existential psychotherapy (or counseling)
grounded in existential philosophy; focuses on self-awareness, facing the unavoidable conditions of human existence, & authentic living.
- Sartre claims there are no absolute or essential truths (essences). Instead, individuals create their own truth & reality.
Existentialism is antideterministic
dialectic
process where learning is stimulated from the integration of opposites -> one hand, some existentialists embrace religious faith, where others are atheistic & some claim agnostic middle ground. These differences in beliefs represent a sweep of intellectual diversity & provide for philosophical exploration.
Viktor Frankl
Logotherapy focuses on helping clients find meaning.
- Although he was a strong proponent of freedom, Frankl believed freedom would degenerate wout responsibility
Rollo May
The Meaning of Anxiety -> argued that anxiety was an essential component of the human condition.
“…I happen to exist at this given moment in time and space,
and my problem is how am I going to be aware of that fact and what am I going to do about it?”
Georg Wilhelm Friedrich Hegel
believed human reasoning & ideas evolve through a dialectical process that involves: (a) concept or idea is developed, which (b) fuels generation of the opposite idea, which (c) produces conflict between the ideas. Through this (d) a new, synthesized, & higher lvl of truth is understood.
- DBT practitioners adopt a dialectical position of radical
acceptance when working w clients: “I accept you as you are, and I am committed to helping you to change for the better”
ongoing polarized struggles w/in ppl can be seen as a primary pathway toward deeper understanding of the true nature of the self
the I-am experience (ontological experience)
experience of being, of existing; focus of existential therapy consists of exploring immediate human experience.
Four Existential Ways of Being
- Umwelt: Being-w-nature or the physical world.
- Mitwelt: Being-w-others or the social world.
- Eigenwelt: Being-w-oneself or the world of the self.
- Uberwelt: Being-w-the-spiritual or over world.
*the direction your being-ness moves in a situation is likely a combination of several factors, like: awareness, anxiety, previous experiences, intention, &/or spiritual predisposition.
The Daimonic
any natural function which has the power to take over the whole person; an elemental force, energy, or urge residing w/in all persons that functions as the source of constructive & detructive impulses.
- Daimon possession was used to explain psychotic episodes & is popularly referred to as demonic possession (but not the same)
The goal is to integrate natural daimonic urges & energies in ways that maximize constructive & creative behavior
the nature of anxiety
anxiety leads to authenticity & freedom.
- anxiety should be explored, experienced, engaged, & redirected into constructive activities; not seek to avoid it.
normal vs neurotic anxiety
normal - directly proportional to situation; meaningful as it enters awareness & stimulates constructive action. It doesn’t require repression or other defensive processes.
neurotic - disproportionate to the situation; usually repressed, denied, or avoided; it’s not used for creative or constructive purposes; it is destructive.
Three key differences:
1. Deny the importance of your life demands.
2. Respond or react to situation out of desperation, rather than proactively & w creativity.
3. End up increasing chances of having difficulties down the road bc haven’t responsibly maintained yourself.
normal vs neurotic guilt
Guilt inspires ppl to act in thoughtful & conscientious ways.
normal - like a sensor: alerts us to what is ethically correct & guides us toward morally acceptable behavior.
neurotic - consists of a twisted, exaggerated, or minimized version of normal guilt.
As w anxiety, guilt is best dealt w directly & constructively.
existential psychodynamics or “ultimate concerns”
Ultimate concerns produce anxiety; these concerns must be dealt w directly or indirectly via defense mechanisms (pattern of avoiding anxiety that should be brought to awareness).
4 ultimate concerns (everyone must confront these 4 demands):
1. Death.
2. Freedom.
3. Isolation.
4. Meaninglessness.
death
1) death & life exist simultaneously, death cannot be ignored. 2) death is a “primordial source of anxiety” & a main source of psychopathology
- facing death is one method for experiencing life more deeply & fully.
- when ppl embrace the present, they can approach death w/out increased psychopathology or emotional distress.
freedom
humans are condemned to freedom (an anxiety-laden burden)
- the more freedom you experience, the more choices you have; the more choices you have, the more responsibility you have; & having a large load of responsibility can translate into a large load of anxiety.
you & you alone are the author of your experiences
isolation
every individual is fundamentally alone; being alone can be a terrifying truth.
- help clients connect as deeply as possible w others, while acknowledging their incontrovertible separateness.
- I-thou relationship: deepest of all possible connections between 2 ppl. It’s a mutual & celebratory relationship, in which both self & other are fully experienced.
- isolation vs fusion: denial is a common way that humans deal w frightening existential isolation -> one way to deny isolation is through love or fusion w another person.
meaninglessness
can be painstaking to grapple with the meaning of one’s life.
- humans are meaning makers: exenstentialists say: “Life has no inherent meaning. It’s up to you to invent, create, or discover meaning in your life.”
- “will to meaning” is a primary motive; it isn’t a drive or push; instead, meaning involves striving or willing.
- a sense of meaningfulness, religiosity, & spirituality are predictive of positive mental health
- Frankl was claiming two things: 1) humans have a will to meaning; 2) meaning exists in the world, up to us to find it.
logotherapy
(logos=meaning; therapeia=healing). Clients are pushed to deal directly w the need for meaning -> individual responsibility: clients are responsible for their choices in the pursuit of meaning. Humans can resolve existential neuroses through a number of paths toward meaning:
- altruism: serve others through kindness & unselfishness
- dedication to a cause: dedicate to political, religious, medical, familial, scientific, etc. (take person beyond selfishness).
- creativity: create smtg beautiful, powerful, & meaningful
- self-transcendence: guilt, depression, personal salvation, & other self-oriented goals put aside to pursue selflessness.
- suffering: face suffering w optimism, dignity, & integrity.
- God/religion: serve God or religion instead of serving self or pursuing material goals.
- hedonism: live life to the fullest each moment & drink up the excitement, joys, & sorrows of daily life.
- self-actualization: dedicate to self-improvement & meeting potential.
self-awareness
central to existential therapy
- the goal of existential therapy is to facilitate self-awareness—including the awareness of death, freedom, isolation, & life’s meaning
Diminished self-awareness might include some or all
of the following characteristics:
- Emotional numbness or automaton living.
- Failure to acknowledge & reconcile life’s ultimate concerns.
- Avoidance of anxiety, guilt, or other meaningful emotions
Keshen (2006)’s psychopathology sequence:
- There is a will to meaning (or purpose) in life.
- The ind is unable to “find or fulfill” authentic meaning.
- The ind therefore experiences an “existential vacuum.”
- Symptoms associated w this vacuum may include: anhedonia, worthlessness, boredom, anxiety, apathy,
emptiness, low self-esteem, or low mood. - The ind engages in a “purpose substitute” instead of directly addressing the need for meaning in life; this substitute might involve addictions, excessive television viewing, or overzealous emphasis on acquisition.
the I-thou relationship
relationship includes depth, mutuality, connection, & immediacy including therapist transparency & authenticity.
can be open to liabilities - given self-deception, it’s possible for therapists to have intuitive impulses that are more attuned to address their own issues & agendas than that of their clients
personal responsibility
as a therapist, you’re responsible for your behavior w/in the therapy session.
- You aren’t responsible for your client’s welfare, you are responsible for the therapy process to which your client is exposed - create conditions that facilitate a good therapeutic encounter & to avoid behaviour that may inhibit therapy progress.
Existential integrative therapy (EIT)
empathic mirroring and focusing are components of (a) presence & (b) invoking the actual. -> Invoking the actual involves a calling of attention to help clients to experience the expansive rage
3 verbal invitations (skills) to aid in invoking the actual:
1) Topical focus: “Take a moment to see what’s present for
you,” “What really matters right now?” & “Can you give me an example?”
2) Topical expansion: “Tell me more,” “Stay w that (feeling) a few moments,” or “You look like you have more to say”
3) Content-process discrepancies: “You say you are fine, but
your face is downcast” or “Your body hunches over as you talk about your girlfriend, I wonder what that’s about” or “When you talk about that job, your eyes seem to moisten”
ways therapists can be responsive or facilitative in the moment w/in therapy sessions
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Chapter 1: Psychotherapy & Counseling Essentials41
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Chapter 2: Psychoanalytic Approaches55
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Chapter 5: Person-Centered Theory & Therapy44
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Chapter 4: Existential Theory & Therapy47
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Cognitive Behavioural Therapy20
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Interpersonal Therapy20
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Motivational Enhancement Therapy16
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Chapter 13: Multicultural Orientation and Skills21
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Pharmacotherapy & Psychotherapy26
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Future Directions & Integration12
