Existential

Running Head: FREEDOM TO THRIVE: INTEGRATIVE EXISTENTIAL THERAPY 1

Freedom to Thrive: Integrative Existential Therapy

Molly Gum

Grand Canyon University

FREEDOM TO THRIVE: INTEGRATIVE EXISTENTIAL THERAPY 2

“Joy, rather than happiness, is the goal of life, for joy is the

emotion which accompanies our fulfilling our natures as human beings.

It is based on the experience of one's identity as a being of worth and dignity.”

- Rollo May


Freedom to Thrive: Integrative Existential Therapy

Although philosophy and psychology share many similar roots, contemporary

psychology typically seeks to align itself with the scientific method by producing and utilizing

theories that are supported by empirical research. Existential therapy is almost entirely based on

philosophic ideology, although currently the body of research available in support of this

approach is continuously growing. Although it is the target of widespread criticism as a formal

therapeutic model, many practitioners inadvertently implement several aspects of existential

theory into their counseling (Corrie & Milton, 2000). Although there are no formal guidelines

illustrating how to practice existential therapy, there are several beliefs that serve as a foundation

for clinical practice. According to existential theorists, the only way to truly understand what it

means to live is through an exploration of an individual’s concrete existence in the context of the

world they live in (Buxton, 2005). They emphasize the importance of choice and personal

responsibility in everyday living, and believe that increased awareness will lead to a better

understanding of self and an improved quality of life (Corey, 2001).

Rollo May, one of the founders of Existential Theory, believed that individuals are

essentially responsible for their choices and actions and must therefore be accountable for their

own lives (Corey, 2001). Unlike other schools of psychology, Existential Theory does not offer

any sort of systematic viewpoint or methodology regarding human development and

psychotherapy practice. It emphasizes the importance of human interactions and maintains that

individuals are most fulfilled when seeking deep, personal meaning in their lives. Advocates of

the Existential model shy away from using specific techniques, claiming that they only hinder

the true meaning and value of the counselor-client relationship (Murdock, 2009). Viktor Frankl,

one of the pioneers of Existential Psychology, explained that, “as long as we actually interpret

our task merely in terms of techniques and dynamics, we have missed the point—and we have


missed the hearts of those to whom we wish to offer mental first aid” (Frankl, 1969, p. 6).

Existential therapists rely on their own humanity and life experiences to relate to clients and

assist them in taking personal responsibility for change, growth, and fulfillment. It is ultimately

up to the client to determine the effectiveness of treatment (Feist and Feist, 2006).

Existential Theory is widely criticized for lacking structured therapeutic methods and

theories regarding human development and neuroses. It is often labeled as more of a philosophy

than a science since most of its practices cannot be supported with empirical evidence.

As someone who strives to find meaning in all aspects of life, I find existential therapy to

be most aligned with my values and worldview. I believe that we all have the power to

determine the course of our lives, and although there are physical, biological, and social

limitations at play, we can still determine how to perceive and define our existence. Meaning

can be found in even the darkest of circumstances, and progress and growth can come from the

most painful of experiences. Existential therapy helps individuals discover their own personal

strength and live more meaningful and productive lives.

As an aspiring psychologist, my goal is to work with adolescents who are struggling with

the following issues: eating disorders, chemical dependency, difficulties stemming from trauma,

and self-injuries. According to Hanna, Hanna, & Keys (1999), adolescents are often seen as the

most challenging clients to work with. Adolescence is often a period of existential crisis as

teenagers struggle to discover an identity of their own. A struggle common to all of humanity,

but more prevalent in adolescent populations is the tendency to adhere to the expectations that

others have on us (Corey, 2001). Adolescents are torn between childhood and adulthood and

often battle with which way to turn, often seeking the answers anywhere but within themselves.

Existential therapy can help adolescents grapple with the realities of freedom and limitation, and

encourage the development of new attitudes regarding those realities. Existential therapy helps


clients understand that they are free to decide what to make of their circumstances; most

adolescents hunger for this type of freedom, and Existential therapy can help them develop new

attitudes regarding their abilities, create meaning in their lives, and cultivate a stronger sense of

self-awareness. Additionally, adolescents receiving Existential therapy may develop a healthier

and more fulfilling approach to their lives which can assist in a healthy transition into adulthood.

Allowing adolescent clients to claim responsibility for their own choices and attitudes

may help them feel more respected by their therapist, especially since many teenagers have a

strong distrust for adults including suspicious of manipulation, control, and dishonesty. What

also makes this approach to counseling ideal for adolescents is the lack of formal clinical labels.

Focusing on the person rather than the diagnosis is what will assist in crafting a trusting and

productive therapeutic relationship (Hanna et al., 1999), for as Yalom (1980) says, “It is the

relationship that heals” (p. 401).

Therapeutic Goals in an Existential/Cognitive-Behavioral Approach

One of the benefits of combining existential therapy with cognitive-behavioral techniques

is the ability to adequately address multiple dimensions of an individual’s functioning. A

primary goal of the phenomenological models is to enable clients to take personal responsibility

for their lives by choosing how to live. This involves examining levels of authenticity in

thoughts and behavior, establishing meaning in their lives, challenging rigid beliefs that limit

freedom, facing anxiety, and cultivating awareness (Corey, 2001); cognitive-behavioral

techniques provide the tools necessary to accomplish these tasks. More specifically, cognitive-

behavior therapy involves challenging negative and automatic thoughts, monitoring thinking and

behavior, and developing healthier styles of coping with distress. Merging these two approaches

allows the therapist and client to examine functioning on cognitive, social, physical, and


interpersonal levels. Goals would include intercepting, challenging, and modifying faulty

cognitions, stepping out of the victim role by accepting personal responsibility for attitudes and

behavior, developing effective coping strategies, discovering and defining a personal role within

the world, and discovering a sense of purpose and meaning in existence (Corey, 2001).

Role of the Therapist

According to Viktor Frankl (1969), one of the pioneers of existential therapy, “What

matters in therapy is not techniques but rather the human relations between doctor and patient, or

the personal and existential encounter” (p. 6). Existential therapists are less concerned with

techniques and clinical labels than they are with understanding the subjective worlds of their

clients (Corey, 2001). In the phenomenological therapeutic approaches, the counselor-client

relationship is the most important determinant of therapeutic outcomes. Existential therapists

strive to develop an authentic relationship with clients in order to foster an environment of trust

and empathy (Murdock, 2009). Existential therapy is guided and defined by who the therapist is

in the counseling relationship rather than the use of formal techniques and clinical terminology

(Buxton, 2005).

Existential therapy is based heavily on the philosophy of thinkers such as Jean-Paul Sarte

(1981), who emphasized that because the human experience is subjective in nature, no one can

ever fully know or understand the experience of another person. As a result, therapists do not

attempt to offer solutions or answers to clients, but instead assist them in self-inquiry and efforts

to clarify and understand their freedoms and limitations in the world they exist in. In order to

adequately do so, existential therapists must maintain a high level of self-awareness and a

willingness to continuously learn and grow from life experiences and interactions with clients

(Corrie & Milton, 2000).


Role of the Client

Existential therapy requires clients to take responsibility for their lives. This includes

recognizing the fact that we cannot always control the circumstances we are presented with, but

we can always control the way we handle and react to those circumstances. Clients are active

participants in the goal-setting process and are responsible for establishing and defining their

own set of values without the influence of external factors. Beyond goal-setting and self-

exploration is the need to actively live out personally defined values. Therapy helps the client

transition from the old self to the new self, and this can only happen through actively making

changes (Corey, 2005).

Resistance in Existential Therapy

Resistance is quite common when working with adolescent clients, especially when they

are brought to therapy unwillingly. Clinically, resistance is defined as the process of avoiding or

impeding the therapeutic process by evading participation and communication with the therapist.

Each conceptual model has its own reasoning for resistance; the Existential approach holds that

clients demonstrate resistance as a way to avoid uncomfortable or painful feelings that may

challenge or damage their current perception and experience of the world (Watson). Ultimately,

individuals are attempting to protect themselves from any sort of threat to their self-efficacy or

self-concept, even if these views are already flawed or self-defeating (Murdock, 2009).

“Although such methods may at first seem crude, crippling, or even life-denying, to most clients

they are starkly preferable to the alternatives” (Schneider & May, 1995, p. 167).

As an existential therapist, it is important to respect both the “life-giving” and “life-

taking” qualities of client resistances (Schneider & May, 1995, p. 167). Empathy and patience


are powerful and necessary tools in working with clients and developing a strong therapeutic

alliance. Schneider & May (1995) recommend avoiding challenging a client’s resistance

prematurely, as this may actually aggravate their condition rather than mitigate it (p. 167).

Working with resistance in existential therapy would involve helping clients realize that they are

in control of their own lives and at every moment have choices about how to “be”. This reminds

clients that it is not the therapist who has the power to create change; the power lies within the

individual and must be claimed. Therapists are interested in understanding the subjective world

of their clients, and would need to demonstrate empathy and compassion when encouraging

clients to break the pattern of resistance. Some situations may require therapists to indirectly

challenge a client’s resistance in order to prevent confrontation (Schneider & May, 1995).

Because the counseling relationship is seen as the most important therapeutic tool, developing a

trusting and authentic relationship with the client may help break down their barriers. In this

situation, the therapist can metaphorically “hold up a mirror” to the client so they can examine

themselves and the world they have constructed (Corey, 2001). By allowing clients come to

these realizations on their own, the therapist is indirectly challenging resistance by helping them

determine a need for change (Schneider & May, 1995). Direct verbal feedback is sometimes

used to confront client resistance; however, an indirect approach is more preferable to existential

therapists so they can work with the client to better understand their subjective experience

(Corrie & Milton, 2000).

Therapeutic Techniques Using an Integrated Existential/Cognitive-Behavioral Approach

Psychotherapy integration involves looking beyond the limits of a single framework and

discovering what can be gained and how clients can benefit from other perspectives (Corey,

2001, p. 458). When combining approaches, Corey (2001) cautions that a therapist must have a


firm understanding of the ideology that frames their reasoning for integration and a distinct

purpose and vision in mind for implementing specific therapeutic techniques. “An undisciplined

eclectic approach… can be an excuse for failing to develop a sound rationale for systematically

adhering to certain concepts and to the techniques that are extensions of them” (Corey, 2001, p.

3). Each model has its own approach to helping clients on the journey of self-discovery, and

most have proven to be highly effective when used properly and in the right context (Corey,

2001). Although cognitive-behavior therapy maintains a constructivist approach, there are many

similarities and compatibilities between existential therapy and CBT.

According to Aaron Beck (1979), one of the leading cognitive therapists, most of the

problems that individuals face are a result of how they perceive situations. These perceptions are

usually filtered through a set of schemas that develop as a result of previous experiences, and

these filters can easily distort an individual’s perception by incorrectly relating current

experiences to past events. Additionally, negative automatic thoughts have the power to corrode

an individual’s self-esteem and perpetuate anxiety and depression. The goal of cognitive therapy

is to change the client’s defective thinking patterns and create new, more functional patterns that

support healthy psychological functioning (Murdock, 2009). More specifically, cognitive

behavior therapy, according to Meichenbaum (1993), aims to modify a client’s overt behavior by

teaching them to modify their thoughts and feelings in order to improve functioning.

One of the commonalities between existential therapy and CBT is the tendency to focus

on the here and now rather than past experiences. While I will not disregard the influence of

unconscious and past experiences from my own personal philosophy, I will still utilize cognitive-

behavioral techniques within the existential framework in my own practice; interestingly, this

can be done even when working within a client’s personal history. Cognitive-behavioral

techniques seek to relieve or eliminate symptoms and develop better coping strategies while


existential techniques aim to help clients take responsibility, develop awareness, and discover

meaning in their lives. Combining these two models offers a comprehensive approach to

treatment (Corrie & Milton, 2000) and can help clients deal with physical, social, interpersonal,

spiritual, and personal issues.

In working with the specified adolescent population, my first goal would be to establish a

trusting and authentic relationship with clients in order to cultivate a safe and productive

counseling environment. Both existential and cognitive therapists acknowledge that counseling

will not be effective without this crucial component (Corey, 2001). Secondly, I will aim to help

clients alleviate their current symptoms and develop coping strategies to better manage their day-

to-day lives. This includes addressing, disputing, and modifying faulty thinking patterns;

changing one’s language from “shoulds” and “musts” to words that indicate preference and

therefore place power and responsibility in the client’s hands; and self-monitoring/self-

evaluation. Additionally, Dialectical Behavior Therapy can help clients develop relaxation

techniques and coping strategies that can reduce distress and anxiety (Nanda, 2010). Once the

client’s symptoms are reduced, we can delve into deeper aspects of their lives including the

nature of their anxiety and fear. Additionally, we will address freedoms and limitations and how

to live a meaningful and fulfilling life within those boundaries.

Limitations

Although existential therapy can be highly effective, certain limitations such as managed

health care programs, time limits, and session limits can pose problems when implementing this

approach. Existential therapy is typically a long-term treatment process requiring up to a year of

counseling in order to reach certain goals. Furthermore, this form of therapy is not appropriate

for all clients and issues. An individual must have the capacity to engage in existential self-


exploration before they can begin this form of therapy; if certain symptoms impede this ability,

then other forms of treatment might be necessary before proceeding (Corey, 2005).

Some practitioners might be opposed to using existential therapy with adolescent clients,

especially since teenagers have difficulties constructing ideas and perspectives outside of

parental and social influences. Alternatively, I see this age as an excellent time to begin the

process of self-exploration; if adolescents can learn to trust themselves and take responsibility

for their lives at a young age, they can enter adulthood having a stronger sense of self-efficacy.

Many adults underestimate adolescents’ abilities to engage in self-reflection and think critically

and philosophically about existence. As a high school teacher, I witness their astounding

abilities every single day; most teenagers just want to have a voice, and when that voice is

constantly being minimized and disregarded by adults, they begin to lose their sense of self-

worth and personal power. Existential therapy can help them recover and cultivate that power.

Concluding Thoughts

One of the most interesting aspects of counseling is that clients will bring varying needs,

goals, and qualities to the table, and a therapist must be open-minded and flexible in order to

adequately meet the individual needs of clients. In my own personal growth beyond counseling,

I found that taking responsibility for my choices and pursuing deep and significant meaning in

my life has transformed me into a more secure, confident, and compassionate individual. In my

own practice, I plan to lean heavily on contemporary Existential theories while utilizing more

specific techniques to influence client growth and insight. By strictly adhering to an inflexible

model, I feel that therapists limit their ability to truly understand their clients. While theories

provide framework to guide the therapeutic process, I plan to tailor my approach to meet the

unique needs of each individual client. This means that the dynamics of each counselor-client


relationship will differ, interpretations will be based on a wide variety of factors (conscious,

unconscious, relational, and environmental), and goals will be determined based on the client’s

personal values (Corey, 2001). Expecting to work with each client in a similar fashion is

unrealistic and detrimental. Each and every individual has their own way of experiencing the

world, and as a therapist, my task is to acknowledge, respect, and do my best to understand the

world through each client’s eyes.

Three PassionsBy: Bertrand Russell

Three passions have governed my life:The longings for love, the search for knowledge,

And unbearable pity for the suffering of [humankind].

Love brings ecstasy and relieves loneliness.In the union of love I have seen

In a mystic miniature the prefiguring visionOf the heavens that saints and poets have imagined.

With equal passion I have sought knowledge.I have wished to understand the hearts of [people].

I have wished to know why the stars shine.

Love and knowledge led upwards to the heavens,But always pity brought me back to earth;

Cries of pain reverberated in my heartOf children in famine, of victims tortured

And of old people left helpless.I long to alleviate the evil, but I cannot,

And I too suffer.

This has been my life; I found it worth living.


References

Buxton, A. (2005). Conceptualisation and Existential Therapy. Existential Analysis, 16(1), 131-

143.

Claessens, M. (2010). Mindfulness Based-Third Wave CBT Therapies and Existential-

Phenomenology. Friends or Foes? Existential Analysis 21(2), 295-308.

Corbett, L. & Milton, M. (2011). Existential therapy: A useful approach to trauma? Counselling

Psychology Review, 26(1), 62-74.

Corey, G. (2001). Theory and Practice of Counseling and Psychotherapy. Belmont, CA:

Wadsworth Publishing Company.

Corey, G. (2005) Case Approach to Counseling and Psychotherapy. Belmont, CA: Wadsworth

Publishing Company.

Corrie, S. & Miltin, M. (2000). The relationship between existential-phenomenological and

cognitive-behaviour therapies. European Journal of Psychotherapy, Counselling &

Health, 3(1), 7-24.

Feist, J, & Feist, G. (2006). Theories of Personality. New York, NY: McGraw-Hill.

Frankl, V.E. (1969). The Will to Meaning: Foundations and Applications of Logotherapy. New

York, NY: Plume.

Hanna, F.J., Hanna, C.A., & Keys, S.G. (1999). Fifty Strategies for Counseling Defiant,

Aggressive Adolescents: Reaching, Accepting, and Relating. Journal of Counseling &

Development, 77, 395-403.

Murdock, N.L. (2008). Theories of Counseling and Psychotherapy: A Case Approach. Upper

Saddle River, NJ: Prentice Hall.

Nanda, J. (2010). Embodied Integration. Existential Analysis, 21(2), 331-350.

Sarte, J.P. (1981). Existential Psychoanalysis. Washington, DC: Gateway Editions.


Schneider, K.J. & May, R. (1995. The Psychology of Existence An Integrative, Clinical

Perspective. New York, NY: McGraw-Hill.

Watson, J. C. (n.d.). Addressing Client Resistance: Recognizing and Processing In-Session

Occurrences . Counseling Outfitters. Retrieved April 4, 2011, from

http://counselingoutfitters.com/Watson.htm

Yalom, I.D. (1980). Existential Psychotherapy. New York: Basic Books.

Existential

Documents

Transcript of Existential