Existential Psychotherapy

Existential psychotherapy stems from the basic assumptions of Existential Philosophy which is a philosophical movement originating in Europe in the 19th century in the works of Nietzsche, Kierkegaard, Heidegger, Husserl and Sartre.  The central theme of this movement is existence and what it means to be human in a world subject to random occurrences and intrinsic meaning.

Existential psychotherapy is based on the assumptions that issues such as Freedom of Choice, Anxiety, Guilt, Responsibility, Meaninglessness, Uncertainty and Death are inherent to existence and hence unavoidable.  These issues can be the source of many difficulties in one’s life if they are met with dissatisfaction and distress, as well as hinder a functional and fulfilling life.

What are the benefits of existential therapy?

Existential therapy can alleviate anxiety, guilt, shame, and other difficult emotions through honest self-evaluation.  Moreover, this approach confronts the realities of life such as meaninglessness, death, suffering, and loss, with the aim of promoting positive experiences, relationships, and emotions. 

In this manner, existential therapy encourages clients to:

What conditions does existential therapy work with?

Existential therapy works with people struggling to make healthy choices in life and take responsibility of those choices. As a result, they may struggle with anxiety, addiction, depression, relationships, and wide range of behavioral and psychological issues.
Just like most of the therapeutic approaches, existential therapy will mostly benefit those who are willing to engage in honest self-exploration. Those who wish to receive immediate relief from their symptoms and are reluctant to engage in a discussion of meaning may not be appropriate for existential therapy.

Existential Psychotherapy

Existential Philosophy and the ‘Givens’ of Existence

There are events in our lives that we may have no control over.  Such events are the givens of our existence. For example, we do not chose our family members, our gender, our body, our social background or even our own birth into this world.  As Heidegger put it, we are “thrown into the world” and we have to deal with whatever life randomly throws at us.  Hence, we have to deal with the devastation an earthquake, a tragic accident, the death of a child and so on can bring to our life.  In such circumstances we can either resent them or accept them as part of our unpredictable lives.  Even so, we can interpret such unpleasant experiences in a positive light, by finding value in them and learning from them, or alternatively poison our lives with the bitter taste of resentment and confusion.  The choice is ours; as we are free to choose our approach towards anything.

"Man is condemned to freedom"

Jean-Paul Sartre

Freedom of Choice and Responsibility

The concept of freedom of choice is central to existential thought. According to Existential philosophy, even though our freedom is limited to our context, our facts of life and values, we still possess a far greater degree of freedom than what we think or are willing to admit to. In other words, within our given limits, we are free to choose our responses. This means we are ‘condemned’ to our freedom, and ‘condemned’ to choose.

Our freedom to choose how to respond to any situation is both a curse and a blessing for many reasons. On one hand we are exhilarated by our freedom and on the other our anxiety increases. For freedom to choose comes with the freedom of making the ‘wrong’ choice. Thus to make a choice entails the renunciation of all other choices available to us and subsequently a loss, which inevitably forces us into the realm of responsibility which we cannot escape from. This can be very uncomfortable which makes it easier to blame the circumstances in our lives rather than own choices. Here, we are faced with another choice. In our effort to make sense of our lives we can either choose to accept responsibility of our actions and own our role-play, or avoid responsibility by attributing events to the situation we find ourselves in. Denial of responsibility, would push us to experience ourselves as victims of fate, and in turn the loss of our power and the mastery of our life, while acceptance would give us back some degree of control over our life and empower us. Therefore if we are free to choose our paths, then the power to change is also in our own hands, within the limitations of our ‘given’ circumstances. The aim of Existential therapy is to make us aware of such power.

Anxiety and Existential Anxiety

Existential psychotherapy and Existential philosophy emphasize that anxiety is an inevitable aspect of existence and therefore a given of existence. Anxiety stems from the experience of being confronted with our limitations, with our finiteness and with the unknown. It is directed towards the unpredictable future. It prompts us to reflect on our life, warns us of our fragility and draws our attention to our unfulfilled potentiality. We may choose to push it away by various means such as chemical substances, entertainment, or sex and subsequently live in self-deception, or we can choose to learn from this experience and live our life to the maximum.

Existential anxiety strikes us unexpectedly from nowhere, and has no form or object. It is about nothing in particular. Thus, since we do not know what we are afraid of, our experience with anxiety is unsettling, frustrating and terrifying. On the other hand fear has a distinctive object or ‘enemy’ to fight back or run away from. Existential anxiety is about our own being in existence. It is regularly a warning that in some unknown way we are failing ourselves or falling short of our potentiality of being.

From the standpoint that anxiety originates from our own existence, we can proceed to live a life that is neither filled nor free from anxiety, but in balance with the tension between both. Living in balance means not ruled by recklessness, nor letting one’s life be controlled by anxiety. Existential anxiety wants to warn or teach us about something. It redirects us towards knowledge and self-actualization. Trying to eliminate anxiety is not only an illusion but also an obstacle to a reflective and courageous life.


Uncertainty is one of the most upsetting and anxiety provoking ‘givens’ of existence, as well as one of the most prevalent issues in the therapy room. At the end of the therapy session my clients say ‘see you next week’ and I respond with the same phrase. Will I see them next week? How do I know? How does anyone know? We don’t. It is only an assumption with no guarantees that either of us will be there. Events beyond our control could happen in between our meetings.

Uncertainty is definitely difficult to live with, even unbearable at times, while the quest for certainty is in vain, unachievable and a waste of energy. Yet, most individuals seek certainty and attempt to gain control over their life. To a certain extent, this is a natural and sensitive response to this ‘given’ of existence. We try to ‘minimize’ the risks by increasing the level of ‘safety’. This is a distortion of reality as the more safe we feel, the more certain we are, and the more we seek it out. It is a natural quest and part of our survival instinct. However, when our quest for ‘safety’ and ‘certainty’ is taken to extremes, it becomes an obstacle to our personal growth, detrimental to a greater range of experiences, a limitation to live life to its fullest potential and to the maximum of one’s possibilities. It diminishes life and ‘confines’ our freedom.

Existential therapy aims to help the client become aware of the consequences of their attitude towards this unavoidable fact of life. This can result in an eye-opening experience for the client. For this process to take place, it depends on the level of risk the client is willing to take and their acceptance of the impossibility of absolute ‘certainty’ or ‘safety’.


Death is the ultimate source and object of anxiety, as it is the only certainty. Still, paradoxically enough, it is filled with utter uncertainty for it lies ahead of us, but we never know when or how we will meet. Its’ very unpredictable nature can be our greatest friend or greatest enemy, depending on whether we use it as a propellant or a deterrent.

Death is the ultimate and unavoidable limitation of our existence, and is a fundamental ‘given’ in Existential thought and Existential psychotherapy. As Heidegger put it, it is “the possibility of no further possibility”. In other words, of all possibilities, death is the only certainty. Thus, we lose ourselves in activities and thoughts to keep this truth away from our awareness. Hence, we live in a false certainty of tomorrow, we procrastinate, we experience anxiety, we fear the unknown, we miss our possibilities, we feel guilty and we fall into despair.

The belief in God, in reincarnation or in death as a process of transformation from a physical to a spiritual dimension are comforting to our consciousness. For these beliefs can make death much less frightening and can help us deal with the finitude of our physical existence. Even so, it does not eliminate the fact that death is the end of our existence as we know it and all its possibilities.

The thought of death can either lead us to despair or save us from wasting our life. Meaning, if we really acknowledge death as the greatest unknown that can materialize at any moment, anywhere, in any form, it can save us from missing opportunities. Facing the possibility of death authentically makes us re-evaluate our values and priorities in life. In turn, matters lose their relevance, and relationships take on a new importance. Our awareness of the possibility of death, can induce us to live life more fully, in the present, rather than in a past that does not exist or a future that might never come. Consequently, we move forward with a newly found passion for life.

Guilt and Existential Guilt

Guilt spurs inside us the moment we realize that our best was not good enough, that we could have done more or less depending on the case, and that we cannot undo what has already been done in the past, nor live what we have ‘left’ out. In this manner, we feel we have ‘failed’ ourselves which bring about our guilt.

Guilt, just like anxiety, confronts us with our limitations. On one hand, anxiety is projected towards the uncertainty of the future, and ultimately towards death, and on the other, guilt is directed towards the past with its unrealized potential and unfinished business. It reveals a present that is lived short of our potentiality for being. Guilt is yet another inevitable aspect of existence. For as finite beings we can never fully actualize all our possibilities and we will never be true to our dreams, as we will always fall short of something. Thus, existential guilt can never be completely avoided, only minimized by living a life that resembling our dreams as closely as possible.

Existential psychotherapy focuses on the experience of the clients’ guilt and anxiety. The purpose is not to cripple us with fears and regrets but to alert us to live more fully. Heidegger’s philosophy encourages us to listen to the voice in our conscience warning us that we are falling short, and living inauthenticaly, in order to wake up and return to our true selves. Authentic living requires taking stock of our limitations and responding to them. Hence, guilt throws us back into anxiety, but if anxiety is faced with courage and the courage to become, then we stop living fractionally, and we are plunged into the dizziness of life.


An Existential psychotherapy assumption is that we are ‘thrown into a world’ that has no fundamental meaning and continuously march towards death. So what is the point of it all? From this perspective, life seems pointless, absurd, and worthless. The experience of meaninglessness is unbearable, and therefore, we fall in despair. Hence, to make our life worth living we need to find purpose.

If life has no fixed meaning, then we need to create it ourselves and discover what is meaningful to us. Our freedom gives us the possibility to create meaning according to our inner predispositions and limitations. However, our family or the society we live in can exercise pressure on us to fulfill what is expected by them. If we give in to their demands in the name of ‘security’ or a quiet life, we hinder our opportunity to be true to ourselves. Living a ‘safe’ life has its consequences. When we fail to listen to our being and avoid life’s essential struggles, we forego its fulfilment. As Existential guilt and Existential anxiety set in, they can either lead us to despair or save us depending on how we choose to proceed. We are free to choose whether not to live our life, or to have courage in becoming our own master, regardless of the struggle. The choice is ours.

Existential psychotherapy suggests that meaning is continuously changing and evolving. This implies that what gives meaning to us at one point in our lives may not be meaningful any longer. We give meaning to our relationships, parenthood, partners, professions, society, and to life. The loss of any one of our meanings can throw us into meaninglessness and therefore depression. This overwhelming experience can bring about despair and push us to the point of losing our will to live. Here, new meaning must be created to move forward in life. As this is not an easy process, it takes willingness to re-evaluate our life’s purpose, to look into new meanings and to have the courage to change direction.


Existential psychotherapy focus on relationships is a key element of healthy living. The relationships we have with people in our lives, with the animals, and the natural world, shape our world view and the meaning we give to them. The therapist – client relationship and the relationship with our selves is core to the development of therapeutic work.

Relationships are another ‘given’ in our existence, for we are not born alone into this life. Heidegger points out that we live in a world with other beings and we are all interdependent. We are born as dependents of our parents or caregivers and slowly become independent as we grow older, but as long as we live in a world with others, we never become totally independent. This is because our physical, emotional, social well-being and survival depends on our interdependence. Hence, living a harmonious life in a world with other beings, utterly depends on the quality of our relationships. For this reason, it is fundamentally important for existential therapy to focus on the exploration of our personal relationships.

Interpersonal relationship difficulties are vastly common reasons that people seek therapy. Life’s painful experiences such as sorrow, trauma, or suffering have a tremendous impact on the way we relate to other people, ourselves, and the world. They can bring about obstacles in establishing satisfactory relationships. These obstacles also enter the therapy room and impact on the very relationship between the client and therapist. In other words, the therapeutic relationship is used as a mirror to the relational difficulties that the individual is confronted with in the outside world. It becomes a tool to identify and remove the individual’s relationship issues.

Group therapy is an excellent space to work on interpersonal difficulties. This is because the therapist has the opportunity to observe their client’s way of relating to others in a space which exposes a wider range of behavioral patterns than within their individual sessions. As group members interact with each other, various interpersonal relationship difficulties will be triggered and in turn manifest. In this manner, the client will receive feedback from both group members and the therapist which will push the individual to question themselves. Thus, the individual becomes aware of how they are with others, how they affect or are affected by others, and how others perceive them to be. The goal is to learn what stands in our way of establishing satisfactory interpersonal relationships and to help us work through these obstacles by exploring our response and behavior as it reveals itself.

Isolation and Aloneness

Existential therapy describes isolation as a common experience in people’s lives, across cultures, gender and age.  It is not considered an existential ‘given’ since we are relational beings by nature. 

At some point in our lives we may have great difficulties in relating to other beings and to the world.  The feeling of isolation is not necessarily the product of physical isolation, but from our emotional, spiritual or intellectual disconnection. For a sensitive person, the experience of isolation can be quite painful and debilitating.  It is the deep sorrowful realization of our fundamental aloneness in the world, in the face of our existence with others. 

Our freedom to choose and the responsibility of its consequences can generate enormous anxiety.  When faced with a difficult choice we often ask for advice. However once we have made a choice, we cannot ask someone to act on our behalf.  The moment I make the decision to act I am utterly alone with myself and therefore ‘condemned’ to deliberate one way or another.  Hence in the face of the advice, the final choice is mine and only mine.  From this light, aloneness is also a ‘given’ of existence. 

Brief summary of Existential Psychotherapy

The existential approach to psychotherapy is essentially philosophical.  Its basic assumptions derive from existential philosophy and uses phenomenology – a branch of philosophy – as a method of exploration into the individual’s experience of being in the world.  The aim of the therapist and client is to engage in a process of philosophical dialogue, in order to bring to light and clarify the internal conflicts that pose a problem to the individual seeking therapy. This helps them come to terms with the paradoxical aspects of existence. 

Existential therapy encourages us to transform into a butterfly, rather than to remain a caterpillar.  It is not an easy journey but it is certainly a fulfilling one.