Psychiatric ethics as professional and biomedical ethics -- The distinctiveness of the psychiatric setting -- Psychiatric ethics as virtue ethics -- Elements of a gender-sensitive ethics for psychiatry -- Some virtues for psychiatrists -- Character and social role -- Case studies in psychiatric virtues.

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.

Socrates famously compares himself to a midwife in Plato'sTheaetetus. Much less well known is the developed metaphor of pregnancy at the centre of the initiation ritual that begins Brahmanical education. In this ritual, calledUpanayana, the teacher is presented as becoming pregnant with the student. TheArthavavedastates:The teacher leads the student towards himself, makes him an embryo within; he bears him in his belly three nights.

This paper argues that the medical conception of health as absence of disease is a value-free theoretical notion. Its main elements are biological function and statistical normality, in contrast to various other ideas prominent in the literature on health. Apart from universal environmental injuries, diseases are internal states that depress a functional ability below species-typical levels. Health as freedom from disease is then statistical normality of function, i.e., the ability to perform all typical physiological functions with at least typical efficiency. (...) This conception of health is as value-free as statements of biological function. The view that health is essentially value-laden, held by most writers on the topic, seems to have one of two sources: an assumption that health judgments must be practical judgments about the treatment of patients, or a commitment to "positive" health beyond the absence of disease. I suggest that the assumption is mistaken, the commitment possibly misdescribed. (shrink)

The standard approach to ethics in psychotherapy is to focus on the therapist. Although normative “boundary” ethics revolves around what the therapist ought, or ought not, to do, virtue ethics can revolve around the kind of person the therapist ought to be. One can thus apply virtue ethical theory to clinical practice and argue for therapist virtues that are relevant to meeting professional standards and to working effectively through the problems that arise in psychotherapy. Considerably less attention has been paid (...) to how virtue ethics relates to the patient. The ethics of psychotherapy can also revolve around the sort of person the patient should be. I argue that there are nascent virtues which the patient can bring to psychotherapy that, when cultivated with the therapist, can facilitate a beneficial outcome and virtues that can be seen as psychotherapeutic goals toward which the patient ought to strive. (shrink)

This article examines Nietzsche's engagement with Stoic philosophical therapy in the free spirit trilogy. I suggest that Nietzsche first turned to Stoicism in the late 1870s in his attempt to develop a philosophical therapy that might treat the injuries human beings suffer through fate or chance without recourse to the metaphysical theodicies discredited by Enlightenment skepticism and positivism. I argue that in HH and D Nietzsche adopts a conventional form of Stoic therapy. The article then shows how Nietzsche came to (...) take a critical stance against Stoic therapy on the grounds that it entails a radical extirpation of the value judgments that underpin the emotions. For this reason, I claim that in GS he attempts to develop a rival philosophical therapy, one that aims to enable human beings to unconditionally affirm fate but without this affirmation entailing, as it does for the Stoics, the dissolution of all emotional valuations. However, despite Nietzsche's belief that he had fundamentally broken with Stoicism, I argue, first, that Nietzsche's therapy in GS is deeply indebted to a "cosmic" model of Stoicism, which consists in the loving consent to the events that happen to us, and second, that he gives us no reasonable account of how it is possible to unconditionally affirm fate without adopting some form of Stoic indifference or apatheia. (shrink)

Richard Sorabji presents a ground-breaking study of ancient Greek views of the emotions and their influence on subsequent theories and attitudes, Pagan and Christian. While the central focus of the book is the Stoics, Sorabji draws on a vast range of texts to give a rich historical survey of how Western thinking about this central aspect of human nature developed.

For much of its history, philosophy was not merely a theoretical discipline but a way of life, an "art of living." This practical aspect of philosophy has been much less dominant in modernity than it was in ancient Greece and Rome, when philosophers of all stripes kept returning to Socrates as a model for living. The idea of philosophy as an art of living has survived in the works of such major modern authors as Montaigne, Nietzsche, and Foucault. Each of (...) these writers has used philosophical discussion as a means of establishing what a person is and how a worthwhile life is to be lived. In this wide-ranging, brilliantly written account, Alexander Nehamas provides an incisive reevaluation of Socrates' place in the Western philosophical tradition and shows the importance of Socrates for Montaigne, Nietzsche, and Foucault. Why does each of these philosophers—each fundamentally concerned with his own originality—return to Socrates as a model? The answer lies in the irony that characterizes the Socrates we know from the Platonic dialogues. Socratic irony creates a mask that prevents a view of what lies behind. How Socrates led the life he did, what enabled or inspired him, is never made evident. No tenets are proposed. Socrates remains a silent and ambiguous character, forcing readers to come to their own conclusions about the art of life. This, Nehamas shows, is what allowed Montaigne, Nietzsche, and Foucault to return to Socrates as a model without thereby compelling them to imitate him. This highly readable, erudite study argues for the importance of the tradition within Western philosophy that is best described as "the art of living" and casts Montaigne, Nietzsche, and Foucault as the three major modern representatives of this tradition. Full of original ideas and challenging associations, this work will offer new ways of thinking about the philosophers Nehamas discusses and about the discipline of philosophy itself. (shrink)

This article examines Nietzsche's engagement with Stoic philosophical therapy in the free spirit trilogy. I suggest that Nietzsche first turned to Stoicism in the late 1870s in his attempt to develop a philosophical therapy that might treat the injuries human beings suffer through fate or chance without recourse to the metaphysical theodicies discredited by Enlightenment skepticism and positivism. I argue that in HH and D Nietzsche adopts a conventional form of Stoic therapy. The article then shows how Nietzsche came to (...) take a critical stance against Stoic therapy on the grounds that it entails a radical extirpation of the value judgments that underpin the emotions. For this reason, I claim that in GS he attempts to develop a rival philosophical therapy, one that aims to enable human beings to unconditionally affirm fate but without this affirmation entailing, as it does for the Stoics, the dissolution of all emotional valuations. However, despite Nietzsche's belief that he had fundamentally broken with Stoicism, I argue, first, that Nietzsche's therapy in GS is deeply indebted to a “cosmic” model of Stoicism, which consists in the loving consent to the events that happen to us, and second, that he gives us no reasonable account of how it is possible to unconditionally affirm fate without adopting some form of Stoic indifference or apatheia. (shrink)

In this paper, we explore the desires that play a role at the palliative stage and relate them to various approaches to patient autonomy. What attitude can physicians and other caregivers take to the desires of patients at the palliative stage? We examine this question by introducing five physicians who are consulted by Jackie, an imaginary patient with metastatic lung carcinoma. By combining the models of the physician-patient relationship developed by Emanuel and Emanuel (1992) and the Hellenistic approaches to desires (...) analyzed by Nussbaum (1994), five different ways of dealing with desires in the context of palliative care are sketched. The story of Jackie shows that desires are to a certain extent responsive to reasoning. In the palliative process, that can be a reason to devote attention to the desires of patients and caregivers and to determine which desires need to be fulfilled, which are less important, and how they are linked to emotions the patient has. (shrink)

Medical analogies are commonly invoked in both Indian Buddhist dharma and Hellenistic philosophy. In the Pāli Canon, nirvana (or, in Pāli,nibbāna) is depicted as a form of health, and the Buddha is portrayed as a doctor who helps us attain it. Much later in the tradition, Śāntideva described the Buddha’s teaching as ‘the sole medicine for the ailments of the world, the mine of all success and happiness.’ Cicero expressed the view of many Hellenistic philosophers when he said that philosophy (...) is ‘a medical science for the mind.’ He thought we should ‘hand ourselves over to philosophy, and let ourselves be healed.’ ‘For as long as these ills [of the mind] remain,’ he wrote, ‘we cannot attain to happiness.’ There are many different forms of medical analogy in these two traditions, but the most general form may be stated as follows: just as medicine cures bodily diseases and brings about physical health, so Buddhist dharma or Hellenistic philosophy cures mental diseases and brings about psychological health—where psychological health is understood as the highest form of happiness or well-being. Insofar as Buddhist dharma involves philosophy, as it does, both renditions of the analogy may be said to declare that philosophy cures mental diseases and brings about psychological health. This feature of the analogy—philosophy as analogous to medical treatment—has attracted considerable attention. (shrink)

Of the many interrelated themes in Pierre Hadot's Philosophy as a Way of Life: Spiritual Exercises from Socrates to Foucault, two strike me as having a particular centrality. First, there is the theme of attention to the present instant. Hadot describes this as the ‘key to spiritual exercises’, and he finds the idea encapsulated in a quotation from Goethe's Second Faust: ‘Only the present is our happiness’. The second theme is that of viewing the world from above: ‘philosophy signified the (...) attempt to raise up mankind from individuality and particularity to universality and objectivity’. Insofar as both attention to the present and raising oneself to an objective view imply the mastery of individual anxiety, passion and desire, they belong to a single conception, that conception being one of a ‘return to the self’: Thus, all spiritual exercises are, fundamentally, a return to the self, in which the self is liberated from the state of alienation into which it has been plunged by worries, passions, and desires. The ‘self’ liberated in this way is no longer merely our egoistic, passionate individuality: it is our moral person, open to universality and objectivity, and participating in universal nature or thought. (shrink)

Abstract: The notion that philosophy can be practised as a kind of therapy has become a focus of debate. This article explores how philosophy can be practised literally as a kind of therapy, in two very different ways: as philosophical therapy that addresses “real-life problems” (e.g., Sextus Empiricus) and as therapeutic philosophy that meets a need for therapy which arises in and from philosophical reflection (e.g., Wittgenstein). With the help of concepts adapted from cognitive and clinical psychology, and from cognitive (...) linguistics, the article shows that both philosophical projects address important and literally therapeutic tasks and explains how they can do so with genuinely philosophical argument and analysis. This brings into view new applications for philosophy, a need for therapy in core areas of the subject, and the outline of a new approach to meet what will be shown to be a central need. (shrink)

The paper develops and addresses a major challenge for therapeutic conceptions of philosophy of the sort increasingly attributed to Wittgenstein. To be substantive and relevant, such conceptions have to identify “diseases of the understanding” from which philosophers suffer, and to explain why these “diseases” need to be cured in order to resolve or overcome important philosophical problems. The paper addresses this challenge in three steps: With the help of findings and concepts from cognitive linguistics and cognitive psychology, it redevelops the (...) Wittgensteinian notion of “philosophical pictures.” Through a case study on seminal versions of familiar mind-body problems, it examines how such pictures shape philosophical reflection and generate ill-motivated but captivating problems. Third, it shows that philosophical pictures are constitutive of “diseases of the understanding,” in a quite strict sense of the term. On this basis, the paper explains when and why philosophical therapy is required. (shrink)

Characterizations of philosophy abound. It is ‘the queen of the sciences’, a grand and sweeping metaphysical endeavour; or, less regally, it is a sort of deep anthropology or ‘descriptive metaphysics’, uncovering the general presuppositions or conceptual schemes that lurk beneath our words and thoughts. A different set of images portray philosophy as a type of therapy, or as a spiritual exercise, a way of life to be followed, or even as a special branch of poetry or politics. Then there is (...) a group of characterizations that include philosophy as linguistic analysis, as phenomenological description, as conceptual geography, or as genealogy in the sense proposed by Nietzsche and later taken up by Foucault. (shrink)

Pierre Hadot, whose inaugural lecture to the chair of the History of Hellenistic and Roman Through at the Collège de France we are publishing here, is one of the most significant and wide-ranging historians of ancient philosophy writing today. His work, hardly known in the English-reading world except among specialists, exhibits that rare combination of prodigious historical scholarship and rigorous philosophical argumentation that upsets any preconceived distinction between the history of philosophy and philosophy proper. In addition to being the translator (...) and author of monographs on Plotinus, Vitorinus, Porphyry, and many others, Hadot’s most important general philosophical work is entitled Exercises spirituels et philosophie antique.1 Combined with detailed studies of Socrates and Marcus Aurelius, this work presents a history of spiritual exercises from Socrates to early Christianity, an account of their decline in modern philosophy, and a discussion of the different conceptions of philosophy that have companied the trajectory and fate of the theory and practice of spiritual exercises. Hadot’s “Forms of Life and Forms of Discourse in Ancient Philosophy” provides an overview of his major themes and preoccupations, and gives some indication of the historical scope of his work. This lecture also illuminates the methodological problems one faces in studying the history of thought, especially problems concerning the evolution, reinterpretation, and even misunderstanding of the meaning and significance of philosophical terminology. In this brief introduction, I can do no more than attempt to provide a context for Hadot’s inaugural lecture, by way of summary of his major work, and, more specifically for reader’s of Critical Inquiry, to sketch the profound importance that Hadot’s writings had for the last works of Michel Foucault. Arnold I. Davidson, executive editor of Critical Inquiry, is associate professor of philosophy and a member of the Committees on the Conceptual Foundations of Science and General Studies in the Humanities at the University of Chicago. He introduced and edited the “Symposium on Heidegger and Nazism” . He is currently working on the history of horror as it relates to the epistemology of norms and deviations. (shrink)

The ancient Stoics notoriously argued, with thoroughness and force, that all ordinary “emotions” (passions, mental affections: in Greek, pãyh) are thoroughly bad states of mind, not to be indulged in by anyone, under any circumstances: anger, resentment, gloating; pity, sympathy, grief; delight, glee, pleasure; impassioned love (i.e. ¶rvw), agitated desires of any kind, fear; disappointment, regret, all sorts of sorrow; hatred, contempt, schadenfreude. Early on in the history of Stoicism, however, apparently in order to avoid the objection that human nature (...) itself demands and indeed justifies—under certain circumstances at any rate—emotional attachments to or aversions from, and reactions to, some persons, things, and happenings, they introduced a theory of what came to be called eÈpãyeiai, good and acceptable ways of feeling or being affected. For short I will render these in English by “good feelings.”1 They divided these into three generic kinds, which they dubbed “joy” (xarã), “wish” (boÊlhsiw) and “caution” (eÈlãbeia). They ranged these alongside, and set them in sharp contrast to, three of the four highest genera into which they divided the normal human emotions: “pleasure” (≤donÆ), i.e., being pleased about something,2 “appetitive desire” (§piyuµ€a), and “fear” (fÒbow), respectively. The Stoics maintained that, though ordinary, familiar human emotions such as these last-named ones were always bad, the three sorts of “good feeling,” and their more specific variations (since these three are only the basic genera into which lots of other good ways of feeling will fall), were not merely free from the grounds of criticism on which ordinary emotions were rejected, and so were perfectly acceptable. The fully perfected human being (the “wise person”) would indeed regularly be subject to them.3 Their theory of the perfect human life did not, then, they could claim, require any outrageously unnatural demand, presumably unrealizable in any case, for a life completely without all feelings of involvement in the sweep and flow of life.. (shrink)

Papers about philosophy, as distinct from papers within it, are like homeopathic medicines – thin in content. We can only hope to provide some substance if we confine ourselves to some particular aspect. The aspect I have chosen to discuss is this. What hope should we have of finding from within this rather curious and academic subject of ours a help in the affairs of life? Could we expect a doctor of philosophy to give practical advice, rather like a medical (...) doctor? (shrink)

'Empty are the words of that philosopher who offers therapy for no human suffering. For just as there is no use in medical expertise if it does not give therapy for bodily diseases, so too there is no use in philosophy if it does not expel the suffering of the soul.' The philosopher Epicurus gave famous voice to a conception of philosophy as a cure or remedy for the maladies of the human soul. What has not until now received attention (...) is just how prominent an idea this has been across a whole spectrum of philosophical tradition. Philosophy as Therapeia presents a collection of papers by leading scholars, providing a new reading of the history of philosophy, one which perhaps contradicts those who have wanted to maintain that philosophy is a peculiarly European cultural product, and instead affirms its identity as a global intellectual practice. (shrink)

This volume is a wonderful introduction to Foucault and a testimony to the deep humanity of the man himself.

The Hermeneutics of the Subject is the third volume in the collection of Michel Foucault's lectures at the College de France, one of the world's most prestigious institutions. Faculty at the college give public lectures, in which they can present works-in-progress on any subject of their choosing. Foucault's were more speculative and free-ranging than the arguments of such groundbreaking works as The History of Sexuality or Madness and Civilization . In the lectures comprising this volume, Foucault focuses upon the ways (...) the "self" and consequently "self-study" have been conceived since the days of antiquity, starting with Socrates. Definitions and conceptions of "self-study" in Greek and Roman literature, Foucault argues, remain in force today, and underlie modern interpretations of the self. Engaging, engrossing, and provocative, The Hermeneutics of the Subject reveals Foucault at the height of his powers. (shrink)

In recent years, virtue theories have enjoyed a renaissance of interest among general and medical ethicists. This book offers a virtue-based ethic for medicine, the health professions, and health care. Beginning with a historical account of the concept of virtue, the authors construct a theory of the place of the virtues in medical practice. Their theory is grounded in the nature and ends of medicine as a special kind of human activity. The concepts of virtue, the virtues, and the virtuous (...) physician are examined along with the place of the virtues of trust, compassion, prudence, justice, courage, temperance, and effacement of self-interest in medicine. The authors discuss the relationship between and among principles, rules, virtues, and the philosophy of medicine. They also address the difference virtue-based ethics makes in confronting such practical problems as care of the poor, research with human subjects, and the conduct of the healing relationship. This book woith the author's previous volumes, A Philosophical Basis of Medical Practice and For the Patient's Good, are part of their continuing project of developing a coherent moral philosophy of medicine. (shrink)

Argues that Wittgenstein's early ethical notion of agreement with the world pivoted to become his later therapeutic notion of agreement with living forms, which satisfies the conditions necessary for a full therapeutic philosophy.

Shaping the Future maps out the ascetic practices of a Neitzschean way of life. Hutter argues that Nietzsche's doctrines are attempts and "temptations" that aim to provoke his free-spirited readers into changing themselves by putting philosophy into practice in their lives.

Nietzsche's Therapy explores the ethics of self-cultivation that Nietzsche forged in his middle works.

This book presents a history of spiritual exercises from Socrates to early Christianity, an account of their decline in modern philosophy, and a discussion of ...

Pt. I. Philosophy and cognitive-behavioral therapy (CBT) -- Ch. 1. The "philosophical origins" of CBT -- Ch. 2. The beginning of modern cognitive therapy -- Ch. 3. A brief history of philosophical therapy -- Ch. 4. Stoic philosophy and psychology -- Ch. 5. Rational emotion in stoicism and CBT -- Ch. 6 Stoicism and Ellis's rational therapy (REBT) -- Pt. II. The stoic armamentarium -- Ch. 7. Contemplation of the ideal stage -- Ch. 8. Stoic mindfulness of the "here and (...) now" -- Ch. 9. Self-analysis and disputation -- Ch. 10. Autosuggestion, premeditation, and retrospection -- Ch. 11. Preditatio malorum and mental rehearsal -- Ch. 12. Stoic fatalism, determination, and acceptance -- Ch. 13. The view from above and stoic metaphysics. (shrink)

_Philosophical Delusion and its Therapy_ provides new foundations and methods for the revolutionary project of philosophical therapy pioneered by Ludwig Wittgenstein. The book vindicates this currently much-discussed project by reconstructing the genesis of important philosophical problems: With the help of concepts adapted from cognitive linguistics and cognitive psychology, the book analyses how philosophical reflection is shaped by pictures and metaphors we are not aware of employing and are prone to misapply. Through innovative case-studies on the genesis of classical problems about (...) the mind and perception, and on thinkers including Locke, Berkeley and Ayer, the book demonstrates how such autonomous habits of thought systematically generate unsound intuitions and philosophical delusions, whose clash with reality, or among each other, gives rise to ill-motivated but maddening problems. The book re-examines models of therapeutic philosophy, due to Wittgenstein and J. L. Austin, and develops an approach that may let us overcome philosophical delusions and the problems they engender. In this way, the book explains where and why therapy in called for in philosophy, and develops techniques to carry it out. (shrink)

Most of these papers were delivered at institute seminars.

Questioning the premise that philosophy can only be conceived as a rational discourse, Sellars presents it instead as an art (techne) that combines both 'logos' ...

A magisterial mappa mundi of the terrain that Pierre Hadot has so productively worked for decades, this ambitious work revises our view of ancient philosophy- ...

First Published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.