Existential Psychotherapy: What is it and who can it help?

Updated: 26/11/24

Written by Dr Sara Tookey, Clinical Psychologist​​

 

 

Existential Psychotherapy: Exploring Life's Fundamental Questions

 

Existential psychotherapy is a philosophical approach to therapy that focuses on the human condition as a whole. Drawing from the works of philosophers like Sartre, Kierkegaard, and Nietzsche, this approach helps people confront life's fundamental questions about meaning, purpose, freedom, and authenticity.

 

 

 

 

What is Existential Psychotherapy?

 

Existential therapy explores how individuals grapple with the fundamental givens of existence:

 

• Death and finitude

• Freedom and responsibility

• Existential isolation

• Meaninglessness and meaning-making

• Authenticity versus inauthenticity

 

 

The Theoretical Foundation

 

Existential therapy is grounded in several key concepts.

 

The Four Dimensions of Existence (van Deurzen, 2012):

 

1. Physical World (Umwelt)

 

Our existence is fundamentally grounded in our physical reality - our embodied experience in the natural world. This dimension encompasses our relationship with our body, its needs and limitations, and our connection to the physical environment. It involves how we navigate health, aging, death, and our place within the natural world. Understanding this dimension helps us confront fundamental anxieties about mortality and physical existence.

2. Social World (Mitwelt)

We exist in constant relationship with others, embedded in a complex web of social and cultural connections. This dimension explores how we relate to others, find our place in society, and negotiate cultural expectations and norms. It addresses fundamental questions about belonging, isolation, intimacy, and how we create meaningful connections while maintaining our individuality.

​

3. Personal World (Eigenwelt)

 

This dimension concerns our relationship with ourselves - how we understand and experience our own identity and sense of self. It explores our inner world, including our self-concept, personal values, and the meaning we create in our lives. This realm addresses questions of authenticity, personal growth, and how we maintain a coherent sense of self while navigating life's changes.

​

4. Spiritual World (Überwelt)

​

The spiritual dimension extends beyond immediate personal experience to encompass our relationship with the transcendent aspects of existence. This includes our values, beliefs, and how we make sense of life's ultimate questions. It explores how we create meaning in life, our relationship with the unknown, and our understanding of our place in the larger cosmos. This dimension helps us grapple with questions of purpose, meaning, and what lies beyond our immediate experience.

 

These dimensions are interconnected and continually influence each other, creating the complex fabric of human existence. Existential therapy helps clients explore and navigate these different realms of experience, fostering greater awareness and authenticity in how they engage with each dimension.

 

 

Who Can Benefit from Existential Therapy?

 

Existential therapy can be particularly helpful for people:

• Facing life transitions or crises

• Questioning life's meaning or purpose

• Dealing with illness or mortality

• Struggling with identity or authenticity

• Experiencing spiritual or philosophical concerns

• Managing anxiety about life choices

• Coping with loss or grief

 

 

What to Expect in Existential Therapy

 

Sessions typically involve:

 

1. Open exploration of experiences

2. Examining life choices and responsibilities

3. Discussing fundamental life concerns

4. Exploring personal values and meaning

5. Developing authentic ways of living

 

 

Key Concepts and Techniques

 

Core Therapeutic Tasks

• Increasing self-awareness

• Exploring personal values

• Understanding freedom and responsibility

• Developing authentic relationships

• Finding personal meaning

• Accepting life's uncertainties

 

Common Themes

• Authenticity versus inauthenticity

• Freedom and responsibility

• Death awareness

• Meaning in life

• Isolation and connection

• Identity and selfhood

 

 

The Evidence Base

 

While existential therapy has historically focused more on philosophical understanding than empirical validation, recent research shows promising results:

 

Research Findings:

 

• Effective for treating anxiety and depression (Vos et al., 2015)

• Helpful in managing terminal illness (LeMay & Wilson, 2008)

• Beneficial for existential concerns in cancer patients (Kissane et al., 2018)

• Positive outcomes in meaning-centered therapy (Breitbart et al., 2015)

 

 

Unique Aspects of Existential Therapy

 

Distinguishing Features:

​

• Focus on human experience rather than symptoms

• Emphasis on personal responsibility and choice

• Integration of philosophical concepts

• Attention to life's fundamental questions

• Consideration of death as a catalyst for living

 

 

Want to learn more about Existential Therapy and what it's like to engage in this therapeutic approach?

 

Read our blog post: Existential Psychotherapy: Embracing Meaning and Authenticity, by Existential Psychotherapist, Dr Sara Tookey

 

 

Special Considerations:

Existential therapy may be particularly valuable during major life transitions, illness, or when facing significant life decisions. However, it may not be the best first-line treatment for acute mental health crises or severe mental illness where immediate symptom management is needed.​​​

​