Existential Therapy: History and Principles

Existential Therapy

• A philosophical approach influencing a counselor's therapeutic process
• Emphasizes freedom and responsibility in our choices

Historical Background

• Includes philosophy and existentialism

Soren Kierkegaard (1813-1855)

• Danish philosopher interested in ANGST
• ANGST is a feeling of deep, typically unfocused anxiety about the human condition or the state of the world

Friedrich Nietzsche (1844-1900)

• Emphasized subjectivity
• Focused on will power, potentiality, and creativity

Martin Heidegger (1889-1976)

• Focused on Phenomenological Experience

Jean-Paul Sarte (1905-1980)

• Defined values as what we choose
• Introduced the concept of Bad Faith

Martin Buber (1878-1965)

• Betweenness is important
• "No I, always Other"

Ludwig Binswanger (1881-1966)

• Focused on the Self

Medard Boss (1975)

• Early existential psychotherapist
• Focused on Being-in-the-world

Irvin Yalom (1980)

• Defined Givens of Existence

View of Human Nature

• There is therapeutic practice based on understanding what it means to be human
• Asks, "Who am I? What can I know? What ought I to do? What can I hope for?"

Basic Dimensions of the Human Condition

• The capacity for self-awareness
• Freedom and responsibility
• Creating one's identity and establishing meaningful relationships with others
• The search for meaning, purpose, values, and goals
• Anxiety as a condition of living
• Awareness of death and nonbeing

Capacity for Self-Awareness

• Involves increasing capacity to live fully
• Understanding that we are finite with limited time
• Recognizing the potential to act vs. react and the ability to choose our actions
• Meaning is a product of discovering how we are thrown in this world
• Increasing awareness and sense of responsibility is needed
• We are subject to loneliness, meaninglessness, and emptiness
• We are basically alone
• We see how they are trading the security of dependence for anxiety that accompanies choosing themselves
• People see their identity anchored in someone else
• Learning that they are imprisoning themselves in their own past
• Learning they are not condemned to failure
• Realizing they are preoccupied with suffering and refuse to appreciate life
• Being able to accept their limitations
• Coming to realize they are failing at the present moment

Freedom and Responsibility

• Bad Faith: excuses like "Since that's the way I am made, I couldn't help what I did"
• Sarte stated that we are our choices
• It's important to recognize one's uniqueness and strive to become what one inherently is, rather than losing oneself in a crowd
• Assuming responsibility is a condition for change
• Clients who refuse to accept responsibility by blaming others are not likely to profit from therapy

Striving for Identity and Relationship with Others

• Includes preserving uniqueness and interest in going outside
• Acknowledging the experience of aloneness and relatedness
• Struggling to keep our identity

The Search for Meaning

• Posing questions like: Why am I here? What do I want from life? What gives my life purpose?
• Problem of discarding old values may occur
• Meaninglessness needs to be dealt with
• Creating new meaning is important

Anxiety as a Condition of Living

• Includes confrontation with givens of existence
• Listening to the message of anxiety can contribute to self-growth
• Normal Anxiety is an appropriate response to an event
• Neurotic Anxiety is out of proportion to the situation and tends to immobilize the person

Awareness of Death and Non-Being

• Death is not a threat
• Grasping the reality of death strengthens a person
• Death can be viewed as a positive motivation to give life significant meaning

Person-Centered Therapy

• Reaction against directive and psychoanalytic approaches
• Challenges: assumption that the counselor knows best and the validity of advice, suggestion, persuasion, teaching, diagnosis, and interpretation Challenges: belief that clients can't understand/resolve problems without direct help, focus on problems over persons

Overview

• Founder: Carl Rogers, (1902 - )
• Rogers was born in Oak Park, IL
• Rogers was trained at the University of Wisconsin and Columbia University
• Rogers' educational background was in agriculture, science, philosophy, theology, education, and psychology
• There was a fundamental shift in the theory from helper-to-client to person-to-person

Emphasizes

• Therapy as a journey shared by two fallible people
• The person's innate striving for self-actualization
• The therapist's personal characteristics and the quality of the therapeutic relationship
• the counselor's creation of a permissive, “growth promoting" climate
• People are capable of self-directed growth if involved in a therapeutic relationship

Major Philosophies and Nature of Humans

• Humans are essentially rational, constructive, positive, independent, realistic, cooperative, trustworthy, accepting, forward-moving, and full of potential
• Like all organisms, humans naturally tend toward actualization of their full potential (Gilliland & James, 1998)
• Experience is key to Rogerian Theory because each person's perception of their own experience is unique, the client is the only expert on their own life

Major Constructs

• Includes actualizing tendency: inherent tendency to develop in ways to maintain or promote growth
• Conditions of Worth: A person's worth is conditional when their self-esteem is based on significant others' valuation of experience
• Congruence: state of consonance among acting, thinking, and feeling states

Other Constructs

• Empathic Understanding: Perceiving as if one were the other person without losing the “as if” condition
• Experience (noun): All cognitive and affective events within the person that are available or potentially available to their awareness
• Experience (verb): To receive the impact of all sensory or physiological events happening at the present moment
• Genuineness: The state where there is no difference between the real and the perceived selves
• Organismic Valuing Process: Process whereby experiences are accurately perceived, constantly updated, and valued in terms of the satisfaction experienced
• Positive regard: Perception of another person's self-experience that leads the individual to feel warmth, liking, and respect for acceptance
• Self-actualization tendency: Tendency to move toward achieving one's full potential
• Self-concept: Person's total internal view of self in relation to the experiences of being and functioning within the environment
• Self-Experience: Any event in the perceptual field that one sees as relating to the "self", "me", or "I"
• Unconditional Positive Regard: Perception of another person without ascription of greater or lesser worthiness
• Unconditional Self-Regard: Perception of self where no self-experience is more or less worthy of positive regard
• Positive attitude toward the self that is not dependent on perceptions of significant others

The Self

• According to Rogers, it is organized and consistent
• Includes one's perceptions of all that comprises "I" or "me"
• Includes the relationship among I or me, other people, and features of life, as well as the value and importance of these relationships
• Available to consciousness, but not always conscious
• Constantly changing, yet always recognizable

A Self-Actualized Person Has the Following Characteristics

• Open to experience
• Aware of all experience
• Deal with change in creative ways
• Socially effective
• Lives existentially, in the here and now
• Trusts self

Major Personality Constructs

• Person-centered therapists don't focus on personality theory, but rather the manner in which change comes about (Gilliland & James, 1998)
• Each person is unique and has the ability to reach full potential

Other Traits

• The need for positive regard from others
• The need for positive self-regard
• Rogerian theory speaks primarily of “incongruence” as the primary maladaptivity.

Nature of “Maladaptivity”

• Maladaptivity relates to the blocks that are put in the road to actualization (Gilliland & James, 1998)
• External locus of control and looking to others for worth are seen as maladaptive

Major Goal of Counseling

• The central focus of counseling is the client's experiencing feelings

A Growth-Promoting Climate

• Includes congruence (genuineness or realness), unconditional positive regard (acceptance and caring, but not approval of behavior)
• Accurate Empathic Understanding: Ability to deeply grasp the client's subjective world
• Helper attitudes are more important than knowledge

Major Techniques/Strategies

• The most important technique is the establishment of the relationship between client and counselor as one of mutual trust and safety
• Counselor deals directly, in the here and now, with the client's feelings and experiences rather than intellectualizing about the experiences
• Person-centered theory is a phenomenological approach, meaning each person is unique

Six Conditions

(necessary and sufficient for personality changes to occur)

• Two persons are in psychological contact
• The client is experiencing incongruency
• The therapist is congruent or integrated
• The therapist experiences unconditional positive regard or real caring for the client
• The therapist experiences empathy for the client's internal frame of reference
• Communication to the client is achieved to a minimal agree

Major Roles of Counselor and Client

• Counselor's role is to create an atmosphere of genuineness, unconditional positive regard, and empathic understanding, and to reflect content to the client
• Reflection may include the counselor's own genuine feelings
• The challenges for the counselor lie in their willingness to be changed by and grow through the counseling relationship and to be open and transparent to the client
• The client's role is to do, think, say, or feel whatever they are experiencing in the moment
• Within unconditional positive regard, the client can experience their feelings and the incongruence in their life

The Therapist

• The therapist focuses on the quality of the therapeutic relationship
• The therapist serves as a model of a human being struggling toward greater realness
• The therapist is genuine, integrated, and authentic, without a false front
• Therapists can openly express feelings and attitudes that are present in the relationship

Gestalt Therapy

• "I am not in this world to live up to other people's expectations, nor do I feel that the world must live up to mine" - Fritz Perls
• Gestalt is a German word for the total shape of something
• A Gestalt, or whole, both includes and transcends the sum of its parts
• It cannot be understood simply as a sum of smaller, independent events
• GESTALT means a structure, configuration, or pattern of physical, biological, or psychological phenomena
• The proposer of Gestalt Therapy is Fritz Perls (1893-1970) / wife Laura Perls (1905-1990)
• It aims to help clients focus on the present and understand what is happening in their lives right now, rather than the past
• Gestalt process means clients learn to become more aware of how their own negative thought patterns and behaviors are blocking true self-awareness

Therapy

• It is a process of psychotherapy where gestalt therapists are more interested in the process as a whole, rather than individual events or experiences
• Aims to improve one's contact and with the environment in general and is achieved through aware, spontaneous dialogue between client and therapist

Key Concepts of Gestalt Therapy

• Gestalt Therapy is based upon the existential framework and includes key elements Key elements: -Focus on client's perception of reality "Power is in the present.”
• Individuals can self-regulate when they are aware of their surroundings

Gestalt: View of Human Nature

• If people become fully aware, people can deal with their problems
• Change happens when a person can reintegrate a disowned part of the self back into the mix of identity
• Gestalt is a process of “re-owning” parts of the self that have been disowned
• Change takes place when a person is more aware of who and what he or she is
• Living with “masks” does not promote change but stagnation of personality
• People who try to be who they are not, the more they stay the same Individuals who become neurotic try to attend to too many needs at a time and therefore do not take care of one fully

Therapeutic Goals

• Includes emphasis on moving towards increase awareness of themselves and assuming ownership of their experience
• Also includes to develop skills and acquire values that will allow one to satisfy their needs
• Become more aware of all of their senses and learn to accept responsibility for what they do
• Move from outside support toward increasing internal support
• Be able to ask for and get help from others, and to give to others

Gestalt helps Clients with

• Gestalt therapy can help clients with issues such as anxiety, depression, self-esteem, relationship difficulties
• Even physical ones like migraine headaches, ulcerative colitis, and back spasms
• Techniques are often used in combination with body work, dance, art, drama, and other therapies
• Focus on verbal as well as non-verbal behavior

Other functions

• includes Helping clients to resolve the past to become integrated and pushing clients to experience feelings and behavior

Therapist's Function and Role

• Therapists encourage the present time, and bring the past into the present by re-enacting it
• Therapists should focus on the “what” and "how" of a person without asking the "why” questions to promote awareness of the moment
• Therapists shouls ask questions such as “what is happening now?” or “What are you feeling in this moment?” to intensify the experience of the present and create awareness
• They should Pay attention to the client's body language
• They should Focus on the language

Other Goals

• Create an atmosphere that promotes clients' explorations of what they need to grow
• Assist clients in blocking energy and using it in positive and adaptive ways
• Assist clients in recognizing patterns in their lives
• Some Gestalt techniques are: Dream work, Empty chair, Confrontation, Making the rounds, I take responsibility, and Exaggeration

Therapeutic Methods/Techniques

• Experiments: Increase the client’s awareness of actions, experiences, and the how
• Role Play: Experience emotions and better understand how they present themselves

Open chair Technique

• Involves two chairs and role-play, and gives rise to emotional scenes
• The client sits opposite an empty chair and must imagine someone in it, communicating and engaging with this imaginary being and asking questions to represent them
• Clients are briefed to switch chairs while physically sitting in the chair

Role Reversal

• Technique where Clients has reversed roles so that they are speaking on behalf of the imagined part of their problem This helps to locate a specific feeling or a side of the client's personalities they had disowned and ignored
• Helps them accept polarities and acknowledge that conflicts exist in everyone

Other Techniques

• Dialogue: The therapist engages the client in a meaningful, authentic dialogue to guide their thinking and behavior
• Dreams: Has a pivotal role to realize spontaneous aspects
• Fritz Perls asked clients to relive dreams by playing different objects and people in the dream
• Body Language: Therapist also pays attention on the body language as it may be a subtle indicator of intense emotions
• The technician may question the client to exaggerate movements/behaviors

Additional Techniques

• Topdog: Therapist identifies opposing opinions/attitudes
• Fantasy: Increases self-awareness of thoughts and emotions
• The Body as a Vehicle of Communication: Physical sensations create “wholeness” for the client
• This is used to Locate emotions as well

Other Techniques

• Clients may report that they are feeling nervous about something so that the therapist may ask that the client identify where the feeling is coming from
• Repetition and exaggeration means the client is moving so the therapist makes a point that exaggerates
• This may elicit their emotion and should help to release blocked awareness

Other

• Confusion: The technique draws attention to the client’s hesitation
• Identification Gestalt: Help clients recognize physical signs
• Applications: Can be applied to long-term therapy or focused approach.
• Originally used to treat individuals with anxiety or depression
• Also treats Personality disorders, Managing tension, Addiction, and Post-traumatic stress

Strengths of Gestalt

• The goal is self awareness which is bult and therapy helsp understand connections
• The process can involve exercise and be administered in group settings
• This aids with resolving interperosnal interations
• Those with personltiy disorers also benefiti and stay stable

Weakness of Gestalt

• To be an therapists requires significant expertice development
• Has less established
• Has the potential of abusing authority

Weakness

• Lacks a strong theoretical base and emphasis and a more focused kind of experience

Behavior Therapy

• Introduction: Behavior is considered maladaptive include of age or not in alignment of adaptive fuctions/cultural or others not in the same place
• Basic Approach: People learn habits through enironmental factors and learning expereinces

Other

Problemantic behaviors need correcting with the right provision and learning experiences Therapy

• The beginning was in the 20th century and foucse don broad range of reinforcement

B.F skinner- Classified as behaviorla determinism

• Watson was the major advocate, a key experiment has a child and is ameanble with the right behavior

View

A key view is that the human personltiy is leared The appliaction of classical conditioning or S-R response The learning of assocation incondtioning Emotions like pair with condtioning

Counter COndtioning

• After worl war II by researcher demostartted in Mary Cover Jones

Applied Bheavioral

• Is based on focused on how individual opeartes and acts upon what reaws or do not what they receive

SKinner

• American physchologly the conenction between teh respons and stimulus is reinforced
• A responsse if called reniforcer or increased if said behaivor is used

The Role of the couselot

• Counselores will act to aid in new ways and modfiies actiosn in session an dworks adivces

Goals of Couselosr

• Modifes behavior, and allows client to set up well and fine goals so thay act properly

Setps for Couselor

• Define the problem with a hisotry and method

Process/Techneques

• Behaviorals therapy for the process and maints
• This ahould b ehwer enow and not a past
• Should obtain empirical evidence and have good technuies

Used by Reinforcers and behavior

• This process works better wiht short intermmit reinfrocemtn vs consistent punishment
• Also behaviorists wil not use punishment

Techneques

• Shaping occurs with behaivoir by refocnement given
• MOdellign allows to imitate beheaiorf
• Contraticng devleops postirv emaintaing and explicit contracts
• There shoul be oversenstion by aversion and uplesant ones

Other

• There also should be a a covert sesittaiton an dimgery stimulus to dive those
• The nurisign process ahould be veichle for assitnace
• There ssoudl be nuinssign diangisies and an ssessnemt of unptable actiosns
• Should be pland to d evice to find a techne for th client
• Must be aware of mdoificatiokn

Final Steps

• Consistent among staff and evalauted wiht crtieria