SEVEN PAPERS ON EXISTENTIAL ANALYSIS ... - Wagner College

They will demand another approach to the human way of be-ing, which is so different from that
of the other mammals.
What Existential Psychotherapy Is Not
Let us turn again to some basic questions. Perhaps a comparison of existential psychotherapy
with other forms of psychotherapy will at least show what it is not. What is meant today by
existential psychotherapy? How is existential psychotherapy related to psychoanalysis and the
forms of psychotherapy rooted in humanistic psychology? Here we may be brief, since the story
has been told countless times.
The unique character of existential psychotherapy is often overlooked, especially when it
is thought of as a modified form of psychoanalysis. Orthodox psychoanalysis is marked by the
controlled regression of the analysand during analysis. This is a delicate procedure that is risky for
individuals whose ability to discern the difference between consensual reality and private or
personal reality is tenuous or impaired. When fantasies become powerful, such individuals may
be unable to anchor their fantasies to the relatively unyielding realities of everyday life, including
the therapist. Even analysands with fairly strong ego functioning often experience great anxiety
during periods of regression. However, unless there is sustained regression for extended periods
of time, the treatment may be a form of psychotherapy but it is not psychoanalysis.
While the origins of psychotherapy lie well before Freud and the invention of the "talking
cure," the near history of psychotherapy begins, of course, with psychoanalysis and the
treatment, by two Viennese physicians of the several forms of hysteria that they, Josef Breuer
and Sigmund Freud, described in a series of Studies on Hysteria published in 1895. Hysteria was
then defined as a neuropathic disorder fit for diagnosis and treatment by psychiatrists, whose
specialization in a branch of medicine determined how hysteria was conceptualized. We recall
that, for a medical doctor, in order for pathology to be confirmed, an observable lesion
(damaged tissue) or physiological dysfunction has to be identified. The treatment of the
disease, which is named only when a lesion has been identified, is based on its etiology. The
source of the ailment is treated, not only its symptoms. Palliative treatment is temporary while
the organism, now given the advantage, heals itself. In the absence of a lesion, however, no
etiology can be named, no cause of the illness can be identified, and no treatment justified. It
is then just a matter of guesswork, and that is not medicine.
Freud was certain underlying neurochemical disorders would eventually be discovered
to explani the neuroses he named and classified. In a series of letters to a rhinologist friend of his
in Berlin, Wilhelm Fliess, he also described likely cellular anomalies of cortical functioning that
might account for the neuroses. A very capable histologist, he thought he was on solid ground
in hypothesizing neurological pathology, although he admitted that the lesions of the nervous
system that produced hysteria and neurasthenia were too subtle to be seen at the time he
investigated them. At the present time, at the end of the twentieth century, we see more, and I
have not doubt that Freud would have been delighted by the findings of neuroscience.
Freud's treatment, however, and not his discussion of the causes of the diseases he had
discovered, was revolutionary. In a sense, he need not have been a medical doctor to do what
he did as a psychotherapist. This is why he was not opposed to lay analysts. The “talking cure”
was the work of a philosopher. Freud conceptualized mental disorders as diseases of the brain,
but he treated them as though they were problems of living or disturbances of the soul. He
limited his method to the psychoneuroses – hysteria, anxiety neurosis, obsessional neurosis and
neurasthenia – and believed that the more severe disorders of the personality, know collectively
at his times as the psychoses, were untreatable by his method. Unlike some of his followers,
beginning with Carl Gustav Jung, he kept his distance from dementia praecox or schizophrenia
unless his investigation was buffered by time and the absence of the patient, as in the case of
his study of Hofrat Paul Schreber.