Book Review: Integrating Existential and Narrative Therapy: A Theoretical Base For Eclectic Practice

Existential and narrative approaches to psychotherapy and the philosophies they are based on are both known for their diversity. This lack of unity on both sides of this integrative model requires the author to describe and choose a position from within these already complex and divergent areas. As if this isn't enough, Richert attempts to integrate his person-centred orientation into the mix, further complicating the field. Perhaps this is made easier by the humanistic strand of existential therapy as practised in the United States in which it becomes increasingly clear Richert is situated. For readers looking for a thoroughgoing study of how existential thinking from Heraclitus to Heidegger and beyond might sit with narrative ideas in psychotherapy, this is not the book for you.

If one can gauge the understanding an author has of a particular area by the references he uses most frequently, Richert grounds his existential thinking on Macquarrie (1970) and then a range of works by the existential practitioners Yalom, Bugental and May, in decreasing order of frequency. Other existential figures get an occasional mention, including Deurzen and Laing with a rare quote here and there from foundational sources such as Buber, Heidegger, Sartre and Tillich. While drawing on practitioners is important and instrumental to Richert's integrative proposal, the fact that foundational existential thinkers are for the most part sidelined is a limitation of the book.

This limitation is shown clearly in regards to Richert's overall purpose to present a framework for the process of change. So that when he describes the mutative elements of existential therapy he cites the therapeutic relationship as the sole factor in client change and describing it as lacking in challenging questions. This ignores the traditional use of Socratic dialogue by existential therapists for relating to experience and the questioning of assumptions (Cooper 2003), or Pyrrhonian scepticism for the questioning of dogmatic stances and suspending judgement while weighing different sides of an argument (Heaton 2010), nor for that matter Heideggerian questioning: What is the nature of Being? What is a thing? How do we relate to it? What does it make available to us? How does it influence us? And what of the possibility of things being otherwise? (Heidegger 1968, 1971, 1993). Rather than a gap to be bridged, as Richert suggests, these existential questions and challenges are similar to the narrative questioning which seek to understand how we construct our world and a common foundation of the two frameworks.

This is not the only time he makes a significant error in describing existential therapy that he later claims to bridge with his integrative model. Concluding his definition of the self in existential terms vis-à-vis the narrative position he says:

Despite the diversity of points of view [in both camps], it seems reasonable to conclude that among narrative therapists the self is not a central concept and that self is understood as fluid and multiple rather than as unitary as is the case for most existentially rooted psychologists

(p44)

This is simply not true. He contradicts himself when he says on this same page that Bugental, May and Yalom view 'the self as process rather than a fixed set of contents' (ibid). He also fails to point out that alongside 'true social constructionists' the self 'exists only as it is defined at any given moment in interactions between two people' (ibid). This is very similar to Merleau-Ponty's (1968) notion of 'the intertwining' and the 'phenomenological "I"' that Spinelli (1989) describes. Such confusions and contradictions are, well, confusing, and while I know something about existential thinking and therapy, I am less clear on narrative ideas and wonder if he is trustworthy guide in this area as well.

Turning to narrative thinking, Richert explains that narrative therapy is based on constructionist ideas. He identifies three main branches of constructivist thinking as radical constructivism, social constructionism and critical constructivism. Foundational ideas within these branches range from the view that if reality exists it is unknowable and that human reality is based on biology and neurology, to the idea that reality is constructed between people via language or simply by our efforts to make sense of our experience. The latter idea is associated with the critical constructivists, which is the group that Richert chooses to integrate with existential thinking. It is worth pointing out that the Society for Existential Analysis is an organisational member of the Constructivist College of the UKCP, so that there is an institutional precedent for common ground between these modalities. Happily, the summary he gives of the critical constructivist position is consistent with the philosophical statement of the Constructivist College posted on the UKCP website (UKCP 2012). Richert devotes more time and space to constructivist and narrative ideas and a look through his references show they are heavily weighted on this side of things, however I did not get a feeling for what narrative therapy might be like in practice until I was a quarter of the way into the book (totalling 400 pages by the way), despite having researched this area in connection with using poetry writing in therapeutic groups.

Richert does show that the two therapies have enough common ground for integration despite ignoring some important similarities and their even deeper philosophical roots. With some reservations, I can generally agree that these include that we are meaning-making individuals who create our own reality, that change rather than stasis is the norm, that dysfunction occurs through an inability to choose and that the therapeutic relationship is based on equality. He does identify two differences which I agree are important. The first is about language. He points out that language is presentational or lived for existentialists and representational or symbolic for the constructivists. The ideas here are complex and this is one area where a deeper exploration of foundational sources would be useful. The philosophers he mentions, such as Johnson (2007) and Polanyi (1958) thicken the discussion, but are too brief. The second difference is the existential stress on embodiment and the narrative privileging of cognition. He uses Gendlin's (1964) ideas on the 'felt implicit' to tackle both of these problems to good effect. The felt implicit is a pre-conceptual bodily experience of emerging meaning that becomes explicit in language. As an existentialist I am very comfortable with this move, but wonder how a constructivist would feel about this.

In the second half of the book, Richert moves away from theory and the book becomes more of a training manual for therapy, ostensibly based on the integration of existential and narrative theory. In reality, he proposes a wider integration than described at the outset, and this is where his subtitle: A Theoretical Base for Eclectic Practice comes in. While using the integrative principles listed above, in the case studies provided he shows how he meets the client where the client is, exploring the clients narrative and the relationship to the problem they face in order to assess the mode of therapy he will employ, whether by cognitive and practical means or toward constructing internal meaning out of personal experience. This is a worthwhile project and from the examples he presents, he has developed a sound integrative system of working, but in my opinion, it is more suited to narrative and constructivist therapists who want to work more integratively rather than existential therapists who want to integrate narrative therapy, as the existential elements are already present in narrative therapy.

On the whole I found this a confusing book. The title and the introduction are somewhat misleading; masking the nature of the wider integrative project Richert has in mind. The structure of the book bogs it down, by giving an initial outline of the two frameworks in the first chapters and then widening and deepening their differences and similarities in ensuing chapters before discussing the implications of integration in a further chapter, resulting in frequent repetition and review that becomes tiresome. For existentialists who are interested in exploring narrative or constructivist ideas, I would look elsewhere. I suggest, White and Epston (1990) and Angus and McLeod (2004), detailed below.

References

Angus, L. and McLeod, J (2004). Handbook of Narrative Psychotherapy, Practice, Theory and Research. Sage Publications, London.

Cooper, M. (2003). Existential Therapies. Sage Publications, London.

Gendlin, E. T. (1964). A theory of personality change. In P. Worchel & D. Byrne (eds) Personality Change (Pp 100-148). John Wiley & Sons, New York.

Heaton, J. (2010). The Talking Cure: Wittgenstein's Therapeutic Method For Psychotherapy. Palgrave Macmillan, Basingstoke.

Heidegger, M. (1962). Being and Time, J. Macquarrie and E. Robinson, trans. Blackwell, Oxford.

Heidegger, M. (1971). The Thing. Trans A. Hofstadter. In Hofstadter, A. (ed.) Poetry, Language, Thought (Pp 163-182). Harper & Row, New York.

Heidegger, M. (1993). The Question Concerning Technology, W. Lovitt, trans. In Krell, D. (ed.) Basic Writings, Revised and Expanded Edition. (Pp 307-341). Routledge, London.

Johnson, M. (2007). The Meaning of the Body: Aesthetics of Human Understanding. University of Chicago Press, Chicago.

Macquarrie, J. (1970). Existentialism. Penguin Books, Harmondsworth.

Merleau-Ponty, M. (1968). The Intertwining—The Chiasm, A. Lingis, trans. In Merleau-Ponty, M. The Visible and the Invisible, C. Lefort (ed). (Pp 130-155). Northwestern University Press, Evanston.

Jamie McNulty