Existential Therapy in the Treatment of Victims of Domestic Violence

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Existential Therapy in the Treatment of Victims of Domestic Violence

Updated May 4, 2011
9 minute read

Review of Existentialism

Existential Counseling is a profound approach to helping clients of many cultures find meaning and peace in their lives. Because all people face the same basic issues of love, suffering, and death, existentialism is really a universal philosophy of life. Wherever existence is difficult for whatever reason, individuals are very much aware of life and death- the existential twins. When one devotes most of time to surviving, they are generally more other-directed because others are needed for psychological and material support. Existential counseling seeks to help us relate to ourselves, others, nature, and God, however these are conceived by the individual. It is the beginning of a search for the hope, love, and meaning that is based in reality. It is applicable to all life problems, though particularly useful when a client feels life has no meaning or is on the verge of making a decision that offers a life of passion. Existentialism sees the responsibility of freedom, the value of choice, the anxiety that comes with wrong choices, and the ambiguity of it all (Christian Existentialism, n.d.). Existential counseling is tailored to a client’s issues, explicitly addressing life, and implicitly addressing death (Epp,1998). It uses the harsh reality of life to prompt the search for love and meaning.

The existential counselor is a companion in reviewing life in it’s totality, and a facilitator of self-reflection in the pursuit of a better life. The counselor and client interact with equality and genuineness, as they both acknowledge they are on the same road toward an eventual death. Growth and healing occurs as they interact as two equal human beings, with the relationship being the most powerful therapeutic factor in existential counseling. A loving human relationship acts as a powerful antidepressant, triggering the very same neurochemicals that a medical antidepressant does. Pharmacological medications work because they mimic natural processes. Antidepressants mimic the neurochemical effects of love. This is why psychotherapy is as effective as antidepressants in depressed clients. If you simply medicate one’s depression or anxiety, you ignore part of their existence that may have an important meaning. When one suffers it is usually in response to another person or a circumstance that upsets us. Symptoms of depression and anxiety force us to reflect on our personal existence and to change behaviors that brought on these emotions. If antidepressants mask those symptoms, we evade the search for reasons behind the emotions.

Existential counselors are not against the use of medications, but rather against the routine sedating of our existence. We are designed so that our pain is instructive for our personal growth. Existentialist belief is that we live with a certain level of discomfort, which is called existential anxiety. The fear of death, tragedy, and uncertainty is our constant companion, while courage in the face of these simultaneously teaching us to appreciate the fragility and brevity of life. Being an intimate friend therapeutically may be emotionally draining for the counselor, while quite healing for the client. But when counselors are guided by the spirit of helping, they will most likely find themselves enriched and rejuvenated by this closeness. Any counseling techniques used are primarily for the counselor’s benefit, to give structure to the therapeutic interview when the counselor is unsure what to do. Client’s primarily need a caring and compassionate person to listen to their personal struggles (Epp,1998).

Mental health to the Existential counselor is being at peace with one’s inner-self, one’s companions, one’s physical environment, and with one’s spirituality. The existential counselor examines every sphere of the client’s life to discover if each part is fulfilled. The quality of the client’s physical world is important to connect us to our natural state. A periodic return to nature is beneficial to our sanity. Existential counseling defines and focuses on eternal issues of love, suffering, meaning, and death that everyone faces, and which must be broached in a counseling session. When these deeper issues are confronted, the results of counseling are more enduring than when just addressing the immediate issues the client is struggling with at the time. The counselor doesn’t direct the client to these issues, but brings them out of the issues presented, confronting the deeper concerns the client may be facing. There is a paradoxical principle of human behavior that when you confront the painful realities of life, you can transcend them and find greater happiness than you can if you deny them. If we pretend our pain doesn’t exist, it builds rather than diminishing. When we talk about our pain we free ourselves from the psychological demons that dwell in our minds (Epp,1998).

Existential counseling is a holistic approach that can accommodate other views of human behavior without losing it’s own integrity. It freely lends itself to an eclectic orientation that is creative in it’s essence. Counselors can be directive and existential when the aim is to confront the ineffective behavior patterns of the client in order to prod the client’s own thinking. A directive existential style would be used with the understanding that the counselor’s directives are suggestions for discussion, not prescribed truths. The thrust of existential counseling is encouraging the client to take responsibility for their own life. Counselors can encourage those who dwell on their helplessness that they can always do something to make their lives better. They always have choices, but must draw on their innate creativity to find them. Victor Frankl found beauty and love in the midst of the horror of a concentration camp by enjoying a sunset and remembering his wife, demonstrating the undaunted creativity of the human spirit (Epp,1998).

Victor Frankl developed a revolutionary approach to existential psychotherapy known as logotherapy, which is from the Greek word for meaning, Logos (Holocaust). Out of his experiences during the Holocaust he wrote his most famous book, Man’s Search for Meaning, in which he depicts “average individuals” who became “extraordinary” people, in the midst of unimaginable circumstances (Biography). Frankl wrote many books on existential analysis and logotherapy (Holocaust), the most important being The Doctor and the Soul, Man's Search for Meaning, The Unconscious God, and Man's Search for Ultimate Meaning (Contribution). His theory of proposes the idea that humanity's fundamental inspirational force is “the search for meaning”, while the work of the logotherapist focuses on “helping the patient find personal meaning in life.” Frankl once said: "There is nothing in the world . . . that would so effectively help one to survive even the worst conditions as the knowledge that there is meaning in one's life" (Holocaust). The existential aspect of Frankl’s logotherapy affirms man’s ability to choose, whatever the biological or environmental forces he may face (Biography). “Everything can be taken from a man but one thing . . . to choose one’s attitude in any given set of circumstances . . .” (Quotations). Frankl’s logotherapy also proclaims “The truth-that love is the ultimate and the highest goal to which man can aspire.” He prophesies that the “salvation of man is through love and is love” (Biography). The focal point of logotherapy, Frankl says, is that it sees the patient’s humanness,“And that is a being in search of meaning, a being transcending the self, a being capable of acting in love for others.”

The tenets of Logotherapy are existential in nature dealing with the twin domains of life and death. The first tenet of Logotherapy suggests that the search for meaning is humanity's fundamental inspirational force. Logotherapists focus on their patients finding personal meaning in life. Meaning can be discovered in one of three ways, by creating a work or doing a deed, by experiencing something or encountering someone, and by our attitude toward suffering. The second tenet of Logotherapy states that love is the ultimate and the highest goal of mankind. Logotherapy also affirms a human’s choice. It also views suffering as necessary for happiness. Pain turns suffering into achievement, guilt brings the opportunity for change, and death is an incentive for responsible action (Contribution). These experiences allow us to take pleasure in our periodic moments of joy. Suffering is not just pain without meaning. It teaches us to not revisit those past actions that brought suffering on us in the first place. Without suffering, there would be no potential for growth, and without hope and joy there is no reason for growth (Epp,1998).

The intangibles of life- happiness, meaning, love, and morality – which is the core of psychotherapy can’t be understood by science alone but must be guided by a philosophical outlook. Existentialists are understood to believe that the world is meaningless and absurd. Many Existential authors expressed the absurdity of life and the anxiety of facing a world where people’s lives have no meaning (Christian Existentialism, n.d.). Anxiety, futility, absurdity, and meaninglessness are all key themes in much of Existential philosophy. Sartre believed you couldn’t be existential and believe in God at the same time. Nietzsche insisted that without God, purpose and meaning can have no basis. While some prominent existential philosophers were atheists, many were devout in their religious beliefs. Soren Kierkegaard, who has been identified as the father of Existentialism, was a very devoted theist and blatantly Christian. He wrote about humanity’s freedom and the anxiety such freedom carries with it. He saw anxiety coming from the biblical scenario in the Garden of Eden. God gives us the gift of freedom, allowing us to pursue our desires and define ourselves, while also holding us responsible for the outcome of that pursuit. Kierkegaard believed God demanded individual responsibility and commitment.

Following Kierkegaard, Martin Buber and Paul Tillich continued down the Christian Existentialist path. Christian Existentialism seems to have come about as a study of how individuals come to terms with the demands of faith (Christian Existentialism, n.d.). The place where believers and unbelievers part company is when the believer feels wonder and awe and the unbeliever experiences hopelessness and despair. So Existentialism is not atheistic by definition, but often incorporates much of spirituality into its concepts of anxiety, freedom, and responsibility. “Spirituality is our need to search for meaning and connection with others and the transcendent force of the universe (Epp1998).” The search for meaning and connection is as important a psychological need as any other. There may be obstacles to our understanding of the world, but the world can be understood in the limited fashion of humanity. We may not see the big picture, but that doesn’t mean we can’t discern the details in our small corner of it.

My View of the counseling process and how people change has to do with the age old problem of selfishness that is innate to the human psche. People only change when they are motivated for their own benefit (Abelson, Osman, 2002). It’s the “What’s in it for me?” exchange of the thought process. Punishment temporarily deters but is not effective for permanent change unless the person sees some additional benefit to changing their behavior. Avoiding punishment or consequences may help deter behaviors, but is usually not motivation enough for permanent change. Those who are capable of understanding the consequences of their actions can develop insight into their behavior, and finally see the benefits to changing their behavior for their own good. When people actively decide to change their thoughts, emotions, or behaviors, their own power and autonomy is reinforced, rather than the sense of powerlessness that is reinforced by the passive decision-making that comes with the forced change of punishment. The decision to change is often obstructed by passive decision-making tactics that either delay the decision-making process or lets others make decisions for an individual. Neither non-action, nor active behaviors that force circumstances on a person are truly beneficial to permanent change. People must be confronted with their passive decision-making tactics and be shown the personal benefits of making an active choice to change circumstances or behaviors. Existentialism appeals to me because it emphasizes one’s responsibility for one’s own choices of thoughts, emotions, and behaviors. There is no motivation for change without owning responsibility for ones conditions of existence. Everyone has an active contribution to their own situation. You may not be responsible for certain uncontrollable situations such as child abuse, or illness, but you are responsible for how you react to that situation. You can choose how you feel about it, what you think about it, and how you react toward it. Your choice of behavior affects yours and others opinion of yourself. You are responsible for how others treat you and how you regard yourself.

Women who have been abused need support, empathy, and a nonjudgmental therapist to help them build trust and feel safe again. (Smith, Kelly, 2001.). Supportive responses from important people in their lives can be very healing, giving them comfort and relief. As a therapist, being supportive, without taking control is essential in the therapeutic process and allows abused women to regain control and rebuild their lives. As a professional, I must be a mentor that helps victims of domestic violence to gain the courage needed to reach their potential and complete their journey to recovery. Therapy needs to build a secure base through regular contact, warm acceptance, and a levelheaded and undisturbed disposition (Maunder & Hunter, 2004). Appointments should be scheduled closely enough to minimize feelings of isolation, but should be far enough apart to allow development of an internal locus of control and to establish an internal regulation of emotional affect. Appointments should not be contingent on distress in order to prevent dependency on the therapist. Depression, anxiety, and substance use may result from chronic emotional and/or physical suffering, and each contribute secondary effects that add to the initial problem. Relating this to the client may be helpful in treatment.

After the initial run of individual therapy, a group experience may be helpful in a continuing therapeutic role. Participation in a Group Experience will be recommended during the course of or at the close of individual therapy. Group members may overcome debilitating ideas that their unacceptable problems are unique by sharing their stories. Hearing others who are experiencing or have experienced similar issues helps reduce the sense of isolation and validates each member’s humanness. Groups also offer unconditional acceptance that enables participants to fully accept themselves. Groups also allow members to help and comfort each other by giving support, reassurance, and suggestions. Participation in group therapy helps members to recognize that human existence is limited and occurs in uncontrollable contexts, and that they are ultimately responsible for themselves (Waldo, 1985).

The first two or three sessions need to focus on developing a secure base in the therapist-client relationship by immediately providing a supportive and nonjudgmental stance, and by thoroughly hearing out the client’s story. I help the client to find validation within herself in her spiritual context, noting that if God loves her unconditionally, and she loves herself, then others opinions don’t really matter. Emphasis on love of self and God’s love for her will be focused on here. The “I am” technique will be implemented, underscoring the idea that God, “the great I Am” loves her because she exists, not because of who she or others perceive her to be. I am a victim of domestic violence becomes I am a victim, which becomes I am, which becomes I am a survivor of Domestic violence, which becomes I am a survivor, which becomes I am. I will emphasize that though descriptives may change, the fact that she exists and that God loves her because she exists does not.

Middle sessions should give attention to helping the client understand and accept responsibility for her choices along with further education of options, and training in assertive and non-aggressive responses to abusive behaviors by the husband. I help clients to embark on a self-investigation with the goals of understanding their current conflicts, identifying defense mechanisms and responsibility avoidance tactics, diminishing anxiety by unrestricting their modes of action (introduction of other options), helping them to take responsibility for their feelings, actions, and conditions of existence, and by eliminating anxiety that hinders the decision-making process. As a therapist, I help clients to recognize that they must choose for themselves among their options, and understand that making decisions require relinquishment of some options. Boundary situations that require immediate decisions will be discussed. I can’ts should be met with You mean you won’t.

Later sessions will focus on existential issues of spirituality, isolation and loneliness anxieties, decision-making anxieties. Together, we will also discuss the “What if” scenarios and their possible ramifications, while analyzing the emotions that accompany these. I will catalyze the “will to act” through the encouragement to become their own “parent” by caring for and protecting themselves from further abuse, by taking responsibility for their choices, and by making the best decision for themselves and the others concerned. I will stress that we are creators like our Heavenly Creator and that just as Jesus chose to go to the cross by his own free will, we ourselves choose our own crosses and whether or not we will bear them. Some questions that will be asked are: How did you create your situation, or what is your responsibility in this situation? What is your moral responsibility in this situation? What do you believe and how does that affect how you treat yourself? Who do you love most in life and who loves you most? What prevents you from loving or enjoying this person, work, or spiritual aspect of your life? What do you want or wish for in life? Where do you hope to be in life in 1 year, 5, years, 10 years, and why do you want this? What or who is in the way of you achieving what you want? How might your natural abilities and creative capacities overcome these obstacles and make it happen? The Miracle Question may be used here to further facilitate the discussion. The clients will then be asked to decide what they can decide to do to get what they want. If they want a mutually loving and respectful relationship, then they must decide to not remain in an abusive relationship. I will remind them that every yes has a no and that this does not necessarily mean they cannot retain the relationship all together, but that she must decide not to remain in an abusive environment. They can attempt measures to convince their husbands of the need to change by stepping out of the relationship for a time or other possibilities that will encourage change on the husbands' part as well as theirs. Homework assignments may consist of self-isolation for short periods of time, depending on client preference, in order to record in a journal thoughts and feelings associated with loneliness. Participation in a Group Experience will be encouraged as a continuation of individual therapy.

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©2005, 2009 Kimberly Hartfield