Psychotherapy

Brief description of Freud's life and work, emphasising the role of fictive belief and experience (phantasy) in his account of mental disorder.

In ‘Psychotherapy, Placebos and Informed Consent’, I argued that the minimal standard for informed consent in psychotherapy requires that ‘patients understand that there is currently no consensus about the mechanisms of change in psychotherapy, and that the therapy on offer…is based on disputed theoretical foundations’, and that the dissemination of this information is compatible with the delivery of many theory-specific forms of psychotherapy (including cognitive behavioural therapy [CBT]). I also argued that the minimal requirements for informed consent do not include (...) information about the role of therapeutic common factors in healing (e.g., expectancy effects and therapist effects); practitioners may discuss the common factors with patients, but they are not part of the ‘core set’ of information necessary to obtain informed consent. In a recent reply, Charlotte Blease criticises these two arguments by claiming they are not supported by empirical findings about the therapeutic common factors. Blease’s response is based on serious misunderstandings of both CBT and what the common factor findings actually find. Nevertheless, addressing the reasons for these misunderstandings is instructive and gives us an opportunity to clarify what, exactly, needs to be explained to patients in order to obtain informed consent for psychotherapy. (shrink)

In this article I aim to make progress towards the philosophical goal of ascertaining what, if anything, all mental illnesses have in common, attempting to unify a large sub-set of them that have a relational or interpersonal dimension. One major claim is that, if we want a promising theory of mental illness, we must go beyond the dominant western accounts of mental illness/health, which focus on traits intrinsic to a person such as pain/pleasure, lethargy/liveliness, fragmentation/integration, and falsehood/authenticity. A second major (...) claim is that the relational facets of mental illness are plausibly understood theoretically in terms of a person’s inability to identify with others or to exhibit solidarity with them, relational values that are salient in the African philosophical tradition. I show that these two extrinsic properties well explain several intuitive instances of mental illness, including, amongst several others, being abusive, psychopathic, narcissistic, histrionic, paranoid, and phobic. (shrink)

En este artículo abordamos los conceptos de «salud» y «enfermedad» tal y como han sido entendidos en el seno de la Logoterapia del psiquiatravienés Viktor Frankl, uno de los métodos psicoterapéuticos más importantes del siglo XX. Esta psicoterapia existencial otorga preeminencia a la dimensión noética o espiritual de la salud, que ha sido, sin embargo, totalmente obviada en el debate naturalismo/normativismo propio de la filosofía de la medicina. Por ello, en este escrito tratamos de mostrar de qué modo las aportaciones (...) teóricas de Viktor Frankl pueden contribuir a la discusión filosófica acerca del estatuto ontológico de la enfermedad, especialmente en el ámbito polémico dela psiquiatría. (shrink)

Psychotherapy is effective. Since the 1970’s, meta-analyses, and meta-analyses of meta-analyses, have consistently shown a significant effect size for psychotherapeutic interventions when compared to no treatment or placebo treatments. This effectiveness is normally taken as a sign of the scientific legitimization of clinical psychotherapy. A significant problem, however, is that most psychotherapies appear to be equally effective. This poses a problem for specific psychotherapies: they may work, but likely not for the reasons that ground their theoretical explanations for their effectiveness. (...) A prominent explanation for the findings of common efficacy in psychotherapy is to postulate that all successful therapies work by altering maladaptive meanings and providing patients with new, more adaptive meanings. This paper argues that the ‘meaning view’ of psychological change is likely mistaken; psychological problems are not normally problems of meaning nor are they directly ameliorated by changes in meaning. This paper then outlines a skill-based explanation for the findings of the common efficacy of psychotherapy. (shrink)

The article describes a comparative analysis of research on the approaches and peculiarities of the implementation of supervision and intervision in the professional activity of teachers abroad and in Ukraine. The concept of supervision and intervision in the work of teachers in the secondary school is revealed. The use of supervision and interference in the professional activity of teachers makes it possible to effectively prevent their emotional and professional burnout. It is noted that in Ukraine, for the first time, a (...) program of psychosocial support, which includes regular supervision for teachers and school psychologists, was developed and implemented by specialists of the National University of Kyiv-Mohyla Academy with the support of UNICEF in the eastern regions of the country where the military conflict has been taking place. However, among the teachers around the country, this practice is not used because there is no system for the preparation of supervisors; most teachers are not familiar with this concept at all. Intervision in schools abroad is quite developed, it is carried out systematically, it is aimed at creating a special and safe space for professional support, exchange of experience, and information, and it prevents emotional and professional degradation. In Ukrainian schools, the intervision between colleagues is partial. Therefore, this form of work needs support and development from the school administration. Examples of the plan of work during intervision among the teachers on the basis of foreign experience are given and recommendations on conducting intervision in pedagogical collectives are offered. (shrink)

Cognitive Behavioral Therapy has become the dominant form of psychotherapy in North America. The CBT model is theoretically based on the idea that all external and internal stimuli are filtered through meaning-making, consciously accessible cognitive schemas. The goal of CBT is to identify dysfunctional or maladaptive thoughts and beliefs, and replace them with more adaptive cognitive interpretations. While CBT is clearly effective as a treatment, there is good reason to be skeptical that its efficacy is due to the causal mechanisms (...) posited by the CBT model. This paper will argue that the specific cognitive schemas posited by the CBT model likely do not play a direct role in the development or treatment of psychological illness. Cognitive schemas, as identified in CBT interventions, are likely to be the result of patient confabulation and epistemically under-supported practitioner-based identification. CBT interventions appear to impose coherence on patients’ psychological states, rather than identifying and modifying preexistent causally efficacious core beliefs. (shrink)

Philosophy and psychoanalysis should address the problem of sorrow qua melancholia and even, in a popular manner, Major Depressive Disorder. I have tried to take both philosophy as a therapeutic tool, as well as use DSM criteria to help the lonely.

This is a study in Buddhist psychoanalysis, especially the care of the care-giver.

Therapists and related theorists and practitioners of mental health tend to hold one of two broad views about how to help patients. On the one hand, some maintain that, or at least act as though, the basic point of therapy is to help patients become clear about what they want deep down and to enable them to achieve it by overcoming mental blockages. On the other hand, there are those who contend that the aim of therapy should instead be to (...) psychologically enable patients to live objectively desirable lives, say, ones that involve developing their inherent talents or exhibiting an authentic/strong/integrated self. In this chapter, I argue that neither of these prominent approaches is complete. Contra the former, sometimes what patients want deep down is not something to promote, and, against the latter, it can sometimes be reasonable for patients to want to sacrifice their own objective interests and for therapists to assist them in this regard. I argue that the category of meaningfulness does well at accounting for these counterexamples to the two dominant approaches, while capturing the kernels of truth in them. The proper aim of therapy, I suggest, is to enable patients to live meaningfully. (shrink)

Lilly was one of the greatest scientists and pioneers on the limits of human possibility but after his death a collective amnesia has descended and he is now almost forgotten. His Wiki is good but inevitably incomplete so here are a few missing details and viewpoints. Lilly was a generation (or more) ahead of his time. He is almost single-handedly responsible for the great interest in dolphins (which led to the Marine Mammal Protection Act in the USA and helped to (...) found the animal rights movement). In 1958 he noted that the brains of elephants and cetaceans were larger than ours, that we should not abuse them and that it was one our most important projects to communicate with them. He invented sensory isolation tanks (at NIMH in 1954) and used them extensively with and without powerful psychoactive drugs at a time when it was thought that either the brain would shut down or one would go insane if external stimuli were eliminated. He created methods for implanting electrodes in mammal brains and was planning to do it to himself. He was one of the first to make serious use of computers in bioscience research and created the hardware and software to make the first attempts to communicate with dolphins. He self experimented with dangerous physiological investigations in high altitude medicine for the military during WW2, took LSD with dolphins and movie stars, submitted himself to the rigors of various forms of yoga and of Arica training, and taught classes at Esalen. He was a computer pioneer who forsaw the rapid advances in A.I. and it's inevitable clash with humans. He was the first one to investigate the bizarre psychedelic ketamine (" vitamin K "), and his results (published in the two last chapters of his book `The Scientist`) are still the best data on the dose/effect relation of any psychedelic on one person. It cured his lifelong daily migraine headaches (see http://www.conspiracyarchive.com/UFOs/Gorightly.htm). And all this happened before most of us were born! He had courage, honesty and integrity that is rare anywhere and almost nonexistent in science. His goal was to find the ultimate truth about everything and he went about as far as anyone ever has. He had little patience with the stupid and hypocritical games one has to play to fit into monkey society. Of course the reaction of the establishment was predictable. He left the NIMH and was never given any government or academic support for the last 35 years of his life. His paper and comments at a conference on sensory deprivation were removed from the published version. He was not invited to government sponsored symposia on dolphins (he had refused to help develop them as weapons), though he clearly knew more about them than anyone in the world. He liked to live and work on the edge and few could keep up with him, as his books make clear. If you have read some of his other books it will be much easier going. He was a pioneer in consciousness research and pushed the boundaries of our understanding of who we are and what we might become. Among other things he catalogs the various states reached by drugs, meditation, and isolation, tries to determine their significance, and suggests how to use them. I very briefly review and comment on his life and work. -/- Those interested in all my writings in their most recent versions may download from this site my e-book ‘Philosophy, Human Nature and the Collapse of Civilization Michael Starks (2016)- Articles and Reviews 2006-2016’ by Michael Starks First Ed. 662p (2016). -/- All of my papers and books have now been published in revised versions both in ebooks and in printed books. -/- Talking Monkeys: Philosophy, Psychology, Science, Religion and Politics on a Doomed Planet - Articles and Reviews 2006-2017 (2017) https://www.amazon.com/dp/B071HVC7YP. -/- The Logical Structure of Philosophy, Psychology, Mind and Language in Ludwig Wittgenstein and John Searle--Articles and Reviews 2006-2016 (2017) https://www.amazon.com/dp/B071P1RP1B. -/- Suicidal Utopian Delusions in the 21st century: Philosophy, Human Nature and the Collapse of Civilization - Articles and Reviews 2006-2017 (2017) https://www.amazon.com/dp/B0711R5LGX -/- . (shrink)

The science of psychology is believed to consist of objective and meaningful knowledge about a realm of our own direct experiencing with which we are all intimate and familiar, yet about which we also feel we have very little understanding, and no real insight, and so feel inclined to submit to psychology as if it were revelatory and definitive. Society’s default attitude to psychology is one of deferential, if occasionally grudging, respect. The quasi-medical arm of psychology – psychotherapy - is (...) accorded a similar authority even when it appears to employ questionable methods and dubious reasoning. Yet our submissive, compliant attitude to these disciplines is deeply counterproductive to any serious quest for authentic metaphysical knowledge and self-fulfilment, because it effectively neutralises sceptical enquiry and intellectual self-reliance, both of which are essential precursors to, and indispensable features of, any meaningful commitment to metaphysical gnosis. And if one is to achieve clarity of thought and observational accuracy, it is especially important to approach one’s psychological capacities directly – without intermediary - in an independent and self-reliant spirit, free of the misguided and inappropriate interventions of psychology and psychotherapy, however well intended they might be. One should never allow one’s judgement to be distorted by specious theories formulated by people who can never know more about you than you can know about yourself. (shrink)

Psychological approaches to treating mental illness or improving psychological wellbeing are invariably based on the explicit or implicit understanding that there is an intrinsically existing ‘self’ or ‘I’ entity. In other words, regardless of whether a cognitive-behavioural, psychodynamic, or humanistic psychotherapy treatment model is employed, these approaches are ultimately concerned with changing how the ‘I’ relates to its thoughts, feelings, and beliefs, and/or to its physical, social, and spiritual environment. Although each of these psychotherapeutic modalities have been shown to have (...) utility for improving psychological health, there are inevitably limitations to their effectiveness and there will always be those individuals for whom they are incompatible. Given such limitations, research continuously attempts to identify and empirically validate more effective, acceptable and/or diverse treatment approaches. One such approach gaining momentum is the use of techniques that derive from Buddhist contemplative practice. Although mindfulness is arguably the most popular and empirically researched example, there is also growing interest into the psychotherapeutic applications of Buddhism’s ‘non-self’ ontological standpoint (in which ontology is basically the philosophical study of the nature or essence of being, existence, or reality). (shrink)

Though the psychoanalytic method of interpretation is seen by psychoanalysts as a reliable scientific tool for investigating the unconscious mind, its reputation has long been marred by what’s known as the consensus problem: where different analysts fail to reach agreement when they interpret the same phenomena. This has long been thought, by both practitioners and observers of psychoanalysis, to undermine its claim to scientific status. The causes of this problem, however, are dimly understood. In this paper I attempt to illuminate (...) one important cause of the consensus problem by investigating the role which reliance on ‘associative evidence’ has in generating consensus failures. Various options for overcoming the difficulties with this form of clinical evidence are then examined. It is argued that these problems can be mitigated by the notion of overall associative fit, though they are exacerbated by certain loose standards used for what counts as acceptable associative evidence. The possibility of using more rigorous standards is discussed. (shrink)

The prevalence of workaholism in Western populations is approximately 10%,although estimates vary considerably according to how “workaholism” is defined.There is growing consensus that workaholism is a bona fide behavioral addiction that exists at the extreme end of the work-engagement continuum and causes similar negative consequences to other behavioral addictions such as salience, conflict, tolerance, withdrawal symptoms,and mood modification. Other more specific consequences include burnout, work compulsion,work–family conflict, impaired productivity, asociality,and psychological/somatic illness.

The paper discusses the manner and extent to which Epicurean ethics can serve as a general philosophy of life, capable of supporting philosophical practice in the form of philosophical counseling. Unlike the modern age academic philosophy, the philosophical practice movement portrays the philosopher as a personal or corporate adviser, one who helps people make sense of their experiences and find optimum solutions within the context of their values and general preferences. Philosophical counseling may rest on almost any school of philosophy, (...) ranging — in the Western tradition from Platonism to the philosophy of language or logic. While any specialist school of philosophy may serve valuable purposes by elucidating specific aspects of one’s experiences and directing future action, the more ‘generalist’ the philosophy used as the basis for counseling is, the broader and more far-reaching its potential impact on the person undergoing counseling. Epicurean ethics is a prime example of a philosophy of life that is suitable for philosophical counseling today. Its closer examination reveals that, contrary to superficial opinion, it is not opposed to Stoicism and may in fact incorporate Stoicism and its antecedent virtues (including many Christian virtues) in a simple yet comprehensive practical system of directions for modern counseling. (shrink)

Philosophers and psychologists have advanced a plethora of explanations of the self in relation to narratives, positing varying degrees of connection between them. For some, narratives created by a subject about herself shape her self-constitution (Flanagan 1991; Fivush 1994). For others, they help the subject to participate in social cognition (Hutto 2008). Some represent narratives as merely one basis of personal identity and consider them cognitive tools used by the subject to construct self-concepts (Neisser 1997; Tekin 2011); others render narratives (...) the basis for self-constitution (Dennett 1992; MacIntyre 1981; Schechtman 1996). Some require that the subject create her ‘whole life narrative’ unifying her .. (shrink)

Abstract This article proposes and outlines an integrally informed 12 Step-based therapy that is adapted for treating addicted populations. Integrated Recovery Therapy (IRT) as a therapeutic orientation is an Integral Methodological Pluralism to therapy for treating addiction. Its two main features are paradigmatic and meta-paradigmatic. The paradigmatic aspect refers to the recognition, compilation and implementation of various methodologies in a comprehensive and inclusive manner. The meta-paradigmatic aspect refers to IRT’s capacity to weave together, relate and integrate the various paradigmatic practices. (...) IRT is a meta-therapy derived from the Integrated Recovery Model, which is a comprehensive, balanced, multi-phased and multi-disciplinary clinical model designed for in-patient addiction treatment. As with the Integrated Recovery Model, IRT’s philosophy is derived from an integration of the 12-step abstinence-based philosophy, mindfulness, positive psychology, and Integral theory. It is suggested here that the application of IRT as a meta-therapy provides a truly comprehensive and integrated therapeutic orientation for therapists who treat addicted populations. -/- Keywords: Integrated Recovery Therapy, Integrated Recovery model; 12 Steps; mindfulness; Integral theory; positive psycholog. (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)

Starting with the reference to “Plato’s dictum” that Freud added in the second last page of the first edition of The Interpretation of Dreams, the author explains the convergences between the conception of dreams expounded by Plato in the Republic and Freud’s fundamental insights. The analysis of bibliographic sources used by Freud, and of his interests, allow than to suppose not only that Freud omitted to acknowledge the Plato’s theoretical genealogy of “the Via Regia to the unconscious”, but also the (...) possibility that the Republic constituted a tacit source of inspiration for the composition of The Interpretations of dreams. -/- Muovendo dal richiamo al «detto di Platone» inserito nella penultima pagina della prima edizione de "L’interpretazione dei sogni" di Freud (1899), vengono preliminarmente esposte le convergenze tra la concezione del sogno di Platone esposta ne "La Repubblica" e le intuizioni poste alla base dell’edificio freudiano. Alla luce delle fonti testuali citate e utilizzate da Freud, e dei suoi interessi, viene poi avanzata l’ipotesi che egli non soltanto abbia omesso di riconoscere la genealogia teoretica platonica della «via regia che porta alla conoscenza dell’inconscio» (p. 282), ma che l’antico dialogo abbia potuto rappresentare una fonte tacita di ispirazione per la composizione de "L’interpretazione dei sogni". (shrink)

Reply to Ronald de Sousa and Douglas W. Heinrichs.

Empirical assessments of Cognitive Behavioral Theory and theoretical considerations raise questions about the fundamental theoretical tenet that psychological disturbances are mediated by consciously accessible cognitive structures. This paper considers this situation in light of emotion theory in philosophy. We argue that the “perceptual theory” of emotions, which underlines the parallels between emotions and sensory perceptions, suggests a conception of cognitive mediation that can accommodate the observed empirical anomalies and one that is consistent with the dual-processing models dominant in cognitive psychology.

The constructivist perspective has shed new light on the conception of psychopathology and the practice of psychotherapy, surmounting the shortcomings of behaviorism and rationalist cognitive thought, by abandoning the empiricist principle of associationism. In this field, Vittorio Guidano introduced the Cognitive Post -Rationalist model, influenced by attachment theory, evolutionary epistemology, complex systems theory, and the prevalence of abstract mental processes proposed by Hayeck. Guidano conceives the personal system as a self-organized entity, in constant development. The role of the post - (...) rationalist therapist is to strategically upset the system in search of newer and more flexible ways to construct personal experience. (shrink)

Con il termine psicoterapia è d'uso riferirsi al trattamento del "disagio" mentale attraverso mezzi psichici, ma l'ovvietà "tautologica" della definizione tende a svanire se si affronta un esame più approfondito dei termini "psiche", "mezzi psichici" e "disagio mentale". Una definizione non può in linea generale che assumere un significato ed un valore limitato nel tempo e nello spazio, ma il sostanziale polimorfismo teorico, metodologico, tecnico e linguistico che contraddistingue la psicoterapia ne rende ancora più ardua una chiara ed univoca definizione. (...) Vi è un sostanziale accordo, che però lascia inalterati i problemi sottostanti, su definizioni che sono sulla stessa linea di quelle ad esempio di Wolberg o di Frank. Wolberg(1) parla di: «trattamento, con mezzi psicologici, di problemi di natura psichica, in cui una persona appositamente qualificata stabilisce deliberatamente una relazione professionale con il paziente con lo scopo di rimuovere, di modificare e di attenuare i sintomi esistenti, di mediare modi di comportamento disturbato e di promuovere la crescita e lo sviluppo positivo della personalità». (shrink)

In this essay, I attempt to outline a feminist philosophical approach to the current debate concerning (allegedly) false memories of childhood sexual abuse. Bringing the voices of feminist philosophers to bear on this issue highlights the implicit and sometimes questionable epistemological, metaphysical, and ethical-political commitments of some therapists and scientists involved in these debates. It also illuminates some current debates in and about feminist philosophy.