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Post-existentialism and the Psychological Therapies

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A valuable contribution to the field by a professor of psychotherapy and author and editor of many titles in this area.

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10 Chapters

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CHAPTER ONE: On the very idea of post-existentialism

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Del Loewenthal

This book is for individual and group psychological therapists: counsellors, psychotherapists, psychoanalysts, psychologists, and arts and play therapists, whether they be integrative, humanistic, pluralistic, psychodynamic, existential, systemic, or cognitive behavioural, who want to start with practice. I am therefore proposing the possibility of exploring the psychological therapies at the start of the twenty-first century, in a way that is in contrast to the prevailing culture that has led to the increasing dominance of approaches such as cognitive behavioural therapy (CBT) (which start with theory and are increasingly being manualized). Though what is ultimately being criticized in this book is any theoretically driven model.

An attempt is made to offer a space where we might still be able to think about how alienated we are through valuing existential notions such as experience and meaning, whilst questioning other aspects such as existentialism’s inferred narcissism and the place it has come to take up with regard to such aspects as psychoanalysis and the political. The post-existential would also include the post-phenomenologi-cal, where, for example, Merleau-Ponty’s notion of being open to what emerges in the between (Merleau-Ponty 1962), as well as his notion of embodiment, would be given primacy over Husserlian notions of intentionality. As a result, questions such as those of mystery, an unknown and an unconscious, and the non-intentional can be re-examined. A third element to be explored will be the extent to which we might consider more recent ideas—for example, those of Saussure, Levinas, Derrida, Foucault, Lacan, and Wittgenstein (as explored, for example, in Loewenthal & Snell 2003)—without becoming too caught up in them. It is hoped that by having a possible space to explore what some would now call our “wellbeing”, theoretically through post-existentialism, and methodologically through post-phenomenology, that this can provide a loose base, without concerns of any further generalization, for a greater possibility of accepting, rather than escaping, who we are.

 

CHAPTER TWO: From existentialism (and post-modernism) to post-existentialism: from Buber to Levinas

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Del Loewenthal

If one thinks that nature can only be researched by instruments, then does the measurement frame the material? I understand the Greek word phusis or physis to mean what comes out of itself, the natural, from its own origins. But phusis has become only the results of measurement, what comes out of an auditing process (see Loewenthal 2010): this is a major change, and was not the original meaning of the word. Force then becomes the critical word: force is used in an attempt to reveal the truth. Perhaps what doesn’t come through in such notions of wellbeing is life itself with its wonderment including those aspects of which, as the French phenomenologist Merleau-Ponty suggested, may be defined by mystery? More generally, one may need to consider moving the parameters of science beyond the quantifiable to a different notion of the qualitative. This is not so much intellectual and rational but ethical, in a new dimension that is only starting to emerge (Loewenthal 2003). The science of quality might regard the ethical as arbiter; it is the well-being for one’s fellow person. (However, advocating quality in this way to the current technological priests does sometimes make Galileo’s job of advocating science to the Church seem rather easy.) I wish to explore such questions as: what helps or hinders an exploration of the most effective expressions of our and other psychological therapists’ (and their teachers’) desire to help? Is it possible to have both justice and action? Are, for example, our theories mainly perpetuating unintentional violence? Has traditional thoughtfulness been replaced by theories with fields of knowledge, territories, and ownership of subject disciplines policed by economic licensing arrangements, which in turn attempt to control language and thought, appropriating difference sometimes in the name of difference? Alternatively, in examining issues of the psychological therapies as a practice of ethics in terms of ideas of truth, justice, and responsibility, are there ethical post-existential considerations from which we can assist in an embodied way so that we can help others not do violence to others? Indeed, is it possible for us as psychological therapists not to interrupt our own and others’ continuity, not to play roles in which we no longer recognize ourselves and whereby we betray not only our commitments but our own substance?

 

CHAPTER THREE: Post-phenomenology and the between as unknown

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Julia Cayne and Del Loewenthal

This chapter is concerned, with what might be considered, a post-existential/post-phenomenological view of the relational. As such it takes a view of the relational as involving beings who are separate but neither isolated from each other or incorporating of each other, as in reducing the other to one’s own world view. In other words, there is play in the relationship. A way of viewing the relational is that it occurs in the play between two people and it will be argued that what occurs in this between is largely unknown. There is, however, the problematic that as soon as we speak of the between, which represents a gap or disjuncture, the problematic of language tends to lead to defining and locating that which cannot be treated or defined as a “thing” and which can be known only through the phenomena that emerge. We are thus in the domain of temporal spatiality. Some ways in which we respond to the idea of the between are explored in order to highlight how the meeting between existential phenomenological, psychoanalytic, and post-modern ideas can inform post-existential practice (Loewenthal 2007a: 221–240).

 

CHAPTER FOUR: On learning to work with someone with a label: some post-existential implications for practice, theory, and research

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Dennis Greenwood and Del Loewenthal

This chapter examines a clinical case study of psychotherapy with a person diagnosed with dementia which lasted for over three years and formed part of a research project exploring the possibility of psychotherapy with this client group. The practice example described here provided the opportunity to explore possible implications for both research and theory in relation to what is being described as the post-existential. A phenomenological hermeneutic approach to case study is outlined, which allows the researcher the freedom to explore the theoretical implications for practice without being overwhelmed by the dogma of scientific method and notions of truth or certainty. This chapter explores the “subjective” limits of phenomenology and existentialism by looking at the work of Buber and the “I-Thou” relationship and considering the challenge made by the continental philosopher Emmanuel Levinas to the whole concept of “intentionality”.

An assumption is made in this chapter, and throughout this book, that there is an association between the terms “counselling”, “psychotherapy”, and “psychoanalysis”. As Bond (2000: 24) suggests, “it is not possible to make a generally accepted distinction between counseling and psychotherapy” and “when used in their widest sense, they encompass each other”. The generic terms of “psychological therapist” and “psychological therapy” are used here and they refer to counselling and psychotherapy (which is taken to include psychoanalysis).

 

CHAPTER FIVE: Language, experience, and representation: a re-examination of the case of Lola Voss

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Rhiannon Thomas and Del Loewenthal

“The Case of Lola Voss” is one of Binswanger’s papers on schizophrenia in which he considered a young woman whom he encountered during his work in the Bellevue sanatorium. Lola was of a German/Spanish/ South American heritage and appears to have also spoken English and French. The relevance of this is in her moving between German/ Spanish/English in her creation of her own language meaning system. However, what seems to be missed, in a case in which “language” features so prominently, is what Lola might be saying. What is intended by “saying”, in this context, is a reference to her language system, in that it is assumed to still be a form of communication—or at the least to carry significant meaning—rather than whether this is also a retreat from the world. The position taken by Binswanger, in his construction of an existential analysis is that Lola’s “superstition”, as he sees it, is evidence of her experiencing the “hostile crowding of the world” (Binswanger 1963: 340); a world from which she is in “flight” and in doing so, her “existence” has surrendered itself in so large a measure that it remains totally closed to itself. This concept is consistent with the existentialist position that an “essential function of language is communication, meaningful exchange between persons” (Macquarrie 1972: 106).

 

CHAPTER SIX: Laing and the treatment is the way we treat people

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Tom Cotton and Del Loewenthal

In many ways, when exploring a relationship between treatment and the way we treat people as individuals, we might be seen as exploring the grey area between psychotherapeutic treatment epistemolo-gies and, what might be considered, the ontology of psychotherapeutic treatment. In other words, the gap between the theory of treatment and the being or doing of treatment—the gap between ideals and actuality. It could be seen as a slippery liminal space, which should (and does) challenge even our most basic assumptions about theory and the knowledge structures on which we base them. This space can provide an opportunity for valuable exploration, reflection, and learning, and yet, all too often, the uncertainty that arises here is met by the attempt to shut this space down, or simply ignore it and retreat behind entrenched psychological therapistized positions. Might a post-existential perspective help us to remain open to what emerges in this space, or might it be just another way of attempting to shut it down? In this sense, we might hold in mind the chapter’s title not only in reference to “clinical treatment”, but also to the treatment of the research participants and their experiences as well. This chapter explores the experiences of a group of research participants, including Laing’s peers, which we wish to consider when exploring this liminal space, particularly in regard to treatment and how the way we treat one another as individuals might impact on that treatment. In the current mental health mainstream, Laing’s work now tends to be “regarded more as a ‘typical’ sixties extravagance than an important contribution to our understanding of serious distress” (Smail 2007: 14). Whatever one’s view of that perception (and we acknowledge that it would take up at least an entire book to unpack it), Laing’s psy-choanalytic-existential-phenomenological perspective might be considered an important path towards a post-existential framework.

 

CHAPTER SEVEN: Post-existentialism, counselling psychology, and the diagnosis of schizophrenia

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Patrick Larsson and Del Loewenthal

This chapter will explore some implications of post-existentialism for counselling psychology with a particular focus on diagnostic categories. Issue will be taken with Cooper’s (2009) argument that the question of diagnoses in counselling psychology has been extensively debated in the literature. Even though Cooper’s assertion that we need to “welcome—and work with—the richness and vastness of clients beyond their diagnoses” (p. 122) is one which should be encouraged by counselling psychologists—is this possible in practice?

There is the question of how counselling psychologists retains its “value base within a framework dominated by a medical model of distress” (Douglas 2010: 24) whilst making further inroads into the National Health Service (NHS) as practitioner psychologists. This chapter reviews the literature that pertains to the topic of counselling psychology and diagnostic categories, and critically examines the place of post-existentialism in relation to this issue.

 

CHAPTER EIGHT: A training in post-existentialism: placing Rogers and psychoanalysis

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Del Loewenthal and Robert Snell

This chapter describes a model of a training in post-existentialism. It is argued that much of the emerging dominant training model of today is unbalanced, with too great an emphasis on CBT and short-term cost-effectiveness, rather than on the provision of a sound understanding based on learning from lived experience. There is concern at the extent to which the authors are concerned about how the depths of thinking and feeling can be brushed aside, and with this a focus on the relationship and understanding of people’s experiences. The authors provide an analysis of their chosen training model, a Professional Doctorate/ MSc in Psychotherapy and Counselling through locating it historically in trends within European philosophy. After the MSc (out of which has come Chapter Six), it is also possible to do a PhD programme (out of which has come Chapter Three, Four, and Five). We are also involved with a BSc in integrative counselling which has come out of the Psy-chD/MSc described in this chapter; as well as PsychD in counselling psychology (out of which has come Chapter Seven) which has been influenced by what is described here.

 

CHAPTER NINE: Research, ideology, and the evolution of inter subjectivity in a post-existential culture

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Del Loewenthal

Freud and Rogers would both seem to suggest that it is important, for what in the UK we now term the “psychological therapies”, to keep up to date with cultural changes/fashions in what is taken to be research (and evidence). But is keeping up to date in terms of coming alongside different to doing it, let alone believing in it? It would appear that both Freud and Rogers did actually attempt to carry out what was in vogue in terms of research and evidence. So, would it be futile to attempt to convince our society of the need to consider other forms of evidence and research which may be more suited to the psychological therapies, yet contradict the current dominant evidence/research discourse? This does seem to have happened in, for example, France, whereas previously, as reported in the European Journal of Psychotherapy and Counselling, the French Minister for Health proposed that psychoanalysis should not be subject to prevailing notions of evidence-based practice, but should be allowed to develop in its own way (Snell, 2007). It is suggested in this chapter that in considering what we should take as evidence and research in the psychological therapies, one fundamental question is “what is the ideology we bring in exploring the nature of psychological therapeutic knowledge”? Particularly as it would appear that we don’t really know how such therapies work. Furthermore, notwithstanding the phenomenological arguments against theory (Heidegger; Merleau-Ponty), it is increasingly being questioned as to the usefulness of the various competing theories (Craib 1987; Heaton 2000; House 2008). Perhaps they are there more to take the psychological therapists’ minds off their problems than necessarily to be of any direct benefit to their clients/patients !!

 

CHAPTER TEN: Towards a therapy without foundations

ePub

Del Loewenthal

In this book, we have argued for the place of practice at the heart of psychotherapy. This aim can be seen as stretching from the time of Pyrrhonian scepticism to, more recently, the writings of Wittgenstein, where post-existentialism can be understood to be more about the activities in which we participate with our clients/patients. There is therefore an increasing body of opinion showing the futility of theory as the basis of the psychological therapies and, with it, what is currently regarded as research. But the psychological therapies are also cultural practices, and this book is an attempt to reformulate an understanding of meaning as contextual and emerging through psychological therapists and patients having social intercourse.

Thus, how we understand such emerging meaning will be mediated by cultural practices through the mixture of ideas that permeate our society in any period. This book is therefore an attempt to put the case for what is termed “post-existentialism”, by defining a potential cultural moment in contrast to the positivistic, managerialist, audit culture that currently pervades. The hope is that the implications of examining meaning, through post-existentialism, show how such enterprises can never have a foundation. The book is therefore written to increase the possibility that what is termed “post-existentialism” will help psychological therapists start with practice and will enable them to help their patients/clients. Thus, not only CBT, but any therapies whether they be humanistic, existential, or psychoanalytic, which become totalizing moves, are potentially violent. At best, such theories are secondary and, whilst they may have implications, they can never provide a foundation to the primacy of practice.

 

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