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Existential Psychotherapies

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

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Existential Psychotherapies

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  1. ExistentialPsychotherapies

  2. 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 Freedomto be ourselves implies responsibility

  3. 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

  4. 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)

  5. Irving Yalom https://www.youtube.com/watch?v=tuCa8Rc1Sao (2005)

  6. 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

  7. 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

  8. 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

  9. 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

  10. Guilt • Normal Ethical aspects of behavior • Existential failure to live up to one’s capacities; avoid responsibility of making own choices • NeuroticFantasized transgressions toward others or self

  11. 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

  12. 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

  13. Responsibility: Defenses • Displaceit others/circumstances • Deny responsibility e.g. victim role • Avoid responsibility e.g. symptoms

  14. 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

  15. 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

  16. Isolation • Awareness of our intrinsic isolationvs. desire to be part of something larger • Interpersonal social skills, intimacy • Intra-personalconnected with self • ExistentialUnavoidable • Defense: • Fusion: soften our ego boundaries and become part of another individual, group, or cause

  17. 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

  18. 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

  19. 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

  20. 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

  21. 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

  22. 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 authenticlife • Focus on the future • Main vehicle of therapy is an authentic, real relationship with therapist

  23. 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)

  24. 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

  25. Psychotherapy: Techniques • Paradoxical intention • Situational reconstruction • Compensatory self improvement

  26. 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

  27. 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

  28. Contributions • Philosophical orientation applicable regardless of counselor’s theoretical orientation • Particularly useful to understand issues presented by clients who may be confronting existential crises

  29. 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

  30. 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 experiencingrather than talking about situations • talk about a childhood trauma vs. become the hurt child

  31. 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 1905-1990) in delivering workshops and writing

  32. 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 processof therapy than on the content

  33. 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

  34. 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

  35. 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

  36. Therapist Role • Provide an authentic relationship • Focus on process versus content • Experiments to increase client’s self-awareness • 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.

  37. 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….

  38. Gestalt Experiments • Internal Dialogue • Empty Chair • Making the Rounds • Reversal Exercise • The Rehearsal Exercise • Exaggerating Exercise • Staying with the Feeling

  39. 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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