Existential therapy

Existential therapy is a form of mental health treatment that focuses on helping people make good choices in the present as opposed to dwelling on events in the past. It is based on the premise that conditions such as anxiety and depression result from not accepting responsibility for past decisions and allowing things that have already happened shape the present and future. Instead of analyzing the past to look for the source of problems, existential therapy focuses on helping the person establish core values and beliefs and understand that his or her own decisions and actions determine happiness and success.

Background

Existential therapy evolved from the work of the existential philosophers of the nineteenth and twentieth centuries. Existentialists such Soren Kierkegaard, Friedrich Nietzsche, Simone de Beauvoir, Maurice Merleau-Ponty, Albert Camus, and Jean-Paul Sartre believed that it was pointless to look for order in the world. Instead, they believed that people created their own order and meaning by utilizing the ability to make their own decisions and directing their own choices. They emphasized the need for people to develop values and beliefs and then act in a way that was authentic and true to them.

The therapy of Austrian psychologist Otto Rank reflected the influence of existentialism after he broke from collaboration with Sigmund Freud, creating the earliest recognized connection between existential philosophy and psychology. As psychology and psychotherapy grew in popularity in the twentieth century, others included elements of existentialism in their practices. It was most notable in the work of Jewish Austrian psychiatrist Viktor Frankl who survived a Nazi concentration camp but lost his parents, wife, and unborn child during the Holocaust. Frankl emphasized that a person’s ability to make choices about how to think and feel in even the worst possible circumstances is the key to finding meaning in life.

Overview

Unlike many other forms of talk therapy that delve into a person’s past to determine why he or she is experiencing problems in the present, existential therapy looks forward. It strives to help people realize that they have choices and can control the course of much of their lives by using their free will to make good choices. Existential therapy also emphasizes accepting that there are some things that are out of an individual’s control.

Existential therapists stress that there are four core “givens” that people must accept to avoid anxiety, depression, and other mental health issues. These are inevitability of death, isolation, meaninglessness, and freedom and its responsibilities.

A mental health professional applying existential therapy encourages the patient to accept that life comes with challenges. The patient is taught that a happy life with minimal stress comes not from having a life free of challenges but from recognizing that many of these challenges come from choices that the patient has made. Others are from things over which the patient has no control. In either case, dwelling on what has been done or cannot be changed will result in additional challenges in the form of mental health issues. The solution lies in accepting those challenges that cannot be changed and making good choices to deal with the challenges to prevent future problems.

Existential therapists also emphasize that people sometimes need to accept things that are unpleasant or frightening. For example, death can sometimes be dodged but cannot be permanently avoided; therefore, becoming anxious or depressed about it is futile. They also note that while humans are generally social creatures and many people thrive on being in relationships with others, requiring these to have happiness often results in disappointment. Existential therapy encourages developing practices of self-validation so that people are not dependent on others for affirmation or happiness.

The effort to find meaning in life’s experiences also causes frustration and anxiety for many people. Existential therapists encourage people to accept the fact that while there can be meaning in even the worst experiences, that meaning may not be apparent at the time. It can take years to make sense out of why something happened. Dwelling on a seemingly meaningless experience can cause anxiety and other negative emotions; therefore, existential therapy encourages people to accept that a meaning will become clear at some future point and to focus on the present.

As in other approaches to psychotherapy, success in existential therapy requires the patient to be willing to be introspective and open to self-examination. The patient will need to be or become self-aware and acknowledge areas where he or she has been avoiding taking responsibility for personal choices. Patients also need to be willing to begin making different and better choices going forward, changing past patterns and recreating their responses to circumstances so that they can experience different outcomes.

Existential therapy is often used for patients whose poor choices in the past have led to substance abuse or other unhealthy life choices. The goal of the therapy will be for patients to identify core values and beliefs that give meaning and purpose to their lives, conduct a realistic evaluation of how past choices have led to their present situation, acknowledge and accept both the limitations and potential of their personal lives and situations, and develop better decision-making and communication skills to help facilitate better choices. Because it takes time to accomplish these things, existential therapy is not a “quick fix” for someone dealing with crushing anxiety, depression, or other mental health issues. Instead, it is a commitment to creating a better life for the long term.

Bibliography

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