Book Review: Everyday Mysteries: Existential Dimensions of Psychotherapy

Everyday Mysteries: Existential Dimensions of Psychotherapy by Emmy van Deurzen. London and New York, Routledge 1997, 307pp, £15.99

As a second-year student on the MA programme at Regent's College who was suddenly deprived of the opportunity to study with Emmy van Deurzen, I was excited at the prospect of getting my hands on her recent book, Everyday Mysteries. I hoped that it would be some consolation for my loss and offer me a glimpse of how I might have experienced being taught by her. I was also hoping that this book would help me to dig what I knew I had earlier learned of existentialism out from under my confusion. I was not disappointed.

The book is clearly organised into sections which apart from anything else make it accessible as a reference text. There are two principal parts: Theory and Practice

The first section of Part 1 (Theory), "Philosophical Underpinnings" serves as a reminder of, or an introduction to, the thinking of Kierkegaard, Nietzsche, Heidegger and then passes more briefly over Husserl, Merleau-Ponty, Jaspers, Buber and Tillich. The subsections devoted to each of these people offer a flavour of their contribution but are hard for this near-novice to evaluate. Emmy moves between what appears to be a clear restatement of the philosopher's thought and more rhetorical passages in which, without an extensive knowledge of the material, it is hard to be sure what is the philosopher's and what is Emmy's. I am therefore left with a rather fuzzy picture of who said what, but with a strong "feel" for a kind of amalgam of existential thought. What I call the "rhetorical passages" are usually very clear, sometimes obscure, but are generally expressed in a style which has its own persuasive quality. This quality persists despite the absence of any clear explanation at this point in the book of how an existential approach to life differs from any other, particularly in relation to therapeutic practice. (That comes later.) In this sense the Theory part of the book is refreshing, since it does not seek to criticise and disavow, but rather to offer something which stands in its own right. The tone changes somewhat in the subsection devoted to more recent philosophical contributions, in which Emmy provides an introduction to Ricoeur, Derrida and Foucault. Here there is more comment on therapeutic applicability - largely of a cautionary nature: don't be a Derridian deconstructionist with your more insecure clients (they probably need some vestige of a system for constructing meaning); nonetheless we are asked to consider how, within an existential tradition as outlined earlier, we construct meaning and whether this is valid. My own response to the section on Derrida, without knowing anything more about him than what Emmy has chosen to write here, was an uncomfortable one, which is perhaps what is intended. Here again I felt the power of Emmy's rhetoric: it was not possible for me to take a purely academic approach to her text.

What follows in the next section is a broader exposition than I have read elsewhere of a "map of the world" divided up into the physical, social, personal and spiritual dimensions. Given the author's proviso that these dimensions interweave with one another and are fraught with paradox and tension, the descriptive passages on each dimension are extremely clear, peppered with everyday examples of points of reference. Having recently chosen to do battle with Binswanger's analysis of Ellen West, I was mightily relieved to find that there is much here with which I could identify my everyday experience. The section on the spiritual dimension serves to clarify and to put in context much of what was written before on the philosophers. Emmy offers her personal view of what is meant by "spiritual", and an equally personal and for some controversial value judgement about humanistic or otherwise "transpersonal" approaches to therapy. We hear more of her caution about post-existential deconstructionist thinking which denies the possibility of there being an ultimate truth and therefore scorns the desire to look for meaning: "such attitudes are fortresses against the process of life. People who are ensconced in them are slowly dying out and withering on the vine" (p 128). The reader who wonders how a person can have a philosophy based on open questioning and a phenomenological enquiry into "what is", and at the same time can produce what amounts to a systematic way of looking at life, will find an acknowledgement of the paradox at the end of this chapter.

Part 2 of the book is entitled "Practice". It begins with a whistle-stop tour of some of the practitioner "names" associated (sometimes, I think, loosely) with the existential approach, revisiting Jaspers and passing through Minkowsky, Lacan, Binswanger, Boss, May and Yalom, Frankl, Lang and ending up with Szasz and then a couple of philosopher practitioners, Hoogendijk and Aschenbach, who were entirely new to me. The objective seems to be to give an overview of that person's practice in order to indicate in what senses it can be regarded as "existential" and in what senses it can't, with a special focus on the extent to which the notion of pathology continues to be adhered to. This is extremely useful for the student, if necessarily sketchy, but there are ample references to individual works for one to follow up if one so wishes. Emmy's personal voice comes through loud and clear, I thought, in some spirited criticism of Jacques Lacan. What follows is a reworking of some psychoanalytic dogma in existential terms. For example, the myth of Oedipus is examined for what it tells us of the human condition, and the use which Freud made of it is neatly debunked. A little later in the book a long section is devoted to consciousness; the whole idea of an unconscious is questioned and an alternative way of looking at our varying levels of awareness is posited. Equally the existential position of wonder and not-knowing is set against a reductionist psychoanalytic position of explaining all of human experience in intra-psychic terms.

The later part of the book is more clearly devoted to the practical aspects of practice. There is much provocative material here. To begin with, Emmy proposes a set of ground rules, neatly divided up into physical, social, personal and spiritual dimensions, one or two of which were very surprising indeed. For example, she recommends that therapists show their written accounts of sessions to their clients. Given that this is what she does with Laura, the subject of the case study which concludes the book, it is understandable that she should include it in the ground rules; whilst not discarding the possibility completely, I wonder if this might be the exception rather than anything approaching the rule. There follows an extremely thought-provoking section dealing with the biases and assumptions that client and therapist each bring to the encounter, and a necessarily selective description of what existential therapists do, and do not do. She then offers a rather narrow definition of a series of emotions representing a cycle between fulfilment and emptiness. Much of this struck a loud note with me; but I was still left wondering whether such a cycle, represented diagrammatically as it is, is not a step further away from a phenomenological approach to a client's material and the meaning which the client attaches to emotions and their interplay. Indeed, much of the latter part of the Practice section seems to be very far from phenomenological. This is particularly true of the case study. Why does Emmy offer an interpretation of Laura's dream? Isn't the work to explore what meaning the client finds? She challenges her client in a very directive fashion. The client's response is anger. She does seem surprisingly anxious to teach this client something. Whether or not one believes that part of the therapist's role is to teach the client how to live, there is a contradiction here between what Emmy does with her client and her statement that "you have to follow your own tracks rather than follow in the footsteps of great gurus".

I know that Emmy's particular approach to existential-phenomenological psychotherapy does not meet with universal approval and it is not always easy to extrapolate from her account of "practice" in this book precisely what is her personal, idiosyncratic approach and precisely what is recommended as a basis for others. What is refreshing is that she fully acknowledges that by writing the book she risks laying down tablets of stone; this is not her intention. Her intention is to "shine a new light on the predicaments that make people consult psychotherapists". I believe she succeeds in this. She does not pretend to write a definitive, conclusive account of existential therapy, making clear in the prologue that what she offers is "an honest account of my experience, which inevitably includes a large amount of doubt". What seems most didactic in this book is often followed by an expression of this doubt, and that, for me, is exhilarating.

In summary, then, this is a deeply personal and provocative book. It is measured, carefully structured, but wonderfully vital and stirring. These qualities make it at once very easy, and very difficult, to read. I don't agree with some aspects of Emmy's practice, but nonetheless I found the book immensely practical, not least because of its translation of sometimes rarified and theoretical philosophical ideas into the realm of the everyday. The book is intended to present existential psychotherapy to "the wider community of psychotherapists". A psychodynamic supervisor of mine once said, as I claimed to be trying to work existentially, "It is not going to do any good to spout Nietzsche at your client." I hadn't mentioned Nietzsche. I couldn't remember much about him. Nor could I explain what I meant by an existential approach. And she hadn't a clue. This book could serve me and my erstwhile supervisor well.

Jackie Hornby