Existential counselling – an alternative approach?

Ever since counselling became established as a useful way to help individuals work through difficult emotional issues, there have been ongoing discussions about what is the most effective therapeutic approach.

There are a myriad of different approaches now offered to clients. These can range from a standard formulaic approach to counselling sessions to alternatives that are specific and unique to each individual.

For some, CBT will be seen as an example of that standardised and structured technique which is sometimes provided within a very disciplined and even directive framework. Other approaches such as open ended psychodynamic therapy will have a greater focus on facilitating understanding and personal development rather than looking to achieve something akin to a cure.

If CBT and psychodynamic counselling are perhaps the best known models, there many other counselling strategies for clients to choose from. These can range from further therapies found within the CBT family and purporting to be so called evidence based through to more open therapies which encourage a sense of self exploration. 

Clients seeking therapy may want to ensure that they have some understanding of the therapy to be offered to them in order to ensure that there is a good fit between their particular needs and the therapeutic approach followed by a particular counsellor. The challenge for the potential client is to understand what is meant by some of the different counselling offerings available and that is not always easy to do.

One of the less well known forms of counselling for not just members of the public but also some therapists, is existential therapy. Yet for many people this way of working can provide an extremely helpful insight into her or his immediate emotional world.

This short article is intended to provide a reflection of two specific ideas which can often form a key focus within existential counselling work.

We should recognise at the outset that the term existential can be off putting. The very word existential carries with it a suggestion of some intellectual pretentiousness. Pictures can quickly form of earnest philosophers smoking Gauloises cigarettes somewhere on the Left Bank and ruminating on the meaning of existence over endless espressos or copious amounts of red wine. For the seekers of the absurd, there is surely a Monty Python sketch hidden somewhere in the archives which captures this image.

Despite this expected fog of obscurity, much existential literature from the likes of Albert Camus and Sartre can be very readable. The same is true of some existential counselling work. Two key existential therapists and writers who are always worth reading, whether by client or counsellor, are Irvin Yalom and Emily van Deurzen.

And if the prospect of reading about existential therapy sounds perhaps too intense, do not be put off. There is a misconception that existential work must always be heavy with a sense of the desolate.  In fact the reverse is true. Existential thought encourages us to embrace the world as it is today. More importantly there is a focus on our personal world which is fashioned by our choices and our own sense of responsibility. A key issue for the existentialist is to see the world as it is and to be both willing and able to acknowledge our individual place within it. An exciting and liberating thought is that we own that place.

Yet this way of thinking is not intended to be insular or to suggest that we are somehow beyond the influence of others. We act and interact on a daily basis with people both close to us and those who are passing strangers. We are impacted by the behaviour of others but it is very much up to each of us to decide how to react to those influences. A key tenet of existential thought is to accept that we may not be able to change either the behaviour of others or our immediate surroundings but we can choose how to react to and think about the circumstances we find ourselves in.

An existential thinker Viktor Frankel who spent time in Auschwitz and Dachau provides a moving exploration of this way of thinking in his book Man’s Search for Meaning. Frankel reflects on his experiences within the concentration camps. The subject matter may sound bleak but the content is remarkable. There is a sense of liberation within a place of incarceration.

A key existential concept centres on choice. We are not always free to choose how to act. An example is around health. We do not of course have control over the inevitable health impact of the aging process. We can however choose how to think about what is happening to us. The internal picture of how we are coping with for example any physical change, is created according to our own thoughts and decisions on how things should be. In the case of difficult circumstances, that internal image can show us as the victim, rescuer, prosecutor or bystander according to the internal narrative we choose to speak. 

Life can on occasions be challenging and even cruel. We may be hurt by what has occurred – and that hurt can be physical or emotional. We may not have control over the immediate impact of that hurt but we can choose how to show that pain. We can decide how to subsequently allow our emotions to develop. Whether we wish to search for understanding and compassion or revenge and retribution is for each of us to choose.

A second existential concept which walks alongside choice, is that of responsibility. And responsibility is something which clients can occasionally be almost too ready to seek out in the therapy room.

“It is all my fault,…I am to blame…..if only I had not…. “ and then fill in the missing words to fit many different scenarios. What will often follow those self-blaming phrases is an outburst of shame as the client wrestles with internal guilt.

Of course there are occasions when that sense of guilt has an understandable basis to it but often that guilt can be magnified by clients out of all proportion to what has occurred. In those situations we can work in the therapy room to help the client re-examine and perhaps lessen that feeling of responsibility.

The reality of responsibility can present in different ways. For example if I am to end a relationship then the manner in which I choose to do that will certainly have an influence on how the news is received by the other person. To end a relationship by openly flaunting the existence of a new lover is likely to be more painful than some carefully chosen words quietly and gently conveyed.

Yet whatever the message and however it is delivered, the response, whether anger or tears, fury or contempt, belongs not to me but to the other person. The resulting decision by that person to perhaps take to substance abuse, to hide away or to actively seek out multiple replacement lovers is one for that individual to own. I take responsibility for my actions but I am not the other person.

I live my life according to the rules that I decide to adhere to. Responsibility is about both understanding why and accepting what has occurred. To focus on responsibility is to take an opportunity to achieve a deeper level of understanding – and to then decide what to do with that understanding. That acceptance of responsibility may lead to an apology or a repetition; it may lead to a rebirth or a resignation. The choice lies with us and that choice is firmly rooted in our personal sense of responsibility. 

Existential therapy encourages us to work with what is real for us.  Our lives are our responsibility and our choices are our decisions.

Sometimes however these ideas can be challenging to face. It may be on those occasions that it can be helpful to have a place such as the therapy room to both work through those choices and to explore the implications of our responsibility. The structure and the limits to this work will be decided by therapist and client – and the client will decide how to be with the outcome.

The existential world can be bleak or exciting, lonely or liberating.  Within the counselling room there is a chance to explore that existential sense of self alongside a therapist who will support that work. But as to the responsibility? Does the therapist share the responsibility for what occurs within the room or does that belong to the client. Perhaps both hold their own area of responsibility for this work? 

So let us return to the start of this note.

Some therapies will have a structure and a set of techniques which some counsellors may impart in an almost didactic way. For some clients seeking well defined programmed relief that may be a helpful approach.

For others there may be a compelling wish to explore a wider and deeper context and that is when an existential approach may be particularly helpful. Existential counselling like some other open ended approaches invites exploration. Within existential counselling there is no set structure. There are no diaries to complete and no forms to hide behind. Just a reality to face. Your reality, your life and your opportunity, 

The terrain may be familiar and yet challenging. It is up to the client to decide how far up to climb or how far down to descend. But within the therapy room with a trained counsellor there will be the equivalent of some supporting ropes to help keep the client safe.

So back to those counselling approaches and techniques. There are many different ways of working in the therapy room. That means for the new client there are some choices to be made. And from an existential perspective, that decision as to how to work and who to work with, ultimately belongs to you!