Existential Therapy

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Existential Therapy

• EDCE 655
• Theories Techniques II

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Existential Approach
I Am Aware that I am Unique Have Meaning
Who Am I?
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• Existential Psychotherapy is more of a
  therapeutic attitude train of thought than a
  Process Theory!

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Victor E. Frankl (1905-1997)

• That which does not kill me makes me stronger!!!

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Victor Frankl (1905-1997)

• Born in Vienna on March 26, 1905, he earned a
  doctorate in medicine in 1930 and was put in
  charge of a ward treating female suicide
  candidates.
• When the Nazis took power in 1938, Dr. Frankl
  became chief of the neurological department of
  the Rothschild Hospital, the only Jewish hospital
  in Vienna at the time.
• But in 1942, he and his parents were deported to
  the Theresienstadt concentration camp near
  Prague.
• 1945, Dr. Frankl returned to Vienna, where he
  became head physician of the neurological
  department of the Vienna Polyclinic Hospital, a
  position held for 25 yrs.
• Starting in 1961, Dr. Frankl took five
  professorships in the USA -- at Harvard and
  Stanford universities, as well as at universities
  in Dallas, Pittsburgh, and San Diego.

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Victor Frankl (1905-1997)

• Obituary (4 pages) began VIENNA, Austria --
  Psychiatrist Viktor E. Frankl, who transformed
  years of suffering in Nazi concentration camps
  into insights for his lifelong study of man's
  quest for meaning, has died at 92. Dr. Frankl had
  been suffering from heart problems, the Austria
  Press Agency reported, citing the Vienna Viktor
  Frankl Institute. He died in Vienna on Tuesday
  and his funeral was held immediately.
• Dr. Frankl survived Auschwitz and three other
  Nazi concentration camps from 1942 to 1945, but
  his parents and other members of his family died
  in the death camps.
• Dr. Frankl's teachings have been described as the
  Third Vienna School of Psychotherapy, after those
  of Sigmund Freud and Alfred Adler.

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Victor Frankl (1905-1997)

• Dr. Frankl's native Austria virtually ignored
  him, even while his teachings were acclaimed in
  the United States and elsewhere.
• Dr. Frankl's 32 books have been translated into
  26 languages. He also held 29 honorary doctorates
  from universities around the globe.
• "There is nothing in the world, I venture to say,
  that would so effectively help one to survive
  even the worst conditions as the knowledge that
  there is a meaning in one's life," he wrote.
• Dr. Frankl wrote that one can discover the
  meaning in life in three different ways "by
  creating a work or doing a deed by experiencing
  something or encountering someone and by the
  attitude we take toward unavoidable suffering."

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Rollo May

• American spokesperson for Existentialism
• Unhappy childhood 2 failed marriages,
  tuberculosis but not a negative outlook on life
• Studied with Adler in Vienna
• Greatest influence Paul Tillich (German
  Philosopher)
• Writings deal with the nature of the human
  experience, recognizing and dealing with power,
  accepting freedom responsibility, discovering
  ones identity
• Feels that counseling should be aimed at helping
  people discover the meaning of their lives
• Feels the greatest challenge for a person is to
  live in a world alone where they will eventually
  face death

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Definition, Focus, Purpose of Existentialism

• Definitions
• The doctrine that existence takes precedence over
  essence and holding that man is totally free and
  responsible for his acts. This responsibility is
  the source of dread and anguish that encompass
  mankind.
• A philosophy that emphasizes the uniqueness and
  isolation of the individual experience in a
  hostile or indifferent universe, regards human
  existence as unexplainable, and stresses freedom
  of choice and responsibility for the consequences
  of one's acts.
• Focus
• Mankind has free will Life is a series of
  choices that creates stress
• Few decisions are without any negative
  consequences - If one makes a decision, he/she
  must follow through
• Some things are irrational or absurd, without
  explanation
• Emphasizes the limitations and the individual
  power of human existence
• Focus is on the individuals experience while
  dealing with existential key concepts
• Understanding of the persons subjective view or
  the world
• Purpose
• To challenge clients to discover alternatives and
  choose among them
• To allow members to learn that they can chance
  and some things cannot be changed
• Group represents a microcosm of the world where
  self discovery arises through sharing existential
  concerns
• Enabling members to become truthful with
  themselves
• Widening their perspectives on themselves and the
  world around them
• Clarifying what gives meaning to the present and
  future

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Existential Key Concepts

• Self Awareness
• Basic goal - expand self-awareness and increase
  potential for choice
• Help members discover their unique being in the
  world
• Expression of own unique feelings
• Learn to deal with anxiety
• View anxiety in a positive manner
• As we become more aware - it is harder to revert
  back to our old ways
• Higher degree of self-awareness allows us to
  recognize
• to chose to expand our awareness vs. limit our
  perception of self
• determine the direction of our lives vs. allows
  others to determine our lives
• use our potential for action vs. choose not to
  act
• choose to establish meaningful ties with other
  vs. choose to isolate self
• search for uniqueness vs. allow for conformity
• create find meaning in life vs. lead empty
  lives
• engage in risks and anxieties vs. choose security
  of dependence
• make the most out of the present vs. hide from
  reality

• Self-Determination Personal Responsibility
• Freedom to choose between alternatives
• Responsible for directing our lives
• How we are and what we have become is the result
  of our own choices
• Freedom can never be taken form us because we
  have choices
• Help members face and deal with anxieties and
  situations that they cannot escape
• Self-determination is to confront members with
  the realities of freedom and not letting them
  deny it
• When people come to believe that they can direct
  their own destiny, they assume control over their
  lives
• Assistance with observing how one creates a
  victim like existence
• Leader encourages members to assume genuine
  responsibility for their role in group

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Existential Key Concepts

• Existential Anxiety
• A basic characteristic of human beings
• Basic to living with awareness and being fully
  alive
• Can be a strong motivation toward growth
• Results form having to make choices w/o knowing
  the outcomes
• Members adjust too comfortable and resist anxiety
  -this change to accepting anxiety involves
  viewing life as an adventure
• Encourage members to accept anxiety as a
  growth-producing experience
• Assisting members to come to terms with paradoxes
  of existence
• life - death / success - failure
• Must be faced and worked through in counseling
  that involves
• Recognition of need for self and others
• Guilt over not living authentically
• emptiness and lack of meaning
• burden of responsibility choice
• fear of death non being

• Death Nonbeing
• Life has meaning because it must end
• The present is important because it is all we
  have (May, 1983)
• Living life fully vs. merely existing - asking
  how they feel about the quality of their life
• How would you change your life if you knew you
  were going to die?
• Expand death to include other forms of death
• We have areas of our lives that die to make room
  for new growth
• Aloneness Relatedness
• Ultimately we are alone
• We must accept our aloneness and then we can
  genuinely and meaningfully relate to others
• We must stand alone before we can truly stand
  besides another

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Existential Key Concepts

• Search for Meaning
• Who Am I?
• Where Am I Going?
• Why am I here?
• What gives my life purpose and meaning?
• Life does not have a positive meaning itself
• It is up to us to create meaning
• A lack of meaning is the major source of
  existential stress and anxiety
• Existential Vacuum feeling of inner void due to
  lack of meaning
• Counselors assist members in finding meaning for
  themselves
• Challenging and discarding values to become
  meaningful is central for the counselor
• Do you like the direction of your life? If not,
  what are you doing about it?
• What are the aspects of your life that satisfy
  you most?
• What is preventing you from doing what you really
  want to do?

• Search for Authenticity
• Paul Tillich The Courage to Be
• Authentic living is a process
• Being true to ourselves
• Engaging in activities what is meaningful to us
• Becoming a person that we are capable of becoming
• Challenging members to become authentic by
  engaging in life and making commitments

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Strengths Limitations of the Existential
Approach

• Strengths
• People do not have to remain victims of their
  past
• People have the power to decide for themselves
  and take action
• Wide range of applicable group settings
• Help individuals reclaim a sense of power
• Techniques follow understanding - less ability of
  abusing techniques
• Very suitable for those living in foreign
  countries
• Highly Multicultural in orientation
• Respect of uniqueness

• Limitations
• Quite abstract
• Difficult to apply
• Must have the mindset or may feel that concepts
  are elusive and lofty
• Not good for those not interested in
  self-exploration
• Not good for problem-solving or the relief of
  specific symptoms
• Counselors do not serve as a director or
  substitute parent
• Counselors must have a good grasp of the approach

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Group Leader Roles

• Counselor is fully present
• Counselors first concern is with genuinely
  grasping the core struggles of the members
• Experiencing the clients present moment
• Counselor tries to understand the members
  subjective world
• Tasks are accomplished through encounter not
  techniques
• Focus on the human side of members
• Counselors bring their own subjectivity into the
  group
• Change comes from the relationship between
  counselor and member
• Counselors are free to draw from other techniques
  from other orientations
• Counselor must foster meaningful relationships
  among members
• Focus on key existential concepts and explore
  them fully
• Counselors must be and become somebody rather
  than doing or implementing techniques

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Appropriate Populations for Existential Groups

• People who
• feel alienated
• search for meaning
• are at a cross roads
• are at the edge of existence
• Those interested in dealing with their problems
  rather than curing pathology

• Rape Groups
• Battering Groups
• Crime Groups
• Abuse Groups
• Bereavement / Loss Groups
• Empty Self Groups
• Multicultural Groups
• ? ? ? ? ?

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Phases of the Existential Method

• INTAKE PHASE Determining the appropriateness of
  the method and introducing terminology and
  concepts
• Is the method suited to the clients
  expectations, treatment, and capacities?
• What level of reading material is appropriate for
  the client?
• What will be the frequency of the sessions and
  duration of treatment?
• PHASE 1 Recognizing anxiety as a provocation
  that begins the transition to authenticity
• What personal message is contained in my
  quietness?
• What facets of my life have become a matter of
  dissatisfying routine?
• Am I living according to beliefs and values that
  are not my own?
• PHASE 2 Conceptualizing that our existence is
  temporary
• How do I perceive the temporal limits of my
  existence?
• Have I postponed my authentic projects due to
  assuming an abundance of time?
• Am I willing to consider that an awareness of my
  heritage and sense of destiny may open
  possibilities in my present dilemma?

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Phases of the Existential Method

• PHASE 3 Reviewing familial-cultural heritage and
  demonstrated possibilities
• What resources from my heritage and personal
  history are essential for a sense of wholeness
  and purpose?
• What possibilities have I closed off due to their
  anxiety-producing quality?
• PHASE 4 Selecting possibilities for future
  repetition
• What few uncustomary and meaningful activities am
  I prepared to initiate that will draw on my
  newfound sense of heritage and destiny?
• How will I continue to hold myself open, so as to
  recognize those few projects that are truly my
  own?
• PHASE 5 Resolving to continue in authenticity
  despite the presence of nonbeing
• How will I draw on my accomplishments in therapy
  to persevere in authenticity?
• Brent, J. (1998). A time-sensitive existential
  method for assisting adults in transition.
  Journal of Humanistic Psychology, 38 (4), 7-24.

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Existential Case Study
Pauline The existentialist views death as a
reality that gives meaning to life. As humans we
do not have forever to actualize ourselves. Thus,
the realization of the fact that we will die
jolts us into taking the present seriously and
evaluating the direction in which we are
traveling. We are confronted with the fact that
we have only so much time to do the things we
most wanted to do. Thus, we are motivated to take
stock of how meaningful our life is. With this
existential perspective in mind, assume that a
young woman of 20 comes to the center where you
are a counselor. Some Background Data Pauline has
recently found out that she has leukemia. Though
she is in a period of remission, her doctors tell
her that the disease is terminal. Pauline is
seeking counseling to help herself deal with the
crisis and at least get the maximum our of the
remainder of her life. She is filled with rage
over her fate she keeps asking why this had to
happen to her. She tells you that at first she
could not believe the diagnosis was correct. When
she finally got several more professional
opinions that confirmed her leukemia, she began
to feel more and more anger toward God, toward
her healthy friends, whom she envied, and
generally toward the unfairness of her situation.
She tells you that she was just starting to live,
that she had a direction she was going in
professionally. Now everything will have to
change. After she tells you this, she is sitting
across from you waiting for your response.
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Case Study Review Questions
Attempting to stay within the frame of reference
of an existential counselor, what direction would
you take with her? Think about these
questions What do you imagine your immediate
reactions would be if you were faced with
counseling this client? What would be some of the
things that you would initially say in response
to what you know about Pauline? What are your own
thoughts and feelings about death? To what degree
have you reflected on this reality as it applies
to you? Do you avoid thinking about it? In what
ways have you accepted the reality of your
eventual death? How do you think that the answers
to the above questions will affect your ability
to be present for Pauline? What goals would you
have in counseling her? In what ways would you
deal with the rage that Pauline says she
feels? Pauline tells you that one of the reasons
that she is coming to see you is because of her
desire to accept her fate. How would you work
with her to gain this acceptance? What specific
things might you do to help her find ways of
living the rest of her life to the fullest? Do
you see any possibilities for helping Pauline
find meaning in her life in the face of death?
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Existential Therapy Outline

• Introduction
• 3 Phases of Therapy
• ID clarify clients assumptions about the world
• Encourage client to examine the source and
  authority of their value system
• Help client to put what they learn about
  themselves into action

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Existential Therapy Outline

• 6 Major Existential Propositions
• The capacity for Self-Awareness
• The greater our awareness, the greater our
  possibilities for freedom
• We can choose to either expand or restrict our
  consciousness
• A price is paid for increased awareness (you
  cant go home again)
• Freedom Responsibility
• Focus is on clients responsibility for their
  situation
• Challenge client to explore other ways of being
  that are more fulfilling
• Striving for Identity Relationship to Others
• Challenge client to examine ways in which they
  have lost touch with their identity
• Confront clients with the reality that they alone
  must find their own answers
• Lack of relationship to others cause anxiety
• The Search for Meaning
• Clients are faced with the task of creating
  meaning for their own lives
• Existential guilt is explored to help clients
  learn about the way they are living their lives
• Anxiety as a Condition of Living
• Anxiety is used as a tool to motivate change in
  the client
• The counselor helps the client move from
  dependence to autonomy
• Awareness of Death and Non-being

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The Purpose of Life Test

• This questionnaire consists of twenty items to be
  rated on a seven point scale. On each item
  position 4 is designated as neutral and
• different descriptive terms are given for
  positions 1 and 7. A persons response can fall
  anywhere in between 1 and 7.
• 1. I am usually Completely bored 1 2 3 4 5
  6 7 Exuberant, excited
• 2. Life seems to me Completely routine 1
  2 3 4 5 6 7 Always exciting
• 3. In life I have No goals or aims at all
  1 2 3 4 5 6 7 Very clear goals aims
• 4. My personal existence is Utterly meaningless,
  Very purposeful,
• without purpose 1 2 3 4 5 6 7
  meaningful
• 5. Every day is Exactly the Same 1 2 3 4
  5 6 7 Constantly new different
• 6. If I could choose, I would Prefer to have
  never Like nine more lives like
• been born 1 2 3 4 5 6 7 this one
• 7. After retiring, I would Loaf completely the
  Do some exciting things Ive
• rest of my life 1 2 3 4 5 6 7 always
  wanted to do

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The Purpose of Life Test

• 12. As I view the world in
• relation to my life, Completely Fist
  meaningfully
• the world confuses me 1 2 3 4 5 6 7 with
  my life
• 13. I am a Very irresponsible 1 2 3 4 5 6
  7 Very responsible
• 14. Concerning mans freedom Completely bound
  by Absolutely free
• to make his own choices, limitations of
  heredity to make all
• I believe man is environment 1 2 3 4 5
  6 7 life choices
• 15. With regard to death, I am
  Unprepared/Frightened 1 2 3 4 5 6 7
  Prepared Unafraid
• 16. With regard to suicide, Thought of it
  seriously Never given it a
• I have as a way out 1 2 3 4 5 6 7 second
  thought
• 17. I regard my ability to find a
• meaning, a purpose or
• mission in life as Practically none 1 2 3
  4 5 6 7 Very Great

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2 Key Figures in Existential Therapy

• Victor Frankl
• Born Educated in Vienna
• Prisoner in German Concentration Camp where his
  parents, brother, first wife and children died
• Views love as the highest goal to which humans
  can aspire our salvation is through love
• Feels that everything can be taken from a person
  except the right to choose ones attitude in any
  given set of circumstances
• Feels that we can discover the meaning of being
  human through our actions and deeds, by
  experiencing a value and by suffering
• That which does not kill you makes you stronger

• Rollo May
• American spokesperson for Existentialism
• Unhappy childhood 2 failed marriages,
  tuberculosis but not a negative outlook on life
• Studied with Adler in Vienna
• Greatest influence Paul Tillich (German
  Philosopher)
• Writings deal with the nature of the human
  experience, recognizing and dealing with power,
  accepting freedom responsibility, discovering
  ones identity
• Feels that counseling should be aimed at helping
  people discover the meaning of their lives
• Feels the greatest challenge for a person is to
  live in a world alone where they will eventually
  face death

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Historical Background in Existential Philosophy

• Counseling was not founded by any particular
  person or group
• It grew out of an effort to help people engage
  the dilemmas of contemporary life (i.e.,
  isolation, alienation, meaninglessness
• The thinking of existential counselors was
  influenced by the themes of many 19th and 20th
  century philosophers and writers such as
• Dostoyevski creativity, meaninglessness, and
  death
• Kierkegaard creative anxiety (angst), despair,
  fear and dread, guilt nothingness
• Nietche death, suicide, and will
• Heidegger authentic being, caring, death, guilt,
  individual responsibility, isolation
• Sartremeaninglessness, responsibility, choice
• Buber interpersonal relationships, I / thou
  perspective in counseling, self-transcendence

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3 Phases in the Process of Existential Counseling
Middle Phase The client is encouraged to more
fully examine the source and authority of their
value system
Initial Phase Counselor assists client in
identifying clarifying their assumptions about
the world
Final Phase Counselor focuses on helping the
client put what they are learning about
themselves into action
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Examples of Topic Within the 6 Dimensions of
Human Condition
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Existential Therapy Case Study

• Susan, a 30 year old client has come to see a
  counselor at a local mental health agency.
  Although Susan tells the counselor that she
  doesnt think she has any serious problem, she
  has come to counseling after a long period of
  fights with her husband which climaxed recently
  in her husband threatening divorce unless she
  gets some help for what he describes as her
  clingy-ness.
• Following is a summary of the information Susan
  shared during her initial interview with the
  counselor
• Im 30 years old and married for almost 9 years
  now. I have a 8 year old daughter, Olivia. I met
  my husband Tim in college. He is 1 year older. At
  the end of my sophomore year, I got pregnant and
  we decided to get married. Since Tim was almost
  ready to graduate, he finished school but dropped
  out after the 1st semester of my junior year.
• For a while the relationship was pretty good, I
  think. Tim worked a lot and I was busy taking
  care of Olivia. Ever since Olivia started going
  to school all day, things between Tim and I seem
  to have gotten worse and worse. I dont have as
  much to do, so I look forward to spending time
  with Tim at night and on the weekends, but he
  says Im suffocating him. And he gets mad and
  cant understand why I dont what him to go off
  all the time for a whole day to play golf on
  Saturday when thats the only time he has to
  spend with me and Olivia. Well, like I said, its
  just gotten worse. Last week, he actually said if
  I didnt get a life of my own he wasnt sure
  how much longer he could take it.
• I sometimes think it would be nice to do
  something else with the free time Ive got now,
  but I cant exactly get a job. Olivia still needs
  someone to be home after school and I dont even
  know if thats what Tim means. If he wants me to
  go to work, I wish hed just say so, butI dont
  know what he wants.
• Watch the role play of the next session between
  Susan and the counselor. Does the therapist
  accomplish (or attempt to accomplish) theses 3
  key tasks?
• Assist the client in recognizing that they are
  not fully present in the counseling process
  itself.
• Support the client in confronting anxieties they
  have been avoiding.
• Help the client redefine themselves in a way
  that encourages greater genuine of contact with
  life.