Book Review: Existential Perspectives on Human Issues: A Handbook for Therapeutic Practice

From first sight, Existential Perspectives on Human Issues: A Handbook for Therapeutic Practice intrigues, prompts curiosity and raised questions.

For me, the first question arose from the use of the term 'handbook'. An dictionary definition (www.thefreedictionary.com) gives the following: "A concise manual or reference book providing specific information or instruction about a subject or place". Yet, as it stated within the book (pp15), existential therapy is thought of as not having "….a shared starting point", and is "….based on a highly diverse set of philosophical assumptions" and, most importantly, "…..associated with a philosophical outlook that rejects homogenous, unified systems in favour of autonomous and individual forms of practice." Existential therapists and counsellors tend towards the standpoint that the philosophical underpinnings of this approach lead to an individual open-ending questioning and sense of 'not knowing'. So how can such an approach have a manual of practice?

This has always seemed to me to be a thorny issue for existential therapists; we work in an approach that takes inspiration from a philosophical 'attitude' and yet, as may be a main area of interest in many practices, how are we able to attempt to bridge the gap between this open-ended theoretical stance and the practical realities of our own practice?

Existential Perspectives on Human Issues: A Handbook for Therapeutic Practice very cleverly addresses this on several levels, the first of which is the structure. After an excellent and clear introduction to the philosophical and therapeutic background, the book follows the framework of the four worlds of existence; that is, physical, social, personal and spiritual. It is within this particular arrangement of the four worlds that different aspects of the human experience are addressed and discussed. So, for example, the physical dimension contains chapters that discuss an existential view of some human issues within that particular dimension - procreation to sexuality to death and much in between - with subsequent sections covering similarly relevant aspects.

And it is within this framework that I feel that there has been a stroke of brilliance - each chapter has been written by different authors, each of whom practice in or write about some of the existential areas of concern that may be brought to therapy. Thus we are not only presented with an overall framework of existential therapeutic areas but also the variety of 'voices' within this area. This tension between the formality of a framework and the individual voices within seems to me to reflect some of the experience of being with a client; that is, we have our own formalities and way of working within which we work with our own open and questioning stance.

Some chapters may speak to each reader more than others but this in itself also seems to me to reflect the very nature of individual opinion and view that is present within the current existential school of thinking.

As an addition to the varied and various reflections on the interpretation of theory into practice, each chapter also contains a relevant case study that can give the reader a sense of clarification of theory translated into practice.

Many of the chapters reflect upon areas of existential therapeutic practice that have previously had limited discussion. It is likely that each reader will find their own particular omissions satisfied in different and differing chapters, again reflecting the wide range of human experience that is addressed within this book. For me, the chapters on families and groups not only seem of great relevance but also raise the question of why there has not been more reflection on the individual within groups. Indeed, as Naomi and Anthony Stadlen state in their chapter on families (p. 134): "Understanding families is not an optional extra for existential therapist or for those who consult them. The quest to understand how one has responded to one's family of origin, and to transcend it, is at the heart of any existential search for self-knowledge." However, as the editors acknowledge in the preface, there are many areas addressed within this book that could easily expand into longer papers or a complete book.

Overwhelmingly the flavour throughout this book is one of questioning and bringing one back to a stance of maintaining a sense of 'unknowing'. Reminders of this important aspect of being and becoming an existential therapist are many. Hans Cohn writes (p 221) eloquently of the existential grounding of understanding within interpretation: "In the act of understanding we are confronted with a message, a phenomenon which addresses us all, asking for our response." This speaks directly to part of our experience with clients. However, by referring to the philosopher Freidrich Schlieremacher's description of "hermeneutik" or 'the art of avoiding misunderstandings', he warns us that "all understanding is partial; misunderstanding can never be completely avoided. Something always remains un-understood."

Similarly, Sarah Young in her chapter on dreams reminds us (p 211) that "The process is never completed, there are no final answers and aspects of any phenomenon remain concealed." Both of these examples - two amongst many - can remind us that within the therapeutic context there should always be a continual striving to understand and clarify whilst emphasizing that any such understanding can only be partial.

As a 'handbook for therapeutic practice' this book presents a framework within which to work which, as Emmy van Deurzan states, (p.278) "….works best when it remains invisible, used as a transparent map of human existence, which provides a background frame for the investigation of the client's particular predicament.". But is also, through its many and varied points of view represented, presents a continually questioning and challenging stance to the way in which we translate our philosophical theory into practice. It is perhaps this questioning curiosity and rigour that this book is reminding us that we would be advised to 'keep to hand'.

Kathy Parsons