Existential Therapy

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Existential psychotherapy is a philosophical method of therapy that operates on the belief that inner conflict within a person is due to that individual’s confrontation with the givens of existence.[1] These givens, as noted by Irvin D. Yalom, are: the inevitability of death, freedom and its attendant responsibility, existential isolation (referring to Phenomenology), and finally meaninglessness. These four givens, also referred to as ultimate concerns, form the body of existential psychotherapy and compose the framework in which a therapist conceptualizes a client’s problem in order to develop a method of treatment. In the British School of Existential therapy (Cooper, 2003), these givens are seen as predictable tensions and paradoxes of the four dimensions of human existence, the physical, social, personal and spiritual realms, (Umwelt, Mitwelt, Eigenwelt and Uberwelt).

Contents

• 1 Background
  • 1 Development in Britain
• 2 Existential Therapy’s View of the Human Mind
• 3 Psychological Dysfunction
• 4 The Good Life
• 5 Existential Therapy
• 6 Four worlds
• 7 See also
• 8 References
• 9 Further reading

Background

The philosophers who are especially pertinent to the development of existential psychotherapy are those whose work is directly aimed at making sense of human existence. But the philosophical movements that are of most importance and that have been directly responsible for the generation of existential therapy are phenomenology and existential philosophy.

The starting point of existential philosophy (see Warnock, 1970; Macquarrie, 1972; Mace, 1999; Van Deurzen and Kenward, 2005) can be traced back to the nineteenth century and the work of Kierkegaard and Nietzsche. Both were in conflict with the predominant ideologies of their time and committed to the exploration of reality as it can be experienced in a passionate and personal manner.

Kierkegaard (1813–55) protested vigorously against popular misunderstanding and abuse of Christian dogma and the so-called ‘objectivity’ of science (Kierkegaard, 1841, 1844). He thought that both were ways of avoiding the anxiety inherent in human existence. He had great contempt for the way in which life was being lived by those around him and believed that truth could ultimately only be discovered subjectively by the individual in action. What was most lacking was people’s courage to take the leap of faith and live with passion and commitment from the inward depth of existence. This involved a constant struggle between the finite and infinite aspects of our nature as part of the difficult task of creating a self and finding meaning. As Kierkegaard lived by his own word he was lonely and much ridiculed during his lifetime.

Nietzsche (1844–1900) took this philosophy of life a step further. His starting point was the notion that God is dead, that is, the idea of God was outmoded and limiting (Nietzsche, 1861, 1874, 1886) and that it is up to us to re-evaluate existence in light of this. He invited people to shake off the shackles of moral and societal constraint and to discover their free will in order to live according to their own desires, now the only maintainable law in his philosophy. He encouraged people to transcend the mores of civilization and choose their own standards. The important existential themes of freedom, choice, responsibility and courage are introduced for the first time.

While Kierkegaard and Nietzsche drew attention to the human issues that needed to be addressed, Husserl’s phenomenology (Husserl, 1960, 1962; Moran, 2000) provided the method to address them in a rigorous manner. He contended that natural sciences are based on the assumption that subject and object are separate and that this kind of dualism can only lead to error. He proposed a whole new mode of investigation and understanding of the world and our experience of it. Prejudice has to be put aside or ‘bracketed’, in order for us to meet the world afresh and discover what is absolutely fundamental and only directly available to us through intuition. If people want to grasp the essence of things, instead of explaining and analyzing them they have to learn to describe and understand them.

Heidegger (1889–1976) applied the phenomenological method to understanding the meaning of being (Heidegger, 1962, 1968). He argued that poetry and deep philosophical thinking can bring greater insight into what it means to be in the world than can be achieved through scientific knowledge. He explored human being in the world in a manner that revolutionizes classical ideas about the self and psychology. He recognized the importance of time, space, death and human relatedness. He also favoured hermeneutics, an old philosophical method of investigation, which is the art of interpretation. Unlike interpretation as practised in psychoanalysis (which consists of referring a person’s experience to a pre-established theoretical framework) this kind of interpretation seeks to understand how the person himself subjectively experiences something.

Sartre (1905–80) contributed many other strands of existential exploration, particularly in terms of emotions, imagination, and the person’s insertion into a social and political world. He became the father of existentialism, which was a philosophical trend with a limited life span[citation needed]. The philosophy of existence on the contrary is carried by a wide-ranging literature, which includes many other authors than the ones mentioned above. There is much to be learned from existential authors such as Karl Jaspers (1951, 1963), Paul Tillich, Martin Buber, and Hans-Georg Gadamer within the Germanic tradition and Albert Camus, Gabriel Marcel, Paul Ricoeur, Maurice Merleau-Ponty and Emmanuel Lévinas within the French tradition (see for instance Spiegelberg, 1972, Kearney, 1986 or van Deurzen-Smith, 1997).

From the start of this century some psychotherapists were, however, inspired by phenomenology and its possibilities for working with people. Ludwig Binswanger, in Switzerland, was the first to attempt to bring existential insights to his work with patients, in the Kreuzlingen sanatorium where he was a psychiatrist. Much of his work was translated into English during the 1940s and 1950s and, together with the immigration to the USA of Paul Tillich (Tillich, 1952) and others, this had a considerable impact on the popularization of existential ideas as a basis for therapy (Valle and King, 1978; Cooper, 2003). Rollo May played an important role in this, and his writing (1969, 1983; May et al., 1958) kept the existential influence alive in America, leading eventually to a specific formulation of therapy (Bugental, 1981; May and Yalom, 1985; Yalom, 1980). Humanistic psychology was directly influenced by these ideas.

In Europe existential ideas were combined with some psychoanalytic principles and a method of existential analysis was developed by Medard Boss (1957a, 1957b, 1979) in close co-operation with Heidegger. In Austria, Viktor Frankl developed an existential therapy called logotherapy (Frankl, 1964, 1967), which focused particularly on finding meaning. In France the ideas of Sartre (1956, 1962) and Merleau-Ponty (1962) and of a number of practitioners (Minkowski, 1970) were important and influential but no specific therapeutic method was developed from them.

Development in Britain

Britain became a fertile ground for the further development of the existential approach when R. D. Laing and David Cooper, often associated with the anti-psychiatry movement, took Sartre’s existential ideas as the basis for their work (Laing, 1960, 1961; Cooper, 1967; Laing and Cooper, 1964). Without developing a concrete method of therapy they critically reconsidered the notion of mental illness and its treatment. In the late 1960s they established an experimental therapeutic community at Kingsley Hall in the East End of London, where people could come to live through their madness without the usual medical treatment. They also founded the Philadelphia Association, an organization providing alternative living, therapy and therapeutic training from this perspective. The Philadelphia Association is still in existence today and is now committed to the exploration of the works of philosophers such as Wittgenstein, Derrida, Levinas and Foucault as well as the work of the French psychoanalyst Lacan. It also runs a number of small therapeutic households along these lines. The Arbours Association is another group that grew out of the Kingsley Hall experiment. Founded by Berke and Schatzman in the 1970s, it now runs a training programme in psychotherapy, a crisis centre and several therapeutic communities. The existential input in the Arbours has gradually been replaced with a more neo-Kleinian emphasis.

The impetus for further development of the existential approach in Britain has largely come from the development of a number of existentially based courses in academic institutions. This started with the programmes created by Emmy van Deurzen, initially at Antioch University in London and subsequently at Regent’s College, London and since then at the New School of Psychotherapy and Counselling, also in London. The latter is a purely existentially based training institute, which offers postgraduate degrees validated by the University of Sheffield and Middlesex University. In the last decades the existential approach has spread rapidly and has become a welcome alternative to established methods. There are now a number of other, mostly academic, centres in Britain that provide training in existential counselling and psychotherapy and a rapidly growing interest in the approach in the voluntary sector and in theNational Health Service.

British publications dealing with existential therapy include contributions by Jenner (de Koning and Jenner, 1982), Heaton (1988, 1994), Cohn (1994, 1997), Spinelli (1997), Cooper (1989, 2002), Eleftheriadou (1994), Lemma-Wright (1994), Du Plock (1997), Strasser and Strasser (1997), van Deurzen (1997, 1998, 2002); van Deurzen and Arnold-Baker (2005); van Deurzen and Kenward (2005). Other writers such as Lomas (1981) and Smail (1978, 1987, 1993) have published work relevant to the approach although not explicitly ‘existential’ in orientation.

The journal of the British Society for Phenomenology regularly publishes work on existential and phenomenological psychotherapy. An important development[citation needed] was that of the founding of the Society for Existential Analysis in 1988, initiated by van Deurzen. This society brings together psychotherapists, psychologists, psychiatrists, counsellors and philosophers working from an existential perspective. It offers regular fora for discussion and debate as well as major annual conferences. It publishes the Journal of the Society for Existential Analysis twice a year. It is also a member of the International Federation for Daseinsanalysis, which stimulates international exchange between representatives of the approach from around the world. An international Society for Existential Therapists also exists. It was founded in 2006 by Emmy van Deurzen and Digby Tantam, and is called the International Community of Existential Counsellors and Therapists (ICECAP).[2]

Existential Therapy’s View of the Human Mind

Existential therapy starts with the belief that although humans are essentially alone in the world, they long to be connected to others. People want to have meaning in one another’s lives, but ultimately they must come to realize that they cannot depend on others for validation, and with that realization they finally acknowledge and understand that they are fundamentally alone (Yalom, 1980). The result of this revelation is anxiety in the knowledge that our validation must come from within and not from others.

Psychological Dysfunction

In the existential view, there is no such thing as psychological dysfunction or being mentally ill.[citation needed] Every way of being is merely an expression of how one chooses to live one’s life. However, one may feel unable to come to terms with the anxiety of being alone in the world. If so, an existential psychotherapist can assist one in accepting these feelings rather than trying to change them as if there is something wrong. Everyone has the freedom to choose how they are going to be in life, however this may go unexercised because making changes is difficult; it may appear easier and safer not to make decisions that one will be responsible for. Many people will remain unaware of alternative choices in life for various societal reasons.

The Good Life

Existentialism suggests that it is possible for people to face the anxieties of life head-on and embrace the human condition of aloneness, to revel in the freedom to choose and take full responsibility for their choices. They courageously take the helm of their lives and steer in whatever direction they choose; they have the courage to be. One does not need to arrest feelings of meaninglessness, but can choose new meanings for their lives. By building, by loving, and by creating one is able to live life as one’s own adventure. One can accept one’s own mortality and overcome fear of death. Though the French author Albert Camus denied the specific label of existentialist, in his novel, L’Etranger, his main character Meursault, ends the novel by doing just this. He accepts his mortality and rejects the constrictions of society he previously placed on himself, leaving him unencumbered and free to live his life with an unclouded mind.[citation needed]

Existential Therapy

The existential psychotherapist is generally not concerned with the client’s past; instead, the emphasis is on the choices to be made in the present and future. The counselor and the client may reflect upon how the client has answered life’s questions in the past, but attention ultimately shifts to searching for a new and increased awareness in the present and enabling a new freedom and responsibility to act. The patient can then accept they are not special, and that their existence is simply coincidental, without destiny or fate. By accepting this, they can overcome their anxieties, and instead view life as moments in which they are fundamentally free.(The outline above is based on a strictly Sartrean perspective)

Four worlds

Existential thinkers seek to avoid restrictive models that categorize or label people. Instead they look for the universals that can be observed cross-culturally.[citation needed] There is no existential personality theory which divides humanity into types or reduces people to part components. Instead there is a description of the different levels of experience and existence with which people are inevitably confronted. The way in which a person is in the world at a particular stage can be charted on this general map of human existence (Binswanger, 1963; Yalom, 1980; van Deurzen, 1984). One can distinguish four basic dimensions of human existence: the physical, the social, the psychological and the spiritual. On each of these dimensions people encounter the world and shape their attitude out of their particular take on their experience. Their orientation towards the world defines their reality. The four dimensions are obviously interwoven and provide a complex four-dimensional force field for their existence. Individuals are stretched between a positive pole of what they aspire to on each dimension and a negative pole of what they fear.

Physical dimension

On the physical dimension (Umwelt) individuals relate to their environment and to the givens of the natural world around them. This includes their attitude to the body they have, to the concrete surroundings they find themselves in, to the climate and the weather, to objects and material possessions, to the bodies of other people, their own bodily needs, to health and illness and to their own mortality. The struggle on this dimension is, in general terms, between the search for domination over the elements and natural law (as in technology, or in sports) and the need to accept the limitations of natural boundaries (as in ecology or old age). While people generally aim for security on this dimension (through health and wealth), much of life brings a gradual disillusionment and realization that such security can only be temporary. Recognizing limitations can bring great release of tension.

Social dimension

On the social dimension (Mitwelt) individuals relate to others as they interact with the public world around them. This dimension includes their response to the culture they live in, as well as to the class and race they belong to (and also those they do not belong to). Attitudes here range from love to hate and from cooperation to competition. The dynamic contradictions can be understood in terms of acceptance versus rejection or belonging versus isolation. Some people prefer to withdraw from the world of others as much as possible. Others blindly chase public acceptance by going along with the rules and fashions of the moment. Otherwise they try to rise above these by becoming trendsetters themselves. By acquiring fame or other forms of power, individuals can attain dominance over others temporarily. Sooner or later, however, everyone is confronted with both failure and aloneness.

Psychological dimension

On the psychological dimension (Eigenwelt) individuals relate to themselves and in this way create a personal world. This dimension includes views about their own character, their past experience and their future possibilities. Contradictions here are often experienced in terms of personal strengths and weaknesses. People search for a sense of identity, a feeling of being substantial and having a self. But inevitably many events will confront them with evidence to the contrary and plunge them into a state of confusion or disintegration. Activity and passivity are an important polarity here. Self-affirmation and resolution go with the former and surrender and yielding with the latter. Facing the final dissolution of self that comes with personal loss and the facing of death might bring anxiety and confusion to many who have not yet given up their sense of self-importance.

Spiritual dimension

On the spiritual dimension (Überwelt) (van Deurzen, 1984) individuals relate to the unknown and thus create a sense of an ideal world, an ideology and a philosophical outlook. It is here that they find meaning by putting all the pieces of the puzzle together for themselves. For some people this is done by adhering to a religion or other prescriptive world view, for others it is about discovering or attributing meaning in a more secular or personal way. The contradictions that have to be faced on this dimension are often related to the tension between purpose and absurdity, hope and despair. People create their values in search of something that matters enough to live or die for, something that may even have ultimate and universal validity. Usually the aim is the conquest of a soul, or something that will substantially surpass mortality (as for instance in having contributed something valuable to humankind). Facing the void and the possibility of nothingness are the indispensable counterparts of this quest for the eternal.

See also

• Gestalt Therapy
• Existentialism
• Viktor Frankl
• Martin Heidegger
• Søren Kierkegaard
• D. Laing
• Rollo May
• Friedrich Nietzsche
• Otto Rank
• Jean-Paul Sartre
• Irvin D. Yalom
• Karl Jaspers
• Martin Buber
• Contextual therapy
• Emmy van Deurzen
• William Glasser
• Philosophical Consultancy
• Jan Hendrik van den Berg
• Martti Olavi Siirala
• Kirk J. Schneider

References

1. ^ Yalom, I.(1980)Existential psychotherapy,New York: Basic Books (pg.9)
2. ^ Template:Cite web www.icecap.org.uk

Further reading

• Frankl, Viktor; Man’s Search for Meaning(rev. & updtd.); Pocket, 1997
• Yalom, Irvin D.; Existential Psychotherapy; Basic Books, 1980
• Cooper, Mick; Existential Therapies; Sage Publ., 2003
• Spinelli, Ernesto; The Mirror and the Hammer: Challenging Orthodoxies in Therapeutic Thought; Sage Publ., 2002
• Kierkegaard, Søren; The Concept of Dread and The Sickness Unto Death, Princeton University Press
• Deurzen, E. van (2002) Existential Counselling and Psychotherapy in Practice, 2nd edition, London: Sage Publications.
• ibid (1997) Everyday Mysteries: Existential Dimensions of Psychotherapy, London: Routledge. (2nd edition 2006)
• ibid (1998) Paradox and Passion in Psychotherapy, Chichester: Wiley.
• Deurzen, E. van, and Kenward, R. (2005) Dictionary of Existential Psychotherapy and Counseling, London: Sage Publications.
• Deurzen, E. van and Arnold-Baker, C., eds. (2005) Existential Perspectives on Human Issues: a Handbook for Practice, London: Palgrave, Macmillan.
• Glasser, William, Choice Theory
• Willburg, Peter, “The Therapist as Listener: Martin Heidegger and the Missing Dimension of Counseling and Psychotherapy Training”[1]
• Wilkes, R and Milton, M, (2006) Being an Existential Therapist: An IPA study of existential therapists’ experiences, Existential Analysis. Jan 2006
• Milton , M., Charles, L., Judd, D., O’Brien, Tipney, A. and Turner, A . (2003) The Existential-Phenomenological Paradigm: The Importance for Integration, Existential Analysis
• Judd, D. and Milton, M. (2001) Psychotherapy with Lesbian and Gay Clients: Existential-Phenomenological Contributions to Training, Lesbian and Gay Psychology Review, 2(1): 16-23
• Corrie, S. and Milton, M . (2000) “The Relationship Between Existential-Phenomenological and Cognitive-Behavioural Therapies”, European Journal of Psychotherapy, Counseling and Health.
• May, R. “The Discovery of Being: Writings in Existential Psychology”
• May, R. “The Cry for Myth”
• May, R. “Power and Innocence: A Search for the Sources of Violence”
• May, R. “Man’s Search for Himself”
• Milton, M (2000) “Is Existential Psychotherapy A Lesbian and Gay Affirmative Psychotherapy?” Journal of the Society for Existential Analysis,
• Milton , M. and Judd, D. (1999) “The Dilemma that is Assessment”, Journal of the Society for Existential Analysis, 102-114.
• Milton, M. (1999) “Depression and the Uncertainty of Identity: An existential-phenomenological exploration in just twelve sessions”, Changes: An International Journal of Psychology and Psychotherapy,
• Milton, M (1997) “An Existential Approach to HIV Related Psychotherapy”, Journal of the Society for Existential Analysis, V8.1, 115-129
• Milton, M (1994) “The Case for Existential Therapy in HIV Related Psychotherapy”, Counselling Psychology Quarterly, V7 (4). 367-374
• Milton, M. (1994) “HIV Related Psychotherapy and Its Existential Concerns”, Counselling Psychology Review, V9 (4). 13-24
• Milton, M (1993) “Existential Thought and Client Centred Therapy”, Counselling Psychology Quarterly, V6 (3). 239-248
• Schneider, K.J. (2004). “Rediscovery of Awe: Splendor, Mystery, and the Fluid Center of Life.” St. Paul, MN: Paragon House.
• Schneider, K.J. (2008). “Existential-integrative Psychotherapy: Guideposts to the Core of Practice.” New York: Routledge.
• Schneider, K.J. (2009). “Awakening to Awe: Personal Stories of Profound Transformation.” Lanham, MD: Jason Aronson.
• Schneider, K.J.,& Krug, O.T. (2010). “Existential-Humanistic Therapy.” Washington, DC: American Psychological Association Press.
• Schneider, K.J. (2011). “Existential-Humanistic Therapies”. In S.B. Messer & Alan Gurman (Eds.), Essential Psychotherapies. (Third ed.). New York: Guilford.
• Seidner, Stanley S. (June 10, 2009) “A Trojan Horse: Logotherapeutic Transcendence and its Secular Implications for Theology”. Mater Dei Institute. pp 10-12.
• Tillich, Paul (1952). The Courage to Be. Yale University Press.
• Wilberg, P. (2004) The Therapist as Listener – Martin Heidegger and the Missing Dimension of Counselling and Psychotherapy Training

. . . . .

Wikibooks Article

Existential psychotherapy is the only established form of psychotherapy that is directly based in philosophy rather than in psychology. It was founded at the beginning of the century, on the one hand by the original work of Karl Jaspers in Germany, ( 1951, 1963, 1964) which itself influenced Heidegger’s thinking and on the other hand by the work of two Swiss psychiatrists, Ludwig Binswanger (1946, 1963) and Medard Boss (1957, 1962, 1979, 1988), who were in turn inspired by the work of Heidegger to create an alternative method of dealing with emotional and mental distress. All three turned from psychiatry to philosophy, in an attempt to understand the human predicament, paradoxes and conflicts of their patients. These early applications of existentialist philosophy to psychotherapy have been followed by a number of other and varied attempts, as for instance in the work of Frankl (1946, 1955, 1967), May (1958, 1969, 1983), Laing (1960, 1961, 1964, 1967), Szasz (1961, 1965, 1992) Yalom (1980, 1989), van Deurzen (1984, 1988, 19, 1997) and Längle A (1990, 2003, 2014), Längle S & Wurm CSE (2015).

There has however continued to be great diversity between these and other authors as no official or formal rendering of existential psychotherapy has ever been agreed. To confuse matters further existential principles have also been applied more indirectly to psychotherapy as part of the humanistic psychology movement, for instance in Person-centred and Gestalt approaches to psychotherapy, which often pride themselves in their existential origins. Personal-construct therapies also have a basis in the phenomenological approach and there are a number of psychoanalytic writers who take existential ideas into account as well. All of these approaches however tend to focus on the intra-personal dimensions of human existence and they have formulated psychological theories that do not allow the philosophical dimension to come to the fore or to be central. Radical existential psychotherapy focuses on the inter-personal and supra-personal dimensions, as it tries to capture and question people’s world-views. Such existential work aims at clarifying and understanding personal values and beliefs, making explicit what was previously implicit and unsaid. Its practice is primarily philosophical and seeks to enable a person to live more deliberately, more authentically and more purposefully, whilst accepting the limitations and contradictions of human existence. It has much in common with the newly developed practice of philosophical consultancy, which is just finding its feet in Germany, the Netherlands, Israel and the United States (Lahav 1995, Achenbach 1984, Hoogendijk 1991).

There continues to be a lack of systematic theorizing about existential psychotherapy and a lack of research to demonstrate the effectiveness of this kind of work. This is mostly because the existential approach resists formalisation and opposes the fabrication of a method that can be taught as a technique and followed automatically. Existential psychotherapy has to be reinvented and recreated by every therapist and with every new client. It is essentially about investigating human existence and the particular preoccupations of one individual and this has to be done without preconceptions or set ways of proceeding. There has to be complete openness to the individual situation and an attitude of wonder that will allow the specific circumstances and experiences to unfold in their own right. We can however distinguish a number of themes that will predictably emerge in this process. The following list of existential issues is a personal selection based on the compilation of the work of the major philosophers of existence. The order in which the issues are presented and discussed is based on my experience of teaching trainee psychotherapists some of the predictable patterns that emerge when clients in psychotherapy present their concerns and begin to examine their lives in a philosophical manner. Of course life is a great deal more complex than this list suggests and one can look at the same issues in many different ways. What follows is a brief description of my particular pathway towards clarity. It is important to remember that existential psychotherapists aim to assist their clients in finding their own.

EXISTENTIAL ISSUES

• Ontological description

The first thing to keep in mind when applying philosophy to psychotherapeutic practice is that when philosophers think about human living they do so not as anthropologists or psychologists. They do not primarily preoccupy themselves with concrete experiences, but they rather allow themselves to build theories about human living in an abstract sense. They are concerned to describe the ontological dimension of life and only secondarily come to the concrete experience of the individual. They try to pinpoint what it is that makes human living possible and difficult in the first place. Ontological descriptions are thus descriptions that tell us what the sine qua non of human existence is. They sketch out the conditions without which there would be no real human life. It is extremely useful to ask oneself what the basic foundations of human living are. Heidegger’s book Being and Time (Heidegger 1927) is just such an attempt at describing the essential being in the world of humans. His consideration of human beings as Dasein, or being-in-the-world, redefines questions of self and psychology as questions of living and philosophy. His sharp thinking about what makes human being possible provides a useful map of existence, which can certainly be argued with and revised, but which nevertheless asks important questions about people in general, allowing for a closer examination of the particular individual life afterwards. Of course there are many such possible maps and ontological theories to be found in philosophy. Existential philosophy is particularly focussed on the predictable dilemmas of human living that will be regularly encountered when doing psychotherapy.

• Meaning of life

According to Heidegger the most fundamental philosophical question is: ‘Why is there something rather than nothing?’ We do not actually know the answer to this question, but it remains a fundamental question to ask ourselves if we are going to be serious about examining human living from scratch. Clients ask themselves this question regularly and in particular they are unclear about the meaning of their own life. Philosophers show such questioning to be necessary in order to become a self-reflective human being. Doubts about the meaning of life are the beginning of all philosophy. Doubt and wonder enable us to rediscover the miracle of being. Children have not lost this ability to wonder and they ask the question ‘why’ at the most inopportune moments. Adults tend to wonder about the meaning of life particularly when things are difficult and no longer self-evident. Once upon a time the meaning of life was given by religion or by social rule. These days meaning is often looked at in a far more sceptical manner (see Tantam, this volume). It is therefore not surprising that people often find themselves in what we can be called a vacuum of meaning (Frankl 1946,1955). The experience of meaninglessness becomes a major problem in many people’s lives and it may lead to a number of concrete difficulties, which may look like personality problems or other forms of pathology. Psychotherapists, psychologists or psychiatrists often have considerable difficulties in recognizing the validity of philosophical questioning. They are reluctant to engage in theoretical discussions with clients and patients who are seemingly disturbed, but who actually may be in search of meaning. We can only engage in such discussions if we have been willing to question our own lives and can recognize that anxieties and doubts about meaning do not have to be equated with personal pathology or mental illness (Szasz 1961, 1965, 1992).

It is by no means easy to be truly available to help others in finding meaning in their lives when their existence is in crisis. The meaning of life is never given and can not be transmitted unless a person is willing to search for it independently. Phenomenologists recognized that meaning making is one of the defining characteristics of human consciousness. It could therefore be argued that the meaning of human living is to learn to give it meaning. In order to come to a position from which we can learn to give meaning we have to first come to a point of doubt and a realization of the lack of intrinsic meaning in our lives. Frankl (1946) spoke of three sources of meaning. Firstly through taking from the world what is there, learning to savour and appreciate what is already given to us, as in aesthetic enjoyment of nature or the pleasures of the senses. Secondly to give to the world and add new enjoyments to it through acts of our own creativity and by giving to others in this way as well. Thirdly by our attitudinal values, which could include suffering, when it is necessary to endure the harsh conditions we may be exposed to. If there is no alternative to our suffering, it is always possible to find an attitude of human dignity by enduring the hard labour, pain and disappointments, Frankl argues, even when we have to face up to extremes of torture and deprivation. Längle (2003) developed a system of four fundamental dimensions of existence which build ground for meaning. According to this structure of existence meaning as the fourth dimension is based on the three preceding dimensions of existence: accepting reality, relating to values and life, being oneself authentically.

• Existential anxiety

The experience of meaninglessness and the creation of meaning are closely related to the experience of Angst or existential anxiety. This occurs against the backdrop of the personal realization that I am ultimately alone in the world and that I have to contend with my mortality and other limitations, taking responsibility for myself in the face of endless challenges and confusions. This crisis of meaning was first described by Kierkegaard (1844, 1855), who thought that it was a great deal preferable to begin to feel anxious about life and question it, rather than to live in the despair of those who deny the need to think for themselves. Kierkegaard thought that human beings would only gradually become capable of such questioning. He believed that people are vegetative to start out with, not taking much notice of the meaning of anything at first. They then grow sentient as they are beginning to follow their senses and relate more intensely to the world. After this they grow conscious of the world around them and as they begin to form judgements about things, eventually they become knowing about some of what is. Out of knowing can grow self-knowing as we apply the ability to think and recognize, compare and judge for ourselves. Out of self-knowing can come a self-awareness that leads to autonomy and the ability to make choices and decisions for oneself. This process plunges us into Angst, or existential anxiety, likened by Kierkegaard to a dizziness of freedom. He thought that experiencing Angst was the sine qua non of us assuming our responsibility as individuals and that without it we could never come face to face with the demands our life makes on us.

Anxiety or Angst is a core concept in existential philosophy, which sees it as the basic ingredient of vitality. Learning to be anxious in the right way, i.e. not too much or too little is the key to living a reflective, meaningful human life. As Kierkegaard put it:

Whoever has learnt to be anxious in the right way has learnt the ultimate. (Kierkegaard 1844:155)

Anxiety has to be distinguished from fear. The former is a generalized feeling of Unheimlichkeit (Heidegger 1927), of not being at ease, or at home in one’s world, whereas the latter has a concrete object. It is anxiety that allows us to define ourselves as a separate person and to become responsive and responsible as well as aware and alert. Although we may become overwhelmed with anxiety, so that it becomes counterproductive, on the whole anxiety is to be seen as a positive breakthrough towards the goal of the fully lived human life.

• How are we to live our lives?

In this sense existential psychotherapy does not reassure people when they come to talk about the predicaments and conflicts in their lives. They are encouraged to consider their anxiety and their problems as a valid starting point for the work that has to be done. When people wonder what is wrong with their life it is tempting to treat such questioning as symptomatic of emotional problems, but existential psychotherapy sees it as an attempt at coming to grips with philosophical dilemmas. Most of us are all likely to encounter such dilemmas sooner or later and people should be assisted in getting clarity on how they want to live when such issues arise. People easily lose their sense of direction. Moral and ethical issues are increasingly obscure in the world we live in today. It may be helpful to turn to Nietzsche’s challenge (Nietzsche 1883) that we should re-value all values. He insisted that our thinking had gone astray and that much that people took for granted had to be reconsidered. He thought it crucial to consider afresh what a good human life consists of. In order to do so it is useful to turn to the map of human existence that can be pieced together from the writings of existential philosophers, so that we can find our way through the obstacles of human living without losing our bearings.

• Intentionality

The lynchpin of human existence is the concept of intentionality. It was Husserl’s phenomenology that established intentionality as its new foundation following Brentano’s original idea (Husserl 1900, 1913, 1929). Phenomenology posits that human consciousness is essentially transparent and in this sense is always and necessarily connected to a world. It is never independent and always has an object. As we are non-substantial, transparent, beings we cannot but reach out to a world. We are always in relation. Through us the world comes to light. We always, think, do, desire, imagine something. There always is some contents to our mind. It is possible to set aside our automatic ways of intending things and judging things and take heed of our tendency to do so. We can learn to be disciplined about our intentionality and through the phenomenological reduction question all the automatic judgements we normally take for granted. Husserl called this process ‘coming to things themselves’ and it is often referred to as the epoche. It consists of putting our usual assumptions about the world in brackets. This does not mean that we get rid of them or pretend they do not exist, but rather that we deal with them separately so that we can describe the situation, object of our attention or other person we are dealing with fairly and as it really is. To make oneself consistently query one’s assumptions about the world and reconsider it with a cleared attitude of openness is obviously extremely relevant to the practice of psychotherapy. What we find when we apply this manner of observing other people is that they themselves are always in a relationship of intentionality to the world they live in. It is their mode of being in the world that we need to turn to next.

• Lived world

Husserl spoke of the Lebenswelt, or lived world to describe the sort of universe that we live in. Everyone has their own perspective on the world, their own particular point of reference their own atmosphere and outlook. The lived world of the cat is obviously different to that of the dog or the bird for instance. When a cat comes into a room it may seek out cosy hiding places, while a dog may orientate himself by his sense of smell, looking for good spots to lift a leg on, whereas a bird might be focused on finding high places to perch on. The same room would seem a very different place to different people. In an even more complex manner they have a world of their own. This world determines where people go and what they want and do. Heidegger (1927) described the human world in quite a lot of detail, showing it to always have a horizon, a home ground and a foreign ground. We are always at a certain distance from things, although our relation to things might be determined by our intentional stance towards them more than by the actual space that separates us. When I run for the bus for instance, it seems closer to me than the ground that I run over. I see it as near and if it suddenly pulls out the severance that I experience and the sudden distance between me and the object of my desire may plunge me into confusion and disappointment. To describe the experiences of my world as completely as possible and without the usual assumption that I already know what I am describing leads to new insights into what human living entails.

• Situations

We discover immediately that people are always connected to the world in a number of concrete ways. Heidegger in this context spoke of our ‘thrownness’. He said that we are always thrown into a world that is already there to start with and into which we simply get inserted. It is important to recognize the factual situations that we are confronted with. We are part of a certain culture, a certain environment with a particular climate and history, a certain society and a specific situation. It is only within the givens of that situation that we can exercise our own choices. Sartre (1943) called this our facticity and he recognized that we can never release ourselves from this, even though we can choose our position in relation to it. In terms of psychotherapy it also means that it may be necessary to look at people’s problems in a structural way. Instead of seeing everything as the person’s personal, emotional or internal problem, problems can be seen as part of an overall situation. Context is crucial and has to be taken into account.

• Limit situations

Of all the situations in which we can find ourselves there are certain ones that are irrevocable. These situations have to be accepted. We cannot avoid them or overcome them: we have to learn to live with them. Heidegger emphasised the importance of death as a marker of our finite nature. Death in this sense is not to be taken as something happening to us at some point later, but as something that is relevant to us right now. The realities of our mortality and of our incompleteness have to be faced for us to become aware of and true to our nature, which is to be finite. Heidegger considered that the reality of our death is that it completes us. The recognition of the inevitability of death gives us a certainty that nothing else can give us. The fear in the face of death allows us to claim back our individuality, our authentic being, as we are inevitably alone in death and find ourselves much sobered and humbled by the knowledge of our mortality. Death, according to Heidegger:

amounts to the disclosedness of the fact that Dasein exists as thrown being towards its end. (Heidegger 1927:251)

In other words: death is part of me and to accept my living towards this end gives my life back to me in a new way.

Jaspers (1951, 1971) spoke of limit situations as those situations, which define our humanity. Sooner or later we inevitably come up against guilt, death, pain, suffering and failure. The philosophical take on this is that we should encourage people to come to terms with some of the inevitable conflicts and problems of living whilst also asking themselves how they can move forward in a new and desirable direction. Limit situations are what bring us in confrontation with ourselves in a decisive and fundamentally disturbing way. They evoke anxiety and therefore release us from our tendency to be untrue and evasive about ourselves and our lives.

• Self-deception

Sartre was particularly adamant that as human beings we try to pretend that we are solid and definite in the way that objects are. People do not like to face up to their fundamental nothingness and mortality. We think we can pretend to be like a stone or a solid thing, but in fact in doing so we are deceiving ourselves, reinventing ourselves in bad faith (Sartre 1943). To be in bad faith is an almost unavoidable state of play for human beings as we seem to find it particularly difficult to face up to the implications of our freedom as consciousness. One of the objectives of human living is to become increasingly aware of our ability to choose to live deliberately rather than by default and to diminish the extent to which we seek to tell ourselves false stories about ourselves. Sartre said that the only choice we do not have is not to choose because not to choose involves a choice as well.

In fact we are a freedom which chooses, but we do not choose to be free. (Sartre 1943:485)

The coward is fulfilling the project of cowardice, in the same way in which the hero is fulfilling the project of heroism. They can both either choose to take responsibility for their choice or pretend that it just happened to them and is not open to question.

Heidegger saw the existence of other people, with whom we are fallen into a world where the anonymous ‘They’ decides about our actions and our identity as the major obstacle to authenticity. He recognized, as Sartre did, that human beings are condemned to living inauthentically for much of the time, but that we should nevertheless aim to retrieve ourselves from inauthenticity. It is the anxiety of our possible death and our discovery that we are alone in the face of our own fate and destiny that allows us ultimately to take ourselves seriously and posit ourselves firmly, resolutely as individuals facing death.

• Time

This is when it also becomes possible to become more aware of the dimension of time, which is a crucial category of human living. It is always today and not tomorrow or yesterday. I am always no longer and not yet. We orientate ourselves in relation to the various ways in which we stand out in time. Our lives are a constant process of transformation that we cannot stop. Heidegger spoke of the three ec-stasies of time (Heidegger 1927:329), which are the ways in which we stand out in the past, in the present and in the future. We go back to ourselves in terms of remembering the past. We let ourselves be encountered by the world in the present and we reach out towards ourselves in the future. The past (Erbe) is the legacy we go forward with and which we can recollect in different ways. This means that we can re-present the past to ourselves in a new and creative manner. The present is our fate (Schiksal), which we have the task to live out as fully as possible, obviously drawing on the legacy of the past and making ourselves present to our own fate by facing our limitations rather than hiding away in inauthenticity. The future is our destiny (Geschick) and the destination that we choose for ourselves in relation to what is available to us. Our destination is thus created from our legacy and our fate. All of my actions are full of the awareness of my temporal change. There is decay and development around me. Life consists of movement, transformation and action. All of these are only possible in time. My existence is historic. It creates a story. How I create this story is of utmost importance. Existential psychotherapy is about retracing the story and reorienting a person in time.

• The fragile self

The way in which I tell my story is the way in which I create a self. Existential philosophy does not posit the notion of a fixed and determined self. There is no such thing as an essential solid self, only intentionality and being in the world. Sartre used to say that existence preceded essence. I come into the world first and exist and only after that do I create a self for myself out of my actions. The self is a window on the world and out of our living in time and standing out in the world we become what we are. Sartre went as far as to say that people were the sum of their actions. Therefore the choices we make are constitutive of the sort of person we become. We are constantly in the process of creating a self, yet when we try to capture this self, we realize it is as if we were trying to catch our shadow: it moves away from us and changes as we try to fix it. We cannot be a definitive something. Our stories change as we live and so we are changed too. As we saw before the only way in which we can believe in a self is by being in bad faith, i.e. by using self-deception. Any image we create of ourselves is in a sense a lie: it never tells the full story about who we are or could be. We have to re-create ourselves every day and to become aware of this is to become authentic and true to the self which isn’t one. We are thus doomed to feel a sense of incompleteness as life requires us to try ever harder to be equal to what we are capable of, even though we can never achieve it.

• Existential guilt

Most of us will therefore have a frequent sensation of unease with ourselves. The awareness that we are not true to our full human ability and that we live inauthentically will lead to the experience of existential guilt. In existential guilt we hear the voice of our conscience and this must be taken extremely seriously. We are not guilty because we have fallen short by other people’s standards or because we have behaved badly, but simply because we fall short as human beings. It is important to note that most existential philosophers assume that human living will inevitably expose us to falling short and therefore to feeling existential guilt. We are always indebted to life. We are always capable of being more alive, more open, more true to the potential of human consciousness than we actually are. We are therefore condemned to feel existential guilt, as we are condemned to feel existential anxiety; largely because we are, as Sartre said condemned to be free. Heidegger greatly valued the call of conscience which he believed to warn us of our existential guilt, thus bringing us back into confrontation with our human fate, allowing us to rediscover our authentic being.

The call is the call of care. Being guilty constitutes the Being to which we give the name of “care”. (Heidegger 1927:333)

To become authentic requires us to take into account our essential ways of existing and conduct ourselves accordingly. All of these modalities of existence, which Heidegger refers to as the existentialia are consequences of our intentional nature.

• Care

Our intentional nature, and the nature of our consciousness as the place where being comes to light, as Heidegger put it, makes us care. People are the custodians of Being because they are nothing in themselves but need to reflect something, in order to fully exist. As transparent entities human beings are therefore condemned to care. The world always matters to us and we have to take account of our care for the world, which manifests in lots of different ways. It is therefore not the question whether we care, but how. Care is not to be understood as a negative or a positive, but rather as the inevitable mode of our relating to a world that is of importance to us. Heidegger speaks of care as manifesting as our concern for things and our solicitude for people. But our care also manifests in some specific ways in which we are in the world and relate to it.

• Mood

The fact that the world always matters to us is evident in the way in which we are always in a mood. We cannot be separate from the world, but always respond to it in a particular state of mind. Heidegger (1927: 134) called this: Befindlichkeit, or the way in which I find myself. This state of mind is a response to the atmosphere created between the world, and me by my care for what is happening in it. Stimmung, or attunement, is the way in which I respond to the atmospheres, the way in which, like a musical instrument I am attuned in a particular way to the world around me. Through my resonance with the world I disclose the world in a particular way. My mood colours the world as it is also coloured by it. My own being is disclosed in my moods at the same time as it discloses the world. Moods are therefore invaluable indicators of what is happening between my world and me. We can never not be in a mood and we cannot just stop a mood. We can only get out of one mood by getting into another. Sartre elaborated on this idea of the central position of mood or mode of being by describing emotions as active rather than passive. He spoke of emotion as a kind of magic by which I alter the world and therefore myself in one blow (Sartre 1939).

• Understanding

As human beings we can respond to the world through our emotions, but we can also through our emotions and our ability to reflect on them come to grasp things in a new way. This new way of understanding (verstehen) is not just about human intelligence and the capacity for calculating things in the world. Heidegger makes the distinction between Vernunft (rational mind) and Verstand (understanding) which is our ability to see the whole of what is rather than analyse things with our mind (Heidegger 1927:144). Understanding discloses the potential of our being, as it shows us what we are capable of. In his later work he made the distinction between calculative thinking and meditative thinking (Heidegger 1954). He showed how important it was to learn to think again in this more encompassing meditative manner where we are open to the world and receive it with gratitude for what is, rather than trying to subject it to the analysis and manipulations that our calculative mind imposes. Heidegger suggests that we use Sicht, or vision to understand the world and our relation to it. Umsicht, or the vision of looking around one, applies to objects and we need to approach objects with the care of circumspection. We use Rucksicht, which suggests a kind of withholding, in relation to other people, which manifests as considerateness. Finally and perhaps most importantly we employ Durchsicht, or seeing through things in relation to ourselves. It is thus transparency that brings into being careful understanding of ourselves.

• Discourse

Language is an essential vehicle for understanding our modes of being. Heidegger speaks of discourse as the third essential mode of being (together with mood and understanding). Discourse is a broader concept than language and includes it. Although discourse is obviously linked to language it can also manifest as silence. We have to struggle to retrieve valuable discourse out of all the possible misuses of talking. Speech can turn to idle talk (Gerede rather than Rede). Discourse can flounder in curiosity, which is a moving across the surface of things, distracted by their novelty, as we collect and accumulate useless information. In this way we drown in existence and we go under in ambiguity. (Merleau Ponty 1945). Discourse is to be used carefully for it to become a valuable resource for the manifestation of being. In language or in silent thought we can capture and express ourselves in relation to life and begin to come to terms with our essential function of being the shepherds of being.

• Communication

The mastery of language makes human communication possible. However communication is a lot more complex than simple speech. Heidegger was aware that Mitsein, or being with others, was part of our essential nature. He also described people as at the mercy of the anonymous other who defines their being-in-the-world. Authentic being is only possible when we set ourselves aside from others. Sartre described our struggle with others as a desperate attempt at survival and at gaining a false sense of security. He saw human communication, which is by no means only about language as taking place either in a sadistic, a masochistic or an indifferent way. We can try to dominate the other or we can submit or withdraw from communication altogether. In sharp contrast to Sartre’s pessimistic view of human relations and human communication the philosopher Martin Buber (1923,1929) saw the possibility of a more positive way of human interaction. He distinguished between I-it and I-Thou modes of relating. He noted that the way we relate to others determines what kind of person we become. In the I-It mode of relating I treat the other as an object and become an object myself. In this mode I see the other only for part of what the other is capable of and at the same time become partial myself. In the I-Thou mode I relate to the other for all the other is capable of and I relate thus with my whole being as well. The I-Thou mode of relating has a spiritual dimension. Buber described the way in which we create a space between others and ourselves. In this space human communication becomes a reality. He called this space the in-between. True dialogue can be created in this space when we release our self-reserve and reach out to the other with our whole being.

Where un-reserve has ruled, even wordlessly, between men, the word of dialogue has happened sacramentally. (Buber 1929:3-4).

• Mastered irony

Kierkegaard believed that language should be used with what he calls mastered irony. This requires the ability to detach oneself sufficiently from one’s situation to be able to see oneself in some perspective. He claims that those who lack irony do not have even the beginning of a personal life. To have a personal life and be able to be objective about oneself and subjective about others is to Kierkegaard a primary objective.

Most men are subjective toward themselves and objective toward all others, frightfully objective sometimes-but the task is precisely to be objective toward oneself and subjective toward all others. (Kierkegaard 1967, IV 4542).

He distinguishes fanatics, who cling to certain beliefs and nihilists who deny all beliefs, but sees them both as lacking in courage. In mastered irony one questions one’s own beliefs while still being committed to them. As usual the challenge is to be able to live in the tension between opposites.

• Paradox

This idea that human living takes place in the tension between opposing forces is present throughout existential philosophy. Most obviously this is represented by Heidegger’s (1927) description of the tension between life and death, or by Sartre’s descriptions of the tension between being and nothingness, expressed in the tension between being-for-itself (the being of consciousness) and being-in-itself (the being of objects) (Sartre 1943). Kierkegaard for his part described this tension as one between the infinite and the finite. He claimed that one can get too much drawn into either the finite or the infinite and that the challenge of living is to maintain the right sort of tension between both. The person who is immersed in the finite gets caught up in the dangers of concrete living. The person who gets too immersed in the infinite is the dreamer, who merges with the universe and becomes either overwhelmed or terrified or depressed by it ending up feeling alienated from everyday reality. Kierkegaard thought it was important to be capable of modulating between the two extremes. Merleau Ponty was equally aware of the paradoxical nature of human living and he firmly believed that we have to live with what amounts to an essential ambiguity (Merleau Ponty 1945, 1968).

• The four dimensional force field

In this force field of opposites there are a number of different dimensions of experience. Systematic descriptions of human experience have outlined four dimensions. Heidegger spoke of the different dimensions as those of earth, world, man, and gods (Heidegger 1957). Binswanger (1946,1963) spoke of the Umwelt (environment), Mitwelt (world with others) and Eigenwelt (personal world), whilst a spiritual dimension (Uberwelt) is also implied in his work (van Deurzen-Smith 1984). In essence philosophers have recognized that human experience is multiple and complex and takes place on a number of different levels. Firstly there is our involvement in a physical world of objects, where we struggle between survival and death. Secondly there is our activity in a social world of other people, where we struggle with the contradictions between our need to belong and the possibility of our isolation. Thirdly there is a personal dimension where we grapple with the tension between integrity and disintegration. Finally there is a spiritual dimension where we seek to find meaning against the threat of meaninglessness. On each of these dimensions we have to learn to stand in the tension between opposites, discovering that we cannot have life without death, love without hate, identity without confusion, and wisdom without doubt. As Paul Tillich once said:

The courage of confidence takes the anxiety of fate as well as the anxiety of guilt into itself (Tillich 1952:163).

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