Existential approach.

Dimensions of human conditions according to the existential approach.

The basic dimensions of the human condition, according to the existential approach, include (1)
the capacity for self-awareness; (2) freedom and responsibility; (3) creating one’s identity and
establishing meaningful relationships with others; (4) the search for meaning, purpose, values, and
goals; (5) anxiety as a condition of living; and (6) awareness of death and nonbeing. I develop
these propositions in the following sections by summarizing themes that emerge in the writings of
existential philosophers and psychotherapists, and I also discuss the implications for counseling
practice of each of these propositions.

Proposition 1: The Capacity for Self-Awareness

As human beings, we can reflect and make choices because we are capable of self-awareness. The
greater our awareness, the greater our possibilities for freedom. We increase our capacity to live
fully as we expand our awareness in the following areas:

• We are finite and do not have unlimited time to do what we want in life.

• We have the potential to take action or not to act; inaction is a decision.

• We choose our actions, and therefore we can partially create our own destiny.

• Meaning is the product of discovering how we are “thrown” or situated in the world and then,
through commitment, living creatively.

• As we increase our awareness of the choices available to us, we also increase our sense of
responsibility for the consequences of these choices.

• We are subject to loneliness, meaninglessness, emptiness, guilt, and isolation.

• We are basically alone, yet we have an opportunity to relate to other beings.

We can choose either to expand or to restrict our consciousness. Because self-awareness is at the
root of most other human capacities, the decision to expand it is fundamental to human growth.
Here are some dawning awarenesses that individuals may experience in the counseling process:

• They see how they are trading the security of dependence for the anxieties that accompany
choosing for themselves.

• They begin to see that their identity is anchored in someone else’s definition of them; that is, they
are seeking approval and confirmation of their being in others instead of looking to themselves for
affirmation.
• They learn that in many ways they are keeping themselves prisoner by some of their past
decisions, and they realize that they can make new decisions.

• They learn that although they cannot change certain events in their lives they can change the way
they view and react to these events.

• They learn that they are not condemned to a future similar to the past, for they can learn from
their past and thereby reshape their future.

• They realize that they are so preoccupied with suffering, death, and dying that they are not
appreciating living.

• They are able to accept their limitations yet still feel worthwhile, for they understand that they
do not need to be perfect to feel worthy.

• They come to realize that they are failing to live in the present moment because of preoccupation
with the past, planning for the future, or trying to do too many things at once.

Increasing self-awareness, which includes awareness of alternatives, motivations, factors

It is the therapist’s task to indicate to the client that a price must be paid for increased awareness.
As we become more aware, it is more difficult to “go home again.” Ignorance of our condition
may have brought contentment along with a feeling of partial deadness, but as we open the doors
in our world, we can expect more turmoil as well as the potential for more fulfillment.

Proposition 2: Freedom and Responsibility

A characteristic existential theme is that people are free to choose among alternatives and therefore
have a large role in shaping their destinies. A central existential concept is that although we long
for freedom, we often try to escape from our freedom (Russell, 2007). Even though we have no
choice about being thrust into the world, the manner in which we live and what we become are the
result of our choices. Because of the reality of this freedom, we are challenged to accept
responsibility for directing our lives. However, it is possible to avoid this reality by making
excuses. In speaking about “bad faith,” the existential philosopher Jean-Paul Sartre (1971) refers
to the inauthenticity of not accepting personal responsibility. Here are two statements that reveal
bad faith: “Since that’s the way I’m made, I couldn’t help what I did” or “Naturally I’m this way,
because I grew up in a dysfunctional family.” An inauthentic mode of existence consists of lacking
awareness of personal responsibility for our lives and passively assuming that our existence is
largely controlled by external forces. Sartre claims we are constantly confronted with the choice
of what kind of person we are becoming, and to exist is never to be finished with this kind of
choosing.
Freedom implies that we are responsible for our lives, for our actions, and for our failures to take
action. From Sartre’s perspective people are condemned to freedom. He calls for a commitment to
choosing for ourselves. Existential guilt is being aware of having evaded a commitment, or having
chosen not to choose.

Proposition 3: Striving for Identity and Relationship to Others

People are concerned about preserving their uniqueness and centeredness, yet at the same time
they have an interest in going outside of themselves to relate to other beings and to nature. Each
of us would like to discover a self—that is, create our personal identity. This is not an automatic
process, and creating an identity takes courage. As relational beings, we also strive for
connectedness with others. Many existential writers discuss loneliness, up rootedness, and
alienation, which can be seen as the failure to develop ties with others and with nature.

The trouble with so many of us is that we have sought directions, answers, values, and beliefs from
the important people in our world. Rather than trusting ourselves to search within and find our
own answers to the conflicts in our life, we sell out by becoming what others expect of us. Our
being becomes rooted in their expectations, and we become strangers to ourselves.

Existential therapists may begin by asking their clients to allow themselves to intensify the feeling
that they are nothing more than the sum of others’ expectations and that they are merely the
introjects of parents and parent substitutes.

How do they feel now? Are they condemned to stay this way forever? Is there a way out? Can they
create a self if they find that they are without one?

Where can they begin? Once clients have demonstrated the courage to recognize this fear, to put
it into words and share it, it does not seem so overwhelming.

The Experience of Aloneness: The existentialists postulate that part of the human condition is the
experience of aloneness. But they add that we can derive strength from the experience of looking
to ourselves and sensing our separation. The sense of isolation comes when we recognize that we
cannot depend on anyone else for our own confirmation; that is, we alone must give a sense of
meaning to life, and we alone must decide how we will live. If we are unable to tolerate ourselves
when we are alone, how can we expect anyone else to be enriched by our company? Before we
can have any solid relationship with another, we must have a relationship with ourselves. We are
challenged to learn to listen to ourselves. We have to be able to stand alone before we can truly
stand beside another.

There is a paradox in the proposition that humans are existentially both alone and related, but this
very paradox describes the human condition. To think that we can cure the condition, or that it
should be cured, is erroneous. Ultimately we are alone.
The Experience of Relatedness: We humans depend on relationships with others. We want to be
significant in another’s world, and we want to feel that another’s presence is important in our
world. When we are able to stand alone and dip within ourselves for our own strength, our
relationships with others are based on our fulfillment, not our deprivation. If we feel personally
deprived, however, we can expect little but a clinging and symbiotic relationship with someone
else.

Perhaps one of the functions of therapy is to help clients distinguish between a neurotically
dependent attachment to another and a life-affirming relationship in which both persons are
enhanced. The therapist can challenge clients to examine what they get from their relationships,
how they avoid intimate contact, how they prevent themselves from having equal relationships,
and how they might create therapeutic, healthy, and mature human relationships.

Struggling with Our Identity: The awareness of our ultimate aloneness can be frightening, and
some clients may attempt to avoid accepting their aloneness and isolation. Because of our fear of
dealing with our aloneness, Farha (1994) points out that some of us get caught up in ritualistic
behavior patterns that cement us to an image or identity we acquired in early childhood. He writes
that some of us become trapped in a doing mode to avoid the experience of being.

Part of the therapeutic journey consists of the therapist challenging clients to begin to examine the
ways in which they have lost touch with their identity, especially by letting others design their life
for them. The therapy process itself is often frightening for clients when they realize that they have
surrendered their freedom to others and that in the therapy relationship they will have to assume
their freedom again. By refusing to give easy solutions or answers, existential therapists confront
clients with the reality that they alone must find their own answers.

Proposition 4: The Search for Meaning

Existential therapy can provide the conceptual framework for helping clients challenge the
meaning in their lives. Questions that the therapist might ask are, “Do you like the direction of
your life? Are you pleased with what you now are and what you are becoming? If you are confused
about who you are and what you want for yourself, what are you doing to get some clarity?”

The problem of discarding old values: One of the problems in therapy is that clients may discard
traditional (and imposed) values without finding other, suitable ones to replace them. What does
the therapist do when clients no longer cling to values that they never really challenged or
internalized and now experience a vacuum? Clients may report that they feel like a boat without a
rudder. They seek new guidelines and values that are appropriate for the newly discovered facets
of themselves, and yet for a time they are without them. Perhaps the task of the therapeutic process
is to help clients create a value system based on a way of living that is consistent with their way
of being.
The therapist’s job might well be to trust the capacity of clients to eventually discover an internally
derived value system that does provide a meaningful life. They will no doubt flounder for a time
and experience anxiety as a result of the absence of clear-cut values. The therapist’s trust is
important in helping clients trust their own capacity to discover a new source of values.

Meaninglessness: When the world they live in seems meaningless, clients may wonder whether
it is worth it to continue struggling or even living. Faced with the prospect of our mortality, we
might ask: “Is there any point to what I do now, since I will eventually die? Will what I do be
forgotten when I am gone?

Given the fact of mortality, why should I busy myself with anything? For Frankl (1978) such a
feeling of meaninglessness is the major existential neurosis of modern life.

Meaninglessness in life can lead to emptiness and hollowness, or a condition that Frankl calls the
existential vacuum. This condition is often experienced when people do not busy themselves with
routine or with work. Because there is no preordained design for living, people are faced with the
task of creating their own meaning. At times people who feel trapped by the emptiness of life
withdraw from the struggle of creating a life with purpose. Experiencing meaninglessness and
establishing values that are part of a meaningful life are issues that become the heart of counseling.

Creating New Meaning: Logotherapy is designed to help clients find a meaning in life. The
therapist’s function is not to tell clients what their particular meaning in life should be but to point
out that they can discover meaning even in suffering (Frankl, 1978). This view holds that human
suffering (the tragic and negative aspects of life) can be turned into human achievement by the
stand an individual takes when faced with it. Frankl also contends that people who confront pain,
guilt, despair, and death can challenge their despair and thus triumph. Yet meaning is not
something that we can directly search for and obtain. Paradoxically, the more rationally we seek
it, the more likely we are to miss it. Yalom (2003) and Frankl (1978) are in basic agreement that,
like pleasure, meaning must be pursued obliquely.

Proposition 5: Anxiety as a Condition of Living

Anxiety arises from one’s personal strivings to survive and to maintain and assert one’s being, and
the feelings anxiety generates are an inevitable aspect of the human condition. Existential anxiety
is the unavoidable result of being confronted with the “givens of existence”—death, freedom,
choice, isolation, and meaninglessness (Vontress, 2008; Yalom, 1980). Existential anxiety can be
a stimulus for growth. We experience this anxiety as we become increasingly aware of our freedom
and the consequences of accepting or rejecting that freedom. In fact, when we make a decision that
involves reconstruction of our life, the accompanying anxiety can be a signal that we are ready for
personal change. If we learn to listen to the subtle messages of anxiety, we can dare to take the
steps necessary to change the direction of our lives.
Existential therapists differentiate between normal and neurotic anxiety, and they see anxiety as a
potential source of growth. Being psychologically healthy entails living with as little neurotic
anxiety as possible, while accepting and struggling with the unavoidable existential anxiety
(normal anxiety) that is a part of living.

Many people who seek counseling want solutions that will enable them to eliminate anxiety.
Although attempts to avoid anxiety by creating the illusion that there is security in life may help
us cope with the unknown, we really know on some level that we are deceiving ourselves when
we think we have found fixed security. We can blunt anxiety by constricting our life and thus
reducing choices. Opening up to new life, however, means opening up to anxiety.

The existential therapist can help clients recognize that learning how to tolerate ambiguity and
uncertainty and how to live without props can be a necessary phase in the journey from dependence
to autonomy. The therapist and client can explore the possibility that although breaking away from
crippling patterns and building new lifestyles will be fraught with anxiety for a while, anxiety will
diminish as the client experiences more satisfaction with newer ways of being. When a client
becomes more self-confident, the anxiety that results from an expectation of catastrophe will
decrease.

Proposition 6: Awareness of Death and Nonbeing

The existentialist does not view death negatively but holds that awareness of death as a basic
human condition gives significance to living. A distinguishing human characteristic is the ability
to grasp the reality of the future and the inevitability of death. It is necessary to think about death
if we are to think significantly about life. From Frankl’s perspective, death should not be
considered a threat. Rather, death provides the motivation for us to live our lives fully and take
advantage of each opportunity to do something meaningful (Gould, 1993).

Rather than being frozen by the fear of death, death can be viewed as a positive force that enables
us to live as fully as possible. Although the notion of death is a wake-up call, it is also something
that we strive to avoid (Russell, 2007). If we defend ourselves against the reality of our eventual
death, life becomes insipid and meaningless. But if we realize that we are mortal, we know that
we do not have an eternity to complete our projects and that the present is crucial. Our awareness
of death is the source of zest for life and creativity. Death and life are interdependent, and though
physical death destroys us, the idea of death saves us (Yalom, 1980, 2003).

Yalom (2003) recommends that therapists talk directly to clients about the reality of death. He
believes the fear of death percolates beneath the surface and haunts us throughout life. Death is a
visitor in the therapeutic process, and Yalom believes that ignoring its presence sends the message
that death is too overwhelming to explore. Confronting this fear can be the factor that helps us
transform an inauthentic mode of living into a more authentic one (Yalom, 1980).
One focus in existential therapy is on exploring the degree to which clients are doing the things
they value. Without being morbidly preoccupied by the ever-present threat of nonbeing, clients
can develop a healthy awareness of death as a way to evaluate how well they are living and what
changes they want to make in their lives. Those who fear death also fear life. When we emotionally
accept the reality of our eventual death, we realize more clearly that our actions do count, that we
do have choices, and that we must accept the ultimate responsibility for how well we are living
(Corey & Corey, 2006).

Existential anxiety?

Existential anxiety can be a stimulus for growth. We experience this anxiety as we become
increasingly aware of our freedom and the consequences of accepting or rejecting that freedom. In
fact, when we make a decision that involves reconstruction of our life, the accompanying anxiety
can be a signal that we are ready for personal change. If we learn to listen to the subtle messages
of anxiety, we can dare to take the steps necessary to change the direction of our lives.

Normal anxiety according to existential approach.

Normal anxiety is an appropriate response to an event being faced. Further, this kind of anxiety
does not have to be repressed, and it can be used as a motivation to change. Because we could not
survive without some anxiety, it is not a therapeutic goal to eliminate normal anxiety.

Neurotic anxiety according to existential approach.

Neurotic anxiety, in contrast, is out of proportion to the situation. It is typically out of awareness,
and it tends to immobilize the person. Being psychologically healthy entails living with as little
neurotic anxiety as possible, while accepting and struggling with the unavoidable existential
anxiety (normal anxiety) that is a part of living.

Limitations and Criticisms of the Existential Approach.

A major criticism often aimed at this approach is that it lacks a systematic statement of the
principles and practices of psychotherapy. Some practitioners have trouble with what they perceive
as its mystical language and concepts. Some therapists who claim adherence to an existential
orientation describe their therapeutic style in vague and global terms such as self-actualization,
dialogic encounter, authenticity, and being in the world. This lack of precision causes confusion
at times and makes it difficult to conduct research on the process or outcomes of existential
therapy.
Both beginning and advanced practitioners who are not of a philosophical turn of mind tend to
find many of the existential concepts lofty and elusive.

And those counselors who do find themselves close to this philosophy are often at a loss when
they attempt to apply it to practice. As we have seen, this approach places primary emphasis on a
subjective understanding of the world of clients. It is assumed that techniques follow
understanding. The fact that few techniques are generated by this approach makes it essential for
practitioners to develop their own innovative procedures or to borrow from other schools of
therapy. For counselors who doubt that they can counsel effectively without a specific set of
techniques, this approach has limitations (Vontress, 2008).

Practitioners who prefer a counseling practice based on research contend that the concepts should
be empirically sound, that definitions should be operational, that the hypotheses should be testable,
and that therapeutic practice should be based on the results of research into both the process and
outcomes of counseling. Certainly, the notion of manualized therapy is not part of the existential
perspective because every psychotherapy experience is unique (Walsh & McElwain, 2002). From
the perspective of evidence-based practices, existential therapy is subject to criticism. According
to Cooper (2003), existential practitioners generally reject the idea that the therapeutic process can
be measured and evaluated in quantitative and empirical ways. There is a distinct lack of studies
that directly evaluate and examine the existential approach. To a large extent, existential therapy
makes use of techniques from other theories, which makes it difficult to apply research to this
approach to study its effectiveness (Sharf, 2008).

According to van Deurzen (2002b), the main limitation of this approach is that of the level of
maturity, life experience, and intensive training that is required of practitioners. Existential
therapists need to be wise and capable of profound and wide-ranging understanding of what it
means to be human.

Authenticity is a cardinal characteristic of a competent existential practitioner, which is certainly

Meaning of existential tradition.

The existential tradition seeks a balance between recognizing the limits and tragic dimensions of
human existence on one hand and the possibilities and opportunities of human life on the other
hand. It grew out of a desire to help people engage the dilemmas of contemporary life, such as
isolation, alienation, and meaninglessness. The current focus of the existential approach is on the
individual’s experience of being in the world alone and facing the anxiety of this isolation.
Key figures in Contemporary Existential Psychotherapy.

Viktor Frankl, Rollo May, James Bugental, and Irvin Yalom all developed their existential
approaches to psychotherapy from strong backgrounds in both existential and humanistic
psychology. Viktor Frankl was a central figure in developing existential therapy in Europe and
also in bringing it to the United States.

Frankl developed logotherapy, which means “therapy through meaning.” Frankl’s philosophical
model sheds light on what it means to be fully alive.

“To be alive encompasses the ability to take hold of life day by day as well as to find meaning in
suffering”. The central themes running through his works are life has meaning, under all
circumstances; the central motivation for living is the will to meaning; the freedom to find meaning
in all that we think; and the integration of body, mind, and spirit. According to Frankl, the modern
person has the means to live but often has no meaning to live for. The therapeutic process is aimed
at challenging individuals to find meaning and purpose through, among other things, suffering,
work, and love (Frankl, 1965).

Along with Frankl, psychologist Rollo May was deeply influenced by the existential philosophers,
by the concepts of Freudian psychology, and by many aspects of Alfred Adler’s Individual
Psychology. Both Frankl and May welcomed flexibility and versatility in the practice of
psychoanalysis (Gould, 1993).

May was one of the key figures responsible for bringing existentialism from Europe to the United
States and for translating key concepts into psychotherapeutic practice. His writings have had a
significant impact on existentially oriented practitioners. Of primary importance in introducing
existential therapy to the United States was the book Existence: A New Dimension in Psychiatry
and Psychology (May, Angel, & Ellenberger, 1958). According to May, it takes courage to “be,”
and our choices determine the kind of person we become. There is a constant struggle within us.
Although we want to grow toward maturity and independence, we realize that expansion is often
a painful process. Hence, the struggle is between the security of dependence and the delights and
pains of growth.

Along with May, two other significant existential therapists in the United States are James
Bugental and Irvin Yalom. Bugental developed an approach to depth therapy based on the
existential concern with an individual’s immediate presence and the humanistic emphasis on the
integrity of each individual (Sharp & Bugental, 2001). In The Art of the Psychotherapist (1987),
Bugental describes a life-changing approach to therapy. He views therapy as a journey taken by
the therapist and the client that delves deeply into the client’s subjective world. He emphasizes
that this quest demands the willingness of the therapist to be in contact with his or her own
phenomenological world. According to Bugental, the central concern of therapy is to help clients
examine how they have answered life’s existential questions and to challenge them to revise their
answers to begin living authentically. In Psychotherapy Isn’t What You Think (1999), Bugental
illustrates the here-and-now experiencing in the therapeutic relationship.

Irvin Yalom (1980) acknowledges the contributions of both European and American psychologists
and psychiatrists who have influenced the development of existential thinking and practice.
Drawing on his clinical experience and on empirical research, philosophy, and literature, Yalom
has developed an existential approach to therapy that focuses on four “givens of existence” or
ultimate human concerns: death, freedom and responsibility, existential isolation, and
meaninglessness. All of these existential themes deal with the client’s existence or being-in-the-
world. His classic, comprehensive textbook, Existential Psychotherapy (1980), is considered a
pioneering accomplishment.

He acknowledges the influence on his own writings of several novelists and philosophers. More
specifically, he draws on the following themes from those philosophers:

• From Kierkegaard: creative anxiety, despair, fear and dread, guilt, and nothingness

• From Nietzsche: death, suicide, and will

• From Heidegger: authentic being, caring, death, guilt, individual responsibility, and isolation

• From Sartre: meaninglessness, responsibility, and choice

• From Buber: interpersonal relationships, I/Thou perspective in therapy, and self-transcendence

Yalom recognizes Frankl as an eminently pragmatic thinker who has had an impact on his writing
and practice. Yalom believes the vast majority of experienced therapists, regardless of their
theoretical orientation, employ many of the existential themes discussed in his book. These
existential themes constitute the heart of existential psychodynamics, and they have enormous
relevance to clinical work.

There have been significant developments in the existential approach in Britain. Laing and Cooper
(1964) critically reconsidered the notion of mental illness and its treatment, and they established
an experimental therapeutic community in London. Further development of the existential
approach in Britain is due largely to the efforts of Emmy van Deurzen who is currently developing
academic and training programs at the New School of Psychotherapy and Counselling. In the past
decades the existential approach has spread rapidly in Britain and is now an alternative to
traditional methods (van Deurzen, 2002b).