Philosopher as Spiritual Physician? Pierre Hadot, Ancient Greek Philosophy, and Relational Psychotherapy
Can philosophy be therapeutic, again? Nietzsche famously called philosophers ‘cultural physicians,’ or at least felt they should be. And it’s no accident that he was a specialist in Ancient Greek philosophy.
But in a time dominated by philosophers as university professors, the demands of academic publishing, book markets, the rise of therapy as a separate field with many sub-branches and disputes within it, the widespread critique of religion in the West with the rise of modern science, capitalism, and industry, is it possible for philosophy to play a role in helping us live well? Is that even its role anymore?
We speak of ethics, of course. But rarely do philosophers and theorists speak of therapeutics. Even those who engage with psychoanalysis do so often as simply one more worldview, a way of looking at things, rather than as a lived practice. And for those who do live philosophy and/or psychoanlaysis, this is something rarely talked about in one’s philosophical texts.
Pierre Hadot: What is Ancient Philosophy?
Reading the texts of Pierre Hadot recently have been a revelation of sorts to me. I’m not sure why he is spoken of so infrequently by those studying ‘post-structuralist theory’ or ‘continental philosophy’ today. Certainly he wasn’t mentioned even once during my grad school training. After having read the incredible What is Ancient Philosophy? and the more specialized Plontinus: The Simplicity of Vision, and moving on to other works, I find myself amazed I haven’t heard of Hadot before.
Everyone, from any and all areas of study and life, needs to read What is Ancient Philosophy? It’s potentially life-changing. It reminds me of why I started studying philosophy in the first place. It’s written so anyone can understand it. It’s paradigm shifting.
After reading Hadot, I feel like I never studied Ancient Greco-Roman philosophy properly before. Not only is Hadot a rigorous scholar and translator of these texts, but he situates Ancient philosophy within the historical, social, discursive, and lived contexts in which it was produced. Rather than allow us to produce ‘close readings’ of texts completely out of context, Hadot describes in great detail the various ways these texts were produced and used at the time. He describes the methods in the various ancient schools, and how to study as an Epicurean was radically different than to do so as a Stoic, Academic/Platonist, Peripatetic/Aristotelian, the primary four schools of Greco-Roman Antiquity, or to live as a renegade Cynic or Skeptic.
Hadot’s texts show, above all else, how philosophy wasn’t something one merely studied in the Greco-Roman period. It was a way of life, and primarily, a therapeutics. The study of physics, for example, was often in the service of helping one to see one’s place in the world, rather than for its own sake, or to build new technology. Philosophy was a “choice of life,” and one chose to live as a Stoic or Peripatetic, for example, in order to lead a better, more satisfied life, not to write conference papers, publish books, or get a job or tenure.
And Hadot shows how, during the Middle Ages and after, philosophy shifted to commentary on texts, rather than primarily being something one did in person, verbally, in a school in a particular city, usually connected by direct descent to a founder. After Athens was burned in 79 B.C. this largely changed, but it wasn’t until the rise of what Hadot calls ‘Scholasticism’ that we see philosophy cede much of its relation to lived practice to the Church and the monasteries in the Christian world.
When philosophy was reborn in the Christian world, or had gone through the Islamic world, it had been separated off from therapeutic and spiritual concerns, which were carefully guarded by religious authorities in both traditions. And after philosophy threw off religion in early modern period, in many senses it seemed to shy away from the need to deal with these issues. Psychoanalysis emerged as a separate discipline, likely symptomatically in response to this. Marxism in it’s own way as well can be seen as a secular, social therapeutics. Kierkegaard, Nietzsche, Dostoevsky, Sartre, Levinas, these thinkers tried to deal with these issues. But these concerns still remain distant from mainstream philosophy.
Is it possible to imagine philosophy as an attempt to guide life as lived praxis again? Something like a ‘this-worldly’ theology, or a philosophical therapeutics? Because after the so-called ‘death of God’ in the west, many have simply tried to do away with questions traditionally dealt with by theology or therapy, and simply put them outside of the purview of philosophy. It’s my belief that this is a real curtailment of what philosophy can, and perhaps should, be.
This post will be a bit more personal than usual, but it will also try to continue to speak philosophically, which is to say, in a way that isn’t just about myself. As the last thing I wrote here makes clear, it’s been a rough few months. A great personal loss, and loss to my family. And other tragedies and traumas to others close to me. It all has me focused on different questions than before. Which isn’t to say that some of these questions weren’t already emerging, but now they have greater urgency.
Reading Laura Marks, opened up Islamic thought to me, and that lead me to rediscover Plotinus. And so questions related to what, for lack of a better term, might vaguely be called ‘spiritual’ concerns have been at the forefront of my research concerns, even before tragedy and trauma of myself and others came to the fore.
‘Spiritual’ is clearly the wrong term here, because it implies something new-agey, something related to religion, or some vague notion of spirits. As someone raised born-again Christian, I feel I’ve had enough of that sort of stuff. And I take Nietzsche’s critique of the ‘otherwordlism’ of Christianity seriously. I don’t think it makes sense to base one’s conduct in this world on one which no-one has ever seen. If anything, this seems, as Nietzsche argues, ‘life-hating.’
But I can’t help but think that there are very visible, ‘this worldly’ effects of what many call spirituality of various sorts. The fact that humans have searched for something like God, spirits, or ‘other worlds’ for most of their history is symptomatic of some very this-worldly needs, practices, and effects. And I don’t think philosophy should shy away from these.
Psychoanalysis and Marxism have often been referred to as secular religions of a sort, and many eastern spiritual practices don’t necessary espouse a deity, belief in an other world or immortality, or even the need for exclusive belief in that system alone, as do many western ‘religions.’ Buddhism clearly falls into this category, as does, to one extent or another, Confucianism (more of an ethical code), Taoism (more of a philosophy), though many of these have been practiced in a wide variety of ways, some of which involve worshiping, praying or sacrificing to, or otherwise treating as a deity figures like the Buddha, Confuscius, Lao-Tzu and other Taoist teachers, etc.
What all these ‘spiritual’ approaches seem to share in common with western ‘secular spiritualities’ like psychoanalysis and Marxism is a set of preoccupations. And these seem to go beyond, even if they are related to, the contemporary philosophical concerns of ethics. What are these?
Why is there suffering, pain, and death? What meaning can we make of these things? How can we decrease these and lead a more fulfilled life? What should we value in relation to these issues? How can we, as individuals or societies, change ourselves or our world to help bring these things about? What is the best way to live, based on all of this? Are there any particular practices I should engage in that can help me change myself so as to suffer less, and become a more fulfilled person?
These questions seem shared by all spiritual and therapeutic traditions. And, as Hadot argues, many of these traditions make use of aspects of what we’d today call physics, ethics, epistemology, ontology, or various other branches of knowledge, in order to help answer these questions. But their goals are different.
We can even see the split within the way psychoanalysis and Marxism operate in today’s world. Psychoanalysis is treated like a philosophy and hermeneutic in universities, but a lived practices by practicing therapists. Likewise, Marxism is treated like a doctrine and sometimes even a ‘science’ by many inside and outside the university, and yet, it is also a lived practice that many have sought to use to change the world, a structure which provides meaning to life. And while psychoanalysis and Marxism have little to say about death, they say a lot about all the other concerns, in their role as ‘secular’ theologies of sorts.
Hadot’s investigation of Ancient Greco-Roman philosophies, however, provide a model for how philosophy can once again begin to think about these issues, but in ways that aren’t simply a return to being the ‘handmaiden of theology.’ And clearly the return to “philosophy as a way of life” is Hadot’s goal. He is a former priest, after all, someone who spoke of the life-changing impact of a personal mystical experience when younger. This is someone for whom “spiritual” questions were never far from the study of philosophy.
And yet, Hadot’s work is not one of facile beliefs. It is a this-worldly therapeutics. And in this, it reminds me, in many ways, of Buddhism, as well as psychoanalysis. Of course, I’m not talking here about psychoanalytic philosophy, but rather, the way it is practiced today in therapy around the world as a living, largely oral tradition. This was the sort of psychoanalysis I trained in providing for two years, one of which I spent working as a therapist in a low-fee clinic. This is the psychoanalysis which, when mixed with my philosophical worldivews, is for me, in many ways, my lived praxis.
Relational Psychoanalysis as Clinical Practice
This sort of psychoanalysis is that practiced by my own therapist, and both her and myself would generally identify as being most influenced by the “relational” school in contemporary psychoanalytic thought. What follows is a very brief and personal account of what this might mean.
This pluralistic approach views therapists and clients as existing in a mutually multi-determined relational field, in which meaning is always constructed in a dialogue in relation to the outside world, and all the parameters of the treatment, including its goals, are, with a few exceptions (ie: fee and time, generally called ‘the frame’), up for grabs. The ethical desire to help the client grow and develop to live a fuller, more satisfying life directs the treatment, as does the general sense that the client is the teacher, and the therapist the one trying to learn what it is like to be the client, and to learn this not only intellectually, but empathically what it feels to be like for the client.
Aside from this, the various sects and divisions that divide treatment modalities and models of the mind are all potential sources to be drawn upon by the therapist. There is no sense that there is one way to look at clients, no ‘one size fits all,’ but a multiplicity of potential models, some of which may fit some clients better than others. The only way to tell if something will work is based on your own personal experience as a therapist, and the laboratory and mutual experimentation ground of the session itself. The client is co-conspirator, and the therapist isn’t necessarily ever right, for even right and wrong, true and false, are constructed together in relation to the outside world.
What matters, in all of this, however, is the agreement to try to work together to reduce the suffering of one of the two, the client. The therapist will generally have their own therapist, or have had years of such work to which they may return at any time, for themselves. The direction of the treatment is that ethical drive, the growth of satisfaction and reduction of suffering of the client, as mutual project. Anything and everything else is generally negotiable, although some ground rules like the frame, or professional ethical guidelines (ie: not to become erotically involved with clients) help this happen.
While I trained at a relatively classical psychoanalaytic institute, it was clear that training to be a therapist was largely still an oral process and practice, which is why I refer to it as training rather than as schooling. While we read theoretical texts, we were taught how to use them in relation to countless anecdotes, general guidelines, rules of thumb, stories, parables, and other oral helpers. Many of the best techniques I didn’t come from books, came from no books, or from the sort of books that only practicing therapists, rather than theorists of psychoanalysis, seem to read. For example, a great general rule of thumb “strike while the iron’s cold,” meaning that when someone is defensive isn’t likely the time they will be open to critique or rethinking something, wait until that issue isn’t upsetting them. This wasn’t something I read in a book, but simply hear from a teacher in class, and it stuck with me.
Despite my strong reservations about how conservative some of my training was, my analyst was relational, and the conflict between my relational analyst, who was my training analyst during this time, and my more conservative supervisors and teachers at the training institute, remained a tension. I saw myself as a relational therapist in training schooling at a more traditional institute, but many of the more relational institutes requires an MSW, so I remained where I was, because I didn’t have time to get an MSW while finishing my PhD as well.
Either way, I pulled from many psychoanlaytic traditions, and we were taught many different traditions, even at my more conservative training school, even if we were only directed to use a much smaller sampling. Ego-psychology, object-relations theory, self-psychology, and a few other traditions that most who study psychoanalysis as philosophy only never hear about were often taught in full semester-long classes. And I supplemented this by reading those from the interpersonal, intersubjective, relational, gestalt, and other schools of training.
And in the process of having to act as a therapist for others, while being a client for my own therapist, I developed a strong personal ethics that has remained with me, and impacted my teaching and life in many ways. Psychoanalysis, my own quirky, eclectic, relational version of it, is my ethical life-orientation. Then again, it is often difficult to explain this to others. Most who are from other schools of therapy (ie: cognitive behavioral for example) might view this as mysticism, and for those who study psychoanalysis in universities as a philosophy, my version of psychoanalysis is likely much different from the Freud and Lacan, and occasionally a few others they read, largely because it is disconnected from the largely oral tradition of the clinical room and encounter.
And yet, being a therapist and client has changed everything for me. It has taught me how to listen to people differently, think of their needs differently, to be empathic differently. As a teacher, I constantly think about the transference and counter-transference in relation to my class. When the class doesn’t go well, I immediately search myself for what I did wrong, viewing the class conduct as partially a mirror of my own issues. When friends or loved ones have traumatic experiences, I immediately switch on my ‘therapists mode,’ and pull on my training.
But there’s also a massive ethical change that comes over you when you spend an hour at a time trying as hard as you can to put the other person truly first. Even though they are paying you, and that needs to be there, you try to imagine ways in which your own issues could cloud your judgement. For that hour, you try to imagine not only what that person feels they need to grow, but what they might not even would realize would help them achieve these goals. If you are truly working as a therapist, for an hour, you put your needs on hold, and put those of the other first, and only worry about yours to the extent that they may be getting in the way, in order to defuse them. You have other places to worry about you own needs. And your time outside the therapy room changes as well. You find yourself spending time outside that hour thinking about your patients. They become crucial parts of your life.
And that hour spent putting another person first is good practice for being in love romantically, and being a parent. While in both of these situations you can think of your own needs, you often have to put them second as well. Being a therapist strengthens that muscle, as well as those which produce empathy and self-questioning.
While you learn many different theoretical models of how people deal with conflicts, unhappiness, suffering, growth, etc., all of these stay in the back of your mind as you listen to a client. There is an ethical need to stay curious, to keep reading and learning more models, or more in-depth ways to use them. And the more models the better, because at the right point, one will leap to mind, and help you understand a client better. But your empathetic gut needs to lead the process, because therapy isn’t an intellectual exercise. It’s a lived one. You listen with your empathy. The theories come up as you try to listen to yourself, and how your own emotions and thoughts react to that of the client.
And this is why your own therapy is essential to this. You need to know yourself very, very well. You need to know when it is your own issues that are making you want to react a certain way to a client, and in a way that you think might not be best for the therapy just then. You need to know what it’s like to be on the other side. To be vulnerable, dependent in some senses, not knowing what to do. Of course, this is why most good therapists go in and out of therapy for the rest of their lives, even after they finish training. The need to keep learning about themselves, even as they go through life changes.
Had I not got the job of my dreams in academia, it is likely I would still be a training and working as a therapist. While I would have switched schools to one more in line with my theoretical orientation, I had little hope in getting the sort of academic job I wanted, which is part of why I decided to take on a second course of study while in graduate school.
In hindsight, I wouldn’t trade that experience for anything in the world. It changed me deeply, and I continue to see my therapist, if much less frequently, not as much because I need to as I did when I first started, but because I want to continue to grow, recharge, and wonder. It’s like going to religious services is for many. A way to remember, recenter oneself, to perform what Hadot calls, for lack of a better term, a “spiritual exercise.”
My account of relational philosophy as lived, ethical, even political practice, complete with its exercises and rituals of sorts, is my own, and from what I can tell, each therapist ultimately forges their own path. No two therapists are alike, and you can tell this from reading what they write. This sort of writing, for therapists by other therapists, is rarely taught in universities, at least, not in non-clinical programs. We read Freud and Lacan, sometimes Jung or even Klein, in classes on philosophy or theory, but rarely the more poetic, case-oriented writings of working therapists. This literature is often published by different presses, and most working in academia in psychoanalysis often don’t know it is even there.
But therapists, and by this I mean any who work vaguely in the psychodynamic schools of various sorts, who see their primary vocation as healing rather than diagnosing or treating behaviors, who view humans more holistically, are like a secular preisthood, and are the contemporary inheritors of shamans and healers throughout the centuries. And as my recent readings in contemporary Buddhism have lead me to understand, therapists aren’t only in clinical rooms. Buddhism is yet another form of secular therapeutics.
It’s my belief that in today’s world, filled with such isolation and the various anxieties caused by the disorienting shifts in modern life, we need more therapists. Therapy has often been mystified by those who want to maintain it as an exclusive profession commanding high fees. But I believe that the profession needs to be radically democratized. Rather than the province of only medical doctors, who I think often make terrible therapists, becoming a therapist should be a more straightforward process. Today, there are a labyrinthine set of paths to this, often involving private institutes which, for various institutional reasons, are distinct from universities.
Becoming a therapist should require less money, less degrees, and more human contact. We need more therapists like we need more school teachers, and I believe strongly that therapy shouldn’t be a resource only available to the wealthy.
I believe a three year course of study, from anyone who has a B.A. in any field, is all that should be required, so long as there is at least 2 years of supervised clinical work during this period, and this is followed by about 3 years of apprenticeship in a clinic of some sort under supervision. Many programs have precisely this today, but require an MA or even MSW, if not M.D. or Ph.D. or Psy.D., to start the program. I feel this is unnecessary. My sense is that the skills being taught here are as much a trade as any other, if an ethical and intellectual trade, and that training in other things, like medicine or social work policy, shouldn’t be needed to go into this training.
For those interested in reading more on any of this, here’s some books I can strongly recommend. The best general introduction to therapy as lived practice is, without question, Irvin Yalom’s amazing The Gift of Therapy: An Open Letter to a New Generation of Therapists and their Patients. Yalom’s book has no difficult terms or obscure theory, it’s all about lived practice, and it’s powerful. For those curious about links between Buddhism and clinical therapy, see Mark Epstein’s Thoughts Without a Thinker: Psychotherapy from a Buddhist Perspective, and Jeremy Safran’s excellent collection Psychoanalysis and Buddhism: An Unfolding Dialogue. Both are clinically oriented, and relatively easy reading. For those looking for more on relational psychotherapy, see any of the great introductions by Stephen Mitchell, Paul Wachtel, Lewis Aron, Patricia DeYoung, etc.