Existential Psychotherapy: A brief review.
Existential therapy is a phenomenological method of psychotherapy in which therapists work with clients to help them more fully and deeply experience their own existence (Diamond, 2021). Existential therapists are deeply concerned with the subjective experience of their clients, and seek to enable them to understand their innate freedom (to choose the way they experience their life) and the responsibility they have to make those choices (Diamond, 2021).
Existential therapy is not a school of therapy or a structured approach with prescribed techniques (Yalom & Josselson, 2019). It is an attitude towards the human experience with a theoretical framework that guides therapists while allowing them to use improvisation, intuition, creativity, and spontaneity to individualize their approach to the subjective experience and needs of the client (Yalom & Josselson, 2019). The existential framework focuses on the client’s relationship with what are termed the ‘ultimate concerns’, which are said to be the fundamental challenges that exist for all humans (Yalom & Josselson, 2019). Existential theory posits that most psychopathology could be the result of a client’s relationship with one or more of the ultimate concerns (Yalom & Josselson, 2019).
The ultimate concerns are defined as freedom, meaning, isolation, and death (Yalom & Josselson, 2019). Therapists work with clients to identify and understand the potentially unconscious conflict clients have with these concerns in order to identify the maladaptive defense mechanisms they have developed in response to these conflicts (Yalom & Josselson, 2019). Therapists then work with clients to address the anxiety produced by these conflicts in a way that supports and enriches the clients experience of autonomy and agency with the world (Yalom & Josselson, 2019).
A future blog post will be dedicated entirely to the ultimate concern of death, so for now we will explore freedom, isolation, and meaning.
The ultimate concern of freedom within existential theory is about the responsibility each person has for the way they experience the world, the way they design their life, and how they choose to act (Yalom & Josselson, 2019). Responsibility is at the center of freedom as an ultimate concern because each individual is responsible for the way they either act, or do not act, within the world and how they choose to make sense of it (Yalom & Josselson, 2019). Freedom is about choice, as people are free to choose how they experience their life regardless of the context they are faced with (Yalom & Josselson, 2019). Psychopathology can be the product of defence mechanisms that a client erects when faced with the immense responsibility and dread of the extent and reality of their ultimate freedom (Yalom & Josselson 2019).
The ultimate concern of isolation focuses on the concept of aloneness, which is not to be confused with loneliness (Yalom & Josselson, 2019). Existential isolation is experienced intrapersonally (Breitbart, 2017) and refers to the fundamental aloneness of the self that exists despite connections one may have to others (Yalom & Josselson, 2019). Existential isolation speaks to the uniqueness of individual experience, and the reality that the perceived world of one person can never be experienced by another person (Breitbart, 2017). Interpersonal relationships and deep connections can offer great comfort given the reality of individual aloneness but there is no cure to the reality of existential isolation (Yalom & Josselson, 2019). A client must take responsibility for their life and recognize their existential isolation in such a way that foregoes the idea that their aloneness is impacted or guarded by the existence of others (Yalom & Josselson, 2019). Living authentically is to live with the understanding that the individual is responsible for their life and for every decision that creates their life (Breitbart, 2017).
Meaning as an ultimate concern is founded in the belief that humans require meaning in their life, one of their own making, that is robust enough to build a life around (Yalom & Josselson, 2019). The unmet desire for meaning, along with the associated structure that meaning provides, can be at the core of numerous manifestations of psychopathology (Yalom & Josselson, 2019). Finding meaning is about focusing on the internal, to see that meaning comes from the individual and not at the individual (Yalom & Josselson, 2019).
Resources
Breitbart, W. (2017). Existential isolation. Palliative and Supportive Care, 15(4), 403-404. doi:10.1017/S1478951517000621
Diamond, S. A. (2021). Existential therapy and Jungian analysis: Toward an existential depth psychology. Journal of Humanistic Psychology, 61(5), 665-720.
Yalom, I. D., & Josselson, R. (2019). Existential psychotherapy. In D. Wedding & R. J. Corsini (Eds.), Current psychotherapies (11th ed.) pp. 273-308. Boston, MA: Cengage.