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Existential psychotherapy is partly based on the existential belief that human beings are alone in the world. This aloneness leads to feelings of meaninglessness which can be overcome only by creating one’s own values and meanings. We have the power to create because we have the freedom to choose. In making our own choices we assume full responsibility for the results and blame no one but ourselves if the result is less than what was desired. The psychotherapist helps his or her patients/clients along this path: to discover why the patient/client is overburdened by the anxieties of aloneness and meaninglessness, to find new and better ways to manage these anxieties, to make new and healthy choices, and to emerge from therapy as a free and sound human being.

Existential therapy focuses on the development of a patient/client’s self-awareness by looking deeply into the issues of our aloneness, meaninglessness, and mortality. The therapist emphasizes the patient/client’s ability to freely make choices in the present, not under the influence of deterministic aspects or past conditioning. The existentialist attempts to convert meaninglessness into meaningfulness, giving the patient/client the courage to make his or her own healthy choices and to lead a socially rewarding life. Existential therapists have their own unique views about human nature, mental dysfunction, wellness, and therapeutic techniques.

View of the Human Mind

Although humans are essentially alone in the world, we long to be connected to others. We want to have meaning in their lives while they have meaning in ours, but ultimately we must come to realize that we cannot depend on others for our validation, and with that realization we finally acknowledge and understand that we are fundamentally alone. The result of this revelation is anxiety in the knowledge that our validation must come from within and not from others. This anxiety is a positive thing, since it makes us aware of the limits of human existence and this makes us capable of reflecting on life instead of living thoughtlessly.

Because we are alienated and isolated our lives are also meaningless. Nothing exists which is greater than ourselves, therefore there are no external sources of values and absolutes from which we can draw. Taken to an extreme we might conclude that there is nothing for which to live, however, there is hope in the possibility of creating our own values and our own meanings and applying them to our condition, giving us feelings of significance and purpose that are strong enough to carry us through life. This freedom we have to choose our own values is another source of anxiety: we must summon the requisite strength and courage to choose our life-meaning and hold fast to it, undoubtedly a task which many find difficult.

Human beings are also mortal. As we come to grips with the fact that our lives are limited, we develop even more anxiety: we are afraid of death. The knowledge that at some point in the future we will cease to be, while frightening, is at the same time invigorating because it is relevant right now. The juxtaposition of life and death is one thing that does give us some certainty.

Finally, humans are responsible. Being isolated, alone, and free to choose means that one cannot assign blame for his or her problems to someone else. The individual alone makes the choices and therefore is responsible for the outcomes. At any point we are free to make different choices and thus re-invent ourselves; we are at once the architect, the planner, and the builder of our lives, throughout our lives.

Psychological Dysfunction

There is no such thing as psychological dysfunction or being ill in the existential view. Every way of being is merely an expression of how one chooses to live one's life. However one may feel unable to come to terms with the anxiety of being alone in the world. If so an existential psychotherapist can assist one in accepting these feelings rather than trying to change them as if there is something wrong. Everyone has the freedom to choose how they are going to be in life, however this may go unexercised because making changes is difficult; it may appear easier and safer not to make decisions that you will be responsible for. Many people will remain unaware of alternative choices in life for various societal reasons.

The Good Life

It is possible for people to face the anxieties of life head-on and embrace the human condition of aloneness, to revel in the freedom to choose and take full responsibility for their choices. They courageously take the helm of their lives and steer in whatever direction they choose; they have the courage to be. One does not need to arrest feelings of meaninglessness, but can choose new meanings for their lives. By building, by loving, and by creating one is able to live life as one's own adventure. One can accept one's own mortality and overcome fear of death.

Existential Therapy

The existentially-oriented psychotherapist guides his or her patients/clients to confront life’s anxieties. If the patient/client has not been fully exercising the freedom to choose, the counselor will lead a discovering into how and why he or she is stuck. Perhaps the patient/client has been allowing others to make the important decisions which he or she alone should be making. Possibly the patient/client is afraid to take the risks required to grow and is instead choosing an easy and non-threatening path. The counselor will encourage his or her patient/clients to reflect on the aloneness and meaninglessness of life, and to understand that they must find their own ways to cope with these anxieties. The counselor does not try to eliminate these anxieties, but instead encourages the patient/client to face them head-on. Alternative paths can be explored together. The risks entailed with these paths can be evaluated, and then the patient/client will be able to make new, more authentic choices. The existential counselor is not overly concerned with the patient's/client’s past. Instead, the emphasis is on the choices to be made in the present. The counselor and the client may reflect upon how the client has answered life’s questions in the past, but then attention shifts to searching for a new and increased awareness in the present and enabling a new freedom and responsibility to act.

See also

Further reading

  • Frankl, Viktor; Man's Search for Meaning (rev. & updtd.); Pocket, 1997
  • Yalom, Irvin D.; Existential Psychotherapy; Basic Books, 1980
  • Cooper, Mick; Existential Therapies; Sage Publ., 2003
  • Spinelli, Ernesto; The Mirror and the Hammer: Challenging Orthodoxies in Therapeutic Thought; Sage Publ., 2002
  • Kierkegaard, Søren; The Concept of Dread and The Sickness Unto Death, Princeton University Press
  • Deurzen, E. van (2002) Existential Counselling and Psychotherapy in Practice, 2nd edition, London: Sage Publications.
  • ibid (1997) Everyday Mysteries: Existential Dimensions of Psychotherapy, London: Routledge. (2nd edition 2006)
  • ibid (1998) Paradox and Passion in Psychotherapy, Chichester: Wiley.
  • Deurzen, E. van, and Kenward, R. (2005) Dictionary of Existential Psychotherapy and Counselling, London: Sage Publications.
  • Deurzen, E. van and Arnold-Baker, C., eds. (2005) Existential Perspectives on Human Issues: a Handbook for Practice, London: Palgrave, Macmillan.
  • Wilkes, R and Milton, M, (2006) Being an Existential Therapist: An IPA study of existential therapists’ experiences, Existential Analysis. Jan 2006
  • Milton , M., Charles, L., Judd, D., O’Brien, Tipney, A. and Turner, A . (2003) The Existential-Phenomenological Paradigm: The Importance for Integration, Existential Analysis
  • Judd, D. and Milton, M. (2001) Psychotherapy with Lesbian and Gay Clients: Existential-Phenomenological Contributions to Training, Lesbian and Gay Psychology Review, 2(1): 16-23
  • Corrie, S. and Milton, M . (2000) The Relationship Between Existential-Phenomenological and Cognitive-Behavioural Therapies, European Journal of Psychotherapy, Counselling and Health.
  • Milton, M (2000) Is Existential Psychotherapy A Lesbian and Gay Affirmative Psychotherapy? Journal of the Society for Existential Analysis,
  • Milton , M. and Judd, D. (1999) The Dilemma that is Assessment, Journal of the Society for Existential Analysis, 102-114.
  • Milton, M. (1999) Depression and the Uncertainty of Identity: An existential-phenomenological exploration in just twelve sessions, Changes: An International Journal of Psychology and Psychotherapy,
  • Milton, M (1997) An Existential Approach to HIV Related Psychotherapy, Journal of the Society for Existential Analysis, V8.1, 115-129
  • Milton, M (1994) The Case for Existential Therapy in HIV Related Psychotherapy, Counselling Psychology Quarterly, V7 (4). 367-374
  • Milton, M. (1994) HIV Related Psychotherapy and Its Existential Concerns, Counselling Psychology Review, V9 (4). 13-24
  • Milton, M (1993) Existential Thought and Client Centred Therapy, Counselling Psychology Quarterly, V6 (3). 239-248
  • Wilberg, P. (2004) The Therapist as Listener - Martin Heidegger and the Missing Dimension of Counselling and Psychotherapy Training [1]
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