The Art of the Psychotherapist

Rating:
Summary: A touchstone
Review: As a therapist 'out there', after my training, I know that my learning is ongoing. Supervision, workshops, colleagues, patients and books are all sources of this learning. Some books are like old friends that I keep turning back to. The Art of the Psychotherapist by James Bugental is one of these.

Published in 1992, and writing it in his seventies, Dr.Bugental was drawing from a well of some half a century's worth of psychotherapy experience. He writes in the preface "writing this book is a culminating effort for me. I have been invested in trying to find ways of communicating what hundreds of patients have taught me about how we humans frame our being, how we express our questing, and how we - wittingly and unwittingly - defeat some of our best efforts". This giant task of processing, distillation and communication is a wish to "aid therapists, of different orientations, who intend doing depth, life-changing work to extend the range and power of their own perspectives". To understand the book better some words need to be said about 'depth psychotherapy'. 'Depth psychotherapy', as the author explains, values subjective experience as primary for examining and changing the way we have answered the 'big' questions of life, the existential questions of life. Questions such as how do I live? Who am I? What do I want from my life? On the objective-subjective psychotherapy range of working this is different from the also valuable objective endeavours of aiming and reducing symptoms. Time is another distinguishing factor. In an increasingly speedy world depth psychotherapy requires not a paddock of five sessions but open land - twice weekly meetings and years.

The challenge, which I believe the author has met, is laying down some routes into working with subjectivity while at the time preserving it. Like a rainforest rich with experience it wouldn't be quite the same from an air con coach with piped musak. As well as providing compasses, maps and vehicles, the author shares his experiences as a psychotherapist on a journey. His honesty is rewarding. He shares some frank lessons. For example, he reflects on the folly of a time when he was overly involved in taking care of his patients. The example is echoed in a recent interview when he said 'just yielding to the neediness of the client is not therapy'. The lure of engendering positive tranference.

Of all the chapters in the book I particularly enjoyed the one about 'Intentionality and Spiritedness'. For me it is the engine of the book and crucial to my understanding of depth therapy. I did wonder why though it came so late in the book though. The chapter describes the Jacob's ladder like ascent of impulses from the unconscious (our intentionality), up the steps of wish, want and will to their actualisation, or not, in the world. The death of impulses along the way makes me think of a witty remark said by a colleague to me about a certain place where we worked. 'This place' he said, 'is like a water butt in which the kittens of possibility are drowned'. So it is with our wishes.

In sum, the book is wise, imaginative and practical. Copious clinical examples of patient and therapist dialogue aid this communication. There's even an appendix with suggestions and exerices to develop the principles within the book. Someone, I forget where, described it as a 'gem of a book'. I agree and I hope that in an ever busy and competitive world The Art of the Psychotherapist is a spirit that will never be drowned.