Happiness And Psychotherary Worcester Feb 2010

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Emmy van Deurzen Worcester 6 February 2010

description

Emmy's thoughts about the well being and happiness, and the contribution of psychotherapy to it. A presentation given to the Worcester Therapeutic Training Network in February 2010

Transcript of Happiness And Psychotherary Worcester Feb 2010

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Emmy van Deurzen Worcester

6 February 2010

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Director: New School of Psychotherapy and Counselling

London

• Honorary Professor University of Sheffield • Visiting Professor Middlesex University • Professor Schiller International University

• Director Dilemma Consultancy Ltd. and The Existential Academy Ltd.

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•  Edited by Emmy van Deurzen and Sarah Young

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•  Emotional Well Being and Health, with Digby Tantam, London: Sage, 2010

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•  ‘perhaps the relationship between the modern psychotherapist and his patient is a beacon that ever-increasing numbers of men will find themselves forced to follow, lest they become spiritually enslaved or physically destroyed’ (Szasz 1962:272).

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•  Enable clients to tell the truth about their lives and themselves.

•  Help them live passionately and to the full. •  Facilitate their greater understanding of

the human condition. •  Recognize strengths and weaknesses and

make the most of both.

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•  It is a worldview which allows to integrate a variety of methods

•  Addresses universal problems •  Provides philosophical questioning and

logic tools •  Non prescriptive

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•  What are the life issues this client is preoccupied with?

•  What understanding of these does the therapist have?

•  What are the client’s values and project?

•  How can I enhance my own engagement with these issues, values and projects?

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Existential approach: related to, but not the same as positive psychology and well-being research: Mihaly Csikszentmihalyi, Ed Diener, Ruut Veenhoven, Martin Seligman. The tragic depth of being human is as important as human potential and joy.

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•  What does it mean to be alive? Who am I? What is the purpose of my existence? How should we live? What can I hope to achieve? Is happiness possible? What is expected of me? How should I act and be in relation to other people? Is there fairness in the world? Can I make a change for the better? Is it possible to understand life and get a grip on it? Can I find ways of overcoming my troubles? Is it necessary to suffer this much? How can I be a better person and live a worthwhile life?

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•  The unspoken yearning for happiness is often what drives a person to therapy.

•  Sometimes this is made explicit. •  Sometimes it is implied. •  Sometimes it is taboo and unknown. •  What we want, at some level, is to live a better

life but we have no idea what that means. •  Wishful thinking for happiness and perfection

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•  There is but one truly serious philosophical problem and that is … whether life is or is not worth living. (Camus: The Myth of Sisyphus)

•  Is rolling the stone up the hill sufficient to fill a human heart?

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•  Many people believe that it is ultimately happiness that makes a life worth living, i.e. that the good life is identical with the happy life.

•  On this view, things like love, friendship, meaningful activity, freedom, human development, or the appreciation of true beauty are ‘‘merely’’ instrumentally valuable for us, i.e. they are not good as ends but merely as means to the only thing that is good as an end, namely happiness. Bengt Brulde 2006.

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•  Happiness is a prolonged or lasting emotional or affective state that feels good or pleasing.

•  Experiences associated with happiness include wellbeing, joy, pleasure, delight, health, safety and love, while contrasting ones include suffering, sadness, grief and pain. (Wikipedia 06)

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•  Positive emotion: feeling good •  Life satisfaction: an evaluation of overall

picture of one’s life •  Absence of problems: having a good time •  Contentment or state of harmony •  Elation or bliss and ecstasy •  An aim which is always elusive

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•  Hedonism: Pursuit of Pleasure. (drugs, alcohol, sex, consumerism, the painless

civilisation). Object: Finding the holy grail: the promise of something that will save us and stop suffering. (Epicureanism, Utilitarianism: greatest happiness for the greatest number)

•  Eudaimonia: living in tune with one’s power, one’s daimon: the good force. Object: learning to live a good life. (Aristotle, virtue ethics: happiness is an activity)

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•  There are at least four conceptions of happiness, namely •  (1) the cognitive (or attitudinal) view: evaluating life

favorably •  (2) the hedonistic view: having pleasure •  (3) the mood view (or emotional state theory): feeling

happy •  (4) the hybrid view, according to which happiness is a

complex mental state consisting both of an affective and a cognitive component : life satisfaction depends on how good life seems and feels. (Brulde,06)

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•  If bliss is the objective positive evaluation should be given to situations where it does not apply: Nagel’s post accident situation of not having a care in the world, yet being pitied: happy fool (view from nowhere 1986).

•  If pleasure is the goal, then what of Nozick’s ‘experience machine’ (1974) which is not favoured by most people for more than a couple of hours.

•  Need for pleasure is addictive and undermines happiness

•  Pure happiness is unrealistic: not true to life.

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•  Gorgias:493d. ‘Tell me now whether a man who has an itch and can scratch to his heart’s content, scratch his whole life long, can also live happily.’

•  Callicles replies that no, in order to be happy some impulses need to be curbed.

•  The question is which, how and to what extent.

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•  Walhalla, Utopia, el Dorado, Garden of Eden, Nirvana, Land of the Lotus eaters

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•  Kierkegaard: Even though the Fall was a tragedy, it was also both necessary and beneficial.

•  Man rejected the wholeness and happiness of Eden in order to explore his destiny to its inmost depths.

•  Return to Eden is not the objective. To understand the contrast of good and evil is to live with consciousness.

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1.  Try your best 2.  Be true to yourself 3.  Enjoy life 4.  Appreciate what you have 5.  Respect your parents 6.  Protect your family 7.  Never be violent. 8.  Look after the vulnerable. 9.  Protect the environment 10. Protect and nurture children. 11. Do not steal 12. Be honest 13. Do not kill 14. Take responsibility for your actions 15. Treat others as you would want them to treat you.

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•  Nothing about love •  No mention of God or transcendence •  No struggle •  No self-reflection •  Prescriptive mode •  All about action •  What happens to aspiration and

inspiration?

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•  Psychologists came up with a formula for happiness.

•  Pleasure + engagement + meaning = happiness.

•  Yet: pleasure can take us over and have opposite effect. Engagement can make us lose track of other things and meaning can change.

•  It may be formulae themselves that are dangerous. Trying to be happy may also be wrong.

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•  1. Get physical Exercise for half an hour three times a week

•  2. Count your blessings End of each day, reflect on five things you're grateful for.

•  3. Talk time Hour-long uninterrupted conversation with partner or friend each week.

•  4. Plant something Even if it’s a window box or pot plant. Keep it alive!

•  5. Cut your TV viewing by half

•  6. Smile at and/or say hello to a stranger At least once each day.

•  7. Phone a friend Make contact with at least one lost friend or relation.

•  8. Have a good laugh at least once a day.

•  9. Every day make sure you give yourself a treat Take time to really enjoy this.

•  10. Daily kindness Do an extra good turn for someone each day.

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•  Concrete actions which give the illusion of self-improvement : aspirational

•  Useful but not conducive to dealing with the ups and downs of life : no inspiration

•  No attention to personal loss, conflict, difficulty, tragedy, suffering.

•  Assumption is: if I am happier everything will be alright.

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•  Economical factors have an impact (some countries more happy than others)

•  We can measure how an increase in salary gives less benefit than a cut in salary takes happiness away.

•  Above poverty line extra money does not increase happiness

•  But ultimately happiness is a psychological phenomenon: attitude has a lot to do with it

•  Two big problems in society decrease it: chronic pain and mental illness

•  People need to learn to live better lives: counselling has a role to play in this

•  Mechanical and prescriptive theory of counselling

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•  Renewal of human potential movement: build on positives rather than looking at pathology, akin to humanistic psychology

•  Seligman: authentic happiness •  Diener: subjective well being •  Veenhoven, Mihaly Csikszentmihalyi

•  Science of happiness also espoused by Lord Layard and the proposal for more counselling (CBT) in the IAPT programme.

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•  positive emotions (like comfort) •  positive activities (like absorption). •  Signature strengths. •  Virtues •  Authenticity is the derivation of positive

emotions in exercising signature strengths.

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•  About 500 people soon volunteered and each person received a battery of tests, one simple week-long web exercise (no human hands) and then was tested about their well-being repeatedly for the next six months.

•  Three exercises proved to be placebos and three worked well, producing lasting reductions in depression and lasting increases in happiness.

•  The three that worked were "three blessings" - writing down three things that went well today and why; "the gratitude visit" - writing a gratitude testimonial and delivering it personally; and "using your signature strength in a new way" - taking the signature strength test and using your highest strength in a new way.

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•  People were happier in modern industrial society than people in underdeveloped countries.

•  Income only matters if you are poor. •  People in the country were no more satisfied

with life than people in towns •  Bond with a spouse was one of the most

essential conditions of happiness in modern western society.

•  Friendships could not compensate for its absence completely.

•  Having children makes it harder to feel happy though they bring happiness too.

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•  Most people around the world, except those living in dire circumstances, report being happy the majority of the time, but very few report being consistently elated or extremely happy. Thus, slight to moderate happiness is the rule not the exception.

•  This is something he calls subjective well being: life satisfaction, pleasant emotions.

•  Life satisfaction differs from the affective components of happiness in that it is based on a reflective judgment.

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•  DIRECTIONS: Below are five statements with which you may agree or disagree. Using the 1-7 scale below, indicate your agreement with each item by placing the appropriate number in the line preceding that item. Please be open and honest in your responding.

•  1 = Strongly Disagree;2 = Disagree;3 = Slightly Disagree •  4 = Neither Agree or Disagree;5 = Slightly Agree;6 = Agree •  7 = Strongly Agree.

•  ______1. In most ways my life is close to my ideal. •  ______2. The conditions of my life are excellent. •  ______3. I am satisfied with life. •  ______4. So far I have gotten the important things I want in life. •  ______5. If I could live my life over, I would change almost nothing.

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•  Flow: The Psychology of Optimal Experience. He defined and explored the concept of "flow"—as in "in the flow"—as our experience of optimal fulfillment and engagement. Flow, whether in creative arts, athletic competition, engaging work, or spiritual practice, is a deep and uniquely human motivation to excel, exceed, and triumph over limitation.

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•  1. Clear goals: challenge level and skill level should both be high.

•  2. Concentrating and focusing •  3. A loss of the feeling of self consciousness •  4. Distorted sense of time, altered subjective experience •  5. Direct and immediate feedback : immediate response •  6. Balance between ability level and challenge •  7. A sense of personal control over the situation or

activity. •  8. The activity is intrinsically rewarding: effortlessness of

action. •  9. People become absorbed in their activity, and focus of

awareness is narrowed down to the activity itself, action awareness

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Existential approach similar yet different to positive psychology and well-being research: Mihaly Csikszentmihalyi, Ed Diener, Ruut Veenhoven, Martin Seligman. The existential tradition in philosophy includes the tragic depth of being human as well as human potential and joy. Not just positives, not just negatives: but all of life.

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•  Happiness and unhappiness are twins that grow up together. (Nietzsche, 1882: 270)

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•  How do people overcome obstacles? •  How do they survive difficulties, crises, trauma? •  Are there personal qualities that enable a person

to be resilient? •  Are there certain ways of being that are more

conducive to survival and learning from traumatic experience?

•  Role of creative use of trauma. •  Happiness is a genetic given for 50% of our

happiness quotient. •  How do we live well?

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•  Are we after happiness or meaning? •  Is the ultimate objective something else,

like intensity or contact with reality? •  Are we perhaps just after life itself? •  What does it mean to live a good life? •  Does a good life include suffering? •  Does a good life include a good death?

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•  Crystallization of discontent may be the beginning of insight into what is wrong.

•  Conflict, dilemmas and problems are an intrinsic part of being alive

•  Being cured of difficulties is the death of possibility and creativity

•  Are constant problems and troubles necessary to a well lived life?

•  What about truth?

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•  For some it is all darkness; for me too, it is dark. But there are hands there I can take, voices to hear solider than the echoes without. And sometimes a strange light shines, purer than the moon, casting no shadow, that is the halo upon the bones of the pioneers who died for truth.

R.S. Thomas, Groping:99.

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•  Kierkegaard Nietzsche Husserl Jaspers Heidegger Sartre de Beauvoir Buber Camus Merleau Ponty Foucault

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•  Binswanger Boss Frankl •  Tillich May Laing

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•  Courage is the universal self-affirmation of one’s Being in the presence of the threat of non-Being(Tillich 1952:163).

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•  A neurotic person can take on board only a little bit of non-being

•  The average person can take on a limited amount of non-being

•  The creative person can accommodate a large amount of non-being

•  God can tolerate an infinite amount of non-being.

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•  Existential therapists have shown that anxiety far from being something to shun and treat as a symptom to eliminate is the source of energy that makes us come to life.

•  Equally our capacity for despair is what makes us deep and capable of feeling and empathy and ultimately creativity.

•  Without suffering our lives would have less meaning.

•  To be human is to be conscious and be aware of lack, trouble and strife.

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•  The essential components of life dynamics consist of:

•  Paradoxes, conflicts, dilemmas, contradictions, alternatives, dialectics, and experiments in living.

•  Most people are in some trouble or other most of the time. People are rarely without some preoccupation or problem. The body often has sore spots or pains or discomforts. The ego is often bruised or fearful. The self is often lacking in identity or strength. The soul is often confused or distracted and wary.

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•  What does it mean to be alive? Who am I? What is the purpose of my existence? How should we live? What can I hope to achieve? Is happiness possible? What is expected of me? How should I act and be in relation to other people? Is there fairness in the world? Can I make a change for the better? Is it possible to understand life and get a grip on it? Can I find ways of overcoming my troubles? Is it necessary to suffer this much? How can I be a better person and live a worthwhile life?

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•  Happiness as a high is doomed: every high is followed by a low. Constant pleasure leads to addiction and misery.

•  Happiness as contentment may be more feasible, but could easily lead to an existence of mediocrity and lack of awareness.

•  We need to go beyond happiness towards an ability of dealing with both the happy and the sad, the pleasure and the pain of life.

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•  Man’s task is simple: he should cease letting his existence be a thoughtless accident.

(Friedrich Nietzsche: The Gay Science).

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•  Any idiot can face a crisis –

•  it’s day to day living that wears you out

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•  It is not death that a man should fear, but he should fear never beginning to live

•  The paradox is that death, troubles, labour, failures, pain and sorrow are unavoidable and necessary

•  They are the things that wake you up to awareness and that open you to life.

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•  When I speak to Rita, who is grieving over her husband and small son who have perished in a car accident, the words that I say to her at first hardly reach her.

•  She is in a place of relative safety deep inside of herself, in a state of suspended animation behind the façade that she turns to the world. She barely engages with people at all.

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•  At first it is not my words that make the link to her world, but the consistency that I can offer in being attentive and careful to not hurt her further or push her too hard.

•  I spend nearly half an hour in relative silence with Rita, at times formulating her fear on her behalf, gently, tentatively, checking for verification by noting her response.

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•  Mostly the work consists of me letting myself be touched by her suffering and learning to tolerate her pain with her, so that I can offer reactions and words that soothe and move her forward to a place where she can begin to face what has happened to her so shockingly out of the blue. In this process she guides me and exposes more and more of her nightmarish universe to me as she perceives me as capable of venturing further into it with her.

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•  Understand the Lebenswelt: the world in which we live.

How do we co-constitute the world?

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‘ …The restoration of an unlived dimension of life, whether this is described as forgotten, denied, repressed or abandoned’

(Cohn, 2004: 384)

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•  Thesis, antithesis, synthesis. •  Human evolution proceeds with constant

conflict and forward movement in overcoming a previous state.

•  Paradoxes and dilemmas can be integrated and gone beyond.

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Transcendence

Thesis Antithesis

Synthesis

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Physical space

Social space

Personal space

Spiritual space

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•  Things are structures – frameworks – the stars of our life: they gravitate around us. Yet there is a secret bond between

us and them – through perception we enter into the essence of the flesh

(Visible and Invisible: 220)

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•  Corona, chromosphere, photosphere, convection zone, and core.

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4.Physical: Umwelt

3.Social: Mitwelt

2.Personal: Eigenwelt

1.Spiritual: Uberwelt

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•  The soul is the hollow of the body, the body is the distension of the soul. The soul adheres to the body as their signification adheres to the cultural things, whose reverse or other side it is. (233)

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4.Physical: Umwelt

3.Social: Mitwelt

2.Personal: Eigenwelt

1.Spiritual: Uberwelt

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Spiritual: Good/Evil

Intuitions, values, beliefs, purpose, meaning. Worldview/Ideas.

Personal: Strength/Weakness

Thoughts, memories, identity, freedom. Selfhood/Me.

Social: Love/Hate

Feelings, relations, belonging, acknowledgement. Communication/Others.

Physical: Life/Death

Sensations, actions, environment, body, things. Survival/World.

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•  Emotions like the weather: never none. •  They are the way we relate to the world. •  They define the mood of the moment. •  They are our atmosphere and modality. •  They tell us where we are in relation to

what matters to us. •  We can learn to understand our emotions

by tuning in, using the emotional compass. •  Not suppression, not expression, but

understanding.

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•  Our world always seems personal and yet is universal for the way we see the world determines our view on how things are.

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•  Recognize your clients’ values and differentiate them from your own.

•  Learn to read and understand the text of the client’s life, find the narrative point of gravity, the subtext and the context.

•  Take into account the social, cultural and political dimension of the client’s life. Put this in context with your own worldview and beliefs.

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•  Depending on where we stand light refracts differently through the prism of life.

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•  They create different atmospheres at different times.

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•  Emotions are like the weather: never none. •  They are the way we relate to the world. •  They define the mood of the moment. •  They are our atmosphere and modality. •  They tell us where we are. •  Learn to tune in rather than tune out. •  Use the emotional compass.

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•  When we master a mood, we do so by way of a counter-mood; we are never free of moods. Ontologically, we thus obtain as the first essential characteristic of states-of-mind that they disclose Dasein in its thrownness, and – proximally and for the most part - in the manner of an evasive turning-away.’ (Heidegger 1927:136)

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•  Above the clouds the weather is steady even when it rains below.

•  Transcending our own situation and emotions allows us to understand our own response.

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Desires Fears

Physical Life pleasure

Death pain

Social Love belonging

Hate isolation

Personal Identity integrity

Freedom disintegration

Spiritual Good purpose

Evil futility

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•  Baumeister concluded that there are four basic needs for meaning:

1.  Need for purpose (spiritual) 2.  Need for value (social) 3.  Need for efficacy (physical) 4.  Need for self-worth (personal) •  It is the process of going in the general

direction of these four objectives that makes for a good life.

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•  Happiness is when ‘reality lives up to your desires’.

•  Long-term goals offer a sense of direction, but it is necessary to have short-term goals in order to derive daily meaning.

•  In fact it is having short term achievable goals that allow us to feel efficient and purposeful that gives us most of a sense of self worth and value of life.

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•  To live a meaningful life and have goals and values is not enough: you must also feel you are capable of achieving these things.

•  ‘It is necessary to find moderately difficult tasks to maintain that middle ground between boredom (too easy) and anxiety (too hard).’ (41)

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•  Freedom is not strictly the exercise of the will, but rather the experience of accurate vision which, when this becomes appropriate, occasions action (Murdoch 1970:67).

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•  Find out what the inner landscape of a person is: what is meaningful to them.

•  Find out what their purpose in life is.

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•  ‘Man is characterised above all by his going beyond a situation and by what he succeeds in making of what he has been made. This is what we call the project. (Sartre, Search for a Method: 91).

•  We define project by praxis. Action, passion and reflection. Constant transcendence and dialectical progression.

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DESIRES FEARS VALUES

PHYSICAL life death vitality

SOCIAL love hate reciprocity

PERSONAL identity freedom integrity

SPIRITUAL good evil transparency

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•  Helping clients to live deliberately rather than by default.

•  Recognize particular life situation and its advantages and disadvantages.

•  Understand the what, the why, the how, the where and when of the client’s position in the world and connect to the what for.

•  Make room for new choices and for liberation. •  Problematize, don’t solve the issues. Question,

query, encourage creativity.

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•  Experience is not the be all and end all •  Life is more complex than state of mind

and bliss is not the objective •  Conflict, paradox, dilemma and struggle

are all part of the everyday •  Perhaps there is the more satisfaction in

living as we take more of this in our stride. •  Greater values than happiness: love, truth,

beauty, loyalty, honour, courage, freedom.

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•  An ability to creatively encounter challenges and crises.

•  Capacity for re-establishing equilibrium through strong, dynamic centre of narrative gravity.

•  Enhanced enjoyment of life, appreciation of physical world, others, self-worth and meaning.

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Learning to live with paradox and the tensions of life

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•  Personhood is a synthesis of possibility and necessity. Its continued existence is like breathing (respiration), which is an inhaling and exhaling.

•  (Kierkegaard, Sickness unto Death: 40)

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People have to accept the unspoken givens of life:

We have to accept those things that remain true whatever may come We can rise above our condition, by dialectical transformation, evolution and understanding

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•  Is learning about life, each other and ourselves; we learn to be, by living and overcoming our mistakes.

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1.  Earning your keep with your own labour 2.  Understanding others 3.  Pondering your own motivations 4.  Reflecting on your life 5.  Living true to your own values 6.  Living in line with the purpose and truth of human existence. 7.  Contributing more to the world than you take from it. 8.  Respecting nature and the universe 9.  Making your life matter 10. Loving as much as you can. 11. Being prepared for change and transformation. 12. Knowing when to be resolute and when to let go. 13. Having rules to live by and change them when necessary.

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•  to be healthy and look after your body the best way possible. •  to enjoy what is free in the world and be close to nature •  to be loving with others and care for someone deeply. •  to respect and esteem yourself and make sure others do too. •  to find concrete goals worth putting your whole energy into. •  to learn to question things and not take anything for granted •  to find life interesting and relish every minute •  to be prepared to let things go and be ready to die •  to strive for wisdom and excellence •  to be content and find routines that satisfy you •  to achieve something, whatever, and leave the world a better place

than you found it.

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All living things are struggling for existence, even unwittingly and unwillingly. They struggle passively just to exist, to be left in what seems to be peace and quiet; and they struggle actively to grow and to expand. (Jaspers,1951:204)

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•  My conclusion is similar to that of Camus: happiness is simply to live in harmony with your own life and to love it in all its manifestations (Nietzsche’s Amor Fati)

•  Challenges and difficulties are not the enemy, nor to be avoided but rather to be welcomed as grist for the mill and par for the course: life as an adventure.

•  We determine how we want to live: we can increase our capacity for feeling or decrease it.

•  If we increase it we will also suffer more. The price for less suffering is to care less and be less sensitive.

•  Do we want to live for real and to the full, or do we want to hide in fear and pretend to be happy and contented?

•  The choice is yours. Your life belongs to you.

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www.existentialpsychotherapy.net www.dilemmas.org www.nspc.org.uk www.psychotherapytraining.net www.septimus.info

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•  The interhuman: das Zwischenmenschlichen; the in-between is where real communication takes place.

•  (Buber, Between Man and Man, 1929).

•  All actual life is encounter (ibid: 62) •  This is where truth is found.

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•  There is no such thing as a separate human being, in the same way in which as Winnicott suggested there is no such thing as a baby.

•  We are only what we are in as much as we are connected to a world.

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•  Physical: relationships to nature, world of things and bodies around us

•  Social: relationships to other people •  Personal: relationship to ourselves, our

thoughts, dreams, memories and fantasies •  Spiritual: relationships to ideas, beliefs,

transcendence and eternity

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•  Umwelt: understand physical context and embodiment: person’s relation to the world around them.

•  Mitwelt: describe and take into account the social, cultural and political dimension of the client’s life.

•  Eigenwelt: read and understand the text of the client’s life, find the narrative point of gravity. Who do they think they are?

•  Uberwelt: recognize worldview and values: what is the purpose of the person’s life?

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•  Phenomenology •  Wesenschau: to things themselves. •  Intentionality (Franz Brentano). •  Intuition:question natural attitude. •  Knowledge begins with experience. •  Bracketing assumptions.

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I. Phenomenological reduction •  Noesis

II. Eidetic reduction •  Noema

III. Transcendental reduction •  Cogito

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•  Cogito(subject):transcendental reduction •  Noesis(process):phenomenological reduction •  Noema(object):eidetic reduction

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1. Noesis. 2. Epoche: suspend assumptions. 3. Description. 4. Horizontalization. 5. Equalization. 6. Verification.

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1. Noema. 2. Abschattungen:profiles. 3. Wesenschau: looking for essences. 4. Genetic constitution (vs. static). 5. Universals beyond the properties.

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– 1. Cogito. – 2. Transcendental ego. – 3. Solipsism overcome. – 4. Horizon of intentionality. – 5. Self as point zero. – 4. Transcendental intersubjectivity.

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•  Become aware of your own bias: outlook, assumptions, beliefs, prejudice, blind spots.

•  Locate and articulate the client’s worldview and life space.

•  No judgements. Understanding rather than interpretation.

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•  Attitude: based on aptitude, genetic predisposition, constitution,

temperament, previous experiences

•  Orientation: based on worldview, beliefs and theoretical framework, perspective, cultural bias

•  State of Mind: current situation, basic orientation in the world, point

of view, emotional state, mood

•  Reaction: response to this particular client, situation, interaction, provocation

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•  Attitude: based on aptitude, genetic predisposition, constitution,

temperament, previous experiences

•  Orientation: based on worldview, beliefs and theoretical belief system, perspective, cultural bias

•  State of Mind: current situation, basic orientation in the world, point

of view, emotional state, mood, disposition

•  Reaction: response to this particular person, situation, interaction, provocation