Existential Psychotherapy. Existential Psychotherapy is a dynamic approach which attends to certain ultimate universal concerns that are rooted in an individual’s very existence, explains Irvin D. Yalom. His book, Existential Psychotherapy, addresses four of these concerns, each defined by a spectrum with two ends between which a human is sure to oscillate and feel conflicted – Death (the awareness of its inevitability and the wish to go on living),  Freedom (experiencing a sense of groundlessness and our wish for structure),  Existential Isolation (awareness of our absolute isolation, that some part of us will always be unknown to the other and the wish to be fully connected) and Meaninglessness (a meaning seeking creature thrown into the waters of an inherently meaningless world). Yalom believes that a therapeutic confrontation with these givens of existence is painful but ultimately healing. 

Death. Death is simply not the last moment of life, it takes birth as soon as one is born. Death is right there from the start. This other side of the coin makes us confront how everything must fade, that we fear this fading and it is with this fear in our hearts that we must continue living. But when death is denied, life shrinks because one becomes ignorant of the stakes involved, making one’s life shallow and empty as one’s sensibilities towards the wonders of life are blunted. Incorporating death richly into the narrative of our life only makes our living more authentic and pleasurable. To put it simply, to live well one must learn to die well and to die well, one must learn to live well.

Yalom believes that as soon as one becomes aware of any of the four ultimate concerns, one experiences anxiety, to ward off which one uses defence mechanisms. In case of death anxiety, he writes about two fundamental defences: a strong belief in one’s specialness i.e. even though death may come and knock at the doors of others, it shall never come at my door because I am different from the rest and secondly, a strong belief in an ultimate rescuer i.e. there is someone or something out there which will ask death to go away when it has come to knock at my door. These two defences are intricately interdependent (“Because I am special, I am protected” and “Because I am protected, I am special”l), highly adaptive unless stretched too thin, resulting in psychopathology.

Freedom. From the moment we are born we are doomed to be free, free to create ourselves in entirety. For psychotherapy, this means that a client creates one’s own state of suffering. Such an amount of responsibility can be overwhelming and so we convince ourselves that we constitute the world in a manner where it appears independent of our constitution. This belief can manifest itself in the form of many defence mechanisms like compulsivity, displacement of responsibility, denial of responsibility by playing an innocent victim or acting like one is losing control and avoidance of autonomous behaviour. 

Exercising this freedom responsibly and in its truest sense involves shifting one’s locus of control inside oneself by gaining insight (I am responsible for myself), making a decision (I will be responsible for myself) and taking actions accordingly.