Continuing the project begun in Demystifying Therapy, Tales of Unknowing seeks to demythologize the therapeutic process. Spinelli's book is organized around eight case studies, which serve to highlight the characteristics of the existential-phenomenological approach. The theoretical underpinnings of existential therapy are often regarded as inaccessible to the layperson, with influences from notoriously difficult philosophers such as Friedrich Nietzsche, Jean-Paul Sartre, Martin Heidegger and Maurice Merleau-Ponty. In this book, Spinelli elucidates existential concerns through recounting experiences with patients. The effect of this approach is twofold: Firstly, theory is rendered more accessible through example. Secondly, and most importantly, we are shown how prioritizing the client/therapist relationship means that Spinelli avoids using patient's narratives merely as an illustration of theory.

Successfully conveyed in these patient narratives is the essentially relational nature of the existential approach. Unlike other current models, such as cognitive behavioral therapy, it is not the current 'symptom' that is immediately focused upon. The job of the therapist is not to help the client collate evidence to disprove a particular belief, nor primarily to 'remove symptoms.' Spinelli's existential approach does not examine the individual in isolation, eschewing the typically Western conception of self as 'inner' and world, relationships as 'outer'. Instead, the human being is conceived as a co-constituting self-world, or self-other relationship. Following philosophers such as Heidegger, Spinelli stresses that a constant negotiation is taking place as a result of this necessarily relational experience. As such, the ways in which we conceive of our identity (i.e. who we must or must not be, or whom we are allowed to be) are a series of highly selective fictions. In this sense 'fiction' is not a derogatory term, for there is no right or 'objective' way in which we should or could define ourselves, our past and relationship with the world, and it is therefore not the role of the therapist to offer a 'correct' interpretation or solution.

Spinelli describes the particular fictions or narratives which we use to describe ourselves as self-constructs. These self-constructs are continually challenged by our experiences. If they are sufficiently rigid, experiences that seem to contradict them will be a source of distress of anxiety. Our response to these challenges itself expresses the stance we take towards our relations with the world, and therefore an exploration of these responses provides a picture of the self-construct in place. For Spinelli, the role of the therapist is to aid the client in examining and clarifying the self-construct in order to illuminate both the limitations that such a narrative may place upon us, but also the possibilities that it offers the individual.

Spinelli's approach has important implications for the relationship between therapist and client. Since the therapist brings his own self-construct to the encounter, he cannot be a detached and objectively critical observer. Thus, the interpretations he may offer cannot be considered as having priority over those of the client. This approach also prevents the recourse to theory as a justification for the therapist's views, as theory itself would be another form of self-construct which, whilst providing other possibilities, also imposes its own restrictions and limitations. Thus for both client and therapist alike, Spinelli advocates an openness to what he describes as un-knowing. Un-knowing refers to the attempt to remain open to the various ways of conceiving the self-world, self-other relationship. The therapist aids the client in regarding the necessarily relational construction of self as unfixed in meaning. This allows previously inaccessible possibilities to be considered, and renders previously unacknowledged self-constructs more perspicuous. Thus it is not simply the case that we can trace back an objective, causal link between past and present, identifying particular events which have caused us to be the way we are.

An obvious criticism is that this stance appears not to acknowledge the importance of 'real' events which influence a person, which persist in memory apart from their interpretation of them.  Surely, we might argue, there must be fixed and 'real' events which have shaped the person, or an 'originating' cause for a particular neurosis. This was a concern for Freud, for although suggesting that the psyche of the individual is shaped by early infantile experiences, his case studies read rather like novels or dramatic recountings, which do not posit a fully categorical causal explanation. In his seminal 'Constructions in Analysis' Freud makes the more radical claim that the importance of the past lies in the way it is interpreted by the patient, rather than in the actual events that may (or may not) have taken place. However, whilst at times Freud acknowledges the fictional nature of his own therapeutic constructs, this is frequently superseded by the desire to provide a fully causal explanation. The notion of the past as an essentially interpretative construct is more consistently espoused by Spinelli, who advises his students to consider client's accounts as a species of 'story-telling'. Through re-telling his client's stories, Spinelli demonstrates that the past is better described as past-as-it-is-currently lived. For the remembered past is itself an expression of the way in which we currently conceive of ourselves, and as such validates our current self-construct.

In the first chapter we meet 'Jim' who appears to exist simultaneously in two time zones. On one hand he is an elderly, retired man living with his wife. However, he frequently has spells where he believes himself to be living back in Ireland as a young man, with a young wife. In this case, Spinelli does not view his role as that of uncovering which events in his past may have led to what psychoanalysis would term 'regression', or exploring the past in order to 'resolve' previous conflicts. Instead he begins with Jim's present life, showing the ways in which this instance of experiential dissociation expresses a dissatisfaction with the present, rather than an unresolved issue from the past. We learn instead that Jim's wife has become a 'near-dead' burden, rather than the passionate, engaged person with whom he had shared his life.

What is refreshing about Spinelli's use of 'case studies' is that they are not used merely to illustrate a particular theoretical contention. Spinelli's recounting of eight therapeutic encounters is not an attempt to 'explain' the predicament of the client, but rather to offer a descriptive analysis, concerned with narrative truth rather than historical fact. In selecting, describing and constructing a case study the therapist is also involved in the creation of a particular fiction. The idea of this is not to 'interpret' or 'illustrate', but to describe the client's way-of-being as one picture among others with not only its own limitations, but also its own possibilities. As such, the quotation from Beckett's Worstward Ho! with which Spinelli concludes his prologue may serve as an epigraph for the whole of his therapeutic enterprise:

Ever tried. Ever failed. No matter. Try again. Fail again. Fail better.

© 2007 Laura Cook

Link: Publisher web site

Laura Cook is a doctoral candidate at the University of East Anglia where she teaches philosophy and psychoanalytic theory. Her research interests include philosophy of psychopathology, modernist literature and psychoanalysis. She is the editor of Applying Wittgenstein by Rupert Read, forthcoming with Continuum Books.

Categories: Psychotherapy