The Combination of Psychotherapy and Philosophy - Essay Example

What is the nature of human existence from a Heideggerian perspective, and what relevance may this have to psychotherapy? Introduction It is often considered that the combination of psychotherapy and philosophy is uncooperative at best because of the latter’s preoccupation with theory and the former’s focus on pragmatism in relation to human life. The link however between the two approaches has increasingly been recognised (Robertson, 2010). Despite the abstract nature of philosophy and its seemingly difficult reconciliation with psychotherapy, the Hellenistic philosophical concentration on human life (eudaimonia) sought to encourage individuals to establish the beliefs they held of the world so that they could understand the purpose of their existence (Nussbaum, 1994: 15, 302). This paper will examine the application of existential philosophy to psychotherapy, particularly focusing on Heidegger’s approach, though other existentialists will be touched upon in order to form a more general overview of Heidegger’s theory as it stands alone and in comparison to other similar theories. Heidegger’s concept of being and his fundamental issue of where being begins will be explored, as well as his notion of dasein and anxiety in application to psychotherapy. It will then be evaluated in order assess its effectiveness and contributions to psychotherapy both actual and potential. It will ultimately argued that Heidegger’s contributions to psychotherapy have the potential to be extremely useful, though they have as of yet struggled to have any major influences on psychotherapy practice. While this is due to the seemingly negative lack of structure when applying existentialism and philosophy in general to psychotherapy, it is possible that after some time the philosophical approach to psychotherapy can gradually develop into a methodical, structured practice. Existential Psychotherapy Heidegger was greatly influenced by philosophers such as Jaspers (1964) and laid the ground for later philosophers such as Binswanger (1963). The central theme of all was the shift from psychiatry to philosophy so that human problems and paradoxes could be better understood. This was of course initially received as an almost impossible task. A number of philosophers have applied existentialism to psychotherapy in several different forms and manners (Frankl, 1967; Szasz, 1965), and the stubbornness with which theories have been proposed suggests that future approaches to psychotherapy will increasingly incorporate existential themes. Heidegger’s existential philosophy concentrates on the supra and inter personal dimensions through its attempts to discover and analyse individual’s views of the world. He questioned where we start from in his search for being. It seeks to explain and understand personal beliefs and values, causing unspoken and implicit aspects to become explicit and visible. The philosophical aim of psychotherapy under this existential strand is to empower individuals to live purposefully and genuinely whilst allowing them to acknowledge and accept the contradictions and limitations of their existence as humans (Schuster, 1999: 6-18). The most important aspect of applying existential philosophy to psychotherapy is the approach to human life and living not as an anthropologist or psychologist but as a philosopher, emphasising the relevance of abstract theories on human life and living. Indeed Heidegger sought to focus on the metaphysical facet of life over the concrete experiences of individuals; to determine what causes human living to be so problematic (Stambaugh, 1991: 3-10). Yet at the roots of the theory, existentialism examines the basic requirements for human living to be able to take place or exist. Heidegger attempts to describe the requirements of being in the human world, what is necessary for us to begin as beings. He considers humans as ‘being-in-the-world’ (dasein) (1962: 67-76). Dasein for Heidegger rejected the literal translation of ‘being there’, and rather defined dasein as entity rather than human being, as a basis for understanding and interpreting the world. He sought to make the ontological difference between existence and cohesion of existence, which in turn established the difference between entity and the cohesion or being of entity. He defines the requirements for forming human beings which in turn creates the basis of existence which forms important enquiries about individuals (1962: 102-104). This allows examinations of individuals to be undertaken more effectively than psychological and scientific theories, based on dilemmas of life which are often presented during psychotherapy. Heidegger Heidegger tackled what he considered to be the most important and basic philosophical question, and “not just any question”: why does something exist rather than nothing (1962: 21)? The question is considered almost impossible to answer on an objective level; Heidegger claimed that ‘being’ is “indefinable” (1962: 23). Patients of psychotherapy often ask such questions, usually because they are not certain about the meaning of their lives. Heidegger considered that such questions were not only relevant but necessary so that individuals can become self-reflective and aware (1962: 149). He proposed that such questions are the fundamental roots of all philosophy, allowing individuals to discover the wonder of existence. The vast openness of modern life and the existence of endless possibilities have caused, as Frankl claims, the “existential vacuum” of meaning to become formed (2004: 111-112). Many individuals thus experience some form of meaningless or other, causing difficulties to arise in a concrete manner, appearing as personality disorders and pathological problems. Szasz alternatively proposes that such individuals not be seen as psychologically ill per se, but that they be able to engage in philosophical conversation about the meaning of life with the psychotherapist (1961). The search for meaning in life and living is thus defined one of the main characteristics of human existence, or consciousness. The approach is that, in order to imbue life with meaning, one must give it that meaning (Polt, 1999: 33-35). This begins, according to the existentialist, with the stage at which the individual experiences doubt as a result of realising that life lacks actual intrinsic meaning. Heidegger (1962: 36) saw the world in a detailed manner; he described the world as containing three main elements: horizon, foreign ground and home ground. For Heidegger we are constantly situated a specific distance from things, though our relation to these things are likely to be determined by our individualistic stance towards them as defined by our intentions rather than by physical space. By causing the individual to describe the world under the assumption that it is not actually known by the individual can lead to the discovery of new assumptions about that individual’s world. Heidegger sought to challenge our tendency to assume that what we know is the be all and end all of our worlds, so that we may discover new elements to human life and living (1993: 9-11). Heidegger saw individual entry into the world as insertion; that we are simply ‘thrown’ into the world as it already is, which causes us to become concretely connected to the world in several manners. We are constantly confronted with factual situations due to our participation in a specific culture, and society; a certain environment and historical era as well as specific situation and set of circumstances. We are only able to exercise personal choices when placed within situations, termed ‘facticity’ by Sartre (2003: 103-108). Though we are able to take a certain position in relation to this facticity, we are not able to escape or avoid it. In application to psychotherapy, such an approach proposes that an individual’s problems be observed in a structural manner, so that concepts cease being viewed as internal or emotional problems and become viewed as part of a general, external situation. The existentialism of Heidegger proposes that as humans we are unable to view the world in an external manner; we rather process it via emotional responses (Nichols, 2000: 7). The ability to understand issues is based on more than simple intelligence and the ability to calculate concepts; Heidegger distinguishes between rationality and understanding (1962: 82, 385). While the former represents our emotional view of the world, the latter represents our capacity to externally view a circumstance as a whole as opposed to internal analysis (Heidegger, 1962: 144). Through the ability to understand, Heidegger obtained the ability to recognise the potential of an individual’s being; the capability of the individual. He distinguished between meditative and calculative thought (1977: 133), emphasising the importance of the ability to analyse in a meditative way rather than calculative way; to view the world as it is rather than manipulating it according to the individual’s calculative mind. According to Heidegger, if we adopt the use of vision (sicht) in order to understand and analyse the world we obtain the ability to deepen our understanding of our relation to the world. This in turn enables us to obtain meaning, to imbue life with value through the finding of our place in the world. Observing those around us is evident through consideration and observing things around us is evident through circumspection. Observing persons and objects as they stand in relation to ourselves is evident through transparency and allows is to understand not only the world but ourselves as individuals. Heidegger and Existential Anxiety The process of individuals lacking meaning and progressing to form meaning in life and living are closely linked to experiences of existential anxiety (Heidegger, 1962: 228-234; Mulhall, 1996: 109-112). The individual will internally realise that he is singular, or alone in the world and thus have to address his mortality and limitations as a result of this singularity. This need to take responsibility for oneself when presented with unending difficulties, confusions and challenges bring the crisis of meaning that Kierkegaard describes (2008: 56). Far from negative, this is viewed as a positive, even desirable stage of life because it enables the person, as a result of his anxiety felt about life, to question life rather than experience the hopelessness of denial of thinking for oneself. As we develop we become more aware of our senses which causes us to observe and exist within the world in a more intense manner (Sallis, 1984). From knowing about the world flows knowledge about oneself which again allows self-knowledge and awareness to flourish, as well as self-autonomy (Heidegger, 1962: 86-88). The progression through these stages causes individuals to experience existential anxiety, termed ‘the dizziness of freedom’ by Kierkegaard and representative of the assumption of an individual of responsibility (Marino, 1997: 308-327). Such assumption of responsibility allows us to deal with the difficulties and problems of life, something that could not be achieved without such existential anxiety. Hence, existentialists view anxiety as an important aspect, in that it is vital to deal with anxiety in the correct manner so that individuals may experience life in a meaningful way: “whoever has learnt to be anxious in the right way has learnt the ultimate” (Kierkegaard, 1844: 155). Heidegger highlighted the importance, however, of distinguishing between fear and anxiety. While he defined anxiety as the individual’s general, unspecific feeling of lack of ease or belonging in the world, he defined fear as a concrete, specific object (1962: 228-232). Unlike fear, anxiety for Heidegger allows the individual to define himself and his place in the world as a person so that he may respond as an individual to the world. Ultimately, anxiety allows the individual to live a full life; to experience existence. Authenticity and Inauthenticity Many existentialists claim that individuals attempt to feign the feeling of solidity and definiteness, so that they may avoid feelings of mortality and senselessness in the world in which they live. Such attempts to view himself as an object causes the individual to deceive himself so that he becomes redefined in an erred manner (Sartre, 2003: 70-90). Although this is largely unavoidable due to our fear of freedom (Sartre, 1956: 485), we eventually increase our awareness of our autonomy which thus causes us to deliberately live rather than exist automatically, and thus reduce the degree of self-deception that we undertake. Heidegger described individual existence as often defined by others, which causes the individual to have his actions determined and dictated by others, and they thus become false, creating within the individual conflicts and problems. He described this as one of the biggest hindrances to authenticity, and it causes most of us to live in an inauthentic manner for the majority of our lives (1962: 352-356). We are however able to pull ourselves from such inauthenticity through our anxiety felt in relation to being mortal and alone in the world; it causes us to put meaning into ourselves as individual beings and inject purpose into our place in the world as mortals (Sikka, 1998: 302-303). Authenticity for Heidegger is thus the ability to be true to oneself, to one’s existence and spirit. The central aim is to aid the individual in gaining autonomy and hence an ability to accept the world as a complex, paradoxical place, defined as an authentic courageous life by Tillich (2000: 29-30), so that he may assign himself a place in the world with meaning and existence. For Buber the existential aim of psychotherapy is self-reflection and the ability to effectively communicate with fellow humans (2002: 147-150, 198-199), though the various alternative definitions of the psychotherapeutic aims of existentialism are perhaps problematic. Heidegger’s Contributions to Psychotherapy The existential psychotherapy of Heidegger forms a basis of individual-therapist interaction which resides in his main work, Being and Time. He sought to reject the Cartesian distinction between subjective and objective self, criticising it as undesirable, inaccurate and useless. Heidegger achieves the provision of a theoretical approach explaining the way in which an individual observes life and the way in which such observations are communicated. This allows the individual and the therapist to share the experience mutually, allowing the therapist to gain a greater understanding of how the individual views life. Being and Time also proposes that signs have certain meanings in relation to the whole, for the being has the ability to automatically possess meaning and comprehend signs before thought or speech of the ego intervenes (1962: 107-113). The objects and persons are thus analysed to see what meanings they are given within the context of the individual’s world. The individual speaks, forming words and using gestures and expressing emotions within a number of contextual backgrounds. The therapist is able to understand the meanings, gestures and emotions within their personal projected world. Meanings are borne of the contextualisation of expressions against an array of referential worlds. Heidegger thus proposed that different meanings can exist on an array of different levels, primarily primordial interpretation and primordial understanding (1962: 36, 76, 188-195). These exist as non-verbal awareness which precede spoken words and verbal thoughts within the individual. The primary goal of psychoanalysis is to aid clients in their personal breaking down into concepts and elements which can be assessed and reassessed, thus allowing the client to feel less alienated. The client largely participates in a direct manner in this practice rather than the therapists dictating to the client. Heidegger draws a distinction between the external senses of the world as located in bodily movements and connections, and the existence of being as a pre-reflexive existence (1962: 244-254). Individuals are engaged in a connection with contexts of a social kind, and it is here that semiotic codes depicting similarity and difference take place. Meaning is not however restricted to just non-verbal body existence and speech; an event or object can be given meaning through its situation within general meaning codes. The link between this approach and psychotherapy is the premise that the psychotherapist may make a verbal statement or comment which serves to form meaning connections which were not otherwise evident to or recognised by the individual, due to the stress and confusion of his problematic situation. It is arguable that the individual is not internally experiencing true meaning changes, yet it is evident that such changes of meaning, to be effective, are only successful or able to be achieved if the individual is freely and consensually participating in the process. Should the therapist attempt to force meanings or concepts at any point, the individual will resist the therapist, thereby reducing the effectiveness of their relationship. The natural and helpful flow between the therapist and the patient will cease, become blocked, and the therapy will no longer be effective. It is however important to distinguish between forced problems onto the individual and mere coaxing or highlighting of evident problems to the client. The latter can actually prove helpful in gaining a better understanding of their life’s occurrences which they may not have been aware of. The distinction between forcing and coaxing is however fragile and paper thin. The therapist is thus limited to mere interpretation of the individual’s problems, limited to the context and input of the individual. Individuals experiencing high levels of distress or depression may not be able to make the connection between their life’s predicaments and perhaps past experiences which have caused such reactions. In such situations, it is within the therapist’s limitations to provide or interpret such connections. There is a clear distinction which is evident in Heidegger’s work between interpretation and suggestion, and forced issues and problems onto the patient. Indeed, only the former practice is suitable according to Heidegger, which coaxes the patient based on evident sigs rather than forcing the patient based on unfounded assumptions on the part of the psychotherapist. Heidegger’s theory can be interpreted to allow for such minor coaxing though it adequately prevents forced connections. Psychotherapy from an existential perspective thus seeks to alter previously existing connections between understandings of meaning and experience which provide primordial-level meaning. Conclusion There is little doubt that Heidegger’s theory has contributed greatly to the world of psychotherapy; he sought to refute traditional notions that pre-reflexive existence is obtained from conscious experiences. A proper application of Heidegger to psychotherapy requires that greater importance be given to semiotic understanding, which arguably resides within and is fundamental to the existence of the pre-reflexive being. The importance of signs and the application of Heidegger has been largely overlooked due to its lack of structure, yet this lack of structure is necessary at least if a theory is to be adequately applied to existential psychotherapy. If it can be adopted as a proper and particular practice of psychotherapy, it has the potential to hugely benefit both patients and psychotherapists, and hence develop naturally into a structured and more specifically defined approach to psychotherapy. 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