Existential Therapy is a way of thinking or an attitude about psychotherapy, more than is a particular style of practicing psychotherapy
Yolam & Josselson, 2019 – existential psychotherapy is an attitude toward human suffering and has no manual. It asks deep questions about the nature of human being and the nature of anxiety, despair, grief, loneliness, isolation and anomie. It also deals centrally with the questions of meaning, creativity and love.
Existential therapy focuses on exploring themes such as mortality, meaning freedom, responsibility, anxiety and aloneness as these relate to a persons current struggle. The goal of existential therapy is to assist clients in their exploration of the existential givens of life how these are sometimes ignored or denied and how addressing them can ultimately lead to a deeper, more reflective and meaningful existence.
Existential therapy is grounded on the assumptions that we are free and therefore responsible for our choices and actions. We are authors of our lives, and we design the pathways we follow.
A basic existential premise is that we are not victims of circumstances because to a large extent, we are what we choose to be. Once clients begin the process of surrendered control, they can start down a path of consciously shaping their own lives. The first step in the therapeutic journey is for clients to accept responsibility. The aim of existential therapy is to invite clients to explore their values and beliefs and take action that grows out of this honest appraisal of their lifes purpose.
The European existential perspective focused on human limitations and the tragic dimensions of life. The thinking of existential psychologists and psychiatrists was influenced by a number of philosophers and writers during the 19th century. Religious writings of Soren Kierkegaard, Friedrich Nietsche, Martin Heidegger, Jean Paul Sarte and Martin Buber. These major figures of existentialism and existential phenomenology provided the bassi for the formation of existential therapy.
- Kierkegaard – creative anxiety, despair, fear and dread, guilt and nothingness
- Nietzsche – death, suicide and will
- Heidegger – authentic being, caring, death, guilt, individual responsibility, and isolation
- Sarte – meaninglessness, responsibility and choice
- Buber – interpersonal relationships, I/Thou perspective in therapy, and self-transcendence
Soren Kiekegaard – 1813 – 1855 – Danish philosopher – addressed the role of anxiety and uncertainty in life. Existential anxiety is associated with making basic decisions about how we want to live and it is not pathological. Believed hat the sickness unto death arises when we are not true to ourselves.
Friedrich Nietzsche – 1844 – 1900 – German philosopher – emphasised the importance of subjectivity. As ration was entirely misleading. ‘Subjective truth’ of an intense concern with God. Located values in ‘will to power’. Kierkegaard & Nietzsche with their pioneering analyses of anxiety, depression, subjectivity, and the authentic self together are generally considered to be the originators of the existential perspective.
Martin Heidegger – 1889 – 1976 – Our moods and feelins are a way of understanding whether we are living authentically or whether we are inauthentically constructing our life around the expectations of others. Provides a view of human history that does not focus on past events but motivates individuals to look forward to authentic experiences that are yet to come.
Martin Buber – 1878 – 1965 – German to Israel – we live in betweenness, there is never just an I, but always an other. The I, the person who is the agent changes depending on whether the other is an it or a thou. Importance of presence which has 3 functions, 1. It enables that I/Thou relationships, 2. It allows for meaning to exist in a situation, 3. It enables an individual to be responsible in the here and now. Buber argued that the therapist and client could never be on the same footing because the latter comes to the former for help.
Ludwig Binswanger – 1881 – 1966 – Existential analysis – emphasises the subjective and spiritual dimensions of human existence. Contended that crises in therapy were typically major choice points for the client
Medard Boss – 1903 – 1991 – Talked of dasein or being in the world, which pertains to our ability to reflect on life events and attribute meaning to these events. Both Binswanger and Boss were significantly influenced by Heideggers seminal work, which provided a broad basis for understanding the individual.
Jean-Paul Sartre – 1905 – 1980 – French – between the whole of our past and the new frees us to choose what we will. No matter what we have been, we can make choices now and become something quite different. Everyone of our actions represents a fresh choice
Key figures in Contemporary Existential Psychtherapy – Viktor Frankl, Rollo May nd Irvin Yalom created their existential approaches to psychotherapy from their strong backgrounds in both existential and humanistic psychology.
James Bugental 1915 – 2008 – wrote about life changing psychotherapy, which is the effort to help clients examine how they have answered lifes existential questions and to invite them to revise their answers so they can live more authentically. Coined the term ‘existential- humanistic’ emphasised the cultivation of both client and therapist presence. He developed interventions to assist the client in deepening inner exploration or searching. The therapists primary task involved helping clients make new discoveries about themselves in the living moment, as opposed to merely talking about themselves. Central to Bugentals approach is his view of resistance, which from an existential humanistic perspective is not resistance to therapy per se but rather to being fully present both during the therapy hour and in life. Resistance is seen as part of the self and world construct. Bugentals theory and practice emphasised the distinction between therapeutic process and content. Impromptu here and now dialogue and exploring in the context of self as client or therapist.
British Contribution to existential therapy – Emmy van Deurzen, a key contributor to British existential psychology, is a philosophy, psychotherapist and couseling psychologist. States that existential therapy is not deigned to cure people of illness in the tradition of the medical model because people are not sick but are sick of life or clumsy at living. Individuals have incredible resilience and intelligence in overcoming their problems once they commit themselves to a self-searching process.
Key Concepts – The existential movement stands for respect for the person, for exploring new aspects of human behaviour and for divergent methods of understanding people. It uses numerous approaches to therapy based on its assumptions about human nature. The existential tradition seeks a balance between recognising the limits and tragic dimensions of human existence on one hand and the possibilities and opportunities of human life on the other hand. The current focus of the existential approach is on the individuals experience of being in the world and facing the anxiety of this isolation. The existential view of human nature is captured, in part by the notion that the significance of our existence is never fixed once and for all; rather, we continually recreate ourselves through our projects. The basic dimensions of the human condition according to the existential approach include, 1. The capacity for self-awareness, 2. Freedom and responsibility, 3. Creating ones identity and establishing meaningful relationships with others, 4. The search for meaning, purpose, values and goals, 5. Anxiety as a condition of living, 6. Awareness of death and nonbeing.
Position 1: The capacity for self-awareness – freedom, choice and responsibility constitute the foundation of self-awareness.
- We are finite and do not have unlimited time to do what we want in life
- WE have the potential to take action or not to act, inaction is a decision
- We choose our actions, and therefor we can partially create our own destiny
- Meaning is the product of discovering how we are thrown or situated in the world and then through commitment, living creatively
- As we increase our awareness of the choices available to us we also increase our sense of responsibility for the consequences of these choices
- We are subject to loneliness, meaninglessness, emptiness, guilt and isolation
- We are basically alone, yet we have an opportunity to relate to other beings
Here are some areas of emerging awareness that individuals may experience in the counselling process:
- They see how they are trading the security of dependence for the anxieties
- They being to see that their identity is anchored in someone elses definition of them
- They learn that in many ways they are keeping themselves prisoner by their past decisions
Increasing self awareness which includes awareness of alternatives, motivations, factors indluencing the persons and personal goals, is an aim of all counselling.
Position 2: Freedom and Responsibility – Krug 2017 – write that existential therapy embraces 3 values, 1. The freedom to become within the context of natural and self-imposed limitations, 2. The capacity to reflect on the meaning of our choices, 3. The capacity to act on the choices we create our own destiny by the choices we make. Jean=Paul Sarte – 1971 refers to this as the inauthenticity of not accepting personal responsibility. We can then avoid choosing and instead make excuses such as ‘ that’s the way I am’. Freedom implies that we are responsible for our lives, for our actions, and for our failures to take action. He called for a commitment to choosing for ourselves. Existential guilt is being aware of having evaded a commitment or having chosen not to choose. Guilt may be a sign that we have failed to rise to the challenge of our anxiety and that we have tried to evade it by not doing what we know is possible for us to do. Existential guilt can be a powerful source of motivation toward transformation and living authentically. Authenticity implied that we are living by being true to our own evaluation of what is a valuable existence for ourselves; it is the courage to be who we are. One of the aims of existential therapy is to help people face up to the difficulties of life with courage rather than avoiding lifes struggles. For existentialists, then being free and being human are identical. Frankl 1978 – also links freedom with responsibility. The therapist assists clients in discovering how they are avoiding freedom and encourages them to learn to risk using it. People often seek psychotherapy because they feel that they have lost control of how they are living. Cultural factors need to be taken into account in assisting clients in the process of examining their choices. A person who is struggling with feeling limited by her family situation can be invited to look at her part in thei process and values that are part of her culture. It is essential to respect the purpose that people ehave in mind, when they initiate therapy. If we pay careful attention to what our clients tell us about what they want, we can operate within an existential framework. Through the therapy experience clients may be able to discover new courses of action that will lead to a change in their situation.
Proposition 3 – Striving for identity and relationship of others – people are concerned about preserving their uniqueness and centeredness, yet at the same time they have an interest in going outside of themselves to relate to other beings and to nature. Our being becomes rooted in their expectations and we become strangers to ourselves.
The courage to be – Paul Tillich – 1886 – 1965 – believed awareness of our finite nature gives us an appreciatation of ultimate concerns. Courage entails the will to move forward inspite of anxiety producing situations such as facing our death. By assisting clients in facing the fear that their lives or selves are empty and meaningless, therapists can help clients to create a self that has meaning and substance that they have chosen. Existential therapists may begin by asking their clients to allow themselves to intensify the feeling that they are nothing more than the sum of others expectations and that they are merely the introjects of parents and parent substitudes.
The experience of Aloneness – the existentialists postulate that part of the human condition is the experience of aloneness. We have to be able to stand alone before we can truly stand beside another.
The experience of Relatedness – We humans depend on relationships with others. If we feel personally deprived, however, we can expect little but a clinging and symbiotic relationship with someone else. Perhaps one of the functions of therapy is to help clients distinguish between a neurotically dependent attachment to another and a life affirming relationship in which both persons are enhanced. Speak of intersubjectivity which is the fact of our interrelatedness with others and the need for us to struggle with this in a creative way.
Struggling with Identity – because of our fear with aloneness, Farha 1994 – points out that some of us get caught up in ritualistic behaviour patterns that cement us to an image or identity we acquired in early childhood. By refusing to give easy solutions or answers, existential therapists confront clients with the reality that they alone must find their own answers.
Proposition 4 – the search for meaning – A distinctly human characteristic is the struggle for asense of significance and purpose in life. Existential therapy can provide the conceptual framework for helping clients challenge the meaning in their lives.
The problem of discarding odl values – one of the problems in therap is that clients may discard traditional, values without creating other suitable ones to replace them. One of the tasks of the therapeutic process is to help clients create a value system based on a way of living that is consistent with their way of being. The therapists job is to trust in the capacity of clients to eventually create an internally derived value system that provides the foundation for meaningful life. The therapists trsust is important in helping clients trust their own capacity to create a new source of values.
Meaningless – according to Frankl 1963 – the central human concern is to discover meaning that will give one lifes direction. He views existential neurosis as the experience of meaninglessness. Meaninglessness in life can lead to emptiness and hollowness or a condition that Frankl calls the existential vacuum. This condition is often experienced when people do not busy themselves with routine or with work.
Creating new meaning – logotherapy is design to help clients find meaning in life. Logotherapists do not tell clients what their meaning in life should be. Instead existential therapists facilitate an exploration of past, present, and future meaning in their lives. Meaning is not something that we can directly search for and obtain.
Proposition 5 – anxierty as a condition of living – anxiety arises from ones personal strivings to survive and maintain and assert ones being, and the feelings anxiety generates are an inevitable aspects of human condition. Existential anxiety, is the unavoidable results of being confronted with the givens of existence, death, freedom, choice, isolation, and meaninglessness as we recognise the realities of our mortality, our confrontation with pain ad suffering, our need to struggle for survival, our basic falliability. Existential therapists differentiate between normal and neurotic anxiety and they see anxiety as a potential source of growth. Normal anxiety is an appropriate response to an event being faced. Failure to move through anxiety results in neurotic anxiety which is anxiety about concrete things that is out of proportion to the situations. Neurotic anxiety is typically out of awareness and it tends to immobilize the person. Facing existential anxiety involves viewing life as an adventure an uncertainty and how to live without props can be a necessary phase in the journey from dependence to autonomy.
Proposition 6 – Awareness of Death and Nonbeing – The existentialist does not view death negatively but holds that awareness of death as a bsic human condition gives significance to living. A distinguishing human characteristic is the ability to grasp the reality of the future and the inevitability of death. Deurzen and Adams 2011 – life is a taskmaster while death is a master teacher. Our awareness of death is the source of zest for life and creativity. Death and life are interdependent and though physical death destroys us , the idea of death saves us. Yalom 2008 – recommends that therapists talk directly to clients about the reality of death. Death is a visitor in the therapeutic process and Yalom, believes that ignoring its presence sends the message that dealth is too overwhelming to explore. One focus in existential therapy is on exploring the degree to which clients are doing the things they value. Without being morbidly preoccupied by the ever-present threat of non-being clients can develop a healthy awareness of death as a way to evaluate how well they are living and what changes they want to make in their lives.
The Therapeutic Process – the aim of therapy is to assist clients in moving toward authentically and learning to recognise when they are deceiving themselves. Existential therapy aims at helping clients face anxiety and engage in action that is based on the authentic purpose of creating a worthy existence. May 1981 contends that people come to therapy with the self-serving illusion that they are inwardly enslaved and that someone else can free them. Schneider and Krug 2017 – 4 essential aims – 1. To help clients become more presentto both themselves and others, 2. To assist clients in identifying ways they block themselves from fuller presence, 3. To challenge clients to assume responsibility for designing their present lives, 4. To encourage clients to choose more expanded ways of being in their daily lives.
Therapists Function and Role – primarily concerned with understanding the subjective world of clients to help them come to new understandings and options. Therapists with an existential orientation usually deal with people who have what could be called restricted existence. These clients have limited awareness of themselves and are often vague about the nature of their problems. One of the therapists functions is to assist clients in seeing that ways in which they constrict their awareness and the cost of such constrictions. The therapist may hold up a minor so to speak, so that clients can gradually engage in self-confrontation. Existential pracitioners may make use of techniques that originate from diverse theoretical orientations yet no set of techniques is considered essential. Practioners often ask clients to reflect on or write about problematic events they encounter in daily life.
Clients experience in Life – clients in existential therapy are clearly encouraged to assume responsibility for how they are currently choosing to be in their world. Effective therapy does not stop with this awareness itself, for the therapist encourages clients to take action on the bassi of the insights they develop through the therapeutic process. The experience of opening the doors to oneself can be frightening, exciting, joyful, depressing or a combination of all these. Gradually, they become aware of what they have been and who they are now, and they are better able to decie what kind of future they want. May 1981 – reminds them that their journey toward freedom began by putting one foot in front of the other. Existential therapists assist people in facing life with courage, hope and willingness to find meaning in life. Deurzen and Adams 2011 – maintain that a therapist must resonate with the clients experience and struggle to face life honestly.
Relationship between the therapist and client – existential therapists give central prominence to their relationship with the client. The relationship is important in itself because the quality of this person to person encounter in the therapietic situation is the stimulus for positive change. Therapists with an existential orientation believe their basis attitudes toward the client and their own personal characteristics of honesty, integrity, and courage are what they have to offer. Bubers 1970 conception of the I/Thou relationship, this form of relationship is the paradigm of the fully human self, the achievement of which is the goal of Bubers existential philosophy. The core of the therapeutic relationship is respect, which implies faith in clients potential to cope authentically with their troubles and in their ability to discover alternative ways of being. Bugental 1987 – emphasises the crucial role the presence of the therapist plays in the therapeutic relationship.
Application – Therapeutic Techniques and Procedures – the existential approach is unlike most other therpies in that it is not technique oriented. The interventions existential pracitioners employ are based on philosophical views about the nature of human existence. It is not theories and techniques that heal but the encounter that occurs between client and therapist as they work together. A primary ground rule of existential work is the openness to the individual creativity of the therapist and the client. Existential therapists need to adapt their interventions to their own personality and style as well as being sensitive to what each client requires. Deurzen 2012 – believes that the starting point for existential work is for practitioners to clarify their views on life and living. She stresses the importance of therapists reaching sufficient depth and openness in their own lives to venture into clients murky waters without getting lost. Deurzen reminds us that existential therapy is a collaborative adventure in which both client and therapist will be transformed if they allow themselves to be touched by life.
Phases of Existential Counseling – clients are invited to define the question the ways in which they perceive and make sense of their existence. The counsellor teaches them how to reflect on their own expistence and fully examine their role in creating their problems in living. During the middle phase of existential counselling clients are assisted in more fully examining the source and authority of their present value system. The final phase of existential counselling focuses on helping people take what they are learning about themselves and put it into action. Transofmation is not limited to what takes place during the therapy hour. The therapeutic hour is a small contribution to a persons renewed engagement with life or a rehearsal for life. The aim of therapy is to enable clients to discover ways of implementing their examined and internalised values in a concrete wawy between sessions and after therapy has terminated.
Client Appropriate for Existential Counselling – has been applied in variety of settings and with a diverse population of clients, including those with substance abuse issues, ethnic and racial minorities, gay and lesbians clients and psychiatric inpatients. Disappointments = marriage issues, work etc. These developmental challenges involve both dangers and opportunities. Deurzen 2002 suggests that this form of therapy is most appropriate for clients alienated from the current expectations of society or for those who are searching for meaning in their lives.
Applications of Brief Therapy – maininta that short term applications of existential approach require more structuring and clearly defined and less ambitious. It is essential that both therapist and client determine that short term work is appropriate and that beneficial outcomes are likely.
Application to Group Counselling – 1. Enables members to become hoenst with themselves, 2. Widening their perspectives on themselves and the world around them, 3. Clarifying what gives meaning to their present and future life. Leszcz 2015 notes that the leader engages in appropriate self disclousure and transparency gives dieback and shares their reactions within the group. The existential group provides the optimal conditions for therapeutic work on responsibility. The members are responsible for the way they behave in the group and this provides a mirror for how they are likely to act in the world. Building on what members learn about their interpersonal functioning in the group, they can take increased responsibility for making changes in everyday life. In existential group counselling members come to terms with the paradoxes of existence. Through the support that is within a group, participants are able to tap the strength needed to create an internally derived value system that is consistent with their way of being. A group provides a powerful context to look at oneself and to consider what choices might be more authentically ones own. Existential group leaders help members live in authentic ways and refrain from prescribing simple solutions.
Strengths:
- Vontress and Collegues 1999 write about the existential foundation of cross cultural counselling. These are the human experiences that transcend the boundaries that separate cultures.
- Existential therapy emphasises presence, the I/Thou relationship and encourage.
- Schneiders 2008 – existential integrative model, believes existential therapy is especially useful in working with culturally diverse populations because of its focus on universality or the similarities we all share.
- The existential focus on subjective experience, or phenomenology, is a strength from a multicultural perspectives. Another strengths consists of inviting clients to examine the degree to which their behaviour is being influenced by social and cultural condition.
- There is a wide range of international interest in existential approach. These international devcelopments confirm that existential therapy has wide appeal for diverse populations in many parts of the world.
Shortcomings:
- Excessively individualistic and ignore the social factors that cause human problems.
- Schneider 2011 existiential practitioners are not only concerned with facilitated individual change but with promoting an indepth inquiry that has implications for social change.
- Some individuals who seek counselling may operate on the assumption that they have very little choice because environmental circumstances severely restrict their ability to influence the direction of their lives.
- A potential problem within existential theory is that it is highly focused on the philosophical assumption of self-determination which may not take into account the complex factors that many people who have been oppressed must deal with.
- Many clients expect a structured a problem-orientated approach to counselling that is not ound in the conventional existential approach.
Contributions of Existential Approach:
- Has helped brings the person back into central focus. It concentrates on the central facts of human existence: self-consciouness and our consequent freedom.
- Deurzen 2012 – views the existential practioner as a mentor and fellow traveler who encourages people to reflect upon the problems they encounter in living.
- Its emphasis on the human quality of the therapeutic relationship
- Existential psychotherapy continues to have an enduring impact on a variety of psychological practices
- A key contribution is the possibility of a creative integration of the conceptual propostions of existential therapy with many other therapeutic orientations.
- Dattilio 2002 – who integrates cognitive behaviour techniques with the themes of an existential approach. He uses techniques such as restricting of belief systems, relaxation methods and a variety of cognitive and behavioural strategies but he does so within an existential framework that can begin the process of real-life transformation.
- Existenital therapists favor intensity and passionate experience including that of happiness, but they equally value the darker side of human nature and would encourage clients to learn to value both sides of their experience.
Limitations:
- Describe their therapeutic style as vague and global terms.
- Both beginning and advanced practitioners who are not of a philosophical turn of mind tend to find many of the existential concepts lofty and elusive.
- Level of maturity, life experience, and intensive training requires of practitioners.
