Why existential-psychoanalysis?
I’ve lately found myself reflecting on why it is that the models of existence exemplified by the psychoanalytic and existential tradition carry such a deep resonance with the ways in which I choose to practice psychotherapy. Their marriage seems obvious to me, but as is sometimes the case when something seems obvious, I think that obviousness has interfered with my finding it necessary to clearly articulate what it is that makes sense about this theoretical marriage, both for myself and in the broader sense of why they have long seemed to other theoreticians to be of some use as a paired theoretical approach. The desire to do some of this explicating, leads in some sense to the question of whether their union constitutes an alliance of unlikely associates or whether they are of a single nature, in which some basic ontological truth is bent into differing expressions as though of a beam of light refracted through a glass prism. My belief is that it is much more likely that the latter, rather than the former, is the case.
Of course, this is not a novel combination. The two have been in some kind of conversation nearly since the development of psychoanalysis as a discipline, with a contingent of European practitioners quickly trying to find ways in which this new “science” overlapped with the more recent (at that time) work of Martin Heidegger or earlier philosophers like Kierkegaard and Nietzsche. In fact, Heidegger himself at one point gave a series of lectures, now known as the Zollikon Seminars, to Medard Boss and some of his colleagues during the 1960s, to help aid in their developing of an understanding of his phenomenological concepts and how they might integrate with the work of doing psychotherapy and psychoanalysis. However, the first to really explore the fertile ground between these two orientations was likely Ludwig Binswanger, a Swiss psychiatrist who studied with Freud, Jung, and many in that generation of psychoanalysts, who brought into those studies a rich understanding of the prior 100 years of European philosophy.
When it comes to interrogating these traditions, one challenge to be considered before we examine the ways in which they may or may not link up or overlap is in defining our terms to begin with. Psychoanalysis as a practice is a bit easier to give meaning to, though even this covers a rich and decades long intellectual tradition that has transformed and taken on new meaning since its conception over a century ago. What could be said to link these theoretical frameworks, which run the gamut from the strict Freudian tradition; through the mid-period of object-relations, self-psychology, and ego-psychology; and on into today’s intersubjective and relational emphases, is a foundational interest in the development of the psychic apparatus which mediates the relationship between imagination and reality; some ideas about how that apparatus impacts human relationships; and a belief that this apparatus usually operates in a manner that is beyond perception and easy expression. Each methodology suggests something different in the manner of interpretation and technique, but there are theoretical throughlines and a chronological sense to how the whole of the tradition folds together.
Existentialism is a bit dicier. Best to quote Walter Kaufman here. In the introduction to his monograph on the topic, Kaufman observes the conflicting worldviews and philosophical premises many of those thinkers deemed to be “existential” brought to bear on the work they produced. Tracing a through line from Pascal and Kierkegaard through to Sartre and Camus, Kaufman infers that existentialism may not be a “school of thought or reducible to any set of tenets”. Kaufman describes existentialism as a “sensibility” rather than a rigorous philosophical system. For Kaufman, that sensibility has something to do with a “dissatisfaction with traditional philosophy as superficial, academic, and remote from life”. Kaufman also describes the tradition as anti-systemic in a way, though I don’t think that characterization is quite right. What may be a more accurate representation is to say the tradition is against systems that operate from a philosophical position of strict rationalism. Beginning with Kierkegaard and Nietzsche, this movement in philosophy has been profoundly compelled by things like paradox, contradiction, complexity, human subjectivity, and a desire to amplify and honor these qualities of existence, rather than feeling that the purpose of philosophy is to employ scientific principles and argumentation to eliminate or reduce them. These philosophers find a richness in human experiences like anxiety, guilt, the possibility of the repression of aspects of experience, the process of making meaning (as opposed to making sense), and the impact of a phenomenon like time on what it means to understand what it is to be human.
(One minor note here: we are pretty much trapped at this point in the use of existentialism as a label for this movement, both within philosophy and especially within the realm of psychotherapy—where we have less of a claim on the jurisdiction to taxonomize philosophical traditions. As far as schools of philosophical thought go and how these thinkers have continued to bear influence on the tradition, it would really be more accurate to call what most therapists do “continental psychotherapy”. Not only would this more accurately frame the philosophical tradition being borrowed from and how it is categorized by those who do academic philosophy, but it would also allow for the incorporation of later thinkers like Derrida, Levinas, Foucault, Habermas, various critical and gender theorists, and anyone else one might want to incorporate from schools that might have later been defined as “postmodern”, post-structural, or who seemingly carry this tradition forward in their work. Rollo May and his compatriots did a great service in bringing awareness to this tradition and how it could be essential in understanding ways of doing psychotherapy, but we’ve been somewhat stifled by the emphasis on the use of the terminology of existentialism.)
So, what do these two schools bring together that seem to be important in conducting this work we call psychotherapy? This is a hard question for me to answer without reflecting on some of my own experiences in therapy. I recall the first time walking into a therapist’s office, sitting down with someone who presumably had some kind of master’s degree in social work or counseling, and within minutes being run through a battery of questions (probably the Beck Depression Inventory), at the end of which they told me I had depression, said we’d do a referral to the in-house psychiatrist, and proceeded to meet with me weekly to give me advice on ways I should probably try to change my life. A few weeks later, this therapist referred me to another counselor, who proceeded to do the same thing, same battery, same hyper-directive feedback, and eventually (following some complications in insurance coverage) I stopped going back and stopped taking the medication after only a few weeks being on it.
To my understanding, what was ineffective about this entire process? I think the principal issue (and as we proceed now, I will be offering thoughts on what I think both psychoanalysis and existentially informed practice do well, unless otherwise stated) is nothing about this seemed interested in honoring or exploring the subjective aspects of my experience. From the initial interview, there was an interest in labeling, generalizing, objectifying, and narrowing the scope of my problems into something that could be easily compartmentalized and “treated”. Nothing about what was being offered or explored, or about the ways in which anything resembling exploration was being conducted, seemed at all interested in finding its point of origin in what I as the client thought I had to offer. There is an existential argument to be made that the purpose of therapy might even be to try to transcend the subject-object divide and get to a more descriptively phenomenological understanding of one’s experience, but even at the absence of being able to get to that level, good therapy should operate in a way that honors and attempts to withstand the dialectic tension between our being-as-object and being-as-subject. All this experience seemed to be about my being-as-object of psychological inquiry for both clinicians in a manner that was invalidating, alienating, and unrelational. This process as it was conducted failed in its very inception to honor one of the fundamental paradoxes of existence, that we as subject can be the object of our own inquiry, and that we are an object that is imbued with an experiential subjectivity.
I think also existentialism and psychoanalysis are rooted in a kind of dynamism about what it means to be human. The process I was subjected to above had a very linear kind of framework: patient/client enters therapy, is unilaterally diagnosed, this diagnosis causally leads to an expected course of treatment enacted by some measure of the authority of “clinical expertise”, lifestyle changes are suggested that are meant to theoretically “improve” quality of life. This process lacks any sense of the true complexity of human experience. There was no undertaking to consider why I had come to structure my life the way that I had. No sense of what possible means of expression and meaning making were supported by the activities I was presently taking part in, including my so-called “depression”. No curiosity about other aspects of my emotional life and how this sadness may interact with experiences of anger, anxiety, loss, desire, fulfillment, stability, connection. No interest in probing my basic sense of what it meant to love and be love by another. No attentiveness to increasing my sense of personal agency and power to impact and change myself and the world around me. Nor could I have reasonably expected either clinician to be able to hold the complexity of what it means for all of these factors to be working simultaneously at nearly all times, or at least so it seemed both at the time and now in retrospect. Any good diagnosis and treatment approach from a psychoanalytic or existential lens is going to be interested in delving into each of these, examining the ways in which they overlap, impact and inform one another at the nexus point of self-understanding.
The third and final factor I will offer now, and there are likely many more ways in which these are compatible, is the relationship of both paradigms to the conceptual idea of “lack”. Though used in comparably different ways, both psychoanalysis and existentialism developed as practices which were interested in identifying and considering possible responses to a part of the human condition that is rooted in an awareness of an essential absence in some aspect of what that experiencing is. In the existential tradition, it is something like our essential “non-being”, the ways in which we are responsible for constructing the meaning of our existence, and what all this means in the context of our eventual death. In psychoanalysis, it is about something having to do with the fundamental separation that occurs in the moment of birth, the traumatic impact that separation seemingly has on us, and the ways in which various forms of separation and grief (or experiences of illusion/disillusionment) initially characterize and repeat throughout the life cycle. There is also, within psychoanalysis, the metaphorical lack, which is that of the symptom as symbol of some kind of repressed psychological activity. Neither tradition expects that we should be able to “fill” that absence. Rather, the activity of therapy is a way of upholding an appreciation for this quality of human experience, of recognizing anxiety, grief, guilt, desire and other of these emotions that operate in the context of the lack as fundamental to what it means to be human.
As I stated above, these are just a few of the initial thoughts I had when beginning my inquiry into what makes these two approaches feel so lush, so generative, so fertile. Of course there is more to be said about what they offer, or how they interact with other equally rich traditions I sometimes fold into the work that I do (that of black-feminist and/or queer theorists and the Buddhist tradition have shown up in recent years, usually (depending on the client and context) heavily caveated and with the acknowledgement of what it means for a white-cis-hetero-Catholic-raised male to be borrowing from frameworks that think out of completely different spaces of knowing). For now, I will leave it at that, and maybe save a more pointed criticism of contrasting of the two for some post somewhere further down the road.
