Soon after the Second World War and the fall of the fascist regimes, the existential psychotherapy movement started to grow all over Europe, and it is still developing. It seems, however, that the approach has not yet reached its climax.
From the psychological establishment’s point of view one can see the growth of the existential approach as a reaction to the psychological and the behavioristic movements. From an historical-social point of view, the development of the existential approach could be seen as a reaction to the Second World War.
The existential approach is first and foremost based on philosophy; therefore, it could be said that its roots lie some 2,500 years ago, in the time of the Greek philosophers. Or was it even earlier?
The Age of Psychology
Is it possible to discover how old psychology and psychotherapy are? While trying to find an answer to this question, one faces a paradox: they are both ancient and new at the same time.
On the one hand, psychology is one of the oldest issues of human knowledge. Humans have questioned themselves and the causes for their behavior, feelings and thoughts from the day they stood upright on two legs. Therefore psychology is ancient.
On the other hand, it is also common to specify the year 1897 as the birth of scientific psychology. In this year, Wilhelm Wundt (1832-1920) founded the first laboratory that was devoted to the teaching and research of the psychological process. This was the first time that man left the chair where he was siting and thinking for thousands of tears about the mysteries of the behavior of human kind, and wore his white uniform in order to question it scientifically. This was the year when man first moved into the laboratory in order to observe under controlled conditions the source and the results of human beings and experience.
Even the word ‘psychology’, though modern, is older than the subject it now names. It is composed of Greek elements, but it is not Greek. It was created in the fifteenth century to refer to one aspect of the study of spiritual being. The whole study was called pneumatology, and psychology was the part concerned with the human soul. The roots of psychology can therefore be found much earlier than 1879 (O’neil, 1982).
One can learn about the dawn of psychology only from the time when man started writing. The first evidence of primary psychology is to be found in the “Golden age of Athens”, whose chief philosophers were Democritus (460-270 b.c.), Socrates (469-399 b.c.), Plato (427-347b.c.) and Aristotle (384-322 B.C.). These philosophers and others from the same era has raised significant psychological issues that are still relevant today.
The history of psychology is characterized by the raise and the fall of different schools of thought. Such changes do not occur peacefully. Schools of thought rival each other on the suitable definition of the right way to learn about the human being. What is important? What is to be investigated? Should one concentrate on the unconscious and the early childhood experiences or whether one’s system of behavior and the influence of the environment are the main issues.
The struggles between different schools of thought were always very strong. The new movements were usually created by younger scientist that had no obligations to the older ones. New scientific truth did not triumph by convincing the opponents and making them see the light, but rather because its opponents eventually died and a new generation grew up.
The Roots of Existentialism
Similar to the paradox of the age of psychology in general, a paradox occurs upon trying to find the birth date and the age of the existential approach. The answer to the question concerning the beginning of the existential approach can be divided into two main parts.
The first part traces the origins back 2,500 years, to the Greek philosophers. The second part regards the nineteenth and early twentieth centuries as the beginning of the modern existential approach.
It is widely accepted to find the roots of the existential approach in the writings of the Danish philosopher Soren Kierkegaard (1813-1855) and the German philosopher Frederic Nietzsche (1844-1900). However, modern existential approach developed mostly after the Second World War, and its main foundation was Martin Heidegger’s philosophy (1889-1976).
Existentialism is actually a philosophy that identifies the concept ‘reality’ with the concept of ‘human being’. This philosophy places the individual in the center (in a certain context though) and the only reality that exists is the one to which the individual refers and gives meaning to. Following this idea, all human being share similar universal-ontological givens, yet every man experiences and respond to these shared universal givens a bit differently. On the personal-ontic level, as Heidegger coined it, every man has a different reality and different truth, and therefore searching for objective universal truth is meaningless.
Identifying the concept of ‘reality’ with the concept of ‘human being’ is actually based on the philosophy of phenomenology, which was founded by Husserl (1859-1938). Therefore, Husserl might as well be regarded as one of the founders of modern existential- phenomenological philosophy.
The existential approach rejects the attempt of society to impose its set of morals and values on the individual. Religious sects, regimes and different kinds of ideologies obstruct the freedom of the individual and his ability to find his own personal truth.
The mass destruction that the fascist regimes had caused, the regimes that forced the supremacy of society and state on the individual and murdered millions of people, had the effect of replacing the individual and not the state or the society in the center. This phenomenon has led the flourish of modern existentialism.
Existentialism as a Therapeutic Approach
The Swiss psychiatrist Ludwig Binswanger (1881-1966) was among the first ones to apply existential thinking in his practice. He claimed that existential research orientation in psychiatry arose from dissatisfaction with the prevailing efforts to gain scientific understanding in psychiatry. Psychology and psychotherapy should not be merely concerned with mentally ill man, but rather with man as such.
Rollo May (1909-1994), the American existential psychologist, argued that the urge to investigate new direction in psychotherapy rose from the gap between the various psychoanalytic theories and the inability to bring ‘cures’. There was a need to understand the reality of a patient who cannot be categorized in any of the existing theories.
Ronald Laing (1927-1989), Scottish psychiatrist, challenged in his work the traditional psychiatrist diagnosis, questioned the use of medications and called upon seeing the individual rather the ill patient.
The existential approach sprang up spontaneously in different parts of Europe, and among different schools. Among the many thinkers, therapists and researchers were Eugene Minkowski (1885-1972) in Paris, Erwin Straus (1891-1975) in Germany, Ludwig Binswanger (1881-1966), Medard Boss (1903-1990) and Roland Kuhn (1912-2005) in Switzerland. These experienced therapists wanted to break away from Freudian and Jungian theories, although they agreed that sometimes those theories were necessary.
Ludwig Binswanger and Medard Boss who started their work at the beginning of the twentieth century, were among the few who attempted to refer their therapeutic experience to a new conceptual framework in order to see more clearly what had eluded previous explanations. Their work and writings are the most comprehensive and radical attempts made to provide a philosophical answer and alternative to Freud’s scientific project. They both called their approach ‘Daseinanalyse’, basing it to Heidegger’s philosophy of existence.
Recent existential psychotherapists and psychologists, such as Hans W. Cohn and Emmy van Deurzen, lead the growth of existential psychotherapy in United Kingdom. In 1996 Emmy Van Deurzen opened in London school for existential psychotherapy and counselling, with a specific purpose to create a training programme for existential psychotherapists and counsellors. The school attracted students from around the world, including myself. Few years later, in 2007 a postgraduate training programme in existential psychotherapy and counselling, led by Gideon Menda and Yali Sar-Shalom was launched at Kibbutzim College in Tel-Aviv, Israel. It was the first and sole full training programme in existential psychotherapy in Israel and it led to a greater awareness of the relevancy of this approach now-a-days.
Emmy Van Deurzen sees the existential approach as an approach concerned with the understanding of people’s position in the world and with the clarification of what it means to be alive. It concerns with the search for truth with an open mind and an attitude of wonder. In this sense, the historical background of the existential approach goes much further back, encompassing 2,500 years of philosophy.
During the history of mankind people have tried to make sense of human existence in general and their personal one in particular. The whole philosophical tradition is therefore relevant and can help an individual understand his position with regard to existential issues. The philosophical movement that is directly responsible for the generation of existential psychotherapy is that of phenomenology and existential philosophy.
The ancient existential approach started to flourish again in the nineteenth century as epitomized by the work of Soren Kierkegaard who protested against Christian dogma and the ‘objective science’ and Frederic Nietzsche who took this philosophy of life a step further, into the place where psychiatrists like Medard Boss and Ludwig Binswanger could bravely apply it to therapy.
Existentialism and the Purposes of the Therapeutic Process
Within the boundaries of existential psychotherapy, one can find a wide range of views. Opinions on the purpose of the approach vary between each therapist, between each philosopher and even between clients. Such is the unique quality of the existential approach that it opposes a strict framework, and allows a variety of colors. Nonetheless, it has a few main guidelines that identify it as a unique approach.
Four main existential givens and themes usually stand in the heart of existential psychotherapy: Death (and ontological anxiety); Isolation (and loneliness); Freedom (and responsibility); Meaning (and meaninglessness).
In the next paragraphs I will explore two of these themes, in addition to another purpose that stand in the heart of the existential approach: Facing reality.
o Death and Ontological Anxiety
Death and guilt motives are recognized as central issues in existential psychotherapy. It was Heidegger who argued that the fact of existence has to be faced in the certainty of death. Furthermore, anxiety over death has the potential to give life meaning in that death is the only certainty in life. The possibility of not existing or not being was believed by Heidegger to be an anxiety central to the human condition (Heidegger, 1962)
The well-known existential psychiatrist Viktor Frankl (1905-1997) believed that death and guilt means twofold fact of man’s mortality and fallibility. It has become fashionable to blame existential philosophy for over emphasizing the tragic aspects of human existence, says Frankl, and it is true that existential psychotherapy does center on issues such as death and suffering.
Psychotherapy cannot avoid confronting the client with pain, death and guilt. These three existential facts of life should be faced by the client rather than blurred and clouded by the therapist. Pain, death and guilt are inescapable. The more the neurotic tries to deny them, the more he entangles himself in additional suffering. Death and suffering belong to the human condition though they provoke anxiety.
Man cannot escape ontological anxiety and the fact that man is destined to die is the main and most terrifying truth. However, through therapy this terrifying truth can be shifted into optimism. If man were immortal, he would be justifying in delaying everything. There would be no need to do anything right now. Therefore, exploring death and ontological anxieties is part of the purpose of existential psychotherapy.
The theologian and existential philosopher Paul Tillich (1886-1965) argued that ontological anxiety is only one of three anxieties that are essential to the existence. The second anxiety is fear in the absence of knowledge of future outcomes. Man knows that there is no certainty that his aims would be fulfilled. Because man takes full responsibility for his destiny, he knows at the same time that he can make wrong decisions that will lead to failure. The knowledge that one’s future outcome depends on him makes the uincertainty especially frightening.
To this, the existential therapist James Bugental (1915-2008) added the fear of isolation. This anxiety is an outcome of the understanding that man is solely responsible for his life and when the time comes, he must face death alone.
These anxieties do not reflect psychopathology; on the contrary, they reflect authentic existence. Those anxieties are evidence of man’s eminence above the beast, since only man can ask questions and doubt his own meaning of existence. Existential therapy accepts these anxieties as an inseparable part of the human existence. Existential psychotherapy aims to provide the possibility of facing the anxieties, acknowledge the danger, yet still advance.
Through therapy, man can accept his finiteness and guilt. It still leaves man the freedom to choose the right attitude towards it. The therapist should recognize existential anxiety and guide the client in finding ways of dealing with it constructively.
o Freedom of Choice and Claiming Responsibility
Another central issue in the existential approach that also leads to a specific purpose in existential psychotherapy is the freedom of choice. In complete contrast to the psychoanalytic approach and behaviorism, Medard Boss claimed that existential phycology regards man as a totally free entity. That freedom of choice is absolute but it also exists within a given framework. Binswanger defines this as the ground of existence (Boss, 1963)
One of the meanings of comprehending a human being as a free entity is to regard him as the sole bearer for the responsibility of his existence. Unlimited freedom means also unlimited responsibility. A free man cannot give responsibility for his destiny to any other person. Any choice one takes is one’s own and sole choice. This means a heavy responsibility from which man, every now and then, tries to escape.
Every choice made by man necessarily means giving up other possibilities. Therefore man can never actualize all possibilities and he is doomed to experience existential guilt. Most people try to evade sole responsibility for themselves, and choose to live their lives not striving for self-fulfillment, but trying to match themselves to the expectations of their environment. Such people can experience cries that will make them experience neurotic guilt, which is more devastating than existential guilt.
Rollo May argued that the psychopathological choice is always a choice of the limited way of being. It is a choice that tries to evade ontological anxieties and neurotic guilt; therefore it leads to anxiety and neurotic guilt. The source of pathology is always the escape of a person from claiming responsibility for his life and from actualizing his authentic existence (May, 1958).
The only clients who can claim that their will is not free and there is no real freedom of choice are schizophrenic clients, suffering from delusions that their mind is manipulated by others who control their thoughts (Frankl, 1967).
The purpose of existential psychotherapy is therefore to bring the client back to an understanding of his ability and duty to choose and make decisions about almost every matter in his life. The purpose is to help the client bravely claim responsibility for the choices he makes, even though some of the choices may be wrong and disastrous.
o Facing Reality
Social and personal success and strong ego are not the true self. According to Kierkegaardian therapy, one has to shake off the outer façade in order to question and rediscover the true reality.
The existential purpose is to help people to meet their destiny, no matter what price has to be paid. People have to do this, no matter how much they mighty to hide. The existential project is to open up to the destiny that is our rather than try to evade it, and learn to open up to what is there in one’s life, no matter how hard the truth of one’s troubles.
The purpose of existential psychotherapy is to help in bravely confront reality. The aim is not to make things look better nor different from what they really are, but instead, to help clients to accommodate reality and become more full of life (Van Deurzen, 1997).
The questions that an existential psychotherapist initially asks are: what is it that the client does not want to know, cannot open up to, and cannot allow to be true. These questions illustrate the fundamental thinking of the existential approach. One has to face truth, the reality and the things one tries to hide from. The attempt to escape misfortune is a tragic mistake (Cohn, 1997).
The purpose of existential psychotherapy is therefore to help clients to acknowledge their ontological and ontic reality, confront it and bravely live their life more fully. This is done through a genuine nonjudgmental dialogue. A dialogue that allows a true communion and makes man feels he belongs, loves and is being loved, or as the Jewish philosopher Martin Buber named an ‘I-Thou’ encounter
These three purposes are strongly inter-connected. During the course of therapy, it is possible that only one, or more than one, will be explored.
During the history of mankind people have tried to make sense of human existence in general and of their personal one in particular. Although modern existential psychotherapy began only in the twentieth century, its seeds can be found way back. One can trace the main purposes of the existential approach in ancient philosophy and stories: the acceptance and exploration of death and ontological anxieties and still having a full life; understanding the potential in having free will and taking responsibility on one’s life while bravely taking chances and being ready to fail; and facing reality, which is looking bravely at reality and truth.
It is always about what one chooses to see and understand from what is there before one. By making its main issue ‘the existence of human being’, existential psychotherapy is connecting itself to the very essence of the creation of human beings.
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Menda, Gideon (2012). The Roots of Psychology, the Growth of existential psychotherapy and central purposes of existential psychotherapy; Tel-Aviv: Israel. in: www.metapel.co.il