Existential therapy
Existential therapy is a form of psychotherapy focused on the client’s lived experience of their subjective reality. The aim is for clients to use their freedom to live authentic fulfilled lives.
Existentialist traditions maintain:
- People are fundamentally free to shape their lives and are responsible for their choices, even under difficult circumstances.
- Distress around existential concerns—such as death, isolation, freedom, and the search for meaning—are not pathological, but natural parts of the human condition and potential catalysts for living more authentically.
- An emphasis on exploring the client’s subjective world and lived experience, rather than providing an authoritative interpretation of what feelings mean.
- A de-emphasis on standardized techniques, favoring instead a collaborative, dialogical encounter grounded in authentic presence, openness, and mutual exploration of the client's world.
- A critique of reductionist models of mental health that attempt to explain psychological suffering solely in terms of symptoms, diagnoses, or biological causes.
Background
The starting point of existential philosophy works of Søren Kierkegaard and Friedrich Nietzsche. Their works conflicted with the predominant ideologies of their time and committed to the exploration of reality.
Søren Kierkegaard (1813–1855)
protested vehemently against popular misunderstanding and abuse of Christian dogma and the so-called 'objectivity' of science. He thought that both were ways of avoiding the anxiety inherent in human existence. He had great contempt for the way life was lived by those around him and believed truth could only be discovered subjectively by the individual in action. He felt people lacked the courage to take a leap of faith and live with passion and commitment from the inward depth of existence. This involved a constant struggle between the finite and infinite aspects of our nature as part of the difficult task of creating a self and finding meaning. As Kierkegaard lived by his word, he was lonely and much ridiculed during his lifetime.Friedrich Nietzsche (1844–1900)
took this philosophy of life a step further. His starting point was the notion that God is dead, that is, the idea of God was outmoded and limiting. Furthermore, the Enlightenment—with the newfound faith in reason and rationality—had killed or replaced God with a new Truth that was perhaps more pernicious than the one it replaced. Science and rationality were the new "God," but instead took the form of a deity that was colder and less comforting than before. Nietzsche exerted a significant impact upon the development of psychology in general, but he specifically influenced an approach which emphasized an understanding of life from a personal perspective. In exploring the various needs of the individual about the ontological conditions of being, Nietzsche asserted that all things are in a state of "ontological privation," in which they long to become more than they are. This state of deprivation has major implications for the physiological and psychological needs of the individual.Edmund Husserl (1859–1938)
While Kierkegaard and Nietzsche drew attention to the human issues that needed to be addressed, Edmund Husserl's phenomenology provided the method to address them rigorously. He contended that natural sciences assume the separateness of subject and object and that this kind of dualism can only lead to error. He proposed a whole new mode of investigation and understanding of the world and our experience of it. He said that prejudice has to be put aside or 'bracketed,' for us to meet the world afresh and discover what is absolutely fundamental, and only directly available to us through intuition. If people want to grasp the essence of things, instead of explaining and analyzing them, they have to learn to describe and understand them.Max Scheler (1874-1928)
developed philosophical anthropology from a material ethic of values that opposed Immanuel Kant's ethics of duty. He described a hierarchical system of values that further developed phenomenological philosophy. Scheler described the human psyche as being composed of four layers analogous to the layers of organic nature. However, in his description, the human psyche is opposed by the principle of the human spirit. Scheler's philosophy forms the basis of Viktor Frankl's logotherapy and existential analysis.Martin Heidegger (1889–1976)
applied the phenomenological method to understanding the meaning of being. He argued that poetry and deep philosophical thinking could bring greater insight into what it means to be in the world than what can be achieved through scientific knowledge. He explored human beings in the world in a manner that revolutionized classical ideas about the self and psychology. He recognized the importance of time, space, death, and human relatedness. He also favored hermeneutics, an old philosophical method of investigation, which is the art of interpretation.Unlike interpretation as practiced in psychoanalysis, this kind of interpretation seeks to understand how the person himself/herself subjectively experiences something.
Jean-Paul Sartre (1905–1980) and French Existentialists
significantly shaped existential psychology by emphasizing human freedom, responsibility, and the construction of meaning in a world devoid of inherent purpose. His work on ‘radical freedom’ - the idea that humans are "condemned to be free" and must take full responsibility for their actions - is a fundamental aspect of existential therapy. Under this framework, anxiety is not seen as a sort of medical pathology, but a natural process that occurs when individuals are confronted with this burden of choice.In addition, the works of Albert Camus, Simone de Beauvoir, Maurice Merleau-Ponty, and Emmanuel Lévinas were also highly influential. Simone de Beauvoir expanded existentialism into feminist and relational territory, emphasizing that individuals must not only assert their own freedom but also recognize the freedom of others. Camus explored the experience of absurdity and argued for an ethic of personal responsibility and defiant authenticity. Merleau-Ponty brought phenomenology into dialogue with psychology by highlighting the embodied nature of consciousness, showing that perception, emotion, and experience are always rooted in the lived body and situated in a social and physical world. Finally, Lévinas added an important ethical dimension, saying that we become truly human through our responsibility to others, especially when we recognize their vulnerability and need for care.
Additional figures who laid the work for existentialist psychology include:
- Karl Jaspers, a philosopher and psychiatrist credited with founding the field of phenomenological psychiatry. This approach moved away from the reductionist medical model of mental illness in favor of understanding the patient's subjective, lived experience. His writings on "limit situations", moments where humans encounter existential boundaries of human existence, was also fundamental.
- Friedrich Schleiermacher, Wilhelm Dilthey, and Hans-Georg Gadamer, central figures in the development of hermeneutics, or the philosophy of interpretation. Dilthey argued that while the role of the natural sciences was to explain, the role of the human sciences should be to understand lived experience.
- Martin Buber, whose concept of the I-Thou relationship formed the model for the therapeutic relationship in existential therapy. Under this framework, the client should not be treated as a thing to be analyzed. Rather, the therapist and client should have a relationship characterized by mutual presence, empathy, and authentic openness.
- Paul Tillich, an existentialist theologian who explored anxiety in The Courage to Be. In it, he described anxiety as a fundamental part of human existence that comes from confronting death, guilt, and meaninglessness. Rather than treating anxiety as a symptom that must be removed, it is a gateway to developing authentic faith and courage. His notion of "ultimate concern", or the idea that each person is oriented toward something that gives their life ultimate meaning, resonates with existential psychology’s emphasis on values, purpose, and the individual's search for meaning in an uncertain world.
Existentialism and Therapy
Throughout the 20th century, psychotherapists began incorporating both the themes of existentialism as well as the phenomenological methods of describing experience into their therapeutic practice:Otto Rank was an Austrian psychoanalyst who broke with Freud in the mid-1920s. He did not consider himself an existential therapist, but his ideas revolving the concept of "will" as a factor in human motivation, as well as the fear of death and the fear of living authentically would pave the foundation for later writers.
Throughout the 1930s and 40s, the Swiss psychiatrists Ludwig Binswanger and Medard Boss each developed a form of psychotherapy known as Daseinsanalysis. Daseinsanalysis merges Freudian psychoanalysis with the existential phenomenology of Martin Heidegger, particularly his concept of Dasein. It focuses on understanding the client's experience of Being-in-the-world, rather than diagnosing symptoms.
In America, topics in existential therapy were first touched on by Rollo May in his works The Meaning of Anxiety and Man’s Search for Himself. In 1958, he published Existence: A New Dimension in Psychiatry and Psychology, a collection of essays by May and others that - in addition to providing the first English translations of Binswanger's work - was the first major text to introduce existential therapy to an American audience.
During the 1950s and 60s, May worked closely with Paul Tillich and James Bugental to help develop a uniquely American strand of existential-humanistic therapy. May also worked closely with Carl Rogers and Abraham Maslow, founders of the humanistic psychology movement. As such, existential therapy in America became closely associated with humanistic psychology and the principles of Rogers' person-centered therapy, particularly on its emphasis on an empathetic, relational therapeutic relationship as a vehicle for personal growth.
Meanwhile, Viktor Frankl authored the best-selling work Man's Search for Meaning, which created a unique branch of existential therapy known as Logotherapy. Logotherapy is premised on the idea that the primary motivation of individuals is to find meaning in life. Man's Search for Meaning was a worldwide bestseller, selling more than 16 million copies and translated into more than 50 languages.
In the United Kingdom, the psychiatrist R.D. Laing became a central figure of the anti-psychiatry movement that emerged in the 60s. Laing was inspired the European existential-phenomenological tradition and the psychiatrist Karl Jaspers, rejecting the medical model and emphasized a style of therapy that attempted to understand the client’s subjective world before attempting any explanation or treatment. In his groundbreaking work The Divided Self, he argued that conditions such as schizophrenia were not medical brain disorders but existential crises of the self, often rooted in interpersonal alienation and social "double binds".
In 1980, Irvin D. Yalom published Existential Psychotherapy. This book was the first to provide a comprehensive overview of existential therapy. In it, Yalom identifies four existential concerns, or "givens", of life that underlie human experience - death, freedom, isolation, and meaninglessness. Yalom argues that the role of the therapist in existential therapy is not to provide solutions or answers, but to guide the client in exploring and confronting these challenges. Unlike other forms of therapy, Yalom does not prescribe specific techniques, rather, Yalom suggests existential therapy should be a personalized collaboration between therapist and client, tailored to each clients’ unique existential concerns.