‘Till this moment, I never knew myself’: Individual, family, and existential psychotherapy. Naomi and Anthony Stadlen (2005)

‘Till this moment, I never knew myself’:
Individual, family, and existential psychotherapy

Naomi and Anthony Stadlen

Copyright © Naomi and Anthony Stadlen 2004
Not to be copied, reproduced or quoted without permission from the authors

[From Existential Perspectives on Human Issues: A Handbook for Therapeutic Practice. Edited by Emmy van Deurzen and Claire Arnold-Baker. Palgrave Macmillan (2005): 133-142] 

1. Introduction

Existential thinking on families has a fine tradition to build on.
Insight into family relationships is not new. Stories from many different cultures record a wealth of such insight, existential in all but name. For example, many stories describe what happens when parents favour (or disfavour) one of their children above the rest. In Genesis (25.28), Isaac and Rebecca have twin sons: ‘Now Isaac loved Esau, because he did eat of his venison; and Rebecca loved Jacob.’ A complex story unfolds from this. Shakespeare shows in Richard III how Richard was a disfavoured son, a trouble to his mother, as she tells him (Act 4, Scene 4), from birth onwards, presumably unlike his brothers. In Pride and Prejudice, Jane Austen (1990 [1813]) points out that Elizabeth Bennet is her father’s favourite, while Lydia is her mother’s. In Jane Eyre, Charlotte Brontë (n.d. [1847]) introduces Jane as an orphan, who was frequently compared unfavourably with her cousins, with whom she lived, like a sibling. In each story, the adults try to impose on the child their own, sometimes contradictory, views of who the child is, or should become. However, the child gradually discovers the moral and existential imperative to seek to transcend this constriction of his or her being. As Elizabeth Bennet cried (Austen 1990 [1813]: 285[i]): ‘Till this moment, I never knew myself.’ [1]
This rich tradition takes it as self-evident that the individual is indebted to his family but has the task of moving beyond it. Family influence is not seen as ‘linear causality’. Rather, traditional stories imply that an individual encounters crises, which offer a challenge to transcend the family heritage. (See also, for example, Tolstoy [1873–77], especially Part 2, Chapters 1–3; Olsen 1980 [1962]; Hopkins 1967.)
Psychotherapy has drawn from this tradition. Freud acknowledged the great novelists and playwrights as his precursors. He revered the book, Moderne Geister, by the Danish literary critic Georg Brandes (1882, 1923 [1882]); and, as it is contains various allusions to Kierkegaard, Freud probably read Kierkegaard himself. Freud wrote his case histories, he said, ‘like novellas’ (GW 1: 227; SE 2: 160; PFL 3: 231; our translation[2]), to illumine ‘the relation between Leidensgeschichte and Leiden’ (GW 1: 200; SE 2: 138; PFL 3: 206). ‘Leiden’ (‘suffering’) was the patient’s complaint, the ‘symptoms’. ‘Leidensgeschichte’ (‘suffering history’) was the existential ‘passion narrative’ that the ‘symptoms’ concealed and the ‘talking cure’ revealed (Breuer 1987 [1895]: 229, 238; Freud SE 2: 30, 40; PFL 3: 83, 95), like a deeper ‘archaeological’ layer (GW 1: 201; SE 2: 139; PFL 3: 206), but still phenomenological, ‘beneath’ the ‘banal’ known history (GW 1: 207; SE 2: 144; PFL 3: 212). Kierkegaard (1988 [1845]: 185) used the equivalent Danish word, ‘Lidelseshistorie’, as subtitle of the section ‘“Guilty?”/“Not Guilty?”’ in Stages on Life’s Way. This ‘passion narrative’ centred on the patient’s family relationships, from childhood on. For example, Freud’s early ‘Katharina’ case (GW 1: 184–195; SE 2: 125–134; PFL 3: 190–201) is his narrative of how, starting from Katharina’s complaint of headaches and breathlessness, he helped her tell her ‘passion narrative’: she had discovered her father having sexual intercourse with her cousin, and had herself been sexually molested by her father. Freud claimed Elisabeth von R.’s leg pains hid her ‘repressed’ love for her dead sister’s husband (GW 1: 196–251; SE 2: 135–181; PFL 3: 202–255), and Dora’s hoarseness, hers for her father’s friend Herr K., who had sexually molested her with the tacit permission of her father in exchange for sexual favours from Herr K.’s wife (GW 5: 161–286; SE 7: 1–134; PFL 8: 29–164; Stadlen 1989 [1985]). Freud’s search for the ‘passion narrative’ was in principle existential and phenomenological (Stadlen 2000); but sometimes the narrative, and perhaps the passion, was more his than his patient’s. He opened up the phenomenological study both of families and of ‘unconscious phantasy’, but tended to discount his perception of family interactions, replacing it with merely ‘assumed’ ‘unconscious phantasies’ he attributed to his patients (Stadlen 2003a, Note 77: 163–166; Appendix: 174–176). Freud thus effected an opening and a closure (Stadlen 1989 [1985], 2003a). Both have had a profound influence.
Jung (1912: 265–294; CW B: 266–293; CW 5: 274–305) wrote of ‘The battle for deliverance from the mother’. The Jungian analyst John Layard (1944) sought to help a teen-age girl by facilitating change in her whole family through analysing her mother’s dreams.
Other psychotherapists studied whole families, and tried to ‘treat’ the ‘illness’ of the individual by so-called ‘family therapy’ of his family. They made valuable findings (Haley and Hoffmann 1967; Handel 1968; Jackson 1968a,b; Framo 1972). But the family was described as a ‘system’ (Jackson 1968 [1957], Haley 1967, Sonne 1967, Minuchin 1974, Weichert 1975), or as an ‘organism’ (Bowen 1960: 346), with its own ‘family pathology’ (Whitaker 1958: 208; Jackson, Riskin and Satir 1968 [1961]: 233; Bell 1967; Haley 1967; Fleck 1976: 211; Sander 1979: 82). Szasz (1961), however, insisted that ‘mental illness’ is a ‘myth’. And Laing (1962: 13) wrote: ‘Family pathology is an even more corrupt concept than individual psycho-pathology. It simply extends the unintelligibility of individual behaviour to the unintelligibility of the group’.

2. An existential perspective

Understanding families is not an optional extra, for existential psychotherapists or those who consult them. The quest to understand how one has responded to one’s family of origin, and to transcend it, is at the heart of any existential search for self-knowledge.
Ludwig Binswanger is regarded as the ‘father’ of ‘existential psychiatry’. Psychiatry has always used compulsory intervention. But we understand by ‘psychotherapy’ a voluntary, contractual relationship between consenting adults, as defined by Thomas Szasz (1965). Binswanger threw some light on the relevance of families, but introduced some confusion. He wrote phenomenological analyses of his ‘schizophrenic’ patients’ ‘worlds’. He described Jürg Zünd’s ‘upstairs world’ (with his parents), ‘downstairs world’ (with his grandfather, aunt and uncle), and ‘street world’ (Binswanger 1957b [1946–47]; Sonnemann 1999 [1954]: 223–228; Sadler 1969: 300–312). But Binswanger (1957a [1944–5]; 1958 [1944–5]) made next to nothing of his own data showing Ellen West’s family’s interference with her personal relationships. As Laing (1982: 55) points out, ‘it is not clear whether [Binswanger] ever puts two and two together’ to ask if her experience of the ‘swamp-world’, ‘grave-world’, and ‘ethereal world’ might be her despairing response to her family’s invalidation of her, which she perhaps lacked the insight to transcend.
Binswanger himself divided human being-in-the-world in general into three ‘worlds’: ‘Mitwelt’ (‘with-world’), ‘Umwelt’ (‘around-world’), and what he called ‘Eigenwelt’ (‘own world’) (Binswanger 1942: 428). But he appears to have misunderstood Heidegger’s term ‘Mitwelt’. ‘Mitwelt’ is not just one ‘world’, or ‘dimension’, among others. As Heidegger says (1986 [1927]: 118; 1962 [1927]: 155; 1996 [1927]: 112; our translation and brackets): ‘The world of Da-sein is with-world [Mitwelt]’. We are always already in the world with others. ‘Mitwelt’ needs no supplementing with ‘Umwelt’, ‘Eigenwelt’, ‘Überwelt’ (‘overworld’, to make room for spirit), or ‘Unterwelt’ (‘underworld’, to allow for Freud’s and Jung’s findings), for the simple reason that it includes them. Even ‘private’ modalities of experience, such as dream, imagination, sexual desire, ‘unconscious phantasy’, memory, transcendental experience, are modalities of our being-in-the-world-with-others. Being in the world with others is not one ‘dimension’ of being human. It is what being human is.
The philosopher Max Scheler wrote (1954: 24 7): ‘Imbued as [the child] is with “family feeling”, his own life is at first almost completely hidden from him.’ Heidegger said (1987: 208; 2001 [1987]: 163; our translation: the American translation of Zollikoner Seminare omits the second sentence altogether): ‘The child is absorbed in the comportment of the mother. It is absorbed in the ways of being-in-the-world of the mother. It is exactly the opposite of having introjected the mother.’
Medard Boss (1954; 1963 [1957], 1975 [1971]; 1983 [1979]) and Gion Condrau (1998), who studied with Heidegger, acknowledged in their case studies the relevance of family ‘upbringing’. Boss wrote (1975 [1971]: 506; 1983 [1979]: 236; our translation): ‘… with no single patient can one speak of his being schizophrenic per se. Rather, one must always ask: schizophrenic under the excessive demands of what pattern of human relationships?’ But this still begs the question of what ‘schizophrenic’ means.
Heidegger liked talking with ‘schizophrenics’, and doubted that they were medically ‘ill’ (Wiesenhütter 1979: 158; Stadlen 2003b: 173–175). He revered the poetry of the allegedly ‘mentally ill’ Hölderlin (Heidegger 1981, 2000 [1981]) and Trakl (Heidegger 1993a [1959a], 1993b [1959b], 1971a [1993a], 1982b [1993b]). However, in a 1965 Zollikon seminar, while discussing critically a case study of a ‘schizophrenic’ by Franz Fischer (1930), Heidegger (1987: 66–70; 2001 [1987]: 51–54) was silent on Fischer’s report (1930: 249–252) of an ‘unexpected’ visit to the ‘hospitalised’ patient by his father. (See also Stadlen 2002: 169; 2003b: 173–175; 2003c.) The patient says (Fischer 1930: 249–250; our translation):

‘… I don’t know you. Are you the father? … He looks like my father, but false and not real, perhaps made of mist or painted air, a great deception against me … How long have I been here? … Perhaps I’ve already been here longer than my father is actually old…’

Fischer analyses the patient’s alleged ‘disturbance’ of ‘thought’ and ‘space-time structure’, but does not consider the possibility that the patient might be stating accurately what he feels about his father. Fischer mentions the patient’s ‘internment’ in the ‘institution’, but not the father’s necessary role in this. He does not say how the father related to his son, or what he said to him. Heidegger, Boss (1975 [1971]: 492–496; 1983 [1979]: 228–231), Paul J. Stern (1983 [1979]: xix–xx), and the ‘phenomenological’ psychiatrist Eugène Minkowski (1995 [1933]: 269–270; 1970 [1933]: 288–289), all discuss this case of Fischer’s at length, without mentioning the father, or the son’s ‘internment’. This is the standard psychiatric tradition.
Yet Sartre had already published Saint Genet, a lengthy existential analysis of the writer, Jean Genet, in which he sought to discover Genet’s ‘original project’, the fundamental existential choice he had made in childhood as a way to live his family situation (Sartre 1952; 1964 [1952]; Laing and Cooper 1964: 65–90). Sartre had discussed the principles of existential analysis of the ‘project’, anticipating his later work on Flaubert, in Search for a Method (Sartre 1960a: 60–111; 1968 [1960a]: 85–166; Laing and Cooper 1964: 49–64).
Moreover, Bateson et al. (1956) had hypothesized that the interactions in families of individuals diagnosed as ‘schizophrenic’ would be characterised by the ‘double bind’, which they defined as an incongruity between a communication and a metacommunication. The hypothesis was derived from observation of individuals, not of their families, but subsequent family studies tended to confirm the prediction. (See also Jackson 1968b, Berger 1978.)
As Laing wrote (1961: 140–141; 1969 [1961]: 129), the work of Bateson et al. ‘revolutionized the concept of what is meant by “environment”’. But Laing anticipated Scheflen’s 1977 criticism that Russell’s (1956a [1908]) theory of logical types was ‘not the best language’ in which to describe the ‘double bind’, to which Bateson responded, ‘Maybe not…’ (Berger 1978: 97). Laing himself (1961: 162–170; 1969 [1961]: 145–153) analysed how Raskolnikov, in Dostoevsky’s Crime and Punishment, is driven frantic by contradictory attributions and injunctions in a letter from his mother, the day before he commits his murders.
Almost all family studies still presupposed the existence of ‘schizophrenia’. It was regarded as an ‘illness’, to whose ‘aetiology’ family interaction was a possible contributing factor (Lidz, Fleck and Cornelison 1965). The family itself was often described as ‘sick’ (Jackson and Satir 1961: 265).
The one exception was Sanity, Madness and the Family, by R. D. Laing and Aaron Esterson (1964, 1970a [1964], 1970b [1964]). This book built on the work of the Bateson group and other American family studies, but was also informed by the existential tradition, including Sartre’s Critique of Dialectical Reason (1960b, 1976 [1960b]), and Szasz’s The Myth of Mental Illness (1961). It reported the findings of Esterson’s research on the families of eleven ‘schizophrenic’ women. He pioneered the method of phenomenological study of all subsets of each family. The case studies, containing extracts from his tape-recorded interviews, make ordinary human sense of the women’s experience and behaviour. The book reveals as the women’s praxis (Sartre 1960b, 1976 [1960b], Laing and Cooper 1964), her intentional, intelligible activity, what the psychiatrists saw as ‘signs’ and ‘symptoms’ of an unintelligible process, a medical-type ‘illness’, ‘schizophrenia’, ‘inside’ the person.
 For example, one of the women, Mary Irwin, aged twenty, explained (Laing and Esterson 1964, 1970a [1964]: 198–201; 1970b [1964]: 211–214) that her mother would ‘just go on and on’. ‘She seemed to stop me from thinking.’ ‘Tell you what I do, I sort of go rigid so nobody can get at me.’ What the psychiatrists saw as her ‘catatonic’ behaviour, the outcome of a meaningless ‘schizophrenic’ process, was simply Mary’s intelligible, intentional act of self-protection, her understandable, purposeful praxis. Mary’s sister confirmed this, both in the book (Laing and Esterson 1964, 1970a [1964]: 201–202; 1970b [1964]: 214–215) and to us four decades later (interview with A. Stadlen, 1 August 2001) after Mary’s death. (See also Esterson 1976.)
In The Leaves of Spring (1970, 1972 [1970]), Esterson studied in depth one of the families, the Danzigs, shifting the focus from the daughter, Sarah, to the family itself. He showed that the Danzigs saw Sarah as ‘sick’ for seeking autonomy rather than ‘ontic security’ and ‘alterated identity’ (concepts derived from Heidegger and Sartre, respectively). Their family ‘harmony’ was an appearance of harmony, their ‘religion’ a search for respectability. They saw Sarah’s ‘thinking’ and serious reading of the Bible as caused by the ‘illness’ they said she had.
These existential-phenomenological case studies by Laing and Esterson show in straightforward detail who is saying and doing what to whom. The families’ use of language to define the being-in-the-world of the ‘patient’, by invalidation, mystification, and subtle ambiguity, is made crystal clear. (See also Laing 1971, Hopkins 1967.)
This is a fundamental advance on the vague, stereotypical summaries of patients’ families in Boss’s case studies, for example. It is curious that, despite Heidegger’s dictum that language is ‘the house of Being’ (1991 [1947]: 5; 1998a [1947]: 239; 1993c [1959c]: 90, 111–118; 1982a [1993c]: 5, 21–28), the Daseinsanalysts have neglected this field.
There is a noble philosophical tradition of thinking on so-called ‘intersubjectivity’, better called ‘being-with’ (Heidegger 1987: 145; 2001 [1987]: 111) or ‘Thou-Thou relationships’ (Heidegger 1987: 263; 2001 [1987]: 210): Kierkegaard, Feuerbach, Husserl, Scheler, Stein, von Hildebrand, Heidegger, Ebner, Rosenstock, Rosenzweig, Buber, Marcel, Sartre, Merleau-Ponty, Macmurray, Levinas. But this is not enough. The fine detail revealed by Laing and Esterson attunes psychotherapists to aspects of an individual’s Leidensgeschichte that Freud, Jung, Binswanger, and Boss did not focus on.
This is the proper field of study for existential psychotherapists. It goes to the heart of how an individual can adopt a false or untenable existential position in relation to others under the influence of some of those others.
Claire Church was diagnosed as a chronic, institutionalised, ‘paranoid schizophrenic’. Laing and Esterson give a careful analysis of the complex interaction between her and her mother (1964, 1970a [1964]: 69–75; 1970b [1964]: 83–89). Claire told us four decades later (interview with A. Stadlen, 3 January 2001) that her discussions with Esterson, individually and with her mother, had enabled her to leave hospital and pursue a satisfying career.
Recent writing (Goldstein and Doane 1985, Tompkins 1995, Alanen 1997) offers a bland, ‘interdisciplinary’ approach to ‘schizophrenia’ and the family, endorsed by many ‘existential’ psychotherapists, for example, Yalom (1995). This approach sees ‘schizophrenia’ as an ‘illness’, and ‘family therapy’ as a ‘technique’, ancillary to compulsory clinical psychiatry, to ‘improve the course of the disease’ (Tompkins 1995: 334). Such writing either ignores Laing and Esterson’s work, or implies that it has long been assimilated and surpassed. In our view, Laing and Esterson’s work has not been understood. The chronologically later writing is, existentially, a retrogression.
Most clients who seek psychotherapy are explicitly struggling to make sense of their family relationships, past and present. Some clients are at first preoccupied with other relationships; but their own attempts at understanding usually lead them spontaneously to start reconsidering their family relationships from earliest childhood on. It is the responsibility and privilege of existential psychotherapists to develop a discipline to help clients in this quest.

The case study that follows illustrates the way we work, which is informed by these principles. The study has been intentionally written in everyday English, which is a language overflowing with existential and phenomenological insight. Although we have not used the terms we have just been discussing, such as ‘praxis’, ‘process’, ‘Mitwelt’, or ‘Leidensgeschichte’, we hope the reader will have no difficulty in seeing how these are exemplified in the case.

3. Case illustration (by Naomi Stadlen)

Lucy, aged thirty-two, sought counselling because she couldn’t decide whether to let her small son continue breastfeeding at night. She said that her head ‘told her’ that a boy of eighteen months should be weaned and sleep in his own bed, whereas her heart disagreed. But she didn’t trust herself to decide because, she said, ‘I keep feeling that something deep down is terribly wrong with me. It’s a very familiar feeling.’ All kinds of everyday situations would evoke this feeling. Lucy would feel distressed until the feeling wore off.
At first, it sounded as though Lucy’s difficulties related entirely to the present. The task of counselling seemed to be to help Lucy explore the conflicting logic of ‘head’ versus ‘heart’. Yet this seemed premature. Lucy preferred to talk about weekly events that troubled her. Nor was it helpful to encourage Lucy to experience the full anguish of feeling ‘terribly wrong’. She seemed oddly relaxed in her distress. It might therefore have been possible to challenge her calm as a form of resistance, which prevented her from engaging more fully in life and in her counselling. Was Lucy in bad faith, going through the motions of having counselling while remaining untouched? The evidence did not support such an interpretation. Lucy always came on time, and usually wanted to discuss a current problem. She seemed to be ‘voting with her feet’, and for some time that seemed to be all she could manage.
Like most clients, Lucy talked spontaneously about her parents and her childhood. At one session, Lucy said she had ‘nothing to say’. ‘Really nothing?’ I asked. She replied: ‘I feel I’ve said everything already.’ I asked: ‘When did you say it?’ She explained that her mother had been visiting, and had followed her in and out of rooms, talking constantly. ‘Is that when you said everything?’ I asked. Lucy suddenly realized that she herself had hardly said anything. Her mother had done the talking. ‘When she talks, she never stops, and I can’t hear my own voice,’ she said. She was shocked to realise this and wondered whether she really had any voice of her own. ‘I never have my own opinions,’ she said. ‘When something new happens, I have to ask other people what they think. I haven’t got an opinion of my own. She was in despair and could not imagine speaking with her own voice.
To reach this realisation took more than a year. Most of what I did was to listen, remember, and ask questions to help her to explain what she meant. So that, even while she said that she seemed to have no voice of her own, she was struggling to voice her difficulty. Talking to me like this was a new venture for her, and her ‘heart’ felt it was right, while her ‘head’ accused her of ‘navel-gazing’ and fruitless introspection.
Even so, she needed a long time before she felt ready to say any more about her statement that ‘there must be something terribly wrong with me’. What seemed to make this so difficult was the corollary it implied: that, if there were not something wrong with her, then there would have to be something wrong about her parents, and therefore about her entire perception of life which she had based on theirs. Lucy said that her parents presented family life to her as ‘a beautiful picture’. ‘I bought their picture,’ Lucy said. At first, the idea of radically questioning this picture was so far-reaching that Lucy preferred to doubt herself, even if this meant devaluing countless contradictory feelings and observations of her own.
Lucy described her parents as a highly educated and cultured couple, so she could find plenty of evidence to confirm the ‘beautiful picture’. In her childhood home, anything that did not fit into this picture was simply never acknowledged. For example, she told me: ‘I was expected to be good at school.’ Yet, even in the first class, because her parents only acknowledged some perceptions but not others, Lucy, at five years old, felt a nameless and terrifying confusion about what she was ‘supposed’ to perceive. She was afraid to learn, she was terrified that this meant there was something wrong with her, she was puzzled that other children were apparently so at ease, and she felt in despair at failing her academic parents. She settled for pretending, and created the impression of an intelligent and well-adjusted child, as good a match as she could manage to the parental picture.
Dramatic events occurred in the family story. However, Lucy’s difficulty lay in finding the words to substantiate her continual sense that something was ‘terribly wrong’, even in her most ordinary and everyday interactions. As her family did not talk about conflict and difficulties, Lucy had no vocabulary that she could use to help hold on to her feelings.
She would often describe her small son’s ‘difficult’ behaviour. However, when we discussed how he might feel, his ‘difficult’ behaviour made sense. This led her to compare his childhood with hers. Her parents had not listened to her feelings in her childhood or even thought that she had any. Now she started to reconsider some of her own previously devalued childhood observations and feelings. I used to suggest possible reasons why she might have felt as she did, and then she, with integrity, would separate what ‘feels absolutely right’ from what, as she politely put it, ‘might be right’. Slowly, her own feelings and observations began to connect together as crucial parts of her whole coherent story. This gave her a completely different picture of herself. Slowly she started to rethink everything, her entire ‘picture’. She also wanted to make sense of her parents, and their parents in this new way. She was fascinated that so much made sense, but shocked at how much the parental picture had left out. Often, the ‘beautiful picture’ would seem so much more attractive than the untidiness of her own honest feelings and observations, and she would succumb to the seductive pull of thinking that, after all, there must be something terribly wrong with herself.
However, connecting together her honest feelings enabled her to feel more whole. Even her failures of memory made sense. ‘I suppose there’s a lot I don’t remember because it didn’t feel like me,’ she observed. Once she saw how she had settled for pretending, as a child, to be someone she was not, she kept noticing how much she was still living that pretence as an adult. But, because she had started to value her real feelings and observations, the old pretence felt intolerable. Connecting with her past gave her the understanding to face difficult moments when she chose to transgress an unspoken parental prohibition, and to take responsibility for her own perceptions. This gave her a voice that was distinct from her mother’s. However, her voice had no language. She wanted to voice ideas that she had been taught to overlook as a child. It was her lack of vocabulary that made it so easy to think that ‘there was something terribly wrong with me.’ She felt she had a vacuum where everyone else seemed so articulate. Slowly, she began to use simple words to address interpersonal difficulties that arose with her husband and children. The question of ‘head’ versus ‘heart’ seems to have resolved imperceptibly, as she began to respond as a more whole person. Her husband (whose childhood family she described as having its own methods of avoiding confrontation) overheard Lucy having an honest dialogue with their son, and commented to Lucy: ‘I like the way you talk.’

4. Critical considerations

Family interactions are complex. Yet, once a client starts to understand them, details fall into place, and the client is freed to decide how to use this new understanding.
‘Existential’ psychotherapists often do not understand what understanding is. They see their clients’ attempts to understand as a search for ‘linear causality’. They disdain questioning and attending to detail. Yet Heidegger said (1954a: 44; 1977a [1954a]: 35; our translation): ‘Questioning is the piety of thinking.’ And (1957 [1953]: 157; 1961 [1953]: 172): ‘To know how to question means to know how to wait, even a whole lifetime.’ Therapist and client need patience and perseverance to question, until the detail reveals its existential meaning. This cannot be learned from books or taught in modules. Trainees need to explore, through truly existential psychotherapy, their own family experience. Few ‘existential’ training therapists or supervisors have attempted this themselves.
It can be a shock to examine one’s interactions, and to see, as both Elizabeth Bennet and Darcy recognised, how one’s apparently clear perceptions may be utterly warped by the restrictions of one’s family outlook. Both Elizabeth and Darcy felt ashamed when they first took moral responsibility for their actions. Both despaired of one another’s love, because of their new understanding of their earlier actions. Jane Austen shows that their love for one another depends on their new self-knowledge.
‘The novel,’ wrote D. H. Lawrence (quoted by Leavis 1965–66: 7), ‘is the highest form of subtle inter-relatedness that man has discovered.’ Will the insights of existential psychotherapists into family relationships ever be good enough to challenge this claim?

Further reading

Readers may be surprised that most of our recommended reading stems from the 1960s and 1970s. Present-day writing ignores or patronizes these works, without, in our view, understanding them. As we stated at the end of section 2, the chronologically later works are, in existential terms, a retrogression.

Anonymous [actually, Murray Bowen]. ‘Toward the differentiation of a self in one’s own family’. In Framo, J. L. (ed.) Family Interaction: A Dialogue between Family Researchers and Family Therapists.
J. Hopkins. Talking to a Stranger: Four Television Plays.
R. D. Laing & A. Esterson. Sanity, Madness and the Family: Families of Schizophrenics.
T. Olsen. Tell Me a Riddle.
L. Tolstoy. Anna Karenina (Especially Part 2, Chapters 1–3.).

See Bibliography, below, for full details of these recommended writings. 

Naomi Stadlen has practised since 1991 as an existential counsellor and psychotherapist, specialising in work with parents of small children. She has practised for twenty years as a breastfeeding counsellor. She teaches and supervises psychotherapy at several London institutes. She is the author of What Mothers Do – Especially When It Looks Like Nothing (Piatkus, 2004), based on her observations of new mothers, and on conversations with them about the experience of becoming a mother.

Anthony Stadlen has practised since 1970 as an existential-phenomenological psychotherapist with individuals, couples and families. He teaches and supervises at several London institutes. Since 1977, he has researched the paradigmatic case studies of Freud, Layard, Fordham, Boss, Laing, Esterson, and others. From 1988–1990 he was a Research Fellow of the Freud Museum, London. Since 1996, he has conducted the Inner Circle Seminars, an ethical, existential, phenomenological search for truth in psychotherapy. He was the recipient of the 2003 Thomas S. Szasz Award for outstanding services to the cause of civil liberties (professional category).


We thank Professor Emmy van Deurzen, Mr Richard Skues, and Professor Thomas S. Szasz for their constructive criticisms and suggestions.

[1] In Volume 2, Chapter 13; or, in some editions, Chapter 36.
[2] We refer to standard English translations where available, but give our own translations.


Alanen, Yrjö (1997). Schizophrenia: Its Origins and Need-Adapted Treatment. London: Karnac Books.
Alpert, Murray (ed.) (1985). Controversies in Schizophrenia. New York and London: The Guilford Press.
(Anonymous) (1972). Toward the differentiation of a self in one’s own family. In: Framo 1972: 111–173.
Austen, Jane (1990 [1813]). Pride and Prejudice. Oxford and New York: Oxford University Press.
Bateson, Gregory, Jackson, Don D., Haley, Jay and Weakland, John H. (1956). Toward a theory of schizophrenia. Behavioral Science, 1.4: 251–264 (October 1956). (Also in: Jackson 1968b: 31–54 and Berger 1978: 5–27.)
Bell, Norman W. (1967). Terms of a comprehensive theory of family psychopathology relationships. In: Zuk and Boszormenyi-Nagy 1967: 2–10.
Berger, Milton M. (ed.) (1978). Beyond the Double Bind: Communication and Family Systems, Theories, and Techniques with Schizophrenics. New York: Brunner/Mazel.
Binswanger, Ludwig (1942). Grundformen und Erkenntnis menschichen Daseins. Zurich: Max Niehans.
Binswanger, Ludwig (1957a [1944–5]). Der Fall Ellen West. In: Binswanger 1957c: 57-188.
Binswanger, Ludwig (1957b [1946–7]). Der Fall Jürg Zünd. In: Binswanger 1957c: 189–288.
Binswanger, Ludwig (1957c). Schizophrenie. Pfullingen: Günther Neske.
Binswanger, Ludwig (1958 [1944–5]). The case of Ellen West. In: May, Angel and Ellenberger 1958: 237-364.
Boss, Medard (1954). Einführung in die Psychosomatische Medizin. Bern and Stuttgart: Hans Huber.
Boss, Medard (1963 [1957]). Psychoanalysis and Daseinsanalysis. New York: Basic Books.
Boss, Medard (1975 [1971]). Grundriss der Medizin und der Psychologie: Ansätze zu einer phänomenologischen Physiologie, Psychologie, Pathologie, Therapie und zu einer daseinsgemässen Präventiv-Medizin in der modernen Industrie-Gesellschaft. (Second edition.) Bern, Stuttgart, Vienna: Hans Huber.
Boss, Medard (1983 [1979]). Existential Foundations of Medicine and Psychology. (Second edition.) New York and London: Jason Aronson.
Bowen, Murray (1960). A family concept of schizophrenia. In: Jackson 1960: 346–372.
Brandes, Georg (1882). Moderne Geister: Literarische Bildnisse aus dem neunzehnten Jahrhundert. Frankfurt am Main: Rütten and Loening.
Brandes, Georg (1923 [1882]). Creative Spirits of the Nineteenth Century. New York: Thomas Y. Crowell.
Breuer, Josef (1987 [1895]). Beobachtung I. Frl. Anna O …. In: Freud 1987: 221–243.
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