‘ONE of US?’ Could Existential Therapy have an explicit social role?
By: Greg Madison Ph.D.
Click here to contact Greg and/or see his GoodTherapy.org Profile
Abstract – Community Care is often seen as an enlightened and
compassionate response to the needs of the mentally distressed.
However, a discussion of the development of community care
policy and a look at attitudes of the community to those
experiencing distress suggest that this is not so. Uncaring
community attitudes seem to be a result of current policy. The
tragedy at Dunblane highlights the urgent need for a return to the
original philosophy of care in the community. This philosophy
maintains that a policy of mental health care is inseparable from
social policy on the whole. This paper is presented in the spirit of
encouraging existential-phenomenological therapists to attend to
the realm of social critique by describing the nature of our
communities and their impact upon our clients and ourselves. By
developing a phenomenological way of addressing the context of
our interactions with others, could we develop a valuable social
dimension to our work as therapists?
I am interested in the interaction between the ‘community’ and those members of the
community who are experiencing mental distress. Increasingly since 1948, British
mental health service provision has been devolving to the community level. This deinstitutionalisation
is promoted as an indication that we live in a caring society. The
‘community care movement’ is based upon the idea that institutions segregate people
from the rest of society and that this is unacceptable (Bennett and
Morris,1983,cf.Goodwin,1993,p.2). According to the Irish Psychiatrist Ivor Browne,
the original pioneers of community care
… saw this movement as primarily the democratisation of human
relationships and the breaking down of the contradictions within
society which created total institutions such as mental hospitals …
They saw this movement as a struggle towards independence and selfesteem
for those human beings we call patients … (Browne,1980, p.1).
I need to begin by looking at the development of community care policy to explore
whether it really is an expression of these original intentions. I will then discuss
community attitudes to the mentally distressed and take a speculative look at the
newspaper reports of the tragic killings in Dunblane. I will suggest that unless
community attitudes to ‘care in the community’ are taken seriously, continued
implementation of the current policy may be dangerous. I will propose that a return to
the original intentions of the movement is crucial to the success of community care.
Models of care which emphasise equally the individual and the community are
mentioned.
Explaining policy development
In Community Care and the Future of Mental Health Service Provision, Simon
Goodwin describes the emergence of a community care policy for the mentally
distressed (1993,pp.5-30). The conventional understanding is that the state adopted an
enlightened and benevolent approach. New psychoactive drugs enabled psychiatrists
to control behavioural symptoms so that patients could leave hospital sooner or be
treated entirely as out-patients. Administrative changes in service provision from
hospital sites to out-patient or day centres allowed more flexible and socially-minded
intervention. And the legislative response of the state was to encourage voluntary and
informal treatment and an emphasis on community services (Goodwin,1993,pp.6-17).
This conventional understanding of ‘community care’ relies upon specific
assumptions. It equates mental distress with a medical model of ‘illness’. Provision is
drug-centred rather than caring in a broader sense. Sufficient resources to develop
community facilities were never forthcoming (Goodwin,1993,p.9) so custodial care is,
in reality, born by families when possible, or by private sector Bed and Breakfast
accommodation. It proposes that the development of new medications made
community care possible, yet Goodwin points out that there is no evidence that the
introduction of psychotropic drugs had any appreciable effect upon the organisation
of mental health services (1993,p.11). The “propaganda” surrounding the change in
mental health provision assumes a cohesive community which wants to support the
mentally distressed. While the mentally distressed were cared for in institutions, there
was a growing concern for democratising staff/patient relationships (for example the
work of Basaglia) yet there was no corresponding work done in the community before
de-institutionalisation began. There is no actual evidence that the move to a
‘community care’ policy grew out of the original benevolent intentions.
Goodwin offers an alternative explanation for the development of the community care
policy based upon Habermas’s ‘Critical Theory’. He sees the policy evolving out of the
state concerns of cost, control, and legitimation (Goodwin,1993,p.47). The
antagonisms between these three state concerns accounts for the subsequent twists
and turns in community care policy. As the economy contracts and unemployment
increases, the number of people seeking mental health services increases (Dooley and
Catalano,1984,c.f.Smith and Giggs,1988,pp.137-42). Just as the demand for services
increases, the state must decrease its provision of services in order to meet the cost
criteria set down by decreasing capital accumulation. We have designed a system that
cannot respond when a response is most needed.
Goodwin argues that the policy of community care is not simply about ‘care’, but
about fiscal and social control, while seeming to be compassionate (legitimation). The
state is caught between the constraints of revenue from capitalist economics and its
own public propaganda. Therefore, we have a policy of ‘care in the community’ but a
practice of closing institutions without providing new facilities.
Rather than the medical model, Goodwin sees mental distress as a socially
constructed phenomenon derived from the struggle between an individual’s
interests/actions and their particular environment. In Goodwin’s words;
“Mental distress”, in many (though perhaps not all) of its
manifestations, represents a socially constructed phenomenon that is
intrinsically related to the nature and development of societies; in this
case British capitalism. It is a category that allows for the setting of
limits about what constitutes acceptable behaviour, and also allows for
the legitimate management of people who “fail” to perform certain
roles (1993, p.42).
Psychiatry’s role is to manage this distress cost-effectively in order to maintain current
social roles. It is cheaper to provide treatment to a distressed (unpaid) housewife, and
maintain her at home and in that role, than to let her “breakdown” and have to provide
expensive hospital accommodation while also introducing professionals to provide
support for her family. It also appears to be the appropriate response of a humane
society to care for a miserable woman (this appearance of care bolsters the legitimacy
of the state while simultaneously masking the possibility that her misery is a product
of these social relations). Contemporary community care and its medical model of
mental illness seems a coverup for the underlying motives of the state in capitalism.
‘The real dispute is … between those who want to improve the social prospects of
people with long-term mental illness, to reclaim them not for mental patienthood, but
for citizenship, and those who settle for a highly restricted vision of the ‘place’ of
people with mental illness in social life’ (Barham,1992,c.f.Goodwin,1993,p.217).
Goodwin thinks that community care should be supported on the basis that
desegregation in the long run is possible, and that attitudes can change enabling the
distressed to participate in mainstream society. In other words, the original motivation
of the pioneers of this policy might be realised if we take a more holistic approach,
looking at both care and community. Before we can do this, the community must be
willing to reflect upon its attitude to individuals experiencing distress, and the true
nature of distress itself.
Community Attitudes are Crucial to Community Care
The medical view prevails in society. If someone is labelled as mentally ill, then they
are victims of a disease. A criminal can be morally wrong, evil even, but a mad
person is sick. This creates a problem for society;
The social disruption the mentally ill create indicates a punishment
response, while at the same time, the appearance of inability to control
the behaviour indicates that a more humane response would be
appropriate. This ambiguity in the status of the mentally ill makes the
societal reaction to them highly problematic (Horowitz,1982,p.28).
Rabkin (1985,c.f.Dear and Taylor,1982,p.54) found that characteristics of the patient
influenced the response by the community. Unpredictable patients who were seen as
unaccountable for their actions, especially males with low socio-economic status,
exhibiting behavioural symptoms (rather than physical ones), and without social ties
in the community, were the most likely to be rejected by the community. If the
person’s behaviour was incomprehensible, bizarre or disruptive (rather than
withdrawn or depressed), and especially if there were manifestations of violent
behaviour, the person would be rejected by the community.
Homogeneous and highly cohesive neighbourhoods tend to reject the mentally
distressed. Neighbourhoods of well-educated, transient residents without children tend
to be more supportive (Armstrong,1976;Trute and Segal,1976,c.f. Dear and
Taylor,1982,pp.53-4). Two studies published in 1996 (Wolff et.al.) found that
education is an important determinant of attitudes toward the mentally distressed,
except when the respondent had children at home (1996a,p.192). This is not because
parents of young children lack understanding of mental illness but due to an
‘accentuated wariness’ of their children’s vulnerability (1996a,p.197). The nature of
the tragedy in Dunblane, and many tragedies since then, will undoubtedly and
understandably entrench the attitudes of parents.
But a community can also facilitate the re-socialization of an ex-psychiatric patient,
and this can be associated with a decrease in symptoms. However, the ability of the
community to fulfil this role is questionable not only because of its attitude to the expatient
but also because of the increased atomisation of society as it adapts to later
capitalism. Psychiatry can label and prescribe, but it cannot create the sense of
community, the interpersonal ties, which are necessary for integration. The result of
maintaining the mentally distressed in a setting where they cannot be received is that
they are kept on the fringe, where they are subject to control rather than care. And as
acceptance can facilitate recovery, so can rejection aggravate the already difficult
position of the individual, adding greatly, perhaps unbearably, to their distress.
The Dunblane Tragedy
In the small village of Dunblane, Scotland, on the morning of March 13, Thomas
Hamilton shot 16 young children and their teacher before turning a gun on himself. In
order to try to get a sense of this man and the community in which he lived, I
reviewed the newspaper articles for the week immediately following the tragedy. As
much as possible I stayed with accounts of Hamilton’s life and quotes by people in the
community. I am anxious to avoid making a study of the actual reporting, or a
pseudo-analysis of the murderer. My main intention is to inquire about the community
attitude towards Hamilton and the impact this may have had upon his life.
Thomas Hamilton grew up with a false sense of who he was. He was raised to think
that his grandparents were his mother and father and that his real mother was his
sister. His natural father had left when Hamilton was eighteen months old. He only
discovered the truth at the age of thirty-eight (Bogan and McKie,1996,p.1;Smith and
Gordon,1996,p.4). According to neighbours of the time, the grandmother tried to
convince people that Hamilton was her son by inventing stories of the pregnancy and
labour (Ferguson et.al.,1996,p.17). Meanwhile the real mother was shut away. The
grandmother was described as a ‘ … sour, narrowly respectable woman … [who] …
fancied herself a cut above the neighbours’ (ibid.). Her husband was described as a
shy and retiring man who spent most of his time away from home (ibid.).
In primary school, Hamilton was described as a loner, ‘… who didn’t play with other
children…’ (Smith and Gordon,1996,p.5). In secondary school he was still considered
an ‘outsider whom no one liked’ (Ferguson et.al.,1996,p.5). In his early twenties,
Hamilton became active as a volunteer with the Scouts, until in 1974 he was expelled
due to ‘irresponsibility’ (and not sexual misconduct as is constantly alleged, Campbell
et.al.,1996,p.3). As an adult Hamilton operated his own DIY shop and was viewed by
local shopkeepers as ‘ambitious’. His business collapsed in the early 1980s due to
rumours that he abused boys. He never worked again (Ferguson et.al.,1996,p.17).
Dunblane is one of the communities in which Hamilton operated boy’s clubs after his
expulsion from The Scouts. Isabelle Murray, the Sun’s City Editor, knows Dunblane
and described it as a ‘comfortable prosperous place’ (Murray,1996,p.17). It has very
little unemployment, a population of 8000, made up of mostly ‘conventional’ twoparent
families of owner-occupiers. There are remarkably few single parents. A quiet,
traditional way of life was enjoyed by young parents and retired couples;
A Gothic cathedral towers over the tiny high street where shops have
been in the same families for generations. Butchers, bakers, and
florists still close for an old-fashioned half-day on Wednesdays …
There is no McDonalds or multi-plex cinema … Many families have
settled in Dunblane because it is considered a safe and clean place to
bring up youngsters … (Murray, 1996,p.17).
It is described as an idyllic community for the prosperous young families who live
there. For someone in mental distress however, it could have been a very different
place. A homogeneous tight-knit community of single family dwellings can be a most
alienating and rejecting environment for anyone who is ‘marginal’. Hamilton was kept
very much on the fringe of his community.
The attitude toward Hamilton is obvious from a comment made by a neighbour who
moved to the area four years ago; ‘The first thing you heard from people here was that
the guy was weird’ (Clouston and Boseley,1996,p.2). A local newspaper girl said, ‘ He
made your flesh crawl, he was rubbing his hands and walking with a stoop’ (Parker
et.al.,1996,p.4). He was described as ‘creepy’, ‘smarmy’, and ‘ a very tactile person
who was forever putting his arm around the boys’ (Parker et.al.,1996,p.4). A
neighbour said, ‘He was a real weirdo. His hair was cut strangely with a “V” at the
back and bald on the top. He looked like something from outer space. I called him
Spock because he was like an alien’ (ibid.). There are many references to his
appearance, and his gait; ‘ He just seemed to walk at the one pace, he sort of crept
along by the side of the hedge’ (ibid.). We get the impression of an extremely isolated
man who was perceived as ‘weird’, ‘devious’, ‘sick and perverted’.
The rumours about Hamilton seemed to start partly because of his unusual
demeanour, his ‘high-pitched effeminate voice’, and his behaviour towards the boys in
his clubs. He was thought to have ‘interfered’ with boys in his clubs and to have been
kicked out of the army for being a homosexual. None of this could be verified. The
boys called him ‘ … “gay man” because he acted a bit poofy’ (Parker et.al.,1996,p.5).
A local woman saw his photos of boys playing games with their shirts off; ‘I told all
my friends and family and the word got around’ (ibid.). Hamilton lived in a world of
rumours. Police and education authorities investigated him but nothing could be
proved, meanwhile boys stopped coming to his clubs and his business failed.
Hamilton protested his innocence to charges of child molesting. He wrote to council
authorities, the Scouts, his MP, and the Queen. A city councillor recounts meeting
him in the street;
As usual he brought up the subject and again said that he was being
harassed by inference and innuendo. He said people still seemed to
suspect him of this conduct but how grateful he was that nobody had
been able to get any proof because there wasn’t any. I was really
listening to a man who had this burden and was trying to unload it a bit
(Farrell et.al,1996,p.2).
This councillor, as well as a council ombudsman and some parents, felt Hamilton was
being treated unjustly. The council had decided to ban Hamilton from using schools to
run his clubs, based upon the ‘gossip’ of ‘hysterical parents’ according to the
ombudsman (ibid.). There were years of innuendo and years of Hamilton trying to
clear his name. Meanwhile, daily life was becoming increasingly alienating, as
Hamilton wrote in a letter to the Queen; ‘I cannot even walk the streets for fear of
embarrassing ridicule’ (Victor,1996,p.2).
Since childhood Hamilton was isolated. It seems that being an isolated person became
the community’s excuse to isolate him even further, until he found himself
unemployed and humiliated as he walked the streets of his neighbourhood. No one
wanted to know him, he was banned from his local camera shop due to his photos,
and unable to convince anyone of his innocence (Campbell et.al.,1996,p.3). Hamilton
saw himself as trying to help bored children stay out of trouble. In return the police,
teachers, neighbours, and young people spread the rumour on a ‘nod and a wink basis’
that he was a ‘pervert’ (quoted from Hamilton’s letters,c.f. The Guardian,1996,p.5). In
a final attempt to combat his mounting isolation Hamilton delivered a circular to
parents; ‘I have no criminal record nor have I ever been accused of sexual abuse by
any child and I am not a pervert’ (Eastman,1996,p.17).
After the murders, articles appeared from so-called experts, forensic psychiatrists
mostly, who humbly offered different opinions as to the source of Hamilton’s
problems and whether he was ‘ill’ (see Johnson,1996,p.19; Cusick,1996,p.3;
Bailes,1996,p.4). Questions of whether Hamilton was ‘mad’, ‘evil’, or both
(Eastman,1996,p.17) seem to highlight our current confusion and inadequate
understanding of so-called mental illness. These articles all focus on Hamilton as an
individual, not upon the community in which he lived. There were a few articles and
letters to the editor which suggested that Hamilton should not have been in the
community at all. These letters focused on the inadequacies of community care and
called for powers to force treatment on individuals because ‘treatment does work’
(Young,1996,p.17; Dallas,1996p.24).
There were a couple articles that did draw a link between Hamilton and the
community;
… strong community ties can have only increased the pressure on
loners like … Hamilton, when despite the bonding of most of the
population, they found themselves excluded. A successful community
is one which is able to reach out to everyone living in it, no matter
how unattractive they may be (Thompson,1996,p.18).
Andrew O’Hagan wrote about Hamilton as a member of our society and ‘there is
something up with our way of life, and no amount of repression will quite rub it away’
(1996,p.2). He continues, ‘Dunblane has something behind it … Something crazy, of
course, but something real’ (O’Hagan,1996,p.2). To make even a little sense of what
happened in Dunblane, and to understand it as a general warning, we need to
acknowledge and understand the role of the community. In other words we need to
look at how ‘… the two worlds met, close-knit community and unravelling mind’
(Ferguson et.al.,1996,p.19).
Community care is about ‘community’
There is a dangerous contradiction between care in the community and the medical
model which it is currently based upon. Current policy relies upon maintaining the
mentally distressed in community settings where they are viewed as ‘sick’, different in
kind from their neighbours. This thinking relieves both the state and community
members from facing the anxiety of identifying with the mentally distressed or
questioning the causes of their condition. It encouraged the community to view
Thomas Hamilton as different from them, eliciting scorn rather than empathy. There
is no lessening of the tragedy which Hamilton caused, but there is a warning of the
situation which may arise when individual distress and community rejection collide.
We need to develop models of community care which are based upon the nature of
contemporary community, and which are willing to address its dehumanising aspects.
Radical Care
In The Politics of Mental Health, Ragnhild Banton et. al. (1985) present a
psychoanalytic account of individual development within a Marxist perspective. This
is a practical application of the model of Critical Theory. Whereas Goodwin
emphasises the competing motives behind policy and the subsequent strains, Banton
et.al. propose an alternative and highly political form of mental health service
delivery, and emphasise its revolutionary potential to change society.
Their theory balances the social and the personal by regarding the psyche as
internalised social ideals, so individual meaning and desire originate from the social
world. This counters the individualising of distress as simply personal illness. The
social forces which contribute to suffering are reinforced within and without;
… whenever there is a battle for change there must be a change in
awareness or ideas as well as practice; … ideas are not just linked
through discourse to power relations of diverse kinds, but also to
unconscious and conscious feelings that need to be registered in order
for change to come about … The internal sources of resistance to
change should not be ignored or underestimated (Banton
et.al.,1985,pp.150-1).
The individual psyche will circumvent social change unless it is freed from its own
internalisation of the prevailing ideology (Habermas stressed emancipation from selfdeception
through self-reflection). This equal emphasis on social structure and
internalised oppression seems to be an attempt to develop a form of mental health
provision that questions rather than reifies economic and social constraints.
Psychological needs are real needs and ‘everyone is entitled to have those needs met
by psychotherapy if that should be appropriate’ (Banton et.al.,1985,p.163).
In contemporary conventional psychiatry there is no interest in subjective experience
because it is irrelevant in the treatment of illness. There is no need for social analysis
because it’s not about society. So the practice of psychiatry becomes an effective,
indirect form of maintaining conformity without seeming to be in conflict with
democratic values. This ‘community care’ is more clearly about social control than
compassion.
Care and the Human Community
The unconventional Irish psychiatrist Ivor Browne1 says we need to make ‘Being’ a
priority and ‘Doing’ a by-product of our societies; ‘ To be is the primary task of a
human being, any doing or function which deprives him of his consciousness as a
Being is destroying him as surely as slow starvation’ (Browne, 1972,p.1). He draws
upon the Systems Theory of Maturana and Varela who say a living system is
autopoietic, self-producing ;
A living creature only functions satisfactorily when it has autonomy,
that is when it takes responsibility for itself. When it is denied
responsibility it becomes allopoietic or dependent, defined from
without (1975,c.f. Browne,1972,p.5).
The hypothesis is that a human group operates as a living system. It has an internal
organisation, an emotional life, a boundary, and functions as a self-regulating system
in order to preserve its stability and continued existence.
Human communities are biological systems in which every individual is embedded
within a social institution, itself embedded within a larger institution. All of these
levels are autopoietic. This explains why change, at the individual or state level, is so
difficult. Each self-contained autopoietic ‘it’ is simultaneously a component of another
autopoietic system. So that the first is allopoietic with respect to the second, making
the second a viable autopoietic system. But this means that the larger system will
mistakenly perceive the smaller, embedded one, as diminished – and treat it as less
than a living system (Browne, 1972,pp.6-20).
In this capitalist society we have created institutions which have taken on their own
existence and control us as allopoietic components. So we find ourselves working for
the structures we initially designed to work for us. We are not living in whole
communities. Our ruthless and competitive communities are “sick” (metaphorically
so), in order to function as independent individuals we need to create a barrier against
them. The more we have to create a barrier the more difficult it is to develop intimate
and loving relationships (Browne,1977,p.11). The more impossible it is for us to
experience ‘care’.
Browne pleads for a humane response to mental distress and a model of community
care which emphasises independence. Rather than simply releasing patients or
attempting care in community settings, we should enable individuals to be as
1 Dr. Browne was a colleague of RD Laing and was also influenced by Timothy Leary and most
independent as possible. A thirty-year-old “schizophrenic” should not be released
from institutional incarceration only to be incarcerated in his family and frozen into a
parent/child relationship. Institutionalisation is a state of dependence and can happen
anywhere; ‘ I can remember one girl I dealt with back in 1959 who was being washed,
fed with a spoon and dressed by her mother, although a few years earlier she had held
down a good job in New York …’ (Browne, date unknown,p.3).
Browne believes that delusions can be dishonesties, an escape from living (Browne,
date unknown, pp.8-9). Removing symptoms alone (the medical model) does not
result in a ‘normal’ person. Browne stresses that social supports, skills training,
employment, and housing, will enable the independent development of the mentally
distressed by addressing their deficits. Studies have suggested that schizophrenics do
much better when discharged to neutral environments with less contact with their
families, than when discharged back into the family home (c.f. Browne and
Kiernan,1967,p.8). All of this is of course contrary to the current practice of keeping
people in the community without providing facilities – relying on relatives to take care
of them.
It would be interesting to examine the differences between the two models of
alternative community care outlined above. However, for now it is more important to
note their general similarities. They both bring the community into the analysis. They
do not simply individualise distress or label it as illness. By not making distressed
members of our communities different in kind, they increase our capacity to
empathise. We are encouraged to realise that there is a social meaning to distress, a
meaning we can understand because we are subject to the same forces. At the same
time both models suggest why individual change is so difficult; either a system is
trying to maintain you unchanged, or your own internalisation of social norms inhibits
change.
When the community cannot recognise itself in the face of the mentally distressed,
that is of crucial importance,
… the “return to the community” of mental health services and patients
recently by the transpersonal work of Stanislav Grof.
is a return in an alienated form: the community receives back a part of
itself in a form not recognisable as having belonged, or as still
belonging, to the community (Banton et.al.,1985,p.179).
There will be no welcome for a stranger who is not ‘one of us’. Community attitudes
to the mentally distressed expose the crucial need for a radical attitude to mental
health; the necessity to accept as political and social what has been hidden as
personal, silent pain. What are the ramifications of this for us, as existential
therapists?
Concluding Summary
Looking at recent plans for community care in the London Boroughs of Camden and
Islington suggests that the issues I am trying to present here are not being addressed.
There are progressive policies highlighting the need to maximise independent living
for people with ‘mental health problems’. There is a recognition that ‘community care
is not a cheap option’ (Islington Community Living Plan,1995,p.0.3) and a willingness
to lobby the government for increased funding. But there is also an implicit
individualising of distress.
These plans contain no mention of social factors in the incidence of the onset of
mental distress and most worrying there is nothing about community attitudes.
Although there have been improvements in recognising community needs in some
areas, the policy response has been piecemeal and has not resulted in a re-evaluation
of the underlying philosophy of care. Goodwin would explain this reluctance to reevaluate
care with reference to the state concerns of cost, control and legitimation.
Banton et.al. would emphasise a psychoanalytic theory regarding the power of
internalised ideology. Browne would take a holistic look at the overall system trying
to maintain itself at the expense of individual members. As existentialphenomenological
therapists, what is our view?
I have argued for the need to return to the original intentions of care in the
community. We cannot use the medical model to maintain the distinction between
distressed individual and host community without impairing the therapeutic potential
of community care. A model of mental distress which acknowledges social and
economic factors is necessary to alter the meaning of ‘care’ from custodial care and
drug treatment to care as empathy for the welfare of another person as a whole human
being. This is described by Heidegger as caring for other dasiens, constituting beings,
and he terms it ‘solicitude’ (Yalom,1980,p.409). Community attitudes to its mentally
distressed members could be addressed fundamentally in this way.
Perhaps it is obvious then, that the community health care system cannot be separated
from the overall social system. The tragedy at Dunblane highlights the potential
danger of pursing current policy2. De-institutionalisation continues at such a pace that
any initial understanding by the community has since turned to friction and
‘exacerbation of public fears’ (Taylor,1988). One cannot escape the thought that as the
mentally distressed are maintained in an unprepared, unwilling, and under-serviced
community, there will be a corresponding hardening of community attitudes towards
them. How will this be presented to us in our consulting rooms, and what will be our
response? To have ‘care in the community’, it seems that we need to develop a
community that incorporates a willingness to reach out to the “otherness” in others,
without the motive of control and without complete understanding. What could be
more existential, and perhaps more impossible?
2 The fact that Hamilton was not a patient or under a ‘community care order’ does not diminish the
validity of using his situation to illustrate the present argument.
Greg Madison works as a psychotherapist, lecturer, and supervisor in various public
and voluntary settings and in private practice. He is also involved in Focusing and
mediation training. Greg is currently working towards his PhD on the topic of the
‘existential significance of home’, with a special interest in those of us who leave our
home culture to live as foreigners.
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——- (1977) Personality Development and Growth. unpublished manuscript.pp.1-12
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——- (date unknown) ‘New Chronicity’, Address to a Seminar Run By GROW.pp.1-
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