Existential therapy explores the darkest corners
and craggy edges of the many-sided self. The result is true transformation
Over the past 60 years, I’ve had the privilege to witness many poignant
transformations. As a practising psychologist, I’ve witnessed them in state
hospitals, in psychiatric emergency clinics, in drug and alcohol agencies, and
in private practice; and as a youth I experienced them in my own intensive
psychotherapies. There is little ‘pretty’ about these ordeals, but when they
succeed they are profoundly gratifying: life-changing.
Poignant
transformations emerge from the depths of despair, but they result, if one is
fortunate, in the heights of renewal. Certainly this was true for me, and many
of the people I’ve known or worked with. What could be more precious than the
gift of liberation from crippling despair, of being freed to pursue what deeply
matters? What could be more critical than participating in – really grappling
with – the rescue of one’s soul?
Yet what I’m seeing
today throughout our culture is an increasing tendency to skip over this
grappling part of the equation and to shift abruptly to the transformational
part. Not that there’s anything untoward about desiring to be rapidly
transformed, it’s perfectly natural. When one is in distress, one seeks an
instant remedy. I do that, my friends do that, and it’s a good bet that you do
that also; it’s instinct. However, there are solid reasons to question instinct
at times. For example, most people don’t punch someone just because they feel
slighted. Similarly, most people don’t just blurt out whatever they feel just
because they feel it. To the contrary, there is much to consider from the
people you might hurt, to your conscience, to the setting and circumstances of
the event. I’ve seen many clients who initially want to assault someone who
assaulted them; however, they rarely do. This is because through the course of
therapy, these clients recognise that their assailant is often someone they can
relate to – or perhaps even love – and they don’t, in the end, want their
fellow human being to suffer as they themselves have suffered. There are many
times when delay is much preferred to reacting, especially when it comes to
emotions.
Emotions are
wonderful signals – they alert us to danger and they mobilise us when action is
called for. But they are also highly complex, variegated. For example, many
people feel contemptible or unwanted at times, yet they don’t resort to suicide
or drugs. They see that, despite their dark mood, they have a right to live and
grow, just as others live and grow, and that they can become something more
than the stereotyped messages about themselves, such as that of being a
failure. These are messages, by the way, that too often come from others who
themselves feel contemptible and unwanted and who project those devaluations
onto their unwitting victims. But such realisations, particularly if they are
to endure, often take time, they take struggle, and they take encounters with
larger parts of ourselves that go beyond our internalised oppression to a kind
of conciliation. In the end, depth and existential therapy promote a hard-won
coexistence between rivalling parts of ourselves, parts that sometimes agonise
yet in the long run shed light on the experience of being fully human: of being
deeply and richly alive. Put more formally, existential therapy emphasises
three major themes: freedom to explore what deeply matters to
oneself; experiential or whole-bodied reflection on
what deeply matters; and responsibility or
the ability to respond to, act on, and apply what deeply matters.
Yet today it is all
too easy to bypass such freedom, experiential reflection, and response-ability
– such grappling with who we are and who we are willing to be. For today we are
seduced by an avalanche of devices, formulations and machine-meditated
transactions making it all too tempting to let others, including mechanical
others, do the job. Whether it is psychiatric medication, psychotherapy apps,
12-session clinic appointments or the distraction of net-surfing, there are
innumerable ways to surmise that our pain has been dissolved, that we have been
transformed, and that life proceeds apace.
But the looming and
overarching question is: at what cost? At what cost is an externally or even
cerebrally normalised life, a life of routine and regulation, elevated over a
life that flops and flutters but also throbs? At what price is a life that
sails over the many-sided intricacies of emotion and the ripples of discontent?
Too often the price is death, both literal and figurative, and the statistics
bear that out. Consider rising rates of depression and addiction, and the sense
of isolation often linked to smartphones.
My earliest memory is
a gauzy image of my parents weeping on the living room couch. That was when I
was two and a half years old, and my seven-year-old brother Kelly had just
passed away. It was 1959, and the combination of chicken pox and pneumonia
proved too much for an otherwise radiant and vigorous child. The explosion of
this event in the collective psyche of our family cannot be lucidly grasped.
The most I can say is that the parents I knew before the event were dimly recognisable
in its crushing aftermath. The warm and playful sibling I knew – the smiling
leader – was vanquished, and in his place yawned an unrelenting void, a pit of
rage, sorrow and terror.
By three years old, I
was imploding. My defences were all but expired. I had night terrors and I had
tantrums. I was panicked and I was lost – floundering, tailspinning into a
helpless and paranoid world.
Given that ordeal,
I’m fairly certain that if I had the same experience today that I’d had in
1959, I would be hastily pacified by drugs. Instead, my parents sat with me
back then. They did all they could to talk me through my battles and,
eventually, at age five, they referred me to a psychoanalyst. This
psychoanalyst helped to turn my life around; for although I continued to have
profound fears and outbursts, he helped me to work through rather than mask
over these potentially restorative maladies. Greatest of all, he was a
rock-solid presence who enabled me to say or feel anything. I was hanging on by
a thread, but he remained a pillar, steadfast and supportive, until I passed
through the storm.
Yet today, how many
children are encouraged to work through their torment – or even to supplement
their medication with an emotionally supportive encounter? How many are granted
the time and money to do so? Few, I would venture. But what most are encouraged
to do is to ingest antidepressants, anti-anxiety meds and a variety of
mood-stabilisers. While these remedies can at times be lifesaving, too often
they are pushed by pharmaceutical companies and insurers more concerned with
profit margins than the enduring care of people and people’s own resources to
live the life they seek.
I wonder how I would
have turned out if I had been treated by today’s standard. I wonder if I would
have experienced the rigours of being alone, or being challenged, as I was by
my analyst, to develop inner resources such as my creativity, curiosity and
imagination. He encouraged me to reflect on the bases for my fears and to move
at my own pace. He respected me and my capacities, which in turn spurred me to
create drawings, stories and thoughts about life’s puzzlements; or to venture
out into uncertain terrains, relationships and ideas, which I eventually did
after much tussling and even further therapy.
The chief problem
with many contemporary interventions is that they are one-dimensional. For
example, psychotropic medications aim at making people feel calmer if they’re
anxious, or more energised if they’re depressed. Cognitive therapies aspire to
change so-called irrational thoughts (such as fear of flying or a sense of
worthlessness) into rational, evidence-based thoughts. Behavioural therapies
aim at reinforcing adaptive habits to replace maladaptive habits, and so on.
However, the problem with these strategies is that they work on a limited
basis. If one wishes to live more efficiently along clear and culturally
approved lines, then one is notably helped by such techniques. If one wishes to
live a comparatively regimented and low-risk life, these remedies are
appropriate. However, if one is among the sizeable and perhaps growing
population that seeks more dimensionality in life – more meaning, more
vitality, more personal and interpersonal richness – then something more
challenging might be called for.
After a lifetime of
research, the existential psychologist Rollo May concluded that many of the
most vital and creative people through history were strongest at precisely
their most vulnerable points. In The Psychology of Existence (1995),
a book I co-wrote with May, he included a chapter called ‘The Wounded Healer’,
about what makes a good therapist. There, May gave the example of the renowned
psychologist Abraham Maslow who was lonely and unhappy as a child but who
formulated theories about optimal living and peak experiences. May went on to
describe a host of well-known and lesser-known people who faced and integrated
the sides of themselves they feared and, through that process, fostered
creative and productive lives.
May’s thesis is
backed by a host of distinguished investigators, including Carl Jung, Silvano
Arieti, Frank Barron, and Maslow himself, who described the self-actualiser –
the optimal personality fulfilling his potential and life’s true dreams. ‘One
observation that I made has puzzled me for many years but it begins to fall
into place now,’ Maslow wrote in Toward a Psychology of Being (1962).
‘It was what I described as the resolution of dichotomies in self-actualising
people … These most mature of all people were also strongly childlike. These
same people, the strongest egos ever described and the most definitely
individual, were also precisely the ones who could be the most easily egoless,
self-transcending, and problem-centred.’
The clinical
psychologist and researcher Kay Jamison – the author of seminal studies on
bipolar disorder and the book Touched With Fire: Manic-Depressive
Illness and the Artistic Temperament (1993) – agrees. Bipolar herself,
Jamison described dozens of artistic luminaries throughout history who appeared
to fall on the bipolar spectrum, yet went on to forge exemplary contributions
to society.
Now, granted, many of
these luminaries lived very trying lives, and some even committed suicide, but
many also had rich and invigorating lives with deeply gratifying results. Hence
one of the chief questions for our age is what happens if we remove such life
struggles, if we flatten the biology, if we remove the rough edges through
technology and drugs? What happens if we bypass the need for people to confront
their demons, their discomforts and their tears? Would the artistic creation
that results be the emotional equivalent of one that was inspired by the
pathos, perplexity and toil of the human artist?
The most popular
treatments today, such as medication and cognitive behavioural therapy (CBT),
are often short-term and have a mixed record with regard to effectiveness. The
emerging view is that they are helpful for relief of symptoms such as negative
thoughts, poor appetite and phobias, but questionable when it comes to complex
life issues, such as the search for meaning and purpose, and the struggle with
love.
Is the experience
of a therapist or device enacting an empathic response the same as actually
empathising?
Other new remedies
include the development of virtual reality (VR) exposure-based therapy for post-traumatic stress disorder,
the use of neurofeedback from fMRI data to guide therapeutic practice, and apps
for everything from anxiety, to depression, to irritable bowel syndrome. The
research on these devices is still very much evolving, but I have the creeping
feeling that we are entering a brave new age where statistical and mechanical
manipulation is replacing personal discovery and risk.
Is the virtual
encounter with one’s anxiety – or desire, for that matter – the same as the
actual encounter? Is an app the same as a human healer (let alone a wounded
healer)? Is the experience of one’s therapist or device enacting an empathic response
the same as him or her actually empathising? Is this performance of a
relationship, based on manuals and statistics, the same as a personal evolving
relationship, with all its angst and vulnerabilities, its challenges and
surprises?
I doubt it, and
mounting studies uphold the value of
person-to-person, genuine therapeutic relationships as well. Now, there can be
much value to short-term ‘mechanised’ relationships. They can reach people
where few human professionals live, or they can help anyone with disability who
has difficulty travelling, or they can relate to young people schooled on
hand-held devices. But are they the ‘be all and end all’ that so many in our
society are embracing?
It seems to me that
we are moving headlong into the engineering quagmire that so many humanistic
therapists have feared. This is an approach where the emphasis is on the
device, technique or algorithm and not on the patient’s inbred capacities for
revitalisation. It is a model that stresses standards of normalcy, regulation
and calmness that are imposed from without as distinct from within the
subjective and interactive energies of persons. Finally, it is a model that can
rob many of us of the virtues – not just the anguish – of our many-sidedness.
Here is a list of
sensibilities that I probably would have been ‘spared’ had I been drugged and
plugged into devices as a child:
- the
trial of being alone;
- the
angst of great sorrow;
- the
inertia of great despair;
- the
shudder of great fear;
- the
terror of fragility;
- the
distress of uncertainty;
- the
bitterness of rage;
- the
panic of feeling lost.
But here now is a
list of sensibilities that I likely would not have developed had I been
‘drugged’ and ‘plugged’:
- the
creativity of being alone;
- the
sensitivity of experiencing sorrow;
- the
mobilisation spurred by despair;
- the
defiance sparked by fear;
- the
humility generated by fragility;
- the
possibilities opened by uncertainty;
- the
strength aroused by rage;
- the
curiosities prompted by disarray;
- the
self-exploration, depth therapy and enquiry inspired by my entire ordeal.
It seems to me that
one overarching property distinguishes human from mechanical existence. It is
not consciousness, because artificial intelligence is already showing that
mechanical entities can achieve a kind of signal detection that simulates
awareness – consider robots that register temperature changes in the
environment. It is not reflexive consciousness, which is the ability of
consciousness to have some level of awareness of itself, because scientists are
already working on machines that can readjust their calculations based on
incoming data; and it is not even the capacity to experience emotions, because
there are neural chips in development that will someday be able to replicate
the biochemical processes that comprise, say, sadness or elation. (In crude
form, this is possible today with psychotropic drugs.)
By contrast, the
biggest if not insurmountable hurdle for artificial intelligence is a much more
complicated problem – it is the experience of life’s paradoxes. As with the
testimony of my childhood ordeal, it is the experience not of a single image,
thought or emotion, but of the sublimely interwoven image, thought and emotion;
each of which can both dovetail and clash with one another.
Such paradoxes
include the sliver of fear in a loving relationship, or the hint of sorrow in a
moment of glee, or the taste of envy in the most admiring friendships; and it
is many more delicately nuanced combinations that lend life its zest, its
pathos and its intensity: its awe.
Consider how each of
these so-called negative emotions echo awesome ranges of awareness:
Sadness comprises
sorrow and despondency, the profound sense of bereavement and loss. But
post-traumatic growth studies also indicate that sadness alerts us
to the fleeting nature of life, the preciousness of the moment, and the need to
have empathy for others’ woes. Conversely, it serves as a point of comparison
with – and therefore can help to intensify – contrasting feelings such as
unbarred joy, elation and delight. Finally, sadness can ‘go through the centre’
of ourselves, as Rainer Maria Rilke put it in Letters to a Young Poet (1929);
it can bring something new, something life-altering. ‘Were it possible for us
to see further than our knowledge reaches,’ he wrote, ‘perhaps we would endure
our sadnesses with greater confidence than our joys. For they are the moments
when something new has entered us, something unknown.’
Without anger,
tenderness might be thin, the poignancy of kindness unnoticed
While fear diminishes
and confines us, it also highlights that which towers over us. Certainly, fear
can humiliate, but research suggests that it can also sober us
about what can and cannot be achieved. Fear acts as a backdrop for courage.
For, without fear, courage would mean little, and likely impact little in the
course of our lives. Would we even seek to be courageous if we had no fear?
Would we seek new fields and fresh thoughts, sensations or innovations without
encountering some degree of fear? These questions are rarely asked by
enthusiasts of so-called transhuman technologies.
Anger arouses danger,
explosiveness and domination. It is a fiery blast, and an expansion that
threatens decimation of others. But informed studies also
show that anger is a way of standing up for oneself as in righteous
indignation; it is an impetus to courage and rejuvenation of spirit.
Invigorating revolutions have upwelled from anger, and so have personal
liberations. Without anger, tenderness might be thin, the poignancy of kindness
unnoticed.
Coveting the
qualities of another is the seedling of envy; obsessing over and
fantasising about possessing those qualities is how envy blossoms. Envy arouses
desperation to be something other than what one is; it is a maddening torment.
But my experience as a therapist, and as a client too, has shown me that envy
is also an aspiration, a prospect and a potentially life-changing breakthrough.
We see the glimmers of our desires in those we envy, and thereby have some
capacity to nurture those desires in ourselves. Envy contrasts with contentment
and, by way of contrast, lends contentment its restorative depth.
Guilt alerts us to
words or deeds we regret. It is a hammer in the depths of conscience, and it
pummels all forms of complacency. Guilt dims our acceptability and dashes our
esteem. At the same time, as studies of psychopathy have shown, guilt –
and its social counterpart, shame – jars us to improve, apprises us of our
potentiality to do better, and moves us to heal others’ wounds. It’s hard to
inspire change if we fail to encounter guilt.
The key to my own
therapy, and indeed to depth-existential therapy as a whole, is that it
supports the coexistence of emotional and intellectual contraries. I loved and
I hated at the same time; I was terrified of death, and yet I was intrigued by
its mystery, by the mystery of life. I was jarred by scary movies, and yet they
opened me to alternative approaches to life, future possibilities and my own
imagination.
By emphasising
presence, depth-existential therapists make every effort to ‘hold’ the
contradictions that naturally arise in the course of their relationships with
clients, as well as within the clients themselves. In this way,
depth-existential therapy becomes a staging ground for the humility and wonder,
sense of adventure and awe for living that are the hallmarks of what we call a
‘whole-bodied’ transformation.
As a client in
therapy myself, I have moved from positions of abject terror, to gradual
intrigue, to wonder about my life circumstances. For example, I have shifted
from paralysis before the unpredictability of fate, to incremental trust,
curiosity and fascination with what might be discovered. Through their abiding
presence, my therapists supported me to feel safe enough to face my inner
battle. They ‘held a mirror’ for me to see ‘close up’ both how I was currently
living as well as how I could live, should I gradually step out of my cramped
yet familiar world. Back and forth I swung between terror and wonder, and
wonder back to terror; from quailing apprehension and incremental intrigue
toward that which horrified; from social withdrawal to growing risks with my
therapists and the world at large.
The result was that,
after several years of therapy, I was able to experience the fuller ranges of
my thoughts, feelings and sensations. I, like many of the people I have worked
with, was freed to attain goals but also a greater presence to my life and to life
itself. The result was that I became less identified with the old and crippling
parts of life, and more identified with the new and evolving parts – the parts
that deeply mattered.
Any decision
emerging from the therapy is energised by the whole body and that patient’s
visceral core
Personally, I
practise what I call ‘existential-integrative’ (EI) therapy, which coordinates
a range of useful modalities under the existential approach. As a therapist, I
am available to work with the patient at the most immediate, affective,
kinaesthetic and profound level of contact possible.
For example, when I
work with a patient, I see myself more as a fellow traveller, as the
existential analyst Irv Yalom put it, rather than the formal ‘doctor’ serving
up a remedy. I attempt to be available as a person rather than an engineer; I
attune to the needs of my human patient, not to a bundle of electrochemical
processes or a diagnostic label. That doesn’t mean I won’t try to support that
patient in whatever way might be helpful at the given time, for example, with a
medical referral or a problem-solving strategy, but I will strive to be
available to that patient to address the feelings, body sensations and images
behind the words and explanations.
All this involves
attention to process, not just content. The approach supports a ‘whole-bodied’
awareness of both what the patient desires, as well as what blocks him or her
from what is desired, on the deepest of levels, often beyond words. In this
way, any decision emerging from the therapy is energised by the whole body and
that patient’s visceral core.
Not every patient can
or wants to work at that level, explaining my integrative offering; but for
those who can and do, the approach provides the chance for a life-changing
shift. This shift bolsters one’s capacity to experience the fuller ranges of
one’s thoughts, feelings and sensations – one’s whole-bodily encounter with
life. Based on that foundation, it’s possible to make bold, concrete,
meaningful changes in one’s life. Put another way, such clients are able to
cultivate a deep and abiding presence to themselves and the world, and through
that presence, to experience humility, wonder and a sense of adventure toward
living. This sense, for those who can really live it, fosters meaning,
poignancy and awe.
The reason we need
such therapy today is precisely because the awe-based is too often left out of
our programmatic, medicalised approaches to life. We assist people to change,
but increasingly the impetus for that change is expedience: regulating our
emotions, stopping negative thoughts, sleeping better at night, becoming more
efficient, living more rationally and so on. And while these therapeutic ends
are by no means trifling, they are but ‘footholds’ for many people along a broader
and deeper path – the zest, meaning and awe of being alive.
Parts of this essay
were adapted from ‘The Spirituality of
Awe: Challenges to the Robotic Revolution’ (revised edition,
2019), published by Colorado Springs, CO: University Professors Press.
This Essay was made
possible through the support of a grant to Aeon from the John Templeton
Foundation. The opinions expressed in this publication are those of the author
and do not necessarily reflect the views of the Foundation.
Funders to Aeon
Magazine are not involved in editorial decision-making.
