Moral Dilemmas and Existential Issues Encountered Both in Psychotherapy and Philosophical Counseling Practices.

Beatrice A Popescu

doi:10.5964/ejop.v11i3.1010

Abstract

This paper stems from clinical observations and empirical data collected in the therapy room over six years. It investigates the relationship between psychotherapy and philosophical counseling, proposing an integrative model of counseling. During cognitive behavior therapy sessions with clients who turn to therapy in order to solve their clinical issues, the author noticed that behind most of the invalidating symptoms classified by the DSM-5 as depression, anxiety, hypochondriac and phobic complaints, usually lies a lack of existential meaning or existential scope and clients are also tormented by moral dilemmas. Following the anamnestic interview and the psychological evaluation, rarely the depression or anxiety diagnosed on Axis I is purely just a sum of invalidating symptoms, which may disappear if treated symptomatically. When applying the Sentence Completion Test, an 80 items test of psychodynamic origin and high-face validity, most of the clients report an entire plethora of conscious or unconscious motivations, distorted cognitions or irrational thinking but also grave existential themes such as scope or meaning of life, professional identity, fear of death, solitude and loneliness, freedom of choice and liberty. Same issues are approached in the philosophical counseling practice, but no systematic research has been done yet in the field. Future research and investigation is needed in order to assess the importance of moral dilemmas and existential issues in both practices.

Highlights

The main topics of this paper refer to the moral dilemmas and existential issues encountered both in psychotherapy and philosophical counseling
The paper aims to theorize some of the main ethical dilemmas encountered both in psychotherapy and philosophical counseling practices, especially the dilemmas raised by the clients or
I am trained in Cognitive Behavior Psychotherapy and Rational Emotive Behavior Therapy, two of the few forms of evidence-based psychotherapies and two of the therapies that use techniques similar to those used in philosophical counseling, I regard the PC approach as a promising avenue for improving psychotherapy

Summary

Introduction

The main topics of this paper refer to the moral dilemmas and existential issues encountered both in psychotherapy and philosophical counseling. The problem of selection could get even more complicated when a person comes to a philosophical consultation in order to ask for life advice or for help to solve a moral dilemma If this person has emotional disturbances or has previously been diagnosed with depression, anxiety or panic attacks, the philosophical counselor should refer this client either to a psychotherapist or to a psychiatrist. I would argue in this paper that there may be a lot of clients for whom none of the theories or techniques of psychotherapy work on their particular type of problems (moral or ethical dilemmas) and here is where philosophical counseling or training in ethics may help. In the initial interview or discussion, the client is usually asked first: 1. What is the reason of approaching a particular professional (a psychiatrist, a psychotherapist or a philosophical counselor)?

What are the objectives he or she would like to achieve in the sessions?

Conclusions