Book Review: Why in the World Not? An introduction to daseinanalysis

In Why in the World Not? An introduction to daseinanalysis, Miles Groth seeks to introduce and make the concept of daseinanalysis accessible to English-speaking audiences. He provides both an introduction to daseinanalysis and a review of the writings of Medard Boss, a foundational figure in daseinanalysis who coined the title. It was Boss who proposed the question in response to an analysand trying out something for the first time in analysis, "Actually, why not [Warum eigentlich nicht]?" The German expression, sometimes translated as "Why in the world not?", captures the core spirit of daseinanalysis wherein the analyst invites the analysand to embrace their freedom and to fully explore their authentic possibilities without restraint.

The book's introduction states that psychoanalysis had a dismal therapeutic efficacy, a shortcoming attributed to Freud's metapsychology. It also makes note of the limited effectiveness of psychodynamic therapies. However, there seems to be a bit of confusion as Groth cites Shedler's (2018) work, suggesting it reports the poor outcomes of psychodynamic psychotherapy. Yet this is a nuanced issue as Shedler is a proponent of psychodynamic therapy and has been openly critical of 'evidence-based' therapies such as cognitive behavioural therapy (CBT), which he argues to have a stunningly low efficacy rate. At times the book appears to be arguing against the psychoanalysis of the past, whereas contemporary therapists may be looking for a lively critique of today's widely practiced forms of psychotherapies. Despite these debates, the book is at its best when inviting professionals from the so-called helping professions to explore daseinanalysis as an alternative therapeutic approach. The approach is further illuminated by the mention of the Dutch psychiatrist and psychotherapist H.C. Rümke, who defined psychotherapy as the 'art of conversation'. The first part of the book is thus dedicated to elucidating the style of conversation that is unique to daseinanalysis, setting it apart from other therapeutic modalities. Part one of the book opens with a discussion of the term 'Daseinanalyse'.

For readers who might be daunted when encountering German, the first chapter is useful as it seeks to demystify the term and untangle some of the conceptual confusions that have arisen from translating the term into English. Groth thoughtfully provides a rationale for using the term daseinanalysis in English, in contrast to the term 'daseinsanalysis' which many readers may be familiar with. While such minutiae may turn off the reader, it is important to remember that Heidegger referred to translation not as merely a linguistic exercise but as a central philosophical issue (Groth, 1997). Indeed, the translation of the German Daseinalyse as 'existential analysis' has led to conceptual confusions and may give the impression that daseinanalysis is just another form of existential psychotherapy. The book carefully dispels this misconception. Also, for those who have trouble understanding Heidegger's ontological/ontic distinction, the introduction provides a brief and clear explainer.

Chapter 2 clarifies what daseinanalysis is not. Firstly, it is not psychoanalysis, although both Boss and Ludwig Binswanger, the other major figures in the early history of daseinanalysis, were familiar with Freud. Chapter 3 also briefly touches on the relationship between daseinanalysis and psychoanalysis, as Boss was both an analysand of Freud and was mentored by C.G. Jung. The influence of psychoanalysis is seen in Boss retaining the couch, the importance of dream life, and the 'evenly suspended hovering' of attention. However, Boss rejected the notions of the unconscious, transference and countertransference. Whereas psychoanalysis postulates an ego, daseinanalysis takes Dasein as its starting point. The fundamental question of psychoanalysis is "Why?" as it seeks the past causes of the analysand's behaviour, while the fundamental question of daseinanalysis is "Why not?"

A sizeable portion of the second chapter is also dedicated to the difference with psychiatry. There is an interesting history of daseinanalysis and Heidegger's reputation in American psychiatry, through the eyes of the psychiatrist Eugen Kahn. Groth is critical of Kahn and his criticism opens many strands of thought for the reader to consider. Is daseinanalysis a kind of existentialism? Would the history of American psychiatry have been different if Kahn had not poorly portrayed Heidegger and the early work of Boss, Binswanger and Roland Kuhn? Groth also writes that Kahn's failed to recognise Binswanger's misunderstanding of Heidegger, thus causing further confusion by merging the different strands of daseinanalysis developed by Binswanger and Boss. The chapter concludes with a section on why daseinanalysis is not psychotherapy, since there is no psyche involved, and distinguishes it from the sort of pastoral care made famous in the United States by Smiley Jordan Blanton and Norman Vincent Peale.

For those looking to become better versed in the theory and principles of daseinanalysis, chapter 4 provides a summary of five themes from Heidegger's work that provide a basis for daseinanalysis. The themes are (1) Dasein and temporality; (2) the existentives [Existenziale]; (3) language; (4) person and other; and (5) the distinction between caring about things (Sorge) and caring about the Other (Fürsorge). The section on the existentives, a renaming of what is usually translated as existentials, provides a succinct summary of them, which will be familiar to readers of Heidegger, but also adds one from Boss on dreaming life (Träumen). Understanding the distinction between caring about things and caring about the Other is also instructive for understanding the way-making (vorausspringend) sort of care provided by daseinanalysis. Unlike therapies based on the medical model such as psychoanalysis or CBT, daseinanalysis is non-interventional and aims not to change the Other, nor to do anything to or for them.

The second part of the book, 'Practice and preparation', begins in chapter 5 with an outline of the fundamentals of daseinanalytic practice. For those wanting to understand what makes daseinanalysis different from other forms of psychotherapy, this, along with the preceding chapter on theory, will be instructive.

These fundamentals are: (1) the use of the couch; (2) the fundamental rule of openness (not censoring oneself); (3) encouraging oneself); (4) the art of conversation; (5) the psychotherapeutic eros; (6) dreaming life; and (7) questions like "Why?" and "Why in the world not?". Each section provides a phenomenological perspective of key aspects of psychoanalysis through Boss' eyes. Perhaps most important is a discussion of love in daseinanalysis, the psychotherapeutic eros, as written about by the Peruvian psychiatrist Carlos Alberto Seguin. For those who have come to find therapy to be a sort of sterile medical intervention, or who have been trained to rationalise away feelings in therapy as transference or countertransference, this is perhaps the most challenging and potentially liberating section of the book. A brief overview of dream life is also important for those who had the importance of dreams dismissed during their formal training.

Chapter 6 is a brief account of the curriculum in use for the American Daseinanalytic Institute (ADI), of which the author is the president (note: this reviewer is the secretary of the ADI). For those interested in joining the ADI, it outlines a summary of what to expect if they choose to train as a daseinanalyst. It may also serve as a model for establishing similar institutes abroad. A special emphasis is placed on the importance of teaching analysis, which prospective daseinanalysis candidates must complete. While undergoing therapy is no longer mandatory in many training programmes, it is a foundational aspect of daseinanalysis training.

Much of the book is dedicated to the work of Medard Boss, offering a comprehensive review of his key papers on daseinanalysis. If the first two parts of the book serve as a beginner's introduction to daseinanalysis, the third part provides a deeper look at the man who has inspired the recent renaissance of interest in daseinanalysis in the United States. The concluding section is divided into two subsections, the first dedicated to biographical texts about Boss and the second to Boss's writings on selected themes such as the theory and practice of daseinanalysis, the influence of India upon Boss and his relationship with Heidegger. Together, these subsections form the bulk of the book, combined and comprise its core. Those looking to read more of Boss's writing will be glad to know there is also a sizeable bibliography in the book.

As an introduction to the basics of daseinanalysis, this book achieves its goal. Existential practitioners unfamiliar with daseinanalysis find it interesting to explore Boss's work and challenge and deepen their own practice. Ultimately, the book springs from the hope of the author that "daseinanalysis will offer what Western psychiatry and psychotherapy have been unable to provide" (p202), an approach to therapy that is truly human. If that is of interest to you, I would recommend this book. To all of those wondering whether to take some of their precious time to read it, I would only ask…well…you know the question by now: why not?

Kyle C. Glover

References

Groth, M. (1997). Heidegger's Philosophy of Translation. New York, NY: ETD Collection for Fordham University.

Shedler, J. (2018). Where is the evidence for 'evidence-based' therapy? Psychiatr Clin N Am. Vol. 41: 319-329.