Existential Psychotherapy

Existential Psychotherapy

Existential psychotherapy is a style of therapy that places emphasis on the human condition as a whole. Existential psychotherapy uses a positive approach that applauds human capacities and aspirations while simultaneously acknowledging human limitations. Existential psychotherapy shares many similarities with humanistic psychology, experiential psychotherapy, depth psychotherapy, and relational psychotherapy.

Timeline of Existential Therapy

Existential therapy developed out of the philosophies of Friedrich Nietzsche and Soren Kierkegaard. As one of the first existential philosophers, Kierkegaard theorized that human discontent could only be overcome through internal wisdom. Later, Nietzsche further developed the theory of existentialism by introducing the idea of free will and personal responsibility. In the early 1900s, philosophers such as Martin Heidegger and Jean-Paul Sartre began to explore the role of investigation and interpretation in the healing process. Over the next several decades, other contemporaries started to acknowledge the importance of experiencing in relation to understanding as a method to achieving psychological wellness and balance.

Otto Rank was among the first existential therapists to actively pursue the discipline, and by the middle of the 20th century, psychologists Paul Tillich and Rollo May brought existential therapy into the mainstream through their writings and teachings, as did Irvin Yalom after them. The popular approach began to influence other theories, including humanistic psychology and logotherapy, developed by Viktor Frankl. At the same time, British philosophers expanded existentialism further with the foundation of The Philadelphia Association, an organization dedicated to helping people manage their mental health issues with experiential therapies. Other institutions that embody the theory of existentialism include the Society for Existential Analysis, founded in 1988, and the International Community of Existential Counselors, created in 2006.

A man gazes out the window

Existential Psychotherapy 'Givens'

Existential psychotherapy is based upon the fundamental belief that each individual experiences intrapsychic conflict due to his or her interaction with certain conditions inherent in human existence called givens. The theories recognize at least four primary existential givens:

  • Freedom and associated responsibility
  • Death
  • Isolation
  • Meaninglessness

A confrontation with any of the aforementioned conditions, or givens, fills an individual with a type of dread commonly referred to as existential anxiety. This anxiety is thought to reduce a person’s physical, psychological, social, and spiritual awareness, which may lead to significant long-term consequences.

For example, the fact that each one of us and each one of our loved ones must die at some unknown time may be a source of deep anxiety, and this may tempt us to ignore the reality and necessity of death in human existence. By reducing our awareness of death however, we may fail to make decisions that can actually safeguard or even enrich our lives. At the other end of the spectrum, people who are overly conscious of the fact that death is inevitable may be driven to a state of neurosis or psychosis.

The key, according to existential psychotherapy, is to strike a balance between being aware of death without being overwhelmed by it. Individuals who maintain a healthy balance are motivated to make decisions that can positively impact their lives as well as the lives of their loved ones. Though these people may not know how their decisions will actually turn out, they do appreciate the need to take action while they can. In essence, the reality of death encourages us to make the most of opportunities and to treasure the things we have.

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Like death, the threat of isolation, the perceived meaninglessness of life, and the weighty responsibility of making life-altering decisions may each be a source of acute existential anxiety. According to the theories of existential therapy, the manner in which an individual processes these internal conflicts and the subsequent decisions he or she makes will ultimately determine that individual’s present and future circumstances.

Accepting Fears and Overcoming Through Existential Psychotherapy

Existential psychotherapy encourages people to address the emotional issues they face through full engagement and to take responsibility for the decisions that caused them to develop. People who undergo this form of therapy are guided to accept their fears and are given the skills necessary to overcome them through action. By gaining control of the direction of one’s life, the person in therapy is able to design the course of his or her choosing. This creates in the individual a sense of liberation and a feeling of letting go of the despair associated with insignificance and meaningless. Existential psychotherapy involves teaching the person in therapy to grow and embrace his or her own life and to exist in it with wonder and curiosity. By doing so, a person is able to view his or her life experience as a journey rather than a trial, and can eradicate the fear associated with death.

Existential Therapists' Process

Therapists who practice existential psychotherapy do not focus on an individual’s past, rather they work with the client to discover and explore the choices that lie before him or her. Through retrospection, the person in therapy and therapist work to understand the implications of past choices and the beliefs that led those to take place, only as a means to shift to the goal of creating a keener insight into oneself. The emphasis is not to dwell on the past, but to use the past as a tool to promote freedom and newfound assertiveness. By coming to the realization that they are not unique nor are they destined for a specific purpose, the person in therapy is allowed to release the obligatory chains that encumbered him or her from existing in fullness from moment to moment. When that happens, he or she is truly free.

What Mental Health Conditions Can Existential Psychotherapy Treat?

People in therapy who are willing to explore the reasons for their intrapsychic conflicts and the decisions that led to their current circumstances can benefit greatly from existential psychotherapy. There are many behavioral and mental health issues that may be successfully treated with this therapeutic approach, including depression, anxiety, substance dependency, and posttraumatic stress resulting from exposure to military combat, rape, childhood sexual abuse, interpersonal violence, or other life-threatening experiences.

Individuals who respond to treatment tend to find meaning and purpose in their lives and often experience heightened self-awareness, self-understanding, self-respect, and self-motivation. The realization that they are primarily responsible for their own recovery increases the likelihood that people in treatment will see beyond the limits of a therapy session, and view recovery as a therapeutic process.

Common Concerns and Limitations

Existential psychotherapy, much like other types of therapy, may be misunderstood by people who do not have a thorough grasp of the fundamental principles or scope of the associated theories. Common misperceptions of existential psychotherapy include the following beliefs:

  • There is one distinctive, united existential theory which is free of internal tension and covers all the basic assumptions of existential psychology.
  • There is no difference between existential psychology and existential philosophy.
  • Existential psychology takes an antireligious or anti-spiritual approach, for example, denying the existence of God.
  • Existential and humanistic theories are the same thing.
  • Existential psychotherapy involves taking a negative, dark, or pessimistic view of life.
  • The approach is fundamentally an intellectual one.
  • It is only beneficial to people of high intellect, who are not experiencing chronic behavioral or mental health conditions.

Due to the fact that existential psychotherapy targets the underlying factors of perceived behavioral and mental health concerns, these approaches may not directly address the primary issue that the person in treatment is experiencing. As such, existential psychotherapy is often used in conjunction with other treatments in order to maximize its effectiveness and promote recovery. Additionally, the in-depth, penetrative approach used in existential psychotherapy may not appeal to individuals who do not wish to explore their intrapsychic processes, or who are solely interested in finding a quick fix for their mental health challenges.


  1. Center for Substance Abuse Treatment & Substance Abuse and Mental Health Services Administration. (1999). Treatment improvement protocols (tip) series. No 34. Rockville (MD). Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK64939/
  2. Prochaska, J. O. & Norcross, J. C. (2003). Systems of psychotherapy: A transtheoretical analysis, 5th Ed. Pacific Grove, California: Brooks/Cole.
  3. Yalom, I. D. (1980). Existential psychotherapy. New York, NY: Basic Books.


Last updated: 12-12-2016

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