Existential-integrative therapy

Existential-integrative therapy (EIT) is a form of psychotherapy that combines the insights and methods of existential and humanistic approaches with those of other therapeutic modalities, such as cognitive-behavioural, psychodynamic, or gestalt therapy. EIT aims to help clients face the challenges and opportunities of human existence, such as finding meaning, coping with anxiety, expressing emotions, and relating to others. EIT also emphasizes the importance of the therapeutic relationship as a vehicle for growth and change (Schneider, 2008). It was developed by Kirk J. Schneider, a leading figure in the existential-humanistic tradition, who was influenced by the work of Rollo May, James Bugental, and Irvin Yalom, among others (Schneider, 2014). EIT is not a fixed or rigid model, but rather a flexible and creative framework that can be adapted to the needs and preferences of each client and therapist. In this article, we will explore existential-integrative therapy and understand its benefits and limitations.

Schneider’s thinking behind combining multiple therapeutic models to create his version of existential-integrative therapy was based on the idea of expanding the scope and depth of psychotherapy. He believed that existential therapy, which focuses on the exploration of human existence and its meaning, limitations, and possibilities, could be enriched by integrating other modalities that address different aspects of psychological functioning, such as cognitive, behavioural, interpersonal, or somatic (Schneider, 2008). According to Schneider (2019), EIT is a “deeply relational approach which uses a range of therapeutic concepts and strategies to help clients engage more fully with their experiencing” (p. 2).

Conversely, he also argued that mainstream modalities could benefit from incorporating existential themes and methods, such as awareness, authenticity, freedom, responsibility, and awe, into their practice. Schneider (2008) proposed that existential-integrative psychotherapy is a flexible and creative approach that adapts to the needs and preferences of each client, while also challenging them to confront their existential dilemmas and expand their experiential being.

Example therapeutic scenario

One possible scenario to illustrate how EIT can integrate other modalities is as follows:

A client who suffers from anxiety and low self-esteem comes to therapy seeking relief from his symptoms. The therapist begins by establishing a trusting and empathic relationship with the client, using humanistic techniques such as active listening, unconditional positive regard, and reflection. The therapist then explores the client’s existential issues, such as his sense of purpose, identity, values, and choices. The therapist helps the client to recognize his existential anxiety as a natural response to the uncertainty and finitude of life, and to confront his existential dilemmas, such as freedom versus responsibility, isolation versus connection, and meaning versus absurdity. The therapist also encourages the client to develop his own world-view and to live authentically according to his values.

In addition to existential exploration, the therapist also uses cognitive-behavioural techniques to help the client identify and challenge his negative thoughts and beliefs that contribute to his anxiety and low self-esteem. The therapist teaches the client coping skills, such as relaxation, mindfulness, and problem-solving, to manage his stress and emotions. The therapist also assigns homework tasks for the client to practice these skills and to apply them in real-life situations.

Furthermore, the therapist also integrates psychodynamic techniques to help the client understand how his experiences and relationships have shaped his current patterns of thinking, feeling, and behaving. The therapist helps the client to uncover and resolve any unresolved conflicts or traumas that may be affecting his present functioning. The therapist also helps the client to develop a more coherent and positive sense of self.

Finally, the therapist also incorporates transpersonal techniques to help the client access his higher potential and transcend his ego-bound limitations. The therapist introduces the client to concepts such as spirituality, consciousness, peak experiences, and Self-actualization. The therapist facilitates the client’s exploration of his own spirituality and helps him to connect with a higher power or a larger reality. The therapist also supports the client’s expression of his creativity and uniqueness.

By integrating different modalities, EIT can offer a comprehensive and holistic approach to therapy that addresses the client’s psychological, existential, relational, and spiritual needs. EIT can help the client to achieve greater well-being, fulfilment, and growth in their life.

Level of adoption

The level of adoption of EIT is not very high, as it is a relatively new and complex approach that requires extensive training and supervision. However, some studies have indicated that EIT can be effective for various clinical issues, such as anxiety, depression, trauma, and personality disorders (Schneider, 2019). For example, Schneider (2014) presented a case study of a client with borderline personality disorder who benefited from EIT by developing a more authentic and integrated sense of self. The client reported that EIT helped her “to feel more alive, more connected, more hopeful” (p. 15).

EIT is based on the premise that human beings are inherently creative and capable of transcending their difficulties. As Schneider (2008) stated, “Existential-integrative therapy is not about curing people; it is about helping them to live more fully in the face of their inevitable suffering” (p. 3). EIT offers a flexible and holistic framework that can be tailored to the needs and preferences of each client.

Criticisms of EIT

Existential-integrative therapy is not without its limitations and criticisms. Some of the main challenges that EIT faces are:

The lack of a systematic and coherent framework that guides its practice and research. Some critics argue that EI is too vague, eclectic and inconsistent in its theoretical and methodological foundations (Existential Approaches and cognitive Behavior Therapy, 2020). They claim that it does not offer clear criteria for selecting and integrating different techniques, nor does it specify how to measure its outcomes and effectiveness.

The potential conflict between existential values and integrative goals. Some existentialists question the validity and appropriateness of combining existential therapy with other approaches that may have incompatible assumptions or objectives. For instance, some cognitive-behavioural therapies may focus on reducing negative emotions and enhancing happiness, while an existential perspective emphasizes the potential value and gains of experiencing a broader array of emotions (Existential-integrative Therapy, n.d.). To simply blindly seek happiness without considering the client’s values or the consequences of this striving is dangerous (Existential-integrative Therapy, n.d.). A second concern is the internal inconsistencies that potentially arise in integrative work (Existential-integrative Therapy, n.d.).

The difficulty of addressing the social and cultural dimensions of human existence. Some humanistic and existential therapists have been criticized for neglecting the role of social justice, diversity and oppression in their work. They have been accused of being too individualistic, universalistic and ahistorical in their understanding of human nature and experience (Challenges and new developments in existential-humanistic and existential-integrative psychotherapy, 2019). However, some recent developments in EH and EIT psychotherapy have attempted to incorporate more social and contextual factors into their practice, such as relationality, identity, Self-actualization and social change (Challenges and new developments in existential-humanistic and existential-integrative psychotherapy, 2019).

These are some of the main criticisms of EIT therapy that have been raised by various authors and researchers. However, EIT therapy also has many strengths and benefits, such as its flexibility, creativity, authenticity and depth. EIT therapy can offer clients a holistic and humanistic approach to their psychological well-being that respects their uniqueness, freedom and dignity.

References

Cooper, M., & McLeod, J. (2011). Pluralistic counselling and psychotherapy. Sage.

Existential Approaches and cognitive Behavior Therapy: Challenges and Opportunities for integration. (2020). Journal of Rational-Emotive & cognitive-Behavior Therapy, 38(3), 211–227. https://doi.org/10.1007/s41811-020-00096-1

Existential-integrative Therapy. (n.d.). Retrieved December 11, 2023, from https://existential-therapy.com/existential-integrative-therapy/

Hoffman, L., Vallejos, L., Cleare-Hoffman, H., & Rubin, S. (2015). Emotion, relationship, and meaning as core existential practice: Evidence-based foundations. Journal of Contemporary Psychotherapy, 45(1), 11-20.

Schneider K.J., Pierson J.F., & Bugental J.F.T. (2014). The handbook of humanistic psychology: Theory, research, and practice (2nd ed.). Sage.

Schneider, K. J. (2008). Existential-integrative psychotherapy: Guideposts to the core of practice. Routledge.

Schneider, K. J. (2014). Existential-integrative therapy: Foundational implications for training. Psychotherapy, 51(3), 350-355.

Schneider, K. J. (2019). The spirit of existential-integrative therapy: A primer for practitioners. Journal of Humanistic Psychology, 59(1), 3-25.

Schneider, K. J. & Bugental, J. F. T. (2019). Challenges and new developments in existential-humanistic and existential-integrative psychotherapy. In The handbook of humanistic psychology: Theory, research, and practice (2nd ed., pp. 323–340). American Psychological Association. https://doi.org/10.1037/0000124-018