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Despite its long history, existential psychotherapy has remained on the fringes of mainstream practice. This is unfortunate because the therapy could be useful in a society that, some argue, is becoming more existentially minded. One reason for its limited acceptance is that the literature to date has tended to be quite convoluted, and the existential psychotherapists’ ideas heterogeneous. Another reason for its limited acceptance is the dearth of empirical validation studies. Again, I think the lack of clear definition and cohesiveness makes it difficult to evaluate the therapy quantitatively (Cooper, 2003).
The type of existential psychotherapy to be developed revolves around the issue of purposelessness. The concept is more tangible and amenable to quantitative evaluation than other existential foci (e.g. scales are available to evaluate purpose in life). As a result, it is more feasible to develop this existential domain into a manualized model that can be rigorously evaluated. One argument against focusing on purpose-centered existential psychotherapy is that historically it has tended to impose value judgments on its clients. Purpose-centered existential psychotherapists may, for example, suggest to clients that there is one ultimate meaning or that only certain types of “higher” activities are legitimate sources of purpose.
Experiential therapy seems to be relatively free of the common problems associated with differences between the client and the therapist. These include such dimensions as gender, age, body size, skin color, physical state, sexual preferences, religious beliefs, and cultural background. “Physical state” may include health conditions such as paraplegia, being blind, being in a wheelchair, or having cancer. (Mahrer, 1997)
The Existential Psychotherapy theory is most appropriately narrated as a “movement wanting to know to the best level probable the survival of the patient in the world in which he lives, moves, and experiences” (May, R. 1983). According to May, the purpose of this approach is to understand human existence, not a system of “how-to” (p.43) and his objective “to understand the life history of a patient as modifications if his being-in-the-world, not as the idiosyncratic pathology of specific theory” (May, R. 1983, p.40, 151).
The ability of the therapist to be aware and knowledgeable to incorporate the right elements of the patient’s ethnic and cultural background will improve therapeutic results and will make possible a more appropriate intervention strategy that will match with the patient’s cultural values.
But it does not matter how our therapy techniques evolve, the important thing we should remember is that as therapists we need to focus on how our patient’s process, store, and use the information and how this information influences what they attend to, perceive, learn, remember, believe and feel and how those feeling are then decoded based on their ethnic and cultural background, their age, gender, and past experiences so we can attempt to understand the cultural influences on identity development, the barriers that affect multicultural counseling and develop culturally appropriate intervention strategies for our patients.
The goal of therapy is to allow the patient to experience his way of life as real while becoming aware of his potentialities and becoming able to act on the basis of his own discoveries (May, R.2005). “As the patient gains insight and knowledge about himself he will then make appropriate decisions.” (May, R.2005) One thing is certain, ethnic background combined with culture will have an intense effect on attitudes, emotions; behaviors, and that failure to consider ethnicity can be an obstacle to an effective treatment. Related concepts that will also have an effect include multicultural therapy and culturally competent psychotherapy (Pope-Davis, 1997). Ethnicity and culture will “influence in the therapeutic relationship and will shape the nature of the interaction between the therapist and patient” (Wong, 2005).
In Viktor Frankl’s existential psychotherapy, the therapist is not a co-creator of reality. The therapist is, instead, a co-explorer who helps the client discover the reality of the meanings and meaning potentials that call to the client for their discovery, actualization, and re-collection as a way to “shrink” the existential-meaning vacuum (Frankl, 1955; Lantz and Gregoire, 2000). Frankl’s ideas about time and reality suggest that the function of the therapist is to induce a phenomenological struggle in the life of the client that will help the client “notice” the meaning potentials in the future, “actualize” such meaning potentials in the “here and now” and remember, re-collect and “honor” those meaning potentials previously actualized and deposited into the forever of the past
Rogers would describe his kind of therapy as a process of freeing a person and removing any obstacles that would inhibit them, in hopes that normal growth and development can advance and the client can become independent and self-sufficient. (Richard, 1975) Certain conditions are necessary for this process to become successful. A growth-promoting environment requires the therapist to be congruent, have unconditional positive regard for the client, as well as show empathic understanding. It is necessary during therapy for the therapist to try to be completely congruent, meaning absolutely genuine no matter neither what their own beliefs are nor what the client’s case is at hand.
Another condition that is necessary is having accurate empathy, which refers to understanding the client’s feelings and personal meanings as they are experienced and communicated back and forth. Most importantly, as Rogers sees it is having unconditional positive regard at all times. This “unconditional positive regard involves relating from therapist to client, not as a scientist to an object of study, but as a person to a person. He feels this client be a person of self-worth; of value no matter what his condition, his behavior, or his feelings. He respects him for what he is and accepts him as he is, with his potentialities (Rogers, 1965, Pescitelli, 1996).
The client can then feel accepted, not feel judged, whereas this tends to reduce the need to defend his self-concept and begin to accept and value himself. In order for the client to be able to accept experiences that have been distorted or denied to their own awareness, there must be a decrease in the client’s conditions of worth and an increase in the client’s unconditional self-regard. If the therapist can demonstrate unconditional positive regard for the client, then the client can begin to become accurately aware of experiences that had been previously distorted or denied because they experienced a loss of positive regard from significant others.
These “significant others” most times are the client’s parents, teachers, bosses, someone that is seen to have some control over the client. When a client perceives unconditional positive regard, their existing conditions of low worth are weakened and are soon replaced by a stronger unconditional positive self-regard. Existential Psychotherapy is a form that aims to enhance self-knowledge in the client and allows them to be the sole person responsible for their own lives and choices.
References
Cardemil, E. & Battle, C. L., 2003. (Brown University and Butler Hospital) Professional Psychology: Research and Practice American Psychological Association, Inc. Vol. 34, No. 3.
Carl Rogers. On Becoming a Person: A Therapist’s View of Psychotherapy: Boston: Houghton Mifflin, 1965.
Cooper, M. (2003). Existential Therapies: London: Sage Publications.
Frankl, V. (1955). The doctor and the soul. New York: Vintage.
Lantz, J., & Gregoire, T. (2000). Existential psychotherapy with Vietnam veteran couples: A twenty-five year report. Contemporary Family Therapy, 22, 19-37.
Mahrer, A. R. (1997). Experiential psychotherapy: An unabashedly biased comparison with some other psychotherapies. In C. Feltham (Ed.), Which psychotherapy? Leading exponents explain their differences (pp. 119–148). London: Sage.
May, Rollo. (1983). The discovery of being: Writings in existential psychology. New York: Norton.
May, Rollo: The Meaning of Anxiety: 2005: W. W. Norton & Company; Revised edition.
Pope-Davis, D. B. & Coleman, H. L. K., 1997: Multicultural counseling competencies: Thousand Oaks, CA.
Richard I. Evans. Carl Rogers: The Man and His Ideas. Vol. 8 of Notable Contributors to Personality Theory: New York: E. P. Dutton, 1975.
Schaeffer, F., 1968: The God Who is There. Published by Inter Varsity Press (U.S.A. and Canada).
Wong, P.S., 2005. The inscrutable Dr.Wu. In C. Muran (Ed.) Dialogues in Difference: Diversity Studies of the Therapeutic Relationship. APA Books.
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