Compensatory self improvement

Existential Therapy

Probing the nature of being human

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Rollo May
Born April 21, 1909, in Ada, Ohio. (died in 1994)

Childhood was not particularly pleasant
His parents didn’t get along and eventually divorced
His sister had a psychotic breakdown

Went to Michigan State (asked to leave because of involvement with a radical student magazine). Received B.A. from Oberlin College in Ohio.

After graduation, went to Greece
Taught English at Anatolia College for three years
Worked as an itinerant artist
Studied briefly with Alfred Adler

Returned to U.S. and entered Seminary (received B.D. in 1938)
Suffered from tuberculosis (spent three years in a sanatorium).  Facing the possibility of death was probably the turning point of his life
Studied psychoanalysis at White Institute. Met Harry Stack Sullivan, Erich Fromm.
Went to Columbia University in New York, where in 1949 he received the first PhD in clinical psychology that institution ever awarded.
Taught at a variety of top schools.  In 1958, he edited the book Existence, which introduced existential psychology to the U.S. 

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Existential Theory
Based in philosophy
“How did I get into the world? Why was I not asked about it, why was I not informed of the rules and regulations but just thrust into the ranks as if I had been bought by a peddling shanghaier of human beings? How did I get involved in this big enterprise called actuality? Why should I be involved? Isn’t it a matter of choice? And if I am compelled to be involved, where is the manager—I have something to say about this. Is there no manager? To whom shall I make my complaint?”

Helps people examine issues of personal meaning

“Now it is no longer a matter of deciding what to do, but of deciding how to decide.”
Less about theory and more about offering perspective on the human condition

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Basic Assumptions of Existential Therapy
The Primacy of Experience: Every individual is unique
Isolation: We are born alone and die alone.
Personal Meaning: What is the purpose for living?
How we live our life (being-in-the-world)
Do we visit all the rooms in our house?

Self Awareness: Live in the here and now

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Basic Dimensions of Existentialism
Self-awareness –the greater the awareness the greater the potential freedom; everything is a choice; anxiety accompanies awareness of our finitude and the consequences of our choices.
Freedom and responsibility — bad faith of not accepting responsibility -“There are no victims here.”
Creating oneself and relationships — looking beyond the conventional guidance and what others expect of us; using our sense of aloneness to get in touch with what are truly our values and goals
Choosing relatedness
Challenging clients—-What they get from they relationship? How they avoid close relationship?

Basic Assumptions (free choice)
Free Choice: People can choose what they become

Freedom: People have fear of freedom because with freedom comes choice and the possibility of choosing poorly (responsibility)

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Basic Assumptions (responsibility)
Responsibility: We are responsible for our own lives
Genes and environment are important. They are just not deterministic
Many individuals, at some point, struggle with accepting this responsibility and, therefore, deny or limit their own freedom
Sartre: “Statements of bad faith”; inauthentic to assume that our existence is controlled by forces external to ourselves
Displace responsibility onto others (“My boss made me work late”)
Think of self as helpless victim of circumstances (racism)
Attribute behavior to unconscious drives (“I’d never do something like that”)

Absolve themselves of responsibility by a sort of temporary insanity (“It was the beer talking”)

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What are the possible reasons that people tend to blame others for their problems?

Existential Principles (Rollo May)
Wish: To be in touch with what one really wants
Indecisiveness
Impulsivity?
Will:  To organize oneself in order to achieve one’s goals (roughly “ego”) or “the ability to make wishes come true.” 
Neo-puritan: All will, but no love.  Amazing self-discipline, can “make things happen”… but no wishes to act upon.  So they become “anal” and perfectionistic, but empty and “dried-up.”  (archetype?)
Infantile: All wishes but no will.  Filled with dreams and desires, lack self-discipline to make anything of their dreams and desires, and so become dependent and conformist.  They love, but their love means little.  (archetype?)
Creative: A balance of these two: “Man’s task is to unite love and will.” 

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What is the meaning or purpose of your life?
What do you want from life?
Where is the source of meaning for you in life?

Anxiety and fear
Neurotic anxiety is not good.

Choices are opportunities, not problems

Sometimes “life happens” Deaths, accidents and traumas can:
Force us to become aware of a problem
Force us to reconsider how we live life
Cause us to accept responsibility for the direction of our life

Existential anxiety
Makes us aware of the “big issues.”
Helps us steer an effective path through life
Helps us become aware of separations from:
Self
Others
World
Cannot be lived with constantly, but should be revisited time to time

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The gift of death
Death: It kills us but without it we would not know we were alive

“As death, when we come to consider it closely, is the true goal of our existence, I have formed during the last few years such close relations with this best and truest friend of mankind, that his image is not only no longer terrifying to me, but is indeed very soothing and consoling! And I thank my God for graciously granting me the opportunity . . . of learning that death is the key which unlocks the door to our true happiness.”
– Wolfgang Amadeus Mozart

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May’s stages of development

(age-salient, not age-dependent)
Innocence — the pre-egoic, pre-self-conscious stage of the infant. The innocent is pre-moral (i.e., is neither bad nor good).  Like a wild animal that kills to eat, the innocent is only doing what he or she must.  But innocents do have a degree of will in the form of a drive to fulfill their needs!
Rebellion — the childhood and adolescent stage of ego development or self-consciousness. It is characterized primarily through contrast with adults, from the “no” of the two year old to the “no way” of the teenager.  The rebellious person wants freedom, but does not yet understand the responsibility that goes with it.  The teenager may want to spend her allowance in any way she chooses — yet still expect the parents to provide the money, and complain about unfairness if she doesn’t get it!
Ordinary — the normal adult ego: conventional and a little boring.  This person has learned responsibility, but finds it too demanding, and so seeks refuge in conformity and traditional values.
Creative — the authentic adult, the existential stage, beyond ego and self-actualizing.  This is the person who, accepting destiny, faces anxiety with courage!

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Therapeutic Goals
Find meaning in life — even from the terrible
Change meanings to those that are more healthy and adaptive
To “live as if you were living already for the second time and as if you had acted the first time as wrongly as you are about to act now” (Frankl, Man’s Search for Meaning)
How can this be accomplished?
Listen and understand client’s worldview.
Communicate your understanding to client.
Only when client recognizes that therapist understands, can therapy focus on shifting meanings.

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The Therapeutic Process
Being in the moment: Focusing on the here and now.
Focus on owning feelings, desires, and actions
Can’t vs. Won’t
Whose unconscious is it?
Making connections to the past: Clients are encouraged to emotionally relive past life events.
Integrating the felt experience (including in therapy) into primary relationships
Integrating what was learned: Being a new person in the present moment.
Deal and confront inability to feel and/or want
Identify and deal with conflicting wants
Help client process the “what ifs”

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Specialized techniques (Lukas, 1984)
Reframing — searches for the positive in the situation.  Must wait until client feels heard

Paradoxical intention — encourages client to do what client is afraid might happen.  Returns control to the client.

Dereflection — redirects focus from the maladaptive to the healthy
You’ve been spending a lot of time worrying about your daughter — and driving you both crazy!  Perhaps this would be a good week to find something else to do.  You’ve talked about wanting to…

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Techniques
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

Disadvantages of Existential Therapy
It is dense, complex and difficult to master.
There is very little guidance for the practitioner.
You can be an existentialist but you cannot do it. It is not about technique but your own personal stance.

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Gestalt

Existential & Phenomenological – it is grounded in the client’s “here and now”

Goal: clients gain awareness of feelings and behaviors in the here and now

Promotes direct experiencing rather than talking about situations

talk about a childhood trauma vs. become the hurt child

Goal Gestalt Therapy

Gain awareness
Know the environment
Know oneself
Learn about dominant ways of avoiding contact
What does the resistance (defense) does for the client
What it protects the person from
What it keeps the person from experiencing

Accept oneself and responsibility for self
Allow oneself to make contact

Areas of Application
Grief work, facing a significant decision, developmental crisis, coping with failures in marriage and work, dealing with physical limitations due to age……

From a multicultural perspective
Contributions
Applicable to diverse clients to search for meaning for life
Be able to examine the behavior is influenced by social and cultural factors.
Help clients to weigh the alternatives and consequences.
Change external environment and recognize how they contribute

From a multicultural perspective
Limitations
Excessively individualistic
Ignore social factors that cause human problems
Even if clients change internally, they see little hope the external realities of racism or discrimination will change
For many cultures, it is not possible to talk about self and self-determination apart from the context of the social network
Many clients expect a structured and problem-oriented approach instead of discussion of philosophical questions.

Summary and Evaluation
Limitations
Lacks of a systemic principles and practice for therapy

No empirical research validation yet

Limited to apply to lower-functioning clients, clients who need directions, are concerned about meeting basic needs, and lack of verbal skills

Case 1
I find myself terrified when I am alone. I need people around me constantly, and if I’m forced to be alone, then I run from myself by watching TV. I’d like to learn how to be alone and feel comfortable about it.

What are the issues?
What can you do to help this client?

Case 2
I feel like my existence does not matter to anyone. If I were to die today, I fully believe that it wouldn’t make a difference to anyone.

What are the issues?
What can you do to help this client?

Case 3
I rarely feel close to another person. While I want this closeness, I am frightened of being rejected. Instead of letting anyone get close to me, I build walls that keep them removed. What can I do to lessen my fear of being rejected?

What are the issues?
What can you do to help this client?