Existential Psychotherapy
From top left - bottom right : Viktor Frankl, Rollo May, Irvin Yalom, James Bugental, and Clemmont Vontress
Goal : "to help people find value, meaning, and purpose in their lives...not specifically seek to ameliorate symptoms...but to help them
become aware of what they are doing and to get them out of the victim role" (Seligman & Reichenberg, 2014, p. 185-186).
Goal : "to help people find value, meaning, and purpose in their lives...not specifically seek to ameliorate symptoms...but to help them
become aware of what they are doing and to get them out of the victim role" (Seligman & Reichenberg, 2014, p. 185-186).
Theoretical Concepts
Ultimate Concerns of the Human Condition :
Life is full of challenges and emotional development can be delayed or even blocked if people don't meet life's challenges with openness and courage.
Example : A person who just had both their parents pass away and instead of celebrating their lives, this person retreats into isolation and
self-pity.
Four ultimate concerns at the core of emotional difficulties:
1. Inevitability of death : Death will happen to everyone, including ourself and life can seem pointless when thinking about the non-
being each of us will become.
Example : What is the point of life if I'm just going to die at some point?
2. Isolation : Even when surrounded by others, we are alone. No one understands us like we do and no one can save us from the death
and loss that everyone will suffer from in his/her lifetime.
Example : A person's grandmother passes away. While at the funeral and after, this person is surrounded by people paying
their respects and offering condolences. Guests reiterate to this person that they understand what he/she is
going through and that they are there for him/her but the person still feels alone.
3. Meaninglessness : The things that happen in life are random and the only given things are birth and death. This meaninglessness can
lead to feelings of hopelessness and emptiness.
Example : What is the meaning of my life? What will my future hold?
4. Freedom and responsibility : Life is all about choices. The choices that we make will give our life purpose for the time that we are in
existence.
Examples : The choice to go to college, the choice to get married, the choice to have a baby
Existential and Neurotic Anxiety
Everyone suffers from anxiety due to ultimate concerns. However, anxiety is broken down into two categories: existential and neurotic. Existential anxiety can be defined as anxiety that runs deep and causes a feeling of unease that there is no purpose in life except for the one that we create for ourselves. This is a positive sign that people accept responsibility and are trying to make their lives meaningful. On the other hand, neurotic anxiety and existential guilt occur when we don't take responsibility and realize that we didn't become what we might have. Instead of creating a meaningful life, life has been controlled by chance and because of this, depression often results.
Examples : Existential : People who appear calm and collected but on the inside may be contemplating big questions like "What is my
purpose here? or Who am I?"
Neurotic : People who are dying and hadn't created a meaningful life were depressed and unable to accept death where the
people who had created meaningful lives were better able to accept their death.
Dasein
Dasein means being present in the world and that we are aware that we are conscious and responsible for our existence.
Ways of being:
1. Umwelt : Natural world around us
Examples : biology (broad)
living arrangements (personal)
2. Mitwelt : Relationships, interactions, and being present in the world with others; subjective
Example : Introjection of the Catholic religion or of the African American race
3. Eigenwelt : "Our own subjective world. It is our world of thoughts, feelings, and desires..." that impact how we interact with people
and live our lives.
Binswanger's Being-in-the-world: Selected papers of Ludwig Binswanger (as cited in Seligman & Reichenberg, 2014)
Example : A person's interests and values
4. Uberwelt : Spiritual or metaphysical dimension
Example : A person finding meaning by following the Catholic religion.
All four of these ways of being are essential for understanding oneself and one's experiences. People are not only a part of the world but they are also interacting with the world as the world impacts people. Unlike other living things, we are aware that our time in this world is temporary.
Concept of Mental Health
Mental health is being in balance with ourself, other people, our "environment, and our spirituality" Epp's The courage to be an existential counselor: An interview of Clemmont E. Vontress (as sited in Seligman & Reichenberg, 2014) . It exists when all four Dasein are in harmony. People are the makers of their own lives and in life, we always have choices.
Potentials of the Human Condition
Existential therapy is optimistic and strives to integrate all the dimensions of man. The human spirit has a healthy core and people need to have the courage to live life and overcome obstacles.
Awareness : People are aware of themselves and of the world around them. The more aware that someone is, the better he/she can
resolve fear and anxiety. It helps us to make wise choices by acknowledging challenges and limits.
Example : Patients with terminal illness being told rather than hiding the information so the patient can make wise choices
that will help make the rest of his/her life worthwhile.
Authenticity : Living a life that is dictated by the person and not by others. There are three features of authenticity: being aware of oneself
and his/her relationships with the world, making choices, and taking responsibility for those choices. By doing this, this
allows people to live their lives more fully and prevents inauthenticity.
Frank's Existential theory (as sited in Seligman & Reichenberg, 2014)
Example : A person deciding not to go to college and continuing working at his/her place of employment instead of letting
his/her parents dictate that he/she has to go to a certain college, major in a certain area, etc.
Freedom and responsibility : Freedom has four aspects: awareness, choice, action, and change. Because we have freedom, we have the
responsibility that goes along with it. We have choices to make and we are in charge of our lives.
Example : We have the freedom to live in an apartment but we have the responsibility that goes with that in
paying the rent and the bills on time.
Actualization : Actualization requires fulfilling the universal nature of the individual and the unique nature of the individual. This process
helps people realize their potential and leads them towards fulfillment. A couple of factors that block actualization are
repressive environment and overwhelming fear and guilt.
Example : A person who has intrinsic musical abilities may never realize or achieve his/her potential due to his/her need to
first fulfill his/her basic needs (i.e. food, water, shelter- Maslow's Hierarchy of Needs).
Making meaning : Lives have the potential to be meaningful if people use their abilities to give their lives purpose. The potentials of the
human condition help people to confront difficulties head on and the choices people make also help to give life meaning.
Examples : A person wanting to increase world peace or a person who wants to write a play
Treatment
Therapeutic Alliance : The I-to-thou relationship is the most meaningful kind of relationship. In this relationship, there is a strong bond
between the therapist and the client. The therapist helps to empower him/her. Both therapist and client are on
the journey together and therapists encourage clients to face their fears. In addition, therapists will express
their values and will be companions with their clients. This is an intense relationship that requires the therapist
to always be involved and to value the client's beliefs, even if they're different from his/her own.
Example : Client and counselor spend a sufficient amount of time getting to know each other and feel comfortable
sharing personal information, viewpoints, and values in order for empowerment and growth to occur.
Yalom's The Yalom Reader: Selections from the work of a master therapist and master storyteller (as sited
in Seligman & Reichenberg, 2014)
The Process of Treatment
There is no time frame for existential therapy. However, there are three phases to treatment. In phase one, the counselor is getting to know the client. He/she wants to know his/her background, values, beliefs, etc. During the middle phase, the client is finding meaning and purpose via the information that he/she told the therapist. In addition, the therapist is encouraging the client to be authentic and is providing different interventions for the client. Lastly, therapy will end when the client is able to be more aware and to make his/her life more meaningful. Yes, the client still has anxieties but he/she still finds fulfilling ways to live life.
Specific Intervention Strategies
Symbolic Growth Experience : This strategy explains "the relationship between experience and the discovery of meaning" (Seligman &
Reichenberg, 2014, p. 188). People are consciously trying to interpret the meaning of experiences that
lead to self worth. Symbolic Growth Experience has four steps:
1. People are educated about the concept of SGE
2. They select a salient past experience and explore its importance and symbolism in their lives
3. They are helped to understand the meaning embedded in the experience
4. They have a clearer sense of that meaning and are able to repeat their use of these strategies to grasp the
significance of other experiences
Frick's The symbolic growth experience and creation of meaning (as cited in Seligman & Reichenberg, 2014)
Example : A person has been educated on SGE and is exploring the significance of his childhood cancer
diagnosis and treatment. He's getting a great sense of meaning and it's helping him to under-
stand his fear of death. In addition, the process is helping him to deal with his emotions about
his childhood cancer, what people thought/said, and the prognosis for the future.
Frankl's Logotherapy and Paradoxical Intention
Logotherapy is another way of saying therapy through meaning. Frankl would help well-functioning people to find meaning in their lives when they were struggling to do so. He also coined the expression "the unheard cry for meaning" Frankl's The unheard cry for meaning (as cited in Seligman & Reichenberg, 2014).
He described a cycle in which fears create symptoms which in turn create fears; in order to break this cycle, he used paradoxical intention which requires the person to do what he/she fears most. By doing this, the therapist is helping the client to overcome his/her fear and increasing his/her courage.
Examples : Logotherapy - A person with a fear of heights avoids heights therefore making them even more afraid of heights.
Paradoxical Intention - "A woman was afraid to leave her house lest she faint. Frankl instructed her to go outside and try her
best not to faint. Not surprisingly, she was unable to faint" (Seligman & Reichenberg, 2014, p. 188).
Dereflection
Dereflection is a type of paradoxical intention which is based on the capacity of self-transcendence and self-detachment
Frankl's The will to meaning: Foundations and applications of logotherapy (as cited in Seligman & Reichenberg, 2014) . With dereflection, the focus is taken off the individual and put on others or on the goals they find meaningful
Graber's Viktor Frankl's logotherapy: Method of choice in ecumenical pastoral psychology (as cited in Seligman & Reichenberg, 2014) .
The goal of doing this is to redirect the individual's attention to more positive things and to reduce compulsive self-observation. This approach also works well in group settings.
Example : A couple who is in therapy for sexual dysfunction. "By focusing away from one's own performance anxiety and instead
pleasuring one's partner, the end result is less anxiety and less attention being paid to oneself"
Schulenberg, Schnetzer, Winters & Hutzell's Meaning-centered couples therapy: Logotherapy and intimate relationships (as
cited in Seligman & Reichenberg, 2014)
Addressing the four dimensions of the human condition
Responses to death, isolation, meaninglessness, and freedom:
1. Faith in our own existence in the present can ameliorate fears of death
2. Love is the authentic response to isolation
3. Drawing on our inner creativity, find ways to realize our potential, can counteract the inherent meaninglessness of life
4. Responsibility and commitment, making choices and staying with them, help us cope with our overabundance of freedom
Bauman and Waldo's Existential theory and mental health counseling: If it were a snake, it would have bitten! (as cited in Seligman & Reichenberg, 2014)