The Existential 'Givens of Existence' in Practice
Yalom
(2002) once noted that although “the physicality of death destroys us, the idea
of death may save us” (p. 129). He later went on to assert that the “four
fundamental facts of existence” (p. 140) include isolation, freedom, death, and meaninglessness. Corey (2013) noted that existential anxiety (i.e. the
“inevitable unease” (van Deurzen, 2002, p. 34) that follows one’s awareness of
oneself, the finitude of existence, and the fact of freedom; Iacovou, 2011) occurs
when one is confronted with these “givens of existence” (p. 140). In
psychotherapy these existential givens manifest themselves in a variety of
situations. van Deurzen (2005a) wrote that the role of an existential therapist
was to search for “underlying unifying concerns” (p. 277) that presented
themselves in a client’s story, and to draw the client’s attention to any
inevitable tensions that may be apparent in order for the development of higher
self-awareness and learning. This, in turn, may serve as a catalyst for
positive change and development within the client through self-actualising
behaviour. This essay describes the recent literature that elucidates these
four ‘facts of life’ as they apply to existential psychotherapy using a number
of case examples where these themes were deliberated upon, and a foundation
implemented for ongoing existential development in the client.
Yalom
(2002) wrote that although death is so central to our existence many therapists
choose to bypass direct discussion of one’s relation to this phenomenon. He
asserted that some therapists might rather work with the tangible concerns of
everyday life rather than involve themselves to deep discussion of themes that
are outside one’s locus of control. Other therapists, Yalom noted, might not
attempt to examine death if the client was not the one to initially advance
such discussion. However, he cautions against the notion of avoiding discussion
of death simply because it might not be a palatable theme to deliberate upon.
He asked, when we consider “the centrality of death in our existence… how can
we possibly ignore it?” (p. 128). Similarly, to van Deurzen (2005b) death is
the most central philosophical theme in existential psychotherapy. In order to
“rise to the challenges of human living” (p. 5) we must accept our own final
predicament. Within the context of the therapeutic process death is the great
equaliser. Corey (2013) posited that once a client fully realises that they are
mortal they understand that they do not have an endless expanse of time in
order to accomplish their goals. This realisation has the potential to be “the
source of zest for life and creativity” (p. 142). Through a client’s
meaning-making abilities and discussion of core existential themes such as
death, he or she is able to succeed is shaping themselves into the person they
would like to become. It is this meaning-making ability intrinsic to each
individual we shall turn to now.
To
Frankl (2012) logotherapy was a therapeutic approach that had its centrality in
the search for meaning. Logotherapy was developed to supplement psychotherapy –
to approach psychotherapy in “spiritual terms” (i.e. spiritual in the sense of
our relation to the unknown, values and ideals, and our ideologies and
philosophies; p. 38). For Frankl the most powerful motivating factor was one’s
“will to meaning” (Corey, 2013, p. 131). In existential psychology, living
authentically is an outcome of one’s establishment of one’s own subjective
meaning and thus living accordingly (Jacobsen, 2007). Sartre (1943) noted that
when one is living inauthentically they are living in ‘bad faith.’ These
individuals can be understood as having an external locus of control in that
their ‘way of being’ is determined by things outside of themselves (e.g.
culture and society). Yalom (2002) considers the formulation of subjective
meaning as one of life’s major tasks. He noted that humans are “meaning-seeking
creatures” which have been thrust “into a world devoid of intrinsic meaning”
(p. 136). Frankl may have disagreed with Sartre and Yalom in that he did not
believe that one must accept the suggestion that one is at bottom devoid of
objective meaning, but that one may believe in an ultimate meaning that
transcends oneself – however, Frankl did assert that this might be the job of a
theologian to distinguish rather than a psychiatric professional (Iakhan90,
2011). Frankl also understood that the will to meaning could only be
established given one’s freedom of the will, sense of responsibility, and the
ability to choose (Corey, 2013; Iakhan90, 2011).
Logotherapy was at bottom a brand of psychotherapy that emphasized
one’s search for values and meaning, and one’s sense of responsibility to act given
their freedom of the will (Corey, 2013). Upon reflecting on his experiences in
one of the Nazi concentration camps Frankl maintains that “the last of human
freedoms [is] to choose one’s attitude in any given set of circumstances, to
choose one’s own way” (p. 104). As one might observe, a few existential themes
work together with the concept of freedom. Freedom of the will implies that one
has the choice to act on the freedom that one finds within oneself. This choice
to act also carries with it a sense of responsibility as to the extent of
perceived benefit in the person and his surroundings, or to his deficit. Adams
(2013) noted a personal freedom paradox in that as one acknowledges that one is
vulnerable and weak he or she could evolve a sense of responsibility and
strength. Freedom is a consequence of being. Not only is freedom a fact of
life, but when one understands that they are evidently free, this realisation
might serve – much in the same way as all other existential ‘givens of life’ –
as a catalyst for productive change in one’s life. As Tolstoy noted, “We don’t
reach freedom searching for freedom, but in searching for truth. Freedom is not
an end, but a consequence” (Gabriel, 2013, p. 104).
Echoing
the interrelatedness of freedom of the will, personal responsibility, and
choice, Mooren (2013) delved into the ‘spiritual’ world of inmates in
correctional facilities in order to explore a number of aspects of experience
as understood in existential terms. He noted that when an individual can
“actualise existential themes” (i.e. gain a greater self-awareness that can
help one realise their own potential) such as freedom and responsibility through
past, present and future choices, he or she demonstrate “existential
development” (p. 283). For inmates, existential development can only proceed
once one realises the paradox that although they may be free in the ontological
sense, they do experience the limitations and constraints of being
incarcerated. For the general population this means that although, like inmates
in a penitentiary, we are ontologically free, we do experience various
constraints imposed on us such as the adherence to a certain legal system, our
biological sex, one’s own culture and family unit, and so on. Once we
understand this paradox and demonstrate that we are able to reflect on what
this might mean for our own life can we understand our sense of freedom,
responsibility, and choice and thus act in a self-actualising way.
The
ways these ‘existential givens’ relate to psychotherapy are many and varied. However,
to begin with, the degree of client authenticity (in the existential sense as a
mode of existence) can be asserted as
a necessary precursor to one’s growth and understanding of a number of
existential themes as they relate to one’s own life. As Heidegger put it, only
once an individual understands that he or she is “in the world” (i.e. in an
“ontological mode” of existence) and are not, at bottom, the product of others’
expectations could existential development begin (Corey, 2013, p. 129; Yalom,
2002, p. 130). Regarding the application of thematic dialogue concerning death,
isolation, meaninglessness, and freedom (herein lying discussion around
responsibility and choice) one can begin with death.
When
Janice was not envious of other young new mothers (given she could not bear
children herself) she was preoccupied with death – she thought about dying “all
the time” (Yalom, 2002, p. 133). Once Yalom explored this theme with her in
greater depth she was able to understand that her fear of death brought about
emotions regarding the guilt of leaving her mother as she was dying of breast
cancer. This brought about an even deeper exploration of her longing to have children
in order for her not to die alone. Janice opened up about her jealousy
regarding the pregnancy of friends and how this had negatively affected her
friendships. Once exploring this briefly she also made note that – immediately
after Yalom questioned her about what else she thought of when she was not
thinking about having babies – death was constantly on her mind. Thus the theme
was explored in necessary depth in order to understand her story in a more
holistic manner. Without her dialogue regarding her fear of death she might not
have engaged in a deeper discussion and thus may not have come to a realisation
of her ‘emptiness’ and sense of isolation as it manifested in her ruminations
about death.
Similar
to Janice, Molly also exhibited a sense of isolation (among other significant
presentations) when speaking to van Deurzen (2005c) about her feelings that
“other people did not want her there, because she had really nothing to
contribute” (p. 284). Molly later discussed her engagement in self-harming as
an attempt to remind herself that she was still alive rather than a wish to
complete suicide. This was in a sense a personal paradox given that she
regarded her body as her only true friend, yet “she was hesitant to be a good
friend to it” (p. 286). It was only when she agonised about her incongruence in
thought and action that she was able to agree that she would try and stop
harming herself. Within the time van Deurzen and she spent together attempting “get
a better picture of Molly’s life world” (p. 291) Molly was able to realise that
she could see herself as giving to other children the comfort that she had
always craved, leading her to contemplate becoming a teacher or carer as
opposed to a businesswomen (as her partner had been urging her to be). Understanding
this sense of isolation propelled her to realise that it was comfort that she
needed, and this could be attained through her giving back to others in
potentially pursuing a teaching or caring career. van Deurzen described this
realisation as a “crucial insight that moved her forward” (p. 291). Molly was
thus able to take ownership of herself and decide where she wanted to go with
her life – authentically – rather than succumbing again to the expectations of
others.
Regarding
meaning making in cancer-related bereavement, MacKinnon et al. (2013) discuss
the danger of noogenic origin (or neurosis): A construct described by
Frankl (1981) as the psychological distress when one loses a sense of meaning
in life. To Frankl, only once a client is able to engage in a meaning making
process that includes creative
contributions to the world, experiential
processes of one’s being in the world, and attitudinal
responses to phenomena outside ones locus of control, can they hope to experience
any sense of existential development and thus a greater life satisfaction
(Frankl, 1981). Yalom (2002) described his experiences of working with
terminally ill patients as rewarding given that many patients achieved positive
and significant personal change through the process of dying. He noted that
many would say “‘But what a pity… that we had to wait until now, until our
bodies are riddled with cancer, to learn how to live.’” (p. 130). Using Joan
(recently bereaved of her husband to cancer) as an example, one could observe
her possible benefit in meaning making through the context of an existential
framework (MacKinnon et al., 2013). Through Joan’s derivation of meaning after
the death of her husband she may engage in creative engagements and activities
that might serve as a “buffer against the difficult aspects of the loss” (p.
226). That is, she need not ruminate on the belief that she should not enjoy
herself or give back to society because this may not be honoring her late
husband in some way, but rather work towards the belief that given her freedom
to act and meaning that could be derived through any given action she would
adjust to her new world in a beneficial rather than a self-deprecating manner.
Finally,
regarding one’s road to freedom in existential therapy, Gabriel (2013)
described the case of Sara and her struggle in her relationship with her
girlfriend Marta. A critical episode in therapy in which Marta was infuriated
with Sara’s delayed text message prompted further discussion as to Sara’s
habits in terms of her missed sessions with Gabriel and her delayed
correspondence as to why she could not make it. Being abused by her uncle earlier
in life (her parents had forced her to go to his home periodically regardless
of her not wanting to), Sara and Gabriel were able to uncover that one of the
main reasons for her distance towards others was her fear of being trapped. She
did not want to be backed into a corner as she had been when she was younger,
and this realisation propelled her into further discovery of herself in that
she eventually separated with Marta and pursued a relationship with a man
called Pedro. Her recognition that she was not living in accordance with her
wishes, and the only way to live authentically was to leave the somewhat dependent
relationship she was in with Martha brought about sense of freedom and
liberation in her life. Sara ended the therapy by asserting that she liked,
little by little, to feel as though she was the person deciding (thus showing
the importance of choice in the process). Her eventual freedom from the
relationship she had had with Martha – a relationship that at times echoed the
panic she experienced when she was forced to go to her uncle’s house as a child
– was brought about through the acceptance and understanding of the anxiety she
experienced, and a rational assessment of the repercussions of being stagnant
in an unfruitful relationship. It was an experience that could be described
best by citing Kierkegaard’s vertigo (as cited in Gabriel, 2013), “anxiety is
the dizziness of freedom, which emerges when the spirit wants to posit the
synthesis and freedom looks down into its own possibility, laying hold of
finiteness to support itself” (p. 105).
Yalom,
van Deurzen, Corey, Frankl, and others deliberated upon a number of existential
themes that arise in all individuals; namely freedom of the will, isolation,
meaninglessness, and death. Throughout the body of this essay it was observed
that these themes arise in therapy in a number of ways. From broken
relationships, self-harming, bereavement, and incarceration, one is able to
work through large and complex existential themes that are often ignored when
not looking through an existential lens. Through understanding these themes one
is able to work towards a foundation for self-actualising behaviour, which
strives towards an authentic being. Although a number of paradoxes are evident
when one encounters these themes, one’s meaning making abilities often serve to
work towards existential development in the client. The danger of not erecting
a sense of meaning when faced with a paradox where some subjective meaning was
held before is to enter into noogenic neurosis. Thus, only once these
“underlying unifying concerns” (van Deurzen, 2005a, p. 277) are encountered and
deliberated upon can there be the possibility of existential development in
terms of authentic self-actualising thought and behaviour.
References
Adams, M. (2013). Human development from
an existential phenomenological perspective: Some thoughts and considerations. Existential Analysis, 24(1), 48-56.
Corey, G. (2013). Theory and practice of counseling and psychotherapy (9th
ed.). Scarborough, ON: CENGAGE Learning.
Iacovou, S. (2011). What is the
difference between existential anxiety and so called neurotic anxiety?. Existential Analysis, 22(2), 356-367.
Iakhan90. (2011, October 27). Finding meaning in difficult times
(interview with Dr. Viktor Frankl) [Video file]. Retrieved from
https://www.youtube.com/watch?v=LlC2OdnhIiQ&lc=owbL5ex-WOkKhbLm1zWb29a0c2YetjrkPLwfBtwI8ag.
Gabriel, G. (2013). Roads to freedom – An
existential-phenomenological approach to a psychotherapy journey. Existential Analysis, 24(1), 95-105.
Frankl, V. E. (1963). Man’s search for meaning. Boston, MA: Beacon.
Frankl, V. E. (1981). Will to meaning: Foundations and
applications of logotherapy. New York, NY: Meridian.
Frankl, V. E. (2012). The doctor and the soul: From psychotherapy
to logotherapy. Abingdon, OC: Souvenir Press.
Jacobsen, B. (2007). Authenticity and our
basic existential dilemmas: Foundational concepts of existential psychology and
therapy. Existential Analysis: Journal of
the Society for Existential Analysis,
18(2), 288-296.
MacKinnon, C. J., Milman, E., Smith, N.
G., Henry, M., Berish, M., Copeland, L. S., Korner, A., Chochinov, H. M., &
Cohen, S. R. (2013). Means to meaning in cancer-related bereavement:
Identifying clinical implications for counseling psychologists. The Counseling Psychologist, 41(2), 216-239.
Mooren, J. H. M. (2013). Humanist
counselling and existential communication on moral issues. Existential Analysis, 24(2),
281-296.
Sartre, J. P. (1943). Being and nothingness: A phenomenological
essay on ontology. Paris: Gallimard.
van Deurzen, E. (2002). Existential counselling and psychotherapy in
practice. London, UK: SAGE.
van Deurzen, E. (2005a). The
phenomenological method. In The
interpreted world: An introduction to phenomenological psychology (2nd
ed., pp. 19-34). London, UK: Sage Publications.
van Deurzen, E. (2005b). Philosophical
background. In E. van Deurzen, & C. Arnold-Baker (Eds.), Existential perspectives on human issues: A
handbook for therapeutic practice (pp. 3-14). Hampshire, UK: Palgrave
Macmillan.
van Deurzen, E. (2005c). Conclusion:
Therapeutic work on four dimensions. In E. van Deurzen, & C. Arnold-Baker
(Eds.), Existential perspectives on human
issues: A handbook for therapeutic practice (pp. 277-300). Basingstoke, UK:
Palgrave Macmillan.
Yalom, I. D. (2002). The gift of therapy. London, UK: Piatkus.
Images retrieved from:
http://d75822.medialib.glogster.com/mwilgus93/media/d0/d0a91b6ce40e33adce92386542a542a2f1bd4252/sartre-quote.jpg
http://fc08.deviantart.net/fs71/i/2011/024/b/0/existentialism_wide_format_by_dev_john-d37yakb.jpg
http://www.uri.edu/students/szunjic/philos/snoopy.jpg
http://homebrewedchristianity.com/wp-content/uploads/2012/04/Existentialism.jpg
http://www.australianfinancecentre.com.au/wp-content/uploads/2013/10/pictures-love-freedom-feelings-54292.jpg
http://www.visionnoblesville.com/wp-content/uploads/2012/11/GREEN-GROWTH.jpg
https://www.google.com.au/search?q=meaning&safe=active&es_sm=91&source=lnms&tbm=isch&sa=X&ei=RadPU4HjM4WakQWYloGgBA&ved=0CAgQ_AUoAQ&biw=1152&bih=818#facrc=_&imgdii=_&imgrc=PuvAQskoYGVW5M%253A%3BfEsqUemTn-YhbM%3Bhttp%253A%252F%252Fmarindakotze.files.wordpress.com%252F2013%252F09%252Fsacred-geometry-meaning-of-life-is-te-jpg-37460.jpg%3Bhttp%253A%252F%252Fmarindakotze.wordpress.com%252F2013%252F09%252F05%252Flife-and-its-supposed-meaning%252F%3B1024%3B768
http://marindakotze.files.wordpress.com/2013/09/sacred-geometry-meaning-of-life-is-te-jpg-37460.jpg
