Post-existentialism instead of CBT.
Abstract: The purpose of this paper is to describe a place for exploring notions of well-being at the start of the 21st Century that is in contrast to the increasing cultural dominance of Cognitive Behavioural Therapy (CBT). An attempt is made to offer such an alternative place where we might still be able to think about how alienated we are through valuing existential notions such as experience and meaning whilst questioning such other aspects as existentialism's inferred narcissism and the place it has come to take up with regards to such aspects as psychoanalysis and the political.

The article describes an approach that is being developed, in part as a reaction to CBT, where existentialism and phenomenology are critically revisited and, as a result, post-existentialism is offered in terms of its implications for practice. It is argued that post-existentialism has significant implications for our cultural practices in general, including the current interest in 'wellbeing', enabling the psychological therapies to have a quite different emphasis to that provided by CBT.

It is considered by many that the German philosopher Heidegger (1962), is one of--if not the--foremost writer on the subject of being. Heidegger is associated with existentialism and in many ways, post-existentialism implies a combination of both Heideggerian and some post-Heideggerian approaches. One aspect important to post existentialism is that we start with considering such notions of being and not attempt to add them on afterwards to a technique that is based on more rational assumptions as to what it means to be human as some more recent CBT theorists have done. This article is part of work-in-progress at the Centre for Therapeutic Education at Roehampton University, London where we are re-looking at existentialism in a post-Heideggerian era, with particular reference to the psychological therapeutic practices of counselling and psychotherapy (see for example, forthcoming special issue of the Journal of Philosophical Practice--Loewenthal, forthcoming 2008).
Article Type: Report
Subject: Cognitive therapy (Research)
Existential psychology (Research)
Philosophy of mind (Research)
Author: Loewenthal, Del
Pub Date: 07/01/2010
Publication: Name: Existential Analysis Publisher: Society for Existential Analysis Audience: Academic Format: Magazine/Journal Subject: Psychology and mental health Copyright: COPYRIGHT 2010 Society for Existential Analysis ISSN: 1752-5616
Issue: Date: July, 2010 Source Volume: 21 Source Issue: 2
Topic: Event Code: 310 Science & research Canadian Subject Form: Cognitive-behavioural therapy
Geographic: Geographic Scope: United Kingdom Geographic Code: 4EUUK United Kingdom
Accession Number: 288874204
Full Text: The changing nature of Escapism

In keeping with the post-existential including something of the phenomenological, I would like to start by describing an experience I had whilst preparing this article. At the time I was visiting a Canadian University and on my first evening after returning to my hotel I switched on the TV. The first programme focussed on a section of road where, one by one people, in cars picked up other people who they made carry out various sexual acts that one did not see in close-up, but one did later see, in detail, these victims being horrendously beaten-up. I changed channels and it was an evangelical preacher entrancing his audience. The next time I watched TV, it was a programme advertising sleeping tablets that showed beautiful people waking up in beautiful houses to the background of sweet music and the enticing voiceover saying "this could be addictive"! As someone who watches very little TV I still feel traumatised by the first programme. I am not suggesting that this is only a North American problem: on returning to London I went into a pub where there were at least two TV programmes and two different sound systems on concurrently. I assume this entertainment is provided in order help the clients be anaesthetised in the name of relaxation--is it that the dose of these different stimuli (as with the evangelical preacher, medication and simultaneous entertainments) are having to be continually increased in order for people not to think? Is CBT, when it becomes the main State approved approach to our wellbeing, a logical development of this need to take our mind off those thoughts coming to us that are individually and culturally too much?

In a previous era, many spoke of alienation and existentialists spoke of self-estrangement: Heidegger (1962) for example with 'the crowd', Sartre (1943) in terms of 'bad faith'. However, it would appear, as in the Canadian example above, that new ways of dealing with our increasing alienation have been established which include no longer naming it as such. Thus, such ways of reduced awareness--what I have termed 'escape motivation' (whether it be of death, nothingness, oneself, others or the world)--and which organisations including the state can use to manipulate us (Loewenthal, 2002), are no longer in our everyday vocabulary. Perversely, it is as if the better the escape the better our so called 'well-being'. For example, it is as if the more CBT and its equivalents can help take our minds off our problems the better we will be. CBT may well be individually helpful but when adopted as the main mode of 'treatment' by a society then individually and collectively the implications are we cannot allow thoughts to come to us and we will not therefore be able to come to our senses, with catastrophic consequences. There would be, for example, no point in worrying about our and other's responsibilities for how we are, in deed such concepts as alienation are in an age of happiness (Layard, 2006; Seligman 2002) not only unnecessary but counterproductive!

Developments in the United Kingdom

In the UK, the so-called 'British school of existentialism' (Van Deurzen, 1997; 2005, Spinelli 1989, 2007), which has done so much to put existentialism on our map, initially appears to have favoured Boss over Binswanger (Cooper, 2003) as they were influenced by Heidegger working with Boss, whereas Binswanger had said that he had misunderstood Heidegger although the misunderstanding was a fruitful one. However, what then seems to have developed is a reaction to the psychoanalytic influences on Boss. Whilst the post-existential would not want to get caught up in Freud's particularly later, universalising, meaning-making schemas, it would also not wish to ignore the writings of psychoanalysis, in that for example, our past can unknowingly influence the present and that we will always be subject to something 'lifegiving' in ourselves that we are not in control of. It is therefore considered not helpful to attempt to deny this in therapy.

In some ways the work of R.D. Laing (1967, 1969, 1990) would come close to one attempt to keep open (with failings) what is being termed here a post-existential approach. There are those at the Philadelphia Association, which he founded, who continue this tradition (Cooper, 1990, Gordon and Mayo, 2004) registering their students as psychoanalytical psychotherapists. Here, psychoanalysis is considered together with philosophy. The Roehampton programme, with which the term 'post existential' is primarily associated (Loewenthal, 2007), is also influenced by Laing and the Philadelphia Association, (I am a member and trained there). However there are significant differences in that for example at Roehampton phenomenology is initially explored with an emphasis on practice through Rogers and then existentialism, followed by a phenomenological reading of Freud, then what happened to phenomenology is followed through those who might be labelled 'post--modern' such as Lacan, Derrida, Levinas and the French feminists before examining the implications of all this for carrying out 'relational research'. Previous descriptions of this have been given in terms of theory (Loewenthal and Snell, 2003), research (Loewenthal, 2007) and training (Loewenthal and Snell, 2008). At Roehampton with post existentialism and its post-phenomenology as the particular focus the psychotherapy students are registered as integrative and the counselling psychology students take relational approaches as their major model and contrast this with Cognitive Behavioural Therapy (CBT). Thus besides its relationship with psychoanalysis, our post existential training may have a greater emphasis on starting with the experiential and exploring what is meant by research than most of the UK trainings in existentialism. There also might be less enthusiasm, to what appears to be developing in some quarters, to incorporate the existential with the cognitive and, even then, only if the cognitive influences are developed from a post-existential basis and not the other way around.

Research and the post-existential

Does this need to increasingly escape from what Aristotle called the 'what is' also apply to what we regard as research? Positive psychology together with positivism and, as already has been mentioned, such techniques as Cognitive Behavioural Therapy are increasingly dominating our culture. Indeed, are such rarely questioned contemporary approaches as evidence-based practice the only way we can think about things so that we can not allow thoughts to come to us? It seems that if those supporting a particular therapeutic approach can afford randomised control trials, it cannot then be said that this therapeutic approach is better that another (Seligman, 1995) and the research methods currently in fashion seem not to be able to allow for all the significant variables, such as the characteristics of the therapists let alone their supervisors. Also, what is presented is so often not scientific, for example, Rogerians suddenly have treatment goals (Elliott, 2002) and Freud is also being manualised (for example, Allen and Fonagy 2006), in the hope this will ensure public funding. As a researcher said to me when I questioned what the evidence-based research she had successfully carried out for her modality had to do with truth and justice, 'not a lot about truth but it is justice as my approach has been accepted'. Of course selective watering down is in some ways not new, not only can it be seen to have happened to Freud and Rogers but also to the founding fathers of psychology such as Wilhelm Wundt and William James. Indeed, those such as Wundt (1904) insisted that psychology should be not only about the experimental (of which he is regarded as the founder) as this must always be accompanied by the historical and cultural (a point which will be developed later with regard to Foucault). Instead, what has happened is the measuring tool now determines the therapy, even though Physis or Phusis is what comes from itself, yet it seems increasingly too difficult for most people to be able to hear what is coming from themselves or another. It is as if we are now so alienated, that we are unable to explore our alienation.

Practice, Post-existential and the training of counsellors, psychotherapists and psychologists (psychological therapists)

What has just been discussed in terms of, for example, science has particular implications for the development of practitioners. Whilst existentialism can be seen as healing various dualisms, for example, subject vs. object, mind vs. body, reason vs. passion, fact vs. value (Cooper, 1990), neither existentialism nor post-existentialism can dissolve the scientific/technical with the soul and it is vital that the soul comes first. There are of course many ways of developing post-existential practitioners but such programmes may, in their different ways, need to start with, again in different ways, what is increasingly being termed, 'a relational' and find a way of considering science not as technique or positivism, but including the experimental with the cultural and social, yet recognising that the soul can never be incorporated by even this.

Post-existential approaches are likely to attempt to start with practice and explore what it might mean to be human whilst accepting that we will never fully understand, at times considering, for example, Merleau-Ponty (1962) who suggests, mystery (not to be confused with mystification) sometimes defines the very thing itself and to attempt to take away from it means we lose what is, and Levinas' concern of the potential violence through attempting to know. Thus, theories including the psychoanalytic and the post modern can then come to mind on a case by case basis as implication but not application. There is therefore an important distinction here therefore with the work of those such as Askay and Farquhar (2006) who, in contrast to the post-existential, first take psychoanalysis and then examine the existential phenomenological.

Questions of Definition

One way of looking at the Greek roots of existentialism is that it is about something that is both astonishing and ever changing (Heaton, 1990), yet has existentialism got stuck in nostalgia of the 1950's and 1960's and is therefore no longer forever changing. What then would we need to re-look at? There is also the very question of definition in a post post-modern era. By locating post-existentialism with both some aspects of existentialism and some of post-modernism, this raises the question as to the appropriateness of universalising definitions. Rather, the attempt here is to locate an approach that is broadly defined and forever open to new possibilities (but not all possibilities). In fact, existentialism was never clearly defined. It appears to be a term used by the French philosopher Marcel to describe the work of those such as Sartre (1943) and De Beauvoir (1972), even though they initially disagreed with being labelled in this way. Heidegger is thought of as probably the most important thinker on existentialism, particularly for psychotherapy. Both Heidegger (1962) and, before him, Kierkegaard (1941, 1980) saw our being as always in the process of becoming, and as such it fundamentally questioned technical categorisation. (Besides Heidegger and Kierkegaard, Nietzsche (1883; 1974) can also be seen as an important influence in the development of existentialism). In some ways the method of existentialism might be seen as phenomenology, but again, there has never been agreement of its definition. Husserl's (1983) idea of 'to the things themselves' is grounded in the notion of intentionality, which others such as Sartre were not at one with. It was however Foucault (1974) who whilst being initially a strong adherent, criticised phenomenology in the light of developments in structural linguistics. But would it not be possible to take, for example, Merleau-Ponty's notion of phenomenology being to do with what emerges in the between and at times also then, consider the implications of Saussure and others for helping us make sense of our being-in-the-world? In fact, it may be even more important to consider what is being suggested in this article as not only being post-existential, but in particular post-phenomenological.

What we will then have for post-existentialism, is some of existentialism in terms of experience and meaning together with something from post-phenomenology of what emerges in the between, whilst at the same time allowing to come to mind the developments that have been termed postmodern without getting stuck in them.

Further differences of Post-existentialism from existentialism and post-modernism

Post-existential would challenge existentialism, particularly in terms of questions of choice, politics, psychoanalysis and feminism. Sartre's 'I am my choices' has been taken by many to be about the development of autonomy, for some to the extent that one could almost decide what one wanted to be. The post-existential might be more about finding ourselves taking a certain place where we will have some agency but never full agency: we will always be subject to. What we might be subject to can be explored in various ways, for example, heteronomy and ethics (Levinas), an unconscious (Freud), writing and difference (Derrida), language (Lacan). From a post-existential perspective we might look at the implications of an aspect of one of these authors for our practice without being fully caught up by a Levinasian, Freudian, Lacanian or Derridean mode of thought (see Loewenthal, 2006). Indeed, Derrida (1990) acknowledged this in showing us how we are always caught up in a way of looking. So we would end up being destructured but not to the extent that this makes communication impossible and destabilisation too much to take. In some ways it would appear that post-modern ideas on their own have also become too much for people to take and what we seem to have done is to culturally return to the straightjacket of the positivistic. The post-existential might therefore be seen to lie somewhere between the existential and the post post-modern.

Other important difference between post-existentialism and existentialism would include greater political awareness (in some ways it seems too easy for existentialists to be fascists or royalists and for psychotherapists to say that they are not interested in the political). Feminism, as developed by those such as Cixous (1975), Irigaray (1977; 1990) and Kristeva (1986) can provide important insights for the post-existential, though some understanding of Lacan would be necessary to reach these important cultural developments

Approaching, post-phenomenologically, the individual with the historical/ cultural

Foucault became interested in power and knowledge and the political status of psychiatry as science. Questioning, through post-existentialism issues such as well-being, power and knowledge and the political nature of psychology as science would be, in some ways, similar to how Foucault and some existentialists questioned the political status of psychiatry as science. In this, at least a primacy would be given to first thinking of what is termed 'mental illness' as not like a physical illness but more to do with relations with others. Yet there would be vitally important distinctions.

Foucault's (1974) abandonment of his early interest in phenomenology was, as Hoeller (1986) points out, because he took Husserl's notion of transcendental phenomenology which does not really allow for the historical and cultural. Yet Heidegger with his dasein as being in the historical/cultural world with others, enables phenomenology to be released from Husserl's attempts to show a pure subjectivity and thus 'a universal doctrine of the structures of individual subjectivity and intersubjectivity' (Hoeller, 1986: 7). Binswanger, Boss and Laing further developed this opening up of phenomenology for psychotherapy.

Thus if we could perhaps both be attentive to what emerges in the between of client and therapist and be aware of what is regarded culturally and historically as common sense we could have an interest in how both our clients and those around them have brought and bring pressures on each other. This meeting which could include the implications for the present of the client's history and the history of the culture, without being caught up in a potentially totalising Foucauldian genealogical approach would be an example of post- phenomenology and might also be closer to what those such as Wilhelm Wundt saw as psychology.

Conclusion

So post-existentialism can be seen on the one hand to be attempting to find a place between existentialism and post, post-modernism. Enabling us to take from the existential and the post-modern that which can be helpful to us in exploring our existence at the start of the 21st century? Another dimension of post-existentialism is to find a place between natural and social science though by starting with notions of existence is to imply starting with the human soul (Plato, in Cushman 2001) and the historical and cultural aspects of social (rather than starting with the natural) science. With this emerges the possibilities of a political viewpoint which, unlike CBT, could engage with various notions of democracy as well as an unconscious--coming more from those such as Kierkegaard (1941, 1980) and Nietzsche (1883, 1974).

I would however again, in developing post-existentialism in part as a reaction to CBT, like to emphasize that I am not doubting the integrity of people who are cognitive behavioural therapists and that some clients will benefit more from CBT; furthermore that in terms of conventional costings it can be more cost effective. There is however the danger of any approach, including post-existentialism, being a totalising move and whilst there has been the dangers of this previously with both psychoanalysis and humanism, CBT (despite the unheard protestations of some of its adherents) appears particularly susceptible to being used in this way.

I have previously attempted to explore some of these dimensions: initially through how individuals and structures in society conspire to produce a form of alienating escape motivation (Loewenthal, 2002). More recently I have been interested in exploring how post-modernism has emerged from phenomenology (Loewenthal and Snell, 2003) with particular reference to Levinas as a post-existential philosopher (Loewenthal, 2007). There are, of course, others who are developing interesting ideas that have some similarities. For example, there are those who are considering some of Wittgenstein's ideas to question the very nature of how we use theory (Heaton, 2000); whilst, with regard to research, Heideggerian ideas are becoming increasingly in evidence--for example Polkinghorne (2000); Rennie (2007). Certainly, what these approaches do have in common is a concern with the humanness of the human which is different to a managerialism based on very narrow notions of so-called evidence with which CBT has come to fit so well. The danger is that rather than being useful for the specific we are making CBT culturally dominant in a way that we can no longer recognise ourselves and are too frightened at any possibility of doing so.

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Professor Del Loewenthal has a private practice in Wimbledon and Brighton. His latest book Post-existentialism for Psychological Therapists is to be published by Karnac later this year.

Address: Prof. Del Loewenthal, Convener, Doctoral Programmes in Psychotherapy, Counselling and Counselling Psychology, Research Centre for Therapeutic Education, Department of Psychology, Roehampton University, Whitelands College, Holybourne Avenue, London, SW15 4JD.

Email: d.loewenthal@roehampton.ac.uk
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