3.3. Dimension of theoretical understanding of therapy
This dimension unfolds the theoretical comprehension of some aspects of existential therapy. Participants were encouraged to speak about their personal experience and not to theorise, but still some patterns were found which clearly relate to the theoretical aspects of existential practice.
The first theme ‘Fundamental human interrelatedness with others’ is an interesting finding of this study and the most frequent pattern in theoretical dimension, although none of the therapists specially focused on it. Rather it was present in their narrative as something that goes without saying. Therefore it was not noticed by the researcher for a long time, but when the pattern was discovered it became clear that therapists put this principle as a cornerstone of their work. Therapists do not see clients as isolated subjects or objects on whom they perform therapy, but see human being as fundamentally interrelated with others: ‘each therapeutic process is unique with each client,’ ‘I never know before what the path with every person will be,’ ‘we don’t try to change people, but still they are changing,’ ‘the most important factor is contact, or at least the road toward contact,’ ‘experiencing something together with another person is healing,’ ‘people can change because they are in fact open to the world and to others’. Therapists refer to client and therapist as two others who constitute each other.
The theme ‘Phenomenology of the uniqueness of the client’s lived world’ here unfolds phenomenology as a method of cognition which allows one to explore the client’s lived world in its uniqueness. Phenomenology as a method of cognition means paying attention to what is directly perceived by the therapist, what forms the therapist’s direct experience before he attends to his rational assumptions, but as well phenomenology as a method of cognition means focusing on the client’s pre-reflective experience. None of the therapists used the word ‘phenomenology’, but they talked about ‘exploring the life experience of the client as a whole,’ ‘to see how the client is present here before all the labels and before all my concepts,’ ‘trying to grasp how he sees the world,’ ‘the client’s unique lived world is an indivisible entity and I can experience, perceive something from it through experiencing my own being with the client’. Speaking about exploration of the client’s lived world therapists frequently mentioned the category of time: ‘the right time,’ ‘everything takes time in therapy,’ ‘simultaneity,’ ‘give time to the client,’ ‘therapists share their life time with the client and vice versa,’ ‘it’s important not to hurry,’ ‘not helping too fast.’ Participants also spoke that all three ecstasies of time can be phenomenologically explored through focusing on ‘what appears in the client’s consciousness.’
The last theme ‘Openness to life experience as healing’ unfolds an important theoretical question about healing, health, illness and the nature of human suffering. In interviews therapists talked about health, illnesses and diagnoses and this matched with therapists’ phenomenological position towards clients and their life-experience, including their experience of diagnosis. Therapist M. says about a diagnosed client: ‘of course, not the diagnosis itself says something about my client or his illness, but his own life, his own experience’. Therapist A. says: ‘I can see a client as healthy if he can be open to different opposites, joy and sadness, wealth and poverty, company and solitude, but if he runs away or closes completely to one polarity, he won’t feel healthy soon’. Interviewees connect mental health and healing with the ability of a person to keep an open, accepting attitude towards everything that is in his life and with the ability to integrate this experience.
This research was started with a good dose of skepticism as there was no idea if any repeating patterns could be found. The first impression of richness obtained in in-depth interviews only strengthened this feeling. It was present until three main dimensions were noticed showing that all participants speak about: therapeutic relationship, therapeutic interactions and theoretical understanding of therapy.
Pulling the findings of the research together we can say that the Birštonas School of existential therapy has strong roots in an existential and hermeneutic tradition. Most of the themes show the presence of ideas of such authors as Husserl, Heidegger, Buber, Sartre, Boss and Levinas. The main common methods of therapeutic work in Birštonas School are phenomenological exploration and hermeneutical understanding of the client’s life as being- in-the-world (Spinelli, 2005). In therapists’ narratives we can discern ideas close to Gadamer (2013 /1975). First of all, that in comprehending some phenomena we always have presuppositions, prejudices from our past. Research shows that existential therapists of the Birštonas School have a different position from Spinelli, who speaks about bracketing or setting aside therapists’ biases and assumptions to focus on the immediate experience (Spinelli, 2005). Therapists in interviews showed another strategy: they detect their assumptions and during the whole therapy process evaluate the impact of their presuppositions; they tend to ‘look after’ them, but quite often therapists can introduce them into the therapeutic dialogue as the sign of therapist’s otherness and by doing so pay respect to client’s otherness.
Quite often we can hear that existential therapy is not a distinct modality among other psychotherapies, that there is only some kind of existential stance or approach to psychotherapy. Such a position is maintained, for example, by Yalom (1980), but this research challenges such an attitude. Existential therapy practice can be hardly imagined without a deeper understanding of conditio humana, without setting the therapist’s own questions about human existence, human suffering, without putting his questions in context with existential thinkers. This study shows that to explore the lived- experience of every client, no matter if they are a drug-addict or a murderer, without slipping into a much more easy and less anxious knowing, curing, educating or theme-discussing position, arouses a lot of anxiety in the therapist and it takes vigour to keep exploring. An existential therapist needs some systematic understanding of why it can be useful to stay in such a humble, sometimes miserable position in front of a client’s suffering. He needs to have some answers about why his answers are not so important to the client, he needs some knowing about why to stay in un-knowing. If this is not on the therapist’s professional agenda, it is hard to speak about an existential stance in therapy. The results of this research showed that for existential therapists of the Birštonas School of existential therapy these are weighty issues which are alive in their relationship with clients.
The most important precondition for a successful therapy process is a collaborative, trustful and free therapeutic relationship. Through this short formula of success we can discern the ideas of such existential thinkers as Sartre (1956) and Levinas (1991/1969), whose further developments of Heidegger’s aspirations to describe being-with-others bring us to a whole new level of understanding of the role of the Other, who is always already present in our understanding of ourselves. This study emphasises the importance of a therapeutic relationship where the otherness of therapist and client is not camouflaged, but creates the uniqueness of the therapeutic relationship. Uniqueness becomes reality through a sincere and honest attitude towards the client and therefore it opens up a variety of conscious possibilities for the client to constitute himself in the presence of the therapist in a new way. Therapists in interviews expressed their awareness of the unavoidable change every client brings into their own world. Therefore this stance is in accordance with the philosophy of the Other we know from Emmanuel Levinas.
The understanding of healing in the Birštonas School reflects the findings of late existential thinking. Therapists in interviews linked the client’s health and healing with openness to their lived world and and the ability to integrate their life-experience.
According to the results of research, the central focus in existential therapy process is the client’s life as a wholeness in all its manifestations which enables us to talk about exploring ‘being-in-the-world-with-others’ (Heidegger, 1962). This forms one of the significant distinctions between existential therapy and other psychotherapies where there are other focuses – mainly intrapsychic processes. The main content of therapeutic work in the Birštonas School is associated with clarifying and unraveling the complex interweawings of possibilities and limitations in the client’s existence and his interelatedness with others.
In every unique therapeutic situation, therapists of the Birštonas School choose freely their methods of therapeutic interaction, but in general they are not inclined to apply ready-to-use techniques. An important and interesting aspect, formulated as one of the themes, allows us to say that existential therapists do constant assessment work during the whole therapy process and see this work as care for their clients and therapeutic relationship.
The study of the reference points of therapeutic work in the Birštonas School of existential therapy gives us a reason to assert that therapists of this school are more explorative, and neither clinically or educatively oriented.
This study allows us to speak about a distinctive Birštonas School of existential therapy among others in a wide spectrum of different existential therapies. If we try to position the Birštonas School on the spectrum of different existential therapies we are familiar with, it could possibly be somewhere in the quadrant formed by: Alekseichik’s method ‘Intensive therapeutic life’; Frankl’s logoanalysis; the American existential-humanistic approach (and specifically May); the British school of existential therapy (and specifically Spinelli and van Deurzen).
Based on these results, it may be concluded that reference points of therapeutic work in the Birštonas School of existential therapy are:
- the phenomenological and existential tradition of philosophy;
• the main common methods of therapeutic work are phenomenological exploration and hermeneutical understanding of the client’s life; • the central focus of the therapist’s attention is the client’s life as a
wholeness in all its manifestations;
• the main content of therapeutic work is clarifying the complex
interweavings of possibilities and limitations of the client’s existence
and his interelatedness with Others;
• the most important precondition for a successful therapy process is
collaborative, trustful and free relationship between therapist and client; • therapists associate the client’s health and healing with openness to
his world and life-experience;
• the relationship with the Other is a necessary environment for
transformation of self-understanding;
• therapists do constant assessment work during the whole therapy process
and see this work as care for their clients and therapeutic relationship; • in every unique therapeutic situation therapists choose freely their
methods of therapeutic interaction;
• therapists are not inclined to apply ready-to-use techniques or patterns
• therapists are more explorative, and neither clinically or educatively
The given study gives us a reason to rethink critically the understanding
of existential therapy in Europe. This also might encourage further qualitative research of ‘embodied’ existential therapy as it is practised by particular existential therapists, as theoretical constructs created at the desk do not always grasp the essence of existential therapeutic practice.
Elita Kreislere is an existential therapist in private practice, Riga, Latvia, and a supervisor and therapist in the Institute of Humanistic and Existential Psychology, Birštonas, Lithuania. She is a registered psychotherapist in the Latvian Psychotherapists Association and President of the East European Association for Existential Therapy.
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