The Influence of Existentialism on Therapeutic Practice

How philosophy can be a tool to frame the therapeutic work

by Alix Ibar

The relatively new science of psychology is constantly developing, far from the prejudices that are sometimes attributed to it. The plurality of visions and teachings in psychology is quite unknown, this article is an introduction to the existentialist approach to therapy.

Irving D. Yalom, a prominent psychiatrist and psychotherapist, has been a pioneer in the realm of existential psychotherapy and the integration of philosophy into clinical practice. He has also been one of the first psychiatrists to explore the possibilities of group therapy, believing that empathy can be a strong tool for self-understanding. The book “Existential Psychotherapy”, published in 1980, has become a cornerstone for mental health professionals seeking a profound understanding of existential principles and their application in therapeutic practice. Meanwhile, it is also an accessible example of the concrete application of the philosophy of Sartre for non-professionals.

Existentialism

Existentialism is a philosophical movement that emerged in the 19th and 20th centuries. One of the foundations of this philosophical movement can be found in this affirmation of Sartre in the book published in 1946 “Existentialism is a humanism” : «Existence precedes essence ». This statement means that individuals exist first, and their essence is determined through their choices and actions. This concept highlights the importance of personal responsibility and the idea that individuals shape their own destinies. His most famous citation : « In life, we cannot do whatever we want, but we are responsible for what we are » is characteristic of the central place that liberty takes in his work.

In life, we cannot do whatever we want, but we are responsible for what we are.

This fundamental principle implies a reflection on liberty as a responsibility of every human being. As liberty is no longer an idealistic goal to reach, but a daily choice that no one can avoid, existentialist philosophers consider it to be the main source of human anguish.

For Irving Yalom, the two main sources of anxiety are death and meaning anxiety. Those two fears are intrinsically linked, in the sense that the fear of death is often motivated by the feeling of not having lived a meaningful life. The application of this philosophy in therapy is a way to bring the patients in front of their own choices and start a reflection to understand what can be changed by the patients themselves.

Existential therapy

In “Existential Psychotherapy”, Yrving Yalom mostly presents some cases of patients that faced near-death experience, he has worked with several terminal cancer patients for a long time, allowing them to confront death peacefully and at the same time, he also gives the reader a chance to understand that it’s never too late to change the perception we have of our own lives.

At the heart of Existential Psychotherapy lies the exploration of fundamental existential themes that shape the human path. Drawing inspiration from existential thinkers such as Kierkegaard, Nietzsche, and Sartre, Yalom delves into the complexities of existence, including the inevitability of death, the pursuit of meaning, the anxiety of freedom, and the isolation intrinsic to human life.

One of the central tenets of Yalom’s existential approach is the idea that therapists and clients engage in a shared exploration of the human condition. Yalom encourages therapists to be involved in the relationship with their patients, embracing authenticity and fostering a genuine connection. Through this process, clients are guided to confront their fears, anxieties, and dilemmas, leading to personal growth and self-discovery.

By using some examples of situations he has been confronted as a therapist, he invites the reader to enter the private space of the consulting room and understand the dynamic of therapeutic work by analyzing not only the reactions of the patient but also his own.

Group therapy

This relationship between the patient and the therapist highlights another fundamental concept of existentialism that Sartre theorizes in the play ”No Exit” (1944) in theses words : « Hell is other people ».

By this sentence, Sartre implies that the only place in life where our freedom is taken away from us, is the look of other people on ourselves. The perception that others have of us is beyond our control. and the desire to change this perception is an obstacle to the freedom we have to shape the person we want to become, by being influenced by the desire that the others project onto us. The way others look at us acts as a distorting mirror, exposing aspects of our personality that we had no knowledge of.

For a therapist, confronting the patient with this mirror can also create a trigger catalyst for change. The mediation of a therapy group implies understanding how to create the conditions for empathy. Thus, allowing each person to transform the way we look at the other, to overcome their judgements and preconceptions, can help the individual question their own assertions about themself.

Conclusion

This therapeutic approach has sparked much debate in the academic community because it is in total opposition to the behaviorist approach to therapy, which is still prominent today. Behaviorists analyze the patient’s individual choices and reactions as a starting point for working on their past in order to understand what drives the patient to act this way. Existentialist therapists consider the individual in his or her present environment, and tend instead to question the instantaneous emotions provided by events and reactions and thus avoid the deterministic pitfall of analyzing the past, in order to focus on future possibilities for improvement.

Recommendations for familiarizing yourself with the work of Irvin D Yalom

Novels:

- When Nietzsche Wept, 1992

- The Schopenhauer cure, 2000

Essays:

- Existential Psychotherapy, 1980

- Love’s Executioner and Other Tales of Psychotherapy, 1989

Show:

- In Treatment, 2008, HBO, directed by Rodrigo Garcia, 4 seasons, 106 episodes of 25 minutes.