Philosophical Problem?

[The2abraxis]

So I was having a conversation with a friend, and the question popped up, what do you do if a client asks philosophical questions in therapy? This could include the meaning of life, the search for god, why are we here, etc...

What have you guys learned to do in these kinds of situations??

I can see where it can "waste time" and get off track in the session. They are already short enough :-D

But it also could be very insightful and just what the person/needs look for.

What to do?

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[nononora]

Firstly, keep your personal views to yourself as much as possible.

The first thing that popped into my head in response to "What is the meaning of life" was "Do you feel as if life is meaningless for you now?" If that goes nowhere, you could perhaps work on helping the patient accept the ambiguity that is life

 

[Therapist4Chnge]

I'd inquire why such questions are coming up.

 

[hereandnow]

Refer also to: "Existential Psychotherapy" by Yalom.

Or Frankl's logotherapy: http://en.wikipedia.org/wiki/Logotherapy

"People say that what we're all seeking is a meaning for life. I think that what we're seeking is an experience of being alive, so that our life experiences on the purely physical plane will have resonances within our own innermost being and reality, so that we actually feel the rapture of being alive.".....Joseph Campbell

 

[GiantSteps]

What should you do if these philosophical questions are asked? I am surprised at all of you! Are we really that far behind psychiatry? They have no research skills and push pills but at least they have taken the necessary precautions. Under such circumstances, you have no choice but to follow Dr. Gag Halfrunt's lead. I only hope it is not too late. Just to be safe I would also remove any mention of the number 42 from your office.

 

[PsyDr]

in psychodynamic theory, you are not supposed to gratify such needs.

you are supposed to explore them though.

 

[The2abraxis]

What should you do if these philosophical questions are asked? I am surprised at all of you! Are we really that far behind psychiatry? They have no research skills and push pills but at least they have taken the necessary precautions. Under such circumstances, you have no choice but to follow Dr. Gag Halfrunt's lead. I only hope it is not too late. Just to be safe I would also remove any mention of the number 42 from your office.

You seem pretty opposed to this questio being asked, but why?

Is it worth it to delve into a conversation that takes up session time and may bleed into the next session? Is this really in the clients best interests? Will it really help them, or will continuing with the exposure session or whatever help them more?

Also, it seems like a lot of philosophical questions lie in faith and opinion, and not so much reason. Why would we want to spread our opinions and faith onto a client, isn't this what we are told not to do? When do therapists all of the sudden have the say in what is truth and not truth??

I know my first reaction was, "how can we not! it is what the client wants to talk about!". But then again it might not be the best thing. Like posted before, a good answer was don't put your personal opinion in (which is hard to do with certain questions) and even question why they think that way.

edit- of course it would matter what type of therapy one is doing. If someone is doing existential, then of course this will be talked about. If someone is doing a strictly behavioral intervention, then it may not be the best idea. I am asking mostly about CBT :-D

 

[GiantSteps]

What should you do if these philosophical questions are asked? I am surprised at all of you! Are we really that far behind psychiatry? They have no research skills and push pills but at least they have taken the necessary precautions. Under such circumstances, you have no choice but to follow Dr. Gag Halfrunt's lead. I only hope it is not too late. Just to be safe I would also remove any mention of the number 42 from your office.

You seem pretty opposed to this questio being asked, but why?

http://en.wikipedia.org/wiki/List_of_minor_characters_from_The_Hitchhiker's_Guide_to_the_Galaxy

http://en.wikipedia.org/wiki/Notable_phrases_from_The_Hitchhiker's_Guide_to_the_Galaxy

 

[The2abraxis]

This depends on the patient, their intellectual level, their current emotional state (e.g., telling a suicidal patient that there are reasons to live is a philosophical statement. .. and I think I'd likely say that), the cause of their problem, how they cope with whatever it is they are dealing with, and the context of the therapy.

Let's say someone is depressed and they're vocalizing it as an existential crisis. I'd probably explore their thought process in detail to help them resolve the crisis in whatever manner works for them, while, of course, working in an appropriate theoretical framework. I might bring up various philosophies as counters or discussion points. I likely wouldn't say, "I believe. . ." But I've certainly, for example, encouraged reliance on a church, if that's one of the patient's social support networks, and I think it would be beneficial. I'm an atheist, don't particularly like religion (opiate of the masses and all that. . . my one nod, among many jeers, to Karl Marx), but I'd still use it if I thought it might work. There's certainly plenty of empirical evidence out there about the effects of religious coping skills. One important tool for a therapist is to be able to communicate with patient's from their framework. But, it's a delicate dance.

So lets say you are working on something in particular (working on a hierarchy or something) and in the middle they mention an existential crisis (ex: what is the point, life has no meaning). Would you stop working on the hierarchy and focus on the existential part, or perhaps acknowledge it and try to work back on task? I am really wondering if it is advisable to stop what you are doing to address the crisis or continue on. This would be a case-by-case thing of course (isn't everything? ), but in most situations, what is the "right" course of action?

 

[psychmama]

Sorry, but I don't think there's a "right" answer. As Jon Snow said, it depends on so many variables. Because I'm more psychodynamic, I generally would be interested in asking about these types of philosphical questions, because I believe there's something important behind the philsophizing that the patient is trying to tell me. On the other hand, have had patients who use intellectualizing, including philosophical debate, as a way of defending against other issues that are more at the root of their problems. In such cases, I usually call them out (gently, and often using humor) and redirect them to what I think is really going on for them.

So -- it depends....

 

[The2abraxis]

Sorry, but I don't think there's a "right" answer. As Jon Snow said, it depends on so many variables. Because I'm more psychodynamic, I generally would be interested in asking about these types of philosphical questions, because I believe there's something important behind the philsophizing that the patient is trying to tell me. On the other hand, have had patients who use intellectualizing, including philosophical debate, as a way of defending against other issues that are more at the root of their problems. In such cases, I usually call them out (gently, and often using humor) and redirect them to what I think is really going on for them.

So -- it depends....

Haha ya, I guess there is no either-or here

 

[psychmama]

Yes, no right answer in absolute terms. In thinking about your question, I realize that I'd be less likely to discuss philosophical issues in a CBT manualized-type treatment. For instance, I've run a DBT group where clients sometimes digress quite a bit. Because my job there is to work on skills-training, I try to stick to the matter at hand and not get lost in tangents. We'd never get anywhere if I allowed us to get that far afield. I usually say something like "That's a very interesting topic and perhaps we can explore that more later...but for now, let's get back to [fill in whatever I was covering with them]. These situations can be tough -- I don't want to put the person off or make them feel ashamed for asking. Doing this gracefully is an art!

 

[sunlioness]

What to do?

"Go inside and ask yourself that question and see what comes up."

Though that works better for "Why do I do that?" type questions than philosophical ones.

 

[The2abraxis]

Yes, no right answer in absolute terms. In thinking about your question, I realize that I'd be less likely to discuss philosophical issues in a CBT manualized-type treatment. For instance, I've run a DBT group where clients sometimes digress quite a bit. Because my job there is to work on skills-training, I try to stick to the matter at hand and not get lost in tangents. We'd never get anywhere if I allowed us to get that far afield. I usually say something like "That's a very interesting topic and perhaps we can explore that more later...but for now, let's get back to [fill in whatever I was covering with them]. These situations can be tough -- I don't want to put the person off or make them feel ashamed for asking. Doing this gracefully is an art!

haha ya I can imagine that being tough!

 

[Cosmo75]

What should you do if these philosophical questions are asked? I am surprised at all of you! Are we really that far behind psychiatry? They have no research skills and push pills but at least they have taken the necessary precautions. Under such circumstances, you have no choice but to follow Dr. Gag Halfrunt's lead. I only hope it is not too late. Just to be safe I would also remove any mention of the number 42 from your office.

You beat me to the #42 reference

 

[Johnson42]

What should you do if these philosophical questions are asked? I am surprised at all of you! Are we really that far behind psychiatry? They have no research skills and push pills but at least they have taken the necessary precautions. Under such circumstances, you have no choice but to follow Dr. Gag Halfrunt's lead. I only hope it is not too late. Just to be safe I would also remove any mention of the number 42 from your office.

See my screen name.