Confronting the Human Condition
Existential Therapy
Existential Therapy is a philosophical approach to counseling that emphasizes the human capacity for self-awareness, freedom, and responsibility. Rather than focusing on techniques or symptoms, it explores the deep, universal concerns (or "givens") of human existence—such as death, freedom, isolation, and meaninglessness—as the source of anxiety and distress. Healing occurs when a person confronts these realities and chooses to live authentically.
Who Created Existential Therapy?
Existential Therapy is not attributed to a single founder but draws heavily from the works of several philosophers and psychiatrists.
Philosophical Roots: Its concepts stem from 19th and 20th-century European philosophers like Søren Kierkegaard (who emphasized anxiety and choice), Friedrich Nietzsche (will to power and meaning), and Jean-Paul Sartre and Albert Camus (freedom and responsibility).
Psychological Pioneers: Key figures who applied these ideas to therapy include:
Viktor Frankl: Developed Logotherapy, focusing on finding meaning even in suffering (Frankl, 1984).
Rollo May: Instrumental in introducing European existential concepts to American psychology, emphasizing anxiety, despair, and the courage to be (May & Yalom, 2000).
Irvin Yalom: Synthesized the approach and identified the four primary "ultimate concerns" (givens) that form the core of the therapy: Death, Freedom, Isolation, and Meaninglessness (Yalom, 1980).
Perspectives in Existential Therapy
The Therapist's Perspective
The Existential Therapist's role is to be a philosophical companion who meets the client with authenticity and deep presence. They do not view distress as strictly a "mental illness" but often as a natural result of confronting the givens of existence or avoiding the necessary anxiety that comes with freedom.
The therapist strives for:
Authentic Relationship: The therapeutic relationship is viewed as a genuine, human-to-human encounter where the therapist shares their own humanness.
Focus on the Givens: They guide the client to confront the four ultimate concerns, believing that anxiety is reduced when clients accept these realities.
Enhancing Awareness: The goal is to help the client become fully aware of their freedom to choose and their responsibility for their life choices ("We are our choices").
The Client's Perspective
The client shifts from asking "Why am I suffering?" to "What meaning will I find in this suffering?" They confront the reality that while they cannot control external events, they are fully free to choose their attitude and response to those events.
The client learns to accept:
Responsibility: Recognizing that avoiding choice (e.g., through indecision or acting like a victim) is itself a choice.
Non-Being (Death): That life has an endpoint, which can be a powerful motivator to live fully now.
Existential Isolation: That while relationships are important, they are fundamentally alone in the task of facing life and death, fostering self-reliance.
Meaning Creation: That life has no intrinsic, pre-determined meaning; they must actively create their own purpose and values.
What to Expect in an Existential Session
Existential therapy is often less structured than CBT or DBT and is deeply personal and exploratory.
Exploration of the "Here and Now": Sessions focus on the client's immediate experience in the room, particularly how they relate to the therapist and how their concerns manifest in the present.
Deep Questioning: The therapist uses profound, open-ended questions to challenge the client's assumptions and deepen self-awareness (e.g., "If you had only six months to live, how would you live differently?", "What about this situation reveals a core value to you?").
Analysis of Meaning and Purpose: Much time is spent exploring the client's values, goals, and sense of purpose. This often involves looking at times when the client felt most alive or most meaningful (Frankl's logotherapy).
Confronting Avoidance: The therapist gently challenges ways the client is avoiding freedom, responsibility, or the anxiety associated with change.
Integration of Anxiety: The therapist helps the client distinguish between normal existential anxiety (which is a necessary call to action) and neurotic anxiety (which is debilitating avoidance).
How Existential Therapy Can Help a Person
Existential therapy helps a person by fostering authenticity and empowering them to live a deeply meaningful life despite, and perhaps because of, life's inevitable challenges.
Reduces Meaningless: By actively engaging in the creation of purpose, clients overcome feelings of emptiness and apathy.
Increases Courage and Action: Confronting the reality of death and freedom motivates clients to stop procrastinating and take responsibility for enacting their values.
Improves Relationships: By reducing neurotic fusion and dependence, clients can form healthier, more authentic relationships that respect the separateness and freedom of both individuals.
Common Uses and Applications (DSM-5 Disorders and Life Problems)
While existential therapy can be used alongside other modalities to treat DSM-5 disorders, it is primarily suited for life problems and adjustment difficulties that involve identity, meaning, and choice:
Major Life Transitions: Retirement, career changes, divorce, "empty nest syndrome," or severe illness.
Grief and Loss: Dealing with the death of a loved one, which forces confrontation with one's own mortality.
Addictions: Focusing on finding meaning as an alternative to substance dependence (as a "meaning substitute").
General Anxiety and Depression: When the root cause is a pervasive feeling of emptiness, lack of purpose, or overwhelming feelings of responsibility.
Mid-Life Crisis and Quarter-Life Crisis.
Ready to Confront Your Life's Deepest Questions?
If you are facing a major life transition, struggling with a lack of purpose, or feeling weighed down by the meaning of your existence, Existential Therapy can help you find courage and create an authentic life.
Book a consultation today to connect with a therapist trained in this profound, human-centered approach.
