Therapeutic homework

I often have clients who like to do homework between appointments.  I love this.  I think it increases the chances that the client will be able to successfully integrate healthier thinking and behaving in their day-to-day lives. I think homework also suggests that the client is particularly motivated to change, which is essential for growth. Plus, some concepts would take a long time to properly discuss during an actual session, so it can be a better use of a client’s time (and money) to prep outside of therapy.  As a big reader myself, I often suggest books (in therapy-speak, it’s called bibliotherapy) that I think can help a client gain insight into their issues.

Lack of control

One of the issues clients often wrestle with is a lack of control.  For example, a client wants to have a better relationship with their partner but said partner reportedly does not seem interested in making any changes.  In such a situation, perhaps the client can influence or advocate for their own needs but ultimately, they cannot control the partner’s actions.  Another client may really want to get a new job.  They can apply for the job, they can prepare for interviews, network, conduct research, etc. but they cannot actually make the hiring manager choose them.  What can you do?  Well, one approach is to let go of your need to control and not define success by outcomes.  I wrote a blog on this in 2023 – check it out here. 

Frankl’s Man’s Search for Meaning

One of the books I most commonly recommend is by Viktor E. Frankl and is called Man’s Search for Meaning.  It is quite a serious read, in that Frankl talks about how he survived as a prisoner in four separate Nazi concentration camps.  I suggest it not to make people feel guilty for “complaining”, as I don’t find that particularly constructive.  Rather, it is to share Frankl’s uniquely inspiring view of life to see if it helps the reader to gain insight into their own suffering. In this book, he discussed how he created meaning in his thoughts, feelings, and actions in his brutal concentration camp experience in order to survive.  He shared that he sought to create meaning: in his work, though love and caring for another, and by being courageous in bad times.

Frankl’s Existential Therapy

Frankl, a prolific writer, shared his view of life and inspired a new way of thinking about psychology, ultimately founding his own branch of therapy called Existential therapy or logotherapy based on the belief that human beings are primarily motivated by their search to create meaning.  He teaches that our existential suffering is a consequence of failing to recognize this drive and ultimately create one’s own sense of meaning.  In this framework, people are neither innately good nor bad; rather, we are all just either seeking to make meaning through our choices or avoiding doing so. Existential therapy is anti-deterministic, in that Frankl believes that people can affect change that reduces their suffering, as opposed to Freud, who questioned how much people could change due to the power of our subconscious drives. 

Key Themes of Existential Therapy

The Existential Void

Interestingly for his time, Frankl does not suggest that psychotherapy focus on one’s childhood, as instead he suggests that fear of death and an absence of meaning are the ultimate underlying problem.  Frankl talks about the lengths to which people go to avoid accepting the meaninglessness of our existence, and points to various mental struggles that he sometimes refers to as neuroses.  While coming to terms with this belief in a great void or existential vacuum can be foundation-shaking for people, he also notes that it can also be very liberating because we can release ourselves from internally imposed constraints or limits.

About Anxiety

Frankl shares a perspective that there are two types of anxiety: existential anxiety and neurotic anxiety.  Existential anxiety is derived from the ultimate fear of being alone, that life has no meaning and that death is inevitable.  Neurotic anxiety, he believes, stems from all the things we do to prevent ourselves from dealing with existential anxiety, or are messages about our own lack of authenticity.

Guilt – Existential and Neurotic

Guilt is a big one for many people. Frankl uses the same categories as with anxiety: existential and neurotic.  He shares the view that neurotic guilt is related to concern about hurting oneself or others, where existential guilt is –you guessed it—guilt over avoiding facing up to one’s own mortality and the utter meaninglessness of life.  

Authenticity

An existential therapy adherent might say that being authentic is to live with understanding and acceptance of the meaninglessness of life and take responsibility for creating our own meaning in life. Furthermore, for one to live authentically in this way requires intentionality and a desire to free oneself from neurotic anxiety and guilt. 

Attends to the social world of the client

Like Alfred Adler, Frankl also saw the importance of one’s social connections, despite his belief in the utter aloneness of self. Logotherapists would view the client in the context of their society and seek to bridge the gap in understanding between the social world of the client and of the therapist themselves.

Efficacy

While other may have a different perspective, existential therapy is a bit hard to measure. Given that there are no specific goals, it might be difficult to organize a research study to test this approach. Perhaps not impossible, though. For individuals who are comfortable with this approach, it may be helpful to regularly assess an individual’s experience with anxiety or overall distress and compare that with scores at the end of treatment.

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References

Neukrug, E. (2018). Counseling theory and practice (2nd ed.). Sorrento Valley, CA: Cognella Academic Press.

 Frankl, Viktor E. (Viktor Emil), 1905-1997, author. (1962). Man's search for meaning : an introduction to logotherapy. Boston :Beacon Press.