Born in 1931 in Washington, Columbia, from Russian parents, Irvin Yalom has been a doctor in medicine since 1956 and a professor emeritus of psychiatry at Stanford College since 1994. He simultaneously plied a psychiatrist career and a group therapies animator career. Yalom is also the author of many publications ranging from essays and various articles to several novels including “When Nietzche wept” (1992), adapted as a movie in 2007 ; “Lying on the couch” (1996) ; “The Schopenhauer cure” (2005) and “The Spinoza Problem” (2012). In addition, one of his greatest works was to conceptualize existential therapies in his book “Existential psychotherapy” (1980). Indeed, this book is a standard to everyone studying existential therapies and more broadly to all humanist practitioners. The aim here will be first to define existential psychotherapy and then to develop the existential matters on which this therapeutic concept relies.
Existential psychotherapy can be defined as a dynamic approach of the therapy that aims to focus on the issues that are at the core of the human’s existence, in the here and now. This approach shares with the psychoanalysis the postulate that the psychic life is articulated around forces, motivations and conscious and unconscious fears. Nevertheless there is an important divergence between the existential approach and the psychoanalytic one about chronology and individual’s development. Indeed, the breaking point relies on the fact that existential psychotherapy is about finding the strengths and motivations that are the heart of one’s internal struggles. Existential therapy studies the internal struggles of psychic life, taking thorough reflections, dreams, nightmares, individual’s experiences, psychotic manifestations and insight into account. This approach considers the conflict of psychic life as being based on people’s confrontation with the foundations of existence. The consciousness of the ultimate stakes of life leads to existential anguishes causing the setting up of defense mechanisms.
Yalom suggests that there are four ultimate stakes: death, freedom, isolation and meaninglessness. The first fundamental stake, death, is also the most understandable : we exist today, but someday we will stop being. Death will come, we can not escape from it. This is a terrible truth to which we respond by a mortal terror. Spinoza said that each thing as it is in itself seeks to persist in its being, and a key existential conflict emerges from this tension between the knowledge that death is inevitable and the desire we have to continue to exist. The second stake is more difficult to understand, as freedom is often considered as being totally positive. Yet, when considered in terms of ultimate stake, freedom is inseparable from terror. Unlike our daily experience, human beings do not live in (and nor do they leave) a well-structured universe with a predefined purpose. In contrast, individuals are absolutely responsible and are the authors of their world, their life projects, their choices and their actions. With this acceptance, freedom gets a terrifying implication, as it means that there is no ground under our feets, nothing but an abyssal void. This conflit, born from the confrontation between this absence of ground and our desire to have one (and to have a structure), is the heart of a key existential dynamic. The third stake is about fundamental isolation: each of us comes alone to the world and leaves it equally alone. Thereupon, an existential conflict arises from this opposition between this absolute isolation and our desire of contact, of protection and of belonging to a whole that would transcend us. Last but not least, the fourth stake is characterized by meaninglessness. If we have to die, if we build our own world, if each of us is meant to remain alone in an indifferent universe, then what sense does life have ? What do we live for ? How to live ? As there is no predefined purpose, all of us have to design the sense of our life. However, is the sense we give to our own creations enough to help us to endure life ? This existential questioning derives from the dilemma that a being greedy for meaning dropped in a meaningless universe has to face.
In the existential approach, deep investigation is not synonymous with exploring the past. On the contrary, it implies distancing oneself from everyday concerns in order to reflect on the meaning of one’s own existence. This exercise requires us to think of ourselves not by our actions, but because we are beyond what we do, beyond how we present ourselves to others. Who am I if I don’t do what I was meant to do? What is the point of having a life where I feel worthless because I am dependent on others for the smallest of daily tasks? The memory we have of the past is important because of the role it plays in our present and how it influences fundamental issues. The future, on the other hand, is actualised in our present and is, according to existential psychotherapy, the most fertile part of the exploration of the therapy. Thus, the interview style is dynamic as the therapist is in a symmetrical relationship to accompany the patient to explore his or her fundamental issues, which may translate into psychopathological suffering or not.
In conclusion, this paradigm affects us all since, in the face of life as in the face of death, human beings are led to approach themselves as a being and not as a representative of the role they have to play in the various aspects of life.
Bibliography :
Yalom, I. D. (1980). Existential psychotherapy. Hachette UK.