Book Review: Committed Uncertainty in Psychotherapy

Essays in Honour of Peter Lomas

Edited by Lucy King. 1999. London: Whurr. 162pp.

Although not described as such, this book is a Festschrift, in honour of Peter Lomas' 75th birthday. It consists of papers by twelve authors, including Michael Jacobs, David Smail, Paul Roazen and our own John Heaton, on Lomas contribution to psychotherapy. Trained originally as a G.P., Lomas became a psychoanalyst as a part of the Independent group, i.e. not aligned with either the Contemporary Freudians or the Kleininians, and worked for a time at the Tavistock Clinic. His own earliest papers on issues of family dynamics are from this period. He was apparently well regarded by his teachers among whom were Charles Rycroft, D.W. Winnicott, Michael Balint and Marion Milner, and also by his peers. While he worked with R.D.Laing researching into family dynamics and according to Mullen (1995) he is one of the few people Laing had any respect for. Laing contributed a paper to Lomas' first book (1967) which is referred to in Clay's (1996) biography of Laing. Lomas eventually found both the claustrophobic atmosphere of British psychoanalysis and the narrowness of the analytic thinking of the time so unsympathetic that he left. As did Rycroft, Bion and Laing, all for similar reasons, although entirely independently of one another.

He first stated his objections to psychoanalysis in 1968 (ed. Rycroft 1968) and this still makes for relevant and exciting reading today. His thesis, echoing that of Laing (1965), is that since psychoanalysis is based upon research carried out under the paradigm of Natural Science it is an inadequate tool for conceptualising and making sense of the human condition, and what is needed is an Existential Analysis which values

experience and views the person as a being, as the agent of his or her actions. He was not necessarily abandoning the notion of science as such because science is simply '...systematic and formulated knowledge'. (The Oxford English Dictionary) merely saying that psychoanalysis should not be submitted to the rigours of Natural Science because it is based on observations in order to determine causal relationships and qualities with the assumption of that both people i.e. therapist and client are essentially passive or reactive. And this is not a realistic description of being. Lomas (1968) makes a convincing case for psychoanalysis to regard itself as a Human Science based upon phenomenological investigation similar to that made by Giorgi (1970) with respect to that of psychology as a whole. Although few would disagree with this now, it was Lomas who grasped most fully the implications for understanding the human condition, therapeutic practice and also training. What gives his stance such authority is the depth of his knowledge of psychoanalytic theory and practice as well as of Existential philosophers like Heidegger, Sartre, Kierkegaard, Tillich and Buber. His first two books (1973 and 1981) are regrettably out of print but his more recent work can be accessed in The Limits of Interpretation (1987). In this book he explores his objection to psychoanalytic practice with respect to its reliance on theory and technique over relationship.

Regarding the therapist's role which he explored in Cultivating Intuition (1994) he felt there was nothing mysterious, technical, exclusive or prescribed about the care and attention that characterises an effective therapist: client relationship. It is fundamentally ordinary. The paradox is that although ordinary it is also intensely special, and any attempt to prescribe it is a corruption of reality and doomed to failure. A further paradox is that it cannot be taught either. The psychotherapy training programme he devised in Cambridge embraces this practical and ethical dilemma. He talks a little about this in Cultivating Intuition and in the present book some students of the programme get the opportunity to reflect on the experience.

In his latest book (1999) he extends his previous work arguing that therapists become dependent on the technical aspects of their profession at the expense of the many moral issues like the use and abuse of power, and he explores the dilemmas involved when there is a clash of moral beliefs between two people. This avoidance of the moral issues in the cause of spurious scientific neutrality means that the dialogue between the therapist and patient tends to be distorted, potentially confusing, and too remote from the healthy reality of ordinary conversation, and may hinder rather than help the healing process. What Lomas has done in his life's work is to combine the dynamic conception of psychoanalysis with an existential ethical regard for the person as experiencing being. As such he occupies an almost unique position within the British therapeutic tradition and can be thought of as an originator of the existential perspective. His writings

are as relevant today as the day they were written and he deserves to be read more widely. This particular book although interesting for Lomas scholars, is not as rewarding a read as going to the original works which are as fresh now as when they were written.

Zollikon Seminars

Protocols - Conversations - Letters by Martin Heidegger, edited by Medard Boss. (2001). Evanston: Northwestern University Press. pp352.

Originally published in 1987, the Zollikon Seminars are an important work for any person who is interested in philosophical guidelines for psychotherapy practice, research, supervision and theory. The book contains the full set of verbatim seminar material from September 1959 to March 1968 at the home of Medard Boss; plus notes written by Boss concerning verbal clarifications made by Heidegger; plus an edited set of letters between the two men. Thereby Heidegger presents his manner of thinking to assorted mental health professionals in an informal context. For this alone, the book is most useful in trying to plot the constant themes and the developments within both the orbits of philosophy for philosophers and philosophy for mental health workers, from 1924 to 1971.

A very great deal could be written on what Heidegger said concerning psychology, psychiatry, Freud and other matters. For this review I shall limit myself to discuss only the difference between Heidegger's philosophical thinking and the Daseinsanalysis of Boss and conclude with some comments on what it means for the current situation in the UK.

By Heidegger's own proclamation, in 1955 at the Cerisy conference, there is no Heideggerian philosophy. To follow Heidegger's thought is to try and think being through a comparison with the historically accruing ways in which it has been thought - and to think about thinking and that which is the referent of thought of different types. Heidegger's thought is an idiosyncratic language that is exceptionally influential in its attempts to overcome perceived problems of superficial, ontic, inaccurate, 'anthropological' and subjectivistic thinking in philosophy, and by extension the human sciences. Heidegger's thought is not the transcendental philosophy of Kant nor the transcendental phenomenology of Husserl. Despite footnote 10 to section 10 of Being and Time where it is stated that ' A priorism'' is the method of every scientific philosophy which understands itself... the investigation of the a priori requires the proper preparation of the phenomenal foundation," (p.401). So for those who would like to plot the development between Kant, Husserl and Heidegger, I am sure that the Zollikon Seminars is important. The analytic of Dasein is a genuine study of the conditions for understanding the relation between Dasein and being (cf BT §9, p.42). The language used characterizes human existence as an openness to being that is "care," a shared being in the world. It is temporal, historical, a clearing or illumination of being. Such thinking overcomes the 'problem' of subjectivity because it is the nature of human being to have a world or to enable it to happen. The philosophical underpinning seems to be the finding of the conditions for the unity of Dasein and being, all the types of existence of what exists. This truth is found through dispelling mere appearance and illusion and finding hidden insights, the existentiale, or ontological essences or categories of Dasein.

However, the Daseinsanalysis of Boss is not the same as Heidegger's existential analytic of Dasein. The mental health applications of Heidegger's thought concern specific examples of actual persons who are understood through the philosophy. For those who use Heidegger in psychological helping are much freer to use any insights that shine some light on the task. This may entail the overcoming of false solutions created by false understandings; whilst possibly showing some genuine problems that are not yet sufficiently understood. The genuine problems may be currently obscured by the false clarity of superficial thinking an untested belief. What looms large are the problems of the medical model in psychiatry and psychiatric nursing and the scientist-practitioner model in clinical psychology. Both are exponents of natural science interpretation of the mind and body, understood as a strange duality, a difficult question for empirical research. The malaises of realism, material reductivism and the unquestioned bad inheritance of practices and assumptions that maintain an excessive focus on the biological and experimental entirely miss the

phenomena of meaning and being. Or perhaps construe them as mere epiphenomena, a useless luxury.

The consequence of the natural science understanding and its values creates natural psychological science as a dominant force. This is particularly evident in the current valuing of the quantitative random control trial model to justify practice, training and funding in the National Health Service for all types of services. Indeed, there appears to be a consequent valuing of the psychological technique, and the questionnaire as the assessment tool, over the arguably more fundamental understanding and relational nature of being human, the psychosocial skills, that enable the brand name therapeutic orientations to exist.

The Zollikon Seminars is a lucid document towards attending to the phenomena, albeit the phenomena construed in a certain way. For me, it still seems an open question as to how practice, theory, research and supervision can be better slanted towards the phenomena of receiving and providing therapy understood as part of a whole of a complex series of causes and effects. Let us hope that the tendency to ignore the understanding and experiences of clients, for the easy vanity of pining pet theory on to them, will be decreased through further applications of the phenomenological ontological type of thinking.

Ian Owen