SEVEN PAPERS ON EXISTENTIAL ANALYSIS ... - Wagner College

structures, which were in effect personifications of the agents of the client’s misery. The
structural agencies were shown to be simulacra of the analysand’s parents (imagos), including
their own attitudes and values, and their own intrapsychic conflicts.
Unlike medical techniques, application of the fundamental rule of psychoanalysis had to
be carried out by the patient herself (on her own psyche) and not by the physician.
Practitioners soon realized that fluency in engaging in “free” association was, in fact, the
ultimate aim of psychoanalysis. Once the uncensored association of memories was possible,
analysis could be terminated, at least formally. The work of the “analytic instrument” (the
personality of the analyst) had been completed, but the much desired side effect of a
complete analysis was to have set into motion in the patient a habit of self-reflection that she
could be expected to continue throughout her life.
Many other forms of psychotherapeutic intervention have been devised in the wake of
classical psychoanalysis. It is estimated that there are currently more than 400 varieties of
counseling and psychotherapy available in the United States, and this does not include the
impressive array of homeopathic (“holistic”) and self-help regimens on the mental illness and
mental health market, or the formidable physiological and legal interventions of psychiatry
(pharmacotherapy and the “milieu therapy” of mandatory hospitalization). Some plans of
intervention are based on the ideological motivation and role of the counselor (e.g., medical,
pastoral, forensic), while others target an area of psychological life (e.g., cognition, motivation,
conation, perception) or a realm of human experience (e.g., sexuality, “ingestive behavior”).
Still others focus on a social institution (e.g., marriage, family) or lifestyle or role (e.g., gender) in
which significant numbers of the population participate. Many are grounded in a formal and
complex theory of personality (e.g., Jungian analytical psychology, Adlerian individual
psychology). Others have a more broadly theoretical basis (e.g., client-centered, systemsbased,
information-processing). Still others have been developed for a specific diagnostic
category (Kernberg’s work with “borderline” personalities, Kohut’s self psychology for work with
“narcissistic” personalities). At the end of a day of consultations, however, all have common
cause in having actively intervened in the lives of those who sought their counsel and help.
Whether the patient or client is required by law or coerced by a family member into agreeing to
work with a therapist or when it is the client’s wholehearted desire to form a therapeutic alliance
with a practitioner, she expects management of her life in some way through the agency of the
therapist. [3]
While psychotherapy entails some degree of participation of the client, it also implies an
essentially passive stance vis-à-vis the psychotherapist’s interventions. Any form of treatment
implies at least two players: one who takes a passive role in receiving treatment and one who
take an active role in providing and effecting it. Just as medical patient gives herself permission
to become less adult in the arrangement of a visit to the doctor’s office by allowing (even
welcoming) her physician the authority to touch and even invade her body, in psychotherapy
the patient gives the therapist access to her private thoughts and feelings, and permits the
therapist to manipulate that part of her world in which she makes decisions and creates her self.
In doing so, she gives the therapist permission to take an authoritative, quasi-parental role to her
“less adult,” childlike role.
Modes of counseling and psychotherapy run the gamut from providing information,
giving instruction, educating (or re-educating) and offering advice, to providing emotional
support, being a surrogate ego, or accompanying the patient on an odyssey in search of insight.
The goal of psychotherapy is always change. Or is it? Here we arrive at what I take to be the
critical concept for a discussion of authenticity in psychotherapy.
Psychological change may be the result of outside intervention, inner self-transformation,
or a shift in one’s being-in-a-world. [4] In most of its incarnations, psychotherapy has been
associated with one of the first two roads to change. The second also has a place in the
venerable traditions of spiritual discipline. The first, outside intervention, is also ominously at home
with various kinds of indoctrination (e.g., military training, mandatory schooling, religious