Maryam

Existential theory

If we allow ourselves to set aside the everyday concerns of life and let ourselves be deeply affected by our situation in the world, we inevitably arrive at the deep structure of existence.

Four ultimate concerns stand out in existential psychotherapy: life and death; freedom, responsibility and choice; isolation and love; meaning and meaninglessness.

Life and death

There is one certainty in life: that it comes to an end. Although we do not know how or when we will die, we know that we certainly will. Awareness of death, frightening as it is, can pave the way for a creative life. In his work with cancer patients, Yalom shows how they came to terms with their approaching death. He does not limit his discussion to adults: he points to many studies showing how children deal with death through denial. Some children believe that children do not die; some personify death (“death takes bad children”); and some see death as a temporary state or a kind of sleep. Frankl did not see death as a threat; he believed that death moves people to live life to the full and to use every opportunity to do meaningful things. So attending to death can open the way to creativity and a full life.

Freedom, responsibility and choice

The right to life also brings responsibility. In the existentialist view, human beings do not enter or leave a structured world with a coherent design. Rather, in seeking freedom, people are responsible for their world, their life plans and their choices. We are free to choose paths that fit the responsibility we have for our own lives, and to adopt the values that matter to us. Sartre held that human beings are condemned to be free: they are responsible for creating their own world, which is built on nothingness. The choices we make, Sartre says, are what make our true selves.

Responsibility means owning our choices and dealing honestly with freedom. Sartre uses the term “bad faith” in speaking of human limitation and finitude. A person who says, “Because I was mistreated as a child, I can’t treat my children well”, or who says, “Because I didn’t go to a good secondary school, I can’t get into a good university”, is acting in bad faith, because they blame someone else and do not consider their own inherent limitation. Responsibility also includes being considerate of others and not blaming them for one’s personal problems.

In discussing freedom, May uses the concept of willing — turning responsibility into action. Willing has two aspects: wishing and deciding. May sees mental illness as not wishing, which means emptiness and despair. Part of an existential therapist’s task is to mobilise clients’ feelings towards wishing and carrying out decisions. After wishing or desiring, people must choose. This is somewhat frightening, and it leads people to expect someone else to choose for them. After every choice, people must also bear the other side of what they chose. Accepting responsibility for choice, depending on a person’s situation and their ability to act in good faith, can cause intense anxiety.

Isolation and love

Yalom describes three kinds of isolation: interpersonal, intrapersonal and existential. By interpersonal isolation he means a distance — geographical, psychological or social — that has opened between us and others. Someone with schizophrenia, for example, is cut off from others by being unable to form relationships with them. When a person separates parts of themselves from other parts, through defence mechanisms or other ways of ignoring their own wishes, they are in intrapersonal isolation: someone who does not focus on what they need to do, does not trust their own judgement, and is unaware of their inner abilities and capacities.

Existential isolation is more fundamental than the other two. It means distance and separation from the world. In such isolation we are captive to deep loneliness and solitude. Existential isolation intensifies in the face of death: a car crash brings existential isolation and intense fear. The feeling of complete loneliness and helplessness brings with it a deep terror of nothingness.

Meaning and meaninglessness

Throughout their lives people ask themselves questions about the meaning of life, such as: Why am I here? What if I found the meaning of life? What in my life gives it purpose? Why do I exist? As May and Yalom say, human beings need life to be meaningful. Meaning lets people interpret events and form values about how to live and what they want from life.

Frankl stressed the important role of finding meaning in life. He was concerned that people would neglect spiritual meanings and stay within the bounds of material values. It may seem paradoxical, but Yalom found that people with a fatal illness discover the meaning of their lives — a meaning they had paid no attention to before they fell ill.

Moeen Counselling Centre plans to run specialist existential therapist training courses for students and professionals in counselling, psychology and psychiatry, taught by Dr Bahman Bahmani. To hear about dates and course requirements, join our network.

Gestalt therapy is an existential, phenomenological and process-based approach, founded on the principle that:

People must be understood in the context of their ongoing relationship with their environment

Fritz Perls believed that clients must grow up, stand on their own two feet and deal with the problems of their lives themselves.

Perls’s style of therapy

Perls had two aims in therapy: moving the client from environmental support towards self-support, and reintegrating the disowned parts of their personality.

In Gestalt, maladjustment rests on two principles:

1. Body and mind are inseparable.

2. The person and the environment form an organismic unity.

In Perls’s view, neurosis comes down to three main issues:

1. The growth and development of aggression

2. Self-preservation and the search for balance

3. The interaction of person and environment

The Gestalt theory of change holds that the harder we try to become who we are not, the more we stay the same. It matters that clients be as fully as possible what they are now, rather than trying to become who they “should be”. Rather than relying on change directed by the therapist, Gestalt therapists focus on creating conditions that help the client grow (Yontef, 2005).

Key concepts in Gestalt therapy:

The here and now

Organismic self-regulation

Responsibility

Polarities and polarisation

Holism

Therapeutic goals:

Although Gestalt therapists do not stress predetermined goals for their clients, they do attend to one particular goal: helping the client gain greater awareness, and with it greater choice. Awareness includes knowing the environment, knowing oneself, accepting oneself, and being able to make contact.

Six elements of method are vital in Gestalt therapy: 1) the continuum of experience, 2) the present moment, 3) the paradoxical theory of change, 4) experiment, 5) authentic encounter, 6) process-oriented diagnosis.

For those interested in this approach, Moeen Counselling Centre plans to run workshops and specialist Gestalt therapist training courses taught by Dr Amir Askari. To hear when workshops are held, join our network.

History:

The existential therapy movement was not founded by any one person or group; several currents of thought gave rise to it. Existential therapy grew out of philosophy and emerged spontaneously in different parts of Europe, among different schools of psychology and psychiatry, in the 1940s and 1950s. After the Second World War many Europeans felt the war had devastated their lives, and they were wrestling with existential issues such as isolation, alienation and meaninglessness. Early writers focused on the individual’s experience of being alone in the world and facing the anxiety of that condition (Sharp and Bugental, 2001).

The thinking of existential psychologists and psychiatrists was influenced by several nineteenth-century philosophers and writers. To understand the philosophical foundations of existential psychotherapy, we need to know figures such as Søren Kierkegaard, Friedrich Nietzsche, Martin Heidegger, Jean-Paul Sartre and Martin Buber. These major figures of existentialism and existential phenomenology, and their cultural, philosophical and religious writings, laid the foundation for existential therapy.

Key figures in existential psychotherapy:

Irvin Yalom, Viktor Frankl, Rollo May and James Bugental developed their existential approaches to psychotherapy from strong roots in existential and humanistic psychology.

Irvin Yalom:

Yalom may be called one of the most influential people in existential psychotherapy. Building on the idea that existentialism deals with the “ultimate concerns of existence”, he developed his own approach to individual and group psychotherapy. Isolation and relationship with others, death and living fully, and meaninglessness and meaning are its most important elements.

The existential school seeks a balance between recognising the limits and tragic dimensions of human existence on the one hand, and the possibilities and opportunities of human life on the other. It grew from a wish to help people deal with the hard situations of modern life.

“No relationship can eliminate existential isolation, but aloneness can be shared in such a way that love compensates for the pain of it” (Yalom and Josselson, 2011)

Moeen Counselling Centre plans to run specialist existential therapist training courses for students and professionals in counselling, psychology and psychiatry, taught by Dr Bahman Bahmani. To hear about dates and course requirements, join our network.

History:

Influences that shaped Gestalt psychology:

Freud’s psychoanalytic theory

Psychodrama and the work of Jacob Moreno

Frederick Perls (1893–1970) was the founder and chief designer of Gestalt therapy. He joined the German army in 1916 and served as a doctor in the First World War. His experience with soldiers who had been gassed on the front line turned his interest towards psychological functioning, which led to Gestalt psychology.

After the war Perls worked with Kurt Goldstein at the Goldstein Institute in Frankfurt, which cared for brain-injured soldiers, and through this collaboration came to see the importance of viewing people as wholes rather than as collections of separately functioning parts. He later moved to Vienna and began his training in psychoanalysis.

In 1952 Perls and several colleagues founded the New York Institute for Gestalt Therapy. He eventually left New York and settled in Big Sur, California, where he ran workshops and seminars at the Esalen Institute and made his name as an innovator in psychotherapy. There he had a great influence on people, partly through his professional writing but mainly through personal contact in his workshops.

Perls himself was a lively and astonishing man. People usually responded to him with a mixture of fear and respect, or saw him as a harsh confronter who met his own needs through a talent for acting. He had loved the theatre since childhood. For a first-hand account of Fritz Perls’s life, we recommend his autobiography In and Out the Garbage Pail (1969); for the history of Gestalt therapy, Bowman (2005) is recommended.

Source: Gerald Corey, Theory and Practice of Counseling and Psychotherapy, Persian translation by Yahya Seyed Mohammadi, Arasbaran Publishing, 2013

For those interested in this approach, Moeen Counselling Centre plans to run workshops and specialist Gestalt therapist training courses taught by Dr Amir Askari. To hear when workshops are held, join our network.

“Lifetrap” is an everyday term; the word specialists use for a lifetrap is schema. The concept of the schema comes from cognitive psychology. Schemas can be defined as deep, unshakeable beliefs about ourselves, others and the world around us that formed in our minds in childhood.
These schemas play a decisive part in how we feel about ourselves. Letting go of them means giving up the security we have found in their shelter. So, despite the harm these beliefs do us, we feel safe in their shelter, because they give us predictability and reassurance. That is why cognitive therapists believe that changing these beliefs is hard, exhausting work.

Three features of schemas

Schemas have three features by which we can recognise them:
1. Schemas are long-standing patterns or themes in our lives.
2. Schemas are self-damaging.
3. Schemas fight for their own survival.
A schema is a pattern or theme formed in childhood that imposes itself on a person throughout life. If you have fallen into a lifetrap or schema, what it brings you in adulthood is a re-creation of the conditions of your childhood — the very conditions that harmed you and caused you problems.
Schemas are self-damaging. People circle like a moth around a flame: they are constantly drawn to situations that closely resemble their past. Schemas can harm identity, health and social relationships, work and mood. A schema brings every dimension of life under its sway.

A schema fights hard for its own survival. There is a strong pull in a person to keep their schema — part of the human wish for consistency and stability. We can recognise a schema. Painful and troublesome as it is, it has become normal and familiar to the person, which is why changing it is hard, exhausting work. Above all, in childhood these schemas were ways of adapting to a dysfunctional family. In childhood these traps were realistic. The problem is that, although they are of little use now and we have many paths open to us, we cling tightly to keeping them going.

Sources:

– Jeffrey Young, Reinventing Your Life, Persian translation by Dr Hassan Hamidpour, Arjmand Publishing

– Martin R. Bamber, Schema Therapy for Occupational Stress (Persian title), translated by Dr Hassan Hamidpour, Arjmand Publishing

Moeen Counselling Centre plans to run specialist schema-focused therapist training courses for professionals and students in counselling and psychology, taught by Dr Amir Askari. Because schemas form in childhood, the centre also runs parenting courses for the public. To hear about course dates and requirements, join our network.

Early adverse experiences and the formation of schemas

Early maladaptive schemas form through exposure to early adverse experiences in the environment. Young and his colleagues extended Beck’s concept of underlying assumptions and named them early maladaptive schemas (EMS). They see these schemas as deep, pervasive themes or patterns about oneself and one’s relationships with others, and as highly dysfunctional. The schemas form in childhood or adolescence and go on ruling absolutely over the course of a life.

Young and his colleagues believe that early maladaptive schemas are activated when a person meets environments that recall the adverse environment of their childhood. When this happens, the person is overtaken by intense and often overwhelming negative emotions. A growing body of evidence supports the existence of early maladaptive schemas.

What is a maladaptive coping style?

Early maladaptive schemas show themselves through maladaptive coping styles. Young and his colleagues describe three coping styles, linked to the three basic responses of fight, flight and freeze: surrender (freeze), avoidance (flight) and overcompensation (fight). In any given situation a person probably uses only one coping style, but with early maladaptive schemas they may show different coping styles in different situations.

The surrender coping style

Schema surrender: people with this style become obedient followers of the schema and let it win. They do not try to fight or avoid it. They put their seal of approval on the schema and act in ways that confirm it. As adults they ruminate over the childhood experiences that feed their early maladaptive schemas.

The avoidance coping style

Schema avoidance: people with this coping style try to arrange their lives so that their schemas are never activated, and act as if no schema existed at all. They avoid situations that might trigger their schemas, and if a schema is activated they may take refuge in behaviours that let them avoid and escape the emotional turmoil linked to it — such as heavy drinking, drug use, workaholism or compulsive behaviours. All of these behaviours serve to avoid the feelings the schema brings.

The overcompensation coping style

Schema overcompensation: people with this style fight the schema in their thinking, feeling and behaviour, as if its opposite were true. For example, a person adopts perfectionistic attitudes to make up for underlying feelings of worthlessness.

A child who was submissive may become defiant as an adult. A person who was controlled as a child will try to control others as an adult, and someone who was abused as a child may mistreat others as an adult.

Sources:

– Jeffrey Young, Reinventing Your Life, Persian translation by Dr Hassan Hamidpour, Arjmand Publishing

– Martin R. Bamber, Schema Therapy for Occupational Stress (Persian title), translated by Dr Hassan Hamidpour, Arjmand Publishing

Moeen Counselling Centre plans to run specialist schema-focused therapist training courses for professionals and students in counselling and psychology, taught by Dr Amir Askari. Because schemas form in childhood, the centre also runs parenting courses for the public. To hear about course dates and requirements, join our network.

Family therapy is a term for the many ways of working with families who suffer from problems of biological, psychological and social[1] origin.

What is a family?

A family is a unit of at least two people with fairly complex emotional relationships between its members. This smallest and oldest social institution, which exists to meet its members’ mutual needs, has its own rules, relationships, boundaries and limits. The family is where people’s relationships begin. That is why the relationship between parents and children matters so much: these contacts are a person’s first relationships with another person, and these interactions lay the foundation for our future relationships with others and with society.

The family therapist

Some family therapists believe that all human problems have a relational[2] basis, and so family therapy applies in every case. Others believe that couples therapy[3] and family therapy suit particular relationship problems, or can be used alongside medication in particular conditions such as schizophrenia.

Approaches also differ in the kind of intervention therapists believe in. Some like to invite every family member to every session. Others meet members individually to help them handle their interactions with the rest of the family better, while others try to widen family therapy to take in the broad social and professional network surrounding the family. There are very complex situations that involve or affect every member of the family, and some of them can also affect or involve other members of the community the family belongs to.

[1] relational

[2] marital therapy

[1] Biopsychosocial

Moeen Counselling Centre plans to run specialist family therapist training courses for students and professionals in counselling and psychology, taught by Dr Bahman Bahmani. To hear about course dates and requirements, join our network.