The Integrity Model: A Trialogue (Discussion‪)‬

Danielle: The impetus for this 'trialogue' came from an invitation from Simon to talk about our recently released book, The Integrity Model of Existential Psychotherapy in Working with the 'Difficult Patient' (Lander & Nahon, 2005). After our brief 'phone conversation some months ago, Simon, you had graciously agreed to read our book, and our 'trialogue' began. Simon: I can tell you that I almost didn't get beyond the title of your book as it attracted me and distanced me in almost equal measure--although clearly the former response prevailed! Right there I think I can sense the 'tensions', which led me to read on (and when I began I found I could hardly put the book down) by which I mean that it held the promise of foregrounding the concept of 'Integrity', which is implicit I think in most existential writing but is rarely made explicit. The differences/similarities between your use of 'Integrity' and 'values' struck me as interesting. More, the reference to practice excited me as again, existential texts rarely address concretely how therapists actually conduct themselves in sessions. Then again, the reference to the 'Difficult Patient' led me to wonder whether we were back in the Diagnostic and Statistical Manual of Mental Disorders (DSM) terminology world again, with all the challenges this poses for existential practitioners: what do we mean by 'difficult'; whose perspective/power is expressed here; and why 'patient' with all its medical overtones? Anyway, as you know, I read on and found your book very intriguing. I hope we will address some of my misgivings in our conversation as it develops. I think it will be as important to highlight what makes the book and your framing of a model of Integrity relevant for UK existential therapists.