Book Review: Everyday Mysteries: Existential Dimensions of Psychotherapy (with author response)

* Everyday Mysteries - Existential Dimensions of Psychotherapy by Emmy van Deurzen-Smith. London, Routledge 1997, 307 pp.

Anybody who teaches existential psychotherapy or supervises the work of therapists with existential leanings will be asked, sooner or later: 'Is there any book which will tell me more about it?' The other day a colleague of mine, a psycho-analyst who had not seen me for a long time, asked me on the phone: 'And what are you doing now?' When I told him that my main concern had been for some time the existential-phenomenological approach to psychotherapy, he asked:

'And what is that?' When I replied it was impossible to answer this in a few words, he wondered whether I could recommend some introductory literature that was both accessible and comprehensive. I had to admit that I could not think of any.

There are, of course, books on existential psychotherapy, but most of them require some knowledge of the relevant philosophical concepts. And more importantly, the authors bring their own specific interpretations to bear on particular aspects of therapeutic practice. In itself this is obviously a perfectly valid undertaking that, however, may mislead the reader into assuming that these interpretations are based on a general consent, and that other authors would use them similarly. This, in fact, is not so. For example, the word 'existential' is used differently by different authors whose views are rooted in different philosophical assumptions.

This is not the case, at least not to the same extent, in other therapeutic orientations. Freudian concepts, for instance, were also differently used by later practitioners, but their interpretations were based on or could be compared with concepts that had clearly defined meanings. I cannot discern anything comparable in existential psychotherapy. There are many ways of doing phenomenology, and many ways of being an existentialist. There is, of course, nothing wrong with this. In fact, it results in a wider field of possibilities, and the danger of inflexibility and dogmatism can more easily be held at bay. But it makes it extremely difficult to present a comprehensive picture of the rich and complex ramifications of theory and practice. It is not surprising that writers have shied away from this task.

The author of this book, Emmy van Deurzen, is not easily deterred by difficulties. It is mainly due to her efforts that existential psychotherapy has been established in this country as a therapeutic orientation that increasingly engages people's interests. It might be fair to say that without her, there would not be a demand for such a book. And now she has written it.

There are, in my view, broadly two ways of writing a book on existential psychotherapy. You can either present a framework that shows what various existential and phenomenological approaches have in common and how aspects of such a framework can be fruitfully applied to the specific tasks of the psychotherapist. The drawback of this method is that it will pay for its conciseness and comparative rigour with the neglect of many interesting and illuminating variations and deviations, and thus run the risk of making existential psychotherapy appear a much more consistent approach than it actually is. Alternatively, you can depict the full conceptual

spectrum of existential-phenomenological thinking with its many roots and branches, including the various ways in which therapists have used it in their work. Such a picture is probably nearer to what is actually happening but readers may lose their way due to a lack of clear guidelines, and they will not know how to distinguish between what is relevant and what is not. I do not think there is a 'right' way to write such a book - both ways have their pitfalls and it is important to be aware of them. Of the two ways I have described, it seems to me that Emmy van Deurzen has chosen the one that tries to present the full spectrum of an existential-phenomenological approach rather than a concise outline of its framework.

An overview of the structure and the contents of the book will illustrate my impression. The book has two main parts - one is called "Theory' and the other 'Practice'. The first section of 'Theory' offers 'Philosophical underpinnings'. These are short descriptions of certain ideas of twelve writers whom the author considers to have made relevant contributions to the philosophical background of existential psychotherapy. Four of them - Kierkegaard, Nietzsche, Heidegger and Sartre - she clearly considers of central importance, and she gives them more space than the others. To these are added five 'Other existential philosophers' - Husserl, Merleau-Ponty, Jaspers, Buber and Tillich - and three 'recent philosophical contributions' - Ricoeur, Derrida and Foucault. I give the full the list of names to show the range of references the author is aiming at.

The second section of the theoretical part is called 'Existential dimensions' and presents what seems to be an important aspect of the author's approach: 'a four-dimensional forcefield' (p.100). This is influenced by an early attempt of Binswanger's to describe three categories of man's relationship to the world, and it tries to do justice to the author's view of human beings as 'complex bio-socio-psycho-spiritual organisms' (p.94). We shall return to this, as the way it is presented and its placement after the summaries of philosophical ideas seems to indicate that it is an aspect of the author's own very personal contribution to the existential theme.

The first section of 'Practice' mirrors the first section of 'Theory' by introducing the thought and work of practitioners who were also theorists. Again I give a list of the names to illustrate the width of the spectrum: Jaspers, Minkowski, Lacan, Binswanger, Boss, May, Yalom, Frankl, Laing, Szasz, Hoogendijk and Achenbach. The chapters on these writers are brief, but informative and critical.

The second section of the practical part is called 'Parameters of existential psychotherapy', and covers the actual therapeutic prac-

tice as well as some of the immediately associated theoretical issues. Practice and theory are here not clearly distinguished, as indeed they cannot be.

There is a chapter dealing with issues like boundaries, the choice of consulting room, the arrangement for payment, the client's seating, etc. This is followed by a thorough examination of the problem of consciousness. There is a discussion of aspects of the 'Therapeutic dialogue' as well as a chapter on 'The changing self', which ends with the author's own 'theory of emotions' (p.243). There is a third section called 'Illustration', which is one extended 'case study' of thirty-six pages.

It is, of course, impossible to review such a book in any depth without having lived with it for a time. It has to be read more than once as it covers so many different issues and its structure necessitates a frequent change of focus. Thus I shall confine myself to raising some general questions and what I say is open to revision and rethinking.

As we have seen, this is a very comprehensive book. It would be difficult to find another book on this subject in which the reader could find under the same cover information on the thoughts of Heidegger, Tillich and Derrida; outlines of the therapeutic approaches of Boss, Lacan and Frankl; discussions of complex theoretical issues such as the 'unconscious' and important practical questions on the actual management of therapy. But it is also a very personal book. Personal in the sense that the author seems present to us throughout, but personal also because she admits generously her doubts and failings.

This also means that the book is not an encyclopedia. You will not necessarily find in it what you are looking for. It offers a great deal, but it is what the author has chosen to be there. You may be disappointed not to find Marcel among the existential philosophers, and you may be surprised to find Lacan among the existential practitioners. You may wonder why there is almost nothing on sexuality.

It is always somewhat questionable to list what a book has left out. However, my awareness of the author's person made me miss something that she had perhaps not wished to provide but which I felt in need to receive - namely a clearer presentation of her own position in the field of existential phenomenology. Perhaps a greater familiarity with her book may satisfy this need but at present I am puzzled.

I am, for instance, confused by the author's use of the word 'existential'. Heidegger describes the essence of being human (which he calls 'Dasein') as 'existence'. This word has a Latin origin and means 'standing out'. Macquarrie, in his interpretation of 'existence', says of man 'that among all the beings that may be observed on earth he 'stands out' as the only one that not only 'is' but takes over its being in awareness of who or what it is and of who or what it may become' (Macquarrie, 1972: 69). 'Dasein' stands sufficiently apart from its Being to be able to reflect on it while also standing out into the future. This I cannot see as a 'blueprint for living' (van Deurzen-Smith, 1997: 34) but only as a phenomenological description of 'Dasein'.

In many ways, Emmy van Deurzen seems to be guided by Heidegger's definition. There are, however, many places in the book when she uses the word 'existential' in a more general sense, as when the aim of the 'existential project' is seen as the retrieval of 'the intensity and fullness of human existence' (1997: 188). The meaning of the word seems to slide from being descriptive to being prescriptive.

Of course, I do not suggest that the author has the obligation to use the word only in one or another way. But it would be helpful if she pointed out more clearly which meaning she chooses to give it, and how this relates to other meanings.

I am also unclear about the author's attitude towards phenomenology. There are, as we know, different kinds of phenomenology - Husserl's approach was modified by Heidegger, and the rift between them was, to some extent, due to this. The phenomenon at the centre of Husserl's concern was consciousness as such, while for Heidegger the central phenomenon was existence as he saw it. But the basis of what is generally understood as phenomenology is an understanding that - in Heidegger's words - 'the expression "phenomena" signifies "that which shows itself in itself," the manifest' (Heidegger, 1962: 51). Is this how Emmy van Deurzen sees it? For me, this understanding implies a 'letting be', an acceptance of what shows itself and the process of 'horizontalization' - nothing is assumed and expectations are suspended. Is this reconcilable with a notion of the existential approach as a guidance towards a more intense and fuller living?

Acceptance of what shows itself is certainly not the method the writer employs in her sessions with Laura. These are very courageously described in great detail as an illustration of the ideas developed before. I do not know how representative this short therapy is of the work the writer generally does with her clients. But it is the only illustration we are given, and it is rich in suggestions and

interpretations. I am not here criticizing this method (though it is not mine) but I am unable to see it as phenomenological.

Finally, I would like to turn to the author's presentation of four 'existential dimensions', which is also graphically shown in an appendix. In a different form it can already be found in her earlier book, Existential Counselling in Practice (1988). Here the influence of Binswanger is more clearly seen; she uses English translations of his concepts of 'Mitwelt', 'Umwelt' and 'Eigenwelt' - the natural world, the public world and the private world - to which she adds 'Uberwelt', the spiritual world. It would be interesting to know why she chose to replace 'world' with 'dimension'. To me the division of 'world' into a number of 'worlds' seems to contradict the meaning of Heidegger's 'Being-in-the-World', where 'world' signifies the totality of Being and its indivisibility. Her talking of 'dimensions' may be due to similar concerns.

But I remain uneasy. In order to show why, I would like to quote the author at greater length:

We are first of all regulated by physical, biological, natural forces. We are, secondly, inserted into a social, cultural network. Thirdly, we are regulated by our own personality, character and mental processes. Finally, we are modulated by our relationship to the overall framework of meaning through which we experience the world and make sense of it on an ideological or spiritual dimension (1997: 100).

We are regulated, we are modulated, we are inserted - by whom, into what? This way of putting it seems to ignore the relational aspect of Being, the mutuality of our relation to the world into which we are not 'inserted' but which we create as much as it creates us. There are certainly 'givens' which we do not control, but we have the freedom to respond to them - this is our responsibility.

There are, of course, different modes of experience, but are they ever separable? Are all experiences, to some extent, physical, spiritual, private and social? Emmy van Deurzen stresses that there are 'connections and overlaps' between these dimensions, but by saying this, she also seems to indicate that they are essentially separate. It is my understanding of the existential-phenomenological approach that - with Husserl's concern with intentionality and Merleau-Ponty's elucidation of intersubjectivity - the splitting of 'world' into separate areas has come to an end. Therefore a 'map' is perhaps a somewhat misleading image, with its emphasis on difference and boundaries. Countries on a map lie side by side, and you have to

move from one to the other. Experience involves the whole person. I find it difficult to imagine that Emmy van Deurzen's views of these things are really as different from my own as they seem to be. If they are, I would be interested to learn how they fit into an existential-phenomenological framework. But, naturally, it is also possible that I have misunderstood her - in which case a clearer presentation of her position would have helped me. Meanwhile I have been left with some questions, and I have sent the author this review so that she has the possibility to respond if she feels she wishes to. Personally, I am grateful for having read her book, it has widened my horizon and has given me the opportunity to ask some important questions - one of the best things any book can do.

Hans W. Cohn

References

Macquarrie, J. (1972) Existentialism Harmondsworth: Penguin Books.

Heidegger, M. (1962) Being and Time Oxford: Blackwell.