What is the existential approach?
Existential Counselling and Psychotherapy
Emmy van Deurzen
An expanded version of an article 'The Meaning of Life' published
in the Counselling and Psychotherapy Journal, Dec 2001, p. 32-33
Existential counselling and psychotherapy are directly based in
philosophy rather than in psychology. As a therapeutic approach
it was founded at the beginning of the last century, on the one
hand by the original work of Karl Jaspers in Germany, (1951, 1964)
and on the other hand by the work of two Swiss psychiatrists, Ludwig
Binswanger (1946, 1963) and Medard Boss (1957, 1962, 1979). All
three practitioners turned from psychiatry to philosophy, in an
attempt to understand the human predicament, paradoxes and conflicts
of their patients. The philosophies they based their work on were
the 19th century philosophers of existence Kierkegaard (1844,1855)
and Nietzsche (1882, 1883)and the methods they used were modelled
on the phenomenological work of Husserl (1900, 1913) and Heidegger
(1927,1954). Since then other therapists have developed new methods
based on these early attempts as well as on the philosophical works
of existentialist, structuralist and post-modern philosophers such
as Sartre (1939,1943), de Beauvoir, Camus, Merleau Ponty, Levinas,
Derrida and others. Out of this wealth of theoretical background
and early clinical work a myriad of therapies have emerged. Some
therapies like the person-centred approach or Gestalt psychotherapy
are to some extent rooted in this existential thinking. But the
practitioners who have really made a significant effort to base
therapy and counselling in philosophical considerations rather than
in restrictive psychological models, are people like Frankl (1946,
1955, 1967), May (1958, 1969, 1983), Laing (1960, 1967), Szasz (1961,
1965,) and Yalom (1980, 1989, 1996). Recently the approach has been
intensively developed in the UK, mainly through the publication
of Existential Counselling and Psychotherapy in Practice (van Deurzen,
1988, 2nd edition 2002) and publication of subsequent books (van
Deurzen, 1997, 1998) and also by my initiating the founding of the
Society for Existential Analysis in 1988 with the support of colleagues
from the Philadelphia and Arbours Associations. The Journal of the
Society has gone from strength to strength and is an important international
voice in the field of psychotherapy, as is the work of the editors
who have given it much of their time, Simon Du Plock (1997) and
Hans Cohn (1997).
In terms of training much has happened in those past twenty years
as well. After setting up the first University based psychotherapy
training in existential counselling and psychotherapy for Antioch
University in London in 1982 I developed this into the School of
Psychotherapy and Counselling at Regent's College, which has trained
many practitioners over the years. After my departure from the College
in 1996, I founded the New School of Psychotherapy and Counselling,
which is entirely devoted to the training of existential counsellors
and therapists and which is validated by the University of Sheffield.
Establishing the approach in the UK has taken a long time, but now
there is a new generation of new practitioners who have become teachers
in their own right and the existential approach is firmly on the
map. Other courses in the approach can for instance be found at
Brighton and Surrey Universities and in a number of Colleges across
the country.
There are many differences of opinion between various practitioners
and authors over what existential psychotherapy consists of. This
diversity and ongoing debate is one of the strengths of the approach.
Some practitioners who claim the existential label however seem
to disagree with the most fundamental existential ideas. An approach
can not be truly existential unless it takes into account the cultural,
social, political and ideological context of a person's existence
for instance. An existential approach is an approach that explores
the human condition and tries to capture and question and individual's
experience of it. It aims at clarifying and understanding personal
worldviews, values and beliefs and it makes explicit what was previously
implicit and unsaid. Its practice is primarily philosophical and
seeks to enable a person to live more deliberately, more authentically
and more purposefully, whilst accepting the limitations and contradictions
of human existence. It is essentially about investigating human
existence through the particular preoccupations of one individual
and this has to be done without preconceptions or set ways of proceeding.
It is certainly nothing like the magical make-believe of the Dumbo
school of thought that Spinelli described in a recent article in
this Journal (Spinelli, 2001). The existential counsellor or therapist
needs to come to the sessions with complete openness to the individual
situation and with an attitude of wonder that will allow the specific
circumstances and experiences to unfold in their own right. Assisting
other human beings in understanding their own life in a genuine
and meaningful manner is a serious matter. Each and every discovery
is personal and unpredictable. We can however distinguish a number
of themes that will often emerge in this process.
According to Heidegger the most fundamental philosophical questions
are: 'Why is there something rather than nothing?' and 'What is
the meaning of being?'. We do not actually know the answer to these
questions, but most people sooner or later ask them. When people
wonder what it is all good for and they cannot find a satisfactory
answer for themselves they may come to a counsellor or a therapist.
But in actual fact such doubts about the meaning of life are the
beginning of all philosophy and should not be confused with pathology.
Doubt and wonder enable us to rediscover the miracle of being. Once
upon a time the meaning of life was given by religion or by social
rule. These days meaning is often looked at in a far more sceptical
manner (Tantam, 2000). It is therefore not surprising that people
can find themselves in what has been called a vacuum of meaning
(Frankl 1946,1955). The experience of meaninglessness becomes a
major problem in many people's lives and it may lead to a number
of concrete difficulties, which may look like personality problems
or other forms of pathology. We can only engage in discussions about
meaning if we have been willing to question our own lives and can
recognize that anxieties and doubts about meaning do not have to
be equated with personal pathology or mental illness (Szasz 1961,
1965, 1992).
It is by no means easy to be truly available to help others in
finding meaning in their lives when their existence is in crisis.
The meaning of life is never given and can not be transmitted unless
a person is willing to search for it independently. Phenomenologists
recognized that meaning making is one of the defining characteristics
of human consciousness. Logotherapist Frankl (1946) spoke of three
sources of meaning. Firstly through taking from the world what is
there, learning to savour and appreciate what is already given to
us, as in aesthetic enjoyment of nature or the pleasures of the
senses. Secondly to give to the world and add new enjoyments to
it through acts of our own creativity and by giving to others in
this way as well. Thirdly by suffering, which is to endure the harsh
conditions we may be exposed to. If there is no alternative to our
suffering, it is always possible to find an attitude of human dignity
by enduring the hard labour, pain and disappointments, Frankl argues,
even when we have to face up to extremes of torture and deprivation.
The experience of meaninglessness and the creation of meaning are
closely related to the experience of Angst or existential anxiety.
This occurs against the backdrop of the personal realization that
I am ultimately alone in the world and that I have to contend with
my mortality and other limitations, taking responsibility for myself
in the face of endless challenges and confusions. This crisis of
meaning was first described by Kierkegaard (1844, 1855), who thought
that it was a great deal preferable to begin to feel anxious about
life and question it, rather than to live in the despair of those
who deny the need to think for themselves. Kierkegaard thought that
human beings would only gradually become capable of such questioning.
For the process of thinking alone plunges us into Angst, or existential
anxiety, which was likened by Kierkegaard to a dizziness of freedom.
He thought that experiencing Angst was the sine qua non of us assuming
our responsibility as individuals and that without it we could never
come face to face with the demands our life makes on us.
Anxiety or Angst is a core concept in existential counselling and
therapy, for it is seen as the basic ingredient of vitality. Learning
to be anxious in the right way, i.e. not too much or too little
is the key to living a reflective, meaningful human life. As Kierkegaard
put it:
Whoever has learnt to be anxious in the right way has learnt the
ultimate.
(Kierkegaard 1844:155)
Anxiety has to be distinguished from fear. The former is a generalized
feeling of Unheimlichkeit (Heidegger 1927), of not being at ease,
or at home in one's world, whereas the latter has a concrete object.
It is anxiety that allows us to define ourselves as a separate person
and to become responsive and responsible as well as aware and alert.
Although we may become overwhelmed with anxiety, so that it becomes
counterproductive, on the whole anxiety is to be seen as a positive
breakthrough towards the goal of living fully.
It is hard enough to find your way in the world at the best of
times, but when you start to live in openness to your anxiety, it
is easy to lose your sense of direction. Moral and ethical issues
are increasingly obscure in the world we live in today. It can be
helpful to turn to Nietzsche's challenge (Nietzsche 1883) that we
should re-value all values. He insisted that our thinking had gone
astray and that much that people took for granted had to be reconsidered.
He thought it crucial to consider afresh what a good human life
consists of. This leads to noticing with phenomenologists such as
Husserl (1900, 1913, 1929) that human consciousness is essentially
transparent and in this sense is always and necessarily connected
to a world. It is never independent and always has an object. As
we are non-substantial, transparent beings we cannot but reach out
to a world. We are always in relation. Through us the world comes
to light. We always, think, do, desire, imagine something. There
always is some contents to our mind. It is possible to set aside
our automatic ways of intending things and judging things and take
heed of our tendency to do so. We can learn to be disciplined about
our intentionality and through the phenomenological reduction question
all the automatic judgements we normally take for granted. Husserl
called this process 'coming to the things themselves' and it is
often referred to as the epoché or suspension. It consists
of putting our usual assumptions about the world in brackets. This
does not mean that we get rid of them or pretend they do not exist,
but rather that we deal with them separately so that we can describe
the situation, object of our attention or other person we are dealing
with fairly and as it really is. To make oneself consistently query
one's assumptions about the world and reconsider it with a cleared
attitude of openness is obviously extremely relevant to the practice
of psychotherapy. Existential therapists and counsellors learn to
have a phenomenological attitude and to set aside their assumptions
about everything, in order to look at their values and those of
their clients in recognition of their bias.
When we do this we discover immediately that people are always
connected to the world in a number of concrete ways. Heidegger (1927)
in this context spoke of our 'thrownness'. He said that we are always
thrown into a world that is already there to start with and into
which we simply get inserted. It is important to recognize the factual
situations that we are confronted with. We are part of a certain
culture, a certain environment with a particular climate and history,
a certain society and a specific situation. It is only within the
givens of that situation that we can exercise our own choices. Sartre
(1943) called this our facticity and he recognized that we can never
release ourselves from this, even though we can choose our position
in relation to it. In terms of psychotherapy it also means that
it may be necessary to look at people's problems in a structural
way. Instead of seeing everything as the person's psychological,
emotional or internal problem, difficulties can be seen as part
of an overall situation. Context is crucial and has to be taken
into account.
Of all the situations in which we can find ourselves there are
certain ones that are irrevocable. These situations have to be accepted
and worked with. We cannot avoid them or overcome them: we have
to learn to live with them. Heidegger emphasised the importance
of death as a marker of our finite nature. Death in this sense is
not to be taken as something happening to us at some point later,
but as something that is relevant to us right now. The realities
of our mortality and of our incompleteness have to be faced for
us to become aware of and true to our nature, which is to be finite.
Heidegger considered that the reality of our death is that it completes
us. The recognition of the inevitability of death gives us a certainty
that nothing else can give us. The fear in the face of death allows
us to claim back our individuality, our authentic being, as we are
inevitably alone in death and find ourselves much sobered and humbled
by the knowledge of our mortality. Death, according to Heidegger:
amounts to the disclosedness of the fact that Dasein exists as
thrown being towards its end. (Heidegger 1927:251)
In other words: death is part of me and to accept my living towards
this end gives my life back to me in a new way.
Jaspers (1951, 1971) spoke of limit situations as those situations
which define our humanity. Sooner or later we inevitably come up
against guilt, death, pain, suffering and failure. The philosophical
take on this is that it is more helpful to encourage people to come
to terms with some of the inevitable conflicts and problems of living
than to help them cover them up. Limit situations are what bring
us in confrontation with ourselves in a decisive and fundamentally
disturbing way. They evoke anxiety and therefore release us from
our tendency to be untrue and evasive about ourselves and our lives.
Sartre was particularly adamant that as human beings we try to pretend
that we are solid and definite in the way that objects are. People
do not like to face up to their fundamental nothingness and mortality.
We think we can pretend to be like a stone or a solid thing, but
in fact in doing so we are deceiving ourselves, reinventing ourselves
in bad faith (Sartre 1943). To be in bad faith is an almost unavoidable
state of play for human beings as we seem to find it particularly
difficult to face up to the implications of our freedom as consciousness.
One of the objectives of human living is to become increasingly
aware of our ability to choose to live deliberately rather than
by default and to diminish the extent to which we seek to tell ourselves
false stories about ourselves. Sartre said that the only choice
we do not have is not to choose because not to choose involves a
choice as well.
In fact we are a freedom which chooses, but we do not choose to be free.
(Sartre 1943:485)
The coward is fulfilling the project of cowardice, in the same way
in which the hero is fulfilling the project of heroism. They can
both either choose to take responsibility for their choice or pretend
that it just happened to them and is not open to question.
Heidegger saw the existence of other people, with whom we are fallen
into a world where the anonymous 'They' in our own mind decides
about our actions and our identity as the major obstacle to authenticity.
He recognized, as Sartre did, that human beings are condemned to
living inauthentically for much of the time, but that they can nevertheless
aim to retrieve themselves from inauthenticity. It is the anxiety
of your possible death and your discovery that you are alone in
the face of your own fate and destiny that allows you ultimately
to take yourself seriously and affirm yourself resolutely as an
individual facing death.
This is when it also becomes possible to become more aware of the
dimension of time, which is a crucial category of human living.
It is always today and not tomorrow or yesterday. I am always no
longer and not yet. We orientate ourselves in relation to the various
ways in which we stand out in time. Our lives are a constant process
of transformation that we cannot stop. Heidegger spoke of the three
ec-stasies of time (Heidegger 1927:329), which are the ways in which
we stand out in the past, in the present and in the future. We go
back to ourselves in terms of remembering the past. We let ourselves
be encountered by the world in the present and we reach out towards
ourselves in the future. All of our actions are full of the awareness
of temporal change. There is decay and development around us. Life
consists of movement, transformation and action. All of these are
only possible in time. My existence is historic. It creates a story.
How I create this story is of utmost importance. Existential psychotherapy
is about retracing the story and reorienting a person in time.
The way in which I tell my story is the way in which I create a
self. Existential philosophy does not posit the notion of a fixed
and determined self. There is no such thing as an essential solid
self, only intentionality and being in the world. Sartre used to
say that existence preceded essence. I come into the world first
and exist and only after that do I create a self for myself out
of my actions. The self is a window on the world and out of our
living in time and standing out in the world we become what we are.
Sartre went as far as to say that people were the sum of their actions.
Therefore the choices we make are constitutive of the sort of person
we become. We are constantly in the process of creating a self,
yet when we try to capture this self, we realize it is as if we
were trying to catch our shadow: it moves away from us and changes
as we try to fix it. We cannot be a definitive something. Our stories
change as we live and so we are changed too. Any image we create
of ourselves is in a sense a lie: it never tells the full story
about who we are or could be. We have to re-create ourselves every
day and can never really take anything for granted, nor will we
ever be all that we could be.
Most of us will therefore have a frequent sensation of unease with
ourselves. The awareness that we are not true to our full human
ability and that we live inauthentically will lead to the experience
of existential guilt. In existential guilt we hear the voice of
our conscience and this must be taken extremely seriously. We are
not guilty because we have fallen short by other people's standards
or because we have behaved badly, but simply because we fall short
as human beings. It is important to note that most existential philosophers
assume that human living will inevitably expose us to falling short
and therefore to feeling existential guilt. We are always indebted
to life. We are always capable of being more alive, more open, more
true to the potential of human consciousness than we actually are.
We are therefore condemned to feel existential guilt, as we are
condemned to feel existential anxiety; largely because we are, as
Sartre said, condemned to be free.
Systematic descriptions of human experience have outlined four
dimensions on which we exercise our freedom. Heidegger spoke of
the different dimensions as those of earth, world, man, and gods
(Heidegger 1957). Binswanger (1946,1963) spoke of the Umwelt (environment),
Mitwelt (world with others) and Eigenwelt (personal world), whilst
a spiritual dimension (Uberwelt) is also implied in his work (van
Deurzen 1984). In essence philosophers have recognized that human
experience is multiple and complex and takes place on a number of
different levels. Firstly there is our involvement in a physical
world of objects, where we struggle between survival and death.
Secondly there is our activity in a social world of other people,
where we struggle with the contradictions between our need to belong
and the possibility of our isolation. Thirdly there is a personal
dimension where we grapple with the tension between integrity and
disintegration. Finally there is a spiritual dimension where we
seek to find meaning against the threat of meaninglessness. On each
of these dimensions we have to learn to stand in the tension between
opposites and hold the paradox, discovering that we cannot have
life without death, love without hate, identity without confusion,
and wisdom without doubt. As Paul Tillich once said:
The courage of confidence takes the anxiety of fate as well as
the anxiety of guilt into itself (Tillich 1952:163).
Approaching psychotherapy from an existential perspective is to
see that a dialectical process manages all these tensions of human
existence. Conflicts are constantly generated and then overcome,
only to be reasserted in a new form. Paradoxes are inevitable and
life flows out of contradictory forces working against and with
each other. The existential psychotherapist has as primary task
to recognize together with the client the specific tensions that
are at work in the client's life. This requires a process of careful
scrutiny and description of the client's experience and a gradually
growing familiarity with the client's particular situation and stance
in the world. To understand the worldview and the states of mind
that this generates is to grapple with the way the client makes
meaning, which involves a coming to know of clients' values and
beliefs. The particular circumstances of the client's life are recognized,
as is their wider context. The psychotherapeutic process of existential
therapy is then to elicit, clarify and put into perspective all
the current issues and contradictions that are problematic. Part
of the work consists in enabling the client to come to terms with
the inherent contradictions of human living. Another part of it
is to help clients find a satisfactory direction for their future
life with a full recognition of the paradoxes that have to be faced
in the process. Ultimately the therapeutic search is about allowing
the client to reclaim personal freedom and a willingness and ability
to be open to the world in all its complexity. Authentic living
with courage (Tillich 1952) and in humility would be a suitable
existential objective. Learning to reflect for oneself and communicate
effectively with others is another (Buber 1923, 1929). As mentioned
before existential psychotherapy can take many different shapes
and forms, but it always requires a philosophical exploration of
what is true for the client. When this exploration is conducted
satisfactorily and fully it often leads to a greater recognition
of what is true for human beings in general, affording the beginning
of a genuine philosophical exploration, which is meaningful in itself
and which may make it easier to tackle life's inevitable darkness
and adversity.
Existential therapy is a serious, deep and far-reaching enquiry
into what it means to a particular person to be a human being. It
involves an often-painful process of squarely facing up to those
things that are ordinarily avoided and evaded. Paradoxically such
a process can bring great strength and unexpected joy. Existential
work is not for the fainthearted and it may sometimes consist of
encouraging rather than soothing anxiety and guilt. The essence
of the existential approach is to deflate our human vanities and
remember that at the end of all our worldly adventures and preoccupations
we are born to die. Lots of good therapists from different orientations
understand about existential issues, but very few have investigated
the philosophical dimension of the subject in any great depth. Training
in existential therapy and counselling requires students to thoroughly
familiarize themselves with the philosophical investigation of human
living, to practice the application of such ideas by intensively
supervised philosophical therapeutic practice and from having a
deep and real understanding of their own experiences of crisis and
distress, through their training analysis. It is a remarkable fact
that those who come for existential training tend to have varied
and often-intense life experiences behind them. The approach just
does not make sense unless you have first come to find out a bit
about life the hard way and quite by yourself.
Binswanger, L. (1946) 'The Existential Analysis school of thought',
in Existence, ed. May, R., Angel, E., Ellenberger, H.F., (1958)
New York, Basic Books.
Binswanger, L. (1963) Being-in-the-World, transl. Needleman J. New
York: Basic Books.
Boss, M. (1957) Psychoanalysis and Daseinsanalysis, transl. Lefebre
J.B. New York: Basic Books.
Boss, M. (1962) 'Anxiety, Guilt and Psychotherapeutic Liberation'
Review of Existential Psychology and Psychiatry, Vol 11, no.3, Sept.
Boss, M. (1979) Existential Foundations of Medicine and Psychology,
New York, Jason Aronson
Buber, M. (1923) I and Thou, Transl. Kaufman W., Edinburgh: T&T
Clark, 1970.
Buber, M. (1929) Between Man and Man, Transl. Smith R.G., London:
Kegan Paul, 1947.
Cohn, H. (1997) Existential Thought and Therapeutic Practice, London:
Sage
Deurzen E. van (1988) Existential Counselling in Practice, London:Sage
Publications, 2nd edition 2002.
Deurzen-Smith E. van (1997) Everyday Mysteries: Existential Dimensions
of Psychotherapy, London: Routledge.
Deurzen E. van, (1998) Paradox and Passion in Psychotherapy, Chichester:Wiley.
Du Plock, S. (ed) (1997) Case Studies in Existential Psychotherapy
and Counselling, Chichester: Wiley
Frankl, V.E. (1946) Man's Search for Meaning, London: Hodder and Stoughton, 1964.
Frankl, V.E. (1955) The Doctor and the Soul, New York: Knopf.
Frankl, V.E. (1967) Psychotherapy and Existentialism, Harmondsworth:Penguin.
Heidegger, M. (1927) Being and Time, Transl. Macquarrie J. and Robinson
E.S., London: Harper and Row, 1962.
Heidegger, M. (1954, 1977) What is called Thinking?, trans. Scanlon
J., The Hague, Martinus Nijhoff.
Husserl, E. (1900) Logical Investigations, Transl. Findlay J.N.,
London: Routledge.
Husserl, E. (1913) Ideas, Transl. Boyce Gibson, W.R., New York:
Macmillan.
Jaspers, K. (1951 ) The Way to Wisdom: trans. Manheim R., New Haven:Yale
University Press.
Jaspers, K. (1964) The Nature of Psychotherapy, Chicago: University
of Chicago Press.
Kierkegaard S. 1844 The Concept of Anxiety Transl. Thomte R., Princeton,
Princeton University Press 1980.
Kierkegaard S. (1855), The Sickness unto Death, Trans. Lowrie W.,
Princeton, Princeton Univ. Press, 1941.
Laing R.D. (1960) The Divided Self London: Tavistock Publications.
Laing R.D. (1967) The Politics of Experience London: Tavistock Publications.
May, R., Angel, E., Ellenberger, H.F., (1958) Existence, New York: Basic Books.
May, R. (1969) Existential Psychology, New York: Random House.
May, R. (1983) The Discovery of Being, New York: Norton and Co.
Merleau Ponty, M. (1945) Phenomenology of Perception, Transl. Smith
C., London: Routledge.
Merleau Ponty, M. (1964) Sense and Non-Sense, Transl. Dreyfus H.
and Dreyfus P., Evanston:Northwestern Univ. Press.
Merleau Ponty, M. (1968) The Visible and the Invisible, Transl.
Lingis A., Evanston: Northwestern Univ. Press.
Nietzsche, F. (1882, 1974) The Gay Science, trans. Kaufman W., New
York: Vintage Books.
Nietzsche, F. (1883) Thus spoke Zarathustra, transl. Tille A., New
York: Dutton 1933
Sartre, J.P. (1943), Being and Nothingness: An Essay on Phenomenological
Ontology, Trans. Barnes H., New York: Philosophical Library, 1956.
Sartre, J.P. (1939, 1962) Sketch for a Theory of the Emotions, London:
Methuen & Co.
Spinelli, E. (2001) The psychotherapist's magic feathers, in Counselling
and Psychotherapy Journal 12, no. 6:6-9.
Szasz T.S. (1961) The Myth of Mental Illness, NewYork: Hoeber-Harper
Szasz T.S. (1965) The Ethics of Psychoanalysis: The Theory and Method
of Autonomous Psychotherapy, Syracuse, N.Y.: Syracuse University
Press (1988)
Tantam D. (1999) Can meanings be causes? In: Heart and Soul, ed.
Mace C., London:Routledge
Tillich P. (1952) The Courage to Be, Newhaven: Yale Univ. Press
Tillich P. (1954) Love, Power and Justice, Oxford: Oxford University Press.
Yalom, I. (1980) Existential Psychotherapy, New York: Basic Books
Yalom, I. (1989) Love's Executioner and Other Tales of Psychotherapy,
London: Bloomsbury Publications.
Yalom, I. (1996) Lying on the Couch, New York:Basic Books.
|
Feed Entries
Home 
The Existential Approach
