Book Review: Existential Counselling And Psychotherapy In Practice (Third edition)

It was the end of last year when I was asked whether I was interested in receiving the latest 'batch' of books to come out of the British School of Existential Analysis. Of course I was interested, it is not every day when you get offered such a smorgasbord of treats all at one time! What a pleasure! (The culinary metaphor is intentional as you will see later). That same discussion gave rise to the realisation that these authors – all well published and respected in their fields – are not likely to put out unreadable or verbose books or texts that failed to engage the reader, and so the review was unlikely to focus a great deal on those aspects. I am delighted to confirm that this initial assumption proved to be correct as they are indeed all engaging and thought-provoking in their different ways. I experienced these books as one might enjoy a fine meal in a restaurant. The Adams and Cooper books were clearly identified as 'introductions' and when I sat down to read them, they were indeed my hors d'oeuvres. The Deurzen and Langdridge books are lengthier and weightier and acted as my main courses.

To start…

Martin Adams has tried to 'embody' an existential approach – both to the writing of his book and to the readers' experience of it – and this comes across in the consistent reflection on his own experience and his work with one particular client, Maria. I thought this focus on just one client was a very useful strategy as the reader is facilitated in their ongoing reflection on what it might be like to be Maria, to be Martin and to be a part of their relationship alongside the consideration of existential concepts and ideas. This means the novice reader has no reason to be distracted and miss the key points, it also means that inter-subjectivity is central to this approach.

One of the key concepts foregrounded in Adams' book is the importance of what he calls 'The Law of Existential Consequence' – a reminder that whether we are thinking about our clients or our own contribution to the therapeutic endeavour, our actions (and of course, lack of action is still an action) will have consequences and that an ongoing curiosity and reflectiveness is key to really coming to understand oneself and one's relationships.

One aspect that surprised me a little – but which I really enjoyed – was Martin's moving away from 'just' the philosophers. The surprise is due to the fact that so many existential texts seem to argue that the existential approach is of a different type and kind to all others and that it is so distinct and so different, that it has no need to engage with any other viewpoint. As if one cannot think existentially and think about disorder, evidence and the like. Yet Martin Adams draws our attention to the fact that our work means we HAVE to engage with some of these other epistemological assumptions because… our clients hold these worldviews and may not be ready to consider other perspectives; we may work in contexts that prioritise a certain way of understanding the world and we need to try to navigate between the therapeutic and the managerial, the individual and the socio-political. We ourselves may also veer between conflicting worldviews at times. And while Adams doesn't try to tell anyone how this should be done, his openness to working with colleagues and clients who have other perspectives opens up a place for us to revisit the conversation about how we welcome such dialogue rather than simply trying to do what so many fields try to do, argue that we are right … or at least that everyone else is wrong.

Mick Cooper's book is written with a different strategy in mind. While it too should be applauded for its brevity (it is after all conceived of as a 'Primer') Cooper adopts a slightly more 'objective' stance to the field and offers an overview that I suspect would be particularly useful for those wanting to inform service managers of the place of existential therapy in the wider psychotherapeutic landscape. Having said that, it is important to note that Cooper ends his book with a chapter entitled 'Client Study: A personal existential practice', where he talks about his own assumptions and practices. In this section he too offers the novice reader insights into another person's practicing of existential therapy. I thought this section was very illuminating as it offered me the chance to engage with a dilemma I have long had – and that is the place of the political in one's work as an existential therapist. I have never quite understood some writers' argument that to be politically minded is to impede a focus on the phenomenology of the client.

One perspective of Cooper's that I thought was incredibly useful is his understanding of the field as being understood as a spectrum of beliefs and practices rather than any single, rigid, prescriptive, manualised set of 'must do's'. We, like psychoanalysts, are actually a rather broad church. He writes that 'enormous variety exists across the existential approaches to therapy. Indeed, in some instances, they are hardly recognisable as the same therapeutic approach (for instance Logotherapy versus Spinelli's phenomenologically informed practice)' (Cooper, 2012: p 24). To help understand this he outlines nine interrelated dimensions that can be considered to understand the variations. He suggests these dimensions include bracketing assumptions versus adopting existential assumptions, directivity vs non-directivity, working descriptively vs making interpretations, psychological orientation vs philosophical orientation, individualising the client's difficulties vs normalising them, pathologising the client's difficulties vs de-pathologising them, Intrapersonal focus vs Being-in-the-world focus, orienting the therapeutic work around the therapeutic relationship vs placing no great emphasis on the client-therapist relationship and finally therapeutic spontaneity vs using techniques (Cooper, 2012: p 24).

He goes on to note that if we reduce:

these dimensions down further, it is possible to conceptualise the existential approaches as lying roughly along a hard-soft axis: with the more directive, pathologising, interpretative and technique-based ways of working at the former end and the more phenomenological, descriptive, relational practices at the latter. So a harder existential approach challenges clients to face up to particular existential realities; while a softer existential approach supports them to explore and understand the ways in which they experience their world

(Cooper, 2012: p 26)

On the whole Cooper steers clear from making any particular value judgements as to whether any place is better than another. It is not until the final chapter where Mick outlines his own way of working that he explicitly discloses the fact that he 'quickly became critical of the harder, more elitist elements of existential thought' (Cooper, 2012: p 80) and therefore he locates himself on the 'softer, more phenomenological, postmodern end of the existential continuum' (Cooper, 2012: p 81).

So I got to the end of my hors d'oeuvres with my appetite stimulated… but not yet sated. For anyone wanting to get a comprehensive view of the field they need to stay seated and move on to a main course or two.

The main courses

The fact that the Deurzen and Langdridge books are substantially longer than the introductory books means that the authors are able to talk about issues and practices at much greater length. This means the reader is treated to greater insight, suggestion and possibility of questioning and challenge.

Both authors identify as being members of the British School and this may explain why there is a great deal of overlap between the two – including their titles! Having the same publisher, I was surprised at how close their titles are – but that is not a key issue. One interesting difference (and it might be more a matter of expression than an actual stance) is that Deurzen's arguments steadfastly use examples of the ways in which experiences can be understood philosophically. Langdridge of course attends to this too but his examples are often socio-politically contextualised as well, therefore inviting a reflection on the possibilities, not only of the 'self' but also of what I think of as a 'culturally generated self'. Now, as I write this I feel a certain sense of risk. Deurzen does after all talk at length about the spiritual world and the ways in which individual's strive to make meaning of these experiences. But there is something different about Langdridge's focus. He seems to emphasise that being identified as a member of a specific group – gay or lesbian, black or white, male or female carries with it experiences that are phenomenologically relevant and in need of understanding. Langdridge seems to me, to be addressing the ways in which our situatedness offers – or maybe even forces – some meanings.

In terms of therapeutic style, Deurzen's is clearly not just a reflective one. Reflection and understanding are key but so is questioning and challenging. Deurzen even talks about mentoring to help people face their limit situations in the same way that an art teacher may mentor a student (or in my metaphor the way a chef may mentor a novice cook). One is facilitating and engaging and offering direction but recognising that the limits and the passion must come from the person themselves. For Deurzen an understanding of the givens of existence allow us to recognise universals and comment on them with clients, showing them how they are personalising these issues and the effect of their action – maybe akin to Adams' Law of Existential Consequence.

I particularly liked Deurzen's snapshot of her work as focusing on three core steps – defining assumptions, determining values and exploring talents. It is these three steps, applied over the four dimensions of existence that offers us a glimpse into the 'how' of existential therapy.

Langdridge also has an interesting style in this book and one strategy I hadn't thought of before was the openness to teaching by mistakes. He explains concepts by explaining where he went 'wrong' or 'too far'. This is useful as what comes with this is a description of what he learnt in situ – something that many of us – not only trainees – can benefit from; It offers some ideas as to how we engage with our limitations without letting expectation or shame drive us into bad faith.

The advantage of reading Langdridge and Deurzen close together is that they look at the same philosophers (which helps deepen our appreciation of those ideas) and also at different philosophers which brings home the spectrum that Cooper suggests existential psychotherapy spans. In particular, Langdridge's historical eye helps us consider the fact that philosophers may be affected by the age and context in which they are working. This adds nuance to the concepts of the givens, encouraging us to consider whether we understand them as universal and somehow static over time, or whether they are better understood in terms of their historical and social situatedness. It left me wondering whether an ontological given in one age, may be understood slightly differently at another point in time?

Langdridge is another author who looks at formal empirical research and evidence alongside philosophical critique and practice. He utilises insights from research and theory, including quantitative studies. This is something that seems rare in much philosophical and existential-phenomenological discourse – and I would suggest that this may well prove useful in the wider application of theory to everyday contexts.

To conclude…

So at the end of this, can I outline a Cooper-ian, Langdridge-ian, Adams-ian and Deurzenian therapy? Not really, at least not without falling into that deterministic style that our contemporary world seems to like, i.e. that A is completely different to B and has no overlap. When in fact A and B may be different but very similar, like crème fraîche and clotted cream. These authors – and their slightly different perspectives are all useful as long as the reader reads with an enquiring and critical mind. The reader should not be reading to decide which of these has the 'right' answer, but more to consider how each of us might draw on these insights in our own practice with the unique individuals we encounter in our work as existential-phenomenological therapists.

A side issue

If I may step outside of the content that the authors address and finish with a brief consideration of the presentational issues. I might be wrong but it seems to me that publishers may be having quite a say in the new books. There seems to be an emphasis on standardised formats, bullet points as summaries, a requirement for multiple vignettes, etc. Some people might relish this but being familiar with the classical Deurzen text and having oriented myself through a different era of books, I do miss the older style of book – where you engaged with the material as presented and wondered what it meant that you had to review a certain section more than once; where the book didn't interrupt the wonderful flow of the author. I am sure publishers have good intentions but I do wonder if it helps or really whether it hinders. How, for example, do we embody existential philosophy through standardised formats? Is that not a clash of the overt and the covert messages, noema and noesis in conflict? It's a bit like odd architecture in a restaurant won't necessarily change the taste of the meal but if it is unsettling enough it may mean that you are distracted and it interferes with your enjoyment of the meal that has been so lovingly prepared.

Martin Milton