Clients enter therapy grappling with a range of difficulties. They don’t speak in diagnostic terms, but instead focus on the everyday problems that confront them. Their struggles may include isolation, loneliness, anxiety, guilt and regret, and problems making decisions in a world that offers seemingly endless choice. In contrast, the cognitive-behavior therapist is trained in the language of conditioning and extinction, avoidance and safety behaviors, behavioral activation and attentional biases. This book explores the ideas of the existentialist philosophers as a bridge between the suffering client and technically trained clinician. The volume is not a rejection of cognitive behavior therapy (CBT), but seeks to place CBT in the broader context of the most popular philosophic tradition of the 19th and 20th centuries.
Therapists versed in existentialism argue that the individual's starting point is characterized by a sense of disorientation in the face of an apparently meaningless and absurd world. Each individual must become solely responsible for giving meaning to life and living it passionately and authentically. Each of us must confront the ‘Big 5’ existential issues of death, isolation, identity, freedom and meaning and find our solutions to these problems.
The present volume explores each of these existential themes in turn. Each section opens with a theoretical chapter describing the relevant existential dilemma and its impact on human experience. The second chapter in each section explores its relationship to mental health disorders and psychopathology. The third chapter in each section explores the evidence for treating the existential issue from a CBT framework. This book will be of value to those interested in CBT, philosophy and mental health, and will appeal to psychotherapists, clinical psychologists and psychiatrists.
Author(s): Ross G. Menzies, Rachel E. Menzies, Genevieve A. Dingle
Publisher: Springer
Year: 2022
Language: English
Pages: 305
City: Cham
About This Book
Contents
About the Editors and Contributors
Editors
Contributors
Part I: Introductory Issues
Existentialism and the Problems of Being
1 Introduction
2 Truth as an Illness
3 Being-in-the-World
4 Conclusion
References
Existentialism and Its Place in Contemporary Cognitive Behaviour Therapy
1 CBT and Existentialism: An Uncanny Relationship?
2 Existential Issues Versus Existential-Phenomenological Thinking
3 Identifying the ‘Existentials’
4 Existential Uncertainty
5 Existential Relatedness
6 The ‘Way’ of Existential Thinking: Phenomenology
7 Standard ‘Beckian’ CBT and Existential Thinking
8 Schema Therapy: Working with the ‘Depths’ of Meaning
9 Constructivist and ‘Post-rational’ CBT
10 Acceptance and Commitment Therapy: An Existential CBT?
11 Summary: Finding a Place for Existential Thinking in CBT
12 Exercises in Phenomenological Listening
13 Conclusion
References
Part II: Death
Death Awareness and Terror Management Theory
1 The Denial of Death
2 Terror Management Theory
3 Empirical Support for Terror Management Theory
3.1 Evidence for the Effects of Proximal Reminders of Death
3.2 Evidence for the Effects of Distal Reminders of Death
3.2.1 Evidence for the Protective Role of Self-Esteem
3.2.2 Evidence for the Protective Role of Cultural Worldview Defence
3.2.3 Evidence for the Protective Role of Close Relationships
3.3 Evidence for the Role of Death Awareness in Mental Illness
3.4 Individual Differences in the Use of Defensive Mechanisms in the Face of Death Awareness
4 Criticisms of Terror Management Theory
5 Summary
References
Fears of Death and Their Relationship to Mental Health
1 Introduction
2 Anxiety Disorders
2.1 Specific Phobias
2.2 Panic Disorder
2.3 Agoraphobia
2.4 Social Anxiety Disorder
2.5 Separation Anxiety Disorder
3 Somatic Symptom-Related Disorders
4 Obsessive-Compulsive Disorder
5 Post-Traumatic Stress Disorder
6 Mood Disorders
7 Eating Disorders
8 Psychotic Disorders
9 Treatment Implications
References
Creative Approaches to Treating the Dread of Death
1 Introduction
2 Assessment
2.1 Clinical Interview
2.1.1 Screening for Death Anxiety
2.1.2 Emotional, Cognitive, and Behavioural Responses
2.1.3 Life History
2.1.4 Protective Factors
2.1.5 Establishing Treatment Goals
2.2 Measures
2.2.1 The Collett-Lester Fear of Death Scale–Revised (CLFDS-R)
2.2.2 The Multidimensional Fear of Death Scale (MFODS)
3 Treatment Approaches
3.1 Cognitive Approaches
3.2 Behavioural Experiments
3.3 Exposure Therapy
3.4 Tolerating Uncertainty
3.5 Imagery Rescripting
3.6 Psilocybin-Assisted Psychotherapy
4 Conclusion
References
Part III: Isolation
Existential Isolation: Theory, Empirical Findings, and Clinical Considerations
1 Introduction
2 Existential Isolation
3 Confronting Existential Isolation
4 Existential Isolation in the Day-to-Day
5 Relating Existential Isolation to Other Existential Concerns
6 Empirical Research on Existential Isolation
7 Implications for Psychotherapy and the Treatment of Existential Isolation
8 Concluding Remarks
References
Isolation, Loneliness and Mental Health
1 Interpersonal Isolation and Loneliness
2 Conceptualisation and Measurement of Loneliness
3 Theoretical Understandings of Loneliness
3.1 Cognitive Approaches
3.2 Social Identity Approach
3.3 Combined Approach to Understanding Loneliness
4 Loneliness, Health and Psychopathology
4.1 Loneliness and Depression
4.2 Loneliness and Anxiety Disorders
4.3 Loneliness and Psychosis
4.4 Loneliness and Substance Use Disorders
5 Conclusion
References
Social Prescribing: A Review of the Literature
1 Addressing Loneliness
2 Individual Therapy
3 Group Interventions
4 Groups 4 Health
5 Cognitive Barriers to Connecting with Others
5.1 Stigma
5.2 Mistrust
5.3 Fear of Negative Evaluation
6 Groups 4 Belonging
7 Social Prescribing
8 Conclusion
References
Part IV: Identity
Identity and the Courage to Be: From Kierkegaard to Covid-19
1 Vignette
2 Identity, Existentialism, and Christianity
3 Identity and Existential Humanism
3.1 Sartre and Heidegger: Identity as Reinvention
3.2 Heidegger and Ricoeur: Identity as Momentary
3.3 Merleau-Ponty: Becoming Some-Body
4 Existentialism and Diverse Identities
4.1 Feminist Identity and the Male Gaze
4.2 Racism and Identity
4.3 Gendered Identity
5 Synthesis
6 Global Dread and Identity
6.1 Eco-existentialism and Sustainable Biographies
7 Covid-19
8 Conclusion
References
Yet You May See the Meaning of Within: The Role of Identity Concerns and the Self in Psychopathology
1 Obsessive-Compulsive Disorder
2 Hoarding Disorder
3 Examining Depression and Eating Disorders via a Social Identity Approach
4 Conclusion
References
Clarifying Identity and the Self in a CBT Context
1 Introduction: Why Bring Together the Self and CBT Literatures?
2 What Is Identity and ‘The Self’?
3 Selected Self-Constructs, Self-Structures, Self-Processes and Self-Contents
3.1 Self-Contents and Self-Schemas
3.2 Self-Structures and Self-Processes
4 Developmental Considerations in Delineating Identity and ‘The Self’
5 The Self and Treatment Considerations
6 Future Directions
References
Section IV: Freedom
Freedom, Responsibility and Guilt
1 Introduction
2 Freedom
2.1 Freedom as a Concept in Philosophy and Politics
2.2 Freedom as an Existential Concern
2.3 Freedom in Behaviourism, Cognitive Therapy and New Developments in CBT
3 Responsibility
4 Guilt
4.1 Three Forms of Guilt According to Yalom
4.2 Ontological Guilt
5 Regret
6 Conclusions
References
Failed Potentialities, Regret and Their Link to Depression and Related Disorders
1 Freedom, Failure and Depression
2 The Problems of Rumination
3 Social Anxiety Disorder and Post-event rumination
4 Regret and Obsession
5 Health Anxiety and Related Disorders
6 Summary
References
Reframing the Past and the Treatment of Existential Guilt and Regret
1 Regret and Its Role in Mental Health
2 Stoicism and the Principle of Desire
3 Amor Fati
4 Learning to Live with Doubt
5 Self-Compassion
6 Touching the Present Moment
7 Future Directions in Regret Regulation
8 Concluding Comments
References
Part VI: Meaning
On the Need for Meaning
1 Introduction
2 Language: Scaffolding or New Meaning?
3 Leaving the Land Behind
4 Conclusion
References
Meaninglessness, Depression and Suicidality: A Review of the Evidence
1 Introduction
2 Conceptual Proposals for the Importance of Meaning to Mental Health
3 Life Meaning
3.1 What Is Meant by Life Meaning?
3.2 Measuring Life Meaning
4 The Association Between Life Meaning and Hope
5 Life Meaning’s Conceptual Link to Depression and Suicidality
6 Evidence for the Association Between Life Meaning and Depression
6.1 Evidence from Correlational and Group Difference Studies
6.2 Evidence from Moderation/Mediation Studies
6.3 Evidence from Treatment/Intervention Studies
6.4 Summary
7 Evidence for the Association Between Life Meaning and Suicidality
7.1 Evidence from Correlational and Group Difference Studies
7.2 Evidence from Moderation/Mediation Studies
7.3 Evidence from Treatment/Intervention Studies
7.4 Summary
8 Summary and Conclusion
References
Letting Go, Creating Meaning: The Role of Acceptance and Commitment Therapy in Helping People Confront Existential Concerns and Lead a Vital Life
1 Language, Self-Awareness, and Crisis
2 The ACT Approach to Existential Crises
3 A Quick DNA-V Overview
4 Valuer: Crisis of Meaning
5 Advisor: Crises Involving Incoherence and a Shattering of “Reality”
6 Noticer: Crisis Involving Emotions and Alienation from the Physical Body
7 Discoverer: Crises of Action
8 Self-View: Crisis of Identity
9 Social View: Crisis of Isolation and Loneliness
10 Conclusion
References
Index
