If people can talk their way out of mental illness, what does that mean for our definition of it? Is mental illness in its various forms indeed a disease, as modern psychiatric conventions say, or is it a less-than-optimal state of being created by one’s life experience and perspective?
University of the Fraser Valley philosophy professor Peter Raabe will be discussing this and related topics in Change Your Brain; Change Your Mind, next up in the University Lecture Series.
Dr. Raabe’s presentation will take place on Wednesday, Feb. 23, in Room B121 at UFV’s Abbotsford campus. Admission is free and the public is encouraged to attend.
Raabe is a well-known figure in the field of philosophical counselling, which guides counsellors and clients through a type of talk therapy that focuses on the basic tenets of philosophy. Raabe says that conventional talk therapy as practised by psychologists has its basis in philosophical tradition, but that many modern psychologists and psychiatrists are unaware of this.
“I use the analogy that they can drive the car, but they don’t know how the engine works,” Raabe notes. “They have success with talk therapy, but they don’t know why it works.”
Some of the key aspects of philosophy that philosophical counselling encompasses include existentialism and morality, Raabe explains.
“From an existential standpoint, you make the decision to run your own life,” Raabe notes. “And the essence of morality is to avoid harming others. So we can ask the questions of who is being harmed by our actions, and what can we do to address that?”
Raabe contends that the “biomedical model” of treating mental illness, which sees it as a disease and tends to treat it with medication, is flawed in the first place because it is not a complete medical model encompassing testing that identifies a distinct biological dysfunction (as can be done with physiological diseases such as heart disease or diabetes).
“A true medical model includes biological testing that identifies a disease, diagnosis, and then treatment protocol,” Raabe says. “With mental illness you get the diagnosis without testing or physical proof of disease, and then a treatment protocol. And there is very little agreement among psychotherapists as to what constitutes a diagnosis or a treatment for particular set of symptoms.”
There are diseases of the brain, such as Alzheimer’s and fetal alcohol syndrome, that can be identified through biological testing, Raabe notes. But, he says, conditions such as depression, schizophrenia, and anxiety are not biological diseases, but rather symptoms.
“Mental illness is not the cause of what is wrong with a person’s mind, it is a symptom,” he says. “For instance, with depression it’s often said that it causes sadness, lethargy, and excessive sleepiness. I would say that the word ‘depression’ is what this state of mind is. The symptoms are depression. Depression doesn’t cause the symptoms. We have to look deeper into what causes it. In the case of schizophrenia, it is said that schizophrenia causes hallucinations, but I would say that having hallucinations is called schizophrenia, and that difficult life circumstances have led you to a situation that causes you to hear voices.”
As for the tendency for mental illness to run in families, Raabe says that this is mostly learned behaviour being passed down the generations.
“The way we treat our children runs in families. But people don’t want to take responsibility for having raised a child with schizophrenia, so they are relieved when it appears to be a biomedical diagnosis. But 50 percent of schizophrenics recover spontaneously, and 25 percent recover with counselling. That is not indicative of a biological disease.”
Medication may mask symptoms, Raabe says, but they don’t address the core problems that make the symptoms appear.
“If you get away from looking at mental illness as a type of biomedical disease, then it becomes more apparent why talk therapy works,” Raabe says. “We need to ask: does my thinking change because of changes in my brain chemistry, or does my brain chemistry change because of changes in my thinking?”
And the type of talk therapy that purposefully incorporates philosophy is particularly effective, according to Raabe. “As a philosophical counsellor, I can share many perspectives from a range of different strains of philosophy. Philosophy in counselling and therapy is much more than just a casual discussion. It is a careful examination of the beliefs, values, and assumptions held by the client to determine what the reasons are for their distress. So when we understand so-called mental disorders as suffering that is experienced due to some reason, then we can see how philosophy is a legitimate approach to treatment.”
Raabe teaches a course in philosophical counselling to third-year students at UFV. Many of the students who choose to take the course are majoring in psychology, nursing, or social work, rather than straight philosophy.
“I find that students who major in philosophy are more interested in pure theory than its application, generally,” Raabe says. “But the students from other disciplines who will be counselling people as part of their career find the course very interesting.”
The students have started the world’s first student associations for philosophical counselling, Raabe says, and arrange presentations by guest speakers connected to the discipline. Raabe himself has been a visiting professor in several Asian countries.
As for his own entry into the field of philosophical counselling, it was almost accidental.
“I was asked to volunteer in a group home for recovering drug and alcohol addicts, and to use my philosophy education to teach them critical thinking skills,” he recalls. “Occasionally some of the men would want to talk about personal problems, and I would use philosophical reasoning to help them. For instance, if they faced the dilemma of giving up or keeping friends who were still into drugs, we would look at that as an ethical issue. A colleague of mine found out what I was doing and told me it was called philosophical counselling and gave me a book on it. I eventually decided to write my PhD dissertation on it, which became my first book — Philosophical Counselling: Theory and Practice.”
Dr. Raabe’s lecture is the third in the UFV University Lecture Series this academic year. Next up will be Dr. Trevor Carolan of UFV’s English department on March 23 on Ecosystems, mandalas, watersheds, and citizenship: The works of Pulitzer Prize-winning poet and environmental activist Gary Snyder.