Existential Therapy Existential therapy is a philosophical mindset in psychotherapy, not a specific style or school with defined techniques. It explores deep life themes such as mortality, meaning, freedom, responsibility, anxiety, and aloneness about a person's struggles. The goal is to help clients explore fundamental aspects of life, often overlooked, or denied, and how addressing them can lead to a more meaningful existence. It emphasizes self-reflection, recognizing life choices, and making decisions based on the belief that we are free and responsible for our choices and actions. ROLLO MAY (1909–1994) Purpose VIKTOR FRANKL (1905–1997) Although Frankl had begun to develop an existential approach to clinical practice before his grim years in the Nazi death camps, his experiences there confirmed his views. Frankl (1963) observed and personally experienced the truths expressed by existential philosophers and writers who hold that we have choices in every situation. Frankl was a central figure in developing existential therapy in Europe and in bringing it to the United States. He was While May was pursuing his doctoral program, he came down with tuberculosis, which resulted in a two-year stay in a sanitarium. During his recovery period, May spent much time learning firsthand about the nature of anxiety. IRVIN YALOM (1931) The goal of existential therapy is to assist clients in their exploration of the existential "givens of life," how these are sometimes ignored or denied, and how addressing them can ultimately lead to a deeper, more reflective, and meaningful existence. fond of quoting Nietzsche: “He who has a why to live for can bear with almost any how” Frankl developed logotherapy, which means “therapy through meaning.” His pioneering work, Existential Psychotherapy, written in 1980, is a classic and authoritative textbook on existential therapy. Yalom developed an existential approach to psychotherapy that addresses four “givens of existence,” or ultimate human concerns: freedom and responsibility, existential isolation, meaninglessness, and death. Existential therapy is more a way of thinking, or an attitude about psychotherapy, than a particular style of practicing psychotherapy. It is neither an independent or separate school of therapy, nor is it a clearly defined model with specific techniques. Existential therapy can best be described. Existential therapy focuses on exploring themes such as mortality, meaning, freedom, responsibility, anxiety, and aloneness as these relate to a person’s current struggle. T The goal of existential therapy is to assist clients in their exploration of the existential “givens of life,” how these are sometimes ignored or denied, and how addressing them can ultimately lead to a deeper, more reflective and meaningful existence. A basic existential premise is that we are not victims of circumstance because, to a large extent, we are what we choose to be. The therapist’s basic task is to encourage clients to consider what they are most serious about so they can pursue a direction in life Historical Background in Philosophy and Existentialism Many Europeans found that their lives had been devastated by World War II, and they struggled with existential issues including feelings of isolation, alienation, and meaning lessness. Søren Kierkegaard (1813–1855) concerned with angst—a Danish and German word whose meaning lies between the English words dread and anxiety—and he addressed the role of anxiety and uncertainty in life. Existential anxiety is associated with making basic decisions about how we want to live, “the sickness unto death” arises when we are not true to ourselves. Friedrich Nietzsche (1844–1900) o he emphasized the importance of subjectivity. Nietzsche set out to prove that the ancient definition of humans as rational was entirely misleading o emphasized the “subjective truth” of an intense concern with God, Nietzsche located values within the individual’s “will to power.” Martin Heidegger (1889–1976) Heidegger’s phenomenological existentialism reminds us that we exist “in the world” and should not try to think of ourselves as beings apart from the world into which we are thrown. Martin Buber (1878–1965) He said that we humans live in a kind of betweenness; that is, there is never just an I, but always another. The I, the person who is the agent, changes depending on whether the other is it or a Thou. Ludwig Binswanger (1881–1966) An existential analyst, Binswanger proposed a holistic model of self that addresses the relationship between the person and his or her environment. He used a phenomenological approach to explore significant features of the self, including choice, freedom, and caring. Medard Boss (1903–1991) They talked of dasein, or being-in-the-world, which pertains to our ability to reflect on life events and attribute meaning to these events. They believed the therapist must enter the client’s subjective world without presuppositions that would get in the way of this experiential understanding. Jean-Paul Sartre (1905–1980) The existence of a space— nothingness—between the whole of our past and the now frees us to choose what we will. Our values are what we choose. The failure to acknowledge our freedom and choices results in emotional problems. Therapist’s Function and Role Existential therapists are primarily concerned with understanding the subjective world of clients to help them come to new understandings and options. Existential therapists are especially concerned about clients avoiding responsibility; they consistently invite clients to accept personal responsibility. When clients complain about the predicaments they are in and blame others, the therapist is likely to ask them how they contributed to their situation. Client’s Experience in Therapy Key Figures in Contemporary Existential Psychotherapy James Bugental (1915–2008) Bugental coined the term “existential-humanistic” psychotherapy, and he was a leading spokesman for this approach. His philosophical and therapeutic approach included a curiosity and focus that moved him away from the traditional therapeutic milieu of labeling and diagnosing clients. Therapeutic Goals Existential therapy is best considered as an invitation to clients to recognize how they are not living fully authentic lives and to make choices that will lead to their becoming what they are capable of being. Therapy aims to assist clients in moving toward authenticity and learning to recognize when they are deceiving themselves. Clients in existential therapy are clearly encouraged to assume responsibility for how they are currently choosing to be in their world. Effective therapy does not stop with this awareness itself, for the therapist encourages clients to act based on the insights they develop through the therapeutic process. Therapeutic Techniques Philosophical Approach Openness and Creativity 3 phases of Existential Counseling Time-limited therapy (Brief therapy) Group Counseling Person- Centered Therapy Advantages Broad Perspective and Cultural Relevance Focus on Universal Human Experience Emphasis on Presence, Relationship, and Courage Cultural Diversity Awareness Recognition of Social and Cultural Influences Person-centered therapy is based on a philosophy of human nature that postulates an innate striving for self-actualization. Carl Rogers’s view of human nature is phenomenological; that is, we structure ourselves according to our perceptions of reality. We are motivated to actualize ourselves in the reality that we perceive. Purpose Disadvantages limitations of an existentialist approach are that it lacks systematic statements of principles and practices of therapy. It uses vague and global terms and abstract concepts that can be very difficult to grasp such as the will to meaning. It has not been subjected to scientific research as a way of validating its procedures. Emphasized the attitudes and personal characteristics of the therapist and the quality of the client-therapist relationship as the prime determinants of the outcome of the therapeutic process Carl Rogers stands out as one of the most influential figures in revolutionizing the direction of counseling theory and practice. Carl Rogers has become known as a “quiet revolutionary” who both contributed to theory development and whose influence continues to shape counseling practice. His basic assumptions are that people are essentially trustworthy, that they have a vast potential for understanding themselves and resolving their own problems without direct growth if they are involved in a specific kind of therapeutic relationship Rogers maintained the three therapists’ attributes create a growth-promoting climate which individuals can move forward and become what they are capable of becoming: (1)congruence (genuineness, or realness) (2) accurate positive regard (acceptance and caring) (3) accurate emphatic understanding (an ability to deeply grasp the subjective world of another person). Emotion- Focused Therapy The actualizing tendency is a directional process of striving toward realization, fulfillment, autonomy, and selfdetermination. emerged as a person-centered “approach informed by understanding the role of emotion in human functioning and psychotherapeutic change” EFT designed to help the client increase their awareness of their emotions and make productive use of them. EFT strategies focus on two major tasks: (1) help clients too little emotion access their emotions, and (2) help clients who experience too much emotion contain their emotions. Therapist’s Function and Role Abraham Maslow was a pioneer in the development of humanistic psychology and was a influential in furthering the understanding of self-actualizing individuals. He studied “self-actualizing people” and found that the differed in important ways from so- called normal individuals. The core characteristics of self-actualizing people are self- awareness, freedom, basic honesty and caring, trust and autonomy. The role of person-centered therapist is rooted in their ways of being and attitudes, not in techniques designed to get the client to “do something.” Basically, therapists use themselves as an instrument of change by encountering clients on a person-to person level. Person-centered theory holds that the therapist’s function is to be present and accessible to clients and to focus on their immediate experience. Therapeutic Goals The goal is to assist clients in achieving a greater degree of independence and integration so they can better cope with problems as they identify them. The cornerstone of person-centered theory is the view that clients in a relationship with facilitating therapist have the capacity to define and clarify their own goals. Person-centered therapists are in agreement on the matter of not setting goals for what clients need to change, yet they differ on the matter of how to best help clients achieve their own goals and to find their own answers. Client’s Experience in Therapy Clients seek therapy is a feeling of basic helplessness, powerlessness, and an inability to make decisions or effectively direct their own lives. They may hope to find “the way” through the guidance of the therapist. What clients value most is being understood and accepted, which results in creating a safe place to explore feelings, thoughts, behaviors, and experiences; clients also value support for trying out new behaviors. Therapeutic Techniques No techniques are basic to the practice of person-centered therapy; “being with” clients and entering imaginatively into their world of perceptions and feelings is sufficient for facilitating a process of change. presence—being completely attentive to and immersed in the client as well as in the client’s expressed concerns. Immediacy, or addressing what is going on between the client and therapist, is highly valued in this approach. This development encourages the use of a wider variety of methods and allows for considerable diversity in personal style among person-centered therapists. Advantage and Disadvantage The client usually assesses his/her capability and are responsible for his own development. The client is mostly prone to self-bias and misconceptions even about himself/herself. of it as confrontational and technically narrow. The freshness of her perspectives, the clarity of her language, and the excitement evoked by her radiance all served to raise the charismatic potential of the therapist who entered the realm of simple fascination with the way people lived their lives. Gestalt Therapy An existential, phenomenological, and process-based approach was created on the premise that individuals must be understood in the context of their ongoing relationship with the environment. Purpose The Gestalt approach focuses much more on process than on content. This process involves Gestalt therapists putting themselves as fully as possible into the experience of the client without judgment, analyzing, or interpreting, while concurrently holding a sense of one’s individual, independent presence. Therapists devise experiments deo increase clients’ awareness of what they are doing and how they are doing it moment to moment. Erving Polster is still professionally active and gives presentations, therapy demonstrations, and workshops. He is regularly featured at the Evolution of Psychotherapy conference and the Brief Therapy conference. Erving Polster writes the following about his connection with Gestalt Therapy: Miriam Polster She was a strong advocate of the relational dimension of Gestalt therapy, a counterpoint to the skewed stereotype Therapeutic Goal Gestalt therapy does not ascribe to a “goal-oriented” methodology per se, but therapists attend to a basic goal—namely, assisting the client to attain greater awareness, and with it, greater choice. Awareness includes knowing the environment, knowing oneself, accepting oneself, and being able to make contact. Increased and enriched awareness, by itself, is seen as curative. Therapist’s Function and Role The therapist’s job is to invite clients into an active partnership where they can learn about themselves by adopting an experimental attitude toward life in which they try out new behaviors and notice what happens. Gestalt therapists use active methods and personal engagement with clients to increase their awareness, freedom, and self-direction rather than directing them toward preset goals. Client’s Experience in Therapy The general orientation of Gestalt therapy is toward dialogue, an engagement between people who each bring their unique experiences to that meeting Traditional Gestalt therapists assumed that clients must be confronted about how they avoid accepting responsibility, but the dialogic attitude that characterizes contemporary Gestalt therapy creates the ground for a meeting place between client and therapist. Clients in Gestalt therapy are active participants who make their own interpretations and meanings. It is they who increased awareness and decide what they will or will not do with their personal meaning. Therapeutic Techniques The Internal Dialogue Exercise - One goal of Gestalt therapy is to bring about integrated functioning and acceptance of aspects of one’s personality that have been disowned and denied. The Empty-Chair Technique - this is a role-playing technique in which all the parts are played by the client. In this way the introjects can surface, and the client can experience the conflict more fully. Future Projection Technique - This technique, often associated with psychodrama, is designed to help clients express and clarify concerns they have about the future. Making the Rounds - involves asking a person in a group to go up to others in the group and either speak to or do something with each person. The purpose is to confront, to risk, to disclose the self, to experiment with new behavior, and to grow and change. The Reversal Exercise - The theory underlying the reversal technique is that clients take the plunge into the very thing that is fraught with anxiety and contact those parts of themselves that have been submerged and denied. This technique can help clients begin to accept certain personal attributes that they have tried to deny. Advantages Gestalt therapy can be a useful and effective approach with clients from diverse backgrounds because it takes the clients’ context into account. One of the advantages of drawing on Gestalt experiments is that they can be tailored to fit the unique way in which an individual perceives and interprets his or her culture. Disadvantages Gestalt methods can lead to a high level of intense feelings. This focus on effect has clear limitations with those clients who have been culturally conditioned to be emotionally reserved and to avoid openly expressing feelings. Therapists who operate on the assumption that catharsis is necessary for any change to occur are likely to find certain clients becoming increasingly reluctant to participate in experiments, and such clients may prematurely terminate counseling.
