Existentiell terapi

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Published by John Wiley & Sons, London 1997. Review by Mike Harding

When the novelist Anthony Burgess was a young man he was informed he had but six months to live. As he survived until his 80s, this turned out to be something of a mis-diagnosis, but the initial news had set him writing with a vengeance, and four novels were completed within a year. As Dr. Johnson has commented, the thought of being hung in the morning concentrates the mind wonderfully. For the existential therapist , who often sees death’s metaphor in the guise of all of life’s small endings, the idea of placing a limit on our time together cannot help but evoke the possibility of powerful encounters taking place within its remains. In the Strassers’ book, this point is argued with a skill and clarity which challenges those -the reviewer included- whose natural tendency may be to think that ‘more is better’, or that therapy is by nature an extended process. In truth the book does much more than this, for it introduces the reader to the two interlocking, but different approaches embodied in its title.

Firstly we are introduced to key concepts in existential therapy in a very accessible manner -a fact for which many students will have cause for considerable gratitude. We move from Buber and Heidegger to May, van Deurzen and Spinelli, as main themes and their applications are traced out. The assumptions of many approaches are obliquely questioned as the authors lay out the ground of our ontological ‘givens’, and some of the possibilities for therapy in general are explored within this context. This leads naturally to the authors’ main thesis: the value of brief, or time-limited encounters. Some of their arguments here will be familiar, for the trend towards short-term therapy is growing fast. However the Strassers are not offering endorsement of a trend. Within their chosen model is a challenge to the staid ‘solution-focused’ paradigm that predominates, and we see more clearly how the natural anxieties, which the recognition of our limited time evokes, are not echoes of some symptom to be erased, but may be the very spur that liberates.

In describing both the main concepts of the existential model, and the frame and practice of short term therapy, the authors utilise a novel aid to our understanding, which they term the wheel of existence. As the use of diagrams is very rare within the existential tradition, this is another challenge to more conventional ways of describing. It is also an effective one, for it allows many of the key points that might flow from life’s givens to be clearly identified and placed within their overall context. This device is similarly used when discussing the practice of therapeutic interventions, and the areas with which they might engage. For example, to raise the issue of anxiety brings with it the question of our freedom, how we cope with uncertainty, the sense of who we are both in and out of intimate relationships, how we might polarise our experience of the world, perhaps choosing to fix our sense of reality in only one possibility, and so on. The realms of life that emerge from this careful identification of so many key issues are highlighted again in the case histories that complete the book.

The case histories are brief, but perform their task well. We see clear examples of both themes and practice, and -most importantly- the clients are allowed space for their own assessment or comment, which do not always spare the therapist’ omissions or mistakes. One of the narratives exemplifies a chapter on the experience of the body, a subject often overlooked in the field of existential therapy. This is a book I enjoyed reading, clearly written and to the point, it links a whole range of ideas into a coherent practice. Sometimes, out of necessity, subjects are not always given their due space. Considering the centrality of Time to the described approach, I would have liked a longer chapter on this complex subject, though it is clearly picked up as an experiential component of the case studies.

While Time limits us all, the Strassers are not dogmatic in their own use of its boundaries, and recognise that this, itself, raises the kernel of a question. Throughout the book two main methods of working are described, a fixed term of ten to twelve sessions with two follow up sessions some weeks later, and a series of re-negotiable modules, with or without follow-up meetings. Each approach raises its own issues, and while some may cause us to question again what exactly is meant by the expression ‘time-limited’, each evocation only reiterates the value and importance of time’s initial boundary, both in its own terms, and as a latent recognition of that frame which holds us all. This is a book which has a lot to say about therapy , both at a theoretical level -to which it brings new insights- and, perhaps more importantly, at a practical level, where it forces us to question what we do each day, and offers intriguing possibilities of a different way of working. Strongly recommended!

Mike Harding, April 1998