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Existential Psychotherapy

What is Existential therapy?

Existential psychotherapy or existential therapy takes on a philosophical approach and, is a process of searching for the value and meaning of life, (Corey, 2005, p. 131). It focuses on the self, what it means to be a person, reflection, and free will. It rejects common theories from psychoanalysis as well as radical behaviorism.

According to this theory, we are responsible for our own actions and choices. It is up to us to make improvements upon ourselves. With existential psychotherapy, we are not victims of circumstance, because to a large extent we are what we choose to be, (Corey, 2005, p. 131).

During therapy it is important for the client to reflect, recognize, and decide what to do. Once a client recognizes, the ways in which they have passively accepted circumstances and surrendered control, they can start on a path of consciously shaping their own lives,(Corey, 2005, p. 131).

It is the goal of the therapist to encourage the client to find and develop a greater purpose or meaning in life. Instead of focusing on the negatives or the circumstances that are holding one back, he or she can move and choose how to run his or her life. Instead of focusing on certain therapeutic techniques, clients are also encouraged to just focus on the deep meaning of life.


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The Six Propositions of Existential Psychotherapy

There are six propositions for existential psychotherapy. They are...

First Proposition of existential therapy

The Capacity for Self-Awareness, Second Proposition: Freedom and Responsibility, Third Proposition: Striving for Identity and Relationship to Others, Fourth Proposition: The Search for Meaning, Fifth Proposition: Anxiety as a Condition of Living, and Sixth Proposition: Awareness of Death and Non being(Corey, 2005, pp. 137-144).

The first step is becoming aware and accepting certain things within one’s life. Awareness is expanded through the following: time is limited, we must choose our actions so that destiny is within our hands, meaning of life is important to find, we have the potential to take action or not to act; inaction is a decision, existential anxiety is important, we are alone but can relate to others, and, we are subject to loneliness, meaninglessness, emptiness, guilt, and isolation (Corey, 2005, p. 137).

The second proposition of existential therapy

Freedom and responsibility, focuses on the fact that in this school of psychotherapy, one must take on the responsibility of his or her actions and then has the freedom to choose how to react or act in response to those responsibilities.

The third proposition of existential therapy

is when one strives for identity and relationships with others. The four phases of this are the courage to be, the experience of aloneness, the experience of relatedness, and struggling with our identity (Corey, 2005).

The fourth proposition of existential therapy

is the search for meaning. It is one of the most valued aspects of existential psychotherapy and theory. There are three hardships during this proposition which are discarding old values, lack of meaning, and finding new meaning. When discarding old values, a client may struggle to find new ones that are more realistic or ideal to replace the old values. It is important for the therapist to help properly guide the client or encourage him or her to strive for new more suitable values.

As mentioned several times, the meaning of life is very important for this form of psychotherapy. Finding new meaning to replace the old meaning is difficult but can be accomplished with the help of the therapist.

The fifth proposition of existential therapy

Proposition five has to do with anxiety. Anxiety is coming and is inevitable unfortunately. It is a part of growing up and dealing with life according to existential theory.

The therapist needs to differentiate between normal and neurotic anxiety within the client. The client needs to learn how to recognize this as well. Normal anxiety is a human’s appropriate response to something that happens. It is a good motivator. However, neurotic anxiety, in contrast, is out of proportion to the situation’s and is typically out of awareness, and tends to immobilize the person, (Corey, 2005, p. 143).

The client must learn how to accept some anxiety within his or her life and understand that it is a normal party of life while trying to minimize neurotic anxiety as much as possible.

The sixth proposition of existential therapy

Finally, proposition six is the awareness of death and non being. Existentialism views death as a natural occurring thing that happens and does not fear it. Instead death gives life more meaning and much more appreciation. Take advantage of each opportunity given and live life to the fullest in this form on psychotherapy.


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Major Contributors to Existential Psychotherapy

Viktor Frankl

Frankl lived a very difficult life. He was a prisoner in both Auschwitz and Dachau Nazi concentration camps. He lost his parents, brother, wife, and children there.

Frankl, vividly remembered his horrible experiences in these camps, yet he was able to use them in a constructive way and did not allow them to dampen his love and enthusiasm for life (Corey, 2005, p. 129).

Viktor’s existential approach began before enduring the Holocaust, but his experiences there further confirmed those beliefs. In 1963, Man’s Search for Meaning was published (Corey. 2005). According to him, love is the highest goal to which humans can aspire and that our salvation is through love, (Corey, 2005, p.129).

Even when enduring terrible things, humans can find their own way and appreciate a greater meaning in life.

In the 1930s, psychiatrist and neurologist Viktor Frankl began to lay the foundations for logotherapy/existential (LTEA) analysis based upon Sigmund Freud’s psychoanalysis, and Alfred Adler’s individual psychology (Batthyany, 2016).

This is based upon the concept that was highlighted in his book Man’s Search for Meaning that the primary motivating force in life is the search for meaning.

This concept posits that mankind are not subject to conditions, but have the freedom of choice and will to decide their place in psychological and physical conditions. Man is free to shape his/her own life based upon the opportunities presented, essentially. This is powerful in the therapeutic setting, as it gives clients the space for autonomy in terms of actions. This is the first concept of LTEA.

The second concept, after the freedom of will, is the will to meaning (Batthyany, 2016). Not only is mankind free, but we are free to accomplish goals, and achieve purpose in life.

When a person fails to realize his/her will to meaning, emptiness, and meaninglessness emerge. In LTEA, a therapist will help clients to remove any barriers toward achieving goals and purpose in life. The third concept of LTEA is meaning in life.

This is defined as finding meaning in each and every moment in life. These concepts are fluid, and ever-changing.

Rollo May

Rollo May was a contributor as well publishing books that gained popularity. He believed that, psychotherapy should be aimed at helping people discover the meaning of their lives and should be concerned with the problems of being rather than with problem solving (Corey, 2005, p. 130).

Existential psychotherapy can be quite useful for developing appropriate boundaries, chronic emotional hunger, suffering, coping with death or significant life changes, and persistent disorders such as depression, neurotic anxiety, etc.

Some limitations could be the limited audience that it generally applies to, lack of research-based treatment, and negativity (Day, 2008).

In 1958, Rollo May helped introduce existential therapy to the world. As a 20th century psychotherapist, May was integral in the development and spread of existential psychology (Rollo May, 2015).

Rollo May was born in Ada, Ohio in 1909. His passion and focus on psychology can be attributed to dysfunction between his family and parents during his childhood. May began his collegiate studies in English, where he earned a bachelor’s degree.

The then returned to college after spending time teaching English in Greece, where he was exposed to the teachings and seminars of Alfred Adler. His second bachelor’s degree was in divinity, after which he served as a minister for a short period of time before going back to school at Columbia College where he earned a PhD in clinical psychology.

After graduation, May began a counseling fellowship at William Alanson White Institute in New York City. Three years later, May opened his own practice.

Nearly a decade after opening his own practice, May began teaching at the New School for Social Research. After 20 years of teaching, May relocated to California. Rollo May is most known for his many existential books which include Man’s Search for Himself, Love and Will, The Meaning of Anxiety, and The Courage to Create.

May’s roll in introducing existential therapy began when he partnered with Henri Ellenberger and Ernest Angel in editing the book Existence (Rollo May, 2015).

While May was influential in developing existential psychotherapy, he was also influenced  the philosophical theories of humanism. May’s foal was to understand the underlying components and reality surrounding the subject of human suffering and crises. In gaining a better understanding into such paradigms, May brought together the philosophies of both existentialism and humanism.

As was popular in thought during this time, May believed that development occurred in stages, and that a particular challenge or crisis occurred during each stage.

The first stage identified in the course of development, according to May is innocence (Rollo May, 2015). An infant is innocent, and is driven purely by the will to survive.

The second state is rebellion. This is highlighted by a young child who craves independence, but is unable to properly care for oneself. The third state is the decision stage.

This is a transitional stage during which the child has become a teenager or young adult. Decisions must be made about the course of one’s life during this stage, and is in search of further independence from parental figures.

The ordinary stage follows the decision stage, and this is an adulthood phase during which young adults are faced with demands from society, and there is an urge toward seeking security, and conformity to traditional norms.

The final stage is the creative stage. This is a point during which a human achieves self-actualization, and reaches a certain point in creativity and productivity. During this stage a person has moved past egotism or self-absorbed thinking.

While the stages are related to stages of development, it is possible for a person to be at any of the stages at any period of time (Rollo May, 2015). A person is able to regress into childlike stages, or even skip stages, or return to a certain stage many times.

In addition to identifying stages of development, May placed much attention on anxiety. He believed it was anxiety that served as catalyst in human life, as it allowed for courage in one’s decision making. It also aids in the avoidance of danger and empowers mankind in finding ways to survive.

Irvin Yalom

Irvin D. Yalom is a contemporary educator and psychiatrist. Yalom was born in Washington DC in 1931, after his parents defected from Russia (Irvin D. Yalom, 2013).

Yalom studied at George Washington University, where he earned a Bachelor of Arts degree in 1952. He then earned a MD from Boston University School of Medicine in 1956.

Yalom served his internship and Mount Sinai Hospital, which was followed by a residency as Johns Hopkins Hospital. He also served in the army.

In 1962, Yalom started teaching at the School of Medicine at Stanford University. He was promoted to professor of psychiatry in 1973. He retired in 1994 with professor emeritus status.

Yalom is well-known for his works of literature. He began writing in 1970 with his first publication: Theory and Practice of Group Psychotherapy (Levy, 2001).

After his first publication, Yalom published several works of fiction, nonfiction and even educational textbooks. Many of the writings of Yalom are centered around existential theory, and existential psychotherapy.

In fact, Yalom was considered a pioneer of existential psychotherapy, as he helped explain existentialism and portrayed its importance in the therapeutic process.

In addition to helping aid in the development of existential psychotherapy, Yalom studied and practiced group therapy (Irvin D. Yalom, 2013).

In doing so, he was able to identify 11 factors which attributed to shifts and changes of significance among those in a group. Yalom was a skeptic of group therapy before becoming a true advocate. He believed the following 11 factors were key in implementing healing and change during group therapy:

  1. Installation of hope: Fosters optimism within the group

  2. Universality: Helps group members remember they are not alone in their symptoms or struggles

  3. Imparting information: Educates and empowers clients according to their specific needs.

  4. Altruism: Clients feel a sense of purpose and value in helping others within the group.

  5. Corrective recapitulation: Issues from childhood, or family events are safely resolved within the group.

  6. Socializing techniques: Facilitate social development, empathy, tolerance, and interpersonal abilities.

  7. Imitative behavior: Healthy coping strategies and perspectives of others in the group influence the behavior of others in the group who begin to mimic healthier coping mechanisms.

  8. Interpersonal learning: Clients learn how to engage in interpersonal relationships that offer and receive healthy support.

  9. Group cohesiveness: Acceptance, value, security, and belonging are experienced by group members.

  10. Catharsis: Emotions that have been suppressed are able to be released, and the disclosure of information to members in the group facilitates healing.

Existential factors: Learning how to be, and exist as part of a unit larger than oneself helps clients realize that life continues in the face of loss, pain, sadness, and joy.


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The History of Existential Psychotherapy

A historical look into the formation of existential psychotherapy was taken as it applies to the founding philosophers and psychotherapists who helped form the ideas, and theories; asking difficult questions that first formed the existential movement, then existential psychotherapy later in history.

While existential psychotherapy has been used for several decades as it pertains to administering psychotherapy, there are limitations to this form of therapy, as well as benefits.

When it comes to seeking one form of treatment for all diagnoses, this form of therapy has been found to be highly beneficial in treating many symptoms of mental illness, however there are additional treatments that may provide added benefit when paired with existential psychotherapy.

This form of therapy helps clients to own their choices, and find meaning in life.

The thoughts and emotions that all humans experience during life can be positive and invigorating, or they can be quite the opposite. In fact, much of human existence, along with one’s mentality behind it, can be attributed to pondering the meaning of it all.

Why am I here? What is my purpose? These are the types of questions that have led to a movement that has been termed existentialism.

The dichotomy between flourishing in life, and suffering; struggling to survive vs. having a self-actualized, fulfilling life is the struggle that contributes to the existential dilemma of the human condition.

What started out as a philosophical movement has transformed into its own theoretical orientation of psychotherapy. Psychotherapists who have adopted such an orientation, such as Rollo May (1986), believe that if a person can separate oneself from the labels and diagnoses that society and psychiatry have placed upon him/her, and focus on one’s life’s purpose and goals, he/she can effectively combat symptoms of psychological disorders, and any form of unrest that would drive someone to seek the help of a trained clinical practitioner; ergo the need for existential psychotherapy in modern-day society.


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The genesis of Existential Psychotherapy

Existential psychotherapy is a form of therapy that focuses on the whole of one’s human condition and experiences.

This form of therapy is deeply rooted in the collaboration of many great thinkers of the past. It provides an approach toward therapy that takes the pressure off one’s diagnosis, and encourages clients to own their successes and realities (Vallejos, 2018).

Existential therapy rests upon the foundation that “we are our own choices”, as famously stated by Jean-Paul Sartre, (1946).

Existential therapy is rooted in the collaborative efforts of a variety of thought movements and theoretical orientations (Diamond, 2009). Such collaborations include that of psychodynamic therapy, as well as theories from humanistic and existential psychology.

The practice of Existential psychotherapy is rooted in existential philosophy; a movement influenced by the writings and beliefs of philosophers such as Martin Heidegger, Fyodor Dostoevsky, Edmund Husserl, Franz Kafka, Albert Camus, Friedrich Nietzsche, Soren Kierkegaard, Jean-Paul Sartre, Saint Augustine of Hippo, and Blaise Pascal.

The principles of existential psychotherapy were first implemented into practice by European clinicians in the mid-twentieth century. Such clinicians included Otto Rank, Karl Jaspers, Medard Boss, and Ludwig Binswanger, (Diamond, 2011).

This was soon followed as a predominant theoretical orientation in the practices of Viktor Frankl, Rollo May, R.D. Laing, and Irvin Yalom.

Kierkegaard believed the discontent of mankind could be uncovered, but only with internal wisdom.

These beliefs were then used by the philosopher to further the existential theory with an introduction of the idea of free will, as well as that of personal responsibility.

By the beginning of the 1900s, existential philosophers such as Martin Heidegger and Jean-Paul Sartre began using existential principles such as personal exploration, investigation, and interpretation as tools in aiding the personal, emotional, and mental healing process (AKA: psychotherapy).

This modality has since been applied over the past century as more and more clinicians, psychologists, etc. recognize the importance of the human experience as it relates to personal understanding; finding meaning and purpose as means toward reaching a state of psychological well-being.

One of the first existential psychotherapists to begin using this method of therapy was Otto Rank in the mid-twentieth century (Vallejos, 2018).

It was then psychologists Paul Tillich and Rollo May who introduced existential therapy to the masses with their lectures and written work. This was followed by Irvin Yalom.

Principles of existential therapy started to influence other theoretical orientations over time. These included humanistic psychology and logotherapy, which was formed by Viktor Frankl.

During this time, philosophers from Britain were also spreading existential thought through the forming of The Philadelphia Association. This foundation was designed to help others manage their mental health through experiential interventions.

Another institution which furthered existential therapy include the International Community of Existential Counselors, which was founded in 2006, and the Society for Existential Analysis which was formed in 1988.


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Existential Philosophers

The beginning of the existential movement was born of the writings and beliefs of the aforementioned existential philosophers. Among those, a deeper look into the works of Nietzsche, Kierkegaard,  Pascal and Augustine will be taken as it applies to the history of existential psychotherapy.


Aurelias Augustine, or St. Augustine of Hippo, was an early Roman theologian and philosopher from the Roman province of Africa (Saint Aurelias Augustine, 2011).

While he was born in 354 C.E., several parallels have been made between his work and that of existential philosophy, and what has been termed Christian existentialism.

While many existential philosophers focus on despair and anxiety as being part of the human experience, Augustine describes his childhood as being filled with restlessness at being separated from God (Lewis, 1965).

Augustine’s most influential contribution toward existentialism was his book Confessions. This was often called the first autobiography in the world (Farmer, 2010).

The book  combined intense philosophy, paired with Augustine’s own personal story. He decided that he could not tell the story of God without also sharing his own story.

He treats theology as something that is inextricably bound to his personal life journey and struggle as a human being. Augustine sees humans as having innate longings that pull them toward God, or the source of their existence.

There are two main  ideas Augustine is responsible for that influenced existentialism.

These are the so-called “God-shaped hole,” which was embraced by Christian existentialists; and the concept of nothingness of evil (Farmer, 2010).

This notion was embraced by many, with the exception of Sartre. His thoughts behind curiosity were also influential for Heidegger in his existential philosophies.

Augustine expresses his existential point of view in the quote:

“Thou has made us for thyself and our hearts are restless till they find their rest in Thee” (Lewis, 1965).

Augustine places much emphasis and focus on the sinful nature of mankind. He speaks often of man’s original sin, and views mankind as lost, or fallen, and anxious with despair in the absence of God.

While technically not an existentialism due to his use of universal laws in his judgments of others. He is considered a precursor to this philosophical movement, however, due to his thoughts surrounding human existence, and finding meaning in it.


While Blaise Pascal lived centuries before the term existentialism was used in describing a philosophical movement (1623-1662), his beliefs helped lay foundations for this movement. Blaise Pascal was a French philosopher, born in 1623 (Blaise Pascal, 2018).

He was also a scientist and mathematician. He is most commonly known for Pascal’s Wager. This notion suggests that while there may not be scientific evidence to prove God’s existence, it would behoove us to behave as if he does exists anyway—for if God doesn’t exist, there will be nothing lost.

Pascal’s faith in God began in 1654, after he’d suffered from a major depressive episode (PHIL304, 2010).

He visited a monastery and had a spiritual experience. This was when he chose to dedicate his life to the Christian faith, and to defending it against critics.

He is famous for writing Pensées, which means “thoughts.” This work was thought of as an apology which defended Christianity.  Pensées included meditations surrounding sin, faith, and suffering.

Pascal saw the world as a “harsh” place. He saw man as weak beings, which he expressed in his famous works of writing which at times sought to show the weakness of mankind to others.

His works are now considered to be the beginning of what has been called Christian existentialism, which was first famously introduced by Kierkegaard in the 19th century. Similar to Augustine, and following in his footsteps, Pascal embraced the notion and doctrine surrounding the concept of original sin.

With this acknowledgment came the idea that all humans are imperfect due to original sin, as told in the first book of the Bible with Adam and Eve. Pascal believed that God revealed truths to chosen people over the course of history, and those truths are fundamental in the Christian faith.

In addition to Pascal’s contribution to the foundations which began the existential movement much later with his concern for limitations within human existence, he also stressed the fact that change is constant, and introduced the concept of contingency, paired with the irrationality and suffering of humans experiencing life (PHIL304, 2010).

Being a philosopher, Pascal was a skeptic and believed knowledge was uncertain, and based upon intuition. He was influenced heavily by Montaigne, a Christian French philosopher. This is where his skepticism and view of humans as weak was born. Pascal was also a friend of René Descartes (the father of philosophy).


When it comes to existential philosophers, the role of God and religion as it pertains to one’s existence varies greatly.

Kierkegaard, for example, took on a radical approach toward existentialism as it pertains to Christian faith and doctrine, while Nietzsche formed the “God is dead” thesis (Crowell, 2017).

Still, there were others such as Jaspers, Buber, Heidegger, and Marcel who dove into exploration of an “authentic existence” concept as it pertains to religious consciousness, while Beauvoir and Sartre were staunch atheists.

Despite the different takes Nietzsche and Kierkegaard held pertaining to a higher power and religion, one concept they both agreed upon is what Kierkegaard coined “the single individual.”

This concept focuses on the singularity of the individual; being capable of meaningful reflection, yet at the same time invisible as it relates to traditional philosophies.

According to Kierkegaard, the singularity of an individual’s existence comes into light when there ethical conflict is present, and one’s religious or spiritual faith is put to the test (Crowell, 2017).

He answers the question of how philosophy can conceive of such a meaning of doing God’s will for one’s life by concluding that when an individual is able to elevate oneself to a universal level, and place all desires under ethical law, this represents ones “telos” or what a person ought to be doing.

This allows for an individual to place the good of the universe over personal desires that could cause harm to the whole.

According to Kierkegaard, one’s sense of doing God’s will in life is the source for meaning only if this is in accordance with universal ethics (Crowell, 2017). In pondering this philosophy, one questions instances such as Abraham sacrificing his son in the Bible.

While his actions do not fall in line with universal ethics, Kierkegaard argues that Abraham is both living a meaningful life, and being faced with an ethical dilemma. Since Abraham was following God’s commands, Kierkegaard believes that God’s law doesn’t pertain to all, and therefore it speaks to Abraham in his singularity.

This represents a paradox that shows that laws pertaining to singularity, or one individual, supersede universal laws of ethics. He also posits that there cannot be meaning in life without a universal set of standards that measure actions in regard to ethics.

How does one measure actions? Kierkegaard states that there must be a norm (Crowell, 2017).

This led to his quote “subjectivity is the truth.” This idea encompasses existential authenticity. He toys with the idea that there is no way to prove that the voice Abraham heard was in fact from God, and that it is because of his passion for his faith that he was able to take such a leap.

This was the only way he believes Abraham could justify his actions. The subjectivity of this singularity is defining his way of being, rather than the passion that motivates one to act in a way that goes against universal ethics.

Where there is singularity, there is also the “crowd.” Kierkegaard states that “the crowd is untruth,” (Crowell, 2017).

He believes this is simply a public opinion which is inconsistent and ever changing, and encompasses ideas mankind hold while of a certain age which are often taken for granted.

Examples of this would be doing things the ways that are generally accepted among a group of people or culture, such as going to school, getting a job, or getting married.

He believes this is “untruth,” due to the ways in which these ideas can become embedded into an individual’s sense of who he/she is.

This could cause a person to identify who they are in association to the things they are doing to fit in with societal norms. “I am a mother, I am a wife, I am a student, I am an architect,” etc.

In a sense, this relieves a person of the burden of being his/her authentic self. These labels become masks we hide behind at any given time, on any given day.

This is simply a measure of being. Science and history, for example, are also seen as indifferent, and belonging to the “crowd.”  Essentially, individuals must own their own truths, and to exist is to be confronted with such pondering pertaining to meaning, one’s own truth, and having an authentic life experience.


Whereas Kierkegaard places emphasis on one’s paradoxical struggle in understanding the true presence of God, Nietzsche coined the phrase “God is dead,” (Crowell, 2017).

This was in reference to the popular shift in thinking that was taking place during his time.

Darwinism was growing in popularity, and there was less emphasis now on biblical dogma that had long shaped the parameters in which morality was interpreted by the masses.

Where Dostoevsky believed that if God is dead, then everything is permissible, Nietzsche believed that morality should be measured based upon the human experience in modern-day society.

He saw much complexity as it pertained to morality and the Christian God. He viewed such moralistic beliefs as life-denying in nature, and therefore nihilistic. This followed psychological theories for morality at the time that focused heavily on moral normativity over religious dogma.

Even though Nietzsche and Kierkegaard held different opinions as it relates to morality, Nietzsche arrived at the same conclusion as Kierkegaard: “the crowd is untruth,” (Crowell, 2017).

He saw this is as the notion that humans are merely cattle who have been trained to live docile, enslaved lives in which they conform to universal standards for morality. This isn’t a life sentence for the human condition, however.

He also believed that there was room for change, and that while science was undermining the belief in God during his time, it was placing humans face-to-face with nihilism; the revelation that life is meaningless.

As bleak as this may sound, he also believed that nihilism presented humans with the option to take life into their own hands, and create meaning out of it for themselves.

The aforementioned brought Nietzsche to his view of existence, as the emergence of a philosophical dilemma between obedience to the laws of morality, and an autonomy that was “beyond good and evil” (Crowell, 2017).

Yet, he also believed that the meaning in life, the value of it, autonomy, and being beyond good and evil was something that needed to be spoken about within society, so as to develop a certain standard, as being beyond good and evil couldn’t encompass a lawless state in which arbitrary, impulsive behaviors rule.

He believed that if such a notion were to exist, there must be a standard by which behavior and the state of one’s existence and beliefs behind it could be measured as a success or failure, much like Kierkegaard.

These standards are identified in reference to health, the meaning of earth, and strength.  Such a standard is subjective, such as that of style. It varies from one person to the next pertaining to one’s unique set of beliefs pertaining to meaning in life.

Similar to Kierkegaard, Nietzsche concluded a nuance of existence that cannot be comprehended based upon drives, inclinations, or universal laws for behavior. It wasn’t about what a person was, but the way a person existed and simply was (Crowell, 2017).

While this idea was laid down as a foundation for existential philosophy, it wasn’t systematically developed as of yet.

This was yet to happen by the next existential philosophers of the twentieth-century.


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Fundamental Questions that led to Existential Psychotherapy

Before existential therapy was born, there were some fundamental questions that helped pave the way, and lay foundations for the existential interventions that soon followed.

While many questions that helped for the existential philosophy movement have already been discussed, there are additional questions that were being asked by psychologists and psychiatrists in the 1940s and 1950s in Europe (May & Yalom, 1981).

Existential therapy arose out of a need to understand the human condition in a more reliable way than the current practices of psychology and psychiatry that were available at the time. This need presented out of frustration with the then current methods of trying to gain scientific insight into the human psyche.

While the founders of existential psychotherapy believed the current practices in psychology and psychiatry had their place (Freudian, Jungianism and conditioning in behaviorism), there were some questions left unanswered such as:

  1. Where was the actual immediate person to whom these things were happening?

  2. Are we seeing clients as they really are, or are we simply seeing a projection of our theories about them?

The founders of existential psychotherapy were aware that mankind was in the midst of great change. At the time there were global threats of nuclear war, economic struggles, everyone seemed to feel isolated, or alienated from others, and there were great changes happening with the institution of marriage.

On top of this, anxiety was a very real and common ailment experienced by most, if not everyone at this time. Existential therapy sought to comfort the anxieties associated with the human condition.

This form of therapy doesn’t have a strict set of rules or techniques. The goal of this form of therapy is to ask questions in an effort to gain deeper meaning into the nature of anxiety, grief, loneliness, despair, isolation and anomie as it pertains to mankind.

It also deals with questions surrounding love and creativity. This form of therapy is thought to prevent practitioners from a common pitfall of distorting clients in an effort to help them.

This is believed to happen with other forms of therapy that were prevalent at the time. This form of therapy was designed to seek meaning in suffering, anxiety, and the like. In finding meaning, a person is able to have a purpose for life, and learn to take control of his/her destiny through making decisions geared toward overall goals and desires.


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Influential Works of Existential Literature

In addition to the popular works of literature that have been referenced above, there are a handful of existential works of literature that helped contribute toward the development of existential psychotherapy.

The first was published in 1958, and written by Rollo May, Ernest Angel and Henri Ellenberger titled Existence: A new dimension in psychiatry and psychology.

Other important pieces of existential writings include Victor Frankl’s 1963 book Man’s Search for Meaning, James Bugental’s 1976 The Search for Existential Identity, Rollo May’s 1953, 1961 and 1977 books titled Man’s Search for Himself, Existential Psychology, and The Meaning of Anxiety, as well as the first comprehensive existential psychiatry textbook, which was written by Yalom, and published in 1981 titled, Existential Psychotherapy.

Within these textbooks and beyond, a great many existential fundamentals have been highlighted as they pertain to psychotherapy.


Basic Concepts of Existential Psychotherapy

Human Capacity for Self-Awareness—Possibilities for Freedom

Existentialists believe that our human capacity for self-awareness grants us the possibility of freedom.

Since we are mortal, and there is a finite amount of time for us in our human experience, we have the freedom of choice to act or not to act, to find meaning, and combating feelings of loneliness, despair, isolation, guilt, and anxiety (Existential Therapy, 2004).

Humans have the freedom to shape their own destinies through the choices they make. This involves taking ownership of one’s own choices, and seeing how they have led to one’s current life situation.

When one can find meaning in this, and identify one’s power in creating one’s own reality, there is much freedom. This allows one the freedom and ability to find meaning in life, and to identify ways in which such decisions and choices have been made for us by others.

When one is able to take control of their own choices and destinies, and stray from doing something simply because that is the status quo, it is very freeing, and empowering. This can help human beings to combat feelings of despair, anxiety, etc.

This approach also helps those undergoing such a method of therapy to develop a stronger sense of autonomy, and to live life as one’s authentic self; free from the influences of the “crowd,” (Existential Therapy, 2004).

Once a person is able to break free from the restraints that are placed upon him/her by modern day society, and forge a new way of life that honors one’s true-self, a greater level of existence and healing can take place. One of the integral factors in depression is despair for one’s future. In helping clients to find meaning in life, they can fight against symptoms of depression, anxiety, and even trauma, as previously mentioned.

The “I-Am” Experience

The “I-Am” experience (or ontological experience) encompasses one’s awareness that he/she is a living being who has the choice to take his/her own life (May & Yalom, 1981).

This is a realization that has actually had beneficial affects on clients. Nietzsche said that the idea of suicide has saved many lives of those who felt victim to circumstance, or the actions of others, until they come to the realization that they choose to be.

The concept of being in modern society isn’t always so clearly defined, as humans place so many different labels upon themselves as means of defining who they are.

Gabriel Marcel, a French existentialist, says that, “Indeed I wonder if a psychoanalytic method, deeper and more discerning than any that has been evolved until now, would not reveal the morbid effects of the repression of this sense [of being] and of the ignoring of this need,” (May, Angel, & Ellenberger, 1958).

While the “I-Am” experience is something that is beneficial to one’s psyche overall, it isn’t considered to be a solution by any means; rather a prerequisite for a solution (May et al., 1958). Once a person has a basis of being established, then he/she can begin working on any psychological issues that exist in the existential therapy setting.

While this experience encompasses being, it also addresses the concept of non being, or nothingness. This is, essentially, death, or a psychological ailment that impairs one’s ability to function.

Nonbeing is considered a threat, which prompts certain actions, and this threat is always present, and varying in intensity throughout life.

Normal and Neurotic Anxiety

Anxiety is described by existential therapists in a more broad perspective than other theoretical orientations (May et al., 1958).

It is thought to present out of one’s intrinsic need for survival, preservation and assertiveness. Rollo May describes this symptom as “the threat to our existence or to values we identify with our existence” (1977, p. 205).

An existential therapist will work to help clients confront anxiety as much as possible during treatment. This is done in an effort to help reduce any fears a person may have concerning their existence.

It is believed that “normal” anxiety is part of the human condition, and experienced by all (May et al., 1958).

“Neurotic” anxiety, however, describes anxiety that is inappropriate as it pertains to the situation at hand.

To help differentiate between the two, there are three characteristics that have been identified pertaining to normal anxiety.

The first identifier is that the anxiety is appropriate, or proportionate, to the situation presenting.

The second is that it isn’t so intense that it must be repressed.

And the third is that this form of anxiety can be used in a creative fashion. Normal anxiety can be stimulating, and can help one to identify and confront its cause.

Neurotic anxiety is not appropriate in relation to the situation at hand, unlike normal anxiety. It is also something that is oftentimes repressed. Unlike normal anxiety, neurotic anxiety is destructive to a person’s ability to function, and does not stimulate creativity or lead to confronting any root causes.

Existential therapists believe it is impossible to live completely without anxiety, however it presents as a sign of good mental health to live free from the symptoms of neurotic anxiety.

Guilt and Guilt Feelings

Existential therapists view guilt much in the same manner as anxiety (May et al., 1958). Guilt may present in two ways; normal or neurotic.

It is  believed by existentialists that neurotic guilt is the manifestation of fabricated wrongdoings, while normal guilt is something that brings our attention toward ethical nuances of our personal behavior.

In addition to normal and neurotic guilt, there is another form of guilt; the guilt one experiences toward self as it pertains to any failures to live up to personal expectations and potentials. This has been termed by Medard Boss (1957) as “forgetting being.” This can leave a person feeling guilty, and indebted to oneself. Such feelings can lead to symptoms of mental illness (Medard Boss, cited in May et al., 1958).

The Three Forms of World

Being in the world, is another concept that is principle for existential psychotherapy. It is believed that a it isn’t possible to comprehend a person’s world simply be describing one’s environment.

The environment is only one mode of the world in which a person exists.  Jakob von Uexküll, a biologist, posits that is possible there are as many different environments as animals on the planet. “There is not one space and time only, but as many spaces and times as there are subjects” (von Uexküll, cited in May et al., 1958).

Each human has his/her own environment, or world. This is all confined to our limited, subjective, imaginations within the structures surrounding our existence.

Each individual’s human wold is compiled of the relationships a person builds, and how he/she participates within it. This includes both past and present circumstances, which are subjective to all. Being aware of one’s world entails creating and constructing one’s own world, or reality.

When speaking of a person’s world, there are three different modes, according to existential psychotherapy theory. They are: Unwelt (world around), Mitwelt (with-world), and Eigenwelt (own-world) (May et al., 1958).

Unwelt is the biological world around us, or the environment. This encompasses biological needs, instinctual drives, natural law and cycles, being awake or asleep, and being born or dying.

This i Mitwelt is the world of the other humans, or our peers, and Eigenwelt describes the relationship to oneself. This concept has been understood as it relates to modern and depth psychology.

This is how the world is perceived by “me,” or “for-me-ness.” This is a statement of subjective opinions as concrete , or “for me.” Analysis of  such modes is what allows for a proper analysis or understanding of the human construct of love. This is something that cannot be described in Umwelt.

Without Umwelt, love can become void of power, and without Eigenwelt, it lacks the ability to grow.

Neitzsche and Kierkegaard stress the importance of Eigenwelt in their insistence that in order to love another, one must be enough for oneself.

The Significance of Time

Existential psychotherapists believe that depression, anxiety, and joy occur in the dimension of time, rather than that of space.

We exists in the realm of time, and it is a modern-day error to think of our existence in the realm of space solely (May et al., 1958).

This notion that we are as objects that may be located in specific spaces causes us to lose an existential relation to oneself, and those surrounding us. This is due to excessive emphasis on spacial thinking, according to Bergson, who states, “the moments when we grasp ourselves are rare, and consequently we are seldom free” (Bergson, cited in May et al., 1958, p. 56).

Human Capacity to Transcend the Immediate Situation

Transcendence is a dimension that is to be noted when discussing the concept of human existence.

This involves a continual growth, or evolution; transcending one’s past and present in order to reach the future (May et al., 1958). Every moment of human existence, we are transcending.

The things that can block a person’s transcendence are serious illness, or anxiety/despair. Humans possess the ability to transcend beyond time and space. We can do this through consciousness, and have the ability to think and talk with symbols, or the abstract.

Transcendence is no a “faculty.” It is part of the ontological nature of having a human experience.


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Goals of Existential therapy

One great benefit of existential therapy is its ability to help clients accept and overcome fears. A great motivation behind this methodology is to help others confront and process any emotional issues experienced, while fully engaged, and to be able to own their own choices; taking responsibility for them (May et al., 1958).

Another goal is to help clients to see how their decisions caused any issues to develop (Rollo May, 2015 ).

When a person undergoes this form of therapy, he/she is guided through the process of accepting fears. Therapists are also equipping the clients with the tools they need to overcome said fears through action.

By being cognizant of the fact that we are in control of our own destinies, and feeling this control over one’s life, a client in therapy is then equipped with the necessary tools needed to create the life course he/she wants through making better choices.

Existential therapy is a very liberating experience for clients in therapy. This new sense of empowerment is accompanied by a release of any despair that was tied to fears associated with meaningless or insignificance (May et al., 1958).

This form of therapy is designed to teach clients to embrace life and grow through experiences, while being present in the middle of it all with a sense of wonderment and curiosity.

This is done to help a person in therapy to view life as more of a journey, than that of a trial or tribulation. This can help a person to release any fears held that are associated with death as well.


Workings of modern Existential Psychotherapy

Existential psychology has changed and evolved much over time since the aforementioned pioneers began forming such ideas and putting them into practice.

Today, modern psychologists take the principles from existential psychology and pair them with eastern practices, such as mindfulness, in administering therapy (Wong, 2016). Existential psychology has also been paired with positive psychology, as popular existential literature tends to focus on the more negative—dark—side of the human condition.

Existential psychotherapy stands upon the belief that all of mankind experiences intrapsychic conflict on an individual level as a result of interacting with what are referred to as “givens” (May et al., 1958).

These constructs are inherent conditions that go along with the human experience. There are 4 primary givens that are key to existential therapy. These include the freedom of choice, and the responsibilities that go along with it, isolation, the inevitability of death, and meaninglessness.

According to existential theory as it applies to the human psyche, once a person is confronted with any “given” there is an anxiety that occurs, and is referred to as existential anxiety (May et al., 1958).

This can be summed up as a feeling of dread associated with the “given” one is faced with. Existential anxiety is believed to attribute to long-term consequences to a person’s spiritual, psychological, physical, and social awareness. An example of this would be a deep anxiety a person carries around due to the knowledge that each one of his/her loved ones will die at a time that is unknown.

This could cause a person to check out from such a reality. This could lead to age-denying thoughts, or even greater: an age-denying society altogether. Denying the reality of death could cause a person to take larger risks, or to negate making decisions that will enrich life, rather than add to the underlying anxiety.

One the other side of the spectrum, there may also be those who focus on the inevitability of death to excess; causing them psychological distress such as psychosis, or neuroses.


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The Process of an Existential Therapist

The goal of existential therapy is to help a person find balance between the two extremes of the spectrum surrounding the reality of inevitable death (May et al., 1958).

Research has found that those who are able to find balance are able to also find the motivation to make choices that impact their lives, and the lives of their loved ones, in positive ways. A balanced stance toward death allows a person to make decisions aimed at making the most out of life.  Isolation and meaninglessness are also believed to be sources of existential anxiety.

These realities create an internal conflict, which causes decisions to be made that can affect a person’s present and future life circumstances. The way in which an individual is able to cope with these dilemmas is key in determining their overall success in life.

While there are a great many benefits entailed in engaging in existential psychotherapy, it has been criticized a bit for some aspects of it as well. There are two major cons that have been identified by practitioners in the field of psychology as it pertains to existential psychotherapy, as well as to pros that have been identified as highly beneficial aspects of this modality (Admin, 2017).


Advantages of Existential Therapy

Identify the meaning of life

A major goal of existential psychotherapy is to help a client find meaning in life. This form of therapy focuses on key existential questions that we face in life.

Clients are asked to ponder their existence, and ask why they exist and why they suffer. In doing such exercises, a client is empowered by taking control of their own lives and destinies, through finding purpose and meaning. They are able to own their actions—learning and growing from their decisions.

It is client-centered

This prompts therapists to treat clients with unconditional positive regard, free from judgment.

The therapist also accepts the client’s ability to make his/her own decisions and choices in life.

This is humanistic in nature, and helps promote positive self-worth and dignity. This form of therapy is non-directive, and there are no broad interpretations or analysis that takes place, as the therapist helps the client to come to such conclusions on their own in ways that are meaningful.

The therapist stays mindful and present with the client in sessions in an effort to understand the client’s moment-by-moment reality. Such methods for therapy are integral components for modern-day psychotherapy across multiple theoretical orientations.


Disadvantages of Existential Therapy


It has been criticized that existential therapy can be excessively intellectual, and that for some clients in therapy, it is to deep of a self-reflection or self-examination for them to relate to. Some clients prefer, and work better with a more direct approach that is more time effective.

Religious conflict

Some interpret existentialism as atheistic, or believe that it ostracizes those with religious faith.

Some questions that existential therapy as (such as why we exist) may conflict with a person’s religious faith, and others will have no troubles at all in relating such questions and theories within their own spiritual or religious belief systems. It truly depends upon the client.

Many argue that spiritual belief systems and religion are integral in answering the questions that existential psychotherapy presents.


Conclusion About Existential Psychotherapy

While there are definite benefits to using existential psychotherapy, there are a few limitations to this form of psychotherapy. This approach is highly beneficial in helping clients to own their choices and find meaning in life.

It also gives them the empowerment of knowing they are experiencing life on their own terms, and that they have a choice whether or not to participate. This has helped save many lives. While existential psychotherapy does not hold the cure for all types of mental disorders, it can certainly help heal all kinds of mental disorders when paired with other forms of therapy and medication.

Do you have an experience with existential psychotherapy that you would like to share with us? Would you like to learn more or try out an existential therapy session. Leave your comments below or reach out to us and we would be happy to help.


Positive Existential Therapy

The Future of Existential therapy

Psychotherapist Hussam (Sam) Nabil has developed a new psychological wellbeing approach. Known as Positive Existential Therapy (PET), Nabil combines the traditional method of existential therapy with positive psychology. The new approach was registered at the United States Patent and Trademark Office (USPTO), which is the federal agency responsible for granting US patents and registering trademarks.

Positive Existential Therapy is a flexible approach that caters to patients' needs by building a human relationship between the therapist and the patient, which, studies have shown, accounts for 70% of progress in psychological treatment.


Sam Nabil is the founder of Naya Clinics and is a Boston therapist and a Boston Marriage Counselor.

Sam offers therapy in Boston and Boston Marriage Counseling for adults suffering from relationship challenges, life transitions and anxiety.

Sam was featured in many prestigious publications. Check out his interview with Aljazeera English


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