Existential Counselling in Practice
by Emmy Van Deurzen
Sage Publications July 1988; ISBN: 0803981279

This book review is based on the Swedish edition "Det existensiella samtalet" (Natur och Kultur 1998).

A psychotherapy that is more based upon philosophical theory than psychological, a psychotherapy aiming to help people find their own answers to the eternal questions what it means to be a human being and what goal and meaning our travel has, this is what the British psychotherapist and philosopher Emmy van Deurzen describes in her book "Existential Counselling in Practice".

Existentially directed psychotherapy has a long tradition, much older than Freud and psychoanalysis. Rollo May and Viktor Frankl might be the most wellknown exponents, but many of the central thoughts can be derived from philosophers like Socrate, Søren Kierkegaard, Jean-Paul Sartre, and Martin Buber.

van Deurzen claims that there are a lot of people suffering from anxiety and seeking psychiatric or psychotherapeutic treatment without being helped. Treatment methods aiming to symptomatic relief, like medication, or behaviour adjustment, like cognitive therapy, do not provide the space for reflecting over the client's inner goals with her life. And methods aiming to elucidate unconscious conflict in the past, like psychodynamic therapy, give the client little or no insight in how to cope with her actual life situation, even less about how she can shape her future in concordance with her inner beliefs.

What is central in existential psychotherapy is the view of anxiety. Here, anxiety is not regarded a symptom of some disease, but something that is absolutely necessarily connected to human existence. Anxiety is viewed as an expression of the human being's obligation to choose her own way of existing. Not before the human being is prepared to meet her existential anxiety, she can make herself independent of false security.

The existential therapist, à la mode van Deurzen, does not offer very much support and empathy. She does not tell the client what is false or true, either. The relation between the therapist and the client is of minor importance - instead, the client's relation to herself is very important. The therapist takes a friendly curious and neutral position, and functions as a catalyst in the client's process. She does not give interpretations in order to make the client recognise, what she is not yet ready to understand, but waits until the moment, when the client makes her conclusions herself.

As van Deurzen describes her way of working, it reminds me strongly of some directions of systemic therapy. But with the difference, that here, the focus is upon the human beings coherence with herself and the ultimate meaning of life, instead of her coherence with her family, relatives, and culture.

The book is well written and can be a good model in avoiding difficult-to-understand jargon. The discussion is to and fro on a rather high level of abstraction, but many clinical examples provide that it is understandable.

It can be, that there is a need for a special existential psychotherapy, like what van Deurzen describes, besides psychodynamic, cognitive, and systemic therapy and all their derivations. But most of all I think it is important, that therapists regardless of theoretical stance learn to identify and discuss their clients' existential problems on a philosophical level instead of psychologising, medicalising or pedagogising them. "Existential Counselling in Practice" can be recommended as obligatory course literature in basic educations of psychotherapy, regardless of direction.

But "Existential Counselling in Practice" is not just a professional textbook. By elevating the specific in the clinical examples up to a universal human level, the book can be an interesting reading for everyone, who is reflecting over the meaning of life. Especially, it can be recommended to people who are clients in psychotherapy or consider entering psychotherapy.



©Gustaf Berglund