Case Conceptualization using Existential Therapy

Introduction: Existential therapy is rooted in the philosophical traditions of

existentialism, which emphasize the human experience of existence,
freedom, choice, responsibility, and meaning. It aims to help individuals
understand the dilemmas they face as part of their lived experience and
provides them with tools to make authentic choices in the face of life’s
inherent uncertainties (Yalom, 1980). In this case conceptualization, the
therapeutic approach of existential therapy is applied to an individual
presenting with existential anxiety, stemming from feelings of isolation and a
perceived lack of meaning in life.

Client Background:

Name: Sarah

Age: 32

Gender: Female

Occupation: Marketing Manager

Presenting Concerns: Sarah has come to therapy seeking help with her
feelings of loneliness, anxiety, and a lack of purpose. She describes a sense
of emptiness and disconnection from others, including her partner and
family. Sarah reports feeling overwhelmed by the demands of her job and
has difficulty finding joy in her daily activities. She also expresses uncertainty
about the direction of her life and whether her career choices align with her
true passions.

Therapeutic Approach:

Existential therapy, with its emphasis on addressing existential themes, will

guide the exploration of Sarah’s feelings of isolation, freedom, and the
search for meaning. The approach centers on exploring the individual’s
subjective experience and guiding them toward greater self-awareness and
authenticity. This method involves confronting existential anxieties, which
include the fear of death, the burden of freedom, the isolation of human
existence, and the search for meaning (Yalom, 1980).

Conceptualization Using Existential Therapy:

1. Existential Anxiety and Freedom: One of the key elements in Sarah’s

experience is her existential anxiety. According to Yalom (1980),
existential anxiety arises when individuals confront the realities of life,
such as the inevitability of death, freedom, isolation, and
meaninglessness. Sarah’s feelings of being “stuck” in her job and her
lack of enthusiasm about her life’s direction can be linked to her fear of
taking responsibility for making choices. Her existential anxiety stems
from the overwhelming freedom to choose her own path, which also
brings with it the burden of responsibility and the fear of making the
“wrong” decision.

Example: Sarah has worked in marketing for over 10 years, but she finds
herself questioning whether it is the career path she truly desires. Despite
the security it provides, she feels a lack of passion for the field. The
existential dilemma here involves Sarah’s avoidance of fully confronting her
potential to change her career, due to the anxiety associated with making
such a significant decision. Her feelings of isolation are compounded by the
idea that, while she could change her life, doing so requires a painful
acknowledgment of her own freedom to act.

2. Isolation and Loneliness: In existential terms, isolation is not only the

physical separation from others but also the emotional and existential
sense of being fundamentally alone in the world (Yalom, 1980). Sarah
experiences loneliness despite having a partner and friends, because
she feels disconnected from her deeper self and from the lives of those
around her. She has been distancing herself emotionally and mentally
from others, unable to form authentic connections.
Example: Sarah’s romantic relationship has been strained because she feels
she cannot share her inner thoughts with her partner. They live together but
have stopped communicating meaningfully. Her partner often complains
about Sarah’s emotional withdrawal, but Sarah feels that no one could
understand her true feelings of emptiness. This experience reflects her
existential isolation, where she feels alone in her internal struggle.

3. Search for Meaning: A central tenet of existential therapy is the search

for meaning, which involves confronting life’s inherent
meaninglessness and taking responsibility for creating one’s own
purpose (Frankl, 1959). Sarah’s existential crisis can be understood as
a search for meaning in her life. She has been living according to
external expectations (her career and societal definitions of success)
rather than exploring what she truly values and desires.

Example: Sarah often questions why she is working so hard in a job that feels
unfulfilling. She has been pursuing the “American Dream” of financial
stability and professional success but finds little satisfaction. In therapy,
Sarah reflects on her childhood passions and realizes that she had always
wanted to become a writer or work in a creative field. However, the pressure
to meet societal standards of success has kept her from exploring those
aspirations. Existential therapy can help her confront the meaninglessness of
merely existing according to others’ expectations and encourage her to take
steps toward a more authentic life.

4. Responsibility and Authenticity: The theme of responsibility is essential

in existential therapy. Sarah’s struggle with authenticity arises from her
avoidance of acknowledging her own responsibility in creating the life
she wants. The therapeutic process focuses on helping Sarah reclaim
her freedom to make choices and accept responsibility for those
choices. This shift involves encouraging her to confront the limitations
of her current existence and the fact that she has been complicit in
maintaining her dissatisfaction.
Example: Sarah has spent years resenting her job but never made any
significant efforts to explore alternative career paths. She often blames
external factors (her boss, her work environment) for her dissatisfaction.
Through existential therapy, Sarah starts to understand that she holds the
responsibility for staying in this job despite her unhappiness. The therapy
aims to help her recognize her ability to make a different choice and live
more authentically.

Therapeutic Goals:

1. Increase Self-Awareness: Help Sarah identify and confront her

existential anxieties and how they impact her daily life.

2. Encourage Authenticity: Assist Sarah in discovering her true values and

desires, particularly in terms of her career and relationships.

3. Promote Responsibility: Support Sarah in recognizing her freedom to

make choices and take responsibility for the changes she wishes to
make in her life.

4. Foster Connection: Address Sarah’s sense of isolation by encouraging

meaningful and authentic relationships with others.
Interventions:

1. Existential Reflection: Engage in philosophical discussions about death,

freedom, isolation, and meaning to help Sarah confront and
understand her anxieties.

2. Exploration of Values: Use exercises like journaling or guided imagery

to explore Sarah’s childhood passions and interests to reconnect her
with her authentic self.

3. Choice and Responsibility: Guide Sarah in making small, incremental

changes that align with her values, such as taking up writing in her
free time or discussing her feelings with her partner.

4. Relational Work: Explore Sarah’s feelings of emotional withdrawal from

her partner and develop ways to communicate more openly and
vulnerably.

Conclusion:

Through existential therapy, Sarah can begin to explore and accept her
anxieties surrounding freedom, isolation, and meaning. By facing her fears of
making choices and taking responsibility for her life, Sarah can move toward
a more authentic existence. The therapeutic journey will be one of self-
discovery and reclaiming agency over her life’s direction.
References:

Frankl, V. E. (1959). Man’s search for meaning: An introduction to

logotherapy. Beacon Press.

Yalom, I. D. (1980). Existential psychotherapy. Basic Books.

Case Conceptualization using Existential Therapy

Introduction: Existential therapy is rooted in the philosophical traditions of existentialism,
which emphasize the human experience of existence, freedom, choice, responsibility, and
meaning. It aims to help individuals understand the dilemmas they face as part of their lived
experience and provides them with tools to make authentic choices in the face of life's inherent
uncertainties (Yalom, 1980). In this case conceptualization, the therapeutic approach of
existential therapy is applied to an individual presenting with existential anxiety, stemming from
feelings of isolation and a perceived lack of meaning in life.
Client Background:
Name: Sarah
Age: 32
Gender: Female
Occupation: Marketing Manager
Presenting Concerns: Sarah has come to therapy seeking help with her feelings of loneliness,
anxiety, and a lack of purpose. She describes a sense of emptiness and disconnection from
others, including her partner and family. Sarah reports feeling overwhelmed by the demands of
her job and has difficulty finding joy in her daily activities. She also expresses uncertainty about
the direction of her life and whether her career choices align with her true passions.
Therapeutic Approach:
Existential therapy, with its emphasis on addressing existential themes, will guide the exploration
of Sarah’s feelings of isolation, freedom, and the search for meaning. The approach centers on
exploring the individual's subjective experience and guiding them toward greater self-awareness
and authenticity. This method involves confronting existential anxieties, which include the fear
of death, the burden of freedom, the isolation of human existence, and the search for meaning
(Yalom, 1980).
Conceptualization Using Existential Therapy:
1. Existential Anxiety and Freedom: One of the key elements in Sarah’s experience is her
existential anxiety. According to Yalom (1980), existential anxiety arises when
individuals confront the realities of life, such as the inevitability of death, freedom,
isolation, and meaninglessness. Sarah’s feelings of being "stuck" in her job and her lack
of enthusiasm about her life’s direction can be linked to her fear of taking responsibility
 for making choices. Her existential anxiety stems from the overwhelming freedom to
choose her own path, which also brings with it the burden of responsibility and the fear of
making the "wrong" decision.
Example: Sarah has worked in marketing for over 10 years, but she finds herself
questioning whether it is the career path she truly desires. Despite the security it provides,
she feels a lack of passion for the field. The existential dilemma here involves Sarah’s
avoidance of fully confronting her potential to change her career, due to the anxiety
associated with making such a significant decision. Her feelings of isolation are
compounded by the idea that, while she could change her life, doing so requires a painful
acknowledgment of her own freedom to act.
2. Isolation and Loneliness: In existential terms, isolation is not only the physical
separation from others but also the emotional and existential sense of being
fundamentally alone in the world (Yalom, 1980). Sarah experiences loneliness despite
having a partner and friends, because she feels disconnected from her deeper self and
from the lives of those around her. She has been distancing herself emotionally and
mentally from others, unable to form authentic connections.
Example: Sarah’s romantic relationship has been strained because she feels she cannot
share her inner thoughts with her partner. They live together but have stopped
communicating meaningfully. Her partner often complains about Sarah’s emotional
withdrawal, but Sarah feels that no one could understand her true feelings of emptiness.
This experience reflects her existential isolation, where she feels alone in her internal
struggle.
3. Search for Meaning: A central tenet of existential therapy is the search for meaning,
which involves confronting life’s inherent meaninglessness and taking responsibility for
creating one’s own purpose (Frankl, 1959). Sarah’s existential crisis can be understood as
a search for meaning in her life. She has been living according to external expectations
(her career and societal definitions of success) rather than exploring what she truly values
and desires.
Example: Sarah often questions why she is working so hard in a job that feels
unfulfilling. She has been pursuing the “American Dream” of financial stability and
professional success but finds little satisfaction. In therapy, Sarah reflects on her
childhood passions and realizes that she had always wanted to become a writer or work in
a creative field. However, the pressure to meet societal standards of success has kept her
from exploring those aspirations. Existential therapy can help her confront the
meaninglessness of merely existing according to others’ expectations and encourage her
to take steps toward a more authentic life.
4. Responsibility and Authenticity: The theme of responsibility is essential in existential
therapy. Sarah’s struggle with authenticity arises from her avoidance of acknowledging
her own responsibility in creating the life she wants. The therapeutic process focuses on
helping Sarah reclaim her freedom to make choices and accept responsibility for those
choices. This shift involves encouraging her to confront the limitations of her current
existence and the fact that she has been complicit in maintaining her dissatisfaction.
Example: Sarah has spent years resenting her job but never made any significant efforts
to explore alternative career paths. She often blames external factors (her boss, her work
environment) for her dissatisfaction. Through existential therapy, Sarah starts to
 understand that she holds the responsibility for staying in this job despite her
unhappiness. The therapy aims to help her recognize her ability to make a different
choice and live more authentically.
Therapeutic Goals:
1. Increase Self-Awareness: Help Sarah identify and confront her
existential anxieties and how they impact her daily life.
2. Encourage Authenticity: Assist Sarah in discovering her true values
and desires, particularly in terms of her career and relationships.
3. Promote Responsibility: Support Sarah in recognizing her freedom
to make choices and take responsibility for the changes she wishes to
make in her life.
4. Foster Connection: Address Sarah’s sense of isolation by
encouraging meaningful and authentic relationships with others.
Interventions:
1. Existential Reflection: Engage in philosophical discussions about
death, freedom, isolation, and meaning to help Sarah confront and
understand her anxieties.
2. Exploration of Values: Use exercises like journaling or guided
imagery to explore Sarah’s childhood passions and interests to
reconnect her with her authentic self.
3. Choice and Responsibility: Guide Sarah in making small,
incremental changes that align with her values, such as taking up
writing in her free time or discussing her feelings with her partner.
4. Relational Work: Explore Sarah’s feelings of emotional withdrawal
from her partner and develop ways to communicate more openly and
vulnerably.
Conclusion:
Through existential therapy, Sarah can begin to explore and accept her anxieties surrounding
freedom, isolation, and meaning. By facing her fears of making choices and taking responsibility
for her life, Sarah can move toward a more authentic existence. The therapeutic journey will be
one of self-discovery and reclaiming agency over her life’s direction.
References:
Frankl, V. E. (1959). Man’s search for meaning: An introduction to logotherapy. Beacon Press.
Yalom, I. D. (1980). Existential psychotherapy. Basic Books.