alive in America, leading eventually to a specific formulation of therapy (Bugental, 1981; May and Yalom, 1985; Yalom, 1980). Humanistic psychology was directly influenced by these ideas, but it invariably diluted and sometimes distorted their original meanings
In Europe existential ideas were combined with some psychoanalytic principles and a method of existential analysis was developed by Boss (1957a, 1957b, 1979) in close co-operation with Heidegger. In Austria Frankl developed an existential therapy called logotherapy (Frankl, 1964, 1967), which focused particularly on finding meaning. In France the ideas of Sartre (1956, 1962) and Merleau-Ponty (1962) and of a number of practitioners (Minkowski, 1970) were important and influential but no specific therapeutic method was developed from them.
Development in Britain
Britain became a fertile ground for the further development of the existential approach when Laing and Cooper took Sartre’s existential ideas as the basis for their work (Laing, 1960, 1961; Cooper, 1967; Laing and Cooper, 1964). Without developing a concrete method of therapy they critically reconsidered the notion of mental illness and its treatment. In the late 1960s they established an experimental therapeutic community at Kingsley Hall in the East End of London, where people could come to live through their madness without the usual medical treatment. They also founded the Philadelphia Association, an organization providing alternative living, therapy and therapeutic training from this perspective. The Philadelphia Association is still in existence today and is now committed to the exploration of the works of philosophers such as Wittgenstein, Derrida, Levinas and Foucault as well as the work of the French psychoanalyst Lacan. It also runs a number of small therapeutic households along these lines. The Arbours Association is another group that grew out of the Kingsley Hall experiment. Founded by Berke and Schatzman in the 1970s, it now runs a training programme in psychotherapy, a crisis centre and several therapeutic communities. The existential input in the Arbours has gradually been replaced with a more neo-Kleinian emphasis.
The impetus for further development of the existential approach in Britain has largely come from the development of a number of existentially based courses in academic institutions. This started with the programmes created by Emmy van Deurzen, initially at Antioch University in London and subsequently at Regent’s College, London and since then at the New School of Psychotherapy and Counselling, also in London. The latter is a purely existentially based training institute, which offers postgraduate degrees validated by the University of Sheffield and Middlesex University. In the last decades the existential approach has spread rapidly and has become a welcome alternative to established methods. There are now a number of other, mostly academic, centres in Britain that provide training in existential counselling and psychotherapy and a rapidly growing interest in the approach in the voluntary sector and in the National Health Service.
British publications dealing with existential therapy include contributions by Jenner (de Koning and Jenner, 1982), Heaton (1988, 1994), Cohn (1994, 1997), Spinelli (1997), Cooper (1989, 2002), Eleftheriadou (1994), Lemma-Wright (1994), Du Plock (1997), Strasser and Strasser (1997), van Deurzen (1997, 1998, 2002); van Deurzen and Arnold-Baker (2005); van Deurzen and Kenward (2005). Other writers such as Lomas (1981) and Smail (1978, 1987, 1993) have published work relevant to the approach although not explicitly ‘existential’ in orientation. The journal of the British Society for Phenomenology regularly publishes work on existential and phenomenological psychotherapy. An important development was that of the founding of the Society for Existential Analysis in 1988, initiated by van Deurzen. This society brings together psychotherapists, psychologists, psychiatrists, counsellors and philosophers working from an existential perspective. It offers regular fora for discussion and debate as well as major annual conferences. It publishes the Journal of the Society for Existential Analysis twice a year. It is also a member of the International Federation for Daseinsanalysis, which stimulates international exchange between representatives of the approach from around the world. An international Society for Existential Therapists also exists. It was founded in 2006 by Emmy van Deurzen and Digby Tantam, and is called the International Community of Existential Counsellors and Therapists (ICECAP).
View of the Human Mind
Although humans are essentially alone in the world, we long to be connected to others. We want to have meaning in their lives while they have meaning in ours, but ultimately we must come to realize that we cannot depend on others for our validation, and with that realization we finally acknowledge and understand that we are fundamentally alone. The result of this revelation is anxiety in the knowledge that our validation must come from within and not from others. This anxiety is a positive thing, since it makes us aware of the limits of human existence and this makes us capable of reflecting on life instead of living thoughtlessly.
Because we are alienated and isolated our lives are also meaningless. Nothing exists which is greater than ourselves, therefore there are no external sources of values and absolutes from which we can draw. Taken to an extreme we might conclude that there is nothing for which to live, however, there is hope in the possibility of creating our own values and our own meanings and applying them to our condition, giving us feelings of significance and purpose that are strong enough to carry us through life. This freedom we have to choose our own values is another source of anxiety: we must summon the requisite strength and courage to choose our life-meaning and hold fast to it, undoubtedly a task which many find difficult.
Human beings are also mortal. As we come to grips with the fact that our lives are limited, we develop even more anxiety: we are afraid of death. The knowledge that at some point in the future we will cease to be, while frightening, is at the same time invigorating because it is relevant right now. The juxtaposition of life and death is one thing that does give us some certainty.
Finally, humans are responsible. Being isolated, alone, and free to choose means that one cannot assign blame for his or her problems to someone else. The individual alone makes the choices and therefore is responsible for the outcomes. At any point we are free to make different choices and thus re-invent ourselves; we are at once the architect, the planner, and the builder of our lives, throughout our lives.
There is no such thing as psychological dysfunction or being ill in the existential view. Every way of being is merely an expression of how one chooses to live one's life. However one may feel unable to come to terms with the anxiety of being alone in the world. If so an existential psychotherapist can assist one in accepting these feelings rather than trying to change them as if there is something wrong. Everyone has the freedom to choose how they are going to be in life, however this may go unexercised because making changes is difficult; it may appear easier and safer not to make decisions that you will be responsible for. Many people will remain unaware of alternative choices in life for various societal reasons.
The Good Life
It is possible for people to face the anxieties of life head-on and embrace the human condition of aloneness, to revel in the freedom to choose and take full responsibility for their choices. They courageously take the helm of their lives and steer in whatever direction they choose; they have the courage to be. One does not need to arrest feelings of meaninglessness, but can choose new meanings for their lives. By building, by loving, and by creating one is able to live life as one's own adventure. One can accept one's own mortality and overcome fear of death.
The existentially-oriented psychotherapist guides his or her patients/clients to confront life’s anxieties. If the patient/client has not been fully exercising the freedom to choose, the counselor will lead a discovering into how and why he or she is stuck. Perhaps the patient/client has been allowing others to make the important decisions which he or she alone should be making. Possibly the patient/client is afraid to take the risks required to grow and is instead choosing an easy and non-threatening path. The counselor will encourage his or her patient/clients to reflect on the aloneness and meaninglessness of life, and to understand that they must find their own ways to cope with these anxieties. The counselor does not try to eliminate these anxieties, but instead encourages the patient/client to face them head-on. Alternative paths can be explored together. The risks entailed with these paths can be evaluated, and then the patient/client will be able to make new, more authentic choices. The existential counselor is not overly concerned with the patient's/client’s past. Instead, the emphasis is on the choices to be made in the present. The counselor and the client may reflect upon how the client has answered life’s questions in the past, but then attention shifts to searching for a new and increased awareness in the present and enabling a new freedom and responsibility to act.
Existential thinkers seek to avoid restrictive models that categorize or label people. Instead they look for the universals that can be observed cross-culturally. There is no existential personality theory which divides humanity into types or reduces people to part components. Instead there is a description of the different levels of experience and existence with which people are inevitably confronted. The way in which a person is in the world at a particular stage can be charted on this general map of human existence (Binswanger, 1963; Yalom, 1980; van Deurzen, 1984). One can distinguish four basic dimensions of human existence: the physical, the social, the psychological and the spiritual. On each of these dimensions people encounter the world and shape their attitude out of their particular take on their experience. Our orientation towards the world defines our reality. The four dimensions are obviously interwoven and provide a complex fourdimensional force field for our existence. We are stretched between a positive pole of what we aspire to on each dimension and a negative pole of what we fear.
On the physical dimension (Umwelt) we relate to our environment and to the givens of the natural world around us. This includes our attitude to the body we have, to the concrete surroundings we find ourselves in, to the climate and the weather, to objects and material possessions, to the bodies of other people, our own bodily needs, to health and illness and to our own mortality. The struggle on this dimension is, in general terms, between the search for domination over the elements and natural law (as in technology, or in sports) and the need to accept the limitations of natural boundaries (as in ecology or old age). While people generally aim for security on this dimension (through health and wealth), much of life brings a gradual disillusionment and realization that such security can only be temporary. Recognizing limitations can bring great release of tension.
On the social dimension (Mitwelt) we relate to others as we interact with the public world around us. This dimension includes our response to the culture we live in, as well as to the class and race we belong to (and also those we do not belong to). Attitudes here range from love to hate and from co-operation to competition. The dynamic contradictions can be understood in terms of acceptance versus rejection or belonging versus isolation. Some people prefer to withdraw from the world of others as much as possible. Others blindly chase public acceptance by going along with the rules and fashions of the moment. Otherwise they try to rise above these by becoming trendsetters themselves. By acquiring fame or other forms of power, we can attain dominance over others temporarily. Sooner or later we are, however, all confronted with both failure and aloneness.
On the psychological dimension (Eigenwelt) we relate to ourselves and in this way create a personal world. This dimension includes views about our character, our past experience and our future possibilities. Contradictions here are often experienced in terms of personal strengths and weaknesses. People search for a sense of identity, a feeling of being substantial and having a self. But inevitably many events will confront us with evidence to the contrary and plunge us into a state of confusion or disintegration. Activity and passivity are an important polarity here. Self-affirmation and resolution go with the former and surrender and yielding with the latter. Facing the final dissolution of self that comes with personal loss and the facing of death might bring anxiety and confusion to many who have not yet given up their sense of self-importance.
On the spiritual dimension (Überwelt) (van Deurzen, 1984) we relate to the unknown and thus create a sense of an ideal world, an ideology and a philosophical outlook. It is here that we find meaning by putting all the pieces of the puzzle together for ourselves. For some people this is done by adhering to the dogma of a religion or some other prescriptive world view, for others it is about discovering or attributing meaning in a more secular or personal way. The contradictions that have to be faced on this dimension are often related to the tension between purpose and absurdity, hope and despair. People create their values in search of something that matters enough to live or die for, something that may even have ultimate and universal validity. Usually the aim is the conquest of a soul, or something that will substantially surpass mortality (as for instance in having contributed something valuable to humankind). Facing the void and the possibility of nothingness are the indispensable counterparts of this quest for the eternal.