You're not depressed, exactly. You have a good life by most measures. Job, relationship, the trappings of a functional adulthood. But there's a gnawing feeling underneath it all — a sense that something's missing, that you're going through the motions, that none of it quite means anything.
Existential Therapy: Exploring Meaning, Purpose and Human Experience
You're not sure what you're looking for. You just know this isn't it.
This kind of experience — not a breakdown but a hollowness, not a crisis but a question — is exactly what existential therapy is designed for. It doesn't try to fix you or remove your discomfort. It invites you to look directly at the fundamental questions of being human and find, within them, the material for a more authentic life.
Table of Contents
- What Is Existential Therapy?
- The Four Givens of Existence
- How Existential Therapy Differs From Other Approaches
- Who Existential Therapy Suits
- Viktor Frankl and the Search for Meaning
- The Connection to Humanistic Therapy
- What Existential Therapy Helps With
- What to Expect in Sessions
- Existential Therapy and Gestalt
- Frequently Asked Questions
What Is Existential Therapy?
Existential therapy is a philosophical approach to psychotherapy that takes as its starting point the realities of human existence rather than the mechanics of the mind. Rather than asking "what's wrong with you?" it asks "what is it like to be you — and how are you relating to the unavoidable facts of being alive?"
Its roots lie in the existentialist philosophical tradition of 19th- and 20th-century Europe.
Søren Kierkegaard (1813–1855) wrote about anxiety as the "dizziness of freedom" — the overwhelming weight of human choice and the anguish of not knowing what the right choice is.
Friedrich Nietzsche raised the question of meaning in a world without guaranteed purpose: "He who has a why to live can bear almost any how."
Martin Heidegger explored what it means to exist — to be here, finite, in time, always moving toward death, always responsible for the choices that constitute a life.
Jean-Paul Sartre articulated radical human freedom: "Existence precedes essence." We are not born with a fixed nature or purpose; we are what we make ourselves through choice.
In therapy, these philosophical concerns were translated into practice by thinkers like Ludwig Binswanger, Medard Boss, and — crucially — Emmy van Deurzen, who has been central in developing the existential tradition in Britain. American psychiatrist Irvin Yalom brought existential therapy to a wide audience through both his clinical writing and his acclaimed novels.
Existential therapy is not a set of techniques. It is a way of being with a client — an invitation to genuine philosophical dialogue about what matters, what is real, and what is possible.
The Four Givens of Existence
Irvin Yalom, in his landmark 1980 text Existential Psychotherapy, identified four ultimate concerns — the inescapable facts of human existence with which we all must grapple:
1. Death and Mortality
We are all going to die. Every person we love is going to die. And yet most of us live as though this weren't true — pushing the awareness of mortality into the background, deferring genuine engagement with our lives until some imagined future.
Existential therapy doesn't dwell morbidly on death. It uses awareness of mortality as a clarifying force — a reminder that time is finite and that choices matter. Yalom wrote that confronting death, rather than paralysing us, can awaken a deeper engagement with life.
2. Freedom and Responsibility
We are radically free. Not free in the sense of facing no constraints — life is full of constraints — but free in that we are always choosing how to respond, how to interpret, what to make of our circumstances. With that freedom comes responsibility: there is no one else to blame for the life we create.
This "burden of freedom" is anxiety-inducing. Many psychological difficulties involve ways of evading this responsibility — convincing ourselves we have no choice, blaming others, remaining passive.
3. Existential Isolation
We are ultimately alone. Not socially alone — we have relationships, connections, love — but existentially isolated: no one can fully inhabit your experience, and you cannot fully inhabit another's. We enter and leave existence alone.
This is not cause for despair. But it does mean that relationships can't bear the full weight of this aloneness. Therapy often helps people develop a more honest relationship with solitude and a less desperate need for others to fill the void.
4. Meaninglessness
The universe does not come with instructions. Life doesn't inherently mean anything. We are the ones who create meaning — through commitment, love, work, choice, and engagement.
The anxiety of meaninglessness — particularly common in secular, post-industrial societies where traditional sources of meaning (religion, community, clear social roles) have weakened — is one of the defining psychological challenges of contemporary life. Existential therapy works directly with this, helping people understand what genuinely matters to them and how to build a life that reflects it.
How Existential Therapy Differs From Other Approaches
Existential therapy occupies a distinctive place in the therapeutic landscape.
Compared to CBT: Cognitive behavioural therapy works at the level of thoughts, beliefs, and behaviours — identifying distortions and replacing them with more functional patterns. It is explicitly symptom-focused. Existential therapy is not interested primarily in symptoms; it is interested in the person's relationship to their existence. It doesn't assume that feeling better is the goal. Sometimes, recognising the truth of your situation — including its genuine difficulties — is more valuable than reducing anxiety.
Compared to psychodynamic therapy: Psychodynamic approaches explore how past experience (particularly early relationships) shapes current patterns. Existential therapy is more focused on the present and future — on how you are choosing to live now, and what it would mean to live more authentically.
Compared to person-centred therapy: There is significant overlap between existential and person-centred approaches — both are humanistic, relational, and non-directive. Person-centred therapy emphasises the therapeutic relationship and the conditions for growth; existential therapy brings more explicit philosophical content.
What all these approaches share, and existential therapy perhaps most fully embodies, is a conviction that the quality of the therapeutic relationship — honest, genuine, fully present — is what makes change possible.
Who Existential Therapy Suits
Existential therapy tends to resonate particularly with people who:
- Feel a vague but persistent sense that something is missing from their lives, without being able to name what
- Are going through a significant life transition — midlife, career change, relationship ending, bereavement, major illness — and finding it unsettling in ways that go beyond the practical
- Have a philosophical or intellectual orientation and want therapy to engage their mind, not just their feelings
- Are experiencing what's sometimes called an existential crisis — a confrontation with the questions of meaning, purpose, identity, or mortality
- Feel stuck in a life that works on paper but doesn't feel genuinely theirs
- Are dealing with grief or loss in ways that raise bigger questions about life's meaning
- Have tried other approaches and found them too focused on symptom relief rather than deeper exploration
Existential therapy is not limited to these groups — it can be helpful for many different presentations. But it is particularly well-suited when the question is not "how do I stop feeling this?" but "what does this mean, and how should I live in light of it?"
Viktor Frankl and the Search for Meaning
No discussion of existential therapy would be complete without Viktor Frankl, the Austrian psychiatrist and Holocaust survivor whose work has probably introduced more people to existential ideas than any academic text.
Frankl survived Auschwitz and three other concentration camps. In those conditions of absolute horror, he observed — both in himself and in others — that those who survived were often those who found or maintained a sense of meaning: a person waiting for them, a work to complete, a truth to witness and tell.
From this experience he developed logotherapy (from the Greek logos, meaning "meaning") — a form of existential therapy specifically focused on the human search for meaning. His book Man's Search for Meaning, published in 1946, remains one of the most widely read works in psychology.
Frankl argued that meaning can be found in three ways:
- Creative work — what we give to the world
- Experiential values — what we receive from the world (beauty, love, truth)
- Attitudinal values — the stance we take toward unavoidable suffering
This third source is perhaps the most radical: even when everything is taken from us, we retain the last of human freedoms — the ability to choose our attitude toward our circumstances.
Frankl's work doesn't minimise suffering. It insists that suffering, while not to be sought, can be given meaning — and that this capacity is what makes us fully human.
The Connection to Humanistic Therapy
Existential therapy belongs firmly within the broader humanistic tradition — a family of approaches that share a conviction in human dignity, potential, and the capacity for growth.
Humanistic therapy as a movement was deeply influenced by existentialism. Carl Rogers, whose person-centred approach is one of the most widely practised humanistic methods, drew on existentialist ideas about authenticity, self-determination, and the courage required to be genuinely oneself.
Abraham Maslow, another humanistic pioneer, wrote about self-actualisation — the movement toward one's fullest expression — in terms that resonate with existential concerns about authentic living.
The humanistic tradition shares with existentialism:
- A view of the person as whole, not reducible to symptoms or mechanisms
- A belief in the fundamental capacity for self-directed change
- A focus on present experience and future possibility, not only past causes
- A conviction that meaning, purpose, and authentic relationship are psychological necessities, not luxuries
In practice, a therapist working from a humanistic existential orientation will blend attention to the person's immediate experience with openness to exploring the bigger questions when they arise naturally.
What Existential Therapy Helps With
Existential therapy has demonstrated value across a range of presentations:
Existential anxiety and dread: The low-grade, persistent anxiety that doesn't attach to a specific object — not a fear of something happening, but an awareness of groundlessness, contingency, or mortality. CBT often struggles with this; existential approaches meet it directly.
Depression without clear cause: When there's no obvious precipitant — no bereavement, no crisis — but a flattening of engagement with life, a loss of meaning and pleasure, therapy that works at the level of meaning rather than mood can be more effective.
Midlife crisis: The "is this all there is?" experience — often triggered by success, paradoxically — that asks whether the life you've built is genuinely yours or a performance for others' approval.
Bereavement: Loss confronts us with mortality, with love's limits, with the question of what remains. Existential therapy provides a framework for this that goes beyond grief processing into genuine meaning-making.
Identity questions: "Who am I?" — particularly after significant role changes (retirement, divorce, children leaving), or for people who have always felt uncertain about who they are beneath the roles they perform.
Burnout: When depletion is not merely physical but a deeper question about whether what you're doing matters, or whether you're living the life you actually want.
Facing illness or mortality: Therapy that can sit honestly with the fact of death — rather than rushing to reassure or normalise — is often most helpful when someone has received a serious diagnosis.
What to Expect in Sessions
Existential therapy sessions don't follow a fixed format. They are genuinely conversational — closer to philosophical dialogue than a structured intervention.
You might discuss recent experiences, but the interest is in what they mean to you — how they illuminate your assumptions about yourself, others, or life. The therapist will be genuinely present, curious, and willing to be changed by the conversation — not delivering a pre-prepared perspective.
Challenging questions are part of the work. Not aggressive or destabilising, but honest: "What would it mean to actually do that?" "What are you afraid would happen if you chose differently?" "When you say nothing matters, do you believe that — or is it covering something that matters enormously?"
There is room for silence, for uncertainty, for "I don't know." In fact, not knowing — holding a question open rather than rushing to an answer — is often where the most important work happens.
Sessions are typically 50 minutes. Many existential therapy clients find a rhythm of weekly sessions over a period of months, with some moving to fortnightly as the work matures.
Existential Therapy and Gestalt
Existential and Gestalt therapy share deep philosophical roots and practical overlap. Both are rooted in phenomenology — the study of immediate, lived experience. Both value awareness, authenticity, and present-moment contact.
Gestalt therapy brings a particular emphasis on direct experimentation and contact with what's happening right now — in the body, in the room, in the relationship with the therapist. It complements existential therapy's philosophical depth with a more active, experiential dimension.
Annabel's integrative humanistic approach draws on both traditions — bringing philosophical depth to present-moment experience, and grounding abstract questions in felt, immediate reality.
Frequently Asked Questions
Do I need to be interested in philosophy to benefit from existential therapy?
Not at all. Existential therapy draws on philosophical ideas, but sessions are rooted in your actual lived experience — not abstract theory. You don't need to have read Sartre or Heidegger. The philosophical framework is in the background, shaping how the therapist thinks; what you encounter in the room is conversation about your life.
Is existential therapy evidence-based?
The evidence base for existential therapy is less extensive than for CBT, partly because it's harder to manualise and measure. However, there is a growing body of research supporting its effectiveness — particularly for existential distress, meaning-related difficulties, and end-of-life concerns. The therapeutic relationship, which existential therapy prioritises, is one of the most robustly evidenced factors in therapeutic outcome across all modalities.
Is this just navel-gazing? Will I actually feel better?
Existential therapy is not purely intellectual or abstract. Many clients report significant reduction in anxiety, depression, and a sense of meaninglessness as a result of this work. But the mechanism is different from symptom-focused approaches: rather than reducing distress directly, existential therapy helps you relate to your situation with more clarity, honesty, and agency — which typically changes how it feels.
Can existential therapy help with anxiety?
Yes, though it works differently to anxiety-focused CBT. Existential therapy doesn't aim to reduce anxiety as the primary goal — it recognises that some anxiety is an appropriate response to the genuine uncertainties of existence, and working with rather than against it is more honest. Many clients find that when they stop fighting anxiety and start engaging with its underlying questions, it loses much of its paralysing quality.
How is existential therapy different from life coaching?
Therapy and coaching are distinct in important ways. Therapy has a clinical training context, ethical frameworks (including BACP registration), and works with psychological distress and deeper emotional material. Coaching is typically more future-focused and action-oriented. Existential therapy does engage with big life questions and future direction — but within a relational, depth-oriented therapeutic context that coaching doesn't replicate.
Annabel at Kicks Therapy works from a humanistic integrative approach with strong existential and Gestalt influences — offering the kind of thoughtful, genuinely curious engagement that the big questions deserve. Based in Fulham, SW6, Annabel offers in-person sessions, walking therapy along the Thames Path, and video therapy via Zoom. Sessions are £80, with packages available. If these themes resonate — if you're navigating questions of meaning, purpose, or what you want your life to be — do reach out via the contact page or on 07887 376 839.
About the Author: This article was written by the Kicks Therapy Content Team in collaboration with Annabel, a BACP-registered integrative humanistic therapist with a BSc (Hons) in Humanistic Counselling from the Metanoia Institute. Annabel's practice draws on existential, person-centred, Gestalt, and Transactional Analysis influences.
Further Reading:
- What Is Humanistic Therapy?
- What Is Gestalt Therapy?
- Building Self-Esteem Through Therapy
- What Is Person-Centred Therapy?
Expert Sources:
- Viktor E. Frankl, Man's Search for Meaning (1946/1984) — Beacon Press
- Irvin D. Yalom, Existential Psychotherapy (1980) — Basic Books
- Emmy van Deurzen, Existential Counselling and Psychotherapy in Practice (3rd ed., 2012) — SAGE Publications
- British Association for Counselling and Psychotherapy (BACP): www.bacp.co.uk
- Society for Existential Analysis: www.existentialanalysis.org.uk
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