Existential Therapy: Using The Existential Approach To Cope With Mental Health Challenges

Many people associate the term “existential” with the field of philosophy rather than psychotherapy. However, existential therapy is a valid form of psychotherapy that can provide positive benefits for people with mental health challenges and those who experience an existential crisis. Its basis is generally to find meaning and purpose through self-actualization and self-understanding in therapy. Existential therapy may focus on the future while using the past as a tool, develop self-awareness, promote freedom, teach individual responsibility, help clients take meaningful action, and encourage a positive attitude which can help clients to live more meaningful lives. If you’d like to try existential therapy for yourself, you may connect with a therapist specializing in this type of treatment in person or through an online therapy platform.

Understanding existential psychotherapy: Foundation of existentialism and the existential approach

The Danish philosopher Soren Kierkegaard suggested that mental conditions could only be adequately resolved by developing internal wisdom and that suffering was an inherent quality of the human condition. This philosophy laid the foundation of existential thought, which continued to develop into the 20th century. Since then, existential psychologists like Irvin Yalom and Viktor Frankl, have often sought to put this existential philosophy to use in helping people with both personal growth and recovery from mental health problems. While existential thought typically utilizes expanded and refined wisdom from its philosophy to arrive at a specific set of existential concepts, existential psychotherapy focuses generally on techniques used in practical ways to help people overcome mental health conditions. Humanistic psychology is a therapeutic process that is very similar at its core to existential psychology. The one key difference is that a humanistic therapist views humans as inherently good while existential therapists believe that human beings are neither good nor bad. Both humanistic therapy and existential therapy consider the human as a whole and seek to find meaning and purpose through understanding and self-actualization for clients.

Mental health conditions treated with existential therapy: Anxiety, depression, and more

Therapists with mental health training in existential techniques frequently work with clients to treat the symptoms associated with conditions like depression, anxiety, addictions, and PTSD. The goal is usually to use the existential approach to find a healthy way for clients to cope with the fear, isolation, grief, and hopelessness that can accompany these conditions.

The human condition and existential therapy

Intrapsychic conflicts in existential therapy

According to the existential therapy model, the anxiety many people feel may stem from underlying factors called intrapsychic conflicts. The APA defines intrapsychic conflict as “the clash of opposing forces within the psyche, such as conflicting drives, wishes, or agencies.” 

For example, a person who smokes cigarettes may want to quit for their health’s sake, but if they enjoy taking cigarette breaks at work as a reward for completing tasks, this may cause an intrapsychic conflict and feelings of anxiety. In this case, an existential therapist may work with the patient to isolate the origins of both those thoughts and behaviors to reconcile them as part of the healing process, especially in substance abuse treatment. 

Existential anxiety and mental health

Even though many of us experience similar difficulties in life, sometimes, intrapersonal conflict may become so overwhelming that it can hinder our ability to make decisions or create change if needed. This inhibited ability may cultivate strong feelings of powerlessness, which may result in intense feelings of anxiety that can negatively impact our daily functioning. This can lead individuals to remain unaware of what they’re supposed to do. This is where existential therapy comes in, which aims to increase self-awareness and self-determination to take greater responsibility in life. Existential therapies generally aim to reduce these negative feelings by encouraging patients to face their fears and act in ways that promote well-being. The goal is usually to relieve symptoms of anxiety through these positive actions. It is the therapist’s role to create a space for clients as they explore specific concerns and questions about life and existence which can play a vital role in helping them discover their ultimate purpose.

Implementing the existential approach: Therapist goals 

Existential therapists typically have several objectives when helping participants address existential crises, from fostering self-awareness to encouraging positivity. The following are common goals of existential therapy. 

Existential therapy for fostering awareness of the human condition 

Although theoretically, we may all have the capacity for existential self-awareness, not everyone may follow that strategy for resolving inner conflict. For many reasons, some may find themselves focusing on things that distract from intrapsychic conflict. 

A part of the goal of existential psychotherapy can be to increase self-awareness. As we become more aware, we can choose to act in ways that may increase our understanding of our foundational mental health issues. The belief behind this method is that the more we understand in an existential sense, the easier it may be to make wiser choices.

Currently, you may focus more on others than on your own sensations, thoughts, and beliefs. Through this existential therapeutic modality, you may shift the relational context from others to yourself and learn to notice what is happening within your body and mind to reflect on what is beneficial for you. 

While this may sound like a selfish practice, existential therapists typically believe it is a healthy perspective on human existence. When you take care of your own needs, you generally do not have to depend on others for contentment. Also, existential therapy often functions using the idea that when we feel more satisfied with our lives, we may also become more genuine and caring people who may be better able to help others when needed.

Allowing the existential therapist to promote balance as an existential approach

Existential therapy doesn’t generally seek to eliminate all sources or feelings of anxiety. The belief behind this therapy is often that those feelings can be normal and sometimes necessary for humans. But at the same time, intense feelings of anxiety can paralyze us, leading to inaction. For existential therapists, the solution to this conflict may not be the complete elimination of stress, but the achievement of a balanced level of stress. Many existential therapists tackle ultimate concerns that are inevitably confronted by clients.

One prominent therapist who is widely known for his contributions to group therapy,  specifically in integrating concepts of existential therapy in group settings is Irvin Yalom. According to him, the relational context of group therapy is a good approach with ultimate concerns about hope, life, death, and meaning, because group therapy offers an opportunity to elicit insight and choices, through empathy and support from others. Yalom is also known for using the term “fellow traveler” which describes an existential take on the doctor-patient relationship. The concept of “fellow traveler” indicates that everyone is just the same;  everyone deals and struggles with fears and anxieties. It is the therapist’s role to use a fellow traveler mindset, to promote a more present connection and mutual respect with the client. In existential group therapy, the core question addressed is “How do I exist in the face of uncertainty, conflict, or death?”

The existential therapist uses the past as an existential therapy tool

If you are in existential therapy, your therapist will likely guide you in reflecting on your past. Yet, in this form of therapy, the past is not usually the focus. Instead, exploring your past can serve two purposes. First, it’s usually meant to help you understand yourself better as a unique person. Second, you may examine the consequences and results of the choices you've made in the past so that you can make better choices now and in the future.

Promoting freedom in existential psychotherapy

At the core of existential therapy is the belief that everyone has the ability to choose their actions in their own lives. Guiding patients to a better understanding and acceptance of their freedom is one of the ways that existential therapists may treat them.  

Developing personal responsibility and accepting freedom can be highly self-motivating, however, for some, existential freedom can seem frightening. In these cases, the therapist may help the patient work on balancing their feelings of anxiety as they become more aware of their freedom to choose. 

Teaching individual responsibility

Existential psychotherapy also frequently works with the idea that freedom usually comes with responsibility. An existential therapist can help you identify the responsibilities associated with the freedoms you have in life and teach you how to accept responsibility for your actions without becoming overwhelmed by a sense of burden.

For instance, if a student is responsible for keeping their grades up, but their freedom of choice drives them to go out instead of study, it can cause conflict and stress. A therapist may help the student come to terms with their responsibility without feeling like they are sacrificing their freedoms completely. This will likely alleviate a large portion of the stress associated with the conflict.

Encouraging a positive attitude and improving mental health

Existential therapists generally aim to help their patients cultivate greater happiness by identifying and acknowledging the intrapsychic conflicts and human limitations that may be holding them back. Essentially, after you've come to terms with these deeper issues, your therapist will likely encourage you to find freedom from them and adopt more positive attitudes as a result which develops self-respect. Therapists can also combine existential therapy with other types of therapy or mental health services as a means of helping the client find meaning, purpose, joy, and their unique path in life. 

Finding an existential therapist 

Existential psychotherapy can be viewed as a form of psychotherapy or talk therapy. But in addition to exploring the existential roots of your difficulties, your existential psychotherapist may prompt you to follow insight with action. Existential therapy emphasizes the relational context of a person’s life and uses methods to elicit insight among clients. Through this values-based action, the goal is usually to acquire the knowledge needed to outwardly become the best possible version of yourself and lead a meaningful life. If you’re interested in trying existential therapy for yourself, you may do so with a licensed mental health professional in person or online. 

Try searching for available existential therapists near you with the help of resources online. Make sure your research focuses on therapists' expertise and knowledge regarding the existential approach. As an individual, you can also refer to known associations and organizations for existential psychology such as the Society for Existential Analysis, and the primary international community for existential counselors which is the International Society for the Science of Existential Psychology (ISSEP) to exchange ideas about specific concerns revolving concepts and perspectives about existence.

Utilizing the existential approach with online therapy

Online therapy platforms can match those who wish to seek professional help with experienced therapists virtually, providing them with more freedom over when and where they’d like to speak to their therapist. In addition, online therapy is often less expensive than in-person therapy. 

The efficacy of online therapy for mental health conditions such as anxiety, depression, and more

Online therapists frequently use a wide range of methods, including existential psychotherapy, and it can be as effective as in-person therapy for treating a broad range of conditions such as anxiety, depression, PTSD, and more.