Existentialism in psychotherapy represents an intimately human lens through which we can view the client before us. Though we acknowledge their cognitive distortions, irrational beliefs, and awfulizing, and while we take seriously any evidence of true mental illness, we view these symptoms as being connected to a deep common thread that strings through all of us – the concerns of being human. And if we can help the client to connect the dots of their symptoms to their concern, then perhaps we can do greater work than any psychoactive drug or structured therapy model ever could.
Of the four Ultimate Concerns, death is frequently the most disturbing of all. Perhaps second only to the influence of love, death has inspired more artists, musicians, film makers, and writers from every continent on earth to show us the role death plays in all of ours lives. It thus seems appropriate that we begin our exploration of Existentialism’s place in their CBT/REBT counseling session with the end: Death.
The Concern of Death in Existentialism
For every human being the world over, death is the undoubtedly the foremost existential concern. It is the most unfortunate and terrifying reality that we will die. No matter the argument we advance, death cannot be bought-off or bargained with. It comes for one and all, the only difference being when. It is for this reason that death has earned the dubious distinction of “the great equalizer.”
Worse, human beings are unique in their understanding of death’s inevitability. Somewhere in early childhood, the insidious reality of our mortality creeps in and takes hold of the mind. Displaced into nightmares, playtime games, and a healthy fear of monsters under the bed, our brains process and compartmentalize our shivery fate. It is too all-consuming, too hopelessly burdensome to face with continuous awareness (or as Irvin D. Yalom described it, like staring at the sun).
And so we strive in vane against it. We do what we can to experience control over an uncontrollable destiny. Through the defenses we erect, we make ourselves into characters and our lives into symbols to repress and keep quiet the howling terror of death that lay beneath the surface of our lively countenance.
Death takes with it not just our physical body, but our thoughts, memories, perceptions, and that special uniqueness with which we’ve imbued our lives. One inglorious day, we shall surely see the splendor of our beloved’s face, feel the warmth of a loving embrace, enjoy the savor of our favorite food, hear the mellifluous tones of a human voice, and dance to the magical melody of music, all for the very last time.
From the infinite void of nonbeing, we are thrown into this world and awaken to the specter of the profound significance of human consciousness. But someday, not very long from now, we must give it all up and return with permanence to that endless void. This notion of complete personal extinguishment is perhaps even more disturbing than the physical act of dying could ever be.
Yalom himself echoes this idea in his latest book Creatures of a Day. From chapter three, Arabesque:
For me one of the darkest things about death is that when I die, my whole world – that is, my world of memories, that rich world peopled by everyone I’ve ever known, that world that seems so rooted in granite – will vanish with me. Poof! Just like that.
In this book, Yalom presents beautifully illustrative case dialogues that show how this fear of the future can inspire us to cope in ways that are unhelpful in the present. Imbuing past partners with undying love because the represent a bygone era of life we wish to return to, or marrying old friends because they are tied in memory to youthful excitement – a tendency he has termed love by association – is but one example.
Death Anxiety and the Trouble it Brings
When confronted with serious existential concern, individuals commonly respond in two broad patterns:
- The denial and subsequent displacement of the concern
- A hyper-focus on the concern and resulting despair from it
In examining the concern of death, the first response pattern can cause a litany of emotional problems. When one blocks the frightening reality of his nature from conscious reckoning, he makes a fundamental distortion of reality in the form of a rigid and illogical demand. This demand can roughly be summed up as “I must somehow escape the fate of the others.” Because this demand is impossible to fulfill it will create tension and anxiety, which will then spill out (displace) across the spectrum of life and create dysfunctional emotional disturbances for the individual. These can include:
Demands: Since one has already demanded that the uncontrollable nature of his existence must not be so, it follows that he makes other equally irrational demands to prove that he is indeed in charge of his fate. For example, “I am an intellectual and I absolutely must get into an ivy league graduate school”, “I’m 30, I really should have a husband by now”, or “My career defines me, and I must not fail in my upcoming interview.”
Awfulizing: “And if I do not get into an ivy league grad school, that would truly be awful” the client might continue. Why so awful? “Because then I’ll never be rich and successful!” An irrational premise, but let’s follow and grant the worst possible outcome. Why would it be so awful to be average? A client may have many reasons for believing this, but one possible answer could be, “Because if I don’t accomplish my dreams, it proves my human fallibility; it shows me that I not all-powerful, and that I will one day lay down and die like the rest.”
Low Frustration Tolerance: Accepting death’s inevitability brings with it innate anxiety, and once one has begun avoiding and repressing that anxiety it is possible that he might exhibit Low Frustration Tolerance toward obstacles that remind him of his fundamental helplessness. Thus, as he struggles to feel totally in control of his life, might profess that he truly cant stand it when his holiday travel plans are derailed by outside forces.
On the other hand, the second response pattern carries its own problems. When one focuses for too long on the horridness of death, equally irrational beliefs tend to develop:
Awfulizing Beliefs: Since the terror of the end is constantly obsessed over, it naturally taints the experience of life itself. Not getting what you prefer reminds one of how none of us ultimately get what we want most: immortality. Therefore, frustrations and roadblocks are irrationally experienced as “awful, terrible, unbearable, truly miserable, etc.”
Self-Depreciation: If one bathes themselves in the terror of the end, it is easy to develop self-depreciating beliefs about one’s fallibility. Her failures and shortcoming become visible reminders of her ultimate failure: escaping death.
Life-Depreciation: Taken to the extreme, the nuances of life can become lost in the overriding malaise of death obsession. In these cases, life is viewed as a miserable trudge into obliteration. Hence the popular phrase, “Life sucks, and then you die.”
Can the Great Existential Concern Ever Be Resolved?
In truth, successfully resolving death anxiety is perhaps the most difficult task of any person. Even the ever-rational Albert Ellis frequently used the badness of death to prove the relative tolerability of other discomforts. However, as ugly and empty as death is, life can be equally powerful in its beauty and fullness. Existential therapy encourages one to accept a particular level of innate anxiety in contemplating their own demise, and to recognize that this anxiety is worth examining for the enrichment of their lives.
Once a person explores his death and fully accepts his powerlessness over it, he can cease his railing against it or his obsessional mulling around of it. He can use it to take stock of the life he’s lived and the time he may have left. He may finally shake his paralyzing fears of failure and dare to live with purpose and mindful awareness. He can put an end to his demands of the world and others, stop making himself so needlessly miserable, and begin to experience the elegance of life within his fiercely realistic perspective.