For many people, the big questions are the most interesting: Why are we here? What meaning does my life have? What happens when I die? What is the purpose of my life, of any life? These are existential questions – questions pertaining to existence. They are the stuff of Philosophy 101 courses, they are the questions that might keep you awake at 2am, and they can be the questions you debate with friends and family.
For some people, these questions are not simply an intellectual exercise. Some answers to the questions (such as “life has no meaning“) can produce very deep despair, and depression. Sometimes the absence of an answer produces similar despair or depression. In these instances, therapeutic approaches such as cognitive behavioral therapy (CBT) will be of little or no comfort; the problem isn’t faulty thinking! The reality is that these questions don’t have answers; there is no back-of-the-book to look them up. You may not be able to know for certain what happens when you die, but you can wonder what the various answers might mean for living your life. These questions about meaning may be lifelong concerns, and your conclusions might change in any number of ways.
Existential despair, dread, anxiety, and depression can benefit from deep work with a therapist who takes an existential approach. Martin Buber, often identified as an existential philosopher, made two distinctions in ways of relating to other people: I-Thou, and I-It. The I-It relationship is characterized by one person interacting with an objectified other; some therapists may take this approach, if their interaction with their patient has the form of healthy person treating sick person. On the other hand, an I-Thou approach occurs when the therapist accepts the patient and acknowledges his or her portrayal as valid, stressing the mutual, holistic existence of two beings. Existential psychotherapists meet their patients where they are, and work through the very real struggles that stem from these mighty questions.
In contrast to the existential approach, and although professing to be nonjudgmental, the psychiatric and psychological establishments tend to be embedded in a proscribed vision of normalcy and socialization. One of the most obvious ways this is true is in the use of diagnostic nomenclature – but even setting that aside, there is a more subtle idea, in the view of many mental health professionals, about how people should or shouldn’t be, or what must be going on inside them. Unfortunately, these conceptions are not necessarily in keeping with what is accurate or best for a person, or what may help them develop a positive sense of themselves and their world. (These ideas tend to be culture-bound and/or have a basis in political or economic expedience. The most blatant examples of this may be seen in political regimes that hospitalize and label as mentally ill people expressing ideas which are contrary to the interests of the powers that be.)
This proscribed vision of normalcy interferes with creativity, deep personal growth, and points of view which might bring important and critical changes to the way the larger world functions. Although a therapist may have reasonable ideas of what turns out to be useful or positive for a patient, the final analysis must still be placed in the context of that individual’s experience. Further, the existential therapist must be able to understand and empathize with the patient’s experience of these difficult existential issues.
Ultimately, the existential approach to people and to treatment of their emotional struggles and discomfort is based on helping people find meaning in their lives, and avoids trying to apply external objective criteria and schemas. Victor Frankl, considered to be one of the early existential therapists, believed the striving to find a meaning in one’s life is the primary, most powerful motivating and driving force in humans. His approach was developed during and after his imprisonment in a Nazi concentration camp.
In fact, the struggle for all of us is to put our lives and life histories in a meaningful context. This may be primarily an unconscious emotional endeavor for some, but for others it may also be important to find an articulable structure or credo. Without a meaningful way of making sense of things, we are almost by definition left with a deep sense of emptiness and a feeling of an inner void. From there we are often left with nothing to do but despair and feel hopeless.