Contemplating Practice. Sanja Oakley and Albyn Hall review Anthony Stadlen's SEA Forum answering questions on how he practises psychotherapy. Friday 31 May 2002


Contemplating Practice


Sanja Oakley and Albyn Hall

review

Anthony Stadlens

Society for Existential Analysis Forum

answering questions on how he practises psychotherapy

Friday 31 May 2002


[Hermeneutic Circular (Newsletter of the Society for Existential Analysis), October 2002: 18-23.]

Response from Sanja Oakley

During his seminar on Series and Nexus in the Family

[Laing: ‘Series and Nexus in the Family’. Inner Cir...]

a week before the Friday Forum, I somehow managed to provoke Anthony Stadlen into a vigorous defence of how he neither challenges nor gets into the clients world. He once surprised me by explaining Heidegger’s contention that ‘empathy is for the degenerate’ – now he was challenging me with a rejection of the necessity of challenging. On reflection, I decided Anthony Stadlen had more words at his disposal than most of us to describe what he does and why he does it, hence his reluctance to use vulgar words like challenging.

As I am walking to the Tavistock on a sunny evening, I decide to expose other participants to the same challenge and ask Anthony to explain once again how he engages the client in a process of therapy – Im planning to heckle him! Instead, he gets me: on my way into the building he asks me to write a review of the discussion. As I try to wriggle out of the job (offering to find a replacement reporter), he tells me he doesnt usually ask anybody and that the person he considers for the task has to be very intelligent. Flattered, for the rest of the evening I am too busy taking notes to enquire about the conspicuous absence of challenging in Anthony’s being-with-clients.

I will now try and relate the discussion as it unfolded, illuminating how Anthony works when he sits with his clients.

Steve Ticktin, who chairs the event, tries to open by gently suggesting that Anthony might want to tell us about his practice. Somehow this raises Anthony's blood pressure (my very modernist description/explanation of what occurred) and he responds: “For some unknown reason you invited me here to tell you how I practise. So, what would you like to know?” Steve still unruffled concludes that Anthony wants us to ask him questions. The atmosphere in the room suddenly feels very buzzy as 40 of us (I imagine) try to be very, very good and ask the perfect question – fast! Sarah Young comes to rescue first when she enquires about Anthonys position regarding self-disclosure.

On Self-Disclosure

Anthony starts by looking at the concept in its wider sense and says: “A therapist discloses herself with every breath she takes from the moment she enters the room. Everything discloses the person. It is not usually necessary to disclose the intimate details about a therapists life, but it might be useful. It is difficult to make strict rules about that.

Sarah Young delves deeper and enquires whether there might be times when Anthony would self-disclose intimate details. Anthony reiterates his flexible position and replies that it all depends on what the situation feels like; people sometimes ask personal questions and then the task is to try and judge just what the truth of the situation between the client and you at that particular moment is (Anthony is big on truth – as we shall see later): “If it is crucial for the client to know whether I have children, why is this important? Is it so that they can trust that I can understand them? If they dont believe that I can understand them, I need to explore that. Id say that I couldnt have experienced everything everybody who comes to me has experienced, and arent they familiar with the concept of imagination?” Here Anthony gets a giggle from the audience. His sense of humour is arresting – I can imagine him using this gift as a therapist in order to painlessly challenge the client. I am also starting to realise that I need to find another word for challenging, otherwise Ill make Anthonys blood boil again! The controversial word is becoming difficult to avoid – in his next line Anthony is on his way – via Heidegger – to challenge the concept of empathy. He calls it a dodgy concept. Scheler, too, before Heidegger, contested empathy; for Heidegger only the degenerate and alienated deploy empathy.

On Why Anthony Tries to Avoid Practising Empathy         

Suddenly unsure about the level of his audiences erudition, Anthony stops to ask his audience: Are you familiar with this [Heidegger on empathy]?” The room fills with knowing smiles. We might not know about Heideggers position on empathy, but we know that if we say we dont know, we will encourage Anthony and then we might not be able to stop him again. The truth is, we want to know more. We make ourselves look so unknowing, he feels he needs to start from the beginning and indeed he does start with the existential notion you are familiar with...we are always already with the person.” Therefore, Anthony says, you dont have to infer anger – its a direct experience: “Sometimes you need to check your impressions with the person and correct the experience. Empathy presupposes two separate boxes, one inferring from the other what its like to be inside that box. Being-with and seeing who you are doesnt mean I know what youve had for breakfast, but I could see what sort of person you are the moment I set eyes on you, to some extent; I may be mistaken about that, and may change my perception. But most of the time, it is the first impressions that stay.

The level of arousal in the room has by now reached a high pitch as every-one is stimulated by the above ideas – things we always already knew but didnt dare articulate. (I finally look up a replacement for challenge in my Thesaurus and, amongst other words, I find inquiry, exploration, discovery and dialogue. To Anthonys defence it also lists interrogation, inquisition, cross-examination and even post-mortem.) A brave participant questions Anthonys last statement by pointing out that his impressions of people change all the time. There is a hiddenness about people, Anthony explains: We change our impressions about people as more aspects of a person come into view. The person is not a mysterious something behind what we see, which we have to infer by empathy.” Hans Cohn pleads with us not to start thinking we can put ourselves inside the person, as some therapists think they should do. This is exactly what projective identification means, he explains, but we cant inhabit somebody else... 

By tuning into the discussion, we manage to over-excite our speaker and he proceeds to tell us about the etymology and the history of the word empathy. It is Greek for feeling in, much used in aesthetics and invented by Lipps, a philosopher, contemporary of Freud. The dictionary defines it as trying to understand a work of art by projecting yourself into itHow narcissistic, Anthony snarls, I try not to practise empathy.

Youd think that having made his point so passionately, Anthony could now leave the subject altogether. But no...by this juncture he is at war with empathy and, being a quality historian, Anthony brings us more evidence to prove his point. Anthony tells us that on 16 June, he and Peter Swales will spend 12 hours showing how Freud misses the horns on Michelangelos Moses (and a lot else) by reading his own feeling into the sculpture. Apparently, Freud is so keen to empathise that he loses the point and subsequently generations of analysts and art students do the same. At this moment Simone Lee throws me a sorry glance. Always already with, she must have somehow resonated with my concern that I was going to miss this point; brought up as a communist, my bible knowledge is patchy and makes it difficult for me to to be open to the context (Freuds problem in this instance exactly [except that he grew up with the Bible. A. S.]). Realising hes moved away from a discussion of his practice, Anthony juxtaposes his own practice with his last comment on Freud: This is what I try to do in my practice - open up to peoples context.

Laura Barnett wants to find out how Anthony explains her feeling battered and bruised after a session when the client isnt feeling like that at all. Then a few months later the client reports a similar feeling. Is she carrying an emotion they havent yet had? (She also uses the opportunity to grass on the supervisor who tells her she is merging with her clients.) Anthony is keen to demystify the experience: This happens with friends and families. It is not something that only happens in therapy... We pick up peculiar things... There is telepathy, but picking up mood is not telepathy... We pick up mood from body, from breathing, etc. These experiences are conceptualised in all sorts of peculiar ways, e.g. counter-transference, but its really very simple.

On Therapists Being Unlike Dentists

When another participant wonders how Anthony would deal with the client who is asking How are we doing?”, I realise Anthony is still answering the original question, about self-disclosure. He realises this too and says, “Ginnie, Im still trying to answer your question and Simon, Ill address yours while I answer Sanjas.” To respond to this latest point, Anthony reveals he likes to compare the service we provide with dentistry, gardening and the work of the car mechanic. He is not alone: Emmy van Deurzens current favourite comparison of therapists with other service providers is with cleaning ladies. I find her analogy depressing: the demand for cleaning persons far outstrips supply. I wish this were true of therapists. 

But what does Anthony do with his metaphor? In answer to the clients question How are we doing?” he replies “Thats a reasonable question to your dentist. But this is rather different. I understood you were working on something ... so why ask me? What do you think about this?

On Having an Aim

Alex Smith wants to know if Anthony, as a therapist, has an aim. It transpires that for him purpose is about a search for some sort of truth – the client who is serious’ about therapy will be committed to that search. Anthony shows his anger at the popular debunking of truth’ and positions himself firmly outside. His other aim concerns ethics – the search for the right way to live. He is careful to point out that it is not about telling clients about the truth, committed as he is to his own life-long search. He is weary of becoming grandiose and stresses the importance of being clear that his way is not the clients way. He has been practising more than thirty years; the way he practises now is not quite the same as when he started out, or even ten years ago. Asked how he has changed, he said that, when he started out he used to try and seduce people with his brilliant interpretations.

On Usefulness of Theory in Making of a Therapist  

According to Anthony, we all totally misunderstand the role of theory in practice. The current structure of training courses (theory in the morning, practice in the afternoon) is totally schizoid. Theory is not something you get out of books, and then apply to what youre doing. Theory means contemplating practice, contemplating what you are doing. When Anthony started out, he was much more theory-bound. If existential suggests an absence of theoretical construct, then “you really need to put all the theory into the melting pot”. Anthony dealt with this problem by doing his own research. He took Freud seriously when the latter said “If you want to understand what psychoanalysts do, read the cases”. Anthony read Freud, Jung, Boss, Laing and Esterson. Freud said he practised science – scientific account must be testable. “If Freud said that somebody was helped by psychoanalysis, I want to know if this is true or not,” Anthony states. Anthony engaged in research to find out whether these hypothetical constructs (the theory) could be proven. His conclusion was negative – evidence provided by the cases is shaky. For Anthony, the discipline of standing on his own two feet, not assuming that there is any theory behind it all, meant that he had to contemplate what actually did go on with people. That was his theory, he said: contemplating what actually happened. “Whether youll really be any better at the job for all the stuff youve stuffed your head full of from the books, or whether youd be better just using your common sense, is a very moot question. I suspect youd be better off with the latter,” he concludes.

On Phenomenology in Psychoanalysis

Anthony tells us about the amount of phenomenology he finds in Freud, Jung “and even Klein”. When Freud talks about people who came to see him, he is talking about real phenomena. But then he tries to fit these phenomena into his metapsychology. Anthony says he tries to throw these conceptualisations out, much like Freud (whose practice didnt depend on his theories). Anthony makes sure we dont ignore too much of that which psychoanalysis teaches us: for example, the phenomenon of a client behaving as if the therapist were their parent does happen. Clients behaviour will also be influenced by their perception of their therapists behaviour (and this may be what psychoanalysts call projection). Here Anthony cant resist an opportunity to educate us: In Zollikon SeminarsHeidegger disputes the possibility of projection – if you could really project something onto another, youd get rid of it! But he says Heidegger is being a bit smart Alec here, because Freud obviously didnt mean that you could.

On Asking (and Answering) Questions

Steve Ticktin must have realised that Anthony was still answering the original question when he asked: “How is the person to know that their perception of you is true if you dont self-disclose?

Anthony doesnt think self-disclosure is an answer in this case: One could still be lying. If someone has a wrong perception of me, I ask them to consider the evidence behind their assertion.” He continues: “Students think this pedantic and not phenomenological. They consider the things I ask to be prosaic and the truth to be out of place in counselling. I deal with sheer facts. Supervisees are often vague about what clients have told them. When I ask them why they hadnt asked for more, they wonder if its their place to be asking,” he concludes.

I sense Anthonys sympathetic nervous system changing to a higher gear (Anthony is easily provoked by stupidity). To illustrate his point, he patiently returns to his comparison of therapy and other trades. “Look,” he says, “if you were a gasman, or a piano teacher, and a client asked you a civil question, would you not give them a civil answer? Similarly, if a person asks for help and you dont understand their question, you have a responsibility to ask them what they mean. We ought to understand a lot more than what therapists settle for,” Anthony says. I am being presented with an extremely thought out way of working; tried and tested by years of experience – his own and other peoples. “If I take my car to the garage,” Anthony continues, “and say to the mechanic ‘its out of sorts and the mechanic nods and gives me a bill for £1000...well, thats nonsense. The mechanic will ask detailed questions to find out what Im complaining about and then hell try and help. If I tell my piano teacher that Im stuck, she will probe to find out what it is that I cant get on with.

“Trainees often tell me,” Anthony continues, “that the client was in an abusive marriage, or was abused by her father. I want to know what actually happened. Almost always the student will not have asked what happened. They accept the value judgement without getting a description.” At this point Anthony is in full swing (he is also, coincidentally, providing us with a description of what he does when he doesnt challenge). He moves from Freud to Boss and back again, fully referencing each quote (all user-friendly and extremely challenging). “A question,” he continues, “is opening up, a statement – ex-cathedra. So why privilege a statement over a question? There is a fetishistic taboo concerning the psychoanalytic why?, which supposedly leads people to think about causes. But why does it have to do that? It all depends how you ask. On the other hand, if you say why not?’, it is supposed to open things up. This is based on what Boss wrote. But why not? could become equally paralysing, and why? could open things up.

Philip Chandler is granted the privilege of asking the penultimate question. As it turns out, he would have been better off without this opportunity. In reference to Anthonys stress of the importance of exploring clients context (including their social context), Philip asks why other existential therapists dont subscribe to this thinking. Anthony wouldnt be Anthony if he were to answer the question without first making a number of erudite digressions. He is also masterful at involving his audience, so he asks Philip if he knows Zollikon Seminars. Philip doesnt let this question embarrass him (mainly because he knows most of us are glad it was him who got asked), looks Anthony in the eyes and says, No, I havent read the book.” Anthony first urges Philip to get hold of a copy (he really is sweet) and then explains how it contains a description of Heidegger advocating an enquiry into the relationship of a young schizophrenic with his friend (i.e. exploring the social context, at the same time as R. D. Laings and Esterson’s efforts.) Anthony never manages to answer Philips question because at this point, as you might expect, Stephen Ticktin enquires about David Cooper and then we run out of time.

In the 90 minutes we spend with Anthony Stadlen we are presented with a way of working that makes much sense to me. Its solidity gives his approach the reliability it needs if its going to be useful to us beginners. At the same time his position on therapy clearly advocates the need to remain flexible in order to adapt to all circumstances. We are very lucky to have Anthony among us.

Sanja Oakley 


Response from Albyn Leah Hall

Quest for Truth

Naomi Stadlen, training as a counsellor, once submitted as an essay title: ‘The Question of Truth in Psychoanalytic Counselling’. While finally consenting to it, the tutor was less than enthusiastic, declaring that she did not find truth a useful concept in counselling”. The tutor seemed to imply that, in the highly subjective realms of counselling and psychotherapy, assumptions of truth should not be made.
On the 31st of May, at the Existential Society, Anthony Stadlen discussed his own method of working as an existential psychotherapist. He cited his wife’s story as an example of a ludicrous fashion in contemporary therapeutic circles. Truth not only exists, claims Anthony; but the search for it is part of what we, as therapists, are here to facilitate.
In my own evolution as a therapist, I have to admit that I, like Naomi’s tutor, have been wary of the word truth. ‘Truth’ – in life and in therapy alike – can only be, I have thought, a relative term. A persons truth is as fluid as identity itself, subject to circumstances, gender, mood, age, socio-economic stratum, sexuality, relationships, and so on. Moreover, I have often associated the word ‘truth’ – or worse, ‘morality’ – with protocol and propriety; less to do with actual virtue than social standards of what one ought to do.
In fact, the very process of working existentially has always seemed a challenge to fixed realities. To live in good faith seems less a moral quest than a search for a personal or authentic truth, once liberated from the expectations of others. Adding to this the stew of moral relativism, deconstructionists such as Foucault and Derrida have sought to unveil the very means by which truths are sought or documented; e.g. in the categorical sciences’ of history, anthropology, the legal system, and psychoanalysis, with its predeterminations of wellness and neurosis, a dubious form of ‘doctoring’ based on the notion that the analyst is in a better position to know the ‘patient’ than the ‘patient’ him or herself.
Central to these arguments is the equivocal nature of language itself. No word, nor the image it connotes, can be precisely the same for any two individuals. As we are locked into our own linguistic satellites, how can we begin to share common ideas of truth?
When I accepted a placement at HMP Wormwood Scrubs, I needed an external supervisor for my work with lifers, most of whom had committed murder. At Anthonys suggestion, I sought out Dr. Aaron Esterson (coauthor of Sanity, Madness and the Family, as well as author of The Leaves of Spring). I was delighted to meet this formidable figure – a kind of existential celebrity and survivor of the halcyon age (at least, as it appeared to me) of the anti-psychiatry movement. I was certain that Dr. Esterson would be impressed by my ethical elasticity, particularly as it applied to my work with men who were raised in dire circumstances of poverty and abuse.
After I presented my first client to Dr. Esterson, he grilled me, at length, on the client’s particulars: his background, belief systems, cultural origins. His tone throughout was dry and detached.
Then he asked a different kind of question.
“You are, I take it, confronting this young man with the evilness of his crime?
I asked him what he meant. He repeated himself. The inflection in his voice remained the same.
I mumbled something about how I was not there to condemn; my goal was to understand, to empathise.
Dr. Esterson’s rebuttal was swift: how could I ‘understand’ without judgment? In order to conduct a rigorous investigation (Esterson was keen on rigorous investigations) I must not forget or allow my client to forget that his act of violence was a ‘wicked, wicked thing’.
But, I argued, a person is not defined by an act he commits, no matter how heinous. Dr. Esterson replied that while my client was not exclusively defined by his act of murder, he was a murderer nonetheless. In this, two taboos of existential thought – as I understood them – had been transgressed. Not only was it necessary to judge, but to label! What was more, the label should serve as a sobering reminder. Some things, such as an act of unprovoked murder, are, quite simply, wrong.
I had prided myself on my empathic relationship with my clients, and felt due to my suspension of judgement – that I had gained their trust. Any confrontation regarding the morality of their acts (as opposed to, say, the meaning of their acts) would only, I feared, alienate them; to create a barrier in the therapy and tar myself with the same brush as did the prison system; to, in short, relegate these men as scum.
All of this made me terribly uneasy.
I received no sympathy from Anthony Stadlen. At the time he was supervising my MA dissertation, a phenomenological study of political prisoners in Northern Ireland. For one of my sources, he recommended Frantz Fanon’s The Wretched of the Earth.
In one section of the book, Fanon, working as a therapist, tells the story of a police officer who tortures Algerian patriots in the French-Algerian war. This man comes to Fanon with complaints of discomfort and ‘tiredness’ while torturing, as well as increased violence towards his wife and children. Fanon states the irony of helping him ‘to go on torturing Algerian patriots without any prickings of conscience, without any behaviour problems, and with complete equanimity.’ (p. 271)
Of course, for those clients who have not tortured or murdered – the vast majority, in fact – the search for truth is more nebulous. Fanons message is still relevant. It is not our function to pacify clients about their destructive patterns, to comfortably analyse their way out of the discomfort zone of ethical clarity.
Of course, the declaration of wrongness does not remove the need to contextualise it. In my work with Dr. Esterson, insight was crucial, as was compassion; so long as it was not confused with a condoning of the act itself.
Whether Stadlen and Esterson’s views on truth and morality would have been at variance with those thinkers whom existential practice largely derives from – namely Heidegger and Sartre – may be open to interpretation, though least of all in Anthonys view. In recent discussion with Anthony, I was reminded that Estersons philosophy and practice were significantly informed by Sartre. In this, Anthony was at pains to clarify a frequently misunderstood aspect of Sartres Good Faith [Note by Anthony Stadlen, 2021: Actually, bad faith, in which we dissociate ourselves from what we do.]: We are what we do. While one is not absolutely defined by one act or trait, what that individual does is nonetheless an irrefutable part of who he or she is. (For instance, to say that the repentant murderer is no longer a murderer is as dishonest as claiming that he or she is exclusively a murderer.)
Heidegger, at least to my mind, seems more difficult to fathom. The abstract nature of his writings seems to invite a myriad of interpretations, and with them a myriad of truths (not to mention Heidegger’s own Nazism, something which most of us, regardless of therapeutic orientation, would regard as ‘wrong’). Yet Anthony alludes to Heidegger with a heartfelt, though not unconditional, enthusiasm. Most importantly, Anthony does refer to himself as an existential therapist. [1] If he contests the current climate of moral relativism, this is less a slight to existential texts than our reading of them.

Today, Dr. Esterson is no longer with us. I cannot describe, in concrete terms, how I have applied our work in my own practice. All I know is that I have. Our work together, while rattling me considerably, has sanctioned me to do what I had thought so unthinkable; to judge, or, if the truth be told, to admit to judging (for judgement is never truly absent). To feel that morality and meaning need not pre-empt one another.
Of course, even if, unlike Naomi’s tutor, we concede that truth is a useful concept in counselling and psychotherapy, we are left with the question of how we locate it, and how this process might vary from one individual to the next.
Anthony tells us that the longer he practises, the fewer words he uses with clients. The session is not a lecture, or a conversation as such. I imagine something religious, though not in a sectarian sense. I am put in mind of Buber’s Being-With, a gentle facilitation in which meaning and clarity can be sought. Of course, I can only speculate on how Anthony’s own quest for truth manifests itself, both in and out of the consulting room. While certain truths may be decided collectively, and may even be fit for moral judgement, the journey to find them is what remains most personal.

Albyn Leah Hall  

1. Though it is useful to note that Anthony is not satisfied with the word therapist, with its implications of empathic doctoring. He laments that he can find no appropriate word for what we do; it is easier to describe the process itself.
 

Replying to Reviews from Anthony Stadlen   

I am touched by the trouble Sanja and Albyn have taken. I am grateful to them for their reporting, and to Simone for inviting me to respond. I shall try to clarify a few points.
Facts
As Sanja says, I said: I want to know what actually happened.’ This was shorthand for: I want to know what the trainee says the client says actually happened.’ (This is not the same as wanting to know what is true for the client.)
Why?
Those who say that asking ‘why?’ ‘leads people to think about causes’ are invoking just the mechanistic ‘linear causality’ they claim to be opposing. The crux is whether one asks, or refrains from asking, in a way likely to facilitate the client’s taking responsibility and seeking understanding, or in a way likely to seduce the client away from this. But everything depends on the client’s response. A sensitive therapist will take into account how the client is likely to respond, but there is no certainty. To suppose otherwise is to think mechanistically, as if one could ‘cause’ a given response.
‘Existential’ therapists are often confused about ‘causes’.
Sometimes there is a mechanical cause, as when Freud found his headaches were not psychological but caused by a leaking gas lamp. But clients are usually struggling to understand why they and other people act as they do, and this is a quest for human reasons. A therapist who does not help in this search, perhaps justifying this by quoting Heidegger’s quoting Angelus Silesius on the rose that blooms without asking why, is failing the client in the most fundamental way. It is wrong to encourage a client to avoid responsibility by attributing his or her actions to non-human ‘causes’ in the ‘unconscious’ or ‘brain’. But why reduce asking ‘why?’ to this perversion of it?
‘Social context
If, as Heidegger says, The world of Da-sein is with-world [Mitwelt]’, how can existential therapists ignore social context? Why they ignore it is because they do not take Heidegger seriously. But then, nor does Heidegger. His references to social context in the few ‘cases’ he discusses in Zollikon Seminars are very thin. In discussing Fischer’s ‘schizophrenic’ patient, Heidegger nowhere makes the elementary phenomenological observation about the patient’s Mitwelt that he is, as Fischer admits, interned in Fischer’s ‘nursing home’. Nor does Heidegger mention Fischer’s account of a visit by the patient’s father. To take Heidegger seriously, one must study Szasz, and Laing and Esterson. But ‘existential’ therapists rarely do so.
‘Truth’, ‘Ethics’, ‘Frequently misunderstood
Albyn is polite when she writes that Sartres position, that we are what we do, is ‘frequently misunderstood’. This is the heart of Sartres thinking, in his philosophy, novels and plays. How can one miss it? And how can one misunderstand it? Unfortunately, in my experience, most ‘existential therapists’ are not in a position either to understand or to misunderstand Heidegger or Sartre, because they have not read them. 
Again, heartfelt thanks to Sanja and Albyn for their sensitive reporting.

Anthony Stadlen

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