Psychotherapies
EXISTENTIAL Existential APPROACHES
Way of thinking about humans and about life that may be applied to other psychotherapy approaches Closely linked to European Existential Philosophy:
Dilemmas of contemporary life isolation, alienation and meaninglessness Importance of subjectivity we create our values, our lives, ourselves Truth depends on the existing person, in a given situation and in a given time Freedom to be ourselves implies responsibility
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European Existential Philosophers
Kierkergard
angst - dread and anxiety related to uncertainty in living
Nietzsche
Values are within the individual
Sartre
Freedom to be what we choose and related responsibility
Buber
Stressed the I/Thou Relationship less individualistic
Biswanger
existential analyst, emphasized subjective and spiritual dimensions
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Existentialists in Psychology
Viktor Frankl
Logotherapy logo = meaning Book Mans Search for Meaning Nietzsche He who has a why to live for can bear with almost any how.
Rollo May
Book - Existence: A New Dimension in Psychiatry and Psychology
Irving Yalom
Book: Existential Psychotherapy
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Basic Dimensions of the Human Condition
Capacity for self-awareness Freedom and responsibility Creating ones identity and meaningful relationships with others Search for meaning, purposes, values and goals Anxiety as a condition for living Awareness of death and non-being
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Theory of Personality
Dynamic Model Forces in conflict
The need of the individual to survive and assert his/her being vs. conscious and unconscious fears that arise from the:
Givens of Existence or Ultimate Concerns
Death Isolation Freedom Meaninglessness
Awareness of Ult. Concerns >>>Anxiety >>> Defense Mechanisms
Ways to deal with the anxiety generated by Ultimate Concerns Provide safety, restrict growth
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Anxiety
NORMAL ANXIETY
Proportionate to the situation Does not require repression Can be used creatively
NEUROTIC ANXIETY
Disproportionate to the situation Tends to be repressed Paralyzes the individual
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Guilt
Normal Neurotic Ethical aspects of behavior Fantasized transgressions toward others, or failure to live up to ones capacities
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Objective of Therapy
Explore anxiety related to the ultimate concerns, which may be partially unconscious Identify mechanisms of defense (symptoms) clients use to deal with existential anxiety Move clients to confront the fear and the pain associated with the ultimate concerns Help clients develop adaptive ways of dealing with existential anxiety
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Freedom vs. Responsibility
We are ultimately responsible for who we are, what we believe in, and how we behave (our decisions and choices) We must make authentic choices rather than blindly follow what has been given to us Anxiety is generated by lifes uncertainty and our fear of making mistakes
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Process of Making Decisions
RESPONSIBILITY >>>>>
Defenses
Displace it to others or to circumstances Deny responsibility e.g. victim role Avoid responsibility e.g. symptoms
WISHING >>>> WILLING >>>> ACTION
Impulsive Behavior
Non-discrimination among wishes
Compulsive Behavior
Driven by ego-alien demands
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Freedom:Therapy
Help client recognize and accept responsibility for making choices Confront responsibility avoidance (wont vs. cant) Encourage clients to connect with their feelings Explore how client contributes to problem situation
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Isolation
Awareness of our intrinsic isolation vs. our desire to be part of something larger and feel protected.
Interpersonal
Lack of social skills, of intimacy
Intra-personal
Estranged from part of ourselves
Existential
Unavoidable At a certain level we are alone
Defense:
Fusion: soften our ego boundaries and become part of another individual, group, or cause
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Isolation: Therapy
Help clients confront their fear of aloneness
Personal growth entails a degree of isolation To create authentic relationships with others we must have confronted and accepted our ultimate isolation
Within the real relationship between client and therapist, client may learn limits and rewards of intimacy
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Meaninglessness
We naturally search for meaning, but we live in a world where there are no intrinsic meanings
We need to construct a sense of meaning for ourselves Blockage of affective experience makes it difficult to create meaning in our life - we need to be able to WISH Meaning is usually found when we look beyond ourselves and meeting our material needs A sense of meaning is related to our values that tell us why we live and how to live 15
Meaninglessness: Therapy
May not be an issue for all clients Personal growth Boundary situations Depression Help clients connect with their affective selves, to discover inner sources of motivation and meaning Help clients get engaged in life activities
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Death
Fear of self-destruction considered a primary source of anxiety We develop strong defenses against death awareness denial, reaction formation Awareness of death meaning gives to our life
enhances the importance of the present moment leads us to live more fully
Boundary situation experience or event that propels the person to face an existential situation e.g. terminal illness or death of a loved one
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Defense Mechanisms
Awareness of Ult. Concerns >>>Anxiety >>> Def. Mechanisms Drive >>> Anxiety >>> Def. Mechanism Defense mechanisms provide some temporary relief, but they restrict growth Existentialists ascribe to the defense mechanisms that were proposed by Freud
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Psychotherapy : Goals
Main goal is to help clients
increase awareness about themselves and how they are living confront their anxieties and fears re-define themselves and their world in ways that lead to a more authentic life
Main vehicle of therapy is an authentic, real relationship with therapist
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Psychotherapy: Relationship
Therapy is a journey taken by therapist and client
The person-to-person relationship is key The relationship demands that therapists stay in contact with their own phenomenological world Therapist must distinguish between transference and the actual, real relationship (they co-exist).
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Psychotherapy: Relationship
The core of the therapeutic relationship
Respect and faith in the clients potential to cope Sharing reactions with genuine concern and empathy Focus on the here-and-now experience in the therapeutic relationship
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Psychotherapy: Techniques
Paradoxical intention prescribing the symptom to help clients gain more control of their behavior Situational reconstruction think of three ways in which a situation could be better and three ways in which it could be worse to help people move on from the place they are stuck Compensatory self improvement work on areas that you have control when you are in a situation you don't control
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Contributions
Provides new dimensions to the understanding of death, anxiety, guilt, loneliness, and alienation Emphasizes the person's freedom and responsibility in designing their own lives Importance placed on the human quality of the therapeutic relationship
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Contributions
Philosophical orientation applicable regardless of counselors theoretical orientation Particularly useful to understand issues presented by clients who may be confronting existential crises
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Limitations
Lacks a systematic statement about principles and practices of psychotherapy Does not lend itself to empirical research Concepts are abstract and difficult to apply in practice
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Gestalt
Existential & Phenomenological it is grounded in the clients here and now Initial goal is for clients to gain awareness of what they are experiencing and doing now
Promotes direct experiencing rather than the abstractness of talking about situations Rather than talk about a childhood trauma the client is encouraged to become the hurt child
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Frederick Perls 1893-1970
Born in Germany, Psychiatrist and psychoanalyst Emigrated to U.S. in 1946 and broke form psychoanalyt...