#existential psychotherapy

Existential isolation cuts beneath other forms of isolation. No matter how closely we relate to another individual, there remains a final unbridgeable gap. Each of us enters into existence alone and must depart from it alone. Each individual since the dawn of consciousness created a primary self (transcendental ego) by permitting consciousness to curl back upon itself and to differentiate a self from the remainder of the world. Only after that does the individual, now "self-conscious," begin to constitute other selves. Beneath this act . . . there is a fundamental loneliness; the individual cannot escape the knowledge that (1) he constitutes others and (2) he can never fully share his consciousness with others.

Kierkegaard was the first to make a clear distinction between fear and anxiety (dread); he contrasted fear that is fear of some thing with dread that is a fear of no thing—"not," as he wryly noted, "a nothing with which the individual has nothing to do." One dreads (or is anxious about) losing oneself and becoming nothingness. This anxiety cannot be located. As Rollo May says, "it attacks us from all sides at once." A fear that can neither be understood nor located cannot be confronted and becomes more terrible still: it begets a feeling of helplessness which invariably generates further anxiety. (Freud felt that anxiety was a reaction to helplessness; anxiety, he wrote, "is a signal which announces that there is danger" and the individual is "expecting a situation of helplessness to set in."

The recognition of uncertainty and thrownness is likely to cause existential anxiety, which is simply characteristic of being. Existential anxiety is normal and healthy if 'one can accept the responsibility for choice but recognize the potentiality of tragedy'. When existential anxiety cannot be accepted, that anxiety becomes neurotic. Though conceptualized in different ways, neurotic anxiety in general may be understood as a fear of Dasein loss. Some may suffer from a 'stuck' Dasein, in which the freedom to make decisions is gone; others may feel ontological insecurity, in which they cannot take existence for granted and contrive ways of forcing life to be more 'real'. In addition, neurotic anxiety may also be caused by a perceived inability to understand and interact in the world, what Frankl called 'the existential vacuum'. In these different manners, the 'mentally ill' inauthentically perceive their world and deny the true possibilities of their Dasein.