Existentialism

  • Existential therapy stems from existential philosophyàà what does it mean to exist?
  • It is not a clearly defined model- has few techniques
  • Emphasis on freedom choice
  • Lots of psychologists struggle with this type of therapy because it is not structured enough
  • Clients are searching for meaning in their subjective worlds
  • It is common for clients to come to therapy with a sense of emptiness despite no obvious hardship- they are missing something. This type of therapy can be helpful for these people.

 

Key figures

  • Victor Frankl o First people to try to define existentialism o The primary drive in life is meaning through suffering, work, love. o Wrote the book: Man’s search for meaningàà the thing that differed between people that lived and those who didn’t within Nazi concentration camps was meaning.
    • Logotherapy= therapy through meaning (Greek)
    • Influenced by Freud, Adler, Nietzsche
  • Irvin Yalom o He talks about the importance of isolation, relationships, death and freedom.

o He believes that most therapists use existential themes o Wrote the book: staring at the sun: overcoming the terror of death o Believes that most anxiety boils down to a fear of death (fear of aging)- he believed that all anxiety can be explained by this fear

 

Freedom and existential psychotherapy

  • This therapy emphasis that we have freedom
  • Psychoanalytic therapy says our behaviour is determined by unconscious forces routed in childhoodàà behaviour sees behaviour as determined by condition
  • Whereas, existentialism theory states that we ALWAYS have choices.
  • If we have a choice then we have responsibility to determine our own existence, rather than letting the world determine it for us
  • Because this therapy says we have a great choice of freedom there is a great sense of responsibility.
  • We need to promote a sense of responsibility to patients- help them stop deceiving themselves.
  • Develop an internal locus of control.
  • This freedom can cause anxiety as we become aware of this freedom and accept or reject that freedom

 

Phenomenological approach

  • A philosophy or method of inquiry based on the premise that reality consists of objects and events as they are perceived or understood in human consciousness and not of anything independent of human consciousness.
  • A movement based on this, originated about 1905 by Edmund Husserl.
  • If a tree falls in the woods and no one hears it, does it make a sound? Phenomenological perspective = no

Existential psychotherapy

  • Common questions/sources of existential angst for clients:
    • Who am I?
    • I will die o What does it all mean? o Will I die alone? o How am I going to get to where I want to be in my life?

Client doesn’t typically come in asking these specific questions but comes in with a sense of emptiness or dreadàà the existential therapist can start to tease out where the anxiety is rooted (often in these questions)

 

View of human nature

  • The existential tradition seeks a balance between recognizing the limits and tragic dimensions of human existence and the possibilities and opportunities of human life.
  • The current focus is on the individual’s experience of being in the world alone and facing the anxiety of this isolation.
  • The existential view of human nature is the notion that the significance of our existence is never fixed once and for all; rather, we are recreating ourselves through our projects.
  • One assumption is that: humans are in a constant state of transition, evolving and becoming.
  • Basic dimensions of human condition

 

  1. Capacity of self-awareness
    1. Greater awareness= greater possibilities for freedom
    2. Awareness is realizing that:
      1. We are finite- time is limited
      2. We have the choice to act or not act
  • Meaning is not automatic- we must seek it iv. We are subject loneliness, meaningfulness, emptiness, guilt and isolation
  1. Freedom and responsibility
    1. Although we long for freedom, we often try to escape it
    2. Broadening the vision of our choices
    3. Inauthentic mode of existence- lacking awareness of personal responsibility of our lives/ our existence is controlled by external forces.
    4. Existential guilt- being aware of having evaded a commitment, or having chosen not to choose.
  2. Creatingidentity through meaningful relationships with others
    1. Experience of aloneness is apart of the human conditionàà if we are unable to tolerate ourselves when we are alone, how can we expect anyone else to?
    2. Before we can have any relationship with another, we must have a relationship with ourselves.
  3. Search for meaning, purpose, value, and goals
  4. Meaninglessness àà emptiness and hollowness (existential vacuum).
  5. Anxiety as a condition for living- finding meaning through suffering
    1. Normal anxiety
    2. Neurotic anxiety: out of proportion to the situation
  6. Awareness of death and non-being
    1. Necessary to think about death if we are to significantly think about life
    2. Existentialists do not view death negatively- awareness of death gives significance to living

 

Identity and relationship

  • We create meaning through relatedness
  • Balancing aloneness and relatedness helps us develop a unique identity and live authentically in the moment
  • At their best our relationships are based on our desire for fulfilment, not based on deprivation.
  • Two types: life oriented (meaningful) and neurotic relationship (have friendships based on fear)
  • Relationships that spring from our sense of deprivation are clinging, parasitic, and symbiotic.
  • Neurotic dependence vs. the authentic need to be with others.

 

The search for meaning

  • Searching for meaning isn’t that easy
  • Like pleasure and happiness, meaning must be pursued obliquely o Research shoes when we try to seek happiness/directly seek happiness we often don’t obtain it

o Happiness usually comes as a by-product of what we are doing anyway

  • The will to meaning is our primary drive according to this theory- whereas, Freud said pleasure is our drive

 

Anxiety

  • Existential anxiety is a normal part of lifeàà life cannot be faced, nor can death be faced without some form of anxiety (healthy anxiety).
  • Anxiety can be a stimulus for growth as we become aware of and accept our freedomàà it can be a catalyst for living authentically and fully.
  • Neurotic anxiety (typically we are unaware of this) is anxiety about concrete things that is out of proportion to the situation- not normal (unhealthy anxiety).
  • We try and blunt our anxiety by creating the illusion that there is security in life.

 

Therapeutic goals

  • Help clients move towards authenticityàà living an authentic life
  • Helping clients to accept their freedom and responsibility to act
  • Assisting people in coming to terms with the crises in their lives
  • Inviting clients to become more honest with themselves
  • Broadening clients’ awareness of their choices
  • Facilitating the client’s search for purpose and meaning in life
  • Assisting clients in developing a deep understanding of themselves and the ways they can effectively communicate with others
  • Schneider and Krug (2010) identify four essential aims of existential-humanistic therapy:
    • To help clients become more present to both themselves and others o To assist clients in identifying ways they block themselves from fuller presence o To challenge clients to assume responsibility for designing their present lives o To encourage clients to choose more expanded ways of being in their daily lives –Increased awareness is the central goal of existential therapy.

 

Therapist’s function/role

  • Primarily concerned with understanding the subjective world of clients
  • The therapist invites clients to accept personal responsibility and to grow by modelling authentic behaviour.
  • To assist clients in seeing the ways in which they constrict their awareness and the cost of such constrictions
  • They encourage experimentation
  • They often ask clients to reflect on problematic events they encounter in daily life.

 

Clients’ experience

  • Clients are encouraged to assume responsibility for how they are currently choosing to be in their world
  • Experimentation with new ways of behaving is necessary if clients are to change
  • Clients must be active in the therapeutic process
  • Involves the client confronting ultimate concerns rather than coping with immediate problems.
  • Rather than being solution-oriented, existential therapy is aimed toward removing roadblocks to meaningful living and helping clients assume responsibility of their actions.

 

Relationship between therapist and client

  • People often come to therapy assuming that the therapist can free them- this is about patients shirking their responsibility. The therapist should resist providing answers and solutions

In existential therapy- the therapist is not the guide. The client is on the journey with the therapist.

  • Journey of self-discovery for both client and therapist
  • The person to person relationship is key
  • The core of the therapeutic relationship: respect and faith in the clients’ potential to cope, and sharing reactions with genuine concern and empathy.
  • The relationship demands that the therapist be in contact with their own phenomenological world
  • Therapist must reach sufficient depth and openness regarding their own lives to be able to examine their clients subjective worlds without losing their own sense of identity

 

Therapeutic techniques

  • Existential therapy is not technique oriented
  • One technique that is used is: ‘if you had one year to live what would you do?’
  • Techniques from other models can be used within the context of striving to understand the subjective world of the client, but they must be used in an integrated fashion.
  • When the deepest self of the therapist meets the deepest part of the client, the counselling process.

 

Phases of existentialism counselling

  • Initial phase: therapist assist clients in identifying and clarifying their assumptions about the world.
  • Middle phase: clients are assisted in more fully examining the source and authority of their present value system.
  • Final phase: helping people take what they are leaning about themselves and put it into action.

 

Who is appropriate for existentialism?

  • Existential therapy is appropriate for people who are… o Coping with developmental crises, o Experiencing grief and loss, confronting death or facing a major life decision o Committing to dealing with their problems about living o Feeling alienated form current expectations of society  o Searching for meaning in their lives.
    • At a crossroads and who question the state of affairs in the world o Willing to challenge the status quo.
    • For those who have a ‘restricted existence’

 

Group counselling

  • Group provides optimal conditions for therapeutic work on responsibility – Through feedback, members learn to view themselves through others’ eyes  –     Clients can learn the ways in which their behaviour affects others.
  • Clients are responsible for their behaviour in the group
  • Group settings provide a mirror of how clients may act in the world
  • Allows a group member to relate to others in meaningful ways, to learn to be themselves in the company of others, and to establish reward relationships.
  • Members come to terms with the paradoxes of existence:
    • Learning to experience anxiety as a reality of the human condition o Making choices in the face of uncertainty o Discovery there are no ultimate answers for ultimate concerns o Life can be undone by death  o Success is precarious
    • We are determined to be free

 

Multicultural

  • Strengths
    • Doesn’t dictate a particular way of viewing or relating to reality

 

Focuses on universality, or common ground we all share, as well as subjective experience

  • Enables clients to examine the degree to which their behaviour is influenced by social and cultural conditioning
  • Understands clients phenomenological world and cultureàà empowerment in an oppressive society
  • Examine change options within persons culture o Emphasis the human condition

 

Contributions

  • Existentialists have contributed a new dimension to the understanding of death, anxiety, guilt, frustration, loneliness, and alienati
  • A strength is its emphasis on the human quality of the therapeutic relati
  • The key concepts of the existential approach can be integrated into most therapeutic schools.

 

Limitations

  • The individualistic focus may not fit within the world views of clients from a collectivistic culture
  • The high focus on self-determination may not fully account for real-life limitations of those who are oppressed and have limited choices
  • Some clients prefer a more directive approach to counselling
  • The approach may prove difficult for clients who experience difficulty conceptualizing or have limited intellectual capacities
  • The approach does not focus on specific techniques, making treatments difficult to standardize
  • Limited empirical support

 

Gestalt

  • Fritz Perls and his wife, Lauraàà main originators of Gestalt therapy
  • They named this Gestalt because they believed that the whole person is more than the sum of its parts
  • Most gestalt therapists today are supportive, kind, caring unlike Perls himself- he was very confrontational in his style
  • Gestalt therapy can be viewed as an existential, phenomenological and process-based approach
  • Emphasizes: awareness, choice and responsibility (similar to existentialism)
  • The key emphasis is on creating real experiences in the therapy room rather than a reliance on abstraction; o Rather than talk about a childhood trauma the client is encouraged to become the hurt childàà re-experience.

 

View of human nature

  • Gestalt view of human nature is rooted in existential philosophy, phenomenology and field theory.
  • A basic assumption is that individuals have the capacity to self-regulate when they are aware of what is happening in and around them
  • The Gestalt theory of change asserts that the more we work at becoming who or what we are not, the more we remain the same.
  • Paradoxical theory of change: authentic change occurs more from being who we are than from trying to be who we are not.

 

Principles

  • Holism o Means whole or completion, or a form that cannot be separated into parts without losing its essence.
    • Gestalt therapists place no superior value on a particular aspect of the individual.

Emphasis may be on a figure (those aspects of the individual’s experience that are most salient at any moment) or the ground (those aspects of the client that are often out of his or her awareness).

  • Field theory o Gestalt therapy is based on field theoryàà the principle that the organism must be seen in its environment, or in its context, as part of the constantly changing field.
    • Gestalt therapy rests on the principle that everything is relational, influx, interrelated and in process.
  • The figure-formation process o Describes how the individual organizes experience from moment to moment.
    • This process tracks how some aspect of the environmental field merges from the background and becomes the focal point of the individual’s attention.
  • Organismic self-regulation o The figure-formation process is intertwined with the principle of organism selfregulationàà equilibrium is distributed by the emergence of a need/sensation/interest.
    • What emerges in therapy is associated with what is of interest to or what the client needs to be able to regain a sense of equilibrium.

 

The now

  • Our power is in the present àà nothing exists except the now.
  • The past is gone and the future has not yet arrived
  • For many people the power of the present is lost– they may focus on their past mistakes or engage in endless resolutions and plants for the future.
  • One main focus of therapy is learning to appreciate and full experience the present moment.
  • Phenomenological inquiry involves paying attention to what is occurring now.
  • Gestalt therapists ask ‘what’ and ‘how’ questions rather than ‘why’ questionsàà help client stay in contact with the present.
  • Promotes dialogue in the present tense.
  • When clients speak of the past the therapist asks them to re-enact it as though they were living it now.

 

Unfinished business

  • If we have rejected feelings of trauma in the past than it is considered unfinished business – Feelings about the past that are unexpressed:
    • These feelings are associated with distinct memories and fantasies
    • Feelings not fully experienced linger in the background and interfere with effective contact
  • Resultàà preoccupation, compulsive behaviour, wariness oppressive energy, and selfdefeating behaviour.
  • Unfinished business persists until the client deals with the unexpressed feelings
  • Impasse (stuck point) is the time when external support is not available or the normal way of being does not workàà therapist accompanies client in experiencing the impasse without recuing or frustrating them.
  • By experiencing the impasse they are able to get into contact with their frustrations and accept them.

 

Contact and resistances to contact

  • Contact (similar to mindful)- being your authentic self not being distracted by your future/past
  • Contact is necessary if change and growth are to occur
  • Interacting with nature and with other people without losing one’s individuality
  • After a contact experience clients tend to withdraw in order to integrate what has been learnt.
  • Therapists talk about two functions of boundaries: to connect and to separate.

Both contact and withdrawal are important for healthy functioning.

  • Boundary disturbances/resistances to contact: the defences we develop to prevent us from experiencing the present fully.
  • Five different kinds of contact boundary disturbances:
    • Introjection – Uncritically accepting other’s beliefs. Passive. Disengaging and ‘going with the flow’
    • Projection – Aspect of ourselves which are not consistent with our self image are assigned to the environment
    • Retroflection – Doing something to ourselves that we would like to do to someone else
    • Deflection – Distracting, humour, generalizations- smiling, laugh, making light of difficult situations
    • Confluence – Blurring of self with environment

 

Blocks to energy

  • Special attention is given to where energy is located, how it is used and how it can be blocked.
  • Blocked energy is another form of defensive behaviour.
  • It can be manifested by tension in some part of the body, posture, not breathing deeply, looking away from people when speaking, choking sensations etc.
  • One task of therapist is to help clients identify the ways which they are blocking energy and transform this blocked energy into more adaptive behaviours.

 

Therapeutic goals

  • Main goal of therapy: to assist clients in gaining awareness of moment-to-moment experiencing and to expand the capacity to make choicesàà to foster integrations of the self
  • Without awareness the client does not possess the tools for personality change
  • Psychoanalysis talks about the past, existential talks about meaning and hypothetical but gestalt talks about moment to moment.
  • The six methodological components vital to Gestalt therapy are:
    1. The continuum experience
    2. The here and now
    3. The paradoxical theory of change
    4. The experiment
    5. The authentic encounter
    6. Process-oriented diagnosis

 

Therapists’ function/role

  • The therapists’ job is to invite clients into an active partnership where they can learn about themselves by adopting an experimental attitude toward life and try out new behaviours.
  • They use active methods and personal engagement with clients to increase their awareness, freedom and self-direction rather than directing them towards pre-set goals.
  • The basic work of therapy is done by the client
  • Therapists work within a context of I/thou dialogue in a here and now framework.
  • An important function of these therapists is paying attention to clients’ body language and the relationship between language patterns and personality.
  • Examples of aspects of language that the therapist might focus on: o ‘It’ talk o ‘You’ talk o Questions o Language that denies power o Listening to client’s metaphors
    • Listening for language that uncovers a story

 

Relationship between therapist and client

  • Involves a person-to-person relationship

 

  • The therapist must encounter clients with honest and immediate reactions and explore with them their fears, catastrophic expectations, blockages and resistances.
  • The person of the therapist is more important than using techniquesàà the importance of therapists knowing themselves and being therapeutic instruments.
  • Therapy is a two-way engagement that changes both the client and the therapist.

 

Client’s experience

  • Gestalt therapists do not make interpretations of the clients’ behaviour or tell them why they are acting in a certain way because they are not the experts on the client’s experience.
  • Clients are active participants who make their own interpretations and meanings.
  • Three-stage integration sequence that characterizes client growth in therapy:
    • Discoveryàà clients reach a new realization about themselves, or they take a new look at some significant person in their life.
    • Accommodationàà involves clients’ recognizing that they have a choice. Clients begin by trying out new behaviours in the supportive environment of the therapy room.
    • Assimilationàà involves clients; learning how to influence their environment. The client feels capable of dealing with the surprises they encounter in everyday living.

Techniques

  • Very technique heavy –    Techniques include:
    • The experiment o Internal dialogue exercise- empty chair o Rehearsal exercise– become aware of internal rehearsals
    • Reversal technique- do the opposite of usual- particularly useful in group therapy- people find it very liberating o Exaggeration exercise o Staying with the feeling– instead of running away
    • Making the rounds- group therapy
    • Dream work– all stimulus seen as parts of self- expression of internal conflict

 

Experiment

  • Experiments: grow out of the interaction between the client and therapist; they emerge within this dialogic process.
  • The experiment is fundamental to contemporary Gestalt therapy.
  • Zinker (1978) sees therapy sessions as a series of experiments (avenues for clients to learn experientially).
  • Clients test an experiment to determine what does/does not fit for them through their own awareness.
  • Polster (1987): an experiment is a way to bring out internal conflict by making this struggle an actual process
  • Aimed at facilitating a client’s ability to work through the stuck points of his or her life.
  • Can take the form of:
    • Imagining a threatening future encounter o Dramatizing the memory of a painful event o Reliving a profound early experience o Assuming the identity of one’s mother or father through role playing o Carrying on a dialogue between two conflicting aspects within the person etc.

 

Multicultural

  • Strengths:
    • Gestalt therapy can be tailored to fit the unique way in which an individual perceives and interprets their own culture
    • It is particularly effective in helping people integrate the polarities within themselvesàà applies to bicultural clients who struggle to reconcile with two diverse cultures in which they live.
  • Shortcomings:
    • Gestalt methods produce a high level of intense feelingsàà has an effect on those who have been culturally conditioned to be emotionally reserved. o Some believe expressing feelings is a sign of weakness and a display of one’s vulnerability.

 

Contribution

  • It is a creative and lively approach that uses experiments to move clients from talk to action and experience
  • Clients are provided with a wide range of tools for discovering new facets of themselves and making decisions about changing their lives
  • It is a holistic approach that values each aspect of the individual’s experience equally.
  • The gestalt approach to working with dreams is a unique pathway for people to increase their awareness of key themes in their lives
  • A key strength of gestalt therapy is the attempt to integrate theory, practice and research.

 

Limitations

  • The approach has the potential for the therapist to abuse power by using powerful techniques without proper training
  • This approach may not be useful for clients who have difficulty abstracting and imagining
  • The emphasis on therapist authenticity and self-disclosure may be overpowering for some clients
  • Must used with caution