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9.4: Existential Psychotherapy

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  • Existential psychotherapy is not so much a technique as it is an overall approach to understanding the nature of the human being. By asking deep questions about the nature of anxiety, loneliness, isolation, despair, etc., as well as about creativity and love, existential psychotherapists seek to avoid the “common error of distorting human beings in the very effort of trying to help them” (May & Yalom, 1995). May believed that American psychology has had both an affinity for and an aversion to existential psychotherapy. The affinity arises from an historical place in American psychology that was very similar to existentialism: William James’ emphasis on the immediacy of experience, the importance of will, and the unity of thought and action. The aversion arises from the Western tendency to dehumanize people through strict adherence to scientific principles of research, i.e., to reform humans in the image of machines (May, 1983).

    An essential aspect of existential psychotherapy is to help individuals realize their own being, their own role in choosing the form that their life will take. This is known as the “I-Am” experience. It is all too common for us to associate ourselves with external factors: I am a professor, I am a student, I work at a store, I run a business, etc. We repress our own sense of being. To use an example similar to a case described by May: I am a professor, but that is not really who I am. I am a father and a husband, but that isn’t all that I am. I have a family and a career, but that isn’t quite it either. What is left, or what is common in each of these statements? I am! And as May put it, if I am, I have a right to be (example cited in May & Yalom, 1995). This realization is not the solution to my problems, but it is a necessary precondition to finding the courage to pursue the rest of my life.

    Once an individual finds the courage to recreate their life, the existential therapist will address a variety of issues. As discussed above, May placed a great deal of emphasis on anxiety. Guilt is also an important issue to be addressed, since we may feel guilty about poor ethical choices or instances when we failed to be responsible with our actions. As with anxiety, guilt can be normal (after actually doing something bad) or neurotic (when we fantasize some transgression). Both anxiety and guilt affect how we experience Kierkegaard’s concept of being-in-the-world. Our world can be viewed in several different ways, however. There is the Umwelt (the world around), the Mitwelt (the with-world), and the Eigenwelt (the own-world). The Umwelt is the world around us, the natural environment. It encompasses our biological needs, and the unavoidable reality that we will die one day. The Eigenwelt refers to our self-awareness and our ability to relate to our selves, and it is uniquely human (May & Yalom, 1995).

    The Mitwelt bears a special relationship to another important concept in existential psychotherapy: time. Because we tend to think about ourselves spatially, as objects within our life, we tend to focus on the past. In other words, we focus on what we have become, as opposed to what we might be. Moments when we truly encounter ourselves are rare, but it is only when we grasp the moment that we truly experience life. Those moments can be positive, such as the experience of love, or negative, such as the experience of depression, but they are real nonetheless. The Mitwelt contains the inner meaning of the events that occur in our lives. Individuals who suffer from brain damage often cannot think in terms of abstract possibilities, they become trapped in concrete time. In order to be fully healthy, and something essential to the growth of humans, is our ability to transcend time:

    If we are to understand a given person as existing, dynamic, at every moment becoming, we cannot avoid the dimension of transcendence. Existing involves a continual emerging, in the sense of emergent evolution, a transcending of one’s past and present in order to reach the future. (pg. 267; May & Yalom, 1995)

    Although the content described above might seem very different from the type of psychoanalysis described by Freud, the general process of existential psychotherapy is similar to psychoanalysis. It is accepted that the client experiences anxiety, that some of this anxiety is unconscious, and that the client is relying on defense mechanisms in order to cope with the anxiety. A fundamental difference, however, is the focus of the therapy. Rather than digging into the deep, dark past, the existential psychotherapist strives to understand the meaning of the client’s current experiences, the depth of experience in the given moment. For this reason, the therapist-client relationship remains important, but the emphasis is not on transference. Rather, the emphasis is on the relationship itself as fundamentally important (May & Yalom, 1995).

    Discussion Question: Have you ever had an “I-Am” experience?