What an Existential Ontology Can Offer Psychotherapists

Abstract

This article attempts to illustrate how an existential ontology has a great deal to offer to psychotherapists. Because this complex interaction may often be difficult to see, three ways in which such philosophical work has been applicable and enriching in the context of a particular psychotherapy practice are presented. These include a) the use of existential themes and concepts in psychotherapy, including the notions of existential guilt, existential anxiety, and bad faith, b) the argument that an existential ontology provides a more suitable philosophical grounding for psychotherapeutic theories and practices, one which better describes the life-world, experiential phenomena in question, and c) the idea that an existential version of the mental status examination, centered around six key dimensions of human experience (derived from an existential ontology) can provide us with a more in-depth understanding of, and better description of, an individual’s experiential world.

An existential ontology for understanding the experience of psychosis.

“…First, I will outline the distinction between the ontological and ontic dimensions of lived experience. Consistent with several recently discussed existential-ontological perspectives (e.g., Craig, 2013, 2015a, 2015b; Hersch, 2015; Tratter, 2015), I will contend that the ontological issues of Being and the nature of human existence are implicitly present in, and intertwined with, the ontic activities of psychology and psychotherapy. Second, I will utilize the framework developed by Hersch (2015) to explain six key aspects of human experience that owes much to Heidegger, Sartre and Merleau-Ponty.…”

“…I will elaborate on this point later from the perspectives of persons with PE whose recovery began when they experienced a "turning point" with a significant other who conveyed hope, related to them as persons and did not define them primarily according to "illness." Temporality Hersch (2015) referred to temporality as our experiencing of "an ongoing, necessarily incomplete process of becoming . .…”

“…For Heidegger, anxiety was the fundamental mood of human existence from which we are often fleeing and bracketing below the threshold of consciousness, but which nevertheless precedes and influences consciousness. Hersch (2015) argued that our major cares and concerns range across a continuum of overcaring and undercaring in our interaction with others. Persons with PE may be said to be overcaring when they "hear voices" (auditory-verbal hallucinations), perhaps during periods of stress, which give rise to the anticipation of social threats and paranoid beliefs, fear of annihilation, shame, guilt and/or anger; and which are misattributed to a source external to self.…”

“…The concept of being-with-others, although it was initially described by Heidegger (1927Heidegger ( /1962, has been developed in more depth by others (e.g., Agosta, 2014;Buber, 1947Buber, /2002Levinas, 1972Levinas, /2006Stolorow, 2013b) to explain a fundamental aspect of human being. Hersch's (2015) concept of being-with-others refers to all human experience being "essentially social" and "embedded within an interpersonal, cultural, and socialhistorical context" (p. 118; original italics).…”

“…I will argue that the ontological issues of Being and the nature of human existence are implicitly present in, and intertwined with, the ontic activities of psychology and psychotherapy. Second, the existential-ontological framework developed by Hersch (2015) is utilized to explain six key aspects of human experience that can be applied in, for example, the ontic task of psychotherapy that seeks to understand the lived worlds of persons with PE. While Hersch’s systematic approach owes much to Heidegger, Sartre, and Merleau-Ponty, I will also discuss these dimensions from the viewpoints of persons with PE together with other perspectives from person-centered, cognitive–behavioral and existential psychotherapies, and from neuropsychiatry.…”