Existential Therapy

Existential Therapy


Existential therapy is a form of psychotherapy that focuses on the anxiety experienced by individuals who are having a difficult time in face of the confrontation with their own existence. The concept arose spontaneously in the 1950s and 1960s when psychologists, psychiatrists and creative thinkers became intrigued with the nature of the human being and the forces that create inner turmoil: anxiety, despair, grief, loneliness, isolation, creativity or love[1].

Goals of Existential Therapy

Contemporary existential therapy deals with concerns rooted in the individual’s existence. The modern theories have been laid down by Irvin Yalom. He has identified four major issues that address the core question “How do I exist”[2]. These are death, isolation, freedom and emptiness. Existential therapy seeks to help the client deal with the anxiety that occurs when confronted with these fundamental givens of life.

“If we can brush away or <bracket> the everyday world, if we reflect deeply upon our <situation> in the world, upon our existence, our boundaries, our possibilities, if we arrive at the ground that underlines all the ground, we invariably confront the givens of existence, the <deep structures>”, argues Yalom.

In his opinion, the most important conflict in the individual’s life is the the confrontation with the givens of existence, certain intrinsic properties that are an inescapable part of the human being’s existence in the world.

His approach seeks to help the client understand that death is a basic human condition that gives significance to life.

The therapist should be perceived as a “fellow traveler” who offers empathy and support. The therapy itself should seek to help the patient become more responsible and understand the consequences of their decisions.

To this end, the therapist must identify methods and instances of responsibility avoidance and then make these known to the patient. There are a wide variety of techniques that therapist may use to achieve this. For instance, when the patients say they “can’t” do something, the therapist can intervene and comment “You mean you won’t do it”. As long as they believe they can’t do something, they remain unaware of what an active contribution to a given situation can achieve.

Patients are encouraged to own up to their feelings, statements and actions. For example, if the patient says she or he did something “unconsciously”, the therapist can ask “Whose unconscious is it?”. The point is to inquire how the patients created the situation he laments about.

When is Existential Therapy Used?

Existential therapy can offer support for people who are diagnosed with terminal illnesses and also for people dealing with addiction problems.

Yalom has worked with numerous cancer patients helping them to embrace change in face of death. The therapist argues that although death is a primary source for anxiety, accepting it may allow the patient to live more purposely.

Research suggests that people with low levels of perceived life meaning are more likely to develop a substance addiction as a coping mechanism. In situations like this, the existential therapy is aimed at making the patient understand that if he chooses to avoid anxiety by substance abuse he cannot move forward and he will not find the authenticity he seeks[3].

How Existential Therapy Works

Existential therapy focuses on the human condition and the client’s struggle for meaning in the face of death[4]. The modern approach is both optimistic in that it embraces human potential and realistic in that it acknowledges the individual’s limitations.

The fear of death is the most easily apprehended ultimate concern. The individual must deal with the tension between being aware of the inevitability of death and the wish to continue to be.

Existential theory perceives the notion of “freedom” as a lack of external structure. The individual is the author of his world, choices and actions. “Freedom in this sense has a terrifying implication: it means that beneath us there is no ground – nothing, a void, an abyss. A key existential dynamic, then, is the clash between our confrontation with groundlessness and our wish for ground and structure”, notes Yalom[5].

The concept of existential isolation states that no matter how close one becomes with others, he enters and leaves this world alone. “The existential conflict is thus the tension between our awareness of our absolute isolation and our wish for contact, for protection, our wish to be part of a larger whole”, states Yalom.

Meaningless as an ultimate concern refers to the fact that, lacking any predefined structure, the individual must built his own meanings in life. The question is whether a meaning of one’s own construct is enough. “The existential dynamic conflict stems from the dilemma of a meaning-seeking creature who is thrown into a universe that has no meaning”, explains the psychologist.


[1] Rollo May and Irvin Yalom, Existential Psychotherapy

[2] Yalom, I. D. (1995). Theory and practice of group psychotherapy (4th ed.). New York: Basic Books

[3] Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, 1999, Treatment Improvement Protocol (TIP) Series, No. 34

[4] Mick Cooper, Existential Therapies, Sage Publications, 2003

[5] Irvin Yalom, Existential Psychotherapy, Basic Books, 1980

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