SEVEN PAPERS ON EXISTENTIAL ANALYSIS ... - Wagner College

the DSM-IV of the etiology and treatment of this group of disorders include an admissions of
failure to understand the disorders psychiatrically. We read that the causes of the personality
disorders are not understood. Consequently, in the absence of clear etiology, treatment must
be vague. At the very least, it is not promising. The prognosis of the personality disorders is
generally poor, since the conditions are usually ego syntonic and the individual does not
perceive a problem or seek help. Paradoxically, others suffer from his disorder, a curious state of
affairs.
But what if the individual is set in search not of something wrong – a problem – but of
something right? What are currently termed personality disorders are in fact varieties of being in
a world. While psychiatry would seek to eliminate these eccentric, socially disturbing and
annoying types, existential psychotherapy recognizes them as existential variants. While it is true
that the antisocial personality disturbs society a great deal indeed with his criminal behavior, the
narcissistic personalities annoy us with their immaturity, the borderline personalities are downright
unpleasant to be around, and the histrionic personalities are tedious and puerile, as therapists,
we must not allow ourselves to be in a position to judge or worry about other people in our
patient’s life. Even though the social problems some individuals with personality disorders
engender are real, as psychologists we cannot in good conscience and with scientific precision
say that individuals with personality disorders are ill, when in fact we mean that they are
obnoxious, socially undesirable, or unwanted. On the other hand, these individuals, especially
as they age, are sometimes persuaded that their ways are alienating and their lives are
unfulfilled. They feel isolated from others, their relationships are unsatisfying, but they are unable
to pinpoint anything "wrong" with themselves. Their lives as such and as a whole are out of kilter
and off-balance, or the tone of their experience produces vertigo or prevents them from moving
on. Here, by the way, being stuck (depression) is often a prominent moment of their existence.
And so, they seek clarification or illumination of the texture of their world, which existential
psychotherapists are able to help them discover.
The so-called mood disorders are yet another realm of psychiatric psychopathology that
existential psychotherapy is well suited to treat. We understand that everyone is always in a
mood, although most of the time a person cannot say just what that mood is. One's mood or
attunement may suddenly be highlighted, however, and when it is the individual is likely to find
herself immobilized (depressed) or scattered (manic). His world thickens, moves in slow motion
or is even frozen for long stretches, or it flashes by in a chaos of images and sounds. Feeling at
sea, the world is gray and indistinct, awash in a mal de mer, or caught in a chaos of undulating
forms objects blend with one another and with the individual’s thoughts. As is always the case,
the individual's existence and her world are indistinguishable, but when one’s attunement is
“audible,” the contours and tone of being in a world are highlighted.
Psychiatrists now regularly treat the mood disorders with a cocktail of so-called "mood
stabilizers" and other psychotropic medications, but while the patient's perception of the world
may be adjusted neurophysiologically by the use of medications, the world itself and his own
existence remain unchanged. Much the same happens when I drink a glass of wine. In either
case, once the substance is metabolized everything returns to as it was. The world resumes its
peculiar shape when the palliatives are withdrawn.
Existential psychotherapists are in a better position to understand the personality and
mood disorders, since we know they are in fact orders, though of an unfamiliar, socially
inconvenient or deviant sort.
An Outline of Existential Psychotherapy
How does our way of treating a client differ from other approaches? It has been said that every
effective psychotherapist (to borrow Helmut Kaiser's phrase) is an existential psychotherapist and
that, regardless of one's theoretical model, when a person is seen as a whole, he is seen