Existential psychotherapy: its characteristics and philosophy
Going to a psychologist for treatment can be an arduous process, one that can lead to fears of emotional nudity. This is not a trivial step: it involves opening up to another person who, at least at first, is a total stranger.
Existential psychotherapy starts from a humanist base , that is sensitive to this insecurity and proposes an intervention that seeks to escape from the labels and that provides the patient with the perfect scenario to design a life full of meaning.
In the following pages we will go into this question in greater depth, detailing what the intervention consists of, what objectives it proposes and what methodology it conceives to achieve them.
What is existential psychotherapy?
Existential psychotherapy is based on a current of the same name in philosophy, whose cardinal concern is oriented towards the way in which every human being constructs his or her way of being and being in the world. Søren Aabye Kierkegaard is considered to be the founder of this way of understanding suffering, although his theoretical roots are also found in the contributions of thinkers such as Karl Jaspers, Edmund Husserl, Simone de Beavour or Jean-Paul Sartre.
While “conventional” psychology has dedicated its most important efforts to the understanding of thought and behavior, and many times only with regard to its psychopathological dimensions, this branch has been interested in abounding in the meaning that existence has for each one of us . Thus, it seeks a deep analysis of the great universal questions: death, freedom, guilt, time and meaning.
The founding fathers of the discipline were psychiatrists generally disappointed with traditional biomedical models, such as Medard Boss or Ludwig Binswanger, who sought in phenomenological or constructivist currents the epistemological space with which to express the way they understood their work. In this way, they transcended pain and negatives, to enter fully into the identification of the potential and the positive aspects that contribute to a happy life.
1. Human nature
From the existentialist perspective, each human being is a project under construction, and therefore can never be understood as a finish or conclusion. It is also a flexible reality, open to experience, which holds within itself the potential to live and feel a virtually infinite range of emotions and ideas. Nor is it an isolated being, but rather it acquires its meaning as it is immersed in a canvas of social relations on which it can trace the brushstrokes that draw its subjectivity.
Existentialism does not only focus on the human being as a biopsychosocial reality, but it contemplates him at the intersection of the following dimensions : umwelt (which involves the body and its basic needs), mitwelt (connections with others imbricated in the framework of culture and society), eigenwelt (identity of oneself in the relationship that is built with one’s own self and with the affections or thoughts that give it its form) and überwelt (spiritual/transcendental beliefs about life and its purpose).
These four dimensions are the basis on which the exploration of the client is carried out (this is the term by which the person requesting help is described from the point of view of humanist currents), so that the balance of its totality will be ensured . The disturbance in one of them (or in several) will be raised as a therapeutic objective, within a program that can be extended as long as the person wants or needs.
2. Health and disease
From an existential perspective, health and illness are perceived as the extremes of a continuum in which any person can be located, depending on the concrete way in which he or she relates to himself or to others. Another important criterion is the adherence to one’s own values and principles as guidelines for life. It is not, therefore, a conservative vision, but one that flees from mere survival and seeks an existence through which to find ultimate meaning .
From this perspective, health (proper functioning) would be understood as the result of living an authentic life, guided by our genuine will and open to both the positive and the negative that it may bring. Implicit in this form of existence would be the tendency to self-knowledge, with the aim of discriminating our virtues or limitations and to use an attitude of full consciousness when we have to make important decisions. Finally, it also implies the strenuous search for wisdom .
Illness, on the other hand, involves mainly the opposite of health. From freedom we would move on to the questioning of our own will and the mistrust of taking the reins of our own destiny. One would lead a life lacking in authenticity, distanced from reality as it is presented, in which others would be the ones to decide the paths through which one would have to pass. As can be seen, health transcends the limits of the physical and reaches the spiritual and social spheres.
The intervention from this type of therapy
Next we proceed to describe what are the objectives pursued from this form of psychotherapy, and the phases of which it consists (whose aim is to satisfy these fundamental goals). We will conclude this section by showing the techniques commonly used, which in reality are philosophical positions on one’s own life .
Existential therapy pursues three basic purposes, namely: to restore confidence in those who might have lost it, to expand the way a person perceives his own life or the world around him, and to determine a goal that is personally meaningful.
It is the search for a position in life and a direction to assume , a kind of map and compass that stimulates the ability to explore the limits of one’s own way of being and being. In short, to determine what makes us authentic.
The process of intervention, aimed at mobilizing change based on the objectives outlined, is also three-fold: the initial contact, the work phase and the completion. We will now describe each of them.
The initial contact with the client aims to forge the rapport, that is, the therapeutic bond on which the intervention will be built from this moment on. This alliance must be based on active listening and acceptance of the experience of others, as well as on the search for a consensus on how the sessions will evolve (periodicity, significant objectives, etc.). It is assumed that the response is within the client, so the therapist will limit himself to accompanying the client by investigating matters anchored in the present through a horizontal and symmetrical relationship.
In the work phase, the client’s history, everything that concerns or holds him back, begins to be studied in greater depth. The exploration is carried out following the four spheres of the human, and which define the complexity of his reality (about which we already inquired in a previous section). It is at this point that the main objectives of the model are addressed: detection of strengths and weaknesses, definition of values , examination of the link that unites us to the most important people, reinforcement of autonomy and construction of a life project.
The final part of the treatment exemplifies one of the tasks that the client will have to accept in terms of his own life: that everything that is undertaken has a beginning and a conclusion. This point will be reached after a variable amount of time working together, which will mostly depend on the way the person’s internal experience evolves. The aim is to return to the everyday, but to take on a new vision of the role that is played on the stage of everyday life.
The therapeutic techniques used in the context of existentialist therapy are based on their original philosophical roots, which start from phenomenology and constructivism to diametrically oppose the traditional way from which the process of health and illness is understood. That is why flees from everything related to diagnoses or stereotypes , since they would attempt against the essential goal of finding a meaning for life and identity. Below we propose the three main methods.
The first of these is the epoché, a concept that comes from existential philosophy and in which one of the foundations of therapy is summarised: approaching all the moments of life as if they were new , assuming an attitude of apprentice capable of marvelling at the present that is unfolding. In addition, the aim is to inhibit judgment and to dilute expectations, a naked look at the risk and fortune that destiny holds in its bosom, which facilitates decision making and the capacity to risk being what one wants to be.
The description is the second of the techniques. In this case, the aim is to make an exploratory analysis, and not an explanatory one, which allows knowledge about things without falling into categorization. The aim is to encourage curiosity about oneself and social relations, since both constitute the essence of what one really is from an existentialist perspective. This is why the therapist does not base his work on objectives that are fixed at the beginning of the intervention , but rather these change and adapt to the client as time goes by.
The third and last procedure is based on horizontalization, through which we avoid reproducing the hierarchy of power held by the psychiatrist in the doctor-patient dyad of the historical moment when the proposal for intervention was born. The relationships that are based on this position (of equal to equal) allow the client to quickly identify with the figure and role of the clinician, encouraging him/her to express his/her truth in a therapy context that deliberately flees from judgments and criticism.
- Mendelowitz, E. and Schneider, K.J. (2007). Current Psychotherapies. Brooks/Cole (Pub.) and Corsini, R.J. and Wedding, D., 295-327.
- Spinelli, E. (2006). Existential psychotherapy: An introductory overview. Análise Psicológica, 3(24), 311 – 321.