Lecture 10 existential psychotherapy

1. Introduction to Counselling
Kevin Standish

2. Learning Objectives
Understand the development of existential
therapy
To define the core concepts of existential
psychotherapy
Outline its relevance today

3. Youtube: Pink Floyd Time
http://www.youtube.com/watch?v=x6uaW
ydVf7E

4. Pink Floyd - Time
Ticking away the moments that make up the dull day
You fritter and waste the hours in an off hand way
Kicking around on a piece of ground in your home
town
Waiting for someone or something to show you the
way
Tired of lying in the sunshine staying home to watch
the rain
You are young and life is long and there is time to kill
today
And then one day you find that ten years have got
behind you… No one told you when to run, you
missed the starting gun

5. Time, part II
And you run and run to catch up with the sun, but it's sinking…
And racing around to come up behind you again
The sun is the same in a relative way, but you're older
Shorter of breath and one day closer to death
Every year is getting shorter, never seem to find the time
Plans that either come to naught or a half page of scribbled lines
Hanging on in a quiet desperation is the English way
The time is gone the song is over, thought I'd something more to
say
Home, home again I like to be here when I can
When I come home cold and tired
It's good to warm my bones beside the fire
Far away across the field
The tolling of the iron bell
Calls the faithful to their knees
To hear the softly spoken magic spells

7. History
Existential thinking has occurred throughout
history.
Exemplified by Augustine, Pascal, Kierkegaard,
Nietzsche.
Fundamental questions leading to the
development of existential psychotherapy
included:
Where was the actual immediate person to whom these
things were happening?
Are we seeing clients as they really are, or are we simply
seeing a projection of our theories about them?

8. History
In 1958 existential psychotherapy introduced to
the US with publication of Existence: A New
Dimension in Psychiatry and Psychology by Rollo
May, Ernest Angel, and Henri Ellenberger
In 1981 Yalom published the first comprehensive
textbook in existential psychiatry entitled
Existential Psychotherapy

9. History
Other Important Writings
Rollo May’s The Meaning of Anxiety (1977); Man’s
Search for Himself (1953); Existential Psychology
(1961)
James Bugental’s The Search for Existential
Identity (1976)
Victor Frankl’s Man’s Search for Meaning (1963)

10. Introduction
Existential psychotherapy is not a specific
technique or set of techniques. It is more
philosophical in nature
Existential psychotherapy is a philosophy
about human nature
Proponents of existential psychotherapy have
not advocated specific training institutes
because its presupposition can
underlie any form of therapy

11. Introduction
In existential terms, the conflicts individuals
experience are regarding the givens of
existence
From the existential perspective "deep"
conflict means the most fundamental concern
at that moment

12. Important Influences
Victor Frankl
Prisoner, Nazi Concentration Camps-1942-45-
lost entire family; Spiritual freedom & independence
of mind can be had in the worst situations;
Essence lies in searching for meaning & purpose
Rollo May
 American psychiatrist; many books on existential
therapy, integrated psychoanalysis and existential
therapy - He had two failed marriages- wrote extensively
regarding questions of intimacy, monogamy, morals of
relationships, studied with Adler
Irvin Yalom:
 Therapy through Meaning, therapeutic love themes of
existential work

13. Viktor Frankl
Viktor Frankl's approach to
existential theory is known as
logotherapy.

14. Rollo May
Rollo May has been instrumental in translating
some concepts drawn from existential
philosophy and applying them to
psychotherapy.

15. Irvin Yalom
According to Yalom, the concerns that make up the
core of existential psychodynamics are
 death.
 freedom.
 isolation.
 meaninglessness.
 http://www.youtube.com/watch?v=73wVVNrDI4I&

16. Basic Concepts
Existential psychotherapy is more
philosophical in nature
Existential psychotherapy is not a specific
technique
Focuses on issues central to human
existence

17. Basic Concepts
Existential therapy is basically an
experiential approach to therapy
 It is based on a personal relationship
between client and therapist.
 It stresses personal freedom in deciding one's
fate.
 It places primary value on self-awareness.

20. View of Human Nature
The basic dimensions of the human
condition are …
1. The capacity for self-awareness
2. The tension between freedom &
responsibility
3. The creation of an identity &
establishing meaningful relationships
4. The search for meaning, purpose,
and values of life
5. Accepting anxiety as a condition of
living
6. The awareness of death and
nonbeing

21. 1. The Capacity for Self-
Awareness
 We can reflect and make choices because we are
capable of self-awareness.
 Expanding our awareness in realizing that:
 We are finite - time is limited
 We have the potential, the choice, to act or not to act
 Meaning is not automatic - we must seek it
 We are subject to loneliness, meaninglessness,
emptiness, guilt, and isolation

22. 2. Freedom and Responsibility
The central issue in therapy is freedom and
responsibility.
A concept ultimately associated with freedom is
assuming responsibility
The existential concept of freedom refers to the
fact that we are the authors of our own
world
The bridge between wishing and action is
decision

23. Freedom and Responsibility
 We are free to choose among alternatives
 We are responsible for our lives, for our action,
and for our failure to take action.
 Blaming others for their problems---
 Recognize how they allowed others to decide for
them and the price they pay
 Encourage them to consider the alternative
options

24. We Cannot Escape
Freedom and Responsibility
Existential therapy is rooted in the premise that humans
cannot escape from freedom and responsibility.

25. Freedom and Responsibility
involves the notion that …
 our freedom requires us to accept
responsibility for directing our own life.
 we are free to choose who we will be.
 they go hand in hand.

26. Question
What are the possible reasons
that people tend to blame
others for their problems?

27. The Concept of “Bad Faith”
The concept of "bad faith" refers to
leading an inauthentic
existence.

28. An Example of Bad Faith
A example statement that illustrates
"bad faith" is - naturally I'm this
way, because I grew up in an
alcoholic family.

30. Striving for Identity
 Identity is “the courage to be”
 We must trust ourselves to search within and find
our own answers
 Our great fear is that we will discover that there is
no core, no self
 Struggling with our identity:
 Challenging clients---in what ways that they have lost
touch with their identity and letting
others to design their life.

31. Relationship to others
 Aloneness
 We are alone---So, we must give a sense of
meaning to life, decide how we will live, have a
relationship with ourselves, and learn to listen to
ourselves.
 Relatedness
 We need to create a close relationship with others
 Challenging clients----What they get from the
relationship? How they avoid close relationship?

32. Relatedness can be Therapeutic
Existentialists contend that the
experience of relatedness to other
human beings can be therapeutic.

34. Question
 What is the meaning or purpose of your life?
 What do you want from life?
 Where is the source of meaning for you in life?

35. The Search for Meaning
 Meaninglessness in life leads to emptiness and
hollowness (existential vacuum)
 Existentialists believe that the major solution to
meaninglessness is engagement
Finding meaning in life is a by-product of
engagement, which is a commitment to creating,
loving, working, and building.

36. 5. Accepting Anxiety as
a Condition of Living

37. Anxiety – A Condition of Living
 Existential therapists define anxiety as a
threat to our existence
 Anxiety arises from one’s strivings to
survive.
 If anxiety is proportionate to the situation
confronted, existentialists would consider
it normal anxiety
 In contrast to normal anxiety, neurotic
anxiety is repressed
unconscious impulses

38. Anxiety
Existential anxiety is normal
an outcome of being confronted with the four givens
of existence: death, freedom, existential
isolation, and meaninglessness.
Anxiety can be a stimulus for growth as we become
aware of and accept our freedom

39. Normal Anxiety
According to May, freedom and anxiety are two
sides of the same coin.
Existential anxiety is seen as a function of our
acceptance of our aloneness.
From the existential viewpoint, the aim of therapy is
NOT to eliminate anxiety so clients can live
comfortably.

40. Existential Model of Anxiety
Awareness of Ultimate Concern
Anxiety
Defenses

41. Existential Model of Anxiety
Anxiety is more basic than fear.
Anxiety arises from our personal need to
survive, to preserve our being, and to assert
our being.
Normal anxiety is proportionate to the situation.
It does not require repression and can be
used for creativity.
Neurotic anxiety exceeds or minimizes the
situation, is repressed and destructive.
(Normal anxiety is seen as proportionate to the
situation involved. When the anxiety exceeds the
situation present, it is considered neurotic.)

42. 6.The Awareness of
Death and Nonbeing

43. Death
According to the existential
viewpoint, death gives
significance to living.

44. Question
If you had only have 30 days
left, what would you feel?
What will you do?

45. Awareness of Death
 Death provides the motivation for us to
live our lives fully and take advantage of
each opportunity to do something meaningful.

46. Ontology of Being
The Basic “I-Am” Experience
The "I-Am" experience is about being i.e., the
realization of one’s being
The term ontological means science of being
(or the nature of being)
Existentialists consider the "I am" experience
as a precondition for a solution in life and feel
that this is an ontological experience
 “I am now living and I could take my life”
 “The idea of suicide has saved my life
many times.” Nietzsche

47. Six Ontological Principles
1. Humans are centered in self and derive meaning
from that center.
2. Humans are responsible for mobilizing the courage
to protect, affirm, and enhance the self.
3. People need other people with whom they can
empathize and learn.
4. People are vigilant about potential dangers to self.
5. Humans can be aware of themselves thinking and
feeling at one moment and may be aware of
themselves as the person who thinks and feels in
the next moment.
6. Anxiety originates out of awareness that one’s
being can end.

48. Ontology
Existential psychotherapy seeks a deeper and
more discerning type of therapy
The “I am” experience is not a solution in itself it
is a precondition for a solution
An ontological experience;
Ontis = “to be” and Logical = “the science of”
Nonbeing is illustrated in the experience of fear
of death, destructive hostility, severe anxiety and
critical illness

49. The Three Forms of
Being-in-the-World
1. Umwelt – world around, biological world
2. Mitwelt – with world, world of one’s fellow
human beings
3. Eigenwelt – own world; relationship to one’s
self

50. Human Capacity to Transcend the
Immediate Situation
Transcend means “to climb over and beyond”
Existing involves a continual emerging
When an individual can move past
a situation in order to move
towards their future, it is said that
the person has transcended the
immediate situation

52. Existential Psychotherapy
A form of dynamic psychotherapy
Holds a different view of inner
conflict
Conflict is between the individual and the
“givens” of existence termed ultimate
concerns
Death.
Freedom.
Isolation.
Meaninglessness.

53. Existential Psychotherapy
Death.
The most obvious ultimate concern.
“A terrible truth”.
Conflict between awareness of death and
desire to live.
To cope we erect defenses against death
awareness.
Psychopathology in part is due to failure to
deal with the inevitability of death.

54. Existential Psychotherapy
Freedom
Refers to the fact that humans are the authors of
their own world
We are responsible for our own choices
Conflict is between groundlessness and desire for
ground/structure
Implications for therapy
Responsibility
Willing
Impulsivity
Compulsivity
Decision

55. Existential Psychotherapy
Isolation –
The fact that we are isolated from parts of
ourselves is termed intrapersonal isolation
Intrapersonal isolation = Fact we are isolated
from parts of ourselves
A form of isolation that refers to the fact that each
of us enters and departs the world alone is
existential
Existential isolation differs from
Interpersonal isolation = Divide between self
and others
Intrapersonal isolation = Fact we are isolated from
parts of ourselves

56. Existential Psychotherapy
Meaninglessness
Meaning creates hierarchal order of our values
From a schema regarding the meaning of life an
individual generates a hierarchy of values
Tells us how to live not why to live
Conflict stems from “How does a being who
requires meaning find meaning in a universe that
has no meaning?”

57. Existential Psychotherapy
Existential Frame of Reference
Specialness
Despite rationality we often believe the laws of
biology are not applicable to us
Ultimate Rescuer
Belief in a personal omnipotent servant to guard
and protect us
(To cope with ultimate concerns regarding death
individuals will often use the defense mechanism of
creating an ultimate rescuer)

58. Existential Psychotherapy
Existentialists hypothesize that anxiety is the result
of awareness of ultimate concerns.
Ultimate concerns create experiences, which
force us to confront an existential situation
called boundary situations.
An experience which forces an individual to
confront an existential issue is known as a
boundary situation.
Examples might be diagnosis of a terminal illness or
death of a family member or friend.
Psychotherapy can address existential isolation.
Jung suggested 30% of patients seek treatment
because of personal meaninglessness.

59. Therapeutic Goals
 To expand self-awareness.
 To increase potential choices.
 To help the client accept the responsibility for their
choice.
 To help the client experience authentic existence.

60. Therapist’s Function and
Role
 Understand the client’s subjective world.
 Encourage clients to accept personal responsibility.
 When clients blame others, therapist is likely to ask
them how they contributed to their situation.

61. A Prime Factor in Determining
the Outcomes of Therapy
The existential approach puts emphasis on the therapist
as a person and the quality of the client/therapist
relationship as one of the prime factors in determining
the outcomes of therapy.

62. Client’s Experience in
Therapy
 They are challenged to take responsibility.
 Major themes in therapy sessions are anxiety,
freedom and responsibility, isolation, death, and the
search for meaning.
 Assist client in facing life with courage, hope, and a
willingness to find meaning in life.

63. Philosophically, the existentialist
would agree that:
 the final decisions and choices rest with the client.
 people redefine themselves by their choices.
 a person can go beyond early conditioning.
 making choices can create anxiety.

64. Relationship Between
Therapist and Client
 Therapy is a journey taken by therapist and
client.
 The person-to-person relationship is key.
 The relationship demands that therapists be in
contact with their own world.
 The core of the therapeutic relationship.
 Respect and faith in the clients’ potential to cope
and discover alternative ways of being.
 Therapists share their reactions to clients with
genuine concern and empathy as one way of
deepening the therapeutic relationship.

65. Therapeutic techniques and
procedures
 It is not technique-oriented.
 The interventions are based on philosophical
views about the nature of human existence.
 Free for draw techniques from other
orientations
 The use of therapist self is the core of therapy.

66. Subjective understanding of
clients is primary
In the existential approach subjective understanding of
clients is primary and techniques are secondary.
The term unfolding refers to the therapist's attempt
to uncover with the patient what was there all
along.

67. Questions
 Which populations is existential therapy particularly
useful?
 Which issues is existential therapy particularly
useful?

68. Application of Existential Psychotherapy.
Existential therapy is especially appropriate for clients
who are struggling with:
 Developmental crises.
Identity in adolescents.
Coping with disappointments in family and career
Grief counseling.
Coping with physical limitations as one ages.
Low self confidence
Feelings of inadequacy
Stress / tension
Social anxiety

69. From a multicultural perspective
 Contributions
 Applicable to diverse clients to search for meaning
for life
 Be able to examine the behavior is influenced by
social and cultural factors.
 Help clients to weigh the alternatives and
consequences.
 Change external environment and recognize how they
contribute

70. From a multicultural perspective
 Limitations
 Excessively individualistic.
 Ignore social factors that cause human problems.
 Even if clients change internally, they see little hope
the external realities of racism or discrimination will
change
 For many cultures, it is not possible to talk about self
and self-determination apart from the context of the
social network.
 Many clients expect a structured and problem-oriented
approach instead of discussion of
philosophical questions.

71. Pros
 Something to offer all counselors,
Stresses self-determination,
Accepting the personal responsibility,
Provides perspective for understanding the value
of anxiety and guilt, the role of death, and the
creative aspects of being alone
and choosing for oneself.

72. and Cons
CONS: Lacks a systematic statement of principles and
practices;
writers use vague and global terms or abstract concepts;
 little research,
 limited applications for lower-functioning clients,
clients in extreme crisis who need direction,
those who are nonverbal.

73. http://www.existentialanalysis.org.uk/

74. short film of a cat with
"existential despair."
http://www.youtube.com/watch?v=0M7ibPk37_U

75. Readings
1. McLeod J. (2009) An Introduction to
Counselling. Chap 10
2. Corey, G. (2009) Theory and Practice of
Counseling and Psychotherapy.Chap 6
3. Colledge, R (2002) Mastering Counselling
Theory chap 10 & 11
4.Dryden, W ( 2007) Dryden’s Handbook of
Individual therapy. Chap 8
Advanced reading
Jacobsen (2003) Is Gift-Giving the Core of
Existential Therapy?
Dryden (2007) chap 8

76. Advanced reading
Jacobsen (2003) Is Gift-Giving the Core of
Existential Therapy?
Dryden (2007) chap 8
Yalom (2003) the gift of therapy
Yalom (1980) existential psychotherapy
Cooper, M (2003) Existential Therapies. (in
dawson books)