From Philosophy to Psychotherapy: A Phenomenological Model for Psychology, Psychiatry and Psychoanalysis (Book Review)
Author: Hersch, Edwin L.
Publisher: Toronto: University Of Toronto Press, 2003
Reviewed By: Marilyn Nissim-Sabat, Fall 2004, pp. 69-72
From Philosophy To Psychotherapy has four parts comprising twelve chapters. Chapter 1, “Know thy Philosophical Self,” is introductory; Part I: Ontology: The Groundwork and Foundation, has two chapters: “Ontology (Level A): The Question of Reality,” and “Ontology (Level B): Our Basic Problem or Relation to Reality.” Ontology A and Ontology B provide the foundation of Hersch’s hierarchical schema of “levels of theoretical inquiry.” Going up from the base, we have General Epistemology (C), Validity (D), Field-Specific Epistemology (E), and finally, Psychology (G). The book also contains critical discussions of classical psychoanalysis, object relations theory, self psychology, intersubjectivity theory, constructionism/constructivism, ontological relativism, behaviorism, cognitive psychotherapy, and biological psychiatry. All of the thematic material in the book is organized by Hersch’s own model, which he calls the “Beams-of-Light-through-Time” model. He describes this as follows: “The sR (subject-in-relation) illuminates a portion or an aspect of its o (object, or world).” Hersch adds, “The sort of ‘Consciousness’ with which we are now dealing is conceived here as less akin to Descartes’s isolated Cogito than to Heidegger’s concept of Dasein, or Being-in-the-World” (p. 75). Subsequent discussions of human existence as characterized by its three temporal modes of past, present and future clarify the Beams-of-Light-through-Time model. Hersch believes that this model, which is based on the philosophical stance of ontological realism derived from Heidegger, transcends both subjectivism and objectivism and provides a new existential-phenomenological paradigm for psychotherapy. Hersch illustrates his model through the use of case studies from his own practice.
Hersch’s book is an attempt to clarify and develop the relationship between philosophy and clinical psychology. It is highly innovative and replete with fascinating discussions and important insights. Most importantly, the book is quite unique, bold, and of great value in attempting to create a methodology that would enable systematic conceptualization of the philosophy-clinical psychology nexus. Nevertheless, despite its great strengths, From Philosophy to Psychotherapy manifests a flawed conception of philosophy. The coexistence of this flaw with the book’s strengths complicates the reviewer’s task of evaluation. Put another way, to do justice to this particular book, the reviewer should show that awareness of its flaws is necessary if one is to benefit maximally from studying it.
In the last chapter, Hersch, a Toronto psychiatrist with extensive background in philosophy, explains the tasks he took up in writing the book: “The nature of philosophical work is such that, though important to those in the psychological field, it has been hard to appreciate, difficult to do, and often relatively inaccessible. That is why I took up the tasks in this book of trying to introduce some of these relevant philosophical concepts to the psychological reader in as accessible a manner as possible. For similar reasons I have also presented a method of organizing and systematically approaching these issues (i.e., the hierarchical approach)” (p. 347).
In order to carry out these tasks, Hersch uses his own philosophical perspective as a case study. That is, all of the concepts introduced and the content that fills in the slots in the hierarchical system as presented in the book are drawn from his own philosophical stance. Inspired by Heidegger, Hersch is committed to “ontological realism.” Hersch claims that utilizing his own views is merely illustrative, in order to show the value of the methodology. This is certainly a possible reading of the book; nevertheless, since Hersch argues fervently for ontological realism as the best philosophical stance for the psychological disciplines, the claim that his stance is only illustrative of the method lacks credibility.
The problem is that the author’s notion of the nature of philosophy is flawed and consequently misleading. Hersch negates philosophy when he claims that it begins necessarily with assumptions, and with acceptance that it must begin with assumptions: “Throughout this work I will be maintaining that the most fundamental of our foundational philosophical assumptions—which nevertheless must remain assumptions—are those dealing with the issues described in our hierarchy as belonging to the ontological level(s) of inquiry” (p. 24). Hersch provides no explanation as to why these ontological claims must remain assumptions, of why, that is, they are not subject to a questioning that potentially could lead to conclusive rejection or acceptance of them, or why one must accept that they must remain assumptions.
For example, Hersch states that his own assumption is ontological realism (Ontology A level) and that this assumption is the foundation of all that follows in the book. He defines ontological realism as the view that “there exists a Reality or some form of Truth that is not merely or entirely dependent on us” (p. 37). He maintains that “relativism” is the opposite view, i.e., that no such reality, or “Reality,” exists. But, since for Hersch this too is an assumption, why should we prefer one assumption to another, ontological realism to relativism? Certainly, throughout the book, Hersch argues extensively and passionately against relativism. But why should this matter, since one could also argue cogently and passionately against ontological realism, as numerous philosophers from Plato to Husserl and beyond have already done? If one assumes that assumptions are necessarily the foundation, how can one refute relativism? All assumptions, especially when held to be foundational, are equal qua assumptions, especially when also held to be necessarily assumptive.
Moreover, it is one thing to say that all philosophical stances are based on assumptions, for this may be the case, despite all efforts by philosophers to avoid basing their views on undemonstrated principles, i.e., assumptions. For example, in his A Treatise of Human Nature (Oxford University Press: London, 1958), David Hume based his system on the principle that “all our simple ideas in their first appearance are deriv’d from simple impressions, which are correspondent to them, and which they exactly represent” (p. 4). This is indeed an assumption, but to Hume it was a self-evident principle. By and large, philosophers begin with what they take to be self-evident, not with what they take to be assumptions. For Hersch, it is self-evident that philosophy begins with an assumption. However, it does not follow from the circumstance that one might be mistaken as to what is taken to be self-evident, as, for example, Hume was mistaken, that self-evidence as a criterion of truth should be rejected.
Though it may be the case that philosophies do begin with ontological assumptions, it is quite another thing to say that philosophy begins with acceptance of the notion that all philosophical perspectives are, and can only be, based on assumptions. The latter claim is simply incorrect. Some philosophers, e.g., Gadamer, maintain that one should accept that all philosophies begin with assumptions; but it is patently incorrect to maintain that all philosophies accept this claim.
Related to the above, Hersch maintains further that ontology has priority over epistemology—i.e., that initial assumptions are always ontological in content in that they are assumptions about the nature of being, e.g., his view, ontological realism. I certainly agree with Hersch that this claim is assumptive—i.e., it cannot be demonstrated. I say this because, since whatever we do know, or claim to know, we know or claim to know in virtue of ourselves, it is in principle impossible for us to know whether or not anything exists independently of us, i.e., of whatever about us is held to be our means of knowing, whether our bodies or minds or some mind-body synthesis, etc. Therefore, it is proper that Hersch holds that ontological realism is an assumptive claim, for we cannot know whether or not anything exists independently of us, thus we cannot know whether or not ontological realism, which posits that there is something that exists independently of us, is a true claim. But it does not follow that all other ontological claims are maintained to be assumptive by those holding them. Even if Hersch wishes to argue that all other claims are assumptive whether those putting them forth believe them to be so or not, it still does not follow that it is accepted by philosophers that ontological or other fundamental claims can only be assumptive. This is patently false. That it is so is what led philosophers like Kant and Husserl to turn to epistemology as their starting point, i.e., in order to critique self-evidence and to establish a criterion as to what should count as self-evidence.
Another assumption made by Hersch is reflected in his explanation of the meaning of ontological realism, i.e., maintaining, “there exists a Reality or some form of Truth that is not merely or entirely dependent on us.” Hersch maintains that relativism is the view that there is no such Reality independent of us. But isn’t relativism the belief that there is no reality or truth at all, independent or dependent or both? That is to say, implicit in Hersch’s notion of ontological realism is the view that the only meaning that Reality and Truth can have is that they are that which exists independently of the subject, i.e., independently of us. But there are other non-relativistic notions of reality and truth. That is, relativism is not the only ontological stance that rejects ontological realism. For example, the notion of reality as constituted by Husserl in his philosophical stance known as phenomenology (post-Husserlian philosophies that are loosely called phenomenology, all either follow or deviate, or both follow and deviate from Husserlian phenomenology).
Both Heidegger and Sartre rejected Husserlian phenomenology. In the Husserlian phenomenological perspective, (discussed briefly by Hersch, who incorrectly states that Husserl aimed to bracket our judgments “as to whether objects exist” (p. 47)—but what Husserl bracketed was just the belief that “to exist” can mean only exist independently of the subject), reality, what is real, is just that which is intended by consciousness and intersubjectively constituted as real, i.e., intended with the sense “real” or “really existing.” Husserl showed that the sense “real” is the intentional object of an act of meaning-intending or constituting. Moreover, the constitution of existence-sense can only be grasped as such when all ontological commitments or positings are suspended.
Thus, suspending ontological commitments does not result in bracketing our judgments “as to whether objects exist.” It is in this sense that phenomenology begins with epistemological inquiry—How is the sense “real” constituted? What does it mean?—rather than with an ontological assumption. This is not relativistic because, despite its subjective, intersubjective, and historical embeddedness, meaning is not merely relative to the individual subject, the intersubjective community, or the historical time; rather, meaning presupposes ideality, or the universality of the structures of subjective life, of lived experience. (See E.Husserl, The Crisis of European Sciences and Transcendental Phenomenology, trans. by D. Carr (Northwestern University Press: Evanston), 1970.)
To summarize the foregoing critique then, Hersch confuses philosophy with his philosophy. If one is an ontological realist, one will maintain that philosophy begins with or is founded upon an ontological assumption, an assumption about the nature of ultimate reality, and that this assumption must remain just that—an assumption. Thus, Hersch’s methodological and analytic hierarchy has ontology as its foundation in the form of an assumption. But there are many stances, other than ontological realism, for example Husserlian phenomenology, which do not assume that we can only assume, and thus never strive for knowledge as an ideal. Thus, Hersch’s system presupposes that ontological assumptions are the foundation of all philosophies, yet this is not the case.
Finally, the consequence of Hersch confusing philosophy with his philosophy is that the book does not succeed in clarifying the relevance of philosophy to clinical psychology. A case in point is Hersch’s discussion of the correspondence theory of truth. In this discussion, Hersch both rejects and accepts the correspondence theory simultaneously (pp. 189-194). This is due to his commitment to the stance of ontological realism which seems to Hersch to require the correspondence theory; yet, his commitment to a coherence theory of truth as well, and his, in my view failed efforts to synthesize the two, or to transcend the duality, suggests that ontological realism is highly problematic as a foundation for psychotherapy. However, nowhere in the book does he call that stance, his foundational assumption, into question on philosophical grounds—rather, ontological realism functions as a discussion stopper throughout the book. Thus, despite Hersch’s explicit disclaimer and his very admirable and important commitment to systematic work, once again, like so many other formulations extant in the literature, it presupposes a philosophical stance, in this case ontological realism, and attempts to overlay that stance upon clinical psychology. The more radical alternative is to show that psychology itself cannot advance further either theoretically or practically without reconceiving itself as a philosophical science.
One of the most interesting, creative, and important discussions in From Philosophy to Psychotherapy is Hersch’s discussion of the temporal character of human existence and its bearing on clinical psychology or psychotherapy. Here is how Hersch expresses the clinical relevance of temporality:
“In terms of the future-oriented quality to motivation… when we form our present relationships our horizons are shaped not only by our past experiences but also by our future anticipations and projects. So… when people form new, present relationships that are highly similar to those of their personal past(s)… they are likely trying to get something for the future out of it. For instance, they may repeat not only because they are “driven to do so”… by their past, but also because… they are “trying it again but this time to get it right, to finally make it work for them.”… [T]he transference is an attempt at “finishing one’s unfinished business,” and one’s phenomenological world has become structured so as to favour that particular aspect.” (p. 231)
Many therapists, including myself, have gleaned this insight from their work, i.e., that people will often subject themselves to retraumatization in an effort to undo and redo past traumas. As we know, Freud, too, struggled with the apparent paradox of retraumatization. However, a phenomenological approach to the temporal dimension of human experience shows that failure of a person with a traumatic past to attempt to reconstitute the impact of that past on the person’s present and future may be indicative of far greater psychic crippling than the repeated effort to do so, however traumatic that effort. The commonsense psychological response might be to say that, well, of course, if a person has hope that things can get better, that suffering can somehow be reduced, that person is in a healthier state than those who have no hope. But, what the phenomenological perspective shows is that hope is so to speak the default position.
The same characterization that Hersch provides for the phenomenological notion of the intentionality of consciousness (the psyche as a whole), which he correctly ascribes to Husserl, characterizes the temporal structure of the psyche: “This basic structure of experience would then, of course, be seen as present in all manner of psychological experiences, including psychodynamically ‘conscious’ and ‘unconscious’ thoughts, desires, and emotions.” This holds for the temporality—the lived time as opposed to clock time, inherent in human psychic life, “a basic structure of experience.” (Heidegger’s philosophy of temporality owes a great deal to Husserl’s The Phenomenology of Internal Time Consciousness, which was compiled and edited by Heidegger, a former student of Husserl, in 1928.)
Thus, hopelessness is not just despair or lack of hope; rather, hopelessness is a deformation of our being as human—that is, it is a form of dehumanization whether a consequence of self or other failure to nurture or both Despair is an effort to foreclose the future, any future, and it is an effort doomed to failure for, owing to the structure of the psyche as inherently temporal, it creates its own future as the continued effort to deny any future. I have made this point in my own words, but I believe I have explicated Hersch’s view in his many fruitful discussions of temporality in the book. Most importantly, Hersch’s view of the theoretical, and by implication, clinical relevance of temporality is clearly and powerfully stated: “In terms of theories of psychological motivation, what is especially interesting—and different—about this approach is that it emphasizes the future rather than the past as the main temporal locus of motivation. Unlike most contemporary psychological theories, and necessarily unlike any deterministic ones, the emphasis here is on the uncertain-by-definition future rather than on the potentially more fully knowable past. This approach is thus incompatible with psychologies that adhere to determinisms of the sort that make claims to some potential for certainty in the predictability of human experience and behavior” (p. 199).
In showing that the clinical benefit of a therapeutic perspective oriented toward clients’ motivation to create a better future derives from the temporal structure of human psychic life and experience, Hersch has achieved a valuable theoretical and practical advance.
As mentioned above, Hersch’s book presents particular difficulties for the reviewer. From Philosophy to Psychology is an important study in that Hersch attempts a systematic integration of philosophy and clinical psychology, and in the course of so doing presents astute and insightful discussion of important themes and movements, which he attempts to illustrate with clinical material. On the other hand, the book is permeated by a flawed notion of philosophy that leads Hersch to a position that cannot transcend relativism in that it posits the necessity for unquestioned ontological assumptions at the outset while at the same time suggesting that such assumptions, including others than his own, are equally worthy. This is suggested also in the title of the book. The trajectory of the book, traversed within the parameters of the hierarchical model, is indeed from philosophy to psychology; the implication is that other perspectives, beginning with alternate ontological assumptions, can traverse the same path within the parameters of the hierarchical model. But, given that model, the path must begin with an ontological assumption that is viewed as necessarily assumptive. That this is the only path that can lead from philosophy to psychology is the assumption that I have questioned. On the other hand, Hersch argues for his own position as providing the philosophical foundation for psychotherapy. Bearing in mind the caveats I have expressed herein, Hersch’s book is worthy of serious study.
Marilyn Nissim-Sabat is Professor Emeritus and Adjunct Professor of Philosophy, Lewis University, and is a clinical social worker in private practice in Chicago.
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