What Is Existential Therapy?

Aug 5

Existentialism isn’t a word you hear combined with “therapy” very often. You can read all about the history and development of existential therapy on Wikipedia, so I’m not going to cover that here. Instead, I’ll talk about my take on this work. I will answer some questions, including:

How do existential therapists work?
Is existential therapy effective?
What can existential therapy be used to treat?

What does existentialism even mean? In pop culture, it means you think about death a lot. In the sociopolitical sphere, it’s probably referring to climate change or an impending threat of nuclear war. For the philosophers, it’s about trying to figure out what it means to be human in a chaotic, meaningless world.

In psychology, existentialism is a bit of all of those. The struggles of learning how to live in the world can involve fear of death, fear of factors outside our control, fear of not being enough, fear of the unknown… a lot of fear.

Existential therapy is really about learning how to come to terms with suffering and find a way through the world that feels personally meaningful. For you, the focus might be on isolation and building relationships. Or it might be about figuring out how to live with mental illness. Or about unlearning harmful societal messages so you can embrace your whole self.

Existential psychology holds that we are all capable humans with some amount of freedom in our lives. We each create meaning in different ways—through spirituality or other belief systems, relationships with others and ourselves, work or career goals, and in other ways. In the process, we both internalize and build stories about ourselves that may help us for a time. But sometimes we outgrow those and they become harmful.

Part of my work as an existential therapist is helping you discover what your narratives about yourself and others are and how you construct meaning, in order to see where supportive shifts can happen.

However, I find it important to add that the degree of freedom we each have must be understood in the context of social systems. We live under oppressive systems that limit our freedoms in very real ways and cause a lot of distress in the process. I think it’s important to not let existential therapy lead us into the trap of placing responsibility for distress too much on the individual, but identifying that it is rooted in micro and macro level systems.

Given this, sometimes therapeutic work is a matter of shifting your stories to see how choices can become available, and sometimes it is a matter of working toward acceptance of what feels too hard to change or what is not possible to change.

In sessions, my goal is to first understand you as deeply as possible, and then to draw out the parts of you that need attention and focus on those. Sometimes those parts are hurts from earlier years, sometimes they’re fears you have trouble voicing, sometimes they are aspects of yourself you’ve been forced to keep hidden or that don’t feel welcome in your relationships. Whatever needs attention, getting in touch with your whole self is an essential part of therapy.

What can existential therapy treat?

But what if you’re dealing with mental illness? Don’t you need DBT or something like that? Sometimes, yes. Sometimes, not so much. Underlying causes of the experience of mental illness are often about isolation and a sense of meaninglessness. Researchers and experts outside mainstream psychology regularly challenge the Western psychological system that purports that mental illness is best addressed with a pill. (An excellent resource for a social justice perspective on psychology is Mad in America.)

While some of us absolutely benefit from medication, it’s often not enough, and others find they’re more harmed by it than anything else. This is where existential therapy can be helpful. The despair or listlessness that can accompany depression are sometimes best addressed by figuring out how to live with more purpose. Dissociation can be alleviated by connecting more firmly to what feels real for you individually, not what you’ve been told is real. Anxiety is often about fear of lack of control. These are just a few examples of situations existential therapy can help address.

Even if you have a neurochemical imbalance of some sort going on, long-term mental distress can be quite disruptive to learning about yourself and becoming the person you want to be. My therapeutic approach can help with those things while you build new coping skills and learn how to live with, rather than at the mercy of, mental illness.

Existential therapy is a form of humanistic therapy. This approach focuses on individual experience rather than trying to understand problems through a system of categorization like the DSM. It also places importance on the development of the relationship between client and therapist; the qualities of the therapist are more important than the qualities of the type of therapy.

While this has been studied less extensively than what are currently considered evidence-based approaches like CBT and DBT, there is evidence to support the idea that long-term healing and growth comes from good fit between client and therapist: from the individual relationship we develop. At the end of this article I list some links to research that supports the effectiveness of existential and humanistic therapy, and in general therapy that focuses on meaning.

So can you benefit from existential therapy? I’m obviously biased, but I think most people can. My about page covers some ways this approach can help you grow as a person. Because existential therapy is about deeper work, it can help you with all sorts of big problems, including diagnosed mental health conditions—sometimes instead of and sometimes along with medication or other types of therapies.