Notes on Existential Psychotherapy, Part I: A Short History of Existential Therapy

Existential psychotherapy emerged from existential philosophy, aiming to apply its concepts to practical therapeutic work. In essence, it is a form of applied philosophy. Existential psychotherapists use philosophical ideas to help clients address the big questions of life and find answers that are meaningful and relevant to them.

These questions often revolve around Authenticity (How can I create a life that feels fulfilling and authentic?) , Identity (Who am I, and how do I define my identity amidst societal, relational, and personal expectations?), Making Choices (How do I make choices that reflect my true self?), Freedom and responsibility (What role does freedom play in my life, and how can I take responsibility for my decisions) Isolation (How do I cope with feelings of isolation or loneliness?), Life’s Paradoxes (How can I reconcile life’s contradictions and paradoxes?), Death (How do I deal with the inevitability of death and what does mortality mean for how I live and prioritise my life?), Anxiety (Why do I feel anxiety or despair, and how can I find peace?), Suffering (How do I make sense of suffering and adversity?), Interrelatedness (What does it mean to connect deeply with others?)

These are questions that all of us, at certain points in our lives, have grappled with—questions that can leave us feeling stuck, anxious, depressed, or stagnant. The journey to finding answers is deeply personal and often challenging. Let’s explore how existential philosophers have addressed these profound questions and how psychotherapists have integrated these ideas into their psychotherapeutic theory and practice.

Philosophical Roots

The roots of existential therapy lie in the works of existential philosophers such as:

• Søren Kierkegaard (1813–1855): Søren Kierkegaard, often regarded as a founder of existential philosophy, is central to existential therapy for his focus on individual experience, personal choice, and authenticity. He emphasised the importance of confronting existential dilemmas like anxiety, despair, and the search for meaning, which resonate with the therapeutic process. His idea of living authentically by aligning actions with personal values deeply informs the goal of helping clients embrace their freedom and take responsibility for their lives.

• Friedrich Nietzsche (1844–1900): Friedrich Nietzsche is significant to existential therapy for his exploration of individuality, freedom, and the creation of personal meaning in a world without inherent purpose. His concept of the "will to power" inspires clients to take ownership of their lives, overcome limitations, and pursue actualisation. Additionally, Nietzsche’s challenge to societal norms and emphasis on living authentically align with the therapeutic goal of helping individuals break free from external expectations and live true to their values.

• Martin Heidegger (1889–1976): Martin Heidegger is foundational to existential therapy for his exploration of being ("Dasein") and the human experience of existence. His ideas about confronting mortality, living authentically, and embracing freedom can guide clients in exploring their unique place in the world. Heidegger’s emphasis on how individuals relate to time—past, present, and future—resonates with existential therapy's focus on creating coherence and meaning in life narratives.

• Jean-Paul Sartre (1905–1980): Jean-Paul Sartre is central to existential therapy for his focus on human freedom, choice, and responsibility. His assertion that "existence precedes essence" inspires the therapeutic goal of helping clients recognise their ability to define their own identity and purpose. Sartre’s exploration of existential angst and bad faith provides a framework for addressing self-deception and empowering clients to live authentically.

• Viktor Frankl (1905–1997): Viktor Frankl's work is pivotal to existential therapy through his development of logotherapy, which emphasizes finding meaning in life, even amidst suffering. His belief that meaning is the primary driver of human behaviour aligns closely with existential therapy's focus on helping clients discover purpose and direction. Frankl's experiences in concentration camps underscore the resilience of the human spirit and the therapeutic potential of addressing existential despair with a focus on personal values and goals.

Transition into Psychotherapy

Existential therapy began as a reaction against the deterministic views of psychoanalysis and behaviourism, which often overlooked the uniqueness of individual experiences by reducing human behaviour to unconscious drives or conditioned responses. Psychoanalysis focused heavily on past traumas and instinctual forces, often framing individuals as bound by unconscious processes beyond their control. Similarly, behaviourism reduced human actions to observable behaviours shaped by external stimuli and reinforcement, ignoring subjective experiences, emotions, and personal agency. Existential therapy countered these approaches by emphasising personal freedom, responsibility, and the exploration of lived experience, placing the individual’s unique perspective and search for meaning at the centre of the therapeutic process. It sought to address the spiritual, emotional, and philosophical dimensions of human existence.

Key figures in its development include:

• Ludwig Binswanger (1881–1966): Ludwig Binswanger is a key figure in existential therapy for integrating existential philosophy with psychoanalysis, focusing on the subjective experience of being. His concept of the "world design" (Weltanschauung) highlights how individuals interpret and relate to their world, which aligns with the therapy's focus on personal perspective and meaning. Binswanger's work laid the groundwork for understanding clients' experiences holistically, considering their relationships, culture, and existential concerns.

• Medard Boss (1903–1990): Medard Boss significantly contributed to existential therapy by merging Heidegger's existential philosophy with clinical practice, creating Daseinsanalysis. He emphasised understanding clients' lived experiences and how they relate to their world, rather than focusing solely on symptoms or unconscious processes. Boss's approach encouraged therapists to explore clients' authentic ways of being and their capacity to make meaningful choices, a cornerstone of existential therapy.

• Rollo May (1909–1994): Rollo May was instrumental in introducing existential therapy to the United States, stressing the importance of confronting human challenges such as freedom, anxiety, and the search for meaning. He explored how individuals can harness creativity and courage to navigate life’s uncertainties and live authentically. May’s work bridges existential philosophy and psychotherapy, offering a practical framework for addressing existential concerns in therapy.

• Irvin Yalom (b. 1931): Irvin Yalom is a key figure in existential therapy, known for his focus on universal human concerns such as death, freedom, isolation, and meaning. He emphasised the therapeutic relationship as a vital space for exploring these existential issues collaboratively. Yalom's practical and compassionate approach has made existential therapy more accessible, blending deep philosophical concepts with real-world therapeutic techniques.

• David Smail (1940 - 1918): a British psychologist, is important in existential psychotherapy for his focus on the social and existential dimensions of psychological distress. He highlighted how external forces, such as social inequalities and life circumstances, impact mental health, highlighting the importance of personal responsibility within these contexts. Smail integrated existential themes of power, agency, and social context into therapy, helping individuals understand their experiences within both personal and social frameworks.

• Ernesto Spinelli (b. 1947): Spinelli is renowned for his integration of phenomenology into existential therapy, emphasising the importance of suspending assumptions to explore clients' lived experiences without judgment. He highlighted the co-created nature of the therapeutic relationship and encouraged therapists to engage with uncertainty and ambiguity. By focusing on how clients construct meaning within their relationships and world, Spinelli's approach illuminates existential themes of interconnectedness, personal freedom, and the search for authenticity.

• Emmy van Deurzen (b. 1951): A pioneer of existential therapy in the UK, Emmy van Deurzen highlighted the philosophical roots of therapy, focusing on helping clients confront the challenges of existence, such as freedom, meaning, and responsibility. She advocated for therapy as a tool for enhancing awareness and self-reflection, enabling individuals to live authentically. Her work bridges philosophy and practice, making existential therapy accessible and deeply practical.