‘Existential thought’ may be said to have grown out of a sense of ‘individual isolation and alienation’ in a world that seemed ‘hostile’. The individual within society is aware of the ‘social rules’ within which s/he is expected to function, and presents a sense of self that appears to adhere to these rules to greater or lesser extent. However, determining to what extent any of us are actually, alone/alienated remains, difficult. Although you may accept that it is possible to feel isolated, and alienated, and for others to appear to be isolated and alienated, none of us actually exist in a social vacuum. Our whole being is dependent on being-in-the-world, and by the experiencing of others. Therefore, whilst each individual may find it difficult being in a world that appears to be hostile: s/he is nothing without the anxiety, and the sense of guilt, that may be experienced when s/he chooses to behave in ways that appear to challenge/conflict with societal expectations.
Existential
philosopher, Kierkegaard (1954) construed the world from ‘a place of splendid
isolation’. Due to personal experiences of social constraints that bound his
very existence he attempted to re-claim his subjectivity by purposefully
engaging existential anxiety. He referred to the tension induced as one denies
self that, which is desired. The tension that arises as that which is desired
is denied is also inherent when he refers to the social constraints imposed by
the very nature of the society in which we live. Out of his personal suffering
he devised a schema to represent stages of life. It began with
immediacy/vegetative, through an aesthetic/hedonistic stage, to ethical/ moral
stage, to thinking/cogniscent stage, and culminated in existential doubt/angst.
At the final stage, the individual is required to make a choice. S/he may
either continue experiencing the angst inherent in simply being; or take a
‘leap or faith’ into the unknown; or transcend this experience. None of this is
possible unless the individual is prepared to accept the existence of their
inadequacies; that which gives angst; and confesses to
problems/issues/concerns.
The
idea of being able to carry ‘burdens’; to identify and accept the pre-existence
of difficulty; is visible in Nietzsche’s work. Again the idea of realising
one’s full potential, and having the courage to be is operationalised within
the concept of developmental stages. He refers to the ‘Camel stage’ where the
individual is required to carry, unquestioningly, the burdens of life - to
endure; the ‘Lion Stage’ where one is required to develop the courage to assert
oneself in the world; and the ‘Child Stage’ where one develops the ability to
be optimistic and to enjoy life in spite of experienced difficulties.
Nietzsche’s ideas seem to have grown out of the awareness of the ‘chaos’ that
existed in Germany towards the end of the 19th century, and of the effect
religiosity had had on people, overtime. He argued that people followed
blindly, like a herd of animals, unquestioning, and reluctant to challenge the
current hegemony - the herd instinct’. In renouncing the very existence of God,
he effectively renounced the dogma that goes with adhering to any faith. In
doing so he separated himself from that which was perceived to bind him; that which
curbed self-expression; and, created for himself a place of ‘nothingness’. It
was out of this ‘nothingness’ that he sought to create for himself a new
person; a ‘super person’ (Ubermensch); a new world
where all the rules were, essentially, created by himself. But it must be said
that Nietzsche’s rejection of the prevailing social order would only be
possible if he could isolate himself from existing within any given social
structure. It seems unlikely that such views could co-exist without the destruction
of that which bound society itself, and this poses grave problems where one
considers that which may arise out of the ‘nothingness’ that is left after all
is renounced.
Kaufmann
(1923/1970) in translating Buber’s ‘Ich and Du’ (I and Thou) seemed
to be suggesting that Buber differentiated between ‘I’; as in ‘me’; and, ‘I’;
as in ‘you’. There is a difference between how we perceive ourselves to be, and
how others perceive us. Buber argued that we are able to adopt two ways of
being. ‘I-it’ describes the relationship between self and others where ‘I’
objectifies self such that s/he response to the world in a ‘fragmented’ way:
portraying only fragments, or parts of self in reference to the demands of
others. The other, ‘I-You’ is in contrast to ‘I-It’ where the individual
quantifies self, and others, as a ‘whole’, and suggests that the relationship
between self, and other is more the presentation of self in partiality. The
whole of one’s being is given over to the experiencing of other, and Buber
suggests that this is akin to a spiritual experience between self, and others.
Buber goes on to suggest that there is a ‘continuum’ of being between I-It, and
the I-You, ways of being, and acknowledges the difficulty that may be
experienced when attempting to exist in either extreme of being for any length
of time.
In
the face of adversity, the world appears to us, differently. As individuals we,
arguably, present a sense of ourselves to the world that is relating which ‘I’ as
an object is to a greater or lesser degree. The extent of this objectification
seems to depend on how threatening the world appears to us, and in defence of
self, we protect that part of ourselves that may become disseminated because of
our interactions.
Insofar,
as autonomy is concerned, it would seem that we make personal choices based on
that which is known to us, and believed to be true (James, 1920, pp147-8). Such
‘psychological facts’ (Sartre, 1939) serve as the basis for action, (i.e. they
seem to provide the grounds (or foundations) for future, past, and present
interaction with the world. But are these ‘facts’ not of our own making? Do we
not represent the world, internally, as it appears to us? Sartre would argue
that this is the case, and goes further to suggest that such ‘facts’; in
themselves; are meaningless without showing ‘how’ they may be related, and
‘what’ context in which they may be shown to occur; even the degree of
relatedness is, individually, determined. We choose to view the world in
particular ways; our worldview appears to be preferential. We view the world
through a ‘veil’, and ‘as if by magic’; the world becomes transformed into
something that is more reflective of what is ‘known’ to us, as opposed to the
reality that lies before us. But what is this reality? Who are we to determine
that which is true from that which is not? Do we not all have a personal
worldview? In which case, what are the grounds for action if they are not
personal? Herein lays a paradox, and ‘psychological facts’ are nothing if it
not shown to what extent they are reflective of experience of being in the
world. Sartre argues that without making explicit that, which is signified,
‘psychological facts’ remain meaningless and life appears to be ‘groundless’.
The
‘angst’ that arises out of this ‘groundless’; this uncertainty; it self makes
explicit the difficulty that may be experienced in problem solving, or
decision-making. In the absence of that which may be judged as being ‘concrete’
in our lives we are doomed to remain in state of permanent anxiety. At the same
time we are aware of the passage of time, and its finiteness, and make life
choices in the hope that they will e the right ones. Experiencing ‘Existential
guilt’ when the choices we make fail to have the desired effect. But Heidegger
suggest that this 'thrownness' is often denied, and
in so doing, we deny ourselves autonomy and the ability to be perceived as
behaving, authentically. This apparent inauthenticity may be recognised in the
way people seem to make excessive reference to the past, or future, fail to
make life choices, and the way we see others as being deterministic of our own
behaviours. He argued that when fail to see and accept our own role we, also,
refuse to embrace uncertainty, anxiety, meaningless, and groundlessness. In
asking ‘how’ a person is ‘being-in-the-world (Umwelt), ‘with-the-world’
(Mitwelt), ‘of-the-world’ (Eigenwelt), and ‘above-the-world’ (Uberwelt), you are asking to a person to describe what‘
being-in-the-world’ might be like for that person. Such concepts are difficult
to measure, as this would require the construction of psychological/statistical
tools to determine to what extent the person is relational in the world. As the
contexts in which we find ourselves are so numerous and invariably different,
life experience of a statistically reliable grouping within any society is
difficult beyond that which shows no relation, and is without contextual
relevance. Such findings are reflective of that which is ‘undifferentiated’:
part of the ‘they’: and as such lacks autonomy, individuality, and an ability
to reflect on itself for itself.
Ludwig
Binswanger, a psychiatrist working in
Ellen
West was an only child born to reasonably wealthy and authoritarian parents.
Within the case notes Binswanger was able to show how ‘Ellen West’s
‘throwness’, and inability to cope with this ‘throwness’, made it very
difficult for her to be part of the group; her family; and seem to have led to
the development of mental illness. Through a process of anthropological
description, it was found that’ Ellen’ seemed to oppose the will of her
parents, but seemed reluctant to give up her dependency on them. She developed
anorexia as she tried to ease the pain of her anxiety, and separate herself,
physically from a representation of womanhood that ‘Mitwelt’ would have
conveyed to her. When she, finally, did experience ‘freedom’ whilst on holiday
in
This case illustrates the
different modes of being-there (Van Deurzen-Smith, 1997), and how we seem to
relate to others by attaching meaning to signals that are inherent in a
changing environment, (i.e. a world that seems already pregnant with meaning)
(Merleau-Ponty, 1968). Our action seems to be reflective of the meaning derived
from an interpretation of the signals which when represented, internally, come
to symbolise the world-around us (Umwelt). We seem to strive for a mode of
being that satisfies our spirit; that deters ‘spiritual tension’, and thwarts
growth. For some, existing in a world that denies such freedom of
self-expression, existing seems to become an effort in-itself, and they choose
to only option available to them: that being to “free themselves from that
which appears to bind”. As therapists, we may do well to acknowledge the
pre-existence of soul, (i.e. that which seems spiritual in the being with the
client), lest being with some who claims help and support proves pointless to
the client, and they seek to relieve themselves from us we, too, appear to bind
just like the rest of world-around.
Again,
we hear the application of ‘Peripheric theory’
(William James) with attempts to uncover that, which seems to be ‘hidden’.
Maurice Merleau-Ponty transforms ‘Peripheric theory’
into the concept of ‘embodiment’ by relating that which is sensed, (i.e. external
to the central nervous system), to that which is construed, mentally. This is
more than an internal representation of externally located symbols, (i.e.
internal representation of the world-around-us). In his ‘Phenomenology of
Perception', Merleau-Ponty, dialectically, philosophises on the continuity of
our sensual relationship with the world; that within which we are embodied
always seems to be in connection with a lived-world. We do not ‘speak as we are
spoken to’, ‘we speak that which has been transformed’. That which is made
explicit is a sedimentation of that which has been deciphered. This is very
similar to Sartre’s view of emotion. The world appears viewed through a ‘veil’
that is of our own making, and we choose through which veil to view the world
from one moment to the next, with increasing speed and efficiency. But ‘who’ is
to say that we choose the correct veil; after all, the world seems full of that
which gives rise to uncertainty. During encounter, such ambiguity becomes ‘a
two-way process’ as we search of the ‘middle ground; that which becomes agreed,
mutually. Through this process of theoretical debate, we derive meaning, and in
so doing, become aware of our limitations, the strength of our arguments, and
the ability of others to present the world in ways which confuse us, and from
which we experience a created uncertainty. We experience humility in the light
of that which seems to be the better argument.
Medard Boss, another psychiatrist laid great
emphasis on the ‘uncovering of that which is hidden’ (Aletheia),
and the derivation of the ‘confession’. The ‘confession’ reflects an expression
of self that accepts responsibility for our own actions. It acknowledges our
ability to experience doubt, anxiety and existential guilt, and invites others
to engage in therapeutic encounter. The confession illustrates ways in which
being in the world has proven difficult, and through a process of
interpretation, our behaviour is illuminated and ‘brought forth into the
light’. Paul Ricoeur emphasised the
value of the hermeneutic tradition in which our everyday lives seem full of
‘rules of thumb’, which seem to be represented in the ways in which we behave
in certain situations. Such ‘rules of thumb’ may or not be held by others, and
gaining some incite into the meaning of others apportion to shared experiences
seems to require some knowledge and understanding of these rules. Ricoeur
proposed that by deriving meaning for symbols, (i.e. language), we encounter in
our everyday lives invites thought. Hence, through a process of induction,
hermeneutics could show how different individuals may interpret what they
perceive as being ‘real’ for them.
Many individuals may interpret;
derive meaning from, the same event/situation, differently. There may be ‘many
similarities’ between these different interpretations, but each individual
could effectively derive a different ‘subtext’ for the same event, which would
be reflective of that individual’s understanding of that event. However, Ricoeur
argued that we need to look ‘deeper’ to uncover; the underlying structure, or
the ‘subtext’ inherent within our interpretation(s) of existence. There are no
right or wrong interpretations, per se, each interpretation is simply,
different in-relation to what appears at that time and place, (i.e. that which
reveals itself to us within the context of a fixed limit situations (Ricoeur,
1970; 1974).
Jacques
Derrida acknowledges that any ‘life story’; recount of events/situations in
which a person experiences existential angst; the ‘text’ could give rise to
multiple interpretations, and multiple understandings, and as we have seen we
are not in a position to say which interpretations are either ‘right’, or
‘wrong’, per se. Things are always transformed in symbols, (e.g. language), and
that it is only when we begin to describe the world that the world begins to
have some meaning for us. However, language can mean different things to
different people, and is never complete in-itself. It differs both within and
between words such that we are always waiting for the conclusion. As such, the
construction is never complete, and hence the meaning is never complete;
although language does give the illusion of completeness, in-itself. Therefore,
Derrida advocates the ‘death of the subject’, and ‘working towards a
relativistic discourse’. He argues that we should get rid of the ‘primacy of
truth’; the dominance of ‘God’ over our existence; the dominance of men over
women; the dominance of presence over absence’; speech over writing; to,
effectively, get rid of structuralism, and the view that the ways in which we
are in-relation to, and with, our ‘lived-world’ is "preordained", and
hence unavoidable.
This view seems to contradict
that of Ricoeur in so much as it re-emphasises individual autonomy, and
individual choice. But such views seem to ignore the fact that we are in-relation;
that much of what we believe we believe to be ‘true’ about ourselves is ‘known’
in relation to our ‘lived-world’, and that we are required to exist within the
boundaries that society sets for us on a collective level, or pay the
consequences for revolt (Van Deurzen-Smith, 1997). It seems to me that you
cannot have structuralism without consideration of its polarity,
de-structuralism: the two seem to be intertwined, and inseparable. They are the
opposite sides of the same coin: the ‘Yin and Yang’ of existence. In
discovering ‘self-reflective knowledge’ (Paden, 1998), we are doomed to accept
that we are not ‘free-to-be’ for its own sake; we are free-to-be’ in-relation.
To choose otherwise would be to not exist at all, and we confront
‘nothingness’.
Recent
development in Existential analysis has seen the introduction of a need to
develop psychotherapy that reflects changes in the ways people pay for their
therapy. Insurance companies do not seem to want to pay for therapy that could,
effectively, go on, indefinitely (Van Deurzen-Smith, 1997) As we are
continuously 'throwing ourselves' into uncertainty; continually experiencing
existential angst; there, always, seems to be a need to engage in therapeutic
encounter. People like Lacan, who advocated short or brief therapy have been
asked to leave the ‘International Society for Existential Analysis’. However,
it must be acknowledged that importance of time, and hence, the development of short/brief
therapy has become a social reality (Strasser and Strasser, 1997; Dobson et al,
2001). It reflects the changing nature of the society in which we live, and
offers a greater proportion of society the opportunity to evaluate the ways in
which we are ‘free-to-be’ in relation, and make changes ‘as’, ‘where’, and
‘when’ necessary. To so do, within the changing social constraints that bind us
all seems to require some admission that we accountable to society as a whole,
and that we do not live in isolation of the wider society; that we are doomed
to be n-relation with others; until such time, as we are relieved of duty of
care.
This ‘duty of care’, can only,
be a ‘good thing’ as it shows how we are all intertwined to, and with, each
other; and yet, separate, and individually striving to become autonomous.
Reference to a ‘duty of care’ reflects the requirements of a judicial system
which seems founded on the belief that we as citizens should ‘do no harm’.
Medical practitioners, and even veterinary practitioners, are required to take
such an oath when they have passed their academic examinations. In accusing a
medical practitioner of negligence for instance, the claimant is required to
show the Court of Law in what way the medical practitioner has done harm.
Psychotherapist and counsellors are not required to take such an oath. Thus
making such claims against psychological practitioners seems fraught with
difficulty as their practice seems top remain outside of the law. Where
citizens can show that an individual as done harm, and s/he has supported such
claims with evidence, there seems to be good chance that the claimant will
succeed; unless proved otherwise. Even here, the psychological therapist seems
to protected as his/her practice remains unsubstantiated by what could be
considered to be a standard form of practice; irrespective, of the paradigm
within which the therapist purports to operate. For me, this situation seems
unsustainable in the long-term, and as a therapist, I would support any moves
by society at large to bring psychological therapists online; if, only to protect
the ordinary man in the street, and confer the rights of the citizen to all
people within that given society.
There have been movements to
consider some forms of psychological therapy as fulfilling these essential
components of societal living. Evidence based Cognitive-Behavioural Therapy
seems to support the view that individual practitioners apply forms of
treatment to specified psychological disorders in ways which seem standardised.
In a Court of Law, a claimant could argue with relative certainty that a form
of treatment received was, or was not, within that which a significant body
within a given profession that is Cognitive-Behavioural psychological
therapists considers to be reasonable. This kind of argument could not be
raised in-relation with an Existential psychological therapist, and as such
could not be considered to be a reasonable way of being with a client. Is it
possible to verify the claim I have just made?
Miles Groth describes the
Existential therapist as someone who is interacts with the client as if s/he
was person who exists a lived-world that is as personal, and individual as the
client him/herself. The client is viewed as totality, and not as sum of
constituent parts as is suggested in other forms of psychological therapies
such as CBT, and REBT. An Existential therapists is interested in what the
client has to say about his/her being-in-the-world. The Existential therapist
seems to ignore any form as non-verbal communication. Movements of changes in
the physical presentation of the other seem to be considered meaningless unless
spoken about within the context of the client’s discourse. The Existential
therapist does not assume a position of power within the therapeutic encounter
by assuming that he ‘knows’ what might be wrong with the client, and making a
diagnosis and prescribing treatment in the ways that a Cognitive-behavioural
therapist might. The aim of intervention is not to attempt to change of modify
the client, purposefully. This change may occur during the course of therapy but
it is not considered to be a primary objective of the Existential therapist
(Van Deurzen-Smith, 1997).
Already we have come to some
conclusion as to what an Existential practitioner is, and consequently, what
/she I not. This presents itself to me as a paradox. In order to be considered
to be an Existential therapist, we are expected to behave in the way described
above: as a member of the collective that is the Society of Existential
Analysis, or the International Society of Existential Analysis. Individuality,
and autonomous have been lost. What of the spirit of the individual
practitioner? What makes one Existential practitioner different from the next?
Why should the customer come to visit one Existential Practitioner as opposed
to another?
Existential practitioners claim
to interact with the client in ways which allows the client to reveal
him/herself as individuals being-there in the world. We claim to look for order
in being with the client, not disorder, and as such the clients way of
being-there becomes something that is to be understood not changed fixed or
rendered easier to bare. Whether the client then goes on and does something to
change the experience of being there at some point in the future is left
entirely up to him/her. This presents itself as the primary point about which I
remain uncertain. If, we resist our duty to care, are we not sanctioning the
right of those who appear to be doing harm to themselves and or others? We have
come to understand what being-there might be like for the client as revealed
within their descriptions of being-there. We have come to understand that they
might ‘do harm’ to themselves, or others at some point in the future? Do we
still not intervene to change or modify the client in some way?
If, Existential therapist have
become in juxtaposition to a world that appears to have been hostile, then we
must consider that effect those seeking to impose their own will over others.
Two considerations reveal themselves to me. Firstly, such ways of being in the
world seem to reduce to the status of mere object. All subjectivity seems to be
lost as decisions seem to be made as, if, in isolation of the person being
affected by such decisions. Secondly, I find myself asking in what way is this
way of being-there right, and good, morally. The opportunity to harm self,
and/or others seems to have been eradicated, but the other remains represented
in my own mind as an object devoid of spirit.
I am aware of the movement
within the mind of Existential therapist which argue that whatever the client
does in the world, s/he does of his/her own volition. Therefore, having
illuminated the ways in which the client appears to be there in the world
in-relation with him/her, the client can then choose whether or not they wish
to continue being in these ways. It may well be that the client continues to do
harm either to him/her self, or to others, but the therapist absolves hi8mself
of any responsibility in the choice s their client has to make on the basis
that the client is autonomous in this sense. Does this kind of absolution
suggest reluctance by Existential therapists to accept the responsibility that
goes with a ‘duty to care’? It could be argued that the idea of a ‘duty to
care’ has been imposed by the society in which we live; in other words, as
Existential therapists, we did not choose this way of being-there for
ourselves. Society, and the Law suggests
that as health professionals, we have a ‘duty to care’. This implies that we,
as citizens, and as Psychological practitioners, should not do harm. In not
interacting with our clients in ways which suggest that we are not doing harm
are we behaving unlawfully, (i.e. failing in our duty to care by doing harm)?
This for me, posses a major
problem; especially, for those working within the
Now, the Existential therapist
has observed the client doing harm to him/herself. The Existential therapist’s ‘duty
of care’ would require that s/he do something that attempts to reduce the harm
the client does to him/herself. This implies that the therapist imposes his/her
will over and above the client such that the client is no longer observed doing
harm to him/herself. The right of the client to choose has been ignored. But
this is only possible because the client has been deemed incapable of making
such rational decision for him/herself. The client is judged‘ill’; disordered
in thought evident in their descriptions of being-there. The therapist assumes
that s/he must take responsibility for the health and well-being of the client
as s/he has shown him/herself to be incapable of assuming such responsibility
for him/her. What’s more, the wider society seems to expect the therapist to
assume such responsibility in such circumstances.
What is Existential Psychotherapy?
What is Existential Phenomenology?
What is Existential Counselling and Psychotherapy?
How Existential Counselling and Psychotherapy Can Be Applied Within A National Health Service Setting Such as a Hospital?
Case Study
What May Be Some Of The Implications Following The Development of An ‘Existential’ Cognitive-Behavioural Therapy?