Book Review: Which Psychotherapy?

As someone who sees existential psychotherapy as able to contain learning from many a tradition, and in some ways being an integrative psychotherapy, I am eager to explore thinking on these issues further. I had recently found an article by van Kaam (1963) on Existential Psychology as a comprehensive psychology and I was also looking forward to reading contemporary views in the contributions of people who are known to me by way of their own work or by way of acquaintance. Several of the authors will be known to graduates of Regents College with contributions from John Heaton, Robert Langs and John Rowan.

With this potential I was looking forward to a thought provoking dialogue between the contributors. Alas, this was not forthcoming. For me, this book was not one of dialogue, but self-aggrandisement, either of the model or of the author, and this made for some disturbing reading. This was evident in contributions from both the UK and the US. I found it hard to gain an understanding of several of the models and the issue of integration was, overall, not the main focus of the book. What this book does give us is an insight into the people who are espousing the models, and the dangers of our being attracted to a model by the charisma of its proponents rather than the credible insights/arguments that the theory/view holds.

This focus may be partly to do with the questions that were put to the authors, questions that asked about personal values, personal understandings and the reasons why they developed/adopted the model they did. The authors were also asked to write about what they saw as the strengths of the model. Several of the authors used the editor's questions to highlight their own contributions, where they teach, their current activities, their publications record, etc. While this can sometimes be of great assistance to the reader, in determining the stance that the author takes and the factors that have influenced this, I couldn't help but feel that several chapters descended into self-congratulatory rhetoric at the expense of the argument. As a colleague said to me, "simply shouting often enough and loud enough does not give the argument foundation and legitimacy". The development of an argument seemed to be rejected in favour of an appeal to being special, clever and different.

The existential approach was mentioned in a couple of other chapters, but as is often the case, in a manner which might be foreign to how members of the Society might view the approach. When it was mentioned it was generally as an adjunct to humanistic. Thus, the term 'humanistic/existential' was evident and this was not necessarily an attempt to integrate the two traditions, but rather, a misunderstanding of an existential approach to psychotherapy. Thus, it was particularly important that a chapter had been put aside to represent Existential Psychotherapy.

John Heaton's chapter is different to many in this collection, both in style and in content and is one of the chapters that did provide a chance to think about the meetings between different approaches. John Heaton sticks to a clear description of his understanding of existential psychotherapy and makes the point that an existential approach "is not a psychological school of therapy founded by a charismatic leader who claims to have discovered some truth with profound therapeutic implications to humanity". It was a breath of fresh air to read this after having had to wade through so much which had put style above content.

An interesting result of reading Heaton's chapter was his reference to a number of writers who would not have immediately sprung to mind as Existential writers. This allowed my thinking to be challenged and also equipped me to search further afield than the areas I am used to reading. The existential stance to knowledge as one with a multitude of meanings is evident in this chapter and in this regard shows an area of apparent disagreement with the scientific, technical approaches outlined by Albert Ellis (Rational Emotive Behavior Therapy) and Stephen Palmer (Multimodal therapy).

In reading Albert Ellis' contribution, I came to share some of the concerns highlighted by Heaton regarding 'technical eclecticism'. Ellis' chapter reads with a certain disregard for the meaning of individual experience, in that good assessment will tell us whether clients really are getting 'better', asking clients won't. In this example I was reminded of some of the dire interpretive power games played on clients by certain analytic techniques.

Thus, if I had relied on this book to inform me as to whether or not the psychotherapies are really irreconcilable, I would be tempted to think that they are. I would also have concluded that this is more to do with our egos as individual practitioners than it is to do with the stances inherent in the theoretical models. I think that if we survive the rhetoric, there are areas in which the psychotherapies appear to meet on common ground, and this has been well addressed in the phenomenological literature (see Spinelli, 1994), and this is when they are based in the individuals experience and when the theory recognises the power of the 'Other' in our experience. It might be said that when we are able incorporate a phenomenological stance in our work we are most likely to find a method of integration in practice. As existential psychotherapists we need to learn from this and not feel that we can sit back and feel smug about having 'phenomenological' in our title. While our allegiance to existential philosophy, principles and theory might be a challenging view to sedimented theoretical stances in some regards, we must not forget that any theoretical stance, if taken as gospel might lead us away from being phenomenological in practice. If we find ourselves doing this and 'existential ising' everything, we need to think more critically, as we would expect those who follow other theories to do.

Martin Milton