Existential Treatment Plan Existential Treatment Plan
Michelle Deen, France Goulard, and Jaylene Betcher Michelle Deen, France Goulard, and Jaylene Betcher
University of Calgary University of Calgary
Existential Treatment Plan Existential Treatment Plan Client Name:
Client Name: Stuart LittleStuart Little Date of Birth:
Date of Birth:July 9, 1966July 9, 1966 Date of Report:
Date of Report:November 2, 2011November 2, 2011 Presenting Problem:
Presenting Problem:
Stuart is dealing with a number of concerns.
Stuart is dealing with a number of concerns. Foremost, he feels like he does not have the Foremost, he feels like he does not have the supportsupport that he needs from his friends and family members, specifically, from his mother and his
that he needs from his friends and family members, specifically, from his mother and his children.
children. He is He is experiencing difficulty accepting unpleasant emotions following his experiencing difficulty accepting unpleasant emotions following his divorce anddivorce and is frequently angry when he thinks about his children and their relationship with his ex-wife and is frequently angry when he thinks about his children and their relationship with his ex-wife and her recent fiancé.
her recent fiancé. He also feels a He also feels a sense of loss pertaining to sense of loss pertaining to his life-style, his business, andhis life-style, his business, and propriety, which lead to an inability to let go of his past relationships.
propriety, which lead to an inability to let go of his past relationships. Treatment Goal:
Treatment Goal:
Although a number of concerns were presented, the two issues that Stuart would like to focus on Although a number of concerns were presented, the two issues that Stuart would like to focus on during therapy are his inability to let go of past relationships, allowing himself to experience during therapy are his inability to let go of past relationships, allowing himself to experience unpleasant emotions (e.g., loneliness and anger), and accepting that he cannot avoid these unpleasant emotions (e.g., loneliness and anger), and accepting that he cannot avoid these unpleasant emotions.
unpleasant emotions. On the other On the other hand, the therapist would like Stuart to hand, the therapist would like Stuart to be more self-aware of be more self-aware of his role in his current situation, and accept responsibility for the choices that he has made, as his role in his current situation, and accept responsibility for the choices that he has made, as well as
well as help him help him to confront the to confront the anxieties that he anxieties that he is trying so is trying so hard to hard to avoid. avoid. Working togetherWorking together over a number of sessions, the therapist and
over a number of sessions, the therapist and Stuart will collaborate to guide Stuart’s treatment.Stuart will collaborate to guide Stuart’s treatment. Treatment Plan:
Treatment Plan: Important Not
Important Note:e: Existential therapy is not a comprehensive psychotherapeutic process but aExistential therapy is not a comprehensive psychotherapeutic process but a frame of reference
frame of reference – – a model by which the therapist analyzes and comprehends a client’sa model by which the therapist analyzes and comprehends a client’s suffering in a particular manner (Yalom & Josselson, 2010)
suffering in a particular manner (Yalom & Josselson, 2010)..
The Therapeutic Task: Support Stuart in Becoming Aware of and Confronting the The Therapeutic Task: Support Stuart in Becoming Aware of and Confronting the
Anxieties that he has Tried so Hard
Anxieties that he has Tried so Hard to Avoidto Avoid
Using an existential framework, Stuart’s therapist will help Stuart see that everyone Using an existential framework, Stuart’s therapist will help Stuart see that everyone experiences the four ultimate concerns of the human condition (freedom, isolation,
experiences the four ultimate concerns of the human condition (freedom, isolation,
meaninglessness, and death), which creates feelings of anxiety in everyone (Yalom & Josselson, meaninglessness, and death), which creates feelings of anxiety in everyone (Yalom & Josselson, 2010).
2010). She will encourage She will encourage him to observe that him to observe that existential (normal) anxiety is an inevitable partexistential (normal) anxiety is an inevitable part of the human condition and indicates that individuals recognize the need to accept responsibility of the human condition and indicates that individuals recognize the need to accept responsibility for their lives and are engaged in efforts to create a worthwhile and meaningful existence.
for their lives and are engaged in efforts to create a worthwhile and meaningful existence.
Comparatively, existential guilt and neurotic anxiety, which Stuart is currently experiencing, are Comparatively, existential guilt and neurotic anxiety, which Stuart is currently experiencing, are a result of his failure to take responsibility for making his life meaningful and worthwhile
a result of his failure to take responsibility for making his life meaningful and worthwhile (Corey, 2009).
(Corey, 2009). His current guilt and His current guilt and anxiety reflect his awareness that he anxiety reflect his awareness that he has allowed his life has allowed his life toto be controlled by chance and circumstance.
be controlled by chance and circumstance. Therefore, Stuart’s therapist will act as hisTherefore, Stuart’s therapist will act as his companion and co-explorer to help
companion and co-explorer to help Stuart find value, meaning, and purpose in Stuart find value, meaning, and purpose in his life. his life. TheThe purpose of therapy will be to help Stuart become more aware of what he is doing to cause purpose of therapy will be to help Stuart become more aware of what he is doing to cause existential guilt and neurotic anxiety and to get him out of the victim role.
existential guilt and neurotic anxiety and to get him out of the victim role. Step One: Developing a Therapeutic Alliance Step One: Developing a Therapeutic Alliance
The above case study lists a number
The above case study lists a number of concerns for Stuart. of concerns for Stuart. For the purpose of this case study,For the purpose of this case study, the first step to be taken by the existential therapist is to develop a close and caring therapeutic the first step to be taken by the existential therapist is to develop a close and caring therapeutic relationship so that the therapist is
relationship so that the therapist is a companion and co-explorer with a companion and co-explorer with Stuart (Corey, 2009). Stuart (Corey, 2009). ThisThis type of relationship between Stuart and the therapist will be developed during the initial sessions type of relationship between Stuart and the therapist will be developed during the initial sessions with the therapist coming to an understanding of
with the therapist coming to an understanding of Stuart’s current reality and unconscious fearsStuart’s current reality and unconscious fears before helping him come to
before helping him come to new understandings and options. new understandings and options. There will be There will be little opportunity forlittle opportunity for Stuart to look into his past since the therapist will want to focus on his current state and the
Stuart to look into his past since the therapist will want to focus on his current state and the anxieties he is dealing with now.
anxieties he is dealing with now. The past is what has brought the The past is what has brought the client to the present and anclient to the present and an existential therapist is working towards the future (Yalom & Josselson, 2010).
existential therapist is working towards the future (Yalom & Josselson, 2010). Session Details:
Session Details:
Prior to Stuart’s arrival, the therapist prepared the counseling room b
Prior to Stuart’s arrival, the therapist prepared the counseling room b y having two comfortabley having two comfortable chairs placed face-to-face with a coffee
chairs placed face-to-face with a coffee table between them. table between them. Curtains were checked to Curtains were checked to minimizeminimize any glare and tissues we
any glare and tissues were placed on the table within easy re placed on the table within easy reach of the client’s chairreach of the client’s chair. . TheThe therapist also spent a couple of quiet moments to clear her mind of external, prevailing thoughts therapist also spent a couple of quiet moments to clear her mind of external, prevailing thoughts from other clients in order to ensure Stuart had her full attention.
from other clients in order to ensure Stuart had her full attention.
When Stuart arrived at his session, the therapist introduced herself and spent some time When Stuart arrived at his session, the therapist introduced herself and spent some time developing rapport in an attempt
developing rapport in an attempt to make Stuart to make Stuart feel at ease and feel at ease and comfortable. comfortable. Making generalMaking general conversation about the
conversation about the weather and about how Stuart’s daweather and about how Stuart’s day had been so far started off the y had been so far started off the firstfirst session.
session.
To formally begin the session, the therapist asked Stuart whether he had received the counseling To formally begin the session, the therapist asked Stuart whether he had received the counseling agency’s letter sent to confirm his appointment details and a
agency’s letter sent to confirm his appointment details and a brochure contbrochure containing informationaining information about the counseling service including fees, hours of opening, qualifications of staff and map about the counseling service including fees, hours of opening, qualifications of staff and map location.
location. Stuart confirmed he had Stuart confirmed he had received the leaflet and said received the leaflet and said that it had been that it had been very useful andvery useful and informative.
informative. Afterwards, the therapist asked if Stuart had Afterwards, the therapist asked if Stuart had any questions not covered any questions not covered in thein the information brochure or of t
information brochure or of the therapist’s qualifications he therapist’s qualifications or therapy procedures. or therapy procedures. Stuart replied inStuart replied in the negative and the therapist proceeded to ask Stuart what had brought him to counseling.
the negative and the therapist proceeded to ask Stuart what had brought him to counseling. While the therapist waited for Stuart to start speaking, she maintained good eye contact and an While the therapist waited for Stuart to start speaking, she maintained good eye contact and an open posture.
open posture. After about twenty seconds of After about twenty seconds of silence and looking down silence and looking down at the floor, Stuart finallyat the floor, Stuart finally spoke. “My life is a mess! I left my wife for anoth
spoke. “My life is a mess! I left my wife for anoth er woman and since it didner woman and since it didn’t work out with the’t work out with the other woman, who by the way was my dental assistant, I had to leave my job because I could not other woman, who by the way was my dental assistant, I had to leave my job because I could not deal working with the other woman. My kids are getting older and soon will be out of the house, deal working with the other woman. My kids are getting older and soon will be out of the house, not like they
not like they enjoy being there as enjoy being there as it is. it is. My ex-My ex-wife is now getting remarried and I’m trying towife is now getting remarried and I’m trying to start up a new busines
start up a new business in my home but I’s in my home but I’m really just moping around m really just moping around the house. the house. I just don’tI just don’t seem to be able to move
seem to be able to move on with my life!”on with my life!”
Before the therapist responded, she observed Stua
Before the therapist responded, she observed Stua rt’s emotional r rt’s emotional r eaction and reflecting concerneaction and reflecting concern and said, “You seem rather uncertai
and said, “You seem rather uncertain about all the changes that are gn about all the changes that are going on right now. oing on right now. What doWhat do you think?”
you think?”
Sitting back in his chair, Stuart replied, “Well,
Sitting back in his chair, Stuart replied, “Well, I know I’m pretty angry about what is goinI know I’m pretty angry about what is going on.g on. If Sheera had been a better wife, less emotionally abusive, less neglectful towards my needs, I If Sheera had been a better wife, less emotionally abusive, less neglectful towards my needs, I probably wouldn’t have left the relationship.
rather be with their mom and her fiancé because they are buying their affectio
rather be with their mom and her fiancé because they are buying their affectio n.” Stuartn.” Stuart
continued telling the events of his life during the past year, pausing to take a deep breath or wipe continued telling the events of his life during the past year, pausing to take a deep breath or wipe his eyes occasionally with a
his eyes occasionally with a tissue from the box tissue from the box nearby. nearby. Stuart described the emotional abuseStuart described the emotional abuse from Sheera, how he began an affair with his dental assistant who appeared supportive of him from Sheera, how he began an affair with his dental assistant who appeared supportive of him and his career g
and his career goals. oals. He also voiced his He also voiced his disappointment with his friends and family disappointment with his friends and family members,members, feeling that they blame him for the collapse of his m
feeling that they blame him for the collapse of his marriage. arriage. He felt a lack of He felt a lack of support from them.support from them. Throughout the conversation, Stuart voiced uncertainty about his future.
Throughout the conversation, Stuart voiced uncertainty about his future.
The therapist continued to stay focused on Stuart emotionally and to use encouragers and The therapist continued to stay focused on Stuart emotionally and to use encouragers and reflections of feelings to confirm and
reflections of feelings to confirm and validate his feelings. validate his feelings. After one of After one of many silences, duringmany silences, during which the therapist had remained
which the therapist had remained silent but attentive, Stuart looked up without silent but attentive, Stuart looked up without speaking. speaking. TheThe therapist concluded that this was an opportune time to summarize some of the issues Stuart had therapist concluded that this was an opportune time to summarize some of the issues Stuart had raised so far and said, “Stuart, you’ve described a huge upheaval in your life
raised so far and said, “Stuart, you’ve described a huge upheaval in your life over the past year orover the past year or so.
so. With all of With all of these changes, these changes, there comes a there comes a lot of uncertainty lot of uncertainty and anxiety. and anxiety. Where do yWhere do you think ou think this anxiety stems from?”
this anxiety stems from?”
Stuart replied, “Well, when the kids are
Stuart replied, “Well, when the kids are gone to school or over to gone to school or over to their mother’s house, I’m alonetheir mother’s house, I’m alone in that great, big
in that great, big house. house. I know I should be worI know I should be working on this new business king on this new business venture, but I’m justventure, but I’m just walking around from room to r
walking around from room to room. oom. I guess I’I guess I’m worried that I’m alm worried that I’m always going to be alone, thatways going to be alone, that no one will love and care for me in my old age.
no one will love and care for me in my old age. This may sound silly, but I think that I’ll end upThis may sound silly, but I think that I’ll end up dying alone.”
dying alone.”
The therapist let Stuart vent all his worries and anxieties, expressing emotion that had been The therapist let Stuart vent all his worries and anxieties, expressing emotion that had been bottled up for a very long time.
bottled up for a very long time.
With the session nearly over, the therapist reviewed their results, discussed how Stuart should With the session nearly over, the therapist reviewed their results, discussed how Stuart should deal with the next few days before the next session and gave him a number to call in case of deal with the next few days before the next session and gave him a number to call in case of emergencies.
emergencies. The therapist also provided him with The therapist also provided him with an email address an email address in case he in case he wanted to touchwanted to touch base before the next session.
base before the next session.
Step Two: Understanding the Ultimate Concerns of the Human Condition Step Two: Understanding the Ultimate Concerns of the Human Condition
In the upcoming therapy sessions, Stuart’s therapist must support him in confronting his In the upcoming therapy sessions, Stuart’s therapist must support him in confronting his deepest fears and anxieties about the expected challenges of life, such as freedom, isolation, deepest fears and anxieties about the expected challenges of life, such as freedom, isolation, meaninglessness, and death.
meaninglessness, and death. Reviewing and reflecting Reviewing and reflecting on Stuart’s on Stuart’s histor histor y will facilitate thisy will facilitate this process, and help him identify barriers that impede his movement toward an authentic and process, and help him identify barriers that impede his movement toward an authentic and personally meaningful life (Yalom & Josselson, 2010).
personally meaningful life (Yalom & Josselson, 2010). Freedom
Freedom
Although many human beings desire it, freedom can be terrifying as it conflicts with the Although many human beings desire it, freedom can be terrifying as it conflicts with the innate need for structure and implies responsibility for one’s actions, choices, and
innate need for structure and implies responsibility for one’s actions, choices, and life (Yalom &life (Yalom & Josselson, 2010).
Josselson, 2010). Stuart often refused Stuart often refused to take to take responsibiliresponsibility for ty for his actions as his actions as he routinelyhe routinely blamed others and external events for his misfortu
blamed others and external events for his misfortu nes. nes. For example, StuarFor example, Stuart’s discontent t’s discontent with hiswith his marriage propelled him to employ defense mechanisms (blaming Sheera for emotionally abusing marriage propelled him to employ defense mechanisms (blaming Sheera for emotionally abusing and neglecting him) to help ease the anxiety associated with accepting the responsibility for their and neglecting him) to help ease the anxiety associated with accepting the responsibility for their marital issues.
marital issues. To help Stuart attain freedom, Stuart’s therapist not only neeTo help Stuart attain freedom, Stuart’s therapist not only nee ds to assist him withds to assist him with assuming responsibility for his present distress, but also needs to assist him with finding
motivation to repair his relationship with Sheera, his children, and his mother (Yalom & motivation to repair his relationship with Sheera, his children, and his mother (Yalom & Josselson, 2010).
Josselson, 2010). Stuart’s therapist must continualStuart’s therapist must continually remind him that he is responsible for hisly remind him that he is responsible for his choices, actions, and ultimately his past and present distress (Yalom & Josselson, 2010).
choices, actions, and ultimately his past and present distress (Yalom & Josselson, 2010). Isolation
Isolation
Once Stuart begins to take responsibility for his life, it is likely that he will also encounter Once Stuart begins to take responsibility for his life, it is likely that he will also encounter a sense of
a sense of existential isolation. existential isolation. Existential isolation is the most basic form Existential isolation is the most basic form of isolation, wherebyof isolation, whereby the knowledge of aloneness creates anxiety and sometimes terror (Yalom & Josselson, 2010). the knowledge of aloneness creates anxiety and sometimes terror (Yalom & Josselson, 2010). Stuart’s fea
Stuart’s fear of isolation can r of isolation can be observed through his need be observed through his need for validation from others. for validation from others. ForFor example, when Stuart felt emotionally abused and neglected by Sheera he sought an intimate example, when Stuart felt emotionally abused and neglected by Sheera he sought an intimate relationship with his dental assistant, in which he displayed “suffocating” beh
relationship with his dental assistant, in which he displayed “suffocating” beh aviouaviour to alleviater to alleviate the pain accompanying his feeling of i
the pain accompanying his feeling of isolation. solation. To ease Stuart’s iTo ease Stuart’s isolation anxiety, Stuart’ssolation anxiety, Stuart’s therapist must support him in learning the limits of intimacy and what he can and cannot obtain therapist must support him in learning the limits of intimacy and what he can and cannot obtain from others (Yalom
from others (Yalom & Josselson, 2010). & Josselson, 2010). Furthermore, Stuart needs Furthermore, Stuart needs support in creatingsupport in creating
meaningful and mutual relationships with others, which may be addressed by modeling genuine meaningful and mutual relationships with others, which may be addressed by modeling genuine and receptive interactions to Stuart during therapy sessions (Yalom & Josselson, 2010).
and receptive interactions to Stuart during therapy sessions (Yalom & Josselson, 2010). Meaninglessness
Meaninglessness
In an unpredictable world human beings often become unsettled and search for an In an unpredictable world human beings often become unsettled and search for an
explanation or meaning for their existence, if this search proves to be unsuccessful it may result explanation or meaning for their existence, if this search proves to be unsuccessful it may result in crisis (Yalom &
in crisis (Yalom & Josselson, 2010). Josselson, 2010). Stuart viewed his relationship with Sheera Stuart viewed his relationship with Sheera as the means as the means forfor his existence.
his existence. In high In high school Stuart felt validated when school Stuart felt validated when Sheera expressed interest in him, andSheera expressed interest in him, and throughout their marriage Stuart found meaning in his assumed role of the provider, which throughout their marriage Stuart found meaning in his assumed role of the provider, which eventually drove Sheera away
eventually drove Sheera away and resulted in Stuart feeling anxious and and resulted in Stuart feeling anxious and unwanted. unwanted. To helpTo help Stuart
re-Stuart re-discover meaning in his life, re-Stuart’s therapist needs to query discover meaning in his life, Stuart’s therapist needs to query and challenge Stuart toand challenge Stuart to identify his belief systems, long-term goals and ambitions, and creative interests (Yalom & identify his belief systems, long-term goals and ambitions, and creative interests (Yalom & Josselson, 2010).
Josselson, 2010). Furthermore, Stuart needs Furthermore, Stuart needs to recognize and to recognize and remove numerous obstacles (e.g.remove numerous obstacles (e.g. letting go of his past relationship with both Sheera and his assistant) that are obscuring his view letting go of his past relationship with both Sheera and his assistant) that are obscuring his view of genuine meaning.
of genuine meaning. Stuart is the author of his own life, and he Stuart is the author of his own life, and he must confront his beliefs andmust confront his beliefs and goals to find meaning for why and how he exists (Yalom & Josselson, 2010).
goals to find meaning for why and how he exists (Yalom & Josselson, 2010). Death
Death
Of all anxieties that human beings experience, anxiety towards an inevitable demise is the Of all anxieties that human beings experience, anxiety towards an inevitable demise is the most distressing, resulting in mechanisms to distract and decrease death’s terror (Yalom
most distressing, resulting in mechanisms to distract and decrease death’s terror (Yalom && Josselson, 2010).
Josselson, 2010). Stuart suppressed his anxiety towards death Stuart suppressed his anxiety towards death by always being by always being involved in aninvolved in an intimate relationship, enjoying the company of his children (prior to the divorce), and assuming intimate relationship, enjoying the company of his children (prior to the divorce), and assuming the responsibility of sole
the responsibility of sole provider for his provider for his family. family. However, SHowever, S tuart’s defenses against his anxietytuart’s defenses against his anxiety towards death began to fade as major life events began to simultaneously occur (e.g. marital towards death began to fade as major life events began to simultaneously occur (e.g. marital issues, affair, children getting ready to leave
issues, affair, children getting ready to leave home, and diminished career). home, and diminished career). To help Stuart dealTo help Stuart deal with his anxiety towards de
with his anxiety towards de ath, Stuart’s therapist must emphasize the significance of livingath, Stuart’s therapist must emphasize the significance of living meaningfully, as well as being aware of strengths and weaknesses in a context of free will and meaningfully, as well as being aware of strengths and weaknesses in a context of free will and choice (Yalom &
choice (Yalom & Josselson, 2010). Josselson, 2010). Instead of constantly worrying about dyInstead of constantly worrying about dying alone, Stuarting alone, Stuart must realize what he needs to change to live life with no regrets; ultimately using death to enrich must realize what he needs to change to live life with no regrets; ultimately using death to enrich life.
life.
Step Three: Understanding the Potentials of the Human Condition Step Three: Understanding the Potentials of the Human Condition
The unavoidable concerns of the human condition seem to present Stuart with a bleak The unavoidable concerns of the human condition seem to present Stuart with a bleak image of life; however, through existential therapy, Stuart and his therapist must now explore image of life; however, through existential therapy, Stuart and his therapist must now explore how he can use his various strengths (awareness, authenticity, freedom and responsibility, how he can use his various strengths (awareness, authenticity, freedom and responsibility, actualization, and making meaning) to transcend those inevitabilities (Corey, 2009).
actualization, and making meaning) to transcend those inevitabilities (Corey, 2009). Awareness
Awareness
Stuart must come to realize that he has the capacity for awareness of himself and the Stuart must come to realize that he has the capacity for awareness of himself and the world.
world. The greater his awareness The greater his awareness becomes the more possibilities that are open becomes the more possibilities that are open to him and to him and thethe more successful he will
more successful he will be at addressing his be at addressing his fears and anxieties (Yalom & fears and anxieties (Yalom & Josselson, 2010). Josselson, 2010). ForFor example, he must become aware
example, he must become aware of his role in Sheera’s emotional and phof his role in Sheera’s emotional and ph ysical distancing fromysical distancing from him as well as the
him as well as the role he played in their divorce. role he played in their divorce. Once he is aware of Once he is aware of these aspects he can trulythese aspects he can truly address the underlying anxieties of freedom and isolation, which may have led to him cheating address the underlying anxieties of freedom and isolation, which may have led to him cheating on his wife. Although awareness may not bring Stuart pleasure or peace, it will allow him to on his wife. Although awareness may not bring Stuart pleasure or peace, it will allow him to recognize the limitations and challenges in his life and enable him to make wise choices that can recognize the limitations and challenges in his life and enable him to make wise choices that can make his life worthwhile.
make his life worthwhile. Authenticity
Authenticity
If Stuart takes responsibility for the choices he has made based on his new found If Stuart takes responsibility for the choices he has made based on his new found awareness, he will demonstrate authenticity, which will allow him to live more fully in the awareness, he will demonstrate authenticity, which will allow him to live more fully in the present and he c
present and he can be himself in an be himself in other relationships. other relationships. For instance, when Stuart cheated on For instance, when Stuart cheated on hishis wife with his dental assistant, he began to smother his new partner in an attempt to compensate wife with his dental assistant, he began to smother his new partner in an attempt to compensate for the anxieties of
for the anxieties of isolation that he was isolation that he was experiencing with his wife. experiencing with his wife. Therefore, he was notTherefore, he was not experiencing authenticit
experiencing authenticity in his y in his life. life. His decisions were based on His decisions were based on denial and past losses (e.g., thedenial and past losses (e.g., the failure of his marriage) and he became too dependent on
failure of his marriage) and he became too dependent on his new partner. his new partner. In other words, he wasIn other words, he was wearing a “mask of authenticity” (Yalom & Josselson, 201
wearing a “mask of authenticity” (Yalom & Josselson, 201 0) that prevented others from truly0) that prevented others from truly knowing who he is.
knowing who he is.
Freedom and Responsibility Freedom and Responsibility
Once Stuart accepts that he has freedom to be aware, to make choices, to act, and to Once Stuart accepts that he has freedom to be aware, to make choices, to act, and to change (no matter what the circumstance), he will learn that he has the responsibility to: 1) be change (no matter what the circumstance), he will learn that he has the responsibility to: 1) be aware of his past history, his current options, and his future potential; 2) to make choices that aware of his past history, his current options, and his future potential; 2) to make choices that give meaning to his life; and 3) to exercise courage and thought in taking action toward give meaning to his life; and 3) to exercise courage and thought in taking action toward improving his life (Yalom & Josselson, 2010).
improving his life (Yalom & Josselson, 2010). Once he sees that he Once he sees that he has freedom, he can nohas freedom, he can no longer view his decisions and behaviors as purposeless and accidental, make excuses for himself longer view his decisions and behaviors as purposeless and accidental, make excuses for himself (e.g., sleeping with his dental assistant was ok because his wife was emotionally and physically (e.g., sleeping with his dental assistant was ok because his wife was emotionally and physically unavailable), and shift the blame for his unhappiness to others (e.g., blaming Sheera for their unavailable), and shift the blame for his unhappiness to others (e.g., blaming Sheera for their divorce and blaming Sheera’s fiancé f
divorce and blaming Sheera’s fiancé for taking his wife and or taking his wife and children). children). Overall, throughout thisOverall, throughout this step, Stuart and his therapist will collaborate to help him assume responsibility for himself and step, Stuart and his therapist will collaborate to help him assume responsibility for himself and recognize that he is the only one in charge of his life (not his ex-wife, his mother, his children, or recognize that he is the only one in charge of his life (not his ex-wife, his mother, his children, or his dental assistant).
his dental assistant). Actualization Actualization
During the process of actualization, Stuart will come to realize his potential (as During the process of actualization, Stuart will come to realize his potential (as
determined by his essential nature) and with the support of his therapist he will be lead towards determined by his essential nature) and with the support of his therapist he will be lead towards growth and
growth and fulfillment (Yalom & fulfillment (Yalom & Josselson, 2010). Josselson, 2010). Specifically, Stuart must realize that Specifically, Stuart must realize that hishis actualization has been blocked by his overwhelming fear of ending up alone, which may have actualization has been blocked by his overwhelming fear of ending up alone, which may have
lead to a forced marriage when he was younger and guilt caused by forcing his wife to stay at lead to a forced marriage when he was younger and guilt caused by forcing his wife to stay at home to look after the children and then later cheating on his wife.
home to look after the children and then later cheating on his wife. Making Meaning
Making Meaning Stuart’
Stuart’s awareness, recognition that he has freedom, his authenticity, and his will towards awareness, recognition that he has freedom, his authenticity, and his will toward actualization will eventually allow him to know and face unsettling aspects of himself and the actualization will eventually allow him to know and face unsettling aspects of himself and the world, such as the inevitability of death and his ultimate aloneness, and to surpass these anxieties world, such as the inevitability of death and his ultimate aloneness, and to surpass these anxieties by creating meaning in his life (e.g., having a positive relationship with his children, his ex-wife, by creating meaning in his life (e.g., having a positive relationship with his children, his ex-wife, and his mother as well as continuing to build on his successful career as a dentist).
and his mother as well as continuing to build on his successful career as a dentist). Summary
Summary
During existential therapy, Stuart was encouraged to become aware and examine his own During existential therapy, Stuart was encouraged to become aware and examine his own subjective experience in the world, and to take responsibility for how he chose to be in the world. subjective experience in the world, and to take responsibility for how he chose to be in the world. His therapist taught him how to reflect on his own anxieties and to accept his role in creating the His therapist taught him how to reflect on his own anxieties and to accept his role in creating the problems in his marriage and
problems in his marriage and in his relationship with others. in his relationship with others. In the final In the final phase of existentialphase of existential counseling, Stuart’s therapist
counseling, Stuart’s therapist must now help him take what he has learned about himself and putmust now help him take what he has learned about himself and put it into action (Corey, 2009).
it into action (Corey, 2009). He will soon be able to He will soon be able to use his strengths and find ways to use his strengths and find ways to utilizeutilize them in order to live a purposeful existence.
References References Corey, G. (2009).
Corey, G. (2009). Theory and practice of counseling and psychotherapy.Theory and practice of counseling and psychotherapy.Belmont, CA:Belmont, CA: Brooks/Cole.
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Yalom, I.D., & Josselson, R. (2010).
Yalom, I.D., & Josselson, R. (2010). Existential psychotherapy. In R. J. Corsini & Existential psychotherapy. In R. J. Corsini & D. WeddingD. Wedding (Eds.),
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