Existential Therapy

Hi, this is Dr Diane Gayart, and this is my lecture on existential psychotherapy and counseling. It's designed to accompany my text, "Case Documentation and Counseling," and "Psychotherapy and Theory and Treatment Planning," both published by S. Gage.

You can also find lots of other resources, including links to the various online lectures that accompany the various textbooks, at my website, masteringcompetencies. com. So, we refer to existential therapy, and often you'll hear it referred to as if there's one thing that's existential therapy.

There are actually several different strands of existential therapy that have evolved and exist over the years. They are all similar in that they share a grounding in existential philosophy, which really addresses, as you may remember from some of your college courses, questions related to existence in terms of what's the meaning of life, why are we here, why do we suffer, and what is death—these bigger questions that many of us tortured our parents with at various points in our youth. Teenagers are famous for loving to ponder these, often coming up with answers quite different from their parents.

This is what the whole therapy model is grounded on. If you want to do a really big picture overview, all of these schools of existential therapy are saying that whatever our surface-level suffering is—whether we're fighting with our partners, struggling with our relationship with our children, feeling depressed or anxious, or having panic attacks—the basic assumption in existential therapy is that those kinds of more surface-level symptoms of anxiety, depression, and relational issues are really grounded fundamentally in some of these existential issues and how a person is handling or avoiding them. That's what all of these theories are basically looking at.

There are various strands in existential therapy that can look quite different across these schools. For example, Durkheimian analysis has much more of a psychodynamic feel and focuses on how the person engages with their environment and how that engagement creates the suffering they're experiencing. Logotherapy, associated with Viktor Frankl—many of us are familiar with him—who was an amazing man, actually suffered in Nazi concentration camps and developed his ideas around logotherapy based on his experiences of suffering and observing how people suffered in those concentration camps.

He is a very powerful writer and speaker. His version of existential therapy is a bit different from the others in that most existential philosophers will say life is inherently meaningless, and we have to find or create meaning in life. Viktor Frankl is unique among most of these existentialists in that he believes life is inherently meaningful.

Believe it or not, this is a pretty radical position in the world of existentialism. His book, "Man's Search for Meaning," is very powerful—a classic read both in the field and outside of it. There is also the American existential-humanistic approach, which, as the title reveals, blends in some humanistic assumptions, primarily this idea of trying to find, create, or be true to your true self.

It has a much more inward focus in terms of being true to yourself, whereas Durkheimian analysis focuses more on how you relate to the world. Finally, you'll also hear about the British School of existential analysis, which actually represents a fairly diverse group of practitioners in this area. However, there is a coalescence around some basic themes focusing on the dimensions of physical, social, personal, and spiritual aspects of existence.

It incorporates multiple layers in how they conceptualize our existential dilemmas. All that said, if you really get into existential therapy, these various strands will be more important to you. However, for many of us, we think of existential themes as very similar across these approaches.

Their workings are similar, although you can have variations on this, as there are quite a few people in the 21st century who will combine humanistic approaches, like person-centered therapy, with existential therapy since there is a fair amount of philosophical overlap between the two—especially when looking at logotherapy, which believes that life is inherently meaningful. So, that's the basic lay of the land, and now we're going to move on to discussing existential therapy in a global way. Existential therapy, in a nutshell, covers the least you need to know, and I just want to give you an overview of the main features of this approach.

As the name implies, the basic focus of existential therapy is to address these more profound underlying existential issues that are part of being human, such as finding meaning in life. Dealing with identity and crisis, and identity, and how we shape that—confronting our ultimate aloneness in the universe, confronting the reality of death for ourselves and those we love, managing the larger existential anxieties that are just part of being human. The basic fundamental assumption is that it's these existential issues that are the real source of whatever symptoms a client might be presenting.

There's also a basic philosophical stance that all schools of existentialism assume, and that is that humans are basically free to make choices as well as responsible for their choices and actions. One of the inherent assumptions of existentialism is that there's this inherent tension between our freedom and our responsibility, and those two are inherently connected. I remember when I was first introduced to the ideas of existentialism, there was always this notion that we all want freedom, but with all this freedom does come responsibility.

Those two go hand in hand. The more freedom you have, the more responsibility you have for your choices and for your own happiness, as well as the effect of your choices on others. The basic premise of the existential counseling and psychotherapy process is that clients learn to consciously define themselves in their lives—to consciously make choices and take responsibility for them.

So whether you’re looking at someone who's dealing with depression or relationship issues, underneath it all is the question: what decisions are you making? You are free to make all of these decisions—ultimately, you really are. So, what are you deciding to do, and what responsibilities go with that?

That’s the basic premise of existentialism in a nutshell. Now, I want to take a moment to talk about what I like to call "the juice"—the significant contributions of existentialism to the whole field of counseling and psychotherapy at a broader level. Arguably, there are many things I could have chosen within the scope of existential therapy as "the juice," but for me at least, I identify the concept of the "I-Thou" relationship that Martin Buber so eloquently describes in his work.

Martin Buber's concept of the "I-Thou" encounter is used by existential therapists and sometimes even by humanistic therapists in conceptualizing how to relate to clients. The basic premise here is that humans can relate in one of two ways. The "I-It" relationship is when I relate to you, or a person, as an object.

In fact, as I’m sitting here lecturing, it’s an "I-It" relationship—you're not in front of me, you can't respond, so I am speaking as a speaker and you're listening as a listener. The fact is that 98% of our interactions are going to be "I-It" encounters—when you do transactions at the grocery store or when you come home and talk to your partner about plans for the weekend. All of those are more "I-It" interactions, and while we have to have "I-It" interactions, he distinguishes those from the "I-Thou" experience.

In an "I-It," it’s like it's a person and an object in their world. You're often relating to your conceptualization of the person more than to the genuine, authentic, true self, if you want to call it that, of the person. Even with our partners, a lot of our interactions are "I-It" interactions; they are your partner, and you're interacting with them as your partner.

The "I-Thou" encounter is a much more sacred encounter, and that is more how Buber would describe it. In the "I-Thou," you encounter the other person as a fully independent subject, recognizing that they are creating their own realities and their own meanings. It’s a very profound encounter.

You may recall some of these moments in your life—often they’re dialogues, but not always—where you felt like the other person really was there, setting aside all of their conceptualizations of who you should be or ought to be, fully experiencing you as you are, your true self. You are able to share that and have that encounter, and you are experiencing them in the same way too. This is a very profound experience, and it is what existential therapists would say they are striving to do when they relate to their clients.

The concept of the "I-Thou" relationship is very profound because oftentimes counselors, psychotherapists, psychologists, and social workers can get into playing our role—we're the professional, you know, hiding behind that mask. The existentialists, much like the humanists, would say, “No, you need to take down that mask and have this true, authentic, very raw, and sacred encounter with our clients, experiencing them as a true independent subject and vice versa. ” This is the "I-Thou" encounter, which I think is a very important concept in this theory and can really inform any type of therapy that you choose to work from.

So now, I'm going to move on to tell you a little bit about an overview of the various processes of what existential psychotherapy looks like in the big picture. Existential therapy can be conceptualized in three different phases. The first phase involves the therapist and client working together to identify how the presenting problem is related to the existential assumptions and beliefs.

So, again, here what you're doing is starting at the surface and working down to where, um, depression or anxiety or relationship conflicts are related to their fear of isolation or their fear of death, impermanence, or being alone. Um, so that's what you're focusing on. In the first phase, you would be working on linking the symptoms to the existential assumptions and beliefs.

Then, in the second phase, you're moving into inviting the clients to examine and redefine some of these attitudes regarding death, freedom, responsibility, free choice, meaning, and meaninglessness. You go in and start exploring these beliefs and attitudes, looking at where they may need to shift in order to live a more meaningful life—one that no longer has these symptoms. Finally, in phase three, you take these shifts in beliefs and translate them to the real world, taking specific actions to lead a more fulfilling and meaningful, self-actualized life.

If there were a lot of existential anxieties holding a person back from loving fully or following their life passions—whatever it might be—that action piece would come in phase three. I think it's fair to say that another common theme you will see across these stages is dealing with what they call existential anxieties. These typically fall into four basic areas: death and the anxiety related to that, freedom and responsibility, isolation and relationship, and meaninglessness and life meaning.

These are common themes; they are just part of being human, the existentialist will say, and these themes kind of run through everyone's life. In phase one, therapists look for how these are related to the client's presenting problems. In phase two, you redefine and discuss them, reflecting on and consciously choosing how you are going to express your freedom, how you will take on the responsibilities that come with freedom, looking at isolation versus being in a relationship, and also how a person finds and creates meaning in his or her life.

Now, I want to go on and talk about the therapeutic relationship. We already touched on that a bit in the previous section, but we're going to delve a little deeper here. The therapeutic relationship in existential therapy, as I already mentioned, is grounded in the concept of the "I/Thou" encounter and the relationship between a client and the therapist, which is quite intense in some ways; it’s a very "here and now," moment-focused way of being with clients.

In addition to that, what is distinct—and you would probably notice this if you were watching someone who works from a more humanistic approach, which is often combined with existential therapy—is that where there's a lot of empathy being expressed in humanism, the existentialist is present and empathetic, but that’s not their main leading edge. A lot of what you will see that’s a bit different in this approach is that the therapist promotes responsibility and independence, resulting in a little less warmth and more stepping back to have the client take responsibility for their feelings. Rather than the therapist validating a feeling, the emphasis is on having the client take responsibility for judging whether it's an appropriate emotion for the context.

This difference between existentialism and the humanistic approach can be noticeable, even though the two approaches are frequently combined. Now, let’s talk about the viewing or case conceptualization in existential psychotherapy. Typically, when existential psychotherapists conceptualize their client’s situation, they will look for several themes, including those mentioned before: meaning and meaninglessness, finding purpose, freedom and responsibility, and existential anxiety and guilt.

I should mention that existential anxiety isn't necessarily the anxiety that would be diagnosed in the DSM; existential anxiety is what we all have as part of the human condition: death anxiety, existential angst, and the purpose of neurosis. We’re going to talk through each one of these separately. Most existentialists take the position that life is inherently meaningless and that we possess this will to meaning; we need to have meaning, which is just part of being human.

We seek out meaning because we tend to be happier that way. The existentialists work with their clients to help them consciously choose the sources of meaning and purpose in their lives. For example, many of us receive our meaning handed down from our parents or our culture.

So, you know, for example, the white picket fence story that is, uh, predominant in the U. S. —that, you know, having a house with a fence and the 2.

5 kids, you know, and the nice car and the driveway and the granite counters or whatever it might be, this is our story of, "Oh, now we are living the good life. This is what it's supposed to look like. " And so, um, existential therapists would actually have clients look at that if that appears to be the, um, the place where they’re finding meaning in their lives.

The existential therapist would have clients actually question that: "Does that fit for you? Is it bringing you meaning? Is it bringing you happiness?

Do you agree with this? Are there parts you want to, uh, shift or change or let go of? Are there other places that you want to look for meaning in your life?

" And so, you know, therapists often have these, um, very difficult conversations with clients about where they are finding the meaning and purpose in their life. In this newer recovery model approach to mental health, which has actually been formally adopted by most, um, how do I put it—by the U. S.

, Europe, Australia, Japan, and many other countries that have formalized mental health care services—this recovery orientation for treating, uh, severe and chronic mental illness has become prevalent. One of the main focuses is finding meaning and purpose in your life, even if you, you know, have a history of having psychosis or mania or bipolar issues. Where’s the meaning?

Where’s the purpose? They find that this is very important when working with clients with chronic mental illness. So, freedom and responsibility are another major focus for existential therapists.

Existential therapists look at their clients' lives and, um, the stories clients tell themselves about their freedom and responsibilities, and how they assume that responsibility that goes with it. Because most of us go through life and we kind of don’t feel free; we feel like we have to get up in the morning and go to work. We feel like we have to, um, spend time with our partner.

We have to, um, I don't know, keep our—you know, dress nice, look nice. We have to take care of our children. There is a certain burden, but still the existentialist would say, "Do you have to take care of your children, or are you choosing to do that because you, um, believe that’s the right thing to do and that’s what you want out of your life?

" And so a lot of us begin to feel like we have to do all these things and we don’t have a choice, when ultimately we always have a choice. There are consequences, obviously, with all of our choices. If you choose not to take care of your children, uh, they will most likely, in many countries, be taken over by the state.

The state can take care of them. So, you know, you have to take responsibility if you’re not going to be taking care of your children, or if you’re not going to get up and go to work, you probably won’t have enough money to live—unless you know, unless you have money somewhere else. So, there are consequences.

Um, you’re always free to choose, even though we feel like we can’t because we just don’t want the consequences. With the existential therapist, we would say, "Ah, but you’re choosing not to have those consequences. " But you are choosing; you are free to choose.

And, you know, you may decide you don’t want to maintain that standard of living to, you know, have to keep a job that you don’t really enjoy doing at all. Maybe it’s not all worth it. Um, and so these are the types of conversations therapists will have with clients around freedom and responsibility.

Um, yes, and so they see these two as inherently connected: that freedom always implies responsibility, and even a failure to act is a choice. It is something you freely chose, and then you must be responsible for that. And so, you know, uh, oftentimes existential therapists working with adults will have them look at major choice points in a person's life, in terms of choosing to do homework in high school or not, choosing to, you know, go on to college or not, choosing to study what you studied in college or not, choosing whom you married, choosing where to live, choosing whether or not you took adventurous vacations or, um, did something adventurous or didn't take risks.

You know, they have their clients go back through and analyze and look at how they had freedoms, how they chose them, and what, you know, how they need to take responsibility for those consequences. As clients are talking, an existential therapist is always kind of listening for where it is that the client doesn’t feel free, because ultimately we are all free—um, every moment of our lives—to make decisions. And this comes from some of, um, Viktor Frankl’s very profound and poignant work on even in a Nazi concentration camp, where arguably you don’t have a lot of freedom about where you are, but in your mind you are free.

That’s where some of his insights came from: in your mind, how you think about it, how you engage, um, the choices you make—you’re still free. You’re always free. Even imprisoned, you can still experience a sense of freedom, and that’s very profound.

Um, again, existential therapy is not for the faint-hearted. of heart, um, because you engage in some pretty difficult, um, issues. And so this is how they work with freedom and responsibility.

As you can see, this isn't always warm and fuzzy because most of us don't want to hear, "You are free to not go to work; that's your choice. " Most of us, our initial response to that is not positive, and we normally don't like to hear that. We’re not usually happy with the person who points that out for us, um, but that is some of how an existential therapist would work.

So another area that existential therapists and counselors would use to conceptualize their work with clients and what's going on with clients is, as they listen to clients talk, they will listen for how aware and conscious the client is of their life. This ability to be self-aware: Are you aware of your thoughts, your feelings, your choices, your desires, your actions? Sometimes you can sit with somebody, and they have very little sense of where meaning comes from in their life or where it could come from.

They very often may not even have a sense of who they are. Often, if they've been in an emotionally abusive relationship, people feel very unaware of their own thoughts and feelings because of the abusive situation. And so this is another area that existential therapists use to conceptualize what's going on with clients.

Another signature concept in existentialism is death anxiety, and they posit that part of being human is this fear of dying. It seems to be instinctual, they would say, and they argue that this fear of death plays a major role in a lot of psychopathology, in terms of, you know, depression, anxiety, those sorts of issues. They see that humans—and this is where you can see some psychodynamic influence here—are basically in denial about death.

We live our lives often, um, in denial, many of us do, about death, and they believe that particularly when you're in denial that you may die, others may die, this can create a lot of, um, secondary symptoms. We have to create a lot of defenses, such as denial, to maintain this facade or this kind of untrue belief and go about our daily business as if that's not necessarily the case. I think this um, begins to make some sense when you lose someone close to you.

Often, many of us find that kind of denial is shattered, and it normally puts most of us into a very different state of mind and way of being. Oftentimes, people reprioritize their lives after an experience where the illusion that we're living forever or never going to die gets shattered. That's often a very profound um, moment in a person's life.

They look at assessing how and in what ways this fear of death may be related to the presenting problem. In terms of, um, you know, an example might be a panic attack, which can often be related to, um, this death fear. I think, in a way that makes a lot of sense, that in terms of often panic comes from someone getting into this state of panic where they feel like they might die, that they're going to die, and that anxiety can often be related to something else in their life—the more profound kind of fear of death underneath that.

So also, they work on having their clients accept that they will die, that others will die, and they do this not to be depressing, um, because it's reality. So how do you engage that reality without becoming anxious or depressed? They believe that when you can accept this reality, you'll make better choices, that you will take more responsibility in your life for how your actions and words affect others, how your choices affect your life.

So that you will make choices and take actions that help you get the most out of life, and live with a real respect for life and its sacredness and its fragility, really. Existential therapists will often work on this, and often when I'm working with a client whose life has been touched by death—either a near-death experience or having lost someone—these issues of death, life, and its meaning come up, even if I'm not planning to do existential therapy; it often comes up around these issues. Another term you’ll hear about is existential angst or existential anxiety, and again this is different from, um, garden-variety anxiety that may be diagnosed in the DSM.

You may or may not have a DSM anxiety diagnosis, but the existentialists posit that we all have this existential angst—this anxiety that comes from the freedom and also the burden of responsibility that comes with that freedom. We have to make choices, and those choices have real effects on ourselves and others. So there’s an inherent anxiety that's just part of that that’s not part of the DSM, and that you need to engage those anxieties effectively in order to avoid having more DSM types of anxiety, depression, eating disorders, or whatever it might be.

And so these anxieties are part of the work. Of being human, we're not going to psychoanalyze those away. Instead, we have to engage this type of anxiety skillfully and with responsibility.

So, it's very much a part of living consciously that you have to be aware, um, of your freedom and your responsibility, the impact of your choices. You need to be consciously creating the meaning in your life. This is, um, part of what existentialists help clients to effectively engage: these existential anxieties, so they don't develop other types of diagnosable disorders.

Finally, in conceptualizing, the counselor or therapist will look at the purpose of the neurosis. Again, this has a bit of a psychoanalytic term here. The purpose of the symptom might be a more contemporary or non-psychodynamic way to say this.

So, what is the purpose? Existential therapists maintain that our symptoms, for which we're coming to therapy, are there to preserve our sense of self against a perceived threat in the outside world. The therapist would look at the presenting problems that a person is having, and link that to help understand where action needs to be taken, where they need to be, um, assuming responsibility in their lives.

For example, if a person comes in saying that they're depressed, perhaps because they are unhappy in their job or with their boss, that would give you a clue as to where the person is not taking responsibility for his or her choices, where they are not owning their true freedom in the situation. You would look at the depression and its relation to those issues and link that back down to these more underlying existential issues that the person needs to address. Now let's talk about setting goals and goal setting in existential therapy.

Existential therapy and counseling have embedded within them a set of long-term outcomes that they want for their clients, which is primarily to live an authentic and meaningful life. That's the long-term goal. Finding meaning, being able to manage existential anxieties, and focusing on the existential issues rather than the symptoms are these long-term goals that are kind of embedded in the approach.

In the early to middle phases of treatment, you're going to be taking smaller steps towards recognizing the underlying existential issues, learning to manage those existential anxieties effectively, and exploring a person's relationships and beliefs around death and how that informs how they should live. They start with that long-term goal, then break down small steps to help the client move past their symptoms to effectively engage these existential issues. Now let's talk about the doing interventions in existential therapy.

It is typically a very process-oriented approach, and these interventions are more on the subtle side in terms of promoting this process of identifying the underlying existential issues and reflecting on them to create real-life change. Many of the interventions in existential therapy focus on having direct conversations, inviting clients to talk directly about these existential issues. For example, inviting clients to identify where they find meaning in their life: Do they approve of this?

Is this what they want to keep doing? How do they do that more effectively? How do they find meaning in life?

This is often a very much part of the conversation, especially when working with depression. Also, acknowledging existential isolation is a difficult one because existentialists would say that fundamentally all of us are alone. We come into this world alone and we're going to die alone, most likely.

We journey through life alone, and a person needs to accept that, own that, and make good choices around life because of it. When we're in denial of this and live with the assumption that our partner or child will be with us forever, that this is the way life is supposed to be, we can be left feeling entitled to that. When you live with that attitude, which many of us do, and a lot of cultures kind of have those assumptions embedded in them, it can cause a lot of suffering down the road when life doesn't go according to plan.

They also look at defining and affirming the self to truly achieve a sense of freedom. Many of us are quick to say that we don’t feel our sense of freedom, that we are who we are because we have to be because of our families, or due to circumstances. The existential therapist would challenge all of those excuses for why we're not who we want to be in life and help the client learn to define themselves and be the one who validates and affirms that self, rather than looking to others.

It’s nice when other people affirm who we are; it feels good. However, it does not lead to sustainable happiness and depression- and anxiety-free, symptom-free living. What they do is work on having the client learn how to challenge these thoughts and beliefs.

The client really needs to define who they are and then validate that themselves rather than looking to someone else to do that, whether it's the therapist or someone in the person's life. They do talk about courage and use encouragement as well. The existential therapist will discuss the courage it takes to engage with these uncomfortable issues.

It also takes courage to own one's freedom and to take full responsibility for it. They try to bolster that courage, often using encouragement to do so. They also have clients examine and look at the themes of love and belongingness.

Even though there is a paradox—we are isolated, we come into this world alone, and we leave alone—we have a need to love and to belong. Oftentimes, many of us will sacrifice significant things to make that happen. Existential therapists invite their clients to explore how they are finding love and belongingness and where they are making sacrifices that may be too much.

This may manifest as not being their true self, because, for example, "my partner wouldn't love me if I were a certain way" or "my friends wouldn't like me if they knew that I actually prefer to stay home and watch movies on a Saturday night rather than go out and party. " We often contort ourselves to be who we think other people—or someone else—wants us to be to gain their acceptance, and often we are wrong. Finally, we have paradoxical intention, which is one of the earliest kinds of paradoxical approaches.

If a client is struggling with what would be categorized as neurotic anxiety, in alignment with the DSM's types of anxieties, therapists would often prescribe what we call a paradoxical intervention. This approach was developed largely in family therapy and, to a certain extent, in cognitive-behavioral therapy (CBT), where the therapist would have the client, for example, confront a phobia by going to a particular place and assigning them to double the intensity of their panic attack. By doing this playfully, they are recontextualizing the symptoms, asking clients to consciously engage with their anxiety in a slightly different way.

This method helps people, especially with symptoms they feel are uncontrollable, begin to see where they do have control, choice, and freedom. Paradoxical intention was significantly developed in family therapy, and we see some of its first uses here with existentialists. Now let's talk a little bit about the research and evidence base.

In terms of research studies that look at the effectiveness of existential therapy, there aren't many. Most of the research in this area, or on this approach, consists of case studies, much like a psychoanalytic approach, where a therapist would report on how a person worked through these existential anxieties. As you can imagine, these philosophical concepts can be hard to operationalize, and often an existentialist isn't really interested in operationalizing and measuring them, as it's not philosophically congruent to engage in traditional scientific research.

Thus, not much has been done in this regard. That said, many of the qualities emphasized in how therapists build a therapeutic relationship—being present, being real, being genuine—are identified in common factors research. These factors span various theories that work and explain why most therapies work effectively.

The quality of the therapeutic relationship, supported by existential therapy, does have an evidence base in common factors research. Finally, we will wrap up by discussing the use of the existential approach with diverse clients. When considering work with culturally and ethnically diverse clients, existentialism is a particularly interesting theory in this context, as much of what culture does is provide ways, rituals, and strategies for managing the human condition.

When thinking about death, for example, it is often largely defined by cultural and religious traditions, which help us navigate these challenging aspects of being human. Thus, it's essential when working from an existential perspective to be aware of a person's culture, gender, and social class, as these factors significantly inform our assumptions about very difficult existential issues. They influence how we construct meaning in our lives.

Social class, gender, ethnicity, and cultural stories and values all contribute to this understanding. What we find to be meaningful, um, so that's, you know, even just individualistic versus collectivist cultures. They very much are defining where meaning comes from.

And so, if you're working with someone from an individualistic culture, like the United States or Northern Europe, um, a lot of their meaning is going to be coming from their identity, whereas when working with people from collectivist cultures, there is more meaning found in relationship and community. Also, um, many of the ideas in existentialism are, and many of the values that it's expressing—this whole idea of you have freedom, you have choice—those are very individualistic values. So, you also need to be aware of how that may not translate so well across cultures, especially to those that have more collectivist values.

Um, that's an important point to be aware of, so focusing more on just how meaning is constructed rather than insisting that clients assume certain perspectives that might be more individualistic. It's just important to be very cautious, um, because it can be easy to take these existential ideas and say, you know, "But you really are free; you don't have to do what your parents say, and you don't have to do what your culture says. " Um, that's—I think we need to tread much more gently, um, when working with people who would be from a collectivist culture and say, "No, you know, they don't see it that way.

" Additionally, existentialism has been used to work with clients who are gay, lesbian, bisexual, or transgendered. Um, this can be very, very useful in helping them begin to explore how they are constructing their sexual identity and look at both their experience of their sexuality and the interpersonal reality of it. It also involves looking at the freedom and choices, the responsibilities, and the consequences, and exploring all these things by looking at the underlying existential issues of the person.

Often, being a minority can really augment that sense of isolation, so how do you engage with that? To a certain extent, all of us are alone, and often the experience of being different makes that experience much more painful. So, I hope you found this introduction to existentialism helpful and useful, and I encourage you to read more in my textbooks.

You'll find ways to conceptualize templates for conceptualizing and developing treatment plans using existential therapy. I also encourage you to read further the original works in the field by Viktor Frankl, as I mentioned, and R. May, among many others.

Um, it's a very fascinating area of psychotherapy to explore.