Existential Therapy: What It Is And How It Helps

Medically reviewed by Arianna Williams
Updated November 9, 2023by Regain Editorial Team

Our modern way of life doesn't often leave much time for sitting around discussing philosophy, but philosophy can be an important part of coping with rapid changes in technology and other global issues. Based on the ideas of such great philosophers as Nietzsche and Kierkegaard, existential therapy can be relevant and helpful for many living with mental conditions or trying to improve their everyday functioning. In general, existential therapy works to help clients come to terms with “the givens of life” and work through internal conflicts. It often places emphasis on making good choices for the future and finding meaning in life. You may find an existential therapist online or in your local area.

Experiencing Inner Conflict?

Existential therapy is a type of counseling that generally recognizes everyone's struggles with inner conflict surrounding what existentialists call the “givens” of life. This kind of therapy tends to be a here-and-now solution for coping with inner conflicts related to the deeper issues we all typically face. This therapy normally aims to find meaning that can inform your understanding of yourself and help you make better decisions.

Who Can Benefit From This Therapy?

Existential therapy is typically best used for people in their teen years and older. Anyone old enough to contemplate the deeper issues of their life may benefit from this therapy. Many people have found this therapy helpful when experiencing conditions like addiction, anxiety, and depression.

The Four Realms Of Existence And Experience

Existential therapy may help anyone who experiences problems that come with difficulty resolving inner conflicts. These problems are often categorized into what therapists call “the four realms of existence and experience,” which generally include the following:

  1. The physical realm of birth, death, and physical symptoms
  2. The social realm of culture, language, work, relationships, emotions, race, family, and attitudes toward authorities
  3. The personal realm of intimacy, identity, sense of self, and awareness of our strengths and limitations
  4. The making realm or transcendence realm of religion, values, and beliefs

The Givens

The givens of life are usually issues inherent to the human condition, which can include:

  • Death
  • Freedom and the responsibility that comes with it
  • Isolation
  • Meaninglessness

You may be consciously aware of one or more of the givens at any point in your life, or they may lie below your level of full awareness but still inform the choices you make. Typically, we become aware of a given when we're confronted with a crisis.

For example, if you have a near-death experience, you might become aware of your mortality. Students often struggle with meaninglessness when their long-held childhood beliefs are debunked. Whatever brings you into awareness of the givens, facing and dealing with them successfully can improve your life dramatically.

Inner Conflicts


Inner conflicts usually come from our difficulty to accept and cope with the reality of givens such as death. You might have the intellectual knowledge that you will die someday, but until you confront death personally, that knowledge may be mixed with feelings of invincibility. When that is happening, it can be easy to take incredible risks without any concern.

Once you realize that you're vulnerable, the inner conflict usually begins. You may still have the knowledge you will die, but too much focus on that can keep you from living your life fully in the here and now. This can lead to existential anxiety.

Existential Anxiety

This anxiety is often a part of the human condition. You may feel an overwhelming fear of death, isolation, meaninglessness, or freedom and responsibility. This may be crippling, or it may simply be a nagging fear that causes you to hesitate and doubt yourself.

After all, believing that you'll never die, for example, would be so far from reality that you likely wouldn't be able to function in your daily life. Instead, existential therapy generally aims to help you find a balance between being aware of one of the givens and being overwhelmed by it.

This anxiety, also called existential angst, doesn’t usually constitute a mental disorder. It's something anyone can feel when they contemplate one of the givens. It typically only becomes a problem if you can't resolve your thoughts and feelings about a given in a meaningful and positive way. When that happens, you may either become overwhelmed or careless.

How This Therapy Can Help With Existential Fears

This anxiety often lies at the heart of our human existence. We may not be able to wish the givens away, and if we try to pretend they don't exist, our subconscious mind may still hold those fears. So, what can you do? How can you live your life in fear or denial? The answer for existential therapists is usually that you must balance awareness of the given and overwhelming fear.

You can find your balancing point during existential therapy. You may face your fears directly and overcome them by taking direct action in the here and now. You may learn to become curious about life and find wonder in the world around you. This new perspective on life can help you engage in the moment.

Focus On The Here And Now And The Future

This therapy generally focuses on the present but also on the future. You may talk briefly about the past, but usually only as a tool for making better decisions now and in the future. An important aspect of making those current and future choices can be accepting responsibility for past choices and being aware of the consequences of those choices. However, the primary work in this therapy is normally to examine your current beliefs and awareness to prepare yourself to make better decisions when they arise.

Consider the example of a person who nearly died in a car accident. They might be suddenly overwhelmed by the fear that they will die someday. Knowledge of that given in life may now be very real and immediate. That person might be so frightened by their experience that they stop driving altogether. This therapy could help them face that fear of death and decide what they want to do about driving in light of the meaning they make of their life.

If it was the person's loved one who nearly died, they might suddenly fear losing them. They might face their fear through therapy so that they allow their loved ones to live freely without trying to shelter them too much.

On the other hand, if a person had near-death experiences without accepting the reality of their eventual death, their therapy would likely focus on becoming more aware of this reality and the unexpressed fear associated with it. Then, they might be able to make better decisions about taking risks.

Planning And Decision-Making Skills

When you're in existential therapy, you often learn to plan for the future. Your therapist may guide you in evaluating your options in light of the existential givens. You may learn from your past decisions and their consequences on making better decisions now and in the future.

Identity Issues

Existential therapy theory generally assumes you are capable of self-awareness. As you become more self-aware, you can resolve self-esteem issues and learn more about who you are as a person. You can learn what makes you different from other people, as well as where your commonalities lie. At the same time, you may come to understand that you aren't unique. When you understand that, you may feel sad for a while. You may eventually come to accept that truth and allow it to help you feel less isolated from others.

Relationship Issues

Contemplating your existence isn't necessarily a selfish thing. When you understand yourself better, you can relate to other people on a more meaningful level. You can learn to communicate more effectively. You may learn specific communication skills as well as how to understand others better.

Finding Your Meaning

Experiencing Inner Conflict?

Meaninglessness may be one of the existential givens, but it's also one of the main subjects you may explore as you cope with the other three givens. Usually, difficulties with meaning fall into two main categories. First, you may have never created a comprehensible meaning for yourself. As you face your existential fears, you can then develop the meaning that makes sense to you.

Second, you may have been taught about meaning early in life, especially if you grew up in a religious household or developed meaning for your life early on. At some point, an existential crisis may call that meaning into question or refute it together. In this case, you can resolve the inconsistencies in the meaning you've found for your life in the past and reformulate your meaning based on what you're aware of now.

Finding An Existential Therapist

Existential therapy may have a lot to offer people who are facing serious inner conflicts in their lives. While treatment methods like cognitive-behavioral therapy have become very popular with patients, therapists, and even insurance companies, they may fail to address the larger issues. Existential therapy techniques, on the other hand, often address both concrete behaviors and universal meanings.

Whether you choose to face your challenges in existential therapy or limit your therapy experience to working through your behavior, you can find a suitable therapist through an online therapy platform. These platforms can make it simple to match with a therapist with a particular background or experience in a specific area, such as existential therapy. In contrast, it can often be challenging to find an existential therapist locally. 

As this study shows, online therapy is generally as effective as traditional in-office therapy. If you believe you’d benefit from working with a licensed mental health professional, we encourage you to reach out for the help you deserve.


Existential therapy typically operates on the four realms of existence and experience, with the goal of alleviating the existential anxiety that often comes with “the givens of life.” It often focuses on working through internal conflicts, finding meaning in life, and making good choices now and in the future. If you’re interested in connecting with an existential therapist, you may match with one on an online therapy platform or find one locally.

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