Existential practice: Existential process-diagnosis and goals.

Siebrecht Vanhooren (Manuscript MOOC)

Abstract: For existential counselors, there are no lasting solutions to our deepest existential
themes. Each of us has to find his or her own creative answers. During our lifetime, we relate
to existential givens in our own particular way. There are moments though that we get stuck
in how we relate to these givens. Clients come to us because their former answers to their
existential questions and themes are no longer working for them. How can we help clients to
become aware of the core of their deepest concerns?

For existential philosophers and existential psychologists, there are no lasting

solutions to our deepest existential themes. Each of us has to find his or her own creative
answers. On a deeper level, life resembles to an ongoing work of art. Everyone has his or her
own set of colors or materials to work with, and within our given framework- or our personal
canvas- we have the freedom to paint our own masterpiece. There is no “right” work of art,
and it is always a work in progress: a process.
During our lifetime, we relate to existential givens in our own particular way. It is in
how we relate to our limitations, our possibilities, our body, the Un-known, and our need for
autonomy, relatedness, and meaning that makes us unique. Existential psychology tells us
that becoming more aware of how we relate to life, and becoming more aware of the fact
that we are actually alive at this very moment, helps us to become more authentic. In the
existential approach authentic means: being aware of our own limits and the finiteness of
life and, within that awareness of limitation, finding the courage to make choices which
hopefully will lead to a more meaningful, deeper experience of life with regard to ourselves,
others, and the Un-Known.
There are moments though that we get stuck in how we relate to these givens.
Clients come to us because their former answers to their existential questions and themes
are no longer working for them. For them, being alive is a burden rather than a joy. Most
clients are not aware of their relationship to the existential givens and how this might have
blocked their life process along the way. One of the tasks of the existential therapist or
counselor is to explore with the client how the client’s life process got blocked. We call this
the existential process diagnosis (see section 6 for process diagnosis).

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 There are various ways of getting in touch with the client’s particular way of relating
to the givens:
• The client’s story
• The symptom
• Indicators from the therapy process (non-verbal language and behavior in therapy,
embodiment, and interaction)

The client’s story

The content of the client’s story is the first source of material for our existential
process diagnosis. Through this content, the client reveals what is important (meaning) to
him or her, and in what direction he or she wants to change (choice). The story also reveals
how the client relates to others (autonomy – relatedness). The presence or absence of those
who are deceased might point to how the client relates to death, and the way in which the
client explores this area (or not) can show us how the client relates to the Un-known.

The symptom
The symptom is a rich source of information about the client’s relationship with the
existential givens. Depression, for example, might say something about former choices in life
or perhaps the avoidance of risks. Depression clearly has an embodied core. Depression is
often a sign of the absence of an inner relationship with what is important and significant for
the individual. At the same time, depression is also often an expression of how the client
relates to the ‘autonomy – relatedness’ existential given. At the most basic level, being
depressed means that there is a lack of contact with one’s own source of life energy.
It is important to note that any symptom might lead to a different way of relating in
each individual client. As we know, every person is unique, and also every symptom might
mean something different in a different person. From an existential point of view, symptoms
are nothing more than an expression of life, or an earlier answer to the existential givens
which served the client well for a very long time (Hoffman, 2009).
Sometimes the symptom is a direct expression of an existential given. For example,
mourning is a direct expression of our (changing) relationship with death. At the same time,

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mourning is also an expression of relatedness, freedom and responsibility, meaning and
meaninglessness, embodiment and the Un-Known.

Non-verbal language and ‘therapy’ behavior

Another source of information is the way the client talks. The pace of the voice might
give us information about their relationship with the Un-Known: how does the client deal
with silence, how does the client deal with questions that he or she can’t answer? The voice
might also tell us if the client lives life in a more or less embodied way. Does the client speak
from his or her ‘deeper’ voice, or does he/she speak from her ‘head’? Is the pace of his or
her speech connected to the content? Does the client check their words with their bodily felt
sense? The volume of the voice might give us a glimpse into how the client relates to others
and to his or herself. Does the client mumble, or –at the other end of the spectrum – shout?
Does the client make him/herself understandable? Does the client address the therapist, or
does he or she talk to herself? Does the client speak freely, or hesitantly?
‘Therapy’ behavior might also shed light on how clients relate to the existential
givens. Does the client start the session herself? Does she wait till the very end of the session
to start speaking, perhaps even when the session is finished? This gives information about
how the client deals with limitations. It also points to how the client takes responsibility for
her life. Does the client choose what is to be talked about, or does she let the therapist make
this choice? Other sources of information are the (absence of) eye-contact, gestures,
etcetera.

Embodiment
As we have explained, all existential givens are embodied. Clients who are not aware
of their bodily felt senses and feelings might be cut off from an important life source. Clients’
attitudes towards the existential givens are present when they are felt and sensed in a bodily
way. If death is only approached in a conceptual way, it is easy to handle, but this doesn’t
say much about our relationship with our own finitude. How we really relate to death and
the other givens is only revealed when we are courageous enough to experience our
existential answers in the living moment. Responses which might block us – such as avoiding
life or death, or avoiding choice or being obsessed with responsibility and guilt, being unable
to stay in contact with others because of being too anxious about losing autonomy (or the

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other way around) – can only start to flow if we can actually experience our themes in a
bodily way. An existential change is always an experiential, embodied change (Schneider &
Krug, 2010).
What the client actually experiences will reveal more about his or her relationship
with existence than anything else. For the therapist, being comfortable with the Un-Known
will help him or her to get in touch with the clients’ source of life and change.

Interaction
The final source of information about the client’s response to existential givens is the
client-therapist interaction itself. Not only does this inform us about the autonomy paradox,
it also tells us how the client relates to the other existential givens as well. How does the
client live with the fact that he or she is part of a relationship that has clear limitations and
which is by definition finite (by the way, how is that for the therapist)? How did the client
come to choose this particular therapist? Does the client feel responsible for how he or she
affects the therapy with her or his story? How is it for the client that the therapist’s story is
un-known? Does the client feel comfortable with shaking hands?

Every single element of the interaction can teach us how the client relates to the
existential givens and how his or her issues are interwoven with their particular way of
relating (see Case study Sophie).

Goals of existential practice

Maybe you ask yourself if there is any ‘right’ way to live, or if there are some ways of
relating to the existential givens that are better than others? Existential therapists have
suggested that some ways seem to help us to lead a more fulfilling life. Contemporary
research also seems to confirm this suggestion (eg. Wong, 2012). As Yalom (1980), Hoffman
(2009), Schneider & Krug (2010), van Deurzen (1997) and Leijssen (2014) suggest: it is not
the pursuit of happiness that leads to the ‘good life’, it is finding a creative way to live with
the polarities of the existential givens. In Greenings’s view (1992) the existential givens are
dialectical poles which can’t be ‘solved’ but which can be transcended if we can accept all
sides of life. Existential psychology suggests that we try to live an authentic life. This means
accepting that life is finite and living our life to the fullest, making choices although we don’t

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always know the consequences, and taking full responsibility for those choices, living in
connection with others and with ourselves, trying to live a meaningful life while accepting
that meaninglessness is also part of life, being aware that we can’t control life because we
don’t know what’s going to happen, and because we don’t know, being open to what comes
and what we experience on a bodily level. It doesn’t guarantee happiness, but it guarantees
life.

References
Greening, T. (1992). Existential challenges and responses. The Humanistic Psychologist, 20,
111-115.
Hoffman L. (2009). Introduction to existential psychology in a cross-cultural context: An
East-West dialogue. In L. Hoffman, M. Yang, F. J. Kaklauskas, & A. Chan (Eds.),
Existential psychology East-West (pp. 1-67). Colorado Springs: University of the
Rockies Press.
Leijssen, M. (2014). Existential wellbeing counseling. In G. Madison (Ed), Emerging
Practice in Focusing- Oriented Psychotherapy. Innovative Theory, Applications and
Practice (pp. 142-157). London: Jessica Kingsley Publishers.
Schneider, K. J., & Krug, O. T. (2010). Existential-humanistic therapy. Washington, DC:
American Psychological Association.
van Deurzen, E. (1997). Everyday mysteries: Existential dimensions of psychotherapy.
London: Sage.
Wong, P. T. (2012) The human quest for meaning: Theories, research, and applications,
second edition. New York: Routlegde.
Yalom, I. (1980). Existential psychotherapy. New York, NY: Basic Books.