Yalom's existential psychotherapy

Domain III · Humanistic, existential & experiential · Irvin D. Yalom · 1980

What it is

Yalom's existential psychotherapy is not a manualised, phased treatment. It is a dynamic approach, a way of understanding conflict, plus a therapeutic stance that a clinician brings into ordinary individual or group therapy. Yalom himself says existential therapy is not a separate school to train…

Format

• The sources set out no formal phases for individual existential therapy. The structure below is assembled from the sequence of topics in The Gift of Therapy and is marked where it orders them. The group framework comes from Yalom & Leszcz and AGPA.
• Individual therapy (open-ended; weekly, about 50-minute sessions is the usual frame; Yalom's own cases often ran months to years)

Who practises it, and how they are trained or regulated

• What it is. Yalom's existential psychotherapy is not a manualised, phased treatment. It is a dynamic approach, a way of understanding conflict, plus a therapeutic stance that a clinician brings into ordinary individual or group therapy. Yalom himself says existential therapy is not a separate school to train in: a well-trained therapist develops "a sensitivity to existential issues", and he chose not to found a…

Evidence status, as the guide reports it

• Existential groups for people with life-threatening illness (Spiegel & Yalom 1978; Spiegel, Bloom & Yalom 1981): weekly groups for people with metastatic cancer that address death directly. Yalom describes about a decade of intensive work with such patients. In the 1981 randomised study, 86 women…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• shame. Welcome any disclosure warmly, and treat it as progress in trust.
• if the comment lands as an accusation, slow down and frame it carefully (4.11).
• stock answers like "fine". Persist lightly, and offer your own observation first.
• the patient feeling exposed. Keep the focus on understanding, not on judging the patient.
• a pattern of idealisation followed by disappointment. Bring it into the here-and-now early.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.