Existential Therapy EDCE 655 Theories & Techniques II Existential Approach I Am Aware that I Who Am I? am Unique & Have Meaning Existential Psychotherapy is more of a therapeutic attitude & train of thought than a Process Theory! Victor E. Frankl (1905-1997) That which does not kill me makes me stronger!!! Victor Frankl (1905-1997) Born in Vienna on March 26, 1905, he earned a doctorate in medicine in 1930 and was put in charge of a ward treating female suicide candidates. When the Nazis took power in 1938, Dr. Frankl became chief of the neurological department of the Rothschild Hospital, the only Jewish hospital in Vienna at the time. But in 1942, he and his parents were deported to the Theresienstadt concentration camp near Prague. 1945, Dr. Frankl returned to Vienna, where he became head physician of the neurological department of the Vienna Polyclinic Hospital, a position held for 25 yrs. Starting in 1961, Dr. Frankl took five professorships in the USA -- at Harvard and Stanford universities, as well as at universities in Dallas, Pittsburgh, and San Diego. Victor Frankl (1905-1997) Obituary (4 pages) began: “VIENNA, Austria -- Psychiatrist Viktor E. Frankl, who transformed years of suffering in Nazi concentration camps into insights for his lifelong study of man's quest for meaning, has died at 92. Dr. Frankl had been suffering from heart problems, the Austria Press Agency reported, citing the Vienna Viktor Frankl Institute. He died in Vienna on Tuesday and his funeral was held immediately.” Dr. Frankl survived Auschwitz and three other Nazi concentration camps from 1942 to 1945, but his parents and other members of his family died in the death camps. Dr. Frankl's teachings have been described as the Third Vienna School of Psychotherapy, after those of Sigmund Freud and Alfred Adler. Victor Frankl (1905-1997) Dr. Frankl's native Austria virtually ignored him, even while his teachings were acclaimed in the United States and elsewhere. Dr. Frankl's 32 books have been translated into 26 languages. He also held 29 honorary doctorates from universities around the globe. "There is nothing in the world, I venture to say, that would so effectively help one to survive even the worst conditions as the knowledge that there is a meaning in one's life," he wrote. Dr. Frankl wrote that one can discover the meaning in life in three different ways: "by creating a work or doing a deed; by experiencing something or encountering someone; and by the attitude we take toward unavoidable suffering." Rollo May American spokesperson for Existentialism Unhappy childhood – 2 failed marriages, tuberculosis – but not a negative outlook on life Studied with Adler in Vienna Greatest influence: Paul Tillich (German Philosopher) Writings deal with the nature of the human experience, recognizing and dealing with power, accepting freedom & responsibility, & discovering one’s identity Feels that counseling should be aimed at helping people discover the meaning of their lives Feels the greatest challenge for a person is to live in a world alone where they will eventually face death Definition, Focus, & Purpose of Existentialism Definitions: The doctrine that existence takes precedence over essence and holding that man is totally free and responsible for his acts. This responsibility is the source of dread and anguish that encompass mankind. A philosophy that emphasizes the uniqueness and isolation of the individual experience in a hostile or indifferent universe, regards human existence as unexplainable, and stresses freedom of choice and responsibility for the consequences of one's acts. Focus: Mankind has free will & Life is a series of choices that creates stress Few decisions are without any negative consequences - If one makes a decision, he/she must follow through Some things are irrational or absurd, without explanation Emphasizes the limitations and the individual power of human existence Focus is on the individual’s experience while dealing with existential key concepts Understanding of the person’s subjective view or the world Purpose: To challenge clients to discover alternatives and choose among them To allow members to learn that they can chance and some things cannot be changed Group represents a microcosm of the world where self discovery arises through sharing existential concerns Enabling members to become truthful with themselves Widening their perspectives on themselves and the world around them Clarifying what gives meaning to the present and future Existential Key Concepts Self Awareness Self-Determination & Basic goal - expand self-awareness and increase potential Personal Responsibility for choice Freedom to choose between Help members discover their unique being in the world alternatives Expression of own unique feelings Responsible for directing our lives Learn to deal with anxiety How we are and what we have View anxiety in a positive manner become is the result of our own As we become more aware - it is harder to revert back to choices our old ways Freedom can never be taken form us Higher degree of self-awareness allows us to recognize: because we have choices • to chose to expand our awareness vs. limit our Help members face and deal with perception of self anxieties and situations that they • determine the direction of our lives vs. allows cannot escape others to determine our lives Self-determination is to confront • use our potential for action vs. choose not to act members with the realities of freedom and not letting them deny it • choose to establish meaningful ties with other vs. choose to isolate self When people come to believe that they can direct their own destiny, • search for uniqueness vs. allow for conformity they assume control over their lives • create & find meaning in life vs. lead empty lives Assistance with observing how one • engage in risks and anxieties vs. choose security of creates a victim like existence dependence Leader encourages members to • make the most out of the present vs. hide from assume genuine responsibility for reality their role in group Existential Key Concepts Existential Anxiety Death & Nonbeing A basic characteristic of human beings Life has meaning because it must Basic to living with awareness and being fully alive end Can be a strong motivation toward growth The present is important because it Results form having to make choices w/o knowing is all we have (May, 1983) the outcomes Living life fully vs. merely existing - Members adjust too comfortable and resist anxiety asking how they feel about the -this change to accepting anxiety involves viewing quality of their life life as an adventure How would you change your life if Encourage members to accept anxiety as a growth- you knew you were going to die? producing experience Expand death to include other Assisting members to come to terms with forms of death paradoxes of existence We have areas of our lives that die • life - death / success - failure to make room for new growth Must be faced and worked through in counseling that involves: Aloneness & Relatedness • Recognition of need for self and others Ultimately we are alone • Guilt over not living authentically We must accept our aloneness and • emptiness and lack of meaning then we can genuinely and • burden of responsibility & choice meaningfully relate to others • fear of death & non being We must stand alone before we can truly stand besides another Existential Key Concepts Search for Meaning Search for Authenticity Who Am I? Paul Tillich “The Courage to Where Am I Going? Be” Why am I here? Authentic living is a process What gives my life purpose and meaning? Being true to ourselves Life does not have a positive meaning itself Engaging in activities what is It is up to us to create meaning meaningful to us A lack of meaning is the major source of Becoming a person that we are existential stress and anxiety capable of becoming Existential Vacuum: feeling of inner void Challenging members to become due to lack of meaning authentic by engaging in life and making commitments Counselors assist members in finding meaning for themselves Challenging and discarding values to become meaningful is central for the counselor Do you like the direction of your life? If not, what are you doing about it? What are the aspects of your life that satisfy you most? What is preventing you from doing what you really want to do? Strengths & Limitations of the Existential Approach Strengths Limitations People do not have to remain Quite abstract victims of their past Difficult to apply People have the power to decide Must have the mindset or may for themselves and take action feel that concepts are elusive and Wide range of applicable group lofty settings Not good for those not interested Help individuals reclaim a sense in self-exploration of power Not good for problem-solving or Techniques follow the relief of specific symptoms understanding - less ability of Counselors do not serve as a abusing techniques director or substitute parent Very suitable for those living in Counselors must have a good foreign countries grasp of the approach Highly Multicultural in orientation Respect of uniqueness Group Leader Roles Counselor is fully present Counselor’s first concern is with genuinely grasping the core struggles of the members Experiencing the clients present moment Counselor tries to understand the members subjective world Tasks are accomplished through encounter not techniques Focus on the human side of members Counselors bring their own subjectivity into the group Change comes from the relationship between counselor and member Counselors are free to draw from other techniques from other orientations Counselor must foster meaningful relationships among members Focus on key existential concepts and explore them fully Counselors must be and become somebody rather than doing or implementing techniques Appropriate Populations for Existential Groups People who: Rape Groups feel alienated Battering Groups search for meaning Crime Groups are at a cross roads are at the edge of existence Abuse Groups Those interested in Bereavement / Loss dealing with their Groups problems rather than Empty Self Groups curing pathology Multicultural Groups ????? Phases of the Existential Method INTAKE PHASE: Determining the appropriateness of the method and introducing terminology and concepts •Is the method suited to the client’s expectations, treatment, and capacities? •What level of reading material is appropriate for the client? •What will be the frequency of the sessions and duration of treatment? PHASE 1: Recognizing anxiety as a provocation that begins the transition to authenticity •What personal message is contained in my quietness? •What facets of my life have become a matter of dissatisfying routine? •Am I living according to beliefs and values that are not my own? PHASE 2: Conceptualizing that our existence is temporary •How do I perceive the temporal limits of my existence? •Have I postponed my authentic projects due to assuming an abundance of time? •Am I willing to consider that an awareness of my heritage and sense of destiny may open possibilities in my present dilemma? Phases of the Existential Method PHASE 3: Reviewing familial-cultural heritage and demonstrated possibilities •What resources from my heritage and personal history are essential for a sense of wholeness and purpose? •What possibilities have I closed off due to their anxiety-producing quality? PHASE 4: Selecting possibilities for future repetition •What few uncustomary and meaningful activities am I prepared to initiate that will draw on my newfound sense of heritage and destiny? •How will I continue to hold myself open, so as to recognize those few projects that are truly my own? PHASE 5: Resolving to continue in authenticity despite the presence of nonbeing •How will I draw on my accomplishments in therapy to persevere in authenticity? Brent, J. (1998). A time-sensitive existential method for assisting adults in transition. Journal of Humanistic Psychology, 38 (4), 7-24. Existential Case Study Pauline The existentialist views death as a reality that gives meaning to life. As humans we do not have forever to actualize ourselves. Thus, the realization of the fact that we will die jolts us into taking the present seriously and evaluating the direction in which we are traveling. We are confronted with the fact that we have only so much time to do the things we most wanted to do. Thus, we are motivated to take stock of how meaningful our life is. With this existential perspective in mind, assume that a young woman of 20 comes to the center where you are a counselor. Some Background Data Pauline has recently found out that she has leukemia. Though she is in a period of remission, her doctors tell her that the disease is terminal. Pauline is seeking counseling to help herself deal with the crisis and at least get the maximum our of the remainder of her life. She is filled with rage over her fate; she keeps asking why this had to happen to her. She tells you that at first she could not believe the diagnosis was correct. When she finally got several more professional opinions that confirmed her leukemia, she began to feel more and more anger – toward God, toward her healthy friends, whom she envied, and generally toward the unfairness of her situation. She tells you that she was just starting to live, that she had a direction she was going in professionally. Now everything will have to change. After she tells you this, she is sitting across from you waiting for your response. Case Study Review Questions Attempting to stay within the frame of reference of an existential counselor, what direction would you take with her? Think about these questions: What do you imagine your immediate reactions would be if you were faced with counseling this client? What would be some of the things that you would initially say in response to what you know about Pauline? What are your own thoughts and feelings about death? To what degree have you reflected on this reality as it applies to you? Do you avoid thinking about it? In what ways have you accepted the reality of your eventual death? How do you think that the answers to the above questions will affect your ability to be present for Pauline? What goals would you have in counseling her? In what ways would you deal with the rage that Pauline says she feels? Pauline tells you that one of the reasons that she is coming to see you is because of her desire to accept her fate. How would you work with her to gain this acceptance? What specific things might you do to help her find ways of living the rest of her life to the fullest? Do you see any possibilities for helping Pauline find meaning in her life in the face of death? Existential Therapy Outline Introduction 3 Phases of Therapy ID & clarify client’s assumptions about the world Encourage client to examine the source and authority of their value system Help client to put what they learn about themselves into action Existential Therapy Outline 6 Major Existential Propositions The capacity for Self-Awareness: • The greater our awareness, the greater our possibilities for freedom • We can choose to either expand or restrict our consciousness • A price is paid for increased awareness (you can’t go home again) Freedom & Responsibility: • Focus is on client’s responsibility for their situation • Challenge client to explore other ways of being that are more fulfilling Striving for Identity & Relationship to Others: • Challenge client to examine ways in which they have lost touch with their identity • Confront clients with the reality that they alone must find their own answers • Lack of relationship to others cause anxiety The Search for Meaning: • Clients are faced with the task of creating meaning for their own lives • Existential guilt is explored to help clients learn about the way they are living their lives Anxiety as a Condition of Living: • Anxiety is used as a tool to motivate change in the client • The counselor helps the client move from dependence to autonomy Awareness of Death and Non-being: • Client learns to relinquish the neurotic aspects of their past • Client is encouraged to create a fuller life The Purpose of Life Test This questionnaire consists of twenty items to be rated on a seven point scale. On each item position 4 is designated as “neutral” and different descriptive terms are given for positions 1 and 7. A person’s response can fall anywhere in between 1 and 7. 1. I am usually Completely bored 1234567 Exuberant, excited 2. Life seems to me: Completely routine 1234567 Always exciting 3. In life I have: No goals or aims at all 1234567 Very clear goals & aims 4. My personal existence is: Utterly meaningless, Very purposeful, without purpose 1234567 meaningful 5. Every day is: Exactly the Same 1234567 Constantly new & different 6. If I could choose, I would: Prefer to have never Like nine more lives like been born 1234567 this one 7. After retiring, I would: Loaf completely the Do some exciting things I’ve rest of my life 1234567 always wanted to do 8. In achieving life goals Made no progress Progressed to complete I have: whatever 1234567 fulfillment 9. My life is: Empty, filled only Running over with with despair 1234567 good things 10. If I should die today I would Completely Very feel that my life has been: worthless 1234567 Worthwhile 11. In thinking of my life I: Wonder why I exist 1234567 Always see a reason for being The Purpose of Life Test 12. As I view the world in relation to my life, Completely Fist meaningfully the world: confuses me 1234567 with my life 13. I am a: Very irresponsible 1234567 Very responsible 14. Concerning man’s freedom Completely bound by Absolutely free to make his own choices, limitations of heredity to make all I believe man is: & environment: 1234567 life choices 15. With regard to death, I am: Unprepared/Frightened 1234567 Prepared & Unafraid 16. With regard to suicide, Thought of it seriously Never given it a I have: as a way out 1234567 second thought 17. I regard my ability to find a meaning, a purpose or mission in life as: Practically none 1234567 Very Great 18. My life is: Out of my hands and In my hands and controlled by external I am in control factors 1234567 of it 19. Facing my daily tasks is: Painful & Boring 1234567 Pleasuring & satisfying 20. I have discovered: No mission or purpose Clear-cut goals and a in life 1234567 satisfying life purpose Taken from Existential Psychotherapy, by Irvin D. Yalm, 1980, pgs. 455-456. 2 Key Figures in Existential Therapy Victor Frankl Rollo May Born & Educated in Vienna American spokesperson for Prisoner in German Concentration Existentialism Camp – where his parents, brother, Unhappy childhood – 2 failed first wife and children died marriages, tuberculosis – but not a Views love as the highest goal to negative outlook on life which humans can aspire – our Studied with Adler in Vienna salvation is through love Greatest influence: Paul Tillich Feels that everything can be taken (German Philosopher) from a person except the right to Writings deal with the nature of the choose one’s attitude in any given set human experience, recognizing and of circumstances dealing with power, accepting Feels that we can discover the freedom & responsibility, & meaning of being human through our discovering one’s identity actions and deeds, by experiencing a Feels that counseling should be aimed value and by suffering at helping people discover the “That which does not kill you makes meaning of their lives you stronger” Feels the greatest challenge for a person is to live in a world alone where they will eventually face death Historical Background in Existential Philosophy Counseling was not founded by any particular person or group It grew out of an effort to help people engage the dilemmas of contemporary life (i.e., isolation, alienation, meaninglessness The thinking of existential counselors was influenced by the themes of many 19th and 20th century philosophers and writers such as: Dostoyevski: creativity, meaninglessness, and death Kierkegaard: creative anxiety (angst), despair, fear and dread, guilt nothingness Nietche: death, suicide, and will Heidegger: authentic being, caring, death, guilt, individual responsibility, & isolation Sartre:meaninglessness, responsibility, & choice Buber: interpersonal relationships, I / thou perspective in counseling, & self- transcendence 3 Phases in the Process of Existential Counseling Middle Phase: Initial Phase: Final Phase: The client is Counselor assists encouraged to Counselor focuses client in more fully on helping the identifying & examine the client put what clarifying their source and they are learning assumptions authority of their about themselves about the world value system into action Examples of Topic Within the 6 Dimensions of Human Condition Initial Phase: Counselor (1) helps clients become aware of their choices (2) takes responsibility for those choices (3) assists clients in finding internal direction and (4) reconnecting with who they are and what they want from life. (5) Acquaints clients with the concept fo anxiety and (6) the notion that life and death are intertwined, in order to grow parts of ourselves must die. Middle Phase: (1) Clients come to realize that they are failing to live in the present because of preoccupations with the past, and learn that although they cannot change certain events of their lives they can change the way they view and react to those events. (2) The counselor assists clients in discovering how they are avoiding freedom of choice and encourages them to learn to risk using it. (3) The counselor helps clients to examine ways they have been living to please others and (4) aids them in confronting “existential vacuum” and (5) “existential anxiety”. (6) The counselor challenges clients to examine their own unfinished business. Final Phase: (1) The clients accept their limitations yet still feel worthwhile, for they understand that they do not need to be perfect to be worthy. The counselor challenges the clients to (2) consider using their freedom to create new patterns and (3) to confront the reality that they alone must find their own answers. (4) The clients uses existential guilt and (5) anxiety as a motivation to challenge the meaning and direction of life. (6) Finally, clients become more comfortable with inevitable death and seek to live authentically. Existential Therapy Case Study Susan, a 30 year old client has come to see a counselor at a local mental health agency. Although Susan tells the counselor that she doesn’t think she has any serious problem, she has come to counseling after a long period of fights with her husband which climaxed recently in her husband threatening divorce unless she “gets some help” for what he describes as her “clingy-ness”. Following is a summary of the information Susan shared during her initial interview with the counselor: I’m 30 years old and married for almost 9 years now. I have a 8 year old daughter, Olivia. I met my husband Tim in college. He is 1 year older. At the end of my sophomore year, I got pregnant and we decided to get married. Since Tim was almost ready to graduate, he finished school but dropped out after the 1 st semester of my junior year. For a while the relationship was pretty good, I think. Tim worked a lot and I was busy taking care of Olivia. Ever since Olivia started going to school all day, things between Tim and I seem to have gotten worse and worse. I don’t have as much to do, so I look forward to spending time with Tim at night and on the weekends, but he says I’m suffocating him. And he gets mad and can’t understand why I don’t what him to go off all the time for a whole day to play golf on Saturday when that’s the only time he has to spend with me and Olivia. Well, like I said, it’s just gotten worse. Last week, he actually said if I didn’t “get a life of my own” he wasn’t sure “how much longer he could take it”. I sometimes think it would be nice to do something else with the free time I’ve got now, but I can’t exactly get a job. Olivia still needs someone to be home after school and I don’t even know if that’s what Tim means. If he wants me to go to work, I wish he’d just say so, but…I don’t know what he wants. Watch the role play of the next session between Susan and the counselor. Does the therapist accomplish (or attempt to accomplish) theses 3 key tasks? 1. Assist the client in recognizing that they are not fully present in the counseling process itself. 2. Support the client in confronting anxieties they have been avoiding. 3. Help the client redefine themselves in a way that encourages greater genuine of contact with life.