- The ethical culture of psychotherapy -- "I can't believe it's not therapy" : boundaries of the psychotherapy relationship -- Confidentiality : a critical element of trust in the relationship -- Informed consent : the three-legged stool -- Making the most of supervision -- Ending psychotherapy : the good, the bad, and the ethical -- (...) Putting it all together : toward ethical excellence. (shrink)

The primary purpose behind effectiveness research is to determine whether a treatment with demonstrated efficacy has utility when administered to the general population. The main questions these studies are meant to answer are these: Can the typical patient respond to treatment? Is the treatment acceptable to the typical patient? Can the treatment be administered safely and in its entirety in the typical treatment setting? Is the treatment under study significantly better than the community standard of care both from a cost (...) and outcome perspective? Answering these questions is meant to provide sufficient information to providers and policymakers so that effective interventions can be adopted and become the new community standard. For this research to make a meaningful impact on a provider and policymaker's decision to change the status quo, study interventions should be compared to the existing community standard of treatment, often referred to as treatment as usual (TAU). From an ethical perspective, this decision may not always be the safest choice. In some populations, TAU may mean no treatment at all, and in others TAU may be worse than withholding treatment. The effectiveness researcher is then caught between the pull to do no harm and the need for research to have an impact on change. The purpose of this article is to highlight certain conditions when TAU is ethically acceptable and to discuss alternatives when TAU may be an unethical treatment condition. For purposes of precision, we focus exclusively on psychotherapy effectiveness research rather than system-intervention research or medication-intervention research. (shrink)

Using a couple of Paul Watzlawick's clinical cases as a starting point, the author shows how prescriptive behavioral strategies do not produce predictable effects: the theory of (nonlinear) complex systems prevents us from establishing a precise connection between a so-called psychotherapeutic act and what we consider therapeutic effects. It is precisely the consideration of the "Lorenz attractors" that thus brings us to reconsider the long psychoanalytic work as the condition for a general structural change of subjectivity: the result of this (...) work is a change of the neurotic "strange attractor.". (shrink)

Recent research supports the hypothesis that more active engagement of the patient in occurring illnesses improves quality of life and probably even life expectancy.In this study experience and theoretical knowledge from psychotherapy is transplanted to clinical practice in order to improve the physician''s engagement in the patient-disease relationship. By defining severe and long-term illnesses as a psychotrauma, the transfer of the psychotherapeutical model leads to the creation of a new triangular relationship: patient-illness-doctor. Practical examples are used as illustrations for the (...) conceptual differences between psychotherapy and clinical medicine. Options for dialogue show the difference between adaptation (learning to live with) and adjustment (active coping strategies and controlling). The hypothesis is that a better dialogue will reduce illness-related stress, giving the patient better and more effective access to personal psychic and physical support systems. (shrink)

In the process of individual psychotherapy, the client and the therapist work together towards clarifying the client's problems, unlocking vicious circles, opening new perspectives and creating a new narrative congruent with the client's experiencing. The real and undeniable situation in individual psychotherapy across different therapeutic systems is that therapists enter the therapeutic encounter equipped with their own vision of humanity and their own particular theory and methods of psychotherapy. Through the differences in power between therapists and clients and the powerful (...) role of language, clients in their dependent position are apt to assimilate the percepts and the ideas of their therapists. Consequently therapists tend to exert a dominant and influential force in their client's lives. This raises a main ethical concern: to what extent do therapists from different therapeutic systems really help clients to recover their freedom to live their lives congruent to their own authentic perceptions and experiences? (shrink)

Antidepressant medication and evidence-based psychotherapy have largely equivalent efficacy in the management of the common, less severe grades of depression. As a result, several national guidelines recommend that either can be used in the treatment of this disorder. Psychotherapy, however, differs in that it assists insight into how the depressed person appraises and manages the stressors that frequently trigger depressive episodes. I argue that the self-knowledge achieved through psychotherapy has moral value in that it promotes the autonomy of stressor-related decisions. (...) I further argue that such an effect comprises a compelling moral reason for doctors to see evidence-based psychotherapy not as merely optional, but as a necessary treatment for their patients with depression. (shrink)

What does it mean to be ethical in psychotherapy? Does adherence to ethical codes and rules make a psychotherapist ethical? This article examines standard ways of thinking about ethics in the field and argues that these ways are inadequate, creating a false dichotomy between the ethical and the clinical, and that they are designed only for formal and contractual relationships, in which psychotherapy is more often personal and affecting. The ethic of care and the approach to ethics of Emmanuel Levinas (...) are presented as additional approaches, along with their challenges to rationality and autonomy. An ethic of listening is then presented, and it is argued that ethics should be not an afterthought, but the primary consideration of clinical utility. (shrink)

Standards and Ethics for Counselling in Action is the highly acclaimed guide to the major responsibilities which trainees and counselors in practice must be aware of before working with clients. Author Tim Bond outlines the values and ethical principles inherent in counselling and points out that the counselor is at the center of a series of responsibilities: to the client, to him/herself as a counselor and to the wider community. Now fully revised and updated, the second edition examines issues fundamental (...) to the process of counselling. A wide range of ethical problems is discussed and advice is given for resolving these dilemmas. Topics covered include: confidentiality, legal aspects of counselling, working with suicidal clients, false or recovered memory, record keeping, and the importance of adequate supervision. Full of practical information and guidance, the second edition of Standards and Ethics for Counselling in Action will be essential reading and a continuing source of reference for all those involved in counselling training and practice. (shrink)

In this article, I discuss two principles that can be viewed as universally applicable in psychotherapy and counseling: respect for clients' welfare and respect for their self-determination. Consideration of the practical application of these principles leads to the formulation of a set of guidelines to aid therapists and counselors in making choices about instrumental and end goals. These guidelines are intended to be applicable regardless of the particular personal and cultural values of the therapist and client.

This article defines the nature of paternalistic interventions in psychotherapy and discusses reasons why the client's right to consent to treatment is important. We describe a reasoning process developed by Culver and Gert (1982) that can be used to determine when paternalistic actions are and are not ethically justifiable in mental health practice. We demonstrate how this procedure may be applied to psychotherapy by using a number of case illustrations.

We are very grateful to both Matthew Ratcliffe and Thomas Szasz for taking the time to read and respond to our paper. Ratcliffe is broadly sympathetic to our efforts and provides a very convincing argument against mind–body dualisms by drawing on work from the phenomenological tradition. His comments extend rather than challenge our central thesis. Szasz, however, is dismissive of our position. As a result, most of our response is directed to his commentary. Ratcliffe uses the work of van der (...) Berg to make the case that any easy distinction between bodily and mental illness or suffering is false to our lived reality as human beings. Of course, in the day-to- day world of contemporary medical practice .. (shrink)

This book is aimed primarily at the practitioners of morals such as psychiatrists,lawyers and policy-makers. My professional background is clinical psychiatry It is divided into three parts. The first of these provides an overview of moral theory, morality in non-human species and recent developments in neuroscience that are of relevance to moral and legal responsibility. In the second part I offer a new paradigm of free action based on the overlaps between free will, moral value and art. In the overlap (...) between free will and moral value we find moral responsibility and moral autonomy. Free will and art share characteristics of originality, spontaneity and creativity. Art and moral value are related by way of the moral content of art and the formal similarities of moral and aesthetic judgments. In the overlap between art, free will and moral value we find religious belief, the creation of moral value and the creation of moral identity. In the third part, I discuss the application of these ideas to common clinical conditions such as eating disorders, addictions, personality disorders, post-traumatic stress disorder and the dissociative disorders. Wherever possible, I illustrate the points that are made with real-life clinical examples. I finish by considering how ideas of free will and responsibility are relevant to psychotherapy. (shrink)

I have practiced psychotherapy, family therapy, and hypnotherapy for over 25 years without a single board complaint or lawsuit by a client. For over 3 years, however, a group of proponents of the false memory syndrome (FMS) hypothesis, including members, officials, and supporters of the False Memory Syndrome Foundation, Inc., have waged a multimodal campaign of harassment and defamation directed against me, my clinical clients, my staff, my family, and others connected to me. I have neither treated these harassers or (...) their families nor had any professional or personal dealings with any of them; I am not related in any way to the disclosures of memories of sexual abuse in these families. Nonetheless, this group disrupts my professional and personal life and threatens to drive me out of business. In this article, I describe practicing psychotherapy under a state of siege and place the campaign against me in the context of a much broader effort in the FMS movement to denigrate, defame, and harass clinicians, lecturers, writers, and researchers identified with the abuse and trauma treatment communities. (shrink)

The major argument of this article is that failing to measure what is taking place in treatment and control conditions can lead to scientifically invalid conclusions. It is argued that researchers are ethically responsible for being aware that variables related to the therapist, client, and the therapeutic relationship (as well as their interaction) might play a confounding role when treatment and control conditions are compared. As a consequence, they should either measure these variables or be tentative in their interpretation of (...) their findings. (shrink)

`Hans Cohn has given us a personal and valuable statement about the theoretical underpinnings of his work as a psychotherapist. These can be little doubt about his contribution to our thinking practice is invaluable. Students will find Cohn's easygoing exposition of complex ideas enormously helpful' - Professor Emmy van Deurzen, Existential Analysis `One of the most important books published this year. This long-awaited book by the foremost expert on the relationship between Heidegger and psychotherapy, manages to encapsulate the essence of (...) Heidegger's thinking and make of understandable and relevant to therapists without losing any of the original meaning' - Counsellingbooks.com Anyone interested in modern philosophy is familiar with the name of Martin Heidegger but there is a serious gap in even the most complete accounts of his life and thought. This is Heidegger's association with, and influence on, psychotherapy. Hans C Cohn explores the role of Heidegger's thought in providing an alternative basis for psychotherapeutic practice to the dominant psychodynamic, humanistic and cognitive approaches, also focusing strongly on the practical therapeutic relevance of Heidegger's ideas. This book will be essential reading for students and teachers of modern philosophy, as well as existential psychotherapists, and all practitioners interested in existential approaches to therapy. (shrink)

Two inimical interpretations of psychotherapy look to many of the same features of empirical research. One camp infers that placebo effects are impossible in principle in psychotherapy; the other camp infers from the same research that psychotherapy is essentially placebo. I examine the crucial discussions and conclude that these opposing evaluations ensue because each group presumes a different baseline from which the significance of the research is gauged. I show how different baselines set different standards of significance and invite different (...) comparisons between therapeutic and non-therapeutic practices. Attention to this point about the baseline of significance puts the placebo debate in sharper relief and frames more clearly the merits and demerits of each position. It also leads to the conclusion that neither group really lays hold of in-principle claims, since both interpretations rest on context-dependent features of the empirical situation. Along the way, I discuss salient features of outcomes research, meta-analysis, and the role of symbols in therapeutic transactions. I close with some remarks that link the proliferation of therapies with cultural splintering generally and suggest how this might bear on the placebo issue. (shrink)

John Greenwood (this issue) claims that neglect of an important methodological distinction has contributed directly to the "epistemic impoverishment" of empirical studies of all forms of professional psychotherapy. I challenge this claim, as well as other important claims he makes about the efficacy of psychoanalysis and other forms of psychotherapy.

How good is psychotherapy as a tool of research into human nature? There is an orthodox defence of it as a research tool, which relies on showing that interpretations are true of the patient when they satisfy certain criteria. This defence is examined and rejected. The reply is considered that an interpretation which 'keeps things moving' is true, or an approximation to the truth. This reply is rejected by comparing and contrasting an interpretation in psychotherapy with one from brainwashing sessions. (...) Two suppositions about psychotherapy (which weaken its discovery powers) are deliberately adopted — the suppositions that the material produced is 'perspective' and 'method' dependent. An unorthodox defence of psychotherapy is then offered — by means of a watery sense of 'discover'. This enables us to outline a weak sense in which psychotherapy is a valid enterprise, but one which is still strong enough for research purposes. (shrink)

"After the first 40 pages I was hooked, and it has been a long time since I have been unable to put a book down unitl it was finished. I would highly recommend this book. Colin Feltham has brought together all the elements that have or do influence counselling, including placing counselling in a social context. As far as this publication goes I have actually put my money where my mouth is and paid for a copy of my own." --Gladeana (...) McMahon in British. (shrink)

Understanding Experience: Psychotherapy and Postmodernism is a collection of innovative interdisciplinary essays that explore the way we experience and interact with each other and the world around us. The authors address the postmodern debate in psychotherapy and psychoanalysis through clinical and theoretical discussion and offer a view of the person that is unique and relevant today. The clinical work of Binswanger, Boss, Fromm, Fromm-Reichmann, Laing, and Lacan is considered alongside the theories of Buber, Heidegger, Husserl, Merleau-Ponty, Sartre and others. Combining (...) clinical data from psychotherapy and psychoanalysis with insights from European philosophy, this book seeks to fill a major gap in the debate over postmodernism and bridges the paradigmatic divide between the behavioural sciences and the human sciences. It will be of great interest to clinicians and students of psychotherapy and psychoanalysis who wish to come to terms with postmodernism, as well as those interested in theinteraction of psychoanalysis, philosophy and social theory. experience. (shrink)

For a long time the human sciences have debated the relationship between social structures--the group, and subjectivity--the individual, with much of the debate centering round areas such as identity, (gender, race, sexuality), discourse, (talk, conversation, the limits of language), and therapy. This book, by a well-known and highly respected academic in the cross-cutting fields of gender studies, therapy, and psychoanalysis, brings together important material on these debates, and provides a substantial contribution to theory on the relationships between psychology, psychotherapy, and (...) social theory. (shrink)

Are dual relationships always detrimental? Speaking the Unspeakable provides an in-depth exploration of client-practitioner dual relationships, offering critical discussion and sustained narrative on thinking about and being in dual relationships. Lynne Gabriel draws on the experiences of both practitioners and clients to provide a clear summary of the complex and multidimensional nature of dual relationships. The beneficial as well as detrimental potential of such relationships is discussed and illustrated with personal accounts. Subjects covered include: · Roles and boundaries in dual (...) and multiple role relationships · Client experiences and perceptions of being in dual and multiple role relationships · Developing a relational ethic for complex relationships This book offers an insightful and challenging portrayal of dual relationships that will be welcomed by therapists, trainers, trainees and supervisors. (shrink)

The status quo: dogmatism, the biopsychosocial model, and alternatives -- What there is: of mind and brain -- How we know: understanding the mind -- What is scientific method? -- Reading Karl Jaspers's General Psychopathology -- What is scientific method in psychiatry? -- Darwin's dangerous method: the essentialist fallacy -- What we value: the ethics of psychiatry -- Desire and self: Hellenistic and Islamic approaches -- On the nature of mental illness: disease or myth? -- Order out of chaos: from (...) insanity to DSM-III to a pluralistic nosology -- A theory of DSM-IV: ideal types -- Dimensions versus categories -- The perils of belief: psychosis -- The slings and arrows of outrageous fortune: depression -- Life's rollercoaster: mania -- Being self-aware: insight -- Calvinism or hedonism? -- Truth and statistics: problems of empirical psychiatry -- A climate of opinion: what remains of psychoanalysis -- Being there: existential psychotherapy -- Beyond eclecticism: teaching psychotherapy in the twenty-first century -- Bridging the biology/psychology dichotomy: the hopes of integrationism -- Why it is hard to be pluralist. (shrink)

The Freud Wars offers a comprehensive introduction to the crucial question of the justification of psychoanalysis. Part I examines three powerful critiques of psychoanalysis in the context of a recent controversy about its nature and legitimacy: is it a bankrupt science, an innovative science, or not a science at all but a system of interpretation? The discussion makes sense of the entrenched disagreement about the validity of psychoanalysis, and demonstrates how the disagreement is rooted in the theoretical ambiguity of the (...) central concept of psychoanalysis, the unconscious. This ambiguity is then presented as the pathway to a new way of understanding psychoanalysis, based on a mode of thinking that precedes division into mental and physical. The reader is drawn into a lively and thought-provoking analysis of the central issues: · What would it mean for psychoanalysis to count as a science? · Is psychoanalysis a form of hermeneutics? · How can mental and physical explanations coincide? Part II contains the source material for Part I: the influential critiques of psychoanalysis by Adolf Grünbaum, Thomas Nagel and Jürgen Habermas. No specialised knowledge is assumed, and the book is clear and accessible while still conveying the complexity and richness of the subject. It provides a fascinating introduction to philosophical thinking on psychoanalysis for students and practitioners of psychoanalysis, psychotherapy and philosophy. (shrink)

In this paper, I respond to some criticisms of Greenwood (1996) advanced by Grunbaum (1996) and Erwin (1996). I argue that Grunbaum's problematic account of "placebo effects" and placebo control treatments does not really address, far less resolve, the problems with experimental evaluations of psychotherapy documented in my original paper.

From ornithology to a love supreme : overcoming the forces of gravity, and the teaching of Amor Fati -- Zarathustra's convalescence : cognitive expansions and inner wisdom -- With Nietzsche on the road from revenge to redemption -- Traumatic pain : psychotherapeutic conversation between mediumship and soul wisdom -- Psychotherapy as a vocation : giving voice to soul -- Intuitive and inceptual thinking : the meditative paths of Steiner and Heidegger -- "While my conscience explodes".

Why theoretical orientation is important -- Incorporating theory into practice -- Top ten ways to find your theoretical orientation -- Six schools of thought and their theories of helping -- Case examples for integrating theory to practice.

We analyzed a sample of 356 forms containing information that Colorado law legally requires both licensed and unlicensed therapists to disclose to clients. The majority of forms contained the legally mandated information; fewer forms contained ethically desirable information. The average readability grade level was 15.74, corresponding to upper-level college, and 63.9% of the forms reached the highest (most difficult) readability grade of 17 +. Therapists are obeying the law, but do not appear to be taking advantage of the opportunity to (...) provide their clients useful information in an accessible way. (shrink)

The problem -- Fearless speech -- Talking versus writing -- The critical method -- Reasons and causes -- Elucidations -- Back to the rough ground -- The self and images -- A non-foundational therapy.

I take the APA publication A Spiritual Strategy for Counseling and Psychotherapy (Richards and Bergin 2005), along with a devoted issue of Journal of Psychology and Theology (Nelson and Slife 2006), as a paradigmatic example of a trend. Other instances include the uncritical use of "Eastern" philosophy in Humanistic and Transpersonal Psychology, almost normative appeal to the "Sacred" within the psychology of spirituality, talk of "God in the brain" within neurological research, the neologism entheogen referring to psychedelic drugs, and calls (...) for new specializations such as neurotheology and theobiology. In response to the legitimate ethical requirements of respect and openness regarding clients' religious worldviews, the trend is to make God an essential component in psychological theory. The argument is that God is active in the universe and especially in human affairs to such an extent that any accurate account of strictly psychological matters, not just a comprehensive, interdisciplinary purview that could include a distinct theological dimension, must include God as an explanatory factor. Less nuanced than standard theological thought about divine intervention—including a range of opinions from supernaturalism, to occasionalism, to providential and deistic naturalism—this trend would blur the epistemological differences between religion and science by appeal to claimed knowledge sources such as inspiration and revelation and thus undermine the achievements of evidence-based science and establish particularistic religious beliefs as standard explanatory accounts. The concern to include a spiritual, in contrast to a religious or theist, dimension in psychological theory is welcome; but elaborated approaches, such as my own and those of Roberto Assagioli, Viktor Frankl, and Ken Wilber, open to varied theological applications, already exist. (shrink)

Most books about ethics focus either on the origins of ethics, or on the application of ethical thinking to a single form of therapy. This book sets out to span a range of very different forms of therapy and explores the similarities and the differences between the ethical thinking of the practitioners concerned. By looking at ethical issues in different therapeutic settings the reader is challenged to reconsider the working assumptions which underpin familiar therapeutic practice. Readers of Forms of Ethical (...) Thinking in Therapeutic Practice are offered the unique opportunity to gain insights into the ethical thinking of experienced practitioners offering strikingly different services to their clients and working in contrasting contexts. Essential reading for all practitioners in counselling and the therapies, students, trainers, supervisors and providers of therapeutic services. (shrink)

In the first collection of his essays to be published, Jeremy Holmes discusses the wider application of psychotherapy within psychiatry and suggests that psychoanalysis needs to escape from its esotericism by taking into account contemporary advances in cognitive science, family therapy and the realities of psychiatric work in a public health setting. Illustrating his arguments with literary as well as clinical examples, he emphasizes the importance of creativity in psychotherapy and the connections between the artistic and psychotherapeutic impulse.

This fascinating and thought-provoking book provides much-needed philosophical background for counselors, therapists, and healthcare workers looking for broader, deeper foundations in the struggle to help and make sense of others. While examining the best among 20th century philosophy it shows the wealth of inspiration of earlier centuries, and demonstrates with remarkable clarity the way in which the ideas of, and the relations between, these philosophers can inspire, inform, and underpin much of counseling and psychotherapy.

This chapter introduces the central concerns of Humberto Maturana's theory of autopoiesis as they relate to the domain of psychotherapy. Several common terms which are redefined within his theory in an unusual manner are unpacked as to their idiosyncratic significance including the expressions, 'linguistic behaviour', 'languaging', 'structure determinism', 'organisation', 'structure' and others. The source material used for this exposition include not only the cited texts but also several workshops from which verbatim transcripts are often used in the form of brief (...) quotations. I have attempted to stay as close to the original material as possible in order to convey both the meaning and the texture of Maturana's work. This is not an easy theory to grasp ranging as it does across several specialist fields from the neurophysiology of perception through social communication to epistemology. Nor are the implicative transitions from a theory of biology to the praxis of psychotherapy without complexity and controversy. Nonetheless, Maturana offers a novel theory of conversations which could form the basis of a much needed new paradigm for personal change. (shrink)

As is widely known, the last 25 years have seen an acceleration in the development of theories of emotion. Perhaps less well-known is that the last three years have seen an extended defense of a predominant, though not universally accepted, framework for the understanding of emotion in philosophy and psychology. The central claim of this framework is that emotions are a form of evaluative response to their intentional objects, centrally involving cognition or something akin to cognition, in which the evaluation (...) of the object relates to the concerns, interests, or well-being of the subject. I aim to summarize and review the work of five authors on three of the central themes of this framework, and to note some implications for the understanding of emotion in different psychotherapeutic approaches. (shrink)

Mental health professionals face many complex questions in the course of their work with clients and patients. Among the most difficult are dilemmas that involve ethical issues. This book presents a forthright exploration of these dilemmas and the ethical considerations they raise. Drawing on extensive interviews, the author identifies common ethical problems that practitioners encounter. What happens, for example, when personal interests intrude into therapy? How can the therapist make an accurate assessment of his or her appropriateness as a care (...) provider for a particular patient? What about confidentiality? How are problematic financial arrangements best addressed? The author goes on to show how these dilemmas may be intensified by the unique assumptions of different therapeutic orientations--individual, group, family, marital, and organizational--and how professionals can learn from such experiences to better understand and apply their particular approach. This analysis--and the words of the therapists themselves--provide both a guide to practice and a unique store of experience for the growing number of researchers and students concerned with ethical problems in psychotherapy. (shrink)

Through a warm and passionate investigation of the most fundamental properties of human behaviour, Psychotherapy and Science shows how a scientific foundation for psychotherapy is both necessary and feasible. Addressing psychotherapy's need for a coherent theoretical grounding, the book argues that there are striking parallels between the emotion-processing mind and phenomena that have been scientifically observed and charted in the areas of evolution, the immune system and the brain. The idea that scientific theories might be applied to psychotherapy is thoroughly (...) explored in a surprisingly accessible manner. Throughout the book, the ways in which science has a bearing on the clinical techniques and practice of psychotherapy are emphasized, and priority is given to the needs of psychotherapists to focus their theoretical and clinical efforts on understanding the deep, evolved factors behind human suffering, deception, self-limitations and death anxiety. This rare and engaging insight into a scientific quest for better psychotherapeutic knowledge offers a truly original way through the current impasse of ever-divergent theories, and is one of the most cogent challenges to psychotherapy in recent times. It is essential reading for all training and practising psychotherapists, and for those involved in related research. (shrink)

Independent on Sunday October 2nd One of the country's lead­ing philosophical counsellers, and chairman of the Society for Philosophy in Practice (SPP), Tim LeBon, said it typically took around six 50 ­minute sessions for a client to move from confusion to resolution. Mr LeBon, who has 'published a book on the subject, Wise Therapy, said philoso­phy was perfectly suited to this type of therapy, dealing as it does with timeless human issues such as love, purpose, happiness and emo­tional challenges. `Wise (...) Therapy, is part of a series aimed at promoting an integrative attitude as its ethos. Among all the many perspectives of psychotherapists and counselors, philosophy needs to take its place and needs to find its voice. Tim LeBon has provided an effective means by which counselors can bring philosophy into their work with clients' - APPA journal `Tim Le Bon's Wise Therapy is a comprehensible and well argued book dealing with the practical therapeutic applications of philosophical research that may well be of interest to philosophers but -- as the author himself intends -- will be of most obvious benefit to therapists and counselors, both by informing their dialogue with clients in new ways and by helping them become more informed about ways to resolve the ethical dilemmas arising within the context of their own work' - Metapsychology `A fascinating workshop for therapists and clients, backed up a thorough degree if philosophical acuity' - Journal of the Society for Existential Analysis `I strongly recommend the book for philosophers as well as practitioners, teachers, students and supervisors in counselling and psychotherapy' - Self and Society `Provides some additional and valuable arrows for the therapist's quiver' - Irvin Yalom, author of Love's Executioner `Like Aristotle, Tim LeBon examines what is said and extracts what is best from it…. There are many fascinating exercises designed to bring out and enlighten the client's values, conception of the good life, well-being, happiness, pleasure, and the proper place of reason in life…. Wise Therapy is well written and engaging. The case histories are illuminating examples of therapeutic techniques at work, the thought experiments are well designed, and the philosophical position adapted from the internal debates of the philosophers is level headed…. I recommend it highly to philosophers with an interest in counselling, and psychological counsellors with an interest in philosophy' - Jeff Mason, The Philosophers' Magazine `Tim LeBon has… authored a text which should become a staple on the philosophical counsellor's bookshelf…. Wise Therapy is a concise, well-written book…. His ability to relate philosophical concepts to counselling concerns is admirable and attests to the skill and knowledge he possesses as a working counsellor. But, by far the most important part of Tim LeBon's book to PC is the last chapter, "The Counsellor's Philosophical Toolbox"' - Craig Munns in The Examined Life ` Tim LeBon has done a good job of offering practical approaches to some of the most important and vexing issues that arise in counselling…. Tim LeBon's book contains helpful suggestions, practical information, and useful examples, and would make a good addition to the library of any counsellors willing to allow philosophy to turn mere client sessions into wise therapy' - Peter Raabe, Practical Philosophy Wise Therapy is an original and practical guide to how philosophy can benefit counselling and psychotherapy. Tim LeBon argues that therapy, informed by philosophy, can help clients make better decision and achieve emotional wisdom. He uses philosophical approaches to explore issues of right and wrong, the emotions and reasons, well-being and the meaning of life, and develops a 'counsellor's toolbox' of techniques that can help practitioners apply the wisdom of philosophy to good therapeutic practice. For counsellors who may find philosophical approaches to therapy useful, this work addresses key philosophical topics - the emotions, free will, the meaning of life and ethics. It is jargon-free where possible and assumes no previous philosophical training. From The Independent, 16th November 2004 Plato is my agony aunt It was the end of a love affair that broke her heart. Could the wisdom of the great philosophers show her how to be happy again? Claire Smith tries a novel form of therapy "The unexamined life is not worth living," Socrates said. Nor is the life you're left with after your boyfriend has left you for another woman - at least, that's how it felt in October last year when mine broke rank and went off with an art student from Cleveland, Ohio. We were over there for the opening of his new art exhibition. He'd flown over four days before me and had met her at a party. Supposedly, they "connected". The five months that followed were a roller-coaster of confusion, vitriol and despair. I knew there'd been problems in our relationship. We saw the world very differently; he delighted in the charm of the ordinary, I wanted maximum divinity. He walked; I galloped. He drank tea; I loathed the stuff. But, along the banks of the Thames, we'd made a promise to always stick together. Our love was something unique: "transcendental", I called it. And besides, we recycled. Surely a commitment to save the world would save our relationship? Alas, no. So there I was, a woman scorned. Hell truly hath no greater fury. And what made it worse was that I still believed in our transcendental love. If I wanted to change the way I was feeling, I needed to alter the way I was thinking. But how? A few bottles of wine and a sharp blow to the head might have done the trick. Fortunately, there's an older, more trusted way of turning your head on its head that counsellors are starting to use: philosophy. The idea of employing Plato as an agony aunt was begun in 1981 by the German philosopher Gerd Achenbach. Although philosophy spends a lot of its time asking real-life questions that affect real-life people - What is happiness? And is it always wrong to lie? - most of the debate goes on in ivory towers. What Achenbach and subsequent philosophers including Tim LeBon, the chairman of the UK's Society for Philosophy in Practice, wanted to do was "give practical application" to this gigantic library of great thoughts. So how does it work? Like most types of therapy, you sign up for a set of sessions. "Two would give you a new perspective on one issue; six would help you to make a major life-decision, like a career change; with 12 you can start to rethink your entire life philosophy," explains LeBon. Each session lasts 50 minutes and costs £50 - and, no, you don't have to have any previous knowledge of philosophy. "If you think of Friends, it would suit Ross and Chandler more than Joey," LeBon says. "It's for anyone who wants to make their emotions more intelligent. Or for those who have tried other kinds of therapy, and want something more cerebral." The first session begins with the patient venting off about whatever's troubling them. The rant over, the counsellor then picks out some key concepts that are crucial to the problem - in the case of heartbreak, it is love and happiness that come hurtling to the fore - and then gets the patient to define what they mean. So, what is love? What is happiness? To kick-start the patient's thinking, LeBon describes what a great philosopher had to say about it. In my case, he tells me what Plato wrote about love in his Symposium: that to stop man fighting the gods, Zeus decided to cut each human in two, so they would lose their strength. "This, then, is the source of our desire to love each other," Plato said. "Each of us is a 'matching half' of a human whole, because each was sliced like a flatfish, two out of one, and each of us is always seeking the half that matches him." This method of probing what we might think are "obvious" ideas, such as love and happiness, was devised by Socrates in the squares of Athens. "The only I thing I know is that I know nothing at all," he boasted. What Socrates showed was that although many of the thinkers of his time thought they knew what justice, happiness and goodness meant, their understanding was tied in to their personal agenda and world view, and, what's more, when pushed, their ideas often contradicted themselves. A bit like me on love. Whereas part of my understanding of love was something that gave life meaning, made it worth living and bound us together, I also believed that true love was "transcendental": that it was out of this world, and it didn't matter if the two people who loved each other couldn't get along in the day-to-day. Love was bigger than the mundane. But when it came to the next stage of the therapy, critical thinking - "to check out whether your assumptions stand up to examination" - I walked head first into a contradiction. If I think love's purpose is to make life worth living, but then say it's irrelevant to daily life, surely my two ideas of love are not compatible? As the cogs in my brain start to creak into motion, I feel myself taking a step back from my predicament: thinking about how I've been thinking. This idea I had of transcendental love might have started off as a romantic dream. But when the relationship stopped working, and I found myself feeling trapped and frustrated, I used it to justify the mechanics of a relationship that just didn't work in the daily grind. I used it to lie to myself. In the final stage, LeBon gets me to start thinking about how to go forward. "You can't change what has happened," he says. "You can't change that he's left you, or how you behaved in the relationship. So, as the Stoics did, let's work on controlling the controllables: the things that you can change." To work out what can be changed, he gets me to try out a thought experiment, a method often used in philosophy to imagine other worlds where people can have different codes of behaviour. Thought experiments shatter your preconceived ideas of how the world should be and let your imagination run wild to how the world could be. "I find Viktor Frankl very useful here, the Austrian psychiatrist and concentration-camp survivor who actually believed that everything in life happens for a purpose," LeBon says. "Suppose this break-up did happen for a reason that will work to your benefit," he suggests. "What might that be? The answer might be that you can now focus on something important that was denied in the relationship. Or - the Hollywood version - so you'll meet someone who is really right for you." Temporarily freed of any sense of responsibility for the relationship that was, and its sorry demise, the list came fast. I could now travel more; he didn't like me travelling on my own, but too often he didn't want to go anywhere, preferring to stay in his studio and make art. I'd love to meet someone with a similar sense of adventure to mine. For the first time in two years, I was being honest with myself about what I really wanted - listening to those voices that we all have inside our heads, and too often try to muzzle. So did philosophy save me? Well, I'm now dating a travel writer I have to run to keep up with. I still haven't got over the fact that my replacement came from Cleveland, Ohio. But I guess I never will. Tim LeBon can be reached by e-mail at timlebon@aol.com A FEW WORDS FROM THE WISE Compiled by Ed Caesar · "At the touch of love, everyone becomes a poet" - Plato · "There is always some madness in love. But there is also always some reason in madness" - Friedrich Nietzsche · "That man shall live as his own master and in happiness who can say each day 'I have lived'" - Horace · "The good of man is the active exercise of his soul's faculties in conformity with excellence or virtue... Moreover this activity must occupy a complete lifetime; for one swallow does not make spring, nor does one fine day; and similarly one day or a brief period of happiness does not make a man supremely blessed and happy" - Aristotle · "There is nothing on this earth more to be prized than friendship" - Thomas Aquinas · "Whatever you do... love those who love you" - Voltaire · "Happiness is not an ideal of reason but of imagination" - Immanuel Kant · "Happiness is a state of which you are unconscious. The moment you are aware that you are happy, you cease to be happy" - Jiddu Krishnamurti · "Love is an ideal thing. Marriage is a real thing" - Johann Wolfgang von Goethe I shrink, therefore I am Therapy has many answers, but some questions require the help of a philosopher, says Clint Witchalls Sunday November 21, 2004 The Observer Danny had worked in the City of London for 10 years. As a research analyst, stockbroker and fund manager, he'd made a lot of valuable contacts, earnt a lot of cash, and learnt some important business skills. However, as he approached his mid-thirties, he no longer felt good about himself or what he did for a living, and he found his colleagues cold and unfriendly. A chronic illness made him realise his mortality, and he began to reassess his priorities. Danny had been struggling with his career conundrum for nearly five years when he met David Arnaud, a philosophical counsellor. After a few soul-searching sessions, Danny arrived at a decision. Today, he teaches economics to sixth-formers, and he loves it. 'It's a much better lifestyle,' he says. Many people are turning to philosophical counsellors to get answers to questions such as: 'How do I make sense of myself?' 'What is important to me?' 'Where am I going?' These are perhaps not the sort of questions that require psychiatric intervention, but Arnaud, who recently completed the first empirical study of philosophical counselling in the UK, has found that within just five sessions the majority of clients, with important decisions to make, tend to move from a state of concern and confusion to a resolution. Modern philosophical counselling can be traced back to 1981, when the philosopher Gerd Achenbach opened the first practice near Cologne. Achenbach referred to the new discipline as 'therapy for the sane.' Today, there are hundreds of philosophical counsellors around the world, with the movement particularly strong in the US, Britain and the Netherlands. 'The dilemmas people face aren't always primarily psychological,' says Alex Howard, a philosophical counsellor from Newcastle. 'If people face problems that are social or economic, it doesn't make sense to define their problems in purely psychological terms.' Tim LeBon, a founder member of the Society for Philosophy in Practice (SPP) and author of Wise Therapy, adds: 'We are faced with far more life choices than our grandparents, yet have far fewer resources to deal with them. Our grandparents may have gone to a priest or to other family members for advice; most people don't trust these solutions any more and so want to make their own well-informed, well thought-out choices. Philosophical counselling can help these people - people in mid-life crises who are wondering how to make the most of the rest of their life. People who want to take stock of their values.' Where stressed executives might once have been prescribed a course of tranquillisers or antidepressants, they can now get a dose of Bertrand Russell instead: 'Success is too dearly purchased if all the other ingredients have been sacrificed to obtain it.' While some philosophical counsellors do recommend books for their clients to read, most sessions are about helping the client identify faulty thoughts. For example, a briefing in Aristotelian logic might show a client why their beliefs are erroneous. The person might infer that they're a screw-up because they've screwed up. The counsellor could point out that they're making an error called 'fallacy of composition' - that is, what's true of the part isn't necessarily true of the whole. In philosophical counselling, problems aren't pathologised as they are by the psychiatric profession, and the dialogue between client and counsellor is more like a meeting of equals, compared to many therapies where the client is treated like a patient and seen as someone who is, in some way, inadequate. 'Anybody can benefit from philosophical counselling,' says Howard. 'But it does require someone who is willing to take stock.' Lou Marinoff, author of international bestseller Plato Not Prozac! has done much to promote philosophical counselling. 'Some people who have stabilised their neurochemistry and validated their emotions now wish to examine or re-examine the criteria of their beliefs, the principles of their conduct, or the meaning of their lives,' he says. 'With whom shall they do this? Psychologists and psychiatrists can shed light on such issues - as can rabbis, priests, imams and gurus. Philosophers are now rejoining the ranks of helpers.' LeBon believes certain therapies (such as cognitive behavioural therapy) don't go far enough in helping their clients. 'For instance, if you are anxious about your relationship, a cognitive therapist would try to dispute your catastrophising and jump to conclusions to make you feel less anxious,' says LeBon. 'A philosophical counsellor would do this, but would also look for existential meaning in your anxiety - perhaps you really don't want to be in the relationship and that is what your anxiety is telling you.' LeBon also gives short shrift to psychoanalysts. 'There's very little evidence for the Freudian unconscious, and it's time to move on to more intellectually satisfying and helpful therapies,' he says. However, Alain de Botton, the man who popularised philosophy as self-help, isn't ready to bury psychologists and their ilk just yet. 'The truth is that psychoanalysis grew out of philosophy - it's not some completely new idea, and in fact, done properly, psychoanalysis is philosophical anyway. It may even be dangerous to the mental health of some people to suggest a philosopher rather than a properly trained analyst. The knowledge of analysts when it comes to many emotional problems is now much greater than that of most philosophers.' Guardian Unlimited © Guardian Newspapers Limited 2004. (shrink)

This article explores the relations among and between intimacy, psychotherapeutic relationships and moral advice. The article concludes that a psychotherapeutic relationship is not usefully explained in terms of intimacy. Instead, a psychiatric relationship is a form of moral advice, and it is this dimension of a psychotherapeutic relationship as a form of moral advice that poses a natural limit to the confidentiality necessary for engaging in psychotherapy.

Heart and Soul is a collection of essays which examine those concepts and questions which are at the heart of both psychotherapy and philosophy. Topics discussed include the nature of the self, motivation and subjectivity, the limits of certainty and subjectivity in interpersonal situations, and the scope of narrative, dialogue and therapy itself. Looking at the work of key figures such as Wittgenstein, Socrates, Kierkegaard, Foucault, Lacan and Klein, contributors draw on a wide range of philosophical approaches and examine how (...) they can deepen our understanding of the processes involved in different types of psychotherapy in a wide range of clinical settings. Each chapter includes a summary of the implications to clinical practice of the ideas discussed. Contributors: Joady Brennan, John M. Heaton, Jeremy Holmes, Joan Hurd, Paul Sepping, Geraldine Shipton, Paul Sturdee, Digby Tantam, Myra Thomas, Emmy van Deurzen, Werdie van Staaden, John Wheway, and Catherine Wieder. (shrink)

Spinoza claims we can control any passion by forming a more clear and distinct idea of it. The interpretive consensus is that Spinoza is either wrong or over-stating his view. I argue that Spinoza’s view is plausible and insightful. After breaking down Spinoza’s characterization of the relevant act, I consider four existing interpretations and conclude that each is unsatisfactory. I then consider a further problem for Spinoza: how his definitions of ‘action’ and ‘passion’ make room for passions becoming action. I (...) propose two solutions to this problem, both of which yield a hint regarding what act Spinoza has in mind. Using that hint, I propose that we can appreciate Spinoza’s insight by considering how philosophizing about a feeling can 'kill the mood.' The act of grasping how a passion exemplifies certain general truths, I hold, is a distinctly rational activity that has all the features Spinoza describes. I conclude by showing how this interpretation fits with Spinoza’s larger views on rational knowledge, rational joy, the comprehensibility of passions, and the relation between second- and first-order ideas. (shrink)

Psychotherapy and counselling services are now available on-line, and expanding rapidly. Yet there appears almost no ethical analysis of this on-line mode of delivery of such professional services. In this paper I present such an analysis by considering the limitations on-line contact imposes on the nature of the professional–client relationship. The analysis proceeds via the contrast between the face-to-face case and the on-line case. At the core of the problem must be the recognition that on-line interaction imposes a physical barrier (...) largely permitting only those disclosures of self we choose to make available, and greatly restricting the range of involuntary features and behaviours. I show why this is problematic, first, for the development of a close professional–client relationship, with particular emphasis on such failures as diagnosis and monitoring of the patient. Second I describe the importance of the development of professional character, and of how the on-line environment fails to provide a context for such character traits to emerge and develop. (shrink)

Although touch frequently occurs in psychotherapy with children, there is little written on the ethical considerations of therapeutic touch. Because physical contact does occur, therapists must consider if, how, and when it is used, for both their clients' safety and their own. In this review, I further develop the issues suggested by Aquino and Lee (2000) in the use of nurturing touch in therapy by considering many types of touch that occur in psychotherapy with children; the possible positive role of (...) touch; clients' perception of touch in therapy; considerations related to the therapist, the child's safety, and any history of abuse in the child's and family's background; and other practical considerations. I list guidelines. (shrink)

Intimacy and Alienation puts forward the author's unique paradigm for psychotherapy and counselling based on the assumption that each patient has suffered a disruption of the `self', and that the goal of the therapist is to identify and work with that disruption. Using many clinical illustrations, and drawing on self psychology, attachment therapy and theories of trauma, Russell Meares looks at the nature of self and how it develops, before going on to explore the form and feeling of experience when (...) self is disrupted in a traumatic way, and focusing on ways towards the restoration of the self. Written in an accessible style from the author's singular perspective, Intimacy and Alienation will appeal to professionals in the fields of psychotherapy, counseling, social work and psychiatry, as well as to students and the lay reader. (shrink)

This book is a scholarly mongraph on Sigmund Freud's understanding of the basics of psychotherapy theory and practice from the perspective of phenomenology.

Traditionally, there have been few legal actions brought against psychotherapists that allege negligent psychotherapy and negligent treatment of psychiatric disorders. However, in the case of Osheroff v. Chestnut Lodge, a patient-physician (Dr. OsheroE) sued Chestnut Lodge, a private psychiatric facility, for negligence based on the staff's decision to apply a psychodynamic model of treatment (through psychotherapy) and not a biological model. The case sparked a heated debate between adherents of the psychodynamic model and those of the biological model. This article (...) explores the implications of the Osheroff litigation for mental health professionals. It is proposed that an interactive informed consent process be used to protect psychotherapists against Osheroff-type litigation. (shrink)

I shall begin with the "anti-psychiatry" view that the lack of a physical basis excludes many familiar mental disorders from the category of "illness". My response to this argument will be that anti-psychiatrists are probably right to hold that most mental disorders do not involve any physical disorder, but that they are wrong to conclude from this that these mental disorders are not illnesses.

Neuroscience and psychiatry -- Psychotherapy and psychiatry -- Diagnosis in psychiatry -- The boundaries of mental disorders -- Mood and mental illness -- Psychiatry's problem children -- Evidence-based psychiatry -- Psychiatric drugs: miracles and limitations -- Talk therapies: the need for a unified method -- Psychiatry in practice -- Training psychiatrists -- Psychiatry and society -- The future of psychiatry.

This book takes the discursive and postmodern turn in psychotherapy a significant step forward and will be of interest to all those working in mental health who want to work wiht clients in ways that will facilitate challenges to oppression and processes of emancipation. It achieves this by: · reflecting on the role of psychotherapy in contemporary culture · developing critiques of language in psychotherapy that unravel its claims to personal truth · the reworking of a place in the transforative (...) therapeutic practice Deconstruction is brought to bear on the key conceptual and pragmatic issues that therapists and clinical psychologists face, and the project of therapy is opened up to critical attention and reconstruction. The book provides clear reviews of different viewpoints and will help readers to orient themselves on the complex terrain of debates. (shrink)

This book tracks a particular understanding of self, philosophically, from research evidence and its implications for psychotherapy.

Psychologists are ethically obligated to obtain informed consent to psychotherapy "as early as is feasible" (American Psychological Association, 2002, p. 1072). However, the range of topics to be addressed includes both information that may be immediately and uniformly applicable to most clients via policy or rule, as well as information that is not immediately presentable because it varies widely across clients or emerges over time. In this study, licensed psychologists were surveyed regarding the earliest feasible point at which they could (...) provide information regarding specific aspects of psychotherapy. Results indicate that, although psychologists believe that they are capable of presenting some information, such as payment and confidentiality policies, at the outset, they believe that a discussion of more substantive issues, such as psychotherapy duration, goals, orientation, and activities, can take place only after some therapy has transpired. Implications are discussed regarding the process and event models of informed consent. (shrink)

Praise for Ethics in Psychotherapy and Counseling, Third Edition "This is absolutely the best text on professional ethics around. . . . This is a refreshingly open and inviting text that has become a classic in the field." —Derald Wing Sue, professor of psychology, Teachers College, Columbia University "I love this book! And so will therapists, supervisors, and trainees. In fact, it really should be required reading for every mental health professional and aspiring professional. . . . And it is (...) a fun read to boot!" —Stephen J. Ceci, H. L. Carr Professor of Psychology, Cornell University "Pope and Vasquez have done it again. . . . an indispensable resource for seasoned professionals and students alike." —Beverly Greene, professor of psychology, St. John's University "[The third edition] focuses on how to think about ethical dilemmas . . . with empathy for the decision-maker whose best option may have to be a compromise between different values. If there is only room on the shelf for one book in the genre, this is it." —Patrick O'Neill, former president, Canadian Psychological Association "This third edition of the classic ethics text provides invaluable resources and enables readers to engage in critical thinking in order to make their own decisions.?This superb reference belongs in every psychology training program's curriculum and on every psychologist's?bookshelf." —Lillian Comas-Diaz, 2006 president, APA Division of Psychologists in Independent Practice "Ken Pope and Melba Vasquez are right on target once again in the third edition, a book that every practicing mental health professional should read and have in their reference library." —Jeffrey N. Younggren, risk management consultant, American Psychological Association Insurance Trust "Without a doubt, this is the definitive book on ethics within psychology that can inform students, educators, clinical researchers, and practitioners." —Nadine J. Kaslow, professor, Department of Psychiatry and Behavioral Science, Emory University School of Medicine "This stunningly good book . . . should be on every therapist's desk for quick reference." —David Barlow, professor of psychology and psychiatry, Boston University. (shrink)