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THEORIES

What to Know About Existentialism—Philosophy and Existential Therapy

By Amy Marschall, PsyD Updated on May 04, 2023

Reviewed by David Susman, PhD

person walking a trail on the side of a mountain with grass

Jordan Siemens / Getty Images

Table of ContentsTable of Contents

History

Existential Therapy

Effectiveness

Interventions

Risks and Limitations

Existentialism is a philosophy of human nature that identifies people as having free will to determine the
course of their lives. It emphasizes individual responsibility to create meaning rather than relying on a
higher power or religion to determine what is important, valuable, or morally right.1nm

Existentialists believe that the nature of existence varies and is individualized to each person. We are
defined by our existence, and our existence is made up of our relationship to other people and things in
the world. They believe each person must choose and commit to meaning and direction in life.
History of Existentialism

Søren Kierkegaard was a Danish philosopher from the 1800s who is considered the father of
existentialism. He was critical of Christianity and religious philosophy, emphasizing living as an individual
within reality rather than abstract thought experiments.2

He believed that individuals must give meaning to their own lives rather than receiving it from society or
religion. Kierkegaard additionally focused on human emotion, particularly the anxiety that comes with
making choices and discovering meaning and value in life.

Other early existential philosophers, including Friedrich Nietzche and Fyodor Dostoevsky, wrote about
creating one’s own identity to give meaning to existence. The inability to identify meaning in one’s life
causes anxiety, known as an existential crisis.

Throughout the nineteenth century, existential writers created novels and plays containing analogies
and metaphors for existence and the importance of individuals determining their own meaning.

Many existential philosophers have explored the anxiety that comes with the responsibility to create
your own meaning in life. In a world where you create your own meaning, it is easy to fall into the belief
that life has no meaning. However, existentialists believe it is important to make the choice to continue
on and find this individual meaning.

What Is Existential Therapy?

The German psychoanalyst Otto Rank is considered the first therapist to practice existential therapy. He
emphasized present feelings and thoughts rather than focusing primarily on one’s past experiences or
subconscious in treatment.

He believed that people need to learn more effective ways of thinking and acting in order to overcome
mental health issues.
Existential therapy is based on the following:3

Every human being is capable of self-awareness

Every human being has free will and is responsible for their free choices

Every human being is unique and can only be understood through interpersonal relationships with
others

Every human being is constantly being reborn and recreated

Meaning is constantly changing, and no one can fully comprehend the meaning in their life because it is
always changing

Every human being experiences anxiety as part of their human experience

Death is inevitable and gives life meaning

Existential therapists believe that anxiety comes from uncertainty about the changing nature of the
meaning of life and uncertainty about existing in the world, including the physical world, the “world”
involving relationships with other people, and the relationship each person has with themselves.4

An existential therapist will help clients confront anxiety about their existence, such as fear of death,
fear of loneliness, fear of making the wrong choices with the freedom they have, and fear of living a life
without meaning. When confronting these fears, you experience psychological distress.

An existential therapist helps the client “focus on personal responsibility for making decisions.”3 They
help the client develop insight into the reasons why they make their decisions and make future choices
based on the value and meaning that they identify for themselves.

Is Existential Therapy Effective?

Viktor Frankl, an Austrian psychiatrist, researched patients in inpatient drug dependence treatment and
noticed that substance use might be a method of coping with perceived meaninglessness in life.5
Research suggests that existential therapy focused on meaning can help alleviate mental health
symptoms but has not been shown to impact a personal sense of well-being.6

Additionally, experiential and cognitive approaches to existential therapy have not been shown to
alleviate symptoms. Supportive and expressive existential therapy has shown only a small impact on
mental health symptoms and has not been shown to improve a sense of well-being.7

However, many existential therapists note that “evidence-based practice” requires specific, controlled
treatment settings, which are not conducive to an existential approach to treatment. Components of
existential therapy, including an emphasis on the therapeutic relationship and finding a sense of
meaning, are difficult to measure objectively in a research setting.6

Existential Therapy Interventions

Existential therapy offers specific interventions that can help clients develop a sense of meaning and
alleviate mental health symptoms.

Existential interventions include:8

The Four Worlds of Human Existence. Existential therapists believe humans exist in four worlds: the
physical, social, personal, and spiritual worlds. The therapist helps the client identify which of their
worlds they have not explored fully and what contradictions between the four worlds might be causing
distress.

Mapping Worldview. An individual’s worldview includes expectations, assumptions, and beliefs about
themselves, the world, and the other people in the world. By better articulating their worldview, the
client can identify what changes to their behavior can make their life more fulfilling.

Naming Avoidance. The therapist points out when the client is avoiding by discussing past and future
rather than present events or describing themselves as passively experiencing life rather than actively
making choices.
Developing Emotional Vocabulary. The therapist has the client list their most common emotional states
and explore what emotions they did not include, and explore the reasons why they might have
overlooked these states.

Taking Ownership. Because existentialists believe strongly in free will, an existential therapist will help
their clients take ownership of their choices and the consequences of these choices.

Exploring Values. The therapist guides the client with “values questions,” such as “How do you want to
live your life?” and “What is your overall sense of meaning?”

Role Playing. The therapist and client role play ideal life scenarios, such as what specific details would
indicate that the client is living their most meaningful life. This helps the client determine what a
“meaningful life” means to them.

What Is Psychodrama?

Risks and Limitations of Existential Therapy

As described above, existential therapy lacks solid research backing to demonstrate its effectiveness.
Although existentialism is difficult to study empirically, it can be difficult to understand what progress
looks like in treatment if this is not clearly defined.

Similarly, existential therapy has faced criticism for having vague approaches and goals,9 though this
allows individual clients to find meaning in the way that works best for them.

Can Existential Therapy Treat Trauma?

Additionally, because existentialism focuses on individual freedom and choice, this treatment approach
is often not ideal for survivors of trauma and abuse. Emphasizing personal responsibility for one’s state
in life can be seen as victim blaming for these clients.

What Is Trauma Therapy?

A Word From Verywell

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By Amy Marschall, PsyD

Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents
who also identify with these neurotypes among others. She is certified in TF-CBT and telemental health.

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