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Richard Karel's piece in the April 17 issue on "philosopher practitioners" (philosophers who claim to practice a form of psychotherapy) brought back memories of Thomas Mann's novel, The Magic Mountain. There we meet the humanist scholar, Settembrini, who embodies the enlightened classicism of the Renaissance.
"There is one power, one principle, which commands my deepest assent. . . ," Settembrini says, and this "is the intellect." When spring comes to the Alpine sanitarium, Settembrim is ecstatic: "All the disquieting, provocative elements of spring in the valley were here lacking: here were no seething depths, no steaming air, no oppressive humidity! Only dryness, clarity, a serene and piercing charm."
Reading the words of the "philosopher practitioner" Dr. Lou Marinoff, one feels that he and Settembrini are kindred spirits. In a recent article in the New York Times, Professor Marinoff holds forth hope to troubled souls, who would "explore and address their dilemma through the long history of thought, rather than through Prozac, for example."
Let us leave aside Professor Marinoff's admission that "the history of thought" might not suffice for those with "severe personality disorders"-or, presumably, psychotic disorders or suicidal depressions. Let us leave aside the matter of how philosopher practitioners will be trained to recognize when their "clients" are too sick to benefit from Sartre or Nietzsche. Let us defer the critical issue of unrecognized medical and neurological illness in many patients with so-called existential problems. Let us even put aside the huge medicolegal question of whether unvalidated "treatment" by philosophers may delay lifesaving care by mental health professionals.
We must still return to Settembrini, with his love for dryness and clarity and his distaste for seething depths and steaming air. It is in precisely such a tropical clime that the psychotherapist must often work. The sexually abused individual who experiences traumatic flashbacks, the narcissistic character who bristles with anger at the world's indifference, the substance abuser who explodes after a single drink: these individuals do not live in Settembrini's (or Marinoff's) sunlit world of philosophical humanism. Many are struggling in that darker land of the shattered self, and there-with courage, care, and passion-must be joined by the therapist. This is no place for well-intentioned scholars, armed with the serenity of the Western philosophical canon. Sometimes the text must come close to the flame before its words take wing.
Ronald Pies, M.D.
Lexington, Mass.