How an Existential Approach to the Question of What It Means to Be a Human Being Hinders or Promotes Concern for Humanity
In an approach that is already overflowing with paradoxes, here is yet another – currently, the living therapist and author most often associated with contemporary existential therapy and recognised by professionals and public alike as the leading voice in the field is the American psychiatrist, Irvin Yalom. For example, in a recent survey, over 1,300 existential therapists were asked to name the practitioner who had most influenced them.
Humanistic and existential psychotherapies use a wide range of approaches to case conceptualization, therapeutic goals, intervention strategies, and research methodologies. They are united by an emphasis on understanding human experience and a focus on the client rather than the symptom. Psychological problems (including substance abuse disorders) are viewed as the result of inhibited ability to make authentic, meaningful, and self-directed choices about how to live. Consequently, interventions are aimed at increasing client self-awareness and self-understanding. Whereas the key words for humanistic therapy are acceptance and growth, the major themes of existential therapy are client responsibility and freedom. This chapter broadly defines some of the major concepts of these two therapeutic approaches and describes how they can be applied to brief therapy in the treatment of substance abuse disorders. A short case illustrates how each theory would approach the client's issues. Many of the characteristics of these therapies have been incorporated into other therapeutic approaches such as narrative therapy. Humanistic and existential approaches share a belief that people have the capacity for self-awareness and choice. However, the two schools come to this belief through different theories. The humanistic perspective views human nature as basically good, with an inherent potential to maintain healthy, meaningful relationships and to make choices that are in the interest of oneself and others. The humanistic therapist focuses on helping people free themselves from disabling assumptions and attitudes so they can live fuller lives. The therapist emphasizes growth and self-actualization rather than curing diseases or alleviating disorders.
An existential approach may be helpful to people contending with a broad range of problems, symptoms or challenges. It can be utilized with a wide variety of clients, ranging from children to senior citizens, couples, families or groups, and in virtually any setting, including clinics, hospitals, private practices, the workplace, organizations, and in the wider social community. Because existential therapy recognizes that we always exist in an interrelational context with the world, it can be especially useful for working with clients from diverse demographic and cultural backgrounds. While existential therapy is particularly well-suited to people who are seeking to explore their own philosophical stance toward life, it may, in some cases, be a less appropriate choice for patients in need of rapid remediation of painful, life-threatening or debilitating psychiatric symptoms. However, precisely due to its fundamental focus on a person’s entire existence rather than solely on psychopathology and symptoms, existential therapy can nonetheless potentially be an effective approach in addressing even the most severe reactions to devastating psychological, spiritual or existential disruptions or upheavals in their lives, whether in combination with psychiatric medication when needed or on its own. A range of well-controlled studies indicates that certain forms of existential therapy, for certain client groups, can lead to increased well-being and sense of meaning (Vos, Craig & Cooper, 2014). This body of evidence is growing, with new studies showing that existential therapies can produce as much improvement as other therapeutic approaches (e.g., Rayner & Vitali, in press). This finding is consistent with decades of scientific research which shows that, overall, all forms of psychotherapy are effective, and that, on average, most therapies are more or less equally helpful (Seligman, 1995; Wampold & Imel, 2015), with specific client characteristics and preferences determining the best therapeutic approach for any given individual. There is also a good deal of evidence indicating that one of the core qualities associated with existential therapy – a warm, valuing and empathic client or patient-therapist relationship — is predictive of positive therapeutic outcomes (Norcross & Lambert, 2011). Additionally, existential therapy's central emphasis on finding or making meaning has been shown in general to be a significant factor in effective treatment (Wampold & Imel, 2015).
Summing up,Sartre concludes by portraying existentialism as “an attempt to draw all of the conclusions inferred by a consistently atheistic point of view.” Sartre’s thought is not atheistic because it seeks to disprove God’s existence, but rather because it refuses to think that believing in God would change anything or rescue anyone from the human condition. He closes by reasserting that “existentialism is optimistic” and his critics act in bad faith, “confusing their own despair with ours.” Sartre closes his responses to his objectors by emphasizing that, if there is no God, subjective value is the realest value there is: life is full of the meanings people create through their choices. In fact, this means that people’s active investment in their relationships, accomplishments, and goals is precisely what makes their lives meaningful.
Norcross, J. C., & Lambert, M. J. (2011). Evidence-based therapy relationships. In J. C. Norcross (Ed.), Psychotherapy relationships that work: Evidence-based responsiveness (2nd ed., pp. 3-21). New York: Oxford University.
Rayner, M., & Vitali, D. (in press). Short-term existential psychotherapy in primary care: A quantitative report. Journal of Humanistic Psychology. [Spanish translation published as Rayner, M. y Vitali, D. (2015). Psicoterapia existencial de corto plazo en atención primaria: Un reporte cuantitativo. Revista electrónica Latinoamericana de Psicologia Existencial "Un enfoque comprensivo del ser". N° 11. Octubre.]
Vos, J., Craig, M., & Cooper, M. (2014). Existential therapies: A meta-analysis of their effects on psychological outcomes. Journal of Consulting and Clinical Psychology, 83(1), 115-128. doi: 10.1037/a0037167
Wampold, B. E., & Imel, Z. E. (2015). The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work (2nd ed.). New York: Routledge.