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Introduction
The world “Existential” refers to the experience of existence, and “existence” refers to a complete and “whole” life (Sykes, 2010). Existential therapy works on a belief that inner conflicts within a person occur due to certain issues of existence that are considered as “existential vacuum”, also referred to as “existential frustration” such as meaninglessness, apathy, boredom, and isolation (Yalom, 1980). It is a philosophical way of treatment (Sapp, 2010), and helps the client by showing him or her that the counsellor is with him or her rather than by doing things for the client (Iacovou & Weixel-Dixon, 2015).
In this essay, I will analyse and critique a Videotaped Counselling Session. I will discuss the summary of the session, problem of the client and the theory, critique of the effectiveness of therapeutic approach chosen, and recommendations for future.
Summary of the Session Content
In the counselling session, the counsellor asked the client about his feelings (Derrick, 2012). The client replied that he did not feel good and remained in pain most of the time. He said that he was unable to do many things. The counsellor asked him about the accident and what happened after the accident. He replied that the accident occurred about 13 years ago, and as a result of accident, he remained in a hospital for many months as he went into comma. Surgeons also performed surgeries of his lungs, knee, and head.
After hearing the situations faced by the client, the counsellor tried to motivate him by saying that he had been through a lot and came out of all the problems boldly. She told that this was clearly showing the will-power and determination of the client. Then she asked him how the life changed after accident, and he replied that everything has changed. She asked him about his relationship with family and parents. He told that he was in pain but apparently it was not visible.
The counsellor asked him whether he had discussed his feelings or requirements with his parents. The client replied that he didn’t talk with his parents. He said that they thought he was OK. He also said that the way they looked at him looked like they were unable to do anything.
The counsellor asked him that how he saw himself. He replied that he was worried and unable to do anything. After this, the counsellor again motivated him by saying that he was a real fighter as he moved out of all those disturbing situations on his own without the help of any counsellor, but he denied and said that he was unable to change anything. He felt that his life had gone. The counsellor said that with the passage of time, he would feel good and he would be able to build a new life. He also wanted to feel good and started a new life. The counsellor then said that they would meet again, and she told him to think about a new life the whole week. He was also asked to work harder to start a new life. The counsellor also advised the client to start a music therapy that could help in dealing with the situation.
Understanding of the theory and client
In the counselling session, the counsellor has adapted the existential therapeutic approach (Derrick, 2012). The counsellor adapted a philosophical style of conversation, i.e., Socratic method of questioning to help the client in thinking about him and evaluate the conceptions (Sapp, 2010).
The conversation with the client clearly showed that the client was not happy with the situations faced by him in his life. Initially, the counsellor started knowing about the client by asking about him and reflecting on his life. This showed that the meeting is completely about the client, his life, and the decision to improve it, which is a part of existential therapy (Corey, 2016).
The client openly described his condition that he felt depressed. However, the counselling session showed that the client is not facing an extreme level of depression as he had no thoughts of suicide. The client also didn’t say that he had any kind of irritability or sleep difficulties, which are among the symptoms of elevated level of depression (Brent, Poling, & Goldstein, 2011). With the help of existential therapeutic approach, the counsellor was able to know that the client had negative feelings about his existence. However, they were not worst type of negative feelings as the client was still thinking of moving out of the meaningless life.
During that meeting with the counsellor, he was also able to tell that he felt pain, i.e. he was not happy with his life. He also showed that he was unable to do anything to make the life better. The counsellor talked with him in different ways, and every time, he showed that his life has changed and he has no power to make it better, though he wanted to make the life better. The therapist empowered the client with the motivating sentences, and gave him strength by saying that he was a real fighter, so that he would be able to fill the inner emptiness and make the life better.
This counselling session also showed that the client was actually in search of some meaning in life, and the therapist was helping the client in giving a meaning to life. In the counselling session, the client told about a decrease in the strength of relations with parents and other family members. He was of opinion that the accident changed everything in his life, even his relations with others. It was clearly showing the state of “existential vacuum”, which is a sense of meaninglessness and emptiness (Heavilin & Heavilin, 2013), and according to which a person may start feeling dehumanization of individuals and the loss of traditional values. It is also showing that the client wanted to be understood rather than interpreted (Sykes, 2010), and an existential therapist can help in this regard.
This is an existential therapeutic approach in real sense as the counsellor showed the client that she is with him in every situation, and together they can move out of the situation. She didn’t show him that she would talk with his parents or other relatives, or make things better for him, but she assured him that with an appropriate strategy and planning they can move out of hopelessness and meaninglessness in life.
Usually, in a good counselling session, a counsellor tells the client that he or she has to look at his own abilities rather than the role of others (Nelson-Jones, 2010), and in this videotaped session, the counsellor was doing the same thing.
Critique of the effectiveness of therapeutic approach chosen
In the counselling session, counsellor asked about the client’s life and his expectations about life. This is one of the most important parts of existential therapy (Iacovou & Weixel-Dixon, 2015). She was right in asking about the client’s own self and telling him that he is free and the only person, who is responsible for improving the situation of life (Corey, 2016). It is important to consider that existential therapy is not related to talking about the past and stuck with it, but it is about the present and future (Jones-Smith, 2011), and the same thing the counsellor had done in the videotaped session.
She also asked about starting a new life, which could help the client in openly discussing his problems faced by him in the life. In the closing part of the session, the counsellor noted the point that the life after the accident has gone, and now with more determination, the client can move forward. Moreover, with the passage of time, the client will be able to build a new life. This is another important point in the counselling with existential therapist. An existential practitioner has to discuss with the client not only the points that are affecting the existence of the client but also encourage the client to move away from all kinds of those thoughts that are making the client unwell and out-of-control (Iacovou & Weixel-Dixon, 2015).
According to the van Deurzen, there are four dimensions of a human existence. These dimensions include
physical dimension (Umwelt),
social dimension (Mitwelt),
psychological dimension (Eigenwelt), and
spiritual dimension (Überwelt) (Sharf, 2015).
In this therapeutic session, the counsellor didn’t talk much about the physical and spiritual dimension of the client.
The counsellor has discussed the psychological dimension in sufficient detail, which is important in understanding the existential vacuum (Koepke & Fahey, 2016). She asked the client about his character, his past, and future. She has also told the strengths to the client and gave him a feeling of substantial and sense of self-importance.
In the counselling session, the counsellor has slightly discussed the social life of the client. She talked with the client about his relations with the parents and other family members. Her discussion with the client has helped the client in showing that he felt isolation and loneliness as his parents are unable to understand his feelings. This is also showing that the client is probably moving away from his relatives. He is not talking with them about the problems.
The counsellor has not discussed much about the physical dimension. This dimension deals with the relation of the client with the environment, nature, and with the givens, which are important in physical dimension. In this regard, Givens many include (Sharf, 2015);
mortality,
meaninglessness,
isolation, and
freedom.
Physical dimension is also related to the concept of time, i.e. the client constantly thinks about the past and considers that he is unable to do anything (Jones-Smith, 2011). In this regard, the counsellor has performed very well by moving out of the past and asking the client to focus on the present and the future.
Moreover, the counsellor has not discussed the spiritual dimension that would help in relating the client with something more religious or personal, thereby creating a sense of an ideal world as well as a philosophical outlook of the life. With the help of exploring and working on the spiritual dimension, the counsellor would help the client in considering the soul, thereby developing a meaning in life by giving a purpose of helping others for the peace of soul.
Concluding Remarks and recommendation for future treatment
Existential therapy is a therapeutic strategy having philosophical basis rather than technical basis. Counselling is an important way of existential therapy as with the help of counselling, a counsellor can help a client in moving towards something better (Sanders, 2011). An existential therapist helps in reducing high levels of depression, anxiety, and feelings of loneliness, but it is not possible to completely eliminate them (Yalom, 1980).
In order to improve the counselling session, a counsellor can also talk about the aspects of physical dimension. A counsellor may ask about the connection with
concrete surroundings,
objects,
weather and climate,
bodily needs, and
health and bodily disorders.
This discussion would help in accepting the limitations posed by nature as, for example, it can help in knowing that a person would not be able to change the situation, if it is caused by nature such as old age or by accidents. Recognition of these limitations could help a client in moving out of the tension and depression.
Counselling session could further be improved by discussing the spiritual dimension with the client. Spiritual dimension, which could be achieved by either adhering to religion or by developing a more personal or secular opinion of life, would help the client in finding a meaning in life by putting the pieces of disturbing thoughts in a particular pattern.
Talking with the client about the society, culture, class, and race can also help him in reducing the problem of meaninglessness and isolation. Moreover, the use of logotherapy, i.e., a therapeutic strategy that helps in providing paths to a meaningful life, could further assist the counsellor (Heavilin & Heavilin, 2013).
References
Brent, D. A., Poling, K. D., & Goldstein, T. R. (2011). Treating Depressed and Suicidal Adolescents: A Clinician's Guide: Guilford Publications.
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Iacovou, S., & Weixel-Dixon, K. (2015). Existential Therapy: 100 Key Points and Techniques: Taylor & Francis.
Jones-Smith, E. (2011). Theories of Counseling and Psychotherapy: An Integrative Approach: SAGE Publications.
Koepke, D. R., & Fahey, C. (2016). The Essential Spirit: Providing Wholistic Services to and with Older Adults: Wipf & Stock Publishers.
Nelson-Jones, R. (2010). Theory and Practice of Counselling and Therapy: SAGE Publications.
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Sykes, B. M. (2010). Questioning Psychological Health and Well-being: Historical and Contemporary Dialogues Between Theologians and Psychologists: Mercer University Press.
Yalom, I. D. (1980). Existential Psychotherapy: Basic Books.
