Existential therapy

Written by Grow Therapy

Clinically reviewed by Grow Therapy Clinical Review Team

Existential therapy is a unique form of psychotherapy based on the existential philosophy of human nature. This therapy, which helps people find purpose and navigate life’s uncertainties, is often used to help people with substance use disorders, anxiety, and, of course, existential crises.

What are the origins of existential therapy?

Existentialism originated in Europe in the 1940’s, with European philosophers Søren Kierkegaard and Friedrich Nietzsche leading the movement. Ludwig Binswanger, a Swiss psychiatrist, pioneered existential psychology, and American existential psychologist Rollo May is considered the founder of existential psychotherapy.

Irvin Yalom, another American existential psychiatrist, also made significant contributions to the field. This new therapy offered a unique abstract approach compared to other existing forms of therapy at the time, like psychoanalysis and psychodynamic therapy.

When is existential therapy used?

Existential therapy is mostly used in an individual setting. However, it may also be used in groups. It’s beneficial for people who are trying to understand their greater purpose in the world, navigate mental health struggles, and cope with existential anxiety. Existential therapy may help people with the following mental health concerns:

People with chronic illness can also benefit from existential therapy.

What is existential therapy like?

Unlike other therapeutic approaches geared toward addressing symptoms of mental health conditions, existential therapy is more abstract and discussion-based. It involves open-ended philosophical conversations rather than specific exercises or coping techniques. As you and your provider strengthen your therapeutic relationship, expect to reflect on your life, values, actions, future, and other dilemmas that are inevitable for human beings.

Existential therapy explores how individuals can engage with their free will and personal responsibility to create meaning in their lives. Existential psychologists believe that individuals have a personal responsibility for their destiny and use free will to create positive choices that give their own life meaning. Another key theme of existential therapy is coming to terms with loss and death being inescapable aspects of life.

How does existential therapy work?

In existential psychotherapy, you’ll confront the (sometimes harsh) realities of the human experience head-on. An existential therapist will guide you through discussions about self-awareness, free will, purpose, death, and more. The aim isn’t to eliminate any discomfort you feel — it’s to learn to accept the uncertainty that comes with being human and using your free will to take control of your choices.

Existential therapy is based on exploring four pillars, or as existentialist Irvin Yalom calls them, the “ultimate concerns of life,” which are:

  • Death
  • Freedom
  • Existential isolation
  • Meaninglessness

Yalom also refers to these as “givens of existence”—unescapable things that come with human existence. Existential therapy helps you explore your fears related to these givens, helping you come to terms with reality and determine how to create a meaningful life, remembering that you alone are in control of your future.

How long does existential therapy take?

There is no specific structure to how long existential therapy takes or how many sessions you need. However, therapy sessions are typically once weekly and around 45 minutes to an hour long. The duration of existential therapy varies, but some individuals may notice shifts in perspective over the course of multiple sessions.

Is existential therapy effective?

While existential therapy lacks robust randomized controlled trials (RCTs) for specific disorders, research suggests benefits for meaning-making, grief, and addiction recovery

Since the therapy is very abstract and philosophical, it doesn’t directly address symptoms of mental health conditions. Rather, there’s more focus on promoting well-being by finding purpose and meaning in life. There is some evidence to suggest the effectiveness of an existential approach to therapy for addiction, helping people find meaning in life and abstain from substances. There’s also research supporting existential therapy to help people cope with grief and fears of death.

If you have severe symptoms of a mental health condition, you may want to opt for a more strongly evidence-based treatment, such as cognitive-behavioral therapy. Or, work with a provider who uses existential psychotherapy alongside other evidence-based interventions so you can both address your condition’s symptoms head-on while also exploring existential themes and your place in the world.

How to find an existential therapist

If you think existential therapy might be right for you, it’s important to speak with a licensed and experienced clinician. There are many types of mental health care providers who practice existential therapy, including licensed marriage and family therapists (LMFTs), licensed clinical social workers (LCSWs), psychologists, psychiatrists, psychiatric nurses, licensed professional counselors (LPCs), licensed mental health counselors (LMHCs) and more.

Finding a therapist who accepts your insurance can make therapy much more affordable. You can find a therapist who accepts your insurance and specializes in existential therapy by using Grow Therapy. After filtering for your location, insurance, and needs, you can then select “Exitsential” from the “Treatment methods” drop-down.

Next up in A Guide to Types of Therapy

Experiential therapy

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This article is not meant to be a replacement for medical advice. We recommend speaking with a therapist for personalized information about your mental health. If you don’t currently have a therapist, we can connect you with one who can offer support and address any questions or concerns. If you or your child is experiencing a medical emergency, is considering harming themselves or others, or is otherwise in imminent danger, you should dial 9-1-1 and/or go to the nearest emergency room.