During a lifetime, most individuals question the meaning of their existence at one point or another. Existential therapy aims to help individuals find purpose, have better defined goals, and live life to the fullest. Existential therapy takes into account cultural, social and political values of the client. It attempts to help the client live more deliberately, while accepting life’s unpredictable challenges and contradictions. Rational Emotive Behavior Therapy (REBT) is complementary to existential therapy by providing techniques to help clients make changes once their awareness is increased through existential discovery.
Existential therapy and REBT integrated approach to counseling can provide successful results by combining individual meaning with reasonable thinking. This empowers clients to take control of their lives. The first step in the therapy process is to help the client become aware of what changes need to be made in order to live a more fulfilling and satisfying life. This is achieved by examining one or more existential themes. In his book Existential Psychotherapy, Irwin Yalom describes four major themes that permeate existential psychotherapy: death, freedom, isolation, and meaninglessness.
In the first theme, death, here are two major ideas that play key factors in therapy (Yalom, 1980). First of all, death and life coexist. Even though physically they are clearly separated, psychologically they exist simultaneously. Death is a natural part of the cycle of life, and as one dies, another is given an opportunity to experience life (Kaufmann, 1975). Death is a realistic threat and a part of our daily lives. Every day we are alive, we are closer to death. Frankl (2006) believes that “if there is a meaning in life at all, then there must be a meaning in suffering.
Suffering is an ineradicable part of life, even as fate and death. Without suffering and death human life cannot be complete” (p. 67). Nothing in this world lasts forever. It is only natural for humans to see death as a part of life that is unavoidable. The awareness of death has a significant impact on life and “Although the physicality of death destroys man, the idea of death saves him” (Yalom, 1980, p. 30). Awareness of death allows individuals to live life more fully, authentically, and appreciate how truly precious life is.
Authenticity is one of the main concepts of existentialism and is defined as being genuine, true to one’s feelings and beliefs, aware of self and surroundings, and ability to successfully deal with issues related to existence (Sharf, 2008). People come to appreciate life more, exist mindfully and purposefully. Nietzsche wrote: “He that consummates his life dies his death victoriously” (Kaufmann, 1975, p. 129). Those who live a complete and happy life are less likely to be afraid of death because they have experienced life to the fullest.
A potential threat of life be taken away makes it more likely for people to appreciate and enjoy life. Without suffering how does one know pleasure? For example, someone with cancer who previously has taken life for granted may have a greater appreciation for life after beating the illness. In such cases, people feel the urgency to take pleasure in life’s every unique moment and relish the simple joys while they still can. Very often people do not value things until they are taken away or are threatened to be taken away.
The second idea is that death anxiety constantly affects the way people experience their life. In addition, most anxiety comes from issues related to death and decreasing anxiety is one the major goals of psychotherapy. Anxiety can stem from many issues, such as control or fear. Fear of death is one of the significant motivators in our society. We constantly come up with new ways to avoid death by building safer vehicles, wearing protective gear, inventing new medical treatments and procedures.
Self preservation is a natural instinct and anxiety related to the end of our life is an unavoidable reality. There are many reasons why individuals are afraid of death: inability to take care of dependents, pain and sadness that loved ones will feel, or fear of the afterlife. But one of the most common reasons is the fear of nothingness and loss of self (Yalom, 1980). Death anxiety can manifest itself in many different ways (Yalom, 1980). One’s feeling of missing exciting events or the desire to control the surrounding world, demonstrate this manifestation.
These unhealthy thoughts help individuals ease fear of death by dealing not with the real and terrifying source of anxiety, but indirectly, through more socially acceptable actions. Many people protect themselves from death anxiety by denying it. Yalom (1980) discussed two ways that accomplish this goal: the ultimate rescuer and personal specialness. Both ideas lead people to feel that they will not be affected by misfortune like others might be. The ultimate rescuer is a type of defense mechanism leading people to believe that someone will come into their life and save them from their problems.
An example of this would be a person with severe financial problems needing money to take care of health problems believing that someone or something will bring the needed money and the situation will work itself out. Personal specialness involves the belief that one is in a way different from others and therefore immune from the hardships of life. Personal specialness can be seen all around us: a healthy woman thinking cancer will never happen to her, couples believing there is no way they can have an autistic child, or a teenager driving recklessly believing that there is no way he will get in an accident and die.
The awareness of finiteness enables people to appreciate the surrounding world at a much deeper level and find what it is they are meant to contribute to the world. The second theme of existential psychotherapy is freedom. Freedom and responsibility go hand in hand. Individuals who are responsible are conscious of the fact that the world is not working against them. They come to realize that their experiences are the outcomes of their own decisions. Some people may feel that their environment, their unconscious mind, or genetic make up is working against them.
Existential theory takes into consideration that these sometimes uncontrollable factors have an effect on events, but do not completely determine them. Frankl (2006) wrote regarding his experiences in a concentration camp: Every day, every hour, offered the opportunity to make a decision, a decision which determined whether you would or would not submit to those powers which threatened to rob you of your very self, your inner freedom; which determined whether or not you would become the plaything of circumstances, renouncing freedom and dignity to become molded into the form of the typical inmate (p.
66). In extreme situations as this, freedom represents psychological separation from a difficult situation. In this case, a person has inner freedom to choose how he feels and what he thinks. His physical freedom and material possessions can be taken away, but his thoughts, feelings, his self, cannot. People have the freedom to make any decision they choose, are responsible for these decisions and have to be able to face the outcomes.
Yalom (1980) wrote that “To be aware of responsibility is to be aware of creating one’s own self, destiny, life predicament, feelings, and if such be the case, one’s own suffering” (p. 218). Having the freedom to control one’s own destiny and “own the insight that you and only you construct your own life design” can be a heavy burden to bear, but once individuals become aware of their power and accept the challenge, they can make significant improvements and live more authentically (Yalom, 1989, p. 38). Simple awareness may not be enough for change to take place.
One must be willing and committed to address the negative aspects of life and become responsible for adopting new behaviors. People must accept responsibility for their lives and decisions they have made; otherwise, growth and positive change cannot take place. The third theme of existential therapy is isolation. Yalom (1980) discusses three types of isolation: interpersonal, intrapersonal, and existential. Interpersonal isolation involves separation of self from others. Many factors can contribute to such isolation, such as personality, culture, or physical location.
In this case the person does not have a social support network, is not involved in healthy relationships and may feel cut off from other people. Intrapersonal isolation takes place when a person represses certain events, separates part/parts of the psyche or no longer has pronounced personal opinions and beliefs. Yalom (1980) sums up intrapersonal isolation by saying that it “results whenever one stifles one’s own feelings or desires, accepts “oughts” or “shoulds” as one’s own wishes, distrusts one’s own judgment, or buries one’s own potential”.
Lastly, existential isolation refers to the feeling of being alone in the world. Regardless of how many friends or family members one has and how closely they are involved together, the person is still isolated and has distinctive experiences of the surrounding world. This may be considered a pessimistic view of life, but it is hard to deny that each person is one of a kind, whose true feeling and experience only they can know. Isolation can be seen as a representation of individuals’ uniqueness. Even though isolation is a part of life, intimate relationships are vital to a fulfilling life.
Frankl (2006) wrote “…love is the ultimate and the highest goal to which man can aspire…The salvation of man is through love and in love. I understood how a man who has nothing left in this world still may find bliss…in the contemplation of his beloved” (p. 37). Genuine and loving relationships, where both individuals are actively involved, provide means to deal with existential isolation and help people find a sense of self. The final theme of existential therapy is meaninglessness. Many people struggle with the idea of what the meaning of their life is.
People need a reason to wake up every day, go to work, do their chores, and repeat the cycle over and over again. Lack of goals, hope and purpose, can lead to stress, depression, and even suicide. It is a natural human desire to search for order, patterns, and explanations in the world. This need for organization raises the ultimate question of why and for what one lives. The quest for the meaning of life is divided into two groups of thought: man creates meaning and man is in search of meaning. The first idea is non spiritual and is based on the fact that there is no prearranged meaning and people create their own reason to live.
The second way of thought regarding meaning of life is spiritual. It states that meaning is predetermined by a higher power and is something that a person needs to find. Frankl (2006) wrote “Everyone has his own specific vocation or mission in life to carry out a concrete assignment which demands fulfillment. Therein he cannot be replaced, nor can his life be repeated. Thus, everyone’s task is as unique as his specific opportunity to implement it” (p. 109). Regardless of the origin of meaning, it helps people truly live and keep going.
As discussed earlier, the themes of death, freedom, isolation and meaninglessness are used to build self-awareness in clients. Following the point when the client is committed to modify behavior, Rational Emotive Behavior Therapy (REBT) concepts and techniques are incorporated to make lasting changes in the client’s life. REBT therapists’ goal is to “help clients to give up their demands for perfection and to strive to develop constructive self-acceptance as well as acceptance of others” (Walen, DiGiuseppe, & Dryden, 1992, p. 14) by overcoming their irrational beliefs.
Irrational beliefs are unreasonable, do not represent actual events, commonly involve “black and white” thinking, lead to anxiety and prevent people from achieving their goals (Walen et al. ,1992). Within an existential theme of death, a client who has severe death anxiety and constantly avoids participating in various activities in order to avoid potential dangers, would first be guided to examine the reasons for death anxiety, and the irrational belief of death threat would be challenged by the therapist. There are six principles of REBT (Walen et al. , 1992).
The core idea of the theory is that “we feel what we think” (Walen et al., 1992, p. 15). External factors do not cause people to feel a certain way, but rather people’s internal perceptions and interpretations contribute to the destructive emotional and behavioral reactions.
The next principle is that irrational thinking causes the majority of emotional distress. Irrational thought patterns such as “musts”, “shoulds” and exaggerations can create extreme anxiety in individuals and make them feel out of control. The third principle states that by changing thinking patterns, the person can overcome anxiety causing feelings. Another principle discusses various factors that affect ways of thinking.
According to Sharf (2008), Albert Ellis took into account biological and social factors that affect human development and susceptibility to develop irrational beliefs. Ellis believed that people have inborn drives to think irrationally and react to the environment in certain way. People are also strongly affected by their interpersonal relationships. Ellis found that if others perceive the person as worthy, the person is more likely to perceive himself as worthy, too. Our society as a whole contributes to this way of thinking by telling us that we “must” and “have to” do things a certain way.
For example, parents telling kids to eat everything on their plate. This promotes the belief in children that if they do not finish a meal, they have failed. In adulthood, this can lead to obesity and other health problems, as well as irrational patterns of thought related to food. The fifth principle encourages clients to focus on the present. People may become “stuck” in the past and previously used thinking and coping patterns. By doing so, they are not able to leave behind destructive habits and move towards healthier ways of dealing with issues.
Finally, REBT has an optimistic view and promotes that people can change. With hard work and determination, irrational and self-defeating thoughts can be reduced and lead to a more satisfying life. REBT uses a three part model to help clients overcome their issues: ‘A’ as activating event or adversities, ‘B’ as belief and ‘C’ as consequences. ‘A’ is the perceived unfortunate event in the person’s life which spurs self-defeating reactions. ‘B’ primarily includes believing, thinking, and also emoting and behaving in relation to ‘A’.
C is characterized as the destructive consequences of ‘B’. According to Ellis (2002), many clients find it difficult to understand the ABC model as they wrongfully believe that ‘A’ directly causes ‘C’. It is important for clients to understand that their beliefs contribute significantly to the emotionally destructive consequences. It is important for individuals to focus on the adverse event and experience the entire range of emotions that occur as a result. Clients are encouraged to focus on specific thoughts that caused negative emotions, such as perceived ‘musts’ and ‘shoulds’.
Then, they are instructed to replace damaging thoughts with healthier ones and work to pinpoint which thoughts contribute to positive versus negative emotions. This technique allows the client to better control their thoughts, leading to more functional emotions and behaviors. It is important to help clients understand that thinking, emoting and behaving frequently happens simultaneously rather than individually. If a client is upset with a loved one, he might be feeling hurt, thinking that he is being ignored, and behaving angrily by raising his voice all at the same time (Ellis, 2002).
Clients are encouraged to honestly and openly experience feelings, accept their existence and how they influence clients’ lives (Ellis, 1997). Sharf (2008) discusses Ellis’ belief in the importance of concentrating on the long-term goals, which he calls responsible hedonism. REBT believes that enjoyment is a significant part of life, but that many individuals focus on short-term pleasure, such as substance abuse, rather than concentrating on the long-term enjoyment of living a healthy life. Humanism is another core concept of REBT. Each person is viewed as a whole and goal-oriented being.
Clients are encouraged to have Unconditional Self Acceptance, which includes assets and flaws. They are taught to value themselves because they are alive, regardless of the mistakes they have made, their socioeconomic status, intellectual abilities or the type of feelings they experience. Existentialism and REBT concepts have several common characteristics, which can make the use of these two therapies together more effective than individual use. This integrated approach provides an “existential framework that balances the appeal to reason with the unique human tendency to discover individual meaning” (Hutchinson & Chapman, 2005, p.
146). According to Ellis (2002), there are seven main ways in which existential therapy and REBT practices are similar and therefore complement each other in achieving change in clients. First of all, both theories accept the fact that anxiety is a normal part of life. Moderate existential anxiety is what keeps people alive. The problem occurs when humans become overly concerned with certain life events and become neurotic. Second, existential theory believes that people are able to rise above potential and existing unfortunate situations.
REBT also believes that people can choose to think about difficult events in such ways that do not cause distress. The third similarity is that both theories agree that it is vital to “directly and firmly show…clients the error in their ways” (Ellis, 2002, p. 253). Clients need to be taught skills in order to make changes to destructive thoughts and behaviors. Clients are ‘free’ to change, but might be unable to do so without concrete techniques. Another similarity is that both theories incorporate the idea that individuals have the freedom and power to be in control of their destiny.
Ellis (1997) wrote: “[choice]…is one of the main advantages of being human: you can choose, usually, to think one thing or another” (p. 38). People have the ability to decide and control how they think, and consequently how they feel or behave in various, sometimes extremely difficult situations. They can choose to feel depressed, helpless and hopeless or take charge of a situation and focus on what they can control. The goal of purposeful living contributing to a more meaningful and fulfilling life can be seen in existential therapy and REBT. A meaningful life helps individuals become more self-actualized and increase personal awareness.
With increased awareness and meaning, people can better control self-defeating thoughts and overcome existential conflicts. The next idea that existential therapy and REBT share is that there is no absolute truth. Each person’s experiences are subjective and unique occurrences. Every individual knows what is true for him only and it is difficult for people to come to an agreement regarding what is true (Kaufmann, 1975). Additionally, both theories focus on the present. It is important to work on problematic behaviors that are happening today. Past and future affect the person, but do not determine the reality.
REBT techniques of staying calm and rational can help clients work logically on the issues of meaninglessness, isolation a nd death. The final similarity relates to the therapist client relationship. Existential and REBT therapists aim to be fully present with the client. They strive to empathize, relate and experience the world through the client’s eyes. Psychological health is subjective and depends on the person’s life style, culture and many other factors. However, there are a number of characteristics that can be used to define psychological health.
In regard to existential theory, Sharf (2008) considers that “to be truly human, individuals must be aware of their own being-in-the-world”, which involves realization of one’s personal value, destiny, and responsibility (p. 151). Considering existential theory and REBT, a psychologically healthy person lives rationally, authentically, purposefully and accepts the uncontrollable life events. Authenticity is one of the main characteristics of a psychologically healthy person. Authenticity includes meaningful existence which allows individuals to feel alive, genuine, aware and fully present in the moment.
Healthy individuals are honest with themselves and are able to accept their freedom to make positive choices, accept the outcomes of their decisions, and successfully cope with unanswered questions of their existence. Genuine and meaningful relationships with others are a significant part of the person’s life and one is able to maintain a healthy relationship without losing a sense of self. Avoidance of feelings that one ‘has to’ or ‘must’ do certain things is also vital. Psychologically healthy individuals do not overreact, overgeneralize and otherwise examine situations logically and rationally.
These individuals are tolerant of difficult or undesirable situations, exhibit low frustration levels, focus on long-term goals, live purposeful and meaningful lives. The increased state of psychological health can take a long time and requires commitment and patience from the therapist and the client. According to Yalom (1989), the first step to increased psychological health is assumption of responsibility. In order for the client to change behavior patters, he must first accept that his current position is due to his own actions.
For the client to change, therapist and client must find specific issues and tensions that play into the client’s life. A significant part of the therapeutic process is to facilitate the client to accept the contradictions and challenges of human existence. Therapist assists the client to set goals and find purpose in life, while accepting and rationally dealing with the obstacles that the client might have to face in the process. The main goal is to empower the client to realize his full potential, accept personal freedom, and be more aware of thinking, emoting, and behaving patterns.
Clients increase personal awareness and start living authentically, with an ability to communicate effectively with others and understand the true self. In addition, clients explore what is important to them and how they can achieve what they want in life. In the process of working through life’s everyday challenges and experiences, clients explore deeper issues having to do with humanity in general, such as death, isolation, and meaning. Clients learn to better control self-defeating emotions, thoughts and behaviors.
They start thinking more lucidly and rationally, which gives them the ability to experience life to the fullest. There are a number of methods and techniques to help clients improve psychological health, authenticity, and life satisfaction. Existential therapy and REBT agree that each person has a unique perception of reality. In existential therapy, an important strategy is to accept the world through the client’s eyes and allow the client to guide the course of therapy. Once the path of questioning is determined, the therapist uses Socratic dialog to help the client come to his own conclusions and decisions.
This technique is a component of both existential therapy and REBT. It involves questions that help the client come to an understanding of a problem or situation or make a decision. Socratic dialog is used “to prompt the discovery of life purpose and meaning at a spiritual level…[as well as] challenge the inflexible shoulds and musts, absolutistic demands, self-downing, and catastrophic beliefs” (Hutchinson & Chapman, 2005, p. 151). Such ways of questioning also contribute to a ‘buy-in’ from the client and improves self-discovery information retention (Walen et al. , 1992).
Existential therapy and REBT take into consideration the past and future, but therapeutic change takes place in the present. By focusing on the present, the client is helped to continually self-actualize, experience his personal existence, and work through the issues preventing authentic existence. The main goal of REBT is to dispute the client’s irrational beliefs. The ABC model discussed earlier is the tool used to change the client’s dysfunctional thinking, but in the actual therapeutic process two more elements are added: ‘D’ as Disputation and ‘E’ as new effect.
Once the activating event is clearly outlined, the therapist points out to the client his irrational beliefs which led to the undesirable consequence. Disputing involves detecting, discriminating and debating irrational beliefs. The therapist outlines and questions the client’s irrational beliefs, helping the client understand the destructive thinking patterns. Now the client is ready to adopt a more functional way of thinking, by replacing irrational beliefs with appropriate thoughts, therefore reducing unpleasant feelings about self and others and start living a more fulfilling life.
Existential discussions can help clients discover personal freedom to change their state of existence and find more pleasure in life. Such self-awareness can make the disputing process easier by providing the client with the power and freedom to overcome self-defeating thoughts (Hutchinson & Chapman, 1992). A genuine therapeutic relationship is a vital factor in existential therapy. The therapist strives to be authentically caring and validate the client’s feelings, thoughts and experiences. The client must feel comfortable expressing himself and allowing the therapist into his innermost thoughts and feelings.
In order for this to happen, the therapist must communicate to the client that the client and his feeling and thoughts are fully accepted. A strong relationship also makes the client more likely to follow the therapist’s advice and trust the REBT disputing process. Although existential therapy and REBT are complementary in many ways, the integration has a number of limitations. The process counts on the client to be fairly insightful and self aware. Someone, whose intellectual abilities are not as strong, may not benefit as much from therapy.
Past experiences of the client are taken into consideration, but are not actively explored. This may limit the insight achieved by the therapist and client, therefore slowing down improvement. Additionally, this integrated approach is more targeted towards individual therapy, so family systems techniques would need to be incorporated in order to accommodate families and couples. Existential therapy and REBT have many common objectives and share a number of underlying concepts. Although this integrated approach to counseling is somewhat directive, the client’s concerns and personal goals are in the center of the therapeutic process.
Therapy is based on leading the client to self-discovery, authentic and rational existence. By combining themes and techniques of existential theory and REBT, clients gain the benefit of examining multifaceted existential themes with the addition of empirically supported REBT techniques. My interest in the integration of existential therapy and REBT originally came from personal beliefs and experiences. Congruent with existential theory, I have often questioned the purpose of my life and whether human beings are interconnected or isolated.
I relate to the spiritually oriented existentialism and have always believed that every person has a certain calling; the difficulty only lies in finding what it is. Consistent with the ideas of REBT, I many times find myself and people around me overreacting, overgeneralizing, and otherwise making inappropriate statements and having irrational thoughts. By becoming more aware of my own existence, thoughts, beliefs and actions, I will be able to help my clients come to similar understandings and lead more fulfilling, purposeful, and authentic lives.
My philosophical inclination, my strive to understand other people’s points of view and my focus on the present will provide a healthy and successful environment for clients to achieve their therapeutic goals. References Ellis, A. , Harper, R. (1997). A Guide to Rational Living. Chatsworth: Melvin Powers Wilshire Book Company. Ellis, A. (2002). Overcoming Resistance: A Rational Emotive Behavior Therapy Integrated Apporach. New York: Springer Publishing Company Inc. Frankl, V. (2006). Man’s Search For Meaning. Boston: Beacon Press. Hutchinson, G. T. & Chapman, B. P.
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