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Unformatted text preview: EMOTIONS & SENSATIONS DIMENSIONS
• • • • • • • • Emotional / physical feelings or combination Overt / covert feelings or combination Positive / negative / neutral feelings In or out of awareness Intensity of feelings Appropriateness for context & stimulus Congruence Helpful or harmful emotions
2/10/2005 Existential Therapy 2 OVERVIEW DIMENSIONS, continued
• Most troublesome are those evident to others but outside our own awareness, especially those unacceptable to others • Congruence: Unity or consistency with which people express their emotions
– Verbal and nonverbal clues to emotions all give the same message
2/10/2005 Existential Therapy 3 IMPORTANCE IN COUNSELING
• Emotions typically lead people into treatment • Must recognize & deal productively with feelings • Helps engender hope & optimism in clients
2/10/2005 Existential Therapy 4 ANALYZING & RESPONDING ANALYZING & RESPONDING,
continued continued • Analysis of emotions along the 8 dimensions • Reflection
– Identifies & feeds back the underlying or important meaning that emotions or experiences have for them – Gives another perspective – Deepens client’s awareness of those emotions client’ – Promotes thought & insight – Lets client know he is heard & understood 2/10/2005 Existential Therapy – Encourages further discussion & self-exploration 5 self- • Reflection of feeling
– Contains a word that labels client’s emotion client’ • Reflection of meaning (content)
– Captures the significance the experience has for the client • Both use language that enhances client’s client’ awareness & demonstrates that therapist is tuned into the client
2/10/2005 Existential Therapy 6 1 ANALYZING & RESPONDING,
continued continued ANALYZING & RESPONDING,
continued continued • Communicating empathy • Empathy • Usually reflections that are inaccurate don’t harm the don’ therapeutic process
– As long as the relationship is open & supportive, enabling client to correct the reflection
2/10/2005 Existential Therapy 7 – Involves feeling deeply connected to people – Being sensitive to the nuances in their words and nonverbal cues – Sensing & almost experiencing their emotions (without losing your boundaries) – Successfully communicating that awareness to the client
2/10/2005 Existential Therapy 8 Existential Therapy EXISTENTIAL THEORIES
A Philosophical/Intellectual Approach to Therapy
• Emphasizes our freedom to choose what to make of our circumstances • Based on assumption that we are free, and therefore responsible for our choices/actions • We are the author of our life – we are what we choose to be
2/10/2005 Existential Therapy 10 Existential Therapy, cont.
• A process of searching for the value and meaning in life • Therapist’s basic task is to Therapist’ encourage clients to explore their options for creating a meaningful existence
2/10/2005 Existential Therapy 11 MAJOR CONTRIBUTORS
• Viktor Frankl in Europe
– Man’s Search for Meaning (1963) Man’ • Rollo May in the US
– The Meaning of Anxiety (1950); Love & Will (1969) • Irvin Yalom in the US
– Existential Psychotherapy (1980) • James Bugental in the US
– The Art of the Psychotherapist (1987) • Clark Moustakas with Children
– Psychotherapy with Children (1959, 1992)
2/10/2005 Existential Therapy 12 2 VIKTOR FRANKL ROLLO MAY 2/10/2005 Existential Therapy 13 2/10/2005 Existential Therapy 14 IRVIN YALOM Development
• Arose in Europe during 1940’s & 1950’s 1940’ 1950’
– Sequalae of the two Great Wars – Pervasive sense of alienation & meaninglessness
• Growing industrialization, urbanization of society • Scientific advances • Response to the need for restoration of their humanness & to help cope with meaningless-ness of life meaningless2/10/2005 Existential Therapy 15 2/10/2005 Existential Therapy 16 Development, continued
• Frankl & May widely read in US during 1950’s & 1950’ 1960’s 1960’ • Existentialism as a treatment has declined, but continues to influence today’s concept of today’ therapist’s role therapist’
– Contributes to realization that therapy is a way to give meaning to lives that lack purpose or fulfillment Dimensions of the Human Condition
• Inevitability of Death
– Fear of our ultimate nonbeing • Existential alienation
– We are ultimately alone • Meaninglessness
– Only certainties are birth & death – Beyond that life is random process – Only we can make sense of it
2/10/2005 Existential Therapy 18 • Theory focuses on the universal issues that people face in today’s world today’
2/10/2005 Existential Therapy 17 3 Dimensions of the Human Condition
• Anxiety & guilt
– Inevitable part of the human condition Dimensions of the Human Condition
• Existential guilt
– When we fail to take responsibility for making our lives meaningful – When we realize that we have not become what we might have become • Existential anxiety
– Deep uneasiness about the givens
• Our existence is finite • We are mortal • There is no purpose but the ones we create for ourselves • Depression results from our efforts to defend against existential guilt & anxiety
– When we avoid the task of making our lives meaningful
2/10/2005 Existential Therapy 20 2/10/2005 Existential Therapy 19 Human Development
• Concentrate on
– Unconscious conflict between wish to escape the givens of the human condition & wish to achieve fulfillment – Emotional difficulties stem from failure to deal successfully with inevitabilities of human condition & to make life meaningful & authentic Dasein
• Being present, being in the world • Acknowledges that humans exist, have consciousness, are responsible for their own existence • One’s ability to simultaneously live in One’ present, be conscious, & take responsibility for making life meaningful, while realizing that death is inevitable
2/10/2005 Existential Therapy 22 • Attend to development thru life span • View life as creating our own continually evolving histories; people are always becoming something new
2/10/2005 Existential Therapy 21 Concept of Mental Health
• “Being in balance & harmony
– – – – With one’s inner-self; one’ innerWith one’s friends, family & colleagues one’ With one’s physical environment one’ With one’s spirituality” one’ spirituality” Potentials of the Human Condition
• Optimistic & hopeful theory • Believe that people have potential to transcend those inevitabilities • Importance of experiencing the unity of self and world • People are not passive victims—they become victims— architects of their own lives • We always have choices always
2/10/2005 Existential Therapy 23 2/10/2005 Existential Therapy 24 4 Potentials of the Human Condition, cont.
– The greater our awareness, the more possibilities that are open to us to address our fears & anxieties – Allows us to recognize life’s limitations & life’ challenges – Allows us to make choices that make these limitations as worthwhile as possible
2/10/2005 Existential Therapy 25 Potentials of the Human Condition, cont.
• Authenticity & intimacy
– The kind of existence human beings have
• When they accept the responsibility for choosing the direction of their lives • When they base those choices on values determined thru increasing self-awareness self- – Taking responsibility for making choices based on awareness
2/10/2005 Existential Therapy 26 Potentials of the Human Condition, cont.
• Authenticity & intimacy, cont.
– 3 essential features (Bugental) (Bugental)
• People are aware of themselves & their relationships with the world • They make choices, knowing that choices, decisions are inevitable consequences of responsibility • They take responsibility for their choices, recognizing that awareness is imperfect
2/10/2005 Existential Therapy 27 Potentials of the Human Condition, cont.
– Freedom & responsibility
• 3 aspects of freedom (Yalom) (Yalom)
– Choice – Action – Change • Brings with it responsibilities
– To be aware of self & own options – To consider past history & future potential – To exercise courage & thought in making changes & choices
2/10/2005 Existential Therapy 28 Potentials of the Human Condition, cont.
– Self-Actualization Self• Each has an essential nature, part universal & part unique (Maslow) (Maslow) • A natural process leading toward growth & fulfillment • Failure to achieve results in feelings of shame, defeat, anxiety, perception of life as meaningless
2/10/2005 Existential Therapy 29 2/10/2005 Potentials of the Human Condition, cont.
– Making meaning
• Life has potential to be meaningful if we use capacities to bring purpose, worth, & meaning into our lives • Meaning is the purpose & logic of our lives • Because life is a process, we are constantly evolving, becoming more fully ourselves, & making meaning
Existential Therapy 30 5 Existentialism: A Dynamic Therapy
• Freud’s dynamics involved an Freud’ instinctually driven being at war with a world that prevents the satisfaction of the innate aggressive and sexual drives • Neo-Freudians stressed conflict Neobetween child’s inner press toward child’ growth, mastery & autonomy vs. his need to receive acceptance & approval from important adult
2/10/2005 Existential Therapy 31 A Dynamic Therapy, continued • Existentialists see the conflict as being between the individual and the “givens” or ultimate concerns of all human beings
2/10/2005 Existential Therapy 32 Existential“Ultimate Concerns”
• DEATH • FREEDOM • ISOLATION • MEANINGLESSNESS
2/10/2005 Existential Therapy 33 DEATH
• A core of inner conflict is between the awareness of inevitable death and the simultaneous wish to continue to live • One of the child’s major developmental child’ tasks is to deal with the terror of oblivion • To cope with this terror, we erect defenses of denial against death awareness
2/10/2005 Existential Therapy 34 FREEDOM
• Conflict issues from our awareness of freedom and groundlessness vs. our deep need and wish for ground & structure • Freedom: The human being is responsible for and the author of his/her own world, own life design, own choices and actions
2/10/2005 Existential Therapy 35 ISOLATION
• Conflict between the awareness of our fundamental isolation and the wish to be protected, to merge and to be part of a larger whole • Existential isolation: No matter how closely we relate to another person, there remains a final unbridgeable gap; each of us enters existence alone and must depart from it alone
2/10/2005 Existential Therapy 36 6 MEANINGLESSNESS
• Conflict: How does a being who requires meaning find meaning in a universe that has no meaning? • Humans are neurologically “wired” to wired” organize incoming stimuli into meaningful patterns • From a meaning schema we generate a hierarchy of values, a blueprint for life conduct
2/10/2005 Existential Therapy 37 TREATMENT: Goals
• Fundamental Goal: Help client find value, meaning, & purpose in life • Purpose:
– To help client become aware of what he is doing – To get him out of the victim role • Therapist helps client confront his deepest fears & anxieties about the inevitable dimensions of life
2/10/2005 Existential Therapy 38 TREATMENT: Goals, cont.
• Treatment also helps client
– Become aware of the freedom he does have – Recognize his options – Make choices that will lead him toward self-actualization & selfmeaningfulness in life
2/10/2005 Existential Therapy 39 TREATMENT Goals, cont. INCREASED AWARENESS IS THE CENTRAL GOAL OF EXISTENTIAL THERAPY
2/10/2005 Existential Therapy 40 Therapeutic Alliance
• Primary vehicle for facilitating change • Therapist has great responsibility
– Be clear about own values – Express own values & beliefs – Give advice – Use humor – Make suggestions & interpretations – Allow client the freedom to determine how he will use this input
2/10/2005 Existential Therapy 41 Therapeutic Alliance, cont.
• Therapist is a fully alive human companion for the client
– Must be with the client as fully as possible – Must communicate respect, support, encouragement, & concern – Must be genuine, open & available 2/10/2005 Existential Therapy 42 7 Therapeutic Alliance, cont.
• Martin Buber: Levels of relationship Buber:
– I to I – I to it – It to it – We to we – Us to them – I to you – I to thou: People have the deepest respect for each other and a great sense of relatedness
2/10/2005 Existential Therapy 43 Therapeutic Alliance, cont.
• I-Thou relationship: Where the core of me meets the core of you (Buber) (Buber)
– Most profound & meaningful – Therapist truly sharing journey with client & empowering client thru this strong & honoring therapeutic connection – Therapist is open to continued learning & awareness, because existential helping operates at an intense level of involvement 2/10/2005 Existential Therapy 44 Process of Treatment
• Not problem- or crisis-focused problem- crisis• Begins with promoting therapist’s understanding therapist’ of client & client’s awareness of self & world client’ • Continues with enabling client to use this information to find meaning in his life, develop sense of purpose & value his life • Closes when client is able to implement his awareness of self & move forward to establish a more meaningful life
– Termination can be reminder of inevitability of endings
2/10/2005 Existential Therapy 45 INTERVENTIONS
• Primary intervention: Use of the person of the therapist & I-Thou relationship I• Being in the World
– Important for therapist to understand client’s client’ objective & subjective world – 3 modes of being
• Being in the physical world • Being in the world of interpersonal relationships • Being in the personal & psychological world – Important to focus on interaction of all 3 modes, helping client keep them in balance (May)
2/10/2005 Existential Therapy 46 INTERVENTIONS, cont.
• Symbolic Growth Experience
– Peak experiences: Intense experiences in promoting learning & growth (Frankl, (Frankl, Maslow) Maslow) – SGE is conscious recognition & interpretation of the symbolic dimensions of an immediate experience leading to heightened awareness, discovery of meaning, & personal worth (Frick)
2/10/2005 Existential Therapy 47 INTERVENTIONS, cont.
• Symbolic Growth Experience, cont.
– Client is educated about concept of SGE – He selects important past experience & explores its importance & symbolism in his life – Is helped to clarify meaning of the experience – Has a clearer sense of meaning & is able to repeat his use of these strategies to understand significance of other experiences 2/10/2005 Existential Therapy 48 8 INTERVENTIONS, cont.
• Paradoxical Intention
– Victor Frankl’s Logotherapy: “therapy through Frankl’ Logotherapy: meaning” meaning” – To break cycle of fear increasing fear
• Therapist urges client to do or wish for the very thing he fears most INTERVENTIONS, cont.
• “Telling the story”: Life Myth Exploration story” • Sharing existence in the moment: Presence • Centered awareness of being • Self-responsibility: Ownership Self49 2/10/2005 Existential Therapy 50 • Dereflection
– Tells client to focus less on self & more on finding meaning outside of self
2/10/2005 Existential Therapy INTERVENTIONS, continued
• Dream Work • Working through resistances • Confronting existential anxiety • Sustaining changes in being APPLICATION
• Themes of meaningfulness, authenticity, freedom, responsibility, spirituality have great relevance for all clients
– Importance of having a sense of meaning that transcends our immediate & finite lives 2/10/2005 Existential Therapy 51 2/10/2005 Existential Therapy 52 APPLICATION, continued
• Applicable to people who
– Are coping with life-threatening & chronic lifeillnesses – Have suffered losses of all kinds – Have challenging limitations in their lives – Are at a crossroads & are looking for direction APPLICATION, continued
• Applicable to diagnostic groups
– Clients coping with relatively mild disorders that do not need rapid relief
• Longstanding, pervasive anxiety (Generalized Anxiety Disorder) • Depression (Dysthymic Disorder) (Dysthymic – Milder personality disorders after other forms of treatment
• Dependent, Avoidant, Narcissistic ??, Histrionic • Applicable over cultures
– “A universal philosophy of humankind” humankind”
2/10/2005 Existential Therapy 53 – Chronic or recurrent mental disorders when symptoms are in remission
2/10/2005 Existential Therapy 54 9 EVALUATION
– Relies heavily on developing strong clientclientclinician relationship & verbal communication – Therapist offers little structure or direction – No offer of specific steps or strategies for intervention in therapy – Leisurely & lengthy process of treatment EVALUATION, continued
– Philosophy of human development that can be infused into other systems of treatment • CONTRIBUTIONS
– Emphasis on importance of collaborative, respectful, authentic client-clinician relationship client– Extended therapy beyond pathology & symptoms – Legitimized inclusion of deep & philosophical issues – Paradoxical intention used in many treatment approaches
2/10/2005 Existential Therapy 56 2/10/2005 Existential Therapy 55 CONTRIBUTIONS, cont.
• Helped bring the person back into central focus • Concentrates on central facts of human existence: Self-consciousness & our consequent freedom Self• Provides a new positive view of death – Death gives life its meaning • New understanding of anxiety, guilt, frustration, loneliness, alienation • Provides framework for understanding universal human concerns • Emphasis on human quality of therapeutic relationship
2/10/2005 Existential Therapy 57 10 ...
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- Spring '08