Existential
Psychotherapies
EXISTENTIAL APPROACHES
 Way of thinking about humans and about life
 Closely linked to European Existential Philosophy:
 Dilemmas of contemporary life (1940-50s)
 isolation, alienation and meaninglessness
 Importance of subjectivity and self-determination
 Truth depends on the existing person, in a given
situation and in a given time
 Freedom to be ourselves implies responsibility
2
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
3
Existentialist Psychology
 Victor Frankle
 Logotherapy: Man in Search for Meaning
 Nietzsche “He who has a why to live for, can bear
with almost any how.”
 Rollo May
 First book: Meaning of Anxiety (1950)
 Co-editor: Existence: A New Dimension in
Psychiatry and Psychology (1958) introduced
existential psychology to the US.
 Irving Yalom
 Existential Psychotherapy, (1980)
4
Irving Yalom
https://www.youtube.com/watch?v=tuCa8Rc1S
ao
(2005)
5
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/Responsibility
 Isolation
Meaninglessness
6
Boundary situation
 Experience or event that propels the person to
face one or more ultimate concerns:




terminal illness
death of a loved one
life crisis – divorce, loss of job
life change – empty nest, aging, retirement
7
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 anxiety of being alive
8
Anxiety
 NORMAL/Existential ANXIETY
 Proportionate to the situation
 Does not require repression
 Can be used in a productive way
 NEUROTIC ANXIETY
 Disproportionate to the situation
 Tends to be repressed
 Paralyzes the individual
9
Guilt
 Normal
 Existential
Ethical aspects of behavior
failure to live up to one’s
capacities; avoid responsibility
of making own choices
 Neurotic
Fantasized transgressions
toward others or self
10
Therapy Goals
 Explore anxiety related to the ultimate concerns,
conscious/unconscious
 Identify mechanisms of defense (symptoms) clients
use to deal with existential anxiety
 Move clients to confront the fear and pain
associated with the ultimate concerns
 Help clients develop adaptive ways of dealing with
existential anxiety
11
Freedom vs. Responsibility
 We are ultimately responsible for who we are,
what we believe in, and how we behave
 Anxiety is generated by our fear of not
knowing or of making mistakes
 We must make authentic choices rather than
follow what has been given to us
12
Responsibility: Defenses
 Displace it
others/circumstances
 Deny responsibility
e.g. victim role
 Avoid responsibility
e.g. symptoms
13
Process of Making Decisions
WISHING >>>> WILLING >>>> ACTION
Symptoms
 Impulsive Behavior
 Non-discrimination among wishes;
 Jump from every wish to action
 Compulsive Behavior
 Driven by ego-alien demands
 Action w/o wishing
14
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 problems
15
Isolation
 Awareness of our intrinsic isolation vs.
desire to be part of something larger
 Interpersonal
social skills, intimacy
 Intra-personal connected with self
 Existential
Unavoidable
 Defense:
 Fusion: soften our ego boundaries and
become part of another individual, group,
or cause
16
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
17
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” finding meaning requires access to
affective experience
 A sense of meaning is guided by our values:
 why we live and
 how to live
18
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
19
Death
 Fear of self-destruction – primary source of
anxiety
 Defenses against death awareness – denial,
reaction formation
 Awareness of death gives meaning to our
life (paradox)
 enhances the importance of the present
moment
 leads us to live more fully
20
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
21
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 authentic life
 Focus on the future
 Main vehicle of therapy is an authentic,
real relationship with therapist
22
Psychotherapy: Relationship 1/2
 Therapy is a journey taken by therapist and
client
 The person-to-person relationship is key
 Therapists stay in contact with their own
phenomenological world -- Genuine
 Therapists must distinguish between transference
and the actual, real relationship (they co-exist)
23
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
24
Psychotherapy: Techniques
 Paradoxical intention
 Situational reconstruction
 Compensatory self improvement
25
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
26
Contributions

Provides new ways of understanding 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
27
Contributions
 Philosophical orientation applicable regardless
of counselor’s theoretical orientation
 Particularly useful to understand issues
presented by clients who may be confronting
existential crises
28
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
29
Gestalt
 Existential & Phenomenological – it is
grounded in the client’s “here and now”
 Goal: clients gain awareness of feelings and
behaviors in the here and now
 Promotes direct experiencing rather than
talking about situations
 talk about a childhood trauma vs. become the hurt
child
30
Frederick Perls 1893-1970
 Born in Germany,
 Psychiatrist and psychoanalyst
 Emigrated to U.S. in 1946 and broke with
psychoanalytic tradition
 Controversial and charismatic figure
 Gestalt therapy became a kind of cult
 Collaborated with his wife (Laura Perls 19051990) in delivering workshops and writing
31
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 process of therapy
than on the content
32
Unfinished Business
 Unexpressed feelings such as anger,
resentment, and fear, that interfere with
effective contact with oneself and with others
 Threatening
 Not fully experienced in awareness
 Result in:
 Preoccupation, compulsive behavior, wariness and
self-defeating behaviors
33
Contact and Resistance to Contact
 CONTACT
 To interact openly with environment w/o losing one’s
individuality
 Requires contact/awareness of one-self
 RESISTANCE TO CONTACT
 Defenses that prevent experiencing the present fully
 Defenses: used to control the environment rather
than allowing real contact
 Typically these defenses are out of awareness; may
contribute to dysfunctional behavior
34
Defenses
Resistance to Contact
Introjection
Uncritical acceptance of others’ beliefs and
standards w/o making them our own.
• Lack of clear sense of self
Projection
Retroflection
To disown certain aspects of ourselves by
ascribing them to the environment
• Victim stance; powerlessness to initiate
change
To turn back to ourselves something we would
like to do (or have done) to someone else
• Self-injury vs. fear of directing aggression
outwardly
• Depression -psychosomatic symptoms vs.
35
expressing anger
Defenses
Resistance to Contact
Deflection
To avoid real contact and awareness by being
vague and indirect.
• Humor, abstract generalizations, ignoring
Confluence
To loose the sense of the boundary between
self and environment (others).
• Go with the flow, enmeshment,
36
Goal Gestalt Therapy
 Gain awareness
 Know the environment
 Know oneself
 Learn about dominant ways of avoiding contact
 What does the resistance (defense) does for the client
 What it protects the person from
 What it keeps the person from experiencing
 Accept oneself and responsibility for self
 Allow oneself to make contact
37
Therapist Role
 Provide an authentic relationship
 Focus on process versus content
 Experiments to increase client’s selfawareness
 Coach clients to arrive at their own
interpretations/ counselor does not interpret
 Confrontation
 To help client become aware of discrepancies
between:
 verbal and nonverbal expressions,
 feelings and actions, and/or
 thoughts and feelings.
38
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….
39
Gestalt Experiments
 Internal Dialogue
 Empty Chair
 Making the Rounds
 Reversal Exercise
 The Rehearsal Exercise
 Exaggerating Exercise
 Staying with the Feeling
40
Contributions and Limitations
• Creative use of active interventions
(experiments) to foster 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
could lead to abuse of power
41