27.1 Complete

Existential
Analysis
27.1
Journal of The Society for Existential Analysis
Existential Analysis
The Journal of The Society for Existential Analysis 2016
Published by:
The Society for Existential Analysis, BM Existential, London, WC1N 3XX
Tel: 07000 394 783 . www.existentialanalysis.org.uk
Journal Editors Distribution & Marketing: Martin Adams

Prof Simon du Plock Journal Production: Katrina Pitts &
Dr Greg Madison Andrew Miller
Book Reviews: Martin Adams Peer Review Coordinator: Derek Bean
Editorial Board
Dr Daniel Burston Dr Greg Madison
Duquesne University, Pittsburgh (USA) The London Focusing Institute (UK)
Prof Betty Cannon Prof Martin Milton
Boulder, Colorado (USA) Regent’s University, London (UK)
Prof Emmy van Deurzen Prof Roberto Novaes
The New School of Psychotherapy and Fluminense Federal University (Brazil)
Counselling, London (UK)
Dr Yaqui Andrés Martínez Robles
Prof (Emeritus) Eugene Gendlin Circle for Existential Studies, Mexico City (Mexico)
University of Chicago (USA)
Prof Simon du Plock
Dr John M. Heaton Middlesex University, London (UK)
The Philadelphia Association, London (UK)
Dr Victor Rodrigues
Dr Alice Holzhey Superior Institute of Applied Psychology,
International Federation of Daseinsanalysis Lisbon (Portugal)
(Switzerland)
Mr Andrea Sabbadini
Dr Bo Jacobsen Arbours Association, London (UK)
University of Copenhagen, (Denmark)
Dr. Kirk Schneider
Prof Rimantas Koèiûnas Saybrook Graduate School/Existential-Humanistic
University of Vilnius, (Lithuania) Institute, San Francisco (USA)
Dr Alfried Längle Prof Ernesto Spinelli
International Society for Logotherapy and ES Associates, London (UK)
Existential Analysis, Vienna (Austria)
Dr Kevin Krycka
Dr Darren Langdridge Seattle University (USA)
Open University, (UK)
Dr M. Guy Thompson
Dr Dmitry Leontiev Psychoanalytic Institute of Northern California
Moscow State University, (Russia) (USA)
Officers of the Society

Chair: Dr Pavlos Filippopoulos
Treasurer: Paola Pomponi
Secretary: Natasha Synesiou
The Journal provides a forum for the analysis of existence from philosophical and psychological
perspectives. It is published biannually. Contributions are invited in areas of philosophical and psychological
theory, case studies, discussion papers, book reviews and letters. The opinions expressed by authors
of the papers and reviews published are those of the authors themselves, and not necessarily
those of the editors, the editorial board, or members of The Society for Existential Analysis.
Existential
Analysis
27.1
Edited by:
Simon du Plock
Greg Madison
January 2016
The Society for Existential Analysis

CONTENTS
Editorial 3
Zhi Mian: Approaching Healing/Therapy Through Facing Reality 4
A Chinese Approach to Existential Thinking and Practice
Wang Xuefu
Why The Distinction Between Ontic and Ontological Trauma Matters For 16
Existential Therapists
Alice Holzhey-Kunz
‘Home’ Is An Interaction, Not A Place 28
Greg Madison
The Therapeutic Functions Of Literature and Narrative 36
Simon du Plock
Considering The Epoché As An Attitude Rather Than As A Method 49
Lucia Moja-Strasser
Existential Therapy As A Skills-Learning Process 58
Martin Adams
Pain Is Not Pathology 70
Robert D. Stolorow
Al Mahrer (1927-2014) – An Appreciation 75
Ernesto Spinelli
Process and Outcome Research in Existential Psychotherapy 78
Sofia Alegria, Inês Carvalho, Daniel Sousa, Edgar Agrela Correia, João Fonseca,
Branca Sá Pires, Sandra Fernandes
Therapy with Children and Adolescents In The Phenomenological-Existential 93
Tradition: Community-Based Clinical Interventions
Branca Sá Pires
Reviving Antiquity: A Consideration of Askésis and Existential Psychotherapy 107
Rebecca Greenslade
Saturated Phenomena and Their Relationship To ‘Extreme Experiences’: 121
A Phenomenological Comparison Between Mystical Experiences and Psychotic and
Depressive Experiences Based on Jean-Luc Marion’s Philosophy
Georgia Feliou
Life And Death – A Meditation 137
Susanna Rennie & Ernesto Spinelli
A Correction and Brief Reply To Montenegro’s (2015) ‘A Comparison Of 142
Freudian and Bossian Approaches To Dreams’
Darren Langdridge
The Scientific Discovery of Emotions – A Turning Point in Philosophy? 144
Aron B. Bekesi
Existential Therapy Institutions Worldwide: An Update of Data 155
and the Extensive List
Edgar A. Correia, Mick Cooper and Lucia Berdondini
Book Reviews 201
EDITORIAL
We are delighted to be able to open this, the twenty-seventh edition of
Existential Analysis, with seven presentations from among the very many
given at the historic first World Congress for Existential Therapy, which
was held in London in May last year. We hope that these will serve as an
aide-mémoire for readers who attended this event, and are sure that they
will be of interest to readers who were not able to participate. A number
of other speakers are currently preparing papers based on their presentations,
and we plan to include as many of these as possible in the next volume
of this Journal.
This volume also contains five papers addressing a wide variety of topics of
relevance to existential thought and therapeutic practice. These include a paper
by Branca Sá Pires proposing a ‘preliminary’ model for working with children
and adolescents, and a research-based paper by Sofia Alegria et al. which examines
‘the therapeutic process’ in existential therapy. We are particularly pleased to
continue the international tone set by our Congress papers, (which include
contributions from – for the first time – China, as well as from Switzerland and
the U.S.), with the inclusion of submissions from Greece, Hungary and Portugal.
The international flavour of the volume is indicative of the spread of interest
in existential therapy documented by Edgar Correia, Mick Cooper and Lucia
Berdondini in their ‘Extensive List’ of existential therapy organizations around
the world, which concludes this volume’s papers.
It is with sadness, but also with a sense of celebration, that we include two
commemorative pieces: Ernesto Spinelli has written an obituary for Professor
Alvin Mahrer, whose work will be familiar to many readers; he is also the co-
author, with Susanna Rennie, of a very moving meditation on life and death,
in which Susanna reflects powerfully and illuminatingly on her own experience
of terminal illness.
As always, we include a number of highly-engaging book reviews; our thanks
to Martin Adams who can be contacted if you would like to review any titles
from our list of publications received for review.
Simon du Plock
Greg Madison
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Existential Analysis 27.1: January 2016
Zhi Mian: Approaching Healing/Therapy

Through Facing Reality
A Chinese Approach to Existential
Thinking and Practice
Presentation, London 14-17 May, 2015
World Congress for Existential Therapy
Wang Xuefu
Introduction
I come from China.
I am coming with a purpose – to introduce you to a term from China: Zhi
Mian, which, in Chinese, is: 直面 .
It represents an approach to existential thinking and practice in China.
The term Zhi Mian is coined by Lu Xun.
I venture to guess that China would mean ‘Tao’ (Tao Te Ching), and ‘I
Ching’ (the Book of Change) to many of you, but few would think of
‘Zhi Mian’. At the same time, you might relate China with Lao Tsu and
Zhuangzi, but not so much with Lu Xun.
A review of Zhi Mian and Lu Xun

Dr. Louise Sundararajan
I would like to end with such a concrete example of IP – a particular

Chinese IP based on the legacy of Lu Xun. My account in the
following is based on Xuefu Wang's works, some of which can be
found on our website (click on Interest Group, then click on publication
under Wang).
Lu Xun is one of the most influential writers in modern China. As
a young man, Lu Xun wanted to save lives by studying Western
medicine, but later gave up medicine for literature. Believing in the
transformative power of literature, Lu Xun used fiction as a form of
culture critique. Lu Xun’s literary works are permeated with deep
feelings for his countrymen. He expressed ‘Grief over their misfortune’
and was ‘indignant toward their servility’ (Wang, 2009: p 162). Known
as the Chinese Nietzsche, Lu Xun’s writing entails an integration of
Western influence with the literary heritage from ancient China. The
following epithet shows how he was admired for the unique combination
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Zhi Mian: Approaching Healing/Therapy Through Facing Reality
of ‘Teachings of Tolstoy and Nietzsche, Writing Styles of Wei and

Jin Dynasty’ (Wang, 2009: p 160).
As a prototype of Chinese IP, the case of Lu Xun suggests some
unique characteristics: First, what is indigenous does not need to be
‘pure’, without Western contaminations. Lu Xun’s literary style is a
hybrid, but every bit uniquely Chinese. Second, it is not a reaction
against Western psychology. Western influences were eagerly appropriated
to serve his project of social reform. Third, self-reflexivity is the
key attribute of Lu Xun’s project, which consists of intense soul
searching on behalf of his fellow countrymen, resulting in one of the
most trenchant cultural critiques in Chinese history. Lastly, the Lu
Xun phenomenon was an intellectual movement that capitalized
on the performative action of arts and literature to have the widest
impact on society.
It is against the backdrop of this that we can appreciate Xuefu
Wang’s ‘Zhi mian’ psychotherapy as a full-fledged Chinese IP. Zhi
mian means ‘directly facing’ reality. It is a term used by Lu Xun,
who said famously that ‘The real warrior dares to face life as it is,
no matter how gloomy it might be; and to look unflinchingly at the
scene, no matter how blood drenched it might be’ (a partial translation
is given in Wang, 2009, p 164). If we wonder about Wang’s strategic
use of a statement so graphic with blood and gore, we may keep in
mind the grisly reality that the zhi mian approach is best equipped
to address – the pervasive devastation and trauma from the Cultural
Revolution and other large scale destructions in modern Chinese
history. Wang claims that the goal of zhi mian psychotherapy is cultural
transformation: He wrote, ‘According to Lu Xun’s observation, the
greatest tragedy in our culture is the suppression of authenticity,
resulting in the lack of sincerity and trust, and the prevalence of
swindling and cheating’ (in ‘The Meaning of Zhi Mian’) (in Chinese).
Zhi mian psychology capitalizes on self reflexivity, which consists
of ‘penetrating observations of the shortcomings in one’s own culture,
as well as integrating the resources in one’s own culture’. Not unlike
Lu Xun, an ideal therapist is supposed to be something of a hybrid,
one who is equipped with ‘Chinese soul and Western talents’. Western
psychotherapy techniques, especially existential psychotherapy, are
eagerly appropriated to solve uniquely Chinese problems.
A case in point is Xuefu Wang’s paper ‘Back to Reverence and
Fear’ (in Chinese). ‘Reverence and fear’ is Wang’s rendition of the
existential psychologist Kirk Schneider’s notion of awe. Schneider’s
China talk (2010) on awe triggered a profound soul searching in the
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Wang Xuefu
Chinese audience. We have lost the basic reverence and fear

toward nature and life, says Wang. Retrieving the ancient Chinese
notion of reverence and fear toward Heaven, Wang reflects on the
pallid lack thereof in the class struggles and the propagandas such
as ‘To the extent humans dare, to the extent the earth yields its resources;’
or ‘With one shout from the gasoline worker, the earth trembles three
times.’ Wang bemoans the fact that ‘In recent decades, our attitude
toward nature, others, and self consists of manipulation, conquest,
deprivation, and control’. The solution lies in zhi mian, which
helps to restore the fundamental reverence and fear toward nature,
says Wang.
The moral of my story is that there are far many more varieties of
IP’s out there. There is much work to be done in terms of documenting,
promoting, and nurturing the so far neglected IP’s. And at the same
time, learn a lot.
Questions related to handout: What is the meaning of Zhi Mian? Who

is Lu Xun?
Maybe I can put it this way: Lao Tsu and Zhuangzi influenced traditional
China, while Lu Xun influenced the development of modern China. Some
scholars even said this: If you want to know modern China in depth you
do not afford not knowing Lu Xun.
In English literature, there is a saying: ‘说不尽的莎士比亚 ’. One can
never talk enough of Shakespeare. In Chinese literature we have the similar
saying about Lu Xun: ‘说不尽的鲁迅 ’. The implication is that, Lu Xun,
as well as Shakespeare, is an inexhaustible topic of interest to study.
Background
With the outburst of Modern Chinese Literature and the upsurge of the
New Cultural Movement in China, Lu Xun emerged as the most brilliant
writer and acute observer of the Chinese psyche during the early 20th
century. He directed his critical gaze at what he considered the cultural
backwardness and psychological cowardice of the Chinese people in his
day. His literary creation of novels and essays is rooted in his penetrating
perception and exposure of the shadowy realm of the Chinese psyche,
which can be synthesized as mental escapism. Some of the literary figures
Lu Xun had created have become the archetypes of our culture, such as
the Madman, Ah Q, Xianglin’s Wife, Kong Yiji, etc.. As in Shakespeare:
Hamlet, King Leer, Shylock, etc.
Through his critical examination of Chinese history, culture and society,
Lu Xun finds the root problem lies in the character of Chinese people. Due
to the long history of feudalistic oppression with repeated wars and changing
6
of dynasties, the Zhi Mian spirit in Chinese character gradually wore off
and was replaced with a slavish, evasive disposition, being content with
temporary comfort, accustomed to self deception and lack of love, authenticity
and courage to face reality.
Lu Xun realizes what China really needs is a ‘revolution’ that intends
to transform Chinese mentality and to build up Chinese character. However,
the new cultural movement for this purpose in the early 20th century, once
regarded as the Renaissance of China, was substituted by political revolution
(intending to change social political economic structure) before long. The
success of political revolution by the communist not only continued to
ignore psychology transformation and personality building up, but went
further, in opposite, however, to devastate the Chinese mentality and
character, such as subsequently happened in the so-called Culture Revolution,
which took ‘culture’ by name, while anti-culture in practice.
If we examine Lao Tsu and Zhuangzi and their Taoist philosophy from
the existential perspective, it is never far-fetched to say that they contain
profound existential thinking, which resonates deeply with Western existentialism.
What of Lu Xun and his Zhi Mian thinking in view of existentialism, then?
Lu Xun’s existential attitude is fully revealed in his term of ‘Zhi Mian’,
which means ‘directly facing reality’. He champions the ‘Zhi Mian warrior’,
as one who ‘dares to face life as it is, no matter how gloomy it might be’.
Lu Xun lived what Nietzsche once said: ‘He who has a why to live for
can bear almost any how’. And he chose what Nietzsche advocated as the
path of a hero: There is no other choice except the choice of living as heroes.
When he was young, Lu Xun was regarded as ‘the Nietzsche of China’,
though he is never a Nietzsche duplication but rather, represents the Chinese
way of existential thinking, which is epitomized in his Zhi Mian thinking.
Times goes on to the year 2010, and we (Louis Hoffman, Mark Yang
and I) organized what we called The International Conference on Existential
Psychology in Nanjing China, intending to inspire East-West dialogue. To
existential psychologists mostly from the States, such as Kirk Schneider,
Erik Craig, Ed Mendelowitz, Louis Hoffman, and some others, I introduced
Lu Xun and his Zhi Mian thought, and the Zhi Mian existential approach
that I have been exploring and formulating based on Lu Xun’s cultural
psychology of Zhi Mian and my twenty years of experience in my psychology
practice in China, and of course, inspiration from the Western existential
psychology.
While studying abroad, Lu Xun began laying the foundation of his axiom:
‘In order to establish a nation, one must first establish her people’
(‘立国必先立人 ’). He searched all over China and abroad for an ideal
character that can be antidote to the weakened Chinese personality.
He exclaimed, ‘If we search all over China today, where will we find
the warrior spirit? Will anyone speak out in sincerity, anyone who will
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Wang Xuefu
call our people to goodness, beauty, strength and vigor? Where are the
compassionate voices to save our people from desolation?’
Then he found the rebellious ‘Mara Poets’ in the foreign, alien lands of
Europe. ‘Mara’ means the devil or Satan, representing the European Romantic
thinkers who are the negative forces that moved society forward, but
nicknamed by the people as ‘Mara poets’. Lu Xun began to admire figures
such as Nietzsche, Tolstoy, Schopenhauer, Dostoevsky, Kierkegaard,
Augustine, Goethe, Shelley, Byron, Henrik Ibsen, Rousseau, Steiner, Darwin,
Huxley, Linne, Lamarck, to name only a few.
Lu Xun’s early writings, including, ‘On the Power of the Mara Poetry’
(摩罗诗力说 ), ‘On Extremities of Cultures’ (文化篇至论 ), ‘Essays on the
History of Science’ (科学史教篇 ), etc., can be understood, in Lu Xun’s
terms, as a chronology of Western heroes of the realm of the intellectual
mind. It was Lu Xun’s fervent hope that visionaries such as these would
emerge in China and ‘speak with powerful voices’, and in doing so break
bonds of loneliness, bring new life to his compatriots, and help advance
China’s prominence in the eyes of the world.
At the 2010 existential conference in Nanjing, a Chinese professor made
such a comment, which impressed me: It is assumed that Westerners know
‘existence’ as Chinese know ‘zhi mian’. In a dialogue between East and
West, the Chinese can get to know ‘existence’ through ‘zhi mian’, while
Westerners can get to know ‘zhi mian’ through ‘existence’.
It was through my friends mentioned above, and others more, the term
of Zhi Mian, and the Chinese existential approach it represents, have been
introduced to the English world of humanistic and existential psychology
when some of my articles were published in American journals.
As to the term ‘直面 ’ in Chinese, we do not yet find an equivalent word
in English to it, and so we just put it ‘zhi mian’ in Chinese pidgeon.
Lu Xun is quite a controversial person in China. Being controversial
itself, in my understanding, may speak for Lu Xun’s profundity, richness
and diversity. In recent years, when I meet with Western friends, I often
bring forth the topic of Lu Xun and Zhi Mian. To my surprise, they respond
with sincere resonance. Meanwhile, when I talk more about Lu Xun and
Zhi Mian to my fellow Chinese, they, ironically, seem to be less responsive
or resonant. The reason I can think of is that a good number of Chinese
assume that they know much about Lu Xun and Zhi Mian, but they do not
understand Lu Xun and Zhi Mian with depth and accuracy. To me, it is
right out of the same reason that Lu Xun and Zhi Mian mean much to
China, as, if I can put this way, Western existentialists (and their thought
and practice) to the West.
Here is a quote from Molly B. Fairfield’s writing ‘A Chinese Philosophy
of Zhi Mian – What I learned living in China’, to whom I introduced Lu
Xun and Zhi Mian.
8
Lu Xun, a lionized writer from the early 1900’s, coined the term Zhi
Mian (直面 ), which literally translates as ‘direct face’, although a better
English translation would be ‘face reality’. In my experience, almost all
Chinese people know what this means and recognize it as a state of being.
Dr. Wang Xuefu, a Chinese psychotherapist practicing in Nanjing, uses
Zhi Mian as a philosophical framework for treating psychological issues.
Dr. Wang’s Zhi Mian calls people to oppose the many cultural systems
that lack grounding in reality and require people to follow blindly. Dr.
Wang uses Lu Xun’s metaphor of an iron house to represent those systems
that claim to provide meaning and truth, but in fact shackle people.
In the quote, she refers to an analogy by Lu Xun:
Imagine an iron house having not a single window and virtually indestructible,
with all its inmates sound asleep and about to die of suffocation. Dying in
their sleep, they won’t feel the pain of death. Now if you raise a shout to
wake a few of the lighter sleepers, making these unfortunate few suffer
the agony of irrevocable death, do you really think you are doing them a
good turn? (Preface to Call to Arms)
Still, however, Lu Xun was determined to knock on the iron house of
China, shouted, desperately sought to awaken the deep slumbering spirit
of his people across the vast land of China. With profound sorrow, Lu Xun
portrayed group after group of apathetic and cruel souls in his fiction,
‘Grief Over Misfortune’ and ‘Indignant Toward Servility’. (哀其不幸，
怒其不争 )
Zhi Mian: A Chinese approach in the making

Now I am shifting further to Zhi Mian as a Chinese approach to existential
thinking and practice.
My specific focus would be:
Zhi Mian: a way to approach healing/therapy through venturing to explore
one’s reality and face one’s reality.
1. Courage to face reality

Quote from Lu Xun:
The real warrior dares to face life directly as it is, no matter how
gloomy it might be; and to look unflinchingly at one’s
circumstances, no matter how blood drenched it might be.
(Xun, 1981a, p. 274). It is from this phrase of Lu Xun that the
term ‘Zhi Mian’ is originated.
The warrior is one who is imbued with courage: not physical courage
on the battlefield, but the courage to Zhi Mian, to face life’s reality.
This reminds me of some significant phrases in the West, such as ‘the
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Wang Xuefu
courage to be’ by Paul Tillich, and ‘the courage to create’ by Rollo May.
Here comes what I formulate from Lu Xun ‘the courage to zhi mian’, i.e.,
the courage to face the reality of life.
Part of life’s reality is that to escape is easy, while to Zhi Mian is extremely
difficult. Therefore courage is a must.
Mencius（孟子） in ancient China advocated for the cultivation of a
noble spirit of courage.
Zhi Mian therapy is about cultivating this same spirit: to help clients
Zhi Mian themselves and Zhi Mian life.
Life can be gloomy, even downright bloody at times. People who face
such challenges with courage can be considered Zhi Mian warriors. Such
warriors will be able to take on life’s various challenges and wrestle with
their own inner fears.
2. To defy and to serve

A quote from Lu Xun:
With fierce determination, I coolly defy a thousand pointing
fingers; yet, I serve our children with my head bowed like a
willing ox.
(Xun, 1981b: p 147)
Zhi Mian’s infrastructure has two fundamental factors, both are real.
One, its determination to resist against those forces and powers that obstruct
and damage one’s growth to become oneself. Many psychological symptoms,
if not all, imply that one possesses weak capacities to resist being overwhelmed.
In our culture we find many elements that tend to mitigate our courage
and capacity to resist. Zhi Mian therapy, however, emphasizes and cultivates
clients’ ability for resistance, to the extend that one can ‘defy a thousand
pointing fingers’.
This is the fierce, sturdy side of Zhi Mian, in parallel with existential
advocate of rebel, hero, calling to arms for a fight with the destructive forces.
But it has another side.
3. A gentle warrior
A Poem by Lu Xun:
Does a true hero have to be heartless?
Surely a real man may love his young son.
Even the roaring, wind-raising tiger
Turns back to look gently at his own tiny cubs.
Zhi Mian therapy is not only about defying or resisting being overwhelmed,
10
it is also about relationships built upon love and service. Here we see
another side of Zhi Mian, the gentle, loving side. The tiger shows its
gentleness like a lamb, and its serving heart as a ‘willing ox’.
In the same way, Zhi Mian as healer/therapist can at times knock on the
iron house and shout loudly, while at other times, he can invite and call
like a mother for her kids: Where are you? Only if you are willing…
4. Zhi Mian: An approach to healing through facing reality

How do we, then, apply Zhi Mian as a therapy?
In essence, Zhi Mian is an approach to healing through adventurously
exploring reality and courageously facing reality. Only by this way can
we see reality clearly and gain awareness of its truth. Based the truth of
reality, we make life choices.
What is a psychological symptom, then?
From the perspective of Zhi Mian, a psychological symptom can take
myriad forms, in essence, it is but avoidance of life’s reality.
Why do we tend to avoid?
From the Zhi Mian perspective, again, people can get hurt in many ways,
by essence, it is but hurting of our humanity.
When we get hurt, we become afraid of getting hurt again. And so we
tend to avoid people, things, and environments that might entail hurting.
We develop an escapist life style or defense mechanism to make us secure.
However, we never achieve the kind of security that we ever expect, rather,
at our over pursuit of security, we make ourselves even less secure. And
it costs us a lot of opportunity to risk trying and gain experience to grow.
In another word, we obtain comparative security only when we dare to
face life’s uncertainty.
The Wise Man Saved the Animal World

Long ago, a hare fell asleep under a mango tree. Suddenly, it was
awakened by a crashing bang. Fearing the arrival of the end of the
world, the hare jumped up and ran quickly away. The other hares
saw it running and asked, ‘Why are you running in such haste?’
The hare replied, ‘The end of the world is coming. Quickly, run for
your lives!’ Hearing this, all the other hares joined in. Then the deer
saw them running and asked, ‘Why are you running in such haste?’
Upon learning of their reason, the deer joined the fleeting horde.
Then, one after another, all the animals joined in until the entire
animal kingdom was in flight, running obliviously toward their
doom.
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Wang Xuefu
Buddha was a wise man. He saw the animals running in desperation

and managed to slow one down enough to inquire as to the reason
for their panic. Upon learning of the reason behind their fear, Buddha
proclaimed, ‘This is not true. The world has yet to come to its end.
Let us investigate the reason for this erroneous belief’. The hearsay
was then traced from the deer and all the way back to the original
hare. Buddha then asked the hare, ‘Where were you when you had
this thought that the world was coming to an end?’ The hare replied
that it was taking a nap under a mango tree. Then Buddha asked,
‘Instead of the end of the world, could it be that what you heard was
a mango falling from its tree? Let’s return to the tree and see’.
Thus, Buddha along with the animals returned to the tree and saw
a mango lying on the ground. And this was how Buddha brought
salvation to the animal kingdom.
An existential therapist can well understand that in humanity there is

an instinct of fear and a propensity to escape. When caught in excessive
fear, we fall into blind escape, which indicates that we surrender ourselves
to a fabricated illusion – the end of the world. We take for granted that we
are escaping away from ‘the end of the world’, but in reality, we are running
right toward our own doom.
The parable of the animal world illustrates the Zhi Mian way of healing:
Zhi Mian healing lies in facing truth or reality. It is through facing reality
that we get to know ‘truth’ of life. When ‘truth’ is discovered, healing is
on the way to achievement.
It is easier said than done. To Zhi Mian reality is not that simple. When
caught in fear, we would rather believe in an illusion and never see that it
is a fantasy by ourselves. We run, run and run, even dare not to take a
pause or to turn back for a glimpse of what we are escaping from. We lack
the courage to do so. However, as the story demonstrates, the wise man
reminds the animals and leads them to the truth of reality and thus saves
the animals world from self-destruction.
A zhi mian-existential therapist, like the wise man, works with people
as a reminder along the way and a leader all the way in their search for
truth. We also work with people to help them find a ‘wise man’ in themselves
so they become a reminder and a leader to themselves.
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The Tiger and The Donkey

Qian was a place at Southern China, where there was no donkey.
Seeing this, a busybody ferried a donkey in here from the north.
Local people had no idea of what was the use of this animal, and
they released it to the mountain. Carefree, the donkey grazed on the
slope day after day.
It happened that one day a tiger passed by. At the sight of such a
giant thing, the tiger perceived it as godlike being. Scared, the tiger
fled. Concealing itself in the woods, the tiger peeped at the donkey.
Later on, nervously and cautiously, it lurked out the fringe of the
woods a little bit, but dared not get too close to the donkey.
On another day, the donkey uttered a thunderous bray. The whole
valley was in resonance. The tiger was so frightened that it ran far
away. The thought that the donkey might approach to bite made the
tiger quiver in terror. Still later, the tiger calmed down and summoned
up courage to reach out, lurking around and watching the donkey,
did not see donkey demonstrate any special capacity. For quite some
days, the tiger dared out to and fro before the donkey, gradually
getting used to its bray, but still lacking the courage to attack. Further
steps were made in getting still closer. The tiger first tried physical
touch with the donkey, then body friction, then shoving and jostling,
intending to test out the donkey’s skill. Finally the donkey was offended
beyond its endurance and, alas, it raised its rear leg and gave the
annoying tiger a big kick. This was one of the happiest moments for
the tiger, ‘Aha, your capacity is not at all remarkable!’ And then,
with overwhelming fierceness, tiger jumped upon donkey’s back and
enjoyed a great meal.
We see in humanity a tendency to escape on the one hand. On the other,

we see in human nature a propensity to Zhi Mian. In this fable of the tiger
and the donkey, we discover that tiger summoning up courage to explore
the truth of the feared object, even though many times the tiger couldn’t
help running away in fear. But each time it returns, until the tiger finally
approach the truth or reality. Such is the process of Zhi Mian.
We human beings need to learn Zhi Mian from the tiger. The tiger, as
the wise man, is our Zhi Mian teacher.
5. Why can we not stand up to reality/truth?

Life’s one ignorance is that we often take for granted that things appear
to be are what they truthfully are. That is the way we see things when
we are kids. However, the way growing to maturity is the way to pursue
truth in reality.
13
Wang Xuefu
Those that live on the surface level of things prone to evade the actually
of life, even to the extend of fabricating an illusion as the substitute of
actual life. They run after security so desperately that they seclude themselves
from the reality.
While reflecting on our culture, we find common cases like fearing truth
and evading reality. Even when we see various persecuting forces imposing
threat to people who stand on truth and reality. They may suppress people
who persist on pursuing the truth of reality. They may fabricate a cosmetic
‘gold world’ to allure people or a dreadful ‘end of the world’ to trap people
into a scared state and thus manipulate them. Lu Xun would confront with
them by openly uttering his doubt.
Another reason to evade reality is that reality at times present its homely
side. It is coarse. It makes us feel uncomfortable. It is not as what we image
and expect it to be.
One way we avoid facing reality is that we turn reality into a fantasy
and believe this is what the world is like. Lu Xun criticizes our evasive
cultural system by likening it to a physical body, people tend to ‘fantasize
its reddish swell into peach blossom, while it festers like cheese’.
Gradually we become lack of capacity to face reality. We do not understand
reality and so run away from it. We behave in a way but we do not realize
our motivation. This is like Jesus saying ‘They do not know what they are
doing’. And so, for Zhi Mian healer or therapist, to cultivate awareness is
a core part of his or her therapy. When people become aware, they will
grow courage to face reality.
However, Zhi Mian-existential model of psychotherapy is not a rough
handling. It does not force or demand people to face reality. It is calling,
inviting, accompanying, and leading, as the wise man did to the animal,
and the tiger did to itself.
As Zhi Mian therapists, we fully understand that the wound stays deep
and keeps saying ‘no’ to Zhi Mian invitation, but a healing of the wound
would change ‘no’ into a new language – saying ‘I am willing…’ to Zhi
Man calling.
Zhi Mian is a way of approaching healing and growth by exploring
reality, getting to know more about reality, and facing reality, and eventually
gaining maturity and integrity on the solid base of reality.
But we are not alone. Looking back all the way through human history,
we find many truths are hidden and reality is shrouded with various cover-
ups. However we also see many great minds, like Lu Xun, who strive hard,
even at the risk/cost of their lives, to reveal truths and to enlighten people’s
awareness to reality. These figures can be ignorantly misinterpreted,
deliberately framed up, or purposely lionized. For the least, as real human
beings, they have faults and can easily be pecked by people who have
idealization for spotless humanity. But all these do not diminish the glow
14
of their Zhi Mian spirit. They are leaders and models for humanity. We
are followers to their footprints.
So far I have shared only a part of Lu Xun and Zhi Mian approach.
Thank you for listening and dialoguing!
Wang Xuefu PhD is currently working at a professional psychotherapy

institution called Zhi Mian Institute for Counseling and Psychotherapy,
Nanjing, China, of which he is founder and leading psychotherapist.
Contact: Zhi Mian Institute for Counseling and Psychotherapy, Nanjing,
China. www.chinancc.net.
Email: xuefu1962@gmail.com
15
Why The Distinction Between

Ontic and Ontological Trauma Matters
For Existential Therapists
Alice Holzhey-Kunz
Abstract
This paper is an elaborated version of my presentation at the round-table
about ‘Trauma, Uncertainty and Crisis’ at the First World Congress of
Existential Therapy in London in May 2015. Its main purpose is to introduce
a distinction between two different types of trauma which is overlooked
even by authors who rely on existential philosophy for their concept of
trauma. I had the idea that there must be more than just one type of trauma
because I came to understand my neurotic patients as traumatized too, albeit
not in the usual sense. Therefore I plead for differentiating between two
types of trauma. I term the usual type of trauma ‘ontic’, respectively
‘existentiell’, the other type ‘ontological’, respectively ‘existential’.1
Key words
Trauma, ontological truth, Angst, everydayness, special sensitivity
(Hellhörigkeit), meaning, pure facticity.
The descriptive criterion for trauma given by the

diagnostic manual of the WHO
Since the word ‘trauma’ is so widely used, its meaning is very vague.
Therefore it is helpful to take a look at how the ‘International Classification
of Mental Disorders’ tries to catch the specific character of ‘trauma’. According
to this diagnostic manual we can speak of trauma when there is a ‘pervasive
distress in someone’ which is caused by ‘a stressful event or situation of
an exceptionally threatening or catastrophic nature’ (ICD-10: p 147). Two
things are important: a traumatic experience always causes pervasive distress,
but not every pervasive distress in someone is caused by events or situations
‘of an exceptionally threatening or catastrophic nature’. Only when the
latter is the case, are we justified in speaking of ‘trauma’.
But the answer to the question of how to differentiate traumatic from
non-traumatic distress is still not satisfactory, as long as there is no objective
criterion for judging an event or situation rightly as ‘exceptionally threatening’
or ‘catastrophic’. Can there be such an objective criterion or do we have
16
Why The Distinction Between Ontic and Ontological Trauma Matters For Existential Therapists
to admit that all criteria are inevitably subjective, depending on time,

culture and the vulnerability of the individual person submitted to certain
events or situations? The diagnostic manual of the WHO is aware of the
problem and solves it by adding a criterion which is immune to the reproach
of subjectivism. It is as follows: An event or situation can be called
‘exceptionally threatening’ or ‘catastrophic’ when it is ‘likely to cause
pervasive distress in almost anyone’ (ibid.).
This criterion allows us to set apart ‘traumatic suffering’ from
‘mental suffering’ in the usual psychiatric sense. It makes it clear that a
traumatized person does not suffer from a ‘mental illness’ respectively a
‘mental disorder’ as it is understood in psychiatry, even when the manifest
symptoms are evidently ‘pathological’ too. Suffering from psychic symptoms
in everyday life indicates exactly the opposite, namely a lack of mental
capabilities to react to everyday situations or events in a way most others
do. Therefore we speak of ‘mental illness’ or ‘mental disorder’ when ordinary
events or situations of everyday life which seem harmless for almost
everybody, cause pervasive distress in somebody. We see the contrast to
a traumatic state which is caused by an event or situation which would
cause a similar reaction in almost anyone. Therefore a pervasive distress
is a traumatic one when to be distressed is the common and therefore
‘normal’ reaction to a totally abnormal situation or event which surpasses
the human ability to endure it.
Examples of traumatizing events, situations or acts belonging

to the ontic existentiell dimension of human existence
The diagnostic manual of the WHO gives the following examples for
‘normally’ traumatizing events or situations: natural or man-made disaster,
combat, serious accident, witnessing the violent death of others, or being
the victim of torture, terrorism, rape, or other crime (ibid.). In these
examples the traumatized person is not necessarily the innocent victim
of terrible events caused by other people or by nature: to be oneself the
perpetrator of harmful and even murderous acts or to be part of such
actions has very often, as we know from war veterans, a traumatizing
effect too. But otherwise these examples have in common that they belong
to the ontic existentiell dimension of human life. We call ‘ontic’ or
‘existentiell’ everything which is part of the concrete world we live in.
And we call ‘ontic’ or ‘existentiell’ our own concrete possibilities and
limitations, our own individual fate and our doings as well. In this sense
a trauma is ‘ontic’ when the cause of it is a contingent event occurring
in a specific time and space which has affected a certain person because
of ontic contingent circumstances.
I am interested in the question whether all traumas are ‘ontic’ in this
sense, or if there is still another possible source of trauma.
17
Alice Holzhey-Kunz
Why I propose additionally another – ontological –

source of trauma
I mentioned at the beginning that I came to understand my patients with
neurotic symptoms as traumatized too. But I have to defend this opinion
right away against a very widespread understanding especially in psychoanalytic
circles – the understanding that all neurotic and psychotic suffering is
caused by a traumatization in early childhood, which the patient mostly
has no memory of because it either happened in a pre-lingual period or
it is successfully suppressed and therefore unconscious. My own proposal
of a possible ontological traumatization gives way to acknowledging that
neurotic or psychotic patients are indeed traumatized too, but not necessarily
by traumatizing childhood experiences.
To speak of an ontological or existential trauma seems at first sight
highly speculative. Let me first indicate quite roughly what I mean by it.
I understand ontological trauma as caused by an unshielded exposure to
the one and only situation we all share with each other: the human condition
in its pure facticity. At first sight there is indeed no evidence for why the
experience of one’s own human condition should (or could) be traumatizing.
This assumption seems even less convincing when we hold on to the criterion
of the diagnostic manual, which accepts as ‘trauma’ only what ‘is likely
to cause pervasive distress in almost anyone’. The idea will become more
plausible when I refer now to important discoveries of existential philosophers,
first of all the discovery of the eminent role ‘Angst’ plays in human life.
Angst as an experience ‘altogether different from fear’

According to Kierkegaard Angst is an ontological experience which was
before him not recognized as such or mixed up with the ontic experience
of fear. This discovery cannot be overestimated, because it gives the answer
to the question of how we human beings are primarily disclosed to our own
being human. As soon as we follow this discovery, the idea of a difference
between ontic and ontological trauma becomes suddenly more plausible,
because it is now possible to relate ontic trauma to fear and ontological
trauma to Angst (either translated as anxiety or as anguish or as dread).
Kierkegaard is right when he insists on the novelty of what he describes
as Angst: ‘The concept of anxiety is almost never treated in psychology.
Therefore I must point out that it is altogether different from fear and
similar concepts’ (Kierkegaard, 1980: p 42). This novelty has been recognized
by Heidegger. Therefore what he writes in Being and Time about Angst is
mostly taken from Kierkegaard. But the general resistance to this discovery
is so deeply rooted in all of us that we tend to take just a cheap imitation
of it for what Kierkegaard and Heidegger meant by Angst.
This cheap version goes as follows: Fear and Angst are different in so far
that fear is always directed to a concrete danger, whereas Angst is not.
18
Because fear is fear of something or someone perceived as dangerous, it is

an intentional emotion. Other examples of intentional emotions are: being
glad or pleased about a positive result, being sad about a loss, being envious
of someone more gifted, being desperate about an unexpected failure etc.
Angst however is not an intentional emotion, because it has no object, but
is what we call a ‘mood’ or a ‘state of mind’ or an ‘attunement’. We are
always in a certain mood, and the mood we are in always sheds a specific
light on everything we encounter. When we are in a good or bright mood
everything seems easy and nice; when we are in a bad or even depressed
mood the world seems indifferent to us and full of obstacles. As soon as
Angst is taken as a mood in this sense, Angst is mixed up with a general
fearfulness or timidness. The mood of a general fearfulness corresponds to
the intentional emotion of fear: for a fearful or timid person the whole world
seems a dangerous place, full of potential concrete-ontic dangers.
But Angst in the sense of Kierkegaard and Heidegger is totally different
from the mood of fearfulness or timidness. Generally speaking it is not a
mood in the usual sense which can be equated with other moods like despair
or gaiety or serenity etc. Kierkegaard claims also for Angst an object,
although this object is of a totally different nature than all objects of fear.
He names the object of Angst either ‘freedom’ (ibid. p 42) or ‘the nothing’
(ibid. p. 61). When Kierkegaard speaks of freedom as the object of Angst,
he has in mind neither social nor political nor psychic freedom, but the
freedom which belongs to the human condition and is therefore independent
of the ontic circumstances we live in. Whereas we can be deprived of social
or political freedom and can feel psychologically unfree, the ontological
freedom Kierkegaard has in mind cannot be taken away from us and we
cannot renounce it either, but we are, as Sartre has put it with his famous
formula, ‘condemned’ to it (Sartre, 2008: pp 506; 574).
Now we are able to give an adequate account of the difference between
fear and Angst: Fear is an ontic emotion which has as its objects all sorts
of concrete dangers which may threaten our life or our well-being, whereas
Angst is an ontological emotion which has as its object only one and the
same danger which marks us as human beings: freedom, respectively the
nothing. We feel fear because we are concerned with our concrete ontic
survival or well-being, whereas we feel Angst because we are disclosed
to our own being human. Fear is like love or joy or envy or rage etc., an
ontic emotion which arises in concrete situations for specific reasons.
Angst is totally different from fear because it is an ontological or existential
emotion which is independent of the ontic concrete situation we live in.
Animals can feel fear, but not Angst. Angst is a fundamental experience
of us human beings. According to Heidegger the human Dasein ‘is anxious
in the very ground of its being’ (Heidegger, 1996: p 177).
19
Alice Holzhey-Kunz
Is Angst a traumatizing experience?

When there are, according to my assumption, people who are ontologically
traumatized, then Angst must play an important role. More exactly:
ontological traumatization must have something to do with being exposed
to Angst. But such an exposure can only be traumatizing when the experience
of Angst has as such a traumatizing quality. Why this is indeed the case,
can only become clear when we take later on a closer look at the one and
only object of Angst, namely ‘existential freedom’ or ‘the nothing’.
But there is also an indirect proof of the traumatizing quality of Angst.
Kierkegaard, Heidegger and Sartre analyze the average and therefore
‘normal’ relationship to Angst as a permanent flight from it. This means
that it belongs to the human being to seek for most of its lifetime refuge
from any direct confrontation with Angst. So the counter-question may be
allowed: Why should we be in need of a constant flight from Angst if not
because being exposed to it causes ‘pervasive distress in almost anyone’?
Everydayness and common sense as protective shields

against Angst
According to Kierkegaard and Heidegger the result of our constant flight
from Angst is what Heidegger calls ‘everydayness’. And at the same time
our everyday being is the best protection against Angst. That goes against
the widespread assumption also shared by Edmund Husserl that the everyday
world we live in is like a last and quasi-natural given which cannot be called
into question anymore. Thanks to the discovery of Angst everydayness
acquires a meaning and a function which is related to Angst as the truly last
existential given. Our daily living along with its sorrows and joys, fears and
reliefs has to be understood as a place of refuge from Angst, and its ontological
function is to ward off Angst. Heidegger speaks in this respect of ‘fallen
prey to the world’ or ‘to the they’; Sartre speaks of ‘living in bad faith’.
Unfortunately all too often ‘fallen prey to the they’ has been interpreted
psychologically instead of ontologically, and therefore as a sign of psychic
immaturity and of a deprived mental state. But Heidegger himself clearly
disclaims this interpretation by defining ‘fallen prey to the they’ as an
‘existential’ which belongs to the human condition (see Heidegger, 1996:
p 167f.). For me it was very helpful to realize that Heidegger means with
the all too negative sounding term ‘fallenness to the they’ what we usually
call ‘common sense’ (in German: Gesunder Menschenverstand). Thanks
to our participation in common sense we share a common worldview with
most others of the same time and culture. And it is this participation which
enables us to lead a normal, mentally healthy life, undisturbed by the
traumatizing experience of Angst.
This makes it understandable that most of us are for most of our time
protected from being exposed to Angst and its traumatizing effect.
20
Who is especially vulnerable for ontological traumatization?

Now I come back to my patients suffering from neurotic symptoms which
hinder them from living a so-called normal life. I already mentioned at the
beginning that in the general psychiatric perspective they suffer from a
lack of mental capacities which are required for being able to cope adequately
with everyday issues. But when I take my patients as ontologically traumatized,
I take them as suffering from an experience which ‘is likely to cause pervasive
distress in anyone’. So the problem of the neurotics is not a lack of mental
capacities, respectively a lack of psychic maturity, but a special sensitivity
(Hellhörigkeit) for the ontological truth of the own being.
This special sensitivity for the truth of one’s own human being cannot be
understood unless we follow Heidegger in his distinction between attunement
and understanding as the two fundamental ways of being disclosed to one’s
own being (ibid.: p 126). Drawing this distinction Heidegger gives attunement
an importance it never had before in philosophy. He stats that we are emotionally
and only emotionally disclosed to the own being in its ‘naked facticity’. This
is the difference to all kinds of understanding of the human condition delivered
by philosophy and theology. Whereas all understanding always already envelops
the own being in meaning, mood discloses the own being as such – in its pure
or naked ‘that’: ‘that it [the Dasein] is and has to be’ (ibid.: p 127). And whereas
there are a lot of different interpretations of the human being which claim to
be true, there is only one and the same attunement which discloses the unveiled
truth about ‘freedom’ and about ‘the nothing’ in its pure ‘that’: Angst.
Therefore the sensitivity I want to introduce here is a special sensitivity
for what is disclosed not by interpretation, but only by Angst. This special
sensitivity for the truth about one’s own being disclosed by Angst is a gift
and at the same time a heavy burden, because it exposes people to what
is – in its ‘naked that’ – hardly bearable. Therefore being especially sensitive
is a quality which singles out and overcharges these people at the same
time. That is why I call my patients reluctant philosophers. Albeit they do
not philosophize about their life in the usual sense, they are philosophers
in so far as they are exposed to the philosophical truth about human existence.
But they are only reluctant philosophers because they cannot bear this
truth and are therefore in a desperate revolt against it.
So let me summarize that I understand my patients as ontologically
traumatized because of their special sensitivity for the ontological truth in
its naked facticity which overcharges almost anyone who is exposed to it.
Why the naked truth about ‘freedom’ and ‘the nothing’

has a traumatizing quality
The traumatizing quality of the experience of Angst is only sufficiently
understood when we take a closer look at what Kierkegaard indicates as
the ‘object’ of Angst: ‘freedom’ and ‘the nothing’.
21
Alice Holzhey-Kunz
We all know the famous formula Kierkegaard has given of Angst as the
‘dizziness of freedom’: ‘He who looks down into the yawning abyss becomes
dizzy’ (Kierkegaard, 1980: p 61). It is all important to understand why
Kierkegaard thinks it adequate to compare the recognition of one’s own
freedom with a look into a yawning abyss. Of course this equation does
not apply to psychic or social or political freedom, but only to ontological
freedom. Whoever recognizes the fact of being ‘condemned’ to freedom
realizes at the same time that his or her life lacks a firm ground. This is
meant by the metaphor of a ‘yawning abyss’. This recognition has a
traumatizing quality because it is not only unfathomable but also emotionally
unbearable. Therefore it is quite understandable that we normally deny
this truth and hold on instead to the illusionary belief that our life is firmly
grounded – grounded in a meaning which supports us and even guides us. 2
Let us make clear why freedom has this abysmal implication. Kierkegaard
is, albeit a religious thinker, adamant in reminding us that there is no
decision ever really guided by a meaning, because every decision has in
truth the character of a ‘leap’: there is no motive strong enough to determine
our behavior and there is no motive tested and proved enough to guarantee
an inerrable decision. Therefore every decision is a leap into an unavoidable
uncertainty of whether this will be in the long run the right or wrong choice
and of what will be the consequences of it. Therefore every decision implies
a pre-moral or existential guilt we cannot avoid.
We understand now why Kierkegaard says in the same breath that the
object of Angst is ‘freedom’ and ‘the nothing’: We are with every decision
inevitably confronted with ‘the nothing’ which opens up like a yawning
abyss and forces us to take the leap and become guilty. And we understand
as well that Angst can arise whenever we have to take a decision, because
it is the adequate experience of the ‘leap’ (Kierkegaard, 1980: p 49). The
fact that most decisions of most people are taken without Angst is due to
their being able to deceive themselves about the true nature of their decisions.
And because they are able to avoid Angst, they seem capable of decision-
taking, whereas people sensitive for what it means to take a decision are
overwhelmed by Angst and therefore in a pervasive distress even when
being forced to take quite harmless decisions of everyday life.
Three different aspects of being ontologically guilty

Let us dwell a little longer on the subject of guilt because it plays such
an important role in psychic suffering. The already mentioned guilt is
only one aspect of three which belong to any decision, because every
decision has the character of a ‘leap’. A second aspect of guilt derives
from the fact that every decision is inevitably done in favor of one possibility
and therefore blocks all other possibilities from realization. Whoever is
sensitive for this truth suffers from the guilt towards all the other possibilities
22
which are sacrificed by his or her decision. The third aspect is even more
fundamental but difficult to grasp in a few words. It is the guilt we are
burdened with as the agent of whatever we do. We come across this guilt
when we ask who has entitled us to make decisions – in the last: who has
entitled us to live and claim an own place in the world? Out of this follows
that we are ‘guilty in the ground of our being’ (Heidegger, 1996: p 264),
because we cannot avoid being the agency that has to authorize our own
life without any given legitimation for it. This being compelled to self-
authorization and therefore being responsible for what we are not able to
justify, is for whoever is especially sensitive a traumatizing truth.
The traumatizing truth of being ‘for’ the other

But let us not forget another traumatizing truth about our being human.
Sartre has a lot to say to this. He contradicts not only Heidegger but all
the current theories of intersubjectivity as well, which pretend that we
are always already intertwined with others and therefore grounded in a
basic togetherness. Sartre contradicts this assumption by asserting that
we human beings are not just related to the others in being-with-them,
but more fundamentally in being-for-them.
I see in Sartre’s formula ‘Being-for-Others’ again a central discovery
of existential philosophy which we should not naively sacrifice to current
intersubjective theories. The formula ‘being-for-others’ is not meant to
replace Heidegger’s formula ‘being-with-others’, but to indicate a more
basic relationship to the others which shapes all our being with them. We
are primarily ‘for others’, because as bodily beings we are always already
visible and therefore exposed to their look. In experiencing the look of the
other, ‘I experience the other’s infinite freedom’ (Sartre, 2008: p 294).
The pure fact that any other person is free in how he or she looks at me
and that I can neither escape his or her look nor dominate it, is also a
traumatizing truth which especially sensitive people experience in Angst
respectively in a fundamental (pre-conventional, ontological) shame.
Whereas ontic (conventional or moral) shame is felt when we are unwillingly
exposed to the look and judgment of others with a conventional or moral
deficit, ontological shame is a fundamental attunement which discloses
nothing else then the pure facticity of being inevitably ‘for’ the others as
long as we live. And whereas ontic shame – like fear and moral guilt –
plays an important role in normal everyday life, ontological shame is mostly
successfully avoided – except for the ‘reluctant philosophers’ who are
often haunted by ontological shame because of ‘nothing’.
The worldly appearances of the traumatizing ‘Angst’

Whoever is especially sensitive for the ontological truth of what it means
to be human, evidently pays a high price for his or her special sensitivity:
23
Alice Holzhey-Kunz
Feelings of irrational fears, of irrational guilt and of irrational shame

are at the bottom of all psychic suffering. From an existential perspective
these certainly impedimental emotions are understandable as the worldly
appearances of the traumatizing Angst which these patients can neither
escape nor endure.
As inadequate and disturbing as these symptomatic feelings may appear
in everyday life, they always contain a basic ontological truth. Because I
understand their irrational fears or feelings of guilt and shame as the worldly
appearance of Angst, I am always impressed by their sensitivity for fundamental
truths which apply to all of us but most of us do not suffer from.
Evidently people who are especially sensitive for the own being in its
naked facticity do not fit in the distinction Heidegger has made of either
authentic or inauthentic life, which has become so popular especially in
existential and daseinsanalytic therapy. These patients are authentic only
in so far as they are unwillingly disclosed to the ontological truth, whereas
most others are immune to it, but they desperately fight this truth with
their symptoms in the illusionary hope to defeat it.
Are ontic and ontological trauma connected with each other?

Now there is still one question left: Is there a connection between ontic
and ontological trauma? Yes, there is. People who suffer from an ontic
trauma are also ontologically traumatized, because they have lost their
previous belief in an unshakable meaning of the world and of their life,
and they have therefore become exposed to overwhelming Angst too. The
difference lies in why someone is involuntarily exposed to Angst: in one
case it is because of a horrible ontic experience, in the other it is just
because of a special sensitivity for the ontological truth as such.
Addendum: A comment on Stolorow’s concept of

emotional trauma
The last question about how ontic and ontological trauma relate to each
other is especially suited to take a short look at Robert D. Stolorow’s
concept of emotional trauma which is widely appreciated by existential
therapists (Stolorow, 2007). Because we both relate philosophically
to Heidegger’s Being and Time, it is no surprise that many of our statements
are close to each other. All the same, the reader of both texts published
in this journal may be puzzled because he or she intuitively senses some
differences which are not so easy to discern. I would like just to hint at
where I locate some differences.
For Stolorow trauma is always caused by an emotionally unbearable
concrete event – it is therefore what I call an ‘ontic trauma’. His central
example for any trauma is his own being traumatized by the all too sudden
and all too early death of his former wife. Quite understandably he is not
24
interested in an objective criterion of trauma: whether a similar loss is

traumatizing for ‘almost anyone’ seems irrelevant in the light of his own
personally traumatic experience. But it is curious to realize that he interprets
his own loss not as an ontic, but as an ontological trauma, even when he
does not explicitly make this distinction. This becomes evident when he
says at first that trauma ‘brings us face to face with death and loss’, but
afterwards interprets loss and death not onticly as concrete events and
situations which have terrible consequences for our individual life, but
ontologically as ‘possibilities that define our existence’.
In this way Stolorow generates a confusion which results from his reference
to Heidegger’s analysis of Angst for interpreting a concrete ontic trauma.
When his concrete loss of his wife has brought him face to face not just with
what this concrete loss means for him and his own future, but face to face
with ‘a possibility that defines our existence’, then the death of his wife has
forced him to acknowledge an ontological truth he must have been able to
negate beforehand but has now overwhelmed him in a traumatic way.
My other question concerns his concept of everydayness. He speaks of
the ‘absolutism of everydayness’ which, according to him, holds us in ‘illusions
of safety’ which are only shattered by an emotional trauma of loss and death.
I cannot share this view of everydayness. Loss and death are in all cultures
and times present in daily life and this is also true for our western culture
of today, even when the average life expectation is much higher now und
here than it was in the old days. Even young and healthy people of today
are constantly reminded of their own possible death and the possible death
of the loved ones, be it by hearing from a sudden terminal illness or a terrible
accident of a colleague or a relative, or just by hearing the siren of the
ambulance in the streets. And in a social sense the feeling of safety is even
much less part of today’s everydayness then it was in the past. Therefore
most people feel socially insecure not because they have been traumatized,
but because they live in a world where everyone has to struggle with the
consequences of globalization, of a tight job market and generally with the
enormous speed of changes in almost all parts of their life. What Richard
Sennett called ‘flexibility’ and a readiness to ‘reinvent oneself on a dime’
is now needed not just for special groups, but for almost everyone in everyday
life. Therefore the illusion of safety does certainly not belong to everydayness
anymore, if it has ever belonged to it.
Because of my quite different view on everydayness I cannot follow
Stolorow’s definition of trauma as an emotional experience which shatters
the former illusions of safety. So let me ask if it may be another, more
fundamental illusion which is shattered by a traumatic experience of loss
and death. To answer this question I turn again to the ‘common sense’
which is at the base of everydayness. At first it is evident that the common
25
Alice Holzhey-Kunz
sense is by no means a ragbag of illusions about being omnipotent and

protected from death – on the contrary: it is full of traditional wisdom
about how to live with uncertainty, with ones own failures, with disappointments,
with betrayal and with unexpected loss and death. I think there is only one
‘absolutism’ which may be central even for the common sense of today,
namely the more or less absolute faith in ‘meaning’: indeed most people
hold on to the belief that everything which happens, loss and death included,
is embedded in a meaning, even when this meaning is hidden to us finite
human beings.
Therefore in my view an event or situation is traumatic when it shatters
the faith in meaning which is at the base of everydayness – in other words:
an event or situation is traumatic when it confronts us with our finitude
in its naked facticity, stripped of any meaning.
Alice Holzhey-Kunz, Ph.D., philosopher and daseinsanalyst, gave

Daseinsanalysis a new turn by developing a hermeneutic theory of psychic
suffering. She is president of the Society for Hermeneutic Anthropology
and Daseinsanalysis and co-founder and co-president of the Daseinsanalytic
Seminar in Zurich. She has published three books and numerous articles
on daseinsanalytic theory and on a new dialogue between psychoanalysis
and existential philosophy. She was co-editor of the new edition of selected
works of Ludwig Binswanger.
e-mail: alice.holzhey@bluewin.ch
Notes
1
I am quite aware that it is not common in the English language to
differentiate between ‘existentiell’ and ‘existential’ in correspondence to
the difference between ‘ontic’ and ‘ontological’. Only the English translation
of Heidegger’s Being and Time acknowledges this differentiation which
is quite common in German as well as in France. However the English
translation of Sartre’s famous chapter ‘Existential Psychoanalysis’ in his
main work Being and Nothingness is totally ignorant in this respect: In
the original French edition this chapter is entitled ‘psychanalyse existentielle’
and Sartre had good reasons to name his psychoanalysis ‘existentiell’ and
not ‘existential’.
2
It is therefore no surprise that the title of the first world congress of
existential therapy in 2015 was not just: Freedom and Responsibility, but
‘Freedom, Responsibility and the Meaning of Being’.
References
Heidegger, M. (1996). Being and Time. Trans. Stambough, J. Albany, NY:
State University of New York Press.
Alice Holzhey-Kunz, A. (2014). Daseinsanalysis, Trans. Leighton, S.
26
London: Free Association Books.

Kierkegaard, S. (1980). The Concept of Anxiety. A simple psychologically
orienting deliberation on the dogmatic issue of hereditary sin, Trans.
Thomte, R. & Anderson, A.B. Princeton, NJ: Princeton University Press.
Sartre, J.-P. (2008). Being and Nothingness. An essay on phenomenological
ontology. Trans. Barnes, H. London: Routledge.
Stolorow, R.D. (2007). Trauma and Human Existence. Autobiographical,
Psychoanalytic and Philosophical Reflections. London: Routledge.
27
‘Home’ Is An Interaction, Not A Place

Greg Madison
Abstract
This brief paper reports on a workshop titled, ‘An Exploration of Being-
at-Home, Homelessness, and Belonging and the Concept of Existential
Migration,’ presented at the first World Congress f or Existential Psychotherapy,
held in London, May 2015. This workshop is another in a series of attempts
to encourage existential therapists to prioritise their own ‘experiential
knowing’ over philosophical concepts and psychological theories, in this
case about home and belonging. It is an expression of the work I and
others have been presenting on the concept of Existential Migration
(Madison, 2006; Yates, 2015). One of the outcomes of this research is a
reconceptualisation of ‘home’ as interaction rather than the usual assumption
that home refers to a geographical location, usually one’s origin.
Key Words
Existential Migration, voluntary migration, Global Nomads, home, belonging,
cross-cultural phenomenology, Focusing, Gendlin
Introduction
This report describes a workshop I presented at the first World Congress
for Existential Psychotherapy, held in London in May 2015. The workshop
is based upon PhD research I undertook about fifteen years ago and subsequently
published in two texts; The End of Belonging (Madison, 2009) a summary
of the topic for the general public, and Existential Migration (Madison,
2010), a publication of the complete thesis including methodology.
I began the workshop by describing how the research topic was inspired
by a trip to Calcutta (described in The End of Belonging) but also how it
was informed by my entire life and how ‘home’ and ‘leaving home’ have
been themes since I was a young boy growing up on the Canadian prairies.
This is important because it illustrates how right at the heart of this topic is
human experience, not a theoretical concept but a bit of real life.
I will not repeat the workshop introduction here except to say that the
topic of ‘home’ is deeply personal to me and when I present these workshops
it often attracts an audience for whom home, leaving home, belonging,
identity, and cross-cultural dislocation, evokes deep emotion. The workshop
is designed to welcome that. It encourages a personal experience of the
28
topic and acknowledges that for some reason, ‘home’ seems to be a resonant
topic for any human being regardless of their position on the spectrum of
settled to migratory. That to me raises a fundamental question: ‘Why is
home even an issue for humans at all?’ It’s not as if we have known any
other planet.... Surely feeling at-home here on earth should be a given, yet
for some of us, it is not.
The concept of ‘Existential Migration’ began to form gradually as I engaged
in the research interviews. It consists of a number of similar themes and
experiences evident in the stories that co-researchers told me, but it is also
a migrating concept, being developed and added to by many others who
have become interested in the concept and have furthered research into it.
I use the term existential migration because these stories of moving across
culture were not motivated by economic advancement, educational betterment,
political upheaval etc, but instead were instigated by a powerful need to
pursue one’s personal potential by maximising freedom, independence and
choice. The motives were indeed ‘existential’ and unlike most studies of
migration, these were not mass movements but unacknowledged solitary
arrivals and departures, not worthy of social scientific study. For this reason
these migrations have gone unnoticed, until now.
Existential migration can be thought of as a process that anyone could
enter into. For some people, like me, it may seem to be a defining characteristic
of the self-process and therefore indicative of the choices one makes
throughout a lifetime. For others, a period of existential migration might
be provoked by an unexpected unsettledness in response to, for example,
a foreign job posting and the ‘culture shock’ of fundamental life assumptions
being challenged and exposed as contingent. However, the process of
existential migration, after some time, could shift into something else and
the unsettled feelings might recede and the person return to a settled life
somewhere. It’s a process, not a personality type. I use the term ‘existential
migrant’ as a shorthand for a person who would currently describe themselves
in this process.
Outline of the workshop

The workshop began with a brief introduction, followed by a session of
experiential Focusing (Gendlin, 1982) on ‘what is home for you?’. After
the experiential session, I presented the themes from the research study
and quotes from co-researchers, and finally we took some time for participant
discussion and questions. The Focusing session invited each person into
a private experience of a time when they felt at home. Here is a summary
of the basic phases of the Focusing exploration:
‘Bring to mind a time when you really felt at home –it could be a time
in nature, at your birthplace or hometown, on vacation somewhere, in the
29
Greg Madison
arms of a loved one, doing something you really love, if more than one
situation comes to you, take time to choose which feels most alive right
now’… ‘Notice what feeling begins to emerge in your body as you hold
that place, that time or situation, in your mind. How does that really feel?’
‘Perhaps you can begin to sense what it is that allows this feeling to arise
for you in this situation, “what is it about this whole situation or this
place that allows me to really feel this being at home?”’
‘Then I’d like to invite you to wonder, what might interfere with this
feeling? What could get in the way of feeling at home like this? What
would you have to do to protect this feeling in order to keep it there –
What could get in the way? Imagine protecting it from anything like that.’
After the Focusing experience I invited the participants to consider these

questions:
1. How would you describe the feeling of being at home for you?
What was the best or worst about it for you?
2. Is the feeling associated with a place, an activity, a time in your
life, other people, or nothing in particular?
3. What could get in the way of that feeling at home?
Discussion of the research study

A few general points
The research study contradicted the assumption in psychotherapy and
migration studies that choosing to leave home makes voluntary migration
less evocative, less distressing, less interesting, and in fact less meaningful.
In contrast, the interview responses actually raised the question, in what
sense were these migrations ‘voluntary’ at all? Co-researchers often asked
themselves , ‘in what sense did I have a choice? Could I have stayed?’
Not leaving home was a very uncomfortable prospect to contemplate.
It seems to me that the ‘migrating body’ becomes elaborated by each culture
it experiences. Subsequently this ‘excessively complicated’ experiential body
is no longer congruent enough with any one place to feel like it ‘fits in’. It
has developed more intricately than any one culture – no one place can hold
the interactions this body now implies. No place feels like home anymore,
except in temporary moments. In this sense, for some people at least, ‘home’
becomes a momentary self-world interaction, not a set geographic place.
In addition to rethinking home as interaction, the research implies a
challenge to the bias towards sedentary life that is evident in our societies
and even in our attitude towards conceptualising and theorising itself.
‘Unsettledness’ can be aspired to rather than pathologised. Our thinking,
30
our concepts themselves, can become temporary interactions, based upon

reflective mobility rather than fixed, set, concretised and defended. Concepts
can be situationally specific, not general, not large edifices, but temporary
waves in human understanding. Perhaps human experience itself is more
fundamentally unfinished and migratory rather than settled and complete?
We may feel the desire to insist upon an explicit truth that is forever
pinned down, but this seems at odds with the nature of felt experiencing
that grounds human truth. The fact that therapeutic insights, like phenomenological
research studies, remain transitory and inconclusive is to be expected and
welcomed. The human tendency to concretise is a ubiquitous obstacle to
remaining open to phenomenological process.
If this perspective has any validity, it seems to suggest that a person is
‘unfinished’ and that some aspect of the self-process seeks the direction
of fulfilling that person’s potential. For some of us, the familiar home
environment (not just the family environment) inhibits the person’s attempts
to fulfill themselves. For ‘existential migrants’ this call to realise one’s
self-potential is more important than the need to belong. In this sense,
leaving is an act that protects one’s potential. But it can be difficult to
maintain a balance between the homeworld threat of encroachment and
the arid isolation that constant relocation can produce. A downside of
existential migration is that finding oneself ‘rootless’ can result in a fragile
sense of self that is constantly unsettled and restless; the inconsolable
seeking respite that does not come.
A few specific points

Having previously published a summary of the research themes from this
study (Madison, 2006), I will only list seven of the topics that we discussed
within the time constraints of the workshop:
1. Co-researcher narratives often included the dichotomy of yearning

to belong yet belonging simultaneously generating a feeling of
claustrophobia and thus a desperate need to escape, for some it
even amounted to ‘running for one’s life’.
2. It is common for many of the co-researchers to recall feeling that
they never belonged at home. For some, as long as they can remember,
they felt that home was not their place, as Graciella (one of the
co-researchers) describes it, ‘it was where I was put to grow up’.
Usually the ‘existential migrant’ was ‘the one’ in the family who
didn’t quite fit in, never felt accepted, and always stood slightly
apart from a sense of community. This experience is painful and
confusing. But the rejection can go in both directions, with these
migrants feeling somewhat superior to a home culture that felt too
homogeneous, conventional, or provincial. For the existential
31
Greg Madison
migrant, ‘culture shock’ is more likely at home.

3. Travel is a valued mode of ‘conscious living,’ keeping a person
aware of surroundings and preventing a slip into habitual and less
mindful ways of being. Seeking out contact with unfamiliar and
mysterious cultures offers the experience of a ‘match’ between the
mystery one finds within one’s own being and the mysteries of the
world. This matching between person and world can generate a
temporary feeling of being at ‘home’ in the world. Continually
encountering unfamiliar cultures is a way to “kick myself alive”. It
remains a mystery why, often in the midst of a home environment
that values similarity, these people should so deeply value the opposite.
4. It is facile to leap from familial accounts to causal explanations –
leaving due to early caregiving experiences, for example. Many of
the co-researchers who mention the significance of their childhood
experiences explicitly caution me not to become reductionist in my
understanding, not to narrow the whole matrix down to early attachments
and ‘individual defect’. If certain early experiences were causally
linked to choosing to leave one’s home country, we should see a
discernible pattern, but no such simplistic pattern emerges. Many
people, including siblings of these people have difficult family
experiences but never consider even leaving their home town. While
early relationships are undoubtedly important, I would contend that
our childhood relationships are as much expressions of our orientations
toward the world as they are formative of them.
5. Obsession with the question of return lurks near the surface for
each of the individuals interviewed; return either as a desired future
possibility, a work in progress, an unlikely option, or an undesirable
threat. The question of returning home arouses deep emotion. No
one was indifferent to the issue. There was some indication that
for some people feelings of wanting to return increase as people
age. Returning home to settle seems to be as much a psychological
and spiritual process of healing as a geographical process of
relocation. The longer one remains away from home the less concrete
seems the experience of home. For many this process culminates
in the person not really feeling at home anywhere. It is interesting
that regardless of the emotional pain and losses inherent in leaving
one’s home culture, none of the co-reseachers would choose differently
if they had the choice again. Everyone would choose to leave again
despite knowing the years of deep difficulties ahead and the inherent
irredeemable loss implied in homelessness.
6. It is a strange inversion of lost and found in which we find ourselves
most fully at the moment when the world sinks into insignificance
and we appear most lost in the eyes of the conventional. “What if
32
man’s homelessness consisted in this, that man still does not even
think of the proper plight of dwelling as the plight? Yet as soon
as man gives thought to his homelessness, it is a misery no longer.
Rightly considered and kept well in mind, it is the sole summons
that calls mortals into their dwelling” (Heidegger, 1964: p 363).
In terms of existential migration, the suggestion is that we are
not-at-home not because we have been exiled from home, but rather
because we have been exiled by home from ourselves.
7. My private practice in London and internationally via Skype has
attracted a number of ‘existential migrants’, dislocated professionals,
and ex-pats. I have found that an existential-phenomenological
approach incorporating Focusing, (a similar approach to the research
interviews) has constituted a helpful invitation to these clients
who seek self-understanding free from assumptions about developmental
pathology. I work in a way that normalises mobility and acknowledges
bodily felt experience that cannot be colonised by language or
concepts. This form of therapy offers intimate human connection
without imposing explicit forms of understanding on the client, a
relationship with process-space and acceptance of difference, even
the difference within the client.
The homelessness of the existential-phenomenological therapist

The expressions of phenomenologists and existentialists (whether therapists,
academics or ordinary life philosophers), are often indistinguishable from
the motives for migration explicated by ‘existential migrants’. It appeals
to me to consider that phenomenology and existentialism itself is a tangible
expression of homelessness. Like each co-researcher, the phenomenological
researcher has left the known, his home, and embarked upon a journey
into unknown territory, perhaps settling briefly, yet yearning for a deep
connection, a conclusion that never comes and, in some cases, trying to
accept that. As a phenomenological account, this project is a venture into
the unfathomable, away from the known concepts and sustaining certainties
of science or theory, at best clearing a source for a path that leads a little
further on, or a little further astray.
The mood of existentialism could be described as ‘a feeling of the homelessness
of man’ (Gray, 1951). The world we are thrown into cannot meet the claims
of the human spirit. ‘Our natural and social environment oppresses us with
its foreignness, its unsuitability as a home for all that is specifically human
about us as individuals’ . If we are sensitive to the human condition, we will
not find a refuge in nature or society, we will remain outcast.
Following Martin Heidegger, Gray presents an evocative description of
the existentialist’s state of being as arguably indistinguishable from the
33
Greg Madison
more profound implications of the individual exemplifying a process of

existential migration,
When you feel [unheimlich]… you are seized with a nameless
fear. You are out of your element, but more than that you have an
intuition of abysses hidden from normal moods. These rare
experiences of the uncanny… are revelatory of the innermost
nature of reality. At such times we feel a deep sense of unease;
we are threatened and oppressed by everything in general and
nothing in particular. We are filled with dread or anguish, a
psychological state which has for the existentialists metaphysical
origins… what has oppressed us is the primary intuition that we
are not sustained by infinite power and plenitude of being… On
the contrary, we, human creatures, perceive dimly in the
experience of the uncanny, that the world rests on nothing. It has
no basis or ground
(Gray, 1951: p 116)
In his lectures, Heidegger is concerned that the whole of humanity is
forgetting itself and sailing into a forsaken state of total homelessness. This
is not the authentic unheimlich but rather an alienated lostness. Heidegger
refers to wanderers who have been far from home, in remote places, as being
the ones capable of bringing home the message concerning the origins that
have otherwise been forgotten (see Heidegger, 1964, c.f. Gray, 1951). This
source can only be pointed at poetically. According to Heidegger, what is
most authentic for humanity is always what is out of the ordinary. Such
sentiments clearly echo the attitudes and experiences of many of the co-
researchers and workshop participants. Homecoming, then, is not the return
home to a geographical and cultural place, but more a fleeing from superficial
hominess back into the mystery of the world.
Greg Madison, PhD, is an existential psychotherapist and psychologist

active in various academic and professional communities across Europe
and North America. He has written and co-edited books as well as articles
on Existential Migration, Focusing-oriented therapy, Existential Therapy,
and contemporary topics related to democracy, psychology and society.
He founded The London Focusing Institute and is a Certifying Coordinator
for the Focusing Institute and co-editor of Existential Analysis.
Contact: info@gregmadison.net
References
Gendlin, E.T. (1982). Focusing. New York: Bantam.
34
Gray, G.J. (1951). The idea of death in existentialism. Journal of Philosophy,

48 (5): 113-27.
Heidegger, M. (1964). Basic Writings, 2nd ed. Krell, D.F. (ed). New York:
Routledge.
Madison, G. (2006). Existential Migration. Existential Analysis 17(2):
238-60.
Madison, G. (2009). The End of Belonging: Untold Stories of Leaving
Home and the Psychology of Globalisation. North Charleston: Create
Space Publishing.
Madison, G. (2010). Existential Migration: Voluntary migrants’ experiences
of not being-at-home in the world. Saarbruchen, Germany: Lambert
Academic Press.
Yates, E. (2015). Existential Migration: Healing the divide between home
and abroad. Global Living Magazine. (Nov): 24-25.
35
The Therapeutic Functions Of

Literature and Narrative
Simon du Plock
Introduction
The talk below was given in the context of a workshop at the World
Congress for Existential Therapy on 16th May 2015. As befits a ‘talk’,
the style is somewhat conversational at times, and the text is not broken
up into discrete sections, each with their appropriate heading or sub-
heading, and there are no key words. I hope that in staying faithful to the
form in which it was given, something of the energy and enthusiasm in
the room (which was full to overflowing) may be conveyed.
If you looked at the title of this workshop today ‘The Therapeutic Functions
of Literature and Narrative’, and wondered how we are going to do justice
to such an enormous topic, then let me say at the outset what I am planning
to offer in the next hour and twenty minutes.
I want to begin by taking you through some of my thinking around therapy
and literature – and I am going to focus for the most part on the act of reading
for reasons that will shortly become apparent. So I am initially going to take
you through my own experience of reading, and the meaning it has had, and
continues to have, for me – personally and to some extent in my work as an
existential psychotherapist. In a way I am going to tell you a story. From
there I plan to take us further into an exploration of the significance of
reading for my colleagues – other existential therapists, most if not all of
us in this room today, and I also want to say something about how reading
can be a valuable element in therapeutic work. I am going to talk a little
about how reading has been taken up as part of something called ‘Bibliotherapy’.
And, drawing on some aspects of my own research in the area, I want to
make some very practical suggestions about how we can engage with clients
who in some way or another bring their reading into the therapy room.
Now because this is a workshop I want to include time for some experiential
activity. I am very eager that all of you are able to join in discussion about
your thoughts on this topic, and I am hoping that many of you will have
first-hand experience of working with client’s reading. Some of you may
have developed models for doing so. And some of you may simply be
curious to see what unfolds in this session!
36
The Therapeutic Functions Of Literature and Narrative
Incidentally, I would normally suggest we start by having everyone

introduce themselves, but given the size of this group I think the most
sensible thing would be for you to introduce yourselves when we get into
small groups in a little while to do some experiential work. So there is no
particular pressure or expectation on any of you – but I am very curious
and excited to see what comes from our time together.
In terms of a structure, then, I am aiming at three small sessions which
look like this:
14.00 – 14.30 Introduction to therapeutic functions of reading

14.30 – 14.55 Experiential work in small groups
14.55 – 15.20 Whole group reflection and concluding remarks
So let us begin. Initially I am going to start with bibliotherapy in the

broadest sense because the thoughts and ideas I want to share with you
are the gleanings, the outcome of my reading around what is or may be
understood to be ‘therapeutic’. Like most of you, I imagine, I am constantly
reading for diversion, but also, and not mutually exclusively, for instruction
and for inspiration. And like you I again imagine, questions about who I
am, what is therapy, what am I doing when I am a therapist, how can I
become a better, more effective therapist, form the backdrop of almost all
my reading – whether explicitly or, more often, implicitly. If you like, in
reading I am ‘trying to understand myself’, and I am trying to ‘improve
myself’. In a very real sense, I am trying to make myself better.
I, like many of you, grew up with books, not with electronic devices. One
of my fondest childhood memories is that of reading my way – or at least
trying to read my way – through my grandfather’s library, a library which
he had acquired many years earlier. I use the term ‘library’ not because he
had the luxury of a dedicated room fitted out with ranks of expensive glass-
fronted bookcases, in the classic style of an aristocratic home, or even a
college or public library. No, the image I intend to conjure up with the word
is one which belongs to a very special moment in British history, and I
suspect in the experience of many people in Continental Europe too.
The moment, the time, I have in mind is the immediate post-World War
II period when the combatants returned home from military service to try
to resume their disrupted, often shattered, pre-war lives once again. At
just this moment their sprung up a terrific thirst for knowledge, which was
given material shape by a resurgence in reading, and specifically in the
activity which became known as ‘building a library’. Paper, of course, had
been scarce during the war and publishing was largely limited to propaganda.
Now, suddenly, people were liberated to read and read they did. And foremost
among the publishers to respond to this hunger for books for a new and
better life was a company called, very appropriately, ‘Everyman’.
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Simon du Plock
This publishing house was originally founded under the name ‘Everyman’s
Library’ back in 1906 with the publication by one Joseph Dent (whose
dates were 1849-1926) of no fewer than fifty titles. Dent, a master bookbinder
turned publisher, was a classic Victorian autodidact. The tenth child of a
house-painter in the North of England, he left school at thirteen, and arrived
in London with a half crown (two shillings and sixpence, much less than
a pound) in his pocket. He promised to publish new and beautiful editions
of the world’s classics at one shilling a volume, ‘to appeal to every kind
of reader: the worker, the student, the cultured man, the child, the man
and the woman’ in the street so that ‘for a few shillings the reader may
have a whole bookshelf of the immortals; for five pounds (which will
procure him a hundred volumes) a man may be intellectually rich for life’.
‘Infinite riches in a little room’, as he also put it.
Popular classic series had existed before, but none was on the scale of
Everyman’s Library. As John Gross wrote in The Rise and Fall of the Man
of Letters, ‘Everyman’s Library was an institution, a benign presence, a
crusade, an act of faith.’ Every Everyman book ever since has carried the
motto ‘Everyman, I will go with thee, and be thy guide, In thy most need
to go by thy side.’ This motto is drawn from the medieval morality play
tradition, where the character Everyman is comforted by another character,
Knowledge, as he sets out on a journey, long, hard, and dangerous. Interestingly,
J. M. Dent employed a symbol for his publishing house which acts as a
visual equivalent to the above and remains strongly etched in my memory
today. Very much of its time, it was the silhouette of two little figures
wearing formal Victorian clothes – top hat and frock coat – one, rather
taller, holding the hand of the smaller, possibly younger one, and pointing
into the distance…presumably indicating the way towards a radiant future.
I remember the books, ranks of them, shelf after shelf, all claret with
gold tooling. These were books promising a better life. Now the reader
was thought to need more than the classics, and the volumes embraced the
arts, history, foreign languages, and the hard sciences too. If they gestured
outwards towards the future, they also functioned to remind the returning
heroes what they had been fighting for. I particularly remember a series
of texts on a bucolic England, Wales, Scotland and Ireland – these conjured
up an idyllic rural life which, in reality, was already rapidly vanishing
beneath the onslaught of factory farming and mechanization.
So you can see that these books were intended to meet the needs of a
generation famished for print. The post-war generation (at least the literate
majority) was a generation of readers. A generation who subscribed to the
notion of ‘self-improvement’). The idea of self-actualization was yet to
be born, and the concept of authenticity hardly known about except among
the French intelligentsia of the Faubourg Saint Germain – yet this generation
was intent on finding its place in the world. And you can see, in thinking
38
in this way about how people create their sense of identity, and what may
be conducive to psychological well-being, I have already strayed somewhat
from what we traditionally regard as therapy or therapeutic.
Or perhaps not… The picture I have presented so far is a fairly optimistic
one – the notion of reading as instruction and inspiration. But it may also have
a more protective function, which is much less to do with re-joining the human
race as withstanding the onslaught of others. As Sartre famously expressed it
in his play Huis Clos, ‘L’enfer, c’est les autres’, ‘Hell is other people’!
In keeping with this protective function, I realized when thinking about
how I used books in childhood and adolescence, that I frequently used the
act of reading and the role of the reader to self-regulate, or maintain a
sense of a relatively stable self. This was an oppositional or transgressive
act in the context of my immediate family of origin, where relationships
had much in common with those in the pathogenic families described by
the existential psychiatrist R. D. Laing. Laing argues that locked into a
suffocating dynamic and without the possibility of escape, a young person
may lose their sense of reality and become ‘absorbed in contriving ways
of trying to be real, of preserving his identity…to prevent himself losing
himself’ (1960: pp. 42, 43).
Laing describes three fundamental anxieties such a person may experience:
first engulfment, or the sense of being completely overwhelmed by the
other; second, implosion, or the sensation of being completely empty and
falling into a pit of nothingness; third, petrification, (literally, turning into
stone), by extension being turned into a thing by the other and of having
one’s selfhood and autonomy negated. This last is reminiscent of Sartre’s
notion of the look of the other which seeks to turn the subject of the gaze
into an object for the observer.
Mary Warnock, describing Sartre’s account of human relationships in
Being and Nothingness, shows how reading provides a way of evading the
demands of other human beings. I find the passage in which she describes
the effect of reading particularly apposite and so worth quoting in full:
We wish people to conform to the descriptions we give of them.
We wish to predict their behaviour entirely, according to the role
in which we have cast them…For other people are essentially, in
themselves, and by their very existence, a danger to us. Once I
realize that I am an object of observation to the Other, I also
realize that he will have his own ways of assessing and of trying
to predict my behaviour. I will reciprocate, and likewise try to
reduce him to the status of a thing. But I know, all the time, that I
cannot entirely succeed in doing this. When I see another human
being, a man, reading his book, let us say, in a public garden, I
experience him partly as a mere physical object; but I am aware
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Simon du Plock
that to describe him in purely physical terms is inadequate.

The fact that he is reading constitutes an all-important difference
between him and any other object. He is thinking his own
thoughts, understanding the words through the medium of his
own perceptions, and orienting round himself a whole new world,
which is his world, not mine. He escapes me, in some essential
part of himself. Sartre speaks of the relation between the reading
man and his book as a little crack in my universe. ‘It appears’,
he says, ‘as if the world has a kind of drain hole in the middle of
its being, and that it is perpetually flowing off through this hole.’
The man is an object for me, but of a particularly slippery and
evasive kind.
(1989, p 116)
I recognize in this description precisely the strategy I adopted as a child
in order to defend myself against the tyranny of relationship. Reading was
for me, then, a purposive act – a strategy intended as a form of defence,
and also aggressive since it appeared to offer a way of subverting the
family in both overt (visible) and covert ways. (Covert since I was not
doing anything obviously ‘bad’ or ‘blameworthy’).
Reading, then, was a mode of withdrawal and a strategy for frustrating
those who frustrated me. This way of engaging with reading led me to an
idiosyncratic relationship with text which, again, I found as an adult
delineated in Sartre’s autobiography of childhood, The Words (Les Mots).
I could – and did – read for hours without gaining a sense of plot or narrative
structure. Instead I would use the text as a vehicle to fantasize and daydream.
Also, like an addict with a cigarette or needle, I could immerse myself in
the paraphernalia of reading – the ritual of ‘when’, ‘how’, and ‘where’
were as important to me as the ‘what’ of reading. I could also lose myself
in contemplation of the ink on the page, the curious form of a sentence,
the (as I learned to regard it later) absurdity of the artefact. So reading,
adopted as a strategy of revolt, could itself become a way of becoming
stuck or, to use Sartre’s term ‘mineralized’ (1943, p. 597).
This tendency to use literature to withdraw, and to find myself fixed in
this withdrawn position, remains strong in me, but I have over many years
of personal therapy and clinical practice discovered that it is useful and
alerts me to the danger of assuming that reading is necessarily therapeutic.
I would argue, rather, that reading (and other forms of engagement with
text including writing), in order to be systematically therapeutic, needs to
take place in a context which offers the ‘challenge of the other’ in the form
of the therapist.
The anthropologist Ruth Behar, writing about the importance of locating
oneself within one’s research, makes the point that doing so ‘is only interesting
40
if one is able to draw deeper connections between one’s personal experience

and the subject under study’. So having traced my interest in the therapeutic
potential of reading to my own early experience of using texts to ‘self-
medicate’, I was curious next to discover if other existential therapists had
similar experience, and how this informed their own clinical practice.
I had assumed – always a dangerous thing to do of course – that such
experience of reading as therapeutic would be a common one that would
be mined by academics and trainers for the possibilities it provides in
client work. I was, then, surprised to discover that reading was rarely
mentioned during my own training. This seemed particularly puzzling
since I had chosen to spend the majority of my time in training in existential-
phenomenological therapy, an approach distinguished by a rich heritage
of existential literature. I was not alone in my reaction: I found then, and
have since found in my role as a trainer, that many people are drawn to
this approach having resonated with some aspect of Dostoevsky, Camus,
Kafka, de Beauvoir or Sartre, and more recently authors such as Cormac
McCarthy, Bret Easton Ellis, Knut Hamsun, and Milan Kundera only to
find their experience of reading this material ignored in formal training.
There is a parallel here, I believe, with the way client’s reading prior to
entering formal therapy is either discounted or is viewed as a precursor to
the ‘real’ therapeutic relationship.
My sense of a ‘lack’ or a ‘gap’ between client’s experience and what
therapists provided was reinforced when I began to practice and found
clients regularly talked about their use of reading. They readily spoke
about how they had identified with a character in a book and often went
on to describe how they felt less alone as a result. This seemed to me to
be a significant part of their lives, and also one where they were able to
find a therapeutic experience for themselves. How much more powerful
might this be if I could find a way to harness it and work in tandem with
them to use their reading more fully in their exploration of their worlds?
My searching in the literature on working therapeutically with client’s
reading didn’t satisfy my hunger for a way forward which was respectful
of, and built on the client’s experience. In fact the North American and
UK versions of bibliotherapy mainly consisted of prescribing CBT-based
self-help texts to clients and largely ignored the client’s subjective experience
– the very aspect of therapy which forms the basis of existential practice.
In the U.S. CBT health practitioners frequently use self-help literature
to support their work. Bibliotherapy generally takes the form of one of the
following interventions:
1. ‘Self-Administered Bibliotherapy’ – Clients have an initial session

in which they are prescribed a CBT self-help text. They have a
post-test assessment at the end of treatment.
41
Simon du Plock
2. ‘Minimal-Contact Bibliotherapy’ – Limited written, ‘phone and

face-to-face contact with a therapist.
3. ‘Therapist-Administered Bibliotherapy’ – Regular, but not weekly,
meetings with therapist.
4. ‘Therapist-Direct Bibliotherapy’ – Standard weekly therapy sessions.
An alternative broadly humanistic approach, ‘Interactive Bibliotherapy’,

uses guided dialogue with the therapist about the client’s personal response
to a story or poem. Both ways of harnessing the therapeutic potential of
reading focus on discrete ‘presenting problems’. Indeed much of North
American bibliotherapy is aimed at ‘problems’; little attention is paid to
existential givens. Stanley, at the most optimistic and pragmatic end of
the spectrum, considers bibliotherapy, when practiced by medical professionals,
to be a ‘science’ (1998, p. 4). Concerned with the ‘growth’ of the ‘whole
person’, and offering a book-based approach which fits with the category
of ‘Self-Administered’ bibliotherapy, she provides recommendations or
‘bookscriptions’ for readers seeking guidance on subjects as specific and
as amorphous as, for example, ‘Creativity’, ‘Coping With a Chronic Illness’,
‘Addiction and Recovery’, ‘Mental Illness’, ‘Self-Esteem’ and ‘Discovering
Your Life’s Mission’. In the UK, Berthoud and Elderkin have recently – in
2013 – echoed Stanley’s approach in their The Novel Cure, An A-Z of
Literary Remedies, albeit with a greater sense of irony. It is interesting to
compare these titles with those suggested by Holbrook Jackson, an English
commentator, in his fictitious corrective to obsessive taxonomy in his 1950
text, The Anatomy of Bibliomania. Inspired by Robert Burton’s 1621 Anatomy
of Melancholy, he addresses the notion of books as pharmaceutical products
in chapters with titles such as ‘Books and Soporifics’, ‘Their Medicinal
Properties Generally Considered’, ‘Preservatives and Prophylactics’, and
‘The Cure of Megrims, Melancholy and Like Distempers’.
Approaches such as that adopted by Stanley are clearly more humanistic
than existential, where the emphasis is less on problem solving than on
the development of a greater appreciation of what it means to be human
– an appreciation which provides an indirect route to engage with difficulties
just as ‘oblique’ literature may prove more liberating than self-help texts.
From an existential perspective we might note how, paradoxically, the
notion of scientific bibliography appears on the one hand to offer the
individual a powerful way of treating him/herself, without the necessity
of deferring to an ‘expert’ such as a psychiatrist, while on the other hand
implying pathology and producing specific ‘drugs’ to address the reader’s
symptoms. We should note that scientific bibliotherapy is firmly grounded
in an individualistic western construct of what it means to be human:
whether writing, as Pardeck and Pardeck (2013) do, for a professional audience,
or, like Stanley (1998), for the general public, advocates of scientific
42
bibliotherapy adopt a normative western perspective on psychological health.

North American bibliotherapy, then, while directed at a very wide spectrum
of consumers, appears to be characterised by a combination of humanistic
optimism and cognitive-behavioural pragmatism. In general it seems to
be devoid of the awareness of the tragic dimension of existence and awareness
of the limitations of the human condition which are characteristic of European
existentialism. Rather, it appears to subscribe to the position adopted by
North America humanistic psychology. Yalom compares this with the
European view:
The European focus is on limits, on facing and taking into oneself
the anxiety of uncertainty and non-being. The humanistic
psychologists, on the other hand, speak less of limits and
contingency than of developing of potential, less of acceptance
than of awareness, less of anxiety than of peak experiences and
oceanic oneness, less of life meaning than of self-realization, less
of apartness and basic isolation than of I-Thou and encounter.
(1980, p 19)
The tragic dimension of existence, then, largely gives way to a pragmatic,
technique-based approach; the notion of connections with a ‘community
of suffering’ is replaced by individual striving towards self-actualization.
This may, in part, relate to the largely Catholic heritage of Continental
Europe which places an intermediary clergy – a community of religious
advice and support – between the individual and their existential anxieties.
In comparison, the dominant Protestant ethic of North America places
responsibility for the searchings of the soul on the individual. The U.K.
seems to stand with a foot in both camps, though erring towards an American
perspective.
In the U.K. the N.H.S. has introduced pragmatic ‘book prescription

schemes’, also referred to as ‘supported bibliotherapy’; these were launched
initially in Cardiff in 2003, followed by Plymouth in 2004. Administered
via libraries, these early initiatives offered patients a 30-minute GP assessment
followed by a ‘bookscription’ from a list of 37 books. 20 schemes existed
in 2005, and the number has grown hugely since. The most recent Books
on Prescription initiative was launched across England in 2013. It is operated
by many NHS Trusts in conjunction with local Library services, all of
which use an identical list of 30 self-help texts. The direction of much UK
bibliotherapy, then, seems to be towards a technological view of suffering
which involves an over-simplification of people’s minds or beings, and a
manualization of practice. This may in part be due to a perceived need to
introduce bibliotherapy into the NHS and a consequent requirement to
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Simon du Plock
present it as an approach which is clearly defined and which lends itself

to evidence-based practice. I think it is obvious that the more pragmatic
and the less philosophically demanding a therapeutic approach, the more
it will lend itself to this form of manualization. Existing book prescription
models do not offer an appropriate vehicle for those working with therapeutic
approaches outside the broadly cognitive-behavioural category. These
schemes focus on simplifying therapy and reducing it to a number of
specific interventions and translating a therapy into a manual. Appropriate
for treatment approaches which seek to encourage changes in cognitions
and behaviour, I think they are far less relevant for therapies which attempt
to engage with less tangible aspects of human existence such as values,
meaning, subjective truth, and authentic living. The challenge for such
therapies, given the rapid increase in demand for ‘talking therapies’, is to
develop bibliotherapies congruent with their own core philosophies. That
manualization is anathema to existential therapy is clear from the opening
paper in the very first edition of Existential Analysis, which describes the
existential approach as:
…a practice of thoughtfulness…It is more like a game, an art, a
drama, a conversation than the application of a technique based
on a theory…It requires education, perhaps a philosophical
apprenticeship, rather than training.
(Heaton, 1990: p 5)
So was I alone in wanting to find a way, congruent with the existential-
phenomenological approach, to work with the meanings clients brought
to their reading? I found I was not, or at least not entirely. I recruited a
sample of thirteen co-researchers and asked them, in the context of a
phenomenological interview, to reflect on their personal experience of
reading, and on their experience of this phenomenon in their own clinical
practice. I discovered they too were very aware of their own experience
of literature as therapeutic and, like me, wondered how to transfer this
awareness into their clinical work. This is the interview schedule I used.
You will see I generated eight questions:
1. ‘Can you tell me, first of all, something about your own early
recollections of reading: what do you recall from childhood reading
which continues to feel significant for you? Do any particular
books or characters come to mind?’
2. ‘What about later reading, your experience of reading, say, in
adolescence? Does anything come to mind which you found helpful
as you were growing up?’
3. ‘What about your current reading: how do you find yourself using
books now? Is it a similar experience, or rather different?’
44
4. ‘Thinking about your work as a therapist, I wonder if there have

been any times when you have become aware of the use client’s
make of books?’ Has a client, for example, ever brought a book
into a session – either metaphorically or as an actual book?’
5. ‘What was the experience like for you – did you feel it was useful
for the therapy, or did it seem to impinge on your relationship with
the client?’
6. ‘Have you ever suggested a client might like to read a particular
book? If so, can you tell me about your reasons for this, and what
happened in the therapy as a result?’
7. ‘Are there any books which you turn to when you feel troubled
by life generally, or want support for your image of yourself as a
therapist?’
8. ‘I wonder, just finally, and it’s quite a brief conversation that we
are having, but I wonder if it has brought up anything for you
which you were not aware of before about your attitude to ‘therapeutic
reading’, for you in particular or in general?’
Now at this point I want to ask you to take part in a brief exercise which
reflects some of these questions:
Please chose a partner and get into pairs. Each of you takes a turn
to name a book, poem, song lyrics, or some other text that is important
to you, that has meaning for you. You take 10 minutes to talk about
the text and its significance for you. Your partner adopts a phenomenological
approach, encouraging you to deepen your description of your
relationship with the text. They will focus on your meaning, and
bracket their own thoughts and feelings.
After 10 minutes, please swap roles so you both have the opportunity
to reflect on your relationship with a text.
When you have each had 10 minutes, take 5 minutes to reflect
together on what this experience was like.
My co-researchers described how they found reading enormously significant

for their psychological well-being, but they also talked about a perception
of bibliotherapy obtained from UK National Health Service ‘bookscription’
schemes. They felt that working with clients’ reading entailed doing rather
than being, directing rather than exploring. The implicit question to me
as someone who had stepped forward as a researcher in this field seemed
to be: ‘how can we practice Bibliotherapy in a way compatible with
existential-phenomenological values?’ This raised a question for me about
how confident my colleagues and I are in our chosen way of working: why
45
Simon du Plock
would we need to deviate from ‘being’ when reading is surely part of the
phenomena available in many of our meetings with clients? Why would
mention of reading lead us to become directive any more than, say, a client
mentioning that they had had a dream – both, surely, are narratives and
have a narrative structure?
The colleagues and co-researchers I met in the course of my research
reminded me how easily we can set aside our own ways of making sense
of life when we meet with clients in a professional capacity. They also
inspired me to propose a relatively simple shift in perspective, that of
returning to the phenomenon itself – clients’ reading – in order to explore
the way they actually use books, rather than prescribe books for the relief
of specific symptoms. This shift of perspective returns the client’s subjective
experience to the therapeutic frame and can enable client and therapist to
act as co-researchers to explore how the client uses reading to create meaning.
Such an ‘existential bibliotherapy’ provides a way of moving beyond
symptom alleviation in order to assist people to engage with problems of
living.
This approach has a number of advantages over ‘standard’ forms of
bibliotherapy:
• It does not exclude clients who are not literate or have physical
problems reading print.
• It is inclusive with regard to the form in which a client engages
with story or information.
• It recognizes the reality of the client, however they use literature.
The experience of someone who reads popular magazines strap-
hanging on the tube or bus to work is of equal interest as the
experience of reading in a public library or listening to an audiobook
while driving or doing housework.
• It can be supportive of people who might feel daunted by the
prospect of book prescriptions and homework.
• The process of co-research offers an opportunity for the client to
be fully involved in a transparent, democratic relationship.
• It recognizes the reality of the client because it starts from the
place the client occupies and values their use of stories which give
expression to their particular culture.
I am making a very modest claim here: what I have proposed is not intended
to be a major, free-standing mode of therapeutic practice. We have very
many of those already. Perhaps too many, since at the latest count there are
at least 350 distinct types of psychotherapy, and the list is expanding year
on year. There is no need to argue for a specific Existential Bibliotherapy
within existential therapy, or complementary to existential therapy.
46
But I think what I am proposing is significant in another way. I am

attempting to indicate how the way clients already use reading can be
recruited into the therapeutic alliance, how it can be welcomed inside our
joint project as what it is – a part of the warp and weft of human life. Such
an appreciation of the therapeutic potential of reading liberates the practitioner
to engage with the client’s reading in as confident a manner as they might
engage with the client’s dream life or any other aspect of their way of
being in the world. It removes a barrier to the consistent application of a
phenomenological attitude – the basis, I would argue, of existential therapy,
and what makes it so distinctive and humane. While there exist specific
ideas within existential therapy about working with dreams, nobody, at
least so far as I am aware, has proposed a separate Existential Dream
Therapy. The whole thrust of existential work with dreams is that they can
be approached as phenomena, as aspects of the client’s way-of-being-in-
the-world. So the client’s reading stops being perceived by the therapist
as ‘external’ or problematic, or extraneous, or as something which requires
them to stop being existential and start being directive. Considered against
the backdrop of other human activities – activities which are to some
degree what define a flourishing life – reading (and in all probability
writing too), can be seen as both ordinary and extraordinary. Reading
viewed in this light can be considered as therapeutic with a small ‘t’, rather
than Therapeutic with a capital ‘T’.
Professor Simon du Plock is Faculty Head, Faculty of Applied Research

and Clinical Practice, at the Metanoia Institute, London, where he directs
psychotherapy research doctorates jointly with Middlesex University. He
is a UKCP Registered Psychotherapist, BPS Chartered Psychologist, and
a BPS Registered Psychologist Specializing in Psychotherapy.
Contact: Simon.duPlock@metanoia.ac.uk
References
Behar, R. (1996). The Vulnerable Observer: Anthropology that breaks
your heart. Boston: Beacon Press.
du Plock, S. (2015). ‘Bibliotherapy and Beyond: Research as a Catalyst
for Change in Therapeutic Practice’, in Goss, S. P. & Stevens, C. (eds)
Making Research Matter. Researching for change in the theory and
practice of counselling and psychotherapy. London: Routledge.
du Plock, S. (2007). Using Phenomenological Research to Make a Difference:
Developing a Democratic Approach to Therapeutic Reading. Proceedings
of the 25th International Human Science Research Conference, ‘New
frontiers of phenomenology, Beyond postmodernism in empirical research’
du Plock, S. (2005). ‘Silent Therapists’ and ‘the Community of Suffering’:
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Simon du Plock
Some Reflections on Bibliotherapy from an Existential-Phenomenological

Perspective. Existential Analysis, 16(2).
du Plock, S. (2005). Some thoughts on the use of Narrative Approaches
in Counselling Psychology. Counselling Psychology Review, 20(2).
Elderkin, S. and Berthoud, E. (2013). The Novel Cure, An A-Z of Literary
Remedies. Edinburgh: Cannongate Books Ltd.
Gross, J. The Rise and Fall of the Man of Letters, Aspects of English
Literary Life Since 1800. London: Macmillan.
Heaton, J. (1990). What is existential analysis? Existential Analysis, 1.
Jackson, H. (1950). The Anatomy of Bibliomania. London: Faber and
Faber Limited.
Laing, R.D. (1960). The Divided Self. London: Penguin.
Pardeck, J.T. and Pardeck, J.A. (2013). Using Books in Clinical Social
Work Practice: A Guide to Bibliotherapy. Abingdon, Oxon.: Routledge.
Sartre, J.-P. (1964). The Words. Trans. Clephane, I. London: Hamish
Hamilton. (Original work published 1963).
Sartre, J.-P. (1958). Being and Nothingness: An Essay on Phenomenological
Ontology. Trans. Barnes, H. London: Routledge. (Original work published
1943).
Sartre, J.-P. (1955). No Exit. Trans. Gilbert, S. New York, Knopf, 1955
(Original work published 1944).
Stanley, J. (1998). Reading to Heal. How to Use Bibliotherapy to Improve
Your Life. Boston, MA: Element Books Inc.
Warnock, M. (1989). Existentialism. Oxford: Oxford University Press.
Yalom, I. (1980). Existential Therapy. New York: Basic Books.
48
Considering The Epoché As An

Attitude Rather Than As A Method
Lucia Moja-Strasser
Abstract
This paper introduces some key notions from the work of the early Greek
Sceptics, namely Pyhrro of Ellis and Sextus Empiricus. It will consider
whether they can offer a different perspective on the epoché and the
possibility of performing a phenomenological enquiry.
The paper begins by giving a brief overview of phenomenology as it is
currently described. This is followed by a presentation of Pyhrro’s and
Sextus’s philosophical stance and their understanding of the epoché, including
their view as to how to approach phenomena.
The following section examines how we can approach and see a phenomenon,
what can prevent us from seeing what is in front of our eyes and how we
can learn to look and see a phenomenon.
The paper concludes by exploring if and in what way Husserl’s and Heidegger’s
use of the epoché is in any way related to Pyrrho’s and Sextus’s description.
Key Words
Connection; consciousness and intentionality; phenomenological description;
bracketing; epistemological; ontological; care; understanding; Hermeneutic
interpretation; Hermeneutic circle; attitude; epoché; equipollence; tranquillity.
Phenomenology
If there is one fundamental basis for therapy about which most existential
psychotherapists would agree, it would be phenomenology. The existential
therapist will approach the client phenomenologically, meaning they will
attempt to be with the client’s experiential world and listen to their narrative,
without imposing their own assumptions and theories that would distort
understanding. What can help in this process? There are several answers
to this question. First, however, it is important to understand how
phenomenology, as we know it today, originated.
Brentano, F (1838-1937)
Brentano has coined the term ‘Intentionality’. Intentionality is derived
from the Latin ‘intendere’, which means reaching towards. The concept
49
Lucia Moja-Strasser
of intentionality, demonstrates that every mental phenomena is directed

towards an object, it does not occur in isolation – consciousness is always
intentional.
Husserl, E (1859-1938)
Husserl’s project is epistemological. The emphasis is on connection and
intentionality. As shown in his well-known injunction ‘To the things
themselves’. He was interested in how we can know the world outside
of our experience. His answer was only by bracketing all assumptions
we hold about the world. He developed the method known as the epoché.
This consists of three steps:
i. The rule of epoché, which invokes us to put aside our biases
assumptions, prejudices and focus on immediate experience.
ii. The rule of description, we should describe what is rather than use
theoretical explanations.
iii. The rule of horizontalisation or equalisation, to treat the data observed
as having equal value to avoid creating hierarchies of importance.
Heidegger, M (1889-1976)
Heidegger shifts the emphasis from connection to the notion of ‘Care’ -
from ‘intendere’ to ‘attendere’. For Heidegger phenomenology was a quality
of engagement that brings about disclosure. It is a way of relating. Only if
there is dialogue is there the possibility for disclosure. Disclosure is the
‘what’ and ‘how’ of that which is being perceived. Heidegger’s project is
ontological. Phenomenology makes ontology possible. The phenomenological
description gives the possibility for an interpretation. Through interpretation
the meaning of Being is being uncovered. The Hermeneutic form of
interpretation is to make the implicit explicit without adding anything. This
type of interpretation is enlightening rather than intrusive. From the
Heideggerian perspective, without understanding there is no possibility of
interpretation and the point of phenomenology is interpretation.
Every interpretation is coloured by preconceptions, these preconceptions
in themselves are the precondition for our understanding of the world and
others. There is no putting aside or bracketing of our preconceptions. This
is the fundamental difference between Heidegger and Husserl.
Every understanding is based on preliminary understanding. What we
understand can be put into words, can be conceptualised. Interpretation
helps us to make sense of what has been disclosed in understanding. Through
interpretation meaning is articulated and projected in understanding. The
Hermeneutic circle brings together the correlation between understanding,
interpretation and meaning.
50
Considering The Epoché As An Attitude Rather Than As A Method
Contributions from the Greek Sceptics that broaden our understanding

of the epoché
The ancient Greek Sceptics were the first to question the manner in which
we relate to phenomena. They present another perspective on phenomenology
and in particular on the epoché.
Scepticism originates from the Greek word ‘Scepticos’, which means
someone who looks, investigates or examines. What sceptics are interested
in is the search – they refer to themselves as ‘zetetikoi’ – searchers.
Pyrrho of Ellis, the first Sceptic and Sextus Empiricus, who was influenced
by Pyrrho, are the most relevant philosophers for extending our understanding
of epoché.
Pyrrho of Ellis (360-260)

Pyrrho is considered the founder of the Greek school of Scepticism. He
was first a painter, interested in observing, he then diverted to philosophy.
He accompanied Alexander the Great on his expedition to India and was
exposed to Eastern life and philosophy; this impacted on his own way of
life. Back in Greece he adopted a life of solitude and lived in poverty.
He believed that unhappiness was the result of not attaining what one
desires, or losing it once attained. For him the wise person, being free
from desire, is free from unhappiness.
Eastern philosophy impacted not only on his life but also profoundly on
his philosophy. He learned from the Indian sages to question dogma in order
to attain peace of mind. Pyrrho advocated attending to phenomena undogmatically.
According to him, we can have opinions but certainty is impossible. We can
be certain of nothing. He believed that human senses did not transmit truth
or lies. We can know things only as they appear to us.
Pyrrho left no writings. We owe our knowledge of his thoughts to his
disciple Timon, though most of these have been lost. His ideas are known
mainly from the writings of Sextus Empiricus.
A few points to retain for reflection:
i. Approach the phenomena undogmatically.
ii. Human senses do not give us truth or lies.
iii. We can know things only as they appear to us, not as they are.
Sextus Empiricus (3rd century AD)

Sextus was described as a Pyrrhonian Skeptic. Many of his works survived,
including the Outlines of Pyrrhonism. Virtually nothing is known about
his life. Sextus was called Empiricus because he belonged to the Empiric
School of Medicine. Empiricism states that knowledge comes from
experience only. Sextus presents Scepticism as a kind of philosophy which
is distinguished from others, not by its content but by its attitude to
philosophical problems.
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Lucia Moja-Strasser
Sextus introduced the notion of epoché, a word that was part of ancient
Greek everyday language, meaning ‘a bird that hovers’ – a wonderfully
evocative image. The epoché ‘comes upon one’ (Heaton 1993). It is an
attitude, an ability with no specific way of how to do it. It is not an aim
but an outcome.So it is an attitude, which consists of neither accepting
nor rejecting a person’s opinions, values or assumptions, but allowing
things to unfold – waiting.
Sextus’ definition of epoché is the ability to suspend judgement over
conflicting opinions, values, beliefs, which leads to freedom from mental
conflict and is followed by tranquillity.
Sceptical tranquillity can only be reached if one does not try for it. In
Greek language, tranquillity is etymologically related to trouble. Literally
tranquillity means lack of trouble. People become sceptics because they are
seeking tranquillity. Advocating scepticism Sextus would say that tranquillity
follows the suspension of judgment, just as a shadow follows a body.
Epoché cannot be willed. It is not something that we do. It is an attitude.
This ability to suspend judgement, that is the epoché, is also called
‘equipollence’ (in the English language, defined as having equal value)
meaning that no one opinion or point of view takes precedence over any
other as being more credible.
Sextus shared some of Pyrrho’s philosophical tenets such as: nothing is
inherently good or bad; we can know things only as they appear to us and
not as they are.
A few points to retain for further reflection:
i. Epoché is not something that we do.
ii. It cannot be willed. It comes upon one.
iii. Epoché is an ability to suspend judgement leading to freedom,
tranquillity. Waiting, allowing things to unfold.
Here I am tempted to put forward the argument that there are common
elements between some of the reflections of Pyrrho of Ellis and Sextus
Empiricus, and that of being an existential phenomenological practitioner
and that of practising Zen Buddhist meditation. For those who practice
both existential phenomenological therapy and Zen Buddhist meditation
may find that the works of both Pyrrho and Sextus not only influence
their working with clients but also the way they live their lives.
Being a phenomenological practitioner and practising meditation both
demand openness, humility and simplicity. What kind of simplicity is
entailed? A simplicity that could pass unnoticed, does not involve trying
to guess or suspect where something is leading to. In this process, the only
thinking that is conceivable is that of non-thinking – an intuitive thinking
that is not steered or contaminated by words.
If we allow the mind to control us and prevent us from being in the
52
present moment this can have consequences for both a phenomenological

practitioner and someone who practices meditation. If we try to fight this
control we fall into the trap. What can overcome this is trying not to fight
it. Also remembering that nothing is inherently good or bad, we need to
remain patient, wait and allow things to unfold.
During meditation the simplicity and the repetition of breathing in and
out without aiming for something, will paradoxically, bring some result.
Whilst we breathe in, we welcome the spirit. Body and mind or body and
spirit are being reunited and then this is followed by the letting go of the
breath. If we try not to get attached to our thoughts, emotions, feelings,
they just come and go like the breath. This is the beauty of meditation that
can bring with it tranquillity.
When it comes to therapy, in a similar way as with breathing during
meditation, you welcome your client and all that they bring to the encounter.
This demands openness and the ‘equipollence’ that Sextus describes, where
no one opinion, or point of view, takes precedence over any other as being
more credible and this allows for not making judgments. Instead, cultivating
patience, waiting and letting things unfold. Like with sceptical tranquillity,
that can only be reached if one does not try for it. Equally in therapy and
meditation, we need to let go of the desire to see results. Only if we are
able to let go of that desire to help, something might just be there as a
reward.
A brief comparison between:
i. Husserl versus Pyrrho and Sextus
ii. Pyrrho and Sextus versus Heidegger
iii. Husserl versus Heidegger
Husserl Pyrrho and Sextus

A Scientist Philosophers
Looking for certainty Scepticism no possibility
for certainty
Can we know the outside world?

We can know the phenomena Can only know things as
they appear
How can we know?

By bracketing Approach the phenomena
undogmatically
Method ----------- versus ------------ Attitude

Epoché – 3 steps Equipollence is an attitude
Rule of epoché: put aside Epoché cannot be willed it is
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Lucia Moja-Strasser
biases, assumptions, prejudices not something we do

Describe rather than interpret It is an outcome of waiting
Treat each observed Nothing is inherently good or bad
phenomena equally
Pyrrho and Sextus Heidegger

Scepticism Ontological
Doubt the possibility of any certainty Possibility for understanding
Attitude, non judgmental Openness, quality of engagement
What is the purpose of phenomenology?

To find peace of mind, tranquillity To throw light on Being
Husserl Heidegger
Project – Epistemological Project – Ontological
Shared: Intentionality
Intendere Attendere
Different stances
Rule of epoché Interpretation
Put aside biases, prejudices We cannot get away from
preconceptions and prejudices
Both Husserl and Heidegger were acquainted with the early Greek Philosophy,
hence the choice of the term epoché. But Husserl being a scientist found
the position of Pyrrho and Sextus was not an option for him. He therefore
moved away from the Greek Sceptics. For Husserl the attitude becomes
a method, a doing, with clear steps to be followed.
Heidegger was interested in understanding Being and believed that there
is the possibility for getting closer to an understanding with the help of
the Hermeneutic type of interpretation. However, he remains closer to the
early Greeks. For him, phenomenology is a quality of engagement that
cannot be quantified.
Some practical considerations regarding how we can relate

to the phenomenon
To think does not mean to remain closed-in, in the head. Neither does it
mean spending time elaborating concepts about this or that. Neither is it
to have a point of view on pain and suffering or injustice. One of the
tasks of thinking is to be able to see what is there in front of our eyes
and truly welcome it.
Such a proposition is disconcerting because since childhood, school
54
days, university, our education consisted of making us learn ready-made

information, rules, facts and numbers and to analyse problems and find
answers. None of us were ever taught how to look and see a phenomenon.
Most of us probably thought that this was an easy thing to do. Actually
it is extremely difficult but essential for us as existential phenomenological
therapists.
First of all we need to connect ourselves to the experience of the phenomenon,
with our whole being and not only with our head. The attitude is that of
being innocent and naive whilst being immersed with the body and soul
in the experience. I like to say: ‘tune-in and resonate, allow the phenomenon
to speak to you’.
A common occurrence, for example, is going to an exhibition and looking
at a painting with some expectations of colours or form. This will certainly
cause you to miss the phenomenon. If possible open yourself to the truth
of that painting and become aware of the impact it has on you.
What are the obstacles that prevent us seeing what is in

front of our eyes?
The four main obstacles are:
i) Getting bored This happens to most of us sometimes and can be
considered a sign of becoming disconnected from our client. We become
uninterested about the subject the client is talking about, or feel a lack
of attention towards the client or we start looking at our watch to check
how long still to go.
ii) Chatter I call this going for ready-made formulas without having a
direct and personal connection with the phenomenon.A good example is
reading someone else’s evaluation of the client.Taking on board what
others have to say. When we meet the client we have already formulated
an opinion about them, we have many assumptions and expectations.
iii) Intellect and concepts If we rely only on our intellect and concepts
the result is that, our rapport or direct connection with the phenomenon
becomes remote or far away from us. We can end up making ideas about
someone or coming up with some diagnosis, we fall into ‘pathologising’
someone.The result can be that we are taking the concept as if it was the
phenomenon.
iv) Relying only on perception If we rely on perception alone it will not
take us closer to the phenomenona. This reliance is a somewhat intellectual
activity. As much as possible open yourself to the truth of the person in
front of you and become aware of the impact they have on you.
Hopefully becoming more aware of these four obstacles we can gain a

greater sense of what prevents us from seeing the phenomenon.
55
Lucia Moja-Strasser
The remaining question is: How can we learn to look and

see the phenomenon?
The first step is to admit that we are not really seeing it. We can remain
blind in front of the phenomenon.
We need to connect ourselves to the experience of the phenomenon

with our whole being, not only with the head. Allow ourselves to be
touched, maintain an attitude of openness, whilst being immersed in the
experience, becoming one with it. This might allow the phenomenon to
show itself. We need to become aware of the impact it has made on us.
It is a two way process.
An example from the world of music might help to illuminate the point.
The Russian pianist Sviatoslav Richter was a magician of the piano. Whatever
he played he would put one in the presence of, let us say, Mozart’s music
and his truth. Making Mozart’s music appear, making it manifest without
adding anything – like a Hermeneutic interpretation. There is no secret
– it is simple but not easy!
Read and interpret

For example, ‘How can you see anger?’ The anger needs to appear and our
role is to make it manifest. I could not tell you how. It all depends on
whether you are able to connect to the experience of anger. If you have
some difficulty in doing so you will not be able to facilitate the process.
No theory about anger will allow us to connect to the experience of anger.
Trust language
It is not only a question of seeing the phenomenon but also a particular
kind of listening is necessary. The phenomenon is speaking to us. How
do we hear it? It is through language that the phenomenon reveals itself.
When you describe the phenomenon, find the word that will allow the
phenomenon to show itself. For this to happen you need to be connected
to the experience, listen and allow yourself to be touched in your whole
being by the ‘look’ that comes from the other.
Conclusion
It seems to me that it would be more useful if those of you who have
been able to find any relevance for your work as therapists, to draw your
own conclusions about what this article has been trying to put forward.
Hopefully this overview will encourage you to read further and in so
doing become more familiar with the process of seeing what is there
before you. I have a bibliography which I am happy to share with anyone
who is interested.
56
Lucia Moja-Strasser, MA, AdvDipExPsych, UKCP Registered was a

Senior Lecturer at Regent’s College, London 2000-2010, when she moved
to Paris. She is accredited with the EAP, is an individual member of the
French Federation of Psychotherapy and Psychoanalysis, and an Honorary
Member of the Portuguese Society for Existential Psychotherapy. She has
experience of working with individuals and couples, long- and short-term
therapy, face to face, on Skype or telephone. She continues to train existential
therapists in Paris, Lisbon, and at Timisoara University, Rumania.
Contact: mojalucia@gmail.com, tel: 00.33.638482058
References
Heaton, J. M. (1993). The Sceptical Tradition in Psychotherapy. In
Spurling, L. (ed.). From The Words Of My Mouth. London and New
York: Tavistock Routledge
57
Existential Therapy As A
Skills-Learning Process
Martin Adams
What follows is an edited version of a presentation given at the first World

Congress for Existential Therapy in London on 16th May 2015.
Abstract
This paper suggests that learning skills is radically different from learning
techniques. The origin of the difference is primarily that techniques are
tools to be used whereas skills are owned ways of being. The way skills
become learnt is through a gradual process of understanding of the personal
meaning of the activity such that the skill becomes embodied and owned
through attention, perseverance and understanding of mistakes, rather
than being simply remembered. It is proposed that not only is there a
defined way that skills get learnt, embodied, but that life is a process of
learning skills, and also that a person’s ability to exercise their skills is
context sensitive. Suggestions are made for the way a therapist can
understand the client’s place in the skills-learning process and match their
actions and interventions accordingly.
Key words
Skills, techniques, learning, phenomenology, emotions, responsibility,
embodied, perseverance.
Introduction
In this talk I want to focus not on what we learn but on how we learn,
because it seems to me that with the exception of things like remembering
simple items of information, there is a common process to all learning
that involves acquisition of new skills. These can range from simple skills
like learning the times tables and the alphabet, to more complex skills
like riding a bike, to becoming a professional and competent psychotherapist,
and on to living with meaning and purpose.
We often find ourselves talking about change, and therapeutic change
particularly, but I want to move the focus of the debate away from change
per se because I believe it skews our thinking and shuts us off from some
important features. ‘Change’ is anyway a rather ambiguous, abstract and
curiously passive word. It is one of those words that the more you use it,
58
Existential Therapy As A Skills-Learning Process
the less you know what it means. This is why I prefer to use the word
‘learn’ because it is more descriptive of the process I want to describe and
it is also more phenomenological, it is more experience-near. It is more
active. I will however be using it here from time to time.
Everything we learn involves understanding ourselves and our place in
the world differently. From the moment of birth, or maybe before, a newborn
baby is actively, not passively, learning. Learning what different sounds,
tastes, touches etc. mean. Total engagement with every moment, every
experience, transforms the baby’s way of understanding its being-in-the-
world. And it doesn’t stop there. Or at least it doesn’t have to stop there.
But it often seems to slow down. As we get older we imagine we know
things and perhaps we do, but often we decide we know enough and actively
stop ourselves learning. We slip into the natural way of seeing. We actively
stop putting ourselves into situations, relationships, ways of being that
will challenge what we think we know. And sometimes when we do, we
fail to take the new features into account.
Skills
With respect to skills, existential therapists have long been suspicious of
technique and with good reason. This suspicion is summed up well by
Viktor Frankl (2000: 26) when he says, ‘…we can see the therapist as a
technician only if we have first viewed the patient as some sort of machine.’
So far so good. But this unexamined assumption has come with some
cost and there is a mistaken subtextual equation here. Skills are not the
same as techniques.
In its simplest form a technique is a specific description of what you do
in a given circumstance to achieve a particular purpose. It is a way of
operationalising a theoretical principle. And it works best, as Frankl says,
if what is acted on is not human. The danger of course is that by mechanising
the intention, the theoretical principle, into an action and generalising it
into a technique we remove not just the person, but also the relationship.
Both the client and therapist become reified, become en-soi and an it-it
relationship is established within which, although the two people are
apparently talking to each other, there is no true dialogue. It becomes a
project of bad faith. This runs counter to all the principles of existential
therapy which focuses on lived relational human meaning and consistency
of the attitude and intention of the therapist.
An action becomes a technique therefore when there is a gap between
belief and enactment; when we are doing something without full attentiveness
or personal commitment. Rather than concentrating on the mutually
dehumanising consequences of technique, existential therapists tend to
rely instead on the authority of their own experience, their integrity and
their values. Valuable and necessary but fraught with danger because they
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Martin Adams
are dependent on rigorous reflexivity for success.

Rather than technique, better terms here would be ‘skills’ or alternatively
‘practice’, to refer to the way we enact and own our beliefs. I am suggesting
here that successful living, and therapy is a context-specific version of it,
is a process of skills acquisition rather than technique acquisition. Techniques
are tools, skills are owned ways of being; they are how we do being. A
hammer is only useful if you have the skill to use it. Otherwise it is dangerous.
This distinction is important in the therapeutic world because the presence
of technique results in the manualising and dehumanising strategies of
therapy so easily recognized in, but not confined to, limited-contract models.
In our work the danger of slipping from skills into technique is ever present
and existential therapists are certainly not immune to this danger; it is a
human failing that we can fall into looking for short cuts – but if we adhere
to existential and phenomenological principles of reflexivity we will both
reduce the danger and increase the awareness of its occurrence.
Skills therefore, are intensely personal ways of being that only become
owned by perseverance and experience of failure.
Learning, responsibility and the sense of self

Existentially, we are both thrown into and out of our lives and on our
path through life from birth to death, we start with something we are
given which is neither ours nor requested – our individual existence – and
our life task is to learn to make it into something which is personal and
owned....only to lose it when we die. The most basic challenge of life,
of our development as human beings, is to learn to find a way to live
with this absurdity and to learn to struggle, persevere and discover ways
of being that get us what we decide we need, bearing in mind that what
we need changes as we go through life. To learn to distinguish between
thrownness and fallenness. And to learn that our decisions are always
temporary. That learning stops on death.
Existentially, human development is a gradual, fluid but permanently
cumulative and active meaning-based process and maturity, which is by
no means guaranteed, is a measure of this active learning and is correlated
more with life circumstances, conditions and choices than with age
(Adams 2013a, 2014).
A principle of all existential work then is to introduce, or re-introduce,
the client to the reality that they have an active part in their learning. I call
this the Law of Existential Consequence (Adams, 2013b) which is that when
I do something, something follows that I have to take responsibility for.
Existentially we know that the idea of a fixed self is an artefact of a
modernist natural scientific way of thinking. Instead we think in terms of
a sense of self that reflects our dynamic relationship with time and space.
Physiologically we have little difficulty having a feeling of ‘being an entity
60
with continuity in time and a location in space’, as Laing (1965: p 41)

says, but psychologically, existentially, it is more problematic. Children
can do it easily, they are more comfortable with their dynamic sense of
self. But adults believe they have understood their place-in-the-world,
children know they have not; they are too busy being-in-the-world. Actually,
anyone who has noticed how small children learn will have noticed that
their natural curiosity leads them to persevere with problems until they
have solved them. The difficult problems are the most attractive, the only
ones worth doing. When we stop learning, we stop living, and start dying.
Since life is change, our natural ‘state’ is one of change. In existential
therapy we do not work on change, as such, we work on stopping stopping.
We work on resistance to change. We work on learning from experience.
Existentially, we help people to stop interfering, out of fear, with their
ability to learn from experience. Working through is the active process of
addressing the obstacles we put in the way of our learning so that we may,
as Nietzsche said, accept reality for what it is.
Action based on learning from experience is everyone’s first language
and by reintroducing the client to personal learning, we reintroduce them
to personal responsibility. The prototypical existential dysfunction is when
we take responsibility for things we do not have responsibility for and
deny responsibility for things we do have responsibility for (Deurzen and
Adams 2011: p 117)
As someone facilitating learning, whether I am doing a jigsaw puzzle
with my granddaughter, supervising a researcher, or working with a client,
the process is exactly the same. I need to acknowledge the context-specific
characteristics of the task, and of the relationship between myself and the
other person, and work such that there is an optimum amount of anxiety,
for the right amount of anxiety will promote learning. And too much, or
too little, will hinder it. This is, as we know, not easy to get right. When
we care for another, what we care for is their autonomy. It is to do with
skills and not techniques.
Phenomenology
Phenomenology asks the question, ‘How can we understand anything
without first understanding that which does the understanding?’ and its
practice begins with and is sustained by attention. Our ability to ask the
open question, What? Rather than the closed question, Why? The overall
aim is to promote understanding, learning, but in order to learn we first
need to attend, and the entire process begins with and is sustained by
attention. This is a reflexive attention where we attend to the object of
attention, the noema, at the same time attending to the process of attention,
the noesis. Our ability to attend is correlated with our ability to live with
ambiguity and uncertainty. If we find we are searching for an explanation
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Martin Adams
or a theory it will probably mean that we are not attending well enough.
We become closed, rather than open. But as long as we attend we will
become increasingly aware of our assumptions and the reductions will
follow. The more we attend, the more we wonder, the more we learn.
Phenomenologically there are distinctive statements and interventions
that a therapist can use (Deurzen and Adams, 2011; Adams, 2013a) but
for these to become owned as embodied therapeutic skills rather than as
disembodied and therefore disowned techniques the therapist will need to
not only translate them into their own context-sensitive language but also
learn the subtleties of timing and placing that can only come about through
sustained and accurate attention, perseverance, and trial and error.
Emotions
Emotions have a central position in existential therapy because they are
constant reminders of what we value. They are not simply physiological
– they are not things we have, they are the way we feel-in-our-body. They
are reminders that we are embodied beings.
Losing touch with our body leads to a sense of personal alienation and
a consequence is the commodification and technologising of the body. The
body is seen as a machine which needs techniques, like medicine, to get
it ‘right’. We also see it in the so-called eating disorders with people who
have lost or learnt to deny – for we are all born with it – the ability to
know whether they are hungry or not.
They are essential for learning and existentially they are like a personal
compass because they orientate and offer us the possibility of action,
responsibility and choice. Someone who can trust their emotions will be
able to guide themselves through uncertainty with courage, but someone
who forgets how to trust their emotions, for we are all born with the
potential for it, loses the ability to know what is important to them. We
actively confuse ourselves when we feel one thing and do another.
But there is a paradox to emotions, that while they point us and connect
us to what matters, they also close us off from alternatives. For example,
if I feel fearful about an aspect of my life I will tend to see that aspect of
the world only as frightening and this will reduce the chance of seeing it
any other way. We never have just one feeling about an event. Similarly
there are no good or bad emotions, and calling them such just refers to
how personally comfortable or unfamiliar they are and whether we think
they will lead us in the direction of what we currently want or what we
dread. We need access to the full range of emotions so that we can resonate
with all aspects of the world. The cost is that if we deny them, we will be
lived by them, and our life will be passive and fearful rather than
active and courageous. We are more likely to experience distress by
trying to stop our feelings, than by letting them be. If we have forgotten
62
this, we need to re-learn it. Learning skills is an emotional, not just

an intellectual, process.
The skills-learning process

Very few ideas are new, and this one isn’t either. The basis of this model
was developed in the 1970s by Noel Burch of Gordon Training International
in the USA who have specialized for over 50 years in delivering Human
Relations training. What I have done here is to draw out its existential
and phenomenological features and also to apply it to therapy.
Learning skills is different from learning information, because it is about

learning to act differently, and learning the skills of living happens in the
same way as learning any other set of skills. It is about finding what obstacles
we put in the way of getting what we claim to want, finding the resources
to overcome them and last but not least, sheer persistence and hard work.
Being a client in psychotherapy is about learning how to live more effectively
and discovering strengths as well as weaknesses, and it is an emotional task,
an existential task, more than it is a technical or intellectual task. Ultimately
it is about learning to be open to life’s difficulties and capable of self-
reflection so that learning becomes continuous and not sporadic.
Although we usually move in the direction of greater competence, events
outside of our control occur that make us feel considerably less competent
than we thought we were. Our resilience is constantly tested and we continue
learning throughout our lives. This applies equally to therapist and client.
But as well as learning the skills of living more resourcefully, clients
also have to learn the skill of using therapy. It is easy to forget this, especially
for the more experienced of us.
The process of acquiring skills is marked by a characteristic sequence
of thoughts, feelings and actions that can evolve backwards and forwards
dependent on context through what can be thought of as four qualitatively
different but interconnected phases. Each contains the other and the
significance of the process as a whole has to be acknowledged in order
that learning can be consolidated, owned and be made transferable. It is a
model of how we learn to live effectively and is just as applicable to
everyday life as it is to therapy. It is not just about what is learnt, it is
about how it is learnt.
Moreover, each phase requires something different from us as existential
therapists.
First phase
Therapy begins even before the two people meet for the first time. For
the client, it begins when they start to ask themselves questions about
their life. When they acknowledge receipt of the gift of despair. This may
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Martin Adams
be intense and clear, or it may be dull and niggling. But either way there
is a sense that things are not the way they should be. However it is felt, it
manifests itself in coming to therapy. It is what tipped the person from their
habitual position of not doing something about an issue to wanting to do
something about it. There is therefore some hope among the despair and
this makes a significant difference to the client’s desire to learn. The question,
‘Why now?’ is always important. For the therapist, therapy begins when
we ask ourselves what we can expect to accomplish as a therapist.
Coming closer to the first session it evolves into the client wondering
how they may be perceived and received by their therapist, and this is no
less true for the therapist.
With every new client an entirely new relationship is created and we
can never take it for granted that it will work. Each therapeutic dynamic
is different and something new is learnt, if we are open to it. Both therapist
and client are there to find out unexpected things they did not know before.
Therefore the starting point for many clients is when they realise that
the things they have tried, have not worked and they are at a loss to know
what to do next.
This can be summarised as:
‘There are a lot of things I don’t know but I don’t know what
they are’.
The thoughts and feelings at this time can be;
• relief – at finally deciding to do something,
• anxiety, fear and apprehension – at what they may discover,
• excitement and curiosity – at finding out something new,
• despair or discouragement – about life in general and their own
life in particular,
• a little hope for the future – they would not be there if they
did not feel a little hope.
Our task during this time is mainly to listen and clarify. We begin to
find out about their worldview and the extent to which they see themselves
as embodied active agents or disembodied passive recipients of life. By
being phenomenological and sticking to description, both the client’s and
our own assumptions will begin to come to light. We become aware of the
noesis, the process, the ‘how’ of the relationship and we use our skill to
know when to refer to this. By virtue of this phenomenological reduction,
the content, the ‘what’ becomes clearer. This is the eidetic reduction.
Second phase
Gradually, the cumulative result of our attention and clarification is that
the client will start to wonder about the meaning of what they are saying
64
and their position in life. They will be beginning to horizontalise. They

will begin to see themselves against a horizon. They begin to gain perspective.
By seeing themselves in context in time and space, objects, people, things,
events or ideas can then be seen as if for the first time and not as separate
from them but as in relationship with them. There is a sense of the experiential
validity of alternative viewpoints and of the sense of self as the centre
of gravity of experience distinct from the ‘ego’ of everyday social situations
that produces the natural attitude and which can easily throw them off
balance. This is not the same as saying that they see ourselves as the
centre of the objective world in a narcissistic way, because implicit in
this kind of understanding is the realisation of their interconnectedness
with the world at the same time as realising the limitations of their own
point of view. The world does indeed become a different place. It is
disorientating and can be as frightening as it can be exciting. This is the
beginning of the transcendental reduction.
This can be summarised as:
‘I now know a great deal more about what I don’t know’
This can be a difficult part of therapy and clients may be inclined to
leave if they have had little experience of the value struggling through
adversity. They may not believe that any good can come from it. It is quite
likely to be familiar to clients in the sense that they have got this far before,
but no further. They are in an impasse.
The thoughts and feelings at this time can be
• anxiety – of having to take responsibility for their actions, but also
at finding out things they did not want to find out,
• anger – at the counsellor not doing enough to make things better,
• discouragement – that they came to feel better but are feeling
worse,
• frustration – at not feeling able to do anything about it,
• cynicism – at why should things be any better than this,
• guilt and blame – at how they have led their lives,
• boredom – this use of boredom is resistance and it does not mean
uninteresting and dull. It means there is too much going on and
that it is new and doesn’t yet make sense. It means they feel
overwhelmed by the complexity of the feelings that they have
hitherto tried to deny,
• ‘sour grapes’ – they may say they are not very interested anyway,
they can get along quite well without it,
• elation at understanding everything and a consequent desire to
leave immediately – but we may know this as a ‘flight into health’.
Our task here is to try to understand and tolerate this anxiety, both
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Martin Adams
intellectually and emotionally, and facilitate the client’s understanding of

its meaning.
We will be challenging and interpreting, which means that we will be
making descriptive interpretations, we will be searching with our client
for accurate re-descriptions of the client’s experience that help them to
understand it, its context and meaning in a new way. Quite often it will
mean focusing on ambiguity and referring to the paradoxes in the client’s
life, or how they repeat past patterns in different parts of their life.
This can place extreme pressures on the therapist because the client is
beginning to face the uncertainty and responsibility of an autonomous life
in-the-world, and we need to bear with them as they find the courage to
discover what might need to change. The therapist will need to fall back on
their own resources, both intellectual and personal to help the client through
what may well seem to them like an unsolvable dilemma. We know from
experience and from research (Denne and Thompson, 1991) that critical
turning points such as there are in phase two are marked by decision, sacrifice,
risk and an acceptance of possible negatives. Accepting that yes, it could
all go horribly wrong. This is the edge of the experiential known world.
Actually we also know that it rarely does go horribly wrong, but neither
does it go wonderfully right and according to plan. Why would it? This is
after all unknown territory. What usually happens is that it goes unpredictably
differently, but because of an increasing resilience and acceptance and
ownership of risk we are in a better position to take it in our stride and accept
it. This brings us in touch with the overarching existential dilemma and
paradox, ‘How can I live as if there is certainty while knowing that there is
none?’. We are subject to randomness and chance far more that we care to
admit (Stolorow, 2005). We can only learn this from experience.
If we did not have the experience of struggling in such ways, preferably
in our own therapy, then it is unlikely we will be of much help. We will
get scared and lose faith in the resilience of the human spirit. If we could
not risk the unknown and learn from it, how can we help someone else do
the same. The therapy might stop here, or it might continue but go round
in circles. We may find we use supervision or our own therapy differently
here too to unpick the dilemmas which echo with our own and which we
unwittingly maintain.
Third phase
Assuming risks are taken, gradually the client will get used to the new
experience of thinking and feeling differently.
It can be summarised as:
‘I know it’s what I wanted but I can’t really believe it and I’m
afraid it won’t last’
66

• excitement – at something new having happened,
• optimism and hope – that life might actually change for the better,
• anxiety – because it is so unfamiliar and because changes have
not lasted before,
• artificiality – changes are still very new and cannot yet be owned,
• despair – at temporary setbacks.
Our task here is to try to consolidate the changes made so they can be
integrated into the client’s idea of who they are and how they came to be.
This often means pointing out how they have actually done things differently,
more competently and more courageously than before.
We need to be affirmative and sustaining of their learning at the
same time as acknowledging that the uncertainty of existence can be
exciting instead of terrifying. That it is there to be learnt from rather
than recoil from.
Fourth phase
As the client gets used to doing things differently a more resilient excitement
can appear.
It can be summarised as:
‘I know how to do it now and I don’t have to think about it’
• power – because of at last being able do something in the new
desired way,
• complacency – this is dangerous because it can lead to arrogance
where the givens of existence are disregarded. This always leads
to a fall.
Our task here is to encourage the emerging competence and confidence

while at the same time guarding against over-confidence. This leads to
arrogance and the end of doubt means the end of learning. The therapist
will have to rely on their own experience of the nature of change in
order to know which is which. We can at times even come across as a bit
of a killjoy. This is necessary though because probably from our own
bitter experience we know that life is unpredictable and there will inevitably
be times when what has been learnt may seem to evaporate. Only to
return later. It is all part of the learning process. An embodied understanding
of the uncertainty of existence and a feeling of resilience in the face
of it is a more valuable outcome for therapy than favourable changes
in the external environment.
67
Martin Adams
A danger for the therapist, and the experienced therapist is particularly

susceptible, is that because they have had some years of experience, this
leads them to think they know, when all it does is to lead them into complacency
and arrogance. They have stopped learning and what were once skills have
now become techniques. This is when they will make a mistake and because
they do not realise it is a mistake they will see it as the client’s mistake,
responsibility or pathology. This can go some way to explaining the phenomenon
that therapists in training and immediately post training can have, to more
experienced eyes, a disproportionately and unreasonably high success rate.
They do well with their clients because of and not in spite of their inexperience.
Because of their openness to learn. This is another paradox.
But a good ending does not mean that all loose ends have been tied up
and everything is understood. This is the end of learning and is a delusion.
It means that both therapist and client have confidence that the client has
learnt enough about self-reflection and a philosophical understanding of
living to be equal to any further ‘slings and arrows of outrageous fortune’
that may come their way.
I’ve said before that with every new client an entirely new relationship
is created and we can never know how it will work. The skills-learning
process is universal to all learning, and therefore applies equally to therapist
and to clients. Clients have to learn how to use therapy at the same time
as learning about themselves. We have to learn how to be with a new client
and how to facilitate their learning. Each therapeutic dynamic is different
and something new is learnt, if we are open to it. It follows then that we
can feel competent at some times with some clients, and incompetent at
other times with other clients. And sometimes with the same client. Its all
part of the process.
Conclusion
To summarise, learning skills is central to all human learning because
meaningful human life is skills based and not technique based because
techniques treat us as machines and distance us from our humanity. An
activity can only be truly learnt when it is owned and its significance
understood and embodied. The process of learning skills is not simply
about remembering an intellectual body of knowledge, it is existential
because it involves understanding our place in the world, our relationship
with the rest of the human world as well as the non-human world, and
form, as well as our relationship with ourselves, our embodied temporality
and spatiality.
Martin Adams is a psychotherapist, lecturer and supervisor at Regent’s

University, London, and the New School of Psychotherapy and Counselling.
He is the author of A Concise Introduction to Existential Counselling
68
(2013 London: Sage) and the co author (with Emmy van Deurzen) of
Skills in Existential Counselling and Psychotherapy (London: Sage
2011/2016). He is also a sculptor.
Contact: adamsmc@regents.ac.uk.
References
Adams, M. (2013a). A Concise Introduction to Existential Counselling.
London: Sage.
Adams, M. (2013b). Human Development from an Existential
Phenomenological Perspective: Some Thoughts and Considerations.
Existential Analysis 24(1): 48-56.
Deurzen, E van. & Adams, M. (2011). Skills in Existential Counselling
and Psychotherapy. London: Sage.
Denne, J. M. & Thompson, N. L. (1991). The experience of transition to
meaning and purpose in life. Journal of Phenomenological Psychology.
22 109-133.
Frankl, V. (2000). Man’s Search for Ultimate Meaning. New York: Perseus.
Stolorow, R. (2007). Trauma and Human Existence: Autobiographical,
Psychoanalytic and Philosophical Reflections. Hove: The Analytic
Press.
69
Pain Is Not Pathology

Robert D. Stolorow
Abstract
After offering a philosophical critique of psychiatry’s DSM, the author
summarizes previous work on the context-embeddedness and existential
significance of emotional trauma. He proposes a comportment termed
emotional dwelling as a non-pathologizing therapeutic approach to emotional
trauma. ‘Trauma recovery’ is replaced by integration of emotional worlds
as the therapeutic aim.
Key words
Trauma, dissociation, grief, DSM, contextuality, existentiality, emotional
dwelling
Psychiatric diagnosing
Recent studies have called into question the fifth and latest version of
psychiatry’s Diagnostic and Statistical Manual’s creation of new diagnostic
entities and categories that are scientifically unsubstantiated and that
over-pathologize vulnerable populations such as young children and the
elderly. Here I seek to expose and challenge the philosophical presuppositions
that underwrite the entire DSM enterprise. These presuppositions descend
directly from the metaphysical dualism of Rene Descartes.
Descartes’s metaphysics divided the finite world into two distinct basic
substances: res cogitans and res extensa, thinking substances (minds) with
no extension in space and extended substances (bodies and other material
things) that do not think. This dualism concretized the idea of a complete
separation between mind and world, between subject and object. Descartes’s
vision can be characterized as a decontextualization of both mind and
world. Mind is isolated from the world in which it dwells, just as the world
is purged of all human meaning. In this vision, the mind is pictured as an
objective entity that takes its place among other objects, a ‘thinking thing’
that, precisely because it is a thing, is ontologically decontextualized,
fundamentally separated from its world.
The DSM is a pseudo-scientific manual for diagnosing sick Cartesian
isolated minds. As such, it completely overlooks the exquisite context
sensitivity and radical context dependence of human emotional life and
of all forms of emotional disturbance. Against Descartes and his legacy,
70
the DSM, I am contending that all emotional disturbances are constituted

in a context of human interrelatedness. One such traumatizing context is
characterized by relentless invalidation of emotional experience, coupled
with an objectification of the child as being intrinsically defective. No
wonder receiving a DSM diagnosis can so often be retraumatizing!
Pathologizing grief
The DSM5 makes it possible to classify traumatic bereavement – that is,
grieving that endures beyond a rather brief span of time – as a mental
illness. This pathologizing of grief has ancient roots extending back at
least as far as the Stoics, whose stern ascetic morality preached a perfect
indifference that eschewed all passionate attachments. The ideal of selfless
asceticism was carried forth in early Christianity, showing up dramatically,
for example, in the Confessions of the prominent 12th century monk,
Saint Bernard, who was wracked with guilt over his grief for his beloved
dead brother. His brother, after all, was enjoying eternal happiness in
heaven, so Bernard could only feel his grieving his loss as a manifestation
of a wicked selfishness on his own part.
The pathologizing of grief was continued by Descartes. In letters to Princess
Elizabeth of Bohemia and Constantijn Huygens, he warned that sadness and
grief could cause serious physical illnesses, and he recommended a form of
mental discipline – reminiscent of both the Stoics and contemporary cognitive-
behavior therapies – in which the imagination was to be directed away from
the sources of emotional pain and toward objects that could furnish contentment
and joy. In the current psychiatric and medical climate pathologizing grief,
psychiatrists (and even general practitioners!) are conflating painful feelings
with clinical syndromes and prescribing anti-depressant medication for
naturally occurring intense or prolonged sadness and grief.
‘Pain is not pathology,’ I wrote in my book, Trauma and Human Existence
(Stolorow, 2007: p 10). The enormity and everlastingness of the grief
following the loss of a loved one are not manifestations of psychopathology;
they are a measure of the depth of love for the lost beloved. Traumatic
states of sadness and grief can devolve into clinical depression when they
fail to find a context of emotional understanding – what I call a relational
home – in which they can be held, borne, and integrated. In a psychiatric
climate that pathologizes grief and that advocates treatments aiming at
emotional riddance, such a relational home for emotional pain is becoming
ever more difficult to find. Such a circumstance is actually likely to increase
the incidence of clinical depression.
The context-embeddedness and existential significance of

emotional trauma
Emotional trauma is an experience of unendurable emotional pain. I have
71
Robert D. Stolorow
claimed (Stolorow, 2007) that the unbearability of emotional suffering

cannot be explained solely, or even primarily, on the basis of the intensity
of the painful feelings evoked by an injurious event. As I alluded in the
previous paragraph, painful emotional states become unbearable when
they cannot find a relational home in which they can be shared and held.
Severe emotional pain that has to be experienced alone becomes lastingly
traumatic and usually succumbs to some form of emotional numbing. In
contrast, painful feelings that are held in a context of human understanding
can gradually become more bearable.
I have also contended that the existential meaning of emotional trauma
lies in the shattering of what I call the absolutisms of everyday life – the
system of illusory beliefs that allow us to function in the world, experienced
as stable, predictable, and safe. Such shattering is a massive loss of innocence
exposing the inescapable dependence of our existence on a universe that
is unstable and unpredictable and in which no safety or continuity of being
can be assured. Emotional trauma brings us face-to-face with our existential
vulnerability, our vulnerability to suffering, injury, illness, death, and loss,
possibilities that define our existence and that loom as constant threats.
Because we are limited, finite, mortal beings, trauma is a necessary and
universal feature of our all-too-human condition.
Therapeutic implications: Emotional dwelling

How can a therapeutic relationship be constituted wherein the therapist
can serve as a relational home for unbearable emotional pain and existential
vulnerability? Recently (Stolorow, 2014), I have been moving toward a
more active, relationally engaged form of therapeutic comportment that
I call emotional dwelling. In dwelling, one does not merely seek empathically
to understand the other’s emotional pain from the other’s perspective.
One does that, but much more. In dwelling, one leans into the other’s
emotional pain and participates in it, perhaps with aid of one’s own
analogous experiences of pain. I have found that this active, engaged,
participatory comportment is especially important in the therapeutic
approach to emotional trauma. The language that one uses to address
another’s experience of emotional trauma meets the trauma head-on,
articulating the unbearable and the unendurable, saying the unsayable,
unmitigated by any efforts to soothe, comfort, encourage, or reassure –
such efforts invariably being experienced by the other as a shunning or
turning away from his or her traumatized state. Let me give a couple of
examples of emotional dwelling and the sort of language it employs from
my own personal life.
In the immediate aftermath of my late wife Dede’s death in February
1991, my soul brother and collaborator of four decades, George Atwood,
was the only person among my friends and family members who was
72
capable of dwelling with me in the magnitude of my emotional devastation.

He said, in his inimitable way, ‘You are a destroyed human being. You are
on a train to nowhere.’ George lost his mother when he was 8 years old,
and I think his dwelling in and integrating his own experience of traumatic
loss enabled him to be an understanding home for mine. He knew that
offering me encouraging platitudes would be a form of emotional distancing
that would just create a wall between us.
My father suffered a terrible trauma when he was 10 years old. He was
sitting in class, the kid sitting in front of him was horsing around, the
teacher threw a book at the kid, the kid ducked, and the book took my
dad’s eye out on the spot. For the rest of his life, he lived in terror of
blindness – a terror that I remember pervaded our household when I was
growing up. Sixty years after that terrible trauma, he was to have cataract
surgery on his remaining eye, and his optic nerve was vulnerable to being
knocked out by virtue of the glaucoma medication he had been using for
decades. When I went to see him just prior to the surgery, I found him in
a massively (re)traumatized state – terrified, fragmented, disorganized,
and deeply ashamed of the state he was in. Family members tried to offer
him reassurance: ‘I’m sure it will be fine’. Really? Such platitudes only
demonstrated to him that no one wanted to be close to him in his traumatized
state. Having gone through my own experience of devastating trauma, I
knew what he needed instead. I said, ‘Dad, you have been terrified of
blindness for nearly your entire life, and there’s a good chance that this
surgery will blind you! You are going to be a fucking maniac until you
find out whether the surgery blinds you! You’re going to be psychotic;
you’re going to be climbing the walls!’ In response to my dwelling with
his terror, my dad came together right before my eyes and, as was our
custom, we had a couple of martinis together. The surgery was successful
and did not blind him.
If we are to be an understanding relational home for a traumatized person,
we must tolerate, even draw upon, our own existential vulnerabilities so
that we can dwell unflinchingly with his or her unbearable and recurring
emotional pain. When we dwell with others’ unendurable pain, their shattered
emotional worlds are enabled to shine with a kind of sacredness that calls
forth an understanding and caring engagement within which traumatized
states can be gradually transformed into bearable painful feelings. Emotional
pain and existential vulnerability that find a hospitable relational home
can be seamlessly and constitutively integrated into whom one experiences
oneself as being.
Integrating emotional trauma: ‘Trauma recovery’

In concluding, however, I wish to add an existential qualifier to the claim
I have just made. Like its analogue, ‘secure attachment’, ‘trauma recovery’
73
Robert D. Stolorow
is an oxymoron – human finitude with its traumatizing impact is not an

illness from which one can or should recover. A felt requirement to recover
from, or become immune to, the circling back to emotional trauma can
be a source of intense shame and self-loathing when, as is inevitably the
case, it cannot be achieved. As I spelled out in my book, World, Affectivity,
Trauma: Heidegger and Post-Cartesian Psychoanalysis (Stolorow, 2011),
‘recovery’ is a misnomer for the constitution of an expanded emotional
world that coexists alongside the absence of the one that has been shattered
by trauma. The expanded world and the absent shattered world may be
more or less integrated or dissociated, depending on the degree to which
the unbearable emotional pain evoked by the traumatic shattering has
become integrated or remains dissociated defensively, which depends in
turn on the extent to which such pain found a relational home in which
it could be held. This is the essential fracturing at the heart of traumatic
temporality and the dark foreboding that is its signature emotion
Robert D. Stolorow, PhD, is the author of World, Affectivity, Trauma:

Heidegger and Post-Cartesian Psychoanalysis (Routledge, 2011) and
Trauma and Human Existence: Autobiographical, Psychoanalytic, and
Philosophical Reflections (Routledge, 2007).
Email: robertdstolorow@gmail.com
References
Stolorow, R.D. (2007). Trauma and Human Existence: Autobiographical,
Psychoanalytic, and Philosophical Reflections. New York: Routledge.
Stolorow, R.D. (2011). World, Affectivity, Trauma: Heidegger and Post-
Cartesian Psychoanalysis. New York: Routledge.
Stolorow, R.D. (2014). Undergoing the situation: Emotional dwelling is
more than empathic understanding. International Journal of Psychoanalytic
Self Psychology, 9(1): 80-83.
74
Al Mahrer (1927-2014) –
An Appreciation
Ernesto Spinelli
My friend and colleague,

Al Mahrer, died on the 13th
of April 2014 in Ottawa,
Canada. He was 86 years old.
Al was wonderful at asking
the most important questions
about therapy, His biggest
(if not impossible) question
was: ‘What is this thing we
call psychotherapy?’ He kept
asking it of himself, and of
pretty much anyone who came
into contact with him,
throughout most of his adult
life (Mahrer, 2010). He never
arrived at a final answer, but
he certainly raised quite a
few more fascinating questions
along the way.
In North America, Al was
recognised and lauded as one
of the very greatest and influential psychologists and psychotherapists of
the 20th century. In 1975, he was made a Fellow of the American Psychological
Association. In 1992, he won the Award for Excellence in Research from
the University of Ottawa, Canada. He received both the Distinguished
PHOTOGRPAH COURTESY OF DR HOWARD GONTOVNICK
Psychologist Award (1997) and the Living Legend in Psychotherapy Award

(2002) from the American Psychological Association, Division 29. In 2006,
he was awarded the Rollo May Award for Pursuit of New Frontiers from
the American Psychological Association, Division 32. Al wrote some 20
books as well as over 300 journal articles on different aspects of psychotherapy
and psychotherapy research. Inbetween such, he maintained a therapeutic
practice, developed an experientially-focused model of psychotherapy,
and taught at the University of Ottawa, Canada where he was appointed
as Professor at the School of Psychology in 1978 and where he remained
in residence (as Professor Emeritus) until his death.
Al developed a radical – even audacious – approach to therapy
75
Ernesto Spinelli
which he called Experiential Psychotherapy (1989a, 1989b, 2003). In a

summary of it, he wrote that every person expresses
potentialities for experiencing; tenderness, gentleness, softness,
playfulness, silliness, violence, whimsicalness, explosiveness,
destructiveness, strength, firmness, toughness; an experiencing
of being mischievous, devilish, wicked; being dominant,
controlling, in charge; being close to, one with, intimate; being
risky, daring, adventurous; an experiencing of being docile,
compliant, yielding.
That is all there is to the structure of a person. Nothing more.
There is no ego or id, no personality traits, no needs or drives,
no unconscious impulses, no psychodynamics or psychic
defenses, no cognitions or core schemas. Nothing.
Potentials for experiencing and relationships between these
potentials – that is all there is to this model of human beings.
The picture is rather clean and simple, especially in contrast
to all the concepts and constructs, pieces and bits, processes
and dynamics, that are present in so many other theories, and
are absent and unnecessary in this model
(Mahrer, 2001, pp 228-229)
Recently, John Rowan provided a very vivid, brief account of Al’s way
of working with clients. He wrote:
There were two huge reclining seats, in black leather, side by
side, and hanging between them a huge black microphone. Al
would lie in a reclining position, and encourage the client to do
the same, and then he would gradually enter into the world of the
client... Anything that could get in the way of that process was
eliminated.
Accordingly, he did not take a history, he did not assess or
diagnose the client, he did not set up a regular meeting, he did
not discuss goals or aims. Each meeting was open-ended…
(Rowan, 2014, pp 71-72)
Many professionals viewed Al’s work as an extention of existential
thought and practice. Although he never saw himself as an existential
therapist, Al’s knowledge of both the philosophers and therapists associated
with our approach was extensive. He rarely ‘talked the talk’ (and when he
did, it was often somewhat dismissive of what he took to be existential
therapy’s unnecessarily arcane and befuddling language) but I think that
76
Al Mahrer (1927-2014) – An Appreciation
what he took most from it, and what most enthused him, was its willingness
to question everything and the centrality it places upon both uncertainty
and possibility at every moment in life.
Al first contacted me in 1995 wanting to engage in a discussion about
a book of mine, Demystifying Therapy (1994), that he’d just read. We
subsequently met up at a conference in Vancouver and ‘clicked’. He was
such a warm, caring man. And such a hoot to be with. For some reason,
as well as boxing (which he loved and which had been his first choice as
a possible profession) and smoked meat sandwiches, we somehow got to
talking about ‘spud guns’. These are objects which shoot tiny pieces of
raw potato up into the air or at your nemesis. I have no idea what on earth
was interesting about them to Al but somewhere along the line I managed
to find one in a toy shop and gave it to him. I will never forget the beatific
smile on his face. From that point on, Al would refer to our discussions
as ‘The Spud Gun Chronicles’. During my time as Academic Dean of the
School of Psychotherapy and Counselling at Regent’s College, I invited
him to come over to the Graduation Ceremony one year and be the Invited
Speaker. Al took it as an opportunity to consider the question of therapy’s
future. He was enchanting and challenging – of course. But also disquieting
to many who heard what he had to say. On reflection, what seemed to some
to sound as somewhat pessimistic seems to me to have turned out to be
all too accurately prophetic.
Al was a genuine maverick within our increasingly docile and
narrow-minded profession.
Professor Ernesto Spinelli is an existential therapist, supervisor

and writer.
References
Mahrer, A.R. (1989a). Experiential Psychotherapy: Basic Practices.
Ottawa: University of Ottawa Press.
Mahrer, A.R. (1989b). How To Do Experiential Psychotherapy: A Manual
for Practitioners. Ottawa: University of Ottawa Press.
Mahrer, A.R. (2001). Experiential Psychotherapy. In R. Corsini (ed.),
Handbook of Innovative Therapy. New York: Wiley.
Mahrer, A.R. (2003). The Complete Guide To Experiential Psychotherapy.
Boulder Colorado: Bull Publishing.
Rowan, J. (2014). Alvin R. Mahrer, Ph.D, 1927-2014 – some appreciations.
Self & Society, 42(3-4): 71-72.
Spinelli, E. (1994). Demystifying Therapy. London: Constable.
77
Process and Outcome Research in

Existential Psychotherapy
Sofia Alegria, Inês Carvalho, Daniel Sousa,
Edgar Agrela Correia, João Fonseca,
Abstract
This study aims to be a contribution to both process and outcome research
regarding existential psychotherapy having used, respectively, Psychotherapy
Process Q-Set and Clinical Outcomes in Routine Evaluation – Outcome
Measurements. Four dyads in a total of 48 sessions were analysed. Results
reflect upon the primacy of the therapeutic relationship.
Key words
Existential psychotherapy, process, outcome, research, dyads, PQS,
CORE-OM.
Research in existential psychotherapy

Existential psychotherapy is considered an approach focused in relational
and intersubjective processes (Spinelli, 2007). It is centred on the analysis
of the personal existential meaning, and on one’s choice and responsibility
for ones own life path (Cooper, 2003). Therefore, it provides a deeper
understanding of human existence as emerging in contradictory tensions
(Van Deurzen, 2002).
A range of existential philosophers have influenced and defined an
existential approach to therapy from different schools of thought. They
include Martin Heidegger and Medard Boss (Daseinsanalysis), Viktor Frankl
(logotherapy), Kirk Schneider and Rollo May (existential-humanistic
approach), Emmy van Deurzen-Smith and Ernesto Spinelli (British school
of existential therapy) and other influences from brief existential therapies
(Cooper, 2003, 2010).
It is believed that deeply humanising engagement within the therapeutic
encounter is one of the common drivers for all existential schools (Cooper,
2015). Several authors have presented different theories and practical
approaches for the existential practice, but none of these contributions
were the subject of empirical validation and characterization (Cooper,
2003; Schneider & May, 1995; Spinelli, 2007; Sousa, 2014; Van Deurzen
& Adams, 2011).
Due to this diversity, and lack of empirical research in existential
psychotherapy (Cooper, 2010; Holanda, 2006; Sousa, 2006), it is still not
78
Process and Outcome Research in Existential Psychotherapy
clear how these multiple schools work from a practical point of view.
Additionally, literature expresses the modus operandi for existential
psychotherapy but there is no scientific evidence of what existential therapists
do in their practice, contrasting with the general international therapy
panorama (Lambert, Bergin & Garfield, 2004).
Process and outcome research

It has become accepted that psychotherapy is indeed beneficial and effective
for the client (Lambert & Ogles, 2004; Lambert et. al., 2004; Wampold,
2001). More recently, research has started to focus on the elements that
contribute to the success of therapy, however it remains an uncommon
research topic. The main point is no longer validating the effectiveness
of psychotherapy, but is rather understanding how the therapeutic change
occurs. Research is then more centred on the outcome and the process
itself (Orlinsky, Ronnestad & Willutzki, 2004, in Lambert et. al., 2004).
Considering the existing gap in existential psychotherapy research (Cooper
2010, 2015; Holanda, 2006; Sousa, 2006; Van Deurzen, 2002), the current
paper presents a study of the therapeutic process and its outcome in therapy.
This research aims to qualitatively investigate and characterize the therapeutic
processes of existential therapy dyads and connect these to outcome measures.
Data may help us clarify which therapy processes occur in real existential
psychotherapy interactions, and also the implications of those interactions
in terms of the outcome.
Method
Participants
As part of this study we had four dyads undergoing an existential psychotherapy
process, during 48 weekly sessions (approximately one year of therapy).
The data collection refers to the period between June 2011 and September
2012, although three of the processes continued into 2013. For that period
of time a total of 48 sessions were analysed, hence 12 sessions per dyad.
These processes were randomly selected from a population of 10 dyads,
part of an ongoing larger investigation in a university clinic. One of the
dyads (D2) dropped-out at the 36th session.
Aged between 25 and 60 years, three clients were female (75%) and one
was male (25%). Clients presented levels of psychological well-being
between 15.3 and 19.7 at the first session (CORE-OM scores), indicating
a moderate level of severity, and standing above the clinical cut-off point
(Barkham, Mellor-Clark, Connell & Cahill, 2006).
Concerning the therapists, three were male (75%) and one was
female (25%). They were all accredited members of the Portuguese
Existential Psychotherapy Society (SPPE) and had six to thirteen years of
professional experience.
79
Sofia Alegria et al
Instruments
Psychotherapy Process Q-Set
For the present study, the Psychotherapy Process Q-Set (PQS) was used.
Developed by Jones (1985) it allows not only the establishment of a
relation between the therapeutic process and the psychological change of
the individual undergoing psychotherapy (Serralta, Nunes & Eizirik,
2007), but also a quantitative and qualitative classification of the process
of therapy (Ablon, Levy & Katzenstein, 2006; Jones, Cumming & Horowitz,
1988; Serralta et al., 2007).
PQS is a q-sort instrument and consists of 100 items, related to three
key aspects in the psychotherapeutic process (Jones, 1985; Serralta et al.,
2007; Carmo & Pires, 2010): a) Attitudes and actions of the therapist (n
= 41); b) Attitudes, behaviours and verbalized experiences of the patients
(n = 40); c) environment and atmosphere where the session occurs and the
nature of the interaction between patient and therapist (n = 19).
Following a normal distribution, these items are classified into nine
categories, ranging from most characteristic (category 9) to least characteristic
(category 1). In between there is category 5, which can be used whenever
the items were irrelevant during the session (Ablon & Jones, 1999, Jones,
1985). In other terms, the raters should sort the items according to their
frequency, intensity and estimated importance to each session (Ablon &
Jones, 2002). Being a q-sort instrument, it aims to foster the specificities
of each therapeutic process and, therefore, provide understanding to variations
and modifications that could happen. In order to achieve reliable results,
it is fundamental to have at least two raters (Ablon, Levy & Smith-Hansen,
2011; Sirigatti, 2004).
Clinical Outcome in Routine Evaluation – Outcome Measure

The Portuguese version of the Clinical Outcome in Routine Evaluation
– Outcome Measure (CORE-OM) was used. It is a useful tool in the
assessment of psychological wellbeing and psychic change of the client
undergoing psychological treatment (Walskow & Parloff, 1975; Barkham,
Margison, McGrath, Mellor-Clark, Milne & Connell, 1998; Barkham et
al., 2006), allowing a quantitative characterization of the therapeutic
process (Barkham et al., 2006).
This is a self-report instrument that measures psychological wellbeing
in adults, being integrated in the CORE System (Clinical Outcomes in
Routine Evaluation) (Sales, Marina, Moleiro, Evans & Alves, 2012). It
consists of 34 items on a five-point Likert-type scale (0-4), where 0 means
never and 4 always or almost always, encompassing the following dimensions:
a) Subjective wellbeing (4 items); b) complaints and symptoms (12 items);
c) social and personal functioning (12 items); d) risk behaviours (6 items)
(Barkham et al., 2006; Sales et al., 2012).
80
The items have different levels of intensity, including experiences of

high discomfort or psychological distress, and relatively frequent situations
in the general population. The validation for the Portuguese population
was recently performed by Sales and colleagues (2011) and its psychometric
properties display moderate to high Cronbach’s Alpha values, ranging
between 0.72 and 0.94, with the exception of the risk domain (0.46).
Procedure
A total of 48 audio-recorded existential psychotherapy sessions, from
four different dyads, were analysed. These psychotherapeutical processes
took place during approximately one year. The analysis and coding of
PQS were performed separately by two inter-raters (first and second
author), although the sessions were analysed simultaneously.
Inter-raters’ correlation coefficients should be higher than 0.50 (Jones,
Parke & Pulos, 1992; Serralta et al., 2007). For this reason, initial individual
training on the adequate use and application of the instrument was provided
to both raters, separately. Using the Portuguese version of the instrument,
translated by Carmo and Pires (2010), raters then trained together on the
PQS application over 10 sessions (not included on this study and randomly
chosen) until inter-rater correlation of 0.50 was achieved. These 10 training
sessions allowed the raters to discuss and reflect upon the criteria being
used for each one of them. In order to avoid misjudgements, this process
was repeated throughout the study.
After the minimum 0.50 correlation rate was achieved, the 48 sessions
used in this study began to be analysed. As inclusion criteria established
that every other session would be included, i.e., a fortnightly interval between
sessions was defined. Thereby, the present study obtained inter-rater correlation
values between 0.502 and 0.933 (mean 0.714), which we consider to be a
high degree of reliability, taking into consideration the relevant literature
on the topic (Ablon, Levy & Smith-Hansen, 2011; Sirigatti, 2004).
CORE-OM data was analysed based on Barkham and colleagues’ (2006)
considerations. Inductive statistics were performed, using SPSS software,
to compare pre- and post-treatment CORE-OM means.
Results
The instruments used enabled a process and an outcome analysis. Therefore,
in this section we intend to parse the four dyads in terms of quantitative
and qualitative results.
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Therapeutic Process Analysis

Table 1
20 (most and least) characteristic items from PQS analysis, according to
the four dyads (in terms of frequency – mean)
10 most characteristic items
Item Description Mean
Q81 * Therapist emphasizes patient feelings in 7,686

order to help him or her experience them
more deeply.
Q6 * Therapist is sensitive to the patient’s feelings, 7,670

attuned to the patient; empathic.
Q65 * Therapist clarifies, restates, or 7,049

rephrases patient’s communication.
Q63 *** Patient’s interpersonal 6,992

relationships are a major theme.
Q69 *** Patient’s current or recent life 6,962

situation is emphasized in discussion
Q23 *** Dialogue has a specific focus. 6,891
Q46 * Therapist communicates with patient 6,831

in a clear, coherent style.
Q28 * Therapist accurately perceives 6,802

the therapeutic process.
Q33 ** Patient talks about feeling close to or wanting 6,732

to be close to someone.
Q86 * Therapist is confident or self-assured 6,723

(vs. Uncertain or defensive).
82
10 least characteristic items
Item Description Mean
Q77 * Therapist is tactless. 1,875
Q9 * Therapist is distant, aloof (vs.responsive 1,908

and affectively involved).
Q15 ** Patient does not initiate or elaborate topics. 2,376
Q42 ** Patient rejects (vs. accepts) therapist’s 2,865

comments and observations.
Q5 ** Patient has difficulty understanding the 2,907

therapist’s comments.
Q44 ** Patient feels wary or suspicious 2,927

(vs. trusting and secure).
Q51* Therapist condescends to, or patronizes the patient. 2,938
Q37 * Therapist behaves in a teacher-like (didactic) manner. 2,982
Q14 ** Patient does not feel understood by therapist. 2,990
Q17 * Therapist actively exerts control over the interaction 3,621

(e.g., structuring, introducing new topics).
Note. *Items concerning therapists’ attitudes ** Items concerning patients’

attitudes; ***Items concerning therapeutic relationship.
Regarding the mean values from PQS analysis (Table 1) there seems to
be specific focus on the dialogue during each session of psychotherapy
(Q23). Also, a focus on current and recent situations in the patient’s life
stands out (Q69). Client’s interpersonal relationships are frequent topics
of discussion (Q63).
With reference to the therapists’ attitudes there exists an empathetic
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Sofia Alegria et al
posture, characterized as confident, secure (Q86) and sensitive towards

the patient’s feelings (Q6). The therapists have an accurate perception of
the therapeutic process (Q28), to the extent that they seem capable of
correctly grasping the patient’s experience within the therapeutic relation.
Furthermore, the implementation of a genuinely interested attitude, responsive
and involved (Q9 – inverted item) was also observed.
As for the communication established with the patient, therapists tend to
communicate in a clear and coherent way (Q46). They favour a direct,
understandable and clear language, showing careful consideration and concern
in their interventions (Q77 – inverted item). The therapists did not assume
a tutorial position (Q37 – inverted item) or a superior attitude (Q51 – inverted
item) in the therapy relation, nor had the intention to guide the interaction
(Q17 – inverted item). The therapeutic work seems to emphasize the patient’s
feelings, helping him/her experience them more deeply (Q81), and often the
therapists clarify, repeat or rephrase the patients’ speech (Q65).
Regarding the patients, they understand (Q5 – inverted item) and accept
(Q42 – inverted item) the therapists’ comments and feel understood by
them (Q14 – inverted item). Initiating or developing topics during the
session is not an obstacle to the interaction (Q15 – inverted item). Patients’
desire for closeness is a frequent topic (Q33), prevailing a sense of trust
and safeness (Q44 – inverted item).
Therapeutic outcome: Analysis

Table 2
Comprehensible analysis of the Therapeutic Outcomes – Clinical scores (pre
and post-treatment) and change indicators, for the four dyads of present study
CORE-OM Clinical Score Change Indicators
Clinically
Pre- Post- Reliable
Significant
treatment treatment Change
Change
D1 15.3 5.6 9.71 5.60
D2 19.7 – – –
D3 16.2 8.8 7.35 8.82
D4 17.7 15.3 2.35 15.29
Mean 17.23 9.9 – –
84
CORE-OM enables a quantitative analysis by measuring wellbeing and

the psychic change of a client undergoing psychological treatment (Walskow
& Parloff, 1975; Barkham et. al., 1998; Barkham et al., 2006). For this
purpose, pre- and post-treatment CORE-OM questionnaires were administrated,
i.e., before the beginning of each psychotherapy process and after one year
of therapy. However, it should be noted that dyad two (D2) is lacking
post-treatment scores due to the client withdrawing from therapy (dropout),
having been analysed only in terms of pre-treatment scores.
The established values for the CORE-OM and the severity levels proposed
by Barkham and colleagues (2006) were considered in this present study.
As one can note, pre-treatment scores are much higher than post-treatment
(see Mean, Table 2), indicating a significant clinical change in terms of
perceived wellbeing by the clients. A value of 17.23 is considered a moderate
level of severity, as 10 is the cut-off point for determining clinical significance
(whereas 0-5 indicates little evidence of distress) (Barkham et al., 2006).
The consistency of this level of severity on pre-treatment assessment
can also be verified in individual dyads’ clinical scores (ranged between
15.3 and 19.7). In terms of post-treatment scores, client from dyad one
(D1) presents a score of 5.6, indicating a healthy psychological functioning.
In dyad three (D3), scoring 8.8, the client presents a low level of severity
in terms of psychological wellbeing. In regards to dyad four (D4), a moderate
level of distress is maintained, although the value decreased to 15.3 on
post-treatment assessment.
In order to assess psychological improvement in the client, two measures
are considered to be essential: reliable change and clinically significant
change (Jacobson & Truax, 1991). Reliable change indicates pre–post
difference, which might be represented by a difference of 5 on the clinical
score. Clinically significant change, on the other hand, is indicated when
a client has clinical scores that are inferior to the cut-off point (<10).
Regarding the current results, D1 and D3 have reliable change indicators
(9.71 > 5 and 7.35 > 5, respectively), which is to say that both have significant
change on their levels of psychological wellbeing after one year of a
psychotherapeutic process. By also having clinically significant change
indicators (5.60 < 10 and 8.82 < 10, respectively), D1 and D3 figure the
normal range of psychological improvement (<10), according to Jacobson
and Truax (1991).
Therapeutic processes with indicators of change

By analyzing the therapeutic processes with clinically significant and
reliable indicators of change (D1 and D3, Table 2) with both instruments
in this study, there is strong evidence that these processes relate to key
characteristics of the existential therapies here studied (18 out of the 20
most salient PQS items, Table 1). Take as an example the low expression
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Sofia Alegria et al
of ambivalence in the therapeutic relation (Q49 – inverted item). On the

other hand, some items become less salient, highlighting the clients’ needs
for a more intense feeling of closeness (Q33), those being two of utmost
importance for the positive development of the therapeutic process itself.
Therapeutic processes without indicators of change

In terms of processes without reliable and clinically significant change
indicators (D2 and D4, Table 2), there is less prevalence of PQS items
(16 of the 20 most salient items, Table 1). Unlike processes with change
indicators, in D2 and D4, patients feel comfortable in a dependent relationship
with their therapists (Q8 – inverted item). Patients also feel dependent
on the therapists’ interventions, which therefore motivates them to facilitate
the patients’ speech (Q3). Sessions lose focus (Q23) and clients feel the
need to break the silence and introduce new topics frequently (Q12 –
inverted item). In relational terms, there is not much trust and confidence
towards the therapist (Q44 – inverted item) and clients no longer feel
understood by the therapists (Q14 - inverted item).
Discussion
One of the biggest contemporary challenges for existential psychotherapy
is to show empirical evidence, in particular regarding the therapeutic
process (Cooper, 2010; Holanda, 2006; Sousa, 2006; Van Deurzen, 2002).
By using simultaneously the PQS and the CORE-OM, a qualitative and
a quantitative study was performed, analysing the relation between process
and outcome on existential psychotherapy sessions.
Approaching an existential perspective to psychotherapy is to consider
the inevitable conflicts and paradoxes of existence. In order to allow a
meaningful and authentic living-world experience, the therapeutic process
requires a deeper description and clarification of the client’s perspective
on the problematic situation (van Deurzen, 2002). At the process level,
results are congruent with some general principles of existential psychotherapy.
In this study, the three most salient items of the PQS refer to the exploration
and deepening of the clients’ feelings, to the empathic manner of the therapist,
and to the reformulation and clarification of the client’s communication.
All these factors can relate to the existential psychotherapy’s most common
practices, which is the application of the phenomenological method (Correia,
Cooper, Berdondini & Correia, 2014).
One fundamental philosophical position of existential psychotherapy is
the inter-relatedness of human existence. Existential philosophers propose
that our existence is in-the-world and, fundamentally, with-others (Cooper,
2003). Therapeutic narrative in the present study demonstrates predominance
of current or recent situations in the client’s life, whilst sharing the client’s
interpersonal relations. More than a merely personal, self-reflexive purpose,
86
this flux of human experiencing suggests that the therapist can potentially
be experienced as a way of deep connection with others – the I-Thou, as
Buber argued (1958, in Cooper, 2003). Such also suggests that therapists
are perceived as safe and interested in the subjective experience of their
clients, through a genuinely engaged posture.
Norcross and Wampold (2011) mentioned in their study the presence of
essential ‘common factors’ for the development of positive therapeutic
processes, especially those related to the relationship elements, such as
client feedback, empathy, collaboration, goal consensus and positive regard.
The current results suggest that existential psychotherapy includes dimensions
in its actual practice which are closely related to the common factors. Take
as an example the fact that clients felt understood by an empathic therapist
who is sensitive to their feelings and experiences; or therapists who do
not position themselves in a tutorial or superior manner, but rather promote
the client’s authentic engagement in the therapeutic process. Within the
existential process, the therapist offers a space of detailed exploration and
further clarification, encouraging the client to face the reality of their
existence (van Deurzen, 2002).
In their studies, Bohart and Tallman (1999) noted clients being considered
mainly as passive recipients. Interestingly, however, the authors also denoted
how resilient and resourceful clients are when overcoming difficulties. In
the present study, the therapists’ attitudes demonstrate facilitating the active
engagement of the client, which is then considered one of the essential
positive development factors (Bohart & Tallman, 1999). Thus, the principle
of un-knowing becomes crucial as it may lead the therapist to be constantly
present, also fully committed in the encounter (Spinelli, 2006). Additionally,
genuinely exploring one’s own experience while communicating effectively
with others, in an openness attitude, can lead to authentic and satisfactory
living (van Deurzen, 2002; Cooper, 2003).
With regard to the present study, and considering the two dyads with
positive indicators of change, there was rather inexpressive ambivalence
in the therapy relationship showed. When combining both process (PQS)
and outcome (CORE-OM) results, we consider that relational factors are
crucial for proper change in the client. In other words, a good therapeutic
relation is believed to be of the utmost importance for the positive
development of the process itself (Norcross & Wampold, 2011).
Unlike the processes with positive indicators of change, there was less
focus on the communication between client and therapist on the other two
dyads. Also, in both dyads without positive indicators of change, the clients
did not feel understood by their therapists, nor did they feel the confidence
and safety that were present in dyads with positive change indicators. Data
seems to suggest that a weaker therapy relationship, with scattered patterns
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Sofia Alegria et al
of communication could benefit from having a more active therapist. In

order to help the clients develop a deeper understanding of their core
beliefs and values, it is important to also challenge the contradictions in
their narratives (van Deurzen, 2002). It is a way of helping them relate in
a more profound and truthful way with themselves and with others. Therefore,
it might have been beneficial to these clients if the therapists would have
clarified their speech more actively and emphasized their feelings more,
in order to help experiencing them deeper.
Contributions
Results of the current study seem to be promising, where meeting the needs
of a broader and more comprehensive research in psychotherapy (Cooper,
2003, 2010; Holanda, 2006; Schneider & May, 1995; Spinelli, 2007; Sousa,
2006, 2014; Van Deurzen, 2002; Van Deurzen & Adams, 2011).
The findings are also promising as they begin to address the common
factors within the existential psychotherapies here studied, e.g. empathic
posture from the therapist, collaboration between both parties and positive
regard or attention (Norcross & Wampold, 2011). It enables us to introduce
and compare existential therapy with other theoretical approaches, showing
how its postulates are equally effective for the client. Two out of three
dyads indicated psychological improvement in the clients, suggesting
empirical evidence on the success of these existential therapies.
Furthermore, by introducing a new quantitative (process research)
instrument to existential therapy, the study enables a deeper understanding
of how therapeutic processes change throughout (Ablon, Levy & Katzenstein,
2006; Jones, Cumming & Horowitz, 1988; Serralta et al., 2007).
The current study also contributed with audio recordings, a much underused,
however more reliable, method of research in psychotherapy, as Serralta
and colleagues (Serralta, 2010; Serralta et al., 2007) would also reinforce.
Limitations and further research and implications

for practice
Although the present study provides promising evidence for research in
psychotherapy, the Portuguese Existential Psychotherapy Society (SPPE)
assumes itself as belonging to the existential-phenomenological branch
of existential therapy (Correia, Cooper & Berdondini, 2014) and is closely
related with the British school of existential analysis (Correia, Correia,
Cooper & Berdondini, 2014).
The small number of dyads in the current study, representing only a
single country and a single school of existential psychotherapy, impairs
the extrapolation of the present data, although this does demonstrate a
valuable small-scale study. Therefore, a larger number of dyads is fundamental
to clarify the results found here. As the current sample supports the postulates
88
of the British school of existential analysis, would be useful to undertake the

research in other schools of existential psychotherapy from different countries,
in order to highlight existential therapy’s unique practices and processes.
In future studies it would be of added value to analyse all the processes
until their completion, making it possible to identify the most salient aspects
in the different phases. It is interesting, however, to note that the current
study contributed to the support for previous research, which has also
reinforced the importance of studying each therapeutic process’ specificities
(Ablon, Levy & Katzenstein, 2006; Jones, Cumming & Horowitz, 1988;
Serralta et al., 2007). In order to grasp the complexity and diversity of
process characteristics and outcome results to an unfinished psychotherapy
process, it would be important to further analyze the dyad in which there
was a dropout.
Creating a wider understanding about how these four therapeutic processes
happened is seen as a cornerstone for research on psychotherapy, especially
on the existential approach. Nevertheless, the present study advocates that
there continues to be a need for ongoing research on the impacts of, and
means by which, therapy occurs.
Sofia Alegria is a Clinical psychologist, training as an Existential

Psychotherapist with SPPE – Portuguese Society of Existential Psychotherapy.
She holds a Masters Degree in Psychology (ISPA-IU).
Email: sofiaalegria@hotmail.com
Inês Carvalho – Clinical Psychologist, Masters Degree in Psychology
(ISPA-IU).
Email: inesferreira.carvalho@gmail.com
Daniel Sousa - Clinical Psychologist, Existential Psychotherapist, founding
Member of SPPE – Portuguese Society of Existential Psychotherapy – and
Professional Member of Society for Existential Analysis (SEA). University
lecturer at ISPA.
Email: daniel@ispa.pt
Edgar Agrela Correia – Clinical Psychologist, Existential Psychotherapist,
founding member of Sociedade Portuguesa de Psicoterapia Existencial
(SPPE) and Professional Member of Society for Existential Analysis
(SEA).
João Fonseca – Masters degree in Psychology (ISPA-IU), trained in
Existential Psychotherapy with SPPE – Portuguese Society of Existential
Psychotherapy.
Branca Sá Pires, Clinical Psychologist, trained as an Existential Psychotherapist
with SPPE – Portuguese Society of Existential Psychotherapy.
Sandra Fernandes – Clinical Psychologist, Psychotherapist and is training
in Existential Psychotherapy with SPPE – Portuguese Society of Existential
Psychotherapy.
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Sofia Alegria et al
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Therapy with Children and Adolescents

In The Phenomenological-Existential
Tradition: Community-Based Clinical
Interventions
Branca Sá Pires
Abstract
The main aim of this paper is to present a theoretical-practical reflection on
the application of Phenomenological-Existential Therapy with children and
adolescents at a community-based clinical setting. Theoretical concepts are
presented as well as practical aspects of intervention. A preliminary model
of intervention is shared, as has been used and is being developed in context.
Key words
Phenomenological-existential therapy, children/adolescents, community-
based practice, working with parents/caregivers.
Introduction
For the past eight years, I have been working at a community-based
service, working in a phenomenological-existential way. Many of the
clients referred are children and adolescents, and I have been continually
reflecting on how phenomenological-existential theory can be applied
when working with younger clients, in this context. This paper is a summary
of the main concepts that have been guiding and inspiring my clinical
work, aiming to contribute to the discussion of how phenomenological-
existential therapy can be applied in different contexts. First, the main
issues that arise in this particular setting will be presented; next, theory
that has guided intervention will be reviewed; following this, a preliminary
model of intervention will be shared, as has been developed in context;
finally, some next-steps are identified for further research and inquiry.
Context and population

Working in a clinical – community context
Clinical work in a community-based setting has its own particular challenges.
The clinic is a part of the community, and not a service provided away
from daily life – for example at a private practice or a hospital, where
the clients only go for therapy or health appointments. Working in this
setting means clients go to the community centre on a daily basis, for
several different reasons, one of them being therapy. If on one hand this
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Branca Sá Pires
means there is a close relationship between client and service, it also

means working closely with clients presenting very distinct and challenging
issues and life-circumstances, and with a diverse age-range. The typical
age-range of the population at the clinic goes from five to six years, with
no top-age limit. Clients may come from several different backgrounds,
with different nationalities, mainly from underprivileged or at-risk families.
Families often do not have basic needs guaranteed, with difficulty in
assuring adequate housing, regular food and water supply, heating and
electricity in the home, etc.
Community-based intervention often includes collaborating with other
professionals who also work with the families – for example, social workers,
healthcare practitioners, teachers, child-protection service professionals,
etc. This work is far from the typical private-practice therapy setting, and
a lot of reflection needs to take place so as to provide this service, in this
specific context. There has been great overall care in integrating the existential
theoretical background with practical aspects of intervention. Therapy in
this setting includes working with various elements of the community, and
the work developed outside therapy (for example communication with
other professionals) is also taken into account, and considered an important
part of the therapeutic process. This way of working, though uncommon,
is at its roots, existential – it takes into account all areas of the client’s
existence, articulating with other professionals as needed, with client
consent, while still preserving the therapy sessions as the most privileged
moment of encounter.
One question that usually comes up when one intervenes in a community-
based service is the following: How can the existential perspective be
useful to people who experience such complicated life situations, in distress,
and on the verge of poverty or socio-economic collapse? There seems to
be a generalized notion that people who are underprivileged only need
basic survival services and nothing more. Experience has led to a somewhat
different point of view. Often we have come to realize that people who do
not have the opportunity to reflect on their life (full of traumatic experiences
in the past and present) do not easily collaborate with basic services offered,
even if they are provided or freely provided. It is exactly by giving the
opportunity to experience therapy or a therapeutic relationship that is not
just problem-based, or even solution-based, meeting the client as he/she
is, with the opportunity to reflect on themselves, their lives, how they
came to be as they are, and perhaps review their life-project – that makes
this way of working unique. It provides exactly what this population often
lacks and is seldom offered – someone who is there for them, in a safe
environment, and is willing to help them reflect and elaborate their suffering,
while other professionals intervene at the same time. This is a therapy
option that takes into account all areas of existence, not just the more basic
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Therapy with Children and Adolescents In The Phenomenological-Existential Tradition
ones related to survival. Often it is in therapy that the clients recognize

the need to collaborate with the solution-based approaches offered by the
other professionals that already work with the family.
Working with children and adolescents

How does one work with children and adolescents in an existential way?
This is also a question that frequently comes up. Several have tried to
answer this, but even today, literature on this subject and particular approach
is sparse. This question has been answered through daily work with
children and adolescents, who come mostly from underprivileged or at-
risk families. Slowly, a model has been developed that is adapted to the
clients’ and community’s specific needs.
As we all know, childhood and adolescence spans several years, and
each different age has with it different needs, skills, and challenges. The
age-range referred to from now on in this paper for childhood and adolescence
is school age – from five to six years until approximately seventeen to
eighteen years of age. Even though it may seem like too big an age span,
it represents the reality of this specific context. Existential therapy, as will
be explained further on, is, in this perspective, in essence, the same at any
age. What is explored in therapy is what is presented in a phenomenological
way. The way in which the phenomenon presents itself in session is what
will differ according to each different age. A smaller child may for example
present suffering due to parental conflict using toys, an adolescent may
do the same using a collage, according to his/her personal experience of
the situation. The techniques used by the therapist in the session with
younger clients are, in essence, the same as those used with adults. For
example, the ones presented by Sousa (2014a) such as: experiential immediacy,
active listening, dialogical attitude or experiential validation, oneself as
another dialogue, existential challenge etc. What comes up in therapy is
explored essentially in the same way, the content may however be expressed
in different ways with different materials.
Theoretical background
This section is a reflection on how theory has guided practice, independently
of the age-range of the population. Four main tenets that are core to
phenomenological-existential therapy in general and used in this context
have been identified and are the following:
1.Phenomenological method, the core ingredient of intervention

In each session, at the basis of all intervention lies phenomenology, ‘the
study of the phenomenon, that is, what appears to the conscience, that
which is given’ (Lyotard, 1999). The phenomenon is the totality of lived
experiences that belong to a person (Giorgi, 1997). Everything that appears
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in a session is relevant and a possibility of reflection. In this comprehensive

approach, the therapist does not start from the stance of knowing what is
best for the patient, but, quite the contrary, has as its theoretical-practical
cornerstone Epoche: ‘…to set aside any initial biases and prejudices and
to suspend, or bracket, all expectations and assumptions regarding the
client’s statements and their implicit meaning’ (Spinelli, 2007). Along similar
lines, Spinelli presents the notion of un-knowing. ‘To attempt to “un-know”
suggests the counseling psychologist’s willingness to explore the world of
the client in a fashion that not only seeks to remain respectful of the client’s
unique way of being-in-the-world, but also to be receptive to the challenges
to the counseling psychologist’s own narrational biases and assumptions’
(Spinelli, 2014). The therapist approaches the client with this attitude of
‘un-knowing’, and, with a dialogic attitude, meanings are found, constructed,
deconstructed and the client is revealed, and reflected upon.
Sousa (2014a, 2014b) elaborates on Husserl’s passive and genetic methods
of phenomenological analysis, by showing us how these two methods ‘are
mutually integrative and do not function exclusively in separation’ (Sousa,
2014a). They are not only applied in therapy as a theoretical framework,
but are also connected to the specific practical skills and techniques employed
in therapy. ‘The static method is characterized by its attempt to describe
the way in which objects are manifested to consciousness… the genetic
method investigates the genesis of the meaning of those experiences of
life.’ This way of working, integrating phenomenology in therapy, can be
applied no matter the client’s age.
2. Existential philosophy
Following the existential tradition, the focus of intervention is not a diagnostic
label, or a problem to be solved, but therapy is based on the encounter with
another being-in-the-world (Heidegger, 1962); (Binswanger, 1963). Thus,
therapy is always situated in the particular time and moment of the client’s
life, taking into account their facticity. A person’s context is not ignored,
or put aside, but is respected and accepted as part of that person’s way of
Being-in-the-world, as is experienced by them. The whole person is in
therapy and the focus is not just one specific aspect of their existence.
Therefore, there are no ‘typical’ cases or issues selected, but each person
is looked upon as the unique person they are, with their specific reality.
The existential issues that are a part of all our lives, that existential
philosophical tradition has tried to identify, question and challenge, are
useful, and aid in understanding the client in therapy. Existential issues
are in fact common to us all, and the focus of intervention is not one in
particular, or pathology or suffering in itself. Existential philosophy comes
to help us better understand ourselves in all the suffering and difficult
moments that life entails. ‘Since life is change, our natural “state” is one
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of change. In existential therapy we do not work on “change”, we work

on stopping stopping. We work on resistance to change. Clients come to
us when their autobiography is not making enough sense’ (Adams, 2013).
As being human means being in constant development, therapy is useful
when this flow seems to have stopped in some way.
The existential tradition also presents us the concept of choice, with Sartre
pointing out how each person always has a choice, within the limitations of
life (Sartre, 1992). Several other authors are also a reference for reflection,
and can be seen as complementary, each focusing on different issues that
are all part of our existence. Viktor Frankl, for example, with his focus on
meaning is particularly useful in the context of working with people from
at risk-families with immeasurable suffering and difficulties experienced
over a lifetime: ‘Man’s freedom is not from conditions but freedom to take
a stand on whatever conditions might confront him’ (Frankl, 1959). Here,
choice and freedom are considered an essential part of being human, beyond
life conditions. This phrase has been an inspiration for practice over the past
years, especially for work with clients with particularly hard life-conditions.
Another concept that aids in understanding the other person, in context,

is the four dimensions of existence as presented by Binswanger – Eigenwelt
(relation to ourselves), Mitwelt (relationship with others), Umwelt (relation
with the physical world), and later by Van Deurzen, Überwelt (relationship
with the transcendent / spirituality). (Van Deurzen, 2007; Binswanger, 1963;
van Deurzen-Smith, 1996 and 1998 cited by Carvalho Teixeira, 2006).
To conceptualize cases, a very simple diagram of the four dimensions
of existence has been used, to aid in better understanding the client in
therapy. When reflecting on a particular case, each square in the diagram
is filled in with information that the client brings to therapy and is of
particular significance. While this diagram has proved useful for understanding
adults, it has also revealed itself to be particularly important for understanding
the life-experience of younger clients. However, with younger clients, the
way they experience the world, still very permeable to others and context,
and in the process of physical and psychological maturation, has led to
two small but significant changes in the diagram. First, the four dimensions
of existence are still in development, and thus, represented by the dotted
lines. These are not yet sedimented aspects of existence, as in the world-
view of an adult as described by Spinelli (2007). Secondly, the life-experience
of children and adolescents is still very dependent of on others around
them (particularly parents/caregivers), and Mitwelt and Umwelt seem to
be of particular significance, taking up great space in the child or adolescent’s
life, represented in the diagram. For example, an adult may say ‘I always
knew I would be a thief’, and when asked about how that came to be,
several contributing factors may emerge, and can be represented in the
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diagram. When a child says something like ‘I know I am going to be a

thief when I grow up’, upon further inquiry they may say: ‘my parents tell
me that because I don’t study, that’s all I will be able to do!’ Here, information
from significant others is what prevails, in a very simple and direct way.
Instead of openness to future, there is limitation… and that way of being
may become sedimented later on in life. Obviously, concrete and abstract
thought processes are involved, and are a significant part of human
development, but unfortunately will not be explored in this paper. It is,
however, important to state that different physical and cognitive skills,
obviously influence world-view development, and more research needs to
be developed on this topic.
The following diagram illustrates how the four dimensions of existence

could be represented in adults – where all dimensions are similar in size,
and somehow more sedimented (thus the straight line), and their representation
for children and adolescents. Understanding how children are so permeable
to others in their lives is useful not only for understanding children, but
also adults, as they reflect on their childhood and how they came to be
who they are at the present moment.
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3. Human life – relational life

Existential tradition has identified and challenged human paradoxes, and
attitudes for many years. Recently, the way we have been looking at some
classic dyads – mind/body or subject/object has changed, and there seems
to be another way of looking at human development emerging.
Challenging dualist theories, we can look at humans as being always in
relationship – We are always in relation with ourselves, others, and the
world at all times, in different ways. Therapy must then take that into
account, and also, when working with children.
Spinelli’s grounding of relatedness (Spinelli, 2014) seems to best describe
the way we relate to each other, foregoing the classical notion of ‘subject-
object’ relations. This enables us to better understand the client, but also
better understand the therapist’s role in therapy, and how this therapeutic
relationship can be useful. The concept of grounding of relatedness can,
in this perspective, also be considered a ‘core ingredient’ of therapy. This
way, the therapist is always in relation, the relationship being an important
part of therapy. With children, this is of significance, as the therapist is an
adult who may play, use different expressive materials, and who would
generally like to not only better understand the child, but also facilitate
that the child may understand his/her own life experience – and this is
quite different from many other adults in a child’s life. It is in relationship
that the process of self-understanding and new meaning making occurs,
not only in life, but in therapy too.
Simms, following other classic existential authors, presents child
consciousness as being non-dualistic, with no definite line between mind
and body, self and other. She proposes: ‘for children and adults alike, the
mind is not an internal, human phenomenon, but a field of significances
in which each of us finds him-herself constantly engaged. Mind is not in
us, but we are in it’ (Simms, 2008). This concept guides our work in therapy
as it helps us better understand what many of us have felt: there’s no clear
line between mind and body, and what a child experiences in his/her body
in therapy, may not be reflected upon (yet), but is significant and meaningful,
and can promote a new way of being-in-the-world.
With this non-dualistic way of looking at human development, we are
not only being existential in the way we look at life itself, but we are doing
so in a way that is particularly respectful of the client in therapy. Often,
the clients at the clinic do not have a history of any good, meaningful
relationships in their lives. To be with a therapist who is not afraid to be
in relationship, (not a subject/object-type relationship), in a meaningful
relationship; who is open to reflect upon the relationship itself, is very
different from other past experiences. This means the therapist working
existentially, must be available to reflect upon him/herself in both professional
and personal life at a deep level, in order to be as authentic as possible,
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and as existentially congruent as possible. Therapy is then: reflecting on

life, experiencing life, with someone who has already reflected upon his
or her own, and lives in a continually reflective way.
4.Therapy attuned to Human Development

This concept is still in elaboration, but it refers to the fact that the intervention
is attuned to the specific needs of the person, whatever age, or physical/
emotional/psychological development phase they are in, and thus provides
the opportunity for the client to use therapy according to their need. In
practice, this means that therapy for a child can include play, and often does,
but does not limit itself to play; that therapy for an adult, for example, who
may have some cognitive impairment or disability or even acute traumatic
past experiences, can use play or expressive materials to better elaborate on
their experience even if they are beyond typical playing age or what is commonly
socially acceptable. This way, therapy is thoroughly adapted to the needs of
the client, and is attuned to their personal development. Existential therapy,
in this way, is then more inclusive, and therefore better adapted to the specific
needs of each person. This is where we move away from a specific therapy
model for children and adolescents, but present a possibility of a therapy that
can be encompassing of human development, thus being truly existential.
This does not mean that the therapist should be obliged to work with any
age-range. It simply means that a therapist can work with these different
age-ranges, if he/she feels the vocation. Once again, this means we move
away from the promotion of dualistic or compartmented therapy, as life itself
is not compartmented and is always a process of becoming. What developmental
stage the client is at, or how old the person is, does not necessarily determine
the skills and practices used. It is their significance to the therapeutic process
and meaning exploration, that makes them useful or not. This means that we
can look at developmental stages from a scientific, developmental science
stance, we can even challenge some categorizations, but what is most important
is to understand that these facts of existence can be experienced and lived
by each person/child in a very particular way. The question here is not so
much – how is adolescence experienced existentially, even though that would
be a pertinent one, but, how is this person experiencing adolescence. The
language used in therapy (more verbal or non-verbal, more talk-based or
more activity-based) is simply adapted to the client’s experience and needs.
Going from theory to clinical practice

Working at a clinical service in a community setting that follows the
phenomenological-existential tradition has led to a simple model of
intervention that is in continual development. It takes into account not
only the clinical aspects but also the community setting. It is attuned to
the importance others have in the clients’ life, in particular using the
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concept of the four dimensions of existence. The others are given particular
attention, be they the wider community or direct caregivers.
Working with children, working with parents/caregivers

Following the footsteps of Moustakas, who points out the importance of
parents in the therapeutic process (Moustakas, 1959), parents and caregivers
can be seen as a) Promoters or inhibitors of the therapeutic process; b)
An ingredient of therapy, as they are responsible for the child, and a very
significant part of the child’s four dimensions of existence.
a) Parents and caregivers as promoters or inhibitors of the

therapeutic process
Parents can be included in the therapeutic process as they are in reality
key figures in the child’s life: They are always somehow connected to
what brings the child to therapy, how therapy is included in the family
life, how therapy ends for the child and the child’s life beyond therapy.
Experience has shown us that they can be crucial to the therapeutic process,
promoting or inhibiting it. Great care has been given to helping parents
make the best use of therapy as a part of a healthy lifestyle choice for a
child in suffering, so as not to have therapy be something separated from
their own reality. The idea that therapy is somewhere where the child can
go for an hour to be fixed, in isolation, makes no sense in this approach.
Existentially, parents or caregivers are incredibly important, for better or
worse, and are given that due importance by the therapist. The way parents
value therapy, will influence the way the child values therapy.
b) Parents and caregivers as an ingredient of therapy

Going back to the diagram of the four dimensions of existence, we can
see the influence others and the physical world have in children and
adolescents’ lives. Children are particularly dependent on their surroundings,
and instead of trying to shut off that reality, our aim is to work with that
reality, as it is always there, before and after therapy. Therapy in this
instance can be seen as a piece of the child’s life, of the child’s wellbeing,
where all main areas of their life are in fact taken care of by someone
else. Basic needs, sleep and food routines, health, school, play etc. must
be taken into account and not be shut out of therapy or out of parental
counseling. They can be essential as part of the initial evaluation on the
case, during therapy and at the end of therapy. Beyond these somewhat
concrete daily actions, emotionally and relationally, parents can also be
included in the therapeutic process (although not in the sessions themselves).
The way parents see the child, and relate to him/her, deeply affects the
way the child relates to him/herself, the world and others. This relationship
must be object of reflection, and is essential to the way each client is
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viewed by the therapist. It is also core to all interpretations and reflections

that may arise along the therapeutic process.
The next table presents a preliminary model of working with children
A Preliminary Model For Working With Children
Sessions Clients in session
Session 1 Parents and Child
Sessions 2-5 Child
In the meantime, 1-2

Parents
sessions
Initial Assessment
Session 6 Parents and Child
‘X’ Sessions Child
In the meantime… Parents

Intervention
Final Session Parents and child, or Child
Follow-up Follow-up Session (1-3) Parents and child
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and parents/care-givers in this phenomenological-existential way, encompassing

several steps, helping guide the intervention from the first contact to the
end of therapy. Although the main focus is the child, the family unit and
local community are also taken into account as part of the child’s existence.
Purpose of sessions
All are included in the initial process of discovery of what issues bring the child to therapy.
(Only in very serious, previously identified cases are the parents seen first)
Initial assessment sessions, based on the four tenets of Phenomenological-Existential Therapy.
Sessions with parents:

- Objective: To better understand the situation, and the child’s development in context.
- The sessions with parents usually only occur after the therapeutic relationship with the child is
minimally consolidated.
- The child always consents to these sessions and may always be present if he/she wishes.
- Feedback relating to these sessions is also given to the child.
- If information collected with parents regarding basic well-being and school participation is not
sufficient, articulation with schoolteachers and other professionals is contemplated, when
necessary.
-Parents and child consent, both get feedback regarding meetings and information shared.
-Typically, no feedback is issued to school or other services at this point, only data/information
collection.
Feedback session
-When therapy is appropriate:
-Together, therapy goals are constructed based on what brings family to therapy, sessions so far,
and information collected.
-When other options are more useful – family is informed of this, and next steps are decided.
-From this point on, some information may be issued to school or other community services,
upon request, and after family consent, always focusing on the child’s best interest. Feedback
regards process, not session content.
- Phenomenological-Existential Therapy sessions.
-Regular counseling sessions with parents or meetings with parents and child, depending
of the situation. Typically the parents are called in for feedback, the child may come as well if
he/she wishes.
-Parents, child and therapist decide when the last session will be. Sometimes the last session
includes all, other times, after this last family meeting, the child will also have a final session.
-After a designated time, decided together, the family returns for a session together, where
feedback is given as to how the child is doing post-therapy.
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The intervention presented here demonstrates the care that has been
taken in constructing the possibility of a model that is respectful of the
child’s needs, the parents’ needs and those of the community of which the
family is part. Experience shows us that this way of working seems to be
pleasing to all who are part of the process. It also shows us that it is
particularly important in terms of promoting a good relationship with the
child, while at the same promoting parental compliance with the therapeutic
process. It does not go against any of the tenets of phenomenological-
existential therapy presented earlier, but provides a possibility, a flexible
structure for working with younger clients. It is not a fixed plan, and all
steps are adaptable to each situation.
Regarding parental participation, in this intervention, at the onset of
therapy, parents are informed of the importance given to their participation
in their child’s therapeutic process. They are included as key elements in
the process, as presented before. If children value parents and caregivers,
then therapy should do so as well, and this simple model of intervention
does so in a very practical way.
Final remarks
The main tenets that have guided practice have been presented in a summary
form, however, it is important to refer state that they are all necessary
for practice, and all must be taken in account simultaneously. In this
approach, it is not possible to work in an existential way without being
phenomenological, or without taking into account inter-relatedness or
without being attuned to human development. All are connected and
fundamental to the intervention.
Beyond the more general questions pertaining to work with children,
adolescents and community-based work, other interesting issues come up.
Some have been presented publically at conferences and workshops, and
some examples are:
• Choice, freedom and responsibility in therapy with children and
adolescents – How can it be put into practice?
• The four dimensions of existence in clinical setting – practical
applications for working with children, adolescents and adults;
• Parents and the therapeutic process of the child;
• The client and the community – therapy and the local community
• Working existentially, working with limits in therapy.
More work needs to be done to congregate all the information that

has been collected so as to build a practice model that is attuned to the
experience and needs of the population, this paper being only a small
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example of what can be done.

After this initial conceptualization of what it is to do phenomenological-
existential therapy in this specific setting, the next step would be to not
only monitor intervention, but also, with clients, reflect on their experience
of being in therapy, and its usefulness to their lives. This information is
significant not only for the local service, professionals in general, and
clients, but it also allows a deeper reflection about the potentialities of
therapy with at-risk populations who typically only mainly work with
professionals from a social-work background. Perhaps this type of work
may help bridge the classic social work / mental health gap, bringing forth
new ways of working in this setting, with this population, in a truly
community-based, existential way.
Branca Sá Pires is a Clinical Psychologist and Existential Therapist at

Fundação AJU- Jerónimo Usera, Portugal. She is also a lecturer and
supervisor at the Portuguese Society of Existential Psychotherapy –
Sociedade Portuguesa de Psicoterapia Existencial (SPPE)
Contact: Fundação AJU – Jerónimo Usera, Rua Amália Rodrigues, 159,
Abuxarda, 2755-020 Alcabideche, Portugal
Email: brancasapires@hotmail.com
References
Adams, M. (2013). Human development from an existential
phenomenological perspective: Some thoughts and considerations.
Existential Analysis 24(1): 48-56.
Binswanger, L. (1963). The case of Lola Voss. In Needleman, J. (ed)
Selected papers of Ludwig Binswanger, Being-in-the-world. Trans.
Angel, E. New York: Basic Books.
Carvalho Teixeira, J. (2006). Introdução à psicoterapia existencial. Análise
Psicológica, XXIV(3), 289-309.
Frankl, V. (1959). Man’s Search for Meaning. London: Rider, Ebury Press.
Giorgi, A. (1997). The theory, practice and evaluation of the phenomenological
method as a qualitative research procedure. Journal of Phenomenological
Psychology, 28(2), 235-260.
Heidegger, M. (1962). Being and Time. New York: Harper and Row.
Lyotard, J.-F. (1999). A Fenomenologia. Lisboa: Edições 70.
Moustakas, C. E. (1959). Psychotherapy With Children: The living
relationship. New York: Ballatine Books.
Sartre, J.-P. (1992). Being and Nothingness. Trans. Barnes, H.E. New
York: Washington Square Press.
Simms, E. M. (2008). The Child In The World. Detroit: Wayne State
University Press.
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Sousa, D. (2014 a). Existential Psychotherapy. The Genetic-Phenomenological

Approach: Beyond a dichotomy between relating and skills. Journal
of Contemporary Psychotherapy – online. doi:10.1007/s10879-014-
9283-y
Sousa, D. (2014 b). Phenomenological Psychology: Husserl’s Static and
Genetic Methods. Journal of Phenomenological Psychology 45(1):
27-60. doi: 10.1163/15691624-12341267
Spinelli, E. (2007). Practicing Existential Psychotherapy - The Relational
World. London: Sage.
Spinelli, E. (2014). An Existential challenge to some dominant perspectives
in the practice of contemporary counselling psychology. Counselling
Psychology Review, 29: 7-14.
van Deurzen, E. (2007). Existential Therapy. In Dryden, W. (ed) Handbook
of Individual Therapy, 5th ed. London: Sage.
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Reviving Antiquity: A Consideration of

Askésis and Existential Psychotherapy
Rebecca Greenslade
Abstract
This paper will consider the practice of spiritual exercises – askésis – in
antiquity and suggest that a revival of these ancient philosophical practices
might support an applied form of existential psychotherapy, where
psychotherapists’ own engagement with askésis enriches and deepens what
they are able to offer their clients’ own enquiries.
Key words
Antiquity, spiritual exercises, askésis, phenomenology, existential
psychotherapy, meditation.
In antiquity, true philosophy is a spiritual exercise, and
philosophical theories, either explicitly or implicitly, are
placed in the service of a spiritual practice that expresses
a particular existential attitude
(Davidson, 1990: p 478)
Introduction
For the Ancient Greeks, philosophy was a way of life. It was not simply
an academic discipline but a way of being-in-the-world. Philosophical
sensibility was enriched through the practice of spiritual exercises, known
as askésis. These held existential value in that they aimed to evoke a
metamorphosis of the self and one’s view of the world. Inspired by the
work of French philosopher, Pierre Hadot, this paper will introduce the
place of askésis within Hellenistic philosophy through a discussion of
the philosophical exercises of the Stoic and Epicurean schools. It will
consider how a revival of these ancient philosophical practices might
s u p p o r t a n a p p l i e d f o r m o f e x i s t e n t i a l p s y c h o t h e r a p y, w h e r e
psychotherapists’ own engagement with askésis enriches and deepens
what they are able to offer their clients’ own enquiries. This revival can
be found within the contemporary philosophical work of Michel
Foucault, which will be considered in relation to psychotherapy practice.
It will also explore my personal relationship to askésis, through a
reflection upon my zen meditation practice and its relationship to
my being an existential psychotherapist. A contemplation upon whether
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the practice of psychotherapy might be considered to be a form of spiritual

exercise itself will conclude this paper.
A problem with phenomenology

In his latest book, Stephen Batchelor (2010) recounts his experience of
meeting Emmanuel Levinas who was delivering a lecture on Husserl’s
phenomenology at Freiburg. At the time, Batchelor was a young Tibetan
monk with an interest in existential philosophy. Husserl adopted the Greek
word epoché to refer to the process by which we attempt to suspend any
preconceptions and presuppositions that we might bring to what we are
examining. Often referred to as ‘bracketing’, epoché shifts our awareness
away from an unreflected experience of the world towards an examination
of how the world discloses itself to us. For Husserl, it is through epoché
that our ‘lifeworld’ (lebenswelt), or lived experience, is revealed and it was
this that Levinas was speaking upon. Attracted to the notion of ‘lifeworld’,
Batchelor asked Levinas how epoché could be attained in practice. He
describes Levinas as ‘puzzled’ and providing no response to his question
(2010: p 52). The lack of phenomenological method did not seem to be a
concern for Levinas, let alone Batchelor’s – and my own – position that a
disciplined meditation practice might be a method for cultivating epoché.
This illustrates a difficulty I have encountered with continental phenomenology;
that it appears to be located within a discursive methodology in contrast
to an applied method. I have illustrated this elsewhere through a discussion
of the distinct contrast between the skeptical attitude of epoché, embodied
by the Greek skeptic Pyrrho of Ellis and Husserl’s later reductive, transcendental
application (Greenslade, 2014). In terms of phenomenology’s relationship
to existential psychotherapeutic practice, my concern has not been in
understanding phenomenological discourse, but in how to cultivate the
phenomenological attitude in order to be as present with and attuned to
my clients’ experiences, as best I can. In other words, my relationship to
philosophy and psychotherapy practice is concerned with being phenomenological
and it is here that I have found continental phenomenology lacking. However,
a possible bridge to this phenomenological dualism of method and methodology
might be encountered through ancient philosophy. In antiquity, philosophical
discourse (methodology) and philosophical life (method) were incommensurable;
they communed through the cultivation and practice of spiritual exercises,
or askésis. It is through a discussion of askésis that I will suggest a more
embodied relationship to phenomenology – and its practical application
to existential psychotherapy – might be realised.
Antiquity’s askésis
In Ancient Greece, philosophy was a way of life. It was an invitation
towards an ontological metamorphosis of one’s being through living in
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Reviving Antiquity: A Consideration of Askésis and Existential Psychotherapy
a way that was oriented towards cultivating wisdom. To learn how to live
the philosophical life, philosophers and non-philosophers engaged with
spiritual exercises, known as askésis. Davidson writes,
Philosophy, so understood to be a form of life, required exercises
that were neither simply exercises of thought nor even moral
exercises, but rather, in the full sense of this term, spiritual
exercises. Since they aimed at realizing a transformation of one’s
vision of the world and metamorphosis of one’s personality, these
exercises had an existential value, not only a moral one
(1990: p 476)
I am using the term ‘spiritual exercise’ in alignment with Hadot’s (1995,
2004, 2009) extensive study and writings upon ancient philosophy as a
way of life. These exercises required discipline, practice and effort and
were intentionally applied to the whole of one’s life, demanding the
engagement of one’s whole being. In that the ancient philosopher was
training not simply in intellectual thought and debate but in how to live,
Hadot refers to these exercises as spiritual.
The way of life of Socrates provides a clear illustration of the practice
of askésis in the form of dialogue. According to Hadot (1995), the Socratic
aphorism ‘know thyself’ is the starting place from which all spiritual
exercises derive. Socrates claimed not to know anything. His role was one
of provocateur, not teacher. His philosophical method consisted not of
imparting knowledge but in questioning his disciples towards a self-
actualization of their inner wisdom. A Socratic dialogue therefore, is an
inner spiritual exercise which provokes the interlocutor to place themselves
into question and coerces them into conferring attention and care towards
themselves. Socrates’ questioning of Agathon’s claims to know the nature
and importance of Love in Symposium (2001) is an illustration of Socratic
dialogue. Notably, Socrates arrives late for the Symposium as he had been
outside meditating. Without interpolating any knowledge or thoughts of
his own, through questioning, Socrates leads Agathon into a negation,
exposing him to the unfoundedness of his epistemology and forcing him
to question himself. Hadot (1995, 2004, 2009) often makes reference to
Victor Goldschmitt’s phrase, used to characterise Platonic dialogues but
employed by Hadot to illustrate ancient philosophy in broader terms, that
ancient philosophical disquisition intends to ‘form more than inform’. This
formation of self occurs less through mastering dogma and more through
the practical exercise of spiritual struggle, or conflict, within oneself. It
is through this inner dialogue that an authentic transformation of one’s
whole being, including, views, attitudes and beliefs, is able to emerge.
This metamorphosis lies at the heart of all askésis.
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Hadot (2004) suggests that the time of Socrates marked a departure from
the Sophist position of ‘doing’ philosophy, through the acquisition of
knowledge, to the Socratic position of ‘being’ philosophy, through questioning
oneself in order to acquire wisdom. He describes, ‘in the person of Socrates,
we have encountered a personality which, by its mere presence, obliges
those who approach it to question themselves’ (ibid.: pp 29-30). In this
respect, Plato’s Symposium was a defining moment in redefining philosophy
as a way of life; this new approach to ‘being’ philosophy continued into
the Hellenistic and Roman philosophical schools, which provide clear
examples of the role of askésis within their philosophies.
In Hellenistic philosophical schools, the principle cause of human suffering
was considered to be the amplification of passions, such as desire and fear,
which obstructed people from living fully and well. Hellenistic philosophy
was therefore primarily a therapeutic practice aimed at generating freedom
from the passions. Each school utilised their own therapeutic methods, but
all shared soteriological aspects in that through philosophical advancement,
they aimed to bring about transformation. The intention of spiritual exercises
was to generate this transformation, leading to tranquility (ataraxia) and
self-sufficiency (autarkeia). Hadot (1995, 2004) frequently reminds us that
these philosophical aims are not simply the objects of philosophical conjecture
but must be demonstrated within one’s philosophical approach to life.
Founded by Zeno (334 – 262 BC), Stoicism became one of the major
Hellenistic schools. Stoicism was known for its strong concept of morality,
involving living virtuously and in accordance with nature. In order to live
stoically, the Stoic was to gain understanding of how little of what occurs in
life is within our control. In this respect, the Stoic must accept nature’s universal
provision and laws without discord or complaint. Everything else, for example,
relationships, knowledge and wealth, are only encountered in passing; these
are external things, temporary and tenuous. Stoics considered suffering to
arise from seeking (desiring) things that might be difficult to attain, as well
as seeking to avoid (fearing) factitious circumstances. Stoic philosophy edifies
in that it intends to educate people to only seek things which are available and
to only avoid difficulties which are avoidable. In this respect, Stoic philosophy
requires a profound existential transformation from living in accordance with
values contingent upon our passions – desire and fear – to values contingent
upon a universal nature, in accordance with natural law (Hadot 1995).
In Stoicism, the essential spiritual attitude is that of attention (prosoché),
which is both a constant state of awareness of one’s consciousness and
‘tension of the spirit’ (Davidson, 1990, p 470). This tension maintains
one’s vigilance and alertness, preventing one from becoming complacent
or lackadaisical in their philosophical practice. Through this attitude, the
Stoic is fully aware of his actions at every moment and this presence
enables him to respond to situations at will. This capacity to respond is
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supported by having the underlying rule of life – the distinction between

what depends on us (for example, morality, the present) and what does not
depend upon us (for example, nature, the past and future) – always to hand
(procheiron) (ibid.). The Stoic rigourously applies this rule to all life’s
situations, testing it out, modifying and assimilating it into their understanding
in order to transform themselves. Always short and concise, an example
is ‘indifference to indifferent things’ (Hadot, 1995: p 86). In order to
maintain moment-by-moment awareness of life’s proceedings and to be
able to consider them in the context of the fundamental principles, the
Stoic must apply exercises of memorization (mneme) and meditation (melete)
to the rule. Hadot describes their function;
The exercise of meditation allows us to be ready at the
moment when an unexpected – and perhaps dramatic –
circumstance occurs. In the exercise called praemeditatio
malorum, we are to represent to ourselves poverty, suffering,
and death. We must confront life’s difficulties face to face,
remembering that they are not evils, since they do not depend
on us. This is why we must engrave such striking maxims in our
memory, so that, when the time comes, they can help us accept
such events, which are, after all, part of the course of nature;
we will thus have these maxims and sentences ‘at hand’. What we
need are persuasive formulae or arguments (epilogismoi), which
we can repeat to ourselves in difficult circumstances, so as to
check movements of fear, anger, or sadness
(1995: p 85)
For the Stoics, therefore, the practice of meditation was an attempt to
bring clarity to one’s inner disquisition. In this respect, prosoché lay at the
heart of Stoic askésis. The Stoic was encouraged to, upon waking each
morning, consider which fundamental rules, or principles, should guide and
motivate their actions for that day. At night they should reflect on lessons
to be learned or spiritual progress made. There was also a place for intellectual
exercises, including reading poetry or philosophical texts. These provided
victuals and points of contemplation for the meditation and memorisation
exercises. Again these intellectual exercises carried the quality of experimentation
and investigation in terms of deliberately putting the instruction or reflection
into practice and testing out its application to one’s life.
By contrast, Epicurean askésis were primarily concerned with the pleasure
of existing. Whilst not placing importance upon attention and constant vigilance,
the Epicurean school nonetheless, considered their philosophy to be a therapeutics
for the soul, which aimed at transforming one’s anxieties and fears of life
into the uncomplicated pleasure of existing. Like the Stoics, the Epicureans
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believed that despair, or despondency towards life, arose from the passions,
such as fear and desire. For the Epicureans, these are fears upon things which
there is no need to fear and desiring things which are not necessary to desire.
And, like the Stoics, it is the passions which obstruct us, in this case from
the sole authentic pleasure available to us, that of existence itself (Hadot,
1995). Epicurean philosophy therefore, intends to help us distinguish between
‘desires which are both natural and necessary, desires which are natural but
not necessary, and desires which are neither natural nor necessary’ (ibid.:
p 86). Through this identification and understanding, we can experience the
pure pleasure of existing, which itself is a spiritual exercise. We see this
perhaps most clearly in the pleasure of friendships formed within the nourishing
sense of community in Epicurus’ Garden in Athens, a place of intellectual
and spiritual growth where ‘hearts could flourish’ (ibid: p 89).
Whilst engaging in meditation practices comparable to those in Stoicism,
the Epicurean school did not emphasise the continued alertness of the
Stoic, instead advocating askésis which cultivated states of relaxation
through extricating painful thoughts and concerns by drawing attention to
pleasurable experiences instead. This included repeatedly recollecting past
and present experiences of relaxation and tranquility in order to revive
one’s choice to constantly evoke these experiences within one’s daily life.
In addition, like Stoicism, aphorisms and texts would supply contemplations
for the meditation exercises. So, whilst the Epicureans also emphasised
the importance of living in the present moment, their emphasis on how
this present moment should be lived was very different. A critique of these
philosophical perspectives is for another paper; my intention here is to
provide an illustration of how Hellenistic schools cultivated existential
attitudes and choices towards how to live. Whilst there is a clear distinction
between Stoic and Epicurean askésis – the former more concerned with
vigilance and morality and the latter with relaxation and peacefulness – it
is through the application of askésis in both schools that therapeutic
transformation occurs; attitudes become embodied and choices applied.
Philosophy becomes an authentic act of living, and in my view, conjoins
philosophical method and methodology. As Davidson describes,
Philosophical discourse, of oneself, with oneself and of oneself
with other, will of course be needed to justify and communicate
these spiritual exercises, to represent the fundamental existential
attitude, but philosophy itself consists primarily in choosing and
living in the attitude
(1995: p 31)
Socrates, Pyrrho and Diogenes are all considered to be great ancient
philosophers, yet none wrote or spoke of an outward philosophical discourse.
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Instead, they were philosophers who lived in society with fellow inhabitants,
distinguishable not by their ideas, but through their conduct and existential
attitudes. To indulge in a reflection possibly tangential to this paper, might
we as existential psychotherapists, have something to learn from these
figures in terms of how to live within the diverse psychotherapy community
that exists today? Perhaps the modern day philosopher/psychotherapist,
often heavily immersed within the discourse of their profession, might
find inspiration in the life of the Stoic Emperor, Marcus Aurelius. In his
diary, To Himself (2010) we encounter numerous examples of when Aurelius
not only prompts himself of the subject matter of important Stoic philosophy,
but also reprimands himself at times when he sees that he has failed to
assimilate this philosophy into his life. Yet, it appears that from the Middle
Ages onwards, the concern with living the philosophical life and of
philosophical schools making real demands of their followers to transform
their lives through existential enquiry and action, seems to have shifted
towards an emphasis upon intellect and theory. In modernity, philosophical
discourse has submerged philosophy as a way of life.
This shift in philosophical approach must hold implication for psychotherapists
whose practice is informed by philosophy. In antiquity, the roles of philosopher
and therapist were conjoined. Ancient philosophical practices were primarily
therapeutic. As an existential psychotherapist, I have chosen a philosophical,
over a psychological, approach to practicing psychotherapy. I have done
so because I believe deeply in the therapeutic roots of philosophical practice
and the capacity of applied philosophy to heal and transform. Therefore,
it seems important to question myself upon whether the context of my
practice lies within philosophical discourse or philosophy itself. Hadot
(2009) describes a dilemma raised in a discussion that took place at the
Société de Philosophie in Paris on ‘Subjectivity and Transcendence’, which,
in my view, speaks directly to the consideration of one’s position as an
existential psychotherapist.
A number of participants discussed the possibility of
distinguishing between an existential philosopher and a
philosopher of existence. Ultimately, an existential philosopher
would be a philosopher who through his existence is a
philosopher, whose philosophy is in a large part confounded with
his existence, while a philosopher of existence is a philosopher
who holds discourses on existence…I have always had the
impression that existentialists ultimately conceive of philosophy
as a decision, a choice of life, but they often remain strictly on
the level of discourse on existence
(2009: p 130)
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Do I present myself as an existential psychotherapist because I am drawn

to existential ideas or in that I attempt to live out these ideas, articulated
through how I respond to clients? Is it possible for my existential choices,
values and attitude to be developed, refined and integrated into my psychotherapy
practice through askésis? Perhaps there are modern-day philosophers we might
turn to for inspiration. Montaigne’s Essays could be seen as a reflection upon
the art of living. Hadot considers Descartes’ Meditations to be rooted in ancient
philosophical practice in so far as Descartes advises his readers to spend some
months meditating upon his first and second Meditations, which inclines
Hadot to think that Descartes saw his work as some form of askésis (Davidson
1995). We can certainly see a revival of antiquity’s call for jolting us from
our habitual, unreflected lives through the works of philosophers such as
Kierkegaard, Nietzsche and Heidegger, all heavily influenced by ancient
philosophy, although in my view, also all relying too heavily upon communicating
their existential calls of conscience through discourse, without attention to
method. I wonder if perhaps Heidegger’s hut in the Black Forest provides the
best insight into his relationship to ancient philosophical practices, since it
was the place from which many of his phenomenological texts emerged. His
claims that the surrounding landscape articulated itself through him, remind
me of the importance of the connection to the natural world in both the Stoic
and Epicurean schools and I wonder how the spiritual exercise of living in a
remote, natural environment to write, might have informed his later writings
on ‘dwelling’ and the freedom one is able to encounter within one’s own
environment (Heidegger, 1971). I am tempted to consider the experience of
Heidegger’s writing in his Black Forest hut a form of askésis. However, I
believe we can encounter an example of a modern-day philosopher embodying
the ancient practices of askésis within their philosophy through the later work
of Michel Foucault, which in my view, inspires and revives contemporary
philosophical practice and holds deep relevance for existential psychotherapy.
Foucault’s askésis: the care of the self

Foucault’s encounter with ancient philosophy allowed him to
experience how the practice of philosophy is (or can be), to
paraphrase Nietzsche, a way of becoming who one is … as his
final lectures made so clear, for Foucault philosophical activity
was an exercise, an experience. Foucault’s work in this last
phase of his life was himself in the act of becoming a
philosopher. The purpose of this exercise was to transform
himself to let himself be altered by the activity of thinking, and to
offer this experience of self transformation to those who would
come into contact with his work
(McGushin, 2007: p xi-xiii)
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In his later lectures, Foucault called upon a form of philosophy that was
practiced in antiquity1. According to Foucault, ancient philosophy was an
exercise in a particular way of being with oneself and others. This way of
being was defined by care of the self. Foucault considered philosophy to
have become neglectful of the self, however it is important to note that he
does not simply settle for a philosophical diagnoses upon the issue of
contemporary self-neglect. Instead he speaks in favour of a revival of
askésis in order to respond to it (McGushin, 2007). Foucault raises concerns
which speak directly to the practice of psychotherapy today. He speaks of
how the modern day obsession with self has become a kind of prison. It
is no longer in accordance with the Socratic aphorism ‘know thyself’, in
terms of taking care of oneself, but has become a meaningless obsession
with self-knowledge and self-expression in that, through institutions of
power and knowledge, we have become certain kinds of selves, fabricated
within powerful, institutional parameters. I see this vividly in my therapy
room through my work with adolescents who struggle to connect to their
sense of self amidst the obstructions of social networking sites such as
Facebook, which predetermine how they are to understand and communicate
themselves to peers. Similarly, it is a dilemma for the psychotherapist to
locate their sense of self amidst a climate of shifting therapeutic paradigms,
zeitgeist approaches and institutional demands. Foucault’s philosophical
project is an invitation to free ourselves from the self-neglect constructed
through mass individualism towards a philosophical conversion of self
which liberates our ‘ethical subjectivity’ (McGushin, 2007: p xxi). Foucault
understood ancient philosophy to be a practice through which one became
a subject; this was cultivated through spiritual exercises which aimed to
integrate truth (parrhesia) as it was spoken, heard, written and practiced.
This conversion towards truth occurs through an askésis of self-care. In
contrast to modern philosophy’s emphasis upon the objective truth of the
subject (as we can find in Husserl’s phenomenology), antiquity’s emphasis
was upon generating knowledge which could transform the subject themselves
(ibid.: p 125). It is this attitude we encounter when reading Foucault’s
final lectures in the 1980s at the Collège de France. These are full of
examples of askésis essential to care of oneself. I regret I am unable to do
justice to them within the scope of this paper; they exist however, as
inspiration for further consideration and application for us all. I will however,
discuss in a little more detail an askésis pertinent to psychotherapy practice,
that of the art of listening.
For Foucault, it is through listening that one’s true inner discourse can
emerge. It is also through inadequate listening that it can become submerged.
Drawing on Hellenistic spiritual exercises, Foucault provides examples
of askésis necessary to cultivate good listening, both in listening to our
own inner discourse and the discourse of others. The first aspect of listening
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is the practice of silence. In order for the truth to become embodied – for
us to ‘take in the logos’ (Foucault, 2001: p 335) – it is necessary for us to
practice periods of silence. Secondly, we must cultivate a physical attitude
towards listening. This involves cultivating stillness since physical agitation,
or fidgeting, can obstruct listening fully. The truth cannot be heard unless
one listens with their whole body (ibid.). Finally, we must practice listening
to not just the words, but to the meaning of the discourse the words provide.
We do this by memorizing what we have heard and meditating upon both
the truth in what we have heard and the manner in which it was said.
Foucault describes,
As soon as one has heard something from the mouth of the person
uttering it, it must be taken in, understood, firmly grasped by the
mind, so that it does not immediately escape. From this follows a
series of traditional counsels of this ethic of listening: When you
have heard someone say something important, do not start
quibbling straightway but try to collect yourself and spend some
moments in silence, the better to imprint what you have learned,
and undertake a quick self examination when leaving the lesson
you have listened to, or the conversation you have had, take a
quick look at yourself in order to see where you are, whether you
have heard and learned something new with regard to the
equipment you already have at hand, and thus see to what extent
and how far you have been able to improve yourself
(2001: p 350)
This is applied philosophy. Foucault’s discourse on power and knowledge
is strong yet does not remain at the level of intellectual diagnoses. Inspired
by antiquity, Foucault’s intention is to offer his audience a method, a means
to disrupt his powerful philosophical discourse through an askésis of self-
care. In my view, his later work holds deep relevance to existential
psychotherapists in that it offers a practical means to consider, integrate
and deepen our relationship to existential theory and practice. This philosophical
approach resonates deeply with my own personal askésis, the practice of
zen meditation.
A personal askésis: the ‘unborn’ meditation

I learnt to meditate when I began training to become a psychotherapist.
My motivation was born from a concern with how to best support the
clients I would soon begin to see and with how to take care of myself
within a profession where dysphoria often dominates the therapeutic
space. I connected early on with the value of the practice, although it
took some time before I was able to organize my life and cultivate the
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conditions to develop a regular and disciplined practice. I strengthened

my practice through attending retreats and spending time with fellow
meditators. The impact a regular practice was making to my life began
to emerge with some clarity; I noticed I was experiencing life with more
joy and connectivity to my environment. I felt more attuned to what
matters to me and began to make better choices. I also began to notice
the difference in the stability and attention I was able to offer clients on
the days I meditated and the days I did not. In this respect, my practice
gained an ethical quality and urgency.
About two and a half years ago, I began to practice zen meditation. I
proceed here with caution in the recognition that, as Thomson describes,
‘trying to understand Zen by reading and thinking, but without practicing,
is a little like trying to appreciate dogs by examining leashes’ (Thomson,
2000: p 533)! Still, I hope to be able to describe it sufficiently in order to
clarify how I consider my meditation practice to be an askésis that forms
my psychotherapy practice. Zazen, literally translates as ‘just sitting’. It
is a practice aimed at cultivating enquiry and brightness of mind. In zazen,
one repeatedly sits in an awareness of the present moment. My current
practice is known as fusho, which translates as the ‘unborn’ meditation.
Fusho is a practice that cultivates presence and awareness. It emerged
from the sixteenth century Zen Master Bankei who described it as, ‘to
practice fusho, to be fully present, is to know the other’s heart’ (Waddell,
2000: p 42). Fusho is a practice of just sitting. It is simple, yet subtle. I
sit in silence, and in this silent stillness I allow anything at all to arise and
pass. My intention is to remain aware and present, similar to the way that
a mirror is just present. A mirror reflects everything that passes its surface
without any kind of discrimination, without any kind of holding on. In
other words, a mirror is presence, awareness itself. Any thoughts, feelings,
memories, bodily sensations, sights, or sounds will arise and will pass.
Anytime I notice myself getting involved in these arising and passing
phenomena, I simply return to the quality of present moment awareness,
again and again. In my view, it is the daily discipline, effort and intention
as well as the personal metamorphosis I have experienced since committing
to this practice which align it to askésis.
How do I consider this practice to form my work as psychotherapist?
An existential therapist whose work is mostly influenced by existential
discourse and ideas might hold the Sartrean aphorism existence precedes
essence as a starting point for understanding the experience of their clients.
As an existential psychotherapist concerned with practicing from a place
where discourse and method conjoin, my own starting point is that presence
precedes practice. Without presence, I am limited in my capacity to respond.
However, being present does not come as naturally to me as it once did as
a child. I now have a number of distractions in my busy life – work,
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relationships, study, for example – all which challenge me in being able

to place my full attention onto one thing at a time. In my view, zen meditation
practice enables me to cultivate and embody presence with my clients,
perhaps in much the same way that Stoicism advocated meditation practices
to cultivate prosoché. What indication might I have that this askésis forms
the therapeutic encounter? I recall a recent exchange with a client, reflecting
upon her experience of psychotherapy.
Client: There has been something about the way you sit
with me…I mean, I’ve been in agony here at times. But
you’re always so steady, so still. And, a lot of the time
you’ve not said anything at all but I’ve always felt you
here, even at times I’ve not wanted to be here.
Me: What difference has that made to you?
Client: Its helped me face that what’s happened has actually
happened to me…like through you being here, I can be here
too. I can be in my life better.
Secondly, I return to the start of this paper and Levinas’ puzzlement
over Batchelor’s enquiry into whether a disciplined meditation practice
might cultivate epoché. There is a concept in zen known as shoshin, meaning
‘beginner’s mind’. It refers to an attitude of openness, where preconceptions
are set aside when encountering a subject, or other. I see no philosophical
difference between the notions of shoshin and epoché, except that the
former is accompanied by a philosophical method. I share Batchelor’s
position that meditation practice, through cultivating an attitude of non-
involvement to arising phenomena, freshness of perception and an awareness
of the present moment, might support cultivating epoché. This feels vital
to me in terms of the importance of the phenomenological attitude, or
‘beginner’s mind’ in existential psychotherapy. It is not my intention to
insist upon a meditation practice for all psychotherapists. However, it is
my position that there is much to be gained in contemplating what forms
of askésis – and there is much to inspire us from ancient Greek philosophy
– might develop and deepen one’s capacity to respond to the therapeutic
encounter. Perhaps this contemplation could occur as askésis itself.
Conclusion
In this paper, I have introduced the role of askésis within ancient philosophy
and considered its potential for enriching an applied existential psychotherapy
practice. However, the question of whether psychotherapy practice might
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be considered a form of askésis itself remains. I believe I have found my

response through returning to Foucault. He wrote,
We will call ‘philosophy’ the form of thought that asks what it is
that enables the subject to have access to the truth and which
attempts to determine the conditions and limits of the subject’s
access to the truth. If we call this ‘philosophy’, then I think we
could call ‘spirituality’ the search, practice, and experience
through which the subject carries out the necessary
transformations on himself in order to have access to the truth
(2001: p 15)
Psychotherapy – seen in this philosophical, Foucaultian sense – is a
frame, one that nevertheless can be both porous and discursive. Psychotherapy
is open to the conditions of how we live, our personal narratives and the
philosophical histories that enrich, form and reciprocally are formed from
life. One’s therapeutic orientation, one’s practice, is spiritual. How I attend
to my clients, how I listen, how I sit, are forms of askésis which contribute
towards the spiritual transformation of both client and therapist. In this
respect, a discursive psychotherapy provides the philosophical environment
for these spiritual forms of askésis to take place. Together, the philosophical
and spiritual dimensions of psychotherapy share and inform a fundamental
ontological metamorphosis. However, as psychotherapists, we must be
open to this metamorphosis ourselves, through our own askésis – which
is not limited to psychotherapy alone. In my view, as psychotherapists,
we are ethically bound to engage with our own personal askésis, clear in
our intention in what we hope to cultivate through exercises in reading,
contemplating, meditating, or memorizing, for example. For we contribute
to the therapeutic relationship as a site through which these forms of spiritual
conversion take place. Foucault’s reflection upon the relationship between
philosophy and spirituality in Greek thought is a powerful and pragmatic
template through which these ideas can become an active and powerful
askésis for an applied practice of existential psychotherapy.
Rebecca Greenslade works as an existential psychotherapist and

supervisor in London.
Email: rebeccagreenslade@hotmail.co.uk
Notes
1 Hadot’s work on spiritual exercises within antiquity was deeply influential
for Foucault, to the extent that he asked Hadot to submit his candidacy
for the chair of the History of Hellenistic and Roman Thought at the
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Collège de France, the first time a philosopher from outside the institution
had been appointed. Hadot was a significant influence upon Michel
Foucault’s later work, which saw him return to antiquity to realise the
projects of his last two books The Use of Pleasure (1990) and The Care
of the Self (1988).
References
Aurelius, M. (2010). Marcus Aurelius to Himself. London: Macmillan.
Batchelor, S. (2010). Confessions of a Buddhist Atheist. London:
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Davidson, A.L. (1990). Spiritual Exercises and Ancient Philosophy: An
Introduction to Pierre Hadot. Critical Inquiry, Vol. 16(3): 475-482.
Davidson, A.L. (1995). ‘Introduction’ to Pierre Hadot, Philosophy as a
Way of Life. London: Blackwell Publishing.
Foucault, M. (2001). The Hermeneutics of the Subject. New York: Picador.
Greenslade, R. (2014). Mindfulness and Therapy: A Skeptical Approach,
in Bazzano, M. (Ed) After Mindfulness: New Perspectives on Psychology
and Meditation. London: Palgrave Macmillan.
Hadot, P. (1995). Philosophy as a Way of Life. London: Blackwell Publishing.
Hadot, P. (2004). What is Ancient Philosophy? Cambridge, Massachusetts:
First Harvard University Press.
Hadot, P. (2009). The Present Alone is Our Happiness. California: Stanford
University Press.
Heidegger, M. (1971). Poetry, Language, Thought. New York: Harper
and Row.
McGushin, E.F. (2007). Foucault’s Askésis: An Introduction to the
Philosophical Life. Illinois: Northwestern University Press.
Nussbaum, M.C. (1994). The Therapy of Desire: Theory and Practice in
Hellenistic Ethics. New Jersey: Princeton University Press.
Plato. (2001). Symposium. Trans. Benardete, S. Chicago: Chicago University
Press.
Thomson, R.F. (2000). Zazen and Psychotherapeutic Presence. American
Journal of Psychotherapy, Vol. 54: 4.
Waddell, N. (2000). (Trans) The Unborn: The Life and Teachings of Zen
Master Bankei. New York: North Point Press.
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Saturated Phenomena and Their

Relationship To ‘Extreme Experiences’:
A Phenomenological Comparison
Between Mystical Experiences and
Psychotic and Depressive Experiences
Based on Jean-Luc Marion’s Philosophy
Georgia Feliou
Abstract
In this paper, the nature of spiritual or mystical experiences is discussed.
An effort to sketch phenomenological criteria for differentiating these
experiences from psychotic and depressive episodes is also provided, based
on Jean-Luc Marion’s phenomenology and on Anthony Steinbock’s analysis.
Key words
Spiritual or mystical experiences, Dark Night of the Soul, mysticism,
schizophrenia, depression, phenomenology, saturated phenomena, giveness.
The worth of a man does not consist in the truth he possesses or

thinks he possesses, but in the pains he has taken to attain that
truth. For his powers are extended not through possession but
through the search for truth. In this alone his ever-growing
perfection consists. Possession makes him lazy, indolent, and proud.
Gotthold Lessing
When it comes to spiritual and in particular mystical experiences, psychologists
and psychotherapists are trying to understand their nature and causes,
and while doing this, it seems that they encounter cases of a ‘gray area’
which lead to a comparison: a comparison between a mystical experience
and a psychotic episode or between a state of a Dark Night of the Soul
and a depressive episode. Both types of experience seem to be extreme
compared to the spectrum of ordinary human experiences and this, along
with the peculiarity and complexity of their nature, has often led some
scientists and philosophers to the conclusion that there is an eidetic similarity
between these two kinds. The only way to ‘solve the problem’, to make
a differentiation, seems to be the obscure criterion of ‘functionality’. In
this paper, I will discuss the nature of spiritual or mystical experiences
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and their right to exist as a legitimate functional human experience, based

on Jean-Luc Marion’s phenomenology. I will further try to sketch
phenomenological criteria for differentiating mystical experiences from
psychotic and depressive episodes. This is an attempt to offer an additional
angle with a view to hopefully enriching this complicated, on-going issue.
Mysticism
Let me first begin with an attempt to give a definition of mysticism and
of the mystical experience.
The term ‘mysticism,’ comes from the Greek verb ‘μυώ’ (myó), meaning
‘to conceal’ or ‘to be in silence or have one’s eyes closed’ (Gellman, 2014;
González Faus, 2013, p 3). During the Hellenistic ages it was connected
to ‘secret’ religious rituals; in early Christianity it was connected to allegorical
interpretations of the Scriptures; later it was connected to ‘mystical theology’,
including the direct, immediate experience of the Divine (Gellman, 2014;
González Faus, 2013, pp 3-4). Although there is no agreement for one
single definition of mysticism or of the mystical experience, generally
speaking ‘mysticism refers to mystical experience and to practices, discourse,
institutions, and traditions associated therewith’ (Gellman, 2005, p 442).
For Evelyn Underhill ‘mysticism is the art of union with Reality. The
mystic is a person who has attained that union in greater or less degree or
who aims at and believes in such attainment’ (Underhill, 2007, p 2). The
goal is the achievement of a relation with God, the Other1 as well as to
achieve higher levels of awareness outside words, thoughts, feelings and
images so as to have as direct a relationship as possible (Miner & Dowson,
2012, p 56; Badalamenti, 2010, pp 597-598). This relation, this union is
non-individualistic; it is characterized by a great desire to be united with
the Other; to be lost in the Other or to embrace the Other. Mysticism is
active and practical, its aim being solely transcendental and spiritual; the
Other is Love and the Object of Love. Finally, its most prominent characteristic
is that it transcends intellectual endeavour and emotional states; it is an
experience. Any knowledge we may acquire through mysticism is certainly
not confined to sense impressions or intellectual processes or ordinary
levels of awareness (Underhill, 2002, pp 23-24, 71, 81).
As we can see, emphasis is thus given to the mystical experiences which
are ‘ecstatic, extraordinary, intimate experiences with the Other’ (Perrin,
2005, p 443). According to William James, the mystical experience is
transient (temporary), ineffable (cannot be described adequately with words),
noetic (the person has actually learned something from the experience),
and passive (it happens to the person, the person cannot control it at will)
(James, 2004, pp 294-296).
These experiences can be visual and/or auditory and/or tactile, and/or
out-of-body. For some, mysticism is not identified with the general religious
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Saturated Phenomena and Their Relationship To ‘Extreme Experiences’
experience of love, peace, or even happiness, but with the specific experience
of a direct contact, a direct relationship with the Other; a strong sense of
union which is often, but not always, accompanied by the above-mentioned
phenomena. Some others view as mystical experiences also less extreme
experiences such as the simple felt sense of surrender to the love of the
Other, the feeling of loving and being loved (Perrin, 2005, p 443 ; Gellman,
2005, pp 139-140), the feeling of euphoria that comes sometimes with
prayer or meditative reading (of the Bible, for instance).
There have been many attempts to categorize mystical experiences.
Epigrammatically, let us say that one categorization refers to the universality
of these experiences. The perennialists (such as William James, Evelyn
Underhill, Rudolph Otto, and others), place emphasis on the common
elements of these experiences and believe that mystical experiences are
largely homogeneous across cultures and religions (Forman, 1997, p 3;
Gellman, 2005, pp 145-146). The constructivists (both weak and hard),
such as Steven Katz believe that the mystical experience is constructed
(heavily determined, shaped or influenced) by historical, cultural, conceptual
and linguistic circumstances (Forman, 1997, p 9; Gellman, 2005, pp 148-
152). A third view concentrates on the so-called Pure Conscious Event
(PCE). This view is supported by Robert Forman (1997) and others (Gellman,
2005, pp 146-147; Gellman, 2014). A PCE is a state of a wakeful yet
contentless consciousness, a state of emptying out or ‘forgetting’ (the
external world, in order to leave space for or contemplating the Other) and
is a form of introvertive experience (mentioned below). All three approaches
strongly disagree with one another and the debate is on-going (Heriot-
Maitland, 2008, p 306).
According to their felt sense, mystical experiences are also divided into
numinous and mystical. Some believe that there is a difference to be observed
between the mystical experiences of religions of the Abrahamic tradition
and those of the Buddhist, Hindu or Taoist traditions (Newberg & D’Aquili,
1998, pp 84-86; González Faus, 2013, p 5). The former are called numinous
and the latter mystical. A numinous experience is dualistic, non-unitive,
where the Other is experienced as ‘wholly other’ than the person (with the
resulting feelings of awe wonder and mystery).
Depending on whether they relate to the external world or not, mystical
experiences are divided into extrovertive and introvertive. In extrovertive
experiences we see that the relationship with the Other involves in one
way or another the senses and there is a connection with the external reality
(i.e. ‘seeing’ the Other in a beautiful flower or by observing the unity of
nature). In introvertive experiences, on the other hand, there is no awareness
of the external world per se; there exists a disengagement from the external
world (Forman, 1997, p 6; Newberg & D’Aquili, 1998, pp 84-85; Cook,
2004, p 153).
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Within this range of mystical experiences, which are often considered

part of a spiritual path (Durá-Vilá, & Dein, 2009, p 544), we see the
phenomenon of the Dark Night of the Soul, where there exists a deep
sorrow due to an almost unbearable longing for the Other, while at the
same time practices (such as prayer) that until then gave a sense of closeness
to the Other are no longer effective and are made with great effort. The
Other seems to be hiding from the ‘sight’ of the person; the person feels
abandoned and isolated; the person’s consciousness is clouded with uncertainty
(Badalamenti, 2010, p 206; May, 2005, pp 136-142; Durá-Vilá & Dein,
2009, p 544). The Dark Night of the Soul, intense as it might be, is considered
to be a stage in the spiritual path, a temporary condition whose duration
varies from person to person2 and is seen before the spiritual awakening.
The Dark Night of the Soul has also been called spiritual emergency,
spiritual madness or spiritual crisis (Badalamenti, 2010, p 206).
The psychologists’ viewpoint on both types of phenomena

These experiences are certainly not very frequent or usual; they are extra-
ordinary, extreme. A depressive or a psychotic episode can also be called
extreme, since in a sense they, too, are extra-ordinary. Many psychologists
and psychiatrists have been working on the mystical experiences and
especially with the concept of the Dark Night of the Soul, and have been
trying to see whether there are points of convergence or divergence with
psychotic and/or depressive episodes. Due to the feeling of ‘abyssal
emptiness and desolation’ (Badalamenti, 2010, p 206), the Dark Night of
the Soul has been compared to madness and depression.
Several questions are raised: where does spiritual/mystical vision end
and hallucination begin? Where does the Dark Night of the Soul end and
depression start? Is there a distinction between them? Is there a continuum? 3
If we accept the premise that both experiences are phenomenologically
similar, to the extent that they are both extreme, both must also be pathological;
therefore a religious experience should be considered a mental disorder.
There is a traditional tendency to either ignore spirituality or pathologise
it. According to Heriot-Maitland (2008), this is due to the existence of
perceived common elements between a psychotic and a mystical experience,
especially regarding the ‘positive symptoms’ (hallucinations, delusions,
etc.) (p 303). Similarities regarding content (ibid, p 304) include: voices
attributed to God or the Devil, delusions of spiritual importance, being
guided by an external power, and a firm conviction of the ‘reality’ of those
experiences. Other ‘symptoms’ include: time distortion, loss of self-object
boundaries, strange behaviour and social withdrawal (Peters, 2010, p 135).
Claridge (2010, p 82) finds similarities between religious ecstasy and
elation in mania. On the other hand, there are some distinct differences
observed (Heriot-Maitland, 2008, p 305; Peters, 2010, p 135). For instance,
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in the emotional tone: psychotic experiences are pessimistic while spiritual

experiences offer an optimistic worldview and positive feelings, as well
as a sense of hope, faith and freedom. Additionally, people have a sense
of control of the mystical experiences (they can go out of them), and find
meaning in them, while psychotic experiences are unwanted and beyond
the person’s control. There are also behavioural consequences: spiritual
experiences are adaptive, life enhancing while psychotic experiences lead
to social and behavioural impoverishment. ‘Negative symptoms’ (apathy,
withdrawal, flat affect, etc.) do not exist in mystical experiences.
Parallels between mystical spirituality and schizophrenic or schizoaffective
conditions have been recorded by other researchers as well (Hunt, 2007,
p 209). Using the notion of ‘ecological self’4, Hunt makes a thorough analysis
between the dark night on the one hand and schizophrenia and depression
on the other, comparing similarities and differences. He claims that a mystical
experience is strongly connected with the ‘ecological’ self, in the sense that
in these experiences this type of self ‘“wakes up” as the felt-being-here-now
of presence, oriented toward a “Being” or “thatness” given forth by the
horizontal openness of time ahead’ (p 212). According to May (2005, pp
154-179) Dark Night and depression may coexist – they may overlap; you
can treat the one and the other is not affected. That is depressive symptoms
(such as hopelessness, guilt, feelings of worthlessness, insomnia, etc.) can
be treated, and the person may be functional but still suffer from this peculiar
‘longing’ which belongs to the spiritual realm and is part of a spiritual path.
Schreurs (2002, pp 45, 56) calls it ‘spirituality in exile’ where there is a
sense of loss of meaning, a sense of ‘throughness’. Durá-Vilá & Dein (2009,
pp 545-546) also state similar similarities and differences between what
they call a ‘salutary’ depression or a Dark Night of the Soul and a pathological
depression. Similarities include passivity and slowness in action and speech,
sadness, feelings of emptiness, etc. while differences include the capability
for social interaction and interpersonal relationships, a sense of meaning,
and the retainment of hope and love (p 547).
Yet there is ‘no fool-proof distinction’. So far, psychiatric diagnosis is
based on the differences. Central to the distinction, and thus diagnosis, is
the criterion of functionality (effectiveness in life and work); the retainment
of humour and compassion for others; a sense that deep down everything
works as it should (that it is ‘right’) (May, 2005, pp 43-46). Johnson &
Friedman (2008, p 513), accepting the fact that spirituality is a legitimate
dimension in the lives of people though it may occasionally have complications
(pp 512-513), try to explore criteria for religious pathology. They find
qualitative differences between a psychotic episode and a spiritual emergence
in daily functioning and in reality5 testing (p 510). Psychotic episodes are
more intense, terrifying, associated with deterioration of social skills and
personal hygiene, involve ‘special messages’ from religious figures, etc.
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They go on in presenting two proposed diagnostic systems by Lovinger

and by Spero, offer eight criteria for differentiation such as the ability to
function on a daily basis, previous history of mental stability, etc. (p 516)
and finally present Lukoff’s criteria for differentiating between a spiritual
experience and psychopathology (p 522). Claridge’s (2010) so-called
‘dimensional model of psychosis’ also relies on functionality as a criterion
for setting apart mystical from psychotic experiences. This model is based
on the idea of ‘schizotypy’. Schizotypy is a continuum of functions that
include mild schizophrenic or schizophrenic-like symptoms, ‘odd’ temperament
traits and schizophrenia is at the very end, at the extreme of these functions
and traits (p 77). A spiritual experience belongs to this continuum and is
an experience with a positive outcome.
Some psychiatrists that have a narrow view of mystical experiences have
been criticized for pathologising experiences that are beneficial to a person
and the community (Cook, 2004, p 160) and for being reductionistic (Swinton,
2001, p 26) and are therefore asked to take these experiences seriously.
The position that pathologises the spiritual experiences has proven to be
unproductive (Cook, 2004, p 151; Claridge, 2010, p 75). Yet, the spiritual
element is neglected by the majority of the psychiatric community. Religiously-
inclined psychiatrists are underrepresented in the profession and professionals
are quite prejudiced against spirituality or religiosity (Swinton, 2001, pp
40-44). However, spiritual experiences may not be religious and may happen
to anyone (Heriot-Maitland, 2008, p 302). Regardless of whether they
occur within a religious context or not, how can we distinguish them from
psychotic hallucinations? How can practitioners understand a mystical
experience? DSM-IV has been vague on this issue6 (Cook, 2004, p 156).
Similarly, DSM-V places emphasis on the cultural setting in which a
‘hallucination’ or a ‘delusion’ may occur but again many concepts (such
as ‘socially deviant behaviour’) are not adequately clarified (see for instance,
pp 20, 93, 98). A problem arises with many practitioners who deny the
possibility of these phenomena happening or that they might have some
validity for the person than envisions them.
The spiritual/religious element is central to existential-phenomenological
therapy. It is incorporated into the Uberwelt (the fourth dimension, the
spiritual dimension), which includes the relationship with our beliefs, ideals,
values and principles (van Deurzen, 2002, pp 87-88). Spirituality is considered
to be an internal force in relation to others and to the world (Cassar &
Shinebourne, 2012, p 135).
As far as experiences of hallucinations are concerned, here too emphasis
is placed on giving a psychological meaning to the experiences (Knudson
& Coyle, 2002, p 117). Helping the individual explore their own values,
their subjective experience, how they perceive what happens to them (du
Plock, 1995, p 100; Knudson & Coyle, 2002, pp 130-131) is central to the
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therapeutic process. The experience (of hearing voices, for instance),

although it signifies an odd relation to the world, is experientially valid
and it is useful to see it as such and maybe not as a symptom (du Plock,
1995, pp 113-114). Kiser, when he described his own painful journey
through psychosis, emphasised how important it is to create meaning in
such pain and gather the fragmented self. More important is the willingness
to create meaning, to see that this suffering is not meaningless, to find a
way to live a full life (Kiser, 2004, p 442).
The bottom-line in all this is that there is no clear-cut distinction. We
cannot tell with certainty when an experience is spiritual, when it is psychotic,
whether they are ontologically different or similar. We know, however, that
very few psychotics had mystical experiences and, on the other hand, that
it is not easy to call all mystics crazy (Claridge, 2010, p 83). Can we explore
the issue from another angle? And if yes, where could this lead us?
Jean-Luc Marion and the study of saturated phenomena

In this very short presentation of this complicated philosophical theory 7
I will discuss the nature of phenomena, as defined by Marion, and their
relation to extreme experiences.
To better understand the nature of the phenomena discussed by Marion,
I must first clarify a few concepts. According to Immanuel Kant, for a
phenomenon to be an object of experience, it must fall under the category
of Reason and of intuition (the senses). First a phenomenon appears to
intuition in various forms (shapes, colours, sounds, etc). Then it falls under
the categories of Reason (which turns the shape into a chair, the colour
into ‘brown’, the sound into a creak). According to Kant, there are 4 categories
under which a phenomenon is categorised as an experience: quality, quantity,
relation and modality.
According to Jean-Luc Marion, phenomena are characterised by their
giveness and not their being-ness or their object-ness. This means the
following: Before judging a phenomenon in relation to its truth (fullness)
or falsity (see Pyrrrhonian skepticism), before judging a phenomenon in
relation to how I understand it and its eidetic is-ness (or existence, one
could say) or being-ness (see Husserl and Heidegger), I must first let the
phenomenon present itself as it is without any presuppositions. By merely
opening our eyes to the world, we presuppose that we will see something.
This is not actually the case. The phenomenon is given to us first. Only
then do we experience it (as something). ‘The most basic form of appearance
for all phenomena is neither objectivity nor being-ness but giveness’ (Lewis
& Staehler, 2010, p 231, emphases in the text). Marion examines this
giveness of phenomena (before we experience them and of course before
we filter them in our consciousness). This means that the phenomenon
itself as given is not to be identified with the experience (personal or
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collective) of the phenomenon. There are phenomena, thus, that exceed

experience in the Kantian sense (including analyses and prejudices) because
they are so rich. These phenomena are called saturated and they exceed
any reduction that we may make. Saturated phenomena overflow the horizon
and provide many meanings or an infinite number of equally legitimate
meanings which call for endless interpretations. (Horner, 2005, p 124;
MacKinlay, 2010, p 63). Since saturated phenomena are not constituted
by the subject, they are received as a gift (Lewis & Staehler, 2010, p 232).
Here we have an emphasis on intuition rather than Reason or intentionality:
‘Saturation is marked by an excess of intuition over the subjective intention’
(Steinbock, 2007b, p 2 ; MacKinlay, 2010, pp 67-69).
Saturated phenomena supersede any of the Kantian categories, yet not
all of them at the same time. There are four kinds of saturated phenomena
which correspond to the four Kantian categories and can be categorised
according to the way they show themselves: the event (corresponding to
quantity); the flesh (corresponding to relation), the idol (corresponding to
quality); and the icon (corresponding to modality). Examples of event
include the historical event, friendship, birth and death. Flesh is that which
is ‘irreplaceably “mine”’ (Steinbock, 2007b, p 3). Here a distinction is
made between the flesh and the body. The body is actual and collective.
The flesh, on the other hand, is passive and individual (Marion, 2011,
p 217, 219 ; Horner, 2005, p 127)8. The idol is seen clearly in the phenomenology
of art9. We cannot see a painting once and for all. Even the combined gazes
of all who look at the painting cannot exhaust its giveness (Horner, 2005,
p 126). The concept of icon, on the other hand, is similar but not identical
to the Levinasian concept of Face (of the other person) (Horner, 2005,
p 129; MacKinlay, 2010, p 170). Here we are talking about the phenomenology
of the invisible. The icon cannot be constituted as an object (Horner, 2005,
p 129). It cannot be object-ified. It is completely independent of its viewer.
The icon, like the Face, affects me. It happens to me. The experience of
the icon cannot be adjusted or manipulated by any of our concepts (Lewis
& Staehler, 2010, p 233). My encounter with the icon makes me envisaged;
it puts me in the place of the seen, and thus, of the constituted. Here, we
have a reversal of intentionality and an introduction to Marion’s idea of
love (Horner, 2005, pp 129-130).
A fifth phenomenon which is an exemplar of all phenomena and combines
all four categories is the phenomenon of r/Revelation which, in Marion,
is seen as a possibility and not necessarily as a reality. By building on the
concept of saturated phenomena, Marion comes to the conclusion that God
(the Other) cannot be understood either as an object or as a being. Nonetheless,
the Other can appear. The Other can be revealed to us. As Steinbock puts
it, this phenomenon may not be real but it is actual10. The Other manifests
in a different way than we, for example, manifest ourselves. The Other is
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a ‘theological possibility’, thus phenomenology must take it into account

(even if it is ‘only’ a possibility) (Horner, 2005, pp 132-134).
Marion’s phenomenology has important implications and applications. He
shifts the focus to the reception of a phenomenon; from Reason/consciousness
to intuition. This is something that, until Marion, was not adequately studied
in phenomenology and especially in existential phenomenology where the ‘I’,
the subject, the individual, the person was looked upon almost exclusively
from the viewpoint of the act-or, the active agent. Moreover, if experience is
defined as the sum of reason and intuition, Marion’s emphasis on intuition
directs us to the conclusion that the more reduction (of Reason)11, is applied
the more donation (of the phenomenon) we will receive (Marion, 1998,
p 203). His establishment of religious (and indeed mystical) phenomena as
an actual possibility is of paramount importance. His thorough study of saturated
phenomena is very inspiring. This is evident in Joseph Carew’s analysis on
schizophrenia from the Marionian viewpoint. Carew (2009, p 100) proposes
the following argument: psychosis is not a deficient openness to reality, as
Binswanger would suggest, where experience reveals its gap and we see a
lack of contact with the external world12. Instead, we have a reversal: A
subjectivity that overflows intuition and that exceeds any schematisation and
categorisation that consciousness might try to apply. The self is overwhelmed,
indeed deluged, by the relentless influx of the phenomenon. This does not
mean, however, that the self is lost within it and is thus unable to establish
contact with external reality and experience it. It is in this sense that a similarity
can be established between the psychotic and the gifted individual (see Marion’s
artist, prophet, lover), meaning that both find themselves open to excess; the
one in a negative way and the other in a positive. Here it is crucial to indicate
that the self stands on the receiving end of its encounter with the phenomenon,
meaning that it is not in possession of the phenomenon but is only its passive
receiver and as a result of the phenomenon’s initiative at that, which precedes
any intention on behalf of the self. The whole process begins and is taking
place outside the self, and cannot be reduced to or explained away with reference
to the latter’s inner life (p 101). Just as important is it to point out that the
phenomenon’s encounter is in actual fact an invasion, no less violent, say,
than a blacksmith’s hammering against the candescent metal. For, certainly,
the onslaught of a deluging phenomenon on individuality, which we normally
try to keep fortified at all times, strips us of every layer of security and comfort
(including, we could add, the illusionary comfort of believing that we always
have a choice to act or re-act).
Here we see a phenomenologico-transcendental ‘violence’ 13 of
giveness and its unrealized possibilities for understanding which
is not necessarily negative – it can be a source of profound joy,
being devoted to something you can never exhaust. It can also
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be something monstrous: a genocide (event), the body as the

site of rape (flesh), an artefact that discloses an intuitive
undercurrent that I cannot withstand (idol), the gaze that
threatens, that traps me in the maddening labyrinth of a
demonic gaze. Giveness is mercurial 14; it knows neither
good nor evil because it is indifferent to both.
(p 108)
Inspired by Marion, Carew claims that the psychotic is in a fundamental
sense just like any other. From this perspective, mental illness can be
accounted for in terms of being open excessively (far more so than in what
is perceived as sanity). Herein lies the kinship of the insane with the gifted.
Those we call sane are ‘more successful’ (emphasis in text) in containing
the phenomena’s overflow, making them more manageable. ‘Resistance
is unavoidable’ (pp 110-111).
A phenomenological comparison
Anthony Steinbock has thoroughly studied mystical experiences from a
phenomenological viewpoint and suggests that we are quite prejudiced
regarding our perception of phenomena. We tend to accept only one type
of giveness. There is another type of giveness, the vertical giveness as
he calls it, meaning a verticality that is given in human experience, expanding
the notion of evidence. The Other (the Holy) falls precisely under this
category 15. The Other cannot be experienced as an object. We must not
equate experience with presence nor should we have a too narrow idea
of what experience is (Steinbock, 2012, p 590). This type of experience
must be investigated in its own terms and within its specific sort of
evidence (Steinbock, 2012, p 596). And still, we cannot speak of evidence
but of indication.
Steinbock, analysing three mystics and their experiences, came to the
conclusion that in mystical experiences the giveness of the phenomenon
seems to share the following common features: ‘internal clarity, power
and authority, and depth, as coming-from-elsewhere16; … immediate, sudden,
non-anticipatable quality17 such that each experience is given as “complete”,
full, “absolutely”’ with effects (spiritual and affective) that have a long-
lasting duration (Steinbock, 2012, p 598; Steinbock, 2007a, pp 117-119,
123). This seems to be a very useful phenomenological description of the
nature of such a phenomenon and of the impact we could expect it to have
on the person who experiences it. A person, after such an encounter, is not
simply functional (able to go to work, relate to friends, relatives and the
public, able to feel emotions and think clearly). The person usually has a
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specific after-taste of the experience itself that affects them deeply though
not necessarily visibly. This type of experience is unique and different to
an ordinary experience (2007a, p 123). Of course there might be self-deception
or psychopathology at work behind a mystical experience. In fact, Teresa
de Avila, one of the mystics Steinbock is analysing, warns about cases of
self-deception: being too eager to have such an experience, being too proud,
being ‘melancholic’ or ‘out of mind’ (2007a, pp 119-120; 2012, p 600). She
even tries to give help by emphasising that to avoid such cases one should
consult a mentor, should sharpen discernment accumulated by previous
similar experience, should service and love others, should have humility,
should continue praying, etc. (2007a, pp 124-126 ; 2012, p 600).
Mystical experiences, according to Steinbock, challenge both our notion
of normal and abnormal since they are ‘hyper-normal’ in the sense that they
lead to new ways of being and living (Steinbock, 2007a, p 175, emphasis
in text). ‘[T]he Holy is “received” in such a way that this reception alters
the structure of experience itself, and this makes a qualitative difference in
how we live with others and in the world’ (Steinbock 2012, p 599, emphasis
in text). Additionally, the person themselves becomes different because s/
he is overwhelmingly affected by this experience (2012, p 123).
Conclusion
Jean-Luc Marion’s phenomenology is catalytic: a saturated phenomenon,
whether negative or positive, may very well deluge us with unanticipated
consequences for us and our lives; a religious and/or mystical phenomenon
is legitimate and possible; it is true that we have the freedom to choose
when faced with a phenomenon (whether this is an event, the other, etc.)
and therefore affect it (even if this power only lies in the way we deal
with it or make sense out of it); but just as true is it that some phenomena
(saturated phenomena) can be imposed on us and affect us in a way we
can do absolutely nothing about them 18. This impact of phenomena on us
is not adequately studied. I believe that we, as existential/phenomenological
psychotherapists have unilaterally placed emphasis on action/re-action
as opposed to reception, thereby undermining the other side of the inter-
action and thus losing an opportunity for new discoveries. Finally, Steinbock
in his phenomenological comparison of similar mystical experiences adds
something valuable to the discussion: beyond the personal meaning each
person may attribute to such kind of experience, this experience in itself
says something about itself. From this viewpoint there is something
‘objective’ to be said about it. Steinbock recorded and analysed this
narrative and the results were quite fruitful.
However, the truth of the matter is that there are no definite conclusions
in this case. We only have clues and indications. It remains uncertain and
largely undeterminable whether in the experiences discussed above we
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might be facing a case of Revelation or self-deception. We remain thus

with an existential uncertainty towards what Gabriel Marcel calls ‘mystery’,
holding a tension that can only lead us to new paths, to new discoveries
and hopefully to a more enlarged openness towards ourselves and the other.
Georgia Feliou is a psychotherapist accredited by the European Association

of Psychotherapy. She lives and works in Athens, Greece.
Contact: 17 Sorvolou & Miniati str., 116 36 Athens, Greece.
Email: geofel01@yahoo.com
Notes
1
There are many names for God: the Divine, Divinity, Cosmos, Fount,
Light, the Universe, the Transcendent, the Transcendental, the Transpersonal,
Reality, Absolute, etc. For this paper I will use the term Other which
refers to the absolute otherness of God (being infinite, uncreated, outside
space and time, not to mention invisible, compared to us who are finite,
created, mortal). This ‘Other’, according to the Abrahamic tradition, we
are called (or not) to relate with as persons (that is unique entities) and
this personal relation can be used as an exemplar for our relationship
with the other, our fellow human being. For reasons of economy, in this
paper I will only study the mysticism related to the Abrahamic tradition,
that is the mysticism which is related to the three most prominent monotheistic
religions (Judaism, Christianly and Islam).
2
This stage, though, may last for 40 years, as the life of Mother Teresa
tells us (Durá-Vilá & Dein, 2009, p 553).
3
In this paper I will only discuss this aspect of spirituality that seems to
lie on the margin between what ‘conventional’ psychology and psychiatry
would call pathology and health. Of course there is a pure positive function
of spirituality and religiosity. Indeed, spirituality in its general sense
contributes to the well being of a person as is indicated by various studies
(Gulliford & Eagger, 2009, pp 1-15 ; Lancaster, 2010, p 24, 26).
4
‘…a primary “ecological” or “bodily” self, “prenoetic”, and basic to
perceptual-motor navigation and postural-spatial orientation’ (Hunt, 2007,
p 210).
5
The exact nature of ‘reality’ is, of course, never quite determined.
6
‘the DSM-IV simply does not differentiate psychotic hallucinations and
delusions from religious and spiritual phenomena, such as visions and
intense meditative experiences, and the DSM-IV does not discriminate
between the disorganized and incoherent speech of the psychotic from
the “noetic quality of the spiritual experience”’ (Johnson & Friedman,
2008, p 516).
7
Understanding and, mainly, presenting Jean-Luc Marion in such a compact
132
way is a difficult endeavor. This effort would be fruitless without the

invaluable help of Miltos Theodosiou and, as always, Haralambos Ventis.
Needless to say that the responsibility of what is here presented lies
entirely with me.
8
Pain is an example. According to Marion, we can never apply our
intentionality on pain. Pain always overtakes us, takes us by surprise,
and imposes itself on us (2011, p 219).
9
Non-theist, non-religious ecstatic experiences or else called ‘secular
ecstasies’ (McBride, 2014) or peak or nontheistic mystical experiences
(Gellman, 2005, p 142) are a result of receptivity of these kinds of
phenomena.
10
‘For to follow a long phenomenological tradition beginning with Husserl,
to say that something is not real does not mean that it is not actual’
(Steinbock, 2007a, p 188, emphasis in text).
11
Let us here remember Ernesto Spinelli (1998): ‘The human brain is a
selective filter of consciousness’ (in Existential encounters with the
paranormal and the uncanny. Existential Analysis, 9(2), 2-17: p 12).
12
We find a similar idea in E. Denyskova’s (2014) article entitled ‘Madness
As An Escape’ (Existential Analysis, 25(1): pp 130-141) where madness
is seen as an escape from responsibility.
13
This ‘violence’ of giveness is evident in mystical experiences as well
since they ‘happen’ to us. Additionally, these phenomena can be manifested
in a cruel way. Examples of the saturated phenomenon of Revelation with
a clearly cruel, if not negative, side are the Dark Night of the Soul and
the type of mystical experiences experienced by St. Paul or Prophet
Mohamed. In other words, a saturated phenomenon can be negative as
well as positive and the impact on such a kind of phenomenon to us is
unforeseeable.
14
We could add that if a divine phenomenon (i.e. the saturated phenomenon
of Revelation) is possible then we must accept the possibility of a demonic
phenomenon. The ‘vertical experience’ as Steinbock calls it (see below)
can go upwards as well as downwards.
15
According to Steinbock, we have five modes of vertical giveness: the
epiphany of the Holy, the revelation of human persons, the manifestation
of cultural products, the disclosure of the Earth, the display of elementary
beings (2007b, pp 3, 15-16).
16
Where the person is ‘made’ to understand completely new things in an
original and unanticipated way (p. 117-118, emphasis on the text). There
is also the sense of unavoidability.
17
Giving a sense of surprise and novelty (2007a, p 118).
18
The tragic event at Charlie Hebdo in 7 January 2015 shows the
catalytic impact of an event. For those cartoonists there was simply
133
Georgia Feliou
no time to process the event. They could do nothing about it – let

alone give it any meaning whatsoever.
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Religion. New York, N.Y.: Springer.
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an interpretative phenomenological analysis of the experience of
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of religious experience. Bloomington, In: Indiana University Press.
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of giveness. Retrieved November, 1, 2013 from www.academia.edu
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a ‘forgotten’ dimension. London and Philadelphia: Jessica Kingsley
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Practice (2nd ed.). London: Sage.
136
Life And Death – A Meditation

Part One: Life
Susanna
The magpies are singing along
with currawongs in this late,
warm morning. Feels like the
right cue…
James and I had some very
difficult news about a month
ago now. After a meeting with
my concerned oncologist, and
a PET and CT scan, he told us
that the cancer had spread
significantly in my liver and
lungs. He said he had been alerted to this by a consistent increase in my
body’s tumour markers. Gratefully, the disease has not spread anywhere
else in my body. He said: ‘We’re in tiger country now’, and proposed a
new, and to us, very demanding treatment regime that simply did not feel
worth it. I felt quite clear, as did James, that I would completely stop
chemotherapy and remove myself from that environment. We told my
oncologist and I thanked him for his work. We both feel deeply relieved
and happy with our decision; it feels right.
I initially felt very angry, resentful, vulnerable and grief-stricken. I moved
through these very painful feelings naturally and have felt much easier
and lighter – mostly – since then. I’m now doing alternative medicine
treatments and they feel right too. We are managing this new space pretty
well – after much upheaval – and now feel optimistic. Mostly.
Confronted with a life-threatening illness I have been exploring the
potential of this experience – what is possible within such limitations.
Before my current diagnosis, having been diagnosed with breast cancer
in 2007 and treated successfully, I held the view that when I died that was
it, THE END.
But then, one day, I was listening to an audio recording by Clarissa
Pinkola Estes called ‘Dangerous Old Woman’. Estes’s story was about
dying as a birthing process, and I suddenly realized that my stance towards
death was a belief, based on a certainty that was an illusion. I did not
actually know what happens when we die – how could I?
137
My new awareness felt like a release. Liberation. I became interested

in staying with ‘not knowing’ and opening to this place of uncertainty – an
expansive listening space.
This has been transformative. Being present here, now, with whatever
is, all that is (as much as possible) and seeing clearly that what is, is
uncertain. This ‘not knowing’ has informed my relationship with my current
illness, my diagnosis, treatment, my relationships and entire life.
I have been reminding myself and loved ones to remain open, including
being open to the mystery of things. I am excited and feel created over
and over again in each movement, in each unexpected gesture. …It is an
openness to the otherness of the other. It is not a free-floating openness,
but in relation to the other. I am scared, affected at the very epicentre (!)
of my being. Yet my courage, my gentle belief in myself, my resounding
belief in James and in what we create together, makes this leap into the
unknown... already part of my BEING.
For ten years I worked in private practice as an existential psychotherapist
both in London and Sydney. I lived the philosophy that felt true to me,
deeply informed by themes such as death anxiety, intersubjectivity and
uncertainty. I still do. To my mind this practice is inseparable from spiritual
practice. I finished work on 1st November 2012, committing myself to the
challenging journey and adventure of life-threatening illness. My illness
has given me permission ‘to stop’ and become more still. While hugely
confronting, this has birthed a wonderful new life. I am learning to hold
the tension between supposedly different worlds, different meanings,
different feelings, and ways of being: being in ‘the flow’ and ‘the mainstream’,
the spiritual and the material; experiencing the tensions between being a
psychotherapist and friend, ill and well, being present and distracted, busy
and still, between intuition and contemplation.
Now, more than ever I feel I could make a contribution and be helpful
to others…
I would like to be part of softening the separation between living and
dying, ‘the’ living and ‘the’ dying, the ‘sick’ and the ‘well’, the patient
and the health service, ‘I’ and ‘you’, ‘me’ and ‘other’. As a patient I have
collided with the view of patient as ‘object’ and passive. I have found this
deeply challenging. I am appreciative of the astonishing developments in
medical science and invaluable contribution of the medical profession,
but I have had to work hard to claim my responsibility and autonomy.
Illness and hospital is one context in which we as humans confront our
vulnerability, impermanence and interdependence. This is profoundly
challenging not just to us as individuals but to us collectively, as a society.
Our humility and humanity can so easily get lost......
I am motivated to make explicit the connection with living ‘now’ with
an acceptance of the inevitability of death. How can we live more interconnected
138
lives now and value all that we have now? I have felt the living of the
dying. Having said this, I am aware that these motivations can so easily
become agendas. For me healing is about ‘meeting’ and a dropping away
of agendas, of separateness. I am motivated to connect with people who
are going through a profound experience in a way that is healing for all.
I hold assumptions around the release and liberation in confronting and
accepting ‘what is’. However, at times I question if I truly accept ‘what
is’ myself. Am I still holding on in some way? I hold beliefs around the
importance of reflection, awareness, clarity, in the centrality of relatedness,
as well as the healing power of listening and talking. Within these assumptions
and beliefs lie my fears, agendas and contradictions. There are times when
I feel fearful and anxious and ruminate at night. I have a threadbare habit
around things being a certain way when they are not that way! I have seen
how judgment, anger and resentment in relationships form as a reaction,
and then as distraction from how things are. This can feel solid, fixed and
thereby ‘secure’. Holding things lightly, being more fluid is a daily practice
for me…
I lose sight of the paradox until I remember and feel this again. Illness,
dying, death. Without these experiences we would not be human. Facing
this in openness takes us deeper into our humanity and into the mystery
of life. To try to avoid this is deeply human. To be with all this lightly
takes us to the very edges, and shows us wondrous possibility: the ordinary,
and the extraordinary – our miraculously small, immensely creative, lives.
Part Two: Death
Ernesto
Susanna and I first met some
time in the second half of
the 1990’s. She had come
to what was then The School
of Psychotherapy and
Counselling at Regent’s
College and I was her first
t u t o r o n t h e M a s t e r ’s
programme. She then stayed
on for the ADEP programme and, subsequently, began to practice first in
London and then, after she’d married James, in Australia. Somehow, we
formed a bond that permitted the connection between us to be maintained
– first as teacher and student, then as colleagues and ultimately as friends.
We met each other’s spouses and, all together, saw one another whenever
139
we could, passing away various unforgettable times either in the UK or

in Australia. Last time I saw Susanna was last year, in London. I was
convinced that we would see one another again and told her so. Just goes
to show how wrong you can be.
Being in Susanna’s company always energised me. She embodied life –
full of fun and curiosity, compassionate, loyal, courageous and fearless. Our
conversations could – and would – go anywhere and everywhere. With
Susanna, the ‘otherness of the other’ was a welcoming rather than a fearful
experience. Of course, the experience was, at times, unsettling in its expansiveness.
Susanna welcomed this, too. I did my best to accompany her.
Susanna had a a bawdy cackle of a laugh. She laughed often and freely.
And when she liked something that someone said or did, she’d say Yes!’
in that long, slithering way she had of saying it. ‘Yessssssssss!’
As her thoughts and words in Part One make clear, Susanna was a gifted
existential thinker and practitioner. She wrote an elegant paper for this Journal
some time back (Rennie, 2006). I wish that she’d written more. A few years
ago, when I was wavering over a life-changing decision and was full of doubt,
Susanna left me a note that read: ‘Every time you feel doubt about whether
you can do it, remind yourself that you can, because you can.’ That was
Susanna’s foundational philosophy. More, it was her whole way of being.
It occurs to me that some people reading Susanna’s engagement with
dying might judge it to be in some way evasive, a defensive response to
what might be called ‘death anxiety’. I hope I’m wrong, but if not, and
there are some of you out there who hold such views, then this is what I
would like to offer:
When I first read what Susanna had written, what immediately came to
my mind – perhaps absurdly – was Heidegger’s question: why Being rather
than just Non-Being? There’s an important assumption that numerous people
have tended to extract from this question. In brief, it is the assumption
that Being somehow arose out of Non-Being and is, therefore, intricately,
inevitably, bound to it.
I’m not so sure that that assumption is correct. And that same questioning
is what I heard in Susanna’s statement. It is also what I’m guessing that
Heidegger might have been getting at.
Here’s my view: Being arose from Being. Non-Being has no generative
connection whatsoever with Being.
Some may read this as existential heresy, a repudiation of death anxiety.
I don’t see it that way. As Susanna’s searching, critical, always questioning
explorations point out, both living and dying are inevitable facets of Being.
I think that current Western cosmological views have arrived at a very a
similar conclusion. In a way, it’s like the science mantra about energy that
everyone learns at some point: energy can neither be created nor destroyed,
140
only transformed. Now, what if we replace the word ‘energy’ with ‘Being’.
What have we got now? Hopefully not some semi-mystical mumbo-jumbo
that suggests some sort of defensive reaction to death anxiety. There’s
more than enough not-knowing and uncertainty still there to generate all
the anxiety we can bear. All the way to the end, Susanna clung on to
whatever security life could give her. No going ‘gentle into that good night’
(Thomas, 1962) for her.
Oh Susanna… I hear your cackle now. I hear that ‘Yessssssssss!’
And yet… What do I know?
I know this:
Suddenly the night has grown colder.
The opening line to that most mysterious, and most moving, of Leonard
Cohen’s songs (Cohen & Robinson, 2001). A song Susanna loved.
And you who had the honor of her evening,

And by that honor had your own restored –
Say goodbye to Alexandra leaving…
Susanna Rennie
18 September 1962 - 22 August 2015.
Life and Death.
Susanna Rennie was an existential therapist, supervisor and visiting tutor

at The New School of Psychotherapy and Counselling. Susanna was also
an Amicus – a ‘midwife’ to the sick and dying.
Professor Ernesto Spinelli is an existential therapist, supervisor and
writer.
References
Rennie, S. (2006). The end..... or is it? Existential Analysis, 17(2): 330-
342.
Cohen, L. & Robinson, S. (2001). ‘Alexandra leaving’. Ten New Songs.
London: Robinhill Music, Sony/ATV Songs LLC.
Thomas, D. (1962). Do not go gentle into that good night. The Poems of
Dylan Thomas. London: New Directions.
141
A Correction and Brief Reply

To Montenegro’s (2015)
‘A Comparison Of Freudian and
Bossian Approaches To Dreams’
Darren Langdridge
Montenegro (2015) presents a comparison of theories from Freud and

Boss on the analysis of dreams that contains a significant error and a
poorly informed and rather dismissive remark that warrant correction.
On page 322 Montenegro seeks to briefly discuss more recent work on
existential dream analysis including my own (Langdridge, 2006). He
makes the statement ‘It is perhaps Ashworth (2003) and the Sheffield
School that made the greatest contributions’. This is incorrect, as Peter
Ashworth has not attempted to make any contributions at all to dream
analysis. The 2003 work in question, which I cite in my 2006 article,
concerns Ashworth’s arguments about research methodology and has no
discussion of clinical application to dreams. The argument for drawing
on ideas from phenomenological research methodologies (such as those
of Ashworth) was, in fact, made by me in the 2006 paper that Montenegro
cites in his article but seemingly misunderstood.
Beyond this error of fact, I would also like to challenge the dismissive
remark made by Montenegro in this same section concerning my proposal
that dreams might offer space for imaginative play. Rather than engaging
in any sustained intellectual critique, Montenegro dismisses my work on
the curious basis that I apparently suggest dreams are in a ‘subservient
relationship to wakefulness, something that Boss would surely oppose’.
At no time do I suggest dreams are ‘subservient’ in this article, though we
should note that ‘dreamworlds’ belong to the waking world and are thus
the focus of analysis only through our waking life, as Heidegger (2001:
p 230) clarifies:
Waking and dreaming are not different objective realms, the
difference between which could be recorded by the characteristics
of their content.…the dreamworlds belong to waking life.
The aim of the 2006 paper was not to dispute this principle but instead
to provide a systematic phenomenological method to enable us to better
carry out the analysis of dreams within a therapeutic context. As Gendlin
(1977) rightly points out, Boss failed to demonstrate the application of
a phenomenological method in his own dream analyses in spite of his
advocacy for this conceptual position. My ambition in the 2006 paper
142
A correction and brief reply to Montenegro’s (2015) ‘A comparison of Freudian and Bossian
approaches to dreams.’
was not to question the Bossian assertion that we need to engage with
dreams phenomenologically but rather to provide a set of tools to better
enable us to achieve this aim.
Professor Darren Langdridge is Professor of Psychology and Sexuality

at the Open University, UK, Visiting Professor of Psychology at Aalborg
University, Denmark and a UKCP accredited existential psychotherapist
working in private practice.
Email: darren.langdridge@open.ac.uk
References
Ashworth, P. (ed.) (2003). An approach to phenomenological psychology:
the contingencies of the lifeworld. Special issue of Journal of Phenomenological
Psychology, 34(2).
Gendlin, E.T. (1977). Phenomenological concept versus phenomenological
method: a critique of Medard Boss on dreams. Soundings, 60, pp. 285-
300. [Downloaded from www.focusing.org/gendlin/docs/gol_2045.html]
Heidegger, M. (2001). Zollikon Seminars: protocols – conversations –
letters. Trans. Mayr, F. & Askay, R. Evanston, IL: Northwestern
University Press.
Langdridge, D. (2006). Imaginative variations on selfhood: elaborating
an existential-phenomenological approach to dream analysis. Existential
Analysis, 17(1): 2-13.
Montenegro, M. (2015). A comparison of Freudian and Bossian approaches
to dreams. Existential Analysis, 26(2): 313-327.
143
The Scientific Discovery of Emotions –

A Turning Point in Philosophy?
Aron B. Bekesi
Abstract
In Moral Tribes, Greene (2013) promotes the proposition that emotions are
crucial for everyday decision making. The author thereby introduces
subjectivity into the contemporary philosophical landscape, which is dominated
by an analytic orientation and a need for objectivity. This perspective has
philosophical and practical implications.
Key words
Emotions, rationality, philosophy, Joshua Greene, Moral Tribes, Antonio
Damasio, healthcare.
In his recently published book, Moral Tribes (Greene, 2013), Joshua

Greene, a researcher at Harvard’s Department of Psychology, attempts to
lay out the basis of a moral philosophy that enables the peaceful resolution
of conflicts among groups holding different values, such as political
parties or entire countries. Greene’s arguments are interesting because
they utilise an interdisciplinary approach: in the justification of his
philosophical arguments, Greene relies on psychological experiments and
fMRI 1 imagery. It is noteworthy that within his theory, Greene admits
that emotionally based decisions have an important role in our everyday
lives. Moreover, according to Greene’s arguments, it seems that emotions
are the basis of rational thinking. Provided that Greene’s results are not
overturned, they could have a significant impact on contemporary philosophy.
If the hypothesis that emotions have a defining significance in cognition
proves true, a process may be set in motion that could reduce the gap
between the two long-opposing schools of philosophy, the continental
and the analytic traditions. Altering the way the human agent is perceived
has implications to the future direction of medical therapy, as it provides
philosophical bases for humanistic treatments.
Because globalisation is bringing into contact distant peoples and institutions
that hold disparate values, there is an increasing need for a philosophical
system that can provide a reliable groundwork for peaceful conflict resolution.
Greene recognised that when people make their case in a controversial
issue, they tend to refer to concepts, which while being emotionally charged,
do not do actual ‘work’ in the logical presentation of their arguments. In
the case of the abortion debate, for example, the ‘right to life’ on the pro-
144
The Scientific Discovery of Emotions – A Turning Point in Philosophy?
life side can be set against the ‘right to choice’ on the pro-choice side.
These emotionally charged phrases initiate an irreconcilable conflict, because
they stand for values, which ultimately are inflexible for both sides. Therefore,
the introduction of a ‘common currency’ becomes crucial to moral philosophy.
Once emotionally charged phrases that do not work as part of the logical
argumentation are discarded, a shared idea can serve as a ‘common moral
compass’. According to the author, a version of utilitarianism is the most
suitable for this purpose (Greene, 2013: pp 170-171).
As presented by Greene, utilitarianism is an ethical theory in which an
act can be deemed ethical if it provides the greatest good for the most
people. Utilitarianism does not assign a value to the level of happiness of
a particular individual; according to the principle of impartiality, each
person’s happiness must be regarded equally. To put it simply: a choice is
valued by how much it promotes or diminishes overall (societal) happiness.
The thesis strictly understood contains weaknesses exposed by the critics
of utilitarianism2. Greene avoids these weaknesses by treating the theory
with flexibility, stating that in certain cases he would not consider it ethically
appropriate to act according to utilitarian thought, and by defining limits
to the theory. A more detailed elaboration on the latter will follow.
Greene’s experiment fulfils the aspirations of analytic philosophy, a philosophic
tradition originally linked to the English-speaking world popular in Western
Europe and North America. Greene constructs his thesis through the rigorous
scientific grounding characteristic of the analytic school. Studying Anglo-
Saxon political and moral philosophy can be a rewarding undertaking per se;
however, on a first reading, Greene’s book does not stand out from the canon.
For example, the Australian philosopher, Peter Singer, one of the best
known contemporary proponents of utilitarianism, who is quoted several
places in Greene’s book, came to conclusions that made him a controversial
figure in the philosophical world. According to Singer, the life of an animal
could be worth more than the life of a mentally challenged human, while
at the same time any luxury is morally impermissible when fellow human
beings are lacking basic needs. Consequently, Singer claims to donate 25%
of his income to charity3. Greene is more permissive in his views: he does
not propose the pursuit of utilitarian principles when they seem to be
counterintuitive or prove to be too inconvenient for everyday life:
The ideal utilitarian ‘moral diet’ is simply incompatible with the
life for which our brains were designed. Our brains were not
designed to care deeply about the happiness of strangers. Indeed,
our brains might even be designed for indifference or
malevolence toward strangers. Thus, a real-world, flesh-and-
blood utilitarian must cut herself a lot of slack…’
(Greene, 2013: p 257)
145
Aron B. Bekesi
Compared to Singer, Greene seems to be a moderate advocate of

utilitarianism. Greene does, though, make some bold statements based on
inferences supported by evidence from the world of ‘hard science’.
Psychological experiments and fMRI images support the cornerstones of
Greene’s philosophical argumentation.
Greene’s curiosity was sparked by the ‘trolley problem’. The trolley
problem is a philosophical thought experiment: a runaway trolley is
approaching five people working on the trolley tracks. By the turning of
a switch we have the option of sending the trolley onto a different track.
On this new track, however, a solitary worker is carrying out repairs.
Therefore, saving the lives of the five necessitates the death of another.
There are several alternate versions to this thought experiment. In one of
these versions, for example, it is only possible to save the five people on
the tracks if we push another person in front of the trolley4. There is a stark
contrast between how most people perceive what is right or wrong in some
of these scenarios. According to the answers scientists received when they
presented these dilemmas to study subjects, in the first version of the
thought experiment most would turn the switch, whereas in the second
version, most people would not push someone in front of the trolley. These
results give an insight into how our brains work. Ostensibly, both cases
are the same ethically: one can choose to sacrifice one to save five. Yet it
seems that in some situations people tend not to choose the act that results
in the logically better outcome, because they feel such an act to be wrong
(Greene, 2013: pp 114-115).
Using fMRI to analyse the processes in the test subjects’ brains that take
place when solving the trolley problem, Greene noted distinct activity in
two areas of the cerebral cortex5. When people gave more consideration
to the outcome of their actions, and consequently chose to sacrifice one
life to save five, the dorsolateral prefrontal cortex, abbreviated DLPFC,
showed greater activity. When people were not willing to make the sacrifice
to save the lives of the five on the tracks, the ventromedial prefrontal
cortex, abbreviated VMPFC, showed greater activity. Decisions that brought
about the greater benefits, i.e. decisions that were in accordance with
utilitarian principles, were reached in cases when the activity of the DLPFC
was not ‘overwritten’ by the activity of the VMPFC (Greene, 2013:
pp 120-122). Greene’s results are supported by his own research and by
research done by other scientists, including Antonio Damasio, who in his
influential work Descartes’ Error (Damasio, 1994) writes extensively about
the role of emotions in the decision-making process.
According to Greene, the conclusions from the experiments indicate
that the area of the brain responsible for the coordination of emotion is
the VMPFC, while the area responsible for cognitive control6 is designated
by Greene as the DLPFC. Alongside the developing categories of the
146
emotional – rational dichotomy the author sets up a double enumeration

of attributes. Emotions are instinctive, irrational, unreliable, biased, and
subjective (the way we experience them changes according to who we
are), they have an automatic nature, are older evolutionarily and developmentally
(the ability to experience emotions develops before the rational capacity),
harder to change, unconscious, and are fast and effective decision-making
factors. Rationality is intentional, logical, reliable, objective, general, not
automatic, younger (developed later), easier to change, and incorporates
conscious decision-making factors that are slower and less effective than
emotions (Greene, 2013: pp 134-137).
Although, according to Greene, the basis of utilitarian decisions is unbiased
DLPFC-determined deliberation, several lines of evidence indicate that
unassisted rational thought would not get us far. Observation of emotion-
based decisions in six-month-old preverbal infants, the primacy of emotions
in evolutionary development, and research done on people with emotional
dysfunction due to brain damage, indicate the dominance of emotions in
the decision-making process. Damasio, to whom Greene refers on several
occasions, reports multiple cases in which people with impaired emotional
functioning due to damage in the prefrontal cortex, but otherwise in possession
of a sound mind, became indecisive when they had to make emotion-based
intuitive decisions. Without emotional motivation, these patients often
displayed an inability to make simple, daily-life choices7. Therefore it
seems that rational faculties are not sufficient for the decision-making
process, and that the ability to think in a rational way per se does not
necessarily make one a successfully functioning person.
patients [with damage in the VMPFC] are more likely than
others to exhibit ‘intransitive’ preferences – that is, to say that
they prefer A to B, B to C, and C to A. With respect to decision
making, this is the hallmark of irrationality.
(Greene, 2013: p 368; cf. ibid.: pp 141-142)
This presents a contradiction for Greene: in delineating the thesis of his
book, Greene states that it would be a mistake to infer that intuition is the
source of all that is good and that rational thought is the enemy of morality;
on the contrary, Greene states that his aim is to correct this false concept8.
At the same time Greene agrees with the primacy of emotions in the decision-
making process:
…I think it’s clear that reasoning has no end of its own, and in
this sense reason is, as Hume famously declared, a ‘slave of
passions’. (‘Passions’ here refers to emotional processes in
general, not exclusively to lusty feelings.) And yet, at the same
time, the function of reasoning is to free us from our ‘passions’.…
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Aron B. Bekesi
Reason is the champion of the emotional underdog, enabling

what Hume called ‘calm passions’ to win over ‘violent passions’.
Reasoning frees us from the tyranny of our immediate impulses
by allowing us to serve values that are not automatically
activated by what’s in front of us. And yet, at the same time,
reason cannot produce good decisions without some kind of
emotional input, however indirect.’
(Greene, 2013: p 137; cf. ibid.: pp 134, 172)
Biological processes in the brain reveal the difficulties of Greene’s theory:
rational thought can override purely emotion-based decisions in several
respects, yet the elimination of emotions from the decision-making process
would have ruinous consequences to the individual. According to Greene,
however, utilitarianism and the greater welfare of humanity require the
suppression of emotions.
The contradiction is resolved by Greene by placing limits on his theory.
Greene distinguishes two kinds of moral dilemmas: one that is more personal,
which arises within smaller communities, and one that is more impersonal,
which arises amongst bigger communities. According to Greene, emotion-
based decisions are more expedient problem solving tools in smaller communities,
while in disputes that develop between communities where considerable
differences in common values may be likely, suppression of emotions serves
the peaceful development of humanity (Greene, 2013: pp 294-295). If Greene’s
theory is correct – that emotions constitute the basis of cognition, and that
it is beneficial to rely on emotion-based decisions and intuitive moral choices
in everyday life – then it will inevitably have a great bearing on the ideas
that have come to dominate contemporary philosophy.
As mentioned, contemporary philosophy9 is defined by the analytic or
Anglo-Saxon tradition10. Scientific standards have become a hallmark of
the analytic tradition; this is manifest in the topics, style, and argumentation
of works coming from analytic schools. In contrast to the analytic tradition,
which stresses the primacy of scientific methods, in the continental tradition,
a way of thought historically connected to the European continent, the
subjective experience of human existence can be more important in philosophy
than scientific rigour. Both philosophical approaches have their own
advantages, yet the opposition along the rational/objective—emotional/
subjective axis, which is in part a political opposition between the Anglo-
Saxons and the Continental tradition, can be a harmful one. In the past
century the influence of analytic philosophy expanded. While the analytic
tradition gained ground, several questions that defined philosophy until
the beginning of the 20th century were marginalised in academic literature
(Bockover, 1992). Insofar as emotions achieve scientific recognition as
genuine forces that influence human behaviour, discourses candidly building
148
on subjective experience can reappear in literature that defines contemporary

philosophy.
It plausibly requires several years, if not decades, for a change of such
a magnitude to take place, nonetheless it seems that such a tendency is
currently unfolding. Neurobiologist Antonio Damasio presents emotions
as complementary to rational abilities, without which rational thought is
not of much worth (Damasio, 1994: p 245). Greene in his moral philosophy
attempts to ‘rationalise’ political philosophy, but in the process presents
emotion-based decision making as the proper decision-making strategy
for everyday moral problems. Through admitting emotions into his system,
Greene inevitably introduces subjectivity into the Anglo-Saxon tradition,
a tradition committed to logical and rational approaches and methods. This
step is even more fascinating, because objective scientific facts are used
by Greene to support his thesis that, via the decision-making process, the
subjective forces of emotions are crucial parts of our lives.
Disregarding the unlikely possibility that Greene’s proposition – that it
is beneficial for the individual to rely on subjective, emotionally based
decision making in daily life – remains unchallenged, the reception of the
philosophical literature can take two distinct courses:
1) It can reject Greene’s theory. This possibility does not seem too
likely, since any rejection also has to overturn the scientific evidence,
including some of the main findings of Damasio’s work, which
seem to solidly support Greene’s inferences. Someone undertaking
such an enterprise would have to discredit the neurological bases
of the theory.
2) It has to consider emotions as subjective factors that define individual
behaviour. While emotions may not yet be fully understood by
science, because emotions provide the foundation of human cognition,
they need to be accepted as genuinely existing forces of decision
making.
It seems that Greene’s proposal will inevitably change contemporary
philosophy. The split between the analytic and continental traditions
developed along the rational/objective – emotional/subjective axis. Greene’s
theory presents emotions, and thus subjectivity, in a novel role of importance
in the tradition of analytic philosophy.
If subjective emotions are fundamental to human cognition, then it seems
likely that the study of emotions can lead to better decision making. Given
that emotion-based decisions are useful, and that one who can make better
decisions has more chance of living a fulfilling life, facilitation of better
decision making through the study of emotions carries the practical promise
of promoting individual wellbeing. The thesis, according to which (a)
emotions lay the foundation of rational thought and (b) emotive decision
making is useful, points towards the need to study the human individual
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Aron B. Bekesi
as a subjective, emotional being. Thus the thread of Damasio’s and Greene’s

argumentation calls for an emotive philosophical view of the human individual
— a fundamental component of the existential tradition. It can be anticipated
that the promulgation of an emotive philosophical view of the human individual
will initiate changes that will start bridging the gap between the long-opposing
analytic and continental philosophical traditions of thought.
Adopting an emotive philosophical view of the human individual does
not, in itself, justify the supremacy of any school of thought, either from
the analytic or continental tradition. Objective reasoning backed up by
scientific evidence as well as the argumentation characteristic of traditional
philosophical discourse both seem to work as effective tools for achieving
a better understanding of the human condition. If analytic philosophy
provides scientific evidence supporting the importance of emotions in
human behaviour, then the human being needs to be examined as an emotive
being. As an emotive being the human subject is an agent defined by
subjective experiences, experiences that have been traditionally in the
focus of the continental tradition. Instead of conflicting with one another,
it is as if the two, prima facie distant approaches, support each other. Thus
the recent developments in the literature that shed light on the important
role emotions play in human cognition imply the justification of a heterarchical
relationship between the different methods of inquiry.
Promulgation of an emotive philosophical view of the human individual
can, however, contribute to the popularity of existentialist philosophies.
Within continental philosophy, ways of thought have been labelled
existentialist that share some core interests. Probably the most typical
amongst these is a shared interest in the subjective human being (Macquarrie,
1972: pp 14-15). Sartre defined the subjective human being in the
following terms:
Man is nothing else but that which he makes of himself. That is
the first principle of existentialism. […] Thus, the first effect of
existentialism is that it puts every man in possession of himself as
he is, and places the entire responsibility for his existence
squarely upon his own shoulders.’
(Sartre, trans. Kaufmann, 1960: p 291)
Sartre’s definition of the subjective human being, in Sartre’s term ‘man’,
has a characteristic potential of defining himself through the act of decision
making. An inherent responsibility towards one’s existence can be derived
from the potential for decision making. Responsibility for one’s existence
raises the question of what existence, or being, is. Ontology, the study of
being, has an extensive tradition within modern continental philosophy.
Probably its most prominent representation can be found in Heidegger’s
150
existential phenomenology. Briefly put, for Heidegger even the external

world is in part a subjective experience:
For [Heidegger] the world is precisely the context in which we
encounter beings and ourselves, and it is this encounter that
determines what they are for our understanding. […] As
Heidegger saw it […] our very being is defined by the fact that
we are beings-in-a-world. This existential analysis consists of a
two-pronged investigation, that elucidates not only in what sense
we encounter entities in the world and what makes them fit for
such encounters, but also what in us constitutes such
encounterings, what in our understanding makes it possible to
disclose the entities to ourselves in this way.
(Guignon, 1993: p 56)
Refraining from presenting a detailed account, my aim here is only to
use these examples to reveal existentialist ways of thought as philosophies
focused on subjective experiences. While some of these ways of thought
might differ in significant ways, they share a common interest in the human
condition. Existentialist ways of thought confront questions of subjective
experiences, a strategy that provides helpful tools to rely on if we are to
understand the human individual as an emotionally based subjective being.
Conversely, the findings reported by Greene and Damasio regarding the
essentiality of emotion to everyday decision making can be viewed as
providing a solid scientific basis to the existentialist perspective.
A shift in the interests of contemporary philosophy can provide the
groundwork for promoting practical emotion-based applications. Healthcare
professionals, for example, might have been reluctant to rely on methods
not widely approved by the medical establishment. The knowledge that
we humans are emotionally motivated can justify an array of procedures
that specifically target people’s emotions in professional medical settings.
Humanistic, emotion-based routines tailored to personal needs can be
successfully used in healthcare. Relaxation techniques, prayer (Tracy et
al., 2005), music therapy (Guenther et al., 2011), distraction, guided imagery,
and hypnosis (O’Donnell et al., 2002) are just few amongst the non-
pharmacological approaches already in use that act on the feelings of
patients. While some of the aforementioned techniques require resources
not always available, there are techniques that can be performed by virtually
any health worker at all times. Holding a patient’s hand, for example,
triggers the release of oxytocin, a hormone that has anti-stress properties
and increases the pain threshold, making the technique useful for acute
pain relief (Gerald, Falk, 2001). Acting on the emotions of patients through
non-pharmacological techniques can reduce patient drug consumption while
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Aron B. Bekesi
increasing patient compliance (Vorster, 1984), thereby saving resources

while decreasing the risk of possible side-effects. As both empirical and
theoretical foundations are given, emotion-based non-pharmacological
methods, amongst them humanistic psychotherapeutic approaches, can be
expected to gain in popularity.
Aron B. Bekesi is a former student of philosophy, a volunteer at

Awakenings Foundation, the Psychiatric Community Centre of
Semmelweis University, and a medical student (University of Pécs)
working towards becoming a psychiatrist.
Contact: Budapest, Hajdú utca 19. 1139 Hungary.
Email: aron.bekesi@hotmail.com
Notes
1
fMRI, or functional magnetic resonance imaging, is an imaging procedure
used to map out the active areas of the brain. Using oxygen in the blood
as a marker fMRI imaging can trace changes in blood flow, the increase
of which indicates the activity of neurons in the given brain region (Huettel,
Song, et. al., 2009: p 26).
2
Two examples: (1) impartiality demands too much sacrifice from the
individual; for most who live in a developing or developed country, for
example, it holds true that people live in greater need in places distant
from their own community than people who live close to it. Maximisation
of happiness and the principle of impartiality would entail in these situations
that instead of supporting their own communities, individuals would have
to spend their resources helping out people that they will probably never
meet in their lives. (2) Utilitarianism considers only the effect, or consequence,
of a decision, not its intent. Therefore, according to a strict version of
utilitarianism, an act motivated by malignance can be considered good.
3
‘FAQ’ on Singer’s webpage at Princeton University, accessed: February
2015.
4
The thought experiment rules out altruism; for example, one does not
have the option to jump in front of the trolley.
5
The outermost layered structure of neural tissue of the mammalian brain.
It plays a key role in memory, attention, perceptual awareness, thought,
language, and consciousness. (Kandel, Schwartz, et. al., 2000: p 324.)
6
According to the definition adopted by Greene: cognitive control is ‘the
ability to orchestrate thought and action in accordance with internal
goals’ (Greene, 2013: p 119).
7
For example, a patient even after much deliberation, was unable to
choose between two dates offered for the next appointment. When after
half an hour one of the dates was chosen by the hospital staff the patient
reported to have felt that the decision was insignificant. Patient ‘Elliot’
152
faced similar problems (Damasio, 1994: pp. 49-50; 193-194).

8
‘From these studies, you might conclude that intuition is the source of
all things good and that careful reasoning is the enemy of morality. This
would be a mistake. Indeed, it’s the mistake that this book was written to
correct.’ (Greene, 2013: p 63)
9
It is contrary to my aims to present an exhaustive report on this complicated
topic. My intention here is to delineate a process in broad lines. I do not
explicitly state everywhere in the text that under philosophy I mean to
refer to Western philosophy.
10
To find support for this claim one only needs to refer to the orientation
of top philosophy departments. Even if they engage in teaching continental
philosophy, the focus is usually on analytic philosophy.
References
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of music as a non-pharmacological pain management tool in modern
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Bockover, M. I. (1992). The emotions. Humboldt Journal of Social Relations,
18(2): 45-56.
Damasio, R. A. (1994). Descartes’ Error: Emotion, Reason and the Human
Brain. New York: AVON Books.
De Wet, V. (1984). What Price Psychotherapy? British Medical Journal.
289(6443): 503.
Gimpl. G. & Fahrenholz, F. (2001). The Oxytocin Receptor System:
Structure, Function, and Regulation. Physiological Reviews, vol. 81(2):
629-683.
Greene, J. (2013). Moral Tribes: Emotion, Reason and the Gap Between
Us and Them. New York : The Penguin Press.
Guignon, C. B. (1993). The Cambridge companion to Heidegger. Cambridge:
Cambridge University Press.
Huettel, S.A., Song, A. W. & McCarthy, G. (2009). Functional Magnetic
Resonance Imaging (2nd ed.), Massachusetts: Sinauer.
Kandel, E.R., Schwartz, J.H. & Jessell, T.M. (2000). Principles of Neural
Science Fourth Edition. New York; London: McGraw-Hill, Health
Professions Division.
Macquarrie, J. (1972). Existentialism. London: Hutchinson and Co..
O’Donnell, J., Maurice, S. & Beattie, T. (2002). Emergency analgesia in
the paediatric population. Part III Non-pharmacological measures of
pain relief and anxiolysis. Emergency Medicine Journal, 19(3): 195–197.
Sartre, J.P. (1946). Existentialism Is a Humanism. In Kaufmann, W.A.
(ed.) Existentialism from Dostoevsky to Sartre, etc. New York : Meridian
Books.
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Singer, P. ‘FAQ.’ Princeton University, Peter Singer’s webpage. 4 February

2015, https://www.princeton.edu/~psinger/faq.html.
Tracy, M.F., Lindquist R, Savik K, et al. (2005). Use of complementary
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American Journal of Critical Care, 14(5): 404–414, quiz 415–416.
154
Existential Therapy Institutions

Worldwide: An Update of Data
and the Extensive List
In recent years, it has been claimed that existential therapy is growing

(Barnett & Madison, 2012; Cooper, 2012; van Deurzen, 2012; van Deurzen
& Arnold-Baker, 2005; Deurzen & Young, 2009; du Plock & Deurzen,
2015; Groth, 1999, 2000; K.J. Schneider, 2008).
Indeed, many new books and journals have been published recently and
new societies, schools, seminars and training courses in existential psychotherapy
have appeared across the globe, including in areas without a prior tradition
in existential psychology or psychotherapy, such as Southern Europe (Greece
and Turkey), Northern Europe (Denmark and Sweden), Eastern Europe
(Baltics and Russia), Asia (Israel, China and Japan) and Australia (du Plock
& van Deurzen, 2015). In Latin-America, existential therapy authors have
been prolific and diverse (e.g., Angerami-Camon, 2007; Cardinalli, 2012;
Erthal, 2010; Feijoo, 2010, 2011; Gómez, 2013; Martínez, 2012a, 2012b;
Martínez & Signorelli, 2011; Rispo & Signorelli, 2005; Romero, 2004, 2010;
Rudio, 2001; Sapienza, 2007; D. R. Schneider, 2011; Tatossian & Moreira,
2012), and several of its existential therapy institutions developed a ‘joint
association’ (Martínez & Signorelli, 2015, p. 90), the Asociación Latinoamericana
de Psicoterapia Existencial (ALPE), where regular meetings, training and
knowledge exchange take place (Martínez & Signorelli, 2014, 2015).
But the theoretical and practical contributions of these new developments
are barely referred to in European and North American existential literature
(e.g., Barnett & Madison, 2012; Cooper, 2003, 2012; Groth, 2000) and little
is known concerning its main features. To a generalized sense of growth
and development (du Plock & van Deurzen, 2015) corresponds a lack of
knowledge and systematized evidence on the actual distribution of existential
therapies and therapists around the globe, and the forms of existential therapy
that they are trained in and practice.
A worldwide search for existential institutions was developed. This study
is a first attempt to map out the distribution of existential therapies (and,
indirectly, psychotherapists) around the globe and build a comprehensive
and systematic sketch of today’s existential therapy panorama.
The present paper updates the one published in this journal two years ago
(Correia, Cooper, & Berdondini, 2014) and presents the whole list of existential
therapy institutions worldwide.
155
Method
Search Strategy
From the 15th of January 2012 to the 2nd of March 2012, the first author
conducted a systematic online search for existential therapy institutions,
using the Google Search engine. The following search terms were used
in English, Spanish, German, French and Portuguese: ‘existential
psychotherapy’, ‘existential therapy’, ‘existential counselling’, ‘daseinsanalysis’,
‘existential analysis’ and ‘logotherapy’. When a website for an existential
institution was identified, links were examined for further institutions,
and followed up where appropriate.
After the First World Congress for Existential Therapy (May, 2015), the
network of contacts for the development of a World Confederation for
Existential Therapy has facilitated a permanent update of the institutions.
Several participants were asked to inform us of non-listed institutions which
were checked and asked for data and confirmation.
Inclusion and exclusion criteria

The present definition of existential institutions included both existential
therapy societies and training centres in existential therapy. Existential
therapy societies were defined as organisations that aimed to disseminate,
promote, study, develop and/or teach existential therapy (counselling and
psychotherapy): These organizations might present themselves as societies,
associations, federations (if they include several institutions), centres or
institutes. Training centres in existential therapy were defined as organisations
that had a full and explicitly labelled training course in existential counselling
or psychotherapy, either professional or academic. Training centres that
offered only small seminars or workshops on the existential paradigm
were excluded.
In the past few years, many different therapies have been integrating
phenomenological or existential principles and practices (du Plock & van
Deurzen, 2015; Jacobsen, 2007). Rational emotive therapy, gestalt therapy,
person-centred therapy, focusing therapy, and all integrative-existential forms
of therapy (e.g., cognitive-existential therapy, existential-psychoanalytic
therapy), have borrowed from the phenomenological-existential tradition,
but do not usually call themselves ‘existential psychotherapy’ (du Plock &
van Deurzen, 2015) and are not recognized as existential therapies by the
tradition (Angerami-Camon, 2007; Besora, 1981, 1994; van Deurzen &
Adams, 2011; Jacobsen, 2007). It was decided to direct this survey only to
the most common and consensual four branches of existential psychotherapy
(Correia, Cooper, Berdondini, & Correia, In press): daseinsanalysis, the
existential-humanistic approach, the existential-phenomenological approach
and logotherapy and/or existential analysis.
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Existential Therapy Institutions Worldwide: An Update of Data and The Extensive List
Results
Of the 147 existential therapy institutions identified, two of them had
closed; six were duplicate names or websites; seven institutions posted
on suggested links were not found; and four training institutions had only
small seminars or workshops on the existential paradigm. This left 128
existential therapy institutions, identified from January 2012 to March
2012 (Correia, 2015; Correia, et al., 2014). Eight new institutions were
added to the previous list via the network of the World Confederation for
Existential Therapy. A total of 136 existential therapy institutions are
now listed in 43 countries across all six continents.
Europe and Latin America amounts to 83.1% (n = 113) of the world’s
total existential therapy institutions (54.4% and 28.7%, respectively). North
America counts with 11% (n = 15). In Asia, four existential psychotherapy
institutions were found: two in West Asia (Israel) and two in East Asia (China
and Japan). There were three institutions in Australia, and just one in Africa.
Austria has the most existential therapy institutions (n = 15; 11%), followed
by the United States (n = 11; 8.1%) and then Argentina and Brazil (n = 9;
6.6%). Germany had eight institutions (5.9%), the UK seven (5.1%) and
Italy and Mexico had six (4.4%). Just over half (n = 71; 52.2%) of the total
existential therapy institutions were found in these eight countries.
The greatest number of institutions came from the logotherapy and/or
existential analysis branch of existential therapy (n = 82; 60.3%). The second
most prevalent was the existential-phenomenological branch (n = 27; 19.9%),
followed by existential-humanistic branch (n = 12; 8.8%) and daseinsanalysis
(n = 11; 8.1%).
Logotherapy and/or existential analysis institutions were spread over 34
countries, but were mainly concentrated in Europe and Latin America: a
total of 91.5% (n = 75) of its institutions are located in these two continents
(56.1% and 35.4% respectively). Worldwide, 65.9% of all logotherapy
institutions are located in either Spanish-speaking (n = 30; 36.6%) or German-
speaking (n = 24; 29.3%) countries.
The existential-humanistic institutions were located mainly in the United
States (n = 8; 66.7%), with two institutions found in Belgium (16.7%) and
single institutions in both China and Russia. Daseinsanalytic institutions
were mainly located in Europe (n = 9; 81.8%), primarily in Central Europe,
with single institutions in both Brazil and Canada.
The existential-phenomenological institutions were more geographically
diverse, with 27 institutions spread over 16 countries. Brazil and the UK
have the largest number of existential-phenomenological institutions (n =
5; 18.5% each). There were no existential-phenomenological institutions
in the German-speaking countries.
Four institutions were identified that aimed at a dialogue between
different branches of existential psychotherapy: two in North America
157
(one in Canada and the other in the United States), one in Europe (UK),
and one in Latin America.
Discussion
Existential therapy is nowadays represented on all inhabited continents
and institutionally represented in 43 countries. It is not possible to state
that the approach has been growing, as there are no previous demographic
studies for comparison. Nevertheless, the geographical span, where
existential therapy institutions and working practitioners can be found,
gives us an idea of the range and relevance that this psychotherapeutic
paradigm has in the world today.
It is mainly concentrated in Europe and Latin America. In South America,
75% of its countries have at least one institutional representation for
existential therapy. Africa, the continent with the greatest percentage of
least developed countries (Committee for Development Policy & UN
Department of Economic and Social Affairs, 2008), had the least existential
institutions, followed by Asia.
The worldwide distribution by branch seems to be associated with geographical
and linguistic characteristics: Logotherapy and/or existential analysis is
particularly popular in German- and Spanish-speaking countries; the existential-
humanistic approach is mainly confined to the USA; daseinsanalysis is largely
found in the Central Europe countries and existential-phenomenology has
no presence in German-speaking countries.
Logotherapy’s concentration in German- and Spanish-speaking countries
may not help a worldwide divulgation and proliferation: One of the most
important logotherapy and existential analysis journals is published in German,
and most of its recent works are still untranslated to English (Correia, Cooper,
& Berdondini, 2015). In contrast, recent existential-phenomenological works
tend to be published in English, a language that is nowadays accessible to
most post-graduate students worldwide.
The existential-humanistic branch, though concentrated in the USA, recently
reached China (Hoffman, Yang, Kaklauskas, & Chan, 2009; K. J. Schneider
& Krug, 2010). The Daseinsanalysis branch has opened no new institutions
in the last decade.
Limitations
This research was an initial and exploratory attempt to build a comprehensive
and consistent sketch of today’s existential therapy institutional panorama.
However, several limitations can be found: a) The option for a World
Wide Web search may have excluded institutions with no Internet presence;
b) The search was biased towards English-, Spanish-, German-, French-
and Portuguese-language websites; c) It is limited and biased towards the
four main existential therapy branches; d) Only half of the institutions
158
confirmed the accuracy of the data collected. Confirmation and information

exchange is important for data reliability and to collect other important
characterizing elements that would enrich the study with deeper and more
conclusive information (e.g., the branch that best represents the teaching
and/or practice of each society; when they were founded; number of associated
members; their scientific, training and social activities and aims).
Implications
Despite the limitations mentioned above, this study gives some valuable
data on the distribution of the key existential therapies around the globe
and helps us understand existential therapy’s worldwide establishments
and influences.
The worldwide relevance of existential therapy should reinforce the
importance of conducting further research into this psychotherapeutic paradigm.
As mentioned above, the data shows some geographical and linguistic
constraints. Logotherapy and/or existential analysis and daseinsanalysis
could benefit from a greater investment in new translations into other
languages, in particular English. The existential-phenomenological branch,
on the other hand, may benefit from a greater dialogue with its German
counterparts (daseinsanalysis and logotherapy) to overcome geo-linguistic
and ideological bridges.
The poor representation in the least developed countries and continents
could stand as a topic of questioning and challenge for a paradigm that has
at its core existential ideas and principles: How democratic, trans-cultural
and open is existential therapy? Is existential counselling and psychotherapy
an elitist therapy? If so, how does this fit with its ideologies and principles?
Further Research
New studies should be conducted to overcome the limitations found,
including: a) Research that goes beyond an Internet search; b) Telephone
and mail contact with each institution’s representative, to confirm and
ask for further data. New studies will allow the possibility of comparing
data and to confirm if existential psychotherapy really is growing and
spreading worldwide.
Edgar A. Correia is a PhD student at the Department of Counselling,

University of Strathclyde, Glasgow, UK. He is a chartered clinical
psychologist and EAP and WCP-registered existential psychotherapist
and a founding member of the Sociedade Portuguesa de Psicoterapia
Existencial (SPPE).
Mick Cooper is a Professor of Counselling Psychology at the University
of Roehampton, London, and a UKCP-registered existential psychotherapist.
Mick is author and editor of a wide range of texts on existential, person-
159
centred and relational approaches to therapy, including Existential Therapies

(Sage, 2003) and Pluralistic Counselling and Psychotherapy (Sage, 2011,
with John McLeod).
Lucia Berdondini is a Knowledge Exchange Fellow at the School of
Psychology, University of East London; and a BACP registered Gestalt
psychotherapist. She is particularly interested in the psychology of disasters
and has focused her professional activity on developing counselling
training courses in countries in war and post conflict.
Contact: Correspondence concerning this article should be addressed to

Edgar A. Correia, Rua de Cabo Verde, nº 10 2º Dto., 1170-067, Lisboa,
Portugal. E-mail: edgar.agrela@gmail.com
Worldwide List of Existential Therapy Institutions
1. ABILE-West Österreich
2. Akademie für Logotherapie und Existenzanalyse
3. American Association for Existential Analysis
4. Arizona Institute of Logotherapy
5. Asociación Argentina de Analisi Existencial y Logoterapia
(GLE Argentina)
6. Asociación Bonaerense de Logoterapia “Por Amor a la Vida”
7. Asociación Cooperativa Viktor Frankl de Venezuela
8. Asociación Española de Logoterapia (AESLO)
9. Asociación Guatemalteca de Logoterapia
10. Asociación Latinoamericana de Psicoterapia Existencial (ALPE)
11. Asociación Peruana de Análisis Existencial y Logoterapia
(APAEL)
12. Asociación Viktor E. Frankl de Valencia
13. Asociaţia Ştiinţifică Internaţională de Logoterapie şi Analiză
Existenţială (LENTE)
14. Associação Brasileira de Daseinsanalyse (ABD)
15. Associação Brasileira de Logoterapia e Análise Existencial
(ABLAE)
16. Associação de Logoterapia Viktor Emil Frankl (ALVEF)
17. Associació Catalana de Logoteràpia i Anàlisi Existencial
(ACLAE)
18. Association de Logothérapeutes Francophones
19. Associazione di Logoterapia e Analisi Esistenziale Frankliana
(ALAEF)
20. Associazione di Logoterapia Italiana (ALI)
21. Associazione Iar Esistenziale
160
22. Ausbildungsinstitut für Logotherapie und Existenzanalyse

(ABILE)
23. Australasian Existential Society (AES)
24. Australian Section of International Society for Existential
Analytical Psychotherapy (ISEAP)
25. Boulder Psychotherapy Institute (BPI)
26. Canadian Institute of Logotherapy
27. Casa Viktor Frankl
28. Center for Existential Depth Psychology (CEDP)
29. Centre et École Belge de Daseinsanalyse (CEBDA)
30. Centre for Existential Practice (CEP)
31. Centre for Research in Existence and Society
32. Centro de Anàlisis Existencial Viktor Frankl de Rosario
33. Centro de Logoterapia de Tucumán
34. Centro de Logoterapia y Análisis Existencial (CELAE)
35. Centro de Psicoterapia Existencial (CPE)
36. Centro Ecuatoriano de Análisis Existencial y Logoterapia
37. Centro Sentido
38. Centro Viktor Frankl para la Difusión de la Logoterapia
39. Českou Daseinsanalytickou Společností
40. Círculo de Estudios en Psicoterapia Existencial
41. Croatia Society for Logotherapy and Existential Analysis
42. Daseinsanalytischer Seminar (DaS)
43. Depth Psychotherapy Institute (DPI)
44. Deutsche Gesellschaft für Logotherapie und Existenzanalyse
e.V (DGLE)
45. Deutschland Gesellschaft für Logotherapie und
Existenzanalyse (GLE-D)
46. Dilemma Training
47. East European Association for Existential Therapy
48. École Française de Daseinsanalyse (EFD)
49. Existanbul – Varoluşçu Psikoterapiler Derneği / Varoluşçu
Akademi
50. Existential Academy, London
51. Existential Analysis Society of Canada
52. Existential Psychotherapy Center of Southern California
(EPCSC)
53. Existential-Humanistic Institute (EHI)
54. Existentieel Welzijn
55. Fundacion Argentina de Logoterapia
56. Fundación CAPAC (Centro de Actividades Psicológicas
Asistenciales Comunitarias)
57. Gesellschaft für Existenzanalyse Schweiz
161
58. Gesellschaft für Logotherapie und Existenzanalyse (GLE-Ö)

59. Greek Association for Existential Psychotherapy and
Counseling (Gignesthai)
60. Grupo Metropolitano de Logoterapia
61. Hellenic Society of Daseinsanalysis (HSDA)
62. Humanistinės ir Egzistencinės Psichologijos Institutas (HEPI)
63. Inštitut Antona Trstenjaka za gerontologijo in medgeneracijsko
sožitje
64. Institut für Existenzanalyse & Logotherapie Graz
65. Institut für Existenzanalyse & Logotherapie Tirol
66. Institut für Existenzanalyse & Logotherapie Vorarlberg
67. Institut für Existenzanalyse & Logotherapie-Oberösterreich
68. Institut für Existenzanalyse & Logotherapie-Salzburg
69. Institut für Logotherapie & Existenzanalyse Salzburg
70. Institut für Logotherapie und Existenzanalyse Essen-Werden
71. Institut für Logotherapie und Existenzanalyse Hamburg-
Bergedorf
72. Institut für Logotherapie und Existenzanalyse Korschenbroich
73. Institut für Logotherapie und Existenzanalyse Tübingen/Wien
74. Institute of Existential Analytical Psychology and
Psychotherapy, Moscow
75. Institute of Existential Psychology and Life Enhancement
(EXPLIEN)
76. Instituto “Viktor Frankl” de Puerto Rico
77. Instituto Chileno de Análisis Existencial (ICAE)
78. Instituto Chileno de Logoterapia, Viktor Frankl
79. Instituto Colombiano de Analisis Existencial y Logoterapia
80. Instituto de Ciencias de la Familia (ICF)
81. Instituto de Logoterapia S.C.
82. Instituto de Psicologia Fenomenológico-Existencial do Rio de
Janeiro (IFEN)
83. Instituto Dominicano de Logoterapia y Analisis Existencial
Viktor Frankl
84. Instituto Especializado en Logoterapia S.C.
85. Instituto Mexicano de Análisis Existencial, S. C. (IMAE)
86. Instituto Peruano de Logoterapia, Viktor Frankl
87. International Collaborative of Existential Counsellors and
Psychotherapists
88. International Federation of Daseinsanalysis (IFDA)
89. International Institute for Humanistic Studies (I.I.H.S.)
90. International Society for Existential Psychology and
Psychotherapy (ISEPP)
91. Internationale Gesellschaft für Logotherapie und
162
Existenzanalyse – GLE-International
92. Istituto di Scienze Umane ed Esistenziali
93. Japanese Society of Existential Therapy
94. Kibbutzim College of Education Technology and the Art
95. Logoterápia és Bölcseleti Embertan Oktatási és Kutatási
Alapítvány
96. Logoterapie, Consiliere, Însoţire şi Psihoterapie Analitic
Existenţială (SAEL România)
97. London Chapter of Viktor Frankl’s Logotherapy and Existential
Anaylsis
98. Magyar Daseinanalitikai Egyesület (MDE)
99. MIEK – International Institute of Existential Consultancy
100. Nederlands Instituut voor Logotherapie en Existentiële Analyse
101. New School of Psychotherapy and Counselling (NSPC)
102. Núcleo Castor - Estudos e Atividades em Existencialismo
(NUCA)
103. Opleidingscentrum voor Experiëntiële, Emotion-Focused en
Existentiële Psychotherapie, Counseling & Coaching
104. Österreichische Gesellschaft für Logotherapie nach Viktor
Frankl
105. Österreichisches Daseinsanalytisches Institut (ÖDAI)
106. Otsmot Institute – The Viktor Frankl Center for Logotherapy in
Israel
107. Regent’s University – School of Psychotherapy and
Counselling Psychology
108. Sällskapet för Existenstiell Psychokoterapi (SEPT)
109. Schweizerische Gesellschaft für Logotherapie und
Existenzanalyse (SGLE)
110. Schweizerischer Fachverband Für Daseinsanalytische
Psychotherapie (SFDP)
111. Seattle University – College of Arts and Sciences
112. SOBRAL - Associação Brasileira de Logoterapia e Análise
Existencial Frankliana
113. Sobraphe – Sociedade Brasileira de Psicologia Humanista
Existencial e Instituto de Ensino e Formação em Psicologia e
Análise do Existir
114. Sociedad de Logoterapia del Uruguay
115. Sociedad Mexicana de Análisis Existencial y Logoterapia
(SMAEL)
116. Sociedad para el Avance de la Psicoterapia Centrada en el
Sentido (SAPS)
117. Sociedad Peruana de Psicoterapia Fenomenológica Existencial
(SPPFE)
163
118. Sociedade de Análise Existencial e Psicomaiêutica (SAEP)

119. Sociedade Portuguesa de Psicoterapia Existencial (SPPE)
120. Società Italiana di Psicoterapia Esistenziale (SIPE)
121. Society for Existential Analysis (SEA)
122. Society of Daseinsanalysis in Canada (SDAC)
123. Společnost pro Logoterapii a Existenciální Analýzu (SLEA)
124. Stowarzyszenia Psychoterapii Egzystencjalnej (GLE-Polska)
125. Süddeutsches Institut für Logotherapie und Existenzanalyse
gAG
126. Südtiroler Institut für Logotherapie und Existenzanalyse
(SILEA)
127. Suomen Logoterapiainstituutti Oy
128. Suomen Logoterapiayhdistys Ry
129. Tiroler Institut für Logotherapie und Existenzanalyse nach
Viktor E. Frankl (TILO)
130. Viktor Frankl Institute of Ireland
131. Viktor Frankl Institute of Logotherapy
132. Viktor Frankl Institute of South Africa
133. Viktor Frankl Institut-Vienna
134. Viktor Frankl Zentrum Wien
135. Zhi Mian Institute for Psychotherapy (ZMIP)
136. Zhi Mian International Institute of Existential-Humanistic
Psychology (ZMIIEHP)
Institutions’ Detailed Information

1. ABILE WEST – Ausbildungsinstitut für Logotherapie und Existenzanalyse
nach Viktor E Frankl, Westösterreich
E.T.: Abile West – Viktor E. Frankl Training Institute of Logotherapy and
Existential Analysis, Western Austria
Website: http://www.abile-west.at
Email: office@abile-west.at
Address: Defreggerstrasse 38, 6020 Innsbruck, Austria
Chair: Heidi Vonwald
Branch: Logotherapy
Aims: Training and research
Confirmed Data
2. Akademie für Logotherapie und Existenzanalyse

E.T.: Academy for Logotherapy and Existential Analysis
Website: http://www.logotherapie-mainz.de/index.html
Email: logotherapie@vhs-mainz.de
164
Address: Volkshochschule Mainz, Karmeliterplatz 1, 55116 Mainz, Germany

Chair: Randolph Ochsmann
Branch: Logotherapy
Aims: Training
Not Confirmed
3. American Association for Existential Analysis

Website: http://www.aa-ea.org/
Email: todddubose@live.com
Address: USA
Chair: Todd DuBose – tdubose@thechicagoschool.edu
Branch: A dialogue among several perspectives
Aims: Training, research and development and promotion of existential
perspective
Confirmed Data
4. Arizona Institute of Logotherapy

Website: http://www.logotherapy.us
Email: azlogotherapy@gmail.com
Address: 13315 W Aleppo Drive, Sun City West, AZ 85375-4903, USA
Chair: Leo Michel Abrami – leoabrami@hotmail.com
Branch: Logotherapy
Aims: Training, experiential workshops
Confirmed Data
5. Asociación Argentina de Analisi Existencial y Logoterapia (GLE

Argentina)
E.T.: Argentina Association of Logotherapy and Existential Analysis
Website: www.gle-argentina.com.ar
Email: Laura Asid – lauriasid@yahoo.com.ar
Address: Mendoza, Argentina
Chair: Julia Casanova – jecasanova@yahoo.com.ar
Branch: Existential Analysis and Logotherapy
Confirmed Data
6. Asociación Bonaerense de Logoterapia “Por Amor a la Vida”

E.T.: Buenos Aires Association of Logotherapy “For Love of Life”
Website: http://www.bsaslogoterapia.com.ar
Email: robertomucci@uolsinectis.com.ar
Address: Buenos Aires, Argentina
Chair: Roberto Juan Mucci
Branch: Logotherapy
165

Not Confirmed
7. Asociación Cooperativa Viktor Frankl de Venezuela

E.T.: Viktor Frankl Cooperative Association of Venezuela
Website: Not Found
Email: maldonadolino@hotmail.com
Address: Venezuela
Chair: Lino Maldonado
Branch: Logotherapy
Not Confirmed
8. Asociación Española de Logoterapia (AESLO)

E.T.: Spanish Association of Logotherapy
Website: http://www.logoterapia.net/
Email: ma_aeslo@yahoo.es
Address: C/ Chantada 2, 1º1. E-28029, Madrid, España
Chair: Ana Mª Ozcariz Arraiza
Branch: Logotherapy
Not Confirmed
9. Asociación Guatemalteca de Logoterapia

E.T.: Guatemalan Association of Logotherapy
Website: Not Found
Email: icf.guate.edu@gmail.com
Address: Guatemala
Chair: María Ángeles de Mollinedo
Branch: Logotherapy
Not Confirmed
10. Asociación Latinoamericana de Psicoterapia Existencial (ALPE)

E.T.: Latin-American Association of Existential Psychotherapy
Website: http://www.alpepsicoterapiaexistencial.com/
Email: funcapac@fibertel.com.ar
Address: International
Chair: Susana C. Signorelli – susig@funcapac.org.ar
Branch: Several branches
166
Aims: Training, research, bringing together existential therapists from

all Latin-America
Confirmed Data
11. Asociación Peruana de Análisis Existencial y Logoterapia (APAEL)

& Sociedad Peruana de Análisis Existencial y Logoterapia (SPAEL)
E.T.: Peruvian Association of Logotherapy and Existential Analysis &
Peruvian Society of Logotherapy and Existential Analysis
Website: http://www.logoterapiaperu.org/
E-mail: info@logoterapia.pe
Address: Miraflores, Lima, Peru
Chair: Lisle Sobrino Chunga
Branch: Logotherapy
Not Confirmed
12. Asociación Viktor E. Frankl de Valencia

E.T.: Viktor E. Frankl Association of Valencia
Website: http://www.asociacionviktorfrankl.org
E-mail: correo@asociacionviktorfrankl.org
Address: c/ D. Juan de Austria 34. 46002, Valencia. España
Chair: Sebastián Tabernero Capella – sebastabernero@hotmail.com
Branch: Logotherapy
Aims: Training and counselling
Not Confirmed
13. Asociaţia Ştiinţifică Internaţională de Logoterapie şi Analiză

Existenţială (LENTE)
E.T.: The International Scientific Association of Logotherapy and Existential
Analysis
Website: http://logoterapia.ro/en/index.php
E-mail: logoterapia@logoterapia.ro
Address: Cluj-Napoca, Str. Iuliu Maniu nr. 5/8 , jud. Cluj, Romania
Chair: János Vik
Branch: Logotherapy
Aims: Training and counselling
Not Confirmed
14. Associação Brasileira de Daseinsanalyse (ABD)

E.T.: Brazilian Association of Daseinsanalysis
Website: http://www.daseinsanalyse.org/
Email: abd@daseinsanalyse.org
167
Address: Rua Cristiano Viana, 172, CEP 05411-000, Pinheiros, São Paulo/
Brasil
Chair: David Cytrynowicz – dcytry@uol.com.br
Branch: Daseinsanalysis
Aims: Training, research and free of charge therapy for people in need
Confirmed Data
15. Associação Brasileira de Logoterapia e Análise Existencial (ABLAE)

E.T.: Brazilian Association of Logotherapy and Existential Analysis
Website: Not Found
Email: logoterapia.brasil@yahoo.com.br
Address: Brasil
Chair: Paulo Kroeff
Branch: Logotherapy
Aims: Training, research
Confirmed Data
16. Associação de Logoterapia Viktor Emil Frankl (ALVEF)

E.T.: Logotherapy Association Viktor Emil Frankl
Website: http://www.logoterapiaonline.com.br
Email: alvef@logoterapiaonline.com.br
Address: Rua Des. Ermelino de Leão, 15 - 10º andar - Conj. 101 CEP
80410-230 – Curitiba, Brasil
Chair: Sheila Maria Hesketh Rabuske – sheilarabuske@logoterapiaonline.
com.br
Branch: Logotherapy
Confirmed Data
17. Associació Catalana de Logoteràpia i Anàlisi Existencial (ACLAE)

E.T.: Catalan Association of Logotherapy and Existential Analysis
Website: http://aclae.org
Email: info@aclae.org
Address: Barcelona, Espanha
Chair: Cristina Visiers – cvisiersw@yahoo.es
Branch: Logotherapy
Confirmed Data
18. Association de Logothérapeutes Francophones (ALF)

E.T.: Association of Francophone Logotherapists
Website: http://www.logotherapie.fr
168
Email: christian.merle@yahoo.fr
Address: 10 rue du Colonel Desgrées Du Lou, F-44100 Nantes, France
Chair: Christian Merle
Branch: Logotherapy
Confirmed Data
19. Associazione di Logoterapia e Analisi Esistenziale Frankliana

(ALAEF)
E.T.: Association of Frankl Logotherapy and Existential Analysis
Website: http://www.logoterapiaonline.it
Email: info@logoterapiaonline.it
Address: Università Pontificia Salesiana, P.zza Ateneo Salesiano, 1 –
Roma, Italy
Chair: Daniele Bruzzone
Confirmed Data
20. Associazione di Logoterapia Italiana (ALI)

E.T.: Italian Association of Logotherapy
Website: http://www.logoterapia.it/web/
Email: natalina.barbona@tin.it
Address: Roma – 00183 – in via Claterna 18, Italy
Chair: Natalina Barbona
Aims: Training, social assistance
Not Confirmed
21. Associazione Iar Esistenziale

E.T.: Iar Existential Association
Website: http://www.iaresistenziale.com/
Email: info@iaresistenziale.com
Address: Via Sant’Agnese 38 – 35030, Caselle di Selvazzano Dentro
PD, Italy
Chair: Lucio Demetrio Regazzo – luciodemetrio@regazzo.org
Branch: Logotherapy
Not Confirmed
22. Ausbildungsinstitut für Logotherapie und Existenzanalyse (ABILE)

E.T.: Training Institute for Logotherapy and Existentential Analysis
169
Website: http://www.abile.org/
Email: abileinstitut@aon.at
Address: Kaiser-Josef-Platz 52, 4600, Wels, Austria
Chair: Otmar Wiesmeyr
Branch: Logotherapy
Aims: Training
Not Confirmed
23. Australasian Existential Society (AES)

Website: http://www.existential.asn.au/
Sydney Email info@existential.asn.au
Brisbane Email pagora@optusnet.com.au
Address: Sydney and Brisbane, Australia
Chair: Alison Strasser
Branch: Existential-Phenomenological
Aims: Training and working platform and network for counsellors,
psychotherapists and other professionals working within an existential-
phenomenological theoretical framework
Not Confirmed
24. Australian Section of International Society for Existential Analytical

Psychotherapy (ISEAP)
Website: http://www.existential-analysis.org
Email: cwurm@adelaide.on.net
Address: c/o Florey Healthcare, 138 Bridge Road, Pooraka SA 5095, Australia
Chair: Christopher S E Wurm – wurmc4@me.com
Confirmed Data
25. Boulder Psychotherapy Institute (BPI)

Website: http://boulderpsych.com/
Email: 123betty@indra.com
Address: 1140 Lehigh Street, Boulder, Colorado 80305, USA
Chair: Betty Cannon
Branch: Existential-Humanistic
Confirmed Data
26. Canadian Institute of Logotherapy

Website: http://logotherapy.ca
Email: info@logotherapy.ca
170
Address: 72 Robertson Road, PO Box 26142, Ottawa, ON K2H 9R0,

Canada340
Chair: Edward Marshall
Branch: Logotherapy
Aims: Training
Confirmed Data
27. Casa Viktor Frankl

E.T.: Viktor Frankl House
Website: http://www.casaviktorfrankl.com
Email: info@casaviktorfrankl.com
Address: Torres Adalid 1165 Del Valle Centro, 03100 Benito Juárez, Mexico
Chair: Genoveva Lizárraga Martínez
Branch: Logotherapy
Aims: Training, therapy
Not Confirmed
28. Center for Existential Depth Psychology (CEDP)

Website: http://www.drstephendiamond.com/index.html
Email: dr_sdiamond@hotmail.com
Address: 6535 Wilshire Blvd, Los Angeles,CA USA
Chair: Stephen Diamond
Aims: Training
Not Confirmed
29. Centre et École Belge de Daseinsanalyse (CEBDA)

E.T.: Begian Center and Scholl of Daseinsanalysis
Website: www.daseinsanalyse.be
E-Mail: dasein.ado@skynet.be
Address: Rue Leys, 18, B-1000 Bruxelles, Belgium
Chair: Ado Huygens
Confirmed Data
30. Centre for Existential Practice (CEP)

Website: http://www.cep.net.au/index.html
Email: admin@cep.net.au
Address: PO Box 358, Paddington NSW 2021, Australia
Chair: Alison Strasser – alison@cep.net.au
171
Aims: Training
Not Confirmed
31. Centre for Research in Existence and Society

Website: http://existence.ku.dk/english/
Email: existence@sociology.ku.dk
Address: University of Copenhagen, Department of Sociology, Øster
Farimagsgade 5, DK-1353 Copenhagen K, Denmark
Chair: Bo Jacobsen - bj@soc.ku.dk or bojac@sociology.ku.dk
Aims: Research
Confirmed Data
32. Centro de Anàlisis Existencial Viktor Frankl de Rosario

E.T.: Existential Analysis Centre Viktor Frankl of Rosario
Website: http://www.logoterapiarosario.com.ar/
Email: At the webpage
Address: Santiago 1149, 2000 Rosario, Santa Fé, Argentina
Chair: Cecilia Saint Girons & Raúl A. Sutich
Branch: Logotherapy
Aims: Training and Counselling
Not Confirmed
33. Centro de Logoterapia de Tucumán

E.T.: Tucumán Logotherapy Centre
Website: http://www.logoterapiatuc.com.ar/
Email: celogtuc@hotmail.com
Address: Marcos Paz 1594, San Miguel de Tucumán, Tucumán, Argentina
Chair: María Yolanda Véliz de Esper
Branch: Logotherapy
Aims: Training and Counselling
Not Confirmed
34. Centro de Logoterapia y Análisis Existencial (CELAE)

E.T.: Logotherapy and Existential Analysis Centre
Website: http://logoterapia.com.uy/
Email: celae@logoterapia.com.uy
Address: Francisco Llambí 1410 esq.Rivera, Montevideo, Uruguay
Chair: Alejandro De Barbieri – psaledebarbieri@gmail.com
Branch: Logotherapy
Aims: Training, Research and Counselling
Confirmed Data
172
35. Centro de Psicoterapia Existencial (CPE)

E.T.: Existential Psychotherapy Centre
Website: http://www.psicoexistencial.com.br/web/default1.asp
Email: psicoexistencial@psicoexistencial.com.br
Address: Serra da Canteira, São Paulo, Brasil
Chair: Valdemar Augusto Angerami – Camon
Aims: Training, research and counselling
Not Confirmed
36. Centro Ecuatoriano de Análisis Existencial y Logoterapia

E.T.: Ecuadorian Center for Logotherapy and Existential Analysis
Website: http://www.wakeup.com.ec/
Email: not found
Address: Ecuador
Chair: Eliana Cevallos
Branch: Logotherapy
Aims: Training, research, psychotherapy
Not Confirmed
37. Centro Sentido

E.T.: Meaning Center
Website: http://logoterapiagalicia.blogspot.com
Email: sentido@cop.es
Address: Galicia, Spain
Chair: José Martínez-Romero Gandos
Branch: Logotherapy
Aims: Training, research, psychotherapy
Confirmed Data
38. Centro Viktor Frankl para la Difusión de la Logoterapia

E.T.: Viktor Frankl Centre for Logotherapy Dissemination
Website: http://www.centroviktorfrankl.com.ar/
Email: info@centroviktorfrankl.com.ar
Address: Argentina
Chair: Gerónimo Acevedo
Branch: Logotherapy
Aims: Training research
Not Confirmed
39. Českou Daseinsanalytickou Společností

E.T.: Czech Association of Daseinsanalysis
Website: http://daseinsanalysis.sweb.cz/
173
Email: daseinsanalysis@seznam.cz
Address: Králíčková, Hekrova 805, Prague 4, 149 00, Czech Republic
Chair: Oldrich Calek
Aims: Training
Not Confirmed
40. Círculo de Estudios en Psicoterapia Existencial

E.T.: Circle of Studies in Existential Psychotherapy
Website: http://www.psicoterapiaexistencial.com/
Email: informes@psicoterapiaexistencial.com
Address: Mexico
Chair: Yaqui Andrés Martínez Robles – yaqui@psicoterapiaexistencial.com
Confirmed Data
41. Croatian Society for Existential Psychotherapy

Email: milankosuta@yahoo.com
Address: Sermageova 17, 10000 Zagreb, Croatia
Chair: Milan Kosuta
Aims: Training
Confirmed Data
42. Daseinsanalytischer Seminar (DaS)

E.T.: Daseinsanalytic Seminar
Website: http://gad-das.ch
Email: frederic.soum@gmx.ch
Address: Sonneggstrasse 82, 8006 Zürich, Switzerland
Chair: Alice Holzhey – alice.holzhey@bluewin.ch and Uta Jaenicke
Aims: Training, study and research
Confirmed Data
43. Depth Psychotherapy Institute (DPI)

Website: http://www.depth-psychotherapy-institute.com/Index.htm
Email: hoffman@center4growth.com
Address: 5350 Tomah Drive, Suite 3600, Colorado Springs, CO 80918, USA
Chair: Louis Hoffman
Aims: Training
Confirmed Data
174
44. Deutsche Gesellschaft für Logotherapie und Existenzanalyse e.V

(DGLE)
E.T.: German Society for Logotherapy and Existential Analysis e. V
Website: http://logotherapie-gesellschaft.de/
Email: dgle.dierenbach@t-online.de
Address: Irmelenweg 9, 79292 Pfaffenweiler, Germany
Chair: Anna-Maria Stegmaier – logotherapie@gmx.de
Branch: Logotherapy
Not Confirmed
45. Deutschland Gesellschaft für Logotherapie und Existenzanalyse

(GLE-D)
E.T.: Germany Society for Logotherapy and Existential Analysis
Website: http://www.gle-d.de/
Email: buero@gle-d.de
Address: Borchersstr. 21, D-30559 Hannover, Germany
Chair: Christoph Kolbe
Confirmed Data
46. Dilemma Training

Website: http://www.dilemmatraining.com/
Email: admin@existentialacademy.com or dilemmaoffice@gmail.com
Address: Sheffield and London, United Kingdom
Chair: Emmy van Deurzen & Digby Tantam
Aims: Online training
Confirmed Data
47. East European Association for Existential Therapy (EEAET)
Website: http://www.existentialtherapy.eu/en/
Email: birutej@gmail.com
Address: Birstonas, Lithuania
Chair: Tatiana Ivanova
Branch: Existential-phenomenological
Aims: Study, training, research
Confirmed Data
48. École Française de Daseinsanalyse (EFDA)

E.T.: French School of Daseinsanalyse
Website: http://www.daseinsanalyse.fr/
Address: Archives Husserl, ENS, Rue d’Ulm, 75005 Paris, France
175
Chair: Jeanine Chamond - jeanine.chamond@wanadoo.fr and Philippe

Cabestan - philippecabestan@orange.fr
Aims: Study, research
Confirmed Data
49. Existanbul – Varoluşçu Psikoterapiler Derneği / Varoluşçu Akademi

E.T.: Society for Existential Psychotherapies of Turkey / Existential
Academy of Istanbul
Website: http://existanbul.org/ www.varoluscuakademi.com
Email: varoluscupsikoterapilerdernegi@gmail.com iletisim@varoluscuakademi.
com
Address: Buyukdere Cad. Oyal Is Merkezi, 108-1/912, Esentepe, Instanbul
34394 Turkey / Buyuk Hendek Cad. No:21/4 Galata Beyoglu 34420
Istanbul Turkey
Chair: Ferhat Jak Icoz
Branch: Several
Aims: Study, training and social support
Confirmed Data
50. Existential Academy, London

Website: www.existentialacademy.com
Email: principal@existential.academy
Address: 61-63 Fortune Green Road, London NW6 1DR
Chair: Emmy van Deurzen & Digby Tantam
Branch: Existential-phenomenological
Aims: Training
Confirmed Data
51. Existential Analysis Society of Canada

Website: www.existentialanalysis.ca
Email: klaass7@mac.com
Address: Existential Analysis Society of Canada, c/o Derrick Klaassen,
Trinity Western University, Graduate Program in Counselling Psychology,
7600 Glover Road, Langley, BC V2Y 1Y1, Canada
Chair: Derrick Klaassen
Aims: Training, research, publications
Confirmed Data
52. Existential Psychotherapy Center of Southern California (EPCSC)

Website: http://www.halleaten.com/site/EPCSC.html
176
Email: halleaten@gmail.com
Address: Los Angeles, USA
Chair: Halle M. Aten
Aims: Training
Not Confirmed
53. Existential-Humanistic Institute (EHI)

Website: http://www.ehinstitute.org/index.html
Email: info@ehinstitute.org
Address: EHI c/o Pacific Institute, 432 Ivy Street, San Francisco, CA
94102, USA
Chair: Nader R. Shabahangi
Aims: Training, Certificate program
Confirmed Data
54. Existentieel Welzijn

E.T.: Existential Well-Being
Website: http://existentialwellbeing.com/
Email: mia.leijssen@ppw.kuleuven.be
Address: Universiteit Leuven, Tiensestraat 102, 3000 Leuven, Belgium
Chair: Mia Leijssen
Branch: Existential-humanistic and experiential
Aims: Training
Confirmed Data
55. Fundación Argentina de Logoterapia

E.T.: Argentina Foundation of Logotherapy
Website: http://www.logoterapia-arg.com.ar/
Email: info@logoterapia-arg.com.ar
Address: Charcas 3151 - Ciudad Autónoma de Buenos Aires, Argentina
Chair: Oscar Ricardo Oro
Branch: Logotherapy
Not Confirmed
56. Fundación CAPAC (Centro de Actividades Psicológicas Asistenciales

Comunitarias)
E.T.: Foundation CAPAC - Centre for Community Assistential Psychological
Activities.
177
Website: http://www.funcapac.org.ar
Email: funcapac@fibertel.com.ar
Address: Alvarez Jonte 456 - Ramos Mejía - B1704EKJ,
Buenos Aires – Argentina
Chair: Susana C. Signorelli – susig@funcapac.org.ar
Aims: Community assistance, training, research, psychotherapy
Confirmed Data
57. Gesellschaft für Existenzanalyse Schweiz

E.T.: Switzerland Society for Existential Analysis
Website: http://www.existenzanalyse.ch
Email: igeap-bern@existenzanalyse.org
Address: Mezenerweg 12, CH-3013 Bern, Switzerland
Chair: Brigitte Heitger – brigitte.heitger@bluewin.ch
Aims: Research, study and international collaboration
Confirmed Data
58. Gesellschaft für Logotherapie und Existenzanalyse –

Österreich (GLE-Ö)
E.T.: Society for Logotherapy and Existential Analysis – Austria
Website: www.gle.at
Email: gle-oe@existenzanalyse.org
Address: A-1040 Wien, Heumühlgasse 11, Austria
Chair: Bukovski Renate -renate.bukovski@existenzanalyse.at
Aims: Training, study, research
Confirmed Data
59. Greek Association for Existential Psychotherapy and Counseling

(Gignesthai)
Website: http://gignesthai-eng.blogspot.com/
Email: gignesthai@gmail.com
Address: Greece
Chair: Evgenia T. Georganda
Confirmed Data
60. Grupo Metropolitano de Logoterapia

E.T.: Metropolitan Group of Logotherapy
Website: Not found
178
Email: juanalbertoetcheverry@hotmail.com
Address: Azcuénaga 1847, 1128 Buenos Aires, Argentina
Chair: Juan Etcheverry
Branch: Logotherapy
Aims: Not found
Confirmed Data
61. Hellenic Society of Daseinsanalysis (HSDA)

Website: http://yparxiakianalysi.wordpress.com
Email: katipgr@yahoo.com
Address: Didotou Street 25 & Asklipiou, GR-10680 Athen, Greece
Chair: Katerina Poulopoulou
Aims: Training, study and research
Confirmed Data
62. Humanistinės ir Egzistencinės Psichologijos Institutas (HEPI)

ET: Institute of Humanistic and Existential Psychology
Website: http://www.hepi.lt/en/index.html
Email: hepi@tdd.it
Address: Vilnius, Lithuania
Chair: Rimantas Kočiūnas - rimask@parkas.lt
Confirmed Data
63. Inštitut Antona Trstenjaka za gerontologijo in medgeneracijsko

sožitje
E.T.: Anton Trstenjak Institute of gerontology and intergenerational
relations
Website: http://www.inst-antonatrstenjaka.si/institut/
Email: info@inst-antonatrstenjaka.si
Address: Resljeva 11, P.O.Box 4443, 1001 Ljubljana, Slovenia
Chair: Jože Ramovš - joze@inst-antonatrstenjaka.si
Branch: Logotherapy
Aims: Social work, research, training, therapy
Not Confirmed
64. Institut für Existenzanalyse & Logotherapie Graz

E.T.: Institute for Existential Analysis and Logotherapy Graz
Website: http://www.existenzanalyse-graz.at/
Email: institut-graz@existenzanalyse.org
Address: Neutorgasse 50, A-8010 Graz, Austria
179
Chair: Christian Probst

Aims: Training, Therapy
Confirmed Data
65. Institut für Existenzanalyse & Logotherapie Tirol

E.T.: Institute for Existential Analysis and Logotherapy Tirol
Website: http://www.existenzanalyse-tirol.at/
Email: institut-tirol@existenzanalyse.org
Address: Adamgasse 30, 6020 Innsbruck, Austria
Chair: Elfe Hofer
Confirmed Data
66. Institut für Existenzanalyse & Logotherapie Vorarlberg

E.T.: Institute for Existential Analysis and Logotherapy Vorarlberg
Website: http://www.existenzanalyse-vorarlberg.at/
Email: institut-vbg@existenzanalyse.org
Address: Deuringstraße 5, 6900 Bregenz, Austria
Chair: Mathilda Rehm-Bader
Confirmed Data
67. Institut für Existenzanalyse & Logotherapie-Oberösterreich

E.T.: Institute for Existential Analysis and Logotherapy-Oberösterreich
Website: http://www.existenzanalyse-ooe.at/
Email: institut-ooe@existenzanalyse.org
Address: Traunsteinstraße 62, A-4810 Gmunden, Austria
Chair: Ursula C. Reischer – ursula.reischer@existenzanalyse.org
Confirmed Data
68. Institut für Existenzanalyse & Logotherapie-Salzburg

E.T.: Institute for Existential Analysis and Logotherapy-Salzburg
Website: http://www.existenzanalyse-salzburg.at/
Email: anton.nindl@existenzanalyse.org
Address: Linzer Gasse 4 5020 Salzburgo, Austria
Chair: Anton Nindl
180
Aims: Training
Confirmed Data
69. Institut für Logotherapie & Existenzanalyse Salzburg

E.T.: Institute for Logotherapy and Existential Analysis Salzburg
Website: http://www.logotherapie-salzburg.at/index.html
Email: office@logotherapie-salzburg.at
Address: Berchtesgadner Straße, 11, 5020 Salzburg, Austria
Chair: Christoph Schlick
Confirmed Data
70. Institut für Logotherapie und Existenzanalyse Essen-Werden

E.T.: Institute for Logotherapy and Existential Analysis Essen-Werden
Website: http://www.logotherapie-essen.de
Email: u.tirier@cityweb.de
Address: In der Borbeck 23, 45239 Essen, Germany
Chair: Ursula Tirier
Aims: Training
Not Confirmed
71. Institut für Logotherapie und Existenzanalyse Hamburg-Bergedorf

E.T.: Institute for Logotherapy and Existential Analysis Essen-Werden
Website: http://www.logotherapie-peeck.de/
Email: speeck@imail.de
Address: Am Baum 40, 21029 Hamburg, Germany
Chair: Stephan Peeck
Aims: Training
Not Confirmed
72. Institut für Logotherapie und Existenzanalyse Korschenbroich

E.T.: Institute for Logotherapy and Existential Analysis Korschenbroich
Website: http://www.loginstitut.de/
Email: kontakt@loginstitut.de
Address: Waldweg 16, De-41352 Korschenbroich, Germany
Chair: Walter Cremer
Aims: Training
Not Confirmed
181
73. Institut für Logotherapie und Existenzanalyse Tübingen/Wien

E.T.: Institute for Logotherapy and Existential Analysis Tübingen/Wien
Website: http://www.logotherapie.net/verlag/
Email: info@logotherapie.net
Address: Haaggasse 37, 72070 Tübingen, Germany
Chair: Jennifer Hadinger
Aims: Training
Not Confirmed
74. Institute of Existential Analytical Psychology and Psychotherapy,

Moscow
Original name: Институт Экзистенциально-Аналитической Психологии
и Психотерапии
Website: http://ieapp.ru
Email: svkrivtsova@mail.ru
Address: Moscow, Russia
Chair: Svetlana Krivtsova
Confirmed Data
75. Institute of Existential Psychology and Life Enhancement (EXPLIEN)

Website: http://institut.smysl.ru/
Email: institut@smysl.ru
Address: 103050 Moscow-50, a/ja 158, Russia
Chair: Dmitry Leontyev – dleon@smysl.ru
Not Confirmed
76. Instituto “Viktor Frankl” de Puerto Rico

E.T.: Institute “Viktor Frankl” of Puerto Rico
Website: Not Found
Email: estrada@coqui.net
Address: San Francisco 409, Plaza Colon, Old San Juan, Puerto Rico
00901
Chair: Javier Estrada
Branch: Logotherapy
Aims: Not found
Not Confirmed
182
77. Instituto Chileno de Análisis Existencial (ICAE)

E.T.: Chilean Institute of Existential Analysis
Website: http://www.icae.cl
Email: contacto@icae.cl or inst.chae@gmail.com
Address: Santiago de Chile, Chile
Chair: Michèle Croquevielle – michele@icae.cl and Gabriel Traverso -
gabriel@icae.cl
Aims: Research, study, training, seminars
Confirmed Data
78. Instituto Chileno de Logoterapia, Viktor Frankl

E.T.: Chilean Institute of Logotherapy, Viktor Frankl
Website: Not Found
Email: hcarmengloria@hotmail.com
Address: Chile
Chair: Carmen Gloria González Parra
Branch: Logotherapy
Aims: Not Found
Not Confirmed
79. Instituto Colombiano de Analisis Existencial y Logoterapia

E.T.: Colombian Institute for Existential Analysis and Logotherapy
Website: http://www.iclogoterapia.com
Email: institutodelogoterapia@gmail.com
Address: Calle 154 No. 19-20, Bogotá Colombia
Chair: Jose Arturo Luna Vargas – lunalogo@gmail.com
Branch: Logotherapy
Aims: Research, study and training
Not Confirmed
80. Instituto de Ciencias de la Familia (ICF)

E.T.: Institute for Family Sciences
Website: http://icfguate.org
Email: info@icfguate.org
Address: 1a. Avenida, 10-20, zona 3 de Mixco, Colonia El Rosario,
Guatemala
Chair: María de los Ángeles de Mollinedo
Branch: Logotherapy
Aims: Research and training
Not Confirmed
183
81. Instituto de Logoterapia S.C.

E.T.: Institute for Logotherapy S.C.
Website: http://www.logoterapia.org.mx
Email: logoterapia@prodigy.net.mx
Address: Mexico
Chair: Rocío Arocha – rocioarocha@gmail.com
Branch: Logotherapy
Aims: Assistance and training
Not Confirmed
82. Instituto de Psicologia Fenomenológico-Existencial do Rio de

Janeiro (IFEN)
E.T.: Institute for Existential-Phenomenological Psychology of Rio de
Janeiro
Website: http://www.ifen.com.br/
Email: ifen@ifen.com.br
Chair: Ana Maria Lopez Calvo de Feijoo – feijoo@ifen.com.br
Address: Rua Barão de Pirassununga, 62, Rio de Janeiro, Brazil
Confirmed Data
83. Instituto Dominicano de Logoterapia y Analisis Existencial Viktor

Frankl
E.T.: Dominican Institute for Logotherapy and Existential Analysis
Viktor Frankl
Website: http://www.facebook.com/pages/Instituto-Dominicano-de-
Logoterapia-y-Analisis-Existencial-Viktor-Frankl/108054042581491
Email: logoterapias@hotmail.com
Chair: Miguel Angel Latorre
Address: Avenida Sarasota, Bella Vista, Santo Domingo, República
Dominicana
Branch: Logotherapy
Aims: Research and training
Not Confirmed
84. Instituto Especializado en Logoterapia S.C.

E.T.: Specialized Institute for Logotherapy
Website: http://www.ielogoterapia.com.mx/logoterapia.html
Email: paulaescalera@hotmail.com or pilargarce@gmail.com
Address: Hidalgo 35 San Ángel Tlacopac D.F, Mexico
Chair: Jacqueline Marie Becker Duprat jacbecker@ielogoterapia.com.
184
mx jacbecker20@gmail.com
Branch: Logotherapy
Aims: Training
Not Confirmed
85. Instituto Mexicano de Análisis Existencial, S. C. (IMAE)

E.T.: Mexican Institute for Logotherapy and Existential Analysis
Website: http://analisisexistencial.org/
Email: analisisexistencialgle@gmail.com
Address: Olivos 29, Jard. San Mateo, Edo. de Mex, CP 53240, Mexico
Chair: David Alejandro Velasco Ramos – alejandro@analisisexistencial.
org
Aims: Research, study, assistance and training
Confirmed Data
86. Instituto Peruano de Logoterapia, Viktor Frankl

E.T.: Peruvian Institute for Logotherapy, Viktor Frankl
Website: http://www.dauperu.com/dau-escuela-de-vida/instituto-peruano-
de-logoterapia.html
Email: info@dauperu.com
Chair: Sandra Barbero Sereno
Address: Jr. Medrano Silva 260, Barranco, Lima - Perú
Branch: Logotherapy
Aims: Research, study, assistance and training
Not Confirmed
87. International Collaborative of Existential Counsellors and

Psychotherapists (ICECP)
Website: http://www.icecap.org.uk/
Email: secretary@icecap.org.uk
Address: London, UK
Chair: Emmy van Deurzen – emmyvandeurzen@gmail.com Digby Tantam
digby.tantam@gmail.com
Branch: Global
Confirmed Data
88. International Federation of Daseinsanalysis (IFDA)

Website: http://www.daseinsanalyse.com/index.html & http://ifdasein.
tumblr.com/
Email: ifda-federation@daseinsanalyse.com
185
Address: Zürich, Switzerland

Chair: Konstantin Gemenetzis – kon.gemenetzis@gmail.com
Confirmed Data
89. International Institute for Humanistic Studies (I.I.H.S.)

Website: http://www.human-studies.com/index.php
Email: mheery@sonic.net
Address: California, USA
Chair: Myrtle Heery
Aims: Training
Not Confirmed
90. International Society for Existential Psychology and Psychotherapy

(ISEPP)
Website: http://www.existentialpsychology.org/
Email: membership@meaning.ca
Address: Langley, British Columbia, Canada
Chair: Paul T. P. Wong
Branch: Meaning-based Psychotherapy
Not Confirmed
91. Internationale Gesellschaft für Logotherapie und Existenzanalyse

– GLE-International
E.T.: International Society for Logotherapy and Existential Analysis –
GLE-International
Website: http://www.existenzanalyse.org/
Email: gle@existenzanalyse.org
Address: Ed. Sueß-Gasse 10 A-1150 Vienna, Austria
Chair: Alfried Längle – alfried.laengle@existenzanalyse.org & alfried@
laengle.info
Aims: Umbrella association
Confirmed Data
92. Istituto di Scienze Umane ed Esistenziali

Website: http://www.isue.it/
Email: info@isue.it
Address: Napoli, Italy
186
Chair: Gianfranco Buffardi - gbuffardi@isue.it

Aims: Research, study, training
Confirmed Data
93. Japanese Society of Existential Therapy

Website: http://www.compmed.jp/?page_id=48
Email: vknagata@nifty.com
Address: Japan
Chair: Katsutaro Nagata
Aims: Research, study, training
Confirmed Data
94. Kibbutzim College of Education Technology and the Art

Website: http://www.smkb.ac.il/en/existentialistic-consultation
Email: gideon_men@smkb.ac.il
Address: 149 Namir Road, Tel-Aviv , ISRAEL
Chair: Gideon Menda – gideon_menda@hotmail.com
Aims: Training
Confirmed Data
95. Logoterápia és Bölcseleti Embertan Oktatási és Kutatási Alapítvány

E.T.: Hungarian Foundation for Research and Teaching of Logotherapy
and Anthropology
Website: http://sites.google.com/site/logoterapiaalapitvany/home
Email: lbe.alapitvany@gmail.com
Address: Liget tér 2. 3/2, H-1102 Budapest, Hungary
Chair: Sárkány Péter – sarkany.p@gmail.com
Branch: Logotherapy
Not Confirmed
96. Logoterapie, Consiliere, Însoţire şi Psihoterapie Analitic Existenţială

(SAEL România)
E.T.: Logotherapy, Counselling and Existential Analitical Psychotherapy
Website: http://www.analizaexistentiala.ro
Email: danut.negru@psiholog-brasov.com
Address: Gheorghe Popa 7/App. 2, RO-2900 Arad, Romania
Chair: Danut Negru – danut.negru@psiholog-brasov.com
187

Confirmed Data
97. London Chapter of Viktor Frankl’s Logotherapy and Existential

Anaylsis
Website: http://www.londonvfi.co.uk
Email: info@londonvfi.co.uk
Address: Uxbridge, UK
Chair: Doreen M. Francis
Branch: Logotherapy
Not Confirmed
98. Magyar Daseinanalitikai Egyesület (MDE)

E.T.: Hundarian Association of Daseinsanalysis
Website: http://www.daseinanalizis.hu/
Email: mde@daseinanalizis.hu
Address: Kuruc utca 75.4/3, H-3535 Miskolc, Hungary
Chair: Tamas Fazekas – tamas.fazekas@aon.at
Confirmed Data
99. MIEK – International Institute of Existential Consultancy

Original name: Международный Институт Экзистенциального
Консультирования (МИЭК)
Website: http://miek.existradi.ru/
Email: miek@existradi.ru
Address: Russia, 344022, Rostov-on-Don, p/b 3382 (also in Moscow,
Nizhny Novgorod, Kiev and Odessa)
Chair: Semjon Yesselson
Branch: Intensive therapeutic life (ITG)
Aims: Training
Confirmed Data
100. Nederlands Instituut voor Logotherapie en Existentiële Analyse

(NILEA)
E.T.: Dutch Institute for Logotherapy and Existential Analysis
Website: http://www.viktorfrankl.nl
Email: info@viktorfrankl.nl
Address: Maartenplein 15 3633 EJ Vreeland, Netherlands
Chair: Pieter Hoekstra
188
Branch: Logotherapy and existential analysis

Aims: Training
Confirmed Data
101. New School of Psychotherapy and Counselling (NSPC)

Website: http://www.nspc.org.uk
Email: admin@nspc.org.uk
Address: 254-256 Belsize Road, London, UK
Chair: Emmy van Deurzen – emmy@nspc.org.uk
Aims: Training
Confirmed Data
102. Núcleo Castor - Estudos e Atividades em Existencialismo (NUCA)

E.T.: Castor Centre – Studies and Activities in Existentialism
Website: http://nuca.org.br
E-mail: nuca@nuca.org.br
Address: Avenida Rio Branco, 404 - Sala 908 - Torre 1 - Centro -
Florianópolis/SC, Brazil
Chair: Lara Beatriz Fuck – larabeatrizz@hotmail.com
Branch: Sartrean Existential Psychology and Psychotherapy
Confirmed Data
103. Opleidingscentrum voor Experiëntiële, Emotion-Focused en

Existentiële Psychotherapie, Counseling & Coaching
E.T.: Focus on Emotion VZW
Website: http://www.focusonemotion.be/
Email: info@focusonemotion.be
Address: Gerhagenstraat 86, 3980 Tessenderlo, Belgium
Chair: Karel Binon
Branch: Existential-humanistic and existential-phenomenological
Aims: Training
Confirmed Data
104. Österreichische Gesellschaft für Logotherapie nach Viktor Frankl

E.T.: Austrian Society for Logotherapy by Viktor Frankl
Website: http://www.ögl.com
E-mail: office@oegl-akademie.at
Address: Körblergasse 10 8010 Graz, Austria
Chair: Klaus Gstirner – klaus@gstirner.com
Branch: Logotherapy
189
Aims: Study and training

Not Confirmed
105. Österreichisches Daseinsanalytisches Institut (ÖDAI)

E.T.: Austrian Daseinsanalytic Institute
Website: www.daseinsanalyse.at
Email info@daseinsanalyse.at
Address: Schwarzspanierstrasse 15/9/1/10, A-1090 Wien, Austria
Chair: Hans-Dieter Foerster
Not Confirmed
106. Otsmot Institute – The Viktor Frankl Center for Logotherapy

in Israel
Website: http://www.otsmot.com
Email forum@otsmot.com
Address: 4 Martin Buber st., Haifa 34861, Israel
Chair: Gideon Millul
Branch: Logotherapy
Not Confirmed
107. Regent’s College – School of Psychotherapy and Counselling

Psychology
Website: http://www.spc.ac.uk
Email: spc@regents.ac.uk
Address: Regent’s Park, Inner Circle, London NW1 4NS, United Kingdom
Chair: John Nuttall – nuttallj@regents.ac.uk
Aims: Training
Confirmed Data
108. Sällskapet för Existenstiell Psychokoterapi (SEPT)

E.T.: The Swedish Society for Existential Psychotherapy
Website: http://www.existens.nu/
Email: info@existens.nu
Address: Sweden
Chair: Gunnar Nilsson - ngn@sept.se
Confirmed Data
190
109. Schweizerische Gesellschaft für Logotherapie und Existenzanalyse

(SGLE)
E.T.: Swiss Society for Logotherapy and Existential Analysis
Website: http://www.sgle.ch/
Email t.bieler@bluewin.ch
Address: 7172 Rabius, Switzerland
Chair: Heinrich Anker - anker@pop.agri.ch
Confirmed Data
110. Schweizerischer Fachverband Für Daseinsanalytische Psychotherapie

(SFDP)
E.T.: Swiss Association for Daseinsanalytic Psychotherapy
Website: http://www.daseinsanalyse.com/sfdp/verband.html
Email: sfdp-dai@daseinsanalyse.com
Address: Spirackerstrasse 5, 8044 Dübendorf, Switzerland
Chair: Josef Jenewein – j.jenewein@bluewin.ch
Not Confirmed
111. Seattle University – College of Arts and Sciences

Website: https://www.seattleu.edu/artsci/Default.aspx
E-mail: powersda@seattleu.edu
Address: Seattle, USA
Dean: David V. Powers – powersda@seattleu.edu
Director, Master of Arts in Psychology: Kevin C. Krycka – krycka@
seattleu.edu
Aims: Training: “Existential-Phenomenological Therapeutic Psychology
MA (MAP)”
Not Confirmed
112. SOBRAL - Associação Brasileira de Logoterapia e Análise Existencial

Frankliana
E.T.: SOBRAL - Brazilian Association of Logotherapy and Frankl Existential
Analysis
Website: http://www.logoterapia.com.br/
Email sobralog@terra.com.br sobral@logoterapia.com.br
Address: Rua Luís Góis, 1238 - Santa Cruz -, São Paulo,SP, Brazil -
191
04043-100
Chair: Marilucy Wandermuren Marucci
Branch: Logotherapy
Confirmed Data
113. Sobraphe – Sociedade Brasileira de Psicologia Humanista Existencial

e Instituto de Ensino e Formação em Psicologia e Análise do Existir
E.T.: Sobraphe – Brasilian Society of Existencial-Humanistic Psychology
and Institute of Teaching and Training in Existential Psychology and
Analysis of Existence
Website: http://www.sobraphe.org.br/
Email sobraphe@sobraphe.org.br
Address: Travessa Álvaro Medina, 17, Pompeia, São Paulo, Brazil
Chair: Josefina Daniel Piccino
Branch: Existential-Phenomenological and Daseinsanalysis
Confirmed Data
114. Sociedad de Logoterapia del Uruguay (SLU)

E.T.: Logotherapy Society of Urugay
Website: http://logoterapiauruguay.org.uy
Email: secretarialogo@gmail.com
Address: 1327 Bvar. Artigas, Montevideo, Uruguay
Chair: Soledad Olave - directivalogo@gmail.com
Branch: Logotherapy
Confirmed Data
115. Sociedad Mexicana de Análisis Existencial y Logoterapia (SMAEL)

E.T.: Mexican Society for Existential Analysis and Logotherapy
Website: http://www.logoterapia.com.mx
Email: smael@logoterapia.com.mx
Address: Narciso Mendoza 45, Col. Lomas Ávila Camacho, Naucalpan,
53910, México
Chair: Leticia Ascencio de García
Branch: Logotherapy
Confirmed Data
116. Sociedad para el Avance de la Psicoterapia Centrada en el Sentido

(SAPS)
192
E.T.: Society for Development of Psychotherapy Based on Meaning

Website: http://www.saps-col.org/
Email: info@saps-col.org
Address: Carrera 14A # 101- 11, Bogotá - Cundinamarca, Colombia
Chair: Efrén Martínez Ortiz
Branch: Logotherapy
Not Confirmed
117. Sociedad Peruana de Psicoterapia Fenomenológica Existencial

(SPPFE)
E.T.: Peruvian Society for Existential Phenomenological Psychotherapy
Website: https://es-la.facebook.com/people/Sociedad-Peruana-De-
Psicolog%C3%ADa-Fenomenol%C3%B3gico-Existencial/100004093625197
Email: rags28@gmail.com
Address: Peru
Chair: Ramiro Gómez – rags28@gmail.com
Confirmed Data
118. Sociedade de Análise Existencial e Psicomaiêutica (SAEP)

E.T.: Society of Existential Analysis and Psychomaieutics
Website: http://www.existencialismo.org.br/saep/index.html
Email: jadirlessa@msm.com.br
Address: Rua Conde de Bonfim, 370 / 1005, Tijuca, Rio de Janeiro, Brazil
Chair: Jadir Lessa – jadir.lessa@yahoo.com.br
Not Confirmed
119. Sociedade Portuguesa de Psicoterapia Existencial (SPPE)

E.T.: Portuguese Society of Existential Psychotherapy
Website: www.sppe.pt
Email: sppe@sppe.pt
Address: Lisbon, Portugal
Chair: Comissão Instaladora (CI)
Confirmed Data
193
120. Società Italiana di Psicoterapia Esistenziale (SIPE)

E.T.: Italian Society of Existential Psychotherapy
Website: http://www.psicoterapiaesistenziale.org
Email: segreteria_sipe@isfipp.org
Address: Italy
Chair: Lodovico E. Berra – prof.berra@isfipp.org
Aims: Promote existential perspective, training, seminars
Confirmed Data
121. Society for Existential Analysis (SEA)

Website: http://www.existentialanalysis.org.uk/
Email: Not found
Address: London, UK
Chair: Pavlos Philippopoulos
Confirmed Data
122. Society of Daseinsanalysis in Canada (SDAC)

Website: Not found
Email: Not found
Address: 316 Dupont Street, Toronto MsR 1L9, Canada
Chair: Anna Binswanger Healy
Not Confirmed
123. Společnost pro Logoterapii a Existenciální Analýzu (SLEA)

E.T.: Society for Logotherapy and Existential Analysis
Website: http://www.slea.cz/
Email: slea@volny.cz
Address: Markova 3, 15800 Praha 5, Czech Republic
Chair: Jana Božuková – jana.bozuk@existenzanalyse.org
Confirmed Data
124. Stowarzyszenia Psychoterapii Egzystencjalnej (GLE-Polska)

E.T.: Existential Psychotherapy Association
Website: http://www.analiza-egzystencjalna.pl/
Email: analiza.egzystencjalna@gmail.com
194
Address: ul. Kokosowa 16b, 15-797 Białystok, Polska

Chair: Agnieszka Sym – nabity@o2.pl or agnieszka.sym@gmail.com
Confirmed Data
125. Süddeutsches Institut für Logotherapie und Existenzanalyse gAG

E.T.: South German Institute for Logotherapy and Existential Analysis
Website: http://www.logotherapie.de/index.html
Email: si@logotherapie.de
Address: Hauptstraße 9, D - 82256 Fürstenfeldbruck, Germany
Chair: Otto Zsok
Aims: Training
Not Confirmed
126. Südtiroler Institut für Logotherapie und Existenzanalyse (SILEA)

E.T.: South Tyrolean Institute for Logotherapy and Existential Analysis
Website: http://www.silea.bz.it/
Email: silea@rolmail.net
Address: Via dei Portici, 9, 39100 Bolzano, Italy
Chair: Robert Steiner
Aims: Training
Not Confirmed
127. Suomen Logoterapiainstituutti Oy

E.T.: Finland Logotherapy Institute
Website: http://www.logoterapia.fi/cmsms/index.php
Email: logoterapia@logoterapia.fi
Address: Linnankatu 11 A, 20100 Turku, Finland
Chair: Liisa Kosonen-Sundberg
Branch: Logotherapy
Aims: Training
Not Confirmed
128. Suomen Logoterapiayhdistys Ry

E.T.: Finland Logotherapy Association
Website: http://www.logoterapiayhdistys.fi
Email: sihteeri@logoterapiayhdistys.fi
Address: Munkvikintie 30 B 10, 21600 Parainen, Finland
Chair: Risto Nurmela – rnurmela@abo.fi or
195
president@logoterapiayhdistys.fi
Branch: Logotherapy
Aims: Public utility, society for everyone interested
Confirmed Data
129. Tiroler Institut für Logotherapie und Existenzanalyse nach Viktor

E. Frankl (TILO)
E.T.: Tyrolean Institute for Logotherapy and Existential Analysis
Website: http://www.existenzanalyse.co.at
Email: info@existenzanalyse.co.at
Address: Innrain 115 6020 Innsbruck, Austria
Chair: Inge Patsch
Branch: Logotherapy
Aims: Training
Confirmed Data
130. Viktor Frankl Institute of Ireland

Website: http://www.logotherapyireland.com
Email: logotherapyireland@gmail.com
Address: 29 Dartmouth Road, Ranelagh, Dublin 6, Ireland
Chair: Stephen J Costello
Branch: Logotherapy
Aims: Training, research, assistance and study
Confirmed Data
131. Viktor Frankl Institute of Logotherapy

Website: http://www.logotherapyinstitute.org
Email: ellisonstacia@yahoo.com
Address: Abilene, Texas 79698-5211, USA
Chair: Robert C. Barnes
Branch: Logotherapy
Aims: Training, research and study
Confirmed Data
132. Viktor Frankl Institute of South Africa

Website: http://www.logotherapyinstitute.org
Email: ucap@unisa.ac.za workshops@vfisa.co.za
Address: South Africa
Chair: Teria Shantall
Branch: Logotherapy
Aims: Training, research and study
Not Confirmed
196
133. Viktor Frankl Institut-Vienna

E.T.: Viktor Frankl Institute Vienna
Website: http://www.viktorfrankl.org
Email: alexander.batthyany@gmail.com
Address: Prinz Eugen-Strasse 18/4, A-1040 Vienna, Austria
Chair: Alexander Batthyany
Branch: Logotherapy, Existential Analysis, Meaning-Oriented
Aims: Research, Publication, Teaching, Archives of European History
of Existential Psychotherapy
Confirmed Data
134. Viktor Frankl Zentrum Wien

Website: http://www.franklzentrum.org/
Email: office@franklzentrum.org
Address: Mariannengasse 1/15, 1090 Wien, Austria
Chair: Heidemarie Zürner & Johanna Schechner
Branch: Logotherapy
Aims: Training, Research and study
Not Confirmed
135. Zhi Mian Institute for Psychotherapy (ZMIP)

Website: http://www.ep-china.org http://www.chinancc.net/
Email: zhimian@chinancc.net
Address: Nanjing, China
Chair: Xuefu Wang – xuefu1962@gmail.com
Aims: Psychotherapy, training, research and study
Confirmed Data
136. Zhi Mian International Institute of Existential-Humanistic

Psychology (ZMIIEHP)
Website: http://zhimianinstitute.com/home
Email: mark.yang@zhimianinstitute.com
Address: 1561 Acorn Way, Monument, CO 80132, USA
Chair: Mark Yang
Aims: Training, Research and study
Confirmed Data
197
References
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Paulo: Thomson.
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vibrancy and dialogue. London: Routledge.
Besora, M.V. (1981). La psicología humanista: Historia, concepto y
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Besora, M.V. (1994). Las psicoterapias existenciales: Desarollo historico
y modalidades conceptuales. In Teixeira, J.A.C. (ed.), Fenomenologia
e psicologia. Lisboa: ISPA.
Cardinalli, I.E. (2012). Daseinsanalyse e esquizofrenia: Um estudo na
obra de Medard Boss. São Paulo: Editora Escuta.
Committee for Development Policy, & UN Department of Economic and
Social Affairs. (2008). Handbook on the least developed country
category: Inclusion, graduation and special support measures. New
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Cooper, M. (2003). Existential Therapies. London: Sage Publications.
Cooper, M. (2012). The Existential Counselling primer: A concise, accessible
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Correia, E.A., Cooper, M., & Berdondini, L. (2014). The worldwide
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Correia, E.A., Cooper, M., Berdondini, L., & Correia, K. (In press).
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main branches. Journal of Humanistic Psychology.
Deurzen, E. van. (2012). Existential Counselling & Psychotherapy in
Practice (3 ed.). London: Sage Publications.
Deurzen, E. van., & Adams, M. (2011). Skills in Existential Counselling
& Psychotherapy. London: Sage Publications.
Deurzen, E.van., & Arnold-Baker, C. (eds.). (2005). Existential Perspectives
on Human Issues: A handbook for therapeutic practice. Hampshire:
Palgrave Macmillan.
Deurzen, E. van., & Young, S. (Eds.). (2009). Existential Perspectives
on Supervision: Widening the horizon of psychotherapy and counselling.
Hampshire: Palgrave Macmillan.
du Plock, S., & Deurzen, E.van. (2015). The historical development and
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Erthal, T.C. (2010). Trilogia da Existência: Teoria e prática da psicoterapia
vivencial. Curitiba: Honoris Causa.
Feijoo, A.M.L. (2010). A Escuta e a Fala Em Psicoterapia: Uma proposta
fenomenológico-existencial. Rio de Janeiro: IFEN.
Feijoo, A. M. L. (2011). A existência para além do sujeito: A crise da
subjetividade moderna e suas repercussões para a possibilidade de
uma clínica psicológica com fundamentos fenomenológico-existenciais.
Rio de Janeiro: Via Verita.
Gómez, R. (Ed.). (2013). Relación Psicoterapéutica: Enfoque fenomenológico-
existencial. Lima: Universidad Garcilaso de la Vega.
Groth, M. (1999). The background of contemporary existential psychotherapy.
The Humanistic Psychologist, 27(1): 15-22.
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Psychology & Psychiatry, 25(1-3): 7-27.
Hoffman, L., Yang, M., Kaklauskas, F.J., & Chan, A. (2009). Existential
Psychology East-West. Colorado Springs: University of the Rockies.
Jacobsen, B. (2007). Invitation to Existential Psychology: A psychology
for the unique human being and its applications in therapy. Chichester:
John Wiley & Sons.
Martínez, Y. A. (2012a). Filosofía Existencial Para Terapeutas y Uno
Que Otro Curioso (4 ed.). México: Ediciones LAG.
Martínez, Y. A. (2012b). Psicoterapia Existencial. Teoría y práctica
relacional para un mundo post-Cartesiano. México: Diana Reyes Trigos.
Martínez, Y. A., & Signorelli, S. (2014). Breve repaso a la historia de la
psicoterapia existencial en latinoamérica. Revista LatinoAmericana de
Psicologia Existencial, 9: 38-40.
Martínez, Y.A., & Signorelli, S. (2015). Brief review of the history of
existential psychotherapy in Latin America. International Journal of
Psychotherapy, 19(1): 89-94.
Martínez, Y. A., & Signorelli, S. (eds.). (2011). Perspectivas en psicoterapia
existencial. Una mirada retrospectiva y actual. México: Ediciones
LAG.
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Fundación CAPAC.
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(4 ed.). São Paulo: Della Bídia Editora.
Romero, E. (2010). O Inquilino do Imaginário: Formas malogradas de
existência (4 ed.). São Paulo: Della Bídia Editora.
Rudio, F.V. (2001). Diálogo Maiêutico e Psicoterapia Existencial:
Uma reflexão sobre a teoria psicoterápica (2 ed.). São Paulo: Novos
Horizontes Editora.
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Sapienza, B. T. (2007). Do desabrigo à Confiança: Daseinsanalyse e

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A new era. In Schneider, K.J. (ed.), Existential-integrative psychotherapy:
Guideposts to the core of practice. New York: Routledge.
Schneider, K.J., & Krug, O.T. (2010). Existential-Humanistic Therapy.
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e psicopatologia fenomenológica. São Paulo: Editora Escuta.
200
BOOK REVIEWS
Next time you go somewhere there are a lot of people, shopping centre,
gig, club, football match, conference, look around and remind yourself
that everyone here, including you, no matter how well they look now will
in a comparatively short space of time start to fade, get weaker and most
probably endure considerable pain and probably humiliation, before they
die. So what do we do with this knowledge? Go for denial, the narcissistic
sense of specialness that pretends that it only happens to other, lesser
mortals. Being existentialists of course we know about all this. Or do
we? What do we really know? What can we know? We may know cognitively,
intellectually but what does it mean to really know it? The musician Wilko
Johnson knows about it and talks about the elation he felt when he discovered
he had terminal cancer. He said ‘Worrying about the future or regretting
the past is just a foolish waste of time. Of course we can’t all be threatened
with imminent death, but it probably takes that to knock a bit of sense
into our heads.’ Is this what is meant by existential maturity? Such things
are possible.
This issue we start with five books on this theme, two contemporary
and three old. The two contemporary are in the now familiar popular case
-study genre, by Yalom and Grosz, and the three old ones are by Seneca,
Bradatan and Epictetus and are a reminder of the value of returning to the
original texts. Age is not pathology. Following this we have a foray into
existential territory, being and doing, by two psychoanalytic writers. Being
and doing are embodied in the next book about the ever present issues of
love, sex and relationships, and this is followed by a necessary moment
of reflection. That is, on the nature of and value of research, which is about
when we ask ourselves how we know all this stuff, what makes us so sure.
Which brings us to the penultimate book, again from psychoanalysis and
is a reminder to remain open to all ideas and experiences. The final book
this issue is the 2nd edition of Spinelli’s influential book on existential
practice.
Martin Adams
Tales from psychotherapy in practice

On 2nd October 2015, David Taylor, Clinical Director at the Tavistock,
was interviewed on the BBC Radio 4 Today programme about the recently
announced outcome of a 10-year study into the efficacy of psychoanalytic
psychotherapy compared with UK/NHS NICE recommended treatments 1.
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Book Reviews
Asked to sum up what this kind of therapy involves he replied ‘it is not
passive…it is a joint endeavour by the patient and the therapist…and that
is to do with understanding the experience of [the patient] and finding
meaning in what is being experienced. Put on the spot to say something
succinct and understandable in a few seconds, I thought this was an inspired
summary of what we do as psychotherapists.
The two books reviewed here, one by an existential psychotherapist the
other by a psychoanalytic psychotherapist, are both about that search for
understanding and meaning in our work with clients. Both talk about how
often we are left with not knowing if or how we have helped and the
nagging feeling we could have done better if only we knew what that was.
Creatures Of A Day
Irvin D. Yalom (2014). London: Piatkus.
Now in his golden years (his description) Yalom has lost none of his
touch as a writer, teacher and therapist. I enjoyed this book as much as
any of his earlier case-history compilations.
Over 10 chapters consisting mainly of dialogue with occasional, minimal
commentary about his private thoughts and concerns, he allows the stories
to tell themselves. These all show clients grappling with existential issues
that require from the therapist a humanistic, holistic approach and the
flexibility to identify and adapt to the client’s needs.
There is only a glancing reference to theory in the Afterword, where he
says he hopes this book will be helpful to novice therapists in counteracting
the prevailing trend toward therapies which consist of ‘highly specific
techniques addressing discrete diagnostic categories’ (p 210). So definitely
not a ‘one size fits all’ or ‘how to’ manual.
The book is potentially useful to any therapist as well as the lay reader.
I certainly found it immediately helpful in suggesting ideas to keep in
mind with some of my current clients. Best of all though for me was reading
about where he breaks the rules and where he messes up – white-knuckle
rides, pratfalls and all.
He illustrates repeatedly that we may never know how we have helped
someone and that we must learn to live with the mystery. Being Yalom he
also constantly reminds, through modeling in the dialogue sections, the
value of using the ‘here and now’, checking in with the client about the
state of their relationship.
Like me he enjoys and encourages a playful relationship with clients
and I appreciated his examples showing how this can enliven therapy,
making it more real and present, allowing the client to speak truth. For
example, at a break in a heavy talk about us all being on the path to death,
he asks the client how she’s doing and she replies ‘a few more healing
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Book Reviews
sessions like this and I’ll need to go home by ambulance!’ (p 49).

Then there are incidents of rule breaking where I’m thinking ‘Oh, no you
didn’t really do that?!’. Such as pressuring a client named Alvin into agreeing
to a home visit in order to discover what was preventing him from allowing
people into his life. This was decades before reality TV shows about extreme
horders and what Yalom found there shocked him. Alvin stopped therapy
abruptly and Yalom was sure he had messed up badly. Then 30 years later
they met (Alvin now happily married with a grown-up family) at the funeral
of a woman called Molly, a household organiser. Yalom had forgotten that
after the final session he had phoned to suggest contacting Molly to sort out
the mess. Now he was told, by a very grateful Alvin, that their sessions and
Molly’s ministrations had turned his life around. Yalom was left with his
mind swirling with thoughts ‘about the impossibility of ever learning how
psychotherapy works’ (p 80). Yes, indeed!
The book title comes from The Meditations of Marcus Aurelius, a second
century Roman emperor, who dictated daily his reflections on how to live
a virtuous life. During a session Yalom quoted from this book and suggested
the client might read it, while muttering to himself that he knows such
suggestions are seldom helpful and often a bad idea. It did nearly backfire
with this client who liked to retreat from the difficulty of the matters in
hand by engaging in theoretical dialogue. But finally he did become inspired
by The Meditations and resolved to make changes, saying ‘every morning
he [Marcus Aurelius] took himself more seriously than I have ever done
any morning in my entire life’ (p 204).
The Examined Life: How We Lose and Find Ourselves

Stephen Grosz (2014). London: Vintage.
Grosz, an American who trained in London, has worked here as a psychoanalyst
for 25 years. In the same number of pages as Yalom, he publishes 31
‘episodes’ covering a wide range of issues including change, loss and
alienation from self. His presentation style is the mirror of Yalom’s in
that his ratio of dialogue to commentary is about 20/80, with much shorter
but still satisfying case histories describing the understanding gained
through the to and fro of client/therapist conversation.
Like Yalom he doesn’t refer explicitly to theory or diagnostic categories,
rather each story illustrates individuals with unique histories and reasons
for how they are now. He says he was gripped early in his career with the
idea that we can become disconnected from ourselves, something he
discovered initially about himself during training therapy and finds here
with some of his patients.
Grosz also makes occasional references to a book or quotation prompted
by something in the client’s story. One which caught my imagination being
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Book Reviews
the short story of Bartleby by Herman Melville first published in 1853

(page 126). With the unwitting collusion of his over-caring employer,
Bartleby gradually stops working and gives up all effort and responsibility
for himself. He increasingly responds to entreaties to action with ‘I would
prefer not to’ while his employer becomes increasingly anxious for him.
Eventually, he even prefers not to eat and dies of self starvation. For Grosz
it’s a gripping illustration of how if someone else takes responsibility for
our anxiety they risk taking away our motivation for change. This story
also illustrates something we all experience when two competing inner
voices say ‘let’s do it now’ and yet ‘I would prefer not to’. Such procrastination
may be about something vitally important to explore, as happened with
Grosz’s client in this episode.
I particularly appreciated Grosz’s penultimate episode where he challenges
the notion of bereavement closure and ‘the tyranny of shoulds’ (p 208)
derived from the proliferation of self-help books. This so often causes the
bereaved person to suffer more because they’re stuck on the idea of closure,
which mostly doesn’t happen. He points out that Kubler-Ross’s grief stages
were originally about the process of dying, only later becoming the inspiration
for the widespread notion that we can permanently end our sorrow while
we continue to live. This idea has taken hold even though we know it
seldom accords with our experience of bereavement. We have the possibility
to suffer the pain of loss repeatedly until we die. It may return less frequently
but can still be as raw (or more raw) when it returns, often unbidden like
a thief in the night. And it can change, as for example when we are old
and feel deeply sad in a different way for someone who died tragically
when they were young. I find clients are hugely relieved when I suggest
this alternative view of bereavement and encourage them to accept the
loss into their life story – making it ‘mine’ – written deep inside for ever
like Blackpool rock.
In his final episode Grosz talks about remembering long gone patients
and yearning to reach out to them, to say one more thing, to get it right
this time. I know that feeling!
In conclusion, I enjoyed both books and recommend them for anyone
doing psychotherapy, whether psychodynamic or existential. They relate
recognisable tales of the everyday situations we encounter with clients
and our struggles to help them. Both writers discuss things they have found
bothersome which is always interesting and instructive. Neither focuses
on theoretical framework, they use simple everyday language which is a
good model in itself. What came across for me was their passion and
commitment to being as good a therapist as possible for each client, and
their wisdom in acknowledging we never really know what that means.
Their presentation styles are different, such as their choice of dialogue/
commentary splits. So that Yalom’s longer and dialogical chapters provide
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Book Reviews
exemplars for therapeutic practice whereas Grosz’s brief episodes encapsulate

and make memorable insights into a wide range of typical client dilemmas.
Both approaches have their merits. Most importantly, these books worked
for me in stimulating reflection on my way of working and development
of my internal supervisor, which I think is the main purpose of this genre.
Notes
1
Details about this study are available on the internet : ‘Adult depression
study (TADS) | Tavistock and Portman’; and ‘Pragmatic randomized
controlled trial of long-term psychoanalytic psychotherapy for treatment-
resistant depression: the Tavistock Adult Depression Study (TADS) -
Fonagy - 2015 - World Psychiatry - Wiley Online Library’
Diana Pringle
Hardship & Happiness

Lucius Annaeus Seneca (2014). Chicago: The University of
Chicago Press.
Stoicism appears to be having a major resurgence at the beginning of the
21st Century. Three authors still celebrated today are Lucius Anneus
Seneca, Epictetus and Marcus Aurelius. Like their Hellenistic predecessors,
these three Roman stoics concentrated on developing concrete, therapeutic
philosophies about daily behaviour and suffering. Today, it is widely
accepted that some of the ancient stoic remedies for emotional problems
bear a resemblance to Rational Emotive Behaviour Therapy and Cognitive
Therapy. Thus, Albert Ellis and Aaron Beck both took explicit inspiration
from stoic philosophy. However, in some ways the roman stoics are closer
to existential therapy and existential philosophy. This similarity is evident
in Hardship & Happiness, which collects a range of essays by Seneca
intended to instruct on how to achieve happiness or tranquility in the face
of a difficult world.
Stoicism is born between an old foreseeable world falling apart and a
new multicultural mass society, the empire of Alexander the Great and the
Roman Empire. Stoic philosophy takes off because it offers human flourishing
and security in a time of existential alienation and rootlessness. It is a
practical and therapeutic teaching aimed at freeing human being from
worries and suffering due to irrational emotions. We can have a life that
truly involves flourishing if we free ourselves from externals beyond our
control and concentrate on the moral and existential aspects of life that lie
within our control. Furthermore, if we have a reflective relation to our
feelings, we can avoid being affectionate and led away from ourselves. If
you lose it, you lose! Similar to the early Greek stoics, the later Stoics of
Roman Imperial times, Seneca, Epictetus and Aurelius, therefore idealize
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Book Reviews
the stoic sage who has gained insight into life and is immune to misfortune.
The question that dominates the essays in Hardship & Happiness is how
an individual can achieve a good life in hard times. The book begins with
three essays that offers consolation to three people who are bereaved. In
Seneca’s time, consolation had become a special literary genre, drawing
on philosophy and rhetoric to present a therapeutic programme. According
to Seneca, grief with the death of a loved one is the product of false beliefs
about death and its effects on the deceased. Since the soul survives, the
deceased person is better off dead than alive. One should also not grieve
over someone who lives in social or existential exile. Because the masses
are themselves estranged from truth. Our everyday involvements and
distractions in mass society do tend to represent a worse kind of alienation.
Seneca rather encourages us to detach ourselves from vulnerability to
external circumstances and look within ourselves. However, this is not an
easy task. Seneca is almost similar to Friedrich Nietzsche, Albert Camus
and Emmy van Deurzen in his way of portraying existential and moral
progress as an arduous struggle.
Seneca wrote the fourth essay On the Shortness of Life after returning
from his own exile in the year 49. Long before Martin Heidegger published
Being and Time, Seneca reflects on how we experience and use the vital
time that makes up our life towards death. Our existential freedom depends
on our mastery over time, which involves that full living comes from
training to death. Thus, stoicism is an art of living based on living in the
here and now, and by promoting an intolerance of time wasted through
submission to comfort or vices, procrastination or meaningless engagement
in trivial pursuits. Seneca’s On Leisure tell us how the philosopher must
remain active throughout his whole life. However, he or she may find it
suitable to do this by withdrawing from the pervasiveness of everyday
social conflicts and unrest.
The essay On the Constancy of the Wise Person elaborates on the principle
that a good life does not depend on good fortune or social status. What
matters to the wise person is mental freedom with a personal autonomy
grounded in reason and virtue. He or she will be able to endure the injuries
and insults of everyday society. Seneca’s On Tranquility of Mind likewise
has some similarities with existential therapy. The essay proposes a cure
for someone’s mental suffering from an inner conflict between personal
values and outsiders’ values. We are able to achieve calmness of the soul
by engaging in society but freeing ourselves from exterior disturbance and
pursuit of wealth and property.
Unlike the rest of the essays, On the Happy Life focuses on how to live
a good life in times of good fortune. Seneca refutes that pleasure and
wealth are the highest good, but he also states that the wise person does
not need to reject these. The final essay On Providence shows that misfortune
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in life is not necessarily something bad. In a more spiritual or religious

perspective, Seneca explains that misfortunes have a teaching purpose as
moral lessons. They are Gods way of testing and training us to be as good
and outstanding as we can be. By enduring misfortune, we learn to be
ourselves and we gain capabilities for living. Thus, Seneca agrees with
most modern existential theory that we are able to convert painful events
in life into self-knowledge and abilities to do well to others.
Hardship & Happiness has an obvious relevance to existential analysis.
Seneca’s therapeutic philosophy probably has the greatest similarity to
van Deurzen’s existential approach. They both insist on combining ethics
and therapy into an art of living. However, Seneca’s experiential approach
to existential issues relates to a wide range of existential authors. In recent
years, The University of Chicago Press has republished many works by
Seneca. I hope that this effort will influence the existential community.
Dying for Ideas. The Dangerous Lives of the Philosophers

Costica Bradatan (2015). London & New York: Bloomsbury.
French philosopher Albert Camus begins his book The Myth of Sisyphus
from 1942 with the famous proclamation that there is only but one truly
philosophical problem and that is suicide. Suicide is the confession that
life is not worth living, and to Camus the fundamental question is whether
this confession must follow the realization that existence is absurd. The
teachings of the book Dying for Ideas from 2015 by American philosopher
Costica Bradatan seems to be a reversal of Camus’ problem. Following
Bradatan, we need to rephrase the most serious problem for a true philosopher:
What is worth dying for? To me, this also seems to be a fundamental
existential question in our current western culture, preoccupied with
individual wellbeing and happy endings. Camus actually embodies this
issue being a resistance fighter in World War II. Yet, the question remains
whether the rest of us have anything to die for in the 21st century, and
whether the artificiality of most academic philosophy might be reflecting
this shortcoming.
Bradatan actually forms part of a new way of perceiving philosophy
that relates closely to the existential tradition. At the end of the 1970’s and
the beginning of the 1980’s, French philosophers Pierre Hadot and Michel
Foucault advocated a reinvention of philosophy as an existential art of
living. Hadot and Foucault argued that originally, Greek and Roman
philosophy was a therapeutic form of life, very different from current
mainstream academic philosophy. From Socrates to Marcus Aurelius this
art of living seemed to focus on transforming and reinventing peoples’
selves and lives around the notion of a training to death. Bradatan expands
this notion by following the martyr-philosophers from Socrates to Jan
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Patočka who chose to die for their ideas. Books on philosophy are rarely
page-turners, but Bradatan takes us through a fascinating exploration of
the existential limit-situation in which philosophers find themselves when
their only means of communicating the truth is their own dying bodies
and the public spectacle of their death.
To ancient philosophers, as well as some modern ones like Michel de
Montaigne, Friedrich Nietzsche, Simone Weil and Patočka, philosophy is
something that engages the whole of existence in order to conduct one’s
life in a resilient and truthful way. Even though I found it rather strange
that Bradatan never mentions Søren Kierkegaard, he manages to make his
point. We can only validate a philosophy to the extent that it is embodied
in the philosophers’ life, and talk is cheap unless it is put into action. Long
before his engagement with ancient philosophy, Foucault declared the
death of the author in the 1960s. However, in this new tradition of reinvented
philosophy, the philosopher’s own biography becomes highly relevant,
because we need to seek consistency between action and discourse. From
this perspective, German philosopher Martin Heidegger’s engagement with
National Socialism speaks for itself. There is no way of separating the
evaluation of Heidegger’s writings from the evaluation of his engagement
with the Third Reich or the fact that Heidegger dreamt of becoming a
philosopher-king for the Nazis.
Bradatans book is fundamentally about the relationship between death
and philosophy, and the author portrays two layers of this relationship.
The first layer regards the existential role of death to philosophy, as death
has always been a basic philosophical problem. French philosopher Montaigne
plays the main role in this part of the book that shows how to philosophize
is to learn how to die. The Platonics, the Epicurians, the Cynics and the
Stoics were the first to show us how the true philosopher is an apprentice
to death, and probably Irvin Yalom is the most direct successor of this idea
within existential therapy. Yaloms book Staring at the Sun: Overcoming
the Dread of Death from 2008 was highly inspired by ancient Greek
philosopher Epicurus in its existential perspective on death and dying. If
we do not confront death, we are not able to live. In addition, as Roman
philosopher Marcus Aurelius stated: it is not death that a man should fear,
but he should fear never beginning to live.
Existential phenomenology in the tradition of Heidegger and Maurice
Merleau-Ponty show us how our mental life presupposes our being in the
world as embodied agents. In an intermediate chapter, Bradatan describes
how the martyr-philosophers take the idea of embodiment to a far more
radical level. Whereas Nietzsche talked about breaking the idols, the martyr-
philosophers break themselves by letting their dying body become the
existential means for their philosophy. While Austrian existential therapist
Viktor E. Frankl stated that even in Auschwitz, you have a freedom of
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mind, Italian philosopher Giordano Bruno showed us that even though

you are being burned alive, as long as you can turn your face away from
your executioners and their symbols, you have all the freedom you need.
We can overcome our mortality and instinctive fear by taking care of our
soul and cut our selves off from the profane world. According to Bradatan,
this is the true meaning of the word ‘sacred’. Thus, through philosophy,
we may learn to detach ourselves from the superficiality of mass society,
and this makes death less terrifying. This insight looks almost like the
existential idea of freeing oneself from inauthenticity and thereby gaining
more orientation and purpose in life.
The second layer points to the world as an existential prison. The true
philosopher has an urge to speak the truth even though it makes people
uncomfortable. In times of crisis, this means that society has a tendency
to turn against the philosophers. The authorities make the philosophers
scapegoats in order to regain order and comfortability. The philosophers
then find themselves in the situation where they either can abandon their
ideas or die for them, which is the choice of the true philosopher. However,
the task of the philosopher is to make his or her death into a public display
so that he or she turns dying into a means of communicating truth.
Traditionally, existential therapy takes inspiration from modern existential
philosophy and phenomenology. In recent years, Emmy van Deurzen and
Irvin Yalom have pointed out that existential therapy could also benefit
from the insights of older philosophy. Bradatans book seems to be a book
on death and dying, but is shows us that dealing with these issues are a
gateway to dealing with life and living. The martyr-philosophers may serve
as role models that grasped a fundamental aspect of daring to live fully.
What does really make life worth living and thus worth dying for? This
problem is the core of philosophy as a therapeutic practice aimed at freeing
us from the worries and sufferings that come from feelings of emptiness
and meaninglessness.
Anders Draeby Soerensen
Discourses, Fragments, Handbook

Epictetus (2014). Oxford: Oxford University Press.
Born around the year 50 and raised a slave in the Roman Empire, Epictetus
was not destined to become an influential philosopher. His thoughts,
however, have been widely read and they have proven to be sustainable
through 2000 years. Recently, Oxford University Press has chosen to
publish the only complete modern translation of Epictetus’ Diatribai or
Discourses, together with the Enchiridion or Handbook, and surviving
fragments. Robin Hard’s accurate and accessible translation is an absolute
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must have for anyone working in the field between philosophy and therapy.
Why does Epictetus’ teaching appear as the most important existential
philosophy of the Roman Empire, and why has it remained popular until
today? One way of answering that question is through the story of American
officer James Stockdale, whose plane was shot down over Vietnam in
1965. Stockdale was held as a prisoner of war for seven and a half years.
In 1959, the U.S. Navy had sent Stockdale to Stanford University, where
he not only received a Master’s degree in international relations and
comparative Marxist thought, but also studied Epictetus’ Enchiridion
intensively. Stockdale was released as a prisoner of war on the 12th of
February 1973, and he later credited Epictetus’ philosophy for helping him
cope as a prisoner of war. Stockdale described his coping strategy during
his period in the Vietnamese POW camp with these words: ‘You must
never confuse faith that you will prevail in the end – which you can never
afford to lose – with the discipline to confront the most brutal facts of your
current reality, whatever they might be’ (Collins, 2001: p 83).
The philosophy of Epictetus is exactly based on the lived experience of
captivity. It is similar to famous existential psychotherapist and holocaust
survivor Viktor Frankl’s experience in Man’s Search for Meaning (1959),
describing his experiences as a concentration camp inmate during World
War II, and explaining how the way the prisoners imagine their future
affects their longevity. In the year 69, Epictetus was freed from physical
slavery, and the rest of his life he taught his students how to free themselves
from existential slavery, caused by dependence on passions and external
things like material goods and social status. In other words, the experience
of existential freedom is at the heart of Epictetus’ teachings that perceive
philosophy as a way of life and not just a theoretical discipline. In accordance
with prevalent Hellenistic and Roman ideas, Epictetus understood philosophy
as a form of therapy, practiced as an art of living. Thus, philosophy is an
attitude and lifestyle, which engages the whole of existence. Epictetus
taught this art of living in his philosophy school in Rome, and as he states
in Discourses: ‘A philosopher’s school, man, is a doctor’s surgery’ (Discourses,
3.23.30). In other words, his philosophy school was a clinic for the soul
that people came to for a period to be treated for the passions and existential
problems from which they suffered. Philosophy thus appears, primarily,
as a therapeutic of the passions and existential challenges.
Epictetus himself apparently wrote nothing down. His teachings were
written down and published by his pupil Arrian. In Epictetus’ view, philosophy
did not consist in exegesis of texts or in teaching of abstract theories. Philosophy
was an experiential practice, which was orally transmitted, and its task was
to educate people who lacked proper training in the art of living.
To Epictetus, the basic principle of living well consisted in the insight
that ‘some things are within our power, while others are not’ (Handbook,
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1.1). Peoples’ existential suffering are caused by irrational beliefs, stemming

from erroneous efforts to control or figure out matters that are beyond our
power. This involves everything that is not of our own doing, like property,
reputation, office and other people’s minds. Any delusion on this point
leads the slavery of the soul. Therefore, the philosophy students must learn
to accept the things they cannot change. Human flourishing, eudaimonia,
is to live from a good spirit, and its achievement also requires that one
learns to control what is within our power, which involves everything that
is of our own doing, like our opinion, motivation and desire. Therefore,
the philosophy students must learn the courage to change the things they
can. This means becoming a better person and benefit others. In 1937,
American theologian Reinhold Niebuhr adopted this ethical principle and
authored the Serenity Prayer, made popular by Alcoholics Anonymous:
God, grant me the serenity to accept the things I cannot change,
The courage to change the things I can,
And the wisdom to know the difference
(Niehbur, 1987: p 241)
To Epictetus, existential slavery and suffering was essentially a result
of bad education, and therefore therapy involved a corrective education
for people who were not able to conform to the norms and conventions of
society. However, the goal of therapy was not to readjust students – or
clients – to the prevalent values and ideals of culture. Rather, therapy
aimed at teaching the students how to live independently in society, and
therefore they had to unlearn everything they previously knew about life.
The philosophy school, then, considered listening as the first step in the
learning of true discourse, which would enable the students to take in logos
and gain some sense in their lives.
Therapy did not consist in simply teaching the students some skills or
competencies. Instead, therapy should raise the students from an inauthentic
and darkened condition of life to an authentic and enlightened way of
living. In other words, therapy aimed at a spiritual awakening that should
completely transform the lives and selves of the students. To learn to accept
what is not of our own doing means to surrender part of our will to God,
and the result of therapy would be that students know their place in the
universe. In the end, what is beyond our power is the fact that one day we
must die and become recycled in nature. Instead of fearing this moment,
therapy trains the student to death by teaching them to let go of everything
which is unnecessary for living well.
To me, reading Epictetus was an eye-opening experience. His teachings
are forceful and challenging, comparable to the very best of contemporary
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writings on existential philosophy and psychotherapy. Even though Discourses

and Handbook have been amongst the most widely read and influential of
all philosophical writings on therapy, they have never directly influenced
modern existential therapy. However, they not only speak to modern readers
seeking meaning in their own lives. The texts are also highly relevant to
existential therapists looking for profound insights into ways of dealing
with clients’ experience of suffering and existential captivity. I can highly
recommend everyone in the existential community to read the new translation
of Discourses and Handbook.
References
Collins, J. (2001). Good To Treat. New York: HarperCollins.
Frankl, V. E. (1959). Man’s Search For Meaning. Boston: Beacon Press.
Niebuhr, R. (1987). The Essential Reinhold Niebuhr: Selected Essays and
Addresses. New Haven: Yale University Press
Anders Draeby Soerensen
Being and Relating in Psychotherapy

Ontology and Therapeutic Practice
Christine Driver, Stephen Crawford & John Stewart (eds.) (2013).
London: Palgrave Macmillan.
This book is an attempt at widening the lens of contemporary psychodynamic
psychotherapeutic practice with its psychoanalytic foundations to considerations
of what it means to be human in a wider context of life. Thus, the various
authors consider not only the intrapsychic (drives, instinct, conflict and
tensions within) but also pay attention to the relationship and situate it within
the wider connections and influences of both the social and the cultural.
It is structured in three different parts, the first part looks at the therapeutic
relationship per se by considering briefly ontology, the healing aspect of the
therapeutic relationship, considerations on the ‘talking cure’ and what might
be going on when clients ‘refuse’ to speak, and an introduction into Buber’s
concept of the I-Thou. The second part explores themes such as love, shame,
loneliness and mortality. And finally, in the third part the net is cast wider
into social and cultural dynamics by considering the nature of the self,
diversity, sexuality, the artist in psychotherapy, religion and time.
The majority of the authors of this book have an association with the
WPF (the Westminster Pastoral Foundation), a charity that came into
existence in the late 1960s within the Methodist Church, as a way of
supporting the community and pastoral work with the insights of psychotherapy,
the psychodynamic and psychoanalytic in particular. It has become a provider
for psychodynamic counselling, therapy and training and most authors of
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the chapters have been or are involved with WPF in the capacity of a
training or supervisory role. It is not made clear in the book as to why
there is this link between the authors and the training institution leaving
the reader wondering about that.
To consider ontological questions invariably requires an attitude of
openness that allows for those fundamental questions about our way of
being and relating both in and outside of the therapeutic sphere to unfold.
This is challenging because it looks at what it means to be alive, what it
means to exist, what existence is, who does the existing and how this being
that exists can reflect on itself and its own way of being. The question as
to how to approach an understanding of human existence inevitably becomes
also a question about methodology. How best do we arrive at an understanding
of ontological questions?
Psychodynamic theory and the psychoanalytic body of thought in general
rely on an interpretative method in order to make sense of client material.
The theory takes centre stage and presentations of problems, or conflicts,
which form a central idea, are relayed back to the theory, thus representing
a closed, rather than an open, system.
Psychoanalytic theory has been hugely influential in the field of human
psychology and in therapeutic practice. It began with Freud at the end of
the 19th century, who developed both theory and treatment methods and
branched out into a wide array of models, such as Jungian psychology,
ego psychology, object relations theory, Kleinianism, post-Kleinianism,
Winnicottism, self-psychology which amounts to a babel tower of orientations
(Rycroft, 1995). Most of the authors seemed to be influenced by many of
these and largely denote a moving away from the solely intrapsychic, to
the interrelational and spiritual realms of being.
One could say that all psychotherapeutic practices of today took Freud
as the starting point and developed into their own systems of thought.
There is no doubt that the drama of being born, of having to go through
developmental stages that necessarily involve separation, therefore loss
and pain, the utter helplessness of the infant in its dependency on a good
enough carer/mother is certainly a powerful thing and Freud’s writings,
and subsequent thinkers like Melanie Klein or Donald Winnicott have
captured people’s experiences and their imagination, giving words to the
dramatic conflicts of being that are universal. All humans are born, and
there is a universal need to be loved and to be seen, and to be able to
express oneself in one’s own right.
How we understand this drama of living and being, what we make of it
in a wider context of social and cultural forces is clearly a complicated
matter. In reading the book I was struggling with feeling a connection
between the psychodynamic and analytic theory and the ontological questions
it was attempting to ask. In a sense it felt that the intrapsychic level of
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enquiry was ever so present, with the interrelational and social taken as a
given, without an unpacking of language or terminology. The relational
world and the interconnection of beings in context is taken as a given in
the existential body of thought and this is clearly more of a challenging
leap to make from a psychodynamic model.
The chosen structure of the book was not helping. It might have been
useful to start off with Chapter 10, an Exploration into the Nature of the
Self, rather than have it in the third part of the book alongside for example
Chapter 13, The Artist’s Fear of the Psychotherapist, where the title already
alerts the reader that this is not tackling an ontological question but rather
works on the premise of an assumption.
In fact the lack of clarity in structure and the place of ontological questions
could be seen as evidence for an epistemological crisis of the authors.
How do they know? Are they trying to get to an objective truth – or is
truth subjective? Human nature and understanding of human existence
continues to be a conundrum both within philosophy and psychology.
There are ongoing debates around whether there is something that exists
or comes before existence or whether existence precedes essence as Sartre
claimed. We have by all means not arrived at a full understanding yet of
this complex state of affairs.
Lets look then at some chapters in the book, in no particular order, and I
will start with Chapter 10 that explores questions about the nature of the
self. Some examples and ideas around the nature of self evoked in the reading
of this chapter are that it encompasses both body and mind, is a totality of
being, is constructed, is relational, is viewed and imagined through the eyes
of the other, can be altered by brain damage, by mood, is evident through
behaviour, posture, way of talking, appearance, who we are surrounded by,
our roles, and outward changes require an assimilation to an inward sense
of self, or perhaps the other way round, and that there is a sense of a cosmic
self in the face of death and the awe of the unknown of existence.
The Healing Relationship in Chapter 2 takes the starting point of self,
perhaps of life even, as originating and unfolding in the relationship between
mother/primary carer and child. Attachment theory and neuroscience is
taken as a given and seen as providing evidence that this first relationship
is crucial in influencing negatively or positively the development of the
infant into adulthood. Is it possible to question this premise? Is it possible
that in this complex web of relationships and existence it is the primary
relationship alone that makes or breaks a person’s development? Attachment
theory has been criticised for putting undue blame and responsibility on
the mother, yet strangely the mother seems to take a subordinated place
in psychoanalytic thought.
Chapter 12 offers an important challenge to the male-centric and phallus
oriented world-view of psychoanalytic thought where the female is subordinated
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and seen as lacking in the possession and the power of the penis, where
both the female and the male have to identify with the father to resolve
inner conflicts of sexual nature, which are at the basis of human development
and intentions. An interesting body of thought is presented drawing on the
French Feminist, philosopher, linguist, psychoanalyst and cultural theorist
Luce Irigaray (born 1930) who ‘insists that a self-reflective psychoanalysis
needs to be able to situate itself historically, accept its limitations and
articulate a subjectivity which is both embedded and embodied within
history and culture’ (Greally, p 150). Irigaray starts from the fact that all
human beings have been born from a mother, a fact that has been denied
in psychoanalysis and amounts to symbolic matricide and misogyny. Women’s
and mother’s subjectivity is denied and Irigaray warns against the danger
of normative presumptions leading to clinical impasses.
Even though the feminist movement has come a long way, as a society
we still struggle to accept and understand difference and discrimination
whether based on gender, race, sexuality, age or religion. The author of
Chapter 11 discusses diversity and argues that psychoanalysis has rejected
Freud’s liberal stance on homosexuality and has remained to this day quite
homophobic because of its reliance on the Oedipal complex theory. The
idea being that homosexuality or transgender or non-binary identifications
are due to an unresolved conflict in the Oedipal phase. The author argues
that remaining in an intrapersonal stance risks objectifying the client. By
contrast moving into an intersubjective and relational stance, by paying
attention to the experience between and within people, whilst exposing
both the therapist and client to the perils of uncertainty and uncomfortable
feelings, opens up the possibility of an interesting creative co-creation.
I like the conclusion of this chapter, which leaves me with a sense of
openness and possibility, which stands as a counterpoint to this sense that
the psychoanalytic central idea of internal conflicts, that have to be overcome
and resolved, leaves little room for the possibility of an experience of self
in relation to an other that is not suffused with conflict. Sometimes connecting
to another feels cooperative, feels like something flows, feels inspirational
and opens up questions about other ways and possibilities of being.
The possibility of such an encounter gets picked up in Chapter 4 where
Buber’s philosophy is looked at, which situates people and their way of
being necessarily in relationship and not in isolation, from a relationship
to the natural world, to that between people where spoken language inevitably
is part of the encounter, to a connection to the spirit world, which does
not necessitate language but connects in the form of creating, thinking and
acting with our being. Healing in Buber’s context happens in the encounter
where the other is appreciated as a whole and not treated as a part or an
object (I-it). The author in this chapter is not sure that such an encounter
is possible but can be aspired to in the therapeutic encounter. The I-thou
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encounter seems possible to me, but it is not a permanent state of affairs.

The second part of the book, entitled the Personal and the Interpersonal,
looks at various topics of great importance in relation to both therapy and
life. It felt hard to contain the ins and outs of those themes within one
chapter alone. Generosity, love, shame, loneliness, mortality from a
psychodynamic perspective seemed to be first and foremost situated as
intrapsychic, and then interpersonal conflicts that need to be resolved first
in order to arrive at a stage of maturity or greater freedom, and their
experience as a given of existence did not come across easily. There was
little discussion of these themes as existential givens. Mortality is the one
thing that can’t be resolved, and the authors suggest needs to be fully
engaged with, in an embodied and authentic way. I agree, but how do we
do that? How can we face the terror of death? And for some death does
not represent terror.
Some people feel a deep religious or spiritual connection to something
bigger than themselves and this faith pulls them through the most distressing
and harrowing experiences. They feel it gives them a meaning that goes
beyond cruelty and helps them to be loving and generous to others around
them. Religious values, the denial of it by Freud and still some psychoanalytic
thinkers, gets tackled in Chapter 4 and the author argues for its value as
giving the believer an ethical outlook on life. The author also rightly points
out the long history of some religions, in this case Buddhism, and how
they have over millennia led people to think deeply about existence and
ethical matters. To deny this seems a little careless.
The authors’ and the WPF’s attempt at bringing ontological questions
into the realm of psychotherapeutic theory and practice is commendable,
but I wonder whether psychoanalytic theory as a whole necessarily fails
in that attempt, because of its deterministic and positivistic outlook on
human experience. This stands in direct contrast to a constructivist outlook
of existential therapy and philosophy, where the experience of being and
existing is created and constructed in the relationship.
The existential-phenomenological body of thought attempts to apprehend
human existence in an as wide and open way as possible. In the realm of
psychiatry, Ludwig Binswanger and Medard Boss were both associated
with Freud or closely following his line of thought but incorporating
philosophical ideas, those of Martin Heidegger in particular. The resulting
body of thought, Daseinsanalysis, as well as later writings within the radical
psychiatry of R.D. Laing, were attempts at encountering the human being
and their existence in an intersubjective world of being and as a totality
of being in its embodied form that is in a continuous process of becoming.
The client’s understanding of their existence is central and challenges
diagnostic labels and interpretative reasoning. A careful encountering of
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the other through the method of phenomenological enquiry, which endeavours

to describe phenomena as they arise in the relationship, by trying to leave
assumptions aside as much as possible and piece information together,
with no hierarchical imposition, to arrive at an as close understanding as
possible of any given experience and the associated world-views.
The way a person experiences themselves and their world can be mapped
onto four dimensions of life, which can serve as a guide of enquiry within
psychotherapy (van Deurzen-Smith, E., and Young, S., 2009); the physical
(Umwelt), the social (Mitwelt), the psychological (Eigenwelt) and the
Spiritual (Überwelt). In response to the questions around the nature of the
self of Chapter 10, I feel that these four dimensions can also be seen as
senses of self that are developing, emerging and interacting with others
and the outside world in different ways. The dimensions also give a framework
onto which the psychoanalytic body of thought can be mapped, where for
example the idea of the instincts and drives belong to the physical dimension,
or internal conflict on the psychological dimension, leaving still space for
other experiences and senses to be examined and understood on the other
dimensions such as the social and the spiritual.
The book was a frustrating read and I feel that it has not managed to
open up to ontological questions. The overall flavour of the book felt like
a community that by and large struggles to free itself from the shackles of
its own paradigm. The book perhaps is relevant to readers training at WPF
or prospective trainees wishing to embark on training in this model. A
better way of approaching this project might have been to enter into a
dialogue with existential philosophy beyond Martin Buber, and to consider
ideas from contemporary existential psychotherapists such as Yalom, Spinelli
and van Deurzen. A dialogue between psychoanalysis and existential
philosophy/therapy is possible, but necessitates openness and a willingness
to be with questions that have the potential to dismantle firmly held beliefs,
on both sides, and a desire to enter the creative realm of intersubjective
truth-finding that opens the space up to how living and being is experienced
without excluding an approaching of the why it may be so.
To find a framework that does justice to the complexity of human experience
is important and on a larger scale will continue to be debated. The funding
of therapy and the understanding of human suffering and dilemmas depends
on that and in the long run becomes a crucial project since the well-being
of people, or the lack thereof, is costing humanity and the health of this
planet a great deal. Perhaps we have reached a point in history where it is
time to lay to rest rivalries and competitions between psychotherapeutic
approaches, to enter into the realm of dialogue and sharing in order to find
a paradigm that assists the understanding of ever evolving ways of being
human in today’s world.
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References
Greally, B. (2013) Sexuality and Therapeutic Practice, in Being and
Relating in Psychotherapy, Ontology and Therapeutic Practice. London:
Palgrave Macmillan.
Rycroft, C. (1995). A Critical Dictionary of Psychoanalysis. London:
Penguin Books.
van Deurzen, E., & Young, S. (2009). Existential Perspectives on Supervision,
Widening the Horizon of Psychotherapy and Counselling. London:
Palgrave Macmillan.
Sara Angelini
Rewriting the Rules: An Integrative Guide to Love,

Sex and Relationships
Meg Barker. (2013). East Sussex & New York: Routledge.
We are in a state of uncertainty about relationships.

I had the pleasure of meeting Meg Barker at the 2010 Sexistential Conference
in London. We shared a short conversation after a presentation about
uncertainty in modern constructed relationships. Barker contrasted certain
‘solutions’ to relational, sexual or love struggles with engaging with
uncertainty in relationships. Barker mentioned the need to ask better
questions and to be curious about our sexual relations and love.
Three years later I had the pleasure of picking up Rewriting the Rules.
I was excited to see where three years of work on this idea had taken
Barker. The title was a bit concerning however. “An Integrative Guide.”
I wondered if this was another book offering me answers. Was Barker
pedalling a concrete methodology or specific processes designed to get
me to certainty?
Thankfully, Barker’s opening line shattered my concerns.
‘We are in a state of uncertainty about relationships.’ A bold opening
statement. Barker states explicitly early on that Rewriting the Rules is an
anti-self-help book. This book does not contain suggestions, ideas, solutions
or new rules to make readers’ love life, sex life or relationships better.
Rather, it attempts to engage readers in questioning the rules that have
governed relationships, sex, gender, identity and commitment. Conveniently
there are two rules to guide this questioning. First, there are no universal
answers. Second, it’s okay to question the rules.
Barker starts by examining rules about self. The first rule she challenges
is the rule that you have to love yourself before you can love anyone else.
She examines what this presupposes, suggesting that it sets up the idea
there is a ‘true self’, or ‘core self’. The secret of loving others is then to
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love our true self. This sets up a relationship with ourselves where our
identity is static. Barker instead suggests we think of our identity as plural,
and a process. Barker’s ability to bring concepts of Dasein, facticity,
situatedness, being-in-the-world and becoming into an accessible opening
chapter is magnificent in my opinion. By the end of Chapter 1, I recognize
the entire book is written on deep existential underpinnings, but not once
in the book is there esoteric language that often turns lay people away.
Barker grounds her insights in the lived life so readers can easily comprehend
her meaning without a philosophy degree.
This is further elucidated in an exercise Barker gives her readers. Pick
five people from your everyday life. Then, based on certain characteristics:
‘outgoing’, ‘fun’ or ‘patient’, you mark an X or O, on a grid. Ultimately,
readers are challenged to look back and see that they are potentially shy
in one relationship, but not in another. They may be impatient with one
person, yet patient with another. This exercise allows for readers to experience
their own plurality in a way they might have not recognized previously.
In existential terms, Barker is offering a process to question readers’ facticity.
This is what I most valued in Barker’s book. Barker’s ability to engage
readers in experiential processes that are defined by a deep understanding
of existential philosophy and psychotherapy while remaining practical and
accessible is what I most value about this book.
The chapters in Barker’s book build upon one another sequentially,
questioning the rules about: yourself, attraction, love, sex, gender, monogamy,
conflict, break-up, and commitment. Each chapter follows the same structure:
offer up rules, explaining why readers would question the rules, alternative
rules, ending with a section she titles ‘Beyond rules? Embracing uncertainty’.
This book’s value becomes apparent to me in the sections about embracing
uncertainty. Each chapter opines that there isn’t an answer. In the chapter
about sex, the uncertainty is an invitation for readers to become curious
about themselves in sexual activities, as well as the meaning and role of
sex in their life. In the chapter on gender, the uncertainty invites readers
to see how their rules on gender set expectations in relationships, and
offers rather than gender being a continuum that gender is plural. Asimple
cartoon drawing illustrates multiple continuums including delicate to tough,
emotional to rational, and submissive and yielding to dominant and bossy.
The drawing is well placed, in that once again, Barker creates an experience
for readers in which to reimagine their own and others’ plurality.
In the final chapter on rules Barker brings her threads together by asking
readers to examine their commitments to ‘being present’, flexibility,
compassion, and freedom. These relational commitments echo the values
and ideas of existential theory. I appreciate Barker’s vision of freedom as
‘taking mutual responsibility in relationships’ and thus ‘valuing the freedom
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of others to make their own choices’ and ‘recognizing that the same is true
for ourselves’.
The last chapter is a practical chapter on the process of rewriting your
own rules. Barker reminds readers this is not a one time event, but a
continual process. The idea introduced in the beginning is reiterated. This
book is an ‘anti-self-help book’. Barker instead suggests we build self
reflection into our lives and use it as a tool to engage with the world.
While I enjoyed the entire book, the final section is what I find the most
valuable. Barker invites readers to live an engaged life with themselves and
others. While the rest of the book is composed of consistent invitations to
start the process, the final section contains the practical suggestions on how
to integrate investigations into uncertainty and curiosity into one’s life.
In my opinion, existential psychotherapy suffers from a lack of accessibility
to those outside our philosophical sphere. Barker’s book, however is
accessible to most clients. I can give this book to clients to read without
the concern that they will get lost in overly intellectual rhetoric. At the
same time, Barker’s book doesn’t hold back from the phenomenological
investigations that are deeply valued in existential thought. Barker’s avoidance
of solutions provides a process for better understanding of ourselves, our
relationships, and love.
Justin Rock
The Descriptive Phenomenological Method in Psychology

Amedeo Giorgi (2009). Pittsburgh, Pennsylvania: Duquesne
University Press.
Whether familiar with phenomenology or not, researchers should find
this book important because it describes what it claims to be a better way
of conducting research into human psychology than empirical statistically-
based methods. Giorgi advocates Husserl’s Phenomenology as a better,
more appropriate approach. As a psychotherapist, I regard myself in part
as a researcher into the way clients’ thinking might generate their complaints.
Or in existential terms, how clients’ intentionalities (valuing, judging,
planning, remembering, hoping, expecting, giving significance and meaning
to, making assumptions, desiring, comparing, measuring, calculating,
etcetera) might sustain their experience of themselves and the world. A
phenomenological researcher does this in a disciplined way to gain
generalised psychological knowledge about the researcher’s particular
field of interest. I find that Giorgi’s text speaks to both therapists and
researchers, describing and fully justifying the steps that can produce
stable and scientifically valid conclusions.
Chapter One lays out what Giorgi calls his Conceptual Framework,
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distinguishing the study of humans from the study of the natural world in
order to explain why a new approach is required. For example, the usual
empirical tools of observation and measurement can hardly be applied to
the study of other people’s dreams, memories, or beliefs. Phenomenology
is a philosophy, broader than empiricism but not anti-empiricism. It suspends
the idea that we see only what is actually there, or that what we see actually
exists concretely, and it takes full account of the subjectivity in the ‘ego-
act-object’ structure of human consciousness, that is, Husserl’s intentionality.
A phenomenological attitude is taken by the researcher to minimise the
researcher’s assumptions, expectations, and interpretations regarding the
participants’ data (descriptions of their experience). In this way, the
participant’s experience can be distinguished from the researcher’s, and
thus validly used as data that can be accurately understood.
Giorgi describes the history of research methods that have included
qualitative methods, showing that phenomenological approaches are more
‘normal’ than the reader might imagine, lending weight to the idea that an
extended qualitative method can be accepted as rigorous by the scientific
community. Over a number of decades, Giorgi travelled the world and read
extensively to uncover what his contemporaries had learnt about Husserl
and how they had interpreted it. He now presents a justification for a
modified Husserlian approach, based on the limitations and inappropriateness
of the natural scientific method for such a diverse population as the contents
and activities of human minds. He notes the impossibility of applying
certain quantitative criteria to the type of data he is interested in – human
experience in a context. I reproduce here his table of criteria for producing
precise, stable knowledge:
Natural science criteria Human science criteria
Experimentation Other research methods

Quantity Quality
Measurement Meaning
Analysis-synthesis Explication
Determined reactions Intentional responses
Identical repetition Identity through variations
Independent observer Participant observer
Giorgi uses a lot of vocabulary that might well be unfamiliar to the general
reader, which he doesn’t always define or explain until later in the text.
Understanding the ideas was therefore a struggle as I found that words
such as eidetic, nomothetic/ideographic, essence, bracketing, formulation,
reduction, noematic, noesis, ‘givens’, irreal, horizon, and so on, weakened
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my motivation to read on. I found myself thinking that what was being
said could have been said in plain English, and with many more examples,
like the one he uses to explain the difference between an element and a
constituent (p 102). Yet Giorgi does explain the differences between the
two sets of criteria in his table, and his explanations act as a summary of
his previous discussions. The reader is then led to consider the requirement
for a new ethical perspective when the object of study is a human being.
Chapter 4 describes and justifies phenomenological methods, whilst
Chapter 5 distinguishes the philosophical phenomenological method (looking
for abstract essences) from a psychological phenomenological method
(looking for invariant psychological structures). Chapter 6 describes a way
of applying the latter, and relates the results (a description of a structure
in consciousness for the phenomenon being investigated) to phenomenological
ideas and terminology.
Georgi’s philosophical method would include:
- assuming the transcendental phenomenological attitude
- looking for essences, using free imaginative variation and eidetic
intuition
- describing of the essence fully (without formulation or explanation).
But this philosophical approach would result in transcending the data we

are trying to collect – the contents of human consciousness.
So in Giorgi’s psychological method the researcher

- gathers data from at least three people
- records the descriptions of the experiences without adding anything
or leaving anything out
- and without any interpretation or theoretical formulation
- assumes the psychological phenomenological reduction
- uses free imaginative variation and eidetic intuition to find an
invariant psychological meaning
- applies the structure to the empirical data to re-substantiate the
findings and draw out inherent implications and possibilities.
Here, as throughout the book, Giorgi discusses possible objections to his

thinking and offers arguments to counter them, questioning his every step
and every choice. Then, by giving examples in Chapter 6, Giorgi shows
what the work of analysing the data might actually look like, what the result
might look like, and where the implications of the result might take us. The
book is therefore persuasive, provided that the reader can understand the
language used, and persevere with the ideas. He points out that the term
‘psychological’ has not yet been adequately defined in the scientific community,
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Book Reviews
and that there are no alternatives to Husserl’s ideas that stand up to close
scrutiny when applied to human experience to create knowledge.
This book is thorough, but not an easy read. If the reader already understands
phenomenology, it might make sense to read Chapter 6 first, since ‘the
primary purpose of this book is to demonstrate how the method is applied
in the analysis of qualitative data’ (p 139). Giorgio admits that he learnt
as much from trying to apply the method as he did from reading philosophical
phenomenology. I too can’t form a general concept until I have seen several
examples, and I assume that this is the way we learn – from examples to
generalities, like the research method he advocates. Yet he writes his book
largely the other way round.
Paula Smith
Boundaries and Bridges: Perspectives on time and

space in psychoanalysis
Andrea Sabbadini (2014). London: Karnac.
Andrea Sabbadini brings together his clinical experience from a life’s
work in psychoanalysis with an existential interrogation of phenomena
as they arise in the room. He does so through the open and receptive lens
of film and literature, in writing which manages to be simultaneously
accessible and rich with meaning. This book, therefore, is of interest to
psychoanalysts, existential therapists and anyone with a keen interest in
how the themes and experiences arising in the clinical situation can be
found represented in over two thousand years of cultural expression. The
book offers an interpretive medium through the arts, and in particular
literature and film.
In some early chapters the book’s title does not always appear uppermost
on the author’s agenda, and at times the links to these themes seem somewhat
tenuous. This, however, never detracts from the quality of the material
under discussion. Importantly, Sabbadini does not shy away from any of
the big questions that are relevant to any modality, and most specifically
what it is that we are attempting to do for our clients or patients. He
challenges the psychoanalytic notion of ‘treatment’ as being central to the
work, and points out that the German term behandlung, has more connotations
of caring than the somewhat sterile and medical overtones of the English
translation. He claims ‘treatment does not describe the nature of what
takes place in my consulting room’ (p xiv), begging the question, ‘If you
do not intend to obtain [particular results for your patients] then why do
it at all?’, which he sets about answering through a model comprising three
key principles: theoretical, technical and ethical. While the first is specifically
psychoanalytic in its application, the latter two might be considered more
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Book Reviews
relevant for the existential reader. However, the particular theoretical framework
upon which one’s training is based can be applied equally to the model,
which Sabbadini uses to underpin and interrogate his own practice, and his
interpretations and understanding, throughout the book.
While making no apologies for his assumption that many of the book’s
readers believe in the existence of the unconscious, Sabbadini invites readers
from an existential belief system to consider the degree to which we are
responsible for actions and behaviours of which we are not aware. This is
explicated beautifully through use of literary metaphor, citing the case of
Oedipus’ marrying someone whom he does not know is his mother. It is
through the interweaving of such rich symbolic material, throughout the
text, that he engages the reader in understanding a common aim; namely
that we are all attempting to make manifest the latent material of the client’s
memory, phantasy, imagination and experience, which can be conceived of
in different ways and using different terminology, in order to generate greater
self-awareness for the client, through being in relationship with the therapist.
Sabbadini gets to grips in Chapter 4 with the central issues in the text,
and in particular the aspect of time in the analytic relationship. Through
his excellent explanation of the impact of temporal elements on the patient,
he demonstrates the main difference between the psychoanalytic method
and other forms of therapeutic help. The re-creation of specific conditions
to bring about a more primitive timeless state are enabled by the very
structure of working analytically for fifty minutes, five times a week, in
an open-ended analysis. He claims that this coexistence of different
temporalities enables a freedom from the exacting bonds of time similar
to the omnipresence of time for the infant, allowing for deep connection
to repressed and past states in the here and now. He draws upon rich cultural
myths to exemplify the relationship between inner and outer and the
boundaries in between, to show how time and space might be undifferentiated,
such as in Sleeping Beauty, where the relationship between time within
and outside the grounds of the castle create the conditions within which
the original trauma can be worked through. His impressive knowledge of
other fields, particularly myth and theatre, enrich the text as he draws upon
ideas ranging back to Aristotle’s Poetics, where the unity of time, place
and action create the ideal circumstances for the internal drama to be
played out to a satisfying conclusion, allowing catharsis as a release.
Sabbadini continues to expand upon these ideas in the next two chapters,
offering interesting insights into the impact of the paradoxical nature of
time-boundaried sessions in open-ended analysis and, through this narrative,
explores notions of endings and, ultimately, death. Other existential themes
and ideas of fluidity of identity are considered implicitly, making the material
interesting for the Existential Analysis reader. The method, however, is
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strictly psychoanalytic, in spite of Sabbadini’s interrogation of purpose

and meaning through existentially oriented thinkers such as Laing.
Where the book becomes less focused is half-way through Chapter 6 on
the subject of the Millennium. The opening part lured me in through its
expounding of unconscious and apocryphal phantasies associated with
millennial boundaries and bridges, such as might appear and be explored
in the clinical situation. I felt that this was not fully taken up, but rather,
Sabbadini’s extensive knowledge of social, political and historical material
surrounding fin de siècle and millennial demarcations, appeared as an
abridged history, interesting in its own right, but hard to connect to the
book’s ultimately psychoanalytic thread.
I found Chapter Seven, On the Couch, one of the most interesting. Counter
to my expectation, I did not feel coerced into accepting the couch as a
non-negotiable legacy from Freud’s days. On the contrary – my own
assumptions about face-to-face therapy as a paradigm for equality in the
co-created relationship, were thrown into question. Through this invitation
for reflexivity on some of my own previously unquestioned methods of
working, I was reminded of Sartre’s idea that accepting one’s identity or
role as fixed, rather than fluid and becoming, is indeed a form of bad faith.
This enabled me to consider the fixedness of my own approach and how
it might actually conceal the imbalance of power in the therapeutic relationship.
Sabbadini’s contribution here was to sharpen my awareness of the requirement
to take responsibility for everything said and done by the therapist, and
its impact on our patients and clients. The author’s openness to exploring
the patients’ resistance or willingness to submit to using the couch enabled
valuable insights into their individual relationship to power and authority.
In so-doing, Sabbadini enabled me to recognise his choice to work with
the couch as an authentic reflection of the power dynamics and as an open
acknowledgement of the operation of barriers or boundaries in the therapeutic
situation, as distinct from interpersonal relationships in the outside world.
In addition to clinical vignettes describing the relationship between
therapist and patient, for the lay reader interested in psychoanalytic models
of the mind, Chapter 10 offers a good description of how internal objects
are formed and relate to one another to develop thinking, creativity and a
sense of self in the infant. Indeed Sabbadini’s invitation to study the complex
relationships between, inner, outer and between, promoted an attitude of
reflection, reflexivity, tolerance and openness throughout the book.
Interestingly, the book’s concluding chapter, ‘In Between and Across’,
with its epigraph, ‘We build too many walls and not enough bridges’ (Sir
Isaac Newton), was what drew me originally to want to review this book.
In it Sabbadini brings together his deep interest in literature, culture, cinema,
and myth, amongst many other fields, in a consideration of what they
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might bring to bear in psychoanalysis, and vice versa – and I felt encouraged
by his writing to bring my own experiences from my theatre background,
as another lens through which to experience the content of his thoughts
and his clinical work.
There is so much more that could be examined and discussed in detail
about each of the chapters, and I have attempted to give a flavour of the
rich material present in the book, in the hope that the existential reader
will feel invested enough to use epoché in coming to the experience of
reading the book, in the same spirit of openness that they apply to their
own clinical work.
The central focus is on a liminal space and time between the fixed
confines of an ideology or field, where ideas can be transformed and spacio-
temporal bridges might enable links and developments in understanding
and thinking. Indeed the psyche itself links together feelings, experiences
and learning to produce new thoughts and creative understanding, and as
long as there is a safe container with appropriate boundaries in which to
do so, one can see the value of such a bridge in our work for both ourselves
and our clients.
For the existential reader, the reading of this book might perhaps
be viewed as such a bridge, a container, where ideas from different
schools hold common truths, and – in a symbiotic way – might produce
new awareness, creativity and thought. I highly recommend the experience.
Donna Savery
Practicing Existential Therapy: The Relational World

(2nd Edition)
Prof Ernesto Spinelli. (2015). London: Sage.
This review concerns the second edition of Spinelli’s most explicit statement
of his own position on existential therapy. I was invited to review this
book as someone who might be able to offer an appropriate critical reading
that did not fall into either hagiography or obloquy. I felt happy to take
up this challenge. I have admired Spinelli’s work for some time and was
looking forward to reading this book. Much of the content remains similar
to the first edition with a beautifully clear exposition of his ‘structural
model’, the major element that should prove useful to trainees and experienced
therapists alike. The second edition contains new material mostly through
expanded consideration of topics that were present in the first edition.
Given that the first edition proved exceptionally popular, I have no doubt
that this new edition will occupy a similarly prominent place on the shelves
of people working in this field. I shall begin this review – somewhat counter
intuitively – by (briefly) discussing the second part of the book that introduces
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Spinelli’s ‘structural model’. After that I shall spend more time on the first
part of the book and, in particular, the rather unfortunate way that Spinelli
sets up his own approach to existential therapeutic theory and practice in
opposition to that of most of the other people writing on this topic. It was
when I read the opening section of the book that I found myself really quite
dismayed at both the way that the work of others was inaccurately portrayed
(and then unfairly dismissed) and how I now – with regret – feel the need
to challenge this misrepresentation in a review of an otherwise excellent
book by an established figure in the field.
The great strength of this text is the very clear way that Spinelli outlines
and explains his approach to therapeutic practice, with numerous practical
exercises included to help develop skills and understanding. Part 2 introduces
Spinelli’s ‘structural model’ in which he outlines the three phases of therapy:
Phase 1 – co-creating the therapy-world, Phase 2 – exploring the therapy-
world, and Phase 3 – closing down the therapy-world. The emphasis
throughout is on being ‘descriptively attuned’ to the client, a position that
I would expect to see shared by most, if not all, existential therapists. This
descriptive stance is understandably strongest in the first phase, described
by Spinelli (p 119) as a stance in which we have ‘the therapist as idiot’.
This is a rather unfortunate phrase but we can see the focus here is on
assuming a phenomenological attitude first and foremost as the relationship
is developed, with the client able to ‘hear their own voice more accurately
and truthfully’. Phase 2 involves more engagement with matters such as
existence tensions, sedimentations, the relational and intimacy. The final
phase is rather briefly described but obviously concerns the ending and
need to facilitate a bridging of ‘therapy-world’ and ‘wider-world’. The
section on the phenomenological method feels a little brief (and somewhat
hidden) considering this forms the basis for practice amongst most existential
therapists, but otherwise there is considerable depth to the material in this
section and a great deal of knowledge generously shared that should be
helpful in thinking through one’s own practice. The book ends with a
slightly expanded ‘addenda’ in which there is consideration of therapy
with couples and groups, supervision and working in a time-limited context.
There is some interesting material here but it does feel like an underdeveloped
‘add on’, as implied in the section title itself. But this must surely be
forgiven given that it is merely reflective of the fact that these areas remain
underdeveloped within existential therapeutic theory and practice in general.
Turning to the first section of the book things become more problematic.
Whilst there is much to like in the first section in terms of the clear
explication of often complex ideas, the book begins with an introductory
statement to the second edition expressing Spinelli’s opposition to an
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amorphous Other (de Beauvoir 1949/1953; Said, 1978). The Other that
has been constructed is rather underspecified but still problematic with
the critical arguments appearing unnecessarily combative in intent. He
positions his own approach to ‘existential therapy’ in opposition to those
of many others, namely: Barnett & Madison, Boss, Cohn, Cooper, Jacobsen,
Langdridge, May, van Deurzen, Adams, and Yalom. This opposition is
made on two grounds. The first is that these others apparently define
existential psychotherapy through ‘themes’ rather than ‘principles’ (p 3),
which he goes on to explicate further in the first substantive chapter. The
second is that they (we) apparently claim existential therapy is ‘uniquely
philosophically grounded’ (p 3). Spinelli rightly points out the rejection
of dualisms as a central feature of existential phenomenology so it is a
terrible shame that he introduces his own (completely unnecessary) dualism
here between self (right) and Other(s) (wrong).
The first argument rests on a spurious distinction between ‘themes’ and
‘principles’ that sets up a false opposition. In order to make this distinction
Spinelli draws on a rather arcane article by Colaizzi (2002) that is itself
deeply problematic. Colaizzi (2002) effectively seeks to explicate a number
of principles for ‘existential therapy’. He does this by setting up a false
distinction between ‘life’ and ‘existence’ that leads to another false distinction
between ‘existential psychotherapy’ and ‘existential therapy’:
This is why psychotherapists are not interested in anything which
is not a problem for the general population, for the public at large,
have no concern or use for the issues that stand at issue for
Self-existence, and have never examined or even been struck by the
distinction between life and existence – not even the so-called
‘existential psychotherapist’, which term, as should be evidence by
now, is an internal contradiction and an existential impossibility.
(p 82)
This distinction is used by Spinelli to frame his work and distinguish it
from those others writing on existential psychotherapy. However, the
psychotherapist described by Colaizzi is a very specific beast, one that
must be understood in a particular cultural and historical context. Colaizzi
is speaking to the US context in the early 2000’s, and also a predominantly
psychological audience, in which positivist ideas imbue most psychotherapeutic
practice. This is not the case for UK psychotherapy, which rests on an
entirely different set of assumptions. UK existential psychotherapy in
particular has been – and continues to be – precisely concerned with those
matters that Colaizzi (2002) describes as the principles necessary for
‘existential therapy’, albeit explicated with less Nietzschean arrogance.
In Spinelli’s (2015) hands these ideas are translated into a distinction
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between ‘themes’ and ‘principles’ as the means by which he can distinguish

his own work from that of the Others. I remain completely baffled by the
supposed distinction between ‘thematic existence concerns’ and ‘existential
principles’. Why are ‘existential relatedness’, ‘uncertainty’ and ‘existential
anxiety’ the ‘foundational principles’ (p. 11) for existential psychotherapy
and how these are distinguished from the self-same entitled ‘themes’
described by other authors? In order to prosecute this argument, Spinelli
once again creates a false Other who apparently fails to understand that,
for instance, death is important to other forms of psychotherapy. I cannot
locate a single existential psychotherapeutic writer who has said anything
like this. Like Spinelli, who spends considerable time discussing such
‘themes’ in his own book, they would all argue that it is the way that
existential philosophers address the issue of death that marks the difference
with many (though not all) other therapeutic orientations. And more
importantly, these other authors would also question the ability to distinguish
‘anxiety’ as a ‘principle’ from ‘death’ as a ‘theme’, given that the former
is in large part the product – in existential terms – of the latter. I could go
on but suffice it to say that throughout this opening position statement
Spinelli misrepresents the views of those Others that are implicitly implicated
through inclusion in the named list above.
The second argument is also easily dismissed for it is a gross misinterpretation
of what other writers actually say about existential psychotherapy. I know
of no one who has made the argument that Spinelli claims. His lack of a
direct reference to a person’s work to substantiate his claim is particularly
problematic. It leaves the accusation hanging, over all of us who have sought
to write about the theory and practice of existential counselling and psychotherapy.
His position that ‘all therapeutic theories are underpinned by philosophical
assumptions and postulates’ (p 3) is obviously true but I know of no one
who has ever claimed otherwise. Existential therapy involves more direct
engagement with philosophy qua philosophy than most other forms of therapy
and that does distinguish it somewhat (in training and practice) but this is
hardly a particularly profound or significant claim, and certainly not one
that warrants the attack presented in the beginning of this book.
It is a shame that Spinelli feels the need to position his own approach
in opposition to others. As Freud might appositely comment, internecine
disputes are rarely more than the narcissism of small differences. Spinelli
does seek to acknowledge that there are many forms of existential therapy
but unfortunately still feels the need to frame his argument from the very
beginning in oppositional terms. I wish he had simply made the positive
case for his approach. I have never considered my own work in opposition
to that of Spinelli and nor – I suspect – do many of those others named in
this book. I have the greatest of respect for his work and have always
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Book Reviews
drawn on his ideas for my own practice. It is unfortunate, therefore, that

in this attempt to outline his own very valuable approach to existential
psychotherapy he has done this in such negative terms.
References.
Colaizzi, P. F. (2002). Psychotherapy and existential therapy. Journal of
Phenomenological Psychology, 33(1): 73-112.
De Beauvoir, S. (1949/1997). The Second Sex. Trans. Parshley, H.M.
(ed.). London: Vintage.
Said, E. (1978). Orientalism. New York: Pantheon Books.
Prof Darren Langdridge
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Book Reviews
Publications received for review
The following publications have been received for possible review. People
who wish to be included in the list of book reviewers for Existential
Analysis for these or other publications are requested to e-mail the Book
Reviews Editor, Martin Adams at adamsmc@regents.ac.uk
Bager-Charleson, S. (2014). Doing Practice-Based Research in Therapy:

A Reflexive Approach. London: Sage.
Belliotti, R.A. (2013). Dante’s Deadly Sins: Moral Philosophy in Hell.
Chichester: Wiley.
Bradford, G.K. (2013). The I of the Other: Mindfulness-based Diagnosis
and the Question of Sanity. Minnesota: Paragon.
Clarke, L. (2009). Fiction’s Madness. Ross-on-Wye: PCCS.
Crawford, M. (2015). The World Beyond Your Head: How to Flourish in
an Age of Distraction. London: Penguin.
Deurzen, E van & Iacovou, S (eds). (2013). Existential Perspectives on
Relationship Therapy. Basingstoke: Palgrave.
Ellis, M. & O’Connor, N. (2010). Questioning Identities: Philosophy in
Psychoanalytic Practice. London: Karnac.
Gardner, L. (2013). Rhetorical Investigations: G.B. Vico and C.G. Jung.
Hove: Routledge.
Goodman, D.M. (2012). The Demanded Self: Levinasian Ethics and
Identity in Psychology. Pittsburg: Dusquesne.
Griffiths J. (2013). Kith: The Riddle of the Childscape. London: Hamish
Hamilton.
Harrison, R.P. (2014). Juvenescence: A Cultural History of Our Age.
Chicago: University of Chicago.
Harrison, R.P. (2010). The Dominion of the Dead. Chicago: University
of Chicago.
Hedges, F. (2010). Reflexivity in Therapeutic Practice. Basingstoke:
Palgrave.
Hills, J. (2013). Introduction to Systemic and Family Therapy: A User’s
Guide. London: Macmillan.
Hockley, L. & Fadina, N. (2015). The Happiness Illusion: How the media
sold us a fairytale. London: Routledge.
Iacovou, S & Weixel-Dixon, K. (2015). Existential Therapy: 100 Key
Points and Techniques. London: Routledge.
Kottler, J., Englar-Carlson, M. & Carlson, J. (2013). Helping Beyond the
231
Book Reviews
50-Minute Hour: Therapists Involved in Meaningful Social Action.

Hove: Routledge.
Martin, A. (2012). The Boxer & The Goal Keeper: Sartre versus Camus.
London: Simon and Schuster.
Montgomery, C. (2014). Happy City: Transforming Our Lives Through
Urban Design. New York: Farrar Straus Giroux.
O’Byrne, A. (2010). Natality and Finitude. Indiana: Indiana U.P.
Owen, I.R. (2015). Phenomenology in Action in Psychotherapy: On Pure
Psychology and its Applications in Psychotherapy and Mental Health
Care. Heidelberg: Springer.
Simms, E. (2008). The Child in the World: Embodiment, Time, and Language
in Early Childhood. Detroit: Wayne State.
Tantam, D. (2014). Emotional Well-being and Mental Health: A Guide
for Counsellors & Psychotherapists. London: Sage.
Thompson. M.G. (2015). The Legacy of R. D. Laing: An appraisal of his
contemporary relevance. London: Routledge.
Van Manen, M. (2014). Phenomenology of Practice: Meaning-Giving
Methods in Phenomenological Research and Writing (Developing
Qualitative Inquiry). Walnut Creek, CA: Left Coast Press.
Welsh, T. (2013). The Child as Natural Phenomenologist: Primal and
Primary Experience in Merleau-Ponty’s Psychology. Evanston, IL:
Northwestern University Press.
232
Information for Contributors
Prospective contributors should send papers or reviews, in English, by email attachment to
The Editors, c/o Andrew Miller to submissions.ea@gmail.com
The Editors may alter manuscripts wherever necessary to ensure they conform to the stylistic and
bibliographical conventions of the Journal.
Papers must:
l not normally exceed 5,000 words. Longer papers that make a significant new contribution to the
understanding of existential practice will occasionally also be considered for publication;
l include a separate title page bearing the title of the paper and name(s) of the author(s);
l include an Abstract of no more than 50 words;
l include a list of no more than 8 Key words;
l include a biographical statement of current professional activity of no more than 25 to 30 words;
l contain contact information which will be printed after the biographical statement: a postal address
(preferably professional) and a professional email address. No telephone number should be included.
l Unless it is very short, the paper should be organised into sections.
References given in the text should be in author (date) style, i.e. Jones, A.B. (1989). Single quotation
marks should be used except where there is a quotation within another. Extended quotations should
be indented and italicised and fully referenced to include a page number. References will be printed
at the end of the article in alphabetical order by author. Citations should be as follows:
Book:
Macquarrie, J. (1972). Existentialism. Harmondsworth: Penguin.
Chapter in a book:
Spinelli, E. (2003). The existential-phenomenological paradigm. In Woolfe, R., Dryden, W. and
Strawbridge, S. (eds) Handbook of Counselling Psychology, 2nd ed. London: Sage.
Paper in a journal:
Kvale, S. (1994). Ten standard objections to qualitative research interviews. Journal of
Phenomenological Psychology, 25(2): 147-73.
Translated book:
Merleau-Ponty, M. (1963). The Visible and the Invisible. Trans. Lingis, A. Evanston, Ill: Northwestern
University Press.
Endnotes should be used rather than Footnotes. They should be indicated by superscript numerals at
the appropriate places (numbering consecutively). The notes should appear at the end of the paper
under the heading ‘Notes’.
Authors should ensure that the submission has been copy edited for correct (UK) English grammar
and spelling as Reviewers are not able to take time to make these corrections.
Authors are responsible for the opinions expressed.
All academic papers are subject to anonymous peer review. Apart from the title page the remainder
of the manuscript should be free of information identifying the author(s).
Existential Analysis is published twice annually in January and July.
Only corrections of printer’s errors can be allowed in proofs. Authors are therefore asked to send any
alterations or additions to the Editors within one month of receiving a letter of acceptance. Authors who
are not members of the SEA will receive a complimentary hard copy of Existential Analysis for that
issue. Authors who are members will receive a complimentary pdf copy of Existential Analysis for that
issue. Book reviewers will not normally receive a complimentary hard copy of the journal.
Photocopying single copies of articles contained in this journal for the purpose of private study is
permissible. For multiple copies and reproduction, permission must be sought from the author(s).
Copyright is retained by the author(s). If authors use the same material in subsequent publications,
acknowledgement should be given to this journal.
© Copyright Society for Existential Analysis 2016 ISSN 1752-5616
The Society for Existential Analysis
The aim of Existential Analysis, the journal of The Society for Existential Analysis,
is to provide a forum for the expression of views, and the exchange of ideas, amongst
those interested in existential-phenomenological analysis and its application to therapeutic
practice and everyday life.
Existential Analysis 27.1 January 2016

ISSN 1752-5616

A Chinese Approach to Existential Thinking and Practice
Wang Xuefu
Why The Distinction Between Ontic and Ontological Trauma Matters
For Existential Therapists
Alice Holzhey-Kunz
Greg Madison
Simon du Plock
Lucia Moja-Strasser
Martin Adams
Robert D. Stolorow
Al Mahrer (1927-2014) – An Appreciation
Ernesto Spinelli
Sofia Alegria, Inês Carvalho, Daniel Sousa, Edgar Agrela Correia, João Fonseca,
Therapy with Children and Adolescents In The Phenomenological-Existential
Tradition: Community-Based Clinical Interventions
Branca Sá Pires
Rebecca Greenslade
Saturated Phenomena and Their Relationship To ‘Extreme Experiences’:
A Phenomenological Comparison Between Mystical Experiences and Psychotic and Depressive Experiences
Based on Jean-Luc Marion’s Philosophy
Georgia Feliou
A Correction and Brief Reply To Montenegro’s (2015) ‘A Comparison Of
Freudian and Bossian Approaches To Dreams’
Darren Langdridge
Aron B. Bekesi
Existential Therapy Institutions Worldwide: An Update of Data
And The Extensive List
Book Reviews

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Existential

Journal Editors Distribution & Marketing: Martin Adams

Officers of the Society

The Society for Existential Analysis

Zhi Mian: Approaching Healing/Therapy

A review of Zhi Mian and Lu Xun

I would like to end with such a concrete example of IP – a particular

of ‘Teachings of Tolstoy and Nietzsche, Writing Styles of Wei and

Chinese audience. We have lost the basic reverence and fear

Questions related to handout: What is the meaning of Zhi Mian? Who

Zhi Mian: A Chinese approach in the making

1. Courage to face reality

2. To defy and to serve

4. Zhi Mian: An approach to healing through facing reality

The Wise Man Saved the Animal World

Buddha was a wise man. He saw the animals running in desperation

An existential therapist can well understand that in humanity there is

The Tiger and The Donkey

We see in humanity a tendency to escape on the one hand. On the other,

5. Why can we not stand up to reality/truth?

Wang Xuefu PhD is currently working at a professional psychotherapy

Why The Distinction Between

The descriptive criterion for trauma given by the

to admit that all criteria are inevitably subjective, depending on time,

Examples of traumatizing events, situations or acts belonging

Why I propose additionally another – ontological –

Angst as an experience ‘altogether different from fear’

Because fear is fear of something or someone perceived as dangerous, it is

Is Angst a traumatizing experience?

Everydayness and common sense as protective shields

Who is especially vulnerable for ontological traumatization?

Why the naked truth about ‘freedom’ and ‘the nothing’

Three different aspects of being ontologically guilty

The traumatizing truth of being ‘for’ the other

The worldly appearances of the traumatizing ‘Angst’

Feelings of irrational fears, of irrational guilt and of irrational shame

Are ontic and ontological trauma connected with each other?

Addendum: A comment on Stolorow’s concept of

interested in an objective criterion of trauma: whether a similar loss is

sense is by no means a ragbag of illusions about being omnipotent and

Alice Holzhey-Kunz, Ph.D., philosopher and daseinsanalyst, gave

London: Free Association Books.

‘Home’ Is An Interaction, Not A Place

Outline of the workshop

After the Focusing experience I invited the participants to consider these

Discussion of the research study

our concepts themselves, can become temporary interactions, based upon

A few specific points

1. Co-researcher narratives often included the dichotomy of yearning

migrant, ‘culture shock’ is more likely at home.

The homelessness of the existential-phenomenological therapist

more profound implications of the individual exemplifying a process of

Greg Madison, PhD, is an existential psychotherapist and psychologist

Gray, G.J. (1951). The idea of death in existentialism. Journal of Philosophy,

The Therapeutic Functions Of

Incidentally, I would normally suggest we start by having everyone

14.00 – 14.30 Introduction to therapeutic functions of reading

So let us begin. Initially I am going to start with bibliotherapy in the

that to describe him in purely physical terms is inadequate.

if one is able to draw deeper connections between one’s personal experience

1. ‘Self-Administered Bibliotherapy’ – Clients have an initial session

2. ‘Minimal-Contact Bibliotherapy’ – Limited written, ‘phone and

An alternative broadly humanistic approach, ‘Interactive Bibliotherapy’,

bibliotherapy adopt a normative western perspective on psychological health.