Book Review: Paradox and Passion in Psychotherapy: An Existential Approach to Therapy and Counselling

If psychotherapy and counselling concern themselves with people's moral, emotional and spiritual well-being, as I believe they inevitably do, then we had better begin by establishing of what this consists. If we want to open people's minds to some greater truth about themselves and the world, then we must have some notion of what that truth is. (p.79)

Emmy van Deurzen's Existential Counselling in Practice and Everyday Mysteries are books that already have an important place in the history of existential psychotherapy. However, I believe that it is with this book that van Deurzen has created something special and, at times, truly inspiring. Not only has she asked fundamental questions about life and the therapeutic enterprise, she has come up with some insightful 'answers' to these confusing questions, that open up possibilities for living a better life without falling into a prescriptive dogmatism. In asking questions of what 'truth', 'wisdom', and 'human well-being', may mean, she has gone back to philosophical basics and hence kept in view the wider questions that surround the creation of existential philosophy and psychotherapy. This is an ethical book, a work of moral philosophy, a meditation on living well that keeps in view most of the paradoxes and difficulties we all face. It offers a refreshing antidote to the majority of books on psychotherapy, including a number of other recent attempts to outline an existential approach. I hope that in the future more books in this field will approach their subject in such an honest, thoughtful and personal way.

This collection of essays (over a third of which have appeared before, in this journal or elsewhere, although some have been revised) is divided into three main sections. The first investigates the character of 'paradox', the second explores 'passion', while the third contains an overview of her particular existential therapy, ending with three case studies that act as illustrations of her theory.

Van Deurzen attempts to outline an existential approach to psychotherapy and counselling that embraces paradoxes inherent in being human which not only 'cause' problems in living but which also hold some of the answers to living a better life. When we accept and even welcome them as part of our human condition, we can see such dilemmas as unavoidable and hence a challenge. This is where passion is needed to commit oneself to the 'truth' of this situation. To commit oneself to this it seems we need an overall commitment to truth in our lives.

Some of these paradoxes may also be described as conflicts or contradictions of existence that engender anxiety. If there are a number of truths which seem contradictory and anxiety provoking then the temptation is to dissolve a part of the contradiction and, in so doing, assuage anxiety. However, as part of the human condition all aspects of the paradox remain true and significant. Consequently, part of them may take on an exaggerated status while other parts remain ignored; this can lead to difficulties. This is where van Deurzen brings in the importance of passionate commitment because it is related to 'truth' and 'wisdom'. An absolutely crucial question is how this view of a life well lived, and the explicit commitment to attempt to live it, fits in with the therapeutic enterprise.

Throughout the book van Deurzen illustrates her theory by relating personal events in her life which have acted as catalysts for the development of her philosophy on life. These events range from childhood experiences to her early professional careers working in mental institutions and 'progressive' therapeutic communities. There is also an open and interesting account of some of the mistakes she has made as a therapist, which have been valuable learning experiences. One example of the candid nature of this book describes van Deurzen's relationship with death. Her preoccupation with death from an early age, 'memento mori (remember that you'll die)', was an attempt to establish 'what it was and where it belonged in relation to me' (p.20). This desire to confront the darkest truths of human life led to an 'impasse', where the concentration on death hindered the living of life. It was after a narrow escape with death that van Deurzen 'embraced life in a much more determined way' (p.29). This is a good example of how a confrontation with mortality can lead to an introversion that becomes a diversion from life. However, this was also an experiential journey that led van Deurzen from a preoccupation with death to a profound realisation about life. This illustrates the problem surrounding a confrontation with the givens of existence - in what way should we think through existential issues such as death? When does the desire for wisdom through the pursuit of these issues become destructive and an avoidance of life? What is the best way to relate to these concerns?

Three case studies draw the book to a close. In these van Deurzen illustrates a handling of paradoxical issues that retains a sensitivity to the client's self-determination while clarifying some of the ways that the client may avoid facing the conflicts that they have played some part in creating. They provide an important attestation to the theory and personal stories that have gone before. I think that generally these case studies do provide evidence for van Deurzen's belief in her interpretation and use of passion, paradox, truth and wisdom.

This book will be controversial for some readers as it dares to talk not only of the importance for therapy of questions as to what it may mean to 'live well', but also about some of the answers that may stem from a passionate belief in the search for 'truth'. But these should not be controversial, as the bottom line of therapy is a search for a better way of living life for the therapist as well as the client. Emmy van Deurzen is passionate about her beliefs, her truths. However, they are not rules or prescriptive formulae' (p.139) to follow. Consequently, in keeping with the spirit of Passion and Paradox, I would like to suggest the following: this book itself becomes a paradox regarding the nature of 'truth' and the difficulties associated with communicating a truth which is both 'objective', as it refers to the human condition, and 'subjective', because the truth, by its nature, has to be chosen and lived by each individual. This dilemma is almost Kierkegaardian, and I do think that this book can be interpreted as raising the paradoxical nature of an existential approach to therapy that is committed to the ongoing search for 'authenticity'. Going by work published in this field it seems that, generally speaking, the existential therapeutic world does not take this paradox, or indeed paradoxes as a whole, seriously enough.

A therapist and their client are two separate individuals who come together in a co-creative relationship whose dialogue is ethical in nature. This alone-with-others paradox is addressed in various ways in this book. Whether the client sees his or her goal as more happiness, confidence, less depression, a better relationship, more self-belief, or any other typical goal of therapy, it makes a great deal of sense to call these goals 'ethical'. Van Deurzen is honest enough to admit her deepest values and attempt the immensely difficult task of thinking what a human 'good life' may consist of. Her version of existentialism follows the asking of fundamental philosophical questions about life with doubt and wonder, and this seems to me to be the right approach to finding/creating our own truths. Van Deurzen's existential philosophy, and she is clear to point out that 'the existential approach has to be created anew by each practitioner' (p.139), is difficult because it not only acknowledges paradox but tackles it head on. Her arguments allow for the paradox of the therapist believing in an authentic approach to being human without dictating to the client what that actually entails. This is a profoundly unsettling paradox for therapists but one that will not go away through a desire to remain safe and secure, within orientations or organisations.

John Pollard