Existential therapy

History of existential therapy

The roots of existential psychotherapy lie in philosophy from the 1800s, and more importantly with philosophers whose work dealt with human existence. The philosophers most commonly associated with existential therapy are Søren Kierkegaard and Friedrich Nietzsche. While the two influential thinkers were in conflict regarding the predominant ideologies of their time, they were committed to the exploration of reality and how it was experienced.

Kierkegaard theorised that human discontent could only be overcome via internal wisdom, while Nietzsche introduced the idea of free will and personal responsibility. By the 1900s philosophers like Sartre and Heidegger had begun exploring the role interpretation and investigation had in the healing process.

Over the next few decades other contemporaries began to acknowledge the importance of 'experiencing' in terms of achieving psychological well-being.  

Theories of the existential approach

A key element of existential counselling is that it does not place emphasis on past events like some other therapy types. The approach does take the past into consideration, and through retrospection the therapist and individual can understand the implications of past events. Instead of putting blame on events from the past however, existential counselling uses them as insight, becoming a tool to promote freedom and assertiveness. Coming to the realisation that you are not defined by your history and that you are not destined to have a certain future is often a breakthrough that offers liberation during this type of therapy.

Practitioners of existential therapy say that its role is to help facilitate an individual's own encounter with themselves and to work alongside them as they explore values, assumptions and ideals. An existential therapist will look to avoid imposing their own judgements and instead help the individual elucidate and elaborate on their own perspective.

The therapist should enter sessions with an open mind and be ready to question his or her own biases and assumptions. Bringing an almost deliberate naivety to the therapeutic relationship, the goal of the therapist is to understand the individual's assumptions with a clarity that the individual themselves may not be able to muster.

A belief that lies at the heart of existential counselling is that even though humans are essentially alone in the world, they long to be connected with others. This belief can help to explain why certain concerns appear and may help the individual understand why they feel the way they do sometimes.

Another interesting theory is that inner conflict stems from an individual's confrontation with the givens of existence. These givens were noted by influential psychotherapist Irvin D. Yalom, and include:

• the inevitability of death
• freedom and its attendant responsibility
• existential isolation
• meaninglessness.

These four givens (also known as 'ultimate concerns') are the cornerstones of existential psychotherapy and compose the framework in which the therapist identifies the individual's issue. Once the issue has been conceptualised by the therapist, a method of treatment can be developed.

Due to the all-encompassing nature of existential therapy, it is near impossible to describe one single view when it comes to the causes for psychological upset. The therapy instead treats each person as an individual, exploring his or her experience and relating it to the experience of all mankind.

The four realms

Within existential psychotherapy there is a description of four different levels of experience and existence with which people are inevitably confronted. These can often help individuals understand the context of their concerns. It is believed that a person's orientation towards the world and the four realms defines their reality. There are various names for the four realms within existential therapy, however the following are perhaps the best-known:

1. The physical realm

This world or realm is centred around physicality. It is the world we share with animals, the world of bodily needs. It is the world that stores desire, relief, sleep/awake cycles and nature. Birth, death and physical feelings/symptoms are also part of this realm.

2. The social realm

Within the social realm lies everything to do with relationships. Culture, society and language are here as well as work, attitudes towards authority, race and family. Emotions, friendships and romantic relationships are also part of the social world.

3. The personal realm

The personal realm is concerned with issues of the self. This includes intimacy (with self and others), identity, personal characteristics and overall sense of self. Personal strengths and weaknesses are also important as well as the question of being authentic.

4. The making realm

The final realm is considered our 'ideal' world. Included within it are religion, values, beliefs and transformation. This is the dimension where we make sense of our lives and is considered the realm of transcendence.

How existential counselling could help

One of the primary aims of existential therapy is to help people face the anxieties of life head on and to embrace the freedom of choice humans have, taking full responsibility for these choices as they do so. Existential therapists look to help individuals live more authentically and to be less concerned with superficiality. They also encourage clients to take ownership of their lives, to find meaning and to live fully in the present.

Individuals who are interested in self examination and who view their concerns as issues of living rather than symptoms of a psychiatric illness are more likely to benefit from this approach to counselling. Existential therapy is also well suited to those facing issues of existence, for example those with a terminal illness, those contemplating suicide, or even those going through a transition in their life.

If you want to find out more about the existential approach, speaking to a professional with experience in this area is advised.