Louis Marinoff isn't a psychologist. But people come to his office, tell him their troubles and pay him $100 an hour.
The folks Marinoff sees aren't patients. He calls them clients. And they're not sick, just ethically challenged.
"I am not in the business of diagnosing people," Marinoff says. "This is not a science; it's an art form."
"This" is therapy as conducted by a philosopher, the academics' answer to shrinks.
The prescription is Plato versus Prozac.
Marinoff, a philosophy professor at City College of New York, is one of the country's first philosophical practitioners. These philosopher-counselors use their knowledge of ideas, not medical science, to help them guide people with problems.
Over seven years he has seen dozens of clients, counseling them through divorces, deaths in the family and professional struggles.
Recently, he began teaching a course on the subject at Felician College in New Jersey. And he's won the support of a New York legislator who is sponsoring a bill that would license philosophical practitioners.
Marinoff has no training in psychology and counseling and says he doesn't need it. Philosophers, he says, are uniquely qualified to deal with troubles of the mind.
"If you go to the psychiatrist, he's going to find something wrong with you. If he doesn't find something wrong with you, he's out of business," Marinoff said.
What his clients can expect is something very different, he says.
"I'm helping them through dialogue to lead a more examined life."
Outraged by Marinoff's foray onto their turf, psychiatrists said his inexperience could cause him to misdiagnose suicidal or schizophrenic people and lead to malpractice lawsuits.
"This guy is practicing medicine without a license and is approaching a major ethical violation," said Herbert Sacks, president of the American Psychiatric Assn. "I would no sooner go to him than I would go to a chiropodist if my heart was skipping a beat."
A patient with severe mental illness that requires medication "would stand no chance of recovery" if the patient sought out a philosophical counselor, said Valerie Rheinstein, a spokeswoman for the National Alliance for the Mentally Ill in Arlington, Va.
Marinoff said he would be able to spot people with serious disorders, because "I've read the DSM-IV [medical diagnostic manual], like anyone else" and would refer them to doctors.
For most people, however, Marinoff says modern psychiatry has failed by focusing on curing illness and not on universal questions of value, meaning and ethics.
Psychiatrists are "very paternalistic," said Keith Burkum, chairman of Felician College's philosophy department and a counselor-in-training. "You go into an office. There's this person sitting there that supposedly has this special kind of knowledge about the human condition."
Philosophical counselors should appeal to people who would never see psychiatrists, Burkum said, because "they'll grasp that this is something more open and non-condescending. It's more adult."
Psychiatrists say they're not hired to be friends giving advice, a role they see philosophical counselors playing, or to talk ethics.
People who go to therapy, New York City psychiatrist Josef H. Weissberg said, "are usually in distress, and the distress does not have much to do with the meaning of life."
"Our business is to diagnose and treat illness," said Weissberg, a Columbia University psychiatry professor and former president of the American Academy of Psychoanalysis.
And while Burkum says psychiatrists are condescending, Weissberg said philosophical counselors seem much more judgmental.
"Maybe a philosopher is uniquely qualified to give advice, but that's not what we're doing," he said. "We try to understand rather than advise."
After several years on the fringe, Marinoff is hoping to give his movement more legitimacy.
Marinoff is executive director of the 130-member American Society for Philosophy, Counseling and Psychotherapy, which was founded in 1992 as an academic group. He has just founded a second group--the American Philosophical Practitioners Assn., which he hopes will become more of a trade organization. The group has a handful of members.
Marinoff sees fewer than 10 people on a weekly basis, in his Manhattan offices or at his Jersey City home. He regularly charges $75 for an initial visit, $100 for subsequent sessions, but a research grant covers the costs for his New York clients.
Earlier this year, New York Assemblyman Ruben Diaz introduced a bill that would license and regulate philosophical practitioners.
Philosophers don't know what to think of Marinoff's new movement.
"Some of our members feel that this is an exciting development, and others feel it is horrible," said Eric Hoffman, a University of Delaware professor who heads the American Philosophical Assn.
He said philosophers should have some training or experience in counseling before starting a business.
Sacks said Marinoff can't treat illnesses he doesn't have the training to recognize. "He is exposing a patient and, indirectly, himself to serious mistreatment," Sacks said.
Marinoff went to psychiatrists as a child--his parents made him go because he was misbehaving in school. They didn't help him, he says.
"What are they trained to talk about? What your mother said when you were 3 years old. How does that help you or me?" he said.
He began counseling on the side in Vancouver while working as an ethicist at the University of British Columbia. He noticed that ordinary people frequently came into the university's Centre for Applied Ethics for advice on personal problems.
"People were just walking into the center and saying, 'I want to see a philosopher,' " he said.
There was John, a graduate student who didn't know whether to bring his ailing mother home to live with him for the summer or leave her in a hospital. In a published case study, Marinoff focused on the notion of moral responsibility in decision-making, concluding that John should make a decision in his mother's best interests, not his own.
Marinoff doesn't send clients to libraries to look up the great philosophers, though he refers to them if he thinks a person's current struggles relate to an ancient one.
For a woman whose mother criticized her for not being more religious, Marinoff cited Socrates' theory that every person had to find his or her own values through self-examination.
Knowing that the world's greatest thinkers faced problems too can be encouraging to his clients, Marinoff said.
"That would make them feel good about having minds, instead of [feeling] sick."