Heidegger and Psychotherapy Cohn & Duploc EA8 1 PDF

JOURNAL OF THE SOCIETY FOR
EXISTENTIAL
ANALYSIS 8.1
Martin Heidegger
and
Psychotherapy
JOURNAL OF THE SOCIETY FOR
EXISTENTIAL
ANALYSIS 8.1
Edited by:
Hans W. Cohn
Simon du Plock
January 1996
----------------------------------- Contents ----------------------------
Editorial ............................................................................................... 1
Some Hurried Notes Expressing Outline Ideas That Someone

Might Someday Utilise as Signposts Towards a Sketch of an
Existential-phenomenological Theory of sexuality
Ernesto Spinelli ..................................................................................... 2
Why Heidegger?
Gion Condrau....................................................................................... 21
Martin Heidegger's Influence Upon British

Psychology and Psychotherapy
Ernesto Spinelli .................................................................................... 28
Phenomenology and Psychotherapy

Hans W. Cohn ...................................................................................... 39
Time-Limited Existential Therapy - A Structural View

Freddie Strasser.................................................................................... 46
Existential Therapy on Heideggerian Principles

Miles Groth.......................................................................................... 57
Martin Heidegger and Psychotherapy

Hansjorg Reck ...................................................................................... 76
Technical and Original Thinking in Psychotherapy

Norbert Vogt........................................................................................ 82
What defines the daseinsanalytic process?

Alice Holzey-Kunz................................................................................ 93
Dream interpretation, the "royal road" to the dreamer's

actual and existential suffering and striving
Utte Jaenicke...................................................................................... 105
An Existential Approach to HIV Related Psychotherapy

Martin Milton ..................................................................................... 115
Heidegger and "Hara" - An Introduction to Maieutic Listening

Peter Wilberg ...................................................................................... 130
Book Reviews .................................................................................... 139

EDITORIAL
The Editors are pleased to open the Journal with the Fourth
Annual Lecture from the Chair which was delivered to a very appre-
ciative audience by Dr Ernesto Spinelli in November 1996
We are pleased, as the title of this, the first edition of Volume Eight
of the Journal indicates, to be able to include a number of papers
which were presented at the highly successful Martin Heidegger and
Psychotherapy Conference which was held in 1996.
The Conference was held jointly by the Society for Existential

Analysis and the International Federation for Daseinsanalysis, of
which the Society is a member, and the majority of the papers which
appear in this edition reflect this. They include the Keynote Papers
given by Dr Ernesto Spinelli, Chair of the Society, and Prof Gion
Condrau, Chair of the Federation. Other contributors include Dr
Alice Holzhey-Kunz and Dr Norbert Vogt.
We hope to include many of the remaining papers from the

Annual Conference in the second edition of this volume.
Hans W. Cohn
Simon du Plock
1
Journal of the Society for Existential Analysis
SOME HURRIED NOTES EXPRESSING OUTLINE IDEAS
THAT SOMEONE MIGHT SOMEDAY UTILISE AS
SIGNPOSTS TOWARDS A SKETCH OF AN EXISTENTIAL-
PHENOMENOLOGICAL THEORY OF HUMAN SEXUALITY
Ernesto Spinelli
As some of you may have detected from its title, my talk to you
tonight reveals some degree of hesitation on my part. This is, in part,
in keeping with an attempt to make clear that I am in no position to
provide you with anything remotely resembling a "grand theory"
and that, instead, all I am prepared to offer is a series of possibly
useful suggestions that might be developed as elements of some
future theoretical model. However, my somewhat wary stance also
reflects more personal concerns. For one thing, I had no idea when
conjuring up the title, just how hurried these "hurried notes" would
turn out to be; this talk is as "hot of the presses" as talks can get. For
which, my apologies. Equally, when I first announced my chosen
topic, I had every expectation that it would be my last "Talk From
The Chair" for quite some time - if not forever - and I allowed myself
to suppose that, under such circumstances, my half-baked thoughts
would likely be treated with the sort of kindness that one bestows
upon a somewhat dotty relative about to take his leave. However, as
it has turned out, such is not the case and, instead, my previous
assumption can be seen to be one more instance of my tendency
towards what might be labelled as "premature enunciation". And,
with that allusion, let me turn to the question of human sexuality.
Alas, like so many other sages, the English poet, Philip Larkin, has
been proven wrong in his assertion that "the sexual revolution began
in 1963". Instead, what has become apparent over time is that, if
anything, the sexual upheavals of the middle to late 1960's were,
more correctly, extensions of a revolution in Western sexual thought
and behaviour that had begun a century earlier. While it may be odd
for us to think so, it seems to me that the evidence is overwhelmingly
in favour of the assumption that, rather than suppress sexuality, our
Victorian ancestors invented sexuality as we have come to think of it
today. Just as, equally, it remains the case that they created those
apparently irresolvable issues and dilemmas that persist in troubling
us, their descendants.
Even our terminology is far more recent than many of us suppose.
The word "sexuality", for instance, did not appear in English diction-
aries until 1800. In similar fashion, terms such as "sex-life", "sex
2
Some Hurried Notes...
appeal", and "sexy" were inventions of the first quarter of this
current century (Heath, 1982).
Michel Foucault, in his uncompleted History of Sexuality (1979-86),
has argued that the Victorian invention of sexuality evolved through
the recognition on the part of the relatively new bourgeoisie that its
recently acquired power base was already under threat from two
"whirlwinds" of socio-political emancipation: the rise of the work-
ing-class and the first women's liberation movement. In turn, this
awareness provoked a number of attempts to control such unruly
forces via various decrees whose aim was to institutionalise several
strands of social behaviour. With regard to sexuality, such decrees
were expressed in terms of the promulgation of numerous pamphlets
and learned texts preoccupied with the issues of policing the popula-
tion, the maximisation of its health, and the development of a new
technology of control over the body. In all cases, the underlying
purpose was that of "normalising" sexuality via the pronouncement
of what were its appropriate expressions and practices.
If one examines the literature and journalistic media of the time,
one finds an explosion of exposes whose concerns are all too similar
to those we read about and discuss today: incest, birth control,
divorce, prostitution, homosexuality, and sexual deviance or
perversion.
And, just as is the case today, who better to pronounce upon such
matters than (predominantly) men of science, and of medicine?
Indeed, a new science was invented - sexology - whose experts (al-
most exclusively male medical doctors) approached the study of
human sexuality via the examination of diseases, illnesses and cures
associated with sexual behaviour as well as with the distinction of
normal and abnormal sexual practices, desires, thoughts and cravings.
Indeed, when such "diseases" did not seem plentiful enough, new
ones could always be invented. One example of this latter tendency
can be seen in the "discovery" of a pernicious disease labelled sperma-
torrhoea.
[I]t is in Britain that spermatorrhoea has its full development... and this
above all as a result of the formidable activity of Dr John Laws Milton,
an indefatigable fighter in what he refers to as "the battle of
spermatorrhoea" (Heath, 1982: 21).
According to Laws Milton, the symptoms of spermatorrhoea in-
clude breathlessness, anxiety, bad digestion, brain fevers, epilepsy,
insanity, paralysis and death (Laws Milton, 1887). This is, I am sure
3
you will agree, serious stuff. Perhaps some of you present here
tonight might even be among the victims of spermatorrhoea. Just as
likely, you may be finding yourselves wondering: What is this dis-
ease? How come I've likely never heard of it?
Well, allow me to enlighten you: spermatorrhoea is the disease of
"involuntary nocturnal seminal emissions". It is the "wet dream
become waking nightmare".
As Laws Milton puts it, "seminal emissions are a real, serious, and
sometimes obstinate disease". Stringent maxims are in order: "in men
who have reached the age of three and four and twenty, everything
beyond one emission a month requires attention"; "lads never really
feel better for emissions, they often feel decidedly worse". Those in the
medical profession who hold that "an emission once a week or so can
do no harm" hold to "a very dangerous tenet.... (Heath, 1982: 21).
As to its remedy, Laws Milton suggests the application of cold
water upon the male genitals, sleeping on the floor, military service,
and, perhaps more attractive to some, the consumption of no less
than a bottle a day of claret. Alternatively, and more extremely, he
advocates the cauterisation of penile skin tissue and the donning of
two specially designed preventative appliances: the "urethral ring"
(which is a spiked circular piece of metal designed to pierce the
tumescent penis), or the "electric alarum" that administers an electric
shock to the penis at the moment of erection (Laws Milton, 1887).
Now, while all this may strike us as being risible, let me strike a
chord of caution into the account. For, no matter that the disease is
pure fiction, Laws Milton - and those who believed in his quackery -
went on to make the claim that there existed both "natural" and
"unnatural" types of emissions. Of the former, there was but one
kind: emission through the "connection" resulting from heterosexual
genital intercourse. All other forms of emission were deemed "un-
natural" and, hence, both leading to, and indicative of, disease.
The early sexologists took their principal arena of investigation to
be the medico-forensic study of abnormal sexuality. In this way, they
claimed, through the delineation of the unnatural and pathological
practices of sexuality, they would be able to discern that which was
"natural" sexual behaviour. Hence, the plethora of sexological stud-
ies by still well-known researchers such as Richard von Krafft-Ebing,
Albert Moll, and Havelock Ellis typically emphasise the study of the
"unnatural" and perverse in order to pronounce upon the "natural"
and the normal (Sulloway, 1979). Equally, the language employed by
4
such authors is cloaked in scientific medical terminology centred

upon "enlightened" notions of health and the prevention of disease
rather than upon more questionable edicts derived from Judeo-
Christian doctrine - although, to be sure, it is remarkable how closely
the former conforms to the latter. Further, it should be noted that all
sexological accounts assumed that the basis of sexuality lay in biol-
ogy and ascribed a direct and seemingly unquestionable line of
connection between reproduction and sexuality. Lastly, the Victo-
rian sexual revolution proposed an indissoluble link between sexual
preferences and practices and the psychological issues of personality
and identity such that deviant and perverse sexual practices were
distinguished as aspects of, or causal antecedents to, "sick" or per-
verted "minds" or identities.
All of these revolutionary ideas continue to dominate contempo-
rary Western views on sexuality. As such, it is to these three crucial
assumptions: the link between sexuality and biology (and reproduc-
tion in particular), the contrast between "normal" and "perverted"
sexual practices, and the connection between sexual expression and
identity, upon which I want to focus tonight's lecture. My aim will be
to suggest that each of these assumptions is significantly challenged
by existential-phenomenological theory and that, via this challenge, a
novel means to examine and understand the sexual concerns that our
clients bring to therapy, or which we ourselves may be experiencing,
can be initiated.
It may strike you as odd that existential-phenomenological theory
has had so little to say about such an obvious expression of "being
human". Surely, this situation cannot be due to a lack of interest in
the subject matter. Perhaps, at least as far as existential psycho-
therapy is concerned, it may be the case that there has been a certain
reticence in approaching an area that has been claimed as the almost
exclusive terrain of psycho-analysis. Perhaps, sometime or other, a
"pact" of sorts was made whereby the psycho-analysis took charge
of human sexuality while we were permitted to "wax lyrical" on
death anxiety.
Whatever the case, it is important to clarify that psycho-analytic
views on human sexuality exemplify those Victorian biases and as-
sumptions that I singled out before. Indeed, Sigmund Freud, while
arguably among the more liberal of his sexological peers, neverthe-
less emerges as the Victorian sexologist par excellence since he placed
sexuality firmly within the domain of biology, viewed the so-called
"sexual perversions" as deviations from either the "natural" sexual
object or the "natural" sexual aim, and, through his constantly re-
5
vised hypotheses concerning psycho-sexual development, proposed
an indissoluble link between the "blocks" or "arrests" that such
might confront and the development of personality and character. In
line with this, Freud's major treatise on this subject, Three Essays on
the Theory of Sexuality (Freud, 1977), conforms precisely to the textual
structure set by earlier sexologists in that it begins by focusing upon
"sexual aberrations", moves to a discussion of their hypothesised
aetiology, and finally lays down a number of implicit guidelines as to
Freud's understanding of what might constitute "normal" sexuality.
Without wishing to deny that, within this structure, Freud manages
to present his readers with a number of supremely powerful and
influential insights and arguments, nevertheless, as Frank J. Sulloway
has shown, Freud's great leap of originality lay not in presenting
novel ideas regarding human sexuality, since every one of the insights
now normally attributed to him had already been presented by
various other theorists, but, rather, in combining these disparate
views into one unified theory (Sulloway, 1979).
My point here is straightforward: far from providing us with a
radical alternative to Victorian views about human sexuality, psy-
cho-analytic theory reveals itself to be the principal and longest
lasting proponent of such views. As such, if existential-phenomeno-
logical theory wishes to move beyond this, it cannot rely upon any of
the theoretical insights derived from psycho-analytic theory but,
rather, must either re-interpret or subvert them.
So, let us consider the first of these assumptions: that human
sexuality must be placed within the context of biology in general, and
human reproduction in particular.
To begin, let us recall Soren Kierkegaard's injunction that, as
conscious beings, we have outgrown the immediate domination of
drives and instincts (Kierkegaard, 1969). With regard to sexuality, it
is evident that, unlike virtually every other creature, our desire to
engage in sexual activities is not solely, nor primarily, dictated by
biological "cycles" linked to the reproduction of the species. We do
not engage in sexual relations with the principal aim that such will
lead to the birth of our offspring. Rather, our most common sexual
activities seek to ensure that just such an outcome is avoided. In-
deed, pace Pope John Paul the Second, even most practising Roman
Catholics seek to find ways to evade this very consequence by
abstaining from genital intercourse other than in "safe" periods.
But more than this, I will go so far as to suggest that, based upon
my own experience, when I have had sexual relations in order to
allow the possibility of reproduction to occur, my perceptions and
6
feelings during such times have been distinctly different to those

when I have engaged in sexual relations where procreation was not
the principal intent. The desire to "make love" and the desire to
"make babies" is not the same, and while there may be a biological
imperative with regard to the latter, I would seriously question the
assumption that such an imperative fuels the former.
The person who has highlighted this distinction most clearly for
me is the French phenomenologist, Maurice Merleau-Ponty. In his
illuminating discussion on the body, Merleau-Ponty has argued that
the body is not a "thing" among other "things" to which one's
consciousness is somehow affiliated. Rather, our body is the vehicle of
being-in-the-world and a basic form of the appearance (manifestation) of the
world itself (Kovacs, 1993: 210). For Merleau-Ponty, the body is the
configuration through which all of our existential projects are real-
ised (Merleau-Ponty, 1962). That is to say, our body is the mode by
which we project our being onto the world. The body expresses our
unique dialogue with the world - it is the very expression of our
existence, of our creative presence, through which that which "I
idealise" becomes that which "I can". "Thanks to my body, the
abstract (ideal) plan of action... which is, at least in theory, realiz-
able... becomes irrevocably mine" (Kovacs, 1993: 210).
Merleau-Ponty stresses the intersubjective quality of incarnational
consciousness such that each of us interprets the world through our
body and, in parallel, interprets our body through the world. In
summarising this view, George Kovacs notes:
The body is not just a means or a secondary instrument of human
existence in the world, but the very expression of existence.... My body
expresses my existence in all its facticity and aliveness. For instance,
by shaking hands my entire body (not only my hand) expresses (on
many levels) the type of welcome (hesitant, happy, fearful, nauseating)
my presence (existence) grants to the appearance of another human
being... (Kovacs, 1993: 211).
This last point provides us with the necessary indication as to
Merleau-Ponty's existential-phenomenological analysis of human
sexuality. Sexual encounters provide us with a pivotal means with
which to express our presence to "the other" and, in turn, to express
the presence of "the other" to ourselves. Merleau-Ponty is not
interested in the issues of male or female sexuality, sexual orienta-
tion, or the socio-political dimensions of sexuality. His is an investi-
7
Journal cf the Society for Existential Analysis
gation aimed toward the clarification of sexuality as it is revealed in its
intentional dimensions (Merleau-Ponty, 1962).
The importance of sexuality for Merleau-Ponty lies in its ability to
"awaken" each of us to our relational being. "[I]n sexual living the
person projects (therefore reveals) his mode of being-towards-the-
world, other persons, and time" (Kovacs, 1993: 213). His stance
presents us with a conception of sexuality that expresses a world-
view in its totality - and not just a limited expression of "genitality".
Now, it seems to me that if we follow through with mis argument,
we are presented with a view of sexuality that undermines all as-
sumptions regarding its links to any biological imperatives derived
from reproductive drives. Instead, it places sexuality firmly within
the arena of inter-relational being and posits that it is a sublime
expression of each being's active desire to establish, and engage with,
a relational presence between self and other. How we are, sexually,
and what we enact sexually, therefore become statements not of
reproductive drive but of our willingness, hesitation, delight and
anxiety to explore the "being-with" of self and other.
The implications of this view for therapy are, I think, obvious and
significant. For they provide a relational dimension to the fears and
concerns regarding our clients' sexual encounters through which
each expresses who and how he or she is willing to be with self and
other. As an example of this, consider how such a stance is likely to
provide new realms of meaning to such experiences as that of the
adult sexual abuse of children or of the self-directed guilt invoked by
victims of rape.
Just as obviously, it allows us to break away from a number of
persistent psycho-analytic dilemmas. First, as I stated earlier, this
stance frees us from the need to explain all the varied manifestations
of sexuality in a fashion that must ultimately reduce them to their
bio-reproductive origins.
Let me explain this view via a simplistic analogy. According to the
ideas being proposed, there would be a significant divergence of
both meaning and intent when contrasting the experience of eating in
order to provide physical nourishment and eating with friends in a
restaurant. While both situations may, in some instances, allow both
physical and relational nourishment, it is evident that both may also
be kept separate. My body may not require any intake of food and
drink in the latter situation, but such activities may be vital compo-
nents of my ability and willingness to be with others in ways that are
mutually relationally satisfying. In similar fashion, no amount of
solitary intake of food and drink will satisfy my experienced "empti-
8
ness", or sense of "unfulfilment" in my intersubjective relations.
Once again, such views may be of value to our understanding and
treatment of various "eating disorders".
In similar fashion, my sexual relations - or lack of them - need not
be understood as being primarily bio-reproductively driven, but,
more pertinently, as expressions (however limited or unsatisfactory)
of my desire to disclose my presence to another and, in turn, to
experience the disclosing presence of the other.
Secondly, this view removes the psycho-analytic necessity of treat-
ing all other forms of engagement with the world as displaced, subli-
mated or symbolic expressions of libidinal drive. Rather, each rela-
tional enactment - be it in the form of friendship, care for another,
social engagement, creative activity, or whatever - need not be seen
as a displaced, sublimated or symbolic attempt to engage in sexual
relations but as a direct instance of my desire to be present, and in the
presence of, another - no matter how limited, limiting or anxiety-
expressing that enactment may be.
In general, this perspective removes the psycho-analytic require-
ment to reduce sexual, social, and private activities to some assumed
bio-reproductive impulse and, instead, allows the "meanings" in
each act of disclosure to stand revealed as they are presented to us.
With this alternative perspective in mind, we can now begin to
consider the second area of enquiry: the contrast of "natural" to
"unnatural", "normal" to "perverse" forms of sexual relations.
Once again, it is important that we remind ourselves that psycho-
analytic theory both embraces and demands such distinctions since
they are necessary to that model's insistence upon reducing all such
either to their bio-reproductive drive origins, or to primitive intra-
psychic object relations.
Of the very few existential-phenomenological authors who have
tackled this subject, it is Medard Boss who has had the most to say on
the matter. His view, however, is both illuminating and troubling.
For, while Boss presents a lucid argument that seeks to demonstrate
"that even in the most grotesque sadistic practices the individual is
attempting to actualize a "loving mode of being"" (Moss, 1978: 308),
such that perversions can be understood as desperate attempts to contact
another human being in the face of "insurmountable worldly barriers"
which [prevent] complete and fulfilled love relationships (Moss, 1978:
308), nevertheless, he persists in maintaining a, sometimes implicit,
sometimes explicit, pathologising attitude that can only be ultimately
understandable when contextualised within a bio-reproductive frame-
9
work (Boss, 1949). In this, by his own admission, Boss is "more
truly" Freudian than Freud and his followers.
However, this stance is riddled with contradictions that derive
from the very use of a term such as "perversion". For, if we maintain
the perspective inspired by Merleau-Ponty, and at least in part
advocated by Boss himself, then we are forced to ask: just what
constitutes a sexual "perversion"? If we can no longer rely upon
biology to guide our thinking as to what may be "normal" or "abnor-
mal", "natural" or "unnatural" sexual expression, then we have no
universally valid basis with which to make our pronouncements.
Instead, all that we have available to us is something far more
tenuous, and far more revealing of our individual and socio-cultural
biases and assumptions.
Allow me to provide you with two, hopefully amusing, examples
that clarify my argument:
I am lying in bed, my bare back turned away from my wife. I
experience a sensation that I interpret as that of my wife licking the
space between my shoulders. Remaining in my position, I say to her
that I am enjoying these sensations and would wish them to continue.
In response, my wife replies that, if so, I should then be thanking our
cat, Siggy, since it is he who is doing the licking. I immediately jump
up, suddenly disturbed, and emit a loud "Euchh!" that expresses not
only my sudden displeasure but also an implicit assumption that it is
somehow "perverse" of me to allow myself to be "turned on" by a
cat. My wife laughs, informs me that she was joking, and that it has
been she all along who had been licking my back. Immediately, the
seeming "perversity" of the experience and its accompanying sense
of displeasure, dissipates and I allow myself to re-interpret the
experience as both enjoyable and acceptable.
What is evident here is that the same stimulus provoked radically
differing reactions. As such, it was not the act itself, but my interpre-
tations regarding the act - such as who was administering it and what
I allowed as "proper" instances of arousal - that were the decisive
factors.
A similar instance to the one just recounted can be seen in the Neil
Jordan film The Crying Game (Jordan, 1992) wherein the principal
character who has previously enjoyed the experience of being fel-
lated by the female nightclub singer he has recently met, suddenly
discovers that "she" is most definitely a "he" and immediately
becomes violently ill.
As my second thematic example, I direct your attention to a brief
stand-up comedy routine presented by Woody Allen. I believe that
10
this sketch is a masterful example of how an absurdist confabulation
can be employed to expose all too prevalent assumptions and biases
with great effect.
In this sketch, Woody tells his audience that he has recently seen a
documentary film about the islanders of the Faroe islands, just off the
coast of Denmark and Sweden, who have a very sexually progressive
life-style. However
Like every society they have to have something in these islands that
they're ashamed of. And they're not ashamed of having sex. They like
it. But they are ashamed, oddly enough, of eating food.
And that struck me as strange, because, in this country, you know,
we'll think nothing of eating three meals a day, you know, in front of
women. Just "do it". But sex is very touchy. And on these islands,
sex is open and progressive and fabulous, but food is a dirty subject.
There's these strange little guys always running up to you saying
"Hey! Buddy! How'd you like to get... a Rye Bread?" Or else: "Say,
I can get ya a picture of a Grilled Cheese Sandwich."
And there are some women who will even eat a bagel. But they won't
put cream cheese on it. And if you ask them why, they say: "Well, I
don't do that."
They showed in the movie, in fact, a man in a convention who checked

into a hotel and the elevator operator fixed him up with a mixed green
salad. And he ate the salad in the middle of the night, you know, and
he put on his pants and went home. He said it was a very empty
experience. (Allen, 1964).
Both these examples raise interesting questions - some of which I
will return to in the final section of this talk. For now, all that need be
said is that our experience of, and ability to designate, the perverse, is
no straightforward matter and, rather than point us toward biology
directs us squarely to the much more relative realm of personal and
socio-cultural biases.
If it is a verity that all cultures designate what is both a natural and
a perverse expression of sexuality, it is equally true that wide areas of
disagreement exist with regard to all conceivable activities.
If we consider this general argument from the standpoint of our
current socio-cultural perspective, we can also note that what that
same culture views as perverse at one point in time can, and does,
11
alter at another. For example, only some thirty years ago, most
North Americans viewed all oral-genital acts between consenting
adults to be perverse, to the extent that, in some States, individuals
caught engaging in such activities were imprisoned. Today, these
same acts, at least insofar as they are between heterosexual partners,
are taken to be both acceptable and desirable. In similar fashion, fifty
years ago, in this country, young unmarried women who engaged in
sexual relations with several male partners were, if discovered,
labelled "mad", subsequently incarcerated, and, to put it bluntly,
tortured by their psychiatrists via the use of electro-convulsive therapy
and lobotomy (or leucotomy). Once again, the basis for such
decisions was derived from highly dubious biological theories.
If we have "progressed" in our attitudes, such "progressions"
reveal only that we have re-interpreted in a more open and accepting
fashion that which we label as "normal" and "perverse". However,
we must remain cautious in our positive evaluations of ourselves.
Sometimes, that which appears to be "progressive" also serves to
maintain suppressive attitudes. For example: one of the most notable
changes in our current heterosexual activities can be seen in the
greater willingness on the part of Western males to accept as "nor-
mal" those sexual positions that place their female partner "on top" -
an attitude that even twenty years ago would have been viewed with
suspicion, possible alarm, and, may well have been theorised as
expressing some form of pathology inherent in either, or both, part-
ners. Now, while this change in attitude may at first be supposed to
be an outcome of the impact of the second wave of women's libera-
tion movements, in fact, the "liberationist" agencies that we have to
thank for this shift happen to be Hollywood in general and the
pornographic film industry in particular. For, it was discovered that
in the filming of sex scenes wherein this particular position was
adopted, the males in the audience were better able to view parts of
the female actresses' anatomies that would otherwise have been
more obscured had they assumed the "male on top" position. That
these questionable rationales also served to suggest that such entan-
glements were both pleasurable and acceptable, rather than per-
verse, and that they may have proven to be the primary spur that
allowed heterosexual couples to adopt similar positions in private,
should, I think, raise questions as to our assumptions about
"progress".
In any case, when it comes to our views on how "progressive" we
are, our continuing dominant attitudes towards any form of homo-
12
sexual relations should serve to remind us of how suppressive our
attitudes remain.
Homosexual relations stand out, for most members of our culture,
as the primary expression of the pathological and the perverse. But,
here, too, note that such labels only make sense, and can only retain
their emotive and explanatory power, when placed within the con-
text of bio-reproductive assumptions regarding human sexuality.
Once again, such activities can only be labelled as "unnatural" if
contextualised within reductive assumptions of "reproductively-di-
rected sexual impulses that have gone awry". Once this assumption
is questioned, and dismissed as being inadequate, what we are left
with is the obvious: that rather than express some form of pathology,
be it the result of bio-chemistry, genetics or, as Freud wrote in his
now-famous letter to the worried mother who suspected her son of
being a homosexual, a variation of a sexual function produced by a
certain arrest of sexual development (Freud, 1961: 277), homosexual
relations express the very same intersubjective desires to be with
others as can be ascertained in all other sexual manifestations. That
such may be the chosen means by which an individual both
expresses and avoids intersubjective anxieties, that such may both
allow and prevent particular forms of self/other dialogue, that they
may be dependent upon interpretational distinctions as to what
form of dialogue is acceptable or desirable with reference to
particular categories of "others", reveals nothing that is not
similarly revealed in any other form of sexual relation, such that to
distinguish this particular means of disclosure as inherently different,
unique, problematic or perverse has no basis - other than at the
level of an interpretative bias that must be challenged rather than
condoned.
However, any such attempted challenge reveals significant prob-
lems. Perhaps the most trenchant among these emerges with the
recognition that an increasingly significant proportion of men and
women who have been labelled, and who label themselves, as homo-
sexual have come to accept and promulgate those "biologically es-
sentialist" views that single them out as different, unique, problem-
atic and, indeed, perverse.
The search for a broadly biological basis for homosexuality has, if
anything, increased since the days of the pioneer sexologists. Neuro-
endocrinal explanations (Dorner, 1976), have given way to
hypothalamic and morphological solutions (Le Vay, 1996) and, even
more recently, to genetic factors found in the Xq28 region of the X
chromosome (Hamer, 1994). Needless to say, all such findings raise
more problems than offer solutions. Not least among these, as far as
13
I can ascertain, is that all the evidence in favour of these explanations
is based upon studies of exclusively male subjects - and, as such,
offer little of explanatory value regarding the basis for female
homosexuality.
Speaking personally, I find the acceptance of these studies by
anyone espousing broadly "liberationist" or "progressive" views as
being deeply disturbing. While they may seem to provide the means
by which an individual is no longer held accountable or responsible
for being the way he or she is sexually, since such is the result of a
biologically-derived anomaly and, in being so viewed, allows some
gains regarding matters of employment, personal insurance, and the
like, nevertheless the price of accepting such is nothing less than the
admission of an inherent deficiency and abnormality in one's very
being. Perhaps, the continual heterosexually-inspired oppression of,
and antagonism toward, those labelled homosexual may have served
to make such separatist options seem substantially preferable to
previous alternatives. Certainly, similar stances have been adopted
by sizable numbers of other harassed and persecuted groups. Ac-
knowledging this, and acknowledging as well that I speak as one
who has suffered little by way of harassment and persecution, I
remain distrustful of such isolationist perspectives - not least because
they both validate and maintain the employment of labels such as
"abnormal" and "perverse".
Is there an alternative? I think there is and, as must be acknowl-
edged, its basis lies in a decidedly Freudian pronouncement. In a
footnote to the 1915 edition of Three Essays on the Theory of Sexuality
(Freud, 1977), Freud posited that from the point of view of psychoanaly-
sis the exclusive sexual interest felt by men for women is also a problem that
needs elucidating... (Freud, 1977:56-7). In other words, in response to
the question "Why homosexuality?" Freud asks, quite correctly,
"Why exclusive heterosexuality?" I emphasise the word "exclusive"
since this implicit qualification is of central importance to Freud's
argument, even if it has passed by most other commentators. Freud
could not truly ask "Why heterosexuality?" since this query would
dismantle the whole of his bio-reproductive model of sexuality. All
he could query was "Why not, sometimes, both?" The limitations of
his own model could not allow him to ask the more pertinent, and
revolutionary question.
However, not being psycho-analysis, there is nothing to stop us
from asking that same question as openly as possible. And, in so
doing, we move to the last of the major concerns that I want to raise
tonight: the relation between sexuality and identity.
14
Before I do so, however, I want to convey my indebtedness to my
students in the various courses I have taught on human sexuality for
their input regarding this area. And, in particular, I wish to single
out two graduates of the MA in Psychotherapy and Counselling
Programme at Regent's College, Darren Wolf and Tony Babarik,
whose writings on this subject have influenced and illuminated my
thinking.
Both Darren and Tony have referred to a quote by Michel Foucault
that is worth repeating:
Homosexuality appeared as one of the forms of sexuality when it was
transposed from the practice of sodomy onto a kind of interior
androgyny, a hermaphrodism of the soul. The sodomite had been a
temporary aberration; the homosexual was now a species (Foucault,
1979: 43).
Considered more generally, Foucault's observation reminds us
that the behaviour under question has existed in all societies since the
dawn of our species. What is new is that the activity has become an
identificatory label to apply to those who practice it.
Such a development allows a crucial internalisation to occur.
Now, all of us are able to identify ourselves either as "beings who are
- or are not - the activity". In other words, what we do, or do not do,
has become who we are, or are not.
A number of critics of this assumption as applied to the label of
"homosexual" have raised serious concerns about its implications.
Both the sexologist, Alfred Kinsey (Kinsey et al, 1948), and the
novelist and essayist, Gore Vidal (1965) have argued that the word
"homosexual" should only be used as an adjective to describe sexual
activity and not as a noun to describe and identify a particular type of
being. In this, they echo Foucault's warning that the Western com-
pulsion to categorise sexual acts leads inevitably to the construction
of sexual categories of identity. Foucault suggests that the way in
which we structure our thoughts, changes the thoughts themselves.
As an extension of this view, I would argue that the way we structure
our being, imposes limits that force us to both sediment and dissoci-
ate various experiences of being-in-the-world.
It is vital to note, that just as such consequences are applicable to
the correlation of homosexual acts with the construction of a "homo-
sexual identity", so, too, is it the case that the correlation of hetero-
sexual acts (or, indeed, arty sexual act) with the construction of a
"heterosexual identity" (or a "sexual identity" in general) imposes
15
significant sedimentations and dissociations regarding our experi-
ence of relational being.
Once again, it becomes apparent that it is not the activities in
themselves but, rather, the particular personal and socio-cultural
meanings associated with them that are of importance to the current
debate on human sexuality.
The tendency to identify our "selves" with our sexual orientations
appears to be a "given" of contemporary Western society. But we
must also recognise that this is a relatively recent development that
still remains open to our reconsideration and re-evaluation.
Terms such as "homosexual" and "heterosexual" serve as instru-
ments of self-definition. Indeed, with regard to these particular
terms, it is evident that each requires the other in order to provide
itself with any substantial meaning. It is equally apparent that such
labels as "straight", "gay", or "queer" now extend far beyond the
specific confines of sexual preferences in that they allude to, or are
identified by many as, compacted statements regarding socio-politi-
cal attitudes and affiliations, economic classifications, and personal
and group empowerment.
But, it must be asked, just how valid are these demarcations of
identity?
On reflection, I would suggest, they enforce an insidious form of
separationist stereotyping that has little basis in the lived reality and
identity of most of us. The label of "heterosexual" or "homosexual",
while alluding to some unified meaning, instead reveals the opposite
in that both retain a wide range of differing and competing mean-
ings. One might label oneself as "heterosexual" or "homosexual" in
order to reflect, or make sense of, a persistent longing for an absent
parent. Someone else may identify with such labels in order to
express his or her comfort or discomfort with traditional gender
roles. Yet another may adopt such labels so as to express a stance of
personal and social rebellion or compliance. And for yet another,
these labels are meant to express his or her preferred, or most
personally satisfactory, means of achieving sexual pleasure and com-
fort.
In line with this, I am certain that I am not the only individual who
has experienced the phenomenon whereby one's friend (or even
oneself) who, in reassessing his or her interpretative stance toward
any or all of these variables, in turn re-defines himself or herself as
being either heterosexual or homosexual. The plasticity of such re-
definitions, whatever their sexual direction, reveals that, far from
16
being "fixed" in biology, our sexual identities rely far more upon
constructivist variables.
It is equally important to recognise that the adoption of either term
does not imply that one's sexual relations need remain exclusively
associated with the same or opposite gender. Research evidence
remains consistent in its conclusion that significant numbers of
heterosexuals and homosexuals engage in pleasurable and meaning-
ful sexual activities with members of the same and opposite gender.
Just as, in similar fashion, the same research points out that not all
those who identify with either label wish to suggest that they engage
in any form of sexual relations with the same or opposite gender.
In following this Une of reasoning, Darren Wolf has raised a
significant question: just how many instances of heterosexual or
homosexual activity are required before each label of self-identity
can be justifiably adopted? Interestingly, he suggests that, from a
legal standpoint, while just one instance of homosexual activity is
deemed sufficient to "prove" homosexual identity, a singular in-
stance of heterosexual activity is, in contrast, considered insufficient
to "prove" one's heterosexual identity. Just as pertinently, he has
argued that this, admittedly absurd, standard is accepted by those
members of the "gay community" who engage in the "outing" of
political and entertainment personalities (Wolf, 1995). While he does
not say so explicitly, I put it to you that the very same standard has
been, and continues to be, applied by, both the "respectable" and
"sensationalist" heterosexually-inclined Western media.
All of the above points raise significant concerns. If, as I and others
have argued, the association of sexual stances with personal identity
remains problematic, not least because of the inconsistencies and
limitations that this link imposes, what allows it to persist for all of
us? Kenneth Plummer provides a concise and valid explanation:
With all these categorisations comes the paradox: they control, restrict and
inhibit whilst simultaneously providing comfort, security and assurances
(Plummer, 1981: 29).
Here, I think, lies the crux of the issue. Just as, in general, the
formation of a self-construct provokes the necessity to adopt dual
dispositions that both serve to sediment the accepted or "owned"
construct beliefs and values and to "disown" or dissociate those
experiences that contradict or seek to de-sediment that construct
(Spinelli, 1994), so, too, is it the case in the specific instance of the
association of sexual attitudes and behaviours with sexual identity.
If the cost of such is the imposition of a fixedness in intersubjective
meaning, its value lies precisely in the identificatory security (however
17
limiting and problematic) that this same fixedness provides. As
Richard Isay has asserted with regard to the development of male
homosexual identities:
In our society where male and female roles and behaviour are rigidly
defined at all developmental levels, conformity is prized and
atypicality is viewed with scorn and usually rewarded with
humiliation and derision. Homosexual youngsters of 4, 5 and 6
particularly those who show any variance from what is considered
typically male, develop a sense that they are outsiders. This early
self-perception may lead in later childhood to secretiveness and
isolation. Such behaviour in turn frequently affects the response of
peers and may result in further social isolation and unhappiness (Isay,
1989: 30).
Surely, his remarks (while, admittedly somewhat simplistic) can
be, broadly speaking, as equally pertinent to assumptions regarding
the adoption of a female homosexual identity or of a male or female
heterosexual identity.
Even so, his statement contains an implicit psycho-analytic as-
sumption based upon a view of linear causality that is, at best,
questionable (Spinelli, 1994). As such, in maintaining an existential-
phenomenological attitude, we must re-interpret his assertion.
In their text Reason and Violence, R D Laing and David Cooper
suggest that homosexuality is an outcome... invented by a child at a
critical moment (Laing and Cooper, 1964: 79). Once again, the state-
ment is equally applicable to heterosexuality. But the crucial word in
that quote is "invented". In this, Laing and Cooper hint at an
existential-phenomenological view of the past that subverts psycho-
analytic analyses. This latter view argues that "the past" as evoked at
any moment in time, cannot be isolated from the evoking being's
current (or present) meaning constructs, as well as that being's
future-directed intentions. With this shift in perspective, the past can
be seen to be not the causal determinant of our current self-construct,
but, rather, as a highly selective interpretative construct designed to
validate, or to provide evidence for, a being's current sedimented self-
construct. In other words, the past that we recall allows us to
maintain the self we believe we are, or must be, through the very
"invention" or construction of "critical moments" that have "made
us the way we are".
Within the specific confines of this talk, what I am suggesting to
you is that, in essence, we identify ourselves as homosexual, hetero-
sexual, or any-kind-of-sexual not because of past circumstances, or
18
biological dictates, but because it is who we say we are. And, in saying

so, we provide the current self-construct with its meaning and valid-
ity. As Jean-Paul Sartre so succinctly put it: we are our choices (Sartre,
1972: 463).
Existential-phenomenology stands in a unique position with re-
gard to the issue of human sexuality. While its investigative stance
demands that we respect the being choices that each of us makes, and
asserts that we can do nothing but make choices that sediment the
meaning we construct as to our being, nevertheless, this same inves-
tigative aim subverts our currently-adopted meaning insofar as it
"opens" it to the consideration of novel meaning possibilities.
With specific regard to the issues and "discontents" surrounding
human sexuality, existential-phenomenological investigation, while
respecting those views that associate sexuality with assumptions of
biology and identity, must also expose the limitations that such
impose upon our intersubjective possibilities. If, as David Smail,
among others, has suggested, sex has become a commodity that
"sells" in an extraordinary efficacious manner (Smail, 1987), then we,
in Heideggerian-inspired fashion, must retort that, today, the bio-
technologicalisation of sex also threatens to kill not only our physical
beings, but, just as importantly, that very spirit that opens us to our
relational existence.
Towards the conclusion of his book, Sexuality and its Discontents,
Jeffrey Weeks writes that, in the end, we are left with the body and its
potentialities for pleasure (Weeks, 1985: 244). Let me re-phrase this
conclusion. In the end, we are left with the body and its potentialities
for being.
References:
Allen, W. (1964) Golden Hour Presents Woody Allen. London: Pye Records,
GH654.
Babarik, A. (1996) A Phenomenological-Existential Perspective on Homosexu-
ality: a non-pathologising therapeutic approach. Unpublished MA Disser-
tation. London: School of Psychotherapy and Counselling, Regent's
College.
Boss, M, (1949) Meaning and Content of Sexual Perversions. New York: Grune
& Stratton.
Dorner, G. (1976) Hormones and Brain Differentiation. Amsterdam: Elsevier.
Foucault, M. (1979) The History of Sexuality. Volume One: An Introduction.
London: Allen Lane.
Foucault, M. (1985) The History of Sexuality. Volume Two: The Use of Pleasure.
New York: Random House.
19
Foucault, M. (1986) The History of Sexuality. Volume Three: The Care of The
Self. New York: Random House.
Freud, E .(ed) (1961) Letters of Sigmund Freud 1873-1939. London: Hogarth
Press.
Freud, S. (1977) 'Three essays on the theory of sexuality' in On Sexuality.
Pelican Freud Library, Vol 7. Harmondsworth: Penguin.
Hamer, D. (1994) The Science of Desire: the search for the gay gene and the
biology of behaviour. New York: Simon & Schuster.
Heath, S. (1982) The Sexual Fix. London: MacMillan.
Heidegger, M. (1962) Being and Time. (J. Macquarrie and E. Robinson, trans).
New York: Harper & Row.
Isay, R. A. (1989) Being Homosexual. New York: Farrar, Straus & Giroux.
Jordan, N. (1992) The Crying Game. Feature film.
Kearney, R. (1986) Modern Movements in European Philosophy. Manchester:
Manchester University Press.
Kierkegaard, S. (1969) The Journals of Kierkegaard. New York: Harper & Row.
Kinsey, A. C. Pomeroy, W. B. & Martin, C. E. (1948) Sexual Behavior in the
Human Male. Philadelphia: W B Saunders.
Kovacs, G. (1993) 'The personalistic understanding of the body and sexual-
ity in Merleau-Ponty', in Merleau-Ponty & Psychology (K Hoeller, ed)
Atlantic Highlands, New Jersey: Humanities Press.
Laing, R. D. & Cooper, D. G. (1964) Reason and Violence. Harmondsworth:
Penguin.
Le Vay, S. (1996) Queer Science. Cambridge (Mass): MIT Press.
Merleau-Ponty, M. (1962) Phenomenology of Perception. (Colin Smith, trans).
London: Routledge & Kegan Paul.
Milton, J. L. (1887) On the Pathology and Treatment of Spermatorrhoea.
London.
Moss, D. (1978) 'Medard Boss', in Existential-phenomenological Alternatives
for Psychology (R S Valle and M King, eds). New York: Oxford
University Press.
Plummer, K. (1981) The Making of the Modern Homosexual. London:
Hutchinson & Co.
Sartre, J-P. (1972) Being and Nothingness. (H Barnes, trans). London: Routledge.
Smail, D. (1987) Taking Care: an alternative to therapy. London: J M Dent and
Sons.
Spinelli, E. (1994) Demystifying Therapy. London: Constable.
Sulloway, F. J. (1979) Freud Biologist of the Mind. London: Andre Deutsch.
Vidal, G. (1965) The City & The Pillar. London: John Lehmann, Ltd.
Weeks, J. (1985) Sexuality And Its Discontents. London: Routledge & Kegan
Paul.
Wolf, D. (1995) 'Describing homosexuality'. Unpublished Essay. London:
School of Psychotherapy and Counselling, Regent's College.
20
WHY HEIDEGGER ?
Gion Condrau
Modern science generally does not ask what its philosophical

premises are. This is not only true for scientific research but equally
for practitioners in the fields of medicine and psychology as well as,
and this is particularly astonishing, for those of the social sciences. At
any rate, the syllabus of medical schools does not foresee any lectures
in philosophy, and psychology and the social sciences also seem to
do without it. But in so doing, two things are deliberately overseen,
firstly that from a historic perspective, there has always been an
intimate association (relationship) between philosophy and the sci-
ences, and, secondly, that this relationship continues to exist, even
though it is no longer specifically considered or made a subject of
discussion. In any case, it is of interest to find out what is at the root
of this reluctance to deal with philosophical issues, why there is such
a secret, often unadmitted, fear of dealing with philosophical ideas
thoughts. The only thing we often hear is that the language of
philosophers has frequently strayed too far from everyday, spoken
language, and that it sounds like a "foreign language" for many. But
there is something else: Whenever there is talk of science, the natural
sciences seem to take such priority that the question regarding their
scientific roots is not only not asked but is considered obsolete. The
more recent developments in the areas of medicine, psychology,
psychiatry, and psychotherapy in particular, the same as the social
sciences with their claim to "scientific method" and corresponding
objectivity, are logical proof of it. Objectivity in the natural-scientific
sense means that the object of our research can be measured, calcu-
lated and weighted. It is no coincidence that people speak of quality
research and mean the proof of measurable, efficient results. In the
area of psychotherapy research, a subject we are more familiar with,
the proof of effectiveness and, consequently, a systematizing, in-
creasingly rigid nomology of disease entities is advancing in keeping
with the current Zeitgeist and demanded by it. This not only feels
uncanny, but also potentially jeopardizes the future of our profes-
sion. We find ourselves in a situation similar to the one at the
beginning of this century, when Sigmund Freud (1856 - 1939) began
to open up new ways of understanding humanity and diseases with
his psychoanalysis. He still believed that he would see his findings
confirmed by future natural-scientific research, and that psychoa-
nalysis would be acknowledged as an applied natural science, in
21
which he was confirmed by a considerable number of successors. But
for others, psychoanalysis did not at all meet the stringent criteria of
an exact natural science; remember the critique of Karl Popper and
Medard Boss. In addition, the dissatisfaction with Freud's theory of
instinctual drives led some of his disciples and successors in Europe
as well as the Anglo-Saxon world to develop new theories at an early
stage, and to deviate from psychoanalysis in practice. Some of them
continued to call themselves "analytical" or "neoanalytical", or the
more behavioural-therapeutic or system-oriented procedures were
developed. Subsequently, psychotherapies of humanistic and exis-
tential orientation differed seriously, most of all probably the
phenomenologically oriented Daseinsanalysis, a terminology that
needs to be explained to non-German-speaking people.
Daseinsanalysis and its history go back to two roots: To psychoa-
nalysis of the Freudian school and the ontologic-phenomenological
thinking of Martin Heidegger (1889 -1976). Whether this assumption
is correct or will require reinterpretation is not our issue here. But it
has to be pointed out that the daseinsanalytical school, as mentioned,
argues against attributing psychoanalysis to the natural sciences.
Also, it should not be forgotten that modern historians also question
the philosophical principles of Freud and feel that its theoretical base
is probably more related to Schopenhauer than to Descartes.
Ludwig Binswanger (1881 -1966) began to criticise Freud's theory
early and distanced himself primarily from the "homo natura" and
his endeavour to satisfy his instinctual drives while maintaining the
pleasure principle. According to Binswanger, this is a scientific con-
struct which is only possible on the ground of a destruction of
humanity's overall experience. A natural-scientific psychology, as
Binswanger sees it, is a contradictio in adjectio because it does not take
into account human existence, that is Being-in-the-world. Only after
the human being "as he or she exists" has been thus destroyed can we
start to design and construct humanity based on a specific principle
or a specific idea, be it according to Nietzsche, with the principle of
the will to power as a possibility to find meaning in human life
coined by suffering, or be it according to Freud who saw the pleasure
principle as a possibility of preserving and enhancing life.
But disproving psychoanalytical basic tenets was not Binswanger's
only concern, far from it. Rather, he was guided by a scientific
discomfort with the traditional, systematizing, clinical psychopa-
thology. More specifically, his sharp criticism was directed against
the one-sided natural-science orientation of psychiatry and psycho-
therapy. This led to the foundation of a "phenomenological anthro-
22
Why Heidegger?
pology," primarily under the influence of Edmund Husserl's (1859 -
1938) philosophical phenomenology. After 1927, Binswanger aban-
doned Husserl's ideas and turned to Martin Heidegger who had just
published his ground-breaking book "Being and Time" that year.
This work and its author turned out to be of decisive importance for
the further development of "existential" psychotherapy.
When we introduce the term "existence," the question arises what
the true meaning of this term is and to which philosophers the
various "existential" therapies can refer. A first cursory glance will
tell us that it is not easy to answer this question. If we go back far
enough, we will probably have to mention Soren Kierkegaard (1813 -
1855) as the first "existential" philosopher where we do indeed find
many clues which seem to indicate that it makes sense to refer to him.
Terms such as "anxiety" and "guilt" especially, gained new depth
through his thinking, the same as the problem of individual responsi-
bility and freedom. Quite a few writers see the philosophical "tap
root" of present psychotherapy in the writings of the Dane. In any
case, he leads the group of philosophers who became known under
the term of "existential philosophy" or "existentialism". This group,
however, does not see itself as an undivided whole. There is a certain
common ground, of course, among other topics with regard to the
discussions of involvement which have to be weighted psychothera-
peutically. Its influence on the discussion concerning psychotherapy,
however, was rather limited. Thus the philosophical and anthropo-
logical ideas of the French existential philosophers Gabriel Marcel
(1889 - 1973) with his "philosophy of hope" and Jean-Paul Sartre
(1905 - 1980) with his "psychanalyse existentielle" as well as the
"existential communication" of the German Karl Jaspers (1883 -
1969), the great opponent of Martin Heidegger, have not had any
significant impact. It is true that Jaspers was a psychiatrist and did
extraordinary work in the area of psychopathology, but he did not
particularly care for analytical psychotherapy.
Unlike Martin Heidegger. He became the primordial philosophi-
cal source of existential psychotherapy, although he disclaimed to be
an existential philosopher, even as he sought to disclose and eluci-
date the fundamental structure and meaning of human existence.
Based on Heidegger's philosophy, Binswanger called his research
orientation "Daseinsanalysis". But what does this term mean? Why
can it not be translated into other languages, and how did coopera-
tion with existential practice come about?
Let me summarize briefly. Martin Heidegger was born on Septem-
ber 26,1889 in Messkirch (Germany), the son of a master cooper, and
23
began his academic studies at the Theological Faculty of the Univer-
sity of Freiburg in the winter term of 1909/10. A short stay with the
Jesuits in Feldkirch led to the later legend that Heidegger had alleg-
edly considered becoming a Jesuit but had, according to the same
source, been rejected by the order for health reasons. At any rate,
Heidegger gave up his theological studies after four semesters and
dedicated himself to philosophy full-time. In 1913, when Edmund
Husserl published his "Ideen zu einer reinen Phänomenologie und
phänomenologischen Philosophie" and Max Scheler (1874 - 1928) his
treatise "Zur Phänomenologie der Sympathiegefühle und von Liebe
und Hass," he embraced phenomenology and spent the period of his
teaching activity from 1919 to 1923 as a private lecturer and Husserl's
assistant in Freiburg. In 1923, he was appointed to a professorship in
Marburg, and in 1928 again to Freiburg as Husserl's successor. From
the moment the formerly apolitical Heidegger was appointed Presi-
dent of the University of Freiburg, a momentous entanglement began
with the politics of the national socialist party which made it impos-
sible for him to teach in Germany after the end of the war and also
gave rise to heated discussions regarding his person. The voices have
not yet been silenced which try to tie his thinking to the national
socialist ideology.
As mentioned before, Ludwig Binswanger and his circle discussed
Heidegger at a very early stage. Strangely enough, however, it was
Medard Boss who could enlist the German thinker for the concerns
of psychiatry and psychotherapy. After an extensive correspond-
ence, initiated shortly after the end of the second World War,
Heidegger gave seminars in Zollikon near Zurich for almost ten
years, from 1959 to 1969. These seminars were attended by psychiat-
ric assistants and were later published by Boss as "Zollikoner
Seminare" (Zollikon Seminars). An English version is under way. Up
to now, some excerpts of the seminars have been published by Erik
Craig (1988) in a special issue of the Humanistic Psychologist. The
seminars were intended for the following purposes:
1. to lead to an adequate understanding of "Daseinsanalysis"

2. to clear misunderstandings about the phenomenological ap
proach to neurosis and psychosomatic illness
3. to hone the thinking of natural-scientifically educated psychia
trists and psychotherapists. (Psychologists were not yet admitted at
that time. In Switzerland, they happened to be admitted to the
profession of psychotherapist much later.)
24
Why Heidegger?
Thus, Heidegger never intended to create a new theory of neurotic

and psychosomatic illness, but he was genuinely interested in the
specific problems of this field which he got to know through Boss and
the participants in the seminars. Questions are raised regarding the
idea of stress, concerning causality, psychoanalysis, time and space,
and last but not least, regarding the psychiatric Daseinsanalysis of
Ludwig Binswanger who, according to Heidegger, had misunder-
stood some basic tenets of Heidegger's thinking. "Dasein" according
to Heidegger is that being which is concerned with its Being, which
has a primary understanding of the Being of all other beings. In other
words: the human being. But why does Heidegger not simply speak
of the human being? By using the term "Da-sein" he wanted to get
away from the biologically oriented definitions of being human and,
instead, indicate the specific nature of the open relatedness to being
and all it encounters. "Da" is symbolic for the openness of Da-sein.
The literal translation of Da-sein into English means Being-there.
Heidegger used Daseinsanalysis in various ways: first as
Daseinsanalytics, questioning the fundamental ontological meaning
of Being or the Being (Sein) of beings (Seiende). "Being" accordingly
is not an abstract concept, but always the Being of beings. Since, as far
as we are able to know, only the human being has a primary under-
standing of Being, an analysis of Being must proceed from an (onto-
logical) analysis of Dasein. In contradistinction to the tradition of
subjectivistic metaphysics, which has persisted in the history of
philosophy to the present day, Heidegger does not see the essentia of
Dasein in a substantiality which may be viewed separately from
existentia, but above all in the existence where he uses the Latin "ek-
stare"or "ek-sistere" as the Essence of the existence. By Ek-sistence
he means standing out into the clearing (Lichtung) of Being. The
essential traits of human existence are described as existentials.
While "Daseinsanalytics" is of ontological nature, "Daseinsanaly-
sis" is ontic, according to Heidegger. What does this mean? As we
know and Heidegger always pointed out, he did not intend to create
an anthropological philosophy or psychology. His primary concern
has been the ontological structure of Being, and yet, in "Being and
Time" as well as in later writings, he expressly called human nature
as being open and responsive to Being. He therefore, and in clarify-
ing the existentials, he dealt with such fundamentals of human
nature as being temporal, spatial, attuned, historical. He dwelled on
the differentiation of anxiety as opposed to fear, he defined human
being as Being-with and World-openness, he called Dasein Being-
towards-death. Now Daseinsanalysis as "ontic is concerned with
25
actual, factical being. So far, it means both the anthropological notion
of human nature (as for instance different from a biological concep-
tion) as well as a specific therapeutic (namely phenomenological)
approach to mental illness. According to Heidegger, we must under-
stand phenomenology as an endeavour to see that which is revealed
from itself as it is revealing itself. This may sound lapidary. Do we
not always perceive things as what they are? We could, as the human
being is fundamentally identified by its openness for all which it
encounters. But everyday experience teaches us a different lesson. In
the same way as openness constitutes human Dasein, we find in the
ontic, that is, the everyday realm exactly the opposite. We find that
the apparently simplest thing at the same time seems to be the most
difficult one. But not only our commonplace speech is interspersed
with misunderstandings and prejudices; so is modem psychology
and psychoanalysis. Not without reason has phenomenology meant
"To the things themselves" since Husserl and Heidegger. But this not
only means a superficial description of what is experienceable through
the senses, but above all a grasp on the essentials of the self-revealing
which is, for the most part, concealed and which has to be
hermeneutically disclosed. This led, in particular, Medard Boss in
various works to criticize the original Freudian metapsychology and
C.G. Jung's (1875 - 1961) analytical psychology as well as some
neoanalytical developments. The concept of the unconscious offered
a central point of vantage for Boss who unmasked it as something
fictitious and abstract. In the same manner, the maxim claimed by
Freud, namely that psychoanalysis were not interested in the phe-
nomena as such but in the forces causing them, was inverted.
Daseinanalysis are precisely interested in the phenomena which are
to be interpreted hermeneutically and must not be falsified by re-
interpretation. This has some immediate, practical consequences, for
instance for the interpretation of dreams or symptoms. It goes with-
out saying that Daseinsanalysis does consistently without interpret-
ing symbols and causal-genetic regressions, although it does, of
course, investigate the motives which let a person get sick. Motive
and causality, however, are not identical. A window closed by a gust
of wind may point to a cause, a window closed by a person will point
to the motive. The wind pushing a window open or closed does not
have the ability to know what it does, nor the freedom to abstain
from it. A human being can do either or both. And this takes us to a
further problem, i.e. the question what human suffering and human
illness really is. Heidegger gave an unequivocal answer: illness points
to health, and health means freedom. This needs an explanation.
26
Why Heidegger?
No sickness can be understood except from the perspective of

health and the undisturbed basic human constitution. This is the case
because the states of sickness are nothing but different privative
manifestations of the state of health. The essence of being a healthy or
"sound" human being, however, can be described as the ability to
dispose freely of the totality of relational possibilities given to human
being in relation to what is manifested from openness of his world
domain. The essence of all sickness is similarly a unity. It can only
consist of a restriction in some form or other of such human "free-
dom of movement." Hence the daseinsanalytic tripartite question: in
what way is there a disturbance of what kind of relational possibility
and in what domain of things encountered?
Because it is fundamentally not really possible to separate theory
and practice, it is inevitable that Daseinsanalysis will also differenti-
ate itself essentially from psychoanalysis in terms of its methodical
procedures. This serves to counter the reproach that Daseinsanalysis
has simply thrown Freudian metapsychology overboard but, for the
rest, has adhered to the practical directives for psychoanalysis, for
instance in using its setting with the couch. There is, of course, no
doubt, that Freud in his practical papers has given many suggestions
which are also fruitful for existential psychotherapists. But there are
definite differences regarding the interpretations and their impor-
tance for the practical treatment. A first distinction is already found
in the treatment of the so-called "transference situation." Certainly,
neurotic patients have limitations in their interhuman relationships
as a result of imprintings which are to be understood in terms of their
life histories. This, however, does not mean that they carry over or
"transfer" their feelings onto other people. The position is rather that
their feelings of love and hatred genuinely concern the therapist and
should not be thrust onto another reference person. Daseinsanalysis,
to mention another differentiation from most other practices, espe-
cially from psychoanalysis and Jungian psychology, rejects every
attempt to reduce the dream events as remembered in waking to
unconscious "latent" dream thoughts or symbols. The dreams them-
selves give us ample information on the dreaming existence of a person
without the necessity to search for other "symbolized" meanings.
This, in short, are a few references of the importance and the influence
Martin Heidegger has had on the development of psychotherapy. His
primary intention was certainly not, as already said, to create a new
Psychotherapeutic school or whatsoever, but to stimulate psychothera-
pists to free themselves from one-sided positivistic and technical thinking.
Prof Gion Condrau is the Director of the International Federation for
Daseinsanalysis based at Zurich, in Switzerland.
27
MARTIN HEIDEGGER'S INFLUENCE UPON BRITISH
PSYCHOLOGY AND PSYCHOTHERAPY
Ernesto Spinelli
In considering the title of this paper it occurred to me that I could

make it the shortest talk I have yet delivered. I could simply ask the
question "what influence have Martin Heidegger's writings had
upon British psychology and psychotherapy?" and then respond, I
think with suitable justification, by stating: "virtually none", thereby
completing my lecture and allowing us all to enjoy the remainder of
this evening in less formal discourse. However, regretfully, I must
inform you that neither you nor I will be allowed to escape the matter
quite so swiftly or easily. At best, all I can offer is that I shall
endeavour to be as brief and coherent as is possible for me to be.
One of my favourite quotes appears in an entry from Sören Kierke-
gaard's Diary of 1852. He writes:
Socrates always kept talking merely about food and drink - but in
reality he was constantly talking and thinking about the Infinite.
The others constantly talked in the loftiest tones about the Infinite; in
reality they were constantly talking and thinking about food and
drink, money and profit (Kierkegaard, 1990: 124)
I think that the sentiments expressed by Kierkegaard concerning
Socrates can be similarly applied to Heidegger in a number of signifi-
cant ways. As is well known, the overriding recurring theme run-
ning throughout Heidegger's work (at least with regard to those
volumes which have been translated into English) is the examination
and elucidation of Being as far as it can be disclosed from the
standpoint of beings who experience their own existence. My own,
admittedly limited, non-philosophically trained understanding of
Heidegger's hypotheses and assertions regarding this, has led me to
conclude that whatever it may be that Heidegger has to tell us about
the human experience of existence remains always tightly bound
within the framework of what such might reveal about existence per
se. As such, I would contend that Heidegger's interest in that which
is specifically human existence remains substantially subsidiary to his
primary concern as a philosopher of existence.
If I am correct in this conclusion, then it seems to me all those non-
philosophers (and I am here exclusively concerned with psycholo-
28
Martin Heidegger's Influence
gists and psychotherapists) who have extrapolated his ideas into

their own realms of enquiry have tended to promulgate a major
misunderstanding insofar as they have represented Heidegger's work
as being principally concerned with the question of human existence
rather than acknowledge that this was the means by which Heidegger
sought to enter the much wider and no less unknown terrain of
existence in general. To put it more simply: they have taken what
was for Heidegger a means to an end and have turned it into the end
itself. It is my contention that this error has led to a significant set of
problems which can be summarised as the outcome of their at-
tempted "psychologising" of Heidegger's ideas.
Let me be blunt: what I am arguing is that Heidegger is possibly
the least psychological of modern philosophers. I think it is absurd to
speak of a "Heideggerian psychology" - much less of a "Heideggerian
psychotherapy" - in the same way that I would say that it would be
absurd to speak of a "Shakespearean psychology", for instance. By
this I mean that while I think that both Heidegger and Shakespeare
undoubtedly provide us with a number of cogent, powerful insights
regarding the human psyche and while each of those insights is
conveyed to the reader with outstanding poetic eloquence, neverthe-
less the purpose and aim of these authors was decidedly not that of a
psychologist or psychotherapist. This is not to say that psychologists
and psychotherapists cannot, or should not, be open to, or inspired by,
their insights - far from it! - but neither should they fall into the trap of
treating such as psychological statements or theses. For to do so, I
maintain, not only impoverishes unnecessarily the impact and signifi-
cance of such authors' works, it just as assuredly places impractical
constraints upon psychological and Psychotherapeutic understanding.
In order to concretize what I am saying, consider the following
example. Many, perhaps all, of us here are aware of Ludwig
Binswanger's numerous and significant misunderstandings of
Heidegger's ideas. Let me highlight but one of these - namely,
Binswanger's contention that "pathology occurs when one of the
basic structural aspects of the human being (what Heidegger called
the "existentiales") becomes predominant over the others" (Brice,
1978: 303). What Binswanger attempted to demonstrate was that the
predominance or subordination of any one mode of being (be it
Umwelt, Mitwelt, or Eigenwelt) towards any other(s), provokes psy-
chic imbalances which express themselves behaviourally in ways
which lend themselves to psychiatric diagnosis and description.
Now, as any number of Heideggerian scholars have argued, such a
hypothesis makes no sense within Heidegger's theory since it ex-
29
pressly argues against the placing of any value upon these modes of
experience and, as such, no one category "could ever take prec-
edence over another" (Brice, 1978: 303). As such, Binswanger can be
seen to have quite clearly erred in his reading of Heidegger's philoso-
phy. This much we know. However, what I think remains unknown,
or at least, remains unknown to me, is whether Binswanger's philo-
sophical error must also be seen to be a psychological (or, more
precisely in this instance, a Psychotherapeutic) error. Binswanger
evidently did not think so since he presents us with several case
examples of how this philosophical misunderstanding actually had
beneficial psychiatric consequences in his work with his patients. As
Charles Brice has put it:
It is safe to say that Binswanger misunderstood Heidegger on this
issue but it may also be true that this misunderstanding was a creative one
(at least for clinical psychology) (Brice, 1978: 303).
What I am getting at here is, I hope, self-evident: it would be
wrong to say that Binswanger was a Heideggerian psychotherapist
since the basis of his interventions rests upon an inaccurate under-
standing of Heidegger's ideas. On the other hand, one could say that
Heidegger's ideas inspired Binswanger to consider certain issues of
psychopathology in a novel, and potentially psychologically valid, fash-
ion - regardless of their erroneous interpretation of Heideggerian thought
Now, what I want to propose is that such an example alerts us in
more general ways to any attempt to directly transpose or extrapolate
psychological or Psychotherapeutic conclusions from philosophical
insight. More specifically, it is my belief that such an enterprise is
particularly problematic when the philosophy in question is that of
Martin Heidegger.
At the risk of repeating myself, it seems evident to me that
Heidegger's aims and realms of enquiry remain sufficiently distinct
from those of psychology and psychotherapy such that any attempted
"marriage" of the two at best compromises both, at worst provokes
insoluble tensions and conflicts of interest. Psychologists and psy-
chotherapists rightly take their realm of enquiry to be that of what we
might refer to in its broadest sense as "the person". Heidegger, on
the other hand, cares little for "the person" per se other than as the
means by which he can bring to light the basic condition of existence
- Being - and thereby overthrow what he argued to be Western
philosophy's destructive and pointless infatuation with the study of
beings (ie. "the person"). While it is true to say Heidegger's analysis
30
of Being inevitably led him to make pronouncements about the

question of "being human", and that these pronouncements un-
doubtedly provide psychologists and psychotherapists with trench-
ant, powerfully original observations and assertions regarding what
it is to be human, such statements best serve psychologists and
psychotherapists when they are taken as starting points to their
enquiries - and not as ends in themselves.
What I have said so far should not lead us to conclude that
philosophy has only a tangential role to play in psychology, much
less psychotherapy, or that, indeed, the "natural" starting point for
psychotherapy lies exclusively or even principally in psychology.
That is quite a different argument whose intricacies I cannot enter
into here. However, if, as is the case for many of us, psychological
discourse remains our Psychotherapeutic lingua franca, then we must
remain cognizant of both its points of contact with, and divergences
from, philosophical concerns.
I would suggest that this last point was well understood by several
significant philosophers whose works have deeply influenced and
enriched British existential-phenomenological approaches to psy-
chotherapy. Edmund Husserl, for instance, seems to me to have
been particularly aware of the necessary distinctions to be made
when considering his ideas from either a philosophical or psycho-
logical perspective (Ihde, 1986). And, in similar fashion, for all his
talk about "existence preceding essence", Jean-Paul Sartre remains
among the most "person" focused (as opposed to "Being" focused) of
existential-phenomenological philosophers - with the consequence
that many of his central philosophical arguments can be, and have
been, successfully and respectfully transposed into psychological
and Psychotherapeutic discourse (cf. Cannon, 1991). As such, one
can properly speak of a "Sartrean psychology" or, to take one other
legitimate example, of a "Merleau-Pontyan psychology" with suit-
able justification. One might even reasonably argue in favour of an
"Husserlian psychology", although I personally think that in this
case one would be on sturdier ground if one focused more specifi-
cally upon the various influential "schools" of psychology such as
gestalt psychology and Dilthey's "understanding" psychology which
were greatly influenced both by Husserl and his teacher, Franz
Brentano (Wolman, 1981). The situation, I believe, is significantly
different when considering Heidegger's impact upon psychology
and psychotherapy.
Now, I am fully aware, as are I would suppose most people
present here tonight, that the whole Daseinsanalytic movement in
31
psychotherapy, as developed by Medard Boss and his followers, is
both obviously and directly indebted to the writings of Martin
Heidegger. Indeed, we are all aware that Boss and Heidegger
collaborated closely with one another and that Heidegger partici-
pated in a number of important seminars - which, unfortunately for
those such as myself, have yet to be translated into English. Given
this significant "meeting of minds", how can I continue to maintain
my argument?
All manner of speculation exists as to why Heidegger should have
involved himself with the development of Daseinsanalysis. Such
speculation ranges from arguments that Heidegger saw such a pro-
gression as a valuable extension of his philosophical ideas to those
which strongly suggest more personal motives linked to Heidegger's
perceived need to both re-establish and redeem his name following
the ending of World War Two, and the implications of his relation-
ship to National Socialism. Now, while such speculations may be
fascinating, I wish to circumvent them in this talk. Instead, I want to
consider just what were the principal elements that Daseinsanalysis
took from Heidegger and which formed the crux of his discussions
with Boss. Well, I think that these can be summarised briefly:
1. Daseinsanalysis seeks to "re-humanise" those individuals who

have been labelled as mentally disturbed by emphasising the contex
tual relationship between an individual's symptomatology and his or
her "way of being".
2. More generally, Daseinsanalysis objects to the dominant view

of the human being as "a psychic apparatus whose reactions to the
world are secondary phenomena determined by the operation of
unseen psychic structures and forces" (Moss, 1978: 310).
3. In similar fashion, Daseinsanalysis insists that human beings

cannot be viewed as isolated, independent entities but, rather, it
emphasises the indissoluble unity of, and interplay between, human
beings and their world.
4. Daseinsanalysis highlights human beings' uniqueness from the

standpoint of world-openness (ie. they are the "illuminated realm into
which all that is to be may actually shine forth, emerge and appear as
a phenomenon, ie., as that which shows itself" (Boss, 1963: 70), and of
world-disclosing relationships - a term which seeks to express the
fundamental "being-with" of human existence.
32
5. When applied specifically to psychotherapy, such notions
allow Daseinsanalysis to emphasise the psychotherapist's "letting
be" of the client so that he or she may become more aware of that
which presents itself to his or her being. Such "letting be" presents
the psychotherapist with the possibility of offering anticipatory care
(Condrau and Boss, 1968) which seeks to assist the client not in a
relief-providing or interventionist manner but rather one which joins
the client in his or her exploration of lived experience. Such an
attitude implicates the psychotherapist within a relationship which
cannot be viewed as objective but as one of "meeting".
6. This recognition of "meeting", provides Daseinsanalysis with

the means to reject Freudian-derived conclusions regarding the ori
gins of a disturbed mental life as being intrapsychic, and, instead, to
promote an intersubjective consideration which places questions of
disturbance not "within" but between the reflectively-derived rela
tions of the being with (and within) the world.
Now, while I am aware that I have only touched upon - and in a

highly simplistic fashion - these central aspects of Daseinsanalysis,
and that, equally, I have said nothing about a number of major
implications that have been derived from these points (namely: the
issues of "existential guilt" and the "call of conscience"), neverthe-
less, I believe that I have said enough to make the following point:
these central ideas upon which Daseinsanalysis is founded and which it has
taken from Heideggerian philosophy, as important and vital as they are, can
be seen to be either explicitly or implicitly present in those aspects of
Heidegger's thought that retain their direct Husserlian influence - in
particular with regard to Husserl's notions of intentionality and of his
method of investigation specifically when viewed from the more psychologi-
cally-influenced Husserlian notion of the "Lebenswelt" (or life-world). On
the other hand, that which remains as crucial to Heidegger's philo-
sophical concerns - the examination and analysis of Being - remains
outside the scope of the psychological and Psychotherapeutic concerns
of Daseinsanalysis - as is the case with any other model of existential
psychotherapy.
If I can remind you of, and play a little with, my earlier quote from
Kierkegaard: like Socrates, Heidegger speaks of the "this and that" of
human existence so that he can approach the "beyond this and that"
of existence per se. Unlike him, Daseinsanalysis (and every other
form of existential psychotherapy) must perforce remain at the "this
and that" level of human existence so that it may offer theorist,
33
practitioner and client alike a clearer understanding of the possibili-
ties and discomforts of human existence.
Again, I state this neither to denigrate Heidegger's contributions
nor to dismiss the possibilities of existentially-derived forms of psy-
chotherapy. I simply wish to alert us to, and remind us of, what each
can - and cannot - offer the other.
The consequences of not heeding this admittedly simple point are
most evident, I think, when considering the two inter-related
Heideggerian terms which I believe have been most widely appro-
priated by psychotherapy - namely the notions of authenticity and
inauthenticity.
Recall that Heidegger posited three modes of existing in the world:
the undifferentiated, the inauthentic and the authentic (Heidegger, 1962,
1966, 1993). The undifferentiated mode refers to an unquestioned,
unrecognised, blindly accepting mode of being adopted from the
world. The inauthentic mode refers to that mode of being which
emerges when one seeks to substitute that which is given with some
other seemingly more desirable or acceptable "given". The third
mode, the authentic, refers to the being's recognition of that which
has been given as that which has been given with all its possibilities,
constraints and angst-ridden implications rather than aspire to that
which it imagines could or should or might have been given.
Now, as Hans Cohn has already and far more extensively argued
elsewhere (Cohn, 1993), any number of psychologists and psycho-
therapists have taken these terms - particularly the latter two - and
transformed them into ideas which hinge upon notions of "psychic
health" - notions which are of no interest or concern to Heidegger's
investigations. In doing so, they have explicitly imposed a psycho-
logical "value system" upon the terms, suggesting, at times implic-
itly, more often explicitly, the related ideas of "better or healthier
ways of being human" if one adopts one mode of existence (the
authentic) over the other (the inauthentic). Such assumptions, for
example, underlie Irvin Yalom's approach to psychotherapy (Yalom,
1980, 1989), and appear in Carl Rogers' Psychotherapeutic model
(Kirschenbaum and Henderson, 1990) and in Abraham Maslow's
psychology as aspects of self actualisation (Maslow, 1968). But in
placing hierarchical values, and in emphasising notions of self-devel-
opment and mental health upon these terms, all such authors deviate
in profound ways from Heidegger's intent. Indeed, in significant
fashion, they turn his intent inside out and upside-down.
As a consequence, they have convinced those who read their
works that there is some means whereby, through psychotherapy,
34
someone may become "more authentic" than he or she currently is.

From a Heideggerian perspective, such an aspiration is patently
absurd. It is tantamount to holding the hope or aspiration that one
can "exist more than one currently does exist". Further, if one
follows Heidegger's train of thought, then that which these authors
present as being a movement towards "authenticity", can be seen to
be, instead, but one more instance of an inauthentic mode of being.
But again, let me be clear: while such psychological re-interpreta-
tions of Heidegger's ideas make little sense within his philosophical
realm of enquiry, it should not be assumed that what is intended by
these "interpreters" has no psychological or Psychotherapeutic value.
It may well do; in fact, it may point us to the core concerns of
psychological or Psychotherapeutic enquiry. But, if this is the case,
then we must not fall into the mistaken assumption that it is Heidegger
who has led us there, or who wishes us to be led there. As with my
earlier example of Binswanger, all we can state is that Heidegger's
philosophy has inspired these thinkers, has inspired us, to think in
ways about human existence that may be significant, may even be
beneficial to us and to our theories and to our clients, but which,
equally, follow a path which diverges significantly from Heidegger's
interests and concerns.
As a final point, I think that what I have been attempting to say may
prove to be of assistance in another, more specific, yet equally relevant,
manner. Perhaps like me, when discussing Heidegger with students,
you are eventually posed the question: "But how could someone who
promotes such a philosophy as does Heidegger end up being an active
and arguably unrepentful supporter of National Socialism?"
Such a question reveals, I believe, a number of significant assump-
tions that rest upon our students' "mixing and matching" of philo-
sophical and psychological concerns.
First, they assume, as do many psychologists and psychothera-
pists, that a being who can imagine certain modes of existence and
relationship is, via that very act of imagination, bound to embody or
give expression to them. This clearly is not the case. Such simplistic
"cause-effect" arguments currently dominate British life (and, for all
I know, that of many other cultures). They express themselves most
blatantly in our concerns about the censorship of images of violence
and sexuality and, more subtly, if no less perniciously, they serve our
politicians and propagandists by presenting abstract principles and
values (whether desirable or undesirable) as embodied features of a
particular person or group, such that one equates directly with the
other - indeed, is the other. In similar, if opposite fashion, our current
35
propensity to tarnish and demolish laudable ideas and ideals by

pointing to the failures, weaknesses, and contradictions of those
individuals or movements that have sought to develop or express
them is itself a consequence of this mode of thought. In such fashion,
we can dismiss the worth of the insights of an Einstein or a Freud, or
indeed, of a Heidegger simply on the grounds that the person was
weak, or wicked or "all too human". From what has recently been
discerned about him by recent biographers and commentators (Ott,
1993; Sluga, 1993), Heidegger was almost certainly a vain, repugnant
"little man" in his life who, in dealing with just about everyone who
treated him with warmth, respect and affection, responded with calcu-
lated contempt - and worse. But we would be wrong to equate genius -
and I believe that Heidegger merits that term - with kindness or good-
ness, or laudable actions. Indeed, on grounds of evidence derived from
any number of biographical exposes of men and women of genius, the
contrary conclusion would seem to be the more accurate.
But as a second, and I think far more pertinent, response to the
posed question, it seems to me that the inability to conjoin the ideas
with the man rests largely on the psychologically-interpreted mean-
ings ascribed to them. Such interpretations emphasise hierarchies of
values associated with each mode of existence. In short, they imbue
them with a broadly ethical constituent. This may be desirable,
perhaps even necessary; but it is precisely this constituent that ap-
pears not to exist in Heidegger's world-view. Yes, of course,
Heidegger speaks of care. But the "care" which he associates with
authenticity is not that care for others or the world for their other-
ness or worldliness - for their "this and that" level of being - but
rather, it is a care that is ultimately focused upon and directed
towards the realm of pure Being.
The person who has pointed out this element in Heidegger's thought
most cogently and eloquently, I believe, is the philosopher Emmanuel
Levinas. As one who found the means to both maintain unstinting
admiration for Heidegger's work while at one and the same time
remaining capable of exposing what he argued to be the amoral core at
the heart of Heidegger's enterprise, it is perhaps worth-while consider-
ing Levinas' concerns a little further. Levinas criticises Heidegger's
emphasis upon what he characterises as "universal, anonymous Being"
since it is precisely this emphasis which allows Heidegger to remain
largely silent with regard to the ethical relations between beings who
exist. Levinas reminds us that, for Heidegger, "all individuality, and
thus all responsibility of the individual towards others, is dismissed"
(Donoghue, 1996: 38). This cold, distanced focus upon "an abstract
36
perception of totality in which individuals are mere neutral parti-

cles" (Donoghue, 1996: 38) is deeply distasteful to Levinas. And
well it might be - but does it not also allow a more meaningful
"marriage" between Heidegger the man and his ideas regarding
differing modes of existence to emerge? And, in so doing, does it
not once again illuminate to us the dangers and confusions that
arise when such philosophical ideas are directly transplanted into
the psychological and Psychotherapeutic "jargon of authenticity"?
So, to conclude. It remains inconceivable to me that any approach
to psychology and psychotherapy that asserts itself to be "existen-
tial" could justify such a claim without fully acknowledging its
primary indebtedness to a number of key notions derived from the
philosophy of Martin Heidegger. In this sense, his constant and
continuing influence upon us all here present is indisputable. Never-
theless, I have sought to argue that however much we are indebted
to, and inspired by, Heidegger's work (or, at least, some aspects of
it), we must be clear that our enterprise is a fundamentally different
one to his, and, indeed, this divergence forces us to remain precisely
in that field of investigation and relation - human existence - which
was for Heidegger the "leaping off" point. If we accept this, as I
believe we must, then we must begin to make much more clear for
ourselves our psychological and Psychotherapeutic relationship to
Heidegger's philosophy. In doing so, we may have to re-create our
terminology, our "jargon", in ways which clarify what we have
arrived at not so much with Heidegger, but through his influence.
Although I suspect that, were she present, Emmy van Deurzen-Smith
would disagree with much of what I have argued, nevertheless,
allow me to conclude by quoting a passage from one of her recent
papers which not only serves to highlight that which we both can
agree upon but also encapsulates in two sentences that which has
taken me an entire paper to argue:
We should not treat Heidegger's work as the definitive version of
human truth, but rather as a pathway to guide our indispensable
investigation of living. As such it is an invaluable source of reflection
for psychotherapists and needs to be mined for its possible use in the
clinical situation (van Deurzen-Smith, 1995: 13).
37
References
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Cohn, H. W. (1993) 'Authenticity and the aims of psychotherapy' in Journal
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Cohn H. W. (1995) 'Misconceptions in existential psychotherapy' in Journal
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Review of Books, vol 43, number 5: 37-40.
Heidegger, M. (1962) Being and Time, (trans J Macquarrie & E Robinson)
Heidegger, M. (1966) Discourse on Thinking, (trans F D Wieck & J G Gray)
Heidegger, M. (1993) Basic Concepts, (trans G E Aylesworth) Indianapolis:
Indiana University Press.
Ihde, D. (1986) Experimental Phenomenology: an introduction. Albany, New
York: State University of New York, Albany.
Kierkegaard, S. (1990) The Diary of Soren Kierkegaard. (P Rohde, Ed) New
York: Citadel Press.
Kirschenbaum, H. & Henderson, V. L. (1990) The Carl Rogers Reader.
London: Constable.
Levinas, E. (1969) Totality and Infinity. (A Lingis, trans) Pittsburgh: Duquesne
University Press.
Maslow, A. (1968) Towards a Psychology of Being. New York: Van Nostrand
Reinhold.
Moss, D. (1978) 'Medard Boss' in Existential-phenomenological Alternatives
for Psychology R S Valle & M King (Eds). New York: OUP.
Ott, H. (1993) Martin Heidegger: a political life, (trans A Blunden) London:
HarperCollins
Sluga, H. (1993) Heidegger's Crisis: philosophy and politics in Nazi Germany.
Harvard: Harvard University Press.
Wolman, B. B. (1981) Contemporary Theories and Systems in Psychology. (2nd
ed) London: Plenum Press.
Yalom, I. (1980) Existential Psychotherapy. New York: Basic Books.
Yalom, I. (1989) Love's Executioner and Other Tales of Psychotherapy. London:
Bloomsbury.
Ernesto Spinelli is a registered existential psychotherapist and chartered
counselling psychologist. He is principal lecturer at the School of Psycho-
therapy and Counselling, Regent's College. He is also the current Chair of
the Society for Existential Analysis.
38
PHENOMENOLOGY AND PSYCHOTHERAPY
Hans W. Cohn
It was Sigmund Freud himself who can be said to have introduced

phenomenology into psychoanalysis - but rather as one would intro-
duce a guest at a party by saying that he would not be coming. There
is an important passage in Freud's "Introductory Lectures" in which
he sums up the place of "phenomena" in psychoanalysis with his
usual precision and lucidity:
We seek not only to describe and to classify phenomena, but to
understand them as signs of an interplay of forces in the mind, as a
manifestation of purposeful intentions working concurrently or in
mutual opposition. We are concerned with a dynamic view of mental
phenomena. On our view the phenomena that are perceived must yield
in importance to trends which are only hypothetical. (SE 15:67)
In other words: what "appears" to us, what we perceive and
experience, has to be seen as the visible "sign" of an interaction that is
not only invisible but even hypothetical. This view Freud calls "dy-
namic" - the hypothetical interaction either re-inforce one another, or
are in conflict. These assumptions have, to this very day, remained
central not only to psychoanalysis but to all those forms of psycho-
therapy which call themselves "psychodynamic". For we need to
distinguish psychoanalysis as a method of treatment from psychoa-
nalysis as a theory of the mind. While the original form of psychoa-
nalysis as a treatment is now not often used, Freud's theoretical
assumptions constituting his theory of the mind underlie, in one way
or another, most forms of psychodynamic psychotherapy.
These psychotherapies tend not to dwell on the phenomena of-
fered by their clients. They consider these phenomena as "symp-
toms", indications that as yet unknown processes are at work which
need to be explored. The example of medical science seems to hover
over this assumption - for here the symptoms of, say, sneezing and
coughing have, in fact, led to the discovery of microorganisms not
immediately perceived which seemed to play a crucial part in the
origin of these phenomena.
However, microorganisms can be discovered with the help of a
microscope. They then become phenomena which can be perceived.
But how do we discover the "interplay of forces in the mind"?
39
Freud's answer to this question was ingenuous. Though mental
processes had to remain hypothetical, they could be described meta-
phorically. Thus Freud described the mind as
an apparatus to which we ascribe the characteristics of being extended
in space and being made up of several portions - which we imagine,
that is, as resembling a telescope or microscope or something of the
kind.
(SE 23:139)
This apparatus shows different "psychical provinces or agencies':
they are the id, the ego and the superego. The interaction between
these "agencies" is fuelled by a special kind of energy which Freud
describes like this;
We assume as other natural sciences have led us to expect that in
mental life some kind of energy is at work; but we have nothing to go
upon which will enable us to come nearer to a knowledge of it... We
seem to recognize that (it) occurs in two forms, one freely mobile and
another... bound... (ibid.:163/4)
Now all this is, of course, a construct - Freud made this quite clear.
This is not the description of something perceived or experienced -
but it has a considerable concreteness and may acquire a strange
reality which we forget to question.
Freud was by no means always at ease with his metaphors. Before
describing consciousness and the unconscious as two adjacent rooms
with a watchman on the threshold between them, he said: 'The
crudest idea of these systems is the most convenient for us - a spatial
one'. And afterwards he added:
Now I know you will say that these ideas are both crude and fantastic and
quite impermissible in a scientific account. I know that they are: and
more than that I know they are incorrect, and, if I am not very much
mistaken, I already have something better to take its place. (SF
16:295/6)
Well, whatever this was, it never emerged, and psychodynamic
therapies are working with various versions of the original internal
psychic system - looking for intrapsychic explanations of the phe-
nomena they perceive.
I am well aware that so far I have given a very limited meaning to
the term "phenomenology". I must admit that to a psychotherapist it
40
is tempting to be quite literal and adopt "phenomenology" simply as
a term denoting the exploration of what is apparent and the content
of our immediate experience. It is particularly tempting when faced
with the wide range of "phenomenologies" reaching from mere
description via an eidetic phenomenology to a transcendental posi-
tion which some people see as a form of idealism.
However, I realize that I need to be more specific. Those psycho-
therapists who - unlike Freud - wish to focus on the phenomenon
itself rather that its explanation will choose a phenomenological
approach which, though rooted in Husserl's thinking) is different
from it. This is the approach presented by Martin Heidegger and
those philosophers particularly influenced by him, like Sartre and
Merleau-Ponty. This approach rejects Husserl's "epoche": it is not so
much concerned with experience as such - independent of what it is
that is experienced or whether it even exists. Instead it is concerned
with the experience of existence which is always a "being-in-the-
world". Robert C. Solomon has expressed this position very clearly:
A man is not a detachable consciousness who can abstract himself from
the world around him... The most important link among the existential
phenomenologists... is their insistence that it is not possible to abstract
oneself from involvement in the world. One cannot "bracket" existence
as the epoche requires; our existence and the existence of the world
around us are given together as the starting point of all
phenomenological description. (Solomon 1987: 179)
A lucid presentation of the important features of an existential
phenomenology is found in Maurice Merleau-Ponty's Phenomenology
of Perception. In what follows I propose to turn to some of its aspects
and to show their relevance to an existential-phenomenological ap-
proach to psychotherapy. Merleau-Ponty, in his preface to the Phe-
nomenology of Perception, sees the task of phenomenology as "descrip-
tion" and not as "explanation" or what he calls "analytical reflec-
tion". By explanation he means the establishment of causal chains
which he sees as the concern of the sciences. Analytic reflection is the
process of identifying the basic concepts underlying the very possi-
bility of experience the a priori precondition of experience which
"ceases to remain part of our experience and offers, in place of an
account, a reconstruction". (Merleau-Ponty 1962: IX) In Merleau-
Ponty's words 'The world is there before any possible analysis of
mine' (ibid.:X)
41
Merleau-Ponty takes up Heidegger's proposition of existence as
"being-in-the-world".
The world is not an object such that I have in my position the law of its
making; it is the natural setting of, and field for, all my thoughts and all
my explicit perceptions.... there is no inner man, man is in the world, and
only in the world does he know himself (ibid.: XI)
'The world is not an object'. In Merleau-Ponty's view, "objective
thought" cannot do it justice. Objective thought sees the world as
consisting of objects with definite properties that are completely
describable. They can be causally explained and the mode of their
interaction is causal. They have a definite location in a single
spatial framework. They are, to use Merleau-Ponty's expression,
"determinate".
We can see that this "objective" view of the world underlies
psychoanalytic theory. The structured psychic apparatus is "deter-
minate". The origin of the interacting agencies whether we call them
ego, id and super-ego, or good and bad objects - is causally ex-
plained, and their interaction - whether, we call it identification,
displacement or transference - is causally conceived. They are local-
ized in a spatial framework, what we might call the conscious-
unconscious continuum, though this is admittedly hypothetical.
Merleau-Ponty insists that the perceived world, the "lived-through-
world" as he sometimes calls it, is not "objective". It is "non-determi-
nate": a complete description of what it contains is impossible, an
object may both have and not have a certain property, it may even-
have contradictory properties. The experience of "being-in-the-world"
is unpredictable, its "space" and ever-changing inexhaustible situa-
tion.
Relationships in the perceived and lived world are not causal or
functional, but expressive and meaningful. The following quotation
illustrates this and also stresses the body's crucial part in the process
of interrelatedness:
In ordinary experience we find a fittingness and a meaningful
relationship between the gesture, the smile, and the tone of a speaker.
But this reciprocal relationship of expression which presents the
human body as the outward manifestation of a certain manner of
"being-in-the-world, had, for mechanistic physiology, to be resolved
into a series of causal relationships. (Merleau-Ponty 1962: 55).
42
Here we reach what I consider to be the heart of the difference
between a psychodynamic and a phenomenological approach to
psychotherapy. In a phenomenological view what we call the mind is
not an enclosed system obeying causal and functional laws describ-
able by physical metaphors. It is a relational field within which the
related entities cannot be identified without reference to each other,
delineations are constantly changing, and no prediction can be made
with any certainty.
In 1959 Martin Heidegger conducted the first of a series of semi-
nars in Switzerland in answer to an invitation by the psychoanalyst
Medard Boss who had become intensely interested in Heidegger's
thinking and was trying to base Freudian practice on Heidegger's
"Daseinsanalytik". Heidegger continued these seminars for ten years,
and there is a book giving an account of what was going on, unfortu-
nately untranslated. Heidegger opened these seminars with a state-
ment which shows the connection of the view which I have tried to
outline with his own philosophical assumptions:
... human existence is essentially never just an object that is somewhere
present, least of all an object closed in itself. Rather this existence
consists of "mere" potentialities - neither visible nor tangible - to
perceive and be aware of all that encounters and addresses it.
All the usual objectifying capsule-like representations (common at
present in psychology and psychopathology) of a psyche, a subject, a
person, an Ego, a consciousness have - in a daseinsanalytic approach
- to be relinquished and give way to a fundamentally different
understanding.
This new "ground" of human existence should be called "Dasein" or
"Being-in-the-World". The "there" of this "Being-there" does
however not mean - as it does colloquially a position in space near to
the viewer. Rather existence as "Dasein" means the opening up of a
sphere where the sense of what is given can be perceived. (Heidegger
1959:3)
Let us now have a look at the consequences of such a shift from the
"determinate" to the "non-determinate", from the individual to the
relational, for the practice of psychotherapy.
1) There is no client "as such", there is only a client in a total
situation which includes the therapist and can never be completely
comprehended. One could say that if two therapists see the same
client, it is not the same client.
43
2) No "history" can be taken, for there is, of course no history "as
such". The history of a client is a blend of past, present and future,
and must be allowed to unfold unchronologically as part of the
therapeutic process.
3) The assumption that the therapist can be "neutral", an unin-
volved observer, a blank screen on which the client can project
memories of previous significant figures cannot be sustained in an
ever-shifting interactional context where relatedness is always mutual.
4) Interpretations of the type "B means A" cannot be made. The
place of such a reductive process which assumes the existence of
definite and finite meanings is taken by a descriptive clarification of
as many aspects of the client's difficulties as is possible.
5) The understanding that all human being is embodied and that -
as Merleau-Ponty has it - it is this embodiment that makes our
experience possible, necessitates a re-evaluation of what is called
"psychosomatic symptoms. For if body and mind are no longer seen
as separate entities, the much-discussed and never-answered ques
tion of their causal interaction does not arise. What Freud called the
"puzzling leap from the mental to the physical" becomes redundant
- when there is no gap we need not jump.
6) A rigid setting ("frame") which is favoured by psychoanalyti
cally orientated therapies would be out of tune with the fluidity of a
phenomenological exploration. Views on the nature of the "bounda
ries" necessary for the creation of a space in which therapy can
happen vary widely, also among existential therapists.
Personally I believe in allowing the therapeutic situation to be as
similar as possible to any situation where two people meet in order to
do something together. If what they are trying to do together is
therapy, the common task will set its boundaries as any common task
will do - for instance, this is the therapy of the client, and not of the
therapist, and this means that the therapist keeps open a therapeutic
space for the client and is its guardian rather than its user.
In this talk I have focused on the phenomenological aspects of an
existential therapy, putting ontological considerations aside. In other
words, I have been concentrating on the manner of this approach
rather than on what it is we are approaching. To talk about the aims
of this form of therapy - or any psychotherapy, for that matter raises
different and even more difficult questions which are outside my
chosen theme.
However, a few sentences might be helpful in envisaging the
different aims of a psychoanalytically and an existentially informed
psychotherapy. All psychotherapy is essentially concerned with what
44
we human beings find difficult to accept, what we turn our backs on

and disown. In the view of psychoanalysis, it is the claims of instinc-
tual desires which are in conflict with reason and reality, and this
conflict leads to disturbances. An existential-phenomenological ap-
proach sees the claims of existence itself, its "givens" - like the
uncertainty of our fate, the inescapability of choice, the inevitability
of our death - in conflict with our responses which are often flights
into denial, distraction and despair. This conflict with the existential
"givens" may also lead to disturbance.
While psychoanalysis finds the origin of such a disturbance within
the structure of the psyche, existential therapy seeks it out in the
manifold involvements of human beings their world which is also the
world of everyone else.
References
Freud, S. (1916/7) Introductory Lectures on Psychoanalysis. Standard Edition

15/6, London: Hogarth Press.
Freud, S. (1940) An Outline of Psychoanalysis. Standard Edition 23. London:
Hogarth Press.
Heidegger, M. (1959) Zollikoner Seminare. Frankfurt a.M.: Klosterman.
Merleau-Ponty, M. (1962) Phenomenology of Perception Transl by C. Smith.
London: Routledge & Kegan Paul.
Solomon, R. C. (1987) From Hegel to Existentialism. Oxford: Oxford Univer-
sity Press.
This paper was first given at the City University Postgraduate Seminar in
Phenomenology and Existential Philosophy on June 17th 1996.
Hans W. Cohn, PhD, is a psychotherapist working with

individuals and groups. He is a lecturer and clinical supervisor at the
School of Psychotherapy and Counselling at Regent's College,
London. He has a special interest in the existential-
phenomenological aspects of psychotherapy.
45
TIME-LIMITED EXISTENTIAL THERAPY - A STRUCTURAL

VIEWE
Freddie Strasser
This workshop was given on 28 September 1996 at the International
Forum of the Federation of Dasein Analysis in conjunction with Society for
Existential Analysis. It is also based on the book by Freddie and Alison
Strasser about Time-Limited Existential Therapy which will be published by
John Wiley & Sons and edited by Emmy van Deurzen-Smith.
Introduction
I did not become an existential brief therapist by design or by
theoretical considerations, but by sheer coincidence. The coincidence
that prompted me to embark on this course was initiated by an
extraordinary decision of an institute where I was employed as a
supervisor. The institute had decided from one day to the next to
change its premise from open-ended to time-limited therapy consist-
ing of a maximum of 12 sessions. My knowledge of brief therapy was
based on courses that I had taken and literature that I had read. In
order to supervise this orientation, I needed some experience. What
you will hear today is based on the experiences that the group of
people who worked on this paradigm with me experienced in exis-
tential time-limited therapy. The structure of this seminar will there-
fore be as follows:
1. I will talk about the evolution of this method and how this
intensive way of working changed certain attitudes of our concept
and method. During this period we developed a structural view that
I feel gave us a basis and an anchor from which to work with clients
in a more grounded and secure environment.
2. We will discuss the major differences that have been highlighted
in the working of this paradigm of what is called 'open-ended'
versus 'brief existential' therapy.
3. I will then present this structure in a visual graphic form and
demonstrate how this facilitated me and my colleagues in our practi-
cal work. I will also acquaint you as to how this structure can have
both negative and positive effects in therapy.
4. I will present a short case vignette, and show how the issues of
this example fit into the structure and interrelate to every aspect of
the concept.
5. We can then discuss your own cases, your own issues and the
way in which they interrelate to the concept of the structure.
46
The evolution of the therapy.
When we began the project, we simply started to work in an
existential way without the explicit focusing and goal-setting that
other non-existential models would use in therapy as a major tool.
The framework and the contract were based on discussion and
agreement with the client about the time limitations that we usually
set, being 12 sessions and two review sessions. There was an interval
of four weeks before the two review sessions. The structure was
weekly sessions of one hour. When we first began using the time-
limited approach, we conformed to the strict ending procedures that
some of the existing psychodynamic and cognitive models suggest.
The modular approach

However, we began to see that there were occasions when the 12
weeks, plus the two follow-up sessions, proved too brief. Many
examples proved that clients needed further support. After a series
of clients demonstrated that a rigid non-negotiable framework could
sometimes appear incomplete, we modified our procedure to allow
for a more flexible setting of boundaries.
The more adaptable approach means that further sessions are
available for those clients that need additional time to explore some
of their unresolved issues. To retain the framework and maintain the
context of a brief therapy approach, we draw clients' attention to the
possibility of further modules of therapy and follow-up sessions in
the initial outlining of the contract. The disadvantage of the modular
versus strict ending approach is that clients in the modular approach
lose some of the impetus and incentive associated with the absolute
finality that strict time-limitation provides. We acknowledge human-
ity over perfectionism, however, and we believe that it is necessary to
accept that clients have changing needs. Some will find that the first
module only begins to touch the surface of the issues they want to
explore. In our opinion, incorporating this flexibility into the frame-
work considerably outweighs the disadvantages involved.
Elements of the brief existential approach

Time as a major tool in the time-limited therapeutic process. We real-
ised that the time factor and knowledge of the end date had both
positive and negative repercussions. The positive side manifested
itself in the necessity to enforce a particular kind of commitment for
the therapist and the client. There had to be greater emphasis on the
ending. The disadvantage, however, in setting a fixed ending for
each module was that on occasions the pressure of the time limit
47
brought its own inherent problems both to the therapist and the
client. However, the skill of the therapist to suspend his or her
preconceived ideas of what should or should not happen in the
therapy could alleviate the pressure to 'achieve' something in the
available time. It needs to be emphasised that one of the most
important advantages in the existential time-limited therapy is the
time element itself. By its very nature brief therapy is about time and
the impact of terminating contact between therapist and client. There-
fore time is always in the minds of both the therapist and the client
and is a constant reminder of the temporary nature of their relation-
ship. Clients often express their feeling about the temporality of the
therapy either explicitly or implicitly. In many cases clients express
great relief that therapy need not be an endless commitment, but
contained within a frame.
Ending as a therapeutical tool.

The knowledge of ending and separation frequently has the effect
of evoking strong emotions, such as the fear of rejection. This can
take many forms including anger, sadness, or relief, all of which can
be worked through as part of clients identifying their value and
coping mechanisms.
Structural view of Existentialism and Existential Therapy

In the process of working and researching the existential brief
therapy we found that the emphasis on the structure was one of the
major factors that provided us and through us the clients with a
background of a supporting and sustaining therapeutic environ-
ment. The basic premise is that everyone, without exception, is
subject to his or her genetic, environmental and cultural 'givens'.
Within these constraints, and between birth and death, human be-
ings create a unique mode of existence. The essence of existential
therapy lies in the clarification of clients' attitudes towards the
concerns that life imposes on them. The 'givens' that this point of
view encompasses are: the need for safety; the importance of having
interpersonal relationships; our attitude towards time and temporal-
ity; the way we form, develop and cope with our belief and value
systems and how we fix (or sediment) them; the way we exist in our
natural, private, public and spiritual worlds; the contradictions and
paradoxes that living creates; the anxieties that we all endure; the
realisation that we all suffer from guilt and loneliness and how these
relate to our self esteem; and that in the final analysis, we have free
will and choice. As such, the structure addresses the idea of the
48
benefits of using a framework. Underlying the axioms of the struc-
ture are the essential existential ideas stemming from the philosophy,
the mode of therapy and the overall meaning one attributes to life. If
we accept that from the moment we are born we are faced with
inescapable uncertainties and inherent limitations, then it becomes
apparent, too, that we all strive in our own way to form and create an
edifice on which we can depend. This bedrock of security will differ
from person to person, but whatever this constitutes for each indi-
vidual, will become the foundation for their solace and stability,
which will be explored in the therapy.
Naturally the paradox is that existentialism, almost by definition,
cannot provide anyone with a framework that can guarantee safe-
guards or stability. By its nature the existential philosophy denotes
uncertainty as a fundamental aspect of living. However, we find that
having a loose but clearly defined structure can also highlight the
uncertainties of being thrown into this world and the certainty of
leaving this world. Van Deurzen-Smith confirms this notion when
she writes that:
Although an existential approach is essentially non-technological, I also
believe that one needs some methods, some parameters, some
framework, in order to retain one's independence and clarity of
thinking (1988, p.6).
Indeed Sartre also acknowledged that structure is the basis of

ontology and he defines it as the "study of the structures of being of
the existent taken as a totality" (1995, p.633).
Heidegger speaks of Dasein's ordinary 'everydayness', and that in
his or her usual state is always subject to a necessary structure which
is universal in every human being:
In its everydayness there are certain structures which we shall exhibit not
just any accidental structure essential ones which, in every kind of
Being that factual Dasein may possess, persist as determinative for the
character of its Being (Mulhall 1996, Heidegger, p. 19)
In other words, human beings manifest their limitations and possi-
bilities, that the world imposed on them, in every aspect of their
existence.
49
The therapist's and client's expectation of the therapeutic
outcome.
One of the factors that we found important regarding time limita-
tion was the client's initial expectation of what therapy can do both
during the process and afterwards. Most clients who have never had
close contact or experienced therapy themselves often expect either
an instant cure and complete elimination of their presenting problem
or some particular method or tool that can specifically help in over-
coming their dilemma. It is therefore important that both the client
and therapist address these kinds of expectations from the outset.
The expectation of the client will be inevitably different to the expec-
tation of the therapist.
The mystery of the insight.

One of the interesting aspects that emerges when working within a
structure is how insight or client's awareness, develops more expedi-
ently. What seems to push clients beyond this is their capacity of
insight.
While we experienced that the comprehension of clients' own
contradictions sometimes creates shifts in their perceptions of the
value and behaviour patterns, the obsessions of their rigid behaviour
nevertheless persist, sometimes in an exhaustive manner. In therapy
we depend significantly on something more than understanding,
which many call intuition or insight. It is claimed by some authors of
experiential learning theories that this type of insight or grasping the
experience is the result of an interaction between experience, com-
prehension and apprehension. This produces the insight of what
some authors call the "Aha" experience. Although this subject is
beyond the scope of this seminar, I would like to mention that in
respect of insights we have relied on the theory of learning processes
(Kolbs, Piaget and Dewey). Where, in Kolb's words:
Immediate apprehended experience is the ultimate source of the
validity of comprehension of both fact and value..("thoughts without
content are empty")..and comprehension are the source of guidance in
the selection of apprehensions ("intuitions without concepts are
blind") (1984, p.106).
In other words, an insight cannot be experienced without a struc-
tural knowledge, just as a structural knowledge is the sine qua non for
an 'AHA' experience. This is best expressed by David Bohm who
50
says: "All knowledge is a structure of abstractions, the ultimate test

of the validity of which is, however, in the process of coming into
contact with the world that takes place in immediate perception"
(Physics and Perception in the Special Theory of Relativity, 1965,
p.220) Thus, the function of the therapist is to allow a learning
process. Through clients' own explorations they can absorb the thera-
peutic process, challenge their contradictions, gain 'insight' and ex-
perience a shift of perceptions. This will continue even after the
termination of the therapy.
In brief existential therapy we therefore constantly place an em-
phasis on the structure of clients' world views in order that these
should continuously come to the foreground of the therapy. While
this accelerates the process of the 'insight' experiences, it does not,
however, mean that in the longer term therapy, without this signifi-
cant emphasis, a similar process would not occur. We have found
that under proper existential conditions, clients themselves have the
capacity to become aware of their issues and their structural inter-
connections.
Although we introduced the idea of a structure, it is not there to
be used as an absolute. It can be useful in terms of a base, as a means
to understand the client from the various givens outlined within it.
However, it must be used with caution. The structure as we describe
it is only a metaphorical representation that will facilitate the thera-
pist's interventions. If it becomes too technical, and impedes the
process of the interpersonal relationship, then it has become counter-
productive. So, in essence, we can use the structure as a way of
understanding which at the same time must be 'bracketed' in terms
of the therapeutic encounter.
The structure that is described is represented graphically in the
two existential wheels shown below. Essentially the segments repre-
sent the limitations and possibilities of human existence or what are
known in existential therapy as the 'givens'. These givens are ele-
ments of living which are universal to all human beings: they are
inescapable, a fact of living. Each of the givens needs to be explored
both from the theoretical perspective and from a practical position.
Structure and the interconnections of all concepts

The two existential wheels demonstrate these 'givens' precisely.
The first wheel represents those existential concepts that encompass
all human concerns throughout a person's life. These can be subdi-
vided into those elements that the world universally imposes on
human beings (printed in bold on Wheel No. 1) and those which
51
human beings create as a response to these universal limitations
(printed in roman on the wheel). While this is outside the scope of
this workshop it is worth mentioning that some authors would see
this difference as a distinctions between the ontic and ontological
characteristics. We believe that the 10 segments of this wheel, from
'safety' to 'freedom of choice', cover both the 'givens' that encom-
pass the limitations of the world and the possibility for human
responses. Within this universality each human being creates his or
her individual answer with all the potential that humans created; the
aspirations, concerns, anxieties, fears, ambitions and joys that collec-
tively comprise one's existence in this world. The assumptions that
lie behind these ideas are stemming wholly from existential and
phenomenological ideas.
The second existential wheel represents the method or the practi-
cal way to apply the underlying concepts. Each segment of this wheel
dovetails with the corresponding segment of the first wheel. For
example, the notion of the human concern with 'uncertainty' is
shown in the first segment of the first wheel, which links with the
first segment of the second existential wheel. Thus, the idea of
'uncertainty' is manifested in the practical concern of setting the
boundaries and framework, as well as the methods employed to
provide that safety. Paradoxically, although we are presenting a
structure in terms of outlining a therapeutic approach, merely exist-
ing in this world is both uncertain and without structure. Yet, as
human beings, we continually try to create and recreate a structure to
gain a sense of safety and personal meaning. This often fails because
we have not taken into account the ever-changing world around us,
which inevitably affects the way we think and the way we conduct
ourselves.
The structure outlined in the existential approach acknowledges
the fluidity of life and its confusing, anxiety provoking limitations. It
allows for our own unique path and the individual freedom to
choose our positive or negative attitude that we have towards that
living. We discovered that working within a structure was one of the
most important issues surrounding the time-limited approach. Struc-
ture in itself gives a different perspective to existential therapy. It
provides therapists with both an 'anchor' and an 'oar'. That is, it
gives therapists a point of reference as well as a valid tool for
recognising and understanding the issues raised by many clients. We
find that by way of this diagrammatic avenue we are able to compre-
hend at a much earlier stage some of the key aspects, such as how
clients view themselves in the world and how their belief and value
52
c 1994 Freddie and Alison Strasser c 1994 Freddie and Alison Strasser
I. II.
THE EXISTENTIAL WHEEL OF
THE EXISTENTIAL WHEEL OF
POSSIBILITIES AND
POSSIBILITIES AND LIMITATIONS IN
LIMITATIONS IN "BEING-IN- "BEING-IN-THE-WORLD"
THE-WORLD" METHODS AND SKILLS
CONCEPTS (A STRUCTURAL VIEW)
(A STRUCTURAL VIEW)
FREEDOM TO IDENTIFY ESTABLISHING

CHOOSE UNCERTAINTY CHOICES AND THE FRAME
MEANING AND CONTRACT
INTERPERSONAL
RELATIONSHIPS
EXISTENTIAL CHALLENGING and phenomeno-
ANXIETY INTERPERSONAL MISCONCEPTIONS logical method
RELATIONSHIPS OF ANXIETY of investigation
53
IDENTIFYING
CREATION OF SELF- SELF-CONCEPT PERCEPTION OF
CONCEPT AND TIME AND The moving self TIME AND THE
SELF-ESTEEM The moving self AND
TEMPORALITY SELF-ESTEEM TIMING OF
INTERVENTIONS
THE FOUR CREATIONS OF

DIMENSION PATTERNS OF VALUES IDENTIFY POLA- IDENTIFYING
OF AND BEHAVIOUR VALUE SYSTEMS
SYSTEMS RITIES AND AND POLARITIES
EXISTENCE PARADOXES
CREATION OF
SEDIMENTATIONS
CHALLENGING
G
OF BEHAVIOUR RIGID
Polarities PATTERNS EXPLORA-
TION OF SEDIMEN-
THE FOUR TATIONS
WORLDS
The diagram represents a non-chronological and non-linear

The diagram represents a non-chronological and non-linear
interconnection of the concepts

interconnection of the concepts
systems have been formed. This helps us to identify and challenge
our clients' discrepancies and contradictions from the outset of
therapy.
Another unexpected advantage of the wheel is that having a
structure helped us to 'bracket' (the notion described by Husserl,
that we need to suspend our preconceived ideas) our own preju-
dices and to distance ourselves from the situation in order to give
us a wider perspective of the client's viewpoint. This has enabled
us to prompt clients to investigate their issues and phenomena
from all angles in a phenomenological fashion as described in
Spinelli's Interpreted World (1989). This is probably because knowl-
edge of the framework gives us a sense of security and thereby
reduces the necessity or the desire to make those all-too-frequent
incorrect assumptions about clients. Furthermore, the structure
highlights the existential-phenomenological hypothesis that all
issues always interconnect and express themselves throughout all
facets of the client's world-relations. It follows that what the client
focuses upon is almost irrelevant, since if the subject is properly
followed through, the client will realise how it is linked to all of
his or her other issues. This idea is highlighted in the diagram that
illustrates the interconnection of all the concepts in relation to the
shifting self.
To make these theoretical concerns clearer, here is an example
to demonstrate rigid sedimentation. Lyn, whose presenting prob-
lem was that of withdrawal from socializing. In one of her therapy
sessions she experienced her fear and loneliness and low self-
concept. When I allowed her to challenge herself about these
emotions she disclosed the following experience in the present: At
an early age she was an extrovert. She was performing by dancing,
joking and singing in front of others when her mother came in and
told her off, saying, "Lyn, you are showing off again". Lyn went to
her room and cried bitterly. She felt isolated, without self-concept,
disconnected from everyone in the world. She described this
situation as she would feel in a black hole.
From this moment the therapy took another turn; in other
words she discovered her rigid value sedimentation (sedimenta-
tion meaning holding strictly to one's value and behaviour pat-
terns. In her perception showing off was negative and modesty
was positive). She realised that as a result of this she became an
introvert, staying in to study and read, which she did very well.
As for her sedimented behaviour pattern she unreflectively, com-
pulsively exercised her withdrawal pattern from every public or
54
group encounter. Her sedimentation meant that, on the positive
side she became knowledgeable about literature, but she paid the
price in relationships because she felt she had to be very careful not to
be a 'show-off', or immodest. It is important to remember that this
event and the emotions that Lyn experienced were only a metaphor:
it was not a causality but it was something that occasionally hap-
pened to her and was reinforced by many situations and many
fantasies.
The second element to be remembered is that the whole structure
must be bracketed and not to use as a technic, but to be a therapist
who is aware of his or her world view.
Interconnections of all the concepts

In this case vignette we have concentrated on one issue only,
although evidently people experience many sedimentations and
their associated behavioural patterns. Nevertheless, the point is
that each issue interconnects with other issues and all of them
relate to all the concepts that have been discussed in respect of
limitations and possibilities in 'being-in-the-world' (as shown on
the wheel). For example, Lyn's exaggerated sedimentation of her
values of being a 'show-off was detrimental in her life, and could
be connected with safety. In order not to feel insecure her coping
strategy was to withdraw from her extrovert tendencies. This in
turn related to her need for interpersonal relationships and yet
she had difficulty with them. Her value system was connected
with her self-concept and anxiety when she contemplated her
fears to relate to other people.
Finally, she always had the possibility of changing her value
system and her sedimented behaviour pattern. She could modify
her outlook, for example, that sometimes to be modest may be a
positive or a negative attribute, and, vice versa, to be a 'show-off
could sometimes have positive connotations.
Towards the end of the seminar one of the participant pre-
sented a case study for everyone to consider. All the known
phenomena that related to the client's presenting problem were
explored; the participant connected the issues to one another and
then linked them up with every segment of the existential wheel.
This way the phenomenological existential concepts were applied
into practice.
55
References
Deurzen-Smith, E. van, (1988) Existential Counselling in Practice, London:
Sage
Heidegger, M. (1990) Being and Time, Basil Blackwell
Kolb, D. (1984) Experiential Learning, New Jersey: Prentice Hall
Sartre, J. P. 1995) Being and Nothingness, London: Routledge
Spinelli, E. (1989) The Interpreted World, An Introduction to Phenomenological
Psychology, London: Sage Publications
Freddie Strasser, PhD, is a psychotherapist in private practice. He is par-

ticularly interested in the application of abstract philosophical concepts to
therapy and ordinary life through experiential learning principles. He is a
member of Visiting Staff at Regent's College School of Psychotherapy and
Counselling.
56
EXISTENTIAL THERAPY ON
HEIDEGGERIAN PRINCIPLES
Miles Groth
Introduction
Existence, the human kind of be-ing, is caught in a curious stance,
which I like to imagine as having one foot planted against the earth
and the other pointing to the zenith overhead. Unsteady with each
step, off-balance and vulnerable as a result, stretched between its
birth to parents it did not chose and an inevitable death of which it
cannot fail to remind itself time and again, each human being is an
experiment in be-ing in the human way. The presuppositions on
which this view is based are derived from Martin Heidegger's analy-
sis of existence [Dasein]. In what follows, I want to outline the
features of an existential therapy that is based upon it.1
The Features of Existence

Everything, including human beings, is characterized only by its
particular kind of be-ing [Seiende], for Heidegger, only the human
kind of be-ing exists. Human be-ing is existence. The unique charac-
ter of existence is be-ing a concrete historical life [Existenz].
Only man exists. A rock is, but it does not exist. A tree is, but it does
not exist. A horse is, but it does not exist. An angel is, but it does not
exist. God is, but he does not exist. The statement that "only man
exists" in no way means to say that only the human <kind of> be-ing
is real, and thus every other <kind of> be-ing is unreal and only a
semblance or idea for man. The statement that "man exists" means
that man is the only <kind of> be-ing whose be-[ing] is marked by
beling] as the outstanding instance of the emergence of be[ing]. 2
Appreciating what Heidegger says in these sentences is essential

to understanding what Heidegger in general means by existence. The
text from which they are drawn is late (1949), but even by the time of
Sein und Zeit (1927), in which Heidegger clarified the ontological
structure of existence for the first time, the verb 'existieren' is already
reserved exclusively for the human kind of be-ing. Forms of the verb
'sein' apply to everything else: things of nature, things fabricated by
human beings, even divine things -but also to the human body [Leib].
The unique status of the human body - that it both is and exists -
means that the human body holds a crucial place in existential
57
psychology and in therapy based upon it. The nature of the human
body determines the fact the human way of be-ing is existence, but
the human body, like any living thing, also "is." This paradox figures
as the source of disturbances of existence.
Heidegger's characterization of existence as manifesting itself as a
concrete historical life has been the source of a great deal of misun-
derstanding. It is important to be clear from the outset that Heidegger's
use of the term 'Existenz' is quite different form that of his col-
leagues, especially Karl Jaspers.3
The human body may be seen from two perspectives: there is, first,
the body I am, the "lived body" or "existential body," which encoun-
ters others and is validated by others. 4 Then there is what may be
termed the body I have, which bears the traces of my past. Talk of the
human body as a Cartesian res extensa, as distinguished from a res
cogitans, has been left behind. German nicely distinguishes between
the body I have [Körper] and the body I am [Leib]. I will have
recourse to this distinction frequently in the course of the following
discussion.
SOME BASIC FEATURES OF EXISTENCE
To begin, it will be helpful to outline the basic features of existence.
The Interrogative Stance

A first essential feature of existence is its interrogative stance. By
this I mean that human beings ask questions. Like other animals, we
are initially astonished by what we experience. Sometimes this be-
comes mere curiosity. Unlike animals, however, we find things amiss,
in nature and among ourselves, so that we ask why things are as they
are and seek answers that will we think enable us to improve upon
what we take to be an unfinished job. We attempt to modify nature
and improve what we take to be human nature. Our answers to the
questions we raise do not bring satisfaction, however, and the indica-
tive statements we generate as answers to the questions we raise only
evoke further questions. We are able to raise questions because we
have a relation to language. The basic form of language, according to
Heidegger, is interrogative. Its indicative forms are secondary.
We attempt to speak what we think, although with just how much
success, we cannot say. According to Heidegger, this is because a
thinker never understands his thought and must rely on an interpre-
tation of what he utters in order to guess at what he might be
thinking. In general, we know that we speak, although we are not
58
sure what language is, which in turn means that we do not under-
stand how language has arisen. It is a gift and a responsibility which
both connects us with our thinking and distances us from is. For
Heidegger, language hides as much as it reveals.
Existence is Coexistence
A second feature of existence is that human beings cannot exist
alone. Human be-ing is existence with others or coexistence. Human
bodies can be isolated from one another, of course, but even under
those circumstances they are always there [da], with us. In fact,
others are most there when they are absent.
As the examples of feral children show, instance of homo sapiens
reared apart from other human beings does not become a human
kind of be-ing. We become and remain human only by acts of what I
term existential validation (or, simply, validation) of our be-ing
human. Acts of validation are mutual, beginning with the existence-
bestowing series of acts of validation that occur between a newborn
and the mothering figure. From an existential point of view, it is
difficult to say how we should conceptualize a feral child. Is it
human? Genetically, that is, as an example of homo sapiens, it is
human, but existentially, it is not.
One's existence is bestowed on him during the first months of life,
and in ensuing encounters with others during childhood and adult-
hood, we continue in acts of validation to accept our existence from
others, while at the same time bestowing it on others. Being encoun-
tered is the initial moment of every instance of existential validation,
including those which are therapeutic. Many interpersonal experi-
ences are not instances of existential validation. They are character-
ized by the exertion of power by one member of the pair over the
other. Beginning in infancy, human experience is comprised of power
relations and experiences of existential validation. The unique fea-
ture of existential validation is its equi-mutuality. We validate each
other in the human look or gaze, by the human touch, and in speak-
ing to each other (or withholding speech).
These are the basic features of existence in rough outline and there
is a great deal more to be said about them, but the pathology of
existence is my concern here. What is the possible sense of a pathol-
ogy of existence? What can existential therapy mean? What are its
principles and underlying presuppositions? What can an existential
therapist do? I want to briefly address these questions in what
follows. 5
59
What Is Existential Therapy?

I do not use the term 'psychotherapy' here, because existential
therapy is not directed to what has been called the psyche. The
distinction between the psyche, or subject, and soma, or object,
which was instituted by Rene Descartes, is not confirmed by experi-
ence. The failure of modern psychology to fulfil its promises can be
traced to this faulty characterization of the human being as a subject
set over against objects, including the subject's most important ob-
ject, its own lived body.
I reluctantly use the term 'therapy', because in existential therapy
nothing is being treated. In contemporary usage, therapy means the
treatment of something, but existential therapy is not directed at
what the person is, but rather at his or her existence. It is well known
that current concepts of psychological treatment or psychotherapy
(including psychoanalysis and psychoanalytic psychotherapy) are
based on the tradition of medical therapeutics, in which procedures
are carried out on the depersonalized organism, not the human being
as such, who is thought to inhabit its body in some way. Of course,
only by treating the body as a sort of living corpse can the physician
regard what he treats with the requisite objectivity and carry out
painful procedures on the body of the person who is not only his
patient but also a cohort. The physician's training begins with the
cadaver, which remains the prototype of the patient who is treated.
On analogy with the physical organism, the psyche is subjected to
treatment. By contrast, existential therapy is directed at the existence
of the person. Existential therapy is directed precisely at a cohort,
someone who coexists with the therapist. Thus I retain the term
'therapy', but use it in its original meaning as care for or attendance
to someone.
Existential therapy is care for the existence of the person, not for
what he is. It takes place in the traditional psychoanalytic setting, in
which the usual parameters of monetary compensation for a service
provided are observed, but only on the condition that the autonomy
of the person is observed and preserved throughout.6 Existential
therapy is not possible when a fee is paid by anyone other than
the patient. It precludes the involvement of third parties,
including employers, insurance companies, courts, schools, and
other family members. For this reason, I question whether a
dependent child or adolescent can participate in existential therapy.
I also use the term 'patient' with many misgivings, since the
person who seeks existential therapy is not in any conventional sense
ill. He has not been injured, nor does he feel the effects of a pathologi-
60
cal physical process.7 The therapist does not intervene or direct the
person to carry out a certain regimen. He does not exercise power
over the patient. Moreover, a physician, who considers disease proc-
esses to be the signs of a viable organism, always aids the body in its
self-restorative tendency. He appreciates that the symptoms of physi-
cal misery, while disagreeable, are nonetheless signs of an organism
fighting for health, but attempts to alleviate pain whenever possible,
once the cause of the illness or injury has been determined clinically.
By contrast, the existential therapist, in his concern for the existence
of the other, helps bring the process of existential validation to the
person's awareness and therefore disturbs the patient in an impor-
tant way. As I will show, the existential therapist thus in general
works against the patient's status quo. With these considerations in
mind, I nevertheless retain the term 'patient' to describe the person
who comes to existential therapy, since he initially agrees to undergo
the experience, just as a conscious patient agrees to the medical
procedures to which he then submits.8
In existential therapy, the therapeutic element is what I term the
validation of a person's existence. As already indicated, validation is
the mutual conferring of existence. It is always dual. Existence is
conferred by the gaze, touch and in speech. As I have illustrated
elsewhere, its paradigm is the greeting.9 In existential therapy, what
occurs spontaneously in human life in certain situations becomes the
focus of interaction between patient and therapist. I will try to
explain what this means.
Since it makes no sense to say that someone's existence is in any
way, therefore, strictly speaking, existential therapy is not directed at
a person's existence. A person's existence is fleeting, yet it is the most
real feature of the human way of being. Like a subatomic particle, it is
never fixed and therefore cannot be captured, yet evidence of it can
be found, although the indications of existence lack the presence and
permanence of what is. Existence lacks presence because it is always,
so to speak, just ahead of the person's consciousness of what is going
on. One's existence is not therefore part of his present. Only another
human being can observe and attest to my existence. I can take hold
of my existence just as little as the other person, who sees indications
of it, can grasp it or bring it to a standstill for observation and
scrutiny. The indications of existence are the same as the acts which
validate existence: the gaze, the human touch, and language.
But if it is the case that existence is nothing determinate, what,
then, is existential therapy directed at? Existential therapy is directed at
all that the person is not, but always within the scope and span of what
61
the human kind of be-ing can be.10 Traditional psychotherapy begins

with a certain notion of human nature which is described by or
implied in the theory of personality on which the particular brand of
psychotherapy is based. Existential psychology assumes, by contrast,
that human nature or what it is to be human has not yet been decided,
and each existence is an instance of human life that has not existed
before and cannot be repeated. Each of us is, in a sense, a species unto
himself, an experiment of human possibility which provides its own
evidence. Each of us is as different existentially as he is genetically
distinct from other instances of homo sapiens.
SOME PRESUPPOSITIONS OF EXISTENTIAL THERAPY

There are number of presuppositions at work which form the
foundation of the theory of existential therapy.
Existence Is Time
Existence is temporal. Like anyone else, the patient exists his own
time. Time is not a product of human life. It is indistinguishable from
existence. As Heidegger said as early as 1924: "Existence ... is itself
time, [it is] not in time."11 Lived time (le temps vecu) is not a measur-
able stretch or a segment of such a span.12 Each person's time is
unique to him, and it is only with great difficulty, and only rarely,
that any two of us coordinate our lived times, but even when we do,
the coordination is brief and difficult to sustain. The coordination of
lived times occurs in moments of existential validation, but it also
occurs, for example, in the aesthetic confluence of performing music
with others, in ritual and sacrament, and in mutual orgasm .13 When
such coordination occurs in therapy, they are due to the characteris-
tics of the therapeutic situation and the efforts of the therapist.
Throughout our lives, we make an effort to coordinate our lived
times by reference to diurnal events and, of course, to clocks, which,
contrary to the express evidence of the cyclic passage of cosmic
regularities, conceive time as linear duration along a continuum.
These efforts make for the establishment of important social institu-
tions. Linear or chronometric time is, however, a derivative of lived
time, which, like cosmic regularities, is cyclic or, more properly,
circular.14 On occasion, including the experiences mentioned above
but also in power relations, two or more existences may coincide.
I would like to characterize the existential therapist as a specialist
in lived time who tries to understand the lived time of his patient
from his perspective, as an outsider, on his patient's existence. The
existential therapist attempts to coordinate his lived time with the
62
patient's lived time, which is to say, to his existence. He is then in a

position to begin to understand the patient's world. As a therapist,
the congruence that results is an opportunity for the validation of the
existence of the patient.
An Instance of the Human Kind of Be-ing Both Is and Exists

In general, from the point of view of his lived body, a person both
is and exists. As indicated earlier, to admit this does not, however,
entail claiming that a person is divided into his "being" and his
"existence." The distinction is only virtual and does not introduce a
new dualism. It merely allows for two perspectives on the real
person: his own perspective and the perspective of an other. The
distinction between the body I have and the body I am, which was
made earlier, allows one to develop Heidegger's view that existence
is always coexistence and apply it to existential therapy.
Applying the distinctions made, we may say that both patient and
therapist have access to the body the patient has, but only the thera-
pist (and here he is no different from any other "outsider") has access
to the body the patient is. All that I am is marked upon the body I
have, and there is no denying that the body I have allows people to
identify me as something. But I exist, and my existence and what I am
calling the body I am are the same. The human organism is the site of
this dual perspective of what I am and my existence. As Heidegger
explains, this duality makes the human body different from the
animal body.15 The body I have is the physical body studied by
natural science, but I do not experience it as something different or
separate from my existence, simply because I cannot experience my
existence at all. Only an other can do this.16
The existential therapist helps the patient understand this duality
of the human body, which is the site of the ambiguity about what he
is and his existence. It is well known among therapists that nearly all
complaints that bring someone to a therapist of any kind concern
how the patient experiences his body, that is, in the terminology of
this paper, the body he has. For example, he says he feels shaky or
nervous, he is fatigued, paraesthesia haunt his limbs, he feels palpita-
tions, he feels crawling sensations on his scalp, he has vague abdomi-
nal pains, and so on. As such, his lived body has been reduced to
something, what I have termed the body he has, and in the absence of
any lesions (which also reduce the lived boy to the body one has), he
nevertheless experiences pain of various kinds.17The body I have has
a past. It openly reveals its genetic heritage, including its gender. It
also exemplifies how the person sees himself, since the body he has
63
come to represent how he has cared or failed to care for his lived
body. The way he carries himself, the way he sits, the ways he dresses
himself, what he chooses to expose or hide - all reveal how the patient
sees the body he has. The body he has shows the scars left from minor
or horrible injuries. Changes in hair style and clothing, loss or gain of
weight, change in his shape and proportions, all of which change the
body one has, signal changes in the person's existence, as we will see.
The body one has is, however, an illusory thing, in that the lived
body itself, which is in constant interaction with its environment, is
always changing of its own but is also being changed by the environ-
ment, sometimes in very noticeable ways (for example, by accidents).
The persistent illusion that the body one has is a fixed item has come
to overshadow the changing nature of body one is, the existential
body. This has happened under the dominance of the Cartesian view
of the body as a res extensa, and it is a habit of conception that is hard
to modify.
When we says that a child has little sense of his body, we mean
simply that he has little sense of the body he has. An infant's body or
a young child's body is entirely a lived body. He has not yet been
convinced that he has anything like a Cartesian body. This body
becomes the focus of what Erik Erikson has termed the child's
Psychosocial identity.18 By contrast, the body one is or the lived body
is the body that moves, exercises, performs, makes love, fights.
Transitive action verbs are used to describe it. The body one is speaks
words and announces nonverbally what the person may not have the
words to express. The existential therapist attempts to help the
person become aware of the body he is.
Only others have direct access to the body one is. For ease of
exposition, let me put this in first-person terms. Only an other has
access to the body I am. I am barred from it by the body I have, which
dominates my world as the embodiment of my past. To the extent
that I have access to the body I have, I also have access to my lived
time. What I do not have access to is my existential body or lived
body. I regularly come to know about my existence from others, just
as I first had my existence bestowed on me by another, the mothering
figure of my infancy. These fundamental experiences of validation
become the focus of existential therapy, in which the patient comes to
recognize the encounters in which his existence was and is bestowed
on him and in which he at the same time bestows existence on others.
With respect to what I am, the body I have is the most important
thing in my world, but from the perspective of my existence it may
not be. My existence is constantly manifesting itself as, for example,
64
religious, political, moral, philosophical, or scientific life. Like a
flame, my existence plays on the surface of the things that comprise
my world, including the body I am. It gives these things the meaning
they have in consonance with my existence. Existence occurs at the
things which encounter me, including the body I have. Thus, my
existence does not occur "inside" me or my psyche, or "inside" my
body. The image of the person as a container for hidden processes
(the word 'person' derives from the Latin persona, which means a
mask) has obscured the fact that my existence is out there [da], at the
things which encounter me, once again, include the body I have.19 A
person's existence occurs between it and another person's existence,
at the things with which we deal together, including the bodies we
are. Existence occurs between pairs of people, just as it originated for
each of us in the dyad of infant and mothering figure.20 Existential
validation, including its occurrence in the therapeutic setting, as we
will see, is always a two-person phenomenon.
The patient's body eventually betrays the lack of an interior. The
hidden parts of the body he has, are, of course, covered by the
integument and skeletomuscular structure, but this is not what peo-
ple have in mind when talk about what is going on "inside," "in"
their "inner world" of affects, images and thoughts - the so-called
representational world. The introspective turn is once again the
legacy of Descartes. To his great disappointment, the patient finds
that there is nothing "inside" except physical organs and empty
spaces. While the body I have (including its hidden parts) is one of
the things (and a very important thing at that) at which my existence
takes place, it is not the only thing that confronts me and, most of the
time, it is not the most important site of my existence. When my
existence becomes an issue for me, however, that is to say, in in-
stances of existential pathology, the body I have tends to take centre
stage because it has become objectified as the body I have. Rarely is
the body one has not a major focus for the person whose psychologi-
cal life is disturbed. Increased interest in the body one has is a
consequence of increasing estrangement from one's existence.
Existence also occurs, of course, at many other things, including
especially the body the other has. For each of us, the earliest of these
sites is, of course, the mothering figure's body and, later, at what the
British psychoanalysis Donald Winnicott calls transitional objects.21
The expanding and contracting world of the older child and of adults
encompasses innumerable sites where one's existence occurs. These
are the things that comprise one's world, and being in a world, as
Heidegger says, is the essence of existence.22 What disturbs the
65
patient who seeks treatment is a change in the things that comprise
his world.23 The disturbed world, which is the correlate of lived time,
has changed tout court, and in such a way that the patient is unable to
appreciate the change. Please notice that I did not say "the disturbed
person". 24
Existential Pathology and Therapy

Like nearly all terms in psychiatry and clinical psychology, the
term 'pathology' is borrowed from medicine. Pathology implies a
lesion of some sort. Yet nothing is dysfunctional when someone's
world changes. In and of itself, the new world has nothing positive or
negative about it, because in general, the things that comprise one's
world are not objects of valuation. The effects of an accident or
physical illness will also introduce changes which also affect one's
existence, but only, in the first place, by way of their influence on the
body one has.25 All the same, I will retain the expression "existential
pathology" to characterizes the change in world that causes a person
to suffer. A person becomes a patient when his world has changed,
and in such a way that he cannot appreciate it and therefore rejects it.
The source of existential pathology is refusal of world.
What can existential therapy mean? Perhaps someone patient has
gone looking for an inner world and, assuming that he thinks he has
found one, has elaborated a solipsistic illusion of processes and
structures to account for his experience. Most patients will have had
at least one such experience in traditional psychotherapy, or they will
have become accustomed to thinking in terms of intrapsychic events.
In any event, the person suffers because his world has changed and
he cannot live in it. He may seek understanding of what has hap-
pened. Existential therapy has no interest in modifying behaviour or
bringing about change. It focuses, rather, on how the patient under-
stands what has already changed.
Existential Change
Existential therapy existential change, that is, the change in the
patient's world that has occurred, and how it has changed. Why the
patient's world has changed may be of great interest, but it is not an
issue of existential therapy.
What does a change in world mean? Again, allow me to revert to
the first-person. My existence is always at play, but ordinarily the
lineaments of that world remain fairly stable. I sees that things are
more or less the same day after day. The determinacy of things is for
the most part steady and their use remains more or less fixed. But
66
when, for example, I am unexpectedly visited by a friend whom I
have not seen for a long time, the world changes entirely, or I am
married, I am confirmed in a religious rite, I am told I have cancer,
my mother dies, I am fired from my job, I realize I have gotten old, I
am awarded a Ph.D., I realize I don't love my wife any more .... I
may welcome the new world and accept it. In instances of existential
pathology, however, I refuse the changed world. My lived time is so
dramatically different that I do not know what time it (the world) is
or, better, I do not know what time I am. It may take me hours, weeks
or years to fully grasp what has changed.
It is my view that the period of gradual understanding of the
change of one's world has been mistaken for a slow process of
change. On analogy with physical growth and maturation, psycholo-
gists have called this development, which they have contrasted with
deterioration. Existential psychology challenges the notion of de-
velopment, which, like so much in modern psychology, is based on
the Cartesian model of physical structures, and organic functions
and processes.
Of course, my world is always changing in small, indiscernible
ways all the time, but as in my examples just now, it may change
dramatically all at once, and during the period that follows, I come to
understand what has changed - or I do not, and there is an instance of
existential pathology. It is clear that my world may change as a result
of bodily processes or an accidents, but it also changes in ritual and
sacrament, in conversion or change of belief (religious, moral or
political), and in so-called mystical experiences. Existence may also
change in existential therapy.
Talk about existential pathology is talk about the things in some-
one's world, including the body he has. Existential pathology refers
to the experience of the things that comprise a person's world, which
are indistinguishable from that world, and of his lived time.27 Thus,
the site of existential pathology is in the patient's world, not inside
the patient's psyche. It is impossible to separate his experience of
things from his world and lived time.
When my world changes, not only does my face change, but so also
does the face (facies) of all of the things at which my existence occurs.
The existential therapist helps the patient see that things have changed
and how these things have changed. The disorder is at the things, not
in the patient.
67
The Aims of Existential Therapy

The primary goal of existential therapy is to reveal the patient's
existence. In view of what has been said, the patient's body (the body
he has) becomes the initial focus, since the patient has turned back to
it and away from the body he is, although he does not know this.28
The therapist observes how the patient lives his time and reveals
what he sees to the patient. The body becomes an object of impor-
tance in the patient's world as a site of the patient's existence, and as
something in the patient's world, the therapist also becomes a site of
the patient's existence.29 While the importance of the patient's body
as a site of his existence cannot be overlooked, too little attention has
been paid to the non-human things in a patient's world. These are
equally revealing sites of the patient's world, so that the therapist
learns a great deal about the patient's world from observing how the
patient experiences inanimate objects, including clothing and the
myriad things a patient handles in the course of a day.
A person, I have suggested, is the site or topos of a world. The
patient comes to therapy to become familiar with his world. He
complains that nothing is the same any more. Things do not feel
right. Everything is wrong. Nothing is working. Nothing makes
sense. Only gradually does the patient begin to focus on the seem-
ingly trivial things that make up his world, and as these little things
come into view, the outlines and then the details of his world as a
whole become discernible to him. The therapeutic situation is unique
in allowing the patient's world leeway and room to become discern-
ible. The therapeutic "space" allows "distance" among things and
lights them up, so that they become distinguishable.
The patient has also become estranged from his lived time, an
outsider in his own time, an Stranger. He comes to the therapist for an
understanding of his time, and perhaps for a different time. As we
have seen, he does not come to be changed. He has already changed
and wants to find out what has happened.30 The patient comes to an
existential therapist for a different time, which allows him to discover
his own lived time. He does not want to be treated, advised, trained,
re-educated, tamed, informed, or corrected. For this, he may turn to
teachers, attorneys and physicians. He comes to existential therapy
to be taken seriously, to be seen and heard again in his own time and
world. In part, we see that he has been silenced and made invisible by
having lost the validation of his existence and this is one reason why
he has become a patient. In a sense, every patient's problem is the
same: his existence is not being validated, but he does not realize that
the reason for this is his own failure to validate the existence of
68
others. Since validation is always mutual, when the patient loses
sight of the existence of others, he himself becomes invisible. When,
as a result, his own existence is not met and validated by that of
others, he ceases to speak about things, and in this sense he is
silenced.31 What then does he speak about instead? He talks for the
most part about what others are and what he is. He has also become
preoccupied with trying to make his personal past remain the same,
which takes a great deal of effort, since the past his always changing.32
The existential therapist encourages the patient to focus on the
existence of the therapist, so that the patient can (perhaps for the first
time) indirectly become aware of his own existence. The therapist's
existence passes under the gaze of the patient, whose own existence
is validated. The therapist brings his existence to the patient some-
what as a newborn's mother brings her existence to the infant, and as
in neonatal life, access is opened for the patient to look and speak,
and for his existence to become visible. One human interaction
exemplifies the validation of existence: the greeting. In mentioning it
at this point, I want to highlight what is typically the first encounter
between a therapist and a patient, and at the same time an opportu-
nity for validation of the patient's existence. The greeting combines
the three modes of existential encounter: the gaze, touch and speech.
I do not mean to imply that the greeting is in and of itself therapeutic,
but what happens in the exchange of a greeting often sets the stage
for other experiences of validation in existential therapy.33
The patient suffers. He says "I feel depressed." His symptom is a
question that cannot be spoken. It speaks mutely, for example, as a
feeling (depression, anxiety), as a physical complaint (pain), or as an
unverifiable and unusual perception (hallucination). For the existen-
tial therapist, all symptoms speak for the existence of the person, not
for what he is. For this reason, it has never been possible in psychol-
ogy to explain symptoms in a satisfactory way in either physical or
psychological terms alone. A symptom is neither something physical
nor something psychological, but rather belongs to the existence of
the person. It expresses the person's existence, not what he is, like the
physical sign of a disease process.34 The therapist helps the patient
express in words or other forms of expression what his existence is
expressing dumbly.35 There is as much in the gaze and the human
touch as there is in words to evoke the words the patient lacks. In
working with so-called deteriorated or decompensated patients, the
therapeutic gaze or touch may evoke more than the therapeutic word
is capable of doing, yet the look or gesture must eventually be
translated into words.
69
Each existential therapist's approach is unique. How could it be
otherwise, since his existence is unique. Following the ancient rule to
"do no harm," certain interventions can be specified which are to be
avoided, so that an existential therapist can be taught what not to do,
but he cannot be taught what to do as a therapist.
Notes
1. I have already presented the lineaments of an existential psy
chology on Heideggerian principles in "Human Being and Existence.
The Beginnings of and Existential Psychology," Review of Existential
Psychology and Psychiatry, 22 (1-3), 1990-91, pp. 116-140.
2. "Einleitung zu 'Was ist Metaphysik?'. Der Ruckgang in den
Grund der Metaphysik" (1949), in Wegmarken, Volume 9 of the
Heidegger Gesamtausgabe, 1976, p. 374. I translate 'Sein' with the
somewhat awkward construction 'be[-ing]', which I pronounce "be."
It is meant to point out the problematic nature of 'Sein' in Heidegger's
thinking and to illustrate the be (Sein) in every kind of be-ing (Seiende).
3. For Jaspers, Existenz is life human life as characterized by limit
situations. His notion of Existenz is grounded in the Lebensphilosophie
of Dilthey which, along with Nietzsche's challenging view of Euro
pean man, spawned twentieth-century Existentialism. Heidegger is
emphatically not an Existentialist in this tradition, as his usage of the
word 'Existenz' illustrates. For some of the background of the use of
the term 'Existenz' by Heidegger and Jaspers, see Theodore Kisiel,
"Existenz in Incubation on the Way Toward Being and Time," in
Babette E. Babich (ed.), From Phenomenology to Thought, Errancy, and
Desire (1995) Dordrecht: Kluwer, pp. 89-114.
4. The word 'other' is shorthand for "another existence." I use the
word 'validate' to describe the unique experience of encounter be
tween two existences. Validation of existence occurs, for example, in
nursing an infant, making love, undergoing ritual and sacrament,
and making a psychiatric diagnosis.
5. The following observations are based on twenty years of clinical
practice. My clinical observations come from work with outpatients
seen in a suburban community mental health clinic, college students
at a small liberal arts college's seen in a walk-in counselling centre,
students attending a private school for emotionally disturbed adoles
cents, young adult criminals from inner-city neighborhoods of a
large metropolitan centre who were seen while on special training
leave at a non-residential state and city subsidized centre for emo
tional and educational rehabilitation, adults seen in two out-patient
70
clinics in a large city, and individuals seen in private practice in
existential psychotherapy.
6. Thomas Szasz has written repeatedly and eloquently about
autonomous psychotherapy.
7. Should what is termed schizophrenia, bipolar disorders and the
like ever be found to have a physiological etiology, which many
psychiatrists have proposed is the case, these conditions would be
the province of medicine, not psychology. Currently, the other psy
chological disorders which primarily "physical symptoms" are dealt
with under the headings of somatoform disorders. See the Diagnostic
and Statistical Manual of Mental Disorders (DSM-IVJ, Fourth Edition
(Washington: American Psychiatric Association, (1994),
p. 445 ff.
8. Nor will the term 'counselling' do for what the existential
therapist does, since one of the immediate effects of existential therapy
is insight, while that is not the primary aim of counselling, in which
the counsellor provides support, informs, and gives advice.
9. See "Existence and Being: The Beginnings of an Existential
Psychology," p. 119.
10. The structure of existence, as first outlined by Heidegger
sketches as the categories or existentialia of existence, is at the same
time the scope of human possibilities. There are important ontologi
cal questions here that are beyond the scope of this paper, for
example, the question about how to understand the duality of be-ing
and existence in the human kind of be-ing. Briefly, the duality is only
virtual or perspectival, the unity of the person is real.
11. The Concept of Time (1992) London: Blackwell, pp. 13-14. "Das
Dasein... ist die Zeit selbst, nicht in die Zeit." This is a bilingual edition,
with a translation by William McNeill, of Heidegger's address to the
Marburg Theology Faculty in July 1924, first published in 1989 as Der
Begriff der Zeit (Niemeyer: Tubingen).
12. I borrow the term, of course, from Eugene Minkowski, Lived
Time [1933] Evanston: Northwestern University Press, 1970.
13. These experiences are important to study in order to better
understand existential validation, which is their prototype.
14. The face of the traditional dock is deceptive in this regard. A
temporal cycle is not a closed line, as defined by geometry, which the
circumference of a clock's face suggests. Another image may be help
ful: a human cycle of lived time can be thought of as one of many
possible closed circuits across the surface a sphere and our several
existences may be likened to such circles that run across the same
sphere.
71
15. See Part II of Heidegger's Die Grundbegriffe der Metaphysik.
Welt-Endlicheit-Einsamkeit ( 1929-30), translated by William McNeill
and Nicholas Walker, as The Fundamental Concepts cf Metaphysics.
World-Finitude-Solitude (1996) Bloomington: Indiana University Press,
pp. 176-276, which is a detailed phenomenological analysis of the
organism. Incidentally, it show's Heidegger's familiarity with biol
ogy and the other natural sciences.
16. The body I have is the body which, since the time of Descartes,
has been distinguished from the mind. For more than two centuries,
it has been thought of as a highly complicated machine. This view of
the human body was first presented by Julian Offray de la Mettrie in
1748. See L'Homme Machine, first translated, in 1921, as Man a Ma
chine by G. C. Bussey and M. W. Calkins (Chicago: Open Court).
17. Pleasure also brings the lived body into focus, but does not reduce
it to the body one has. Here the physiological explanation of pain and
pleasure fails to account for the existential experience of the body.
18. Erik Erikson, The Life Cycle Completed. A Review ( 1982) New
York: Norton.
19. This basic feature of existence is, of course, the reason for
Heidegger's close attention to the etymology and spelling of the
word 'Dasein.'
20. It seems to me that among groups of people something very
different is going on which requires a phenomenological analysis of its on.
21. Donald W. Winnicott, "Transitional Objects and Transitional
Phenomena" (1951), in Through Pediatrics to Psycho-Analysis (New
York: Basic Books, 1975).
22. Sein und Zeit (1927), Gesamtausgabe 2, §§ 12-38, pp. 71-239.
23. Here the work of Jan van den Berg on metabletics or historical
psychology has been very influential on my existential psychology.
See, for example, Things. Four Metabletic Reflections (Pittsburgh:
Duquesne University Press, 1970) and "Phenomenology and
Metabletics", in Humanitas 6(3), Winter 1971, pp.279-290.
24. A world is not the product of lived time, because there is no
difference between one's existence and lived time. From an other's
point of view, my existence and my world are the same. From my
perspective, however, the distinction between my existence and my
lived time never comes up, since I do not have access to my own
existence as something to compare. For access to my existence (if I
may repeat this again), I rely on others.
25. The physical suffering that results is a problem of living. The
existential therapist is not concerned with everyday problems of
living, but with a change in one's existence.
72
26. Psychotherapy was never meant to reduce the ambiguity of
life, although many who now practice clinical psychology seem to
believe that they are in the business of eliminating the sparks of
uncertainty that characterize human life and levelling down all ambi
guity. Heidegger's insights into the structure of existence included
the observation that anxiety [Angst] is a positive element of exist
ence. On anxiety, see Sein und Zeit § 40, and the lecture Was ist
Metaphysik? (1929), in Wegmarken, Gesamtausgabe 9, pp. 111ff. See
also Medard Boss, Existential Foundations of Medicine and Psychology (
1979 [1970]), translated by Stephen Conway and Anne Cleaves, New
York: Jason Aronson, p. 112. On the medicalisation of everyday life,
including psychiatric "care," see Ivan Illich Medical Nemesis. The
Expropriation of Health (New York: Random House, 1976) and Tho
mas Szasz, The Myth of Psychotherapy (Syracuse: University of Syracuse
Press, 1978).
27. The Japanese understand this change in things when they write
about pathos that things have: mono no aware.
28. A great deal of attention has been given to the body in psycho
therapy, and rightly so. The Gestalt therapists, for example, have
contributed a great deal in this area, yet they have dealt only with the
body one has. The existential body has eluded Gestalt therapists,
because, like all traditional psychologists, they begin with the so
called subjective experiences of the patient's body. The patient's
body is understood as a res extensa for the subject (res cogitans) who
is out of touch with his body. The goal of Gestalt psychotherapy is to
reunite the psychological subject with its primary objects, the pa
tient's body. But since these do not occur separated from each other,
there is nothing to reunite. See, for example, the classic statement in
the field, Fritz Perls, Ralph E. Hefferline and Paul Goodman, Gestalt
Therapy. Excitement and Growth in the Human Personality (New York:
Dell, 1951).
29. The problem of the highly sexualized nature of the body for
many patients has plagued psychotherapists since Freud. Briefly,
only when the body of the patient has become objectified, does the
sexual quality of the body become exaggerated. Nonetheless, the
importance of sexuality of the body one is remains paramount.
30. Freud recognized that the patient does not need to be changed,
and this is why he cautioned against encouraging the patient to make
important decisions during psychoanalysis. He did not see, how
ever, that it is not enough for the patient to understand what he is.
Freud assumed that patients came to him to be helped, as they
properly do when they visit a physician (as Freud was by training).
73
The idea of the psychotherapist as a "helper" and a member of the
"helping professions" (including nursing and social work) new per-
vades the field.
31. The extreme autism and negativism of "schizophrenia" may be
conceptualized as an extreme form of world loss, as Binswanger
realized a long time ago. Being-in-the-World. Selected Papers of Ludwig
Binswanger (New York: Basic Books, 1963), p. 338. See also Henri
Ellenberger, "A Clinical Introduction to Psychiatric Phenomenology
and Existential Analysis," in Rollo May et al. (eds), Existence. A New
Dimension in Psychiatry and Psychology (New York: Basic Books,
1958), pp. 121-123.
32. The meaning of the personal past is crucial for existential
psychology. Remembering and reading history are not the same sort
of thing, although they are often thought to be. What I return to in
memory is newly revised each time I return to it, because I return to
it as a different person (my existence has changed, albeit in hardly
detectable ways). The continuity of personality is one of the grand
illusions of psychology. What I recall, let us say, at age 10 of an event
that happened the summer before is not what I recall at age 20 of the
same event. My personal past is to what a camcorder records as lived
time is to what a clock ticks off. I look with disbelief at the figures
moving across the screen as a videotape plays back images recorded
20 years earlier. This is because my memory has changed my past
during the intervening years, so that it no longer corresponds to what
is in the archive, which the outsider takes to be "what really hap
pened." When I try to fix the past as if it were a documented history
which I might later read, I work against what memory does. I
construct a mythic past (usually in connection with a communal
history) that controverts what my memory newly recreates in form
ing my personal past, which is something different each time I
remember an event. My gaze thus remains fixed on a personal myth,
and I do not look in the direction of others and their existence. I can
the easily invent an "inner world" to house the myth. In losing sight
of the existence of others, it can only happen that others lose sight of
my existence, since validation is forestalled. At the extreme, this
myth becomes a highly organized delusion (schizophrenia).
33. Pedro Lain Entraglo, The Therapy of the Word in Classical Antiq
uity (1970 [1958]), edited and translated by L. J. Rather and John M.
Sharpe, New haven: Yale University Press. On the gaze, touch and
tone of voice, see John Heron, "The Phenomenology of Social En
counter: The Gaze," in Philosophy and Phenomenological Research 31
(1970-71), pp. 243-264.
74
34. For this reason, people experience physical illness and pain
differently, depending upon the status of their existence.
35. As Freud recognized, the therapist's interpretations may serve to
provide the patient with words he has lacked which express his existence.
Miles Groth is Assistant Professor in the Department of Psychology at

Wagner College, Staten Island, New York 10301
75
Journal of the Society for Existential A
MARTIN HEIDEGGER AND PSYCHOTHERAPY
Hansjorg Reck
Does Daseinsanalysis, which is based on the thinking of Martin

Heidegger, currently have anything important to say in the area of
child psychotherapy ?
Introduction
In child psychotherapy we are confronted with emergency, entan-
glements, true illness; not only with deviations of the behaviour.
Donald Winnicott's aim, when he does psychoanalysis, therefore is:
to remain living, healthy, awake and be himself. Can the method of
Daseinsanalysis be helpful in this effort? My question "Does Dasein-
sanalysis currently have any importance in child psychotherapy" has
to be answered with NO since it has been mostly neglected and
unknown in spite of many efforts and important modifications in
psychotherapy.
The question "Does it NEED to have any relevance", however, has
to be answered with a YES. The reason is that with it, the existence
(Wesen) of the human being, which becomes more and more ques-
tionable in our technology-centric age, is determined from scratch,
which has both pedagogical and therapeutic consequences.
I maintain that Daseinsanalysis is:
1. highly appropriate to meet a child's way of being

2. simpler
3. richer
4. and worthy of human beings
and I want to elaborate these points in my talk.
I
Daseinsanalysis with its method of phenomenology
(Phaenomenologie) is especially suitable for the child. It allows a view
of the thing itself and thus corresponds to the child's unbiased,
questioning way of discovering its world. It proves useful not only at
the first contact with the child and his family, but also in the follow-
ing therapeutic 'attendance'.
76
The 'being' of everyday life happens to the child in a very elemen-
tary way: with its view and questions it approaches elements of its
world as they are, lets them gradually become more distinct, without
having to put force on them (ihnen Gewaltantun muessen) and thus is
more open for recognition of SEIN.
Experiences of the child, which are abundant, but often cryptic
(verschluesselt), have to be voiced in therapy (Berna); since the spoken
word can relieve and foster the child's development. A potentially
necessary interpretation of the child's offer corresponding to Dasein-
sanalysis (daseinsgemaesse), evolves the thoughts of the child, leads to
its unaffected perception, questions the unsuitable trained and re-
lieves. Besides, sufficient time and readiness to give the child its
scope are essential to make the therapy successful.
II.
In which way is Daseinsanalysis beneficial to understand the
'group' behaviour of human beings, especially in the younger age in
which communication is difficult, so that interpretation (Spekulation)
that seems necessary for educational and therapeutic work becomes
superfluous?
Sigmund Freud's assumption of a 'psychic apparatus' with Id, Ego
and Super-Ego seemed to shed light on the incomprehensibility of a
personality.
Also, Anna Freud's elaboration of the function of the parts of
personality (Persoenlichkeitsanteile) seemed to be sensible and
pedagogically helpful, because it corresponded to the vitality, indi-
viduality and sociality of human being. At least, her thoughts con-
tributed to overcome genetic and moral prejudice concerning neu-
rotic or character-based failures (Fehlentwicklungen) and to see the
implications on each stage of development (Entwicklungsstufe)
But the metapsychological theories, although heavily modified in
the meantime, are too based on a scientific perception of the human
being which is not only not sufficient to its existence (Daseinsart), but
which distorts it as well.
If man is seen as "Dasein", that is a human being, which is needed
to serve with its "SEIN" to all other beings as a location of perception
(Erscheinungsstaette), then those models are short of explanation. It
has to be asked therefore whether, for example, in the context of rage,
aggression and love we can talk about one of those determining
'energies' which cannot be measured, though, but which are sup-
posed to be convertible (Anna Freud); or whether those things have
to be seen as manners of Gestimmtsein (mood), Leiblichsein (bodilyness),
77
Mitsein (to be together), that is as "existentials" (als Ek-sistentiale). As
such they are not only of academic nature, even harmless, but rather
bring human being with its rage, aggression or love into the clearing
of its being in die Lichtung seines Daseins (Heidegger), which means
that for example rage can no longer be an excusable or convertable
drive, but a mood (Gestimrntheit) that has responsibility and which as
matters stand needs educational and therapeutic counselling
(Begleitung). Also, the child's bodyliness (Leiblichkeit) and to be to-
gether (Mitsein) are further-reaching than a 'libido'.
The structure of existence (die Daseinsstruktur) doesn't show any
'Ego-Instances' (Ich-Instanzen) with parts of consciousness
(Bewusstseinsanteilen) and the unconscious (Unbewusstes) which is
disturbed by drive stimuli (Triebregungen) and has to be controlled by
a Super-Ego. Dasein rather consists of a 'Being-In-The-World' (In-
der-Welt-sein) and a 'Being-Open-For-It' (Offen-fuer-sie-sein). It may,
however, still be unfree (unfrei) and narrow (beengt) because of devel-
opment and illness-reasons.
Here, it is profitable to use education and psychotherapy, which is
conformable to the "Dasein", which perceive psychic illness never
only in a scientific way and which are not based on hypotheses of
unconscious mechanisms or mere learning theories, but which in an
unbiased manner are open to immediate facts (Gegebenheiten) and
their relations (ihrem Bezogen-Sein). Consequently they require of the
patient not to give way to or avoid the prejudice of his neurosis, but
to see what it is and to turn to it.
Therapeutic painting, phantasy stories and the 'sand'-, ",Sceno"-
and 'puppet-game' for example do not have as their goal to express
what happens in the inner (im Inneren). All these therapeutic methods
are rather appropriate to show the relation to the 'played' himself
and thus shed light on a thing in order to make it appear in its being
(in Seinem Wesen). The therapist restrains meanwhile. Not, however,
to deal with the motives (Strebungen) that are assumed to be the cause
of the phenomena. But to concentrate, in respect of the given, on the
facts (Vorliegende). This happens in an externally restricted but un-
limited dedication of the therapist during the course of the therapy.
In this though there are several "guests" present with the recollected,
(mit dem Ermnerten) yet always the therapist himself and his patient
are meant. Through such a therapeutic liberation the above men-
tioned vitality of a child, its individuality and its team sense
(Gemeinschaftssinn) become even richer.
78
III
The child adds to a relation its own world with a history mixed
with ill and healthy parts. If this world is accepted as it is, it opens
new possibilities to the child in the present. Above all the child's
world is directed towards the future already happening in it (Rueckert).
If we are to give something of our (present) world to the child's
education and thus possibly augment its wealth, we have to obey
these things. The child perceives things in the first instance as they
are without interpretation and assignment (Zuordnung) - and there-
fore experiences them even more naturally in their being (ihrem Sein).
The child itself is first original, "still entirely what it is, therefore ...
beautiful, rich, peaceful, a divine being", according to Hoelderlin.
It expects from us unconditional acceptance (Rogers), with which
it can develop its character and have free choice, rather than to please
with its "being pretty" and "do-it-right". But it also needs examples,
limits, joining. An adult's consumption offer (Konsumangebot), with-
out renunciation, seduces it to own consumption of as much variety
as possible (moeglichst Vielerlei) and can prevent experience of rich-
ness in small quantity, (des Vielen und Reichen im Wenigen). In the
opposite, attention to details and differences can lead to harmony
and prevent levelling (Nivellierung).
The wealth (Reichtum) of the child also shows up in therapy,
provided that there is enough time and that it is possible to re-
experience the painful as well as the great reminiscences. By staying
with these and paying attention, it is possible to get a greater inde-
pendence (Freiheit) of them - together with the child, we experience
"the beauty of simplicity" and "encouragement" (Ermunterung), when
sadness is not avoided (Heidegger). Child psychotherapy is always
also education, cooperation with parents and educators, especially in
the stationary common treatment (Gemeinschaftsarbeit): together, edu-
cator and therapist strive for the child to experience its world in an
unrestricted and rich way, at the same time to find its place in
community. This happens more easily if we pay more attention to the
child's language as well as to non-verbal therapy forms such as play,
movement and creative action. The advantage of team work can be
seen in the fact that several important impressions and views
(Einsichten) are joined. Here, a rivalling is unnecessary and needless
since phenomenology is not about who has the right view, but how
the matter affects each member - although different - but as truly as
possible. A collection of these different experiences enriches compre-
hension. The effort pays off.
79
IV
Finally, it was mentioned that the conception of man as "Dasein" is
more worthy of human beings than a conception as "animal ration-
ale" which has been established for centuries. Although such a being
based on drives could be improved through cultivation of its ratio
and conscience with an Ego and Super-Ego, it nevertheless kept its
animalitas, which was at the same time subject and object of an
unbroken striving for knowledge (Erkenntnisdrang). Thus the "ani-
mal in man" remained either charming or shocking.
How can the nature of man, however, be seen as more original and
worthy than a simple creature (Lebewesen)? Heidegger answers that
this is possible by man being addressed by 'Sein', that is, by standing
in the clearing of 'Sein' (in der Lichtung des Seins), by enduring it (diese
Lichtung ausstehen), that means by existing. In Daseinsanalysis, man
is a place of appearance (Erscheinungsstaette) for all present rather
than just a consuming being, which increasingly spreads - using the
planet merely as a resource - and encumbered with debts. Here, the
point at hand is not the steadily increasing subjectivity of man, his
Ego with which he makes himself "master of all being" (Herr), but,
according to Heidegger, to be "shepherd of 'Sein'" (Hirte des Seins),
with which he gathers more in the end.
Anna Freud sees the difference between man and animal in his
"evolution from lust principle (Lustprizip) to reality principle" which
denies a "satisfaction of desires according to need" The type of
conflict solution between "Ego" and "Id-Parts" of personality is
decisive for the "normality" or abnormality of the future adult. In her
theories "on drives and phases of child development, she deals with
social adjustment, but also with development of the character of a
child, whereby parental attitude is of great significance. The enor-
mous renunciation of drives (Triebverzichtsleistung) in favour of a
growing Ego and the ability to live in society is stressed.
But doesn't man in spite of his growing self-control give in again
and again to his drives? Would, it maybe be better to face rather than
suppress them, though not understood as drives but as bodily rela-
tion (jeibliche Beziehung)? Could it be that in the steadfast strive of
information-society not only a drive suffers, but our entire bodyliness
(Leiblichkeit), which as an Existential, like for example mood, is a
relation to 'Sein'? (Sein-Bezug). The Leiblichkeit (bodyliness) of man,
however, is as body or animal organism never understood in its
character (Wesen), therefore not reachable only with some sport or
body therapy (Koerpertherapie).
80
The impulse of immediate satisfaction of so-called oral, anal or
phallic desires must not only - as demanded by Anna Freud - gradu-
ally get under the control of the "Ego" for social reasons. Rather,
these desires - like all the separate "partial drives" (Partialtriebe)
nevertheless point to a relation, which is still restricted and which
has to be broadened in the child's interest.
A behavior of addiction (Suchtverhalten), boredom and resigna-
tion, as well as the ever increasing cleverly organized legal or illegal
(technical) exploitation - the sexual exploitation of children as a
booming business up to organized crime - a modern threat - have to
be considered as unfree (unfrei) relation as well. They can neither be
controlled or overcome with "scientific" means nor some humanitar-
ian help.
Hunger, or lack of it, respectively, anorexia, is not only a mere
drive, a pleasure, or dislike for earing respectively, which has to be
adapted to reality. It is rather a reference, to which can be seen as
nourishment, who urges for satisfaction or who is avoided.
The child primarily has an interest to understand the orders
(Ordnungen) and the reference to originality (Urspruenglichkeit), to be
protected, to protect itself; to care (pflegen) and preserve (bewahren).
The dignity and health of man increases if he can relate freely to what
he encounters (dem ihm Begegnenden frei entsprechen kann), instead of
subduing it in subjectivistic manner. On the other hand the increas-
ing restless and thoughtless aspiration and seizure (Sich-Bemaechtigen)
of man make even education and therapy reach their limits.
Heidegger, however, thinking "Sein" considers man not as sub-
ject, who has all the being at his disposal in an objectivistic way, but
he sees his true dignity in ek-sistin standing out, that means in the
endeavour to ensure that "in the light of 'Sein' the being appears as
what it is".
The above paper is reproduced in the form in which Dr. Reck presented it at
the Martin Heidegger and Psychotherapy Conference.
Hansjorg Reck Neuhauser str. 31. D - 78464 Konstant.
81
TECHNICAL AND ORIGINAL THINKING IN
PSYCHOTHERAPY
Norbert Vogt
1. Introduction
Since psychotherapy is practised in a specific cultural and histori-
cal context, both patient and therapist are influenced by the mentality
and ideas of their specific environments. What is considered as
healthy and pathological, normal and abnormal mirrors to a large
degree the thinking of a certain culture and epoch, their concepts of
nature and science, individual and community.
Preceding from the unique events occurring in the life of every
individual, we cannot but recognize the degree of influence being
exerted on all of us by a specifically modern attitude of man in
dealing with everything existing, subsumed under the notion of
technique. Everybody and everything is in danger of becoming sub-
jected to its control and influence.
The German philosopher Martin Heidegger called attention to this
danger and the loss of identity man has been suffering from it.
Beyond a thorough analysis of this our contemporary predicament,
he provided us with insights which enable us to gain the critical
distance necessary to help us resist being completely engulfed by it.
The aim of this presentation is not to present a case study or certain
techniques of therapy. I want to draw on Heidegger's insights into
the ways technique has been conditioning our thinking, our
motivations and behaviour so that as psychotherapists we can be
effective in enabling patients to counter this threat to their selfhood.
2. Efficiency
"Efficiency" is the virtue being praised nowadays in the most
diverse branches and establishments from research labs to old folks
homes. The area of psychotherapy is not immune to this pressure
resulting from the decreasing financial budgets everywhere. The
various methods of psychotherapy are examined as to their effi-
ciency. The degree of efficiency is decisive as to which kind of
psychotherapy does receive approval and is thus able to benefit from
the remuneration distributed by the health insurance companies. In
recent years, endless discussions have been held concerning the
proper criteria according to which the effectiveness of the various
Psychotherapeutic approaches ought to be measured.
82
It is assumed that with the establishment of clearly defined goals

and the application of those methods in treatment which have been
found to fulfil the criteria of effectiveness best, people are helped
most. This evermore increasing demand for objectively demonstra-
ble results, however, may eventually subject the relationship of thera-
pist and patient to the economic necessities to such a degree that all
other factors are reduced to be of secondary importance. There is, on
the other hand, the esoteric movement and various other kinds of
alternative therapies. Often an explicit or implicit rejection of any
rational approach is being propagated which attracts people looking
for more unorthodox forms of treatment which are less technical and
more personal.
To manage like Odysseus to steer the ship between these rocks of
Scylla and Charybdis demands of every psychotherapist very skilled
manoeuvring. The challenge of alternative therapies is not dealt with
here. I want to limit myself to the ever increasing influence of a
mentality we all have been subjected to which I want to call "techni-
cal thinking".
3. The Mechanistic Model of Nature as Prototype

In modern times, science and technique have become dominant
forces in the world, and Western civilization with its pioneering role
in technological development is seen as a symbol of progress and
enlightenment. The mechanistic model of nature has proved to be an
extremely powerful conceptual tool and has become the driving
force behind the scientific and industrial revolutions. This model has
been so successful in its pragmatic technical applications that it has
become the ideal prototype of all scientific thinking. It has been
emulated by other disciplines which modelled themselves after it.
The more complex these disciplines are the harder they are trying to
demonstrate their scientific orientation. This has increasingly be-
come true for fields like psychology, psychiatry and psychotherapy.
Since separating from philosophy in the nineteenth century, modern
psychology has become identified with a specific kind of scientific
methodology.
Freud was a member of the so-called Helmholtz Society whose
explicit goal was to introduce into psychoanalysis the principles of
Newtonian mechanics. While formulating psychoanalysis, he quite
consciously and rigorously used the criteria of Newtonian thinking
in terms of a strictly deterministic linear chain of causes and effects.
He believed - like many after him - that by studying human behav-
iour one can determine the laws of how and why we behave the way
83
we do. Subsequently, ways were devised to apply this knowledge in
a clinical setting in order to alter human behaviour.
In the light of the triumphs of modern science and technique, the
correctness of the basic philosophical assumption has been taken for
granted. Martin Heidegger was one among others (e.g. J. Ortega y
Gasset, J. Ellul) who questioned this monopolistic attitude and pointed
out how the technical thinking at the base of it has become a strait-
jacket, seriously impeding or devaluing other kinds of human knowl-
edge and experience. In the effort to free ourselves and our patients
from this straitjacket, we cannot but profit from getting acquainted
with Heidegger's thorough investigation into the phenomenon of
technique.
4. The Ruthlessness of Technique

When we speak of technique there comes to mind the whole host
of those machines and devices which have proliferated for the per-
forming of all kinds of tasks. Beyond this we are aware of an outlook,
an approach to reality, a way of dealing with problems, things, and
persons which we call "technical". Thus technique refers to a particu-
lar aspect of modern life in which human thought and action produce
and utilize machines and instruments whose functioning is designed
to facilitate all sorts of activities. Heidegger accepts the general
definition of technique as being simultaneously a means to an end
and a human activity. He calls this the instrumental and anthropo-
logical definition of technique (Heidegger 1954, p.6).
Technique focuses its attention on usefulness. Everything pos-
sesses significance only insofar as it is seen and is taken charge of as
something useful for the serving of an end beyond itself. Heidegger
gives us various examples for this kind of attitude, among them that
of the Rhine river. When a power station is built into the Rhine, man
does no longer accommodate himself to the river but the power
station dominates it. The river is now simply supplier of water-
power and a mere link in a chain of supply. The Rhine itself is lost,
swallowed up in a purposeful process, the supplying of electrical
power to the waiting consumers. From the technical point of view,
this alone is of any importance.
Heidegger raises the question whether - even in the presence of the
hydroelectric plant and its dam - the Rhine is not still "a river in the
landscape". He admits it may perhaps be so. Even when we see the
river, however, he denies that we are able to focus our attention upon
it and experience it for its own sake. The Rhine now is part of the
landscape in no other way than as an object (Heidegger 1954, p.l52ff.).
84
The determining power of technique rules everywhere in the

modern world. It dominates our thinking in such a way that every-
body and everything is no longer valued in its uniqueness and for its
own sake but is viewed in its importance to achieve a certain goal or
serve a purpose beyond itself.
Technical thinking suppresses uniqueness and promotes likeness
in the service of greater proficiency. One river is as good as another
as long as it can provide electrical power. A person matters only
insofar he or she can get a specific job done in a certain time, can be
counted on to buy a particular product being promoted, or can be
polled in a representative sampling of voters or consumers. People
become thus indistinguishable just as machines or devices of a given
type are like one another. Millions of examples of a given model are
produced. Parts are and must be interchangeable, dimensions must
be standardized, and manufacturing techniques and processes aim
at greater precision and faster output. The more readily one entity
can be equated with or substituted for another, the more efficiently
technique can function.
Since the machines are power-driven, technique's central need is
for energy that can be used to drive those machines. Modern tech-
nique thus concerns itself with the procuring of its supply of energy.
In its encounter with nature, technique discovers and extracts energy
wherever it can, whether it be in the form of coal and uranium from
the earth or of oil from the sea bed. Everything, including man, is
considered as object to be used, ready and available to be manipu-
lated, consumed, and discarded. Human beings are inexorably drawn
into the process of mass production in every field. Their reason for
existing is ever more reduced to being members of a labour force or
conditioned consumers in thrall to advertising and its patron indus-
tries. In this kind of atmosphere we must constantly struggle to gain
and maintain a genuine sense of integrity and self-identity. On the
other hand, oddly enough, it is nobody else but man himself who is
the means to this end, confronting himself in the name of technique
with the demand of exploitation so that he may serve this purpose.
In a world where technique and technical thinking rules, Heidegger
sees the mere utilization of nature and man as one of our greatest
challenges. He urges us to realize how in all technically motivated
activities invariably a ruthlessness rules toward whatever or who-
ever is being dealt with. To think we could gain control over the
forces unleashed would be an illusion because they neither are a
result of human agency nor are they a simple consequence of a
personal or collective human decision. For Heidegger, not human
85
needs and aspirations gave rise to modern technique but a volition
beyond man. With this position, Heidegger runs contrary to popular
opinion of man being fully in charge of nature, systematically and
effectively applying well calculated procedures to gain control over
inanimate and animate nature.
Even though Heidegger does not disapprove of the understanding
of technical thinking and technique as a human activity and a means
to an end (Heidegger 1954, p.6), he goes beyond this generally
accepted understanding. He points out how man is only seemingly in
control of this phenomenon and in reality is ever more subservient to
it. In his paper "The Question Concerning Technique" (Heidegger
1954), he elaborates his idea how technique seemingly is a human
activity but in reality is not. Man fancies to master technique but
actually is mastered by it. He maintains that in technique something
is revealed (Heidegger 1954, p.12) and points out how the word
"techne" has always had a close affinity with the word "episteme".
Both words allude to knowledge in the broadest sense of the word.
Technique reveals nature in a way characteristic of our times. "To
open up the energy hidden in nature, to transform, store, distribute,
and switch it are modes of revealing" (Heidegger 1954, p.16), pecu-
liar to modern man's attitude toward reality and to his dealing with
it. We ourselves participate in and play a decisive part in this specific
way in which nature is disclosed to us.
Heidegger asks: "Where and how does this revealing occur if it is
not simply a human activity?" He answers immediately with: "Wher-
ever man is open to what is going on in and around him, he experi-
ences that which has become unveiled" (Heidegger 1954, p.18). Man
is the means by which something is unveiled. In our times, this
awareness has been lost to a great degree. Being out of touch with
this fundamental faculty and purpose of his existence, modern man
is driven compulsively to approach and go after what he encounters
by objectifying, measuring and manipulating it. Explaining every-
thing that happens in the light of the law of causality, subjecting
events to the principle of cause and effect, human experiences are
seen and explained in a way that all mysteriousness of reality has
become eliminated. The spectrum of possible experiences gets re-
duced to those aspects of reality which respond to the criteria of
logical and causal explanation and usefulness. These have become
the criteria which confer value and meaning on them. What is such a
reductive attitude based on?
86
5. Method as Creator of Facts

The measure which modern man has come to apply to the world is
the scientific method of positivism with its ideal of "objective reality"
and "objective facts". Empirically attained facts seemingly cannot be
disputed. They are considered to be the supreme judge in what is to
be considered as truth or untruth. With reference to Kant, Heidegger
points out that the fundamental character of this modern attitude
consists in its mathematical nature (Heidegger 1984, p.69). For him,
the essence of mathematics, however, does not primarily consist in
the numbers associated with it but in its axiomatic design of reality.
By either abstracting from or neglecting all individual characteris-
tics, the mathematical design presumes the equality of all bodies
with regards to space, time, and motion. Thus they can be numbered,
i.e. be subjected to the same measurement (Heidegger 1962, p.71).
The way nature is allowed to appear to man is therefore precondi-
tioned by this method. Its design conditions the ways nature is able
or allowed to answer.
Heidegger is not critical of the mathematical design as such but of
its uncritical application to practically all spheres of life. In his book
"Being and Time", he writes:
The classical example for the historical development of a science
and even for its ontological genesis, is the rise of mathematical
physics. What is decisive for its development does not lie in its rather
high esteem for the observation of 'facts', nor in its 'application' of
mathematics in determining the character of natural processes; it lies
rather in the way in which Nature herself is mathematically pro-
jected. Only 'in the light' of a Nature which has been projected in this
fashion can anything like a 'fact' be found and set up for an experi-
ment regulated and delimited in terms of this projection. The 'ground-
ing' of 'factual science' was possible only because the researchers
understood that in principle there are 'no bare facts'. In the math-
ematical projection of Nature, however, what is decisive is not pri-
marily the mathematical as such; what is decisive is that this projec-
tion discloses something that is a priori. Thus the paradigmatic
character of mathematical natural science does not lie in its exacti-
tude or in the fact that it is binding for 'Everyman'; it consists rather
in the fact that the entities which it takes as its theme are discovered
in it in the only way in which entities can be discovered - by the prior
projection of their state of Being. (Heidegger 1962, pp.413-4)
Since there are no pure facts to be discovered but facts are "cre-
ated" by means of an a priori design or theory, it follows that it is the
method, the way we are after things, which decides what we trace
87
and discover, what can become an object of our perception and what
not. A cognition is called "a priori" which is not based on an empiri-
cal, inductive experience but is independent of and prior to experi-
ence (Heidegger 1979, p.100). We thus perceive as meaningful and
valuable only those events in life which comply with the design
imposed on our sense impressions, as Kant makes us believe (Kant
1956, p.26). Nowadays, the designs are drafted by computers. Highly
sophisticated technical sensors feed data into them. Computers de-
vise numerical and statistical models which process and evaluate the
data. Thus additional theoretical and technical constructs have been
inserted between man and nature in his encounter with her.
Consequently we are faced with the question: if and how is it still
possible to perceive reality apart of or beyond the logically consistent
methods applied in science? Given the faith of contemporary man
that only by means of these methods at the disposition of the natural
sciences are we able to gain a solid knowledge of truth, are there
other methods left at all to gain access to and experience reality as
meaningful, methods which are untainted by the antecedent predis-
position and theory of which we are more or less unaware?
6. Original Thinking
To be able to encounter reality in ways and forms not amenable to
technical thinking, a different kind of thinking is necessary. The term
"original thinking" is not meant in the sense of eccentric, inventive,
and new as opposed to a copy or imitation, but of primordial,
belonging or pertaining to the origin or beginning of something. For
Heidegger, the activity of thinking is not limited to employing one's
mind conceptionally, rationally, and objectively in dealing with a
given situation or event. The reasoning activity of the human mind is
based on man's primary and original capacity to be perceptible to the
world around him in such a way that he then subsequently can deal
with it rationally and logically. Thinking means for Heidegger at first
this basic ability of being able to be affected or addressed by someone
or something, becoming aware of and react to it.
Heidegger did not tire in recalling our attention to this primary
capacity of man. It is prior to his subsequent logical reasoning and
methodical analysing and explaining. In valuing this fundamental or
original awareness of man as an event worthy to be considered a
human perception, prior to categorizing into concept what is per-
ceived, reality is experienced by man at first in a non-conceptual way
(Heidegger 1987, p.172).
88
We can be engaged in activities and in dealing with things which
resist a conceptual definition and which do not need a logical proof
for their existence, meaning and value to be recognized (Heidegger
1987, p.89). Heidegger repeatedly asserts the presence of reality to
which man is connected prior to any conceptual perception. To be
able to accept and value this kind of experience of reality in a pre- or
non-conceptual way, an understanding of truth is required, which is
different from the traditional definition of truth as a correspondence
of subjective ideas to external objects and vice versa. Kant had
pointed out how this way the perceived object is necessarily condi-
tioned by the ideas, capacities, and limits of the human mind. How-
ever, truth as understood by Heidegger, is not exhausted and limited
by man's objectifying grasp on reality.
He proposes the following different understanding of truth. What-
ever it is that presents itself or is presented to man, that is to be
considered as true in the sense of it being disclosed or un-veiled to
man, like something stepping out of the dark into light. Truth in this
sense is not a result of an activity of the human mind but of an event
occurring to man, of something being disclosed to him, inviting his
attention and reaction. Man is called upon to allow himself to be
addressed by whatever appears to him without objectifying right
away what may catch his attention. Creating space in one's life for
such a different kind of encounter with and experience of reality is
what is meant by "original thinking". Heidegger gives some exam-
ples of the attitude required for that. Sitting in the garden, he says,
and enjoying the colour and smell of the blossoming roses, we do not
turn the roses into objects. Even in thinking and speaking about the
roses being smelted, we do not objectify it or make a thing out of it.
This way, non-objectifying thinking and speaking is possible. An-
other of his examples is the statue of Apollo in a museum. We can
turn it into an object, examining the chemical and physical qualities
of the marble. This is the kind of objectifying thinking which misses
the beauty of Apollo and the appearance of the God in the statue
(Heidegger 1970, p.42).
In the field of psychotherapy, Daseinsanalysis advocates a form of
treatment which challenges the predominance of any system of struc-
turing human experiences by questioning a person's attitudes and
convictions. The urge to explain everything by means of causality
and consistent logical argumentation is likewise resisted. Such a
practice may be understood as a deficiency. This lack, however, only
appears to be a shortcoming. In reality, it is the predisposition
indispensable for the emergence and appreciation of new experi-
89
ences in man's life. In Daseinsanalysis an effort is made to break
through the technological stratification which in too many hands has
deadened psychoanalytic theory and practice since Freud. An essen-
tial instrument for this purpose besides paying attention to dreams is
the use of Freud's greatest technical invention, the practice of free
association. He gave the following instruction:
Say whatever goes through your mind. Act as though, for in-
stance, you were a traveller sitting next to the window of a railway
carriage and describing to someone inside the carriage the changing
views which you see outside. Finally, never forget that you have
promised to be absolutely honest, and never leave anything out
because, for some reason or other, it is unpleasant to tell it (Freud
p.135). Freud considered this attitude as the best means by which the
unconscious can be methodically and reliably disclosed. Without
taking recourse to the hypothesis of the unconscious, in Daseinsa-
nalysis free association is nevertheless held in high esteem. The
unguarded discourses of the patients move of its own momentum
and can be understood as giving evidence of their experiences, of
encounters with reality prior to their being integrated into the per-
sonally, socially, and habitually conditioned systems of explaining
what has occurred. The thoughts and images which arise in free
association are often experienced and considered as so strange and
even senseless exactly because they are an indication of an experi-
ence on a pre-conceptual, pre-logical and non-objective level, which
has not yet been incorporated into the system of logic and causality
by means of which we habitually make sense of our experiences. Free
association undermines this type of censorship and enables us to gain
access to strata of reality which have previously been closed to us.
When we can proceed from being conditioned by and limited to
technical and objectifying thinking, we become predisposed for be-
ing addressed by whatever we encounter in manifold ways. Differ-
ent aspects, qualities, and dimensions of reality may thus come to
our attention. It is a fallacy to limit man's possibilities for experienc-
ing and dealing with what exists to his capacities for logical and
technical thinking and its inherent limitations. One consequence of
this assumption is a deficiency, resulting from their narrowed and
impoverished spectrum of reality, many of our contemporaries suf-
fer from. They have lost a certain intensity of life because reality has
been filtered and its spectrum reduced too much by their outlook on
and approach to it. Once we have become aware of this reductive
way of thinking and attempt to break out of it by adopting a more
critical attitude toward our very personal filters of conditioned per-
90
ception, we become less subject to the demands of the various
systems, authorities and habits infringing on our freedom. As we
begin to see through the conventions we unknowingly have fallen
victim to, we realize that there are other possibilities at our disposi-
tion and that we can change the rules of the game. An expansion of
our radius of action becomes possible, and we can sovereignly stand
above what we previously had been subjected to. Our spectrum of
possibilities and freedom of choice does increase. We are in a greater
position to choose actively and are less decided upon by others.
There is a greater and richer spectrum of reality for us to be encoun-
tered and experienced.
7. Summary
We have learnt that it is the method applied which determines the
way nature answers our questions, which means the way we per-
ceive and experience reality. Technical thinking enables us to apply
methods which help us reach certain goals in psychotherapy as in
many other fields. There is no question as to its importance, effective-
ness, and usefulness. Some of the people seeking psychotherapy
certainly can be helped by the application of methodical steps toward
clearly defined goals. Others, however, may have dried up in the
process of pursuing and reaching quite methodically and success-
fully all kinds of personal and professional goals. What they need
may consist in enlarging and enriching - anew or for their first time -
their spectrum of approaching and dealing with reality in the sense
of "original thinking".
This requires questioning well-established and often petrified con-
victions and attitudes, breaking up old habits of categorizing and
judging people and events. The necessary conditions are thus pro-
vided for the possibility of gaining a different kind of access to
reality, to its qualities and dimensions, which were previously not
accessible on account of our restrictive "a priori" habits of thinking.
Since they usually remain unreflected and unquestioned, they decide
in our place what we are to consider and appreciate as real, meaning-
ful and worthwhile and what not.
A major goal of Daseinsanalysis and one of its contributions to the
field of psychotherapy consists in promoting "original thinking".
Assisting people to realize how in specific and concrete situations
they are influenced and limited by their accustomed and socially
conditioned habits of thinking plays an important part in the thera-
peutic process of leaving behind these inhibiting and noxious atti-
tudes in order to adopt new ones which allow them qualitatively
91
richer and more satisfying encounters with reality (Boss 1975; Condrau
1962; 1963; 1976; Heidegger 1987; Hicklin 1989).
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1970
Heidegger, M. Prolegomena zur Geschichte des Zeitbegriffes. GA 20.
Klostermann, Frankfurt, 1979
Heidegger, M. Die Frage nach dem Ding. Zu Kants Lehre von den
transzendentalen Grundsatzen. Klostermann, Frankfurt, 1984
Heidegger, M. Zollikoner Seminare. M. Boss (Ed.). Klostermann, Frank
furt, 1987
Hicklin, A. Das menschliche Gesicht der Angst. Kreuz, Stuttgart, 1989
Ortega y Gasset, J. Man The Technician. In J. Ortega y Gasset: Toward a
Philosophy of History. Norton, New York 1941, pp. 87-161
Norbert Vogt Ph.D, of the Daseinsanalytic Institute of Psycho-

therapy and Psychosomatics, Zurich, Switzerland can be contacted
at: Narzissenstr. 8, CH - 8006 Zurich.
92
WHAT DEFINES THE DASEINSANALYTIC PROCESS?
Alice Holzhey-Kunz
The daseinsanalytic process is in every respect a hermeneutic one:

hermeneutic is its method, hermeneutic is its object, hermeneutic is
its goal. To be radically hermeneutic is therefore the essence of the
daseinsanalytic process.
This emphasis on hermeneutics is unusual in Daseinsanalysis.
Since its founding fathers Ludwig Binswanger und Medard Boss
Daseinsanalysis is usually connected with phenomenology. The
phenomenologic slogan "To the things themselves" (Zu den Sachen) is
used as a maxim to withhold from all interpretations which - accord-
ing to Boss - lead away from the things themselves. When Boss
criticised hermeneutics he had especially the psychoanalytic inter-
pretations guided by a mechanistic concept of the psychic apparatus
in mind. But Boss did not look for a better, a less biased interpreta-
tion of the human being and its neurotic suffering because he judged
all interpretations as constructions covering up the things them-
selves. Instead he believed in the possibility of an immediate intui-
tion of the essence of the things. In other words: Boss had a deep
mistrust in hermeneutics and an even deeper faith in phenomenol-
ogy understood as immediate intuition. This faith in immediate
intuition is based on the conviction that the essence of the things is
never hidden, but shows itself. Boss never got tired of assuring that
you have nothing else to do other than just to look closely at the
things themselves to grasp their essence. Of course Boss knew that
this ability to "see" the essence of things is not easy to gain, that it
needs an open mind, freed from all the prevailing psychological
theories. But he did not doubt the possibility to reach this very status
of an unbiassed openness to the things themselves.
When I stress the relevance of hermeneutics for Daseinsanalysis, I
stress at the same time its nearness to psychoanalysis - of course not
to its metapsychological theory of impersonal mechanisms and drive
energies, but to its hermeneutic theory of conscious and unconscious
purposes and the personal meaning of subjective experiences. The
analytic approach in general is necessarily a hermeneutic one - whether
it be realised by the analysis or not. Supposing I am right in this view,
then Daseinsanalysis is ananalytic therapy only in being hermeneutic.
My concept of hermeneutics in the following lecture is entirely
based on Being and Time. Heidegger gave in his main work a philo-
sophical theory of hermeneutics, which has paved the way for
93
postmodern philosophy. Whoever is acquainted with the famous
chapter 7 of Being and Time about "The phenomenological method
of investigation", will remember Heidegger's statements that "the
meaning of phenomenological description as a method lies in inter-
pretation", and that "the phenomenology of Dasein is a hermeneutic
in the primordial signification of this word, where it designates this
business of interpreting" (BT 61f.; 37). We may ask now why Boss
sets phenomenology and hermeneutics in opposition whereas
Heidegger states that in the field of human existence phenomenology
is necessarily hermeneutic because the existential phenomena are
"hidden" and show themselves only 'in disguise' (BT 60; 35). The
answer is not difficult: Heidegger himself dropped the concept of
hermeneutics shortly after he published Being and Time. His later
meditative thinking refines Husserl's faith in phenomenology as
direct intuition. Boss's Daseinsanalysis relies entirely on this later
thinking of Heidegger.
Now I will unfold my thesis about the daseinsanalytic process as a
radical hermeneutic one with 10 points.
1. The hermeneutic method is needed because neurotic symptoms have a

hidden meaning.
Let's make clear when we call a behaviour or a perception or an
attunement 'neurotic'. That's the case when it is not adequate to the
situation in which it belongs. Not adequate means: not in the realm of
seemingly rational reactions to a given situation, understandable for
others of the same culture. This inadequacy is called 'neurotic' under
the condition of not being intended out of a conscious purpose but
out of being urged to react in this way. Examples are all the phobias
as inadequate fear of harmless (safe) situations, the paranoid mistrust
of well-meaning and trustworthy persons, the feeling of being deeply
insulted by harmless remarks, the guilt feelings about innocent be-
haviour and so forth. All these reactions make no sense in their
situation, they are disturbing and make everyday life difficult.
Mostly the term 'neurotic' is used as a diagnostic category in the
medical-psychiatric perspective. Neurosis is by definition a certain
kind of psychic deficiency. The person who is called neurotic lacks
the ability for a better, for a more adequate experiencing or behav-
iour. With Sigmund Freud the term neurotic became a hermeneutic
category. Freud discovered that seemingly inadequate reactions are
in fact adequate, but not to the obvious situations they seem to
belong to, that they respond to other events and experiences, namely
94
to events and experiences which are hidden not only for the others,
but for the person himself or herself1 - which are unconscious.
The central hermeneutic principle says that every single thing
(may it be a word, an action, an experience) has its meaning only in
a certain context, in a certain connection to which it belongs as a part
of this whole, and conversely the meaning of the whole depends on
the meaning of the single things as its parts. So to understand
something means to understand its meaning as part of a meaningful
context. This rule seems not applicable to neurotic symptoms. They
seem not to be a meaningful part of the obvious context, and there-
fore seem dropped out of every meaningfulness: they strike us as
nonsense, Irrational, deficient. The hermeneutic task seems to have
reached its end. Psychiatric diagnosis - the diagnosis of a certain
deficiency - seems the only possible response.
Sigmund Freud's revolutionary turn was a hermeneutic turn. He
showed that hermeneutics is by no means at its end in the field of
psychopathology, but just at a specific and exciting challenge. With-
out following this hermeneutic turn you have to stay with the obvi-
ous fact that a neurotic behaviour is inadequate, is an isolated and
therefore meaningless fact. In the field of neurotic symptoms "phe-
nomenology of the essence" becomes necessarily a psychiatric de-
scription of human behaviour judged as deficient. Boss's
daseinsanalytic approach to neurotic symptoms differs from the
common psychiatric approach only by using Heideggerian terms for
instance the terms of inauthenticity and of fallenness 2. This may be
an advantage, but it is nevertheless a misuse of these terms, because
in Being and Time inauthenticity as well as fallenness are hermeneutic
and not diagnostic notions.
Now I hope that my statement about analytic therapy as necessar-
ily based on hermeneutics has been clarified. What separates analytic
and non-analytic psychotherapies is basically the different approach
to neurotic suffering: either you take neurotic suffering as the result
of a deficiency, or you take it as the expression of a hidden, but most
important struggle of somebody with himself or herself. Either you
take the patient as somebody not yet grown up, still immature like a
little child, or you take him or her as a man or woman struggling with
problems he or she is not aware of and therefore suffering from self-
deception. As a consequence of these two different Psychopathologic
views, psychotherapy has either the target to overcome the defi-
ciency or to understand the hidden meaning of the symptoms. It will
either encourage the patient to abandon his or her old dependent
behaviour, or it will encourage the patient to gain more insight. Only
95
the latter deserves to be called an analytic therapy. Daseinsanalysis is
either connected with a phenomenological description of the essence
and is then a nonanalytic treatment of psychic illnesses, or it is
connected with the hermeneutic method and is then an analytic
practice of interpretation based on the existential anthropology of
Martin Heidegger.
2. The neurotic symptoms are meaningful in the context of the (pre--)

ontological relationship to their own being.
The second point deals not with the method, but with the object of
the daseinsanalytic process. The object of all kinds of therapies is of
course the suffering client, his or her problems and symptoms. The
definition of this object depends on the underlying philosophic view
of the human being. Again it makes a big difference if you join the
Heideggerian thinking of "Being and Time" or of his later ontology.
In Being and Time, Heidegger made the shocking statement that "the
essence of Dasein lies in its existence" (BT 67; 42). When you take this
statement seriously, then you cannot identify the human essence
with any normative conception of authenticity because the human
essence lies not in any "whatness", but in the pure "thatness" of the
existence. This definition of the human essence is freed from norma-
tive implications, but linked instead to hermeneutics. Because the
essence lies in the pure facticity of the own being, in the pure "that I
am and have to be", Dasein is obliged to understand how to be. Its
being is not separable from interpreting its own being. Heidegger
makes interpretive understanding the central mode of human existence.
That's why not only the method, but also the object of the
daseinsanalytic process is hermeneutic.
The statement that understanding is central for the human being in
the world sounds rather banal. It needs some explanation. Two
points are important. First: to understand how to live includes more
than to understand the world we live in, it includes necessarily to
understand the own being in the world. Understanding includes al-
ways self-understanding. Second: to say that Dasein is always inter-
preting its own being has a double meaning. Heidegger states that
Dasein's self-understanding is ontico-ontological. This distinction is
most important and allows us to specify the object of the
daseinsanalytic process: it is not so much Daseins ontical but its
ontological understanding of itself. This ontological understanding of
the own being is the hidden context the neurotic symptoms belong to:
they are part of this context and they play a meaningful role in it.
96
What is the difference between ontical and ontological self-under-
standing? Ontical self-understanding includes all the knowledge
about myself as this individual person in this concrete situation, with
this specific history and specific abilities and disabilities, fortunes
and misfortunes, specific projects for the future, hopes and fears.
Ontological self-understanding includes all the knowledge about
myself as a human being. It is the knowledge about human condi-
tions I share with everybody. Everybody knows somehow that he is
mortal, that he is thrown into a social and gender situation he did not
choose, that his future is basically uncertain, not under his control,
that he has to make many decisions without knowing with certainty
which is right and wrong, that he cannot undo what he has done, and
that he depends on other people which he can loose any time by their
death or their free will, and so forth. In short: he knows somehow
about his finitude, or, as Heidegger calls it, his nothingness.
Now it is important to see that ontical and ontological understand-
ing are different, but they are mostly not separated from each other,
except in philosophical or religious thinking. As Heidegger puts it:
every ontic understanding has its ontological "inclusion" (BZ, 360;
312). For instance when somebody asks me how old I am, then this
ontical question includes the ontological knowledge that time passes
by, that to live means growing older, going towards one's death, that
life is transient. - And when somebody wishes me a good day, then
his wish includes the ontological knowledge that nobody knows
what can happen today to me, that we are basically and all the time
exposed to uncertainty in the different forms of either bad luck or
evil attacks by somebody or unexpected loss or our own failure. -
And when I am late for an appointment by the circumstances of the
traffic and excuse my being late, then this excuse includes the onto-
logical knowledge that we can easily become guilty even by mere
circumstances, that by our mere living we may become a burden for
others, may cramp their lives. - And when somebody says to me that
he likes being with me, then my joy about this 'confession' includes
the ontological knowledge that we are deeply in need of being liked
by others, accepted by them or even loved, but that we cannot force it
but only receive it as a gift. - When somebody says I look well today
than this compliment includes the ontological message that I am
always exposed to the judging look of others, that I never know with
certainty what they can see of me and my state of mind, and what
kind of conclusions they make of my appearance.
These examples elucidate that all ontical events, not only the
negative ones, hint to our being as finite in its different aspects. And
97
they make also clear that the ontological inclusions of ontical events
stay mostly hidden: mostly the question about my age will remain a
simple question which has to be answered and nothing more. And
the wish for a good day will remain a simple politeness and won't
remind me of the fundamental uncertainty of life, etc. That means,
that our attention is mostly directed to the ontic, to that which
actually happens and which demands an adequate response. That is
exactly what Heidegger calls inauthenticity: not confronting the noth-
ingness of our existence, but forgetting it while being concerned only
with what happens here and now. So inauthenticity is not only the
average way of living, it is a necessary ability. I quote Heidegger:
"The self must forget itself if, lost in the world of equipment, it is to be
able actually to go to work and manipulate something" (BT 405; 354).
3. Neurotic symptoms are understandable as different modes of reacting

to the specific ontological inclusions of daily occurrences.
It has become plausible that adequate, successful understanding
and behaviour in everyday life is mostly based on forgetting the
ontological inclusions which show us the nothingness of our exist-
ence. But what happens when an ontological inclusion comes to the
foreground, when it becomes more important to me and demands
more attention from me than the concrete event in which it is in-
cluded? It is again plausible that in this case my reaction is concerned
with this issue. And because this ontological issue belongs to the
concrete event, my reaction is manifestly directed to the latter, but is
by no means adequate to it, seems therefore not understandable and
becomes the label 'neurotic'. So called neurotic symptoms are in fact
understandable when related to the ontological inclusions of daily
occurrences. They make sense as different modes of reacting to
ontological issues.
So the question arises about the specific meaning of a given neu-
rotic reaction. What does the neurotic person intend unconsciously
with his or her behaviour? Let's take hypochondria as an example.
The diagnosis of hypochondria stands for inadequate reactions to
common bodily indispositions, as for instance a headache or diffuse
heart troubles or just a state of weariness. The person who suffers
from hypochondria suffers from being aware of what all bodily
symptoms tell about the human condition of being embodied and
therefore being dependent on hidden bodily processes, exposed to
countless possible illnesses. Every bodily symptom, may it be quite
harmless, refers not only to the frailty of our body, but to the fact that
we never can be certain of not becoming victim to a severe and even
98
mortal illness all of a sudden. So the behaviour of the hypochondriac
in the face of bodily symptoms is a response not to the concrete
danger of this specific indisposition, but to the overwhelming threat
of being frail and exposed to death at any time. Incessant watching of
the own body and running to the doctors all the time are the desper-
ate tasks to cope not with this harmless headache or weariness, but
with the unbearable and senseless threat of being mortal.
4. In neurotic behaviour the ontological facticity is mistaken for the

concrete ontical facts.
Coping with the ontological threat has the purpose of banishing it,
of defeating human frailty. We know that it cannot be successful,
because no ontic manipulations can change the human condition. But
because the ontological facticity is mistaken for a concrete ontical
fact, the neurotic person can live in the illusion that the impossible is
possible. This illusionary endeavour tends to go on and on endlessly
(Freud named it "repetition compulsion").
Now a new question arises: What enables other people to overlook
all the ontological inclusions of everyday life and become totally
absorbed in just the ontic issues of the concrete situation? Again I
look for an answer in Being and Time. I refer to Heidegger's analysis
of the publicness of the "Man" in § 27 and §38. The "Man", translated
either as the "they" or the "one", is Heidegger's name for the com-
mon understanding of the world in each culture, including all the
shared norms and rules and ideals, in short the common sense which
guides in a tacit way our life. Heidegger's characteristic of the
common sense is inconsistent because he does not differentiate be-
tween the constitutive conformity and modern conformism. When
we ignore the negative aspect of the "One" as conformism, then we
can conclude that the ability to forget the ontological inclusions in
everyday life depends on the ability to share the common interpreta-
tions of the world and of Dasein's being, to hold on to them, to be
reassured by them.
However what is more important than the given interpretations is
the implicit assertion of the "One", that "everything is in the best order".
When something is in the best order, then it is meaningful in a
positive sense. Evidently in daily life seldom or never can we say that
everything is in the best order. There are always some problems and
sorrows pending. This assertion is meant ontologically and has a
comforting purpose: it says that there is no need to worry about the
fundamental questions concerning the facticity of our being: every-
thing is in the best order, is meaningful even when the meaning of
99
our life is often hidden to us. Whoever is able to hold on to this
assertion, can forget his or her own being in daily life and just cope
adequately with the ontical tasks.
5. The neurotic person is acting out wishes concerning ontological

conditions of human being instead of interpreting them.
The conviction of the "One" that "everything is in the best order"
is self-deceptive. But it becomes evident that this self-deception is not
only common and therefore 'normal', but that it constitutes normal-
ity. The neurotic person is somebody who does not share this com-
mon conviction. He is of course acquainted with all the public and
traditional interpretations of human nothingness, but he is not reas-
sured by them, because their evidence has no power against the
evidence of the ontological inclusions of daily events which strike
him as true and at the same time as unbearable. So he feels urged to
struggle against this evidence. Freud, and with him the
psychoanalysis, call this struggle acting out. I like this term because
it matches the point. Freud opposes "acting out" to "remembering"
and he states that the neurotic person is acting out wishes which
belong to the past instead of remembering them. In analogy we can
say that the neurotic person is acting out wishes concerning
ontological conditions of human being instead of interpreting them
3
. Acting out is a behaviour with the purpose to set in order what is
felt as not being in order in spite of all the public interpretive
reassurance. So the neurotic acting out is opposite to interpretations
of the meaning of life and a substitute for them: both deal with one's
own finitude which is unbearable in its naked thatness. Both intend
to overcome the pure facticity, either by manipulation or by
reassuring interpretation. One is reminded of the famous sentence of
Karl Marx, that until now the philosophers did nothing else then
interpret the world in different ways instead of changing it. Marx
relates to the social world, specially to the injustice of its structures
which should be changed instead of justified by interpretations. But
the ontological structures of our being human are not open for
change by our own manipulations, they are only open for sense-
giving by interpretation.
6. Interpretive understanding of the acting out is analysis.

This leads us to consider the goal of the daseinsanalytic process.
After all the preceding reflections it is clear that we pursue a
hermeneutic goal. We look for interpretation, but of course not
instead of the neurotic acting out, but interpretation of the acting out.
That means that we do not intend to give the patient reassuring
100
answers to all the ontological questions which trouble him or her, but
that we look for an understanding of the hidden meaning of his or
her behaviour and feelings. The Greek word "ana-lysis" refers to a
loosening of something which has been bound or tied together. An
analysis is loosening what was connected, it is setting apart what was
one, it is differentiating the various elements and lays bare their
difference. That is exactly what happens in interpretive understand-
ing of neurotic acting out. Let's go back to the example of the
hypochondriac: When the analytic dialogue brings forth the insight
of the fundamental wish to overcome the uncertainty of his or her
bodily life by watching and treating all the real and imaginary bodily
symptoms, then it reveals at the same time a basic difference until
now denied. What seemed to be a unity because it was mixed up and
confused, namely ontical occurrences and their ontological condi-
tions, are now differentiated.
7. Analysis is disillusioning and freeing

This analytic differentiation is disillusioning: it shows that one
may treat concrete illnesses so that they are healed, but that nobody
can treat the basic frailty of his or her body in the same way. The
loosening of the ontico-ontological mixture unveils the acting out as
something which cannot succeed, because it was based on an illu-
sion. To accept this insight is not an easy task. It means not only
giving up an illusion which is disappointing as well as wounding our
narcissism. It means also being confronted with the threat that one
has to endure life with the given possibilities and limitations of being
human. That's why analytic therapy needs time, time for the "work
of mourning", as Freud called it.
But neurotic acting out is not only illusionary, it is as such a state of
suffering. The neurotic acting out burdens the daily living with an
impossible task, which all too often consumes all the energy, and
isolates from the others by its seemingly senseless behaviour. To
accept the ontological truth is therefore also freeing. To be released
from the illusion of being able to change the unchangeable means
also to be released to a new openness for what life makes meaningful
and joyful within the boundaries of the human condition.
8. Against a postmodern version of hermeneutics.

In recent time a very fashionable theory of hermeneutics has
provoked a definition of the Psychotherapeutic goal which I want to
contradict. This concept of hermeneutics is based on the postmodern
philosophy of Jacques Derrida and Richard Rorty. Both philosophers
101
are deeply influenced by Heidegger. According to their hermeneutic
vision therapy consists in inventing a more useful and more helpful
interpretation of one's own life. That means: the replacement of the
old narrative which led to neurotic behaviour by a better one, which
enables a good living. I do not share this perspective, because I think
that things are not so easy. Neurotic suffering isn't the consequence
of a negative interpretation of one's own life, but of a special sensibil-
ity for the ontological truth. The neurotic person is not bound to a
insufficient narrative of him or herself, but to the insufferable onto-
logical truth which he or she wants to overcome by manipulations.
That's why the goal of psychotherapy cannot consist in finding a
more reassuring interpretation, but in accepting the analytic inter-
pretation of the acting out as illusionary.
Accepting the truth is contrary to a reassuring interpretation and its
inherent suggestion that everything is in the best order. Accepting the
truth means for instance to endure the anxiety which discloses the frailty
of our existence, the uncertainty of the future, the alienation from others.
Accepting the truth means also to endure the guilt which lies in every
decision, and it means to endure the shame which discloses my being
exposed as myself with all my imperfection to others.
9. Interpretation instead of acting out - a goal of the daseinsanalytic

process?
One question remains: what happens with the special sensibility
for the ontological inclusion of every ontical understanding that we
attributed to the neurotic person? Will this sensibility remain or will
it disappear? Will he or she be able to live in forgetfulness of his or
her own being in daily life after a successful daseinsanalytic therapy?
What happens with the ontological desire once it becomes evident
that it cannot be fulfilled by acting out?
I think it is important to see that the readiness and ability to face up
to one's own nothingness does not lead to a psychic state in which the
longing for salvation has vanished. Nor can we expect that a person
so sensitive to the ontological truth can share in the common sense
that everything is in the best order. So there is an other claim which is
laid upon him or her: not only to face up to his or her own nothing-
ness, but to respond to it. It is the claim to find his or her own answer
in respect to the fundamental questions concerning the own being.
Freud spoke of sublimation. Maybe we could call this search for
answers a sublimated form of fulfilling the eternal wish for perfec-
tion and immortality. Any interpretation of our own finitude changes
the naked thatness of our being into something meaningful and
makes life under the finite conditions worthwhile living.
102
So I think that the daseinsanalytic process leads to and enables a
process of interpretation as sublimation. But the fulfilling of this task
lies beyond the goal of an analytic therapy. The patient has to find
these answers for him or herself and be responsible for them7 the
analyst cannot be a guide in this - otherwise he does not respect the
autonomy of his or her patient.
10. The therapeutic relationship as a hermeneutic one is rooted in the

common lot of being finite.
The last but certainly not least question is concerned with the
therapeutic relationship. There are now impressive results of empiri-
cal studies which claim to prove that the therapeutic relationship is
the only factor that matters, the only thing which causes change,
which really helps. That's why one speaks now of this relationship as
of the "helping alliance".
When we follow these studies, then our concept of the daseinsanalytic
process as a hermeneutic one, as a process of gaining a more truthful
self-understanding, seems not only antiquated but just a false opinion
much too long repeated in analytic circles. But one cannot play off
interpretation against relationship, nor can one play off the helping
alliance against the so called transference and counter-transference. The
therapeutic relationship is not a factor which can be isolated from the
whole process. Interpreting is in itself a specific kind of relationship and
vice versa. How we understand someone and how we understand each
other determines how we are related to someone and to each other.
That's why an analytic relationship based on a hermeneutic theory of
neurosis is entirely different from a therapeutic relationship based on a
theory of neurotic deficiencies. And it is also entirely different from a
therapeutic relationship in treatments where the therapist applies a
certain technique with tactical and strategical interventions to defeat the
neurotic symptoms.
The therapeutic relationship in Daseinsanalysis is defined by two
characteristics: it is a hermeneutic alliance concerned with the dis-
covery of the hidden meaning of the patient's neurotic suffering and
it is a relationship which is rooted in the common lot of being finite.
The first characteristic is the one which all analytic therapies have in
common. Freud declared the transference-relationship and its work-
ing through as the central piece of the analytic process. He is right:
Real insight in one's own being is not possible through introspection,
it needs the experience with the other and through the other. Of
course the daseinsanalytic understanding of the transference-rela-
tionship is wider than the psychoanalytic one: what happens within
103
the therapeutic relationship is not only understood as a revival of
past wishes and disappointments and fears but as the revival of
ontological wishes and anxieties, first of all the revival of the desire
to realise a perfect relationship beyond all human limitations.
The so called working through of the transference-relationship
needs more than the analyst's ability to understand the meaning of
the patient's wishes and fears directed to him or her, it needs his or
her being committed in relation to them. This commitment has to be
an existential one. That means that it has to be more than empathy
with the patients individual problems, that it has to be an affected-
ness based on the accepted knowledge that the patient's wishes and
fears are in a deep sense also his own. Being in tune with the patient's
suffering is grounded in the common lot of being human, and there-
fore grounded in the analyst's knowledge that they are both bound
together by the fundamental claim made upon all human beings to
confront and accept their own nothingness, that they are bound
together by "the burden of being" (BT173; 134), as Heidegger calls it.
Only then we as analysis are able not to accept only the patient's
agreeable features, but to accept him or her as struggling with what
we both have in common and both have to bear. Only this acceptance
will encourage the patient to face up to and accept what he or she
believed to be unbearable and therefore unacceptable.
Notes:
1
To ease reading I will often use only the masculine form in the following.
2
The Daseinsanalysis of Ludwig Binswanger is much more indebted to hermeneutics.
Its central concept of the individual "world-projection" (Weltentwurf), taken from
Being and Time, provides a framework for hermeneutic interpretation of psychotic and
neurotic symptoms.
3
"Wish" as a daseinsanalytic notion is of course entirely disconnected from any drive-
concepts and designates the fundamental striving for an existence freed from the basic
limitations.
References
Boss, Medard. (1971) Existential foundations of medicine and psychology. New
York: Jason Aronson. 1979
Caputo, John D. Radical Hermeneutics. Repetition, Deconstruction, and the
Hermeneutic Project. Bloomington and Indianapolis: I U P. 1987
Gadamer, Hans-Georg. (1960) Truth and Method (J. Weinsheimer, D.G.
Marshall trans.) New York: Crossroad 1989
Heidegger, Martin. (1927) Being and Time (J. Macquarrie, E. Robinson,
trans.) New York: Harper and Brothers. 1962
Holzhey-Kunz, Alice. Leiden am Dasein. Die Daseinsanalyse und die Aufgabe
einer Hermeneutik psychopathologischer Phanomene. Wien: Passagen
Verlag. 1994
Alice Holzhey-Kunz, Ph.D. Zollikerstrasse 195, CH-8008 Zurich.
104
DREAM INTERPRETATION, THE "ROYAL ROAD" TO THE
DREAMER'S ACTUAL AND EXISTENTIAL SUFFERING
AND STRIVING
Uta Jaenicke
The daseinsanalytic approach to dreaming is a phenomenological

approach and deals with the manifest dream. That means taking very
seriously that which appears manifestly in dreaming precisely as it is
given in the experience of the dreamer. This is quite in contrast to
Sigmund Freud's view, which disregarded the manifest dream as a
mere disguise of the hidden latent intent.
Taking seriously what appears manifestly, though, does not mean
taking it at face value. The phenomena of dreaming, like all phenom-
ena of human existence, hide and reveal at the same time a meaning-
fulness which is not obvious at first sight. In order for the essential,
the sustaining meaning, to reveal itself we have to look for what is
hidden in what is manifest (not behind what is manifest, as Freud
said). The hiddenness we are looking for exists essentially as the
manifest. All the same it requires considerable attention and thought
to reveal it.
Attempting to penetrate the immediate appearance of dream phe-
nomena in order to grasp their essential underlying structure or
meaningfulness is quintessential to the interpretation of dreams since
Freud. What distinguishes the different Psychotherapeutic schools in
this respect is not the quest for such a concealed meaning be it in the
manifest or in the latent dream. The crucial question is what kind of
sustaining structure are we interested in, what are we concerned
with and what is our aim when we inquire into the meaningfulness of
dreaming. Freud's concern was to inquire into the dreamer's uncon-
scious, his or her hidden drives and intentions. Daseinsanalytic
therapists, following the philosophy of Martin Heidegger are con-
cerned with human existence. In interpreting dreams we are inquir-
ing into the existential situation of the dreamer. This is in
daseinsanalytic understanding the essential, which dreaming dis-
closes and closes off at the same time.
At this point the question arises, what is it, that we are particularly
interested in and searching for when considering the existential
situation of the dreamer. The answer, of course, is relevant in respect
to what we are aiming at in psychotherapy and shows what we
consider to be the determining structure in being human.
105
For Medard Boss the answer is clear. In being guided by Martin
Heidegger's later philosophical thinking he understands human ex-
istence as a realm of world-openness and as an assembly of possibili-
ties for perceiving and relating to the world. Accordingly his thera-
peutic goal is greatest possible openness and freedom to perceive
and to respond to what is encountered. He considers all phenomena
in psychotherapy under this aspect. What interests him particularly
are all the kinds of impairments and constrictions he can detect in his
patients in so far as they disclose -I quote - "a privation of what is
necessary for carrying out a full and authentic human existence".
This privation in openness and freedom is his major concern of
therapy his main goal being - again a quotation ,"to liberate individu-
als from their unnecessary constraints". To exist openly means, that
the dreamer is open to perceive a world, where the encountering can
shine forth unrestricted and undistorted. To exist freely means, that
the dreamer is free to choose what he will relate to and how he will
relate and behave. In asking, to what extent the dreamer exists
openly and freely Boss has gained a clear guideline for describing the
existential situation of the dreamer, a guideline on normative terms.
What is striking in this view is that Boss is not interested in inquiring
into the meaning of the privations he points out. He characterises
them simply as ,,unnecessary,, and motivated merely by verdicts and
views of influential adults, to which the dreamer has fallen v victim
in childhood.
Now I want to present another Daseinsanalytic view on dreams
which in this respect is quite different. Here constraints in dreaming
existence are considered as particularly meaningful disclosing much
more than just privations.
This view is derived from the hermeneutic approach of Alice
Holzhey, as explicated in her book "Leiden am Dasein".
Her approach, based on Heidegger's Analytic of Dasein in Being
and Time focuses on Heidegger's understanding of human being as
that being, which in its being essentially is concerned with this very
being - a being, to which its own being is an issue.
That implies, that all relating and behaving, all our concerns
dealing with current issues always concurrently refer to fundamental
issues of our being.
In Heidegger's words: Everything that matters to us in a concrete
ontic way, has an ontological inclusion, that is, is referring also to an
ontological issue.
In a very special sense this is true for dreaming. Dreams show
what matters to us in a privileged way, as I will show.
106
Dream Interpretation
Heidegger's analysis of affectedness provides the foundation for
this claim in three fundamental insights. These are:
1 ) World is disclosed primordially in a mood - that implies that

also the world of dreaming is disclosed in a mood.
2) Dasein is disclosed to itself in a mood. The same is true for

dreams, as dreams are evoked and determined by moods. We are
faced with ourselves in our moods and in our dreams.
3) Anything that matters is disclosed in a mood. That implies that

dreams are dealing with aspects of our life that matter to us.
So far we see, that dreams, just like moods, confront us with our
being -in- the -world as it matters to us. But still there is a striking
difference between moods and dreams in explicitness. A mood col-
ours our view and experience of the common world. It determines
the specific emphasis and the width of the horizon for the appearance
of what we encounter, according to the meaningfulness this mood
points to. This disclosure of a meaningful world is not very explicit
and can easily be overlooked as it occurs while we are concerned
with matters of our common world of waking life.
On the other band dreams, having the privilege of being secluded
from the common everyday world, confront us in great explicitness
with that which is meaningful to us. While dreaming we are dealing
with matters referring to our essential current concerns as well as,
embodied in these, with our existential ontological concerns. Dreams
embody and point to the ontological inclusion of our current ontic
concerns.
Dream interpretation according to this new hermeneutic
daseinsanalytic view aims at the very foundation of every concrete
actual issue. Our main interest is the question with which specific
fundamental characteristic of human existence the dreamer is con-
cerned, and how he or she is dealing with it.
Now I want to illustrate this approach to the meaningfulness of
dreaming with an example.
A young man had dreamt: "My little son was playing with a fish
hook. I was anxious, rearing that he might hurt himself. Then I saw
another little child, which also had been playing with a fish hook.
This child had been caught by the hook. In the attempt to set the child
free it was hurt even more and bled to death."
107
The prevailing mood of the dreamer, while dreaming this dream is
anxiousness rear and alarm. At the outset he is aware of a danger
threatening the well-being of a human being which is very close to
him and for which he is responsible. The mood of the child on the
other hand is not at all anxious. The little boy is in a playful mood,
fascinated and attracted by the very thing, which appears as so
dangerous to the dreamer. Then there is a turn for the worse. The
dreamers attention is caught by the alarming sight of a helpless
human being attached to a hook and dying in the attempt to get free.
His apprehension, it turns out, was justified. The mood determining
the dream discloses at the outset a world which is fascinating to a
playful mind but dangerous to some one knowing more and having
more experience, the dreamer himself. The colouring of this world is
ambiguous with an emphasis on the threatening aspect but the
horizon is broad enough to include the possibility of a happy ending.
Then the horizon shrinks. Now there is just one possibility left, the
entire emphasis lies on the dreadful truth or pain and death. The
dream shows that the dreamer fundamentally is concerned with the
fact that human beings are vulnerable powerless beings, apt to suffer
and even having to die. But it shows also what kind of danger and
what kind of death the dreamer currently is fearing above all.
The device around which the dreamworld revolves is a fish hook,
that is a hook destined to catch a defenceless harmless fish in order to
kill it. On a fundamental level, the hook is an instrument that refers to
connecting and being connected, attaching and being attached to. At
the outset of the dream this possibility of relating seems to be
ambiguous - dangerous, but also fascinating. Then the focus shifts
and just the most fearsome aspects of such an attachment can be seen.
The kind of death threatening danger the dreamer is concerned
with is an attachment that hurts him and kills him when trying to
come free. The fundamental issue he is concerned with is the onto-
logical truth that to some extent every close attachment means being
in the power of someone, being more vulnerable to get hurt and to
suffer pains in freeing oneself again. We can conclude that this
dreamer must be suffering from specific painful experiences in essen-
tial attachments in his life history and hence is especially sensitive to
these painful aspects of close attachments. This suffering shows in
the dream. It is a very severe suffering, leading to death, caused by
something which usually never would have such serious conse-
quences. (That is, in our common world of waking the dreamer
would not fear, that a child could be killed by a fish- hook in that
way). This exaggeration and distortion of the danger that the dreamer
108
fears, in such contrast to his waking lire experience, emphasises the
alarming proportions of his suffering respectively of his fear regard-
ing attachments.
However not only this disproportion in the dream itself (that is, a
fish hook experienced as deadly for a child) shows, how extrasensitive
the dreamer is in this regard. There is another disproportion which
can give us a clue to the extent of sensitiveness the dreamer suffers
from. It can be perceived when we include the waking life references
in our consideration of the dream.
In our example it crossed the dreamer's mind, when he reflected
on this dream, that in the therapeutic session immediately preceding
the dream he had experienced feelings matching the feelings in the
dream. In this session he had been more relaxed and more confiding
than usual and then suddenly he had felt as if he was left on his own.
He had experienced himself as being "kept on tenterhooks" by his
therapist. This irritating experience had caused him to withdraw and
close himself off again. The dream pointed out to him that he had
been more deeply affected than he himself had realised. The merely
irritating experience had obviously meant a lot more than would
usually be expected. It must have hinted at an experience much more
severe in his life history, an experience comparably painful and
disastrous as the one experienced in the dream. The allusion to such
a significant and formative experience in his life obviously had
attuned the young man into a corresponding mood, which had
evoked the dream. The fact that this very mood had prevailed over
all the other manifold, different moods concerning his everyday
issues shows that it is referring to an issue of fundamental concern to
the dreamer. The dream evoked by this mood shows precisely the
problem the dreamer is at the moment fundamentally concerned
with and precisely in the way he is concerned with it.
The discrepancy between the dramatic event in the dream and the
rather innocuous event occasioning the dream illustrates the extent
of enhanced sensitiveness to an ontological truth that this young man
suffers from. It is a truth he cannot cope with, a truth he cannot take
as a matter of course which is not to be avoided. As a consequence of
his special life history, he has grown oversensitive to it.
About one year later the same young man had another dream
where a hook played a central role. He dreamt: "I was in the moun-
tains in great danger of slipping down a steep slope. Then I was
waiting to be rescued by a helicopter someone had called on my
request. The helicopter came and I saw a young man who had been
waiting with me, jump out into the abyss to meet the helicopter. He
109
was not secured at all and I was horrified, expecting him to fall to his
death. But instead there came a line with a hook out of the helicopter
to the young man. He was caught by it and out of the hook a net
unfolded in which he was carried softly and gently down to the
ground. Then I myself was rescued, secured as one usually is on such
occasions."
In what a different light and meaningfulness the hook appears this
time! Of course it still is referring to connecting and attaching.
However, instead of pointing to frightening aspects of this kind of
relating, the hook now refers just to the opposite, to support safety
and rescue from the total helplessness of being on ones own. The
device for a close attachment, the hook, reveals totally unexpected
possibilities for rescuing someone from death. During the year in
psychotherapy, in between the two dreams, the dreamer's mood in
respect to the meaningfulness of a close attachment has changed, it
seems. The colouring has changed from threatening to promising.
The focus has shifted from death to life. The horizon or sensitiveness
has widened. The dreamer is still concerned with the problem of
close attachments, but the nature of his concern is quite different
now. Now he is concerned with the astonishing discovery that an
attachment holds, carries and rescues from death. What made this
discovery possible'? Why is this fact- first of all- a new discovery for
the dreamer and not a matter of course? If these gratifying aspects of
an attachment were as self-evident to the dreamer, as they normally
appear to us, he would not dream about them. We remember,
dreams deal with issues that matter to us, not with issues of matter -
of-factness. Of course in his waking understanding the dreamer
could agree that attachments are ambiguous, have aspects which can
make one suffer as well as aspects which one longs for. Emotionally
though he seems to have been totally absorbed in his concern with
the painful aspects. These aspects required all his attention, all his
energy and efforts to defend himself, to keep himself at a distance
himself and facing up to being totally dependent, which means
risking death. Notwithstanding the preposterously imprudent and
irresponsible behaviour, this venture succeeds. The dreamer learns
that it is possible to expose oneself totally unsecured to the void in
order to be met, received and taken care of.
This central scene is an interlude occurring in between the dream-
er's experience of asking for help and his experience of getting help it
occurs just after he had owned up to having confidence in a helping
attachment What he is concerned with at this moment is the ontologi-
cal inclusion of this experience. Very exaggerated and floodlit as seen
110
under magnifying glass, a new aspect of the problem he is concerned
with flashes upon the dreamer. The difference in mood between
himself and the other young man is the decisive point. Having
confidence in a helping attachment, an attitude, which to the dreamer
himself seems to require utmost courage seems to be a quite natural
thing for the other young man. The mood of the dreamer himself
shows his concern with the ontological truth that one always risks
being let down when trusting in an attachment. The mood of the
other young man shows that, in spite of that it is possible to be
trusting. Watching him the dreamer is deeply touched by this won-
derful confidence which allows the young man to give up all control
and all responsibility in getting attached seems to be an experience,
which might be compared to the experience of a child jumping into
the arms of a strong and caring mother or father. This clearly is
something very strange in the eyes of the dreamer being in extreme
contrast to what he is accustomed to and familiar with. He himself is
apparently used to having to care for himself, he is in the habit of
behaving in a prudent and responsible way not taking any risks. That
is the kind of behaving and relating which the dreamer shows in the
dream. It is the way he is experiencing himself. He asks for help
because he needs it. He, of course, lets himself being secured before
leaving the safe ground. Thus the help he gets, though a great relief in
desperate need, appears as something rather ordinary compared to
the fantastic experience of his companion.
Now I want to consider both dreams under the aspect of my title.
In what way do dreams reveal the specific suffering and striving of
the dreamer, meaning his deepest and most passionate concerns in
life?
The two dreams show a very similar dramaturgy. Both dreams
begin with a prelude in which the issue is introduced In both cases
the issue is the dreamer's concern with a dangerous situation. This
prelude displays the matter of concern in a realistic, unobtrusive way
differing in no way from a more or less ordinary waking- life experi-
ence. Then, in both dreams, there is a cut and a strange turn of events.
The attention is drawn to a dramatic scene beyond the scope of
reality. It highlights with eye-catching exaggeration and distortion
the essentials of the dreamer's concern. This concern shows itself in a
strong emotion, meaning some kind of suffering or striving. In the
first dream the prevailing emotion is anxiety in respect to suffering
from a hurting attachment In the second dream, quite contrary, the
prevailing emotion is the ardent wish for a desired attachment. These
prevailing emotions of course always are revealing an implicit mean-
111
ingfulness beside the explicit one. That is suffering from a hurting
attachment implies the wish to come free from this attachment
Striving ardently for an attachment implies a suffering from being
aloof and on one's own.
But that is not all to it if we consider the second dream it strikes us
that it deals very explicitly with two fundamentally different kinds
of striving. The first kind is the striving for relief from suffering and
danger which the dreamer himself experiences. But the other young
man? He seems to be striving for a thrilling adventure, for a daring
facing up to the danger. A danger, which the dreamer himself is
especially sensitive to and by all means wishes to avoid, the danger
of exposing himself and risking to be let down. Clearly the dreamer
admires this courageous approach to the fearsome. The fact that he is
so deeply engrossed with it shows that just this kind of being able to
disregard all possible danger is what he most passionately would
wish for - if only he would feel up to it.
Looking again at the first dream with this knowledge of two
different kinds of striving, we now recognise them here too. The
child at the outset is not related to suffering and relief, but is enjoying
the dangerous toy as something fascinating. Probably he is wishing
to catch something with this hook, striving to prove himself to be a
skilled and capable fisherman.
Let us reflect further on the fundamental significance of these two
different kinds of striving, one desiring relief from the fearsome, the
other desiring to master it. The decisive point is that the suffering as
well as both kinds of striving are related to the same issue of concern.
The dreamer consistently is concerned with the problem of human
attachments, but in very different ways. As long as he is spellbound
by the painful aspects to which he feels totally delivered he is not able
to feel anything else than the wish for relief from being attacked.
Letting himself be attached would mean having to accept these
insufferable aspects. Only when compelled by desperate need can he
wish for an attachment to relieve him from an even greater danger.
Now he is aware of its gratifying aspects. At this point it dawns upon
him that his most intrinsic and passionate desire is not to escape from
attachments but to let himself get attached. Concurrently the precon-
dition for handing himself over into such an attachment obtrudes on
him in the most impressive way. One has to face up to the danger of
being let down, which in his view means to fall to ones death ill order
to make the most wonderful experience regarding an attachment.
However, what to him appears as something terrifying, to someone
else seems to be something rather normal and enjoyable.
112
The problem he is struggling with does not appear to be a problem
for everybody, despite being a fundamental problem of human be-
ing. Obviously the others take these characteristics of human exist-
ence which to him seem so insufferable, for granted. They are not
affected by the ontological problem, which is obtruding upon him
embodied in the respective ontic experiences. Being free from this
special concern the others are able to relate and behave freely in this
respect. He himself on the other hand cannot disregard this problem
to which he is oversensitive. Captivated by it he cannot but be
concerned with it - that means: fear it, try to avoid it, struggle with it,
finally feel compelled to accept it, tackle it, try to cope with it.
According to these different ways of being concerned his mood
varies between the full range from being terrified to yearning, always
regarding the same issue of concern. At the end, having found the
courage to face up to the inescapable, he may experience the former
burden as a challenge, which renders life thrilling and fascinating. In
this process he consistently gains confidence, confidence that the
problem will turn out not to be overwhelming and that he will be able
to master it. Concurrently, naturally, he gains freedom and open-
ness. From the extreme constriction of anxiety in the first dream his
mood in the second dream has shifted to feeling cared for and
confident. In this mood he is open to the possibility of mastering a
terrifying venture in a wonderfully superior style.
What is true for these two dreams is true for all dreaming. A
specific suffering as well as the corresponding striving for relief or
for mastering the issue of concern can be detected in every dream as
the underlying structure. While dreaming we arc always concerned
with some specific problem of ours which is grounded in a funda-
mental characteristic of human existence to which we are especially
sensitive. Being sensitive means not being able to turn away and flee
as one primarily and usually does in regard to painful aspects of
human existence - Heidegger has coined the term Abkehr for this
normally occurring turning away. Issues we are concerned with
while dreaming demand being faced up to in order to release us from
their grip. All fleeing and turning away from it, even when succeed-
ing at times, can only be temporarily successful. Facing up to what
Heidegger calls Ankehr, is what we feel compelled to and eventually
even arc able to consider as an exciting challenge.
Freud claimed that all dreams arc wish-fulfilment. Committed to
the phenomenological method we cannot agree, of course .However,
it is apparent that all dreaming is concerned with some kind of
wishing though very often this is not obvious at first sight. It is this
113
specific wishing and the respective suffering that we are interested in

and searching for. It leads us to the dreamer's main concern in his or
her being and shows, how he or she is able to cope with it. To what
extent is he or she trying to flee and to what extent is he or she facing
up to the problem? Is he or she feeling weak and anxious or confident
and courageous in the face of it? That is the question which guides us
when we inquire into the meaningfulness of dreaming. It is this
question which leads us on a royal road to what we are aiming at in
psychotherapy.
References
Boss, M. (1988) 'Recent Considerations in Daseinsanalysis' in Craig, E.
Psychotherapy for Freedom, Special Issue of The Humanistic Psycholo-
gist, Vol. 16, Nr 1, Spring 1988
Heidegger, M.(1927,1962) Being and Time London, Harper and Row
Holzhey A., (1994) Leiden am Dasein Passagen Verlag
Uta Jaenicke DrMed, Zolliker-Strasse 195 8008 Zurich.
114
AN EXISTENTIAL APPROACH TO HIV RELATED
PSYCHOTHERAPY
Martin Milton
Abstract: This paper outlines some of the issues that arise in the
practice of psychotherapy when HIV is an issue. The paper
argues that, due to the relational focus on the approach & the
fundamental anxieties that arise in this area, the existential-
phenomenological approach is particularly suited to assisting
clients who face the challenges of life with HIV.
Introduction
This paper considers the relationship between issues that arise in
relation to HIV and the practice of psychotherapy. It is argued that
the foci of Existential psychotherapy make this paradigm a particu-
larly appropriate approach for this work.
There is research (Crawford, et al, 1991) suggesting that psycho-
therapists react to people with HIV in a myriad of ways, sometimes
facilitating engagement and sometimes not. There is literature to
show that this same phenomenon occurs within families (Gard, 1990)
and medical professionals (Kelly, 1987). Despite the Crawford study,
there has keen limited research investigating the way that psycho-
therapists can, might should, or do react to HIV and AIDS.
This lack is currently being attended to, and more recently, a
growth in the material relating to the psychological and social as-
pects of the virus now being studied. There are now a number of
regular journals (See AIDS Care) and new books focusing on these
aspects of the HIV phenomenon (See Sherr, 1995). More traditional
psychotherapy and counselling journals are also publishing related
articles (Ratigan, 1991 and Berry, 1995). There is limited material on
the application of existential thought to HIV related psychotherapy
(See Milton, 1994).
Yalom (1980) suggests a formulation of fundamental concerns that
arise in life 'Death' (or Non-Being), 'Freedom', 'Isolation' and 'Mean-
inglessness' - these are often evident in clients from the minute HIV
becomes a personal issue. Yalom expresses it that "these existential
sources of dread are familiar, too, in that they are the experiences of
Everyman; they are by no means the exclusive province of the
psychologically troubled individual (1980: 12).
115
The therapist's reaction is an important factor in the therapeutic
process and the existential approach, with its focus on the relational
aspects of the therapeutic process encourages this aspect to be con-
sidered within the therapy.
While thinking about the nature of the interaction it is important to
consider two ways of relating that Yalom suggests we engage in to
alleviate anxieties we face.
The 'Ultimate Rescuer' relationship. This is a relationship character-
ised by a hope (either overt or covert) that they will find someone to
rescue them from their situation (e.g. anxiety about death or non-
being). A desire to pass on responsibility to others for this rescue,
may be expressed or a tendency to seek answers from the therapist or
others in order to avoid fundamental anxieties.
The setting in which therapy occurs may affect this experience.
Settings may try to offer a 'rescue', e.g. medical settings are caught
up in this discourse, as their remit is seen to be the 'cure' of illness.
The search for the 'Ultimate Rescuer' may be evident in the client's
adoption of an identity as a 'sick patient', and a reliance on tile doctor
or other professional. In turn, this mode of relating may actively be
encouraged, - see the high regard in which the medical profession
holds the 'compliant' patient.
When engaging with a client's hope for an 'Ultimate Rescuer', the
therapist may feel that they are treated as if they are very powerful or
magical. The therapist may recognise that they would like to relieve
the anxiety that the client is feeling, and to meet the demands that
they are making. Alternatively they may experience a sadness as they
realise that an authentic reduction of these anxieties may not be
possible.
Specialness. The mode of relating that Yalom (1980) called 'Special-
ness' can be understood as a description of another way of relating
that rests upon an assumption of difference. It functions to create the
illusion that I will not follow the same fate as others, i.e. Non-Being
may be avoided. This assumption is an isolating one and can be
manifest in the relationship between the client and the therapist. At
some points, especially if the client perceives the therapist as unwill-
ing to accept the assumption at face value, the relationship may be
marked by a sense of difference, e.g. differing power relationships,
idolization of one by the other, or an inability to relate. It is therefore
important to examine these dynamics of difference when they occur.
116
Death as an existential issue

The notion of death is one that will affect us all in some way. As
Becker has said, "Death is ever present" (1973:15). It is one of the few
'givens' of our existence which we can never completely escape,
however, there may be some cultural differences with regard to the
level of anxiety that we experience in this regard (Nahr, 1992, per-
sonal communication) and how we engage with death in life (Osawa,
(1993). Some cultures seemingly have a closer relationship with the
notion of death than is prevalent in the West. In any therapeutic
process, death as an overt topic of discussion may or may not be
addressed, as Yalom suggests: "the clinician rarely encounters death
anxiety in its stark form: this anxiety is handled by conventional
defences... and by some defences specific only to it" (1980:45). As
humans we are anxious about the end of our existence - both our
physical death, and also the metaphorical deaths that we undergo as
our identity develops and changes. The way that many of us relate to
this anxiety is to avoid it, e.g. via religious doctrines talk of going to
heaven, hell or purgatory after death, the beliefs of people that they
can come back in a ghost like form, or the belief in reincarnation or
rebirth.
Macquarrie has said "to be aware of death is to be aware of living
in the face of the end" (1972:37) All the time there is life, there is the
possibility of experiencing and living in the present. As humans, we
have a uniqueness of ourselves and of our existence, and it is this
awareness that facilitates anxiety in relation to death.
Death and HIV. HIV currently has a link to death in the social
discourse, and may present in the client's material. Anxiety may he
heightened due to the social context which is that at this point in
time, large numbers of people who have been infected with HIV have
developed AIDS and have died. This is highly debated and publi-
cised. With HIV the point of death creates an unusual dynamic, as
large numbers of people who have died from HIV have done so at an
early age. i.e. The ages at which the largest number of people are
facing the potential death due to AIDS is 30-35 (PHLS AIDS Centre et
al, 1993). This is a phenomenon which contradicts western assump-
tions that death occurs at the end of a long and full lifetime.
Therapist's reactions to death. McKusick (1988) suggests that thera-

pists may experience a range of reactions when engaging with HIV
related concerns. Examples of such concerns may include feelings of
hollowness and withdrawal, difficulty listening, and the sudden
117
awareness of their own issues about death and dying. The therapist
will not only be witness to the thoughts and feelings of the clients on
this theme, but will be invited to consider their own mortality in the
intersubjective encounter of the therapeutic relationship. If the thera-
pist attempts to avoid the issue of death, it may be difficult to engage
with the client's fears and concerns within the therapy.
Death and the therapeutic relationship. In attempting to engage in an

authentic relationship the therapist may find themselves struggling
with death related anxiety. This may be done in the same manner
that we might see in our clients, i.e. searching for the 'Ultimate
Rescuer' - perhaps looking for the approval of the client or being slow
to acknowledge material which the therapist fears that the client will
not like - or become grandiose or distant with thoughts of being
'Special'. Neither of these are likely to nurture an effective therapeu-
tic relationship. If the therapist fails to engage with the anxiety, the
therapy may be affected by a lack of trust or, an encouragement of the
avoidant modes of Being.
People react differently to this 'given of eventual death. It has been
suggested that the differences may also be evident in the differing
ways people react to the boundary of psychotherapy sessions, e.g.
the inability to complete a task until the deadline is imminent, or the
living of their lives in the future rather than the present. Death and
therapy are private and intense experiences that cannot be fully
explained in an emotionally or experientially accurate way. They are
both processes which are to be understood through experience. What
Heidegger says about death can also be said of psychotherapy:
"Death is not an event; it is a phenomenon to be understood existen-
tially" (Steiner, 1992:104). If this is so, it would seem that it is
important for the therapist to be involved and be affected by this
relationship (van Deurzen, 1995)
Due to practical issues in being with the client who is close to
death, the traditional structures of psychotherapy are not always
attainable and may need to be adapted. For example, if the client is
very ill or dying it may be more appropriate for the therapist to be at
the client's bedside than it would be to insist that the client should be
transported to the consulting room, or the session denied. The effect
of this type of intervention is difficult to document, but personal
experience and that of other practitioners in the field suggests that
this type of flexibility does not result in a collapsing of all the
boundaries of psychotherapy, nor in the blurring of the reasons for
the therapy (Nahr, 1992, personal communication).
118
HIV as a different form of non-being. The meaning of identity needs
to be considered. Infection with HIV may create a sense of non-being
before there are physical manifestations. This is because it will chal-
lenge a view of the self that has been developed and held as central.
It may break a sense of who the person is, and a new sense of self may
need to be developed which integrates HIV and its consequences into
the way the individual and the world sees themselves.
Freedom
In Death we face a fundamental boundary to freedom and thus,
death may be the catalyst for a recognition of freedom in our exist-
ence. This raises the issue of choices available to us. Macquarrie has
pointed out that "it is through free and responsible decisions that
man becomes authentically himself" (1972:16). The act of choosing
may be a more self-affirming experience than to avoid the choice.
However, choice is often one of the most frightening acts people have
to involve themselves in. Choices are decisions, and "decisions are
never simply self-fulfilment. It is also self renunciation. To decide for
one possibility is ipso facto to renounce every other possibility that is
open in this situation" (Macquarrie, 1972:182).
Freedom and HIV. On first thought many people seem to assume

that infection with HIV eradicates freedom. This impression can be
seen in media coverage, in legislation, and personal attitudes. Limi-
tations affect who we can talk openly to, who we might work with,
what activities we can participate in, and where we might travel. It is
also important to recognise that our clients are a part of a wider social
system, that meanings and our understanding are often co-consti-
tuted and influence the course of therapy, e.g. the therapist may find
they are facing pressures from other professional to "do something"
to the client, or to "make them do what is best for them". The client
may be facing pressure from people around them to "get counselling
because you'll need it", or to do certain things for financial benefits.
Acknowledgement of the array of options we are free to choose is
often discouraged when HIV is considered. Reproductive freedom
for people with HIV often being dismissed without thought, and
freedom regarding the disclosure of HIV status may be assumed to
be a societal issue, with scant attention being paid to the freedom of
the individual. Yet, these social factors do not erase the existence of a
choice nor do they consider how we experience the events. Choices
include whether to pay attention to the sanctions, which ones to
listen to or how to make sense of the situation in which one finds
119
oneself. Other choices might be whether to test or not, to collect the
result or not, how they understand the result, how they respond,
what information they request, and what to do with one's life in light
of one's situation, etc. This is very much an intersubjective experi-
ence between the individual and their context - physical, social,
intimate and spiritual.
Freedom may be frightening and filled with tension, and for this
reason it can often be avoided, e.g. by focusing on future death,
rather than current options. Other reactions against facing the free-
dom in therapy can possibly be seen in denial of responsibility,
overwhelming fear, attempted abdication of power and possibility.
Despite this, once infected Freedom may be grasped with more
awareness and enthusiasm than before they were aware of their HIV
infection. As Yalom says "It [the idea of death] acts as a catalyst to
plunge us into more authentic life modes, and it enhances our pleas-
ure in the living of life" (Yalom, 1980:30)
Therapists Experience. As with Death, the Freedom that we face is

not just an issue for clients, it can equally be an issue for therapists.
As therapists, we are faced with choices to make about which issues
seem most important, and when and how we intervene.
The Freedom that the therapist has impacts upon the client. This is
a corner stone of therapeutic activity, often drawing clients to therapy.
Both clients and therapists are aware that they come to therapy for a
certain type of interaction. The therapists remit may be to help clarify
the relevance of Freedom and choices to the clients situation. This
needs to be done respectfully - while trying not to force value on
what choices we would make, or what choice we might think would
be the better. Yet, the therapist may experience powerful reactions to
the issues. These may be linked with
* Power and control - e.g. Therapist reactions to the power and

control available to the client - or not.
* Fear - e.g. Fear of not 'doing" the right thing about a situation, or
about being in relationship with someone considering the limitations
of their freedom.
* Assumptions and illusions - e.g. Are the therapist and client able
to differentiate what Freedom means in each situation, what Free
dom is available and what limitations exist:'?
120
* Acceptance - e.g. What does the therapist feel about the accepting
of limitations? Part of life, or a failure on the part of the client or
therapist? All these reactions might influence the work and thus
require personal reflection and discipline on the part of the therapist.
Isolation
Isolation can be seen to have a number of forms. It might be
described in terms of loneliness (a feeling), or of being alone (a
physical state). In both cases the state might be temporary, and
amenable to change if desired. Choosing to be alone or isolated may
not be necessarily a painful or limiting experience (Storr, 1988). An
existential formulation of isolation relates to the awareness of a
fundamental paradox - Despite our fundamental relatedness by vir-
tue of being-in-the-world, we exist alone, and will die alone, and can
never change this. Such a formulation also acknowledges the anxiety
that stems from this awareness. People may try to limit anxiety
through relationships with people, the world and spiritual aspects.
Existential therapy encourages the practitioner to look at the existent
in terms of their relationships.
An important aspect of this to consider is that of language: "Lan-
guage is what externalises thought and makes it accessible to the
other person" (Macquarrie, 1972:106). Despite language, our isola-
tion remains a fundamental given of our being, as our systems of
language are not developed enough to fully describe the myriad of
events that humans experience and this is compounded in instances
when we do not have a vocabulary to indicate what is meant. This is
a dynamic that surrounds HIV, as we are without a language to
express the events that occur, on both personal and more social
levels. People find it difficult to understand such terms as 'HIV' and
'AIDS'. This can create interpersonal difficulties as a client may try
numerous times to tell parents and friends of his infection, or his
therapist about his experiences, and be unsuccessful as there is no
common experience for them to relate to.
Isolation can be exacerbated by social phenomena, such as the
prejudice and discrimination afforded to people. These effects are
widespread in relation to HIV: "[the] stigmatization process of media
stereotypes, persecution and phenomenal mistreatment [is evident]
on all levels from personal paranoia to the implementation of na-
tional policy" (Edwards, 1992: 151).
Loss. Isolation through loss is another dynamic for consideration.

This may be complicated as loss can be seen to have at least two
121
Journal cf the Society for Existential Analysis
elements, i.e. loss as an event, and the adaptation to loss in physical,

practical and meaningful terms. Parkes (1986) gives evidence that
loss - real or anticipated - increases psychological distress. Infection
with HIV might mean that the client is faced with loss in a variety of
ways:
*Loss of sexual freedom - due to the sexually transmitted nature of

the virus,
*Loss of relationships - many people with HIV are poorly sup

ported and may have lost friends to AIDS.
*Loss of routines and structures - HIV has an effect of bringing life

expectancy to a lower age, and this can challenge our life plans. Once
a person is ill, or coping with social, emotional or medical aspects of
the infection, known routines may go by the wayside.
Isolation and HIV In Europe and the US the two groups of people
considered particularly at risk of HIV infection are gay men and
intravenous drug users. Gay men have historically been marginalised
in terms of the awareness, identity and sexual-political dialectics
before AIDS. AIDS seems to exacerbate these forms of marginalization,
as well as increasing it due to the link with death. (Edwards, 1992).
We might consider that our clients face problems not only emotion-
ally, but in terms of housing and receiving social and medical care
due to their HIV status, sexuality or lifestyle. Many drug users, gay
men or lesbians may not have told others about these aspects of their
lives, possibly due to the stigmatization that these populations have
had to face. Now HIV and AIDS are also exposing these people to
further social sanctions (Plummer, 1988). Sharing such secret aspects
of life with anyone may be very difficult, and may exacerbate the
sense of isolation. Isolation can be a damaging social experience as
some people with HIV come to feel that the fear, stigma and discrimi-
nation afforded them by others is warranted.
Despite the large numbers of people with HIV, HIV infection can
still be experienced as a rare occurrence. Up to December 1993, the
Public Health Laboratory Service reported 20,543 people with HIV in
the UK, out of a population of more than 50 million. Thus, many
people finding out that they are infected with HIV are currently the
first people in their families or communities to be infected.
Isolation may not just be felt in relation to others, but the relation-
ship with ourselves can be estranged at times. We might see others as
122
knowing our bodies better than we do. The medical system that
people enter to find out about their HIV status, for diagnosis of
illness and for treatment, uses technology and expertise to "know"
things about our bodies that we don't know. A danger of this sense of
people knowing others better than they know themselves, is that "we
[as a culture] relate to another person, not in wholeness and in
openness but turn him into a thing, an instrument" (Macquarrie,
1972:108). This is evident when we hear people saying "I'm HIV"
rather than saying "I have HIV" or "I've tested positive for HIV".
Sexuality and Isolation. Sexuality is important with regard to HIV

and Isolation. Macquarrie (1972:117) has said "If sexuality is the
bodily foundation of the simplest kind of community (sexual union
or marriage), it is also the act that has potentiality to found the next
order of community, the family". This is now complicated as sexual-
ity now has the power to be a physically and socially destructive
experience. "It's very, very different to put a condom on as a contra-
ceptive and to put one on because there's a risk of infection" (Edwards,
1992:155).
An attempt to avoid the experience of Isolation may affect the
therapy in a number of ways. One way may be the highlighting of the
sexuality of either the client or the therapist. Examples of this might
be a) the way many clients want to know that the therapist shares the
same sexual orientation or b) sexual attraction being noticed between
the client and the therapist. The therapist's world view will generally
be influenced by assumptions regarding sexuality (Hayes & Gelso,
1993). Alternatively when facing someone with HIV, we may see
personal anxieties being activated. 'Sex phobias' might be reacti-
vated when the therapist becomes aware of the transmission of HIV
through sexual activity, (McKusick, 1988) and resorts to urging celi-
bacy. In some people the opposite reaction might be seen, i.e. the
encouragement for people with HIV not to forgo expression of their
sexuality, and emphasis being placed upon the promotion of safer
sexual practices.
It seems important that thought is given to how sexuality might
affect the therapist if sexual feelings arise between the client and the
therapist. The ethical therapist, according to the codes of practice of
the American Psychological Association (1981), the British Psycho-
logical Society (1985), and the British Association for Counselling
(1990), would be obliged to avoid sexualised behaviour with clients.
123
Isolation and Practice: these dynamics may affect the therapy as
isolation may make relationships difficult to forge. The practice of
therapy, though, is one that has as its bedrock the relationship
between the therapist & the client. The existential approach to psy-
chotherapy highlights one articular aspect more than most approaches
& that is "the client's experience of 'selfbeing-in-relation-with-the-
other'". (Spinelli, 1995:332)
Although a heavily charged issue, an exploration of Isolation
might allow understanding to be gained, and meanings to be under-
stood. What would seem important to explore are the anxieties in
relation to isolation, intimacy and the therapeutic relationship.
Appropriate professional distance may be facilitating of the therapy
(Milton, 1996) as a sensitive exploration of Isolation can be an en-
hancement of the therapeutic experience. May (1983) feels that "all
existing persons have the need and the possibility of going out from
their centredness to participate in other beings" (p27). Rogers con-
curs with this when he says "It is a living together in communication
that breaks the isolation of the patient" (1959:196). The case may be
stated more strongly in that "a person's identity lies in their relation
to others, and is not an entity to be found inside the person" (Burr,
1995:109).
Meaninglessness
Meaning is an important issue for any psychotherapist and client.
Frankl points this out dramatically when he quotes Nietzsche's words
"He who has a why to live for, can bear with almost any how
(Nietzsche, cited in Frankl, 1959:97). Similar thinking is evident in the
cognitive therapies where a major focus is on negative and appropri-
ate thoughts and what they mean to the individual (Trower, Casey
and Dryden, (1988). The notion of Meaninglessness is one that satu-
rates the human condition. Macquarrie (1972) suggests that there is
very little that can be known with a sense of certainty. Yet, meaning is
a guide to our interactions with our environment, ourselves and our
relationships. We use meaning to have a sense of engagement with
the world and with others in it. These relationships in turn, offer a
sense of meaning through a co-constitutive process.
A person can loose a sense of active mastery and his or her ability
to feel an active participant in their existence if Meaning is lost. This
can be distressing, as we might feel vulnerable and at the mercy of
the elements or the world that we are a part of.
An exacerbated need for certainty might be one way people cope
with meaninglessness. When this certainty is not immediately avail-
124
able, we might look to others to provide clarity (See the discussion of
the 'Ultimate Rescuer' above). Pressure might be put on the therapist
from the client to teach them or to provide meaning for them where
a strong need to find the answer, or the Truth. Meaning, though, is
not something that can truly be imposed from without. It is an aspect
which can only emerge in relation to the individual's experience. Yet,
Becker (1973:120) suggests that "These [man made meanings] are the
only meanings that we securely know; nature seems unconcerned,
even viciously antagonistic to human meanings".
Meaninglessness and HIV. The phenomena of HIV and AIDS have

yet to find a collective meaning of any universal consensus. At
present there are no set obvious physiological symptoms that we can
say definitely will occur universally in all who are infected with the
virus. Plummer points out: "At the start of the 1980's, 'AIDS' had not
been invented" (1988:20). AIDS is still being invented and given
collective and personal meaning. The "inventing" referred to is not
the inventing of the medical condition, but the construction of per-
sonal and subjective understandings of HIV and AIDS, which effects
therapeutic relationships.
It may be that HIV will eradicate, or alter, a known set of meanings
for the client e.g. in relation to health, life, relationships, responsibil-
ity and choices. This event may be experienced with a great sense of
loss by some clients. A sense of Meaninglessness is known to be a
common reaction to loss (Parkes, 1986, Frankl, 1984). The experience
of HIV can be saturated with uncertainty, e.g. the period of uncer-
tainty between testing and finding out the result. Because of the three
month "window period" when the body can be creating antibodies to
HIV, the test result may not give certainty regarding one's current
status. A positive antibody result is linked to a whole area of uncer-
tainty in that it may not be possible to tell when the person had been
infected, what course the person's physical or medical condition will
take, or "how long" - before sickness or an AIDS diagnosis. These
types of dynamics may induce a great deal of anxiety.
The Psychotherapy Relationship. Both psychotherapy and HIV are

phenomena that create debate in many walks of life. For large num-
bers of people neither HIV nor psychotherapy have any meaning.
Many people are unaware what these phenomena are, how they
work, and how people will react to them if they "admit" to having
anything to do with either subject.
125
Therapy "works" through the relationship between the two par-
ticipants. Interpersonal relationships are often a wealth of individual
meaning and the relationship between the client and the therapist
will no doubt give clues to the nature of the client's relationships
with others, and the Meaning that these relationships have.
As therapists, if we are heavily influenced by the negative view of
the current culture regarding HIV, a therapeutic relationship af-
fected by HIV might well be very difficult. It is known that a "ten-
dency among psychotherapists, when anxious or assailed by doubts
as to what they are doing, is to become preoccupied with technique"
(May, 1983:39). A preoccupation with theory might also result. With-
out an awareness of these dynamics of Meaninglessness, both thera-
pists and clients may flee to Meaning without careful clarification.
Careful clarification means clarifying the lived experience, rather
than attempting to gain an intellectual understanding of the experi-
ence (Spinelli, 1996).
Another important consideration is the means of the relationship.
It must be recognised that psychotherapy frequently relies on verbal
communication and Meaning can be found through successful com-
munication (Macquarrie, 1972). Language is helpful in communicat-
ing overt facts, but, as May points out, "the grasping of the being of
the other person occurs on a different level from our knowledge of
specific things about him" (1983:92). The difficulty in therapy is of
having access to the experiences of another. The Meaninglessness in
HIV can complicate this. Thus, at times in therapy, communication
may be an attempt to express the Meaning of Meaninglessness -
requiring courage and authenticity on behalf of both participants.
Reflections:
This paper aimed to illustrate that significant anxiety relating to
the four existential concepts of Death, Freedom, Isolation and Mean-
inglessness is particularly evident in relation to HIV-Related Psycho-
therapy. The paper also suggests that Existential psychotherapy has
an important contribution to make to this field.
This paper raises many questions. It seems appropriate that this is
so as therapy is often about engaging with issues that are confusing &
developing new ways of questioning ourselves, our relationships
and the events that we face. In this paper questions are raised with
particular regard to the role of unquestioned assumptions in HIV
infection, the social effects of HIV on the counselling process and
how these are engaged with by the therapist, what are appropriate
Psychotherapeutic structures for those with advanced stages of in-
126
fection and illness, and the long term effects for therapists in terms of
those facing these anxieties and the training and supervision require-
ments.
At this point in time there is an increasing number of people
writing about psychotherapy and counselling in relation to HIV and
AIDS, e.g. Bor applies a Systemic approach (1989), Ratigan a psy-
chodynamic one (1991) and the group analytic approach is applied
by Molnos (1990). The Cognitive-Behavioural approach is used by
many psychologists in the British National Health Service. Much has
been written on the social and sociological aspects of HIV and AIDS
by such people as Plummer (1988) and Edwards (1992) This wide
based exploration into the dynamics of HIV promises to be a useful
and effective means of increasing our knowledge, and our ability to
work with our clients in psychotherapy. The thinking of existential
philosophers and therapists has a great deal to add to this field as the
existential literature has considered many of the basic issues that face
us in our Being-in-the-world. These are the same anxieties that I have
tried to show that HIV brings up for many people.
It is also important for us to ponder the training needs of counsel-
lors and therapists, working with clients affected by HIV and AIDS.
In light of the thesis of this paper - that the anxieties that are likely to
be activated when facing HIV are those same concerns that face us all
- it would seem sensible that those providing therapeutic services are
well trained in the facing of those fundamental concerns. Yet, cur-
rently an insistence on HIV training can be seen as a priority in the
person specifications of those providing HIV Counselling. A change
that might be useful to consider would be that of prioritizing a
thorough psychotherapy training - including exposure to existential
considerations - with a specialised HIV training being provided later
as a supplement. The HIV training that therapists might benefit from
covers the range of medical issues and treatment, as well as emo-
tional and existential issues that this paper has highlighted. It would
also be important for these trainings to give attention to the effects of
the stigmatization and discrimination that people with HIV and
AIDS can face in an effort to keep Meaninglessness to that which is
inevitable, and to limit any exacerbation that an ignorance of infor-
mation might create.
If this type of strategy is not adopted, and the HIV counselling
field continues to rely on expertise in HIV, without this thorough
training in psychotherapy or counselling, we run the risk of being
"experts" on an issue. Clients would then run the risk of being related to
as "HIV patients" rather than individuals with the infection.
127
HIV and AIDS are a dramatic challenge to psychological health as
well as physical. The practitioners in the field face difficult but
important work. They need to be aware of the difficulties in order to
equip themselves properly to engage with the existential anxieties
that become manifest for both clients and therapists.
Acknowledgement: This paper is based on a paper that first appeared in

Counselling Psychology Review, V9, #4 in 1994 as 'HIV Related Psycho-
therapy and its Existential Concerns'.
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129
HEIDEGGER AND "HARA"
AN INTRODUCTION TO MAIEUTIC LISTENING
Peter Wilberg
Myths of our Culture

Not knowing how to listen, neither can they speak
Heraclitus
If discussions concerning the relevance of Heidegger's thinking to
psychotherapy are not to be of merely academic interest or fall into
the sterility of what he called "idle talk" - talking about something as
opposed to really saying something, then they must be grounded in
the type of patient inward listening that first lets something be said,
first allows the word to take root, gestate and mature in the womb of
silence. Does the parent listen because the child is speaking, or does
the child speak because the parent is listening? The central myth of
psychoanalysis as the "talking cure" is the myth of our speaking
culture - the myth that it is language that lets things be said. What if
the opposite is true - namely that it is our way of listening that
determines (bestimmt) what comes to presence in speech, and lan-
guage, speech and writing which then re-present this in words? From
this point of view it is not so much what Heidegger wrote but what
he did - the way of listening that he modelled and embodied - that
holds the greatest significance for psychotherapy.
The myth of our culture: that it is by opening our mouths and
speaking, expressing ourselves or asking each other questions, mak-
ing small talks or telling stories - in a word, by directing words at
each other - that we establish contact with another human being and
open communication. What if the opposite is true, namely that it is in
silence that we establish true contact, a silence in which we lean or list
our whole being towards the being of the other, in which we list-
en?
The myth of our culture: that we know what listening is. As if a
person's listening were merely a matter of their outward body lan-
guage and verbal responses. As if listening had no inner dimensions,
no link with our essential being, held no open questions and con-
cealed no mysteries.
The myth of our culture: that listening is one side of a "skill" called
"verbal communication". As if the meaning of words were itself
anything verbal. As if our inner listening responsiveness to another
130
Heidegger and Hara
human being were not itself a form of communication- a wordless

communication.
The myth of our culture: that we listen because someone is speak-
ing to us. As if the speaker would even begin to speak to us were it
not first clear to them that in some way we were listening or pretend-
ing to listen. As if what is said to us were not itself also a response to
the way we are listening.
Listening and Psychotherapy Training

It is almost universally accepted that the role of a counsellor or
therapist is not to answer a client's questions or solve their problems,
give them advice or impose interpretations on what they say. And
yet many counsellors and therapists, particularly but not only those
lacking experience or still in training, regard their listening merely as
(a) a way of giving clients opportunity to speak and (b) a prelude to
offering some form of (hopefully) helpful verbal response. Indeed it
is by the quality, appropriacy and therapeutic efficacy of their words
and body language that a therapist's skills are principally judged.
Too often this leads the therapist either into a pre — occupation
with finding the right thing to say, to reliance on pre-established
patterns of response (mirroring, paraphrase, elicitative questioning
etc.) or to the use of pre-rehearsed prompts and therapeutic
techniques. Much of the fault for this situation lies with the nature of
the training given to counsellors, therapists and analysis. This
usually includes reading and theoretical seminars, case discussions,
personal therapy and supervision. In addition, practice may be
provided, through role play and other methods, in specific
therapeutic techniques. This diversity of approach conceals an
enormous lacuna. For though it is the depth, tone and style of the
therapist's listening that will primarily colour and determine the
course of the therapy (for both client and therapist) there exists as
yet no form of Psychotherapeutic training in which the nature and
development of the trainee's listening is taken as the primary
concern. Here we see reflected the norms of our social culture,
which treats speech and action as the most direct forms of
communication and sees listening merely as a passive or preparatory
phase of verbal or physical expression.
I believe that a deeper phenomenology of listening would under-
stand speech and body language, words and deeds, as indirect verbal
and physical forms of communication, and acknowledge listening
itself as a direct form of non-verbal and non-physical communication.
From this point of view listening is never a mere prelude to verbal or
physical response. It is itself a form of direct inner response. The way
131
we hear what someone says, says something to them. The way we
understand their words communicates wordlessly. The more our
listening is able to bear what is said, to shelter and nourish it in
pregnant silence, the more directly - and fruitfully - it bears a mes-
sage back to the Other in that silence. This "bearing back" is the
fundamental meaning of the word "relate" (re-latio).
Listening and Maieusis

The German verb gebären (to bear a child) is echoed in the words
Gebärde (gesture or bearing) and gebärden (to comport or bear oneself
in a particular way) in the same way that the English verb "to bear"
(to carry a child) and "gestate" are echoed in the words "bearing"
and "gesture". In a culture more and more dominated by an ethos of
"positive thinking" we have lost touch with the inner meaning of
"suffering" and "illness" - not as a surrender to negativity, or to
mental and physical incapacity but as a type of pregnancy, a gestative
process.
Whenever and for whatever reason we find our state of being
"unbearable" we pay homage to a wisdom buried and yet still
pregnant in language itself. The English verb "to bear" has the
double meaning of to carry or withstand (hence the expressions "I
can't bear it" or "bearing up") and to give birth ("she bore a child").
In our technological age, pregnancy is often treated as a sort of
abnormal temporary condition to be treated with caution and "man-
aged" - rather like an illness. The converse is not the case however.
Medical science does not include an understanding of mental and
physical illness as a form of pregnancy; no less natural and no less
potentially fertile. It is thus incapable of cultivating a way of listening
to patients that is patient and maieutic. Not a mere prelude to
"treatment" but inherently - "in-hear-antly" - therapeutic. The basic
pathology of our age is not aids or cancer, neurosis or schizophrenia.
It is the incapacity to listen, ie. to be with others in silence and to bear
the pregnancy of that silence. If silence is to bear fruit it must first be
borne - tolerated. If our listening attunement to another person is to
be fruitful our inner comportment or bearing must be that of a patient
and forbearing midwife; not one who relies on training, skills or
knowledge alone but one whose embodied presence is an attuned,
sheltering and holding presence.
132
Heidegger and Hara
Maieutic Listening
To hear what is silent requires a hearing that each of us has
and none uses correctly.
Martin Heidegger
No subject is more marginalised in the literature on psychology

than the art of listening - even though it is central to the practice of
both medicine and psychotherapy. Listening is the midwife of speech,
and yet it is seen as a mere prelude to verbal response, diagnosis or
interpretation, or reduced to a set of technical-professional skills. No
profession is more marginalised than that of the midwife, she who
brings life into the world, for in our culture medical technology seeks
to dispense with her art. Maieutic listening is not a theoretical "ap-
proach" to psychotherapy or psychoanalysis. Nor is it a theoretical
deconstruction of psychoanalytic thinking or its refoundation on an
ontological basis (Daseinsanalytik). It is a specific listening praxis; one
which is quite distinct in spirit, mood and character from the way of
listening cultivated in most counselling, psychotherapy and psycho-
analytic trainings - yet one which offers a profound and transforming
experience of the listening process. Listening as maieusis is intrinsi-
cally therapeutic, but not all styles of therapeutic listening are fully
maieutic in character. The praxis of maieutic listening is not rooted in
the listener's theoretical perspective or therapeutic training but in a
specific inner comportment or bearing which Heidegger termed
"forbearance" or "withholding" (Verhaltenheit). Listening as maieusis
is inherently therapeutic, for it is about helping others to find their
bearings in life. This means not only learning to bear and bear forth
their inner reality, but above all, to find an authentic and grounded inner
bearing through which to relate to others and to the world.
Heidegger and Hara

When a woman is pregnant, she needs to adjust her physical
posture and comportment in order to accommodate her big belly and
her lowered centre of gravity. To engage in maieutic listening is to
lower the centre of gravity of our listening to the belly region. To
listen not with the head or heart alone - a typically Western bearing -
but with what in Japan is called hara. One meaning of hara is "belly
talk". In his encounter with Japanese tradition and the spirit of Zen
"transmission without words or scripture" - Heidegger recognised a
thinking that acknowledged "the soundless voice of being" and was
capable of engaging in a listening dialogue, in wordless "belly talk".
133
Hara is the site of what the Greek thinker Heraclitus called logos - the
wordless inner resonance or reverberation of the psyche, echoing not
in words but in tones of silence - feeling tones. Feeling tones are not
emotions but the basic wavelengths of being through which we
attune to others and sound them out in our listening. The listener
does not only attend to the speaker's voice and feeling tones. The
listener also sets a tone, and can modulate the intonation of her
listening. Listening with hara means "sounding out" the other by
modulating the intonations of our listening and the messages that
ride on them. This can be as tangible an experience as modulating the
tone of our speaking voice, for the latter invariably echoes the silent
tones of our listening. These are the logos (speech) of the soul or
psyche . Hara or "belly talk" is psycho-logy - "soulspeak".
The Listening Body

I once had a dream. I dreamt that I, even though a man,
was pregnant, pregnant and full with nothingness like
a woman who is with child. And out of that nothingness, God was born.
Meister Eckhart
Western culture understands communication as either verbal or

physical. Japanese culture, on the other hand, retained for a long time
the awareness of a type of human intercourse and intimacy depend-
ent neither on sounds and words nor on physical contact and touch,
but on the touch of what I call the "listening body". This can be
compared to an invisible psychic womb or capsule that remains after
birth and that is sensed by both man and woman whenever they
experience "gut feelings" in the belly. The relation between the
listening self and the speaking self finds its living bodily metaphor in
the relation between foetus and womb on the one hand and the
maternal body and mother tongue on the other. The womb with its
amniotic fluid is a resonant medium, a "listening body" for the
foetus. After birth our "being in the womb" becomes a "being in the
world". As we acquire language our "being in the world" is more
and more conditioned by our way of listening - our "being in the
word". Maieutic listening means experiencing the word as a second
body, a pregnant womb of meaning. But for many, language becomes
instead a verbal mask or persona, a tool or instrument, a fashionable
garment or ideological uniform. The listening body - our wordless,
felt sense of meaning - is not housed and sheltered but eclipsed by
words and their meanings.
134
Heidegger and Hara
Holding and Handling

Like the foetus in the womb, the listening self and listening body of
an individual is not something visible or audible. The contact we
make with another person with our listening self and our listening
body is not a physical contact. When we really make contact with
someone through our eyes, for example, it is not because we are
staring at or studying their eyes optically. As soon as we focus our
vision on someone's eyes as physical objects we break any contact
established through our inner gaze. The same is true of the ear. To
attend fully to someone, to "be all ears" is not necessarily to really
intend or "mean" them, to touch them with our inner listening gaze.
We attend to "some-thing" with our eyes or ears. We intend "some-
one" - a being. Just as we can hold someone in the inner gaze of our
eyes we can hold someone in our inner listening gaze. This is centred
not in the eyes or ears, the head or heart, but in the hara. In Western
culture we know also the experience of the mutual gaze and the rich
inner communication that can take place through it. We know this
mutual gaze only as a talking of the eyes, however, and not as "belly
talk" - the silent inner communication and communion of listeners.
We seek to make communicative contact by looking at people and
speaking to them, rather than by listening to them. Yet without a
listening contact there is no real contact at all, however many words,
gestures and looks are exchanged. In Western culture, "handling
people sensitively" means either speaking to them or touching them
in a sensitive way. Learning to listen maieutically means learning not
only to hold others in the inner gaze of our listening but also learning
to touch and handle others silently with our "listening body" -
modulating the pressure of our listening gaze and listening touch.
This allows the listener to "act as a midwife" for the listening self of
the other - helping them to find an inner bearing through which they
can fully bear and embody this self.
Maieutic Analysis
Maeiutic analysis is the name I give to a new form of personal
development for listening professionals. This could include not only
psychoanalysis, therapists or counsellors but all those whose profes-
sional work has a strong listening component - for example social
workers, doctors and nurses, teachers and managers. Like psycho-
analysis, maieutic analysis is conducted one-to-one or in small groups.
Unlike personal therapy however, its focus is not so much on the
personal world of the analysand, as on the relationship between the
latter and his or her professional clients. The role of the maieutic
135
analyst can be compared with that of the individual to whom the

practitioner goes for professional supervision, but with two main
differences; (a) that this supervision does itself constitute a specific
form of "analysis" - one principally focused on the analysand's way
of listening to others, and (b) that precisely because of this focus it is
not limited to adherents of particular schools of psychology, psy-
choanalysis or therapy but is instead open to practitioners from a
wide variety of professional training backgrounds.
The maieutic analyst is a listening mentor, listening coach and a
listening "analyst" in the literal sense: sensitive to the analysand's
listening and analysing that listening. The word "analysis" derives
from the Greek analuein - to "loosen" or "free up". The purpose of
maieutic analysis is to deepen the analysand's listening by (a) hearing
the personal and professional parameters in which it operates and (b)
working to loosen these parameters where they function in a restric-
tive or foreclosive way. This requires sensitivity to the character of an
individual's listening and works to free it from characteristic and
characterological restrictions - a definition of maieutic analysis which
echoes the work of Wilhelm Reich on character and character analysis.
Listening and Character

Reich was the first psychoanalyst to take seriously the physical
and physiological dimension of analysis. He observed characteristic
postures and patterns of "muscular armouring" in his clients, which
he saw as their "frozen history". The maieutic analyst is, in a similar
way, sensitive to the inner bearing or "posture" of the listener, their
frozen history - and training. What we call "personality" is the way
we "sound forth" (per-sonare) and in this way bear ourselves forth in
the world. Its medium is speech and action, words and deeds, voice
tones and body language. Character, on the other hand, is more a
matter of how we bear ourselves in silence - our inner bearing or
comportment. A restrictive inner bearing finds its reflection not only
in body language and physical posture but in "linguistic armouring".
Linguistic armour consists of automatic and stereotypical phrases
with which a listener interprets or represents to themselves what
they perceive in their listening. These may be part of the practition-
er's personal language and mental lexicon or constitute a language
internalised in the course of their professional training.
136
Heidegger and Hara
The Inner Bearing of the Analyst

The maieutic analyst is not neutral to the individual practitioner's
characteristic listening style, inner bearing or language - particular
where the latter reveals a restrictive listening vocabulary, agenda or
technique, or where linguistic armouring substitutes for an authentic
capacity for "being with". Nor does the maieutic analyst listen and
respond from an alternative "psychoanalytic" framework or lexicon.
The basic "position" or "posture" of the analyst is not an intellectual,
emotional or physical stance but a specific inner bearing - that of the
midwife who listens with her whole being and whose listening
sensitivity is rooted in the belly or hara. It is through the depth and
intensity of the analyst's own listening that a shift is gradually
induced in the "gravitational centre" or "assemblage point" of the
analysand's own listening, bringing them closer to their own listen-
ing self and helping them to bear and embody, and body forth this
self. This depends on the analyst's capacity to fully embody his or her
own listening self during the analytic session, thereby modelling and
acting as a midwife for the analysand's own listening self. The
profound benefit of maieutic analysis is that the analysand gradually
comes to sense the contrast between his or her own centre of gravity
as a listener and the inner bearing of maieusis. The latter is achieved
by the discipline of "with-holding" verbal responses, prompts and
questions (Verhaltenheit) in order to "with-bear" (mit-baren) what is in
gestation. This is far more than a mere therapeutic technique or style
based on "minimal response" and "acceptance of silence". What
counts is the quality of inner responsiveness, contact and communi-
cation achieved within that silence. Training in maieutic listening
and analysis involves highly focused phenomenological observation
and description of individual listening styles, as well as exercises and
meditations designed to generate an awareness of the rich dimen-
sions of silent communication. These provide the foundation for both
a deepened awareness of our own way of listening, and for the
cultivation of a new experience of listening as "belly talk" or hara..
A listener whose centre of gravity is neither the head nor the heart
but the belly or hara is one whose embodied presence expresses
meditative inner silence and stillness, whose listening communicates
groundedness and gravitas. This enables them to listen intensively,
intuitively and with a wordless inner knowing that is not confused
with concepts or named emotions, or with sophisticated psychobabble.
A listener with hara works on us silently with their whole being -
making us more patient in listening to ourselves before we speak,
helping us to hear our own words in a deeper way after they are
137
spoken. Their being there with us has a quality that helps us hearken
to our own being and heed its inner voice. This recalls the words of
Meister Eckhart, words which should be written large over any
training prospectus for psychotherapists:
Nothing will work of whatever works

they work who are not great in being.
Peter Wilberg is an independent thinker and writer providing

training and supervision in therapeutic listening under the aegis of
Third Ear Education. He can be contacted at: 44 Stanley Road,
Whitstable, Kent. CT5 4NQ
138
Book Reviews
BOOK REVIEWS
*The Truth about Freud's Technique. The Encounter with the

Real by M. Guy Thompson. New York: New York University
Press. 1994 289 pp.
M. Guy Thompson is an American psychologist who received his
analytic training at the Philadelphia Association in London and
whose central concern is the integration of phenomenology and
psychoanalysis. Your final assessment of his writings will depend on
whether you believe that such an integration is possible.
About ten years ago, the author wrote "The Death of Desire"
which defines "desire" - with Hegel - "in terms of the subject's
existential appeal for recognition, in terms of the lack at the heart of
man's being". Desire is no longer, as in Freud, a biologically rooted
need but the experience of the lack of affirmation, of estrangement. It
is a mistaken kind of therapy that tries to extinguish this desire, to
"kill" it rather than to help the client to see it and accept it as part of
the human condition. (This view is, of course, based on the ideas of
Jacques Lacan.)
It is easy to see the existential-phenomenological relevance of the
experience of an emptiness crying out to be filled, the experience of
the desire to be desired by the other. But Guy Thompson tells us also
that this experience goes back to the loss of mother's breast, a "lost
object" that cannot be restored. And at this point, a gap appears to
me between the experience of an aspect of existence as such, and an
explanatory hypothesis which is inexperienced. It reaffirms my sus-
picion that phenomenology and psychoanalysis cannot be integrated.
This problem also arises in the book under review. This book has a
more fundamental theme: it tries to show that Freud's technique was
basically "existential". As so often when writers use this word Guy
Thompson does not tell us what he really means by it. As so often the
word indicates more clearly what it does not mean - Freud's "tech-
nique" was not what his successor expected psychoanalytic tech-
nique to be: controlled, impersonal, bound by rules. Freud was not a
"Freudian" as the famous joke points out.
Guy Thomson does not tire of distinguishing Freud's clinical
approach from that of contemporary psychoanalytic schools. Freud
was intensity involved with his patients. He did not believe in seeing
his patients for longer than a year. He did not believe in the therapeu-
tic usefulness of regression. He was not concerned with counter-
transference. And above all: his technical papers were "recommen-
dations" (Ratschläge), not "rules".
139
In pointing this out, Guy Thompson does an important service to
Freud. He also shows up the dehumanization of psychoanalytic
practice. But does he show Freud to be a phenomenologist or existen-
tialist? Guy Thompson stresses that Freud saw the denial of reality as
the core of neurosis. The task of psychoanalysis then becomes the
attempt to help the patient towards an acceptance of reality. And in
Guy Thompson's view Freud equates reality with truth, psychoan-
alysis is concerned with the uncovering of truth, with un-conceal-
ment - like Heidegger.
"Unconcealment" is the literal translation of the Greek word for
truth ("aletheia"), and Heidegger was indeed concerned with it. What
human beings "conceal", in Heidegger's view, is "Being", not just
reality (which can be defined in many ways) but the inexorable
aspects of existence itself. The reader of Guy Thompson's argument
will have to decide whether the repression of unacceptable impulses
and the flight from "Being" are both "un-truth" in the same way. I
remain unconvinced.
Once again an incompatibility between a psychoanalytic and a
phenomenological approach seem to me to make itself felt. Freud's
assumption that unacceptable impulses are repressed into a special
psychic area called "The Unconscious" from which they can be
helped to emerge is an explanation which may be right or wrong but
is not as such experienceable. But when we talk of the denial of
aspects of existence, of turning our back, for instance, on mortality or
the inevitable insecurity of life or the unavoidable presence of other
people, we remain within the area of immediate experience. We are
talking about what is and how we respond to it. This does not mean
that we are always aware of our response, but awareness and una-
wareness lie on an experiential continuum.
In spite of these reservations I welcome a book which - at a time
when critical comments on Freud abound - tries to do justice to the
boldness and importance of his thinking. However, like Freud's
critics, Guy Thompson seems to me to be blind to the contradictions
at the core of Freud's theory. Freud certainly wished to present
psychoanalysis as a science, the psyche as an "apparatus" ruled by
laws comparable to those of Newtonian physics, moved by an energy
equivalent to physical energy. But Freud also had an utterly unscien-
tific concern for meaning and a deep feeling for the powerlessness of
technical" intervention in the face of the incurable limitations of
being human. Here is a conflict which Freud did not resolve, perhaps
not even realized, though he expressed at various place an impa-
tience with the inadequacy of his conceptualizations.
140
Book Reviews
To present Freud as an existentialist is, in the end, a deeply

unphenomenological move - for it leaves out too much of what we
meet when we read him. It is, I suggest, a selective interpretation. To
attempt to discover the "real" Freud - as already Lacan tried to do -
throws up the old question of our criteria for what is real and what is
not. It is Freud's conflict that is real, and it is, in my view, an aspect of
his greatness as a thinker.
Hans W. Cohn
* The Wing of Madness - The Life and Work of R. D. Laing by

Daniel Burston, Harvard University Press, (1996).
This biography is one of several books in preparation (or already
published) on R.D.Laing. Those by son, Adrian Laing, and Bob
Mullan, I have previously reviewed for this journal. When approach-
ing those previous reviews, as in this, I was particularly interested in
enquiry into and exploration of the professional legacy of Laing, as
well as any charting of the chronicle of his life which inevitably
makes for interesting reading. How much was the rise of Laing to
superstar (if not guru) status part of the counterculture of the 1960's?
What lasting contribution did he make to the study of human rela-
tions - be that in psychiatry or, indeed, in the practice of psycho-
therapy? And what were the philosophical and psychoanalytic
foundations to that contribution ?
An initial difficulty associate to any such endeavour is that Laing,
as Burston comments, is a formidable subject to biography. A man of
wide-ranging intelligence and seemingly endless contradictory quali-
ties who was perhaps at root torn between a craving for acclaim and
the humanistic values which he endorsed. Paradox personified. Fur-
ther complications for the biographer lie in the fact that mental health
professionals (like priests) are expected to live exemplary or at least
orderly lives. Laing's life story stands in complete opposition to this
and, indeed, his identity, Burston goes so far to suggest, could be
described as "oppositional": a sense of selfhood rooted in the defi-
ance of authority. For Laing's renowned capacity for empathy was
matched by his opposition to virtually any form of authority thus
inviting the strictures of psychopathology being applied to himself.
The effect, of course, was and is to spread doubt (and thence dis-
missal) to the validity of his ideas. Burston's thesis, however, is that
Laing's contribution to psychology and psychiatry is "possibly of the
same order of magnitude" as Freud and Jung, and that "in the
present climate of opinion, we must be very careful to assess his
personal virtues and his intellectual merits on separate scales of
141
value." The aim of this book, then, is "to illuminate those aspects of
Laing's life that have a direct bearing on the development of his
work, and, more important, to set his contribution to the human
sciences within the history of ideas." So, how far does Burston
succeed in these two respects ?
The book is structured into eleven chapters but is, in essence,
divided into two parts thus echoing the author's professed aim. The
first part, consisting of the first seven chapters takes us through the
various phases of Laing's life from childhood to his death in 1989.
Rather than simply chronicling Laing's life, the author does indeed
attempt to illuminate aspects of it that have, in his view, a direct
bearing on the development of his work. In chapter one, 'Begin-
nings', we are told the story of a bleak and lonely childhood which
the author suggests to be the springboard leading toward Laing's
"prodigious intellectual accomplishment" which brought for a while
fame and riches and a substitute for the "unconditional love" he
never had from parents. 'Schooling' includes Laing's early experi-
ence as a junior psychiatrist in mainstream psychiatry wherein he
discovered his ability to empathise with very distressed and psy-
chotic people. "Laing was anxious to discover how these miserable,
frightened, and deeply confused people experienced the world, and
how they would respond given the chance to communicate freely."
His primary intellectual commitment was moving in the direction of
existentialism and thence the writing of the manuscript form of The
Divided Self which led to his being invited to train as a psychoanalyst
at the Tavistock Clinic. The move to London and the Tavistock,
however, proved to be more than difficult for Laing both in his
professional and family life.
Laing's discordant and ambivalent relationship with psychoanaly-
sis is portrayed in The Tavistock and Family Research. What is also
revealed is how out of place Laing felt with the (less disturbed)
outpatients of the Tavistock Clinic. He was clearly out on a limb in
the world of psychoanalysis and only qualified as a psychoanalyst
after attempts by the training committee to effectively disqualify him
were contested by his supervisors Milner and Winnicott, and his
analyst Charles Rycroft. It is interesting to read of Rycroft's remark
in his letter to the training committee to the effect that there was
something in Laing's personality which polarized people's feelings
about him in a definitely positive or negative direction. Discord also
prevailed in Laing's marriage which was steadily deteriorating. The
time and energy he devoted to work with Aaron Esterson on Sanity,
142
Book Reviews
Madness and the Family (1964) caused even greater deterioration in his
marriage leading to its eventual collapse.
In and Out of Kingsley Hall and The Turn to Mysticism reveal that the
collapse of Laing's first marriage in 1965 came, interestingly, at the
same time as the foundation of the Philadelphia Association with,
amongst others, David Cooper and Aaron Esterson. Kingsley Hall,
the community alternative to mental hospital, was founded soon
afterward. During this time Laing is portrayed by the author as a
man hellbent on becoming a guru. His "stylizings became porten-
tous, often making it hard to discriminate between his genuine
thought and superficial mantras mouthed for the sake of being
trendy." The publication of The Politics of Experience (1967) with its
despair and vehement criticism of the family highlighted Laing's
ambivalence about the family and underscored "the richly ambigu-
ous nature of Laing's legacy..." He was to father a second family with
another partner, Jutta Werner, in 1967. They later married in 1974.
As the 1970's unfolded Burston considers that Laing encountered
a number of converging crises. The publication of Knots (1970) con-
veyed the impression that his anger and hopelessness had been
transformed into detachment and resignation. It didn't appear to
lead anywhere. And, indeed, after a period of sojourn in India and
Ceylon Laing and his new family returned to London with he trying
to transform his public image from psychotherapist /philosopher to
poet/philosopher. His writing no longer came easily. He became
involved with the practice of rebirthing and published The Facts of
Life (1976). Projects like a record album based on his book of Sonnets
(1979) and numerous musical recitals and poetry readings failed to
impress the public who continued to think of Laing as the "old"
Laing, or else not at all. Silence met his efforts.
The author portrays the 1980's as a decade of growing obscurity
for R.D.Laing. Continuing reliance on alcohol and drugs, fuelled by
wanting creativity and declining popularity, led to another marital
crisis, his leaving the Philadelphia Association, his name being with-
drawn from the register of practising physicians in Great Britain, and
his only work of note being his autobiography Wisdom, Madness and
Folly: The making of a Psychiatrist (1985), which was intended as the
first of two volumes. He died whilst playing tennis in St. Tropez in
1989.
In the second part of the book, being the latter four chapters, the
author sets about his aim of exploring Laing's "contribution to the
human sciences within the history of ideas". I was particularly inter-
ested in this part of the book given Laing's refusal to be directly
143
placed in relation to influence by any of the major existential philoso-
phers in his "conversations" with Bob Mullan in Mad to be Normal
(1995). Burston suggests that, in terms of conceptual underpinnings,
the mental health field can be divided into six basic models of human
nature. Though outlining the existential/phenomenological and psy-
choanalytic models as two of these, he leaves a fuller analysis of
Laing's relationship with them to chapters nine and ten- 'Philosophi-
cal Anthropology' and 'The Critique of Psychoanalysis'. In the former
I was not surprised when the author tells us that Laing never out-
lined an explicit philosophical anthropology and "most of his ideas
on the subject have to be inferred from his texts." It is noticeable,
however, that though the author suggests that "Heidegger's answer
to Husserl's phenomenology engendered the existential-phenom-
enological tradition that influenced Laing" he makes no direct refer-
ences to what Heidegger actually said (in Being and Time). And,
further, references to literature at the end of the book contain no
works by any major existentialist philosopher. John Heaton has
suggested in a previous issue of this journal, that Laing tried to bring
together two radically opposed ways of thinking about persons and
selves - firstly, the object relations theorists, like Winnicott, with a
psychological theory of the mind, and secondly, philosophical thought
about the self as represented by Kierkegaard and Heidegger which
involves thinking through the nature of persons and their relation-
ship to the mind. These two approaches have very different ramifica-
tions regarding the concept of self - be it reified, "true" or "false" self,
as portrayed by object relations theorists and Laing in The Divided
Self, or, a "relation which relates to itself" ie. no fixed core self, as
portrayed by Kierkegaard in The Sickness unto Death which Heaton
suggests Laing claimed to influence his thinking on the problems of
schizoid people. Burston does not reference this issue and believes
that Laing's work discloses a distinctive form of philosophical an-
thropology that merits attention and proceeds to outline such as a
concern for the situational and relational aspects of our being-in-the-
world, a dialectical approach to the concepts of selfhood and iden-
tity, the notion of authenticity, and his conception of a series of
"existential needs" (being a term borrowed from Erich Fromm).
I felt the author to be on more familiar and safer ground in "The
Critique of Psychoanalysis', being the chapter on Laing's ambivalent
relationship with psychoanalysis. References to literature at the end
of the book echo this with multiple references to the works of Freud
and Jung. Laing's criticism of psychoanalysis regarding the infer-
ences and assumptions made by analysis about patients' uncon-
144
Book Reviews
scious experience is set, however, against his belief that it was still
possible to allow for a phenomenological examination of uncon-
scious phantasy. The author suggests that "we are apt to forget that
Laing's rejection of the natural science approach to psychoanalysis,
which is now quite common, was considered radical in the early
1960's." Laing's influence, however, has been unacknowledged by
"humanistic or hermeneutically oriented psychoanalysis." My own
reading of mainstream and current journals of psychoanalysis and
psychoanalytical psychotherapy, however, does not concur with any
rejection of a natural scientific approach or the existence of Humanis-
tic or hermeneutically oriented" psychoanalysis. Cartesian thinking
and the subject/ object split remains a widespread influence or the
whole of psychoanalytic theory goes into collapse.
Laing's most important theoretical contributions, Burston believes,
lay in his interpretation of the meaning of the concept of "uncon-
scious fantasy" and the introduction of the idea of "transpersonal
defences". Rather than seeing unconscious fantasy as a device to
avoid the experience of something real, Laing insisted that fantasy
has its own validity and rationality and its true function is to express
the truth of lived experience in symbols and metaphors. His theory of
transpersonal defences demonstrates that many so-called defence
mechanisms are not situated inside the individual, but are distrib-
uted throughout the various groups and institutions of which we are
part. Transposing the ostensible meaning of symptoms from past to
present, from intrapsychic to the interpersonal sphere, and then
demonstrating the hidden but adaptive aspect of seemingly mala-
daptive behaviours was, according to the author, the "hallmark of
Laing's best case histories and clinical vignettes". In the light of this it
is interesting to speculate on how influential Laing's work may have
been with regard to the arrival of family therapy. The climate might
also have been set for the publication by the Tavistock of Isobel
Menzies' influential paper 'Social Systems as a Defence against Anxi-
ety' in 1970. I enjoyed reading this book which is close to being a
critical monograph. Despite my reservations regarding the author's
knowledge and interpretation of several important aspects of exis-
tential philosophy and theory, Daniel Burston has clearly attempted
and produced a scholarly piece of work. Pulling together the various
strands of Laing's multifarious works, not to say his life, must have
been a momentous task requiring much devotion ! I echo back to
Charles Rycroft's comment that there was something about Laing's
personality that polarized people's feelings about him in a definitely
positive or negative way and have to admit that during the course of
145
reading this book I found myself swinging back and forth in these
respects. On balance, however, I agree with the writer, who is per-
haps more positive than I towards Laing, that Laing's best work
during the 1960's is impressive and that his influence on psychiatry is
unquantifiable. Care in the community in the twentieth century
perhaps started with Kingsley Hall. It is sad, though, that he was
never able to build on these brilliant beginnings with a continuing
methodology leading towards a comprehensive "science of per-
sons". That legacy has been left to others who will write more
singularly in the existential/phenomenological tradition.
Nick Zinovieff
*Accepting Voices (The British Edition) by Prof. Marius Romme

and Sandra Escher (Eds), MIND Publications, London (1993)
258pp. £13.99
This is a book that clearly demonstrates that it is impossible to
prove that one particular theory is superior above all others, and yet,
when it comes to the subject of schizophrenia the dominant theory
tends to be the medical one where we find ourselves sucked into the
world of psychiatric psychosis. According to Marius Romme, him-
self a psychiatrist,' hearers of voices seldom find psychiatric frames
of reference sympathetic or faithful to their personal experience.
What is needed is the freest possible exchange of experience and
theory between professionals and hearers' (p.145). It would be nearer
the mark to say that this book gives both professionals and voice-
hearers a voice, each with something to offer. Marius Romme and
Sandra Escher set out to show how the gulf between the professional
and patient, theory and experience, objectivity and subjectivity can
be reduced or bridged.
Accepting Voices is based on eight years of original research that
really took off with the first ground breaking conference for people
who hear voices in Utrecht, Holland in 1987. This conference fol-
lowed two years of work by Romme, who contacted and set up
meetings with voice-hearers who could in one way or another cope
with their voices. Twenty of these voice-hearers became the speakers
at this conference which was the beginning of what is referred to in
this book as the Dutch experiment, which aims to help people who
hear voices by rescuing them from the impersonality of the illness
model.
The core and by far the most important part of the book are the
thirteen personal accounts and personal theories written by people
who have, in one way or another, come to terms with and accepted
146
Book Reviews
the voices they hear. These voice-hearers are divided into two groups,
the first seven contributors are all people who hear voices but have
never been near a psychiatrist or in psychiatric care. These are all
people who are socially active and have never seen themselves as ill.
They have instead adopted a spiritual, mystical or parapsychological
perspective. All have been able to make contact with people who
have understood and recognized their experiences, which enabled
them to avoid the dangers of isolation.
This section is followed by a chapter on non-psychiatric perspec-
tives which includes inner voice experiences, mystical, religious,
metaphysical, parapsychological and Karmic perspectives.
The other six contributors have all been in psychiatric care, all
have been diagnosed as schizophrenic and from a psychiatric point
of view would be regarded as very ill. These six have not only had to
overcome the stigma and taboo that isolates people who hear voices,
they also have to fight against the powerful psychiatric attitude, that
more often than not believes that the hearing of voices in itself is
proof that someone is suffering from a mental illness. All six have
found it essential to identify with their voices in order to understand
their meaning and to control them, in other words accepting their
voices as part of themselves and their lives is vital in that it also
enables them to overcome the social and relationship problems that
are associated with that experience.
These accounts are followed by a chapter on some of the different
psychiatric and psychological perspectives such as classical psychia-
try, Functional Analysis, Cognitive models, Carl Jung's Extrasensory
Perception, psychosis and many more.
The last section of the book is clearly written for people who hear
voices, particularly for those with a psychiatric diagnosis of schizo-
phrenia, so that the term 'cure' cannot be applied to these voices.
Once again this section is the outcome of a partnership between the
professional and the person who is trying to overcome the negative
effects that hearing voices can have.
The philosophy behind this new approach is very much in keeping
with the existential-phenomenological therapists attitude in that the
emphasis is on the partnership between the voice-hearers and profes-
sionals, where the professionals learn from and follow the 'patient',
and where ultimately the theory about the voices comes from the
person who is actually hearing the voices. In Marius Romme's and
Sandra Escher's own words, the goals they have set for themselves in
this book are: 1. To enable people who hear voices to relate their own
experiences to those of others. 2. To show that the real problem is not
147
so much the hearing of voices as the inability to cope with the
experience. 3. To demonstrate the wide variety of experiences and
their origins, and the different possible approaches to coping. 4. To
provide therapists and families with information that will help both
them and the voice-hearers themselves to cope more effectively with
the voices. One of the conclusions that the authors arrive at is that an
explanatory theory does appear to be essential to the development of
a coping strategy.
At the time I was given this book to read a close member of my
family was hearing voices. I had by then worked my way through
quite a few books on Schizophrenia, because those were the only
books I could find that dealt with the phenomena of hearing voices.
Most of the books were written by psychiatrists, psychotherapists
and psychologists, others were first hand accounts of those who were
personally involved with someone who suffered from schizophrenia
and how they managed on a day to day basis. One was called Coping
with Schizophrenia - A Survival Manual for Parents, Relatives, & Friends
by Mona Wasow (1982). In this book the author gives her heart
wrenching account of how her son gradually succumbed to chronic
schizophrenia. But as the title suggests, there was one person in the
book that had no voice at all and that was the unfortunate son
himself. It was as if he was a lost cause and confined to a completely
different world from the 'normal' family. The absence of the son's
side of the story made this book for me doubly depressing, so as far
as I was concerned I thought I had read my last book about people
who hear voices for a long time.
How wrong I was! As I opened the first page and started reading
the introduction of Accepting Voices I knew I was in for a refreshingly
different experience when I read: 'This book is primarily intended for
those of you who hear voices. Our main objective is to enable you to
relate to the experiences of other voice-hearers in a way that may
help you to manage and understand your own'. Marius Romme and
Sandra Escher certainly kept their word, I have at last found a book
that gives people who hear voices a voice.
Diana Mitchell
148
The Society for Existential Analysis
The aim 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 the
analysis of existence from philosophical and
psychological perspectives.
This issue focuses on current views and

developments in the Theory and Practice of
Existential Psychotherapy. Contributors include:
Ernesto Spinelli, Gion Condrau, Hans W. Cohn,
Alice Holzhey-Kunz.
ISSN 0958-0476

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JOURNAL OF THE SOCIETY FOR

Some Hurried Notes Expressing Outline Ideas That Someone

Martin Heidegger's Influence Upon British

Phenomenology and Psychotherapy

Time-Limited Existential Therapy - A Structural View

Existential Therapy on Heideggerian Principles

Martin Heidegger and Psychotherapy

Technical and Original Thinking in Psychotherapy

What defines the daseinsanalytic process?

Dream interpretation, the "royal road" to the dreamer's

An Existential Approach to HIV Related Psychotherapy

Heidegger and "Hara" - An Introduction to Maieutic Listening

Book Reviews .................................................................................... 139

The Conference was held jointly by the Society for Existential

We hope to include many of the remaining papers from the

such authors is cloaked in scientific medical terminology centred

feelings during such times have been distinctly different to those

They showed in the movie, in fact, a man in a convention who checked

biological dictates, but because it is who we say we are. And, in saying

Modern science generally does not ask what its philosophical

1. to lead to an adequate understanding of "Daseinsanalysis"

Thus, Heidegger never intended to create a new theory of neurotic

No sickness can be understood except from the perspective of

In considering the title of this paper it occurred to me that I could

gists and psychotherapists) who have extrapolated his ideas into

of Being inevitably led him to make pronouncements about the

1. Daseinsanalysis seeks to "re-humanise" those individuals who

2. More generally, Daseinsanalysis objects to the dominant view

3. In similar fashion, Daseinsanalysis insists that human beings

4. Daseinsanalysis highlights human beings' uniqueness from the

6. This recognition of "meeting", provides Daseinsanalysis with

Now, while I am aware that I have only touched upon - and in a

someone may become "more authentic" than he or she currently is.

propensity to tarnish and demolish laudable ideas and ideals by

perception of totality in which individuals are mere neutral parti-

It was Sigmund Freud himself who can be said to have introduced

we human beings find difficult to accept, what we turn our backs on

Freud, S. (1916/7) Introductory Lectures on Psychoanalysis. Standard Edition

Hans W. Cohn, PhD, is a psychotherapist working with

TIME-LIMITED EXISTENTIAL THERAPY - A STRUCTURAL

The modular approach

Elements of the brief existential approach

Ending as a therapeutical tool.

Structural view of Existentialism and Existential Therapy

Indeed Sartre also acknowledged that structure is the basis of

The mystery of the insight.

says: "All knowledge is a structure of abstractions, the ultimate test

Structure and the interconnections of all concepts

FREEDOM TO IDENTIFY ESTABLISHING

THE FOUR CREATIONS OF

The diagram represents a non-chronological and non-linear

interconnection of the concepts

Interconnections of all the concepts

Freddie Strasser, PhD, is a psychotherapist in private practice. He is par-

The Features of Existence

Appreciating what Heidegger says in these sentences is essential

SOME BASIC FEATURES OF EXISTENCE

To begin, it will be helpful to outline the basic features of existence.

The Interrogative Stance

What Is Existential Therapy?

the human kind of be-ing can be.10 Traditional psychotherapy begins

SOME PRESUPPOSITIONS OF EXISTENTIAL THERAPY

patient's lived time, which is to say, to his existence. He is then in a