How to Heal with Existential Therapy

Existential therapy is a form of psychological counseling that is rooted in the ideals and philosophies of existentialism. Because existentialism is the philosophy of basic human existence, the therapeutic methods of existential therapy aim to bring the patient to an individual place of acceptance of the way things are, in particular, his or her existence. In order to understand how existential therapy works, we have to first understand the basic givens of existentialism. Existentialism says that humans are thrown into existence and that we can not fully know why or how. In addition, existentialism says that humans experience isolation, meaninglessness, and death. These absolute givens in the human experience cause all of us to suffer in our lives at one point or another (usually many times throughout our lives). One of the biggest manifestations of that suffering is anxiety. Depression, frustration, and anger are also common ways we express our experience with the givens in existentialism.

How Does Existential Therapy Address Human Pain?

Existential therapy addresses human pain by helping the patient to:

• Understand the pain
• Find ways to alleviate the pain.

The focus of existential therapy is on the development of self-awareness and self understanding because existential therapy contends that we are each responsible for creating the circumstances in our lives and finding meaning for our life experiences.

How Existential Therapy Works Theoretically

First we need to look at the four core dimensions of human existence:

1. Physical
2. Social
3. Psychological
4. Spiritual

We relate first to our physical environment, including our own bodies. Physical limitations due to illness or aging and financial troubles usually fall into this category. Existential therapists help their patients to recognize and accept such limitations. Socially, we relate to others in our world. Therapy issues in this category include relationships, ethnic, class, and race identity, conflict, competition, and failure. The psychological dimension refers to the way we relate to ourselves and our personal sense of identity. Finally, the spiritual dimension has to do with our attitude toward the unknown and how we assign meaning to our experiences.

The Four Main Methods Used in Existential Therapy

Emily van Deurzen, author of the Handbook of Individual Therapy, defines four main methods used in existential therapy. The first is cultivating a naïve attitude, implying that the therapist takes on a naivety that allows the patient to explicitly define his or her own values and themes in life. The second method is facing limitations, meaning that the therapist should help the patients to face the givens in existentialism head on. The givens can be presented as guilt from the consequences of choices and actions, or as anxiety that comes from the many unknowns in life. The third method is exploring a personal world view. This means that the therapist guides the patient in the process of discovering the world according to his or her own unique interpretations. Finally, the fourth method is enquiring into meaning. To do this, the therapist listens carefully to the patient and then guides him or her in the explorations of emotions and beliefs in an attempt to assign meaning to experience.

Existential Therapists: Counseling

In addition to these four methods, there are certain characteristics that existential therapists have that define the way in which counseling should proceed. The first is empathy and neutrality. The existential therapist must remain neutral throughout the process in order to honor the concept of true subjectivity on the part of the patient. The therapist needs to be empathetic so as to alleviate anxiety over loneliness and isolation, but only to the point of easing some of that pain. Ultimately, the experience and concerns are unique to the patient and that autonomy must be honored. An existential therapist is trained to ask “what” and “how” over “why” questions so that the patient can first describe before delving further into the reasons, or meanings of life. Finally, existential therapists are committed to being in attendance during the therapy, and to facilitate, but not do the work because that is up to the patient in order to reach his or her own state of mental health.

How Existential therapy Works Practically

Perhaps the most well-known existential therapy exercise is the technique called the “empty chair” activity. The therapist has the patient sit in one chair facing an empty chair. The empty chair represents another person who is a part of an unresolved issue. The patient then role plays with the imaginary person in the empty chair. The patient moves back and forth speaking out both roles. This helps the patient to become more fully present in the immediate moment and leads to more clarity regarding the unresolved issue. The goal is greater awareness, acceptance of personal responsibility, and resolution.

We see this sort of activity often. The Dr. Phil show is a good example. How many times have you seen either the empty chair activity or something similar as Dr. Phil leads his guests to self-discovery, acceptance, and resolution? Informally I also do this on a regular basis with my dear friend, Kim. She and I are even so good at it that we have quick phone calls to practice out a situation before we actually face it. For example, on her way to work just the other day, she called to play out the potential confrontation she was about to have. She wanted to be clear with herself about her intention and the outcome she hoped to get. My role wasn’t to tell her what to say or what the conflict meant, but rather just to facilitate her own process at figuring it all out. We do this regularly with each other and I often think how fortunate I am to have this sort of friend.

Keep a Journal

Journaling is another common activity in existential therapy. The existential therapist may pose some personal questions that deal with some rather vague ideas and ask the patient to write out his or her thoughts regarding that question. For example, an existential therapist may ask a patient to write his or her own epitaph, asking the patient to delve into the aspect of “who were you in life?” The therapist may have patients explore their feelings of loneliness and isolation, asking when they feel most alone and how they handle it. Another good existential therapy question for patients to write about is what gives your life meaning? Many times, during the process of writing, patients can make great discoveries and uncover meaningful insights.

Why Existential therapy Works: The American Culture

America was founded on dreams and visions of freedom and independence, and on a lot of hard work. We believe that every person has the potential to rise out of any sort of hardship and become a phenomenal success. I remember my second grade teacher telling our whole class that any one of us might grow up to be president of our country. I believed her, even though I was a girl! We preach this potential for self creation all the time in this culture. Freedom of choice is a core American value. We go to wars to defend our freedom and countless Americans have died defending this right. Independence is so highly valued in America that we have to make concentrated efforts to work on collaboration and cooperation. Group identity lags far behind self-identity. These are all existential ideas and values.

It is clear to see then, that we are culturally and socially programmed to be positively receptive to existential therapy. I would even wager to say that existential therapy can be found in some part of all therapeutic strategies in this country to some degree. The strangest place to find it would be in Christian counseling because existentialism does not promote any belief in God and instead, places so much emphasis on the individual self. Nonetheless however, I am certain that existential ideas lie beneath the surface of Biblically based counseling. For example, my first experience in counseling was with a Christian counselor who had me doing the empty chair exercise on my first visit! Our long-term goal was for me to discover me. Now that’s an existential therapy goal if ever there was one!

The bottom line is this: existentialism is based on inevitable realities of the human experience. Whether you believe in a divine power or not, we do exist, and in our existence, we all experience pain and suffering. Existentialism offers us a way to discover our true, authentic selves through the pain and suffering. For me, I see existential therapy as a path through life that is illuminated with hope and yes, those ever coveted American values of freedom and independence.