Existential approach to work with terminal patients. An existential approach to counseling. Existential psychotherapy: a critique of the approach

Recall that I. Yalom defined existential psychotherapy as a psychodynamic approach. It should be noted right away that there are two important differences between existential and analytic psychodynamics. First, existential conflicts and existential anxiety arise from the inevitable confrontation of people with the ultimate given of being: death, freedom, isolation and meaninglessness.

Second, existential dynamics does not imply the adoption of an evolutionary or "archaeological" model, in which the first is synonymous with the deep. When existential psychotherapists and their patients do in-depth research, they do not focus on day-to-day worries but reflect on underlying existential issues. In addition, existential approaches can also be used to address issues related to freedom, responsibility, love, and creativity. [AND. Yalom writes that psychotherapeutic approaches "reflect pathology that can be cured with their help, and are shaped by this pathology."]

In connection with the above, existential psychotherapy is mainly focused on long-term work. However, elements of an existential approach (for example, an emphasis on responsibility and authenticity) can be included in relatively short-term psychotherapy (for example, associated with work with post-traumatic conditions).

Existential psychotherapy can be carried out both individually and in a group form. Usually a group consists of 9-12 people. The advantages of the group form are that patients and psychotherapists have a greater opportunity to observe distortions arising in interpersonal communication, inappropriate behavior and correct them. Group dynamics in existential therapy aims to identify and demonstrate how the behavior of each member of the group:

1) is considered by others;

2) makes others feel;

3) creates an opinion about him in others;

4) influences their opinion of themselves.

The greatest attention in both individual and group forms of existential psychotherapy is paid to the quality psychotherapist-patient relationship. These relationships are considered not from the point of view of a transfer, but from the point of view of the current situation in patients and the fears that torment the patients at the moment.

Existential therapists describe their relationships with patients using words such as presence, authenticity and devotion. There are two real people involved in one-to-one existential counseling. An existential psychotherapist is not a ghostly "reflector", but a living person who seeks to grasp and feel the patient's being. R. May believes that any psychotherapist is existential who, despite his knowledge and skills, can relate to the patient in the same way as, in the words of L. Binswanger, “one existence relates to another”.

Existential psychotherapists do not impose their own thoughts and feelings on patients and do not use countertransference. This is due to the fact that patients can resort to various methods of provoking psychotherapists' connection, which allows them not to turn to their own problems. Yalom talks about the importance of implicit "infusions". We are talking about those moments of psychotherapy when the therapist shows not only professional, but also sincere, human participation in patients' problems, thereby sometimes turning a standard session into a friendly meeting. In her case study ("Every day brings a little closer"), Yalom considers such situations both from the standpoint of the psychotherapist and from the standpoint of the patient. So, he was amazed to find out what great importance one of his patients gave such small personal details as warm looks and compliments about how she looked. He writes that in order to establish and maintain good relationship with the patient, the psychotherapist needs not only complete involvement in the situation, but also such qualities as indifference, wisdom and the ability to maximally engage in the psychotherapeutic process. The psychotherapist helps the patient “by being trustworthy and interested; being affectionately present next to this person; believing that their joint efforts will ultimately lead to correction and healing. "

The main goal of the therapist is to establish an authentic relationship in the interests of the patient, therefore the question self-disclosure psychotherapist is one of the main in existential psychotherapy. Existential psychotherapists can reveal themselves in two ways.

First, they can tell their patients about their own attempts to come to terms with extreme existential worries and preserve the best human qualities. Yalom believes that he made a mistake by too rarely resorting to self-disclosure. As he notes in The Theory and Practice of Group Psychotherapy (Yalom, 2000), whenever he shared a significant portion of his self with patients, they invariably benefited from it.

Second, they can use the process of psychotherapy itself, rather than focus on the content of the session. It is the use of thoughts and feelings about what is happening “here and now” in order to improve the psychotherapist-patient relationship.

During a series of psychotherapeutic sessions, patient A. demonstrated behavior that she herself regarded as natural and spontaneous, while other group members rated it as infantile. She in every possible way showed activity and readiness to work on herself and help others, described her feelings and emotions in detail and colorfully, willingly supported any topic of group discussion. At the same time, all this was of a semi-playful, semi-serious nature, which made it possible at the same time to provide some material for analysis, and to avoid a deeper immersion in it. The psychotherapist, suggesting that such "games" may be associated with the fear of approaching death, asked why she was trying to be an experienced adult woman or a little girl. Her response shocked the entire group: “When I was little, it seemed to me that my grandmother was standing between me and something bad in life. Then my grandmother died and my mother took her place. Then, when my mother died, my older sister turned out to be between me and the bad one. And now, when my sister lives far away, I suddenly realized that there is no longer a barrier between me and the bad one, I stand face to face with him, and for my children I myself am such a barrier. ”

In addition, the key processes of therapeutic change, according to Yalom, are will, acceptance of responsibility, attitude towards the therapist and involvement in life. Let's consider them using an example of working with each of the basic alarms.

Working with Death Awareness

The study of people who have been in extreme situations, survived the experience of clinical death, as well as chronic patients, irrefutably testifies that a deepening awareness of death can lead to a higher appreciation of life. The situation of being close to death causes a wide variety of reactions in people. Many people try to deny this fact. Others fall into panic, apathy or fruitless reflections ("Why me?", "What in my life have I done wrong and how can I fix it?"). Still others begin to take revenge on all healthy people or simply on those who can outlive them. Other people activate the means of psychological protection, distorting reality, but thanks to this, they more or less calmly perceive information regarding death.

Therefore, it is important to prepare any person for this in advance and teach him to use his diseases as an opportunity for personal growth... Awareness of the uniqueness and finiteness of human life leads to the "unbearable lightness of being" - a reassessment of values, acceptance of the present moment, a deeper and more complete experience of art, the establishment of close and sincere contacts with all people, and not only with relatives and friends, an understanding of the relativity of human fears and desires, establishing closer contact with nature. Therefore, a heightened awareness of death can also cause a radical shift in patients who are not terminally ill.

Participant E. began one of the groups of personal growth by voicing the problem of relations deteriorating outside the group with participant S., with whom E. had a fairly strong friendship for some time. According to E., this was due to alienation and antipathy that arose in S. in connection with the pressure of some of their mutual acquaintances, with whom E. is in tense relationship. The group, which consisted mainly of psychology students, willingly began to study the problem posed, quickly discovering that in almost all of E.'s relationships with women, the same scenario is observed - the inability to maintain warm friendly relations for a long time. This topic, both in a broader context (female rivalry) and in relation to E., caused quite strong emotional reactions in the group. Throughout the discussion, E. several times silently flowed tears, however, she responded to the attention of those around her with a request “not to pay attention”, since they flow “just like that”, behind them “nothing costs” and with her “in the last such times often happen. " The facilitator suggested that the next time they flow and emotions are associated with them, which E. can speak about in the group, let her give a signal - for example, stamp her foot. And a few minutes later he asked the question: "E., what is happening in your life now?" The ensuing explosion of emotions of fear, resentment, and sadness shook the entire group: it turned out that for about a month E. was waiting every hour for the news of the death of the only remaining loved one, a mother suffering from a serious oncological disease. A group that had previously actively tried to help E.

to solve the problem she declared, experienced shock, a sense of guilt and tried, due to the available opportunities, to support her. Awareness of the closeness of death every minute led to the fact that almost at the very end of the group, already when summing up its results, one of the participants, J., told that she might have an oncological disease and that due to fear and unwillingness to live it does nothing for his further diagnosis and therapy. The subsequent series of stories about close or similar experiences that time did not convince her to turn to specialists. However, in the next group, she talked about her "secret" trip to the hospital and the ensuing feelings of both relief and disappointment. This allowed the group to focus not only on discussing the problems of death, but also on the meaning of life and the responsibility for translating this meaning into life.

Yalom recommends starting from the following position - anxiety associated with death is inversely proportional to satisfaction with life. Increasing awareness of the inevitability of death can increase anxiety, but the therapist should strive not to anesthetize patients' anxiety, but to help them come to terms with it and use it constructively.

The technique of "permission to endure" is to make patients understand that discussing death issues is highly valued in counseling. This can be done by showing an interest in self-disclosure by patients in the field, and by encouraging self-disclosure. In addition, psychotherapists should not encourage death denial in patients. On the contrary, it is necessary to actively contribute to keeping these issues “in the public eye”. For this, the therapist himself must be resistant to his own anxiety associated with death.

While listening to a patient talk about the importance and responsibility of the work he was doing, the therapist suddenly asked him to stop and listen, and then say what he was hearing. “The ticking of the clock that hangs on your wall,” the patient replied in bewilderment. “Right,” the psychotherapist confirmed. “But it's not just a watch: it measures the time. The time that has been allotted to us for today's meeting. And also the time that is generally allotted to us for life. It is different for everyone and depends on genetics, lifestyle, will to live and a host of other factors. But in one thing it is similar - it cannot be calculated and reversed. Now think about whether the importance and prestige of the work you are doing are those significant things for which you are ready to spend so much of your personal time? "

Technique for working with protective mechanisms consists in identifying inadequate protection mechanisms and their negative consequences. Psychotherapists try to help patients admit that they will not live forever, rather than deny death. Existential psychotherapists require tact, persistence, and timing to help patients identify and change their childishly naive views of death.

Technique for working with dreams is that existential psychotherapists encourage patients to talk about their dreams. Since in dreams (especially in nightmares) subconscious themes can appear in an unsuppressed and unedited form, themes of death are often present in them. Therefore, the discussion and analysis of dreams are carried out taking into account the existential conflicts that are taking place in patients at the moment. However, patients are not always ready to deal with the material presented in their dreams.

Yalom (Yalom, 1997, pp. 240-280) cites the case of Marvin, an elderly man of 64 years. One of his nightmares was this: “Two men, very tall, pale and thin. In complete silence, they glide across the dark field. They are dressed all in black. Wearing tall black chimney sweep hats, long black coats, black leggings and boots, they resemble Victorian undertakers or lackeys. Suddenly they come to a carriage where a little girl is lying, wrapped in black diapers. Without uttering a word, one of the men begins to push the wheelchair. After driving a short distance, he stops, walks around the stroller and with his black cane, which now has a white-hot tip, unfolds the diapers and slowly inserts the white tip into the baby's vagina. "

Yalom gave the following interpretation of this dream: “I am old. I am at the end of my life. I have no children and I face death full of fear. I gasp in the dark. I choke on this silence of death. I think I know a way. I'm trying to pierce this blackness with my sex talisman. But this is not enough. "

Subsequently, when Yalom asked Marvin to tell what associations he had in connection with his dream, he said nothing. When Marvin was then asked how he reworked all the images of death he had in his mind, Marvin preferred to view his nightmare in terms of sex rather than death.

Reminder technique fragility (frailty) of existence ... Psychotherapists can help patients identify and manage death anxiety by “attuning” patients to the signs of mortality that are part of normal life (for example, the death of loved ones can be a powerful reminder of personal mortality; the death of a parent means it’s next generations; the death of children can cause a feeling of powerlessness due to the realization of cosmic indifference). In addition, serious illness can bring patients face to face with their own vulnerability.

Also, the awareness of mortality reminds of itself in the transitional periods of life. Of greatest importance are the transition from adolescence to adulthood, the establishment of permanent relationships and the associated commitment, leaving the home of children, marital separation and divorce. In middle age, many patients begin to become more aware of death, realizing that now they are not growing up, but aging. In addition, the loss of a job or the unexpected emergence of the danger of a career ruin can deepen the awareness of death.

In everyday life, a person is constantly faced with reminders of the passage of time. Physical signs of aging, such as the appearance gray hair, wrinkles, spots on the skin, decreased flexibility of joints and endurance, deterioration of vision - all this destroys the illusion of constant youth. Meeting friends from childhood and adolescence shows that everyone is getting old. Often birthdays and various anniversaries generate existential pain along with or instead of joy, as these dates are milestones in the aging process.

Technique for using assistive devices to deepen the awareness of death is that the patient is asked to write his own obituary or fill out a questionnaire with questions that relate to anxiety associated with death. In addition, psychotherapists may invite patients to fantasize about their death, imagining “where”, “when” and “how” they will meet it and how their funeral will be held. Yalom describes two ways to get patients to interact with death: observing terminally ill people and enrolling an incurable cancer patient in the patient group.

The technique is close to this technique. decrease sensitivity to death. Psychotherapists can help patients cope with the horror of death by repeatedly forcing them to experience this fear in reduced doses. Yalom notes that when working with groups of cancer patients, he often saw that the fear of death in these patients gradually diminishes simply by obtaining new detailed information.

Interesting example semantic reassessment of death leads V. Frankl. He was approached by an elderly doctor who had been depressed for two years about the death of his wife. “How could I help him? What should I tell him? So, I didn't say anything, but instead posed the question: "What would happen, doctor, if you died first, and your wife had to outlive you?" “Oh,” he said, “it would be terrible for her, how she would suffer!” Then I responded: "You see, doctor, she escaped these sufferings, and it was you who delivered her from them, but you have to pay for it by being experienced and mourning her." He did not answer a word, but shook my hand and calmly left my office. "

Working with responsibility and freedom

When patients have extreme anxiety associated with freedom, psychotherapists focus on raising patients' awareness of their responsibility for their lives and on helping patients to take on that responsibility.

Technique for defining types of protection and methods of evading liability is that psychotherapists can help patients understand the functions of certain types of their behavior (for example, compulsiveness) as evasion of responsibility for choice. In addition, psychotherapists can, together with patients, analyze their responsibility for their own unhappiness and, if necessary, put patients face to face with this responsibility.

Vera Gulch and Maurice Temerlin, based on the analysis of audio recordings of psychotherapy sessions, have collected a collection of confrontational interviews aimed at increasing the awareness of responsibility. They cite the example of a man who bitterly and passively complained that his wife was refusing to have sexual intercourse with him. The therapist clarified the hidden choice with the remark: "But you should like this, because you have been married for so long!" In another case, a housewife lamented: "I cannot cope with my child, all he does is sit and watch TV all day." The therapist made the hidden choice explicit with the following remark: "And you are too small and helpless to turn off the television." An impulsive, obsessive man shouted, "Stop me, I am afraid I will commit suicide." The therapist said, “Should I stop you? If you really want to commit suicide - really die - no one can stop you except yourself. " One therapist, in a conversation with a passive, oral-dependent man, who believed that the reason for his discord with life was unrequited love for an older woman, began to sing: "Poor little lamb, he's lost."

The essence of this technique is that when a patient complains about an unfavorable situation in his life, the therapist is interested in how the patient created this situation. In addition, the therapist can focus on how the patient is using “the language of avoidance of responsibility” (for example, people often say “I can’t” instead of “I don’t want to”).

Evasion Identification Technique focuses on the psychotherapist-patient relationship. Psychotherapists put patients face to face with their attempts to transfer responsibility to psychotherapists for what happens within or outside psychotherapy. For this, it is very important for the psychotherapist to become aware of his own feelings about patients, helping to identify emotional reactions in patients.

Many clients seeking psychotherapy expect the therapist to do all the therapy work for them. The motivation for such expectations can be very diverse, ranging from "You are better, you are stronger, you have a more advantageous situation," and to the bottom of "You learned this, this is your profession, I pay you money for this." Influencing in this way the various feelings of the therapist (guilt, conscience, conscientiousness, etc.), the patient shifts the burden of responsibility for the changes occurring to him on the shoulders of the psychotherapist.

In the student study group, participant A. to all attempts at help and support, both from the facilitator and from other group members, responded with approximately the same words: “I don’t know ... Perhaps this is so ... At least , you this is how you see it ... ". Feeling that the position of such a passive confrontation had become familiar to her, and avoiding provocative slipping into a lesson, the psychotherapist told her an anecdote: “Late in the evening, a woman walks along a dark deserted street. Suddenly he hears heavy male steps behind. Without turning around, she quickens her step. The steps also become more frequent. She runs - the pursuer runs after her. In the end, she runs into a courtyard and realizes that there is no way out. Then she boldly turns to the pursuer and loudly shouts: "So what do you want from me?", To which the pursuer calmly replies: "I don't know, this is your dream." Despite the fact that the patient reacted aggressively to this anecdote, later his last phrase served as a good "marker" for identifying deviations. As soon as A. began to demand something from the psychotherapist and the group or to accuse them of something, she was immediately reminded: "But this is your dream."

The technique of facing the constraints of reality. Since objectively unfavorable situations periodically arise in the life of any person, this technique is aimed at changing the patient's point of view. This change has several varieties.

First, the therapist can help identify areas of life that the patient is able to continue to influence, despite the constraints that have arisen. So, for example, no one can change the fact of a serious illness, but it depends only on the person whether he takes the position of a passive victim in relation to this fact or try to find aristos - "the best in this situation" (classic examples - " real man"A. Maresyev, circus artist V. Dikul, etc.).

Secondly, psychotherapists can change the existing attitude in relation to those restrictions that cannot be changed. It is about both accepting the injustice that exists in life and reframing like “if you cannot change the situation, change your attitude towards it”.

V. Frankl illustrated this type of change with the following anecdote: “During the First World War, a Jewish military doctor was sitting in a trench with his non-Jewish friend, an aristocratic colonel, when a massive shelling began. Teasing him, the colonel said: “You’re afraid, aren’t you? This is another proof of the superiority of the Aryan race over the Semitic.” like me, you would have run away long ago. "

Technique for confronting existential guilt ... As already noted, in existential psychotherapy, one of the functions of anxiety is considered to be a call to conscience. And one of the sources of anxiety is guilt due to unsuccessful realization of potential.

In order to launch psychological work with existential guilt in a group format, a modification of the parable from The Process by F. Kafka is well suited.

One person learned that somewhere there is a Castle in which the Law reigns, wisely distributing happiness and misfortune "justly." As expected, he goes on a journey and, having worn out the prescribed amount of clothing and wear off the prescribed number of shoes, finally finds him. The guard, in front of one of the innumerable gates, greets the traveler, but immediately announces that he cannot pass him at the moment. When a person tries to look into the bowels of the Castle himself, the guard warns: “If you are impatient, try to enter, do not listen to my prohibition. But know, my power is great. And I am only the most insignificant of the guards. There, from rest to rest, the guards stand, one more powerful than the other. And with each of them you will have to fight. "

Then the man decided to wait until he was either allowed to enter, or someone else came, ready to fight the terrible and powerful guards. Sometimes he talked for a long time with the first guard on various topics. From time to time he tried to bribe the guard with various bribes. He took them, but still did not miss, explaining his actions as follows: "I am doing this so that you do not lose hope."

In the end, the man grew old and, feeling that he was dying, asked the guard to fulfill it. last request- to answer the question: "After all, all people strive for the Law, how did it happen that for all these long years no one, except me, demanded to be passed?" Then the guard shouted in response (since the person already had poor hearing): “No one can enter here, these gates were intended for you alone! Now I will go and lock them up. "

There is a difference between guilt for making bad choices in the past and guilt for refusing to make new choices. As long as patients continue to behave in the present as they did in the past, they cannot forgive themselves for choices made in the past.

A Buddhist parable illustrates this well. Once two monks were walking along a narrow mountain road and at one of the turns they met a girl standing in front of a huge puddle. The first monk calmly walked by, and the second silently walked up to her, took her on his shoulder, carried her over the puddle and went on. In the evening, approaching the walls of the monastery, the first monk broke the traditional silence: "Our charter forbids touching women." To which the second monk replied: "I have only been dogging her for three minutes, and you have been carrying her for an hour already."

The technique of releasing the ability to want. It is impossible to experience desires without contact with your feelings. Therefore, to understand the true desires of a person, existential psychotherapists work with repressed and repressed affects that block desires. At the same time, unlike other methods of psychotherapy, they try to avoid dramatic global breakthroughs, since their (breakthrough) impact is usually short-lived. Instead, within the context of an authentic relationship, existential therapists continually try to answer the question, "How are you feeling?" and “What do you want?”, thereby exploring the source and nature of the patient blocks and the underlying feelings that patients are trying to express.

Decision Facilitation Technique is that existential psychotherapists encourage patients to realize that every action is preceded by a decision. Since alternatives are excluded when making a decision, decisions are a kind of borderline situations in which people create themselves. Many patients paralyze their ability to make decisions by asking questions that begin with "Yes, but ..." or "What if ..." (eg, "What if I lose my job and can't find another?"). Psychotherapists can help patients explore the ramifications of each “what if…” question and analyze the feelings that these questions induce. Psychotherapists can encourage patients to actively make decisions in such a way that the decision will help them to activate their own strength and resources.

In a situation where the patient is faced with the need to make a decision, but by all means is trying to shift this decision onto the psychotherapist, the therapist can tell another Eastern parable. Once a woman who lived in a remote village and was reputed to be the wisest there, learned that Khoja Nasreddin would pass through this village. Fearing for her authority, she decided to test his wisdom. When he entered the village, she approached him with a small bird clutched in her hand, and publicly asked: "Tell me, is the bird in my hand alive or dead?" It was a very tricky question, because if he answered that she was alive, she would clench her fist tighter and the bird suffocated. If Khoja answered that the bird was dead, the woman would unclench her hand and the bird flew away. “Everything is in your hands, woman,” Nasruddin answered her.

When necessary, existential psychotherapists help patients to exercise will. Psychotherapist approval allows patients to learn to trust their will and gain confidence that they have the right to act.

Yalom recommends that the following attitudes be brought to patients with suppressed will as often as possible: “Only I can change the world I created”, “There is no danger in change”, “To get what I really want, I must change”, “I in the power to change. "

Insulation work

The technique of confronting patients with isolation. The therapist can help the patient understand that ultimately everyone is born, lives and dies alone. This is quite painful, since it destroys all romantic samples of human relationships that are extolled by culture. Nevertheless, like death, the awareness of total loneliness significantly affects the change in the quality of life and relationships. [It is not for nothing that E. Fromm defines the ability to be alone as a condition of the ability to love in The Art of Love.] By exploring their loneliness, patients learn to determine what they can and cannot get from a relationship.

Thus, assessing the groups conducted, many participants note the fact that is important for them that, thanks to the groups, they for some time escaped from their everyday environment.

In addition, the psychotherapist can offer the patient the following experiment - to isolate himself from the outside world for a while and be isolated. After conducting this experiment, patients become more aware of both the horror of loneliness and the extent of their hidden resources and the extent of their courage.

Defense Mechanism Identification Technique consists in identifying the defenses that patients use to cope with the contradiction between the need for belonging and the fact of existential isolation.

One of the groups, which was devoted to the problem of building family relationships, was attended by several people with compulsive behavior, manifested in increased amorousness, chronic unrequited love, frequent change of objects of love, the formation of dependency relationships with them. All attempts to investigate the underlying processes behind this were broken on intellectual defenses. To demonstrate that there are defense mechanisms against loneliness behind such behavior, the therapist told the following parable.

“There was a lonely and unhappy person. And one day his loneliness and despair reached such a degree that he cried out to God: "Lord, send me a beautiful woman!" His cry was so powerful that God heard and paid attention to him. God asked, "Why not a cross?" The man got angry: "I'm not tired of life, I want to find a beautiful woman and a friend." The man got everything, but soon became even more unhappy. This woman became a pain in his heart and a stone on his neck. And then he prayed again: "Lord, give me a sword." God asked again: "Maybe it's a cross after all?" But the man shouted: "This woman is worse than any cross. Send me only a sword!"

God sent a sword, a man killed a woman, was captured and sentenced to crucifixion. And on the cross, praying to God, he laughed loudly: "Forgive me, Lord! I did not listen to You, but You asked whether to send me the cross, from the very beginning. If I had obeyed, I would have gotten rid of all this unnecessary fuss "".

Interpersonal pathology identification technique. Taking ideal freedom from needs or "I-Thou" relationship as a criterion, it is possible to determine the ways patients avoid real relationships with others. To what extent do patients relate to other people as objects serving to satisfy their wants and needs? How capable are they of love? How well do they know how to listen to interlocutors and reveal themselves? How do they keep people at a distance? Psychotherapists can teach patients the "ABC of the language of intimacy", which gives them the skills to accept and express feelings.

Using the psychotherapist-patient relationship to identify pathology. Existential psychotherapists believe that focusing solely on the transference interferes with therapy by eliminating the authentic therapist-patient relationship. This is due to the fact that, firstly, the analytical paradigm eliminates the reality of the relationship itself, considering them as a kind of key to understanding past experience, and secondly, it provides the psychotherapist with a rational basis for self-defense. In turn, the inability to self-disclose blocks the capacity for sincere and empathic understanding. inner peace another. Self-disclosure of the psychotherapist (similar to that described by R. Mayagape - love devoted to the good of another) allows the patient to take step by step towards his own disclosure.

Healing relationships. Existential psychotherapists strive to develop real relationships with patients. Although the therapist-patient relationship is temporary, the experience of intimacy can be permanent. The psychotherapist-patient relationship can contribute to the self-affirmation of patients, as it is extremely important for them that someone, whom they respect and who really knows all their strengths and weaknesses, accepts them. Psychotherapists who have developed deep relationships with their patients can help them resist existential isolation. In addition, it helps patients to realize their responsibility for life and the relationships that develop in it.

Dealing with meaninglessness

Technique for overriding the problem. When patients complain that “life has no meaning,” they seem to admit that life has meaning that they cannot find. This point of view is close to the logotherapeutic position. However, according to other existential approaches, people give meaning rather than receive it. Therefore, existential psychotherapists increase patients' awareness that there is no objectively inherent meaning in life, but people are responsible for creating their own meaning. Often, what falls under the category of meaninglessness is best studied in relation to other extreme concerns of death, freedom, and isolation. We can also find an example of the application of such a technique for redefining the problem of meaninglessness in an eastern parable. So, one legend tells that once Khoja Nasreddin died and went to heaven in a wonderful garden, where an obedient genie fulfilled all his wishes. Very soon Khoja got bored with it and he decided to do some work. However, the genie forbade him to do this. Then after a while Nasruddin began to ask for somewhere else, but at least in hell. "Where do you think you are?" - the genie laughed.

Technique for defining types of protection against meaningless anxiety. Existential psychotherapists help patients become more aware of their defenses against meaningless anxiety. First of all, this is connected with clarifying issues such as to what extent the desire for money, pleasure, power, recognition, status is rooted in their inability to confront the existential problem associated with meaninglessness. How serious is a person in general about life? Protection from meaninglessness can be one of the reasons that patients take life lightly, thereby creating problems that they consciously or subconsciously seek to avoid solving.

Technique to help patients become more involved in life consists in the fact that the psychotherapist proceeds from the assumption of the patient's innate desire to always participate in life. This technique may consist in the fact that psychotherapists invite patients to establish and maintain an authentic relationship during psychotherapy, which is already their significant contribution to the therapeutic process. Psychotherapists can explore a wide range of patients' hopes and goals, their belief systems, their ability to love, and their attempts to express themselves creatively.

Note that working with meaninglessness is different from working with other marginal grounds. In cases of death, freedom and isolation, the therapist organizes the process in such a way that the patient meets them face to face. However, when it comes to meaninglessness, the therapist helps to turn away from the question by deciding to be involved in life.

Existential psychotherapy, as defined by I. Yalom, is a dynamic therapeutic approach that focuses on the basic problems of the individual's existence. Like any other dynamic approach (Freudian, neo-Freudian), existential therapy is based on a dynamic model of the functioning of the psyche, according to which, at various levels of the psyche (consciousness and the unconscious), conflicting forces, thoughts and emotions are present in the individual, and behavior (both adaptive and psychopathological) represents are the result of their interaction. Such forces in the existential approach are considered confrontation of an individual with the ultimate given of existence: death, freedom, isolation and meaninglessness... It is assumed that a person's awareness of these ultimate given gives rise to suffering, fears and anxiety, which, in turn, triggers psychological defenses. Accordingly, it is customary to talk about four existential conflicts:

1. between the awareness of the inevitability of death and the desire to continue living;
2. between the awareness of your own freedom and the need to be responsible for your life;
3. between the awareness of one's own global loneliness and the desire to be part of a larger whole;
4. between the need for a certain structure, the meaning of life and the awareness of indifference (indifference) of the Universe, which does not offer specific meanings.

Every existential conflict is alarming. Moreover, anxiety can either remain normal, or develop into neurotic. Let us illustrate this point with the example of anxiety arising from human existential vulnerability to death. Anxiety is considered normal if people use the existential threat of death to their advantage, as a learning experience, and continue to develop. Especially striking are the cases when, having learned about a fatal disease, a person begins to live his life more meaningfully, productively and creatively. Psychological defenses are evidence of neurotic anxiety. So, for example, a terminally ill person experiencing neurotic anxiety may unnecessarily risk his life by displaying manic heroism. Neurotic anxiety also involves suppression and is destructive rather than constructive. It should be noted that existential counselors, working with anxiety, do not try to remove it altogether, but seek to reduce it to a comfortable level and then use the existing anxiety to increase the client's awareness and vitality.

First existential conflict - this is a conflict between the fear of non-being and the desire to be: the awareness of the inevitability of death and the desire to continue living. The counselor's task in resolving the first existential conflict is to lead the client to such a deeper awareness of death that would lead to a higher appreciation of life, would open prospects for personal growth and would enable him to live an authentic life.

The word "existence" ("existence") comes from lat. existere - to stand out, to appear. According to R. May's definition, being means potency, a source of potential and implies that someone is in the process of transforming into something. The feeling of "being in the world" in people is associated with all the experience of their existence (conscious and unconscious) and is presented in three interrelated forms:

1. "Inner world", eigenwelt - a unique individual world of each person, which determines the development of self-awareness and self-awareness, forms their own attitude to things and people, and also underlies the comprehension of the meaning of life.
2. "Joint world", mitwelt - the social world, the world of communication and relationships. The picture of being in a "shared world" is made up of communication and mutual influence of people on each other. The significance of a relationship with another person depends on the attitude towards him (on how valuable, important, attractive he is to a partner). Likewise, the degree to which people are involved in the life of the group determines how important these groups are to them.
3. "Outside world", umwelt - the natural world (laws of nature and environment). The natural world includes biological needs, aspirations, daily instincts and life cycles of the body and is perceived as real.

The polarity of being is non-being, nothing, emptiness. The most obvious form of non-being is death. However, a feeling of emptiness is also caused by a decrease in life potential due to anxiety and conformism, as well as a lack of clear self-awareness. In addition, being can be threatened by destructive hostility and physical illness.

The fear of death is of great importance in the inner experience of a person, and the attitude towards death affects his life and psychological development. I. Yalom put forward two theses, each of which is of fundamental importance for existential psychotherapeutic and counseling practice:

1. Life and death are interdependent; they exist simultaneously, not sequentially; death, continuously penetrating the limits of life, has a tremendous impact on our experience and behavior.
2. Death is the primary source of anxiety and thus is of fundamental importance as a cause of psychopathology.

Awareness of death can serve as a positive impulse, the strongest catalyst for serious life changes. However, the realization of death is always painful and alarming, so people tend to erect various psychological defenses. Already young children, in order to isolate themselves from the anxiety of death, develop defense mechanisms based on denial. They either believe that death is temporary (it only suspends life or is like a dream); either deeply convinced of their individual invulnerability and the existence of a magical savior; or believe that children do not die. Most children between the ages of 5 and 9 years old deny death by personifying it in terrifying images that present an external danger and which can be influenced (delayed, propitiated, outwitted, defeated). Older children (9-10 years old) make fun of death, and thus try to reduce their fear of death. In adolescents, denial and protection from the fear of death is manifested in exploits of recklessness, and in some cases in thoughts of suicide or delinquent behavior. Modern adolescents counter this fear with their virtual personality, playing computer games and feeling themselves the masters of death.

Existential counseling of children and adolescents on life and death issues is a separate and rather complex topic. Such counseling is focused primarily on reconciling children and adolescents with the inevitability of death. A successful find, in our opinion, is the creation of special therapeutic fairy tales, stories and metaphors that help little clients to cope with the fear of death and begin to function normally.

Over the years, adolescent fear has been pushed aside by the two main tasks of young adults - building a career and starting a family. Further, in the so-called middle age, the fear of death returns and takes possession of people with renewed vigor and never leaves them. It is not easy to live, constantly aware of your own mortality, to live numb with horror is impossible, so people come up with ways to mitigate the fear of death. I. Yalom identified two main mechanisms of protection against anxiety associated with death in adults:

1. Belief in your exclusivity, your own immortality and integrity... In a "revised" form, these protections are manifested in various forms clinical phenomena:

• manic heroism. An example is a terminally ill person who compulsively seeks external danger in order to escape the greater danger coming from within;
• workaholism. For workaholics, time is the enemy, not only because it is akin to mortality, but also because it threatens to blow up one of the pillars of the illusion of exclusivity: belief in eternal ascent. They are involved in a fierce struggle with time and behave as if imminent death was approaching them, and they would have time to do as much as possible;
• narcissism, narcissism. Severe Narcissistic Character Disorder is always accompanied by interpersonal problems. Unconditional love and total acceptance are expected from those around them, while indifference, indifference and a demonstration of superiority are provided in return. Without going into a detailed description of the narcissistic personality, we only note that such clients seem to want to stop time and forever remain in infancy under the magical parental protection.
• aggression and control. Some evidence of deep unconscious fears of death can be found in the choice of professions associated with death (military, doctor, priest, undertaker, killer). With the feeling of possession of power and the expansion of the sphere of control, only conscious fears are weakened, while the deeper ones continue to operate.

2. Belief in a savior, a personal protector who will come to the rescue at the last moment. Such saviors can be not only people (parent, spouse, famous doctor, folk healer, medicine man or leader), but also, for example, any high cause. This defense mechanism assumes that a person overcomes the fear of death, bringing his freedom and life itself to the altar of some higher figure or personified idea. He creates in his imagination "a kind of god-like figure, so that he could then bask in the rays of illusory security emanating from his own creation." People with hypertrophied faith in the ultimate savior are characterized by: self-belittling / devaluation of oneself, fear of losing love, passivity, dependence, self-sacrifice, rejection of their adulthood, depression after the collapse of the system of ideas. Any of these options, when emphasized, can result in a certain clinical syndrome. In the case of a predominance of self-sacrifice, the patient can be characterized as "masochistic". Of course, in an effort to isolate themselves from the anxiety of death, people use not one, but many intertwined defenses.

Self-disclosure consultant can be carried out in various forms:

• telling the client about his own attempts to come to terms with extreme existential worries;
• communicating to the client the thoughts and feelings that the consultant experiences "here and now" about the client's problems;
• "Permission to endure" - the client is informed that the topic of death, a typical and encouraged, necessary topic in the relationship of a psychologist with a client.

Let us illustrate the psychologist's version of self-disclosure with a small example from the transcript of the consultation of a 5-year-old boy who survived the death of his mother:

I remember a neighbor's boy at the end of winter brought me a cage with a bird. It was a bullfinch. “Bullfinches love the cold, because their tummies are bright red, like the cheeks of children who walk in the cold,” the young man explained and gave me a bird. I was happy, the most beautiful bird in the world lived in my house.
The winter is over, the spring has passed, the hot summer has come. Once, returning home from a walk, I saw that the door in the cage was open, but inside it was empty.
- Where is the bullfinch? - I asked my mother.
“He’s no more,” my mother said sadly, “he is very hot in the summer, he could get sick, so I let him go.
That same night I had a dream that early in the morning someone was knocking on my window. I come closer and see my bullfinch. I carefully open the window, gently take it in my hands and gently, embracing it with two palms, carry it to the cage ...
And at that moment I wake up, gently squeezing the corner of the pillow between my palms. Instead of a bullfinch, there is a corner of a pillow in your hands! My grief knew no bounds. Tears did not fall, they flowed in a stream.
- What's happened? Mom asked softly.
I told her my dream, and then my mother told me the truth:
- The bullfinch died, and his soul flew high into the sky, where it is cool ... It's good there ... And we will remember the bird and enjoy life.
She said and cried. We sat for a long time hugging each other, and each cried about something different.

Identification of psychological defense mechanisms. Information about the mechanisms of psychological defense that he uses is made explicit for the client. At the same time, they help him in realizing their naivety.

Working with reminders of the fragility (frailty) of existence. The consultant can use any ordinary event (or tactfully provoke a situation) to help attune the client to the signs of death:

• discussion of birthdays and anniversaries;
• paying attention to everyday signs of aging: loss of stamina, age-related plaques on the skin, decreased joint mobility, wrinkles, etc.;
• looking at old photographs and finding outward resemblance to parents at an age when they were already perceived as old people;
• discussion of disturbing television shows, movies, books;
• careful monitoring of disturbing dreams and fantasies of death.

An example of the analysis of a disturbing dream is the following case from the practice of online counseling.

Client's letter:

My husband and son and I are in a car outside the city. A cell phone call and I am informed that my father is dead. I'm at a loss - he died 4.5 years ago! They say to me: “There was a mistake, but now it’s for sure” ...
We return to the city, and I keep thinking, how could this be a mistake? We arrive, an unfamiliar room, a large table in the middle of the room - people are sitting around the table and talking quietly. No tears, it seems everyone is also at a loss. We sit down too.
An unfamiliar tall, thin man in a black long coat comes in and sits on a chair behind my left shoulder, I turn and invite him to sit at the table, he refuses.
Then someone says out loud: "Maybe what needs to be conveyed there?" And everyone turns to this man. He replies: "No, nothing is needed, only you can hand over a spoon."
A spoon is passed around in a circle, it reaches me, and I see that it is a spoon from our dacha, aluminum, so noticeable. I give it to the man, and he leaves.
Then we go, sort of like to the hospital. For some reason, a village, a wooden house with a covered courtyard, the gates are closed. There is a dirt road in front of the house, as is usual in our villages. We are standing on the opposite side of the road from the house. And that stranger in a black coat is right there.
Suddenly the door at the gate opens, and there is my father. I run to him, at that moment I forget that he really died a long time ago. I am overwhelmed only with the joy that I see him, that then for a long time it really turned out to be a mistake. I'm running, but I just can't cross this road ...
Father smiles, raises his hand and waves at me (waves like that from side to side). And then the doorway begins to flood light, bright, white, and this light simply absorbs the father. Doors are closing. I turn around and try to talk to people, and they ignore me. And I understand that no one saw anything except me.
I wake up. I had no fear either during sleep or later when I woke up. And now the actual question. We are going to go to this dacha next Saturday for the last time this year, to close the season, so to speak. Do I need to bring this unfortunate spoon and take it to my father's grave? Or is this the simplest explanation of everything and the spoon has nothing to do with it at all? "

The psychologist's hypotheses expressed in the response letter:

1. "Life-death". Everything has its time! The unconscious, perhaps, says that you should not die prematurely. A) The man in black who stands behind his left shoulder (Angel of Death) does not sit at a common table with the living. B) He disappears, having received what he came for. And he came, mind you, not for a soul, but with a spoon. C) And again appears to prevent people from crossing the road in the village that separates the world of the living and the dead.
2. "Echoes" of experiences. In dreams, sometimes funny substitutions occur, when new (not yet conscious) experiences are replaced by understandable ones, already experienced sometime. For example, the death of a father can symbolize the onset of winter, since nature "dies" during this period. A second goodbye is another end of the summer cottage season. "To give away the spoon" can mean "to be left without what is used in the process of eating", in this case - gifts from the suburban area.
3. Feelings of guilt (most likely in front of the father). It can be expressed in the struggle between conscious and unconscious messages. Conscious attitudes impose this very feeling of guilt (for example, we rarely go to the cemetery or did not erect a monument). Unconscious experiences, on the other hand, protect mental health (a father who smiles in his sleep and disappears into white light).

Client's reply letter:

... with the first version of the interpretation of my dream, you directly hit my thoughts. Recently, the thought of suicide has simply stuck in my head, and very firmly. Everything is thought out very thoroughly, to the smallest detail. A method was chosen that causes a minimum of anxiety to loved ones. Morally matured completely. Some last drop was missing to explain this decision for others. After all, not many people understand that Bulgakov is right that the only way to know freedom is death. This last drop does not drip, but urgent matters roll in constantly. Well, I think, okay, this issue must be resolved, and then - freedom!
And now ... now I realized that this last drop, apparently, is not just so delayed ... apparently, it is not yet time for freedom ... something else, probably, needs to be done in this life ... There are no irreplaceable , this is 100%, but apparently there is something that will be more difficult for others instead of me to do ...
Now I’m thinking. I believe in the connection of the worlds and believe that the body is a temporary guise, given for some deeds, for the achievement of some goals. But which ones? So a philosophical question about the meaning of life has surfaced. So, WE WILL LIVE!

• Using specific structured exercises to deepen the awareness of mortality. Structured exercises can be classified as "existential shock therapy" and therefore their use assumes that the psychologist himself is not afraid of the topic of death.

Exercise "Segment of my life"

A client with anxiety, fatigue, or irritation is encouraged to: “Draw a line on a blank sheet of paper. One end represents your birth, the other represents your death. Place a cross where you are now. Think about this for about five minutes. "

Funeral Exercise

The client is asked to close his eyes and immerse himself in himself. Further, any relaxation technique is used that allows the client to enter a trance state. The counselor then helps the client to go through their own funeral.

The exercise is especially effective with clients who have experienced the death of loved ones. It allows the client to fantasize about their own death and helps to approach a deeper awareness of death, which, in turn, leads to a higher appreciation of life and opens up opportunities for personal growth.

Exercise "Challenge"

The group is divided into threes and is instructed to talk. The names of the group members are written on separate sheets of paper; the leaves are placed in a vessel, then they are blindly taken out one at a time and the names written on them are called out. The one whose name is called interrupts the conversation and turns his back on the others.

Many participants report that as a result of this exercise, their awareness of the randomness and fragility of existence has increased.

Exercise "Life Cycles"

The group experience of the “life cycle” experience helps participants focus on the core issues of each stage of life. In the period of time devoted to old age and death, they are invited to live the life of old people for whole days: to walk and dress like old people, powder their hair and try to play specific old people they know well; visit a local cemetery; walk alone in the city / forest, imagining how they lose consciousness, die, how they are discovered by friends and how they are buried.

• Encouraging the client to communicate with terminally ill people and observe their behavior.
• Encouraging the client to have stricter control over those aspects of life that he can influence.

Second existential conflict - this is a conflict between the awareness of freedom and the need to be responsible for your life. Respectively, the task of the consultant in resolving the second existential conflict is to help the client to realize personal freedom and to encourage him to take responsibility for his feelings, thoughts, decisions, actions, life.

Let us begin our presentation of the material on the resolution of the second existential conflict with an example. In September 2011, on one of the central TV channels of Ukraine, the second season of the program "From tomboy to ladyboy" began. The essence of the project is to reeducate deviant women (alcoholics, prostitutes, sociopaths, etc.) and turn them into real ladies. Each of the future participants during the casting not only declared, but also openly demonstrated that she does only what she wants, and for her there is no concept of “should”. In other words, each participant in the show stated her personal freedom - freedom, which, unfortunately, she used not for personal growth, but turned to her own detriment.

Let's explain the life situation of the project participants from the standpoint of existential psychotherapy. The twentieth century is known to have been characterized by the destruction of traditional belief systems, religions, rituals and rules; the rapid decay of structures and values; upbringing, in which a lot was allowed. A new generation of people has grown up, for whom the accent from “should” was shifted to “want”. Many people have learned to desire, but have failed to learn how to desire, how to exercise will, how to make decisions and be responsible for those decisions. The test of freedom turned out to be too much of a burden for modern people and, accordingly, caused anxiety, to overcome which people again and again found psychological protection. Participants of the TV show "From the tomboy to the lady" came a shining example of how people find destructive ways to protect themselves from responsibility for their lives.

The following are psychological defenses and evasions in situations where freedom concerns are relevant to clients:

• Compulsiveness as a kind of obsession with a force alien to the Ego (“not I”), which dominates a person, eliminates his personal choice and deprives him of his own freedom.
• Transfer of responsibility on other people, including consultants, or external circumstances.
• Denial of responsibility by portraying oneself as an innocent victim or by losing control (temporarily entering an irrational state of "out of my mind").
• Evasion of autonomous behavior.
• Pathological expression of desires, manifestation of will and decision-making.

The word "responsibility" has many meanings. For existential consultants, it means, first of all, the authorship of their “I”, their destiny, their feelings and actions, as well as their life troubles and sufferings. And as the outstanding French existentialist J.P. Sartre noted, no real therapy is possible for a patient who does not accept such responsibility and stubbornly blames others - people or forces - for his dysphoria. Moreover, existential counselors explain to their clients that people are completely responsible not only for their actions, but also for their inability to act; not only for what they do, but also for what they choose to ignore.

Based on the foregoing, the position of the psychologist and general principle psychological assistance to people who protect themselves from the anxiety associated with taking responsibility. The consultant should always act on the understanding that the client himself created his own trouble, and, accordingly, in response to the client's complaints about his life situation, ask how he created this situation.

Existential psychotechnics in the context of this issue includes:

• Identification of psychological defenses and ways of evading responsibility. The essence of psychological defenses is explained to the client and he is put “face to face” with responsibility for his own actions. For example, if a client asked for help in connection with feelings of isolation and loneliness, and in the course of the consultation himself demonstrates his superiority, contempt or disdain for others, then the counselor can always comment on such attacks with the remark: "And you are alone." Or, for example, if a client complains about the hardships of city life, the consultant may confront him with freedom of choice: "Why don't you move to live in a village?"

Existential counselors have borrowed a lot from gestalt therapists in their work to identify ways of evading responsibility, in particular, focusing on the client's speech. For example, instead of "it happened" the client is asked to say "I did it"; instead of "I can not" - "I do not want." Developing the theme of the client taking responsibility for every word, every gesture, feeling, thought, existential consultants actively use other gestalt games, including:

Exercise "I take responsibility"

The client is invited to add to each statement: "... and I take responsibility for this." For example: "I am aware that I am moving my leg ... and I take responsibility for that." "My voice is very quiet ... and I take responsibility for that." "Now I don't know what to say ... and I take responsibility for not knowing."

Exercise "Conversation with internal symptoms"

The client is encouraged to be attentive to the inner sensations and to take responsibility for both himself and the symptoms of the body.

This exercise will be illustrated by the following example from the practice of F. Perls. The patient was faced with a painful dilemma and, while discussing it, he felt a lump in his stomach, Perls invited him to talk with this lump: “Place the lump on another chair and talk to him. You will fulfill your role and the role of the coma. Give him a voice. What does he tell you? " Thus, the client is invited to take responsibility for both sides of the conflict, so that he realizes that nothing "happens" to us by itself, that we are the authors of everything: every gesture, every movement, every thought.

The identification of the here and now avoidance of responsibility. Depending on the situation, the consultant either exposes the client's attempts to involve himself in scenario games; or prevents the client from assuming responsibility for what happens during or outside the counseling session.

Facing realistic constraints. The consultant helps the client to realize that not all life events are subject to the will and desires of a person, there are circumstances that the client cannot influence, but can only change his attitude towards them. In the practice of existential counseling, the exercise "Classifying Events" can be useful.

Classifying Events Exercise

The client is invited to write on separate cards all the events that led to the occurrence of his problem. Then the consultant asks him to divide these cards into three groups: 1) events that I cannot influence; 2) events that I can partially influence; 3) events that I can influence. Then each group, each event is discussed.

After that, the client is told that in reality the second group does not exist in life, and it is proposed to distribute the cards of the second group between the other two. The client is asked to explain his decision.

Further, the consultant helps the client:
- to change the attitude towards those events that cannot be influenced (it is possible to use the ABC-emotion method from rational-emotive therapy);
- take more responsibility for the circumstances that can be influenced.

• Confronting existential guilt. Psychologists consider one of the functions of anxiety to call to conscience. Such anxiety is fueled, among other things, by feelings of guilt due to failure to realize potential. For example, real mistakes (when the person objectively did something “wrong” in relation to the deceased or, on the contrary, did not do something important for him) can serve as a source of existential guilt of a client whose loved one has died. In this case psychological help in working with existential guilt, it consists in promoting the sufferer's awareness of the significance of guilt, changing attitudes towards it, and extracting a positive experience from it. In order to consolidate the result, it is possible to suggest keeping a “Diary of guilt”.

Guilt diary

To be fair, we will say that in existential psychotechnics, however, as in many other areas of psychotherapy (for example, gestalt therapy, implosive therapy, bioenergetics, psychodrama), consultants work more with the client's inability to feel, considering it the origin of his inability to desire. I. Yalom noted that psychotherapy of clients with blocked “feeling” is slow and laborious, and the consultant must be persistent, repeatedly asking the client the question: “What do you feel?”; "What do you want?"

• Facilitation of decision making. If the client fully feels the desire, he has to make a decision, make a choice. Decision is the bridge between desire and action. At the same time, existential consultants often encounter a situation where clients block decision-making, getting stuck in “What if…” doubts.

In such cases, psychologists help clients explore the ramifications of each “what if…” question and analyze the feelings that arise. If necessary, consultants can assist clients in developing a solution and assessing options. However, it is important that the client feels his own strength and resources.

Third existential conflict is a conflict between the awareness of one's own global loneliness (isolation) and the desire to establish contacts, seek protection and exist as part of a larger whole. The counselor's job in resolving the existential conflict associated with the feeling of isolation is to help the client get out of the state of interpersonal fusion and learn to interact with others, while maintaining and cultivating their own individuality.

I would like to immediately note that the topic of isolation, in contrast to the topic of death and freedom, often comes up in everyday therapy and different approaches are used to resolve it. Existential counselors distinguish three types of isolation: interpersonal, intrapersonal, and existential.

Interpersonal isolation, usually experienced as loneliness, is isolation from other individuals. It can be caused by many factors: geographic isolation, lack of appropriate social skills, conflicting feelings about intimacy, the presence of psychopathology, personal choice or necessity.

Intrapersonal isolation is the process by which a person separates from each other parts of himself or does not recognize any of his parts. This isolation occurs when a person chokes own feelings or aspirations, accepts "need" and "follows" his own desires, does not trust his own judgments, or blocks his own potential from himself. Intrapersonal isolation implies pathology by definition.

Existential isolation is a fundamental form of isolation, namely "separation between the individual and the world." At the heart of existential isolation is confrontation with death and freedom. It is the knowledge about “my death” and the authorship of “my life” that makes a person fully realize that no one can die with someone or instead of someone, and means giving up the belief that there is someone else who creates and protects you. It is also important that existential isolation, which causes a strong anxiety in a person, is capable of disguising and is often kept within tolerable limits, for example, through interpersonal attachment.

Psychological defenses against isolation anxiety include:

• Manipulation other people to protect themselves and use others for self-affirmation.
• Merging with another a person, with a group or business, with nature or with the universe. Fusion as a response to existential isolation provides a framework by which to understand many clinical syndromes (addiction, masochism, sadism, sexual disorders, etc.) For example, a masochistic person is ready to sacrifice himself, endure pain, moreover, enjoy it because pain destroys loneliness.
• Compulsive sexuality... Sexually compulsive people treat their partners more like objects than people. It doesn't take them time to get close to anyone.

Existential psychotechnics in situations of isolation anxiety includes:

• Identification of psychological defenses and interpersonal pathology... The counselor helps the client recognize and understand what they are doing with other people to cope with their fear of loneliness. A definite marker of the client's interpersonal pathology can be the ideal of a need-free relationship. For example, does the client enter into a relationship exclusively with those who can be useful to him? Is his love related to receiving rather than giving? Is he trying, in the fullest sense, to recognize the other person? Is he holding himself partially out of the relationship? Does he really hear the other person? Is using the other to build a relationship with someone else? Does he care about the growth of the other?
• Customer clash with isolation can happen in different ways, for example, to him:
  - it is proposed to experience isolation (for a while, cut yourself off from the outside world and be alone) in doses and with a support system suitable for this person. As a rule, after such an experiment, the client becomes more aware of both the fear of loneliness and his courage and hidden resources.
  - it is recommended to master the practice of meditation as a way that allows a person in a state of reduced general anxiety (that is, in an anxiety-reducing state of muscle relaxation, a certain posture and breathing, clearing the mind) to meet and overcome anxiety associated with isolation.

In our practice, work with aphorisms about loneliness is often used. The client is invited to blindly draw out a card with an aphorism and reflect on what he has read.

• Positive client-consultant relationship... Existential counselors are of the opinion that meeting with a psychologist is beneficial for the client and that the personal relationship between counselor and client is just as important as cognitive merit. According to I. Yalom, an effective consultant:

• responds to its customers in a sincere manner;
• establishes a relationship that the patient feels safe and accepting;
• shows warmth and a high degree of empathy;
• able to “be with” the client and “grasp the meaning” of the client.

Moreover, it is important to note that in this context we are not talking about advisory "techniques" of empathy, sincerity, non-judgmental attitude, etc. We are talking about real relationships that imply genuine concern for the client and contribute to his personal growth.

Summing up, we would like to emphasize that a positive client-consultant relationship helps the client:

• identify interpersonal pathology that can interfere with maintaining relationships now and in the future. Clients often misrepresent some aspects of their relationship with consultants. Counselors can raise clients' awareness of such distortions, in particular by raising awareness of the impact of distortions on relationships with others;
• find out the boundaries of the relationship. The client learns what he can get from others, but also, and this is much more important, what he cannot get from others.
• assert yourself, as it is extremely important for clients that someone whom they respect and who really knows all their strengths and weaknesses accepts them;
• resist existential isolation;
• understand that only they themselves are responsible for their lives.

Fourth existential conflict - this is a conflict between the need of people in the sense of life and the lack of "ready-made" recipes for meaningful life. The realization that the world does not exist in order to determine (systematize, order) the life of an individual, or even completely indifferent to a person, causes strong anxiety and activates defense mechanisms.

According to existential consultants, it is important for a person to feel the meaning of life, be it cosmic or earthly. The cosmic meaning implies a certain design that exists outside and above the personality and necessarily presupposes some kind of magical or spiritual ordering of the universe. The earthly meaning or “the meaning of my life” includes a goal: a person who has a sense of meaning perceives life as having some purpose or function that needs to be performed, some leading task or tasks for applying himself. (The terms meaning and purpose are used interchangeably in existential counseling.)

It is assumed that a person who has a sense of cosmic meaning also experiences a corresponding sensation of earthly meaning, that is, his personal meaning consists in the embodiment of the cosmic meaning or harmonization with it. For example, if a deeply religious Christian is sure that human life is part of a divinely predetermined plan, then, accordingly, the meaning of his life is to understand and fulfill God's will. If the idea that human life should be devoted to the goal of imitating God as perfection is emphasized on the cosmic meaning, then the goal of life is striving for perfection.

Of course, people are extremely comforted by the belief in the existence of some higher holistic plane in which each individual plays his own special role. However, due to the weakening of the influence of religious beliefs, modern people are increasingly faced with the need to find a secular personal meaning in life. Existential counselors believe that such meanings can be self-transcending (altruism, dedication, creativity), hedonistic decision and self-actualization.

Self-transcending is associated with a person's deep desire to transcend himself and to strive for something or someone outside or “above” himself, while hedonism and self-actualization express concern for his own “I”. And although each of these meanings fills a person with a sense of the fullness of life, V. Frankl believed that excessive preoccupation with self-expression and self-actualization comes into conflict with the true meaning of life. The same idea was supported by A. Maslow, who believed that a fully actualized personality is not too busy with self-expression. In his opinion, such a person has a strong sense of self and cares for others rather than using them as a means of self-expression or to fill a personal void.

Earlier it was said that the loss of meaning causes strong anxiety and activates defense mechanisms. V. Frankl distinguished two stages of the syndrome of meaninglessness - existential vacuum (existential frustration) and existential (noogenic) neurosis. The existential vacuum manifests itself in a number of interrelated phenomena: the experience of emptiness, the prevailing feeling of boredom, dissatisfaction with life, negative emotional background, lack of clear ideas about the direction of one's own life and rejection of the goals and meanings of other people.

Existential neurosis is characterized by the occurrence of nonspecific clinical symptoms and manifests itself in the forms of depression, obsession, deviant behavior, hypertrophied sexuality or recklessness, in all these cases combined with a blocked will to meaning. Other nonspecific consequences of existential frustration include such manifestations of maladjustment as neuroses, suicides, alcohol and drug addiction.

Psychological defenses against meaningless anxiety have a common feature- immersion in activities that distract from the comprehension of life:

• Compulsive activity characterized by manic persistence in any activity. For example, in getting pleasure, making money, gaining power, recognition, status;
• Cruzading(ideological adventurism) is characterized by a strong tendency to seek out spectacular and important enterprises for oneself, in order to dive into them later. For example, “professional demonstrators” who grab any excuse to “take to the streets”, almost regardless of the content of the speech.
• Nihilism characterized by a belief in the absence of meaning and activity aimed at devaluing or discrediting activities that make sense for others, for example, to love or service.

It is important to note that psychological support for clients experiencing anxiety associated with a lack of life meaning is fundamentally different from the therapeutic strategies proposed for dealing with other end-factors. In his work "Existential psychotherapy" I. Yalom emphasizes that "death, freedom and isolation must be met directly. However, when it comes to meaninglessness, an effective therapist must help the client.<…>make the decision to engage rather than dive into the problem of meaninglessness. " Thus, the counselor's task in resolving the existential conflict associated with a sense of meaninglessness is to help the client more actively engage in life and help overcome / remove obstacles along the way.

The main existential psychotechnics in situations of anxiety associated with a sense of loss / lack of meaning in life include:

• Identification of psychological defenses... The counselor helps the client to become more aware of the protections they use against meaningless anxiety and the consequences and costs of protecting them.
• Overriding the problem... The essence of this existential technique is to help the client realize: a) that there is no “ready-made” meaning in life that could be found; b) that people are responsible for creating their own meaning. Let us highlight several ways to refocus the problem in this way:

• the psychologist increases the client's sensitivity to the role of meaning in life and helps to identify and evaluate the “best” parts of the client's personality. For this, the consultant is explicitly and implicitly interested in the client's views, deeply studies his love for another person, asks about long-term hopes and goals, explores creative interests and aspirations;
• the psychologist helps the client to look away from himself and turn his attention to other people. (This technique was proposed by V. Frankl and is called "dereflection").
• the psychologist helps to rethink the tragic events of the client's life in the context of new meanings, lessons, achievements, etc. Let us illustrate this method with an example from the practice of V. Frankl.

Frankl was approached by an elderly general practitioner who had been depressed since losing his wife two years ago. Frankl asked him: "What would happen, doctor, if you died first, and your wife would have to outlive you?" "Oh," he said, it would be terrible for her, how she would suffer! " Then Frankl responded: "You see, doctor, she escaped this suffering, and it was you who delivered her from them, but you have to pay for it by being experienced and mourning her." The doctor did not answer a word, shook Frankl's hand and calmly left his office.

• the psychologist helps the client to "program" the meaning by expanding consciousness (more complete coverage of the details and events of life) and stimulating the creative imagination.

• Providing assistance to the client in his more active participation in life. The psychologist helps the client to explore areas and find forms of "involvement" in life. In our opinion, one of the ways to stimulate the client's vital activity is the use of therapeutic metaphors, both with indirect and direct impact. Here are two examples from R. Tkach's book "The Use of Metaphor in Grief Therapy."

Metaphor with indirect impact as an example of a consultant's self-disclosure.

… I dream that I am standing in the middle of a fenced-in plot of land.
- What is this land? And why am I here? - I ask an unknown person.
“This is your dacha,” a benevolent voice says.
- But here there are only weeds and thorns - either I am indignant, or I am horrified in response.
- It's not scary. Thorns and weeds can be dealt with, you just have to pull them out, ”my voice gently soothes me.
“But there’s nothing here. Absolute Emptiness! - I continue to argue.
- That's good. Any Emptiness ceases to be empty if it is filled with something, - the voice teaches me.
- And what can you fill it with? I ask sincerely.
- This is your Emptiness, fill it with whatever you want! - a goodbye voice admonishes me.
And I begin to fill the Void. First, I pull out weeds and thorns. Then I plant fruit trees, bushes and flowers along the fence. Then I start building the house. I have been working tirelessly for several months, maybe more. I work with great enthusiasm and faith in my soul that EVERYTHING will work out for me ...
By the morning my house is ready. I make a path to him ... and with the words: "This is the Road to a NEW LIFE!" - I wake up to meet a new day.

Metaphor with direct impact as an example of the simultaneous use of existential, positive and behavioral therapy techniques.

Quite often, in order to help the client organize his life, determine plans for the future and how to implement them, I tell the parable "Your cross":

“There was only one person in the world, and he carried a cross on his shoulders. It seemed to him that his cross was very heavy, uncomfortable and ugly. Therefore, he often raised his eyes to the sky and prayed: “Lord! Change my cross. "
And then one day the heavens opened, a staircase came down to him and he heard: "Come up, let's talk." The man picked up his cross and began to climb the stairs. When he finally reached heaven, he turned to the Lord with a request:
“Let me change my cross.
“Okay,” the Lord replied, go to the vault and choose whichever you like.
A man entered the storehouse, looked and was surprised that there were no crosses here: small, and large, and medium, and heavy, and light, and beautiful, and ordinary. For a long time the man walked through the storehouse, looking for the smallest, lightest and most beautiful cross, and finally he found it. He went up to the Lord and said: "God, can I take this one?"
The Lord smiled back and said: “You can. This is your life. You chose the cross with which you came to me. "

Then, after a therapeutic pause, I ask: "What is the moral of this parable?" Having listened carefully to the answer, and, if necessary, directing it towards healthy adaptation, I invite the client to imagine that he is a character in a parable.

Then, on a white sheet of paper, from the lower left corner to the center up, I draw a staircase with 5-6 steps and ask the client to write down above each step his thoughts about how he lived after the death of a loved one until today.

Then at the top of the stairs I draw a large square (or circle) and ask the client to make a wish and write down in it a wish, how he would like to live on: “Now imagine that you can make any wish and it will definitely come true. There can be only one desire, but the most important thing for you. Write it down in this square. "

Next, I draw 5-6 steps down (from the center to the lower right corner) and tell the client something like this: “Imagine that you have already received a blessing to fulfill your desire. And now, in order for your dream to come true, you need to make some effort. Write above the steps on the right what you need to do to make your dream come true. "

The work ends with the fact that I ask the client where he would like to start on the path to realizing his dream, how he imagines it, and what he will do in the near future (this week, tomorrow, today).

Bibliography

1. Bujenthal J. The Science of Being Alive: Dialogues Between Therapist and Patients in Humanistic Therapy. - M .: Independent firm "Class", 1998.
2. Leontiev D.A. Psychology of meaning. - M .: Meaning, 1999.
3. Maslow A. New frontiers of human nature. M .: Smysl, 1999.
4. Mєi R. Existential psychology. - M .: April Press, EKSMO-Press, 2001.
5. Tkach R. M. Fairytale therapy of children's problems. - SPb .: Rech, 2008.
6. Tkach R.M.Use of metaphor in the therapy of grief. - К .: University "Ukraine", 2011.
7. Frankl V. Psychotherapy and existentialism.
8. Frankl V. Man in Search of Meaning. Moscow: Progress, 1990.
9. Yalom I. Peering into the sun. Life without fear of death. - M .: Eksmo, 2009.
10. Yalom I. Existential psychotherapy. - M .: Rimis, 2008.

Tkach R.M. ,

Chapter from the textbook "Counseling Psychology".

Material prepared by: Katerina Zykova, psychologist.

Existential psychotherapy: everything burns, but you can be with it

Existential psychotherapy(English existential therapy) is a direction in psychotherapy, which aims to bring the patient to a comprehension of his life, awareness of his life values ​​and change his life path based on these values, with the acceptance of full responsibility for his choice.

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Existential philosophy

XX century, after wars and related social and spiritual crises, it became not very clear how to live. The support diminished: positivism did not lead to a reasonable and wonderful life, "God is dead", saving authorities and values ​​did not work. The time has come to make decisions and make a choice: "the meaning of life does not exist, I will have to create it myself" (J.P. Sartre). Between the two world wars, a school of existential philosophy began to take shape, emerging on "Sunday afternoon in 1834, when a young Dane was sitting in a cafe, smoking a cigar and thinking that he was in danger of growing old without leaving a trace in this world." Cigar lover - Søren Kierkegaard, the founder of existential philosophy, still left a mark on the world.

Existentialists (well-known and influential representatives who developed Kierkegaard's ideas: M. Heidegger, J.P. Sartre, K. Jaspers, M. Buber, etc.) consider a person as a unique being, free (even "condemned to be free"), turned into a future capable of choosing his own destiny and "true" life (Martin Heidegger distinguishes two modes of existence: genuine and inauthentic. A truly person lives in harmony with himself, and not generally accepted norms; alone, meeting with the uncertainty and absurdity of life, the inevitability of death).

The death of "God" (in Nietzsche - "God is dead", in Dostoevsky - "if there is no God, then everything is permitted") - one of the key points of existentialism. By "god" is meant, in principle, any value system capable of providing support in life (religion, ideology, etc.). In Sartre: "If I have eliminated the god-father, then someone must invent values ​​... value is nothing more than the meaning you choose." There is no "God", everyone chooses how to live (by the way, not choosing is also a choice). Thus, a person is "the totality of his actions", decisions taken.

Existential psychotherapy

Existential philosophy is the main source of the emergence of existential psychotherapy. The first to combine existential philosophy and psychiatry was the Swiss psychiatrist Ludwig Binswanger, creating the concept of existential analysis. Then came a Dasein analysis by another Swiss psychiatrist, Medard Boss, a cross between psychoanalytic therapy and Heidegger's philosophy. Existential analysis (dasein analysis) as a direction of existential psychotherapy continues to develop to this day. Another interesting direction is Viktor Frankl's logotherapy. Frankl considers will and striving for meaning to be one of the leading human properties. There is meaning even in situations that seem hopeless, filled with suffering. The frustration of the will to meaning leads, according to Frankl, to problems, crises, neuroses.

Existential psychotherapy does not consider a person as a once frozen set of character traits, reactions, mechanisms of behavior, social roles, etc. Literally "existence" is translated as "becoming", "emergence". Likewise, a person - constantly changing, emerging, becoming - is determined by his "being-in-the-world" (in the translation from German Dasein - "here-being", "here-being", the philosophical concept of M. Heidegger) in the physical, social, psychological and spiritual dimensions.

During life, a person inevitably encounters universal given: being, loneliness, freedom, responsibility, meaning, meaninglessness, anxiety, time, death. The famous existential psychotherapist Irwin Yalom believed that four of these given are especially important for psychotherapy: "the inevitability of death of each of us and those we love; freedom to make our life what we want; our existential loneliness; and, finally, the absence of what - or an unconditional and self-evident meaning of life. "

If you think about it carefully, and then relive any of these given, you can experience a variety of feelings, including intense terror. The existential picture of the world resembles an anecdote: "Actually, life is very simple, son. It's just like riding a bicycle that burns, and you burn, and everything burns, and you are in hell." "We will all die", "life is pain", "there is no sense" and other expressions will successfully fit into an attempt at trolling by an existential psychotherapist (it is generally accepted to reproach them for pessimism). Although such a picture of the world does not look pessimistic, but rather realistic: yes, these realities exist, yes, the bike is on fire, everything is on fire, we will all die, but you can be with it. In the course of existential therapy, a person has a chance to find the courage and courage in himself to accept reality. Moreover, the existential picture of the world is capable of being optimistic: after all, despite the anxiety and fear about the uncertainty of the world and the lack of meaning, "the fate of a person rests in himself."

How it works

Existential therapist Rollo May said that existential psychotherapy does not differ sharply from other areas. And it does not look like a method, but rather like an addition, a superstructure, it addresses a deep level of our existence, with which other types of therapy simply do not work. Another famous existential psychotherapist, Irwin Yalom, writes that there is no existential psychotherapy. But there is a special attitude of the psychotherapist to life - and he can use it in his work.

Some weird psychotherapy school, huh? And where are theories, methods, concepts, techniques. This is the point: the existential school considers a person as a unique being, which means that there can be no single universal methods for solving problems that are suitable for everyone. Existential psychotherapy does not provide for the work on the principle of the medical model "made a diagnosis - wrote a prescription - cured".

For example, Irwin Yalom suggests inventing "your own kind of therapy for each client." This lack of clear set rules adds uncertainty to the existential psychotherapist (therefore, one of the important skills of the therapist is the ability to withstand this uncertainty). On the other hand, the existential therapist is less likely to become an "expert", to hide behind "authority" - thereby to move away from the real person, driving him into labels, frameworks and concepts. As Husserl said, "back to the things themselves": human behavior should be described unclouded, without preconditions.

An existential therapist should be extremely sensitive and attentive in the study of the life of another, in no case impose his own opinion, not look at the world of another through his ideas, projections, attitudes. For such a "pure" view in existential psychotherapy, a phenomenological approach is used - the therapist looks at the client's phenomena with the most impartial view, because in the world "there is no single space and only time, but there are as many times and spaces as there are subjects" (L. Binswanger) ...

The existential therapist is not only a soulless and impartial observer of the life of another. Sincerely, openly, he enters into a relationship with the client, looks for a way to be with him, and first of all explores the process of life of a particular person. It helps him to understand his capabilities and the limits of these possibilities, to accept paradoxes and contradictions - his own and the world: “an existential paradox is a person who seeks meaning and confidence in a world that has neither one nor the other” (I. Yalom). A person who does not repress reality, does not run away from it into self-deception / conformism / infantilism / consumer society, etc., has more chances to choose his own, and not someone else's, fate.

Everything is not as difficult as it seems

Existential psychotherapy may seem too abstruse - this is facilitated by the use of not always clear vocabulary from existential philosophy such as "dasein", "epoch", "existential"; too difficult - it seems that you simply cannot come to an existential therapist, only with a spiritualized face and questions about the eternal and the meaning of life. But this is not the case. "I hate my neighbor", "everything is fine, but I sleep badly", "how can I communicate with my wife / mother-in-law / boss", "I'm afraid to fly on airplanes", "sometimes I feel like something is missing", "I want to become more confident "- you can come with any request, because existential psychotherapy is about life as it is. She, according to Yalom, "is firmly rooted in the ontological foundation, in the deepest structures of human existence." Existential psychotherapy is attractive in that it questions the evaluative attitude towards a person in the categories of norm and pathology, "good" and "bad". She refers to the specific experience of the client's life, with all its paradoxes and experiences, explores its meaning in a practical aspect, supports a person in his aspiration to independently make a choice without focusing on external sources.

Not changing your life and leaving everything as it is is also a choice, this is normal. Existential psychotherapy does not at all strive for any obligatory externally measurable achievements of the client, changes in his life. There are even no guarantees that you will finally find the meaning of life (but there are no guarantees that you will not get it! Although in the existential paradigm this is generally an ambush: it is not the meaning acquired once and for all that is important, but its search, that is, the process of acquiring). A kind of "result" of existential psychotherapy can only be the feeling of life, for Bujenthal - "inner vital confidence in one's own being", the process of consciousness and experience of oneself, one's inner feeling - creative, complete, actualizing.

Bibliography:
1. "The Science of Being Alive" - ​​James F. T. Bujenthal;
2. "Existential psychotherapy" - Irwin D. Yalom;
3. "Existentialism is Humanism" - Jean-Paul Sartre;
4. "Basics of psychological counseling" - Rimantas Kociunas;
5. EA Abrosimova, article "Vulnerability of Existential Psychology";
6. D. Smirnov, article "Existential therapy: how the death of God helps to accept responsibility for one's life and why it is not a shame to be afraid";
7. "Fundamentals of Logotherapy" - Victor Frankl.

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Rollo May (Russian) - Existential psychotherapy

Basic concepts of existential psychotherapy

Open lecture "Existential approach in psychotherapy"

Humanistic and Existential Psychology Maslow, Rogers, Frankl

Bogdanova T.A. Existential psychotherapy, dream-coaching (10.11.2013) - 00130

Subtitles

Hello and welcome! My name is Jeffrey Mishlov. The topic today is existential psychology and in the studio of Dr. Rollo May. Dr. May is a founding sponsor of the Humanist Psychology Association and a true pioneer in the field of existential and clinical psychology. Most recently, he received the Distinguished Career in Psychology award from the American Psychological Association. He is the author of numerous classics including Courage to Create, Love and Will, The Meaning of Anxiety, Freedom and Destiny, and Psychology and the Human Dilemma. Welcome, Dr. May. Thank you. I'm very glad to see you here. Today you are known as a pioneer in establishing existential psychology as an independent discipline in the clinical realm. It is a discipline that, unlike most forms of clinical psychology, which is based on a medical model or a behavioral model, relies more on a philosophical model.You emphasize the work of philosophers such as Sartre, Heideger, Kierkegaard who treat basic concepts such as anxiety differently than many do. medical professionals Yes. When I was ... in the year 56 or 57 (1956-1957) publishers called me and asked if I would edit a book on European existential psychotherapy I was glad to hear that there was a similar book I knew a lot about the existential movement but I knew that in this country, I can firmly believe in him. Since these are the very people who focus on anxiety .... on personality, courage, they emphasize guilt, it must at least be taken into account. And they see people as fighting sometimes successfully, sometimes not successfully. And this was exactly the model that we needed in the field of psychotherapy. And the medical model was at an impasse And I was glad to have the chance to edit a book that includes chapters of European Existential Psychology And it was ... it marked my own needs and my heart anxiety, you perceive it not as a symptom that needs to be eliminated, but as a way to explore the meaning of life. Yes. This is absolutely correct. I believe anxiety is associated with the ability to create. When you are in an anxiety situation you can of course run away from it. This, of course, is not wise. Or you can take pills to deal with her or cocaine or whatever. .. - You can meditate. You can meditate. But I believe none of these methods, including meditation, which I once believed in, none of this will lead you to creative activity. Anxiety means that the world is trying to reach out to you and you need to create, you need to create, you need to do something. I believe that anxiety helps people open their hearts and souls. This is a great start for them to be able to create for courage. This is what makes us human. I assume that the concept of anxiety comes from the basic human dilemma of the model of existence, in which it is inevitably necessary to cope with the awareness of one's own demise. - Yes. We are consciousness of ourselves. tasks that we set ourselves. We know we will die someday. Man is the only creature ... men, women, and even sometimes children are the only creatures who know about their death. And from this comes the usual anxiety When I allow myself to feel it I get ideas I write books I communicate with my peers in other words, there is a creative exchange between individuals based on the fact that we know that we will die someday but animals or, for example , grass, they don't know anything. But our knowledge of death from it comes a normal anxiety that forces us to do everything that we are capable of during the years while we are alive. And that's what I'm trying to do. Another source of anxiety that you described in your book is precisely freedom, the ability to make choices and face the consequences of those choices. Yes it is. Freedom is also the mother of anxiety. If you do not know freedom, you do not know anxiety. Like slaves in films People without any emotion on their faces. They have no freedom. But for those of us who have (freedom) ... we know that what we do matters. and that we only have seven, eight, nine years to do it. So why not do it and enjoy it? Isn't it better than avoiding it? I think this is a kind of anxiety capsule. Is there some kind of conflict between feeling anxious and allowing yourself to be open, vulnerable to anxiety, and at the same time seeking joy? Oh no. There is a conflict in what we usually call "happiness." I'm going to talk about meaningless expressions ... what is "feeling good"? When someone is feeling good, he or she has happy moments. But pleasure is something different from that. Pleasure is something special, the excitement that we get from using our talent, our understanding of the totality of our being ... for great purposes As musicians, people who created world music such as Mozart, Beethoven and others. They were always reasonably anxious because they were in the process of loving beauty ... feeling of joy when they heard the perfect combination of notes. And this is exactly the feeling that is accompanied by creativity, so I call this "courage to create" Creativity does not appear simply from what you were born with. It should go in conjunction with courage. Both of these concepts are disturbing, but also great joy. It seems that most modern culture was an attempt to deal with the underlying feeling of anxiety by distracting from it what you call banal pleasures. You have just touched on the most significant aspect of modern society. We try to avoid the anxiety of becoming rich ... making hundreds of thousands of dollars even though we are, for example, only 21 years old. We become millionaires. But these things do not lead us to the feeling of joy and creativity that I am talking about. A person can conquer the world, but still not find a sense of inner feelings of joy, satisfaction, courage, the ability to create. And it seems to me that our society is undergoing dramatic changes. A society that began its existence during the Renaissance and is now coming to an end. And we see the results of this end of the social period. And interest in psychotherapy is growing Nearly everyone in California considers themselves a psychotherapist. Yes, sort of. Yes, it is. This always happens when an era dies. For example, the Greek Greek philosophers who worked in the 7-6 centuries BC. They talked about beauty, about goodness, about truth and other great things that philosophers usually talk about. But by the third, second, first century before the birth of Christ, they were all forgotten. philosophers have already talked about safety. And they help people cope with this pain as much as possible. And they create models for human existence. Beauty, truth and kindness are lost. Now our Renaissance has begun in the New Time. And at the beginning of this century there are no psychotherapists. Religion, art, beauty and music take on their role. At the end of an era ... and at the end of every era in history, it was the same ... All people become therapists ... because there are no ways to interact with people when they need it And people line up to the therapist's office. I think this is more a sign of the decadence of our century and not a sign of an age of great minds. I know that in your book, Love and Will, you refer to a wonderful verse by T.S. Elliot's "The Waste Land" And you undoubtedly know that many people who read it when it was first written in the first half of this century did not fully understand the prophetic nature of this poem. Of course! After all, the poem describes the emptiness of modern society. Yes exactly. If you remember, the king of the Wasteland was powerless. And neither wheat nor ordinary grass grew on his land. Therefore, the land was called wasteland, and this is an amazing detail. But not much later in the 1920s, in the jazz age, another prophetic book was written The Great Gatsby The movie was terrible! But let's forget about the movie and talk about the book. It's Scott Fitzgerald! Yes, Scott Fitzgerald. This is a small book that best describes how our age is disintegrating. and dies in the end, as the absolutely lonely dies the main character and nobody comes to his funeral. And this is the tragedy. But Fitzgerald saw that all of this was not just happening in the Age of Jazz, when everyone was making a lot of money and trying out new styles, as they do today. But he knew what would happen in the end. And that's why the Great Gatsby came into being. We are now in the century. when things like "Waste Land" and "The Great Gatsby" come to fruition. And that's why I believe that if our society survives and I still believe in the threat nuclear explosion if it survives, we will move into a new age of the century, where the emphasis will not be on how to make a lot of money and then to death be afraid of the fall in performance in the stock market. Still, the emphasis will be on truth and joy, understanding and beauty, and those things that are worth living for. You also characterize the present century as a century in which modern man seems to be robbed by his own by their own desires That, according to Freudian psychology and other scientific movements, we see humanity as dependent on the influence of deterministic forces and threats of large social movements, nuclear war and so on and we can do nothing about the feeling of helplessness and alienation. And you are suggesting, as I understand it, that through philosophical and existential research we can achieve the effect of a different state of consciousness in which we reconnect with our desire on a deeper level. Yes. This is what I wrote about in the book Love and Will. Since we cannot love until we also can not desire ("exercise will") And I thought, I thought and thought, when I wrote this book, that there would be new ways to love. People learn to be close again. They will write letters, a feeling of friendship will arise between them again. Now the New Age is dawning. And I don't think philosophy will be in charge. Look, there are no philosophers today. The last philosopher in this country was Paul Tillich. But people did not give up ... and now they are turning to philosophy. They turn to science and just look over the shoulder of a scientist. They think about how they can help science piece things together. This is not philosophy either. Philosophy is an in-depth search for truth with which I can fill myself in the way of which I can create philosophy based on freedom. It is also the basis of kindness. Which, it seems, does not concern many modern people, but it seems to me that this is a huge mistake. Because we lack ethics, we lack morality. We need kindness and we need beauty. These are all philosophical concepts, but despite this, I am a psychotherapist. Despite all the disgusting things that I had to say about psychotherapy, it is the very way by which at the end of the twentieth century you can help many people find themselves and the way of life that will satisfy them and give them the joy for which a person has full right. And I am absolutely not ashamed of being a psychotherapist. I became a therapist because I saw a way to help people relieve their souls. This is how people show what is in their hearts. They don't show it to philosophy, they don't show it to many of today's religions, they don't show it either, yeah. That is why many people in California join cults. I used to believe in meditation and do it myself. We learned a lot of things from India and Japan. But we cannot become Hindus or Japanese and we need to find for ourselves a form of religious study of a certain religious experience that will suit us - the pioneers of the 21st century. A couple of minutes ago you mentioned the concept of "New Age" and, of course, New Age is a fairly popular concept today, which includes a wide range of different activities. And as far as I am familiar with your work, I can conclude that you are critical of ways to alleviate human suffering and attempts to improve your condition. And I suppose that this criticism is akin to Freud's criticism. Undoubtedly It is very pleasant to communicate with you because you have read what I have written and you know for sure in which direction to direct the conversation. No, I don't like the New Age movement. I think it is too simplistic and makes people feel happy temporarily. But it avoids real problems. The new age will only come when we can face the anxiety, the guilt, over our misconception of the meaning of life as a way of seeing death as an adventure. At the moment, the New Age does not include any of these concepts. He only talks about how to be funny and sing songs. You know, I noticed another paradox here. In your book "Freedom and Destiny" I noticed a mystical chapter and you refer to the great Western mystics like Jacob Boehme and Meister Eckhart, namely, their search for the divine in themselves. And you don't seem to know how to put it right, but you see this as a model deep existentialism. Oh yeah. This is true. I believe and I am a follower of these mystics in our tradition. But I do not believe and I am not a follower of Reignish and other Maharishi Yes, and Maharishi. I will follow the most outgoing of these leaders. But most of them, who came from India, proclaimed their idea but got into trouble and got lawsuits for millions of dollars and their idea failed. Or like Jim Jones, who led 800 or 900 people to the island and they had to create an ideal society, but they all committed suicide ... 819 people ... It seems to me that your criticism is much deeper than just a scandal. It seems to me that what you are talking about is something like a refuge on the mystical Lotus Land, but where, nevertheless, they believe in spiritualism and reincarnation. People lose touch with the basic concept of existence. Absolutely, you said it very nicely. I am critical of these movements that mitigate our problems. They clarify that we must forget them. It seems to me that this is exactly the mysticism that we talked about. Jacob Boehme was burned at the stake and other Christian mystics and Muslim mystics in our long tradition very important. Although the church at one time opposed them. Despite this, they left behind wonderful books of knowledge that we can read, we can understand and learn from them. I know that some existential philosophers like Camus and Sartre and even Janet have contributed to the idea of ​​rebellion against ordinary social morality. It seems to me that what you are talking about is real mysticism. It's like a kind of rebellion of our time against the herd instinct. Yes, that is right. Yes, this is a rebellion against the herd instinct. Sartre was a very important figure in this uprising movement. Camus wrote a book about riot. Paul Tillich has been a dear and very close friend to me for 30 years. He and other existentialists understood that joy and freedom come only with understanding life and facing difficulties. Sartre, when France was invaded by the Nazis, wrote a drama called The Flies. This is a retelling of the ancient Greek story of Orestes. I want to quote a little Zeus is trying to force Orestes not to return to his hometown, and to kill his mother, (what he needed to do to avenge his father) Zeus said: "I created you, so you have to listen to me." Orestes replied: "You created me, but you miscalculated. You created me free." Zeus flew into a rage, he enlarged the stars and planets around to show how powerful he was and said: "Do you know what despair will overtake you if you continue on your way?" Orestes replied: "Human life begins on the far side of despair." And I had to believe it. Human joy begins as alcoholism. People cannot cope with alcoholism if they live through despair, and only then will they be able to comprehend freedom from alcoholism. Therefore, I believe that despair has its constructive side as well as anxiety has its constructive effect. You mentioned earlier the artistic achievements of Sartre and we are talking about the fact that a person can feel what we call tears of joy. And a person can feel this when he feels deep joy. This includes the fullness of human life ... and we see joy ... that gushes through despair. This is real joy. Yes. You understood that well. But there is still a frightening moment. We live our lives and go through our routines. And we are afraid to plunge into the fullness of life. Yes exactly. If it were that simple, it would not be effective. It is not simple. Life is hard. And I believe that there are many conflicts and many trials in it, but it seems to me that without all this, life would not be interesting. Interest, joy, creativity that arises from listening to Beethoven's symphony Enjoy joyful joy from what we admire. For me, this is the end of the ninth symphony. This joyful joy comes only after the agony, which is shown in the first movement of the symphony. Now I believe in life and in the joy of human existence. But these feelings cannot be experienced if you do not experience despair, as well as the anxiety that every person has to experience if he lives without any creativity. Rollo May, I was very glad to be here with you and, so to speak, to consider in a very deep aspect the agony and delight. I must point out that as I read your book Love and Will, preparing for this interview after reading the last chapter, I felt waves of energy pulsing through my body. It is wonderful. As the yogis say, this kundalini is a very strange feeling of rapture and agony. It seems that your desire to look into the eyes of life is like a desire to look into the eyes of God. It is wonderful! I am very glad that you had this experience. It is a great joy for me to be here. I would like to say a few words in conclusion. It seems to me that evaluating your work, I wonder why "tragedy" is considered the highest form Shakespeare, for example. Tragedy is a great pleasure in our time too. Death of a Salesman, for example, is one of the greatest plays of the 20th century. Rollo May, thank you so much for being somnoy today. I like it! And thank you for being with us!

Basic concepts

Existential therapy, following philosophical existentialism, asserts that human life problems stem from human nature itself: from the awareness of the meaninglessness of existence and the need to seek the meaning of life; due to the presence of free will, the need to make a choice and the fear of being responsible for this choice; from the awareness of the indifference of the world, but the need to interact with it; because of the inevitability of death and the natural fear of it. Renowned contemporary existential therapist Irwin Yalom identifies just four key issues that existential therapy deals with: death, insulation, freedom and inner emptiness ... All other psychological and behavioral problems of a person, according to supporters of existential therapy, stem from these key problems, and only the solution, or, more precisely, the acceptance and comprehension of these key problems can bring a person genuine relief and fill his life with meaning.

Human life is viewed in existential therapy as a series of internal conflicts, the resolution of which leads to a rethinking of life values, the search for new paths in life, and the development of the human personality. In this light internal conflicts and the resulting anxiety, depression, apathy, alienation and other conditions are not considered as problems and mental disorders, but as necessary natural stages for the development of personality. Depression, for example, is seen as a stage in the loss of life values, opening the way for finding new values; anxiety and anxiety are seen as natural signs of the need to make important life choices that will leave a person as soon as the choice is made. In this regard, the task of the existential therapist is to bring a person to the realization of their deepest existential problems, to awaken philosophical reflection on these problems and to inspire a person to make the life choice necessary at this stage if the person hesitates and puts it off, "stuck" in anxiety and depression.

Existential therapy has no generally accepted therapeutic techniques. Existential therapy sessions usually take the form of a mutually respectful dialogue between therapist and patient. In this case, the therapist in no way imposes any points of view on the patient, but only helps the patient to understand himself deeper, draw his own conclusions, and realize his individual characteristics, their needs and values ​​at this stage of life.

History

Some authors trace the emergence of existential therapy to antiquity, considering, for example, the dialogues of Socrates with young people, and later the entire schools of Aristotle, Epicurus and the Stoics as a form philosophical therapy, which was designed to improve the understanding of the world and thereby facilitate a person's life, which makes it akin to modern existential therapy.

This purpose of philosophy was largely lost until the 19th century, when it was revived by Kierkegaard and Nietzsche. Their work later inspired many thinkers of the 20th century, such as Heidegger and Sartre, who did not hide the fact that they see the role of philosophy primarily in helping people in concrete terms.

Swiss general practitioner