The Abyss of Madness: A Book Review

This book by George Atwood, is an existential exploration of mental health related issues from a phenomenological perspective.  Atwood explores everything from depression, trauma, psychosis, and anxiety from a human-centered base.  His understanding is rooted in philosophy with a special emphasis on phenomenological disciplines.  Though this book is years old, it contains decades worth of experience and knowledge on how to sit with and listen to the experience of the Suffering Other in the context of therapy.  

Atwood, clinically, grew up in the 60s and 70s ,seeing the dominant influence of the psychiatric and psychoanalytic movements in mental health hospitals.  He pushed against the grain of these dogmatic beliefs, and against those of the forces of Cognitive Behavioral therapy and other ‘evidence-based’ practices.  Atwood challenges the idea of depression as curable, stating that depression is a normal reaction and a normal part of life– and is a healthy response to depressing things that happen to us.  He understands all trauma as the shattering of our world view, and thus frames all trauma as epistemological trauma, or the shattering of understanding.  And he notes the importance of trying everything we can as therapists to prevent our patients from committing self-harm or sucide.  Rather than forcing patients to sign contracts that will not actually matter to them, or letting them carry out their plans without them emotionally affecting us– Atwood proposes listening with empathy, and seeking to understand why someone wishes to annihilate themselves.  

The core principles of Atwood’s approach, and that of the tradition of my academic therapeutic home at the Master’s of Arts Program at Seattle University, is seeking to understand the person’s experience and situating it in a context of culture, society, and history.  Rather than boxing people into diagnostic categories, we can seek to see from the patient’s perspective, how they see the world, and how they make meaning and attempt to overcome their struggles and woundings through what we often categorized as mental illness.  It is a philosophy of not pathologizing the individual, and treating each patient as a unique person with dignity and respect.  This is a great resource for anyone interested in more existential or phenomenological approaches to psychology and psychotherapy.  A definite must read!