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Existential therapy is a form of
psychotherapy Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of Psychology, psychological methods, particularly when based on regular Conversation, personal interaction, to help a person change behavior, increase hap ...
based on the model of human nature and experience developed by the existential tradition of European philosophy. It focuses on the psychological experience revolving around universal human truths of existence such as
death Death is the end of life; the irreversible cessation of all biological functions that sustain a living organism. Death eventually and inevitably occurs in all organisms. The remains of a former organism normally begin to decompose sh ...
,
freedom Freedom is the power or right to speak, act, and change as one wants without hindrance or restraint. Freedom is often associated with liberty and autonomy in the sense of "giving oneself one's own laws". In one definition, something is "free" i ...
, isolation and the search for the
meaning of life The meaning of life is the concept of an individual's life, or existence in general, having an intrinsic value (ethics), inherent significance or a Meaning (philosophy), philosophical point. There is no consensus on the specifics of such a conce ...
. Existential therapists largely reject the
medical model Medicine is the science and practice of caring for patients, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pract ...
of mental illness that views mental health symptoms as the result of biological causes. Rather, symptoms such as
anxiety Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
, alienation and depression arise because of attempts to deny or avoid the givens of existence, often resulting in an
existential crisis Existential crises are inner conflicts characterized by the impression that life lacks meaning and confusion about one's personal identity. They are accompanied by anxiety and stress, often to such a degree that they disturb one's normal funct ...
. For example, existential therapists highlight the fact that since we have the freedom to choose, there will always be uncertainty - and therefore, there will always be a level of existential anxiety present in our lives. Existential therapists also draw heavily from the methods of
phenomenology Phenomenology may refer to: Art * Phenomenology (architecture), based on the experience of building materials and their sensory properties Philosophy * Phenomenology (Peirce), a branch of philosophy according to Charles Sanders Peirce (1839� ...
, a philosophical approach developed by
Edmund Husserl Edmund Gustav Albrecht Husserl (; 8 April 1859 – 27 April 1938) was an Austrian-German philosopher and mathematician who established the school of Phenomenology (philosophy), phenomenology. In his early work, he elaborated critiques of histori ...
and later expanded on by
Martin Heidegger Martin Heidegger (; 26 September 1889 – 26 May 1976) was a German philosopher known for contributions to Phenomenology (philosophy), phenomenology, hermeneutics, and existentialism. His work covers a range of topics including metaphysics, art ...
that concentrates on the study of
consciousness Consciousness, at its simplest, is awareness of a state or object, either internal to oneself or in one's external environment. However, its nature has led to millennia of analyses, explanations, and debate among philosophers, scientists, an ...
and the objects of direct experience. When working with clients, existential therapists focus on the client's lived experience of their subjective reality. While other types of therapies like Freudian
psychoanalysis PsychoanalysisFrom Greek language, Greek: and is a set of theories and techniques of research to discover unconscious mind, unconscious processes and their influence on conscious mind, conscious thought, emotion and behaviour. Based on The Inte ...
are aimed at analyzing and interpreting the client's experience, existential therapists are encouraged to "
bracket A bracket is either of two tall fore- or back-facing punctuation marks commonly used to isolate a segment of text or data from its surroundings. They come in four main pairs of shapes, as given in the box to the right, which also gives their n ...
", or set aside, their preconceived notions and biases in order to identify the core aspects of the client's experience. In existential therapy, clients gain self-awareness into their own existence, confront existential concerns, and are encouraged to use their freedom to choose a path towards a more authentic and meaningful life.


Background

The philosophers who are especially pertinent to the development of existential psychotherapy are those whose works were directly aimed at making sense of human existence. For example, the fields of
phenomenology Phenomenology may refer to: Art * Phenomenology (architecture), based on the experience of building materials and their sensory properties Philosophy * Phenomenology (Peirce), a branch of philosophy according to Charles Sanders Peirce (1839� ...
and existential philosophy are especially and directly responsible for the generation of existential therapy. The starting point of existential philosophy (see Warnock 1970; Macquarrie 1972; Mace 1999; van Deurzen and Kenward 2005) can be traced back to the nineteenth century and the works of
Søren Kierkegaard Søren Aabye Kierkegaard ( , ; ; 5 May 1813 – 11 November 1855) was a Danes, Danish theologian, philosopher, poet, social critic, and religious author who is widely considered to be the first existentialist philosopher. He wrote critical tex ...
and
Friedrich Nietzsche Friedrich Wilhelm Nietzsche (15 October 1844 – 25 August 1900) was a German philosopher. He began his career as a classical philology, classical philologist, turning to philosophy early in his academic career. In 1869, aged 24, Nietzsche bec ...
. Their works conflicted with the predominant ideologies of their time and committed to the exploration of reality as it can be experienced in a passionate and personal manner.


Søren Kierkegaard (1813–1855)

Soren Kierkegaard (1813–1855) protested vehemently against popular misunderstanding and abuse of Christian
dogma Dogma, in its broadest sense, is any belief held definitively and without the possibility of reform. It may be in the form of an official system of principles or doctrines of a religion, such as Judaism, Roman Catholicism, Protestantism, or Islam ...
and the so-called 'objectivity' of science (Kierkegaard, 1841, 1844). He thought that both were ways of avoiding the
anxiety Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
inherent in human existence. He had great contempt for the way life was lived by those around him and believed truth could only be discovered subjectively by the individual in action. He felt people lacked the courage to take a
leap of faith In philosophy, a leap of faith is the act of belief, believing in or accepting something not on the basis of reason. The phrase is commonly associated with Danish philosopher Søren Kierkegaard. Idiomatic usage As an idiom, ''leap of faith'' ca ...
and live with passion and commitment from the inward depth of existence. This involved a constant struggle between the finite and infinite aspects of our nature as part of the difficult task of creating a self and finding meaning. As Kierkegaard lived by his word, he was lonely and much ridiculed during his lifetime.


Friedrich Nietzsche (1844–1900)

Friedrich Nietzsche Friedrich Wilhelm Nietzsche (15 October 1844 – 25 August 1900) was a German philosopher. He began his career as a classical philology, classical philologist, turning to philosophy early in his academic career. In 1869, aged 24, Nietzsche bec ...
(1844–1900) took this philosophy of life a step further. His starting point was the notion that God is dead, that is, the idea of God was outmoded and limiting (Nietzsche, 1861, 1874, 1886). Furthermore, the Enlightenment—with the newfound faith in reason and rationality—had killed or replaced God with a new Truth that was perhaps more pernicious than the one it replaced. Science and rationality were the new "God," but instead took the form of a deity that was colder and less comforting than before. Nietzsche exerted a significant impact upon the development of
psychology Psychology is the scientific study of mind and behavior. Its subject matter includes the behavior of humans and nonhumans, both consciousness, conscious and Unconscious mind, unconscious phenomena, and mental processes such as thoughts, feel ...
in general, but he specifically influenced an approach which emphasized an understanding of life from a personal perspective. In exploring the various needs of the individual about the
ontological Ontology is the philosophical study of being. It is traditionally understood as the subdiscipline of metaphysics focused on the most general features of reality. As one of the most fundamental concepts, being encompasses all of reality and every ...
conditions of being, Nietzsche asserted that all things are in a state of "ontological privation," in which they long to become more than they are. This state of deprivation has major implications for the physiological and psychological needs of the individual.


Edmund Husserl (1859–1938)

While Kierkegaard and Nietzsche drew attention to the human issues that needed to be addressed,
Edmund Husserl Edmund Gustav Albrecht Husserl (; 8 April 1859 – 27 April 1938) was an Austrian-German philosopher and mathematician who established the school of Phenomenology (philosophy), phenomenology. In his early work, he elaborated critiques of histori ...
's phenomenology (Husserl, 1960, 1962; Moran, 2000) provided the method to address them rigorously. He contended that natural sciences assume the separateness of subject and object and that this kind of
dualism Dualism most commonly refers to: * Mind–body dualism, a philosophical view which holds that mental phenomena are, at least in certain respects, not physical phenomena, or that the mind and the body are distinct and separable from one another * P ...
can only lead to error. He proposed a whole new mode of investigation and understanding of the world and our experience of it. He said that prejudice has to be put aside or 'bracketed,' for us to meet the world afresh and discover what is absolutely fundamental, and only directly available to us through
intuition Intuition is the ability to acquire knowledge without recourse to conscious reasoning or needing an explanation. Different fields use the word "intuition" in very different ways, including but not limited to: direct access to unconscious knowledg ...
. If people want to grasp the essence of things, instead of explaining and analyzing them, they have to learn to describe and understand them.


Max Scheler (1874-1928)

Max Scheler Max Ferdinand Scheler (; 22 August 1874 – 19 May 1928) was a German philosopher known for his work in phenomenology, ethics, and philosophical anthropology. Considered in his lifetime one of the most prominent German philosophers,Davis, Zacha ...
(1874-1928) developed philosophical
anthropology Anthropology is the scientific study of humanity, concerned with human behavior, human biology, cultures, society, societies, and linguistics, in both the present and past, including archaic humans. Social anthropology studies patterns of behav ...
from a material ethic of values ("Materielle Wertethik") that opposed Immanuel Kant's ethics of duty ("Pflichtethik"). He described a hierarchical system of values that further developed phenomenological philosophy. Scheler described the human psyche as being composed of four layers analogous to the layers of organic nature. However, in his description, the human psyche is opposed by the principle of the human spirit. Scheler's philosophy forms the basis of Viktor Frankl's
logotherapy Logotherapy is a form of existential therapy developed by neurologist and psychiatrist Viktor Frankl. It is founded on the premise that the primary motivational force of individuals is to find meaning in life. Frankl describes it as "the Third V ...
and existential analysis.


Martin Heidegger (1889–1976)

Martin Heidegger Martin Heidegger (; 26 September 1889 – 26 May 1976) was a German philosopher known for contributions to Phenomenology (philosophy), phenomenology, hermeneutics, and existentialism. His work covers a range of topics including metaphysics, art ...
(1889–1976) applied the phenomenological method to understanding the meaning of being (Heidegger, 1962, 1968). He argued that poetry and deep philosophical thinking could bring greater insight into what it means to be in the world than what can be achieved through scientific knowledge. He explored human beings in the world in a manner that revolutionized classical ideas about the self and psychology. He recognized the importance of time, space,
death Death is the end of life; the irreversible cessation of all biological functions that sustain a living organism. Death eventually and inevitably occurs in all organisms. The remains of a former organism normally begin to decompose sh ...
, and human relatedness. He also favored
hermeneutics Hermeneutics () is the theory and methodology of interpretation, especially the interpretation of biblical texts, wisdom literature, and philosophical texts. As necessary, hermeneutics may include the art of understanding and communication. ...
, an old philosophical method of investigation, which is the art of interpretation. Unlike interpretation as practiced in
psychoanalysis PsychoanalysisFrom Greek language, Greek: and is a set of theories and techniques of research to discover unconscious mind, unconscious processes and their influence on conscious mind, conscious thought, emotion and behaviour. Based on The Inte ...
(which consists of referring a person's experience to a pre-established theoretical framework), this kind of interpretation seeks to understand how the person himself/herself subjectively experiences something.


Jean-Paul Sartre (1905–1980)

Jean-Paul Sartre Jean-Paul Charles Aymard Sartre (, ; ; 21 June 1905 – 15 April 1980) was a French philosopher, playwright, novelist, screenwriter, political activist, biographer, and literary criticism, literary critic, considered a leading figure in 20th ...
(1905–1980) contributed many other strands of existential exploration, particularly regarding emotions, imagination, and the person's insertion into a social and political world. The philosophy of existence, on the contrary, is carried by a wide-ranging literature, which includes many authors, such as
Karl Jaspers Karl Theodor Jaspers (; ; 23 February 1883 – 26 February 1969) was a German-Swiss psychiatrist and philosopher who had a strong influence on modern theology, psychiatry, and philosophy. His 1913 work ''General Psychopathology'' influenced many ...
(1951, 1963),
Paul Tillich Paul Johannes Tillich (; ; August 20, 1886 – October 22, 1965) was a German and American Christian existentialist philosopher, religious socialist, and Lutheran theologian who was one of the most influential theologians of the twenti ...
,
Martin Buber Martin Buber (; , ; ; 8 February 1878 – 13 June 1965) was an Austrian-Israeli philosopher best known for his philosophy of dialogue, a form of existentialism centered on the distinction between the I and Thou, I–Thou relationship and the I� ...
, and
Hans-Georg Gadamer Hans-Georg Gadamer (; ; 11 February 1900 – 13 March 2002) was a German philosopher of the continental tradition, best known for his 1960 on hermeneutics, '' Truth and Method'' (''Wahrheit und Methode''). Life Family and early life Gad ...
within the Germanic tradition and
Albert Camus Albert Camus ( ; ; 7 November 1913 – 4 January 1960) was a French philosopher, author, dramatist, journalist, world federalist, and political activist. He was the recipient of the 1957 Nobel Prize in Literature at the age of 44, the s ...
,
Gabriel Marcel Gabriel Honoré Marcel (7 December 1889 – 8 October 1973) was a French philosopher, playwright, music critic and leading Christian existentialist. The author of over a dozen books and at least thirty plays, Marcel's work focused on the moder ...
, Paul Ricoeur,
Maurice Merleau-Ponty Maurice Jean Jacques Merleau-Ponty. ( ; ; 14 March 1908 – 3 May 1961) was a French phenomenological philosopher, strongly influenced by Edmund Husserl and Martin Heidegger. The constitution of meaning in human experience was his main interes ...
,
Simone de Beauvoir Simone Lucie Ernestine Marie Bertrand de Beauvoir (, ; ; 9 January 1908 – 14 April 1986) was a French existentialist philosopher, writer, social theorist, and feminist activist. Though she did not consider herself a philosopher, nor was she ...
and
Emmanuel Lévinas Emmanuel Levinas (born Emanuelis Levinas ; ; 12 January 1906 – 25 December 1995) was a French philosopher of Lithuanian Jewish ancestry who is known for his work within Jewish philosophy, existentialism, and phenomenology, focusing on the rel ...
within the French tradition (see for instance Spiegelberg, 1972, Kearney, 1986 or van Deurzen-Smith, 1997).


Existentialism and Therapy

Throughout the 20th century, psychotherapists began incorporating both the themes of
existentialism Existentialism is a family of philosophical views and inquiry that explore the human individual's struggle to lead an authentic life despite the apparent absurdity or incomprehensibility of existence. In examining meaning, purpose, and valu ...
as well as the phenomenological methods of describing experience into their therapeutic practice:
Otto Rank Otto Rank (; ; né Rosenfeld; 22 April 1884 – 31 October 1939) was an Austrian psychoanalyst, writer, and philosopher. Born in Vienna, he was one of Sigmund Freud's closest colleagues for 20 years, a prolific writer on psychoanalytic themes, ...
(1884–1939) was an Austrian psychoanalyst who broke with Freud in the mid-1920s. He did not consider himself an existential therapist, but his ideas revolving the concept of "will" as a factor in human motivation, as well as the fear of death and the fear of living authentically would pave the foundation for later writers. Throughout the 1930's and 40's, the Swiss psychiatrists
Ludwig Binswanger Ludwig Binswanger (; ; 13 April 1881 – 5 February 1966) was a Swiss people, Swiss psychiatrist and pioneer in the field of existential psychology. His parents were Robert Johann Binswanger (1850–1910) and Bertha Hasenclever (1847–1896). ...
and Medard Boss each developed a form of psychotherapy known as Daseinsanalysis. Daseinsanalysis merges Freudian psychoanalysis with the
existential phenomenology Existential phenomenology encompasses a wide range of thinkers who take up the view that philosophy must begin from experience like phenomenology, but argues for the temporality of personal existence as the framework for analysis of the human condi ...
of Martin Heidegger, particularly his concept of Dasein ("being"). It focuses on understanding the client's experience of Being-in-the-world, rather than diagnosing symptoms. Much of Binswanger's work was translated into English during the 1940s and 1950s and, together with the immigration to the USA of
Paul Tillich Paul Johannes Tillich (; ; August 20, 1886 – October 22, 1965) was a German and American Christian existentialist philosopher, religious socialist, and Lutheran theologian who was one of the most influential theologians of the twenti ...
(1886–1965) (Tillich, 1952) and others, this had a considerable effect on the popularization of existential ideas as a basis for therapy (Valle and King, 1978; Cooper, 2003). Rollo May (1909–1994) played an important role in this, and is considered by many to be the "father" of existential therapy. His writings in the 1950's and 60's (1969, 1983; May et al., 1958) became the foundation of ''existential-humanistic therapy'' that would flourish in America (Bugental, 1981; May and Yalom, 1985; Yalom, 1980). May also worked closely with
Carl Rogers Carl Ransom Rogers (January 8, 1902 – February 4, 1987) was an American psychologist who was one of the founders of humanistic psychology and was known especially for his person-centered psychotherapy. Rogers is widely considered one of the f ...
and
Abraham Maslow Abraham Harold Maslow ( ; April 1, 1908 – June 8, 1970) was an American psychologist who created Maslow's hierarchy of needs, a theory of psychological health predicated on fulfilling innate human needs in priority, culminating in self-actua ...
, founders of the
humanistic psychology Humanistic psychology is a psychological perspective that arose in the mid-20th century in answer to two theories: Sigmund Freud's psychoanalytic theory and B. F. Skinner's behaviorism. Thus, Abraham Maslow established the need for a "third force" ...
movement. As such, existential therapy in America became closely associated with humanistic psychology and the principles of Rogers'
person-centered therapy Person-centered therapy (PCT), also known as person-centered psychotherapy, person-centered counseling, client-centered therapy and Rogerian psychotherapy, is a humanistic approach psychotherapy developed by psychologist Carl Rogers and collea ...
, particularly regarding how the therapist and client should interact.
Viktor Frankl Viktor Emil Frankl (; 26 March 1905 – 2 September 1997) was an Austrian neurologist, psychologist, philosopher, and The Holocaust, Holocaust survivor, who founded logotherapy, a school of psychotherapy that describes a search for a life's mean ...
(1905–1997) was possibly the individual most responsible for spreading existential psychology throughout the world. His 1959 book
Man's Search for Meaning ''Man's Search for Meaning'' () is a 1946 book by Viktor Frankl chronicling his experiences as a prisoner in Nazi concentration camps during World War II, and describing his psychotherapeutic method, which involved identifying a purpose to eac ...
created a unique branch of existential therapy known as
Logotherapy Logotherapy is a form of existential therapy developed by neurologist and psychiatrist Viktor Frankl. It is founded on the premise that the primary motivational force of individuals is to find meaning in life. Frankl describes it as "the Third V ...
. Logotherapy is premised on the idea that the primary motivation of individuals is to find meaning in life. He was invited by over 200 universities worldwide and accomplished over 80 journeys to North America alone, first invited by
Gordon Allport Gordon William Allport (November 11, 1897 – October 9, 1967) was an American psychologist. Allport was one of the first psychologists to focus on the study of the personality, and is often referred to as one of the founding figures of personali ...
at Harvard University. In 1980, Irvin D. Yalom published '
Existential Psychotherapy Existential therapy is a form of psychotherapy based on the model of human nature and experience developed by the Existentialism, existential tradition of European philosophy. It focuses on the psychological experience revolving around universal h ...
'. This book was the first to provide a comprehensive overview of existential therapy. In it, Yalom identifies four existential concerns, or "givens", of life that underlie human experience - death, freedom, isolation, and meaninglessness. Yalom argues that the role of the therapist in existential therapy is not to provide solutions or answers, but to guide the client in exploring and confronting these challenges. Unlike other forms of therapy, Yalom does not prescribe specific techniques, rather, Yalom suggests existential therapy should be a personalized collaboration between therapist and client, tailored to each clients’ unique existential concerns.


Development


Development in Europe

The European School of existential analysis is dominated by two forms of therapy:
Logotherapy Logotherapy is a form of existential therapy developed by neurologist and psychiatrist Viktor Frankl. It is founded on the premise that the primary motivational force of individuals is to find meaning in life. Frankl describes it as "the Third V ...
, and Daseinsanalysis. Logotherapy was developed by psychiatrist Viktor E. Frankl. Frankl was heavily influenced by existential philosophy, as well as his own experience in the Nazi concentration camps of World War II. The three main components to Logotherapy are Freedom of Will, which is the ability to change one's life to the degree that such change is possible, Will to Meaning, which places meaning at the center of well-being, and Meaning in Life, which asserts the objectivity of meaning. The primary techniques of Logotherapy involve helping the clients to identify and remove any barriers to the pursuit of meaning in their own lives, to determine what is personally meaningful, and to then help patients effectively pursue related goals. Daseinsanalysis is a psychotherapeutic system developed upon the ideas of
Martin Heidegger Martin Heidegger (; 26 September 1889 – 26 May 1976) was a German philosopher known for contributions to Phenomenology (philosophy), phenomenology, hermeneutics, and existentialism. His work covers a range of topics including metaphysics, art ...
, as well as the psychoanalytic theories of
Sigmund Freud Sigmund Freud ( ; ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating psychopathology, pathologies seen as originating fro ...
, that seeks to help the individual find autonomy and meaning in their "being in the world" (a rough translation of "Dasein").


Development in Britain

Britain became a fertile ground for further development of the existential approach when R. D. Laing and David Cooper, often associated with the
anti-psychiatry Anti-psychiatry, sometimes spelled antipsychiatry, is a movement based on the view that psychiatric treatment can often be more damaging than helpful to patients. The term anti-psychiatry was coined in 1912, and the movement emerged in the 1960s, ...
movement, took Sartre's existential ideas as the basis for their work (Laing, 1960, 1961; Cooper, 1967; Laing and Cooper, 1964). Without developing a concrete method of therapy, they critically reconsidered the notion of mental illness and its treatment. In the late 1960s, they established an experimental therapeutic community at Kingsley Hall in the East End of London, where people could come to live through their 'madness' without the usual medical treatment. They also founded the Philadelphia Association, an organization providing an alternative living, therapy, and therapeutic training from this perspective. The Philadelphia Association is still in existence today and is now committed to the exploration of the works of philosophers such as
Ludwig Wittgenstein Ludwig Josef Johann Wittgenstein ( ; ; 26 April 1889 – 29 April 1951) was an Austrian philosopher who worked primarily in logic, the philosophy of mathematics, the philosophy of mind, and the philosophy of language. From 1929 to 1947, Witt ...
,
Jacques Derrida Jacques Derrida (; ; born Jackie Élie Derrida;Peeters (2013), pp. 12–13. See also 15 July 1930 – 9 October 2004) was a French Algerian philosopher. He developed the philosophy of deconstruction, which he utilized in a number of his texts, ...
, Levinas, and
Michel Foucault Paul-Michel Foucault ( , ; ; 15 October 192625 June 1984) was a French History of ideas, historian of ideas and Philosophy, philosopher who was also an author, Literary criticism, literary critic, Activism, political activist, and teacher. Fo ...
as well as the work of the French psychoanalyst
Jacques Lacan Jacques Marie Émile Lacan (, ; ; 13 April 1901 – 9 September 1981) was a French psychoanalyst and psychiatrist. Described as "the most controversial psycho-analyst since Sigmund Freud, Freud", Lacan gave The Seminars of Jacques Lacan, year ...
. It also runs some small therapeutic households along these lines. The Arbours Association is another group that grew out of the Kingsley Hall experiment. Founded by Joseph Berke and Schatzman in the 1970s, it now runs a training program in psychotherapy, a crisis center, and several therapeutic communities. The existential input in the Arbours has gradually been replaced with a more neo-Kleinian emphasis. The impetus for further development of the existential approach in Britain has primarily come from the development of some existentially based courses in academic institutions. This started with the programs created by Emmy van Deurzen, initially at
Antioch University Antioch University is a private university with multiple campuses in the United States and online programs. It is the continuation of Antioch College, which was founded in 1852. Antioch College's first president was politician, abolitionist, and ...
in London and subsequently at Regent's College, London and since then at the New School of Psychotherapy and Counseling, also located in London. The latter is a purely existentially based training institute, which offers postgraduate degrees validated by the
University of Sheffield The University of Sheffield (informally Sheffield University or TUOS) is a public university, public research university in Sheffield, South Yorkshire, England. Its history traces back to the foundation of Sheffield Medical School in 1828, Fir ...
and
Middlesex University Middlesex University London (legally Middlesex University and abbreviated to MDX) is a public research university based in Hendon, northwest London, England. The university also has campuses in Dubai and Mauritius. The name of the university is ...
. In the past few decades, the existential approach has spread rapidly and has become a welcome alternative to established methods. There are now many other, mostly academic, centers in Britain that provide training in existential counseling and psychotherapy and a rapidly growing interest in the approach in the voluntary sector and the
National Health Service The National Health Service (NHS) is the term for the publicly funded health care, publicly funded healthcare systems of the United Kingdom: the National Health Service (England), NHS Scotland, NHS Wales, and Health and Social Care (Northern ...
. British publications dealing with existential therapy include contributions by these authors: Jenner (de Koning and Jenner, 1982), Heaton (1988, 1994), Cohn (1994, 1997), Spinelli (1997), Cooper (1989, 2002), Eleftheriadou (1994), Lemma-Wright (1994), Du Plock (1997), Strasser and Strasser (1997), van Deurzen (1997, 1998, 2002), van Deurzen and Arnold-Baker (2005), and van Deurzen and Kenward (2005). Other writers such as Lomas (1981) and Smail (1978, 1987, 1993) have published work relevant to the approach, although not explicitly 'existential' in orientation. The journal of the British Society for Phenomenology regularly publishes work on existential and phenomenological psychotherapy. The Society for Existential Analysis was founded in 1988, initiated by van Deurzen. This society brings together psychotherapists, psychologists, psychiatrists, counselors, and philosophers working from an existential perspective. It offers regular fora for discussion and debate as well as significant annual conferences. It publishes the ''Journal of the Society for Existential Analysis'' twice a year. It is also a member of the International Federation of Daseinsanalysis, which stimulates international exchange between representatives of the approach from around the world. An International Society for Existential Therapists also exists. It was founded in 2006 by Emmy van Deurzen and Digby Tantam and is called the International Community of Existential Counsellors and Therapists (ICECAP).


Development in Canada

New developments in existential therapy in the last 20 years include existential positive psychology and meaning therapy. Different from the traditional approach to existential therapy, these new developments incorporate research findings from contemporary positive psychology. Existential positive psychology can reframe the traditional issues of existential concerns into positive psychology questions that can be subjected to empirical research. It also focuses on personal growth and transformation as much as on existential anxiety. Later, existential positive psychology was incorporated into the second wave of positive psychology. Meaning therapy (MT) is an extension of Frankl's logotherapy and America's humanistic-existential tradition; it is also pluralistic because it incorporates elements of
cognitive-behavioral therapy Cognitive behavioral therapy (CBT) is a form of psychotherapy that aims to reduce symptoms of various mental health conditions, primarily depression, PTSD, and anxiety disorders. Cognitive behavioral therapy focuses on challenging and chang ...
, narrative therapy, and positive psychotherapy, with meaning as its central organizing construct. MT not only appeals to people's natural desires for happiness and significance but also makes skillful use of their innate capacity for meaning-seeking and meaning-making. MT strikes a balance between a person-centered approach and a psycho-educational approach. At the outset of therapy, clients are informed of the use of meaning-centered interventions appropriate for their predicaments because of the empirical evidence for the vital role of meaning in healing and thriving. MT is a comprehensive and pluralistic way to address all aspects of clients' existential concerns. Clients can benefit from MT in two ways: (1) a custom-tailored treatment to solve their presenting problems, and (2) a collaborative journey to create a preferred better future.


Themes

Existential themes are issues that are considered central to human existence or the human experience. As such, they are broad and are often difficult to describe. The most common framework is given by Irvin Yalom, who divides existental issues into four core themes: Death. The fact that humans are aware of their own inevitable death - and uncertain about what happens after - can cause considerable distress. Some people go to great lengths to deny or avoid thinking about death, while others may succumb to despair or hopelessness. Existential therapy aims to help clients embrace life more fully by recognizing the finite nature of their existence. Freedom and responsibility. Alongside
humanistic psychology Humanistic psychology is a psychological perspective that arose in the mid-20th century in answer to two theories: Sigmund Freud's psychoanalytic theory and B. F. Skinner's behaviorism. Thus, Abraham Maslow established the need for a "third force" ...
, existential therapy places a great deal of importance on the concept of
free will Free will is generally understood as the capacity or ability of people to (a) choice, choose between different possible courses of Action (philosophy), action, (b) exercise control over their actions in a way that is necessary for moral respon ...
. Humans have the freedom to make choices and create their own meaning in life. To be free means to be responsible for one’s life and to be the author of one’s own destiny. However, this freedom carries with it a tremendous amount of responsibility. Experiencing ''existential guilt'' over the choices we have made and the possibilities of what could have been is a natural part of life. If overwhelmed by the responsibility to choose, people may defer to external authorities and societal norms to make decisions for them. Existential therapy encourages clients to recognize their freedom and live more authentic lives by taking responsibility for their actions, choices, and direction in life. Isolation. Yalom describes existential isolation as "An unbridgeable gap between oneself and any other being. It refers, too, to an isolation even more fundamental—a separation between the individual and the world." This represents the tension between the fact that humans are inherently social creatures, and long to be connected to others - Yet at the same time no one can fully share or take on another’s subjective experience, pain, or death. People may attempt to avoid these feelings of isolation through becoming dependent on others or conforming to social norms. Existential therapy helps clients confront their aloneness by building authentic relationships, where connections with others are based on mutual respect rather than an avoidance of isolation. Meaning and meaninglessness. Humans seek out meaning - the question of "What is the meaning of life?" is one of the most central questions to philosophy. Existential philosophers argue that there is no "inherent," fundamental meaning in the world. Rather, the task falls on the individual for *discovering* or *creating* their own meaning in life. This realization can be incredibly distressing to people. In existential therapy, clients learn to create personal meaning through their actions, values, and relationships rather than relying on external, fixed sources of meaning. Viktor Frankl's
logotherapy Logotherapy is a form of existential therapy developed by neurologist and psychiatrist Viktor Frankl. It is founded on the premise that the primary motivational force of individuals is to find meaning in life. Frankl describes it as "the Third V ...
specifically focuses on how a lack of meaning in life can lead to severe mental distress. In addition to these four themes, a central concept that underlies existential therapy is existential anxiety, more colloquially known as an
existential crisis Existential crises are inner conflicts characterized by the impression that life lacks meaning and confusion about one's personal identity. They are accompanied by anxiety and stress, often to such a degree that they disturb one's normal funct ...
. When people become aware of these existential themes, they feel anxiety, guilt, or other forms of distress. Unlike Freudian or medical models of mental illness that strictly view anxiety as a "symptom" that must be "cured", existential therapy stresses that existential anxiety is an inevitable part of life. Under this framework, anxiety is not seen as something to be eliminated but as a natural and even necessary part of life, and that working through these anxieties can provide a powerful source of personal growth and transformation. To this end, one of the central goals of existential therapy is to help clients live with authenticity. To live with authenticity means to fully acknowledge life's existential givens without avoiding them. It also means to live a life that is in line with one's personal values. Many people live inauthentic lives by succumbing to
peer pressure Peer pressure is a direct or indirect influence on peers, i.e., members of social groups with similar interests and experiences, or social statuses. Members of a peer group are more likely to influence a person's beliefs, values, religion and beh ...
or
conformity Conformity or conformism is the act of matching attitudes, beliefs, and behaviors to social group, group norms, politics or being like-minded. Social norm, Norms are implicit, specific rules, guidance shared by a group of individuals, that guide t ...
. Existential therapists guide clients to reflect on their values, choices, and patterns of behavior to identify areas whether they may be living inauthentically. For example, a client may be stuck in an unfulfilling job that does not align with their values or stuck in an unsatisfying relationship due to their fear of loneliness. By helping clients confront existential anxiety, clarify their values, and find areas where they can exercise their freedom, therapists support them in creating a life that feels true, meaningful, and fully their own.


Psychological dysfunction

Because there is no single existential view, opinions about psychological dysfunction vary. For theorists aligned with Yalom, psychological dysfunction results from the individual's refusal or inability to deal with the normal existential anxiety that comes from confronting life's "givens": death, freedom, isolation, and meaninglessness. For other theorists, there is no such thing as psychological dysfunction or mental illness. Every way of being is merely an expression of how one chooses to live one's life. However, one may feel unable to come to terms with the anxiety of being alone in the world. If so, an existential psychotherapist can assist one in accepting these feelings rather than trying to change them as if there is something wrong. Everyone has the freedom to choose how they are going to exist in life; however, this freedom may go unpracticed. It may appear easier and safer not to make decisions that one will be responsible for. Many people will remain unaware of alternative choices in life for various societal reasons.


Personal element

Existential counsellors stress the importance of the examined life, and of preparatory work on oneself, in paving the way for effective counselling. Thus in counselling adolescents the counsellor can optimally model an autonomous life based on the making of realistic decisions, but one which also acknowledges the role of failure as well as success in everyday life, and the ongoing and inescapable presence of anxiety. The strictly Sartrean perspective of existential psychotherapy is generally unconcerned with the client's past, but instead, the emphasis is on the choices to be made in the present and future. The counselor and the client may reflect upon how the client has answered life's questions in the past, but attention ultimately shifts to searching for a new and increased awareness in the present and enabling a new freedom and responsibility to act. The patient can then accept that they are not special and that their existence is simply coincidental, or without destiny or fate. By accepting this, they can overcome their anxieties and instead view life as moments in which they are fundamentally free.


Four worlds

Existential thinkers seek to avoid restrictive models that categorize or label people. Instead, they look for the universals that can be observed cross-culturally. There is no existential personality theory which divides humanity into types or reduces people to part components. Instead, there is a description of the different levels of experience and existence with which people are inevitably confronted. The way in which a person is in the world at a particular stage can be charted on this general map of human existence (Binswanger, 1963; Yalom, 1980; van Deurzen, 1984). In line with the view taken by van Deurzen, one can distinguish four basic dimensions of human existence: the physical, the social, the psychological, and the spiritual; some only believe in the first three. On each of these dimensions, people encounter the world and shape their attitude out of their particular take on their experience. Their orientation towards the world defines their reality. The four dimensions are interwoven and provide a complex four-dimensional force field for their existence. Individuals are stretched between a positive pole of what they aspire to on each dimension and a negative pole of what they fear. Binswanger proposed the first three of these dimensions from Heidegger's description of ''Umwelt'' and ''Mitwelt'' and his further notion of ''Eigenwelt''. The fourth dimension was added by van Deurzen from Heidegger's description of a spiritual world (''Überwelt'') in Heidegger's later work.


Physical dimension

On the physical dimension (''
Umwelt An umwelt (plural: ''umwelten''; from the German wikt:Umwelt, ''Umwelt'', meaning "environment" or "surroundings") is the specific way in which organisms of a particular species perceive and experience the world, shaped by the capabilities of ...
''), individuals relate to their environment and the givens of the natural world around them. This includes their attitude to the body they have, to the concrete surroundings they find themselves in, to the climate and the weather, to objects and material possessions, to the bodies of other people, their own bodily needs, to health and illness and their mortality. The struggle on this dimension is, in general terms, between the search for domination over the elements and natural law (as in technology, or in sports) and the need to accept the limitations of natural boundaries (as in ecology or old age). While people generally aim for security on this dimension (through health and wealth), much of life brings a gradual disillusionment and realization that such security can only be temporary. Recognizing limitations can deliver a significant release of tension.


Social dimension

On the social dimension ('' Mitwelt''), individuals relate to others as they interact with the public world around them. This dimension includes their response to the culture they live in, as well as to the class and race they belong to (and also those they do not belong to). Attitudes here range from love to hate and from cooperation to competition. The dynamic contradictions can be understood concerning acceptance versus rejection or belonging versus isolation. Some people prefer to withdraw from the world of others as much as possible. Others blindly chase public acceptance by going along with the rules and fashions of the moment. Otherwise, they try to rise above these by becoming trendsetters themselves. By acquiring fame or other forms of power, individuals can attain dominance over others temporarily. Sooner or later, however, everyone is confronted with both failure and aloneness.


Psychological dimension

On the psychological dimension (''Eigenwelt''), individuals relate to themselves and in this way create a personal world. This dimension includes views about their character, their past experience and their future possibilities. Contradictions here are often experienced regarding personal strengths and weaknesses. People search for a sense of identity, a feeling of being substantial and having a self. But inevitably many events will confront them with evidence to the contrary and plunge them into a state of confusion or disintegration. Activity and passivity are an important polarity here. Self-affirmation and resolution go with the former and surrender and yielding with the latter. Facing the final dissolution of self that comes with personal loss and the facing of death might bring anxiety and confusion to many who have not yet given up their sense of self-importance.


Spiritual dimension

On the spiritual dimension (''Überwelt'') (van Deurzen, 1984), individuals relate to the unknown and thus create a sense of an ideal world, an ideology, and a philosophical outlook. It is there that they find meaning by putting all the pieces of the puzzle together for themselves. For some people, this is done by adhering to a religion or other prescriptive worldview; for others, it is about discovering or attributing meaning in a more secular or personal way. The contradictions that must be faced on this dimension are often related to the tension between purpose and absurdity, hope and despair. People create their values in search of something that matters enough to live or die for, something that may even have ultimate and universal validity. Usually, the aim is the conquest of a soul or something that will substantially surpass mortality (as in having contributed something valuable to humankind). Facing the void and the possibility of nothingness are the indispensable counterparts of this quest for the eternal.


Research support

There has not been a tremendous amount of research on existential therapy. Much of the research focuses on people receiving therapy who also have medical concerns such as cancer. Despite this, some studies have indicated positive efficacy for existential therapies with certain populations. Overall, however, more research is needed before definitive scientific claims can be made. In the debate on evidence-based research in counselling, existential counsellors tend to stress the dangers of over-simplification, and the importance of qualitative as well as quantitative measurements of outcome. While not necessarily expecting an easy resolution of the specific/non-specific factors in therapy debate, an existential counsellor will nonetheless favor evidence-based practice.M. Adams, ''A Concise Introduction to Existential Counselling'' (2013) p. 124-6


See also

*
Ludwig Binswanger Ludwig Binswanger (; ; 13 April 1881 – 5 February 1966) was a Swiss people, Swiss psychiatrist and pioneer in the field of existential psychology. His parents were Robert Johann Binswanger (1850–1910) and Bertha Hasenclever (1847–1896). ...
* Medard Boss *
Gestalt Therapy Gestalt therapy is a form of psychotherapy that emphasizes Responsibility assumption, personal responsibility and focuses on the individual's experience in the present moment, the therapist–client relationship, the environmental and social c ...
*
Existentialism Existentialism is a family of philosophical views and inquiry that explore the human individual's struggle to lead an authentic life despite the apparent absurdity or incomprehensibility of existence. In examining meaning, purpose, and valu ...
*
Viktor Frankl Viktor Emil Frankl (; 26 March 1905 – 2 September 1997) was an Austrian neurologist, psychologist, philosopher, and The Holocaust, Holocaust survivor, who founded logotherapy, a school of psychotherapy that describes a search for a life's mean ...
* Paul T. P. Wong *
Martin Heidegger Martin Heidegger (; 26 September 1889 – 26 May 1976) was a German philosopher known for contributions to Phenomenology (philosophy), phenomenology, hermeneutics, and existentialism. His work covers a range of topics including metaphysics, art ...
* Thomas Hora *
Søren Kierkegaard Søren Aabye Kierkegaard ( , ; ; 5 May 1813 – 11 November 1855) was a Danes, Danish theologian, philosopher, poet, social critic, and religious author who is widely considered to be the first existentialist philosopher. He wrote critical tex ...
* R. D. Laing * Rollo May * Clark Moustakas * Karlfried Graf Dürckheim *
Friedrich Nietzsche Friedrich Wilhelm Nietzsche (15 October 1844 – 25 August 1900) was a German philosopher. He began his career as a classical philology, classical philologist, turning to philosophy early in his academic career. In 1869, aged 24, Nietzsche bec ...
*
Otto Rank Otto Rank (; ; né Rosenfeld; 22 April 1884 – 31 October 1939) was an Austrian psychoanalyst, writer, and philosopher. Born in Vienna, he was one of Sigmund Freud's closest colleagues for 20 years, a prolific writer on psychoanalytic themes, ...
*
Jean-Paul Sartre Jean-Paul Charles Aymard Sartre (, ; ; 21 June 1905 – 15 April 1980) was a French philosopher, playwright, novelist, screenwriter, political activist, biographer, and literary criticism, literary critic, considered a leading figure in 20th ...
* Irvin D. Yalom *
Karl Jaspers Karl Theodor Jaspers (; ; 23 February 1883 – 26 February 1969) was a German-Swiss psychiatrist and philosopher who had a strong influence on modern theology, psychiatry, and philosophy. His 1913 work ''General Psychopathology'' influenced many ...
*
Martin Buber Martin Buber (; , ; ; 8 February 1878 – 13 June 1965) was an Austrian-Israeli philosopher best known for his philosophy of dialogue, a form of existentialism centered on the distinction between the I and Thou, I–Thou relationship and the I� ...
* Contextual therapy * Emmy van Deurzen * William Glasser * Metapsychiatry * Philosophical Consultancy * Jan Hendrik van den Berg * Martti Olavi Siirala * Kirk J. Schneider


References


Further reading

* * * * *Kierkegaard, Søren; ''The Concept of Dread and The Sickness Unto Death'', Princeton University Press *Längle, Alfried (1990); ''Existential Analysis Psychotherapy'', The Internat. Forum Logotherapy, Berkeley, 13, 1, 17-19. *Längle, Alfried (2003a); ''Special edition on Existential Analysis'', European Psychotherapy 4, 1 *Längle, Alfried (2003b); ''The Search for Meaning in Life and the Fundamental Existential Motivations'', Psychotherapy in Australia, 10, 1, 22-27 *Längle Silvia, Wurm CSE (2015); ''Living Your Own Life: Existential Analysis in Action'', London: Karnac * *ibid (1997) Everyday Mysteries: Existential Dimensions of Psychotherapy, London: Routledge. (2nd edition 2006) * * * van Deurzen, E. and Arnold-Baker, C., eds. (2005) ''Existential Perspectives on Human Issues: a Handbook for Practice'', London: Palgrave, Macmillan. * van Deurzen, E. and M. Adams (2016). Skills in Existential Counselling and Psychotherapy, 2nd Edition (2016). London: Sage. * * Willburg, Peter, "The Therapist as Listener: Martin Heidegger and the Missing Dimension of Counseling and Psychotherapy Trainin

*Wilkes, R and Milton, M, (2006) Being an Existential Therapist: An IPA study of existential therapists' experiences, Existential Analysis. Jan 2006 * *Milton, M., Charles, L., Judd, D., O'Brien, Tipney, A. and Turner, A . (2003) ''The Existential-Phenomenological Paradigm: The Importance for Integration, Existential Analysis'' *Judd, D. and Milton, M. (2001) Psychotherapy with Lesbian and Gay Clients: Existential-Phenomenological Contributions to Training, ''Lesbian and Gay Psychology Review'', 2(1): 16-23 *Corrie, S. and Milton, M . (2000) "The Relationship Between Existential-Phenomenological and Cognitive-Behavioural Therapies", ''European Journal of Psychotherapy, Counseling and Health''. * * * * *Milton, M (2000) "Is Existential Psychotherapy A Lesbian and Gay Affirmative Psychotherapy?" Journal of the Society for Existential Analysis, *Milton, M. and Judd, D. (1999) "The Dilemma that is Assessment", ''Journal of the Society for Existential Analysis'', 102-114. *Milton, M. (1999) "Depression and the Uncertainty of Identity: An existential-phenomenological exploration in just twelve sessions", ''Changes: An International Journal of Psychology and Psychotherapy'', *Milton, M (1997) "An Existential Approach to HIV Related Psychotherapy", ''Journal of the Society for Existential Analysis'', V8.1, 115-129 *Milton, M (1994). "The Case for Existential Therapy in HIV Related Psychotherapy", ''Counselling Psychology Quarterly'', V7 (4). 367-374 *Milton, M. (1994). "HIV Related Psychotherapy and Its Existential Concerns", ''Counselling Psychology Review'', V9 (4). 13-24 *Milton, M (1993) "Existential Thought and Client Centred Therapy", ''Counselling Psychology Quarterly'', V6 (3). 239-248 * Sanders, Marc, ''Existential Depression. How to recognize and cure life-related sadness in gifted people'', Self-Help Manual, 2013. * * *Schneider, K.J. (2009). " Kirk J. Schneider, PhD, Awakening to Awe: Personal Stories of Profound Transformation." Lanham, MD: Jason Aronson. *Schneider, K.J. and Krug, O.T. (2010). " Existential-Humanistic Therapy." Washington, DC: American Psychological Association Press. *Schneider, K.J. (2011). " Existential-Humanistic Therapies". In S.B. Messer and Alan Gurman (eds.), ''Essential Psychotherapies''. (Third ed.). New York: Guilford. *Seidner, Stanley S. (June 10, 2009
"A Trojan Horse: Logotherapeutic Transcendence and its Secular Implications for Theology"
Mater Dei Institute. pp 10–12. * Sørensen, A. D. and K. D. Keller (eds.) (2015): Psykoterapi og eksistentiel fænomenologi." Aalborg: Aalborg Universitetsforlag *Tillich, Paul (1952). ''The Courage to Be''. Yale University Press. *Wilberg, P. (2004) ''The Therapist as Listener - Martin Heidegger and the Missing Dimension of Counselling and Psychotherapy Training''


External links


Existential positive psychology

Searching for meaning
{{DEFAULTSORT:Existential Therapy Psychotherapy Psychotherapy by type