Book Review: The Therapy of Desire: Theory and Practice in Hellenistic Ethics

This is a very significant book for psychotherapists. It is essential reading for existential psychotherapists. It provides the long awaited scholarly overview of the origins of western psychotherapy as it was first conceived in its hellenistic antecedents.

Here, in one book, is the complete account of the initial psychotherapeutic function of philosophy, showing us how much our cultural progress has jeopardized and lost track of over the centuries. Applied philosophy was always meant to have the very practical function that psychotherapy and counselling are attempting to hold in the twentieth century. As Nussbaum puts it herself: 'Aristotle and others knew that where the body had a need for medicine, the soul also had a need for an art that would heal diseases of thought, judgment and desire' (pg. 40).

Philosophy was meant to have a practical application in the form of an art of moral education and good living. Those who are familiar with Socrates' teachings and Plato's philosophy will already be well aware of this. This book concentrates on what became of philosophy during the subsequent centuries, both in Greece and Rome. It highlights the contributions of Aristotle and his followers, Epicurus and the epicurians, the skeptics and the stoics. It does so by distilling the elements of therapeutic value in each of these philosophies and by critically considering their implications.

I found this book fascinating reading, well worth detailed attention and study and I spent many happy hours taking notes from it during my summer holiday. It broadened my mind in terms of the potential of the field of psychotherapy and stimulated my rethinking of existential principles. Hellenistic philosophy was quite blunt about its objectives, which were definitely to achieve eudaimonia, the good, or flourishing life. The definition of what such a life consists of and how it is achieved varies from one philosophical school to another. The author contrasts these views effectively and constantly asks pertinent questions about the ultimate benefit and cost of each of the value systems described. This is precisely the sort of questioning that is lacking from the discipline of psychotherapy, where different methods and approaches are often taught and employed without any examination of the values and principles that they entail and generate. It was ample confirmation for me that philosophy has an important role to play in the field of the allied health professions. At the same time the book demonstrates that philosophy itself needs to be revolutionized by recentering it around issues of applied ethics, bringing it back into the flow of life where it belongs.

The book in addition asks many political questions, for instance by contrasting the Aristotelian emphasis on the good life as something that can only be taught to the privileged intellectual, although it should be attainable by the many, in contrast with the epicurian ideals, which are a much less sophisticated product that can be more easily absorbed by the crowd, but that has the drawback of being dogmatic as a consequence. Equally in many of the hellenistic philosophies, but particularly in the Aristotelian, the condition of an individual's pursuit of the flourishing life, is that it should benefit the community at large rather than only the individual.

I found the guidelines for Aristotelian practice particularly compatible with existential psychotherapy . Note for example the prescription that the philosophy teacher's (psychotherapist's) discourse with the pupil (client) should be a cooperative, critical one that insists on the virtues of orderliness, deliberateness and clarity. Teacher and pupil are both active and independent, though the teacher is able to offer experienced guidance. The ethical inquiry that they engage in together is seen as a 'winnowing and sifting of people's opinions' (pg76). Pupils are taught to separate true beliefs from false beliefs and to modify and transform their passions accordingly. The idea that emotion can be educated, rather than ignored, or merely expressed or suppressed, is a very appealing one, in my view. Aristotle's descriptions of the various emotions and what can be done with them reminded me much of Spinoza, who always has been my guiding light on this matter. At the same time Aristotle's critique of Socrates' teaching that virtue is all and can overcome anything is powerful. It is a much more realistic acknowledgement of the realities of everyday life and the recognition that practical wisdom consists not of being sufficient into oneself, but to be connected to the world and experience all the emotions it evokes.

I had therefore more difficulty with the epicurians who seek to treat human suffering by removing corrupting desires and by eliminating pain and disturbance in the process. The way in which epicurian pupils are taught to adjust their values in order to retain only those that are attainable and may bring them pleasure is very much like a classic version of rational emotive therapy. I simply do not believe that it is possible to promise anyone a life free of stress and nor do I think it desirable. Even so the epicurians knew a thing or two and I picked up some useful hints along the way. The teaching of detachment is similar to that in some forms of buddhism, though for the epicurians detachment happens in relation to externals, rather than in relation to self. What turned me decisively against the epicurian solution is the dogmatic nature of its teaching. When dialectical investigation and critical thinking are replaced with formulae and communal lyre enforcing the creed an important human element of progress is lost. However Epicurus also understood something that neither Plato nor Aristotle had fully grasped, i.e., that false beliefs are often settled deep in the soul and that they may not be available for argument.

Nussbaum credits Epicurus with the discovery of the unconscious and shows how he learnt to use the technique of narrative to contact suppressed and hidden motivations and beliefs. She makes this clear by drawing on Lucretius' work with dreams and emotions and I found many of his insights of deep personal benefit. Witness for instance his statement that 'to attend to the everyday and to make it an object of delight of voluptas, intentional and mutual, is to make a good marriage possible' (pg. 185). The aim of Lucretian therapy? It is 'to make the reader equal to the gods and at the same time, to make him heed nature's voice.' In order to do this we are taught how to deal with love, death and anger, but most other topics also get discussed in the process.

The epicurian view is that pleasure is the only good and we are taught to adjust our needs so as to guarantee the procurement of pleasure from small natural resources. However according to the skeptics this in itself creates anxieties and the only way to stop pain and suffering is to simply not believe in or desire anything. So whilst epicurians try to get rid of false beliefs, the skeptics want to get rid of all belief. To my mind this is pushing things rather too far, but I could not help recognizing the strategy that many people today adopt in order to not get hurt and therefore there was much to learn from the descriptions of the sceptical view of the world. Nussbaum herself notes that skepticism is a knack that anyone can learn and which sets out to protect one against intensity. 'But an intense attachment to the absence of intensity is a funny sort of desire, a desire born of troubles' (pg.311), she comments incisively.

Whilst epicurians and skeptics, unlike Plato and Aristotle, reject reason as a way out of difficulties, the stoics accept it, but use it in a rather forceful and controlling manner. I believe that there are again important points of contact with existential therapy here and much can be learnt from stoicism both in terms of what might be helpful and what might be abusive. Who could disagree with the statement that 'the job of living actively in accordance with one's own reason, rather than passively, in the grip of habits and conventions, requires vigilance and probing' (pg. 328). On the other hand is our culture ready for the kind of ordering of the self and soul that stoics propose to bring about? But then again I would tend to agree with the view that 'daily life is not so much evil as flaccid and lazy. We get truth by toning up the muscles of the mind' (pg. 335). I also like the notion that stoic therapy can begin anywhere, because everything is connected, but that different temperaments need different approaches and that there is a critical moment (kairos) for intervention, a view shared by the epicurians. The stoics make a point of finding ways of penetrating deep into the soul and use story telling to do so.

The educational aspect of this therapy as of all the other hellenistic therapies is very strong, but this particular one also emphasizes the aspect of self-scrutiny, which includes an understanding of one's relationships. For the stoics the pupil's goal is to become his own teacher and pupil and again this fits neatly with the existential model as I conceive of it. I also like the idea that the soul must be exercised everyday, for instance by the use of logic and poetry. The objective is wisdom, which is the only ultimate value and virtue and leads to eudaimonia, the flourishing life. What I find much harder to swallow is the contention that such wisdom is primarily achieved through detachment and self-control. What I violently object to is that this requires us to extirpate our passions, although I agree that passions of which we lose control are counterproductive and that it is vital to be able to be in charge of our own emotions. I believe the trick is to expand one's capacity for passion at the same time as one's ability to control it, rather than to either get rid of passion (as do the skeptics, or minimize it as do the epicurians) or increase control over it (as do the stoics).

As you can see the book set me thinking actively about my own beliefs and their application to psychotherapy. The diversity of the philosophies discussed brings out so many new angles to every aspect of human living that the overall effect is extremely inspirational. My only regret was that Nussbaum is obviously not aware of modern forms of psychotherapy beyond a basic understanding of psychoanalysis. Sometimes her discussion remained rather arid and abstract because of this and exhibited the very weakness that she herself deplores in academic philosophy: that of being too far removed from the real world. This may be the case, but nevertheless I would rather read her scholarly work about what is on offer from centuries of human culture and tradition, than immerse myself in many of the more practical, but undisciplined and uncritical statements made by most psychotherapist authors. Nussbaum's work deserves to be taken up by those who do the kind of applied philosophy that she refers to, namely modern psychotherapy. The possibility of a cooperative venture between psychotherapy and philosophy has come another step closer with this publication. I shall be sure to recommend her text when I teach existential psychotherapy.

Emmy van Deurzen-Smith