Existential Therapy
Existential Therapy helps with the same issues you might take to any mainstream counsellor or psychotherapist; it is counselling and psychotherapy. At the same time it is more, for we are more than our psychology: for example, we also need philosophical reflection, for the sake of growing as people toward greater meaning and value. The word philosophy is a conjunction of two ancient Greek words, which means love of wisdom. It is not inherently about academic scholarship, but rather wiser reflection, which leads to wiser choices, and to a wiser way of being. Decades of working as a therapist have only increased my sense that therapy should be as philosophical as it is psychological. That it has been an error to do philosophy in such a reductively psychological way, as it was the twentieth century (and as it increasingly is!). We need more than psychological technologies, we need growth in wisdom and all that is best in us as individuals, to face our challenges and become more capable.
My philosophical counselling, described here, is the combination of philosophy and counselling. My existential therapy is such philosophical counselling, but with the further addition of psychotherapy. The word psychotherapy is an umbrella term for the range of different psychotherapies. A psychotherapy can be defined as a psychological theory about human nature, including its ills and the antidotes to those ills. This theory is applied as a therapy, as a set of practices aimed at healing and growth. We can see here the difference between psychotherapy, versus counselling (which is not about a theory, but rather a rich set of skills for drawing forth insight and motivation, whatever the topic). Some counsellors are solely counsellors, while others engage in both counselling and psychotherapy. Some psychotherapists focus on one "pure" psychotherapeutic approach--they are psychoanalysts, or gestalt therapists, et alia. Perhaps they have gained their qualification from an institute which focuses solely on one approach. Other therapists prefer to integrate different approaches. Many counsellors were taught a variety of psychotherapeutic approaches during their training, in addition to pure counselling, and this was the case with me. Hence, by training and by preference, I draw on many psychotherapies, as a way of tailoring my work to each client.
Various psychotherapies?
On the previous page I described Philosophical Counselling in some more detail, but what are the various psychotherapies which, when added to it, create Existential Therapy? They include various distinct traditions including the psychodynamic (or psychoanalytic) traditions, the humanistic, and the cognitive-behavioural. What follows are some partial snapshots of those, in terms of their relevance for my therapeutic service to you.
The psychodynamic therapies help you to understand how you became the way you are, especially (but not only) in terms of nurture and experience, and the early defenses and life strategies you developed to navigate life's difficulties. This is not an obsession with the past, rather it helps you to see how, perhaps unintentionally, you are still living in the past, you are still responding to that past world, as your way of being even now. In doing this, psychodynamic therapy helps you free yourself to live more fully in present reality and do life better. After all, some of those defenses and strategies will be out of your awareness, and in adulthood they will backfire or undermine your life. Hence the confusing repetitions of problems in your life. Psychodynamic therapies give us tools for recognising and examining these dynamics and choosing differently.
The humanistic therapies include Person-Centred Therapy, Gestalt Therapy, the Existential Therapies, and others. Many of these therapies help us to "be with" ourselves: to become more in-touch, self-aware, courageous, authentic, and so forth. Through the therapeutic relationship we come to be differently with others and ourselves. This is a less technocratic approach, which relies rather (and quite rightly) on the power of relationship and honesty to bring about something better.
There are various distinct approaches to Existential Therapy. These include Irvin Yalom's work, which frames the challenges of life in psychodynamic-existential terms. That is, death, freedom, responsibility, and so on make us anxious, and so we form psychological defenses against them--bad ways of coping, forms of avoidance--which in many ways come to diminish our lives. The existential therapy of Viktor Fankl, called Logotherapy, suggests that people can readily find their way forward, so long as they develop an adequate sense of meaning and purpose. The Existential Therapy of Emmy van Deurzen is applied existentialism and phenomenology, helping people to take stock of life, to better understand themselves and their context, and to face life with greater resolve and spirit.
The cognitive-behavioural therapies include many skills for creating change, from reshaping how you think, which changes how you feel and act (e.g. CBT), to learning to relate differently to your embodied sensations and emotions--responding rather than reacting (e.g. ACT). These therapies can be quite technological and superficial, especially within therapeutic traditions which reduce everything to science and technology (that is, scientism and technocracy), and yet they provide excellent tools, many of which are repetitions of ancient philosophical and spiritual practices. Rather than reject this approach because of the superficialities of which it is often rightly accused, I make use of its virtues, but within a more meaningful context.
It is worth briefly mentioning a related area which I draw on: Positive Psychology. The essence of this approach is captured in the realisation that psychology spent a century studying what goes wrong, but it was time also to study what goes right. Hence, this is a field of psychological research which studies happiness, success, flourishing, the cultivation of strengths, talents and virtues, moral values, and so forth. It is in many ways the modern scientific answer to the ancient Greek philosophy of Aristotle--they form an excellent complement to each other. I have drawn much from this research.
These different therapies can be very complementary insofar as one is skillful in their combination. For example, psychodynamic therapy may generate insight into your problematic patterns of being, humanistic therapy may bring you into a different way of being, and CBT may give you tools to habituate that new way of being. I wrote on the about me page about how I spent over a decade working in a variety of counselling organisations, developing knowledge and skills across these mainstream psychotherapies. In my service you do not have to choose between the different therapies, for I draw on elements from all of them, mixing and matching as suits each client. Indeed, this is a vital part of my skill and work: reading each different individual, and working with them in ways that suit their psychology and temperament, to bring about desired changes.
What does this approach look like in practice?
So that is the framework--the blending of philosophy, plus counselling, plus psychotherapy--but what does this approach look like in practice? I will answer that question with two fictional examples: Tim who experiences depression, and Jenna who experiences anxiety. I work with many different issues, but I choose these two in particular because some people assume that these are inherently clinical problems, which they are not. There is tremendous and growing pressure today to do therapy in a clincal (medicalised) way, and my therapy resists such ideology--such objectification and technocracy--in favour of a more fully human approach.
Tim comes with depression....
Imagine that Tim comes to therapy because he feels depressed. If Tim sees a psychologist instead of me, that professional will probably draw on the clinical schema for depression and its indicated treatments, as set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). My therapy, however, is in no way clinical. However, research suggests that more than 90 per cent of depression is not an illness, but rather a reaction to a life adversity. For such depression, Existential Therapy can be an excellent option. As such a therapist, I do not view the majority of depression as an illness or disorder, rather I view it as a challenge in living, an expression in a person of the human condition, and an experience of a dimension of reality, which calls for greater insight and personal growth. If Tim views himself fundamentally as an object within the schema of science and technology--as a kind of machine to be diagnosed and fixed--then he may prefer clinical treatment. In that case, Tim will probably find my approach frustrating. However, if Tim sees himself and his challenges as human in a deeper sense, and as requiring insight, effort, and personal growth, then he will probably gain greater benefit from my approach.
I may start by engaging Tim in a phenomenological exploration of his experience. Phenomenology is a philosophical exploration and so description what is, avoiding assumptions and using words that most capture the direct experience. Through such phenomenological exploration with Tim we may find that certain words resonate with and shed further light on what he is actually experiencing. Let us imagine that these include despair, pointlessness, boredom, and anger. Unlike clinical language which is theoretical and often at a distance from individual experience, phenomenological analysis has led Tim to a language which increases his understanding, and which provides handles to do something with his experience at both an inward and outward level.
At one level Tim has generated vital information. At another, he has become more capable. With respect to the latter, Tim now has an increased ability to recognise and navigate what is happening within himself. Phenomenological introspection is a practice and the therapy is leading Tim to become more skilled in it as a habit. This ability to be more insightfully aware of oneself in each moment means becoming more free to choose one's responses, rather than blindly reacting and so becoming entangled in certain patterns of mood and action.
The insights Tim has gained through phenomenological exploration give him sets of handles by which to get a grip on his problems. We might use those handles to do further insight work, for example by developing a clearer understanding of how Tim's despair, pointlessness, boredom, and anger arise and fall in the context of his life. What is contributing that (and what needs to change?) both on a day to day basis, and in terms of Tim's bigger or deeper concerns? This opens up various lines of enquiry and work.
Unlike a purely phenomenological therapist, at a certain point I will lead Tim from phenomenology into other kinds of philosophy. For example we may then explore how Tim's particular worldview contributes to his negative experiences, and how this shows up problems in his worldview. We may then work on those problems, and tweaking or perhaps radically changing how Tim sees the world. For example, is Tim hiding behind cynicism, which he has loosely dressed up as courage or rationality?
All of these explorations will inform each other. For example, having explored Tim's worldview, we might also explore what virtues or character strengths he is in need of? To consider an intellectual virtue, is there a lack of intellectual humility here, for example does Tim assume that he knows with certainty what is possible in life or specifically for him, such that despite there being more possiblities than he realises, he does not even try and gives himself over to despair? We could call this a failure of rationality, despite Tim's hiding behind the pretence of rationality in the paragraph above. Or to take courage, again from the above paragraph, is Tim deficient in the level of courage needed to find adequate purpose and satisfaction in life? If so, we will work on that. After all, the virtues are innate traits, rather they are things we choose and cultivate. There are as many virtues as there are "good qualities" which people need for their good life. Is there a lack of temperace in Tim, such that he does not stick with the things which, in time, make life more meaningful and pleasurable? Is there a lack of justice and wisdom in Tim's way of seeing things, such that in his interactions with others he is constantly angered, at least inwardly, and also such that he irrationally draws conclusions about all of life?
There are many more aspects to consider from a philosophical perspective, for example Tim's cultural influences, but these examples of phenomenological exploration, worldview analysis, and virtue cultivation, give an indication of the kind of work I do with people.
What I have described is, of course, not distinct from Philosophical Counselling. So what about the psychotherapeutic dimension which makes this something more: Existential Therapy? Beyond the above work, I might also engage Tim in a psychodynamic analysis of his way of being. For example, we might explore his attachment style, his defenses, and his old habitual life strategies and projects. Is Tim living out an old way of reacting to the world, which protected him when young, but which now impoverishes his emotional life? In that case Tim's current suffering is a sign, and a map, inviting him to choose a new, more mature way of coping with life, which let's more of the good stuff in. To make that new way of being a reality, we might use tools from cognitive-behavioural therapy, and of course the humanistic aspects of the counselling relationship may be highly impactful even if we never name them.
Hopefully you have a sense that the philosophical work is highly important, as much as the psychological work. Why choose one and neglect or reject the other? It is not a competition, these are not tribes at war. Or at least, they do not have to be. Why not do both kinds of work?
What I have described above is an example; it is not "the schema" for how I work with any depresssion. Rather, it shows some of the things I might do. As a theraist I "read" each client in their individuality, and do the things which may best work for them, integrating different therapeutic approaches as needed. Hence, my work looks different with each client. With some people the counselling is very philosophical, while with others it is barely philosophical and much classically therapeutic, while with many it is a mixture. And that mixture can vary: it is very cognitive and behavioural with some people, very humanistic with others, and quite psychodynamic with yet others.
Jenna comes with anxiety....
If Jenna comes to me speaking of anxiety, we may also engage in a phenomenological exploration and the other kinds of philosophical analysis mentioned above. Let us focus, however, on the kind of distinctly existential analysis which might inform our work, and which gives its name to this therapy. I could make the very existential point to Jenna, that we should not assume that anxiety is merely irrational or disordered--a mental illness--but rather it is an understandable reaction to life; for life is a dangerous situation. To be human is to be vulnerable in so many potentially terrible ways. The typically clinical question Why are you anxious? might have things backwards. Perhaps the better question is Why are people not more anxious? When we see anxiety from an existential lens, the assumption that it is a mental illness appears quite strange. Through guiding Jenna to view her anxiety as a natural part of life, an existential fact of life, I can help her to work on developing a different relationship with it. It is not about curing a mental disease, but rather of becoming more wise, skillful, and strong: the approach of the martial artist rather than the surgeon.
In the light of an existential and phenomenological analysis, we might conclude that Jenna's problem lies less in her anxiety, and more in her reactions to her anxiety. Perhaps Jenna stiffens up physically, emotionally, or socially; perhaps she becomes mentally absent, or aggressive, or self-destructive, as a psychological defense. Perhaps the issue is simply that Jenna becomes anxious about her anxiety, fearful of becoming afraid. Jenna may come to see that she viewed her anxiety simplistically, as a unitary thing, whereas in fact it has parts and levels. She realises that when previous she said "I have anxiety, and it is out of my control" that she was wrong. Yes, there may be elements that are out of her control, but there are also elements that are within her power to change.
As a recovering alcoholic might point out, we need the courage to change the things we can, and the wisdom to accept what we cannot. This idea is taken from Stoic philosophy. Surprisingly, while it is common to assume that acceptance is some simple kind of resignation that is straightfoward even if it is hard, the truth is that resignation is the rich, complex, and active thing, far moreso than change. However, that is a conversation for another day. Focusing, for now, on acceptance from a pragmatic point of view, I might help Jenna attend to her anxiety in a way that reduces it to its most basic phenomenological essence (in a loose sense). We might do this in terms of its sensational components--say a tightened chest, or a churning stomach--and I may coach Jenna to sit with that and attend to it as nothing more than that. This is a very Buddhist practice which is helpful to anybody. This reduction of the anxiety to a certain essence will be in contrast to Jenna's typical and unexamined habit. Typically Jenna has these essential sensations, but also reacts to them with awareness, in a way that generates many further kinds of angst. Jenna has assumed that the fireball of reactions is all part of the essential anxiety, when in fact it is her reaction to the essential anxiety. Through her unawareness and reactivity, Jenna has multiplied her anxiety into something bigger and much worse than the essential sensation. She is in effect assuming that her reactions happen to her, when in fact they are something that she is doing. By becoming skillful at a phenomenologica reduction of her anxiety to, say, its essential sensations, and being able to sit with those without reacting to them, Jenna may find that she can easily live with them, even if they are uncomfortable. Jenna may find that she does not suffer those old conflagrations of anxiety--sensations but also terrible feelings, general distress, catastrophic thoughts which, in fact, she was generating in response to those feelings.
I have just pointed to the path of acceptance--developing a different relationship with what is, accepting it and holding it differently, including non-reactively. This approach can be applied to any form of suffering, and it can make a drastic difference. There is a paradox in such an approach, in that precisely by letting go of the need to change things, and developing a profound form of aceeptance--relating to reality very differently--things often change. But the change only comes by genuinely letting go of the need for it. Such an idea has a rich tradition within Stoicism, Buddhism, and other philosophies, spiritualities, and religions. Of course, even if it is of secondary value, engaging in strategic change is also very important, and Jenna and I will also do that work.
A major action in this "talking therapy" is to expose Jenna's anxiety to the light of reflection and reason, and to see what happens when we do that. For it is in the dark that our psychological tangles fester and grow--the darkness of blindness, ignorance, unconsciousness. In exploring her anxiety, we might notice that when Jenna imagines being old, poor, and alone, she is imagining a state which is in the future, and the future is not something she can control right now. Hence, Jenna's picture of the future includes a notion of the future situation as something out of her control. But she has just conflated her current relationship with a future event, with her relationship with it if and when it happens. This may sound rather abstract, but it is very common. In unpacking the logic of Jenna's terrible fantasies about the future, she may come to see the ways in which they are based on irrationalities which she did not recognise, and by undermining that irrationality the fear starts to lose its hold, especially insofar as we do this with the bundle of various tangled irrationalities that hold together in her mind. This is a process of growing self-awareness and wisdom.
Beyond such irrationalities, there are also many things that Jenna forgets, as she fantasise about the horrible future in store for her. What about her neglected desire for a deeper philosophy or spirituality, which can transform such experience? Why does she not work on that, by exploring those possibilities and putting certain things into practice? Furthermore, what about those old people who are experiencing the poverty or illness which Jenna fears, and yet who make their life deeply meaningful. Some such people turn their late life into gift to the world around them, in terms of how they interact or what they do for others, whether formally or informally. Much of our misery is a failure to grow into our higher possibilities, which in themselves transcend our fears and ego, by making our life into something more. The fact is that we are surrounded by people who make these differences in their life as the years go on, although of course they are invisible to us unless we pay attention and reflect.
Once again, the above work requires more than psychological self-understanding and working on our perception and mindset. Consistent with those tasks is the work of growth in the other virtues. For example, it takes much courage to step up into our better possibilities. It takes virtues such as courage, wisdom, temperance, hope, humility, creativity, and others. Much of our suffering reflects a need for growth in the virtues which enable us to become stronger, happier, wiser. Without those qualities, all the psychological techniques, and all the love from others in our lives, may make little difference. The different maladies also point to key virtues which need cultivation. The corresponding virtue is not always obvious, but consider how depression is a form of despair, and how the opposite virtues may therefore include hope and intellectual humility, or how anxiety is a form of fear which may call for the cultivation of greater courage. I am not blaming people for their maladies--it is human to suffer them, we all so--but I am saying that we each have impressive capacities within ourselves for growing in ways that change them, whether by freeing us from them, or reducing their power over us.
In Conclusion
The view of Existential Therapy is that your suffering and challenges call on you to draw on all that is better within yourself. That includes your capacities for intelligence, insight, wisdom, courage, will-power, determination, emotional skillfulness, compassion, and so on. Your challenges are an invitation to accept and enact your particular "hero's journey," to grow, and to live and experience in fuller ways. The goal of existential therapy is not safety, but rather capacity. It is to take an active rather than passive approach to life. To reach deep within yourself. Existential Therapy is about doing something with what life has done to you. And it is about doing something with life, full stop. It is about shaping things, both within and without. In taking such a stance, and doing these things, this therapy is about finding your strength, your joy, your meaning. In our therapeutic hours I invite you to live this way, to go deep into your concerns and your life, as a springboard to continue such living outside of our hours together.
Existential Therapy helps with the same issues you might take to any mainstream counsellor or psychotherapist; it is counselling and psychotherapy. At the same time it is more, for we are more than our psychology: for example, we also need philosophical reflection, for the sake of growing as people toward greater meaning and value. The word philosophy is a conjunction of two ancient Greek words, which means love of wisdom. It is not inherently about academic scholarship, but rather wiser reflection, which leads to wiser choices, and to a wiser way of being. Decades of working as a therapist have only increased my sense that therapy should be as philosophical as it is psychological. That it has been an error to do philosophy in such a reductively psychological way, as it was the twentieth century (and as it increasingly is!). We need more than psychological technologies, we need growth in wisdom and all that is best in us as individuals, to face our challenges and become more capable.
My philosophical counselling, described here, is the combination of philosophy and counselling. My existential therapy is such philosophical counselling, but with the further addition of psychotherapy. The word psychotherapy is an umbrella term for the range of different psychotherapies. A psychotherapy can be defined as a psychological theory about human nature, including its ills and the antidotes to those ills. This theory is applied as a therapy, as a set of practices aimed at healing and growth. We can see here the difference between psychotherapy, versus counselling (which is not about a theory, but rather a rich set of skills for drawing forth insight and motivation, whatever the topic). Some counsellors are solely counsellors, while others engage in both counselling and psychotherapy. Some psychotherapists focus on one "pure" psychotherapeutic approach--they are psychoanalysts, or gestalt therapists, et alia. Perhaps they have gained their qualification from an institute which focuses solely on one approach. Other therapists prefer to integrate different approaches. Many counsellors were taught a variety of psychotherapeutic approaches during their training, in addition to pure counselling, and this was the case with me. Hence, by training and by preference, I draw on many psychotherapies, as a way of tailoring my work to each client.
Various psychotherapies?
On the previous page I described Philosophical Counselling in some more detail, but what are the various psychotherapies which, when added to it, create Existential Therapy? They include various distinct traditions including the psychodynamic (or psychoanalytic) traditions, the humanistic, and the cognitive-behavioural. What follows are some partial snapshots of those, in terms of their relevance for my therapeutic service to you.
The psychodynamic therapies help you to understand how you became the way you are, especially (but not only) in terms of nurture and experience, and the early defenses and life strategies you developed to navigate life's difficulties. This is not an obsession with the past, rather it helps you to see how, perhaps unintentionally, you are still living in the past, you are still responding to that past world, as your way of being even now. In doing this, psychodynamic therapy helps you free yourself to live more fully in present reality and do life better. After all, some of those defenses and strategies will be out of your awareness, and in adulthood they will backfire or undermine your life. Hence the confusing repetitions of problems in your life. Psychodynamic therapies give us tools for recognising and examining these dynamics and choosing differently.
The humanistic therapies include Person-Centred Therapy, Gestalt Therapy, the Existential Therapies, and others. Many of these therapies help us to "be with" ourselves: to become more in-touch, self-aware, courageous, authentic, and so forth. Through the therapeutic relationship we come to be differently with others and ourselves. This is a less technocratic approach, which relies rather (and quite rightly) on the power of relationship and honesty to bring about something better.
There are various distinct approaches to Existential Therapy. These include Irvin Yalom's work, which frames the challenges of life in psychodynamic-existential terms. That is, death, freedom, responsibility, and so on make us anxious, and so we form psychological defenses against them--bad ways of coping, forms of avoidance--which in many ways come to diminish our lives. The existential therapy of Viktor Fankl, called Logotherapy, suggests that people can readily find their way forward, so long as they develop an adequate sense of meaning and purpose. The Existential Therapy of Emmy van Deurzen is applied existentialism and phenomenology, helping people to take stock of life, to better understand themselves and their context, and to face life with greater resolve and spirit.
The cognitive-behavioural therapies include many skills for creating change, from reshaping how you think, which changes how you feel and act (e.g. CBT), to learning to relate differently to your embodied sensations and emotions--responding rather than reacting (e.g. ACT). These therapies can be quite technological and superficial, especially within therapeutic traditions which reduce everything to science and technology (that is, scientism and technocracy), and yet they provide excellent tools, many of which are repetitions of ancient philosophical and spiritual practices. Rather than reject this approach because of the superficialities of which it is often rightly accused, I make use of its virtues, but within a more meaningful context.
It is worth briefly mentioning a related area which I draw on: Positive Psychology. The essence of this approach is captured in the realisation that psychology spent a century studying what goes wrong, but it was time also to study what goes right. Hence, this is a field of psychological research which studies happiness, success, flourishing, the cultivation of strengths, talents and virtues, moral values, and so forth. It is in many ways the modern scientific answer to the ancient Greek philosophy of Aristotle--they form an excellent complement to each other. I have drawn much from this research.
These different therapies can be very complementary insofar as one is skillful in their combination. For example, psychodynamic therapy may generate insight into your problematic patterns of being, humanistic therapy may bring you into a different way of being, and CBT may give you tools to habituate that new way of being. I wrote on the about me page about how I spent over a decade working in a variety of counselling organisations, developing knowledge and skills across these mainstream psychotherapies. In my service you do not have to choose between the different therapies, for I draw on elements from all of them, mixing and matching as suits each client. Indeed, this is a vital part of my skill and work: reading each different individual, and working with them in ways that suit their psychology and temperament, to bring about desired changes.
What does this approach look like in practice?
So that is the framework--the blending of philosophy, plus counselling, plus psychotherapy--but what does this approach look like in practice? I will answer that question with two fictional examples: Tim who experiences depression, and Jenna who experiences anxiety. I work with many different issues, but I choose these two in particular because some people assume that these are inherently clinical problems, which they are not. There is tremendous and growing pressure today to do therapy in a clincal (medicalised) way, and my therapy resists such ideology--such objectification and technocracy--in favour of a more fully human approach.
Tim comes with depression....
Imagine that Tim comes to therapy because he feels depressed. If Tim sees a psychologist instead of me, that professional will probably draw on the clinical schema for depression and its indicated treatments, as set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). My therapy, however, is in no way clinical. However, research suggests that more than 90 per cent of depression is not an illness, but rather a reaction to a life adversity. For such depression, Existential Therapy can be an excellent option. As such a therapist, I do not view the majority of depression as an illness or disorder, rather I view it as a challenge in living, an expression in a person of the human condition, and an experience of a dimension of reality, which calls for greater insight and personal growth. If Tim views himself fundamentally as an object within the schema of science and technology--as a kind of machine to be diagnosed and fixed--then he may prefer clinical treatment. In that case, Tim will probably find my approach frustrating. However, if Tim sees himself and his challenges as human in a deeper sense, and as requiring insight, effort, and personal growth, then he will probably gain greater benefit from my approach.
I may start by engaging Tim in a phenomenological exploration of his experience. Phenomenology is a philosophical exploration and so description what is, avoiding assumptions and using words that most capture the direct experience. Through such phenomenological exploration with Tim we may find that certain words resonate with and shed further light on what he is actually experiencing. Let us imagine that these include despair, pointlessness, boredom, and anger. Unlike clinical language which is theoretical and often at a distance from individual experience, phenomenological analysis has led Tim to a language which increases his understanding, and which provides handles to do something with his experience at both an inward and outward level.
At one level Tim has generated vital information. At another, he has become more capable. With respect to the latter, Tim now has an increased ability to recognise and navigate what is happening within himself. Phenomenological introspection is a practice and the therapy is leading Tim to become more skilled in it as a habit. This ability to be more insightfully aware of oneself in each moment means becoming more free to choose one's responses, rather than blindly reacting and so becoming entangled in certain patterns of mood and action.
The insights Tim has gained through phenomenological exploration give him sets of handles by which to get a grip on his problems. We might use those handles to do further insight work, for example by developing a clearer understanding of how Tim's despair, pointlessness, boredom, and anger arise and fall in the context of his life. What is contributing that (and what needs to change?) both on a day to day basis, and in terms of Tim's bigger or deeper concerns? This opens up various lines of enquiry and work.
Unlike a purely phenomenological therapist, at a certain point I will lead Tim from phenomenology into other kinds of philosophy. For example we may then explore how Tim's particular worldview contributes to his negative experiences, and how this shows up problems in his worldview. We may then work on those problems, and tweaking or perhaps radically changing how Tim sees the world. For example, is Tim hiding behind cynicism, which he has loosely dressed up as courage or rationality?
All of these explorations will inform each other. For example, having explored Tim's worldview, we might also explore what virtues or character strengths he is in need of? To consider an intellectual virtue, is there a lack of intellectual humility here, for example does Tim assume that he knows with certainty what is possible in life or specifically for him, such that despite there being more possiblities than he realises, he does not even try and gives himself over to despair? We could call this a failure of rationality, despite Tim's hiding behind the pretence of rationality in the paragraph above. Or to take courage, again from the above paragraph, is Tim deficient in the level of courage needed to find adequate purpose and satisfaction in life? If so, we will work on that. After all, the virtues are innate traits, rather they are things we choose and cultivate. There are as many virtues as there are "good qualities" which people need for their good life. Is there a lack of temperace in Tim, such that he does not stick with the things which, in time, make life more meaningful and pleasurable? Is there a lack of justice and wisdom in Tim's way of seeing things, such that in his interactions with others he is constantly angered, at least inwardly, and also such that he irrationally draws conclusions about all of life?
There are many more aspects to consider from a philosophical perspective, for example Tim's cultural influences, but these examples of phenomenological exploration, worldview analysis, and virtue cultivation, give an indication of the kind of work I do with people.
What I have described is, of course, not distinct from Philosophical Counselling. So what about the psychotherapeutic dimension which makes this something more: Existential Therapy? Beyond the above work, I might also engage Tim in a psychodynamic analysis of his way of being. For example, we might explore his attachment style, his defenses, and his old habitual life strategies and projects. Is Tim living out an old way of reacting to the world, which protected him when young, but which now impoverishes his emotional life? In that case Tim's current suffering is a sign, and a map, inviting him to choose a new, more mature way of coping with life, which let's more of the good stuff in. To make that new way of being a reality, we might use tools from cognitive-behavioural therapy, and of course the humanistic aspects of the counselling relationship may be highly impactful even if we never name them.
Hopefully you have a sense that the philosophical work is highly important, as much as the psychological work. Why choose one and neglect or reject the other? It is not a competition, these are not tribes at war. Or at least, they do not have to be. Why not do both kinds of work?
What I have described above is an example; it is not "the schema" for how I work with any depresssion. Rather, it shows some of the things I might do. As a theraist I "read" each client in their individuality, and do the things which may best work for them, integrating different therapeutic approaches as needed. Hence, my work looks different with each client. With some people the counselling is very philosophical, while with others it is barely philosophical and much classically therapeutic, while with many it is a mixture. And that mixture can vary: it is very cognitive and behavioural with some people, very humanistic with others, and quite psychodynamic with yet others.
Jenna comes with anxiety....
If Jenna comes to me speaking of anxiety, we may also engage in a phenomenological exploration and the other kinds of philosophical analysis mentioned above. Let us focus, however, on the kind of distinctly existential analysis which might inform our work, and which gives its name to this therapy. I could make the very existential point to Jenna, that we should not assume that anxiety is merely irrational or disordered--a mental illness--but rather it is an understandable reaction to life; for life is a dangerous situation. To be human is to be vulnerable in so many potentially terrible ways. The typically clinical question Why are you anxious? might have things backwards. Perhaps the better question is Why are people not more anxious? When we see anxiety from an existential lens, the assumption that it is a mental illness appears quite strange. Through guiding Jenna to view her anxiety as a natural part of life, an existential fact of life, I can help her to work on developing a different relationship with it. It is not about curing a mental disease, but rather of becoming more wise, skillful, and strong: the approach of the martial artist rather than the surgeon.
In the light of an existential and phenomenological analysis, we might conclude that Jenna's problem lies less in her anxiety, and more in her reactions to her anxiety. Perhaps Jenna stiffens up physically, emotionally, or socially; perhaps she becomes mentally absent, or aggressive, or self-destructive, as a psychological defense. Perhaps the issue is simply that Jenna becomes anxious about her anxiety, fearful of becoming afraid. Jenna may come to see that she viewed her anxiety simplistically, as a unitary thing, whereas in fact it has parts and levels. She realises that when previous she said "I have anxiety, and it is out of my control" that she was wrong. Yes, there may be elements that are out of her control, but there are also elements that are within her power to change.
As a recovering alcoholic might point out, we need the courage to change the things we can, and the wisdom to accept what we cannot. This idea is taken from Stoic philosophy. Surprisingly, while it is common to assume that acceptance is some simple kind of resignation that is straightfoward even if it is hard, the truth is that resignation is the rich, complex, and active thing, far moreso than change. However, that is a conversation for another day. Focusing, for now, on acceptance from a pragmatic point of view, I might help Jenna attend to her anxiety in a way that reduces it to its most basic phenomenological essence (in a loose sense). We might do this in terms of its sensational components--say a tightened chest, or a churning stomach--and I may coach Jenna to sit with that and attend to it as nothing more than that. This is a very Buddhist practice which is helpful to anybody. This reduction of the anxiety to a certain essence will be in contrast to Jenna's typical and unexamined habit. Typically Jenna has these essential sensations, but also reacts to them with awareness, in a way that generates many further kinds of angst. Jenna has assumed that the fireball of reactions is all part of the essential anxiety, when in fact it is her reaction to the essential anxiety. Through her unawareness and reactivity, Jenna has multiplied her anxiety into something bigger and much worse than the essential sensation. She is in effect assuming that her reactions happen to her, when in fact they are something that she is doing. By becoming skillful at a phenomenologica reduction of her anxiety to, say, its essential sensations, and being able to sit with those without reacting to them, Jenna may find that she can easily live with them, even if they are uncomfortable. Jenna may find that she does not suffer those old conflagrations of anxiety--sensations but also terrible feelings, general distress, catastrophic thoughts which, in fact, she was generating in response to those feelings.
I have just pointed to the path of acceptance--developing a different relationship with what is, accepting it and holding it differently, including non-reactively. This approach can be applied to any form of suffering, and it can make a drastic difference. There is a paradox in such an approach, in that precisely by letting go of the need to change things, and developing a profound form of aceeptance--relating to reality very differently--things often change. But the change only comes by genuinely letting go of the need for it. Such an idea has a rich tradition within Stoicism, Buddhism, and other philosophies, spiritualities, and religions. Of course, even if it is of secondary value, engaging in strategic change is also very important, and Jenna and I will also do that work.
A major action in this "talking therapy" is to expose Jenna's anxiety to the light of reflection and reason, and to see what happens when we do that. For it is in the dark that our psychological tangles fester and grow--the darkness of blindness, ignorance, unconsciousness. In exploring her anxiety, we might notice that when Jenna imagines being old, poor, and alone, she is imagining a state which is in the future, and the future is not something she can control right now. Hence, Jenna's picture of the future includes a notion of the future situation as something out of her control. But she has just conflated her current relationship with a future event, with her relationship with it if and when it happens. This may sound rather abstract, but it is very common. In unpacking the logic of Jenna's terrible fantasies about the future, she may come to see the ways in which they are based on irrationalities which she did not recognise, and by undermining that irrationality the fear starts to lose its hold, especially insofar as we do this with the bundle of various tangled irrationalities that hold together in her mind. This is a process of growing self-awareness and wisdom.
Beyond such irrationalities, there are also many things that Jenna forgets, as she fantasise about the horrible future in store for her. What about her neglected desire for a deeper philosophy or spirituality, which can transform such experience? Why does she not work on that, by exploring those possibilities and putting certain things into practice? Furthermore, what about those old people who are experiencing the poverty or illness which Jenna fears, and yet who make their life deeply meaningful. Some such people turn their late life into gift to the world around them, in terms of how they interact or what they do for others, whether formally or informally. Much of our misery is a failure to grow into our higher possibilities, which in themselves transcend our fears and ego, by making our life into something more. The fact is that we are surrounded by people who make these differences in their life as the years go on, although of course they are invisible to us unless we pay attention and reflect.
Once again, the above work requires more than psychological self-understanding and working on our perception and mindset. Consistent with those tasks is the work of growth in the other virtues. For example, it takes much courage to step up into our better possibilities. It takes virtues such as courage, wisdom, temperance, hope, humility, creativity, and others. Much of our suffering reflects a need for growth in the virtues which enable us to become stronger, happier, wiser. Without those qualities, all the psychological techniques, and all the love from others in our lives, may make little difference. The different maladies also point to key virtues which need cultivation. The corresponding virtue is not always obvious, but consider how depression is a form of despair, and how the opposite virtues may therefore include hope and intellectual humility, or how anxiety is a form of fear which may call for the cultivation of greater courage. I am not blaming people for their maladies--it is human to suffer them, we all so--but I am saying that we each have impressive capacities within ourselves for growing in ways that change them, whether by freeing us from them, or reducing their power over us.
In Conclusion
The view of Existential Therapy is that your suffering and challenges call on you to draw on all that is better within yourself. That includes your capacities for intelligence, insight, wisdom, courage, will-power, determination, emotional skillfulness, compassion, and so on. Your challenges are an invitation to accept and enact your particular "hero's journey," to grow, and to live and experience in fuller ways. The goal of existential therapy is not safety, but rather capacity. It is to take an active rather than passive approach to life. To reach deep within yourself. Existential Therapy is about doing something with what life has done to you. And it is about doing something with life, full stop. It is about shaping things, both within and without. In taking such a stance, and doing these things, this therapy is about finding your strength, your joy, your meaning. In our therapeutic hours I invite you to live this way, to go deep into your concerns and your life, as a springboard to continue such living outside of our hours together.