Existential Counselling Unit 7 Irvin Yalom Part 2. Prepared by M. H. Watson March 23, 2011 Revised and Narrated by Lillith Williams March 17, 2014.

Transcription

1 Existential Counselling Unit 7 Irvin Yalom Part 2 Prepared by M. H. Watson March 23, 2011 Revised and Narrated by Lillith Williams March 17, 2014.

2 Existential Therapy Requires good knowledge of existential psychodynamics Helping individuals face the anxiety that is produced by their existential ultimate concerns Understand the defences and their functions, that help to maintain their maladaptive behaviours Explore the individual's inner self Explore the conflict that is responsible for generating anxiety Anxiety leads to our use of defence mechanisms against the threat of non-being or death (Yalom, 1980). Anxiety may generate - death anxiety defences, isolation anxiety defences, freedom anxiety defences and defences against meaninglessness.

3 Existential Therapy The counsellor brings to awareness the clients defence mechanisms caused by the anxiety arising from the awareness of the four ultimate concerns of isolation, death, meaninglessness and freedom The counsellor helps clients to gain awareness of the negative consequences of excessive reliance on defence mechanisms. Existential counselling does not aim to cure. Effecting a cure is secondary. A primary goal is awareness (Yalom, 1980).

4 Transference and Countertransference in Existential Counselling Transference is perceived to be a distortion of the clients typical needs, shown in different ways. Countertransference can be used to help the client to develop awareness of himself / herself. Nelson-Jones - one of the aims of existential counselling is for the counsellor to develop an understanding of the client.

5 Existential Therapy The therapeutic relationship places emphasis on presence, authenticity and commitment (Nelson-Jones, 1995). The technique focuses on the 'here and now" interaction between therapist and client (client s present being in the world)

6 Existential Therapy Meaning of life /terrestrial - a personal sense of meaning; a coherent pattern to life that suggests purpose in life; with or without involvement of God and/or spirits that purportedly order the universe Cosmic meaning embraces involvement of a supreme being who orders the universe by magical or spiritual design

7 Discussion: The Existential Ultimate Concerns What are the existential concerns that pertain to: Death Freedom Isolation and Meaning? (See Section 3 of Unit 7: Existential Ultimate Concerns).

8 Discussion: The Existential Ultimate Concerns Yalom speaks of three types of isolation. Name and explain these three types of isolation. How is death anxiety manifested? Refer to Fear of pain, fear of others and fear about personal extinction and life after death The defence of specialness which is a conscious defence. Where the defence of specialness is absent or weak, people can develop groups of symptoms such as compulsive heroism, becoming a workaholic, disregarding time or becoming narcissistic with the drive for power and control. The defence of belief in the ultimate rescuer

9 Discussion: The Existential Ultimate Concerns Consider Yalom s quote about schizophrenic patients: The schizophrenic patient perceives that the symbiotic relationship is absolutely necessary to survival: the patient needs protection against any threats to the relationship; and among those threats none is as dangerous as his or her (and his or her mother s) intense ambivalence. The child has a sense of profound helplessness in feeling the deepest hate toward the person whom he or she most deeply loves. The child is helpless, too, in the face of the knowledge that this same person loves and hates him or her with great intensity. This helplessness requires continued maintenance of the fantasy, normal only in infancy, of personal omnipotence. Nothing would so completely destroy the sense of personal omnipotence than the acceptance of the inevitability of death, and the schizophrenic patient clings to his or her denial of death with a fierce desperation. (Searles, 1958, cited in Yalom, 1980, pp ).

10 Schizophrenia** Inserted by Lillith Williams Please note that this explanation by Yalom of the schizophrenic s experience has been contradicted by others who point to the contribution of genetic, psychological and environmental factors in the aetiology of schizophrenia. Infections during the mother s pregnancy, early loss of a parent, witnessing parental violence, being a victim of bullying, physical and emotional neglect and abuse, genetics and insecure attachment all contribute to the development of this illness.(dryden-edwards, R., 2010, Retrieved March 17, 2014 from medicinenet.com/schizophrenia/page 3.htm). Many studies have also reported on the association between relapse and negative attitudes in the immediate family(giron et al, 2010).

11 Discussion: The Existential Ultimate Concerns Please note that as Irvin Yalom indicates, severe stress in young children can injure the child s ego because the child has not yet developed the ego defences needed to cope with the overwhelming anxiety caused by the severe stress. Children need to experience death in reasonable amounts and discuss death with parents who have already learned to deal with their death anxieties. Identify and discuss the defences of death,freedom, isolation and meaninglessness and the nature of the conflict with each of the ultimate concerns. How can the counsellor help the client to manage these maladaptive behaviours?

12 Sources Dryden-Edwards, R., (2010). Schizophrenia. Retrieved March 17, 2014 from medicinenet.com/schizophrenia/page 3.htm). Giron,M. et al, (2010). Efficacy and effectiveness of individual family intervention on social and clinical functioning and family burden in severe schizophrenia: a 2-year randomized controlled study. Psychological Medicine (40), Nelson-Jones, R. (1995). Chapter 6: Existential counselling. In The theory and practice of counselling (2nd ed., pp ). London: Cassell. Yalom, I. D. (1980). Existential psychotherapy. New York: Basic Books.