Existential-Integrative Psychotherapy Theory
Guideposts to the Core of Practice
In Existential-Integrative Psychotherapy: Guideposts to Core of Practice, Kirk Schneider makes the case for the inclusion of an existential-integrative (EI) lens across therapeutic modalities. An existential framework includes a person’s relationship to being and the “structure of human existence” (Rolo May), as part of the therapeutic inquiry and process. Without the EI approach, challenges or issues brought forward in therapy are in a sense worked with in isolation through specialized therapeutic approaches that focus on one aspect of being but neglect to reference the larger frame of existence in which our challenges arise and persist. According to Schneider, the depth and staying power of healing reached through specialized therapies are limited by nature; an EI framework is complementary to specialized modalities and is necessary to apply for authentic transformation to occur.
This framework is phenomenological (experiential) in nature and takes a depth approach. When challenging emotions or when experiences come up like grief or despair, EI supports a client to immerse in the experience, to feel it fully and become intimate with its contours. Only by being in full contact with the experience can we create the space and capacity to be with and from there move authentically within the true nature of our existence.
Schneider outlines 3 core themes of EI:
- Mystery is at the core of the human experience. Within the mystery, people are suspended between the polarity of freedom and limitation
- Extreme aversion (dread) of either polarity results in “extreme counterractions…(i.e. Oppressiveness or impulsivity)” (p. 7)
- Coming up against and working with the polarities is key to having a rich life that includes choice and appreciates the wonder of our existence as humans
Applying an EI approach in session involves:
- A focus on immediate experience for both the client and the therapist, downplaying the narrative lines, bringing attention instead to the present moment experience.
- Emphasis on choice – despite historical circumstances that may explain or motivate behaviour, EI sees clients as making choices in the present moment that are not entirely determined by the past
- Acceptance of limitations – balancing the emphasis on choice is an acknowledgment that humans are not all powerful, they are sometimes constrained by their settings and social circumstances.
- Looking to phenomenological accounts – EI therapists look toward a client’s description of their experience as the way to relate a case rather than a diagnostic or categorization model (i.e. Borderline Personality Disorder with acute anxiety). The therapist is treats each client as unique in their experience, based on their account of their experience.
Generally, it is also important for a therapist to work “with” and alongside a client in their experience rather than “on” a client (i.e. applying a theory and treatment to them). Schneider names to three key roles of a therapist in an EI context: “contain, evoke, reflect” (39)
Theory of the EI approach
The goal of EI is to help people realize their freedom, defined as the capacity for choice within the various internally and externally imposed limitations of life. Schneider organizes a sphere made up of six realms of consciousness, a model for human existence – from the outside in:
Within each realm, an individual navigates the freedom/limitation polarity. Humans are both free in their will, creativity, and expression and limited by their environments and social contexts.
In addition to the freedom/limitation polarity, Schneider identifies the constriction/expansion polarity in human experience. According to this theory, we orient ourselves along each of the 6 existential levels listed above along a continuum of constriction (smallness, connected to limitation) and expansion (greatness, connected to freedom). At the extreme of both ends of this continuum is dread. If we dread expansion we take refuge in constriction and vice versa.
If we fear obesity we might become anorexic; if we fear confusion and complexity we might become obsessive-compulsive. Schneider believes that our dread of either polarity is at its root connected to the larger context of constriction or expansion in the face of existence rather than to do with the objects of dread themselves. Traumatic events may trigger specific fears but these fears run deep and resonate at an overall existential level. To heal and live a life of freedom, we must turn toward the polarities we reject and attempt to integrate them – “by facing and experiencing one’s frailty, finally, one can learn to understand and transform one’s pomposity.” (p. 46)
The EI approach is committed to authenticity, which Schneider defines as centred. The therapy is authentic and not pushing an agenda or a structure if it is attuned to the client’s interest and ability to change as explicitly stated and implicitly observed, if it treats the whole client, not just the symptom, and if it remains open to depth. While the main tool of EI is the facilitation experiential liberation, it is not always appropriate to bring a client into a fully experiential, present-moment exploration – therapists remain aware of the client’s capacity to go into an experiential realm and use other disciplines like cognitive behavioral therapy or mindfulness to help a client manage a difficult emotion or situation without going fully into its depth.
When a client is ready to work directly with experience, the work of therapy is to facilitate “encounters with those wounds – opening them up, seeing what they are about, and discovering their future implications…help clients constructively endure, explore and transform their inmost experiential hurts.” (58-9) The steps involved are: presence, invoking the actual, vivifying and confronting resistance, rediscovery of meaning and awe.
A therapist’s presence holds space for the client’s being – both expressed and held, narratives and silences. Presence is a deep attunement to the client’s field and to the impact of the client on the therapist. In holding all that a client brings, the therapist can then discern what is relevant to bring forward or work with.
Invoking the actual involves the direct naming of what is present in the room, what the client is bringing or expressing. This can be done through simple naming – “I feel great sadness when you say that”, by guided meditations that drop clients into their bodies to explore what is expressing at the physical level, through experiments that enliven dynamics in session and outside of sessions.
Vivifying and confronting resistance involves working with the client’s blockages to evolution through their circumstances. Resistance is a defense or protective mechanism that keeps a client stuck in a place they don’t want to be in for fear that without the resistance, the situation becomes untenable. Resistances offer both protection for existing parts of a person and destruction of possible futures at the same time. It is important to be mindful of timing for working with resistance, and a client’s capacity or willingness to do this type of work. While vivifying amplifies and encourages a client to play out a resistance, confrontation warns the clients of the destructive nature of the resistance, the way it impedes the client in their process. Working with resistance can be sensitive for clients – it’s important to navigate resistances with sensitivity and awareness of the impact on the client’s therapeutic process.
Rediscovering meaning and awe becomes possible when clients become aware of their ability to choose differently, to guide their lives in directions that are authentic to their newly uncovered sense of self. Clients re-orient themselves to specific aspect of their being, and to being as a whole through renewed intention and commitment to action. Often this involves an expansive sense of wonder and spiritual connection.