Even those with little interest in psychology have usually heard of therapies like CBT and Psychoanalysis. Existential psychotherapy, on the other hand, seems to be largely ignored. This is a pity, since it addresses issues that preoccupy so many people, from alienation and loneliness to depersonalization and, above all, meaning.
Existential psychotherapy differs from Freudian, Adlerian, or Jungian analysis in having no single founder. Indeed, it isn't even rooted in psychology. Most encyclopedias begin their history of existentialism with the 19th century Danish philosopher Soren Kierkegaard. But many of the themes and concerns can be found in Shakespeare's plays and even in the writings of the Ancient Greeks. The names most commonly associated with modern existentialism, however, are probably Albert Camus and Jean Paul Sartre.
The central claim of existentialism is that existence precedes essence. In other words, human beings are born with an innate longing for purpose and meaning – and yet there is none (according to the existentialists). For Camus, this makes the human predicament absurd. Existentialists generally agree that human beings are not here for anything; they have no divine purpose or mission and so, in a sense, their existence is unjustified.
Of course, many would dispute this. Some would offer a religious answer. Others prefer not to think about it in the first place and live as if their actions do matter, immersing themselves in their career and taking pride in their job title or academic qualifications. Some escape by adopting a particular role (what Carl Jung called a persona). In one of Sartre's novels, for example, the central character contemptuously notes the self-satisfied portraits of local government officials and the job titles carved on people's gravestones. To an existentialist, such people are living in what Sartre called 'bad faith'.
Before turning to existential therapy itself, it should be emphasized that Sartre and Camus were Europeans, raised in a culture that was losing its monotheistic faith. As faith began to ebb away, a sense of emptiness or abandonment was inevitable. Such concerns would have made less sense to a Chinese Taoist or an Indian Buddhist. Neither would they make sense in the traditional, tribal cultures of Africa.
Existential psychotherapists stress the value and importance of individual experience. Patients often criticise therapists for trying to place them in a convenient box. For example, someone may complain that their Freudian analyst is not treating them as a unique individual but just waiting for an opportunity to link their problems to the Oedipal conflict or the oral stage of development.
The existential therapist would be careful not to do this. They would instead make a point of treating the patient as a unique individual. Empathy is important in therapy, but it is especially important in existential therapy. The existentialist tries to enter into his patient's unique experience of the world, to fully understand what it is like to exist in his skin and experience life as he experiences it.
Existential therapists also emphasize that you are not defined by your past. Indeed, whereas a psychodynamic counsellor may focus on your relationship with your parents, an existential therapist will assure you that your past guarantees nothing. Just because certain things happened, this does not mean you are destined to live a certain way. You are free to create your own life and identity, and you must take responsibility for this.
Irvin D. Yalom, a professor of psychiatry at Stanford University, suggested that inner conflict stems from certain fundamental realities, realities that many people struggle with to the very end of their lives.
First, there is a sense of isolation. This often begins in adolescence, though some experience it in childhood. Maturity involves the gradual realization that you are a separate, distinct individual existing in a universe that does not know you are here – and does not care. This sense of isolation is especially acute when people feel that no one truly understands them, which is why they often feel more alone in a bad marriage than when literally alone.
Next, there is freedom and responsibility. The Russian novelist Dostoyevsky wrote that when people cease to believe in a supernatural being, "all things are permissible." In other words, morality is relative. If there is no supernatural authority, who is to say what is right and what is wrong? The individual must accept the almost limitless freedom he has to do both good and bad – and even to define those terms for himself.
Then, of course, there is the knowledge of death. The members of other species do not live beneath the shadow of death in quite the same way as human beings. A dog or an elephant is not conscious that one day it will die. Of course, most people push this to the back of their minds and get on with the job of earning money and feeding their children. But every now and then, they can be struck by a sense of absurdity – if everything ends in nothingness, why bother to get out of bed?
Yalom also identified a sense of meaninglessness as a 'given'. If existential therapists prioritize one thing, it would be the search for meaning and the need to feel that your life has meaning.
People visit different therapists for different reasons. A man who feels inexplicable anger towards his father and intense love for his mother may indeed have an unresolved Oedipus complex and need to see a Freudian therapist. Those most likely to seek out an existential therapist, however, may have lost a religious faith, or simply feel disconnected, alienated, empty and adrift. Above all, they are likely to have an acute sense that their life is inauthentic and meaningless.
First, the therapist will ask the client what he means by this. He may then encourage him to note the way he hides behind certain roles or titles. Clearly, his status as 'assistant manager of so and so' is not providing the sense of purpose and meaning he wants. The patient will be encouraged to face the identity he has created through the choices he has made and to understand the meaning he has given to his life.
Like all forms of therapy, existential psychotherapy has its critics. One major criticism is that its results are not scientifically verifiable. Others argue that the existentialists underestimate the impact of childhood experiences; it is futile, they argue, to try to create a new life until old patterns of thought have been identified and challenged. Indeed, some dispute its claim to being a therapy altogether, pointing out that existentialism is a branch of philosophy, not psychology. Ultimately, however, it must be judged by its results. If the patient feels stronger and more hopeful, surely it has value.