Lecture 10 existential psychotherapy

Introduction to CounsellingKevin Standish

Learning ObjectivesUnderstand the development of existential

therapyTo define the core concepts of existential

psychotherapyOutline its relevance today

Youtube: Pink Floyd Timehttp://www.youtube.com/watch?v=x6uaWydVf7E

Pink Floyd - TimeTicking away the moments that make up the dull day You fritter and waste the hours in an off hand wayKicking around on a piece of ground in your home

townWaiting for someone or something to show you the

wayTired of lying in the sunshine staying home to watch

the rainYou are young and life is long and there is time to kill

todayAnd then one day you find that ten years have got

behind you… No one told you when to run, you missed the starting gun

Time, part IIAnd you run and run to catch up with the sun, but it's sinking…

And racing around to come up behind you againThe sun is the same in a relative way, but you're olderShorter of breath and one day closer to deathEvery year is getting shorter, never seem to find the timePlans that either come to naught or a half page of scribbled linesHanging on in a quiet desperation is the English wayThe time is gone the song is over, thought I'd something more to

sayHome, home again I like to be here when I can When I come home cold and tired It's good to warm my bones beside the fire Far away across the field The tolling of the iron bell Calls the faithful to their knees To hear the softly spoken magic spells

HistoryExistential thinking has occurred throughout

history.Exemplified by Augustine, Pascal, Kierkegaard,

Nietzsche.Fundamental questions leading to the

development of existential psychotherapy included:Where was the actual immediate person to whom these

things were happening?Are we seeing clients as they really are, or are we simply

seeing a projection of our theories about them?

HistoryIn 1958 existential psychotherapy introduced to

the US with publication of Existence: A New Dimension in Psychiatry and Psychology by Rollo May, Ernest Angel, and Henri Ellenberger

In 1981 Yalom published the first comprehensive textbook in existential psychiatry entitled Existential Psychotherapy

HistoryOther Important WritingsRollo May’s The Meaning of Anxiety (1977); Man’s

Search for Himself (1953); Existential Psychology (1961)

James Bugental’s The Search for Existential Identity (1976)

Victor Frankl’s Man’s Search for Meaning (1963)

IntroductionExistential psychotherapy is not a specific

technique or set of techniques. It is more

philosophical in nature

Existential psychotherapy is a philosophy about human nature

Proponents of existential psychotherapy have not advocated specific training institutes

because its presupposition can underlie any form of therapy

IntroductionIn existential terms, the conflicts individuals

experience are regarding the givens of existence

From the existential perspective "deep" conflict means the most fundamental concern at that moment

Important InfluencesVictor Frankl

Prisoner, Nazi Concentration Camps-1942-45-lost entire family; Spiritual freedom & independenceof mind can be had in the worst situations;Essence lies in searching for meaning & purpose

Rollo May American psychiatrist; many books on existential therapy, integrated psychoanalysis and existential therapy - He had two failed marriages- wrote extensively regarding questions of intimacy, monogamy, morals of relationships, studied with Adler

Irvin Yalom: Therapy through Meaning, therapeutic love themes of existential work

Viktor Frankl

Viktor Frankl's approach to existential theory is known as logotherapy.

Rollo May

Rollo May has been instrumental in translating some concepts drawn from existential philosophy and applying them to psychotherapy.

Irvin Yalom

According to Yalom, the concerns that make up the core of existential psychodynamics are

death. freedom. isolation. meaninglessness. http://www.youtube.com/watch?v=73wVVNrDI4I&feature=related

Basic ConceptsExistential psychotherapy is more

philosophical in nature

Existential psychotherapy is not a specific technique

Focuses on issues central to human existence

Basic ConceptsExistential therapy is basically an

experiential approach to therapy It is based on a personal relationship

between client and therapist.

It stresses personal freedom in deciding one's fate.

It places primary value on self-awareness.

View of Human Nature

The basic dimensions of the human condition are …1. The capacity for self-awareness2. The tension between freedom &

responsibility3. The creation of an identity &

establishing meaningful relationships4. The search for meaning, purpose,

and values of life5. Accepting anxiety as a condition of

living6. The awareness of death and

nonbeing

1. The Capacity for Self-Awareness We can reflect and make choices because we are

capable of self-awareness. Expanding our awareness in realizing that:

We are finite - time is limited We have the potential, the choice, to act or not to act Meaning is not automatic - we must seek it We are subject to loneliness, meaninglessness,

emptiness, guilt, and isolation

2. Freedom and Responsibility

The central issue in therapy is freedom and responsibility.

A concept ultimately associated with freedom is assuming responsibility

The existential concept of freedom refers to the fact that we are the authors of our own world

The bridge between wishing and action is decision

Freedom and Responsibility We are free to choose among alternatives We are responsible for our lives, for our action,

and for our failure to take action. Blaming others for their problems---

Recognize how they allowed others to decide for them and the price they pay

Encourage them to consider the alternative options

We Cannot Escape

Freedom and Responsibility

Existential therapy is rooted in the premise that humans cannot escape from freedom and responsibility.

Freedom and Responsibility involves the notion that …

our freedom requires us to accept

responsibility for directing our own life.

we are free to choose who we will be. they go hand in hand.

QuestionWhat are the possible reasons

that people tend to blame others for their problems?

The Concept of “Bad Faith”

The concept of "bad faith" refers to leading an inauthentic existence.

An Example of Bad Faith

A example statement that illustrates "bad faith" is - naturally I'm this way, because I grew up in an alcoholic family.

Striving for Identity Identity is “the courage to be”

We must trust ourselves to search within and find our own answers

Our great fear is that we will discover that there is no core, no self

Struggling with our identity: Challenging clients---in what ways that they have lost

touch with their identity and letting others to design their life.

Relationship to others

Aloneness We are alone---So, we must give a sense of

meaning to life, decide how we will live, have a relationship with ourselves, and learn to listen to ourselves.

Relatedness We need to create a close relationship with others Challenging clients----What they get from the

relationship? How they avoid close relationship?

Relatedness can be Therapeutic

Existentialists contend that the experience of relatedness to other human beings can be therapeutic.

Question What is the meaning or purpose of your life?

What do you want from life? Where is the source of meaning for you in life?

The Search for Meaning Meaninglessness in life leads to emptiness and

hollowness (existential vacuum)

Existentialists believe that the major solution to

meaninglessness is engagement

Finding meaning in life is a by-product of engagement, which is a commitment to creating, loving, working, and building.

5. Accepting Anxiety as a Condition of Living

Anxiety – A Condition of Living Existential therapists define anxiety as a

threat to our existence Anxiety arises from one’s strivings to

survive. If anxiety is proportionate to the situation

confronted, existentialists would consider it normal anxiety

In contrast to normal anxiety, neurotic anxiety is repressed unconscious impulses

AnxietyExistential anxiety is normal

an outcome of being confronted with the four givens of existence: death, freedom, existential isolation, and meaninglessness.

Anxiety can be a stimulus for growth as we become aware of and accept our freedom

Normal Anxiety

According to May, freedom and anxiety are two sides of the same coin.

Existential anxiety is seen as a function of our acceptance of our aloneness.

From the existential viewpoint, the aim of therapy is NOT to eliminate anxiety so clients can live comfortably.

Existential Model of AnxietyAwareness of Ultimate Concern

Anxiety

Defenses

Existential Model of AnxietyAnxiety is more basic than fear.Anxiety arises from our personal need to

survive, to preserve our being, and to assert our being.

Normal anxiety is proportionate to the situation. It does not require repression and can be used for creativity.

Neurotic anxiety exceeds or minimizes the situation, is repressed and destructive.(Normal anxiety is seen as proportionate to the

situation involved. When the anxiety exceeds the situation present, it is considered neurotic.)

6.The Awareness of Death and Nonbeing

Death

According to the existential viewpoint, death gives significance to living.

QuestionIf you had only have 30 days

left, what would you feel? What will you do?

Awareness of Death Death provides the motivation for us to

live our lives fully and take advantage of each opportunity to do something meaningful.

Ontology of BeingThe Basic “I-Am” Experience

The "I-Am" experience is about being i.e., the realization of one’s being

The term ontological means science of being (or the nature of being)

Existentialists consider the "I am" experience as a precondition for a solution in life and feel that this is an ontological experience

“I am now living and I could take my life” “The idea of suicide has saved my life

many times.” Nietzsche

Six Ontological Principles1. Humans are centered in self and derive meaning

from that center.2. Humans are responsible for mobilizing the courage

to protect, affirm, and enhance the self.3. People need other people with whom they can

empathize and learn.4. People are vigilant about potential dangers to self.5. Humans can be aware of themselves thinking and

feeling at one moment and may be aware of themselves as the person who thinks and feels in the next moment.

6. Anxiety originates out of awareness that one’s being can end.

OntologyExistential psychotherapy seeks a deeper and

more discerning type of therapyThe “I am” experience is not a solution in itself it

is a precondition for a solutionAn ontological experience;

Ontis = “to be” and Logical = “the science of”Nonbeing is illustrated in the experience of fear

of death, destructive hostility, severe anxiety and critical illness

The Three Forms of Being-in-the-World1. Umwelt – world around, biological world2. Mitwelt – with world, world of one’s fellow

human beings3. Eigenwelt – own world; relationship to one’s

self

Human Capacity to Transcend the Immediate SituationTranscend means “to climb over and beyond”Existing involves a continual emerging

When an individual can move past a situation in order to move towards their future, it is said that the person has transcended the immediate situation

Existential PsychotherapyA form of dynamic psychotherapyHolds a different view of inner

conflictConflict is between the individual and the

“givens” of existence termed ultimate concernsDeath.Freedom.Isolation.Meaninglessness.

Existential PsychotherapyDeath.The most obvious ultimate concern.“A terrible truth”.Conflict between awareness of death and

desire to live.To cope we erect defenses against death

awareness.Psychopathology in part is due to failure to

deal with the inevitability of death.

Existential PsychotherapyFreedomRefers to the fact that humans are the authors of

their own worldWe are responsible for our own choicesConflict is between groundlessness and desire for

ground/structureImplications for therapy

ResponsibilityWilling ImpulsivityCompulsivityDecision

Existential PsychotherapyIsolation – The fact that we are isolated from parts of

ourselves is termed intrapersonal isolation Intrapersonal isolation = Fact we are isolated

from parts of ourselvesA form of isolation that refers to the fact that each

of us enters and departs the world alone is existential

Existential isolation differs from Interpersonal isolation = Divide between self and othersIntrapersonal isolation = Fact we are isolated from

parts of ourselves

Existential PsychotherapyMeaninglessnessMeaning creates hierarchal order of our values

From a schema regarding the meaning of life an individual generates a hierarchy of values

Tells us how to live not why to liveConflict stems from “How does a being who

requires meaning find meaning in a universe that has no meaning?”

Existential PsychotherapyExistential Frame of ReferenceSpecialness

Despite rationality we often believe the laws of biology are not applicable to us

Ultimate RescuerBelief in a personal omnipotent servant to guard

and protect us(To cope with ultimate concerns regarding death

individuals will often use the defense mechanism of creating an ultimate rescuer)

Existential PsychotherapyExistentialists hypothesize that anxiety is the result

of awareness of ultimate concerns.Ultimate concerns create experiences, which

force us to confront an existential situation called boundary situations.

An experience which forces an individual to confront an existential issue is known as a boundary situation. Examples might be diagnosis of a terminal illness or

death of a family member or friend.Psychotherapy can address existential isolation.Jung suggested 30% of patients seek treatment

because of personal meaninglessness.

Therapeutic Goals To expand self-awareness. To increase potential choices. To help the client accept the responsibility for their

choice. To help the client experience authentic existence.

Therapist’s Function and Role Understand the client’s subjective world. Encourage clients to accept personal responsibility. When clients blame others, therapist is likely to ask

them how they contributed to their situation.

A Prime Factor in Determining the Outcomes of Therapy

The existential approach puts emphasis on the therapist as a person and the quality of the client/therapist relationship as one of the prime factors in determining the outcomes of therapy.

Client’s Experience in Therapy They are challenged to take responsibility. Major themes in therapy sessions are anxiety,

freedom and responsibility, isolation, death, and the search for meaning.

Assist client in facing life with courage, hope, and a willingness to find meaning in life.

Philosophically, the existentialist would agree that:

the final decisions and choices rest with the client. people redefine themselves by their choices. a person can go beyond early conditioning. making choices can create anxiety.

Relationship Between Therapist and Client

Therapy is a journey taken by therapist and client. The person-to-person relationship is key. The relationship demands that therapists be in

contact with their own world. The core of the therapeutic relationship.

Respect and faith in the clients’ potential to cope and discover alternative ways of being.

Therapists share their reactions to clients with genuine concern and empathy as one way of deepening the therapeutic relationship.

Therapeutic techniques and procedures

It is not technique-oriented. The interventions are based on philosophical

views about the nature of human existence. Free for draw techniques from other

orientations The use of therapist self is the core of therapy.

Subjective understanding of

clients is primary

In the existential approach subjective understanding of clients is primary and techniques are secondary.

The term unfolding refers to the therapist's attempt to uncover with the patient what was there all along.

Questions Which populations is existential therapy particularly

useful?

Which issues is existential therapy particularly useful?

Application of Existential Psychotherapy.

Existential therapy is especially appropriate for clients who are struggling with:

Developmental crises.Identity in adolescents.Coping with disappointments in family and careerGrief counseling. Coping with physical limitations as one ages.Low self confidenceFeelings of inadequacyStress / tensionSocial anxiety

From a multicultural perspective Contributions

Applicable to diverse clients to search for meaning for life

Be able to examine the behavior is influenced by social and cultural factors.

Help clients to weigh the alternatives and consequences.

Change external environment and recognize how they contribute

From a multicultural perspective Limitations

Excessively individualistic. Ignore social factors that cause human problems. Even if clients change internally, they see little hope

the external realities of racism or discrimination will change

For many cultures, it is not possible to talk about self and self-determination apart from the context of the social network.

Many clients expect a structured and problem-oriented approach instead of discussion of philosophical questions.

Pros

Something to offer all counselors, Stresses self-determination, Accepting the personal responsibility, Provides perspective for understanding the value

of anxiety and guilt, the role of death, and the creative aspects of being alone

and choosing for oneself.

and ConsCONS: Lacks a systematic statement of principles and

practices; writers use vague and global terms or abstract concepts; little research, limited applications for lower-functioning clients, clients in extreme crisis who need direction, those who are nonverbal.

http://www.existentialanalysis.org.uk/

short film of a cat with "existential despair." http://www.youtube.com/watch?v=0M7ibPk37_U

Readings1. McLeod J. (2009) An Introduction to

Counselling. Chap 102. Corey, G. (2009) Theory and Practice of

Counseling and Psychotherapy.Chap 63. Colledge, R (2002) Mastering Counselling

Theory chap 10 & 114.Dryden, W ( 2007) Dryden’s Handbook of

Individual therapy. Chap 8Advanced readingJacobsen (2003) Is Gift-Giving the Core of

Existential Therapy?Dryden (2007) chap 8Yalom (2003) the gift of therapyYalom (1980) existential psychotherapyCooper, M (2003) Existential Therapies. (in

dawson books)

Advanced reading

Jacobsen (2003) Is Gift-Giving the Core of Existential Therapy?

Dryden (2007) chap 8Yalom (2003) the gift of therapyYalom (1980) existential psychotherapyCooper, M (2003) Existential Therapies. (in

dawson books)