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Existential therapy focuses on free will, self-determination, and the search for meaning—often centering on the individual rather than on their symptoms. The approach emphasizes a person's capacity to make rational choices and to develop to their maximum potential. Some practitioners regard existential therapy as an orientation toward therapy, not a distinct modality, per se. This type of therapy is often useful for patients who experience existential threat or dread when security and identity feel in peril.

Existential therapy is derived from the work of philosophers Friedrich Nietzsche and Soren Kierkegaard, wherein the nature of being human is a central philosophical problem. Other theorists, such as Martin Heidegger, have contributed to existentialism; and much later Otto Rank applied this philosophy to the healing process of therapy.

The existential approach stresses that:

  • All people have the capacity for self-awareness.
  • Each person has a unique identity that can be known only through relationships with others.
  • People must continually re-create themselves because life’s meaning constantly changes.
  • Anxiety is part of the human condition.
When It's Used

Existential therapy can be useful in treating psychological concerns that are thought to result from an inhibited ability to make authentic, meaningful, and self-directed choices. Interventions often aim to increase self-awareness and self-understanding. Existential psychotherapists try to comprehend and alleviate a variety of symptoms, including excessive anxiety, apathy, alienation, nihilism, avoidance, shame, addiction, despair, depression, guilt, anger, rage, resentment, embitterment, purposelessness, psychosis, and violence. They also focus on life-enhancing experiences like relationships, love, caring, commitment, courage, creativity, power, will, agency, presence, spirituality, individuation, self-actualization, authenticity, acceptance, transcendence, and awe.

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What to Expect

Existential psychotherapies use a range of approaches, but major themes focus on the concepts of responsibility and freedom. Therapists help you find meaning in the face of anxiety by choosing to think and act responsibly and by confronting negative internal thoughts rather than focusing on external forces like societal pressures or luck. Fostering creativity, love, authenticity, and free will are common avenues that help move you toward transformation. Similarly, when treating addiction disorders, the existential therapist coaches a person to face the anxiety that abuse use may be alleviating, and encourages them to take responsibility for their life. The goal: To make more willful decisions about how to live, drawing on creativity and love, instead of letting outside events determine one's behavior.

How It Works

This practice—due to its focus on existence and purpose—is sometimes perceived as pessimistic, but it’s meant to be a positive and flexible approach. At its best, according to 20th-century philosopher Paul Tillich, existential psychotherapy fairly and honestly confronts life’s "ultimate concerns," including loneliness, suffering, and meaninglessness. Specific concerns are rooted in each individual's experience; contemporary existential psychotherapist Irvin Yalom states that universal concerns are death, isolation, freedom, and emptiness.

Existential therapy focuses on the anxiety that occurs when you confront these inherent conflicts, and the therapist’s role is to foster personal responsibility for making decisions. Yalom, for example, perceived the therapist as a "fellow traveler" through life, and he uses empathy and support to elicit insight and choices. And because people exist in the presence of others, the relational context of group therapy is an effective approach, he argues. The core question addressed in this kind of therapy is, "How do I exist in the face of uncertainty, conflict, or death?”

While existential therapy may be grounded in theory, it is also wholly practical. Some consider it an exploration of a patient’s life and what he experiences, discovery of purpose, meaning, who you are, and determination, among other everlasting quandaries of existence.

What to Look for in an Existential Therapist

Screen your potential therapist either in person or over video or phone. During this initial introduction, ask the therapist:

  • How they may help with your particular concerns
  • If they have dealt with this type of problem before
  • Describe their process
  • The treatment for timeline

In addition to their mental health training, existential therapists often have a background in philosophy. Licensure varies state by state, but many existential therapists complete graduate degrees in psychology or counseling, for example. They also complete additional supervised fieldwork in existential therapy.

National Center for Biotechnology Information    
American Psychological Association
Existential Psychotherapy Center of Southern California
Existential Psychotherapy Center of Southern California
Last updated: 09/02/2022