PSY 245CLINICAL PSYCHOLOGY-II

• Assoc. Prof. Dr. BAHAR BAŞTUĞ • Clinical Psychologist

Existential Theory and Therapy

Welcome

• Today we’ll be focusing on existential theory and practice.

• This approach is very much about philosophy and meaning.

• The nature of existential therapy is creative, non-linear and meaning-focused.

• Frankl (1969) noted:“. . . man also only returns to himself, to being concerned with his self, after he has missed his mission, has failed to find meaning in life (p. 9).

Psychoanalysis evolved primarily from medical practice with disturbed patients. Behavior therapy arose from experimental psychological research. Person-centered therapy and individual psychology have roots in clinical practice.

Existential approaches are more directly and deeply linked to philosophy.

• Humans face inevitable conditions, such as death, responsibility, freedom and purpose. This therapy approach focuses on these conditions.

• Existentialists avoid scientific research, they believe that the scientific research is unauthentic.

• They practice therapy with individuals, couples, families, & groups. Their philosophical perspective guides them.

Key Figures and Historical Context

• The roots of existential philosophical thought are diverse.

• Majors players in the early formulation of existentialism are 19th century philosophers,:

• Soren Kierkegaard (1813–1855)• Friedrich Nietzsche (1844–1900)

Soren Kierkegaard (1813-1855)

Soren KierkegaardThe Danish philosopher Kierkegaard lived in

Copenhagen. He was hard religious. For him, traits, such as responsibility, honesty,and commitment are subjective choices.

Kierkegaard did not describe himself as an existentialist, but his work is seen as pioneer to the existential philosophical movement, which formally began some 70 years following his death.

Freidrich Nietzsche (1844–1900)

Freidrich Nietzsche

The German philosopher Freidrich Nietzsche had negative feelings toward Christianity. He coined the phrase “God is dead.” in his book Thus Spake Zarathustra.

He believed that individuals should channel their passions into creative, joyful acitivities, instead of following a religion.

• Yalom combines existential principles into a fictional encounter between Freud, Nietzsche and Breuer.

Learning from Dialectics

• There is a paradox or dialectic within existential thinking.

• Theist X Atheist• Fritz Perls: «every psychological phenomenon...

is experienced as a polarity.»

• Hegel: human reasoning and ideas develop by a dialectical process. thesis, antithesis, synthesis

• Linehan’s Dialectical Behavior Therapy involves a direct application of Hegel’s dialectic. «I accept you as you are and I’m helping you to change.»

• THE GOAL OF EXISTENTIAL THERAPY IS TO HELP THE CLIENT DISCOVER AND EXPLORE THE AUTHENTIC SELF.

• Humans naturally create polarities.• These polarities generate conflict.• There is a potential for synthesis and

intellectual development. • Some traditional theorists emphasize the

centrality of the self, postmodern perspectives don’t emphasize the self.

• We learn from both perspectives, develop a more balanced view of self.

• Beyond Kierkegaard and Nietzsche, the works of Pascal, Husserl, Vaihinger, Sartre, Heidegger, Jaspers, and Marcel were useful in popularizing existential perspectives.

• Zeitgeist: after World War I & II, holocaust of Jewish, key terms of existentialism

Jean-Paul Sartre (1905 –1980)

Sartre claimed “Freedom is existence, and in its existence precedes essence” and “Man’s essence is his existence”. ?????

“Freedom is existence, and in its existence precedes essence”

• There are no absolute or essential truths (essences), but we as individual human beings create our own truth and reality.

• Adler and Vaihinger’s concepts of life style, fictional finalism and «acting as if» are consistent with this statement.

• Each individual constructs his or her reality.

“Man’s essence is his existence”.

• Humans contain no permanent elements. • To reinvent yourself• Existentialism emphasize personal choice,

personal responsibility and personal consciousness. If humans construct their own reality and are continuously capable of self-reinvention, all behavior is owned by the individual.

• Sartre: «I’m my choices.»• Existentialism is antideterministic. • Existentialism XXX Freud and behaviorists

• If you suggest to existentialists that human behavior is determined by particular factors, events, or mental processes, they are likely to react. Existentialists reject the proposition that humans are enslaved by Freudian unconscious, instinctual drives, and they reject environmental stimulus-response determinants.

• They state individual choice and human freedom, in place of instinctual or environmental causes of behavior.

• The past doesn’t determine the future. Our choices in this moment determine the now. Our choices in the next moment determine that moment.

VIKTOR FRANKL (1905-1997)

He was born to a Jewish family in Vienna. In 1944,he and his family were sent to a concentration camp. He worked there as a psychiatrist. His father, mother and wife died in the camp. He was released from the camp in 1945.

«Man’s Search for Meaning, 1963»young Viktor Frankl joined Adler. Logotherapy focused on helping

clients find meaning. “The striving to find a meaning in

one’s life is the primary motivational force. He who has a why to live can bear with almost any how.”

Rollo May (1909-1994)

May introduced and integrated existential thought into American psychotherapy.

He was a missionary teacher in Greece for 3 years. During that time, he took some seminars from Adler in Vienna.

He gave up the life of a priest and studied clinical psychology. He suffered from tuberculosis. May was granted a doctoral degree with his dissertation, The Meaning of Anxiety, argued that anxiety was an essential component of the human condition.

The Courage to Create

• More contemporary key figure:

– Irvin Yalom (1931– )

Theoretical Principles

There is no single theorist. The existential theory of psychotherapy is based on existential philosophy and phenomenology. Principles of existential therapy:

• The I-Am Experience• Four Existential Ways of Being• The Daimonic• The Nature of Anxiety• Normal and Neurotic Guilt

The I-Am Experience (May)

is the experience of being, of existing. This is also referred to as the ontological experience.A major focus consists of exploring the immediate individual human experience.

Boss and Binswanger used Dasein (being in the world) to describe the sense-of-existence. ‘‘Dasein choosing,’’ is also used to describe the-person-who-is-responsible-for-his-existence choosing.

• Existential therapy is in the service of self-awareness or self-discovery XXXXFreud’s interpreting client unconscious processes.

Theoretical Principles

• Four Existential Ways of Being-in-the-world. Boss, Binswanger and May described:

1. Umwelt: Being with nature or the physical world.2. Mitwelt: Being with others or the social world.3. Eigenwelt: Being with oneself or the world of the

self.van Deurzen described:4. Uberwelt: Being with the spiritual or over world.

• Some people focus more on one dimension than others, shift from one to another related to the situations.

The Daimonic

For May, “The daimonic is any natural function which has the power to take over the whole person”.

The daimonic includes both positive and negative potential. It is a form of psychic energy or an urge that is the source of both constructive and destructive impulses, similar to Jung’s general conception of libido.

Jung emphasized the integration of the shadow archetype, May considers the integration of the daimonic to be a main task in psychotherapy. Integrating the biological and natural daimonic urge maximizes creative behavior.

The Nature of Anxiety

Anxiety leads authenticity and freedom. May conceptualized anxiety as a good thing.

May emphasized that anxiety was a normal byproduct of human existence.

We should explore it, experience it, engage it, and redirect it into constructive activities—we should not avoid it.

two types of anxiety: - normal anxiety - neurotic anxiety.

Normal anxiety is proportional to the situation. It is within our awareness and can be used creatively.

Neurotic anxiety is disproportionate to the situation; it is usually repressed, denied, or avoided, and is not used for creative or constructive purposes. It is destructive.

THE GOAL OF EXISTENTIAL TREATMENT IS NOT TO DO AWAY WITH ANXIETY, BUT TO REDUCE NEUROTIC ANXIETY.

This is achived by helping clients live with and cope effectively and creatively with the normal anxiety that accompanies existence.

Normal and Neurotic Guilt

Guilt has positive and negative qualities. Guilt inspires people to act in thoughtful and conscientious ways.

Normal guilt is like a sensor: When functioning well, it alerts us to what’s correct and guides us toward morally acceptable behavior.

• PSYCHOPATHOLOGY ARISES FROM NEUROTIC GUILT. Neurotic guilt usually consists of an exaggerated, or minimized version of normal guilt. Neurotic guilt doesn’t serve a productive purpose.

Existential Psychodynamics

Like psychoanalists, existentialists believe that humans are in intrapsychic conflict with powerful forces. The existential therapist helps clients face «existential psychodynamics» or “ultimate concerns” of existence.

These ultimate concerns cause anxiety.

Yalom describes four ultimate concerns relevant to psychotherapy.

• Death• Freedom• Isolation• Meaninglessness

Death

Yalom outlines two therapy-relevant propositions about death:

1) He emphasizes that death and life exist simultaneously. We can not ignore the possibility of death. Death is knowable and unknowable. We will die; it is only a question of when, where, and how. Death is part of the reality of life.

2) Yalom claims that death is a “primal source of anxiety” and is the main source of psychopathology. For anyone who has directly faced death, the potential influence of death anxiety is obvious.

The purpose of facing death is to experience life more deeply and fully.