Theory Series: Existential Psychotherapy
Existential Psychotherapy (EP) is a deep, philosophical approach to therapy, mixed with contemporary counseling approaches. While it is unique in its theoretical underpinnings, EP draws influence from several other theories, including Transpersonal, Humanistic, and Psychoanalytic theories. Primarily, it is derived from the philosophies of Friedrich Nietzsche and Soren Kierkegaard. In practice, the focus is kept on phenomenology (the idea that events are separate from consciousness and as such they can be observed) and how each individual can hold a unique perspective on the same occurrence. This can differ fundamentally from constructivist concepts that posit that reality exists within the human experience, instead of externally observed by it - way more to come on that!
One of the main goals of EP is to confront the uncomfortable nature of being by finding meaning in the examination and understanding of human existence. To achieve this goal, clients of EP are taught that humans have free will and free choice and that through taking responsibility for their decisions, they can transcend their struggles - an idea that is rapidly falling out of favor in American society to what I view as a detriment to our mental health. This is an intensely powerful idea that often translates to efficacy in the counseling setting. As part of this worldview, suffering is seen as unavoidable in life. As such, it is something to be accepted and can be addressed by focusing on larger life phenomena like the relationships between isolation and connection, life and death, freedom and responsibility, meaning and meaninglessness, and authenticity and vulnerability.
Perhaps the most famous aspect of EP is illustrated by Viktor Frankl’s famous biographical/philosophical reflection Man’s Search for Meaning in which he details his time surviving in a Nazi concentration camp. Frankl came away from his experience believing that, armed with meaning in their lives, individuals can survive any situation and continue to thrive. This powerful insight laid the bedrock for his version of therapy, called Logotherapy, combining meaning and existence. Although EP has evolved since, Logotherapy is deeply embedded in EP and would likely not exist without it.
EP in practice is fluid and does not rely on structured lessons or psychoeducation as with CBT and some other therapies. Instead, it approaches clinical issues pragmatically, seeking to assess the client’s perceptions of their issues, what potential causes could be at play, and finally, how to act and think to ultimately assuage suffering. Although there is no neatly formatted clinical progression for EP, an example of its application could look something like this:
Counselor and client work together to identify troublesome perceptions of phenomena in the world (i.e. what is your take on what your problem is?)
Identify the individual factors contributing the issue
Identify the external factors contributing the issue
Formulate an idea of what the issue is
Act towards resolving the perceived issues and towards finding greater meaning in life
As a feature of EP being phenomenological, the theory adapts to each individual’s experience of the world, making a cookie-cutter approach impossible. EP requires knowledge and experience of each culture, gender, socioeconomic status, etc of the person in therapy, uncovered deliberately and slowly. As a result, it is rarely brief in nature, aiming for long-term change from long term counseling. Because it requires a great deal of self-disclosure, it requires clients to dig deep to make meaningful changes. While some people may prioritize expediency in counseling, in my opinion, this is ideal for individuals who want to make meaningful changes in their lives. Additionally, because it is tailored to the individual, EP can work for nearly any population, in any life stage or circumstance.
For anyone interested in learning more about existential therapy, or in just reading a classic human story, I beg you to start with Man’s Search for Meaning. For something more specific to the therapy/counseling aspect, you can check out Existential Psychotherapy by Irvin Yalom, which is considered one of the founding texts of this theory, aggregating core philosophies of EP packaging them for modern counseling.
