Existential Psychotherapy

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Other important questions can help her to begin to create an alternative story: "As you begin to understand the positive and negative influences in your life, what qualities must you possess in order to remain sober and develop better relationships with your husband and children? As Sandra talks about the people and events in her life, such as her childhood and her children, she can discover some of her feelings, as well as the personal meaning in her story. She can experience a great deal of healing through the therapist's feedback and questions that uncover the desires and emotions beneath her story.

A continued focus on identifying, practicing, or even imagining changes in her story can begin the process of developing new ways of living. Transpersonal psychology emerged as a "fourth force" in psychology in the late s and has strong roots in humanistic and existential psychologies, Jungian analysis, the East-West dialog, and ancient wisdom traditions. Transpersonal therapy may be thought of as a bridge between psychological and spiritual practice.

A transpersonal approach emphasizes development of the individual beyond, but including, the ego. It acknowledges the human spiritual quest and recognizes the human striving for unity, ultimate truth, and profound freedom. It cultivates intuitive ways of knowing that complement rational and sensory modes. This approach also recognizes the potential for growth inherent in "peak" experiences and other shifts in consciousness. Although grounded in psychological theory, transpersonal practitioners also tend to incorporate perspectives from ancient wisdom traditions.

The practice of transpersonal therapy is defined more by its orientation and scope rather than by a particular set of techniques or methods Boorstein, Wittine suggests five postulates for a transpersonal psychotherapy Wittine, : Transpersonal psychotherapy is an approach to healing and growth that recognizes the centrality of the self in the therapeutic process.

Transpersonal psychotherapy values wholeness of being and self-realization on all levels of the spectrum of identity i. Transpersonal psychotherapy is a process of awakening from a limited personal identity to expanded universal knowledge of self. Transpersonal psychotherapy makes use of the healing restorative nature of subjective awareness and intuition in the process of awakening.

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In transpersonal psychotherapy, the therapeutic relationship is a vehicle for the process of awakening in both client and therapist. Integrating insights and practices in everyday life is the goal of every therapy. Bringing the transpersonal dimension to the forefront may involve the following: Exploration of "inner voices" including those of a higher self that provides guidance for growth of the individual Rowan, Refinement of intuition or nonrational knowing Practice of creativity in "formal" art or informal personal relationships encounters Meditation Loving service Cultivation of mindfulness Use of dreams and imagery.

These techniques may be taught and supported explicitly in the therapy session. At times, a therapist may directly cultivate shifts in consciousness e. This may provide clients with a skill they can practice on their own; initiating such activity represents a potential for brief intervention. Transpersonal therapy recognizes the need for basic psychological development to be integrated with spiritual growth Nelson, Without such integration there is danger of "spiritual bypassing," where issues of basic psychological functioning are avoided in the name of spiritual development.

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In other words, the basic psychological work should be undertaken first. Substance abuse disorders may be seen broadly as an attempt to fill a spiritual void. They may also be understood as a means for the ego to defend itself against a natural drive for growth. If growth were to occur, the ego might find its dominance relinquished. Addiction, like spirituality, also raises questions of surrender May, : for example, to what and to whom do we surrender? In a culture and a psychology that are dominated by issues of rational ego control, what is the role of constructive surrender regularly described in spiritual traditions?

How does constructive surrender become destructive and distorted in substance dependency? In addition, substance abuse may be understood as a means for shifting out of a normal waking state of consciousness. This may be an attempt to fulfill an innate drive Weil, for nonrational consciousness. As the existentialists remind us, there is nothing like death to rivet our attention. A glimpse of death--for example, seeing the aftermath of a serious car crash--reminds the witness of how valuable life is, bringing up other issues as well.

Sandra is now confronted with death due to AIDS. This opportunity to face death and life squarely provides a chance to reconsider and reprioritize her life. In fact, it could be argued that the best catalyst to brief therapy may be a death sentence precisely because it has the potential to wake up an individual. In many respects, helping the client wake from habitual, mechanical routines that are often based on ego protection and move toward an appreciation that the individual is not bound to or defined by a limited ego, is the goal of transpersonal therapy.

This can be seen as a transformation of identity. Many inspiring instances of people facing death, including death through AIDS, have shown that emergent spirituality can change the quality and direction of existence very quickly. For treatment, the basic sharing of these experiences with a group of others in a similar predicament often quickly moves the client beyond isolation and a sense of self-separateness to connect intimately with others who understand her situation. This community may not only bring comfort and support but also a deep sense of communion with humanity.

In this instance, breaking through the shell of isolation may enable Sandra to begin to make new connections with her family and with herself. A sense of interconnection, a central postulate and experience in the wisdom traditions, may replace her perceived isolation. Sandra may use this opportunity of facing possible death to begin to encounter and let go of such feelings as guilt, shame, disappointment, and anger that have kept her life less satisfying than it could be.

Accessing the imaginal through art or dreams, for example, can provide a clear and symbolic expression of unresolved issues. The use of rituals or rites-of-passage inspired by the wisdom traditions can provide some catalyst for shifting her consciousness through forgiveness and release. The therapist may engage in a wide variety of methods e. For Sandra, this experience may be seen as an opportunity for practicing love and forgiveness, moving out from behind rigid self-separateness, facing fears, and transforming her self-definition.

Gestalt theory holds that the analysis of parts can never provide an understanding of the whole. In a therapeutic setting, this approach opposes the notion that human beings can be understood entirely through a rational, mechanistic, scientific process. The proponents of Gestalt therapy insist that the experiential world of a client can be understood only through that individual's direct experience and description. Gestalt therapists seek to help their clients gain awareness of themselves and the world.

Discomfort arises from leaving elements and experiences of the psyche incomplete-- primarily past relationships and intrapsychic conflicts that are unresolved, which Perls calls "unfinished business" Perls, According to Gestalt theory The organism should be seen as a whole physical behavior is an important component, as is a client's mental and emotional life. Being in the "here and now" i.

How is more important than why i. The individual's inner experience is central. For Gestalt therapists the "power is in the present" Polster and Polster, This means that the "now" is the only place where awareness, responsibility, and change can occur. Therefore, the process of therapy is to help the client make contact with the present moment. Rather than seeking detailed intellectual analysis, the Gestalt therapist looks to create a "safe emergency" in the therapeutic encounter. Perls' invocation to "lose your mind and come to your senses" implies that a feeling-level, "here and now" experience is the optimal condition for therapeutic work.

This may be accomplished in a fairly short amount of time by explicitly asking clients to pay attention e. How does your fear feel to you? The therapist may point out how the client could be avoiding the present moment through inauthentic "games" or ways of relating such as "talking about" feelings rather than experiencing them directly. Clients may be asked to exaggerate certain expressions e. These may all serve the goal of helping clients move into the immediacy of their experience rather than remaining distant from it through intellectualization or substance abuse.

The term contact in Gestalt refers to meeting oneself and what is other than oneself. Without appropriate contact and contact boundaries there is no real meeting of the world. Instead, one remains either engulfed by the world on one hand or, on the other hand, distant from the world and people. Substance abuse interrupts the flow of what Perls called "organismic self-regulation. The substance abuser may distort or thwart the natural cycle at any of the following points: Experiencing the need Mobilization of energy Contact Satisfaction Withdrawal Rest.

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Existential Psychotherapy by Irvin D. Yalom

Treatment involves bringing awareness to each of these dimensions and the client's strategies of avoidance. Substance abuse may also be understood as "introjection" in which the client attempts to "swallow whole" or "drink in" his environment without contact and discrimination. This type of client bypasses and blocks other experiences that might enable contact and the development of discrimination.

Perls maintains that such a client seeks immediate confluence without preparatory contact. This pattern of interaction extends to other relationships besides the substance as well. In order for this work to proceed, the therapist must maintain a fine-tuned, present-moment immediacy, even serving as a "resonance chamber" Polster and Polster, for the client's experience.


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They, too, must be able to make and sustain contact with the client and with their own reactions. The Gestalt therapist begins with Sandra's current experience of the world, starting with awareness and attention. The therapist may simply help her become aware of basic sights, sounds, somatic reactions, feelings, and thoughts as well as what her attention drifts to. The immediate contact between therapist and client is a component of the "now" where these sensations are explored directly.

The therapist might notice and ask about her style of eye contact, or her fidgeting body, or stream of thoughts e. What is the sensation in your body at this moment? Sandra may also identify certain issues such as substance abuse, relationship difficulties, and the threat of death from AIDS that seem to dominate her life. The therapist might invite her to name and explore the sensation that the thought of death, for example, brings; perhaps this involves a sense of a void, or feeling cold and dark, or a feeling of engulfment.

She then may be asked to become these sensations--for example, the therapist may ask her to be "the void" and encourage her to speak as if she were that void. This may then open possibilities for a dialog with the void through acting out the opposite polarity: separateness and choice. This might involve using an empty chair technique in which the client would literally move into the chair of the "void," speak as if she were that, and then move into an opposite chair and respond in a dialog.

A therapist could also explore her introjection through questions such as, "How is this void different or the same as from the feeling of alcohol or in relationships with your children or husband? Sandra seems to have a great deal of "unfinished business" that involves unexpressed feelings e. Experimentation with these sensations may begin to free her to express and meet these feelings more directly. All of this work encourages Sandra's experimentation with new ways of relating both during and outside of the session in order to move into the "here and now" and work toward the resolution of "unfinished business.

The existential approach to therapy emphasizes the following six propositions: All persons have the capacity for self-awareness. As free beings, everyone must accept the responsibility that comes with freedom. Each person has a unique identity that can only be known through relationships with others. Each person must continually recreate himself.

What It’s Like to Visit an Existential Therapist

The meaning of life and of existence is never fixed; rather, it constantly changes. Anxiety is part of the human condition. Death is a basic human condition that gives significance to life. The core question addressed in existential therapy is "How do I exist? An individual achieves authenticity through courage and is thus able to define and discover his own meaning in the present and the future.

There are important choices to be made e. A core characteristic of the existential view is that an individual is a "being in the world" who has biological, social, and psychological needs. Being in the world involves the physical world, the world of relationships with others, and one's own relationship to self May and Yalom, , p.

The "authentic" individual values symbolization, imagination, and judgment and is able to use these tools to continually create personal meaning. Existential therapy focuses on specific concerns rooted in the individual's existence.

What is Existential Psychotherapy?

The contemporary existential psychotherapist, Irvin Yalom, identifies these concerns as death, isolation, freedom, and emptiness. Existential therapy focuses on the anxiety that occurs when a client confronts the conflict inherent in life. The role of the therapist is to help the client focus on personal responsibility for making decisions, and the therapist may integrate some humanistic approaches and techniques. Yalom, for example, perceives the therapist as a "fellow traveler" through life, and he uses empathy and support to elicit insight and choices.

He strongly believes that because people exist in the presence of others, the relational context of group therapy is an effective approach Yalom, Preliminary observations and research indicate individuals with low levels of perceived meaning in life may be prone to substance abuse as a coping mechanism.

Frankl first observed this possibility among inpatient drug abusers in Germany during the s Frankl, Nicholson and colleagues found inpatient drug abusers had significantly lower levels of meaning in life when compared to a group of matched, nonabusing control subjects Nicholson et al. Shedler and Block performed a longitudinal study and found that lower levels of perceived life meaning among young children preceded substance abuse patterns in adolescence Shedler and Block, In the context of treating substance abuse disorders, the existential therapist often serves as a coach helping the client confront the anxiety that tempts him to abuse substances.

In existential therapy, the emphasis is not to dwell on the past, but to use the past as a tool to promote freedom and newfound assertiveness. By coming to the realization that they are neither unique nor destined for a specific purpose, the person in therapy is able to release the obligatory chains that may have been preventing them from existing in fullness from moment to moment. When that happens, they then achieve the ability to become truly free. People in therapy who are willing to explore the reasons for their intrapsychic conflicts and the decisions that led to their current circumstances can benefit greatly from existential psychotherapy.

There are many behavioral and mental health issues that may be successfully treated with this therapeutic approach, including depression , anxiety, substance dependency , and posttraumatic stress resulting from exposure to military combat, rape, childhood sexual abuse, interpersonal violence, or other life-threatening experiences. Individuals who respond to treatment tend to find meaning and purpose in their lives and often experience heightened self-awareness, self-understanding, self-respect, and self-motivation.

The realization that they are primarily responsible for their own recovery often increases the likelihood that people in treatment will see beyond the limits of a therapy session and view recovery as a therapeutic process. Existential psychotherapy, much like other types of therapy , may be misunderstood by people who do not have a thorough grasp of the fundamental principles or scope of the associated theories. It can help to develop awareness of the principles, theories, and givens before and while participating in treatment.

Combining approaches can help maximize the effectiveness of both and promote greater recovery. Additionally, the in-depth, penetrative approach used in existential psychotherapy may not appeal to people who do not wish to explore their intrapsychic processes, or who are solely interested in finding a quick fix for their mental health challenges. See More. Mental health professionals who meet our membership requirements can take advantage of benefits such as:.

Get Listed Login. Good Therapy. Get Help Learn About. The theories recognize at least four primary existential givens: Freedom and associated responsibility Death Isolation Meaninglessness A confrontation with any of the aforementioned conditions, or givens, fills an individual with a type of dread commonly referred to as existential anxiety. Find a Therapist Advanced Search.

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