by Irene Chiang

(This paper received a score of 100)

前言

存在主義強調自覺、自由和為自己的人生負責,而生命的意義,並非由客觀的外在來定義,而是由主觀的個人所賦予。人類都會面對最終的結果─死亡,一旦體認到生命有限的這個事實,人們就會更專注於此時此刻(here and now),採取行動克服生命有限所帶來的焦慮感,並且設法讓自己度過有意義的人生。

再來談談受虐者的處遇。受虐者因長期承受施暴者的語言及/或肢體傷害,他們的自信心普遍都很低,而且在受虐初期會為了種種緣故(如孩子、恐懼、經濟壓力等)而選擇逆來順受,等走到了忍無可忍的地步才會思考改變現狀的可能性,進而向外尋求協助。以心理的觀點而言,受虐者因為有苦難言,對外又必須粉飾太平,所以他們是處於高度孤立和內外不一的狀態。根據存在主義觀點,孤獨和人際關係共存於人類的生命經驗中。藉由團體諮商和敘事療法的交互運用,提供受虐者一個「被看到/傾聽」的場景,在說出自身故事的同時,也可藉由他人的回饋和分享獲得啟發與更深的覺察,進而強化以行動改變現狀的意願。諮商/治療師除了深度傾聽和同理之外,也必須從這些被說出來的生命故事中整理出共通點加以解構,讓團體成員以新的角度反觀自身現狀和找出盲點。

我很習慣在帶團體時讓成員練習深呼吸,讓他們向內觀以安頓身心,同時也可藉由這樣的方式體驗身心之間密切的連結。受虐者總是為他人著想,因長期隱忍而把自我壓抑得非常徹底。我會透過深呼吸的方式,讓他們從自我內在的源頭覺知自身的存在,接著在團諮過程中強化他們對本身和重要他人的意義,再透過舞蹈治療的過程舒展身心,讓成員藉由自發的肢體表達體認身心和生命的可延展性,逐步建立「我可以過得更好、更堅強、更寬廣」的自信心。

[Abstract]

Traditionally, the focus of psychology and psychotherapy was solely on the mental state of clients, and they had not given appropriate or adequate attention to the bodily experiences of clients. As the year progresses, the existential view on human beings and aspect of human body have both gained increasing attention in the field of psychology and psychotherapy. In the professional arena, more and more psychotherapists are willing to take the client’s bodily experiences into consideration. This paper will introduce an existential body-mind approach of counseling and psychotherapy, and issues regarding its theoretical formation, structure, motivation, personality development, health, dysfunction, and interventions will also be discussed.

INDIVIDUAL COUNSELING BASED ON AN EXISTENTIAL BODY-MIND APPROACH

Between 1940 and 1950, a psychotherapy approach based on existential philosophy has emerged. This was not established by a single person or group, but an application of existential point of view on psychoanalysis. On the surface, it was a clinical application similar to other psychotherapeutic approaches. On the inside, however, it was a unique kind of psychotherapy originated from existentialism. Existential therapists attempt to help people deal with everyday difficulties such as loneliness, anxiety, and a sense of emptiness. They do not treat their clients as patients, but individuals temporarily confronting limitations. Therefore, the focus of these therapists is not to develop a set of therapeutic techniques, but to understand the in-depth structure of their clients’ experiences, believing in their clients’ freedom of choice and the ability to grow (Gong & Hsu, 2005).

Development of Existential Psychotherapy

Existentialism was originated in the 17th century, gradually established in the 18th century, and became a revolutionary philosophical thought in the 19th century. As implied in the name, existentialism deals with issues regarding “existence,” and existential thinkers specifically make differentiations between “being” and “existence.” “Being” means the presence of an object, such as a door or a bookshelf. On the other hand, “existence” is a specific kind of presence, which means the presence of a human being with her or his own individuality and subjective thinking. For them, those who do not think or only think objectively do not fit into the definition of existence. Therefore, existentialism explores all issues about human existence for people to sincerely experience every possibility of their own existence in order to create their own destiny. In this sense, existentialism is full of humanity (Gong & Hsu, 2005).

The early work of European philosophers was the foundation of existential psychotherapy. The Danish philosopher Søren Kierkegaard wrote about anxiety and uncertainties in life, and in the late 19th century, German philosopher Friedrich Nietzsche, who challenged the foundations of traditional morality and the existence of God, put much emphasis on subjectivity and the will to power. He later popularized existential thought in Europe. Furthermore, German philosophers Martin Heidegger and Karl Jaspers elaborated a complicate system of existential philosophy. French writers and philosophers Jean-Paul Sartre and Albert Camus, Russian writer Fyodor Dostoyevski, and Czech writer Franz Kafka have all discussed issues regarding existentialism in their work (Sharf, 2004).

Existential psychologists consider that psychoanalysis puts too much emphasis on an individual’s childhood, and they also reject behaviorism for its point of view that a person’s past in more important than her or his future. Human beings constantly experience changes, so the “present” is the key to determine an individual’s behavior and action. Philosophers such as Kierkegaard, Nietzsche, and phenomenologist Edmund Husserl preferred to see human beings as individuals living in their own phenomenal experiences. In other words, each person subjectively puts her or his own meaning into the so-called reality. In this sense, each of us is responsible for creating our own lives, and we need to utilize every opportunity to recreate ourselves and enrich our lives (Lee, 2000-2004).

Existentialsits put their ultimate concerns on the following issues (Shia, 1998):

A. Self-awareness: to expand our ability of self-awareness is to improve our capability to fully experience our lives.

B. Freedom and responsibility: in the process of pursuing freedom, we are responsible for our own choices and our lives. Freedom and responsiblitiy go hand-in-hand.

C. Self-identification and relationships: these include the courage of being-in-the-world and human experiences of isolation and loving.

D. Pursuit of meaning: human existence is meaningful only if we are willing to live a life full of creativity, love, and constructive activities.

E. Anxiety: “anxiety arises from the basic nature of being” (Sharf, 2004, p. 166), and people consciously or unconsciously want to use every possible means to solve the “givens” of existence (Yalom, 1989). To confront the unknown and pursue meaning in the state of anxiety is to maintain human beings’ motivation for growth and recognize the meaning of existence.

F. Death and non-existence: when we know that we do not have an enternity to achieve all our goals, we will place more importance on the here and now.

Body, Mind, and Meaning

Began with Austrian psychiatrist Wilhelm Reich, somatic psychotherapies are known for their innovative integration of verbal and non-verbal processes. Somatic psychotherapists observe their clients’ breathing, posture, physique, musculature, and other physical features to make comments about their clients’ bodily expression or underlying emotional issues. Reich carefully observed his clients and focused on their breathing and physical changes, particularly when they talked about their emotional issues (Sharf, 2004). He brought the body into the field of psychology. For Reich, the visible appearance of human body is a precise reflection of what is happening internally, and what he wanted was a full-body emotional response to life. If people cover themselves up, they may deaden pain, but also rob themselves of full joy (Daniels, 2005).

Muscular armor is one of Reich’s important contributions to psychology (Sharf, 2004). Major functions of muscular armor are: (a) to keep potentially explosive emotions in; (b) to ward off other people’s emotions. Reich noticed that because people are so used to suppressing their true feelings and emotions that it is difficult for them to take away such an armor. Therefore, he believed that mind-body work is essential for people to get rid of this kind of armor. Next, body armor and character armor are virtually the same, and they function as an attempt to protect human beings against the pain of non-expression about things that society does not allow them to express. In this sense, muscular armor is actually the physical expression of character armor with muscular regidity (Daniels, 2005).

The major distinction between body-mind or somatic psychotherapy and traditional psychotherapy is that the former tend to focus on the improvement of both physical and mental well-being, and explore the physical expressions of the range of psycho-emotional complexes in order to support the self-awareness and psychological development of the client. However, in traditional psychology and psychotherapy, the bodily experiences of human beings has not receive appropriate or adequate attention because they emphasize the body-mind split and claim that mental process is superior to physical aspects of human beings. Reich’s work is to free people from the bonds and constraints of the collective norm, and to assist them on the realization of their potential for a uniquely fulfilling life of creativity (Hartley, 2005). Psyche and soma are both crucial for the wholeness of human beings. In Chinese culture, spirit is also a part of the integrated wholeness, and we highly emphasize the peacefulness of our spirit.

Structure

A. The meaning of existence
It is human nature to pursue values and purposes of their meaning of life (Corey, 2005). As human beings, we need a sense of meaninfulness in our lives. A sense of meaningfulness offers a way to interpret events that occur to us and in the world. It provides an avenue to devlop values regarding how we live and wish to live (Sharf, 2004). If we consider the world we live has no meaning, we may doubt whether to continue living. Existential psychotherapy provides a conceptual structure to help the client explore the meaning of life (Corey, 2005).

B. Confronting ultimate concerns
Ultimate concerns include: (a) awareness of our own death; (b) our freedom to make choices; (c) awareness of our existence as individuals (separateness or isolation); (d) the threat of meaninglessness. These concerns often underlie many of our conflicts, anxieties, and motives; existential psychotherapy can help us connect ourselves with them (Scholten, 2006). Consequently, there is no absolute mode or answer for life; it is a process for us to discover and experience. In Chinese culture, death is a taboo that most people avoid discussing, and the way to deal with it is often through repression. However, it is no use to avoid the unavoidable, and a more constructive way to deal with it is to actively face this ultimate issue to keep ourselves from sinking into endless fear.

C. Individuality and unconditional positive regard
“Existential psychotherapy is an attitude toward life, a way of being, and a way of interacting with oneself, others, and the environment” (Sharf, 2004, p. 196). It does not intend to apply a fixed set of therpeutic procedures to everyone, and the way of therapy differs from one person to another. That is, therapists should accept their clients unconditionally and non-judgementally, let their clients freely explore positive or negative thoughts and feelings without the risk of rejection or condemnation, and provide encouragement and appropriate assistance. One crucial point is that clients have the freedom to explore and express “without having to do anything in particular or meet any particular standards of behavior to ‘earn’ positive regard from the counsellor” (Counseling Resource, 2003-2006, 5).

D. Body, mind, and spirit constitute a whole person
Body is the representation of our accumulated experiences (Caldwell, 1996), and every event and experience in our lives, espeically emotions, thoughts, and willpower, directly affect our physical and mental health. Wholeness involves human body, mind, and spirit; being healthy means we are able to maintain the equilibrium of the three. When the entire organism encounters environmental pollution, social chaos, and psychological pressure, such an equilibrium will not be at ease and thus leads to physical illness, depression, and abnormal behavior (Lay, 2001). Moreover, the balance of body, mind, and spirit represents our repesct toward our own existence, and shows that we take responsibility toward our own life.

Motivation

A. The imminence for people to make sense of inevitable issues
As previously mentioned, isolation and the termination of life are inescapable issues we all have to face. Therefore, how we perceive life and live with purpose become key issues of our existence. For instance, Austrian psychiatrist and Nazi concentration camp survivor Viktor Frankl’s personal experiences during World War II gave him a unique insight of human life, and made him appreciate more toward the meaningfulness of life. He did not see death as a threat, but as an urging that drives people to live their live fully and take advantage of every opportunity to act meaningfully. When we are forced to face the imminent death of ourselves or our loved ones, we must cherish and live in the here and now and be more aware of oursevles and our situation (Sharf, 2004).

B. Human beings discover the impact of ultimate concerns through living their lives
Most people are afraid of death, and isolation, emptiness and meaninglessness are common problems in modern society that lead to despair, various mental illnesses, and destructive behavior. Moreover, some people consider freedom as “I can do whatever I want” but forget about they must take responsibility for their own actions. Therefore, we need assistance to uncover meaning in our lives, including meaning from crises and painful experiences, through deep personal reflection and subsequent action (Scholten, 2006).

C. A person, as the integrated whole of body, mind, and spirit, strive for equilibrium
A harmonious whole depends on the balance of body, mind, and spirit. We are not merely the constitution of abundant cells, nor are we the manifestation of genetic formulas. The human organism comprises the physical presence, intelligence, creativity, and energy. Balance of the entire organism cannot be achieved solely by medication or paying attention only to the human psyche. To accomplish the state of equilibrium, we must actively and wholeheartedly strive for positive transformation of our body and mind in our daily lives, and maintain good living and working habits, adequate and nutritious food intake, and proper exercise and breathing pattern, as well as take good care of our emotions in order to obtain complete and genuine health (Chang Gung Biotechnology, 2005).

Personality Development

A. Recognition of our own death and to cope with it
One distinct characteristic of human existence is the understanding of our control toward future and the certainty of our death. If we want to think about the importance of living, we must also take death into consideration instead of resistance; otherwise, life will become dull and meaningless. If we recognize the certainty of death and know that we do not have eternity to finish all our plans, we will look more seriously at our present and live our lives more authentically. When we are no longer afraid of death, we will be able to develop a healthy awareness of it and utilize this to evaluate our current lifestyle, as well as ponder over how we can discard our old values and make a difference (Corey, 2005).

B. Our sense of being
After discarding old and coerced values, we may not be able to find an appropriate value system as substitution. What should we do if we encouter such an emptiness when we no longer cling to our past values? If we have the opportunity to receive assistance for our own inner exploration and to confidently formulate a inner value system, we will achieve congruence between our ways of being and existence (Corey, 2005). Therefore, what we gain is a “genuine inner vision, in a self-knowing that is more than verbal or logical; it is truly organismic, an experience of the whole being” (Bugental, 1978, p. 17).

C. Our being in the world and participation in meaningful relationships
There are four ways of being-in-the-world: (a) the Umwelt (physical world or environment); (b) the Mitwelt (with-world or world with others); (c) the Eigenwelt (own-world or personal world); (d) the Uberwelt (one’s spiritual dimension) (Sharf, 2004; van Deurzen, 2005). Our experiences are multi-layered and complex that they occur on a number of different levels. First, we involve in a biological world of objects. Next, we participate in social activities and interact with others, struggling with the contradictions between our need of belonging and potential isolation. Thirdly, we have a personal dimension where we struggle between integrity and disintegration. Finally, we have spiritual or religious relationship (Sharf, 2004, p. 164). We must learn to “stand in the tension between opposites and hold the paradox on each dimension” (van Deurzen, 2005, 15), and make our relationships with others positive and meaningful.

D. Physical, psychological, and spiritual aspects affect one another
Condition of one part of the body has an impact on other physical and psychological aspects of the whole organism. When a person has cancer, it not only affects this person’s body but mental state as well, and when an individual becomes depressed, anxious, compulsive-obsessive, or has other psychological disorders, this individual’s physical health will be deteriorated (Sharf, 2004). Next, past events can also affect our physical and psychological states. “Early traumatic experiences may have an impact on how children breathe, stand, walk, or run. Such changes in physiological development may also influence self-image and confidence in physical expression and interaction with others” (Sharf, 2004, p. 537). Moreover, physical health brings people happiness, mental health brings people joy, and spiritual fulfillment brings people a positive sense of value (Gong & Hsu, 2005).

Difference

A. Truth is subjective and depending upon the individual
The major difference of the existential body-mind approach is that the truth is not objective, but subjective. In other words, the truth depends on the existing individual and how this individual perceives, thinks about, and interprets her or his emotions, environment, and interpersonal relationships. We not only make contact with our environment and other people, but we also constantly sense ourselves, our relationships, and our environment within such contact. Because we see and feel the world differently, each of us has our own version of reality. In this sense, individual difference is honored during the therapeutic process. Therefore, it is a person-centered somatic approach.

B. Effect of energy on overall equilibrium
In various body-mind therapies and Chinese spiritual cultivation, energy (or “inner strength”) is a crucial part when looking into a person’s overall well-being, including the following issues: where does the energy come from? How can we utilize it? How does energy blockage happen and why? Energy blockage is considered a form of resisting contact, and such a blockage may reveal on muscle tension on certain body part(s), such as changing posture, tightening of muscle or body, shaking, looking into elsewhere when talking to people, and unusual voice tone (Corey, 2005). Moreover, energy blockage brings negative effects on the balance of body, mind, and spirit, which leads to physical and mental disorders.

Health and Illness

A. Health
Whether an individual is healthy or not depends on this individual. Generally, when we have confronted our ultimate concerns, gained complete awareness of our existence, abilities, and limitations, constantly regulate ourselves, take full responsibility of our own actions, live actively and progressively in the here and now (Gong & Hsu, 2005), and look into our future, we are heading toward a path of healthy living. In addition to the aforementioned aspects, when we achieve a balanced and harmonious state of body, mind, and spirit, we become healthy entities.

B. Illness
Anxiety is a state of our existence and a situation that all of us must confront. It originates from the essence of human existence that individuals pursue living, maintain and recognize their own identity. When we are aware of our strengths, limitations, and mortality, we evolve a way of dealing with normal anxiety and this becomes our motivation (Corey, 2005). However, if we deal with anxiety impractically or take an avoidance stance, we become dysfunctional. Next, if we cannot maintain the balance of our body, mind, and spirit, differentiate between reality and illusion, or even consider ourselves “superhumans,” such an attitude will cause our inner conflicts, distort our sense of being, and make us unhealthy.

Intervention

A. Establishment of positive therapy relationship
Relationship between the therapist and the client is very important, because a positive therapy relationship motivates the client’s willingness to actively make transformation. Therapists should be honest, sincere, integrative, and courageous, and model these characteristics for their clients. Therapy relationship is an “I-you encounter,” a co-created process by both parties, and the therapist should explore deeply on the client’s world, based on the latter’s awareness and experience, with empathy and respect, believing in the client’s potential of truthfully dealing with her or his difficulties and making decisions. Such a sharing experience stimulates therapeutic effects (Corey, 2005).

B. Repeat, restatement, and inquiry
The purpose of repeat is for the client to consciously know what she or he actually says in order to help the client be aware of her or his internal conflicts or incongruence, because awareness is the beginning of organic self-regulation. Through restatement and inquiry, the therapist helps the client honestly express her or his own experiences, admitting and owning the presence of her or his inner world in order to re-activate the self-regulating mechanism, guide the client to feel her or his inner boundary and emotions, and help the client learn how to trust her or his body again (Caldwell, 1996).

C. Recognition, clarification, and acceptance
In this stage, the therapist assists the client to recognize, confirm, and clarify her or his assumption of the world and delve into the ultimate concerns. After expressing her or his ways of awareness and meaning of existence, the client will be able to examine her or his value system, faith, and assumption of the world to see whether these are valid, or they have become the client’s blockage. It is human tendency to blame on outside factors, considering others should be mostly responsible for our actions, and deny our responsibility for our own doing. The therapist should help the client reflect on her or his own existence and examine which role the client has played in her or his issues (Corey, 2005). A useful technique is deep breathing. This will help the client obtain greater and deeper feelings, ease her or his mind, promote free flows of energy, leave sufficient space to let sensations in and out, and become more energetic (Caldwell, 1996).

D. Rehearsal and enactment
Role-play is an effective way for the client to practice and start her or his transformation. For example, if a submissive client needs to practice assertiveness, the therapist may ask this client to play an assertive role she or he is unfamiliar with in front of the therapist or a therapy group, and then the client may interact with others. Through enactment and interaction, the client experience, right at this moment and place, the difference between her or his old self and the new self. With this in mind, the client will learn how to behave according to such a new role, and gradually discover a way to transfer such an enactment into real life through repeated practice and rehearsal.

E. Physical exaggeration and translation
In this process, clients are encouraged to exaggerate a facial expression or a movement such as foot stamping and hand swing. Clients are even encouraged to exaggerate their voice or a way of communication in order to strengthen their senses. Sometimes, the therapist “may find it helpful to copy the actions of a group member to empathically understand what the group member may be experiencing physiologically and affectively” (Sharf, 2004, p. 565). However, the therapist must be careful and avoiding any implication of mockery. Next, the therapist can also embody the client’s issue by translating it into action (Sharf, 2004). For instance, one of my dance therapy teachers once talked about a female student of hers. When she divided her students into dyads and asked each pair to do pulling toward the opposite directions while holding hands, this student suddenly broke into tears. She said that this activity reminded her of her mother who passed away recently. When her mother breathed for the last time, she was holding her mother’s hand. My teacher then brought this issue into movement and held hands with this girl the way she had held her mother’s hand. The entire group shared the experience as the dyad did so.

F. From decision to action
In this stage, the therapist encourages the client to transfer what they have learned in therapy sessions into actions. The purpose is for the client to apply her or his examined and internalized value system to practical action plan in the real world (Corey, 2005). What the client needs is to soberly accept her- or himself, take full responsibility of her or his decisions, and make contact with the outside world. The therapist may guide the client to take deep breath, stretch her or his body, walk around, talk, and connect with other people in order to sense the environment, personal expressions, and take actions from a whole new perspective, as well as make sure these can be extend into the client’s daily life and relationships (Caldwell, 1996). This is the ultimate goal of therapy, and people who undergo this process will eventually discover their own capability to accomplish what they consider is a meaningful life.

[Reference]

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