Today’s guest post is the most epic by far..
I am honoured to have a contribution for you from Twitter friend, gentleman philosopher, intellect and all round decent chap @rascality. Words by himself with myself accompanying on the cartoons.
Enjoy. You lucky people, you.
****************************************
What is Existential-Phenomenological Therapy?
Existential-Phenomenological Therapy (EPT) is a way of doing psychotherapy centered around questions of existence and human meaning. It draws upon important recent developments in philosophy to address human suffering in a unique way.
What developments are those?
For me, the philosophical movements called existentialism, phenomenology, and hermeneutics.
Ok, explain each of those.
Sure. Existentialism is a philosophical concern with human existence and how we extract meaning from life and everyday experience. It asks people what they and their life are about, and tries to see the big picture instead of just a bunch of particular problems or issues. It emphasizes themes like freedom, finitude, authenticity, and commitment, to name a few.
What about “Phenomenological?”
Phenomenology describes a way of proceeding in the consulting room which involves staying very close to the character and structure of experience as given and exploring it thoroughly. Phenomenology tries to identify those parts of experience that are unique to individuals as well as those invariants that are part of the human condition.
And what’s hermeneutics?
Hermeneutics is the philosophical concern with interpretation and understanding. We interpret scripture, legal documents, poems, stop signs, works of art, authors, performances, and each other all the time. Hermeneutics asks what do all these instances of interpretation have in common? And what can the scholarship on the interpretation of scripture, legal documents, art, music, performance, and the like bring to bear on the clinical interpretation of persons and lives?
So how is EPT different than other kinds of therapy, like cognitive-behavioral or psychodynamic?
Well, it’s not so much a separate modality, like the ones you just mentioned, as it is an attitude towards therapy or a perspective on living. It’s a little like Buddhism in that while you can make it into a religion (as you can anything else), it’s really more of an attitude towards religious belief and practice or perspective on religion itself.
Where I think it differs most is with regard to emphasis. EPT doesn’t limit its focus to symptoms, behaviors, patterns, dynamics, or issues but tries to address them as part of the big picture.
The whole person.
No, larger than that.
EPT tries to address questions of ultimate meaning, such as who are you, what are you about as a person, what does life mean, what does your life mean, do you have any sense of purpose in life, where and when have you felt most alive, are you religious, do you believe in God (why or why not), how did you choose your career or marriage (or didn’t you and how did that happen), what would you do with the remaining year of your life if you knew that was all you had left, those sorts of things.
I can’t imagine most of us are equipped to handle such questions when we’re at our most vulnerable, especially the ones about mortality.
I agree, and EPT simply keeps these questions in the background as roadmaps until people can or need to take them up explicitly. In many cases, people suffer more from trying not to ask themselves questions about themselves, where their life is going, or what it all means. In those cases, giving people permission to formulate such questions can feel like a tremendous relief, especially if you we’re trained by your family or society not to ask them.
Ok, so now explain Existentialism.
Existentialism is a philosophical movement that got underway in the later part of the 19th century with people like Kierkegaard and Nietzsche, and continues on to this very day.
Really? I thought Existentialism as a philosophical movement was largely dead.
I suppose it may be, in the sense that people don’t go around calling themselves existentialists the way they used to, especially in the 50s and 60s.
But you do.
Absolutely. And I think existentialism remains very much alive, through all the authors, literature, cinema, and philosophical movements it’s inspired. In fact, I’d argue that almost all the philosophy we call Continental is an outgrowth of the very same concerns that gave birth to Existentialism.
So what are those concerns?
As a philosophical movement, Existentialism began as a reaction to the rationalism and systematizing that was taking place across all forms of experience, but particularly within philosophy and religion. People like Kant and Hegel constructed strikingly elaborate philosophical systems that the Existentialists felt didn’t do justice to the ways human existence is not smooth, neat, ordered, or systematic.
How so?
People come and go into and out of our lives, often without reason, plus all sorts of things happen that affect our lives deeply and resist our attempts to make sense of them.
So does Existentialism say we shouldn’t even try?
It depends; we can certainly make ourselves suffer from trying to extract meaning from some events, yet at the same time searching for meaning is part of what makes us human. EPT tries to honor and do justice to both sides of that tension, as well as others in our lives.
I should also mention a lot of the most important events of our lives — where and to whom we’re born, who we meet, where, when, and how we die — happen outside our conscious control. So in a deep sense the Enlightenment project of trying to predict and control nature is doomed to failure, as the universe simply says “no” or tries to divide by zero. Existentialism simply picks up the ball from here and says, “ok, so now what?”
Ok so who were or are the Existentialists?
The first existentialists were probably Nietzsche, Kierkegaard, and Dostoevsky.
Philosophy, religion, and literature.
Thats right. But that’s just at the beginning. Later there were people like Heidegger, Sartre, Camus, Martin Buber, Simone Weil, and Gabriel Marcel.
Atheists and believers.
Yes. And within psychology and psychiatry there were folks like Ludwig Binswanger, Medard Boss, Viktor Frankl, and Rollo May. Phenomenology comes to us by way of Edmund Husserl, the father of phenomenology (and Heidegger’s teacher) and phenomenologists like Maurice Merleau-Ponty and Paul Ricoeur. While Ricoeur also figures into hermeneutics, the main figures for me are people like Hans-Georg Gadamer and Jürgen Habermas, who probably thinks of himself as more of a social theorist than hermeneutician.
So you’ve told me who these people are. What did they say or believe?
Well I think we probably only have time to talk about existentialism.
That’s fine. What is it?
That’s tricky because it’s not so much a coherent school (Heidegger, for example, hated to be called an existentialist) as a set of shared concerns regarding existence and human being.
You said they came about in response to Kant and Hegel.
Yes. I think it’s safe to say that for both of these gentlemen what makes us human is our ability to reason. Now we all know that ability isn’t the same in all people, nor does it always get the kind of exercise it deserves. Nevertheless, the Enlightenment project from which they emerged placed an extremely high value on rational thinking. The existentialists were simply among the first to question that. The British and German Romantics were another.
Question what, exactly?
The view, still widely shared, that reason is both the defining feature of human nature as well as its best hope for survival. You find this, for example, in many legal systems as well as the scientism of our time.
Wait, what’s “scientism?”
That’s the belief that the natural sciences are normative for knowledge, or that they provide a model for what real knowledge is and/or how it’s obtained. What I call “strong” scientism claims the natural sciences alone provide true knowledge. “Weak” scientism for me is the view that other kinds of knowledge exist (for example, philosophical, artistic, spiritual and religious), just that natural scientific knowledge is the best knowledge.
That sounds right to me.
Of course it does, that’s a very important part of the culture we live in! As a previous age believed in God, we believe in science and the scientific method. So much so, in fact, that there are many people who refuse to undergo any kind of therapy that hasn’t been baptized in the laboratory.
It sounds like EPT comes more from the armchair than the laboratory!
That’s probably true. If EPT was baptized anywhere, it was in places like pubs, classrooms, cafes, and salons. Needless to say, scholars in the humanities, as well as most religious people, would take strong issue with scientism.
So is EPT anti-science? That is, don’t you think therapy is or ought to be a scientific undertaking?
No, it is not, and yes, but with two caveats.
One is that nobody who does therapy well, in my view, disputes the fact that there’s an art to therapy as well as a science. EPT is simply saying that the art component can be well informed by the rigorous philosophical research of the past century, that’s all.
Two is that if we invite science to the therapy party, we use a contemporary philosophy of science, not just one from the 17th century.
What does that mean?
What that means is that we don’t stop the scientific clock at Newton and pretend science has nothing to do with things like relativity, quantum mechanics, math, and the rest of theoretical physics. I think it also means we have to be very careful when we say we want “evidence-based” anything only.
I’m not sure I follow.
For example, in therapy outcome research, what gets to count as evidence? It’s a lot clearer in the medical context, I’d argue. And what effect does our theory of what gets to count as evidence have on what we’re likely to find?
To come back to the sociological point about scientism, how do we as a culture make the leap from from scientific to valid? Now I’m not saying it’s right or it’s wrong; just let’s be clear what we’re excluding from the healthcare marketplace and for what reasons. Is it just because a form of therapy says it’s based on philosophy rather than the laboratory? Okay, why, and what are the consequences for the knowledge base of therapy in general, the kinds of treatments people have access to, and the kinds of training aspiring therapists can get?
Some of these are questions of value, I’d argue, that science alone can’t answer. Another reason why I think we need to bring philosophy into the conversation about therapy in a meaningful way.
Yes, and so back to existentialism.
Right. So while there’s an overall concern with questions of meaning, authenticity, and commitment in existentialism, I think they all revolve around two foci, to use a mathematical term: freedom and finitude.
All right, what’s freedom for the existentialists?
Now there are many ways to think about freedom, but in this case I think the simplest definition is best: the ability to choose one thing from among a set of possibilities and commit to it.
That sounds like a rather heavy and burdensome view of freedom. What about the freedom to do as you please, or even escape commitment?
That’s freedom too. I guess what I’d say here is that commitment in this context doesn’t have to mean marriage or anything permanent. What it does mean is having the kind of relationship to your choices that makes them meaningful. For example, my choice to be a Red Sox fan doesn’t mean much if I’m a Yankee fan tomorrow, or vice versa.
So existentialists believe once you’ve made your choice you have to stick with it? That doesn’t sound like it would always be healthy to me.
It wouldn’t, and that’s not what existentialism demands. It demands, rather, a close look at how and what we choose, for what reasons, and what the consequences of those choices are. For example, being married has certain consequences, like them or not, as does singlehood or divorce.
Choosing one career over another also has consequences, as well as the decision to postpone choosing a career. Here existentialism isn’t that different from other non- directive therapies in placing the emphasis on examination, rather than a particular technique or course of action.
Speaking of non-directive therapies, what does all this examination get you? It seems to me this can be a recipe for paralysis.
It can, and when it does I think the therapist of any stripe needs to ask her client how come they’re choosing to use reflection as a brake on their existential freedom.
But as a philosophically-based modality, doesn’t EPT end up emphasizing reflection and introspection over behavior change?
I think philosophers as well as EPT therapists would take issue with that characterization of both fields! Perhaps somewhat ironically from the standpoint of your question, however, the best case for this kind of assisted self-examination – in this case on freedom – comes from the importance of effective action.
How so?
Well, consider this: when you need to take important action on your life (and emergencies aside) is it better to have more information or less?
More, obviously.
Right. Not unlike other therapies, EPT tries to get you to see how you’re deploying your freedom, so that you can add to the information you already have, which empowers you to make better choices or the very same ones in a whole different, more thoughtful, and committed way.
By the way, I think this is one reason people come to therapy: to find out the hidden implications and consequences of things they’ve done or may even be doing right now, so that they’re in a better position to evaluate them and make whatever changes they see fit.
All right, so how do existentialists see freedom differently than anyone else?
Glad you asked. Now this is an admittedly broad generalization, but I think there’s considerable truth to it. Overall, I think psychoanalytic types place the emphasis on the way biology and childhood determine us, whereas EPT recognizes this, but places the accent on people’s ability to meaningfully author their own lives.
Can you give an example?
Sure. I think Sartre nailed it when he said we as humans are “condemned to be free.” Let me give you one of my examples first, then one of his.
Imagine you and a friend are trying to decide what to do one evening. You ask your friend, “what do you want to do,” and your friend replies, “whatever you want to do.” Then you say, “no, I want to know what you want to do first.”
Now maybe you really know deep down inside what you want to do and just don’t want to say, for whatever reasons. Or maybe you really don’t know, and hope to find out by hearing what your friend wants to do.
But let’s say your friend feels the same way. S/he won’t volunteer a choice until you do first. So there you go, the two of you, asking one another what the other wants and never finding out until the sun comes up or one of you tires of this game.
Wow, that sounds painful!
It is, and do you know why?
Because it’s incredibly annoying?
Yes, because it’s damn hard work effacing one of the things that makes us human, according to the existentialists: our freedom. Why won’t your friend step up to the social plate, take a stand, and become a palpable human being in the room with you? Because what they’re doing by hiding their desires in this way is hiding their very selves from you.
Yes, it’s as if you’re trying to shake their hand and they’re keeping it in their pockets.
Exactly. Now existentialists go a step further and say that in order to take a stand, one has to be free to do so. And when someone is free and pretends not to be, that’s what Sartre call bad faith.
I’ve heard that before. That’s an existential put-down, isn’t it?
Well, not really; people like the early Heidegger would suggest what he calls “fallenness” or inauthenticity is part of who we are, perhaps even the default variable in some cases. So bad faith is something all of us have to contend with, and nothing to use except in the service of getting out of it.
So what’s Sartre’s example?
Well Sartre is famous for another pithy phrase, that we (in this case the French) were never so free as when under the German occupation.
That’s just absurd.
Would seem so from our standpoint, wouldn’t it? But hear him out.
Sartre claims that the constant surveillance by German soldiers made every movement, every gesture take on a powerful meaning it never had before or since. Is this a coded message to the Resistance or just someone adjusting his cap? Should I let myself look at what someone is reading or is that just asking for trouble? Things like who you talked to and didn’t talk to also took on a great significance, as you never knew who could be spying on you, trying to keep you out of jail, or even alive.
So freedom matters. What about finitude?
Glad you asked. Kant believed that if you melted away all the features that distinguished people from one another you’d get the pure alloy of reason. Existentialists would say one of many things that unites all beings is the fact that we’re all going to die.
This is where existentialists get accused of being pessimistic or morose.
Yes, and a similar criticism is made of Buddhism for saying all is suffering. Truth is, it’s actually life-affirming (to use a Nietzschean term) and energizing to acknowledge that life has an end. Think of how much more energy you might put into something you know is going to end, such as the school year, your stay at a particular home, a job, a relationship, or even your life.
That might tempt some people to throw their hands up and say what’s the use, I’m going to die anyway.
There’s a difference between despair and depression. It’s possible to face the absurdities of life and say it’s no use, might as well die now. I think that’s not just wrong morally, but that it draws the wrong philosophical conclusion: we have choices. And using the fact of our death to conceal our choices or pretend we’re not free is bad faith.
So what’s the difference?
Depression is the helpless, hopeless, worthless view of oneself and life which is based on faulty philosophical analysis and existentialism considers bad faith. And of course that’s not to use bad faith as a moral cudgel to beat someone who’s already suffering from depression with guilt or shame. Rather, it’s to give us a clearer sense of what it is depression is denying.
Despair, on the other hand, is the “oh my God I have to change my life” feeling you get when you realize you’re on the wrong track and have been so all or most of your existence. EPT therapists try to convert depression into despair whenever possible.
So why the focus on death?
Death is probably the best example of our finitude. Few of us know how and when we’re going to die, which right away reveals a deeper arbitrariness to life. Do we always die for a cause or even a reason? That’s not always clear.
So death is absurd because it’s arbitrary and meaningless.
Well what seems most clear is that as humans we tend to treat the absence of apparent meaning the way nature treats a vacuum. For example, when a friend stops calling, we don’t typically say, “oh well, this reveals the underlying arbitrary nature of existence, which is absurd, so I don’t need to worry about it.”
Not at all. I’m the kind to ruminate on the loss and wonder why it happened.
Exactly. We blame ourselves, one another, God, or a cold, uncaring universe, whatever. We rush to fill in the vacuum of a departure, a loss, or other lack in our lives with meanings. What is clear, and this leads me to the heart of existentialism, is that life is permeated with gaps, dissonances, disruptions, an
d tensions that no purely rational, mathematical, (or scientific) system can do justice to. Sometimes the universe divides by zero. That’s why we have things like poetry, literature, mythology, and religion.
So existentialists are philosophers of the absurd, the irrational.
I’d say more the pre-rational or non-rational. “Irrational” is still a pejorative and betrays a view of reason – specifically what Heidegger calls “calculative reason” – as normative. But yes, existentialists inquire into the fissures of human existence, the absence of meaning, the “no,” and the “not.”
Can you sum up EPT in a sentence?
Existential psychotherapy is about recovering the intrinsic difficulty of life and helping people face it.
Thank you!
No, thank you!
****************************************
And thank you Rascal! It’s been a pleasure working on this with you 
If you have an amusing or irreverant something to share on mental health, psychology, philosophy or therapeutic subjects and would like to be featured on the Wednesday Guest Blogger spot then drop me a line at woundedgenius[at]gmail[dot]com.
