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“Those with outward courage dare to die; those with inward courage dare to live.”
Lao Tzu


Why am I here today speaking about Existential psychotherapy? Because I believe our society has got off track with its emphasis on the quick fix; on popping pills to alleviate symptoms rather than on encouraging exploration of the meaning of the symptoms and the need for growth which the symptoms point towards. Elio Frataroli, M.D. states that the traditional psychotherapeutic view is that a symptom is the disguised expression of a repressed unconscious emotion. (2001) p.90. I agree with this statement.

Holding this opinion, which has emerged over my own life and my own clinical experience, necessitates that I speak up today and call for change in the way we view inner struggle. Breakdown is not a catastrophe, requiring a chemical fix to return the human being to previous functioning. It is an invitation for exploration, growth, and development of greater self awareness and fulfilment. This inner work cannot be achieved  by suppressing symptoms or by replacing thought with a state of empty quiescence.




Contemporary existential-humanistic therapy is an amalgam of European humanistic and existential philosophy, with American humanistic psychology. Consolidated in the early 1960’s, existential humanistic therapy melds the European heritage of self-inquiry, struggle, and responsibility with the American tradition of spontaneity, optimism and practicality.” (Schneider & Krug.)

Humanism is a way of looking at our world which emphasizes the importance of human beings – their nature and their place in the universe. Humanism teaches that every person has dignity and worth and therefore should command the respect of every other person. Humanism’s approach to the study of humanity formed the intellectual core of the cultural reawakening called the Renaissance. Today many philosophers and educators believe that the greatest challenge to humanism and a threat to the safety of society comes from too great an emphasis on science and technology. Humanism must teach us how to use the knowledge and power from science in a moral and human way. (The World Book Encyclopedia, 1989).

Humanistic Psychology is a mix of existential, transpersonal and constructivist theorizing. It converges on the profound and poignant wholeness of the human lot. It is an integrative psychology that addresses the most pressing issues of our time. It brings in the heart, or personal dimension, while having significance for politics and culture as well as for individuals.  (Schneider, K., 2001).

The founders of Humanistic psychology understood the self not as a mind or a thing but as a propensity.  “One’s self is the urge to develop the fullness inherent in one’s existence, in other words the drive to become the person one truly and authentically can be. Thus the essence of self is the tendency to grow to fullness, and it is the essential characteristic of humans.” Donald Polkinghorne, D.  ( Schneider, K., 2001). p.82

“Rather than human being we should call ourselves human becoming,”

- Rollo May.

The questions asked by an existential-humanistic psychotherapist  are:  “How shall we live? What really matters to us? How can we pursue what really matters to us?” (Schneider & Krug, 2010).

Why do we need Existential-Humanistic Psychotherapy?

We need E-H psychotherapy because most other modalities to not concern themselves with paying attention to the soul. I talk of soul, not in the religious sense, but in its original meaning from the Greek word, “ psyche,” meaning soul; some would say the essential part of ourselves. The idea of the soul is antithetical to scientific inquiry  and has therefore met with considerable resistance, especially in the last few decades when ‘mental illness’ has been thought (and hoped) to be purely biological and therefore fixable with medication. Research into the efficacy of E-H psychotherapy has been considered too challenging.

We dread to be caught believing – and, in fact, knowing – things which are not demonstrable by the measurement of observed variables……we look carefully over our shoulders and pick our words appropriately, to avoid saying anything….metaphysical….for fear of offending the ruling assumptions about the strictly mechanical origin of science.

- Michael Polanyi, “Scientific beliefs.”

Elio Frattaroli, (2001) psychiatrist and psychoanalyst at the university of Pennsylvania, author of “Healing the Soul in the Age of the Brain”  discusses an article written by psychiatrist Robert Stoller in the American Journal of Psychiatry in 1984. In this article, Frattaroli writes, Psychopharmacology was replacing psychotherapy because brain was replacing mind – that is chemical imbalance was replacing inner conflict – as the philosophical basis for psychiatric explanation. P.85  Fratorelli goes on to say that it has become widely held that so-called mental illnesses are really brain disorders and mind is really just another name for brain. He states that the so-called Medical Model of psychiatry no longer treats anxiety as an essential aspect of the human condition, an adaptive signal of emotional conflict that needs tending to. Rather it treats anxiety as a “disorder,” a brain defect, something that leaves you branded with a five digit code number…..p.86

However, that attitude is gradually changing.

The first essential feature of E-H psychotherapy is Presence. The approach requires the psychotherapist  to open themselves to the client in a profound way: full atunement to the client on many levels. “In order to ‘grasp the being’ of the client, and consequently help the client to ‘grasp her being’ the therapist must bring a full and genuine presence to the therapeutic encounter,” May, (1958b). Presence involves aspects of awareness, acceptance, availability and expressiveness in both therapist and client. Presence implies that the encounter is real. Schneider, (2010).

The second essential feature of the approach is Relationship.  John Warkentin, Ph.D., M.D. Editor of Voices, the Journal of the American Academy of Psychotherapists, stated: The only “mental illness” is estrangement from Self and from others; the “cure” is active encountering with a human mediator. John Warkentin, (1971). The psychotherapist therefore communicates (without words) that she is a fellow human being walking the same journey as they, and available to walk with them. E-H psychotherapy also invites the client into a deeper relationship with themselves….  becoming their own best friend.

The third essential feature of EHP is Meaning.   By assisting the client in plumbing their own depths, exploring what provides meaning, and discovering core values, the client learns the power of self contact. Self knowledge leads to self-befriending. Unconditional positive regard, as formulated by Carl Rogers, helps the client towards self-forgiveness and self-acceptance.

Four Core Aims of Existential humanistic psychotherapy

(a)To help clients become more present to themselves and others;

(b) To help them experience the ways in which they both mobilize and block themselves from fuller presence;

(c) to help them take responsibility for the construction of their current lives; and

(d) to help them choose or actualize ways of being in their outside lives based on facing, not avoiding, the existential givens such as finiteness, ambiguity, and anxiety. Schneider, (2010).


“Psychology, or at least Amer. Psych., is a second rate discipline. The main reason is that it does not stand in awe of its subject.” J.J. Gibson, (2001). With the EHP approach the psychotherapist does stand in awe of the subject, the creative mystery of the human being in front of her. The psychotherapist communicates (without words) that it is a privilege and a pleasure to be allowed a glimpse into that mystery and to collaborate in bringing more of that mystery to conscious awareness.

The only “mental illness” is estrangement from Self and from others; the “cure” is active encountering with a human mediator. John Warkington (Intro.)

We must seek bridges along the path toward existing ever more freely, with a willingness to risk our Selves in the venture of becoming. J.W.

One cannot simply heal individuals to the neglect of the social context within which they are thrust. To be a responsible practitioner, one must develop a vision of responsible social change, alongside of and in coordination with one’s vision of individual transformation .

E-H therapy promotes depth inquiry, and depth inquiry promotes a sense of what deeply matters. While such a sense does not always lead to social and spiritual consciousness, in our experience – and that of many E-H practitioners – this is predominantly what results.

My clinical experience suggests a possible link between psychosis and moral unease. Some clients are tormented by self-loathing as a result of a perceived egregious act or way of being.  An extreme lack of acceptance of self at a core level results in torment. Torment must be escaped. Detachment and alienation may follow.

Existentialist psychotherapy emphasises the importance of finding out what a patient means by a symptom, or any other aspect of their expression of themselves. (Van-Deurzen-Smith p.149)

R.D. Laing’s vivid descriptions of the subjectivity of psychotic experience leave no doubt at all that much of so-called mental illness is an extreme form of existential misery that can be understood and worked with. P.163 he showed consistently how it was possible to address the essential sanity in the person and ignore the insanity, or rather, be aware of how the insanity is often a function of the situation or the structure of the family or organisation the person belongs to. P. 166  (Van Deurzen-Smith).

Martin Seligman: His rallying cry of Positive Psychology raised during his American Psychological Association presidency 1998-1999 is a departure from psychology as practised for most of the past century. Instead of focusing primarily on behavioural deficits, positive psychology starts with the assumption that virtues such as courage, altruism and perseverance are just as genuine and important as the pathological conditions that traditionally have held centre stage. Mihaly Csikszentmihalyi. (Schneider, 2001)



Richard E. Johnson stated in 1971: The psychotherapist who tries to function within the confines of structured psychological institutions soon encounters this deeper resistance to existentialism. He soon discovers that the excitement generated by existential study is circumscribed and cannot assuage the pain of his own immediate aloneness. He is still told in the routine of his own professional world that he must do the job of a psychologist as we define it or get out. P.ix

He continues:  Psychiatry and psychology often “want to cut out the pain the way a skilled surgeon cuts out a malignancy……professionals would better understand psychic pain if they made direct contact with it. Such personal contact with pain would reveal that medication and manipulation do not heal the open sores of intrapsychic estrangement. Any treatment based on personal or professional distance perpetuates the deeper cause of pain. Only the balm of a human encounter can close the wound of alienation.

In 19 ?? Thomas  Szasz,  wrote , “..during recent decades, the canons of respectable scholarship and journalism alike have virtually mandated that we view only biological-reductionistic explanations of human behaviour as scientific.”  (Schneider, p.77


Karl J. Schneider and Orah T. Krug: It is one of the supreme ironies of our field that the most salient factors in therapeutic outcome research  i.e.  a healing environment, the therapeutic relationship, and the therapist’s and client’s personal styles- echo incisively the precepts emphasized by existential-humanistic (E-H) therapy, [and yet it remains] one of the field’s least studied modalities. As Elkins (2007) pointed out in a recent article…’s not so much “theories and techniques that heal……but the human dimensions of therapy and the ‘meetings’ that occur between client and therapist as they work together” (Schneider, 2001, p.496). Chapter  called Research supporting efficacy of approach

Leading therapy researcher, Bruce Wampold (2008) is just as adamant. “I have no doubt that EI approaches would satisfy any criteria used to label other psychological treatments as scientific” (p.5). He adds: “it could be that an understanding of the principles of existential therapy is needed by all therapists, as it adds a perspective that might, as Schneider contends, form the basis of all effective treatments” (p.6)

The EST, Empirically Supported Treatment movement, still dominates the thinking in professional practice and training. EST investigates the overt and quantifiable factors while overlooking the contextual factors.

BUT things are gradually changing: relationship, as opposed to technique, has been shown, through extensive research, to be the most important factor in the success or failure of psychotherapy.

  1. 57. “The Talking Cure: The Science behind psychotherapy.” (1997) Susan Vaughan.

“In this book, I present evidence that shows how psychotherapy literally changes the structure of your brain. It actually can alter the web of interconnecting neural cells found in the grey matter of the cerebral cortex. Taken together over time, these physical changes in how neurons are connected help us to produce new, internal representations of self and other, changing the ingrained neural patterns about relationships that were laid down during early childhood development. The techniques of psychodynamic psychotherapy……. make sense in neuronal terms. I believe that the new evidence explains how and why the “talking cure” works at the cellular level.”

In 1998c Moss stated: At present psychology is “fractured, rivalrous and rife with tension.”   There is a continued need to remind human society and the helping professions of the dignity and worth of humans.  (Schneider, 2001)


“No problem can be solved from the same consciousness that created it. We must learn to see the world anew.”




Existential Humanistic client base has widened to include therapy with psychotic clients (Dorman, 200; Mosher, 2001; Thompson, 1995).

Dorman, D.(2008). Dante’s cure: Schizophrenia and the two-person Journey. In K. J. in

J.J. Gibson p.65.  In Kirk.J.Schneider, James F.T. Bugental, & J. Fraser Pierson (Eds.), The Handbook of Humanistic Psychology, (2001).

Johnson, R.E., Existential Man: the Challenge of Psychotherapy, (1971).

May, R. (1958b). Contributions of existential psychotherapy. In R. May, E. Angel, & H. Ellenberger (Eds.), Existence (pp.3-36). New York Basic books.

Mosher, L., Treating madness without hospitals, (2001). In Kirk.J.Schneider, James F.T. Bugental, & J. Fraser Pierson (Eds.), The Handbook of Humanistic Psychology, (2001).

Schneider, K., & Krug, O., Existential Humanistic Therapy, 2010

Schneider, K. (Ed), Existential-integrative Psychotherapy: Guideposts to the Core of Practice,    2008

Van-Deurzen-Smith, E., Everyday Mysteries. Existential Dimensions of Psychotherapy, 1997).

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