This presentation will focus on: This presentation will focus on

This presentation will focus on:

• This presentation will focus on:

• Overview of existential psychotherapy
• History of existential psychotherapy
• Applications of existential psychotherapy
• Treatment techniques associated with existential psychotherapy

Can be integrated with other therapy approaches.

• Can be integrated with other therapy approaches.

• Represents a way of thinking about human experience that can constitute a part of all therapies.

• Asks deep questions about human experiences such as anxiety, despair, grief, loneliness, isolation, anomie, meaning, creativity and love.

People are meaning-making beings who are both subjects of experience and objects of self-reflection.

• People are meaning-making beings who are both subjects of experience and objects of self-reflection.

• Focus on questions like:

• Who am I? Is life worth living? Does it have a meaning? How can I realize my humanity?

• Asserts that only in reflecting on our mortality can we learn how to live.

Existential therapy believes we all must come to terms with the questions related to our existence.

• Existential therapy believes we all must come to terms with the questions related to our existence.

• Each of us is responsible for who we are and what we become.

Because theories may dehumanize and objectify people, authentic experience takes precedence over artificial explanations.

• Because theories may dehumanize and objectify people, authentic experience takes precedence over artificial explanations.

• When experiences are molded into some preexisting theoretical model, they lose their authenticity and become disconnected from the individuals who experience them.

Existential psychotherapists focus on the subjectivity of experience rather than “objective” diagnostic categories.

• Existential psychotherapists focus on the subjectivity of experience rather than “objective” diagnostic categories.

We are thrown alone into existence without a predestined life structure and destiny.

• We are thrown alone into existence without a predestined life structure and destiny.

• Each of us must decide how to live as fully, happily, ethically, and meaningfully as possible.

Diagnosable presenting “symptoms” may mask existential crises.

• Diagnosable presenting “symptoms” may mask existential crises.

• Existential dilemma ensues from the existential reality that although we crave to persist in our being, we are finite creatures.

Freedom

• Freedom

• As authors of our own lives, we face responsibilities we dread and try to escape.

• Isolation

• Interpersonal, intrapersonal, or existential isolation

• Meaning

• Search for purpose can throw us into crisis.

• Death

• Death awareness is painful, but enriches life.

“Humans are condemned to freedom.”

• “Humans are condemned to freedom.”

Awareness of ultimate concerns as givens of existence produces a relationship between therapist and patient as one of fellow travelers.

• Awareness of ultimate concerns as givens of existence produces a relationship between therapist and patient as one of fellow travelers.

• Labels of patient/therapist, client/counselor suggest distinctions between “them” (the afflicted) and “us” (the healers).

We are all in this together; no person is immune to the inherent tragedies of existence.

• We are all in this together; no person is immune to the inherent tragedies of existence.

• Sharing the essence of the human condition becomes the bedrock of therapeutic work.

Humanistic therapies overlap considerably with existential approaches.

• Humanistic therapies overlap considerably with existential approaches.

• Both emphasize growth and fulfillment of the self.

• Goals are for self mastery, self-examination and creativity.

• Most Different Most Similar

• Behavioral Psychoanalytic Humanistic

Existentialists reject concept of the person as propelled by drives and instincts.

• Existentialists reject concept of the person as propelled by drives and instincts.

• Existentialists feel Jungians quickly avoid the patient’s immediate crises by being too focused on theory.

• Client-centered therapists do not confront the patient directly and firmly.

Philosophers, theologians, poets throughout time have wrestled with existential issues.

• Philosophers, theologians, poets throughout time have wrestled with existential issues.

• Epicurus emphasized death concerns may not be conscious to the individual but might be inferred by disguised manifestations.

• Nabokov viewed life as crack of light between two eternities of darkness.

• St. Augustine believed that only in the face of death is a person’s self born.

Term existentialism is associated with Sartre and Marcel.

• Term existentialism is associated with Sartre and Marcel.

• Influenced by philosophers including Heidegger, Husserl, Levinas and Buber.

• Central foundational philosophers of existential psychotherapy are Kierkegaard and Nietzsche.

Existence: A New Dimension in Psychiatry and Psychology

• Existence: A New Dimension in Psychiatry and Psychology

• May, Angel, and Ellenberger
• Introduced existential psychotherapy to the US in 1958.
• May wrote two main chapters:
• The Origins of the Existential Movement in Psychology
• Contributions of Existential Psychology

Other influences:

• Other influences:

• Binswanger
• Ellenberger
• Minkowski
• Straus
• von Gebsattel
• Kuhn
• Fromm

Works by Yalom

• Works by Yalom

• Existential Psychotherapy (1980)
• Love’s Executioner (1989)
• Momma and the Meaning of Life (1999)
• When Nietzsche Wept (1992)
• Lying on the Couch (1996)
• The Schopenhauer Cure (2005)
• The Spinoza Problem (2012)
• Staring at the Sun: Overcoming the Terror of Death (2008)

Victor Frankl

• Victor Frankl

• Man’s Search For Meaning (1956)
• Influential text that sets out an approach to logotherapy, a form of psychotherapy focused on will, freedom, meaning, and responsibility.

• Allen Wheelis

• How People Change (1973)
• Wrote about the specter of death and the search for meaning.

Existential psychotherapy has never supported specific institutes because it deals with issues underlying therapy of any kind.

• Existential psychotherapy has never supported specific institutes because it deals with issues underlying therapy of any kind.

• Existentially-oriented psychotherapists tend to further their knowledge through personal therapy, supervision, and reading.

Therapists trained in different schools can legitimately call themselves existential if their assumptions are in line with those of existentialists.

• Therapists trained in different schools can legitimately call themselves existential if their assumptions are in line with those of existentialists.

• Concerned with rediscovering the living person amid dehumanizing modern culture.

• Human-focused approaches to psychotherapy suffer in a climate of market forces.

Existential focus concerns whether or not people are living as authentically and meaningfully as possible.

• Existential focus concerns whether or not people are living as authentically and meaningfully as possible.

• Utilizes a dynamic model of personality as a system of forces in conflict with one another.

• Emotions and behavior may exist at different levels of consciousness.

Suggest we do not possess a personality rather we embody an experience.

• Suggest we do not possess a personality rather we embody an experience.

• Neurosis is tantamount to avoidance.

• Example: Neurotic individuals are living in the every day rather than dealing with the challenges of ultimate concerns.

Freedom is the capacity to choose within natural and self-imposed limits of living.

• Freedom is the capacity to choose within natural and self-imposed limits of living.
• Freedom implies responsibility.
• Destiny refers to awareness of our limitations.
• The ultimate limitation is death.
• Through struggle, freedom and destiny are appreciated.

Authenticity must be modeled by the therapist.

• Authenticity must be modeled by the therapist.

• Therapist meets the patient in the space between “I” and “Thou.”

• Therapeutic relationship heals through therapist’s presence, genuineness, and receptiveness.

• Done from a position of being a fellow traveler.

Therapist must be aware of the importance of meaning as for some it is profound and pervasive.

• Therapist must be aware of the importance of meaning as for some it is profound and pervasive.

• Jung estimated that >30% of patients sought therapy because of meaninglessness.

• Victor Frankl:

• “Happiness cannot be pursued, it can only ensue.”

“An awakening experience.”

• “An awakening experience.”

• A personal confrontation with death may cause a radical shift in life perspective and lead to personal change.

• Death anxiety may be a primary focus of therapy.

Fear of flying

• Fear of flying

• Ultimate concern of death

• Difficulty adjusting after a divorce

• Ultimate concern of isolation

Individuals hold beliefs of personal inviolability, invulnerability, and immortality.

• Individuals hold beliefs of personal inviolability, invulnerability, and immortality.

• Unconsciously, individuals believe laws of biology do not apply to them.

• People can camouflage their fears of death behind a belief that one’s specialness will somehow override it.

• People may seek therapy when the defense of specialness fails to ward off anxiety.

Belief that someone is watching over in an indifferent world.

• Belief that someone is watching over in an indifferent world.

• People may imagine their rescuer to be human or divine.

• May result in a character structure displaying passivity, dependency, and obsequiousness.

• Individuals may dedicate their lives to locating and appeasing an ultimate rescuer.

Strategies similar to other dynamic therapies, but with different content.

• Strategies similar to other dynamic therapies, but with different content.

• Focus on patient’s current life situation and enveloping unconscious fears.

• Therapeutic relationship viewed as fundamentally important in itself, especially with regard to engagement and connection.

• Emphasis on a here-and-now, not from a longitudinal perspective.

Focus is on the self experience of the patient, and capacity for self-actualization and self-transcendence through engagement in life.

• Focus is on the self experience of the patient, and capacity for self-actualization and self-transcendence through engagement in life.

• Goal is anxiety reduction and constructive use of the anxiety.

Identify methods and instances of responsibility avoidance.

• Identify methods and instances of responsibility avoidance.

• Help patients make decisions and tolerate uncertainty.

• Address existential isolation directly.

• Address meaninglessness with engagement.

• Confront death and death anxiety.

Empathy

• Empathy

• The here-and-now

• Dreams

• Fellow travelers

• Genuineness

Therapists’ personal therapy experiences

• Therapists’ personal therapy experiences

• Therapist transparency

• Seeks unfolding, meeting, and presence

Therapy can be adapted to different situations and conditions.

• Therapy can be adapted to different situations and conditions.

• A thorough existential approach with ambitious goals is most appropriate in long-term therapy.

• Shorter durations can be effective.

Appropriate with patients who confront boundary situations.

• Appropriate with patients who confront boundary situations.

• Confrontations with death, important decisions, sudden isolation, or milestones that mark passages

• Individuals, groups, families, and couples

May take the form of idiographic examples and anecdotes that share some common themes.

• May take the form of idiographic examples and anecdotes that share some common themes.

• Gains continue to elude randomized-controlled trials and objective forms of research.

• Evidence highlights the relationship as the mechanism of healing.

All humans share in the dilemmas of existence and must come to terms with the ultimate concerns.

• All humans share in the dilemmas of existence and must come to terms with the ultimate concerns.

• Difficulties arise when individuals adopt broad formulas for managing ultimate concerns based on their cultural and religious systems.

• Cultures create belief systems that defend against the terrors of stark confrontation with existential concerns.