Book Review: The Psychology of Existence: An Integrative, Clinical Perspective

This book is perhaps best approached and appreciated as an American Existential Psychotherapy "scrapbook". Like your old scrapbook you can take it off the shelf when the mood takes you and you are assured of finding both a collection of "gems" that you can delight in as well as other things that leave you wondering why on earth you put them there.

The work was originally the project of Rollo May and was intended to present the current state of play in American Existential Psychotherapy. However due to his ill health the work was taken over and completed by Kirk Schneider and the final result certainly reflects the latter's particular brand of existentialism.

The overall project of the work is an ambitious one. Its intention is to promote Existentialism as an integrative paradigm including both psychotherapy and general psychological paradigms. Furthermore the author proposes "Existential-Integrative Psychology" as representing a blending of Humanistic-Existentialism and Existential-Psychoanalysis. The rationale for this is an attempt to balance the emphasis of the one on personal growth and peak experience with the emphasis of the other on limits and the tragic dimensions of human existence. Whilst the intention is one of balance it is this reviewers impression that overall the scales tip in favour of Humanism. This is best illustrated by the specification of the goal of therapy as being to "set people free", the description of interventions as "liberation strategies" and consciousness as "liberation levels".

The book is organised into three parts. Part one addresses the literary, philosophical and psychological roots of Existential-Integrative therapy (EI). The literary roots consists mostly of excerpts of Rollo May's work on authors such as Dante, Goethe and F Scott Fitzgerald. The perhaps surprising addition to this list is Schneider's contribution of a seven page analysis of the existential implications of the film Vertigo by Hitchcock. The section on philosophical roots gives a rather short summary of the major Existential-phenomenological philosophers. The brevity of this is perhaps compounded when one compares the single page devoted to Heidegger to the seven devoted to the Hitchcock film. This section also includes some mention of Taoism and Buddhism as well as an extract from May's Biography of Tillich that clearly illustrates the impact of the theologian on May. The description is more personal and biographical than philosophical. This mismatch is continued in the section on psychological roots with extracts from May's early and latter work in addition to extracts from William James, Abraham Maslow and Otto Rank. The remainder is composed of what can be regarded as "tributes" - Bugental on May, Greenberg on Laing and Schneider on Bugental. The "gem" of this section to my mind is the extract from Ernest Becker's work on Kierkegaard's characterology.

Part two is a short section devoted to the beginning student in which two graduate students discuss the trials and tribulations of existential training at the California School of Professional Psychology. Their suggestions for novice therapists are fourfold: (1) focus on the clients immediate experience (2) emphasise the capacity for choice (3) acknowledge the limits of action (4) emphasise phenomenological formulations.

The third section represents the major new theoretical contribution and concerns Schneider's proposals for Existential-Integrative psychotherapy. It is unclear to what extent May contributed to this theoretical development as illustrating nonsectarianism developed to a high degree. Schneider proposes that freedom can be understood as existing on six levels: (1) the physiological (2) the environmental (3) the cognitive (4) the psychosexual (5) the interpersonal (6) the experiential. Each of these levels has been studied by the varying schools of psychotherapy and as such the therapist utilizing the EI approach will choose a liberation strategy depending at which level the clients problems exist. Non-experiential liberation strategies such as cognitive therapy and psychoanalysis are regarded as "footholds" which may if successfully employed open the possibility of the use of experiential liberation strategies aimed at increasing freedom at the experiential or "being" level. This ordering of psychotherapies to my mind constitutes a rather loose technical eclecticism which in the interests of pluralism ignores the important basic theoretical differences between models. Furthermore the restriction of specific models to specific realms ignores the theoretical and research claims of various models to be applicable across the realms identified by Schneider. Schneider's second theoretical proposition is that each of the freedom levels is characterised by the inherent capacities to "constrict", "expand", and "centre". Basic dread of either the potential to constrict or expand promotes the development of dysfunctions. Elaborating on this further Schneider then proceeds to analyse each of the main psychiatric diagnoses in terms of their implied dread of either constriction or expansion. The propositional status of this theory is highlighted and the need for further phenomenological and empirical research is called for.

The final section continues the scrapbook style employed earlier. In it are sixteen case studies drawn from a wide variety of authors broadly representative of the varieties of existential psychotherapy as practised in America. This section is particularly noted for inclusion of transcultural perspectives as well as the inclusion of a paper by Bugental outlining preliminary suggestions for the development of a short term existential-humanistic therapy. Each of the included case studies are analysed according to the integrative theory proposed by Schneider.

Sum this book is best appreciated as providing brief glimpses into the wide variety of permutations that existential therapy is evolving in America. Additionally the book can be read as a tribute to the contributions to American psychotherapy made by May as well as an illustration of one of the forms in which this work is being continued. In its proposal for an integration of therapies within a broadly existential-humanistic framework I have found much to be critical of as I believe much would be lost through ignoring the fundamental critiques offered by existential-phenomenological analysis of the theory and practice of psychotherapy across the field.

Michael Worrell