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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



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

European Existential Philosophers


angst - dread and anxiety related to uncertainty in living


Values are within the individual


Freedom to be what we choose and related responsibility

Simon de Beauvoir The Second Sex


Stressed the I/Thou Relationship – less individualistic


existential analyst, emphasized subjective and spiritual dimensions

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


      • Proportionate to the situation

      • Does not require repression

      • Can be used creatively


      • Disproportionate to the situation

      • Tends to be repressed

      • Paralyzes the individual


    • Normal Ethical aspects of behavior

    • Neurotic Fantasized 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



    • Impulsive Behavior

      • Non-discrimination among wishes

    • Compulsive Behavior

      • Driven by ego-alien demands

    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


    • 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


    • 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


    • 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


    • 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


    • Philosophical orientation applicable regardless of counselor’s theoretical orientation

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


    • 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


    • 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


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

      • Requires awareness, energy and ability to express oneself


      • 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