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It is obvious that individual responsibility is central to existential therapy. You are responsible for the person you choose to become. You may choose to be genuine, or you may choose to lie to yourself and others. It is when you abdicate responsibility for becoming authentic that you will often come to feel anxiety and a sense of guilt. Anxiety and guilt are often present, in other words, when there is a fundamental lack of congruence, of being whole, of being in accord with yourself.
The main contributors to existential psychotherapy have been the Swiss analysts Ludwig Binswanger (1881-1966) and Medard Boss (1903-1990), along with Rollo May (1909-1994), who was the founder of existential psychotherapy in America. Today, existential psychotherapy is practiced under a variety of names: humanistic psychology, experiential psychotherapy, and also in the context of the related approaches, logotherapy and reality therapy (see Chapter 11).
WHAT EXISTENTIAL THERAPY IS LIKE
Existential psychotherapy is usually individual therapy, with sessions commonly scheduled a few times a week, as in psychoanalysis. Existential therapy often shows its psychoanalytic origins: as in analysis, existential psychotherapy focuses largely on anxiety and the suppressed issues that anxiety veils. Existential therapists will push clients to confront anxiety directly; they will try to understand the clients' anxiety in relation to the lies that clients tell themselves in order to protect themselves from more anxiety.
As we have already seen, existential therapists very commonly regard anxiety and depression as promising symptoms because they can shake clients out of unfulfilling patterns of living. Anxiety and depression, instead of being viewed as undesirable symptoms to be eliminated, can motivate people to change and grow. Consequently, existential therapists tend to disapprove of the use of drugs in therapy. If clients take pills to reduce anxiety, for example, they will reduce the awareness of motivating pain that, if faced squarely, may bring about a more meaningful, satisfying life.
Here is an example of the way an existential therapist forces a client to face issues head-on. What the therapist is thinking is in brackets.
CLIENT: I don't know why I stay with my job. It just makes me depressed. All I do is tell you the same things over and over. I'm not getting anywhere.
THERAPIST: [She is complaining because I'm not curing her. She has to do this herself.] To be frank, I'm impatient, too. We talk, but you're not able to act. [She has to see that I can't take responsibility for her procrastinating].
CLIENT: What do you think I ought to do? I can't keep living like this.