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Existential Psychotherapy

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Jamie Crabb

on 2 June 2014

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Transcript of Existential Psychotherapy

Existential Psychotherapy & Demystifying Therapy
Theoretical Foundations
Early Philosophical roots:

Existential Philosophy: Søren Kierkegaard, Friedrich Nietzche,
Phenomenology: Edmund Husserl, Martin Heidegger, Jean-Paul Sartre &
Maurice Merleau-Ponty

Reaction against dominant religious and scientific ideologies of the time; interested in exploration of human reality experienced
passionately, personally and experientially (lived-body)

Spinelli: Existential-Phenomenological Psychotherapy
Demystifying Therapy
"Therapists have tended to mystify both the therapeutic process and themselves as its expert practitioners." (Spinelli 1994, p18)
The Existential-Phenomenological Therapeutic Relationship

Exploring the clients worldview

(self-construct, world-construct, other-construct)

(for both client and therapist: themselves-in-relation; the-other-in-relation; each-other-in-relation)

Stepping Stones

Intro: Being/doing exercise and key understandings
Theoretical Foundations: Existentialism and Phenomenology
Existentialist Psychotherapy: Approaches - Logotherapy,
Daseinanalysis, Humanistic-Existentialism
Spinelli: Demystifying Therapy
Spinelli: Existential-Phenomenological Psychotherapy
The Existential-Phenomenological Therapeutic Relationship

Existential Psychotherapy: Key Understandings
Challenges and critiques contemporary Western models of psychotherapy
Grounded in philosophy: existentialism - the 'existential attitude' (Spinelli, 2007: L127) and existential phenomenology
Resists fitting client into pre-established frameworks of interpretation
Exploration of one's position in the world
Exploration / clarification of what it means to be alive
Exploration of these questions with a receptive rather than dogmatic attitude
Exploring individual truth / authenticity with an open mind and an attitude of wonder
(Deurzen-Smith, 1996: 166)
Nietzche (1813-55)
Kierkegaard (1813-55)
Husserl (1855-1938)
Transcendental Phenomenology
'This - is now my way - where is yours? Thus did I answer those who asked me 'the way'. For the way - it doth not exist'
(Nietzsche in Spinelli 2007: L35)

Set aside 'natural attitude' - initial biases and prejudices, focus on immediate experience [bracket]
Rule of description – describe, don’t explain; refrain from hypothesis, theories, stay with lived experience as they are; feeling, sensation, intuition, physical qualities, colour, etc
Use ‘I notice…’ to begin your readings
Rule of horizontalisation – avoid hierarchies of significance on descriptions; treat all descriptions as equal
to consider alternate possibilities and develop a deeper understanding of how we experience the world
(Spinelli in Cooper, 2003: 10-11)
Heidegger (1889-1976)
Existential Phenomenology

Protested against 'truths' of Christian teachings and 'objectivity' of positivist scientific methods. These were ways of avoiding
the anxiety inherent in human existence
Believed people lacked courage to take a leap of faith and live with passion - human beings should
turn towards their own subjective truths

Challenges Western individualistic, capitalistic, self- conscious concept of subjectivity
Relatedness/inter-relation fundamental to being:
all of our reflections upon and knowledge, awareness and experienced understanding of the world, of others and of our selves emerge out of, and through, an irreducible grounding of relatedness. We cannot, therefore, understand or make sense of human beings - ourselves included - on their own or in isolation, but always and only in and through their inter-relational context
(Spinelli, 2007: L168)

Each of our existences fundamentally and
intertwined with the existences of others:
evidence in early anthropology studies
of non western (Chinese, Japanese and Indian)
and indigenous cultures, mirror neurons

3. Existential anxiety
‘Whilst it may seem that existing as a unique, no-thing-like, freely-choosing happening is relatively agreeable, existential philosophers have argued that such a being-ness brings with it profound feelings of angst – particularly the fact that we are freely choosing beings’
(Cooper, 2003: 23).

Anxiety is a universal given that arrives out of uncertainty
Human beings are 'meaning-making beings...Consequently, we are disturbed by the lack or loss of meaning' (Spinelli 2007: L408)
Meaning = Worldview's attempt to structure Worlding to avoid anxiety:

In our attempts to avoid or diminish the disturbing aspects of anxiety, we seek out and assert fixed truths, facts and statements and deny or dissociate from those instances in our experience that cast doubt or challenge our assertions of certainty and fixed meaning. This denial has been referred to as inauthenticity (Heidegger, 1962) or bad faith (Sartre, 1991)...it serves to allay the unease and uncertainty of being-in-the-world' (Spinelli 2007: 450)

'remains rooted in relatedness and, hence, is subject to the constant possibility of being de-structured' (Spinelli 2007: 416)
Existential Philosophy
Existential Phenomenology
(arose early 20th Century)
Sought to establish phenomenology as primary philosophy of scientific investigation - challenge essentialist scientific methods to identify 'truths'

Challenged 'dualistic split' (subject/object) of scientific enquiry: 'the investigator's ability to consider, describe and manipulate the focus of investigation from an impersonal and detached standpoint so that through research and investigation a true, factual and objective nature of reality can be discerned' (Spinelli, 2007: L150)

Human experience is defined by Inter-relationality - no investigator can exclude self from what is being studied

Emphasises the
of each being's experience of relating with, and constructing meaning from, the world

Primacy of ‘inner evidence’ that is given to us intuitively in our individual conscious experiencing of things
For Husserl: to really know ourselves / our world – we need to turn attention to our conscious lived-experiences
Spinelli's Snowflake Example
There are many principles of existential-phenomenology!

Spinelli usefully groups these into three key principles:
1. Relatedness (Inter-relation)

2. Existential Uncertainty

3. Existential Anxiety
Spinelli: Relatedness as

Daesin (Heidegger) - 'being-in-the-world'
'[T]here is no inner man, man is in the world
and only in the world does he know himself'
(Merleau-Ponty in Cooper, 2003: 18)

Existence is not located
the individual but
the individual and their world

Worlding (process)
pre-reflective, primordial, being as verb-like, in-process, perpetual becoming rather than pointing towards a specific point

'an active and continuing process-like foundational principle…the ongoing, ever-shifting, process-like, linguistically elusive living of being'
(Spinelli, 2007: L272)

Worldview (substantive):
our embodied,
usually fixed standpoint, structural point of focus including structural limitations - 'in many ways an artifice, a construct' (Spinelli, 2007: L291)

Existential phenomenology (and as a consequence existential psychotherapy)...argues that no self can be 'found', nor individual 'emerge', other than via the a priori inter-relational grounding from which our unique sense of being arises (Spinelli, 2007: L201)
1. Relatedness:
Existence as with-others
2. Existential Uncertainty
'if all of one's reflective experience, knowledge and awareness of self, others and the world in general arises through and within relatedness then what is revealed is an inevitable and inescapable uncertainty or lack of completeness in any and all of our reflections' (Spinelli, 2007: L315)

meaning makings, reflections, choices do not exist solely 'within'

Existence is verb-like

an unfolding event, path or process - not fixed selves, the essence of human existence is
'self-interpretation' (Heidegger) even unconsciously
> multiple possibilities

Existence as freely choosing
- freedom is the essence of being - there is the possibility of making choices;
'Man is nothing else but what he makes of himself'
(Sartre in Cooper 2003: 14)

we are our choices - and in our interelationality
our choices impact others...

Existence as limited
- human freedom is ‘hedged in’ in innumerable ways by ‘facticity’ / structural invariants (Heidegger) = limiting factors of existence - e.g. embodied processes, death, gravity, solid walls...

However - existential phenomenology argues each beings lived experience of these certainties are open to multiple possibilities and thus uncertainty....

(Heidegger) - like throwing a dice we cannot choose some aspects of being e.g. particular parents, our social context we emerged...
'meaning-reflections emerging through inter-relation expose me to the many uncertainties of relatedness - uncertainties having to do with meaning, control, responsibility and so forth' (Spinelli, 2007: L315)
We appropriate the world through public rather than private understandings

'Existence is fundamentally contingent and groundless – being in the world – not rooted in some personal truth or reality, but in public and non-specific to us'
(Cooper, 2003: 19)

Mirror Neurons:
'the mirror neurons of a particular subject (for instance an infant human being) 'mirror' or reflect the behaviour of another (for instance, the infant's mother) as though it were the subject (the infant) who performed the action'
(Gallese in Spinelli, 2007: L209)

Individuality: Subjectivity as an expression of relatedness
Individual consciousness part of a larger
inter-relational consciousness
Existential phenomenology argues that one of the essential distinguishing characteristics of being human is that we require meaning of, and impose meaning on to, the world. It is through our relatedness to the world that we experience our selves as meaning-making beings.
(Spinelli, 2007: L408)
what and how it is to be an uncertain being within the open-endedness of inter-relational existence?
the principle of uncertainty:
challenges quest to 'know the self' (worldview)
alerts us to the constant possibility of the unexpected / multiple points of departure
urges us to treat 'the expected' as novel, full of previously unforeseen qualities and possibilities
necessary to maintenance of
World View
'Man is incapable of self-completion, and therefore never wholly predictable; fallible, a complex combination of opposites, some reconcilable, others incapable of being resolved or harmonised; unable to cease from his search for truth, happiness, novelty, freedom, but with no guarantee ... of being able to attain them'
(Chemiss in Spinelli, 2007: L390)

Cooper, M. (2003). Existential therapies. London ; Thousand Oaks, Calif: Sage Publications.
Csordas, T. J. (Ed.). (1994). Embodiment and experience: the existential ground of culture and self. Cambridge ; New York: Cambridge University Press.
Deurzen-Smith, E. van. (1996). Existential Therapies. In W. Dryden (Ed.), Handbook of individual therapy (pp. 166–193). London ; Thousand Oaks, Calif: Sage Publications.
Garner, S. B. (1994). Bodied spaces: phenomenology and performance in contemporary drama. Ithaca, N.Y: Cornell University Press.
Moran, D., & Mooney, T. (Eds.). (2002). The phenomenology reader. London ; New York: Routledge.
Spinelli, E. (2007). Practising existential psychotherapy: the relational world [Kindle Edition]. Los Angeles: SAGE.
Spinelli, E. (1994). Demystifying Therapy. London: Constable
Frankl, V. (1959). Man's Search For Meaning. London: Random House
Yalom, I. D. (1989). Love's Executioner and Other Tales of Psychotherapy. London: Penguin.

Key Terms:
Built on Husserl's Phenomenology in
Being and

(1927) focuses on the Question:
'what is the meaning of being?'
Essence of manifestation:
Used Phenomenological method to explore the meaning of


Is to be
existentially part of:
our history/retention/living now-
time/pretention - not A>B>C:
'intertwining' - in-process
our environment, objects, others

Put aside hypotheses, analytical procedures, theories - focus on
Existence of human beings:
Look at the Cube

How many faces do you perceive?

What does your perception of the cube reveal to you
Existential themes - anxiety, freedom, choice, responsibility, courage emerge...
Introduced the notion 'God is dead' - wanted to
re-evaluate existence
Encouraged people to shake off shackles of moral constraint, discover free will, learn to live with intensity - reject 'the herd' and stand out

Husserl's Phenomenological reduction [bracketing] method
'to return things to themselves'
Key principles:

Uniqueness of each beings experience of relating with and constructing meaning from the world
Experience and reflections on being arise from universal 'givens' - 'structural invariants' (Husserl)
as unique - each of us is distinctive, irreplaceable and inexchageable with a unique potential that we bring to the world
(Cooper, 2003: 11)
The Primacy of Perception
(1945) outlining the foundational role
plays in understanding and engaging with the world: ‘to perceive is to render oneself present to something through the body’ (Merleau-Ponty in Garner, 1994: 27)

- 'Experience in relation to the world is dialectical rather than linear or dualistic... human interrelatedness with the world is essential rather than secondary... Consciousness is the in-between, it is neither entirely in me, or in my mind, nor is it out there in the world of objects' (Van Deurzen, 1997:65) e.g. how we can touch and be touched, how we embody objects

- Centrality of the body as our means of being-in-the-world 'defined by perceptual experience and mode of presence and engagement in the world' (Csordas, 1994: 12).

'Our body and the world are associated and intrinsically bound together: our own body is in the world as the heart is in the organism, it keeps the visible spectacle constantly alive, it breathes life into it and sustains it inwardly, and with it forms a system' (Van Deurzen, 1997:65)
Sartre (1905-1980)
Wrote Being and nothingness (1943): We are not 'things' that have a fixed essence (object-thing) - we are defined by existence:

- Essence // Existence dichotomy -

origin of choice - 'Myself is nothing, but the creation, which is momentary and fleeting, essentially unstable...there is in fact one choice that we do not have and that is not to choose – in that not choosing in itself represents the choice. Not having the choice to not to use condemns us to freedom and responsibility... We are our own future and we choose what we become...what we do is what creates our self and our life for the future' (Van Deurzen, 1997: 49-50)

Bad faith:
We love to act as if we are set and substantial, as if we have a certain character, a certain essence, and a fixed state of being. We like to believe that we cannot alter our circumstances or our attitude. It is actually reassuring to spend our lives in bad faith, acting as being something definite (Van Deurzen, 1997: 47).

Refutes consciousness can be unconscious...

Living A satisfactory life:
we should focus on communal interest
'reorganisation of our understanding and and interpretation of reality can have far-reaching consequences that are always at the same time of an individual and a collective nature (Van Deurzen, 1997: 56).
Existential Psychotherapy: Approaches
‘[F]reedom’s possibility announces itself in anxiety’ (Kierkegaard)
Living Anxiously
People who are most afraid of death are those who have the greatest anxiety about life'
(Boss in Spinelli, 2007: L461)
Anxiety has / can become pathologised:

'untruthful' responses to existential anxiety which seek to avoid or deny the experiential consequences of relatedness and uncertainty, will serve to `fix' and focus existential anxiety so that it expresses itself through the `structures' of symptoms and disorders (Spinelli 2007: L467)

Not so much a question that anxiety is, but rather how each of us
lives with anxiety:

While anxiety can be experienced as confusion or despair...the experience of anxiety can also be stimulating, can re-awaken or enhance our connectedness to being alive, and arouses creativity...permit the reshaping and reconstructing of a novel meaning that can be accepted and 'owned' (Spinelli 2007: L432).

Part of the process is to recognise that a life that was anxiety-free would also be bereft of wonder, enthusiasm and excitement (Spinelli 2007: L439).
Ludwig Binswanger (1881-1996) and Medard Boss (1903-1990) key figures: Daesinanalyitical movement

Critical of psychoanalysis: reject psychopathology, causal mechanisms, instincts and formulae, transference

Grounded in Heideggerian phenomenology - analysis of human
: Psychological wellbeing/difficulties construed as individuals
openness or closedness in relating to their world and towards others

e.g. depression as closedness
to worldly beauty/joy,
manipulated in relationships as a
to a personal sense of agency/power

client-therapist relationship as integral, supportive and warm, loving acceptance
'shepherd to the Being of the client'
- 'enables the client to unfold all his world-disclosing possibilities of relating toward the particular beings which he encounters' (Boss / Cooper, 2003: 41)

Daseinanalysists create
a 'trial world' for clients to experience a more open way of being

Ernesto Spinelli on death anxiety: http://podbay.fm/show/129166905/e/1229202000?autostart=1
American approach to existential therapy: emphasises individual, subjective dimensions of existence. Ideas of
choice and will,
search for independence -
"frontier spirit"
(Cooper p65)

Closely linked to Rogers' humanistic therapy - has most optimistic outlook on life and possibilities of therapeutic change of all existential therapies.

BUT based on a psychodynamic model: humans use
defence mechanisms
to deal with anxiety, these can be conscious and unconscious.


Problem with defining "existential analysis" in any single way as many different approaches.

"Rich tapestry of interesecting therapeutic practices, all of which orientate themselves around a shared concern: human lived existence." (Cooper 2003, p1)

No single founder - different approaches emerged spontaneously, sometimes independently - Cooper
Logos - Greek word for "meaning"
Viktor Frankl
(1905-97) - creator of "logotherapy"
founded what he called "Third Viennese School of Psychotherapy"

"Will to meaning"
- driving force behind human endeavour
(reaction against Freud's pleasure principle/ Adler's will to power)

"Man's Search for Meaning" (1984) - sold more than 9 million copies. Recounts Frankl's experiences in Nazi concentration camps.

Frankl developed idea of logotherapy 10 years before WW2, but his experiences of concentration camp life proved to be a testing ground for his theory:
1. People who could hold on to something meaningful were more likely to survive.
2. People could always choose how to respond to their circumstances: "animals" and "saints".

Lack of meaning can lead to deep sense of frustration, emptiness, depression - in worst cases can become "existential neurosis", where a person turns to self-destructive behaviours (addiction/compulsion/phobia) to fill their existential void.
Illuminating your world exercise
"He who has a why to live can bear with almost any how." (Nietsche, in Frankl 1984, p97)
"However grim these givens may seem, they contain the seeds of wisdom and redemption. ... is is possible to confront the truths of existence and harness their power in the service of personal change and growth." (Yalom 1989, p5)
Ultimate concerns of existence that cause all human anxiety:
Death Freedom Isolation Meaninglessness
What is therapy?
Problematic to define and categorise therapy - Spinelli thinks we ask the wrong question: better to ask "when is therapy?"
Also says counselling/psychotherapy are the same thing.

Does therapy "work" and if so, why?
Lack of evidence that any theory "works" better than any other. (Also training!) So why is theory so important to therapists?
Dumbo Effect:
belief in a "magic feather" that allows Dumbo to fly.
Spinelli says there is "very little" in therapy that is not a Dumbo Effect.
Non-specific factors: relationship/frame/emotion/therapist reinforcement/interpretation.

The issue of power:
Spinelli argues that most abuse/misuse of power is theory-led - causes therapists to be blinkered.
Sexual attraction: therapists should not explain this away as transference/countertransference, instead it demands an "act of sacrifice" in the service of the therapeutic relationship.
Spinelli: Demystifying Psychoanalytic Theory
: how do we know it exists?
Instead suggests theory of "dissociated consciousness"

problem with idea of linear causality. Chaos theory
"The past as currently lived and future-directed"

Invented by therapists "to protect themselves from the consequences of their own behaviour" (Schlien in Spinelli 1994: 184)
How do you know what is transference and what isn't?
Better to invert significance: past experiences clarify the meaning of current experience and current self-construct,
not the other way round

impossible not to interpret, everyone has assumptions and biases, BUT how you interpret is important: descriptive rather than analytic interpretation.
Criticised: Close association with Freudian practical aspects: couch, free association, dream analysis
Numerous assumptions and prejudices about what is meaningful/healthy/normative ways of being (e.g. Boss: normal love is heterosexual, women's destiny to have a family) [bracketting]??
n practice
Fostering within clients:
Human existence as multiplicity of possibilities for relating to the world; autonomy
A state of openness and 'letting be'
Learn for the first time to experience certain things / emotions in-this-therapy-world
Therapist approach:
'I wonder how my client is experiencing her world'
Rule of description: stay with clients in-the-world experiences as they are described - [bracket hypothetical / abstract interpretations] possible??
Not WHY? Why Not? - explore clients world-closing and possibilities for freedom
Leaping ahead rather than leaping in - anticipate the clients potential and providing a space to fulfill
Past history as formative rather than determinative (e.g. stuck by past relationships) - reframing
, (Cooper, 2003)
the whole thrust of the existential enterprise is directed toward disclosing the structure-bound patterns of the client's worldview
(Spinelli, 2007: 1407)
the rule of epoche requires the therapist to attempt to set aside any immediate personal predispositions and preferences toward any particular meaning or explanation of the client's worldview. Instead, the therapist remains temporarily open to any number of alternatives, neither rejecting any one as being out of hand, nor placing a greater or lesser degree of likelihood (2007: L1751)
A: the rule of epoche (bracketing)
B: The rule of description
the task of describing as concretely as possible that which the client presents. The essence of the rule of description is: 'Describe, don't explain' - assist the client in carrying out a concretely based descriptive investigation of his or her currently lived experience (2007: L1762)

is it 'located' in any part of his body? What is the body-feeling associated with it? If the fear had a sound, what would it sound like? How does the client 'feel' the fear - is it awful? Does it have any pleasant aspects to it? (2007: L1769)

Descriptive challenging is the challenging of the client's world view so that its implicit dispositional stances are made more explicit... [uncovering] dissonance between worlding-as-process and worlding-as-structural-worldview is 495 (L1878)

C: Rule of Horizontalisation (equalisation)
the rule of horizontalisation, warns the existential psychotherapist to avoid imposing any hierarchical assumptions of importance with regard to the items of description by temporarily equalising their significance...in being willing to follow this rule to some extent, investigators reduce the likelihood of imposing unnecessary judgements or biases on their initial observations (L1774)
"I was just this living thing that had nothing to offer but my aliveness." (Workshop participant, in Spinelli, 1994 p310)
How do we feel when our "doing defences" are stripped away?

Therapist who has a "being" focus rather than a "doing" focus is less beholden to theory, to "doing it right", less likely to abuse/misuse the client.

"Being with"
- therapist acknowledges the lived reality of the client.

"Being for"
- therapist attempts to enter the client's lived reality, in order that they may experience that reality in a manner that approaches the client's way of being.
("Being for" is never fully achievable). (Spinelli 1994)

Therapists should be "changing beings", have a "flexible self-construct". They should challenge the very idea of the "self-as-therapist", which gives power and mystique to the therapist and therapy.
"Sedimented beliefs": the primacy of one perspective above all others, the "building blocks of our constructed self."
The value of training is for trainees to "learn to challenge their sedimented self-structure so that their 'being' in the encounter is as flexible as they can allow it to be." (Spinelli 1994 p359)
Therapists' tendencies to believe in theory "from an unquestioning standpoint, may both impede the therapeutic process and open it to the possibility of misuse." (Spinelli, 1994: p139)
Spinelli: Demystifying Humanistic Theory
not a bad thing, but depends on what you disclose and how you do it - should be for the purposes of serving the client's interests, not the therapist's.

Spinelli thinks the idea of innate, "naturally directed" growth is naive, questions the assumption that "good change" is "natural".

Conditional unconditionality:
Therapist seeks to give "unconditional" acceptance, but how
is this acceptance on the assumption that all growth is innately positive? What if the client grows in a way that the therapist thinks is "negative"? The therapist is making implicit demands of the client.

The self:
Spinelli has a problem with the idea of a fundamental or "real" self that is a source of the innate goodness. How can you distinguish the "real self" from "false selves"? Humanistic therapists give themselves the
to direct clients towards recognising this "real self" - potentially abusive.
Logotherapy: in practice
Logotherapy aims to help people rediscover a sense of meaning, purpose and hope. Helps client see what Frankl believed were the inherent "true" meanings in any situation.

Appealing technique:
Therapist appeals to client to see the world in particular way. Very didactic.
Socratic dialogue:
Therapist debates with client, using power of argument to show them alternatives to their viewpoint.
Paradoxical intention:
Client encouraged to try to do the very thing that they are anxious about. Eg insomniac trying to stay awake.
Client encouraged to turn their focus outside of themselves towards their relationship with the world, eg a man worried about impotence focuses on his partner rather than himself.
Logotherapy can be seen as authoritarian, some eg Van Deurzen Smith, did not think logotherapy was really existentialist.
Existential-Humanistic: in practice
Therapist encourages clients to face up to the reality of existence by helping them to focus on their
inner world
of subjective experience.

This involves: being
; an awareness of current feelings (particularly towards the therapist); overcoming "blocks" to deeper subjective awareness; being open to the "authentic being" of others. Uses whatever "tools" are useful, eg role play.

The therapist must be
"fully present"
about their own subjective experience in order to facilitate this.

Existential-Humanistic therapy has been criticised for lacking philosophical depth; too much emphasis on subjective experience at the expense of the client's relations with others; idea of linear growth towards a superior "authenticity" of being is problematic.
Exploring Existence Tensions
As a means of clarifying the client's worldview as focused initially upon his or her self-construct the exploration of the client's existence tensions may prove to be useful in generating descriptive discourse....exploration of existence tensions permits a descriptive means of addressing, for example, what Sartre termed as a person's 'life project' (Sartre), the ontic constituents of existential anxiety (Heidegger) (L:1806-1822)
Nothing is more dangerous than a dogmatic worldview - nothing more constraining, more blinding to innovating, more destructive of openness to novelty. Stephen Jay Gould
The worldview expresses the selective focus or bias imposed upon the ontic experience of worlding (Spinelli, 2007: 495)
Flexible dispositional stances in the worldview make it plain that existential phenomenology rejects any entirely static definition of the worldview. Instead, it acknowledges the possibility of a continuing dynamic restructuring of the worldview via shifting dispositional stances throughout one's life (L550)
His critiques of psychotherapy over-emphasise limitations of the therapeutic enterprise?

Has been accused by Cooper (2003: 125) of lacking philosophical depth - redresses this in later work Practicing Existential Psychotherapy!

Closer to a person-centred phenomenological way of working than existential - similarity to Rogers' writing / principles.

Van Deurzen explicitly acknowledges EP is not suitable for all clients - criteria: openness that problem is with 'living' not pathology, not looking for 'symptom relief' or smooth life, wishes to question themselves, someone who questions the status quo (Cooper 2003: 111)
The body, or embodied subject, is the object of seduction by advertising, interpellation by semiotically loaded commodities,torture by a broad spectrum of political regimes, bitter conflicts over reproductive rights and health care, struggles for the revaluation of alternate sexual identities, threats from the new epidemic diseases, and the object of new technologies permitting the alteration of physical attributes hitherto accepted as naturally determined, including cosmetic surgery, asexual and extra-bodilyfertilization, multiple forms of intervention in the biological process of reproduction, the modification of genetic traits, and the artificial prolongation or curtailment of the span of life
(Turner in Csordas, 1994:27).
The body as a cultural phenomenon
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