"Aptuveni pusotru gadu noritēja 60-70 eksistenciālo terapeitu no visas
pasaules neklātienes diskusija par eksistenciālās terapijas redzējumu
vispār un par iespēju radīt visiem kopīgu eksistenciālās terapijas
definīciju. Ar dauzu simtu epasta vēstuļu palīdzību tika lauzītas galvas
un lauzti šķēpi, par to, ko tieši katrs diskusijas dalībnieks vai viņa
pārstāvētā skola saprot ar eksistenciālās terapijas teoriju un praksi.
Diskusijā piedalījās visi tie, kurus mēs asociējam ar eksistenciālo
terapiju un vēl daudzi jo daudzi, par kuru nostāju
eksistenciālās terapijas sakarā mēs it neko nezinām, valodas un dažādu
citu šķēršļu dēļ. Tiek plānots arī šo definīciju
arī iztulkot latviski un krieviski."
Elita Kreislere
Existential
Therapy
World
Confederation for Existential Therapy
Preface
In
2014-2016, an international group representing a cross-section
of contemporary existential therapists joined together in a cooperative effort to create
this broad definition. It was written in the
spirit of inclusiveness and diversity that characterizes this unique
orientation, toward the goal of arriving at an accessible,
succinct, "good enough" working definition of existential
therapy. This definition recognises and honours the shared and unifying
stance which underpins and informs the various differing ways
of understanding and practicing existential therapy today, without
doing violence to its inherent spontaneity, flexibility, creativity and
mystery. What follows is the current version of an ongoing,
continually evolving, collective quest.
1.
What is existential therapy?
Existential
therapy is a philosophically informed approach to counseling or
psychotherapy. It comprises a diverse spectrum of theories
and practices. Due partly to its evolving diversity, existential therapy is
not easily defined. For instance, some existential
therapists do not consider this approach to be a distinct
and separate “school” of counseling or psychotherapy, but rather an
attitude, orientation or stance towards therapy in general. However,
in recent years, existential therapy is increasingly considered by others
to be a particular and specific approach unto itself. In either case,
it can be said that though difficult to formalize and define, at its heart,
existential therapy is a profoundly philosophical approach characterised in
practice by an emphasis on relatedness, spontaneity, flexibility, and
freedom from rigid doctrine or dogma. Indeed, due to these core
qualities, to many existential therapists, the attempt to define it
seems contradictory to its very nature.
As
with other therapeutic approaches, existential therapy primarily (but not exclusively) concerns
itself with people who are suffering and in crisis. Some
existential therapists intervene in ways intended to alleviate or mitigate such distress when
possible and assist individuals to contend with life’s inevitable challenges
in a more meaningful, fulfilling, authentic, and constructive manner.
Other existential
therapists are less symptom-centred or problem-oriented, and
engage their clients in a wide-ranging exploration of existence without presupposing any
particular therapeutic goals or outcomes geared toward correcting cognitions
and behaviours, mitigating symptoms or remedying deficiencies. Nevertheless,
despite their significant theoretical, ideological and practical differences,
existential therapists share a particular philosophically-derived worldview
which distinguishes them from most other contemporary practitioners.
Existential
therapy generally consists of a supportive and collaborative exploration of patients’ or
clients' lives
and experiences. It places primary importance on the nature and
quality of the here-and-now therapeutic relationship, as well as on an exploration of
the relationships between clients and their contextual lived worlds beyond
the consulting room. In keeping with its strong philosophical
foundation, existential therapy takes the human condition itself -- in
all its myriad facets, from tragic to wondrous, horrific to beautiful,
material to spiritual -- as its central focus. Furthermore, it
considers all human experience as intrinsically inseparable from the ground
of existence, or “being-in-the-world”, in which we each
constantly and inescapably participate.
Existential
therapy aims to illuminate the way in which each unique person -- within certain inevitable limits and
constraining factors -- comes to choose, create and
perpetuate his or her own way of being in the world. In
both its theoretical orientation and practical approach,
existential therapy emphasises and honours the perpetually emerging, unfolding,
and paradoxical nature of human experience, and brings an unquenchable
curiosity to what it truly means to be human.Ultimately, it can be said
that existential therapy confronts some of the most fundamental and
perennial questions regarding human existence: "Who am
I?" “What
is my purpose in life?” “Am I free or determined?” “How do I
deal with my own mortality?” "Does my existence have any meaning or
significance?" "How shall I
live my life?"
2. Why
is it called “existential” therapy?
Existential
therapy is based on a broad range of insights, values, and principles
derived from phenomenological and existential philosophies. These
philosophies of existence stress certain “ultimate concerns” -- often
in dialectical tension with each other -- such as freedom of
choice, the quest for meaning or purpose, and the problems of evil, isolation, suffering, guilt, anxiety, despair, and
death. For existential therapists, “phenomenology” refers to the disciplined philosophical
method by which these ultimate concerns or
"givens" are addressed, and through
which the person’s basic experience of being-in-the-world can best be illuminated or
revealed, and
thus, more accurately understood. This phenomenological method begins
by deliberately trying to set aside one’s presuppositions so as to be
more fully open and receptive to the exploration of another person’s subjective reality.
Though
there can be many different motivations for individuals choosing to engage in
this explorative process, as with most forms of counselling,
psychotherapy, or psychological and psychiatric treatment, existential
therapy is commonly sought by people in the throes of an existential
crisis: some specific circumstance in which we experience our basic
sense of survival, security, identity or significance as
being threatened. Such existential threats may be of a
physical, social, emotional or spiritual nature, and may be directed
toward one's self, others, the world in general or the ideas and perceptions we
live by. They shock and shake us out of our sense of safety and complacency, forcing us
to question and doubt our most deeply held beliefs or values. Because, according
to existential therapists, human existence is, by its very nature, continually changing
or becoming, we are naturally prone to experiencing such existential
challenges or crises across the lifespan. In existential therapy, these disorienting
and anxiety provoking periods of crisis are perceived as
both a perilous passage and an opportunity for transformation and growth.
3.
How does existential therapy work?
Existential therapists
see their practice as a mutual, collaborative, encouraging and
explorative dialogue between two struggling human beings -- one of
whom is seeking assistance from the other who is professionally trained
to provide it. Existential therapy places special emphasis
on cultivating a caring, honest, supportive, empathic yet challenging relationship
between therapist and client, recognising the vital role of this relationship
in the therapeutic process.
In
practice, existential therapy explores how clients’ here-and-now feelings,
thoughts and dynamic interactions within this relationship and with others might
illuminate their wider world of past experiences, current
events, and future expectations. This respectful, compassionate, supportive yet nonetheless very
real encounter -- coupled with a phenomenological stance -- permits
existential therapists to more accurately comprehend and descriptively
address the person's way of being in the world. Taking great pains to
avoid imposing their own worldview and value system upon clients
or patients, existential
therapists may seek to disclose and point out certain inconsistencies,
contradictions or incongruence in someone's chosen but
habitual ways
of being. By so doing, some existential therapists will, when
necessary, constructively confront a person's sometimes
self-defeating or destructive ways of being in the world. Others will deliberately choose
to avoid viewing or addressing any experience or expression of the
person's being in the world from a perspective that construes it as being
positive/negative, constructive/destructive, healthy/unhealthy, etc. In
either case, the therapeutic aim is to illuminate, clarify, and place these
problems into a broader perspective so as to promote clients' capacity to
recognise, accept, and actively exercise their responsibility and freedom:
to choose how to be or act differently, if such change is so
desired; or, if not, to tolerate, affirm and embrace their chosen ways
of being in the world.
To
facilitate this potentially liberating process, existential
therapy focuses primarily on enhancing the
person'sawarenessof his or her “inner” experiencing, "subjectivity" or being: the temporal, transitory, vital
flux of moment-to-moment thoughts, sensations and feelings. At the same
time, existential therapy recognises the inevitable interplay between
past, present and future. In this regard, existential
therapists respect the impressive power of the past and the future, and
directly address it as it impacts upon the present.
4.
What makes existential therapy different from other therapies?
In
addition to its unique combination of philosophical worldview, phenomenological
stance, and core emphasis on both the therapeutic relationship
and actual experience, existential therapy is generally less focused
on diagnosing psychopathology and providing rapid symptom relief per
se than
other forms of therapy. Instead, distressing "symptoms" such
as anxiety, depression or rage are recognised as potentially meaningful and comprehensible reactions
to current circumstances and personal contextual history. As
such, existential therapy is primarily concerned with experiencing
and exploring these disturbing phenomena in depth: directly grappling with rather than
trying to immediately suppress or eradicate them. Consistent
with this, existential therapy tends to be more exploratory than specifically or
behaviourally goal-oriented. Its principal aim is to clarify, comprehend,
describe and explore rather than analyze, explain, treat or “cure” someone's subjective experience
of suffering.
5.
What techniques or methods do existential therapists employ?
Existential therapy
does not define itself predominantly on the basis of any particular predetermined technique(s).
Indeed, some existential therapists eschew the use of any technical
interventions altogether, concerned that such contrived methods may
diminish the essential human quality, integrity, and honesty of the
therapeutic relationship. However, the one therapeutic practice common to
virtually all existential work is the phenomenological method. Here, the
therapist endeavors to be as fully present, engaged, and free of expectations
as possible during each and every therapeutic encounter by attempting to temporarily put aside
all preconceptions regarding the process. The purpose is to gain a
clearer contextual in-depth understanding and acceptance of
what a certain experience might signify to this specific person at
this particular time in his or her life.
Many
existential therapists also make use of basic skills like empathic
reflection, Socratic questioning, and active listening.
Some may also draw on a wide range of techniques derived from other therapies
such as psychoanalysis, cognitive-behavioral therapy, person-centered,
somatic, and Gestalt therapy. This technical flexibility
allows some existential practitioners the freedom to tailor the
particular response or intervention to the specific needs
of the individual client and the continually evolving therapeutic process.
However, whatever methods might or might not be employed in
existential therapy, they are typically intentionally chosen to
help illuminate the person's being at this particular moment in his or her
history.
6.
What are the goals of existential therapy?
The overall purpose
of existential therapy is to allow clients to explore their lived experience
honestly, openly and comprehensively. Through this spontaneous,
collaborative process
of discovery, clients are helped to gain a clearer sense of their
experiences and the subjective meanings they may hold. This self-exploration provides
individuals with the opportunity to confront and wrestle with profound
philosophical, spiritual and existential questions of every kind, as
well as with the more mundane challenges of daily living. Fully engaging
in this supportive, explorative, challenging process can
help clients come to terms with their own existence, and take responsibility
for the ways they have chosen to live it. Consequently, it can
also encourage them to choose ways of being in the present and
future that they, themselves, identify as more deeply satisfying, meaningful
and authentic.
7.
Who can potentially benefit from existential therapy?
An
existential approach may be helpful to people contending with a
broad range of problems, symptoms or challenges.It can be utilized with
a wide variety of clients, ranging from children to senior citizens,
couples, families or groups, and in virtually any setting, including
clinics, hospitals, private practices, the workplace, organizations, and in
the wider social community. Because existential therapy recognizes that we
always exist in an interrelational context with the world, it
can be especially useful for working with clients from diverse demographic and
cultural backgrounds.
While existential
therapy is particularly well-suited to people who are seeking to
explore their own philosophical stance toward life, it may, in some cases, be a less
appropriate choice for patients in need of rapid remediation
of painful, life-threatening or debilitating psychiatric symptoms. However, precisely
due to its fundamental focus on a person’s entire existence rather than solely on psychopathology and
symptoms, existential therapy can nonetheless potentially be
an effective approach in addressing even the most severe reactions
to devastating psychological, spiritual or existential disruptions or upheavals
in their lives, whether in combination with psychiatric medication when
needed or on its own.
8. What scientific
evidence is there regarding the efficacy of existential therapy?
A
range of well-controlled studies indicate that certain forms of existential
therapy, for certain client groups, can lead to increased well-being and sense
of meaning (Vos, Craig & Cooper, 2014). This body of evidence is
growing, with new studies showing that existential therapies can produce as
much improvement as other therapeutic approaches (e.g., Rayner & Vitali, in
press). This finding is consistent with decades of scientific research
which shows that, overall, all forms of psychotherapy are effective,
and that, on average, most therapies are more or less equally helpful (Seligman, 1995;
Wampold & Imel, 2015), with specific client characteristics
and preferences determining the best therapeutic approach for any given individual. There
is also a good deal of evidence indicating that one of the core qualities associated
with existential therapy – a warm, valuing and empathic client or patient-therapist relationship
— is predictive of positive therapeutic outcomes (Norcross &
Lambert, 2011). Additionally, existential therapy's central emphasis
on finding or making meaning has been shown in general to be a significant
factor in effective treatment (Wampold & Imel, 2015).
9.
Where can I find out more about existential therapy and/or professional
training to become an existential therapist?
Until
recently, there were few if any formal training programs for existential
therapists. In recent years, this situation has changed, with the creation of
various training programs in the United States, the United Kingdom, Belgium, Austria, Germany,
Switzerland, Italy, Portugal, Russia, Canada,
Scandinavia, Israel, Argentina, Mexico, Chile, Peru, Colombia,
Brazil, Lithuania,
Greece, Australia and many other countries.
Additional
references
Norcross,
J. C., & Lambert, M. J. (2011). Evidence-based therapy relationships.
In J. C. Norcross (Ed.), Psychotherapy relationships that work:
Evidence-based responsiveness (2nd ed., pp. 3-21). New York: Oxford
University.
Rayner,
M., & Vitali, D. (in press). Short-term existential psychotherapy in
primary care: A quantitative report. Journal of Humanistic Psychology. [Spanish
translation published as Rayner, M. y Vitali, D. (2015). Psicoterapia
existencial de corto plazo en atención primaria: Un reporte cuantitativo.
Revista electrónica
Latinoamericana de Psicologia Existencial "Un enfoque comprensivo del
ser". N° 11.
Octubre.]
Vos,
J., Craig, M., & Cooper, M. (2014). Existential therapies: A meta-analysis
of their effects on psychological outcomes. Journal of Consulting and
Clinical Psychology, 83(1), 115-128. doi: 10.1037/a0037167
Wampold,
B. E., & Imel, Z. E. (2015). The Great Psychotherapy Debate: The
Evidence for What Makes Psychotherapy Work (2nd ed.). New York: Routledge.
Author: World Confederation of Existential Therapy.
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