Transcript Slide 1
Existential
Psychotherapies
EXISTENTIAL APPROACHES
Way of thinking about humans and about life
Closely linked to European Existential Philosophy:
Dilemmas of contemporary life (1940-50s)
isolation, alienation and meaninglessness
Importance of subjectivity and self-determination
Truth depends on the existing person, in a given
situation and in a given time
Freedom to be ourselves implies responsibility
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European Existential Philosophers
Kierkergard
angst - dread and anxiety related to uncertainty in living
Nietzsche
Values are within the individual
Sartre
Freedom to be what we choose and related responsibility
Simon de Beauvoir The Second Sex
Buber
Stressed the I/Thou Relationship – less individualistic
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Existentialist Psychology
Victor Frankle
Logotherapy: Man in Search for Meaning
Nietzsche “He who has a why to live for, can bear
with almost any how.”
Rollo May
First book: Meaning of Anxiety (1950)
Co-editor: Existence: A New Dimension in
Psychiatry and Psychology (1958) introduced
existential psychology to the US.
Irving Yalom
Existential Psychotherapy, (1980)
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Irving Yalom
https://www.youtube.com/watch?v=tuCa8Rc1S
ao
(2005)
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Theory of Personality
Dynamic Model
Forces in conflict
need to survive and assert one’s being vs.
conscious and unconscious fears related to:
Givens of Existence or Ultimate Concerns
Death
Freedom/Responsibility
Isolation
Meaninglessness
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Boundary situation
Experience or event that propels the person to
face one or more ultimate concerns:
terminal illness
death of a loved one
life crisis – divorce, loss of job
life change – empty nest, aging, retirement
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Conflict/Mental Health
Awareness of Ult. Concerns
>>>Anxiety >>> Def. Mechanisms
Ways to deal with the anxiety
Provide safety, restrict growth
Mental Health
Ability to cope with anxiety of being alive
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Anxiety
NORMAL/Existential ANXIETY
Proportionate to the situation
Does not require repression
Can be used in a productive way
NEUROTIC ANXIETY
Disproportionate to the situation
Tends to be repressed
Paralyzes the individual
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Guilt
Normal
Existential
Ethical aspects of behavior
failure to live up to one’s
capacities; avoid responsibility
of making own choices
Neurotic
Fantasized transgressions
toward others or self
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Therapy Goals
Explore anxiety related to the ultimate concerns,
conscious/unconscious
Identify mechanisms of defense (symptoms) clients
use to deal with existential anxiety
Move clients to confront the fear and pain
associated with the ultimate concerns
Help clients develop adaptive ways of dealing with
existential anxiety
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Freedom vs. Responsibility
We are ultimately responsible for who we are,
what we believe in, and how we behave
Anxiety is generated by our fear of not
knowing or of making mistakes
We must make authentic choices rather than
follow what has been given to us
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Responsibility: Defenses
Displace it
others/circumstances
Deny responsibility
e.g. victim role
Avoid responsibility
e.g. symptoms
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Process of Making Decisions
WISHING >>>> WILLING >>>> ACTION
Symptoms
Impulsive Behavior
Non-discrimination among wishes;
Jump from every wish to action
Compulsive Behavior
Driven by ego-alien demands
Action w/o wishing
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Freedom:Therapy
Help client recognize and accept responsibility for
making choices
Confront responsibility avoidance (won’t vs. can’t)
Encourage clients to connect with their feelings
Explore how client contributes to problems
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Isolation
Awareness of our intrinsic isolation vs.
desire to be part of something larger
Interpersonal
social skills, intimacy
Intra-personal connected with self
Existential
Unavoidable
Defense:
Fusion: soften our ego boundaries and
become part of another individual, group,
or cause
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Isolation: Therapy
Help clients confront their fear of aloneness
Personal growth entails a degree of isolation
To create authentic relationships with others we
must have confronted and accepted our
ultimate isolation
Within the real relationship between client and
therapist, client may learn limits and rewards of
intimacy
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Meaninglessness
We naturally search for meaning, but we
live in a world where there are no intrinsic
meanings
Need to construct a personal sense of meaning
“Wishing” finding meaning requires access to
affective experience
A sense of meaning is guided by our values:
why we live and
how to live
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Meaninglessness: Therapy
May not be an issue for all clients
Personal growth
Boundary situations
Depression
Help clients connect with their affective
selves, to discover inner sources of motivation
and meaning
Help clients get engaged in life activities
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Death
Fear of self-destruction – primary source of
anxiety
Defenses against death awareness – denial,
reaction formation
Awareness of death gives meaning to our
life (paradox)
enhances the importance of the present
moment
leads us to live more fully
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Defense Mechanisms
Awareness of Ult. Concerns >>>Anxiety
>>> Def. Mechanisms
Drive >>> Anxiety >>> Def. Mechanism
Defense mechanisms provide some temporary
relief, but they restrict growth
Existentialists ascribe to the defense
mechanisms that were proposed by Freud
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Psychotherapy : Goals
Main goal is to help clients
Increase awareness about themselves and
how they are living
Confront their anxieties and fears
Re-define themselves and their world in ways
that lead to a more authentic life
Focus on the future
Main vehicle of therapy is an authentic,
real relationship with therapist
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Psychotherapy: Relationship 1/2
Therapy is a journey taken by therapist and
client
The person-to-person relationship is key
Therapists stay in contact with their own
phenomenological world -- Genuine
Therapists must distinguish between transference
and the actual, real relationship (they co-exist)
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Psychotherapy: Relationship
The core of the therapeutic relationship
Respect and faith in the clients’ potential to cope
Sharing reactions with genuine concern and
empathy
Focus on the here-and-now experience in the
therapeutic relationship
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Psychotherapy: Techniques
Paradoxical intention
Situational reconstruction
Compensatory self improvement
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Psychotherapy: Techniques
Paradoxical intention
prescribing the symptom: help clients gain more
control of their behavior, get “unstuck”
Situational reconstruction
think of three ways in which a situation could be
better and three ways in which it could be worse to help people move on from the place they are
stuck
Compensatory self improvement
work on areas that you have control when you are
in a situation you don't control
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Contributions
Provides new ways of understanding death,
anxiety, guilt, loneliness, and alienation
Emphasizes the person's freedom and
responsibility in designing their own lives
Importance placed on the human quality of
the therapeutic relationship
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Contributions
Philosophical orientation applicable regardless
of counselor’s theoretical orientation
Particularly useful to understand issues
presented by clients who may be confronting
existential crises
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Limitations
Lacks a systematic statement about
principles and practices of psychotherapy
Does not lend itself to empirical research
Concepts are abstract and difficult to apply in
practice
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Gestalt
Existential & Phenomenological – it is
grounded in the client’s “here and now”
Goal: clients gain awareness of feelings and
behaviors in the here and now
Promotes direct experiencing rather than
talking about situations
talk about a childhood trauma vs. become the hurt
child
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Frederick Perls 1893-1970
Born in Germany,
Psychiatrist and psychoanalyst
Emigrated to U.S. in 1946 and broke with
psychoanalytic tradition
Controversial and charismatic figure
Gestalt therapy became a kind of cult
Collaborated with his wife (Laura Perls 19051990) in delivering workshops and writing
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The Now
Our “power is in the present”
Nothing exists except the “now”
The past is gone and the future has not yet arrived
The power of the present is lost if :
We focus on past mistakes or engage in endless
resolutions and plans for the future
Therapist focuses more on the process of therapy
than on the content
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Unfinished Business
Unexpressed feelings such as anger,
resentment, and fear, that interfere with
effective contact with oneself and with others
Threatening
Not fully experienced in awareness
Result in:
Preoccupation, compulsive behavior, wariness and
self-defeating behaviors
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Contact and Resistance to Contact
CONTACT
To interact openly with environment w/o losing one’s
individuality
Requires contact/awareness of one-self
RESISTANCE TO CONTACT
Defenses that prevent experiencing the present fully
Defenses: used to control the environment rather
than allowing real contact
Typically these defenses are out of awareness; may
contribute to dysfunctional behavior
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Defenses
Resistance to Contact
Introjection
Uncritical acceptance of others’ beliefs and
standards w/o making them our own.
• Lack of clear sense of self
Projection
Retroflection
To disown certain aspects of ourselves by
ascribing them to the environment
• Victim stance; powerlessness to initiate
change
To turn back to ourselves something we would
like to do (or have done) to someone else
• Self-injury vs. fear of directing aggression
outwardly
• Depression -psychosomatic symptoms vs.
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expressing anger
Defenses
Resistance to Contact
Deflection
To avoid real contact and awareness by being
vague and indirect.
• Humor, abstract generalizations, ignoring
Confluence
To loose the sense of the boundary between
self and environment (others).
• Go with the flow, enmeshment,
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Goal Gestalt Therapy
Gain awareness
Know the environment
Know oneself
Learn about dominant ways of avoiding contact
What does the resistance (defense) does for the client
What it protects the person from
What it keeps the person from experiencing
Accept oneself and responsibility for self
Allow oneself to make contact
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Therapist Role
Provide an authentic relationship
Focus on process versus content
Experiments to increase client’s selfawareness
Coach clients to arrive at their own
interpretations/ counselor does not interpret
Confrontation
To help client become aware of discrepancies
between:
verbal and nonverbal expressions,
feelings and actions, and/or
thoughts and feelings.
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Gestalt Experiments
Allow clients to express themselves
behaviorally
Lead to fresh emotional experiences and new
insights
Facilitate experiencing in the moment, rather
than talking about….
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Gestalt Experiments
Internal Dialogue
Empty Chair
Making the Rounds
Reversal Exercise
The Rehearsal Exercise
Exaggerating Exercise
Staying with the Feeling
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Contributions and Limitations
• Creative use of active interventions
(experiments) to foster experiential learning
• Confrontational style that deemphasizes
cognitive factors
• Experiments can be used by therapist in a
manipulative way
• Highly active and directive stance of therapist
could lead to abuse of power
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