Existential Psychotherapies: Similarities and Differences Among The Main Branches
Existential Psychotherapies: Similarities and Differences Among The Main Branches
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Journal of Humanistic Psychology
1–25
Existential © The Author(s) 2016
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DOI: 10.1177/0022167816653223
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Abstract
Authors agree that a range of different existential therapies exist. However,
not much has been written about what is characteristic and distinctive of
each existential therapy, and the few claims that have been made are mainly
hypothetical. Practitioners from the four main branches of existential therapy
were asked about the authors and texts that have most influenced their
practice and the practices they considered most characteristic of existential
therapy. From all over the world, 29 daseinsanalysts, 82 existential-
humanistic, 573 existential-phenomenological, and 303 logotherapy and/or
existential analysis practitioners participated in this study. Data show that
the scope of influence of an author is pretty much limited to the branch he
or she is related to and only a few authors, in particular Frankl and Yalom,
influence practitioners from all four branches. Five categories of practice are
shared among the main existential branches as the most characteristics of
existential therapy, with phenomenological practices being the most shared
category: But the frequency of each of these categories of practice differs
significantly depending on respondents’ training or affiliated branch. Data
Corresponding Author:
Edgar A. Correia, Rua de Cabo Verde, nº 10 2º Dto., 1170-067, Lisbon, Portugal.
Email: [email protected]
Keywords
existential therapy, existential psychotherapies, logotherapy, daseinsanalysis,
existential-humanistic, existential-phenomenological
2012; Cooper, 2003, 2012; Cooper, Vos, & Craig, 2011; M. Craig et al., 2016;
Deurzen & Adams, 2011; Jacobsen, 2007). As the British school refers to a
single country, some authors refer to it as part of the existential-phenomeno-
logical branch (Correia, Cooper, & Berdondini, 2014; M. Craig et al., 2016;
Deurzen & Adams, 2011): This is a broader concept that encompasses several
schools and societies worldwide (Correia et al., 2014), which stands at the
same conceptual and international level as the daseinsanalysis, logotherapy,
and existential-humanistic concepts.
Several other schools of existential therapy are proposed by different
authors: for instance, existential psychoanalysis (Besora, 1994), focusing
(Barnett & Madison, 2012), cognitive-existential, and supportive-expressive
therapy (Cooper et al., 2011). However, none of these proposals are sup-
ported by more than one author.
Required Research
From this literature review, it is evident that authors agree that a range of dif-
ferent existential therapies exist. However, little has been published concern-
ing what is characteristic and distinctive of each existential therapy, and the
few claims that have been made are mainly hypothetical, based on each
branch’s main theoretical constructs or assumptions. Norcross’s study (1987)
is the single exception of an empirical approach to the differences between
branches, but 28 years have passed, and his sample was small and limited to
a single country and two single branches.
The present article aims to overcome this gap by looking at the practices
of existential therapists from different branches around the globe, and the
authors and texts that have most influenced those practices. It considers both
the degree to which these branches are different and the specific differences
and similarities between them.
Method
Design
A survey study was developed, with data collected through an online ques-
tionnaire, built according to Dillman and colleagues’ methodology (Dillman,
Smyth, & Christian, 2009; Millar & Dillman, 2011), to compare different
existential practitioners’ influences and practices. The survey application
took place between March 5 and July 20, 2012.
Participants
A total of 1,382 participants from all over the world accessed the question-
naire, and 1,358 gave their informed consent. There were 1,264 practitioners
who considered their therapeutic practice as existential or primarily informed
by existential ideas and practices, participants who didn’t fall into one of
these two categories were excluded. It was not possible to attribute a branch
to 255 participants, due to lack of information about their training
Branch Frequency; n %
Daseinsanalysis 29 2.9
Existential-humanistic 82 8.1
Existential-phenomenological 573 56.8
Logotherapy and/or existential 303 30
analysis
Other 22 2.2
Total 1,009 100
and affiliated institution, and these were also excluded from this study. It was
possible to analyze the branches of the remaining 1,009 respondents, and this
was considered the valid sample for the present article.
Respondents were from 46 different countries, from all inhabited conti-
nents, but mainly from Europe (54.4%) and Latin-America (26%). The
United Kingdom (n = 212, 21%) was the most participative country, followed
by Austria (n = 147, 14.6%), Brazil (n = 144, 14.3%), Australia (n = 68,
6.7%), the United States (n = 68, 6.7%), and Mexico (n = 56, 5.6%)—for
demographics and other participant characteristics’ details, see Correia and
colleagues (2014).
More than half of this sample (n = 573, 56.8%) were trained and/or affili-
ated to existential-phenomenological institutions (see Table 1). Logotherapy
and/or existential analysis contributed with 303 respondents (30%), existen-
tial-humanistic with 82 (8.1%), daseinsanalysis with 29 (2.9%), and 22
(2.2%) participants were trained or affiliated within other psychotherapeutic
paradigms (e.g., gestalt, psychoanalytic, person-centered, etc.), but they still
considered their practice as existential or primarily informed by existential
ideas or practices.
Procedures
Sampling Procedures. Following the results from the literature review, it was
decided to direct this survey only to the most common and consensual four
branches of existential psychotherapy: daseinsanalysis, logotherapy, existential-
humanistic, and the British school of existential analysis. But, to comprise the
wider international reality, the British school was included in its umbrella
branch: the existential-phenomenological. For the same reason, to accommo-
date Längle’s new developments on Frankl’s logotherapy, the term existential
analysis was added to the logotherapy branch. In summary, this worldwide
survey bases its search and analysis of participants from the following branch
division and terminology: daseinsanalysis, the existential-humanistic
approach, the existential-phenomenological approach, and logotherapy and/or
existential analysis.
Following an Internet search, 572 counselors or psychotherapists were
invited directly to participate. From a previous systematic online search of
existential institutions across the globe (Correia et al., 2014), 40 existential
therapy institutions were contacted, and each agreed to cooperate by sending
invitations to their members. It was not possible to accurately calculate the
survey response rate, as 14 (35%) institutions did not provide information
about the number of members that they had forwarded invitations to.
Results
Most Influential Authors
Daseinsanalytic participants gave 46 valid responses, citing 17 different
authors to the most influential author’s question. Boss was their most fre-
quent response (n = 19, 41.3% of responses from daseinanalysts, see Table 2).
Binswanger was the second most common choice (n = 7, 15.2%), followed
by the Brazilian daseinsanalyst Spanoudis (n = 4, 8.7%). An existential-
humanistic (May) and an existential-phenomenological (Spinelli) associated
author were both chosen twice (4.3%). Frankl was chosen a single time
(2.2%), the only logotherapist cited by the daseinsanalysts.
Participants associated with the existential-humanistic branch gave 194
valid choices and 34 different influential authors. Yalom (n = 31, 16%) was
their most influential (see Table 2), followed by May (n = 28, 14.4%) and
Frankl (n = 19, 9.8%). Frankl was the sole logotherapy author considered
influential by the existential-humanistic sample. Spinelli (n = 13, 6.7%) and
van Deurzen (n = 8, 4.1%), both existential-phenomenological associated
authors, were considered the 6th and 7th most influential, and Boss, a dasein-
sanalytic author, was the 11th most influential (n = 6, 3.1%) to their therapeu-
tic practice.
Spinelli was the most influential author for the existential-phenomenological
sample (see Table 2), with 215 (19.3%) of the 1,113 validated responses. This
was followed very closely by Yalom (n = 213, 19.1%), and then van Deurzen
(n = 198, 17.8%). Frankl came next (n = 73, 6.6%), with less than half the fre-
quency of van Deurzen, and was the only logotherapy author considered influ-
ential among the 75 different authors named by the existential-phenomenological
associated participants. Their most influential daseinsanalyst author was Boss,
the 9th most influential (n = 18, 1.6%).
Within the 63 different influential authors chosen by the logotherapy and/
or existential analysis participants, Frankl (n = 267, 35.7%) and Längle (n =
203, 27.1%) add up to 62.8% (see Table 2) of the 748 validated answers.
Table 2. Frequencies and Percentages of the Five Most Influential Authors by
Branch.
Yalom (n = 76, 10.2%) was their 3rd most influential author. The existential-
phenomenological author most influential to logotherapy participants’ prac-
tice was van Deurzen, the 7th of their rank (n = 8, 1.1%). Binswanger, the
10th (n = 6, 0.8%), was the most influential from the daseinsanalytic branch.
The large number of different authors, and the visible differences among
branches made inductive statistics not viable to compare existential thera-
pies’ differences for this question.
Table 3. Frequencies and Percentages of the Five Most Influential Texts by
Branch.
Branch Texts n %
Daseinsanalysis Boss, M., Existential Foundation of Medicine 9 18.8
and Psychology
Heidegger, M., Zollikon Seminars 5 10.4
Binswanger, L., Grundformen und erkenntnis 4 8.3
menschlichen daseins
Boss, M., Lebensangst, schuldgefühle und 4 8.3
psychotherapeutische befreiung
Boss, M., Psychoanalysis and Daseinsanalysis 4 8.3
Existential- Frankl, V., Man’s Search for Meaning 16 9.4
humanistic Yalom, I., Existential Psychotherapy 15 8.8
Bugental, J., Psychotherapy Isn’t What You 8 4.7
Think
Schneider, K., Existential-Integrative 8 4.7
Psychotherapy
Yalom, I., The Gift of Therapy 6 3.5
Existential- Yalom, I., Existential psychotherapy 108 11.4
phenomenological van Deurzen, E., Everyday mysteries 60 6.4
Spinelli, E., Practising Existential 58 6.1
Psychotherapy
van Deurzen, E., Existential Counselling & 56 5.9
Psychotherapy in practice
Spinelli, E., The Interpreted World 47 5
Logotherapy Frankl, V., Man’s Search for Meaning 104 18.1
Frankl, V., The Doctor and the Soul 59 10.3
Längle, A., Sinnvoll Leben 36 6.3
Yalom, I., Existential Psychotherapy 33 5.7
Längle, A., Lehrbuch zur existenzanalyse 26 4.5
Table 3). The five most influential texts (n = 26, 54.2%) are all associated to
the daseinsanalytic branch. No logotherapy text was found among their 23
different choices, and 2 books from the British school were chosen once.
Practitioners associated to the existential humanistic branch gave 171
validated answers and 67 different texts. Frankl’s Man’s search for meaning
(n = 16, 9.4%) and Yalom’s Existential Psychotherapy (n = 15, 8.8%) were
their most influential texts (see Table 3). Bugental’s Psychotherapy Isn’t
What You Think and Schneider’s Existential-Integrative Psychotherapy came
third, both representing 4.7% of existential-humanistic responses (n = 8).
With the exception of Frankl’s Man’s Search for Meaning, the eight most
influential texts are all from the United States (n = 52, 30.4%). Frankl’s text
was also an exception of logotherapy’s influence among existential-humanistic
participants, as only one other Frankl text (The Doctor and the Soul) was
chosen a single time (0.6%).
Existential-phenomenological participants gave 185 different texts in 944
validated answers. Yalom’s Existential Psychotherapy (n = 108, 11.4%) was
their most influential text. van Deurzen’s Everyday Mysteries (n = 60, 6.4%)
and Spinelli’s Practising Existential Psychotherapy (n = 58, 6.1%) came sec-
ond and third, respectively (see Table 3). Frankl’s Man’s Search for Meaning
was their 6th most influential text (n = 45, 4.8%), but the next logotherapy
text, Frankl’s The Doctor and the Soul, appears as the 42nd most influential
text (n = 3, 0.3%). Zollikon Seminars, the 26th most influential (n = 6, 0.6%),
was the daseinsanalytic associated book that most influenced the practice of
existential-phenomenological practitioners.
Participants associated to the logotherapy and/or existential analysis
branch gave 574 validated responses and 128 different texts. Two of Frankl’s
books were their most influential texts: Man’s Search for Meaning (n = 104,
18.1%) and The Doctor and the Soul (n = 59, 10.3%). Längle’s Sinnvoll
Leben (n = 36, 6.3%) was their third most influential text (see Table 3). With
the exception of Yalom’s Existential Psychotherapy (n = 33, 5.7%), the 11
most influential texts are all from Frankl and Längle (n = 311, 54.2%), two
logotherapy and/or existential analysis associated authors. The most influen-
tial existential-phenomenological associated text was van Deurzen’s
Existential Counselling & Psychotherapy in Practice, ranking the 23rd most
influential (n = 3, 0.5%), while a single daseinsanalytic text was considered
influential by a single participant (n = 1, 0.2%): Binswanger’s Trois formes
manquées de la présence humaine.
For the texts question, inferential analysis was again not possible due to
the large number of different texts and the visible differences among branches.
13
Note. Daseins = Daseinsanalysis, Exist-hum = Existential-humanistic, Exist-phen = Existential-phenomenological, Logo = Logotherapy and/or existential analysis. Bold data
refer to the most frequent category and subcategory of practice by branch.
14 Journal of Humanistic Psychology
Inferential Statistics
Chi-square test applied to the thematized answers. A chi-square test of
homogeneity was conducted to determine whether participants’ understand-
ing of existential therapy’s most characteristic practices are equally dis-
tributed among branches. Results show that the frequency of the chosen
categories differed significantly depending on the participant’s branch χ2(12,
n = 2,162) = 1,198.522, p < .001.
associated with specific existential branches, χ2(3) = 461.745, p < .001; prac-
tices of other therapeutic paradigms, χ2(3) = 25.504, p < .001.
The adjusted models show that a daseinsanalyst (see Table 5) is almost
three times more likely to choose a phenomenological practice (odds ratio
[OR] = 2.763, Wald’s χ2(1) = 4.335, p = .037), as the most characteristic of
existential therapy, than an existential-humanistic (reference category), but
70% less likely to choose a practice informed by existential assumptions
(OR = 0.299, Wald’s χ2(1) = 4.080, p = .043). Compared with an existential-
phenomenological therapist, a daseinsanalyst is 75.6% less likely to choose a
practice informed by existential assumptions (OR = 0.244, Wald’s χ2(1) =
6.47, p = .011) and 70.6% less likely to choose a relational practice (OR =
0.294, Wald’s χ2(1) = 4.811, p = .028). Compared with a logotherapist, the
odds of a daseinsanalyst choosing a phenomenological practice will be 3.6
times bigger (OR = 3.671, Wald’s χ2(1) = 8.59, p = .003), but only one das-
einsanalyst chose a method associated with specific existential branches.
The odds of an existential-humanistic choosing a practice from another
therapeutic paradigm as the most characteristic of the existential practice is
two times bigger (OR = 2.056, Wald’s χ2(1) = 6.963, p = .008) than that of an
existential-phenomenological practitioner (see Table 5). But the latter is
almost five times more likely to choose a phenomenological practice (OR =
4.968, Wald’s χ2(1) = 36.232, p < .001) when compared to the former. Except
for phenomenological practices, existential-humanist and logotherapist odds
ratios are significantly different for all thematized practices: The odds of
choosing relational practices and practices related to other therapeutic para-
digms are almost five times bigger for an existential humanistic (OR = 4.925,
Wald’s χ2(1) = 27.573, p < .001, and OR = 4.849, Wald’s χ2(1) = 22.874, p <
.001, respectively) and 7.2 times bigger for practices informed by existential
assumptions (OR = 7.26, Wald’s χ2(1) = 38.271, p < .001). On the other hand,
logotherapists are 43 times more likely to choose their own specific methods
(OR = 43.47, Wald’s χ2(1) = 84.532, p < .001).
The existential-phenomenological odds ratio of choosing existential ther-
apy’s most characteristic practices is significantly different for all categories
of practice, when compared with a logotherapy and/or existential analysis
practitioner (see Table 5): The existential-phenomenological practitioner will
be 2.3 times more likely to choose a practice of another therapeutic paradigm
(OR = 2.358, Wald’s χ2(1) = 6.963, p = .008), 5.2 times more likely to choose
a relational practice (OR = 5.284, Wald’s χ2(1) = 61.646, p < .001), 6.6 times
more likely to choose a phenomenological practice (OR = 6.601, Wald’s χ2(1)
= 120.482, p < .001), and almost 9 times more likely to refer to practices
informed by existential assumptions (OR = 8.905, Wald’s χ2(1) = 85.623, p <
.001). Moreover, the odds of choosing a method associated with specific
Exist-hum Phenomenological practices 2.763* (1.061, 7.190) — 4.968*** (2.948, 8.373) 0.753 (0.431, 1.316)
Existential assumptions 0.299* (0.093, 0.965) — 1.227 (0.750, 2.007) 0.138*** (0.074, 0.258)
Relational practices 0.316 (0.098, 1.021) — 1.073 (0.654, 1.761) 0.203*** (0.112, 0.368)
Specific existential branches 0.381 (0.045, 3.216) — 0.943 (0.428, 2.077) 43.470*** (19.452, 97.144)
From other paradigms 0.319 (0.086, 1.178) — 0.486** (0.285, 0.831) 0.206*** (0.108, 0.394)
Exist-phen Phenomenological practices 0.556 (0.238, 1.297) 0.201*** (0.119, 0.339) — 0.151*** (0.108, 0.212)
Existential assumptions 0.244* (0.082, 0.726) 0.815 (0.498, 1.334) — 0.112*** (0.071, 0.178)
Relational practices 0.294* (0.099, 0.878) 0.932 (0.568, 1.530) — 0.189*** (0.125, 0.287)
Specific existential branches 0.404 (0.053, 3.059) 1.060 (0.482, 2.335) — 46.091*** (29.652, 71.645)
From other paradigms 0.655 (0.191, 2.252) 2.056** (1.204, 3.513) — 0.424** (0.261, 0.688)
Logo Phenomenological practices 3.671** (1.538, 8.758) 1.329 (0.760, 2.323) 6.601*** (4.713, 9.246) —
Existential assumptions 2.169 (0.680, 6.921) 7.260*** (3.874, 13.605) 8.905*** (5.604, 14.150) —
Note. OR = odds ratio (an OR > 1 indicates that the event of choosing that category of practice is more likely to occur in that branch when compared with the
reference category, and an OR < 1 indicates the contrary). CI = confidence interval, Daseins = Daseinsanalysis, Exist-hum = Existential-humanistic, Exist-phen =
Existential-phenomenological, Logo = Logotherapy and/or existential analysis.
aOnly one daseinsanalyst chose a method associated with specific existential branches, making impractical the adjustment of a logistic regression model.
17
18 Journal of Humanistic Psychology
Discussion
Data from both self-reported influences and practices suggest differences and
some similarities among the four main existential branches. Practitioners’
most influential authors and texts are usually related to the branch of their
training or affiliation institutions. Five overarching categories of practice were
found in common but, depending on their training or affiliation branch, prac-
titioners place a different relevance on each of those characteristic practices.
Differences
Influences. Data show that among existential therapists, the scope of influ-
ence of an author is pretty much limited to the branch he or she is related to.
This is particularly so with logotherapists, who reported being both influ-
enced mainly by its own authors and texts and having little influence (except
for Frankl) on other branches. Längle, for instance, was considered a great
influence among logotherapists’ practice but not a single reference to his
name or work was made among participants from other alignments.
These findings were consistent with the literature review about branches’
most influential authors and gives emphasis to the specificities of each branch
influence.
Practices. Five categories of practice are shared among the main existential
branches, but the frequency with which each of those practices are consid-
ered the most characteristic of existential therapy differs significantly depend-
ing on respondents’ training or affiliated branch. Daseinsanalysis,
existential-humanistic and the existential-phenomenological understanding
of existential therapy’s most characteristic practices show significant differ-
ences with each other concerning the choice of two categories of practice (see
Table 5). Logotherapy and/or existential analysis, on the other hand, pre-
sented two or more significant and pronounced differences with all other
branches, in particular with the existential-phenomenological.
Daseinsanalysts presented a similar ranking to the existential-phenomeno-
logical participants regarding the most characteristic categories of practice
(see Table 4). Phenomenological practices were their main category of exis-
tential practice, and a particular relevance (not found with any other branch)
was given to hermeneutic interventions. Rogerian relational practices were as
Similaraties
Influences. Frankl, May, Binswanger, Bugental, and Spinelli were the few
authors considered influential by participants of all four branches. Yalom’s
Existential psychotherapy; May, Angel, and Ellenberger’s Existence; and
Bugental’s The Art of the Psychotherapist were the only texts referred to as
influential by participants of all main branches. Data from both authors and
texts highlight Frankl and Yalom as existential therapies’ most influential
authors across all branches.
Limitations
Data concern practitioners’ self-reported perceived influences and practices,
which may not represent what really influenced them and what they really
practice.
Respondents were not asked directly to which branch they identify their
existential practice. Despite the problems associated with self-reported
answers, this could have been a more accurate way of determining the partici-
pants’ branch: The fact that a participant was trained or is a member of certain
institution may not always mean that their main influences and practices rep-
resent those associated with their institutional branch. Hence, those who
responded to the questionnaire may not be representative of the existential
branch they are associated with.
The number of participants associated to the daseinsanalytic branch was
clearly low, adding some limitations on branch representativeness and statis-
tical power.
Conclusion
In a previous article (Correia et al., 2014), it was shown that the four main
existential therapy branches are differently distributed worldwide, both geo-
graphically and idiomatically, depending on their country of origin and the
mother tongue of the founding or key authors: Daseinsanalysis (Binswanger
and Boss) being mainly concentrated in the German-speaking countries of
central Europe and in Brazil (Boss helped found the Brazilian group), the
existential-humanistic (May, Bugental, and Yalom) branch largely confined
to the United States recently reached China, the existential-phenomenologi-
cal branch, although a more culturally and linguistically diverse branch
(thanks to its origins—e.g., Spinelli, van Deurzen, Feijoo), has no expression
in German-speaking countries, finally Logotherapy and/or existential analy-
sis (Frankl and Längle) is mainly concentrated in German-speaking European
countries and in Spanish-speaking Latin-American countries (both Frankl
and Längle traveled frequently to teach in Latin America).
Here, strong evidence is presented corroborating differences in both self-
reported influences and practices among therapists associated with these self-
same branches.
May, Binswanger, Bugental, and Spinelli, but mainly Frankl and Yalom,
are the few shared authorial influences among the four main branches, while
the rule of each approach’s own authors as their main influences prevails.
The application of the phenomenological method is what most unifies the
different branches’ understanding about existential therapy’s most characteris-
tic practices. The relevance of existential-philosophical assumptions and the
relational attention on practice are also shared beliefs, mainly between dasein-
sanalysts, existential-phenomenological, and existential-humanistic practitio-
ners. Logotherapists’ understanding of the existential practice relies mostly on
their own very specific practices, barely referred to by their counterparts.
Logotherapy and/or existential analysis presented itself in this study as a
more idiosyncratic and technique-based existential psychotherapy; existential-
humanistic branch is characterized as a more relational, experiential, and
Authors’ Note
This investigation was granted ethical approval, under the Counselling Unit research
projects generic ethical approval (UEC0405/38), by the University of Strathclyde eth-
ics committee.
Funding
The author(s) disclosed receipt of the following financial support for the research,
authorship, and/or publication of this article: This research was supported by a schol-
arship (SFRH/BD/71484/2010) from the FCT–Fundação para a Ciência e a
Tecnologia, Ministério da Educação e Ciência, Portugal.
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Author Biographies
Edgar A. Correia is a PhD student at the Department of Counselling, University of
Strathclyde, Glasgow, UK. He is a chartered clinical psychologist and EAP and WCP-
registered existential psychotherapist and a founding member of the Sociedade
Portuguesa de Psicoterapia Existencial (SPPE).
Mick Cooper is a professor of Counselling Psychology at the University of
Roehampton, London, and a UKCP-registered existential psychotherapist. Mick is
author and editor of a wide range of texts on existential, person-centred and relational
approaches to therapy, including Existential Therapies (2nd ed., Sage 2017),
Existential counselling and psychotherapy: Contributions to a pluralistic practice
(Sage 2015) and Pluralistic Counselling and Psychotherapy (Sage 2011, with John
McLeod).
Lucia Berdondini is a lecturer and program leader of BSc(Hons) in Counselling and
Psychotherapy, at the School of Psychology, University of East London, and a BACP
registered Gestalt psychotherapist. She is particularly interested in psychology of
disasters and has focused her professional activity on developing counselling training
courses in countries in war and postconflict.
Karla Correia is a chartered clinical psychologist interested in psychology of stress
and well-being. Karla has a PhD in educational psychology with research in the field
of social and emotional learning.