Time-Limited Existential Therapy. Alison Strasser
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the existential community. Without my father there was no buffer, and yet I wanted to have my voice heard; I was stuck in my own paradox.
This struggle continued until one of my friends insightfully asked me why I was writing. I realised that my intentions were more duty bound than personally motivated. It seemed that my attempts at writing had been in ‘bad faith’.i Of course I’d be finding it hard!
This has not been an easy journey. In time, I began to appreciate that, as the Bible claims, ‘What has been will be again, what has been done will be done again; there is nothing new under the sun’ (Ecclesiastes 1:9), that no ideas are new, only that our understanding of concepts evolves with our experiences and our ability to challenge and experiment with them. Even if I present what I believe are new ideas in this book, they have evolved from what has been co‐created with others, from my many and varied teachers, mentors, colleagues, friends, adversaries, and, of course, my father.
Since the publication of first edition, many other authors and existential practitioners have written about their work and their understanding and integration of existential philosophy. There is a second and possibly even third generation of writers that are widening and also integrating other frameworks and modalities into the space of existential practice. There is the focusing world of Eugene Gendlin (1978) as integrated by such authors as Greg Madison (2010); the Buddhist mindfulness approach as integrated by such authors as Khong (2013) and Nanda (2009); the continuation of Frankl’s (1963) logotherapy with the work of Alfred Längle ( 2015); as well as the humanists such as Kirk Schneider (Schneider & Krug, 2010) and Mick Cooper (Cooper & Mearns, 2005) who have shown how the humanistic tradition is also existential in nature. Research shows that existential therapy is as valid an approach as any other therapy (Correia, Cooper, & Berdondini, 2014). There is a group of therapists, the New Existentialists (Hoffman, 2015), who no longer adhere to the ‘doom and gloom’ perspective that is often associated with French existentialist writing, focusing instead on a positive interpretation of the philosophy and its application. Indeed, we now read about joy and hope, meaning and purpose as an existential tension to their opposites of sadness and despair, meaninglessness and aloneness and about how we can live our life more fully through self‐examination and taking more responsibility for our life journey. And my own perspective continues to shift and modify as I undertake further reading, add my own daily experience of working with clients, supervisees, students, colleagues, and am challenged and inspired by the vagaries of life in all its complexities.
I returned to writing this second edition, deciding to put my father firmly up ‘in the attic’ and to give myself the option of choosing consciously when and how to invite him in.
Simultaneously, I realised that my compulsion to complete this task on my own was driven my childhood determination to prove my worth; this contributed to my stuckness. By staying with the anxiety of my stuckness, I began to understand that to ask for help was not a negation of my independence but potentially a shift towards something new and exciting. And so I chose to ask for help. Jo Silbert has been a friend and fellow therapist for many years. Through her love of language, she shifted into writing and editing articles and books on psychotherapy. With her help, this second edition began to take shape.
My first decision was to consolidate the two Wheels of Existence into one wheel. This new wheel combines the ideas from the original wheels and simultaneously allows for the integration of the philosophical ideas and the essential processes involved in existential practice. Broadly, the Wheel in this edition brings together the concept that our practice is phenomenological while maintaining the existential philosophy as the backdrop that informs our listening, questions, and reflections.
In this second edition, I will expand on the concept of time‐aware therapy to reveal that all therapy can be viewed as time limited and discuss the various possibilities of using a time‐aware approach in practice to reveal how time can be used as an effective stratagem to enhance and highlight some of the existential human concerns. So, while the modular approach still remains valid, its ideas are transferable to all therapies.
Therapy as time limited fits snugly into an existential perspective in that, in its very essence, therapy mirrors life in all its openings and closures, beginnings and endings, with its final culmination in death. These beginnings and endings of life range from the small and everyday – our waking up in the morning and going to sleep at night, starting and finishing a new project, beginning a new friendship and saying goodbye to others – to the more significant beginning of our birth and ending of our death. We are all being carried forward towards death, a being‐unto‐death as described by Heidegger (1962). The manner of our approach to how we tackle or manage these beginnings, endings, openings and closures in therapy can mimic how we negotiate life. Hence, the significance of time is tangible in every session.
Time is also implicit in therapy, though usually unspoken, unless either the client or therapist is taking a break, or the end of therapy is nigh. There are numerous theories and approaches to addressing and grasping the meaning of breaks; yet working explicitly with temporality as an existential given gives a richness to time in all its complexity for both the therapist and client to work with.
I tend to work with clients with no fixed end to their therapy, or what is usually defined as open‐ended. This is partly due to my original training and also my own preference for working with clients over a longer period. The relationship that is at the crux of existential therapy ebbs and flow over a longer period and builds on an in‐depthness that doesn’t always have time to develop within the brief therapy scenario. I build in an ending process so that when it is time for the client to finish, we negotiate a series of sessions before the final closure. This manner of ending brings out many of the advantages of the time‐limited modular approach and the benefits for some clients of working over a longer time period. Later, I discovered that this was similar to Otto Rank’s (1929) concept of time‐limited therapy that I shall return to in Chapter 3. As so cogently described by a supervisee who closed her practice using this ‘time‐aware and time‐limited’ approach, ‘working with the ending was like a dream come true; my clients took up their own baton and truly worked in earnest’.
Yalom (2008) writes about explicitly alluding to death in every session; I propose that our relationship to time is an expansive way of calling attention to endings that might include our relationship to our physical death but is inclusive of all the other beginnings and endings that occur in life. Every session has a start and finish, every day has its morning and night, every job has an induction and termination, and all relationships begin and end. By calling attention to this reality, it allows for the possibility of working with all the intrinsic anxieties, paradoxes, and vulnerabilities highlighted in the modular approach explored in the first edition.
The proposal to bring time‐limited awareness to all therapy is about recognising that contextual working situations are diverse, that our circumstances differ, and that, as therapists, we have personal preferences. My work as a supervisor has privileged me with insights into the gamut of the many and varied circumstances, contexts and experiences of my supervisees: therapists and supervisors in private practice; practitioners that work in agencies with a fixed number of client sessions varying from 6 weeks to 6 months; those that permit additional sessions; those that require clients to be referred elsewhere after the maximum sessions are complete. These insights have highlighted how we all need to find our own path, our own voice as therapists. Working with the idea of time and its limitations has its own flexibility and can be used and worked with as seen fit and appropriate by each individual.
In some obvious, some subtle ways, this second edition was in its conception – both during and as soon as the first edition was put to bed – reflecting the notion that speaks directly to one of the existential ideas that time is in constant flow with no beginning or ending. This might appear to be in direct opposition to time‐limited therapy which honours the idea that time is limited, thus highlighting another existential ‘given’ that life is peppered with paradoxes. This second edition is an opportunity to extend the original ideas around time in therapy to include