existential guilt, existential anxiety, technological thinking, psychotherapy research, existential mental status examination
I wish to thank both Dr. Eagle and Dr. Thompson for their thoughtful and thought-provoking commentaries on my paper. I address some of the concerns they brought up in this response.
Existential Guilt About Writing a Paper
When I began to write this paper, my first thoughts were to the effect of “How does one write a relatively brief article about a topic on which I’ve already devoted a rather lengthy book?” What do I include? And what do I leave out? Although the latter of these questions (ironically) left me dealing with many feelings of ‘existential guilt’ about leaving out ideas I think are important, the former took guidance from the stated purpose of this special issue to address a broad and interdisciplinary audience on the question of what can an existential ontology offer for psychotherapists. Eventually, I decided it would be best to focus on a few key ways in which this line of thinking has personally been helpful to me in own my practice of psychotherapy, and that by sharing these I might illustrate the potential clinical fruitfulness of this approach for others as well.
Each of the discussants suggested that they might have appreciated more specific practice examples to illustrate the differences between my approach and understandings of clinical material and those of others, or to see better how these ideas play out in practice. This is a very sound and important point, with which I generally agree (and have done that elsewhere, e.g., Hersch 2003, 278–96). Nevertheless, for this paper and this audience I decided to forego such case examples, largely for lack of word space and in prioritizing the points I do address. But in reflecting on my ensuing existential guilt in the process of owning up to these choices, I can confirm that my emotional reactions to this can and do go beyond just a sense or feeling of guilt, as Dr. Eagle points out may be the case. Those include some sadness (that I did not have more space to work with), some academic embarrassment (that I chose to edit out most of my reference-filled, literature-review section in the face of word limits), and some degree of contentment that in the end I am happy with and accepting of the choices I did make. But to clarify, I am, in any case, still existentially guilty and responsible for making those decisions (rather [End Page 129] than others), regardless of how I feel about them subsequently.
A Few Important Clarifications
One important misconception I feel I need to address in reading Dr. Eagle’s remarks is that he has somehow gotten the impression that I am insisting on the centrality of existential guilt and existential anxiety for all patients in a dogmatic and, frankly, not at all existential way. He states that: “Hersch suggests that, for all patients and in some form, existential guilt and existential anxiety will be at the center of their suffering and concerns.” (Eagle 2015, 122, italics mine. He then likens this to “Freudian theorists being certain that, for all patients, oedipal conflicts will be central to their suffering and concerns.” (p. 122). I am not quite sure exactly how he got that impression, but I can assure the reader it is not my position that these issues are always or a priori of central importance in all cases in my approach. I apologize if my enthusiasm for the usefulness of dealing with these issues in some particular cases somehow was misinterpreted in that way. But to clarify, I here reiterate what I said in my paper, that (after discussing these two ‘existential emotions’ as being non-pathological, normative, and universal), “Even so their presence and particular significance in a given person’s life at a given time may well be very problematic, or not. [new italics added here],” later adding “For some this is a major source of emotional pain and a frequent topic in psychotherapy” (Hersch 2015, 109...