Existential psychotherapies
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Existential Psychotherapies. EXISTENTIAL APPROACHES Way of thinking about humans and about life that may be applied to other psychotherapy approaches Closely linked to European Existential Philosophy : Dilemmas of contemporary life (1940-50s) isolation, alienation and meaninglessness

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Existential Psychotherapies

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Existential psychotherapies

ExistentialPsychotherapies


Existential psychotherapies

EXISTENTIAL APPROACHES

Way of thinking about humans and about life that may be applied to other psychotherapy approaches

Closely linked to European Existential Philosophy:

Dilemmas of contemporary life (1940-50s)

isolation, alienation and meaninglessness

Importance of subjectivity – we create our values, our lives, ourselves

Truth depends on the existing person, in a given situation and in a given time

Freedomto be ourselves implies responsibility


Existential psychotherapies

European Existential Philosophers

Kierkergard

angst - dread and anxiety related to uncertainty in living

Nietzsche

Values are within the individual

Sartre

Freedom to be what we choose and related responsibility

Simon de Beauvoir The Second Sex

Buber

Stressed the I/Thou Relationship – less individualistic

Biswanger

existential analyst, emphasized subjective and spiritual dimensions


Existential psychotherapies

Existential Psychology

Victor Frankle

LogotherapyMan in Search for Meaning

Nietzsche “He who has a why to live for, can bear with almost any how.”

Rollo May

Co-editor : Existence: A New Dimension in Psychiatry and Psychology (1958) introduced existential psychology to the US. 

Irving Yalom

Existential Psychotherapy


Basic dimensions of the human condition

Basic Dimensions of the Human Condition

  • Capacity for self-awareness

  • Freedom and responsibility

  • Creating one’s identity and meaningful relationships with others

  • Search for meaning, purposes, values and goals

  • Anxiety as a condition for living

  • Awareness of death and non-being


Theory of personality

Theory of Personality

  • Dynamic Model Forces in conflict

    • need to survive and assert one’s being vs.

      conscious and unconscious fears related to:

  • Givens of Existence or Ultimate Concerns

    • Death Freedom

    • Isolation Meaninglessness


Conflict mental health

Conflict/Mental Health

  • Awareness of Ult. Concerns >>>Anxiety >>> Def. Mechanisms

    • Ways to deal with the anxiety

    • Provide safety, restrict growth

  • Mental Health

    • Ability to cope with normal anxiety


  • Anxiety

    Anxiety

    • NORMAL ANXIETY

      • Proportionate to the situation

      • Does not require repression

      • Can be used creatively

    • NEUROTIC ANXIETY

      • Disproportionate to the situation

      • Tends to be repressed

      • Paralyzes the individual


    Guilt

    Guilt

    • NormalEthical aspects of behavior

    • NeuroticFantasized transgressions toward others, or failure to live up to one’s capacities


    Objective of therapy

    Objective of Therapy

    • Explore anxiety related to the ultimate concerns, concious/unconscious

    • Identify mechanisms of defense (symptoms) clients use to deal with existential anxiety

    • Move clients to confront the fear and the pain associated with the ultimate concerns

    • Help clients develop adaptive ways of dealing with existential anxiety


    Freedom vs responsibility

    Freedom vs. Responsibility

    • We are ultimately responsible for who we are, what we believe in, and how we behave

    • We must make authentic choices rather than follow what has been given to us

    • Anxiety is generated by our fear of not knowing or of making mistakes


    Responsibility defenses

    Responsibility: Defenses

    • Displaceit others/circumstances

    • Deny responsibility e.g. victim role

    • Avoid responsibility e.g. symptoms


    Process of making decisions

    Process of Making Decisions

    WISHING >>>> WILLING >>>> ACTION

    Symptoms

    • Impulsive Behavior

      • Non-discrimination among wishes

    • Compulsive Behavior

      • Driven by ego-alien demands


    Freedom therapy

    Freedom:Therapy

    • Help client recognize and accept responsibility for making choices

    • Confront responsibility avoidance (won’t vs. can’t)

    • Encourage clients to connect with their feelings

    • Explore how client contributes to problem situation


    Isolation

    Isolation

    • Awareness of our intrinsic isolationvs. desire to be part of something larger

      • Interpersonal social skills, intimacy

      • Intra-personal connected with self

      • ExistentialUnavoidable

    • Defense:

      • Fusion: soften our ego boundaries and become part of another individual, group, or cause


    Isolation therapy

    Isolation: Therapy

    • Help clients confront their fear of aloneness

      • Personal growth entails a degree of isolation

      • To create authentic relationships with others we must have confronted and accepted our ultimate isolation

    • Within the real relationship between client and therapist, client may learn limits and rewards of intimacy


    Meaninglessness

    Meaninglessness

    • We naturally search for meaning, but we live in a world where there are no intrinsic meanings

      • Need to construct a personal sense of meaning

      • “Wishing” Source of meaning require access to affective experience

      • Meaning is usually found when we look beyond ourselves and meeting our material needs.

      • A sense of meaning is related to our values that tell us why we live and how to live


    Meaninglessness therapy

    Meaninglessness: Therapy

    • May not be an issue for all clients

      • Personal growth

      • Boundary situations

      • Depression

    • Help clients connect with their affective selves, to discover inner sources of motivation and meaning

    • Help clients get engaged in life activities


    Boundary situation

    Boundary situation

    • Experience or event that propels the person to face an existential situation related to any of the ultimate concerns:

      • terminal illness

      • death of a loved one

      • life crisis

      • life change


    Death

    Death

    • Fear of self-destruction – primary source of anxiety

    • Defenses against death awareness – denial, reaction formation

    • Awareness of death gives meaning to our life

      • enhances the importance of the present moment

      • leads us to live more fully


    Defense mechanisms

    Defense Mechanisms

    Awareness of Ult. Concerns >>>Anxiety >>> Def. Mechanisms

    Drive>>>Anxiety>>>Def. Mechanism

    • Defense mechanisms provide some temporary relief, but they restrict growth

    • Existentialists ascribe to the defense mechanisms that were proposed by Freud


    Psychotherapy goals

    Psychotherapy : Goals

    • Main goal is to help clients

      • increase awareness about themselves and how they are living

      • confront their anxieties and fears

      • re-define themselves and their world in ways that lead to a more authenticlife

    • Main vehicle of therapy is an authentic, real relationship with therapist


    Psychotherapy relationship 1 2

    Psychotherapy: Relationship 1/2

    • Therapy is a journey taken by therapist and client

      • The person-to-person relationship is key

      • Therapist stays in contact with their own phenomenological world

      • Therapist must distinguish between transference and the actual, real relationship (they co-exist)


    Psychotherapy relationship

    Psychotherapy: Relationship

    • The core of the therapeutic relationship

      • Respect and faith in the clients’ potential to cope

      • Sharing reactions with genuine concern and empathy

      • Focus on the here-and-now experience in the therapeutic relationship


    Psychotherapy techniques

    Psychotherapy: Techniques

    • Paradoxical intention

      • prescribing the symptom: help clients gain more control of their behavior, get “unstuck”

    • Situational reconstruction

      • think of three ways in which a situation could be better and three ways in which it could be worse - to help people move on from the place they are stuck

    • Compensatory self improvement

      • work on areas that you have control when you are in a situation you don't control


    Contributions

    Contributions

    • Provides new dimensions to the understanding of death, anxiety, guilt, loneliness, and alienation

    • Emphasizes the person's freedom and responsibility in designing their own lives

    • Importance placed on the human quality of the therapeutic relationship


    Contributions1

    Contributions

    • Philosophical orientation applicable regardless of counselor’s theoretical orientation

    • Particularly useful to understand issues presented by clients who may be confronting existential crises


    Limitations

    Limitations

    • Lacks a systematic statement about principles and practices of psychotherapy

    • Does not lend itself to empirical research

    • Concepts are abstract and difficult to apply in practice


    Gestalt

    Gestalt

    • Existential & Phenomenological – it is grounded in the client’s “here and now”

    • Initial goal is for clients to gain awareness of what they are experiencing and doing now

      • Promotes direct experiencingrather than the abstractness of talking about situations

        • Rather than talk about a childhood trauma the client is encouraged to become the hurt child


    Frederick perls 1893 1970

    Frederick Perls 1893-1970

    • Born in Germany,

    • Psychiatrist and psychoanalyst

    • Emigrated to U.S. in 1946 and broke form psychoanalytic tradition

    • Controversial and charismatic figure

    • Gestalt therapy became a kind of cult

    • Collaborated with his wife (Laura Perls 1905-1990) in delivering workshops and writing


    The now

    The Now

    • Our “power is in the present”

      • Nothing exists except the “now”

      • The past is gone and the future has not yet arrived

    • The power of the present is lost if :

      • We focus on past mistakes or engage in endless resolutions and plans for the future

      • Therapist focuses more on the processof therapy than on the content


    Unfinished business

    Unfinished Business

    • Unexpressed feelings such as anger, resentment, and fear that are:

      • Threatening

      • Not fully experienced in awareness

      • Interfere with effective contact with oneself and with others

    • Result:

      • Preoccupation, compulsive behavior, wariness oppressive energy and self-defeating behavior


    Contact and resistance to contact

    Contact and Resistance to Contact

    • CONTACT

      • To interact with environment w/o losing one’s individuality

      • Requires awareness, energy and ability to express oneself

    • RESISTANCE TO CONTACT

      • Defenses that prevent experiencing the present fully

      • There are five major channels of resistance to attempt to control the environment rather than allowing real contact

      • Typically are out of awareness; may contribute to dysfunctional behavior


    Goal gestalt therapy

    Goal Gestalt Therapy

    • Gain awareness

      • Know the environment

      • Know oneself

      • Learn about dominant ways of avoiding contact

        • What does the resistance does for the client

        • What it protects them from

        • What it keeps them from experiencing

    • Accept oneself and responsibility for self

    • Allow oneself to make contact


    Therapist role

    Therapist Role

    • Provide an authentic relationship

    • Focus on process versus content

    • Devise experiments to increase client’s self-awareness

    • Coaches clients to arrive at their own interpretations/does not provide them

    • Confrontation

      • Intervention to help clients become aware of discrepancies between verbal and nonverbal expressions, feelings and actions, and/or thoughts and feelings.


    Gestalt experiments

    Gestalt Experiments

    • Allow clients to express themselves behaviorally

    • Lead to fresh emotional experiences and new insights

    • Facilitate experiencing in the moment, rather than talking about….


    Gestalt experiments1

    Gestalt Experiments

    • Internal Dialogue

    • Making the Rounds

    • Reversal Exercise

    • The Rehearsal Exercise

    • Exaggerating Exercise

    • Staying with the Feeling


    Contributions and limitations

    Contributions and Limitations

    • Creative use of active experiments and activities to help clients achieve experiential learning

    • Confrontational style that deemphasizes cognitive factors

    • Experiments can be used by therapist in a manipulative way

    • Highly active and directive stance of therapist may lead to abuse of power


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