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The key elements of existentialist thought are: Absurdity, Anguish (angst; anxiety, dread), and Authenticity And these inform the understanding of humanbeing within both wider social and more specific ‘clinical’ settings. From around the 1920s, as ‘existenz philosophy’ (Hannah Arendt’s term) was beginning to be understood as a distinct and different trajectory in western philosophy, the application of the idea of a loss of meaning or significance in one’s life, evinced by an underlying sense of anguish or anxiety, to more clinical psychological and psychiatric settings emerged. The stages of the existential analytic of human life as experienced by an individual may be posed as follows: Absurdity the individual questions the meaning of their existence and realises that there is no pregiven significance to their life. The individual may encounter absurdity through some traumatic event loss of job, death of loved one, loss of faith or through facing some wider crisis such as civil unrest, war, financial crash, and so on. Life may be understood as absurd at the moment that one asks the question of the meaning (significance) of one’s own existence, and then asks: “what am I?” and “who am I?” For example, one might ask: “what am I? am I a humanbeing?” and pose the answer, “no, I am no longer human, I am a monster!” Natsuo Kirino’s fiction, for example, deals with those who come to realise that even within their humanform, they are in some way monstrous (e.g., in her novel ‘Grotesque’). Anguish The sense of the absurdity (meaninglessness, lack of significance) of one’s existence leads then to anguish (angst) the sense of dread and anxiety at the very conditions of one’s existing, in which not only the world and objects but even one’s own body appear as uncanny. One might stare at one’s own fingers, for example, for many hours and wonder what they are, feeling even that they belong to someone or something else. The possibility of a radical fragmentation and splitting one’s oneself may arise. A deep ‘ontological insecurity’ (R. D. Laing’s term in ‘The Divided Self’) may precipitate a wide range of behaviours consequent on this sense of ‘not really being’. Sometimes, one might just begin to experience oneself as a kind of object, or machine. Anguish may be linked to a pervasive depersonalisation and a wide range of mental ‘disorders’. To anguish one might also add the idea of ‘alienation’, both of which are connected to ‘inauthenticity’. Alienation may also have politicalexistential implications as in the thinking of Erich Fromm (e.g., ‘The Fear of Freedom’). Authenticity The ‘moods’ of absurdity and of anguish may unsettle and ‘dethrone’ the individual from their imagined sovereignty their sense of I am, I can, I will. However, it is only when the very fact of one’s existing here and now, in this very situation, with this very history, in this very body, and this particularity is recognised that one begins to live an ‘authentic’ existence. That is, one lives without pretence of there being something other than this very existence. What one might term the dissolution of selffantasies (which are many and varied) and the recognition both of one’s actual limitations and possibilities arises. Think, for example, of someone who fantasises about having a political career, “I could become an MP!” It is not the case that this is not a possibility for them, it is more the case that they are not actually choosing to become an MP and to do all that is necessary for them to make this an actuality. Such fantasies, recognised as such and understood as mental diversions or entertainments, do not in themselves mark inauthenticity. Such a fantasy would be inauthentic when it is neither recognised as such nor acted upon one is actually choosing not to become an MP whilst claiming to want to be one (one is thus in what Sartre called ‘bad faith’). Such patterns of ‘inauthenticity’ arise partly on the basis of a lack of sufficient judgement as to what is required to achieve something, but also in deceiving oneself as regards one’s possibilities through a lack of facing one’s very existence and as a means of avoiding that existence. When one avoids what and who one is, one avoids the actual reality of one’s existence, and thus effectively negates one’s possibilities. The authentic individual is the one who poses the meaning of their own existence without preempting that meaning. For example, in posing the questions “what am I? and “who am I?” one is not asking for a definition, but rather asking after the significance of one’s existence. For example, “what am I?” answered “you are a humanbeing … a British citizen … a tennisplayer …” provide factive answers but if one asks, “and what is the significance of being a humanbeing … a British citizen … a tennisplayer …?” then one is faced with an existential question concerning significance. Roughly akin to: so what follows from being a X, Y, or Z? One cannot thus pose questions of fact in distinction to those of significance without evoking once more both absurdity and anguish … “so what if you are a humanbeing ... a British citizen ... a tennisplayer …?” The aim of existential psychology and psychiatry is to resolve, or rather dissolve, the symptoms that arise from absurdity and anguish experienced in the extreme as forms of ontological insecurity in the direction of authenticity. Ultimately, existential ‘mental health’ is about both choice and commitment, from these flow authenticity and a sense of meaning and significance, but meaning & significance located to one’s very life and not to some pregiven idea or ideology. * It is often the case that the ‘existential analytic’ may be taken as the ‘backbone’ of any analysis of suffering to which may be added any of psychoanalytic, cognitivebehavioural, biological, and social psychological approaches. For example, even if one is disposed to anxiety on the basis of an underlying biological condition, the significance of this anxiety and of what one is anxious about are still in the domain of meaning and significance. What is it to be an ‘anxious person’, for example? Likewise, even the unconscious dynamics of a mother or father ‘complex’, raised to consciousness, still involves the construction of meaning and significance under one’s own choice. One may choose to reframe one’s understanding of, and relation to, one’s parent (note that Freudian psychoanalysis would ‘problematize’ such a choice). In general, ‘existential’ psychologists or psychiatrists seek to understand humanbeings as beings in a world of significance, and regard a factive, reductionist account of humanbeing and mental health as insufficient and limited when proposed without reference to lived and experienced beingintheworld. The relations between existential/experiential and scientific accounts of humanbeing need to be carefully articulated. These accounts are not opposed to each other, rather the fact\value or fact\significance distinction must be clarified in order to bring scientific and experiential/existential accounts together. Thinkers such as Alfred Adler, Ludwig Binswanger, Viktor Frankl, Erich Fromm, Karen Horney, R. D. Laing, Rollo May, Thomas Szasz, and Emmy van Deurzen are all associated to a greater or lesser degree with the development of an ‘existentialist’ approach to psychology, psychiatry, and mental health … * Beingintheworld is a doing and becoming. The practice of existential or ‘existenz philosophy’ is perhaps best rooted in the analysis of one’s own concrete life situations and choices, and rather than being orientated towards developing a kind of representation of oneself in the abstract oneself as an ‘object’ of knowledge instead one orientates oneself in terms of one’s immersion, both immediate and mediate, in the world. Relative to one’s ‘professional’ life, if one is, for example, a mathematician, one’s world will be significantly mediated by practices involving the manipulation of formal symbols, if one is a train driver, by practices involving timetables, signals, and so on … such elements of one’s world involve both one’s embodiment and orientation and attitudes. Whilst one may change what one does, as one is doing it, there is no other doing than that of doing mathematics, train driving, and so on. The attempt to adopt a ‘theoretical’ attitude towards oneself may, at best, be somewhat like an animal chasing it’s own tail, and, at worst, involve selfalienation, and malaise. Beingintheworld is beingtowards, one is partof the world whatever one’s mood. This is the primary approach of existentialist mentalhealth, and why the idea of a ‘theory of persons’ is both problematic philosophically but also as a mode of relation to others. Note, for example, the ever increasing categories of ‘mental disorder’ in the Diagnostic and Statistical Manual of Mental Disorders.