Interview with Jonathan Foiles

Belt talks to Jonathan Foiles, author of Reading Arendt in the Waiting Room

Why did you decide to write this book? 

A few different strands converged. The first one started with the COVID-19 pandemic, which began about six months after I left my job in the psychiatry department of a hospital (something I wrote about in This City is Killing Me) to move into private practice. It was a good, but challenging, time of personal transition for me, and once I transitioned into fully virtual work it struck me how much of what was going on in my patients’ lives mirrored my own experiences in the moment. Therapists aren’t exempt from struggle by any means, of course, and at any given point in history I’ve had a patient or two going through something I can relate to personally, but suddenly everyone I saw had the same background hum of anxiety, even if the way it took root in their lives differed. That made me think more deeply about some of the other major issues threatening our way of life—climate change, rising fascism, late capitalism, and so forth—and how many of the tools in the standard therapist tool bag don’t really apply. I don’t think it’s helpful to marinate in anxiety about the future of our country, for instance, but I don’t think such anxiety is misplaced nor can one logic one’s way out of it. Through those reflections I thought more about my own history with anxiety and what I had often turned to, namely philosophy, to cope and wondered if there was something there that could be useful to people. Also, I am very thankful that we have reached a place culturally where we can have much more honest conversations about mental health, but I find the “Five Steps for Lessening Your Anxiety” listicles that have proliferated in recent years to be pretty limited in what they can offer people. They don’t take the nature of what’s making us so anxious very seriously. My hope was to offer more than what I usually see for people dealing with anxiety and fears about the future.

What is the “apocalyptic anxiety” you write about and how does it differ from, say, a DSM-5 definition of anxiety? Can you explain how conventional therapeutic tools don't work or even work against feelings of apocalyptic anxiety? 

I consider apocalyptic anxiety to be about what seems to threaten our very existence or future as a species: climate change, fascism, the Supreme Court, and the like. When it comes to talking about anxiety the DSM talks more about the symptoms it yields (difficulty concentrating, muscle tension, sleep issues, panic attacks, and so forth) more so than the content of the anxiety. Most of the way that we think about treating such anxiety, though, involves some degree of what we call reality-testing. In the case of someone having a phobia of, say, spiders, you could look at the evidence to determine whether it was really worth it to be so afraid of spiders, determine that it isn’t, and work to change it by reducing your reactivity through gradual exposure to spiders, which we call exposure therapy. For more socially oriented forms of anxiety, a common treatment is to check what we call catastrophizing, or assuming the worst: even if I say something stupid on a date, is it really likely the person will immediately decide they never want to see me again? I don’t see anything wrong with these approaches and have even benefited from them in certain situations myself, yet I don’t think they rise to meet fears about, say, the future of democracy, nor should they. In most conventional approaches there is a baseline assumption that one’s feelings are real, but they do not fit the situation—everyone knows the majority of spiders are non-threatening and so forth. I think if such tools are misapplied to many of our current situations, we risk telling people that they are wrong to be paying attention, and I don’t think any serious mental health professional would want to do that. My hope through this book is to expand our idea of what anxiety could be and thus also the tools that we reach to try to help people who are suffering.

Do you use philosophy in your therapeutic practice? How do your patients respond? 

I do, but not in an obvious way. I consider it analogous to how I use psychoanalysis: I find it to be deeply helpful in making sense of people’s lives and the ways in which they suffer but I don’t find it necessary to introduce Kierkegaard or the like in order to help others. When I’m talking with someone, I rarely use jargon—I think at its core therapy is two people talking together. It is a particular kind of conversation, though, one that can touch upon the deepest parts of life. Working in a university community I see a fair number of patients who are philosophically minded. So while I don’t bring up philosophy first, if a patient is considering it, I’m happy to make it part of our conversations—although I want to make sure the focus is on how to lessen their suffering and not the finer points of ethical theory. My goal is never to make anyone feel intimidated, and part of that also has to do with tailoring my approach to the given needs of a particular client. If a client leaves my office and their primary impression is how intellectual or erudite I am, then I haven’t done my job.

Is there a philosopher or thinker you find most influential? 

Probably not when it comes to my clinical work—the British psychoanalyst Donald Winnicott dominates my approach. But speaking personally, Søren Kierkegaard was the first philosopher I encountered in any depth and remains the one I return to most often. There’s something undeniably strange, sometimes even off-putting, at the heart of his work; I don’t know if I would have admired him in the same way if we had been colleagues, for instance. But I have a deep appreciation for how seriously he takes the question of what it means to exist, and to exist ethically, in a world that often seems to not care the slightest about such questions of meaning and depth. That’s one of the reasons why his work looms so large in the book and why I continue to consider his thought decades after I first started reading him.

Can philosophy help us to be more checked-in or aware of the state of the world? 

I don’t think that’s an inherent feature of the discipline, but I think it could. I think of disciplines like philosophy or psychoanalysis to be tools for thinking, to paraphrase William James. I took my fair share of philosophy classes that felt like glorified navel-gazing or quibbling over the minutia of a logical construct. That said, I think we as humans need something that takes us outside of ourselves, that brings us into contact with the world around us and gives us both a prompt and a vocabulary to answer the questions about why we are here, what life should mean, and how we can more fully live into our values. Philosophy is uniquely suited to help us with these questions, so in that sense I think it is invaluable. I also think we need to expand our notion of what counts as philosophy; I think there are poets and writers that do more in a few pages to examine the nature of being than most philosophers could accomplish if given hundreds more pages. I tried to show that in a small way in the book by considering Jane Addams and Dorothy Day alongside more traditional philosophical figures. Regardless of what happens in a given election or Supreme Court decision, the coming years are sure to challenge us in ways we could not have anticipated. My hope is that this book helps us be more clear-eyed about those challenges and, through being better equipped to deal with the emotional heft of the future, we can deal with it more constructively and in a way that refuses to cede to the worst voices in our midst.