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Chapter Five:Existential Theory
and Therapy
Historical Context and Key Figures
 The Third Force
 Strong Link to Philosophy
 Soren Kierkegaard and Fredrick Nietzsche
 Rollo May
 Jean Paul Sartre
 Fritz and Laura Perls
Theoretical Principles of Existential
Theory and Therapy
 Based on “I-AM”
 Daimonic
 The Nature of Anxiety
 Normal and Neurotic Guilt
Existential Psychodynamics
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Death
Freedom
Isolation
Meaninglessness
Other Issues
 Self-Awareness
 Existentialism and Pessimism
Gestalt Theory in Action
 The Whole, Self-Regulating Person
 Field Theory
 The Figure-Ground-Formation Process
 Peeling the Onion
 The Therapy Process
– I and Thou,
– Here and Now,
– What and How.
Theoretical Models of Applied
Learning Theory
 Applied Behavioral Analysis
 Neobehavioristic, Mediational Stimulus-
Response Model
 Social Learning Theory
 Cognitive Behavioral
Theory of Psychopathology
 Failure face and integrate daimonic
impulses
 Failure to acknowledge and reconcile life’s
ultimate concerns
The Practice of Existential
Therapy
 Preparing yourself
 Preparing your client
 Assessment Issues and Procedures
Existential Therapy Techniques
 Techniques are artificial
 Techniques are inauthentic
 The therapeutic encounter
 Buber’s I-Thou relationship
 Assessment is inadequate and does not
serve the relationship
Specific Use of Techniques
 Frankl
– Paradoxical Intention
Gestalt “Experiments”
 Staying with the feeling
 I take responsibility for. .
 Playing the projection
 The reversal technique
 The exaggeration experiment.
 The empty-chair technique or dialogue
experiment
Gestalt Dream Work: Four steps
 Tell the story of the dream.
 Revive the dream
 Organize the dream as a play
 Act out the dream
Extended Case Example
 …and this is my existence
Therapy Outcomes Research
 Existentialists question the suppositions of
the scientific method
 Effects of this type of therapy cannot be
assessed through the use of traditional
outcome measures
Multicultural Perspectives
 Existentialists often accused of only serving
the “worried, wealthy, well.”
 Individually, many are multiculturally
sensitive.
 Focus is on the individual at a deep,
singular level.
Concluding Comments
 Existential theory and therapies tackle life’s
biggest issues.
Student Review Assignments
 Critical corner
 Reviewing key terms
 Review questions
Critical Corner
 Existential approaches have primarily been
developed, promoted, and oriented toward White
men. In fact, aside from Laura Perls, whose
contributions have been relatively ignored, it’s
difficult to find women or minorities who were
deeply involved in the development of existential
thinking and therapy. Even within the domain of
Yalom’s four primary ultimate concerns, the
absence of any reference to the birth experience—
a deeply powerful ultimate experience that must
be dealt with exclusively by women—is striking.
As you contemplate existential theory and therapy,
consider whether it is a therapy for the masses, or
Critical Corner (continued)
 Despite the emphasis in this chapter on the
flexible, clinically astute behavior therapist,
most behavior therapists are just
technicians. For the most part, they aren’t
attuned to or very interested in client’s
feelings, the dynamics of the therapy
relationship or life’s meaning and so they
ignore these bigger issues, focusing instead
on trivial and less important matters.
Critical Corner (continued)
 Although existential therapists encourage
individuals to embrace their deepest fears, they
have not, themselves, embraced the concept of
scientific or empirical evaluation of existential
therapy. Could it be that existentialists are too
afraid to expose their therapy approaches to
scrutinizing scientific evaluation? If existentialists
are interested in the complete human experience,
why do they avoid and demean scientific
procedures? It seems that scientific evaluation of
therapy effectiveness, despite its limitations,
reflects an important part of human experience—
and the effort to understand and quantify
Critical Corner (continued)
 The length to which behavior therapists will
go to dehumanize individuals is scary.
Examples include aversive conditioning
using electric shock, token economies that
curtail the freedom and dignity of patients,
and the excessive punishment of children in
our schools. The biggest problem with
behavior therapy is that humans are treated
more like rats or pigeons than humans.
Critical Corner (continued)
 As noted in the chapter, existentialists are also
generally opposed to standardized psychological
assessment and evaluation. Can you imagine a
situation where the administration of a
psychological assessment procedure might be
helpful to an individual? Can you imagine this
even if you look at the process from an existential
perspective? Are there parts of human experience
that can be accurately measured? Consider anxiety
and guilt. Is it possible to measure a client’s
anxiety and guilt experiences and conclude
whether she is experiencing neurotic or normal
anxiety or guilt?
Critical Corner (continued)
 One of the strong contemporary movements in
psychotherapy and counseling practice is
manualized therapy. The manualized approach is
appealing because it provides therapists with clear
guidelines and structure for conducting therapy.
Although therapy manuals are not to be used like
“cook-books” they provide therapists, both new
and old, with standard procedures. How can
existential or Gestalt therapy approaches survive
when they are based on spontaneity and
authenticity—a foundation that is completely
counter to contemporary emphases on
standardization of therapy?
Critical Corner (continued)
 Gestalt therapy focuses on clients’ body awareness
and trusts the individual to make contact with the
environment and move in a positive and growthful
direction. As practiced by F. Perls and others,
Gestalt therapy is confrontive and provocative.
Consider the application of Gestalt therapy with
low functioning or psychotic clients. What might
be the dangers of using an empty chair technique
with a dissociative client? What might be the
dangers of having a paranoid, borderline psychotic
client “play his projection?” Do you think the
Gestalt Prayer, “You do your thing and I do mine”
would be a useful philosophy to teach men and
Review Key Terms
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Ontological experience
Neurotic anxiety
Neurotic guilt
Ultimate concerns
Logotherapy
I-Thou relationship
Nihilism
Gestalt
Field theory
Figure-Ground-Formation
Key Terms (continued)
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Will to meaning
Self-regulating
Confluence
Retroflection
Deflection
Projection
Contact
Gestalt experiments
Paradoxical intention
Cognitive reframing
Key Terms (continued)
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Staying with the feeling
And this is my existence
The empty-chair dialogue experiment
Top-dog
Underdog
I take responsibility for
Playing the projection
The reversal technique
The exaggeration experiment
Gestalt dream work
Review Questions
 Discuss how Kierkegaard’s Christian faith and
Nietzsche’s atheism can be viewed as
philosophical polarities that lead to a deeper
understanding of the individual self.
 Frankl openly admitted to facing nihilism and
eventually discovering meaning. Did Frankl
initially face nihilism before, during, or after his
concentration camp experiences? Reflect on
whether you believe (a) meaning naturally exists
in the world or (b) individuals must create
meaning in their lives.
 What does Sartre mean by existence preceding
essence? What are the implications of the opposite
Review Questions
 Is Frankl’s will to meaning a drive or a striving?
What difference does it make?
 Gestalt perceptual principles suggest that the
whole is greater than the sum of its parts. If this is
the case, then why do so many Gestalt therapy
techniques involve breaking the individual down
into fragments or parts (as in dream work or the
empty chair dialogue)?
 Describe the figure-ground-formation process and
discuss how it is related to unfinished business.
Review Questions
 Is it possible for a therapist to maintain an “I-
Thou” relationship throughout the duration of a
therapeutic encounter? Discuss ways in which you
might, as a therapist, try to establish and maintain
an I-Thou relationship with your clients.
 According to Yalom, facing death can motivate
individuals to live life more fully. Describe how
the four ultimate concerns of existential theory can
be used as a positive motivation with clients in
therapy.
Review Questions
 What is cognitive reframing and how did Frankl
apply it to confront clients with a deeper sense of
personal meaning?
 Describe the two different ways a therapist can
initiate a Gestalt empty chair dialogue.
 List and discuss the sorts of questions an
existential and/or Gestalt therapist might use with
clients to help keep them focused on their
immediate experience in therapy.
 How does the Gestalt therapist view her client’s
dreams? What are the four steps to dream work the
Gestalt therapist employs?