AN INTRODUCTION TO THE EXISTENTIAL

APROACH TO COUNSELLING & THERAPY

Existentialism, a term covering a number of related doctrines

denying objective universal values and holding that a person must
create values for himself through action and by living each moment to
the full.
[Chambers Concise 20th Century Dictionary, 1985]

Existentialism is not a comprehensive philosophy or way of life, but an

endeavour to grasp reality.
[Rollo May, 1983: 59]

Introduction

“Existential” means simply “concerned with existence”. “Existence”, as

used in this context, means the actual living experience of being
human and being self-consciously aware of one’s human
existence.

The existential approach to therapy is distinctive from other theories in

that it grapples openly with questions which are often hidden, or even
avoided, in other approaches. What is the fundamental nature and
purpose of human life? What gives life meaning? What do we mean by
freedom or choice? Can we ever really know ourselves or another
person? How do we reconcile our strivings and aspirations with the
knowledge that we will ultimately die?

These questions, and the answers that are proposed to them, are the
concerns of existential philosophy. The existential counsellor or
therapist needs to be familiar with the existential tradition in
philosophy and literature, as well as with the more conventional
psychological theories of human development.

Existentialist Philosophy

Existentialism is a rich and diverse philosophical tradition. Starting

with Kierkegaard and Nietzsche in the nineteenth century,
existentialism developed from the 1930s onwards in the philosophical
writings of Martin Heidegger, Karl Jaspers, Jean-Paul Sartre and

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others. Many existentialist ideas are expressed in literature of the first
half of the twentieth century, e.g. Franz Kafka, Sartre, Simone de
Beauvoir, Albert Camus.

It is difficult to define exactly what existentialists believe, not least

because existentialists themselves oppose the idea that we can
concretely define anything about human life, since we are continually
creating our meanings through the process of living.

“Existentialism is a style of philosophising rather than a body of

philosophical doctrines” (Macquarrie, 1973: 3). However, existentialist
philosophers are concerned with several major themes (Macquarrie,
1973: 4-5):

• Freedom, decision, responsibility: What does it mean to take

responsibility for ourselves and our lives, to exercise freedom,
make choices, and take responsibility for the consequences? To
do this is to become an authentic human being, and yet we often
avoid our freedom and our responsibility, either by conforming
to social roles, or by acting irresponsibly.

• Guilt, alienation, despair, death: Human existence is

inevitably difficult and tragic. Our quest for authenticity is often
frustrated, and our existence ends ultimately in death.

• Emotions: In contrast to other philosophical traditions,

existentialists claim that we can learn about the world through
our feelings as well as through rational thought. Feelings such as
anxiety, guilt, boredom, are telling us something about the way
we are living our lives.

Existentialism in Psychotherapy: the context

The existentialist approach spread to psychiatry and psychotherapy in

the work of the Swiss psychiatrists Ludwig Binswanger and Medard
Boss. Although originally trained as Freudians, they used existentialist
concepts to challenge psychoanalytic theory and practice. By 1950, the
existentialist approach began to gain influence in the United States,
mainly through Rollo May, while R.D. Laing introduced some
existentialist ideas into psychiatric practice in the United Kingdom.

Helen Hayes 2 March 1999

In the United States, there has been a tendency for the existentialist
approach to be swallowed up by the humanistic tradition, so that there
are references to “humanistic-existentialist therapy”. Perls drew on
existentialist ideas in the development of Gestalt therapy, and later
Gestaltists have tried to use these ideas in a more systematic way.
Although there are some similarities between humanistic and
existential ideas, there are also significant differences which need to
be recognised. At the same time, the psychotherapist Irvin Yalom
has promoted and developed existentialist ideas within a
psychoanalytic setting.

In British psychiatry, the work of R.D. Laing has become best known
(and nowadays rather discredited) for its radical “anti-psychiatry”
stance and the political debates around this have obscured the
significance of existentialist ideas in his work. However, in more recent
years, the existentialist approach has been pioneered in the UK by
Emmy Van Deurzen-Smith.

Therefore, the existentialist approach to therapy sits in a rather

uneasy relationship with both psychodynamic and humanistic
traditions. I believe that the existentialists’ refusal to be swallowed up
by either approach indicates their insistence on asking difficult
questions about human life which many of us would prefer not to face.

Existentialist Therapy: basic assumptions

To grasp what it means to exist, one needs to grasp the fact that he
might not exist, that he treads at every moment on the sharp edge of
possible annihilation and can never escape the fact that death will
arrive at some unknown moment in the future.
[Rollo May, 1983: 105]

The existentialist counsellor or therapist believes that, whatever the

client’s presenting difficulties, there are several fundamental dilemmas
of human existence that we each have to face throughout our lives.
These are summarised by Yalom (1989: 1-14):

• The inevitability of death, both our own and that of others

close to us. Most of us devise ways of avoiding really knowing
this, as opposed to intellectually acknowledging it. We might
deliberately defy death by undertaking dangerous activities. We
might believe in reincarnation or some other form of life after
death, through religion. We might strive to achieve something in

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 our work that will live on after us, or we might think of our
children as some part of ourselves that carries on into the future.
But there will be occasions in our lives when we face, and really
feel, the inevitability of our own death. The existentialist
counsellor believes that by facing this, feeling to the full our fear
and despair, and understanding it, we can begin to live more
authentically.

• The freedom to create our own lives. Although Western

culture appears to value individual freedom, most of us actually
avoid facing up to what freedom, choice and responsibility really
mean. We imprison ourselves with routines and obligations, or
with neurotic symptoms. We make excuses for not living our
lives to the full, and blame other people or circumstances for our
shortcomings. This is what Sartre terms “bad faith”. “They
realise that opting for freedom means opting for anxiety and so
they opt for duty instead” (Van Deurzen-Smith, 1988: 46).
Making a choice to do one thing inevitably means that we can’t
do another, so being indecisive may be a way of clinging to the
illusion that we can have everything. Authenticity means
realising our freedom, making our choices, and accepting the
limitations and responsibilities that go with that.

• Ultimate aloneness, or existential isolation. No matter how

close we are to other people, we are ultimately different from
each other and alone in the world. We may try to avoid knowing
this by immersing ourselves in our work, our peer group, or our
intimate relationships. But when we face a major life crisis, we
are suddenly aware that we are alone, that no one else can live
our life (or die our death) for us. The existential therapist
believes that by facing terror and the awfulness of our ultimate
aloneness, we are enabled to take responsibility for ourselves
and to value the moments of real encounter with another human
being, recognising that s/he too struggles with the same issues.

• There is no ultimate objective meaning to life. Given the

inevitability of death, our freedom and our aloneness, then our
life is what we make of it. There is no external authority to tell
us what it’s all about. We may try to escape this through
religious belief or adherence to a political ideology, or we may
just avoid the question altogether by burying ourselves in work.
But there will be times in our lives when we will stop and wonder
about the purpose of our life. Existentialists believe that we each
create our purpose for ourselves, and our authenticity depends

Helen Hayes 4 March 1999

 on our willingness to accept that we don’t, and can’t, know
anything for certain, but that we can choose for ourselves what
is important for us and commit ourselves to living by our own
values.

When we face these fundamental existential dilemmas, we experience

existential anxiety (or Angst). This is quite different from other sorts
of anxiety (neurotic, phobic, persecutory or depressive). Existential
anxiety is the moment of recognition of the precariousness of
human existence. We may feel frightened, confused, despairing.

Existential guilt arises when we recognise that we have opted out of

facing the basic dilemmas by taking the path of least resistance. This
recognition may be felt as boredom with our lives, a feeling that what
we are doing is meaningless and shallow.

We may only experience existential anxiety when something happens

to jolt us out of our everyday lives, something that brings the
fundamental existential dilemmas to the forefront of our minds- e.g. a
bereavement, serious illness or accident, redundancy, trauma. Or we
may reach a recognition of existential issues through struggling with
other emotional and psychological difficulties, such as depression,
phobias, relationship problems. However, the existentialist approach
believes that we each need to face the basic existential dilemmas, and
that in face we do so throughout our lives, more or less consciously.

Each individual faces the same dilemmas, but each person will have a
different approach to them. We are each subjects in our own lives, and
we can never truly know what it feels like to be someone else; in a
profound sense, since we each create our own world, no two human
beings inhabit the same world.

The existential counsellor engages with the client to enable the

client to confront existential anxiety. In doing so, the counsellor
operates on the basis of several fundamental assumptions (Van
Deurzen-Smith, 1988: 3-11):

• Despite the lack of objective meaning in the world, it is possible

(and, indeed, necessary) for each individual to make sense of
her/his life in subjective terms. Each individual needs to clarify
her/his fundamental values in order to commit her/himself to
authentic living.

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 • Human nature is flexible and adaptable. However much
someone’s life is influenced or limited by external circumstances,
s/he still has the choice of how s/he will respond to those
circumstances.

• Some situations cannot be changed, and present the individual

with definite limitations. Human freedom has some boundaries
which are absolute, and the individual needs to take these into
account, to recognise the consequences of her/his actions.

Dimensions of the client’s world view

The existential approach holds that there are several dimensions on

which each individual’s world view and values need to be clarified. In
the original existentialist writings, there were three dimensions; more
recently, a fourth has been added. In each area, the individual
encounters both possibilities and limitations.

1. The natural world (Umwelt)

The physical environment in which the individual functions includes
both her/his own physical body and the wider environment, e.g.
climate, living conditions. The counsellor might explore how the client
relates to her/his own body, how s/he experiences physical sensations,
hunger, illness, sex, etc. The counsellor might also explore how the
client relates to the natural world around her/him: feelings about
particular climactic or weather conditions, rural or urban
environments. While many aspects of this dimension are beyond the
client’s control, the counsellor will look for ways in which the client’s
attitudes and beliefs influence or limit her/his approach to life.

2. The public world (Mitwelt)

This dimension is concerned with how the client deals with everyday
social interactions and relationships. Again, there will be some
limitations that cannot easily be changed, e.g. social and cultural
conditions. But again, there will be many ways in which the client can
take responsibility for her/himself. Issues of power, competition,
belonging, social roles, acceptance and rejection, are key dilemmas in
this dimension.

3. The private world (Eigenwelt)

This is the area of the client’s inner world, her/his relationship to
her/himself and also with intimate others. The counsellor encourages
the client to become aware of her/his personality and characteristics,

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strengths and weaknesses, values and desires. Only when the client’s
inner world is securely established can s/he form truly intimate
relationships. Many relationships fail because they slip back from the
inner world to the public world; partners come to relate to each other
superficially, within social roles, because the task of true intimacy is
too threatening. True intimacy, or the I-thou relationship (Buber), is
the encounter between two individuals who know their inner worlds,
know that they are different from each other, and are willing to take
the risk of intimacy whilst still knowing that we are each ultimately
alone.

4. The ideal world (Uberwelt)

This is the dimension that represents the individual’s ideas and beliefs
about life, the world, her/himself. For some people, this may be a
religious or spiritual belief system. Existential counselling aims to
clarify the client’s beliefs and ideals, which s/he may be unaware of,
and to explore their implications for the individual. “Understanding the
ideal world of a person means grasping how this person makes sense
of the world and what it is she lives for and would be willing to die for”
(Van Deurzen-Smith, 1988:98). The existential counsellor is concerned
that the client discovers and clarifies her/his own values, whatever
they may be, in order to establish her/his basic motivations in life.
Once the individual has understood and formulated her/his
fundamental beliefs, the s/he has a clearer understanding of the
choices s/he faces, the values s/he wants to live by, and the
possibilities and limitations that follow from this.

The aim & tasks of existential therapy

The aim of existential counselling is to gain mastery over the art of

living, so that life’s challenges can be welcomed and enjoyed instead
of feared and avoided.
[Van Deurzen-Smith, 1988: 22]

Existential therapy encourages clients to face their basic existential

anxiety, to clarify their personal values and goals, and to make a
commitment to living authentically.

The existentialist counsellor undertakes a sequence of tasks in

collaboration with the client (Van Deurzen-Smith, 1988: 44-45):

• Points out to the client the ways in which the client tries to avoid
existential anxiety and opt out of authentic living

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 • Encourages the client to face her/his existential anxiety
• Assists the client to understand the significance of the anxiety
• Explores constructive ways to rise to the challenges posed by the
anxiety

These stages will be repeated for each instance of the fundamental

dilemmas that the client brings to therapy.

The counsellor’s role is to assist the client in clarifying and

understanding her/his personal world view, her/his values and aims in
life. The counsellor endeavours to accept the client’s values and
choices as that person’s unique way of understanding the world. The
counsellor’s fundamental belief is that the client is able to tolerate
existential anxiety and has the resources within her/himself to create
her/his own life. However, the counsellor does not (in contrast with the
humanistic approach) necessarily believe that the client will make
positive changes or “self-actualise”.

“The existential position is that people may evolve in any direction,

good or bad, and that only reflection on what constitutes good and bad
makes it possible to exercise one’s choice in the matter…. The
existential counsellor is less certain [than the humanistic counsellor] of
human goodness and she will count on people’s weakness as well as
on their strengths.”
[Van Deurzen-Smith, 1988: 56-57]

Counselling Relationship & Skills

Only a counsellor who is genuinely and passionately concerned with

human nature and with the difficult task of living in the human
condition will be capable of honest neutrality.
[Van Deurzen-Smith, 1988: 107]

Clients do not get pampered by existential counsellors.

[Van Deurzen-Smith, 1989: 114]

The existential counsellor adopts an attitude of open-minded interest

in the client and in the client’s views and values. The counsellor needs
to have breadth of life experience, philosophical understanding, and a
clear perspective on her/his own views about life and living. The
counselling relationship is based on mutual respect: The counsellor
respects the client as a human being who is already living as
authentically as s/he is able to, but needs assistance in re-evaluating
her/his life; the client sees the counsellor as someone who has

Helen Hayes 8 March 1999

experience and expertise in the art of living, and who will give the
client assistance and encouragement in a professional relationship.

For the existential counsellor, it is not enough to deal with the

presenting, surface, problems, to relieve symptoms, to analyse past
experiences, or even to express emotions. The real work is to look
beneath these, to explore what they mean to the client in her/his
present life. The counsellor may ask challenging questions: “What is it
that you find meaningless in your work?” “Why do you think that was
the wrong decision?” “What would fulfilment mean to you?” “What do
you think is important in your life?” “What makes you sad about the
situation?” Because this is a challenging approach, it is important that
the counsellor’s attitude of respect, tolerance and genuine interest is
clearly conveyed, so that the client does not feel attacked or
undermined.

Conclusions

The existential approach to counselling is challenging, to both

counsellors and clients. It demands of us that we remove the blinkers
that we often adopt to avoid facing the basic dilemmas of the human
condition. it demands that we confront, honestly and without evasion,
the awfulness of knowing that we are ultimately alone in a world that
has no meaning except the meaning that we create for ourselves, that
we owe it to ourselves to decide our own values and commit ourselves
to living by them, and that no matter how hard we struggle to exercise
our freedom, we will come up against obstacles that may defeat us,
including the final obstacle of our death. In return for our courage in
struggling to face the tragedy of human existence, we gain the skill of
living authentically.

Authentic living is about following one’s own personal direction, while

taking the limitations of the situation and of oneself into account. It
means never taking the path of least resistance. It always means
going in the direction that one’s conscience dictates and gaining the
strength to persist, no matter what, from the sense of reality and
aliveness that comes with being in tune with one’s own purpose and
intentions. This process always includes the experience of defeat and
the recognition of limitations.
[Van Deurzen-Smith, 1988: 53-54]

Only when people stop trying to be cured of life or change it do they

become truly alive. Only then, when they begin to be ready for the
recurrent challenges, crises and troubles, so they start to be open to

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the depth of experience and reality that comes with a true
commitment to existence. It is then that they discover, with surprise
and wonder, that in spite of all their distress, worry and suffering, life
is ultimately full of promise and eminently worth the effort of living it.
The most gratifying task of the existential counsellor is to assist people
in their struggle to live such a worthwhile like. In this process both
counsellor and client will constantly be reminded that earth is a place
somewhere between heaven and hell, where much pain and much joy
is to be had and where some degree of wisdom can make all the
difference.
[Van Deurzen-Smith, 1988: 238]

References

Macquarrie, John, Existentialism, Penguin, 1973

May, Rollo, The discovery of being: writings in existential psychology,
Norton 1983
Van Deurzen-Smith, Emmy, Existential counselling in practice, Sage,
1988
Yalom, Irvin, Love’s executioner and other tales of psychotherapy,
Bloomsbury, 1989

Helen Hayes 10 March 1999