Existentialism—Philosophy and Existential Therapy

Existentialism is a philosophy of human nature focused on our free will to determine the course of our lives. It emphasizes individual responsibility to create meaning rather than relying on a higher power or religion to determine what is important, valuable, or morally right.

Existentialists believe that the nature of existence varies and is individualized to each person. Our existence defines us and is made up of our relationship with other people and things in the world. They believe each person must choose and commit to meaning and direction in life.

Keep reading to learn more about the philosophical ideas behind existentialism, how these ideas have been incorporated into mental health treatments, and whether this approach can help you deal with anxiety and find greater meaning in life.

The Philosophical Origins of Existentialism

Søren Kierkegaard, a Danish philosopher from the 1800s, is often considered the father of existentialism. He critiqued Christianity and religious philosophy, emphasizing the importance of living as an individual based on reality instead of abstract thought experiments.

Other early existential philosophers, including Friedrich Nietzche and Fyodor Dostoevsky, wrote about creating one’s own identity to give meaning to existence. The inability to identify meaning in one’s life causes anxiety, known as an existential crisis.

Throughout the nineteenth century, existential writers created novels and plays containing analogies and metaphors for existence and the importance of individuals determining their own meaning.

Many existential philosophers have explored the anxiety that comes with the responsibility to create your own meaning in life. In a world where you create your own meaning, it is easy to fall into the belief that life has no meaning. However, existentialists believe it is important to make the choice to continue on and find this individual meaning.

Existentialism in Therapy

Existentialism led to a therapeutic approach called existential therapy. This therapy focuses on personal responsibility, individual freedom, and the quest for meaning, aiming to help people manage anxiety, find purpose in their lives, and make genuine choices.

The German psychoanalyst Otto Rank is considered the first therapist to practice existential therapy. He emphasized present feelings and thoughts rather than focusing primarily on one’s past experiences or subconscious in treatment.

Existential therapy is based on several key principles:

• All humans are capable of self-awareness.
• Everyone has free will and is accountable for their choices.
• Each person is unique and understood through interpersonal relationships with others.
• People are continually evolving and recreating themselves.
• Meaning in life is ever-changing, and it’s challenging to fully comprehend it.
• Anxiety is a natural part of the human experience.
• Death is inevitable and contributes to life’s meaning.

Existential therapists believe anxiety stems from uncertainty about the evolving meaning of life and one’s existence, which includes the physical world, relationships with others, and personal self-relationship.

An existential therapist will help clients confront anxiety about their existence, such as fear of death, fear of loneliness, fear of making the wrong choices with the freedom they have, and fear of living a life without meaning. When confronting these fears, you experience psychological distress.

An existential therapist helps the client “focus on personal responsibility for making decisions.” They help the client develop insight into why they make their decisions and make future choices based on the value and meaning they identify for themselves.

Is Existential Therapy Effective?

Viktor Frankl, an Austrian psychiatrist, researched patients in inpatient drug dependence treatment and noticed that substance use might be a method of coping with perceived meaninglessness in life.

Additionally, experiential and cognitive approaches to existential therapy have not been shown to alleviate symptoms. Supportive and expressive existential therapy has shown only a small impact on mental health symptoms and has not been shown to improve a sense of well-being.

However, many existential therapists note that “ev”dence-based practice” requires specific, controlled treatment settings, which are not conducive to an existential approach to treatment. Components of existential therapy, including an emphasis on the therapeutic relationship and finding a sense of meaning, are challenging to measure objectively in a research setting.

Interventions Based on Existentialism

Existential therapy offers specific interventions that can help clients develop a sense of meaning and alleviate mental health symptoms.

Existential interventions include:

• The four worlds of human existence: Existential therapists believe humans exist in four worlds: the physical, social, personal, and spiritual worlds. The therapist helps the client identify which of their worlds they have not explored fully and what contradictions between the four worlds might be causing distress.
• Mapping worldview: An individual’s worldview includes expectations, assumptions, and beliefs about themselves, the world, and the other people in the world. By better articulating their worldview, the client can identify what changes to their behavior can make their life more fulfilling.
• Naming avoidance: The therapist points out when the client is avoiding by discussing past and future rather than present events or describing themselves as passively experiencing life rather than actively making choices.
• Developing emotional vocabulary: The therapist has the client list their most common emotional states, explore what emotions they didn’t include, and why they might have overlooked them.
• Taking ownership: Because existentialists believe strongly in free will, existential therapists will help their clients take ownership of their choices and the consequences of these choices.
• Exploring values: The therapist guides the client with “values questions,” such as “How do you want to live your life?” and “What is your overall sense of meaning?”
• Role-playing: The therapist and client role-play ideal life scenarios, such as what details would indicate that the client is living their most meaningful life. This helps clients determine what a “meaningful life” means to them.

Risks and Limitations of Existentialism in Therapy

As described above, existential therapy lacks solid research backing to demonstrate its effectiveness. Although existentialism is difficult to study empirically, it can be difficult to understand what progress looks like in treatment if this is not clearly defined.

Similarly, existential therapy has faced criticism for having vague approaches and goals, though this allows individual clients to find meaning in the way that works best for them.