|Basic InformationMore InformationLatest NewsQuestions and AnswersBlog EntriesVideosLinksBook Reviews| Maximizing Effectiveness in Dynamic Psychotherapy Self-Compassion in Psychotherapy101 Healing Stories101 Things I Wish I'd Known When I Started Using HypnosisA Primer for Beginning PsychotherapyA Therapist's Guide to Understanding Common Medical ProblemsACT With LoveAlready FreeAssessment and Treatment of Childhood Problems, Second EditionBad TherapyBecoming MyselfBefore ForgivingBeing a Brain-Wise TherapistBiofeedback for the BrainBody PsychotherapyBody SenseBoundaries and Boundary Violations in PsychoanalysisBrain Change TherapyBreaking ApartBuffy the Vampire Slayer and PhilosophyBuilding on BionCare of the PsycheChoosing an Online TherapistClinical Handbook of Psychological DisordersClinical Intuition in PsychotherapyClinical Pearls of WisdomCo-Creating ChangeCompassion and Healing in Medicine and SocietyConfessions of a Former ChildConfidential RelationshipsConfidentiality and Mental HealthConfidingContemplative Psychotherapy EssentialsCouch FictionCounseling with Choice TheoryCritical Issues in PsychotherapyCrucial Choices, Crucial ChangesDecoding the Ethics CodeDepression 101Depression in ContextDo-It-Yourself Eye Movement Techniques for Emotional HealingDoing CBTDoing ItE-TherapyEncountering the Sacred in PsychotherapyEnergy Psychology InteractiveEssays on Philosophical CounselingEthics in Psychotherapy and CounselingEveryday Mind ReadingExercise-Based Interventions for Mental IllnessExistential PsychotherapyExpressing EmotionFacing Human SufferingFairbairn's Object Relations Theory in the Clinical SettingFamily TherapyFavorite Counseling and Therapy Homework AssignmentsFlourishingFlying ColorsGod & TherapyHandbook of Clinical Psychopharmacology for TherapistsHandbook of Counseling and Psychotherapy with Lesbian, Gay, and Bisexual ClientsHealing the Heart and Mind with MindfulnessHealing the Soul in the Age of the BrainHeinz KohutHow and Why Are Some Therapists Better Than Others?How People ChangeHow to Give Her Absolute PleasureHow to Go to TherapyIf Only I Had KnownIn SessionIn Therapy We TrustIn Treatment: Season 1Incorporating Spirituality in Counseling and PsychotherapyIs Long-Term Therapy Unethical?Issues in Philosophical CounselingIt’s Your HourLearning from Our MistakesLetters to a Young TherapistLogotherapy and Existential AnalysisLove's ExecutionerMan's Search for MeaningMeditations on Self-Discipline and FailureMetaphoria: Metaphor and Guided Metaphor for Psychotherapy and HealingMindfulnessMindfulness and AcceptanceMindfulness-Based Cognitive Therapy for DepressionMindworks: An Introduction to NLPMockingbird YearsMomma and the Meaning of LifeMotivational Interviewing: Preparing People For ChangeMulticulturalism and the Therapeutic ProcessOf Two MindsOn the CouchOne Nation Under TherapyOur Inner WorldOutsider Art and Art TherapyOvercoming Destructive Beliefs, Feelings, and BehaviorsPhilosophical CounselingPhilosophical MidwiferyPhilosophical PracticePhilosophy and PsychotherapyPhilosophy for Counselling and PsychotherapyPhilosophy PracticePhilosophy's Role in Counseling and PsychotherapyPlato, Not Prozac!Process-Based CBTPsychologists Defying the CrowdPsychology, Psychotherapy, Psychoanalysis, and the Politics of Human RelationshipsPsychosis in the FamilyPsychotherapyPsychotherapyPsychotherapy As PraxisPsychotherapy East and WestPsychotherapy for Children and AdolescentsPsychotherapy for Personality DisordersRational Emotive Behavior TherapyRational Emotive Behavior TherapyRationality and the Pursuit of HappinessRecovery OptionsRent Two Films and Let's Talk in the MorningSaving the Modern SoulSecond-order Change in PsychotherapySelf MattersSelf-Compassion in PsychotherapySelf-Determination Theory in the ClinicSexual Orientation and Psychodynamic PsychotherapyStrangers to OurselvesTaking America Off DrugsTales of PsychotherapyThe Art of HypnosisThe Case Formulation Approach to Cognitive-Behavior TherapyThe Compassionate ConnectionThe Crucible of ExperienceThe Education of Mrs. BemisThe Fall Of An IconThe Gift of TherapyThe Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work The Husbands and Wives ClubThe Love CureThe Making of a TherapistThe Mummy at the Dining Room TableThe Neuroscience of PsychotherapyThe Neuroscience of Psychotherapy: Healing the Social BrainThe New PsychoanalysisThe Philosopher's Autobiography The Portable CoachThe Portable Ethicist for Mental Health Professionals The Present Moment in Psychotherapy and Everyday LifeThe Problem with Cognitive Behavioural TherapyThe Psychodynamics of Gender and Gender RoleThe Psychotherapy Documentation PrimerThe Real World Guide to Psychotherapy PracticeThe Schopenhauer CureThe Talking CureThe Therapeutic "Aha!"The Therapist's Guide to Psychopharmacology, Revised EditionThe Therapist's Ultimate Solution BookThe UnsayableThe Wing of MadnessTheory and Practice of Brief TherapyTherapyTheraScribe 4.0Thinking about ThinkingThriveToward a Psychology of AwakeningTracking Mental Health OutcomesTreating Attachment DisordersWhat the Buddha FeltWhat Works for Whom? Second EditionWhy Psychoanalysis?Yoga Therapy
by Daniel Sousa
Palgrave Macmillan, 2017
Review by Kate Mehuron on May 15th 2018
Daniel Sousa's Existential Psychotherapy: A Genetic-Phenomenological Approach seeks to legitimize two lesser-known psychotherapeutic approaches. First, Sousa intends to establish the therapeutic legitimacy of existential psychotherapy within the big tent of psychotherapies in general. Second, he defends the value of static and genetic phenomenology, drawn from Husserl's phenomenology of time consciousness, to the existential psychotherapeutic enterprise.
Chapter one provides a review and synthesis of the major meta-analyses of empirical research to date, regarding the most effective, and least effective psychotherapeutic interventions and correlative psychotherapist skills and qualities. The chapter offers a valuable list of the therapeutic principles that receive strong empirical support and that are basic to any effective psychotherapeutic practice. These informative insights from Sousa's synthesis of all the meta-analyses studied are articulated: 1) there is consensus between medical models and contextual models regarding specific effective psychotherapeutic factors, and 2) variability of effectiveness among psychotherapists is not related to therapist age, gender, academic qualifications nor years of experience, nor by their patients' age, gender and diagnosis, but rather to therapists' specific personal and professional qualities. Years of experience do not translate into increased clinical expertise. Rather, the factors that lend to improvement in clinical expertise and those lending to improvement in expertise in other professions are found to be nearly identical: the best clinicians deliberately practice more, acquire deeper knowledge of their area, systematically gather feedback on their performance, learn in a structured way to surpass habits and performance, work harder, focus on specific aims, and consciously monitor their performance and results over long periods of time. Sousa successfully summarizes these general criteria for effective psychotherapeutic practices, supporting his defense of the legitimacy of existential psychotherapy within the big tent of psychotherapies in general.
Sousa's second objective, in Chapter two, is to articulate the value of the philosophical resources of genetic phenomenology for existential psychotherapeutic applications. The chapter is a competent overview of Husserl's phenomenological contribution to philosophies of subjectivity. But Sousa's second objective is a harder sell. To this end, he asks his desired audience, presumably psychotherapists, to assimilate Husserl's conceptual framework: internal time consciousness, phenomenological vocabulary and epistemological formulations, and the techniques of epochéand eidetic analysis, as relationally reconfigured. Thus readers have a model of static and genetic phenomenology to consider, which Sousa argues to be the desirable theoretical underpinning of existential psychotherapy. Sousa concisely summarizes the theoretical framework of the genetic-phenomenological approach into seven theoretical claims that are key concepts presupposed by all existential philosophies: intentionality, inner-time consciousness, self-reflective narrative identity, passive geneses of experience, angst, interrelatedness, and the givens of existence. (133-134)
Many psychotherapeutic practitioners will question whether existential psychotherapies, already a minority within the psychotherapy tent, ought to assimilate this Husserlian epistemological framework. They may wonder: for what reasons and in service to what clinical objectives? Unfortunately, Sousa undermines his own aim when he describes, in Chapter Three, some of the "misconceptions" in the world of existential psychotherapy. One of these, supposedly contributing to its outsider status, is the error of presenting existential psychotherapy as a philosophical approach. Sousa writes, "The approach is based on an existential-phenomenological epistemology, but is not distinguished from other therapeutic models for being philosophical – all models have philosophical roots – since its theoretical principles are rooted in psychology and psychotherapy." (131) The phenomenological scaffolding that is so carefully developed in Chapter Two and Three is contradicted by Sousa's claim, unless we erroneously assume that phenomenology is not "philosophical" but rather "psychological."
Chapter three expansively develops all of these theoretical presuppositions introduced in chapter two, organizing their implications and synthesizing them with the transversal findings of evidence-based effective therapeutic techniques defined in the first chapter. It presents and defines relational stances, organized within "static" phenomenology that encompasses the use of the phenomenological epochéand eidetic analysis within the relational context of the therapeutic situation. (144-147) Further, Sousa presents a schema of existential psychotherapy techniques aligned with evidence-based practices in general and with "genetic" phenomenology in particular. This schema provides the subjective (and phenomenological) fundamentals of techniques facilitating the client's process of change during the existential psychotherapeutic treatment. These include: hermeneutics of dream interpretation, focus on embodiment, existential challenges to the client's assumptions, experiential validation, and reflexive activation of the passive geneses of experience in the present situation of interpretation. (148-151)
The accomplishments of the first three chapters - meta-analysis findings, epistemological and technical schema - are weakened by the editorial error of allowing chapter four, "Practical Applications and Clinical Case" to stand as the final chapter. This chapter is poorly edited: riddled with incomplete sentences, lack of paragraph structure, and typographical errors, such as referencing an "attachment" in the body of the text, instead of the intended Table A.1 that is included in the Appendix. The chapter provides four interviews with four different patients, "vignettes," that are used to illustrate existential clinical methods, and one interview-based case that explores the emotional impact on someone who is indirectly, but deeply affected by the 9/11 terrorist attack on the New York World Trade Towers and occupants. This case is presented in largely descriptive terms, using the psychotherapeutic discourse of trauma and concepts of genetic phenomenology elaborated in chapter four. Some of the existential descriptive passages about this person's suffering seem gratuitously philosophical and esoteric, for example in the application of Heideggerian notions of Dasein and its experience of fallen-ness and the uncanny. The Husserlian notion of "passive geneses sedimented in the retentional chain of temporal consciousness" appears to be a substitute for the more commonly used notion of the unconscious and pre-conscious strata of mind. (208) But there is no theoretical rationale anywhere in the book, for the substitutions of phenomenology for such psychological concepts. It is all offered as an alternative, densely complex discourse. For what reasons and in service to what clinical objectives? This is a question that is never addressed.
© 2018 Kate Mehuron
Kate Mehuron, Professor of Philosophy, Eastern Michigan University, Academic Candidate, Michigan Psychoanalytic Institute. Correspondence: email@example.com