Existential psychotherapy: its characteristics and philosophy

Going to a psychologist for treatment can be an arduous process, before which an emotional nakedness is feared. And it is not a trivial step: it means that we open ourselves to another person who, at least at first, is a total unknown.

Existential psychotherapy is based on a humanist base , which is sensitive to this insecurity and proposes an intervention that seeks to escape from the labels and that provides the patient with the perfect scenario to design a life full of meaning.

In the following pages we will deepen this issue; detailing what the intervention consists of, what objectives are proposed and what methodology is conceived to achieve them.

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What is existential psychotherapy?

Existential psychotherapy is based on a homonymous stream of Philosophy whose cardinal concern is oriented to the way in which every human being builds his way of being and being in the world. It is considered that Søren Aabye Kierkegaard was the founder of this way of understanding suffering, although its theoretical roots also sink into the contributions of thinkers such as Karl Jaspers, Edmund Husserl, Simone de Beavour or Jean-Paul Sartre.

While “conventional” psychology has dedicated its most important efforts to the understanding of thought and behavior, and many times only in regard to its psychopathological dimensions, this branch has been interested in discussing the meaning that existence has for each which . Thus, he seeks a deep analysis of the great universal questions: death, freedom, guilt, time and meaning.

The founding fathers of the discipline were psychiatrists generally disappointed with traditional biomedical models, such as Medard Boss or Ludwig Binswanger, who sought in the phenomenological or constructivist currents the epistemological space with which to express the way in which they understood their work. In this way it transcended beyond pain and the negative, to fully enter into the identification of the potential and the positive aspects that contribute to a happy life.

1. Human nature

From the existentialist perspective each human being is a project under construction, and therefore can never be understood as finished or concluded. It is also a flexible reality and open to experience, which harbors within itself the potential to live and feel a virtually infinite range of emotions and ideas. It is also not an isolated being, but it acquires its meaning as it plunges into a canvas of social relations in which it can trace the brushstrokes that draw its subjectivity.

Existentialism does not focus its focus only on the human being as a biopsychosocial reality, but rather contemplates it at the intersection of the following dimensions : umwelt (which implies the body and its basic needs), mitwelt (connections with others embedded in the framework of culture and society), eigenwelt (self identity in the relationship that is built with one’s own self and with the affections or thoughts that give it its form) and überwelt (spiritual / transcendental beliefs about life and its purpose).

These four dimensions are the basis on which the exploration of the client is carried out (this is the term by which the person requesting help from the point of view of humanist currents is described), so that the balance will be ensured of its totality . The disturbance in one of them (or in several) will be raised as a therapeutic objective, within a program that can be extended as long as the person wants or needs.

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2. Health and disease

From the existential perspective, health and illness are perceived as the extremes of a continuum in which any person can be located, depending on the specific way in which he relates to himself and others. Another important criterion consists in adhering to one’s own values ​​and principles as guides for life. It is not therefore a conservative vision, but it flees from mere survival and seeks an existence through which to find an ultimate meaning .

From this perspective, health (proper functioning) would be understood as the result of living an authentic life, guided by our genuine will and open to both the positive and the negative that it could hold. In such a way of existence, the tendency to self-knowledge would be implicit, in order to discriminate our virtues or limitations and use a mindful attitude when we have to make important decisions. Finally, it also implies the search for wisdom .

The disease, on the other hand, implies above all the opposites concerning health. Freedom would be the questioning of one’s own will and distrust of assuming the reins of one’s destiny. It would lead a life devoid of authenticity, distanced from reality as presented, in which the others would be the ones who would decide the paths through which it will have to run. As can be seen, health transcends the limit of the corporal and reaches the spiritual and social spheres.

The intervention from this type of therapy

Then we proceed to describe what are the objectives that are pursued from this form of psychotherapy, and the phases of which it consists (whose purpose is to meet these fundamental goals). This section will be concluded showing the techniques of common use, which are actually philosophical positions on one’s own life .

1. Objectives

Existential therapy has three basic purposes, namely: restoring confidence in those who might have lost it, expanding the way in which the person perceives their own life or the world around them and determining an objective that is personally meaningful.

It is about the search for a position in life and a direction to assume , a kind of map and compass that stimulates the ability to explore the limits of one’s own way of being and being. In short, determine what makes us authentic.

2. Stages

The intervention process, aimed at mobilizing changes based on the objectives outlined, are also three: initial contact, work phase and completion. We will describe each one of them.

The initial contact with the client intends to forge the rapport, that is, the therapeutic link on which the intervention will be built from this moment forward. This alliance must be based on active listening and acceptance of the experience of others, as well as in the search for a consensus on how the sessions will evolve (periodicity, significant objectives, etc.). It is assumed that the response is within the client, so the therapist will limit himself to accompany him by investigating matters anchored to the present through a horizontal and symmetrical relationship.

In the work phase he begins to delve deeper into the client’s history, in everything that worries or grips him. The exploration is carried out following the four spheres of the human, and that define the complexity of its reality (on which it was already investigated in a previous section). At this moment, the main objectives of the model are addressed: detection of strengths and weaknesses, definition of values , examination of the link that unites us to the most important people, reinforcement of autonomy and construction of a life project .

The final part of the treatment exemplifies one of the tasks that the client will have to accept regarding his own life: that everything that is undertaken has a beginning and a conclusion. This point will be reached after a variable time of joint work, which will mostly depend on the way in which the internal experience of the person evolves. However, the return to everyday life is intended, but assuming a new vision of the role played in the day-to-day scenario.

3. Techniques

The therapeutic techniques that are used in the context of existentialist therapy are based on their original philosophical roots, which start from phenomenology and constructivism to diametrically oppose the traditional way from which the health and disease process is understood. That is why he runs away from everything related to diagnoses or stereotypes , since they would undermine the essential goal of finding a meaning for life and identity. Then we propose the three main methods.

The first one is the epoché, a concept that comes from the existential philosophy and in which one of the fundamentals of therapy is summed up: approaching all the moments of life as if they were new , assuming an attitude of learner capable of marvel at the present that unfolds. Additionally, the inhibition of judgment and the dilution of expectations are pursued, a naked look at the risk and fortune that destiny harbors within it, which facilitates decision-making and the ability to risk being what is desired. be.

The description is the second of the techniques. In this case, an exploratory and non-explanatory analysis is sought, which allows knowledge about things without falling into categorization. This is intended to foster curiosity about oneself and social relations, as both constitute the essence of what one really is from an existentialist perspective. This is why the therapist is not based on immovable objectives at the beginning of the intervention , but that these are changing and adapting to the client as time goes by.

The third and final procedure is based on horizontalization, which avoids reproducing the hierarchy of power held by the psychiatrist in the doctor-patient dyad of the historical moment in which the intervention proposal was born. The relationships that are based on this position (peer to peer) allow the rapid identification of the client with the figure and role of the clinician, encouraging him to express his truth in a context of therapy that deliberately flees prosecutions and criticism.

by Abdullah Sam
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