Investigation into the effects of existential therapy

Who am I? What is the good life? What is the meaning of life? Is life worth anything? How can one find happiness? What does it mean to be an authentic person? The questions above represent a few of what therapists term existential questions (Glassock & Small, 2001). These questions differ from others in that they are philosophical and concern essential matters pertaining human existence. Simply put, existential questions confront the “deeper issues” of life. Existential therapy, therefore, tackles issues revolving around human existence such as conflict between life and death, anxiety, despair, happiness, meaning, and authenticity. Existential therapy emphasizes the importance of the therapeutic relationship in encouraging clients to assume responsibility in confronting existential anxieties and striving after authenticity.

From the outset, existential therapy is markedly different than any of the other psychotherapeutic approaches thus studied. Existential therapy is more of a philosophical approach than a psychological one, placing emphasis on human interaction instead of a set of prescribed, rigid therapeutic techniques. Irvin Yalom, an instrumental figure in the development of existential analysis, comments: “[existential psychotherapy] has no homestead, no formal school, no institution…” (1980, p.14). The roots of this therapy system trace back to nineteenth and twentieth century existentialist philosophers such as Kierkegaard, Nietzsche, Heidegger, and Sartre. These philosophers focused on meaningful existence, creating being, authenticity, human reality, and self-realization. Existential therapy, therefore, parallels existential thought by focusing on the human condition, the need for freedom, the meaning of life, death, and isolation. It is not limited to these faucets, though. Contrary to Freudian psychoanalysis, existential therapy regards the events of the past as irrelevant and this belief further reinforces the existential belief in freedom to choose (non-determinism). The central tenet of this therapy revolves around the idea that clients must take responsibility for their own lives and the choices they make determine the future. The client’s choices are the determining factors in his or her destiny and this allows for autonomy.

Despite the origin of existential therapy in an array of individuals spanning the nineteenth and twentieth century’s, three contemporary individuals (Viktor Frankl, Rollo May, and Irvin Yalom) are noteworthy because of their successful contributions in shaping and explaining the basis of existential psychotherapy. Their success in developing the existential approach, according to Corey (2008), resulted from their “strong backgrounds in both existential and humanist psychology” (p.137). Being instrumental in shaping Europe’s concept of existential therapy, Frankl believed that the essence of humans lies in searching for meaning and purpose. Frankl further developed this idea into what he termed logotherapy-“therapy through meaning” (Wong). Aiding the transition of existential therapy from Europe to the United States, Rollo May emphasized the innate struggle of being and the importance of our choices on who we become. Corey (2008) comments, “[May saw] the struggle between the security of dependence and the delights and pains of growth” (p. 137). Finally, Irvin Yalom focused on what he entitled the four “givens of existence” or ultimate human concerns that “are intrinsic properties…and an inescapable part of the human being’s existence in the world” (1980, p. 8). He maintained that these ultimate human concerns were death, freedom and responsibility, existential isolation, and meaninglessness (Yalom, 1980, p. 8).

So, then, what is existential therapy? First, it is rather deceiving to think of existential

therapy as another school of therapy. Existential therapy is a philosophical outlook on life which

places sole emphasis “on an understanding of what it means to be human” (Corey, 2008, p.139).

Second, it de-emphasizes the role of traditional psychotherapeutic techniques in an effort to

understand the individual as a subjective unit. Third, it is assuredly non-deterministic (as

opposed to Freudianism or Behaviorism) because without free will, existential thought and the

belief in individual autonomy to shape and create life (and meaning) will cease to exist. Fourth,

the existential approach maintains that there are six basic dimensions of the human condition

which are summarized in six propositions:

Proposition 1: The Capacity for Self-Awareness

Proposition 2: Freedom and Responsibility

Proposition 3: Striving for Identity and Relationship

Proposition 4: The Search for Meaning

Proposition 5: Anxiety as a Condition of Living

Proposition 6: Awareness of Death

The goals of existential therapy are multifaceted and variance exists even within the existential discipline. According to Lantz and Kondrat, the treatment goals for existential therapy are “directed towards helping the client discover, actualize and honor the meanings and meaning

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potentials in life” (1996, p. 295). Grant outlines what he believes represents the four goals of therapy. He writes that the goals are “to expand self-awareness, to increase choice potentials, to help clients accept the responsibility of choosing, and to help the client experience authentic existence” (Grant). “Increased awareness” according to Corey is the primary treatment objective of existential therapy and this allows clients to focus on missed possibilities (2008, p.148). Because existential therapy is fluid in nature and lacks a prescribed structure, the goals of treatment vary from therapist-to-therapist and is undoubtedly based on a client’s initial intake interview.

Because the heavy emphasis on philosophy, questions arise regarding the applicability of existential therapy. This approach, however, has broad applications to a wide-array of psychological illnesses and existential crises. Virtually every person in the world has some type of existential crisis at some point in their life. Existential therapy applies to directly to clients experiencing life issues such as life and death, anxiety, meaninglessness, and hopelessness. According to Corey, this approach also had valuable contributions for those struggling with developmental concerns, matters of identity, and disappointments with life (2008, p.152). Because existential therapy lacks rigid structure, de-emphasizes techniques, and requires self reflections, it is ideal for long-term applications. The clinical setting and the initial intake interview should always determine the type of therapy selected and many applications of existential therapy exist beyond those outlined above.

Personally speaking, I would incorporate existential therapy into an integrative approach to psychotherapy and I would likely favor existential therapy over other psychotherapy models if on initial intake my client expresses existential concerns and/or goals. This approach would definitely be a positive asset in the majority of therapy cases because most clients seeking psychotherapy have at least some existential concerns (Yalom, 1980). One positive aspect of existential therapy is that you can use it theistically (Søren Kierkegaard) or atheistically (Nietzsche, Sartre). This allows for a wide range of diversity in clients without compromising your own moral convictions. Another positive aspect of this therapy is the focus on the here-and-now. Existential therapy doesn’t delve into the past, attempting to mend past events in the hope that current predicaments will change. Existential therapy is strictly about the clients’ choices right now and how those will impact their future (as is most humanistic therapy). This model is also preferred in a multicultural setting because it confronts “human experiences that transcend the boundaries that separate cultures” (Corey, 2008, p.154). Finally, because existential therapy is more about a way of thinking, clients that have sought therapy before and quit might be more likely to engage again because of the uniqueness associated with it.

Disadvantages do exist with this approach, though. First, the most obvious drawback of the existential therapy approach is the lack of structure. Many of the existential concepts are subjective and ill-defined, varying even within existentialism. This would pose obvious issues regarding a client’s continuum-of-care seeing that each therapist would have a slightly different approach to existentialism. Second, clients that lack higher level cognitive function will not readily benefit from existential therapy because of its heavy emphasis on philosophical precepts. Third, this therapy is ideally meant to be carried out over an extended period of time where primary responsibility lies with clients by continually reevaluate their meaning, autonomy, and authenticity. Clients in a crisis-situation would not benefit immediately from existential therapy, neither would clients seeking immediate answers or wanting to be “therapized”. Fourth, existential thought is highly individualistic and depending on a client’s cultural background, this approach might violate their cultural ideals. Finally, existential therapy focuses on unmeasureable goals and attitudes, such feelings, thoughts, and emotions. Unmeasureable goals tend to complicate the counseling process as one has to rely on subjective input from clients (which might not always be truthful) to gage the effectiveness of the therapy regimen.

Existential therapy as a philosophical system has a number of applications to psychotherapy. Arising from early existential thought, this therapy system originates from the ideals of existential thought. The primary focus of existential therapy assigns the client responsibility in shaping his or her reality and subsequent meaning. Existential concerns such as life, death, meaning, anxiety, happiness, and development are highly valued in this approach. A exclusive existential approach to psychotherapy could be satisfactory for some clients but I believe it is best when employed in an integrative system of psychotherapies contoured to the client and his or her needs.

Corey, G., (2008). Theory and Practice of Counseling and Psychotherapy. Australia: Thomson Brooks/Cole.

Glassock, G., & Small, N. (2001). EXISTENTIAL QUESTIONS AND THEIR MORAL IMPLICATIONS. The International Work Group in Death, Dying and Bereavement . Retrieved October 9, 2010, from http://www.iwgddb.org/members/LinkClick.aspx?fileticket=Idqu2d%2fMLoE%3d&tabid=55&mid=470

Grant, S. K. (n.d.). Existential Therapy . California State University, Northridge . Retrieved October 9, 2010, from www.csun.edu/~hcpsy002/Psy460_Ch06_Handout_ppt.pdf

Wong, P. (n.d.). Meaning-Centered Counseling and Therapy (MCCT): Dr. Paul Wong’s MCCT. Retrieved October 9, 2010, from http://www.drpaulwong.com/index.php?option=com_content&view=article&id=91:meaning-centered-counseling-and-therapy-mcct&catid=36:sw&Itemid=66

Yalom, I., (1980). Existential Psychotherapy. New York: Basic Books.