Existential psychotherapy: its characteristics and philosophy

Going to a psychologist for treatment can be an arduous process, leading to fear of emotional nudity. And it is not a trivial step: it supposes that we open ourselves up to another person who, at least at first, is a total stranger.

Existential psychotherapy starts from a humanistic base, who is sensitive to this insecurity and proposes an intervention that seeks to escape from labels and that provides the patient with the perfect setting to design a life full of meaning.

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

• Related article: "Types of psychological therapies"

What is existential psychotherapy?

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

While "conventional" psychology has devoted its most important efforts to understanding the thought and behavior, and often only with regard to its psychopathological dimensions, this branch has been interested in elaborating on the meaning that existence has for each one. Thus, he seeks a deep analysis of the great universal questions: death, freedom, guilt, time and meaning.

The discipline's founding fathers 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 job. In this way he transcended beyond the pain and the negative, to enter fully into identifying potential and 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 open to experience, harboring within itself the potential to live and feel a virtually infinite range of emotions and ideas. It is not an isolated being either, but takes on its meaning as you immerse yourself in a canvas of social relationships in which he can trace the brushstrokes that draw his subjectivity.

Existentialism does not direct its focus only to the human being as a biopsychosocial reality, but rather contemplate at the intersection of the following dimensions: umwelt (involving the body and its basic needs), mitwelt (connections with others embedded in the framework of culture and society), eigenwelt (identity of oneself in the relationship that is built with the self and with the affects or thoughts that give it its shape) and überwelt (spiritual / transcendental beliefs about life and its purpose).

These four dimensions are the foundation upon which the client scan is performed (this is the term using which describes the person requesting help from the point of view of humanist currents), in a way what the balance of its entirety will be ensured. 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.

• You may be interested: "The existentialist theory of Martin Heidegger"

2. Health and sickness

From the existential perspective, health and disease are perceived as the extremes of a continuum in which Anyone can be located, depending on the specific way in which she relates to herself and to others. Another important criterion is adherence to one's own values ​​and principles as guides for life. It is not, therefore, a conservative vision, but rather flee from mere survival and seek an existence through which to find ultimate meaning.

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

Disease, on the other hand, involves above all the opposites of health. From freedom, one would pass to questioning one's own will and distrust when assuming the reins of one's own destiny. He would lead a life lacking in authenticity, distanced from reality as it is presented, in which others would be the ones who would decide the paths through which he will have to travel. As it is appreciated, health transcends the limit of the corporal and reaches the spiritual and social spheres.

The intervention from this type of therapy

Next we proceed to describe what are the objectives that are pursued from this form of psychotherapy, and the phases of which it consists (whose objective is to satisfy these fundamental goals). This section will conclude by showing the techniques in common use, which in reality are philosophical positions on life itself.

1. goals

Existential therapy pursues three basic purposes, namely: to restore trust in those who could have lost it, to expand the way in which the person perceives his own life or the world around him and determine a goal 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 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: the initial contact, the work phase and the completion. We go on to describe each of them.

The initial contact with the client aims to forge rapport, that is, the therapeutic bond on which the intervention will be built from now on. This alliance must be based on active listening and acceptance of the experience of others, as well as on the search for a consensus on how the sessions will evolve (periodicity, significant objectives, etc.). It is assumed that the answer is within the client, so the therapist will limit himself to accompanying him, investigating issues 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 which define the complexity of its reality (about which it was already investigated in a previous section). It is at this moment that the main objectives of the model are addressed: detection of strengths and weaknesses, definition of values, examination of the bond that unites us with 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 for the most part will depend on the way in which the internal experience of the person evolves. With everything, the return to everyday life is intended, but assuming a new vision of the role that is played on the stage of day to day.

3. Techniques

The therapeutic techniques that are used in the context of existential therapy are based on their original philosophical roots, which start from phenomenology and constructivism to diametrically oppose the traditional way from which the process of health and disease. It is because of that flee from everything related to diagnoses or stereotypes, since they would undermine the essential goal of finding a proper meaning for life and identity. Next we present the three main methods.

The first of these is the epoché, a concept that comes from existential philosophy and in which one of the foundations of therapy is summarized: approach all moments of life as if they were new, assuming an apprentice attitude capable of marveling at the unfolding present. Additionally, the inhibition of judgment and the dilution of expectations are pursued, a naked look at risk and fortune that fate harbors within it, which facilitates decision-making and the ability to risk being what is Wish to be.

Description is the second of the techniques. In this case, the aim is to make an exploratory, and not explanatory, analysis that allows knowledge about things without falling into categorization. This is to promote curiosity about oneself and social relationships, since both constitute the essence of what one really is from an existentialist perspective. That is why the therapist does not rely on set goals at the start of the intervention, but these are changing and adapting to the client as time passes.

The third and last procedure is based on horizontalization, through which it is avoided to reproduce the hierarchy of power wielded by the psychiatrist in the doctor-patient dyad of the historical moment in which the proposal of intervention.

Relationships that are based on this position (peer to peer) allow rapid identification of the client with the figure and the role of the clinician, encouraging him to express his truth in a therapy context that deliberately flees judgments and review.

Thus, through a psychologist-patient relationship that emphasizes honesty and the need to open up when communicating what you feel and the problem for which one is going to consult, existential therapy has the subjectivity of the individual as the aspect in which the therapeutic process must affect.

Bibliographic references:

• Mendelowitz, E. and Schneider, K.J. (2007). Current Psychotherapies. Brooks / Cole (Pub.) And Corsini, R.J. and Wedding, D., 295-327.
• Richard Sharf (1 January 2015). Theories of Psychotherapy & Counseling: Concepts and Cases. Cengage Learning. pp. 171 - 172.
• Spinelli, E. (2006). Existential psychotherapy: An introductory overview. Análise Psicológica, 3 (24): pp. 311 - 321.
• Iacovou, S. (2015). Existential therapy: 100 key points and techniques. London: Dual First.
• Thomas, J.C. & Segal, D.L. (2005). Comprehensive handbook of personality and psychopathology. Hoboken, NJ: Wiley.
• Vos, J.; Craig, M.; Cooper, M. (2015). Existential therapies: A meta-analysis of their effects on psychological outcomes. Journal of Consulting and Clinical Psychology. 83 (1): pp. 115 - 128.