Book Review: Sexuality: Existential perspectives

No Sex Please, We're British was the classic 1971 London West End show that pushed the boundaries in exploring Western perceptions and attitudes towards sex and sexuality. Despite the stereotypes associated with the British stiff upper lip, the show ran successfully until 1987 fuelling a curiosity with the subject. Were audiences drawn to the topic of sex and sexuality in 1970s Britain as a way of tackling the taboo or were people feeding their natural innate hunger to want to satisfy human desires that are present and universal with all beings? Either way, the human desire to experience love, sex, intimacy, sexuality, acceptance, eroticism and touch has not escaped humanity and nor will it ever. Therefore, as therapists how do we engage with such concepts in our therapeutic encounters in such a way as not to devalue the client as well as not leaving the room with rosy cheeks that imply our own embarrassment in the process?

Our profession has long prided itself on working with difference, diversity, social inclusion and acceptance of humanity in a way that allows clients to explore themselves in a safe and contained space. But what if that space begins to feel unsafe for the therapist? Imagine a client being to develop sexual feelings towards you in the therapy room and this makes you feel uncomfortable or even overjoyed that your client shares with you something you may be feeling towards them? Will this mean the end of the therapeutic relationship that you have so patiently developed with your client? Where does this leave your client? Where does this leave you, the therapist, the professional? Such real dilemmas are explored in-depth with practical clinical interventions in Sexual Attraction in Therapy: Clinical perspectives on moving beyond the taboo – A guide for training and practice (edited by Maria Luca). The book presents the reader with theoretical and clinical perspectives from several therapeutic approaches that explore the reality of sexual attraction in therapy. More engrossing to the reader, the book uses case studies (confidentiality and anonymity maintained) that explore not only the client's attraction to the therapist but the therapist's attraction to the client. As therapists, if we were honest to ourselves and to our profession, can we honestly say that we have never felt a slight sense of attraction to a client? I'm not asking for a confession here, however, what I want the readers to experience as I did whilst reading this book, is to face the subjective reality that sexual attraction can come from the therapist and this is something that can be anxiety provoking for many. Maybe may feel feelings of shame or guilt or even that they are not a good enough therapist, which are the norm responses to this phenomenon. Therefore, therapists (as the book suggests) should be supported to reflect upon and explore these responses through good-quality supervision.

The appeal of this book also comes from the editor's striking ability to move away from the traditional debates and dialogues surrounding transference and countertransference in the therapy room that we have become so accustomed to in academic literature. The book is well-written, with accessible language and 15 succinct chapters that cover a wide range of therapeutic approaches all of which offer practical, clinical strategies in the event of sexual attraction. I found this most useful as the book moves away from the theoretical into the real-world of therapeutic inventions. Eminent experienced clinicians offer perspectives from CBT, Existentialism, Systemic and ACT, which for a counselling psychologist as myself, being able to have different perspectives allows me to inform my work within an integrative approach. The editor has done extremely well in bringing together different psychological strands. What I also found engaging with this book, was its ability to fuse research-informed work within the chapters. An excellent example of this is offered by John Penny and Malcolm Cross (Chapter 12) who through using a discourse analysis of male heterosexual therapists and discourse of sexual attraction concluded with six themes pertaining to masculinity and management of sexual attraction.

The book itself is not written from an existential perspective as it exposes the reader to the variety of therapeutic approaches, practical interventions and research-based outcomes that can appeal to integrative practitioners as well as one-modality practitioners. I do not see this as a criticism, but rather a celebration of the taboo that the book has tackled using different perspectives. I would recommend this book to both trainees and qualified clinicians alike, but also supervisors who have to encounter such disclosures from supervisees. The book is targeted at the specific therapeutic audience however, if someone picked this book up who has no background in therapy, they may benefit from the academic discussions on sexual attraction as a whole. It is liberating to read a book that is not afraid to push the boundaries that therapists work hard to maintain, thus allowing a sense of freedom in exploring a phenomenon that exists both in and out of the therapy room.

The next book Sexuality: Existential Perspectives (edited by Martin Milton) is specifically written from an existential viewpoint, exploring the notion of sexuality in the therapeutic domain. The book is very well presented with an emphasis on an academic foundation which develops as the reader becomes engrossed in the 7 parts that the book has been divided into, which are all rich in diverse content. The book offers an insight from eminent clinicians on the subject of sexuality from an existential perspective. I liked the way the authors discuss sexuality as being a part of life as opposed to it being just one part of or something static in life. The book enables the reader to engage in discourse regarding sexuality by asking the reader to go beyond the therapeutic room and look at their own perceptions of sexuality. It was particularly enlightening to read from the editor Martin Milton, that "..existential theory is no longer just stuck with "death" as a topic of interest. We are well involved in the attempt to clarify understandings and to explore new and creative formulations..." (Milton, 2014; p 12). I found this quote to epitomise the book and support the reader in their journey in exploring existential perspectives on sexuality, even though the death anxiety can be seen lurking in some small areas of the book!

The audience for this book is not just confined to the therapeutic world but to scholars, academics and keen enthusiasts in existentialism. I would suggest however that potential readers of this book should have a sound knowledge of existential theory and practice before reading it, as it is heavily steeped in existential philosophy and practice. From Merleau-Ponty to Sartre, the chapters are embedded in existential history as well as current trends in therapy and sexuality. I particularly welcome the controversial debates on affirmation therapy (chapters 6 and 7) and the LGBT community as a way of opening smooth flowing dialogue between society's assumptions of the LGBT community and LGBT individuals themselves having the space to explore an identity that is important in their journey of discovery. Such chapters support the exploration of the client and the therapist when they are engaged in existential dialogue in therapy, something which as a reader I value. Topics such as gay affirmative therapy, sexuality in the therapeutic relationship, childhood and sexuality are explored in detail and actually were refreshing to read. This book is bold in the topics it covers and the editor Martin Milton has done an excellent job in weaving together the past, present and future of existential therapy and sexuality.

Such a fundamental expression of self, the topic of sex and sexuality has long been synonymous with traditional psychoanalytic theory. It is therefore refreshing to read a book that encapsulates such a topic from an existential standpoint. Yet, the humility of Martin Milton's resonates with Emmy van Deurzen & Claire Arnold-Baker's (2005) Existential Perspectives on Human Issues. In that book, the contributing authors bought together different aspects of human life, engaging with painful parts of human existence through the practice of existential therapy, something which Milton's (2014) book endeavours to do as well. Such a challenging and thought provoking book should not be seen as a passing phase but rather as a gateway for other writers to continue dialogue on this topic. With a mass rise in child exploitation, human trafficking and historical cases of child abuse surfacing, the topic of sex and sexuality should not be shied away from but rather further developed in order to understand the darker side of such acts. Even Martin Milton (2014) in his epilogue acknowledges areas such as pornography, BDSM and sexual violence have not been covered in the book. Entering into such uncharted waters from an existential approach would allow for the therapeutic community to support clients at their most vulnerable and challenging times.