The Use of Existential Phenomenology in Psychotherapy1.docx

7/29/2019 The Use of Existential Phenomenology in Psychotherapy1.docx

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The Use of Existential Phenomenology in Psychotherapy1

RD LAING

R. D. Laing, M.D.R. D. Laing received his M.D. from Glasgow University. Laing's name comes

to mind when onethinks of practitioners who have been most effective at challenging prevailingmedicalthinking on schizophrenia. He has practiced psychotherapy for more than 35years and hasauthored 11 volumes.Laing teaches and practices in London. Formerly he served as Chairman ofThe Philadelphia

Association; was associated with the Tavistock Clinic; and was a Fellow ofThe FoundationsFund for Research in Psychiatry.Laing's chapter is in two parts. Part one is descriptive: He defines terms and

orients us to theidea that praxis and process should not be confused. Part two is experiential:Laing usesvignettes and poetic dialogues to challenge the functional fixedness in whichwe canentrap ourselves.

BY "USE" I MEAN efficacy, effective action, skillful means. I might haveentitled this paper the pragmatics of existential phenomenology.

At present there is no overall definition or system of phenomenology which isagreed upon by all self-styled phenome-nologists. Someone who disclaimsphenomenology, such as the French historian Michael Foucault, maynevertheless be regarded as embodying much phenomenology in his theoryand method.

By phenomenology I mean the science of description. In order to describe athing, a process, an event, an action, a set, or a system of things, events oractions, one will avoid confusion if one is correct about what it is one isdescribing, or, more generally, if one is clear about the domain to which whatone purports to be describing belongs. The description of a biochemicalprocess is of a different order than the description of an intention. The

description of intentional conduct is of a different order than the description ofthe unintentional movements of mindless behavior. Descriptions of intentionalaction, interactions, or transactions, I call praxis descriptions, using 'the wordpraxis to refer to the domain of intentional acts; whereas descriptions ofbehavior, at any level, of any kind (molecular, biologic, mechanical, orelectronic), I call process descriptions.
http://laingsociety.org/colloquia/psychotherapy/evolofpsych.htm#cithttp://laingsociety.org/colloquia/psychotherapy/evolofpsych.htm#cit


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Phenomenology thus takes us into the issue of what it is one is describing.

The discipline that addresses itself to what is this, that, anything is calledontology.

Phenomenology is a critical discipline for any science. All explanationsrequire descriptions in order to explain.

What we take anything to be profoundly affects how we go about describingit, and how we describe something profoundly affects how we go aboutexplaining, accounting for, or understanding what is what we are, in a sense,defining, by our description.

How do we define, how do we describe, how do we explain and/orunderstand ourselves? What sort of creatures do we take ourselves to be?What are we? Who are we? Why are we? How do we come to be what orwho we are or take ourselves to be? How do we give an account ofourselves? How do we account for ourselves, our actions, interactions,transactions (praxis), our biologic processes? Our specific human existence?

In the light of such accounts as we give of ourselves, in our own complex andoften confused ways, we account for our intentions and action, our chemistryand movements, our experience and conduct, our input, central processingand output. The critical reflective monitoring of all this is existentialphenomenology; and the use of this discipline, the effective skillful means ofthis discipline, its pragmatics, its efficacy in the practice of psychotherapy, iswhat I want to address in the following pages.

The term "psychotherapy" now covers many different divergent, and some

apparently antagonistic and mutually exclusive theories, techniques andpractices. However, at present, in 1986, all procedures that are subsumedunder the term "psychotherapy," maybe, have some elements in common.

People come to psychotherapists because they find themselves, or are foundby others to be (1) experiencing themselves, others, or their circumstances or' environment in undesired or undesirable ways, or (2) behaving towardsthemselves, others, or their circumstances or environment in undesired orundesirable ways.

Such patients, or clients, get "into psychotherapy" as the saying goes, withthe hope and intention of changing their experience (E), and/or their behavior

(B), from an undesired, undesirable starting state to a desired, more desirableend-state.


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They wish this change, this transition, this transformation, to occur as quickly,as painlessly, as effectively, as lastingly, and as cheaply as possible. That is,they wish to transit from negative (undesired, undesirable) types or modes ofexperience (E neg, E minus, -E) to positive (desired, desirable) experience (E

positive, E plus, +E); and, similarly, from undesired, undesirable types ormodes of conduct or behavior (neg B, B minus, -B) to desired, desirable,types or modes of conduct or behavior (B positive, B plus, +B).

Whether we are naive or sophisticated, as psychotherapists, our proceduresto facilitate such transformations and outcomes are necessarily, inevitably,based on the way we construe the problem, on what we take the trouble tobe, and on our own willingness, enthusiasm, generosity, in complying with ourclients' hopes and intentions, and in our skill in implementing ways andmeans of fulfilling their hopes and intentions.

We may not be interested in helping someone to be a more ruthless bully,torturer, terrorist, rapist, murderer, hypocrite, liar.

There is room for lengthy discussion here, but I have not the time nor spaceto go into such issues now. However, I must insist that there has to be a basicconsenszis of intention between therapists and clients. We therapists have toregard the experience and behavior our clients hope for and desire as,basically, desirable. I, personally, am interested in practicing psychotherapyonly insofar as I hope that in so doing I am making a contribution to otherpeople, as well as to myself, becoming more fully human, more actual aspersons, more real, more true, more loving, less afraid of what it is notnecessary to fear, happier, more joyous, more effective, more responsible,more capable of manifesting in everyday ordinary life the desiderata ofhuman existence, courage, faith, hope, loving-kindness in action in the world,and so forth.

In a sense, psychotherapy is applied theology, applied philosophy, appliedscience. Our psychotherapeutic tactics and strategies are predicated upon,and are permeated by, who and-what we take ourselves to be, how and whatwe wish and do not wish, want and dread, hope and despair, to be, in andthrough our experience and conduct.

All that is the theory and praxis of existential phenomenology inpsychotherapy.

II

My focus here is to depict and describe what goes on between people'sexperience (E) as mediated by their behavior (B). I want to convey how I seethe interconnections between personal interactions and how different ways ofseeing may generate different ways of acting, and vice versa.


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To this end, my presentation will presently become less orthodox. I shallmingle theoretical discourse with vignettes and verse, and "straight" talk withirony.

Perhaps you will regard it as "inappropriate" to present a paper in such anidiom. Perhaps it is. It is intended as a friendly provocation. It is evident, Ihope, that I am not trying to induce you to adopt a "theoretical model."Rather, I am trying to depict a way of seeing, a way of contemplating what isgoing on, whether praxis or process, a destructing of destructiveconstructions, I shall use irony, humor, paradoxical communication, languageas a sort of therapeutic rasayana, the yoga of poison as medicine, in seriousplay rather than in deadly seriousnes: a la Milton Erickson. Here goes!

III

The first act of a teacher is to introduce the idea that the world we think wesee is only a view, a description of the world. Every effort of a teacher isgeared to prove this point to his apprentice. But accepting it seems to be oneof the hardest things one can do; we are complacently caught in our particularview of the world, which compels us to feel and act as if we knew everythingabout the world. A teacher, from the very first act he performs, aims atstopping that view. Sorcerers call it stopping the internal dialogue and theyare convinced that it is the single most important technique that an apprenticecan learn. (Castenada, 1974, p. 231)

Don't take it serious.It's just an experience.

A man had the following problem. He was married. Over a period of 18months to a year, he became convinced that his wife was having an affair. Hedid not feel it incumbent on himself to indicate to her that he was aware ofthis, since she didn't feel it appropriate to mention it. They conductedthemselves as if she weren't having an affair. Everything was in place justexactly as it always had been.


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Then a day came to have one of those "Let's talk about it" conversations.

She: "Let's talk about us."He: "Let's talk about Ralph as well."She: "What are you talking about?"He: "Well, you know."

She: "I don't know. Please tell me what you are getting at, what you aredriving at."He: "Well, you know, come on."She: "You have to explain to me what you are talking about. I don't knowwhat you are talking about."He: "This affair you're having with Ralph."She: "What affair? There is no affair, it's all in your own mind. It's all in yourown imagination. You're making it up. There is no affair. Why do you thinkthere is some affair?"

There were no gross indices that he could point to. No "proof." She absolutelyinsisted that he had it all wrong. He had become absolutely convinced from

innumerable microevents that the picture he had constructed (she is havingan affair with Ralph) was correct. He couldn't even pin it down to anything intheir own intimate sexual relationship. Everything was "in place," as if nothingwas going on. Indeed, he was at a loss. He wasn't sure. He could have madeit all up. He consulted a psychiatrist, a friend. He put this situation to him andasked, "Am I psychotic? If I am making all this up then I must conclude that Iam suffering from some sort of a paranoid thing. Maybe I am going paranoidand haven't realized it until now. Am I psychotic?" The psychiatrist replied,"Yes, you are."

This precipitated him into a state of catastrophic anxiety at the prospect thathe might be paranoid. He came to see me and told me his story. As ithappened, I knew that his wife was having an affair. In the social circleswhere his network and mine overlapped, "everyone" knew his wife washaving an affair-except him. So I told him.

This precipitated him into another catastrophic reaction in which he became,not paranoid, but very depressed, for about a year. As he came out of it hesaid, "What really threw me? I don't think it was jealousy. I had becometerribly attached to my sense of reality."

Versions of that situation arise at all levels, international, interracial, betweencompanies, men and women, parents and children. Very often no one knowswhat the situation is, what is going on, what is the case, and what is not.

Phenomenology is an attempt to release our minds from the blind, uncriticalattachment to any set of miserable meanings-right or wrong, true or false.

The "cure," in this case, was to see the joke. But it is not always funny.


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A lady consults me. Her son of 14 was diagnosed as schizophrenic and wasreferred to a psychiatric unit for treatment. For some time he had not beengetting on well with his father. He wouldn't do anything his father asked orordered and was coming over with "You aren't my father anyway."

The mother's quandary was that, in fact, her husband wasn't the boy's father,

but no one knew that except her. Perhaps she would tell her husband and/orher son, "Anything might happen."

Or not. If she did not, she would see her son, diagnosed as schizophrenic, anin-patient, under observation, medicated, and possibly beginning a career asa schizophrenic. She didn't want to see that happen. She eventually did tellher husband, though she was risking everything by doing so. She thought hewouldn't be able to take it. He might beat her, kill her, leave her.

The story had a happy ending, almost too good to be true. She told herhusband, she told her son. Her husband was very upset, the son was veryrelieved. The conduct that had led him to be diagnosed as schizophrenicevaporated; and she and her husband went off for a new honeymoon.

She found the courage to take a chance on truth. Even though all through ourlived experience "reality" is constructed (radical constructivism), this strivingto construe our reality correctly, which may lead us to radical relativeperspectivism and radical constructivism, redeems us from despair andempiricism. Truth should be thought of not as a substance, a thing, but as apraxis; grammatically not as a noun for an object, or even for acorrespondence between objects or processes, but as a verb for truthfulspeech and action between us.


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A description is a definition and a prescription.A 14-year-old girl is brought before me by her mother because she issuffering from anorexia, (a process description)

She declaresI am not suffering from anorexia.

I am on a hunger strike, (a praxis description)Shall I treat her anorexia?

Shall I try to break her hunger strike?The plain fact isShe is not eatingShe does not eat

One construction is thatShe is suffering from anorexia

Another construction isShe is on a hunger strike

She does not sit downIs she suffering from

no-sitting downness?Is she on a

not-sitting down strike?

These two ways of describing her not-eating are two ways of defining what isgoing on-in terms of process (suffering from a mental disorder) or in terms ofpraxis (intentional choice-in-action). In such descriptions and definitions, thereare, already, by implication, two prescriptions, two strategies of response-interms of process, treatment of her disorder-in terms of praxis, to treat her as aperson. Her treatment is the way we treat her.

An eight-year-old boydoes not readdoes not write

Is he suffering from alexia? (process description, definition, prescription,explanation)

Is he on a reading strike? (praxis-description, definition, prescription,understanding)

Is he suffering from agraphia?Similarly, is he on a writing strike or

anorexia or refusal to eatalexia or refusal to read

agraphia or refusal to write


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These are constructions, in either case explanations of a sort, already notsimple descriptions

It is useful to discriminate betweendepictions

descriptions, definitions,

constructions,explanations,prescription,

but in much clinical terminology all these categories are confounded, allconfused. (Read DSM-III, alert to these issues)

Epistemologists never tire of telling us thatthe map is not the territory,

a menu is not a meal,the score is not the music, that that painted pipe is not a pipe, Magritte.

This (1) is not a number. The radical constructivists do not let us go home, donot let us off so lightly.

Whatever I take to be the territory may be a map.

Everyone knows thatA menu is not a meal but many people eat menus.

Waves and particles are not light.The brain is not the soul. When my heart stopped it did not attack me.

Death is perfectly safe.The people we see as patients or clients are seldom in physical pain.

They are in mental misery,Many are enmeshed in entangled webs of mixed meanings

An incident in couple therapy.

They are arguing.She gets up and is walking out the door.

He shoutsWhy are you walking out the door?

She repliesI am not walking out the door.

He is confused and bewildered.

Do you love me?If you love me

believe me

Believe meyou don't love me

you don't love anyoneAnd no-one loves you


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except me

Believe meBut

don't believebecause I say so

just look into your heart of heartsand you will find

that everything I've told youis true

The therapy here consists in showing the fly the way out of the bottle. It's asimple booby trap. Once you realize, make real to yourself, that it is a trap itceases to be a trap. Once you see it is a killer, it can't kill you.

You love meYou don't love me

Believe meDon't believe me

We learn what we see and this learning is fraught with complications,contradictions and paradoxes. Sometimes anyone's mind might boggle.

Here are two descriptions of incidents from my own family life. As I did in thebook in which they were published (Laing, 1984, pp. 136-138 & p. 144).* Ishall withhold the many comments I could make on them. I hope, especiallyin the context of these present considerations, their relevance will be evident.If you do not see their relevance, then I am sorry to say you do not see what Iam trying to point out.

CORFU AFTERNOON, ON THE BEACH

Adam+ sights an unidentified object floating fairly far out to sea. He proposesa "project" with "component operations." Basically, he, Arthur, and I are toswim out to it, identify it, and if "feasible," bring it ashore.

The first "component operation" passes uneventfully. Arthur, he, and I standon an offshore rock. Each throws his goggles and snorkle into the sea, divesin after them, retrieves them, puts them on.

Operation Two is to swim out to unidentified floating object. We set off

together. Soon Adam and Arthur were drawing ahead of me, and it was notlong before I had swum out further than I had done for at least 25 years.Further was too far. The object, a black shape, looked just as far away as ithad done from the shore. Adam and Arthur seemed 30 or 40 feet further out.Then Arthur stopped. Adam was still for going on, but Arthur ordered himback. They swam back together to where I was and the three of us swamback to shore together.


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I was grateful to feel the sand under my wobbling knees and very glad to sinkback into the safe sand. Arthur looked quite relieved. Adam was livid. I'venever seen him so enraged. He was hopping mad. He threw himself on thesand and squirmed and twitched around like an eel with vexation.

He blamed it all on Arthur, for turning back.

Arthur; Don't blame me! It was way off.Adam: No it wasn't.Jutta: (who had been watching from the shore) You were only halfway there.

Adam: No we weren't. We were almost there.Daddy: No we were not almost there. It was still far away. Definitely too faraway.

Adam: It wasn't.Daddy: It was.

Arthur: Adam! (he wasn't listening) Adam!! Your mummy saw it from theshore.

Adam: She did not.Daddy: It was too far.

Adam looked at us all.

Daddy: I'm telling you. It was too far.Arthur: It was still far away.Jutta: You weren't even halfway there.

He was completely surrounded.

Adam: You're all lying.Arthur: Look. Why should we lie to you Adam. We're allfriends.

Adam said nothing.Arthur: It was too far for me, and it was definitely too far for you.

He still said nothing.

Daddy: Look. You still can't swim further than Arthur, or me, even.Adam: How do you know?Daddy: Your mummy saw us from the shore. We were only halfway there.Jutta: That's right.

Adam: She's lying.Jutta: No I'm not. You won't listen to anyone, that's your trouble.

Adam: Well I'm not going to listen to you.Jutta: You'd better watch it. You had better watch it.Daddy: Do you seriously think that you know better than everyone else?

Adam said nothing.


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We all took a short breather. Except Adam, who was still "at it," though hewas silent.

Daddy: Anyway. It's not a defeat.Adam: Yes it is.

And it started up again. After the third full round of the above, with minorvariations, Adam's vehemence had in no way abated.

Jutta: It was an optical illusion.Adam: A what??Jutta: An optical illusion.

Adam: An optical illusion!? What is an "optical illusion"?Jutta: Something that looks different from what it is.

Adam: You mean I can't believe my eyes?!Daddy; Well. Not always. Not just like that. Not without reservations.

Adam: Reservations!?

ITEM 144

March 1977

Jutta is taken aback by coming upon Adam making grandiose magical passeswith a stick at our ailing palm tree in the hall.

Jutta: Can I believe my eyes? Can I believe my eyes?Adam: No.

Later

Jutta: I couldn't believe my ears! I can't believe my eyes!

IV

Everyone knows we are affected by our nearest and dearest. It is devilishlydifficult to study the ordinariness of everyday life where most of our clients'happiness and unhappiness arise. Descartean-Gali-lean natural science doesnot help us here, for our theory must be explicitly designed to see the world ofpersonal passions, intentions and actions, that is, praxis as well as process.Neils Bohr's concept of complementary may help us here.

Any cogent, coherent psychotherapy must both draw on and contribute to thepragmatic knowledge, the knowledge-inaction, of how we affect each other,personally.


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There is so much that goes on between us that we can never know. But wedo know that the divide between fact and feelings is a product of schizoidconstructions, which is not useful in the practice of psychotherapy.

In reality, the reasons of the heart (praxis) and the physiology of the brain(process) coexist and are interdependent.

In this presentation, I tried to depict a way of seeing what is seen or not, whatcomes into view or not, from whatever point of view. This pragmaticreflexivity, this reflexive pragmatism is necessarily reflected in my style ofdepiction. It therefore may turn out that the main significance of thispresentation lies in the attempt to disclose or reveal a way to look at what wesee and do that enables what I describe to be seen and done.

__________________________________________

DISCUSSION BY THOMAS S. SZASZ, M.D.

Dr. Laing comes out in this presentation as someone I would characterize,among other things, as a person who fantasizes relativism. He makes a fetishout of relativism. It seems as if everything goes, which is one of the reasonswhy many critics have recently accused him of changing his position. Well, Idon't know if he changes his position, or whether he has so many of them.But I think that this kind of relativism really only applies to the social world andonly to some aspects of the social world. In point of fact, in the physical world,our knowledge of physics, chemistry, and mathematics is not nearly asrelativistic as modern philosophers make it out, at least not in my opinion.

Also, even in the social world it is not nearly as relativistic as it sounds if wetake our point of departure somewhere else. In this respect, although some of

our views are quite similar, we seem to go at it in different ways. I do not go atit from this very anecdotal, personal point of view, but I look for where themoney is, the power. Then things are not so relativistic.

We talk about being teachers and teaching skepticism. But how can youteach skepticism to people until you know something? You can only beskeptical about something you understand. It seems to me, therefore, thatfirst of all children have to have a certain fund of information. As Archimedesput it, I can move the world if I have a place to stand. When we have a placeto stand, then we can begin to be skeptical. I think I know where that place is.That place is having a decent mother and father in childhood, a decenteducation in adolescence, and courage as a grown-up. Then, we can move

things. Then we can be skeptical. Otherwise, we only talk about skepticism.

Of course there is also the question that was raised that somehow we wantto transcend our frame of reference. We always talk, especially nowadays, inpsychotherapy and psychiatry about seeing the world differently. But wordsare cheap. How many people want to see the world differently? They don'twant to do that. I think they want to be left hypnotized.


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__________________________________________

COMMENT BY DR. WATZLAWICK

Let me try to build a bridge. I remember the day when I read Korzybski andwas very taken by this famous quotation, "The map is not the territory." Itoccurred to me a few years ago that radical constructivism is probably right--the map is the territory. In Korzybski's view, there is a real territory for whichthe map is an adequate matching. In the perspective of radicalconstructivism, there are only maps. Of the territory we know nothing. Thishas important implications for the simple reason that when we talk aboutreality, it doesn't occur to us that we can only know the real reality, if it existsin terms of what it is not. That is our only reliable knowledge of anything thatmight be a real reality somewhere because we find out about it only whereour reality construction breaks down. Only in the breaking down and thenonfitting of our view of reality do we realize that we are somehow seeingthings in a way that is not what they appear to be. That doesn't mean that wetherefore know how they are.

As von Glasersfeld says in a book I recently published, The Invented Reality(New York: W.W. Norton, 1984), there is a difference between matching andfitting. The transcendental idealist believes that he has a matching view ofreality, that somehow his ideas express, contain, and embrace reality as itreally is. The radical constructivist, on the other hand, realizes that he hasonly, at best, a view of reality that fits--just as a key fits the lock. The fitting ofthe key only tells us that the key fulfills the function for which it was built. Itsays nothing about the nature of the lock. I think that in therapy we have todeal with people whose reality constructions have broken down. Whattherapy can do is to help them to build a new construction or a slightlymodified construction.

I would take exception to Dr. Szasz's claim that in the natural sciences wehave a more reliable view of reality. I have recently spoken with theoreticalphysicists who have greatly shaken my view that they are any better off thanwe are.

As the editor and author of several books on reality, I get angry letters thathave to do precisely with what Laing said about nihilism: We, theconstructivists, if I may count myself among them, are coming up with aconstructive worldview, something in which all values and rules are beingmade relative. I cannot go into detail, but if you take the idea seriously that weare the architects of our reality, there are three outcomes that seem fairlyacceptable. One is that we begin to realize that we are free. If I am thearchitect of my own reality, it is within my power to construct it one way or theother. The second outcome is that this view makes us responsible, in thedeepest ethical sense, because we no longer have the easy way out into thebehavior of others or the way things are outside of our control. And the thirdthing I think a radical constructivist would arrive at is the idea of tolerance.


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NOTES

*Reprinted with permission from Conversations with Adam and Natasha(1984), Pantheon Books, a Division of Random House, New York.

+Adam is my son, aged eight. Arthur is a friend, about forty. Jutta is my wife,Adam's mother.

REFERENCES

Castaneda, C. (1974). Tales of power. New York: Touchstone Books (Simon& Schuster).

Laing, R.D. (1984). Conversations with Adam and Natasha. Pantheon Books,a Division of Random House.

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The Use of Existential Phenomenology in Psychotherapy1.docx