Book Review: Tales of Un-knowing: Therapeutic Encounters from an existential perspective

I couldn't put it down!' several colleagues have said when I asked them if they had read Ernesto's new book. It is a compelling read. Ernesto writes with such seeming ease in a highly accessible and lively style but he also manages to make the 'tales' informative, humorous and at times profoundly moving. The book gives an account of eight therapeutic encounters that Ernesto experienced with various clients over a period of ten years. These tales were 'unforgettable' for Ernesto and for the reader too the persons described come alive and enter the imagination - we are left wanting to know more about what becomes of them.

We meet middle-aged Edwin who believes he is immune from the inevitable ageing process, Amanda, the attractive young woman who dissociates herself from her body, Michael whose dream of murdering his father clarifies his ambivalent relationship towards his mother and his own sexual orientation, Russell whose difficulties with personal relationships reveal as much about himself as they do about the therapist's own concerns, Lou and Simone whose marriage has reached a crisis point, Jennifer and Susie - two distinct persons inhabiting the same body, Giles whose terrifying experience of seeing 'beyond the blur' has lead others to diagnose him as paranoid schizophrenic and finally the extremely moving and emotional account of Ernesto's encounter with Elizabeth the thirty-two years old woman dying of cancer.

During his discussion of these encounters Ernesto weaves in some of the important theoretical ideas that inform his work and he manages to do this without detracting from the flow of the book. He describes the existential-phenomenological understanding of certain psycho-analytic concepts such as the unconscious, transference and counter-transference. He also argues for a non-linear understanding of time which rejects the idea of the past as determining present behaviour and recognizes the plasticity of memory.

Throughout the book Ernesto continues the process of demystifying therapeutic practice. This is particularly evident when he describes his role as a therapist which he considers to be one of attendance. His attempt is always one of attending to the client and their concerns so that they can be more fully described and clarified. He avoids technique and interpretations that transform meaning and instead strives to 'open up' meaning through descriptively-focused interpretations. The 'Un-knowing' of the title emphasizes this stance of openness and his willingness to enter into a relationship with his clients that allows his assumptions and prejudices to be challenged, inevitably an anxiety provoking experience. 'Un-knowing' is also about avoiding theoretically derived-interpretations that limit the client's experience - for example to unconscious processes. The client too is involved in a process of 'un-knowing', unknowing their fixed assumptions about themselves.

For the most part the central focus of Ernesto's work appears to be on the client's 'self-construct' and it's 'sedimentations' - those fixed ideas we have about ourselves. It is through the exploration of the conflicts between whom the client believes themselves to be and their experience of being that the client learns to 'unfix'/'un-know' those sedimented ideas. Ernesto describes his work as existential-phenomenological, its principal philosophical influences include Soren Kierkegaard, Friedrich Nietzsche, Edmund Husserl, Martin Heidegger, Jean-Paul Sartre and Maurice Merleau-Ponty. Early in the book Ernesto discusses the universal experience of death anxiety and towards the end he focuses on the uncertainty of existence. Despite his references to existential thinking it could be argued that the emphasis of Ernesto's work is more phenomenological than existential, since his concern is with the phenomenological uncovering of the client's self-construct and it's sedimentations rather than with the ontological and ontic givens of existence.

Tales of Un-Knowing is a book both trainees and therapists will welcome, at last someone has had the courage to give us a non-defensive and honest insight into their work. Ernesto also risks using biographical material to enliven the book and highlight theoretical points. This is particularly true of his encounter with Amanda where he reveals a great deal about himself. He acknowledges his reservations about working with teenagers since they evoke painful memories of his own youth and he experiences both jealousy and irritation in the face of their youthful 'melodramatics'. He further acknowledges his sexual attraction towards Amanda and discloses unresolved feelings about a previous relationship. These personal revelations succeeded in dramatizing the book and in illustrating the inter-relational qualities of the therapeutic experience.

In the prologue Ernesto expresses his dissatisfaction with the term 'case study' in that it smacks of an objective, quasi-medical position that he clearly sees as inappropriate in relation to psychotherapy. He also recognizes the limitations of case studies since they are inevitably one-sided, partial and to some extent 'fictions'. A case study can only provide a 'snapshot' of a highly complex interaction between two people and of course it is a snapshot that is taken completely out of context. Despite these limitations Ernesto obviously feels these 'twice-told tales' are worth telling, not least because they are a further step towards the demystification of the mysterious process of therapy. I am sure those who read this book will too feel the tales are worth telling and I have no hesitation in recommending that it should be compulsory reading for all those interested in an existential-phenomenological approach to therapy. The book is also likely to be compulsive reading for anyone concerned with the conflicts and anxieties that are derived from the human condition.

Sarah Young