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.


Augustine


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.


Pascal


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).


Kierkegaard


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.


Nietzsche



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.