Book Review: Case Studies in Existential Psychotherapy and Counselling

This book is a collection of eleven case studies in existential therapy. It is part of the Wiley series, whose overall editor is Emmy van Deurzen, van Deurzen says, in her introduction, that this is an important book which gives practitioners insight into how others in the field work with clients. I noticed that I often thought: 'Well, I wouldn't have done it like that' or 'I'd never have thought of doing it like that'. I found that my imagination and creativity was, once again, being stretched as I looked at how others' meaning and interpretation was set out on the page. Simon du Plock, the editor, says that he imagines that readers will be frustrated with much of what they read but suggests that equally the material may lead them to want to look closely at their beliefs

Each study is set out in a format that consists of a general introduction, an introduction to the client under discussion, a description of what happened in therapy, a reflection by the author and, finally, a question and answer session between the author and the editor. I found this format both helpful and frustrating - the questions asked were not always the ones I wanted answered.

The book looks at life meaning, for both the client and the therapist, through such issues as HIV, brain damage, infertility and mid-life crisis. The editor seems to have taken trouble to include a broad spectrum of case studies that might be of interest to a wide readership. Theory has its place, as each contributor writes about the theoretical background they work with and I found this helped me to examine what I have read and where it fits into my belief system. For instance, Freddie Strasser, in his chapter, talks about Heidegger's description of authenticity and, once again, I realised that I needed to read Being and Time to work out what I believe. It explores how each therapist works within the existential framework to investigate meaning for the client. There is an interesting discussion between Alessandra Lemma and the editor about her attitude to existential therapy within her psychodynamic practice.

I found this book very interesting indeed. It is consistently well written and open to understanding. I found that I was reading about what actually happens with a client and not about a theoretical framework. The therapists appear to be open and honest about their encounters with clients. For instance, Simon du Plock, in his chapter, talks about the bracketing he had to do not to pigeonhole his client as a type. Steve Ticktin, in his chapter, says how he spoke to his client about his own unrequited love, which, he hoped: 'made me a more real person to her .... she was in the presence of someone who understood the particular nature of her suffering'. Zack Eleftheriadou, in her chapter on cross-cultural therapy, describes her struggle to be with clients in their struggle to hold on to two cultures. She describes how easy it would have been to have concentrated on one to the exclusion of the other instead of being with the client in both her worlds. Whilst I might, for instance, have to think deeply about self-exposure with a client, the importance of the book is that it causes that reflection and does not allow me to carry on with working only in my sedimented belief system.

There seems to be a dichotomy for me in recommending this book. As I have said, I found the book very interesting but I also had the feeling, as I finished each chapter, that I did not want to start the next one for some while. It seems to be a book to dip into rather than read straight through, although I think it would be a mistake only to read the chapters whose subject matter might be of special interest to the reader. Because each therapist works within the existential framework it does not really matter what the client brings as a presenting problem. There is something about the way in which existential therapists work, their concentration on meaning in the client's world, that would be missed if a reader were too selective. In all the chapters there are points of interest that caused me to look at myself and reflect on the way I work.

It is very interesting to look at these snapshots in time and learn how these therapists travelled with their clients. In the existential way of working the theory is put to one side and the client's meaning world is looked at as the client presents it. It is thought provoking to note that it is only the therapist's view of each encounter that has been written about. It might have been interesting to have asked each client what she/he thought about the experience and what was considered to be of most value. I found that I could harmonise with a lot that was said but, more importantly, I was often thrown back into looking more closely at how I am when I am with clients. It is this being thrown back once again into the maelstrom of being a human being that makes this book a very worthwhile read.

Nicola Slade