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A DISCUSSION OF PHILOSOPHY AND PSYCHOTHERAPY I recently listened to a lecture in which the speaker said that every psychotherapist must be a philosopher. My colleague Dr. E., the most experienced therapist I have ever known, has expressed contempt for philosophical arguments in a number of talks I have had with him. I wondered what could be the basis of this attitude, and what his overall thinking might be on the significance of philosophy to our work as clinicians. So I decided to see if I could engage him in a conversation on the matter, recognizing I was once again placing myself at risk of getting beaten up by a very difficult old man. PART 1: METAPHYSICS – THE QUESTION OF THE ULTIMATELY REAL G.A. Good morning Dr. E. Today I want to see if I can get you to talk to me on a topic you usually try to avoid: the philosophical ideas that lie behind our work as psychotherapists. Why do you shy away from this sort of discussion? Dr. E. I am violently allergic to discussions that get lost in clouds of abstraction. If you try to draw me into such a thing, you may pay a heavy price, old friend. Philosophy itself, understood as a love of thinking, there is no problem with. We all need to think about what we are doing, and what our assumptions are. It is a challenge, however, for psychotherapists to find a productive way of discussing such matters. I will not embark upon a voyage into this realm with you, G.A., unless I have as my companion the story of a specific 1
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human being in trouble. If the philosophy cannot be directly related to a clinical case, I find it to be a total waste of time. G.A. Let me begin then with a series of clinical stories, ones that I think raise questions that are about the concern of metaphysics: the nature of the ultimately real. 1. My first story concerns a 30 year-old man with whom I sat down last week, a man who had been given a diagnosis of schizophrenia. He was silent, for a number of minutes. I asked him finally: “What are you thinking about, brother?” The answer that came back was: “I don’t think. It thinks.” When I asked him what “it” was, he answered: “The machine. It is. I am not.” No matter what I said after this initial interchange, he kept repeating the statement that he did not think, was not there, and there was only a machine. What do you make of such statements? Most people would regard his words as in plain contradiction to all that is real. Dr. E. I might relate what this young man says to the way you addressed him. Your question asking him what he was thinking about might imply to him that there is a ‘he’ or a ‘you’ within him capable of being spoken to. If there is no such being, the posing of the question opens up a gulf of misunderstanding and invalidation that might well have ended your communication even before it had begun. People carrying the diagnosis of schizophrenia often do not experience themselves as existing. As a result the customary ways of being addressed in our society cast them into a nowhere zone: unseen, unacknowledged. They 2
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This note was uploaded on 03/19/2010 for the course PSYCHLOGY 830 taught by Professor Jacobs during the Spring '09 term at Rutgers.

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