Existential Theory and Art Therapy

I was drawn to existential theory and existential art therapy because I have been interested in existential philosophy for years, particularly books by Albert Camus. Although Camus rejected the existentialist label, his works are considered existentialist by most. An existential therapy book called Man’s Search for Meaning is the number one most popular book in popular psychology psychotherapy and popular psychology psychoanalysis. The author, Victor Frankl, is the father of logotherapy, a type of existential therapy. The “logos” is a concept that was developed by early Greek philosophy, particularly by Socrates, Plato, and Aristotle, in 400 B.C.E. Logos means “meaning” or “reason”, therefore logotherapy literally means “therapy through meaning”. With logotherapy, Frankl uses a technique called Socratic dialogue, inspired by Socrates. An article called “Dialoguing with Dreams in Existential Art Therapy” by Bruce Moon was intriguing to me. It discusses how artistic renditions of dreams can be explored in existential therapy, leading to clarity and healing for the client. Bruce Moon, a prominent art therapist, wrote extensively about existential theory as it pertains to art therapy. Existential therapy is especially effective for those in health crises. (Capuzzi & Stauffer, 2016, p. 161) Because I am passionate about medical art therapy and trauma therapy, I decided to research existential theory.

Now, you might assume the history of existential theory begins with the Socratic dialogue and Socrates, but human beings have been searching for meaning since they developed the mental capacity to do so. Millenniums ago, humans created drawings in caves. Cave art was connected with symbolic and religious practice. In Argentina, there is a cave called Cueva de las Manos (Cave of the Hands) with hundreds of hands alongside animals and people collaged on the walls. The sheer multitude of hands on the wall suggests that the cave was special to the culture of the cave dwellers.

Since early times, humans have used art to make important events such as death special through the creation of visual imagery, and art forms have been part of funeral ceremonies since Neanderthal times. It is clear that art somehow helps human beings cope with loss and that it is a universal human experience to express loss through symbols and to use images to relieve emotional distress. (Malchiodi, 2007, as cited in Story, 2007, p. 29)

The early Greek philosophers discussed existential concepts and developed techniques later used by existential therapists. The Socratic method consisted of dialectic questioning to guide people toward knowledge and understanding. The questioning involves open questions to encourage discussion, guiding questions to intensify discussion, and closing questions to summarize the discussion. Many psychological theories utilize modified Socratic questioning, including logotherapy, Adlerian, rational emotive behavior therapy, and reality therapy.

Many of our clients aim to address existential questions, such as Who am I? Why am I here? What is the purpose or significance of it all? What sense does anything make? How much control do I have over my life? What happens when life ends? Earlier philosophers, such as Plato, Socrates, and Aristotle, and current therapists have studied how people understand their life, experiences, and relationships and how this understanding affects their lives. Thus, the pursuit of meaning influences most of what we do. (Ivey et al., 2023, 257-258)

Existential philosophy was founded shortly before the discipline of psychology developed. Existential philosophers were very supportive of artistic creation in the pursuit of meaning. Albert Camus wrote: “A man's work is nothing but this slow trek to rediscover, through the detours of art, those two or three great and simple images in whose presence his heart first opened,” (2012, p. 17) Many other existential philosophers influenced existential theory, including Friedrich Nietzsche, Soren Kierkegaard, and Jean-Paul Sartre.

The first psychotherapist who practiced under existential theory was Otto Rank, an Austrian psychoanalyst who broke with Freud. Ludwig Binswanger, Rollo May, and Irvin Yalom developed and refined the theory. Yalom wrote about the four “givens” of the human condition: isolation, meaninglessness, mortality, and freedom. Victor Frankl spread existential psychology throughout the world. He survived the Nazi death camps and demonstrated that even under those extreme conditions, it is possible to create meaning. Otto Rank wrote several books focusing on art and psychology, such as Art and Artist: Creative Urge and Personality Development. Bruce Moon is known for working with existential theory in art therapy.

Existentialist philosophy explored topics such as the meaning and purpose of human existence. The “Absurd” arises with the interaction of human beings and the world, such as when a tragedy befalls a generally good person. Actually, in existentialist thought there is no such concept as good and evil outside the human perspective. When people encounter the absurdity of reality, many experience dread and anxiety, referred to as “existential angst”. In existential philosophy, when an individual is experiencing existential angst, they are at a turning point in their identity. Frankl referred to similar concepts in his theory. The Absurd is analogous to the “Existential Vacuum” and existential angst is analogous to “existential frustration”. Frankl believed existential frustration could result in neurosis or noögenic neurosis (from the Greek noös meaning “mind). (Frankl, 2006, p. 101) In contradiction to past philosophies and religions that posited a higher being, existentialists assert that “existence precedes essence”, meaning that human beings shape themselves by existing, not as compared to some a priori category that is assumed to exist beyond physical reality. Authenticity and facticity are important concepts in existentialism. Authenticity refers to being true to oneself. Facticity refers to the facts and limits of one’s existence. Human beings are accountable to create a genuine life within the bounds of their factual self. Frankl thought this was achieved through “noö-dynamics”, during which the client is experiencing tension between themselves and their goals. (Frankl, 2006, p. 104-105) The “Other” and the “Look” are phenomenological ideas in existentialism. The Other is another free individual who has a subjective perspective that is just as valid as your own. The Look is the experience of being perceived by the Other. Imagining oneself as being perceived can lead to altered behavior.

Existential therapy’s fundamental tenets contrast with psychoanalytic and radical behavior therapy. Logotherapy’s focus on a will to meaning contrasts with the Freudian focus on a will to pleasure and the Adlerian focus on a will to power. Psychoanalytic and radical behavior theories view socio-cultural variables and past events as determining the future. In existential therapy, individual freedom in the present is emphasized. With this freedom comes choices that entail responsibility. Because we are free to make choices that determine our lives, we are responsible for the outcomes of these choices. Frankl encapsulated this thought in his statement: “Freedom is in danger of degenerating into mere arbitrariness unless it is lived in terms of responsibleness. That is why I recommend that the Statue of Liberty on the East Coast be supplemented by a Statue of Responsibility on the West Coast.” (Frankl, 2006, p. 132) Other counseling theories are based on the medical model and seek to cure the client. Some existential counselors do not believe that psychological disorders exist in a real sense except as artificial categories. They do not attempt to cure the client but empower the client against adversity. This encourages personal agency for the client. (Story, 2007, p. 22) Existential theory addresses the loneliness that develops once an individual realizes their individuality as separate from others. Existential therapists would help the client to pursue an authentic self and a happy life despite the impossibility of being completely understood by and connected to another person. Existential theory focuses on six different facets of the human condition. These include: the capacity for self-awareness, freedom and responsibility, creating one’s identity and establishing meaningful relationships with others, the search for meaning, anxiety, and awareness of death and non-being. (Story, 2007, p. 25)

There are a number of treatment principles and goals for existential therapy. These include helping the client identify the ways in which they are not living fully authentic lives, encouraging the client towards making choices that will help them to live up to their full potential, helping the client live in the “here and now”, identifying factors that are preventing the client’s freedom, challenging the client to recognize the choices that lead to their current situation, and helping the client accept responsibility for their actions. As counselors are also on the existential journey with the client, the therapeutic relationship is not based on power dynamics. While being professional, existential counselors are present and caring. While therapeutic techniques are utilized in existential counseling, specific methods and procedures are not required. Modifying their techniques to best serve the client, existential counselors are present in the moment. The goal is to expand the client’s perspective on life, not restrict them to over-regimented treatment programs. (Story, 2007, p. 26) Existential therapy has been blended with a variety of other theories. Humanistic existentialism focuses on existential concerns through humanism. Psychoanalytic/psychodynamic existentialism blends psychoanalytic thought with existentialist thought. Transpersonal existentialism adds spiritual aspects to the counseling. (Capuzzi & Stauffer, 2016, p. 150-151)

Existential art therapy maintains all the above principles, while also adding the variable of art making. In existential art therapy, the art functions as the Other. By reflecting on the art, the artist can reach insight on how to change their life for the better.

Existential emptiness, so eloquently defined by the existential philosophers, is unable to be filled alone; only through the relationship to others can an individual hope to come to terms with and thus fill their unique experience of existential emptiness. Existential art therapy asserts that the very image created by a client can be used as an experience of the other. (Story, 2007, p. 27)

While the existential art therapy process can be uncomfortable, the ultimate goal is to create meaning for the client. During the art-making, the existential art therapist is participating with and honoring the client’s existential journey.

A study was conducted by Paul Camic on the efficacy of existential art therapy in the treatment of clients in chronic pain. Seven participants met for fifteen weekly sessions that were ninety minutes each. At the end of treatment, all the men scored lower on the Beck Depression Inventory and the State-Trait Anxiety Inventory. They reported that making art lessened their perception of pain. During art creation, the men reported they did not notice their pain at all. (Story, 2007, p. 30) Frankl noticed a similar result occurring in the concentration camps. He wrote “As the inner life of the prisoner tended to become more intense, he also experienced the beauty of art and nature as never before. Under their influence, he sometimes even forgot his own frightful circumstances.” (Frankl, 2006, p. 39) A lack of meaning in life has been associated with mental illnesses. (Capuzzi & Stauffer, 2016, p. 161) There is a multitude of studies that demonstrate the power of art and cultural activities to heal the psyche.

Creative activities, specifically music, theater, painting, and writing poetry, are known to contribute to existential well-being and are therefore used for therapeutic purposes in areas such as art and music therapy. Empirical studies (Binnie, 2010; Cuypers et al., 2011; Davies, Knuiman, & Rosenberg, 2015; Jensen, 2013; Michalos & Kahlke, 2008, and more) confirm such benefits from not only creative activities such as painting, playing music, and creative writing but also receptive participation in cultural activities such as looking at art, listening to music, and reading fiction. Studies vary according to selected groups of participants, the cultural activities they are involved in, methods of assessment, and how psychological well-being is defined, but even so, they all confirm a positive correlation between cultural activities and some kind of psychological well-being. (Funch, 2021, p. 13)

Frankl developed a technique in logotherapy called paradoxical intention for the treatment of those with neurotic fear. He believed that an excessive intention or “hyper-intention” lead to anticipatory anxiety and hyper-reflection. Through redirection or “dereflection” of thoughts, it is possible to change behavior. For example, someone with social anxiety could try their best not to stutter and blush but this actually will result in more blunders and reinforce the anxiety. Frankl believed by directing one's thoughts to actually doing the opposite of what one was attempting to do made it more likely that the original intention would occur. Returning to the previous example, the client with social anxiety would not try to socialize properly, but would in fact attempt to appear awkward. Paradoxical intention can be applied to other situations such as insomnia. In cases regarding insomnia, the client will not worry about falling asleep but will try to stay awake as long as possible, which will in fact lead to them falling asleep. (Frankl, 2006, p. 122-124)

Socratic questioning is a technique used in many therapy theories, including logotherapy. Socratic questioning attempts to challenge assumptions that are affecting clients’ thoughts and behaviors. It considers alternative points of view, seeking meaning and truth. Although Socratic questioning and critical thinking are closely related, Socratic questioning adds another layer of depth. Socratic questioning is exploratory and encourages clients to transform their thoughts.

In Moon’s article, he describes an existential art therapy technique. The technique is based on Clarke Moustakas’ systematic phenomenological approach to interpreting dreams. When using this technique, the existential art therapist must serve the dreamer by being open to and honoring the dream material. (Moon, 2011, p. 128) An image of the dream is created and a written record, or script, of the dream is written and read aloud by the client. While the dream image is placed between the art therapist and the dreamer, the art therapist reads the script aloud to the dreamer. The horizons, or key elements, of the dream are identified and amplified with associations that are repeated and clarified by the art therapist. The horizons are clustered in groups and existential statements of concern are created. A summary of statements of existential concern and a course of action in response to the dream is outlined. This course of action is commonly found between the poles of paradoxical intention. Finally, a commitment is made to a course of action in response to the dream. (Moon, 2011, p. 129-130) Moon visually describes the process as a sieve or funnel. At the top of the funnel is the manifest content of the dream which is reduced by the creation of the image, script, horizons, and existential concerns. After being processed through the sieve, the identification of the course of action in response to the dream emerges. (Moon, 2011, p. 132) The following is an example of the process with an art piece of my own depicting my childhood dream.

Cloudy City

Mixed media on watercolor paper

9 x 12 inches

In the dream, I was running through a labyrinth of a city. I was lost and alone, trying to find my family. There were shadowy and scary figures that I feared were chasing me. Tears were streaming down my face as I continued to search. When I finally awoke, I was crying in reality as well.

The horizons of the dream would be being in a labyrinth, being lost, being alone, trying to find family, being chased by shadowy and scary figures, and being scared and sad.

I had this dream when I was very young but I have never been able to forget it. Although I do not know the exact date I had this dream, I know it would have been around when I was in preschool, which just so happened to be in 2001. Personally, I believe it may have been linked to the 9/11 terrorist attacks, hence why I incorporated tilted tower imagery. My mom says I would have seen the terrorist attacks on television, but as I was so young I do not think I was able to process the event. Therefore, my dreams tried to process what my consciousness could not. I felt isolated in a confusing city, trying to find solace in my family. I felt like there was a darkness in the world I could not yet comprehend, and this darkness threatened my safety and happiness until I woke up.

I would cluster the horizons into lost/alone/labyrinth, family/shadowy figures, and fear/sadness. Existential statements would be 1. After terrifying and absurd occurrences, I feel lost and alone like I am in a maze. 2. I seek my family to escape people who can hurt me. 3. Fear and sadness occur in these moments but I can ultimately return to my family. The summary statement would be: During difficult times, I might feel disoriented and lonely, but these feelings will pass and I need to find time to be with the ones I love. The paradoxical intentions in response to the summary statement would be 1. I need to be with my family as much as possible. 2. I need to avoid my family at all costs. Between these paradoxical intentions is found 3. I need to make time for my family so I can adequately handle difficult times.

In an article about existential art therapy with couples and families, I found a clinical application based on Frankl’s ideas and art therapy. Art was found to be useful in bringing repressed meanings into consciousness, uncovering meaning potentials, and changing patterns of thinking and behaving. During existential art therapy, the clients are asked to meditate on the art they have created. (Lantz & Alford, 1995, p. 331-333) A drawing task called “two pine trees in a forest” was used with a couple named Sandy and Bill to encourage contemplation and conversation on communication and independence issues. Sandy and Bill entered therapy after their youngest child moved out and they started experiencing “empty nest syndrome”. Sandy told the therapist that the children had distracted Bill and her from addressing their issues. The couple had some trouble being vulnerable in therapy because this had been avoided in their marriage. After they completed the art task, their communication showed marked improvement.

Sandy and Bill’s drawings significantly contrasted with each other, indicating the differences in how they interpret their relationship. Sandy’s drawing possessed one very small tree and one very large tree that towered over the smaller tree. The trees were placed far from one another on the page. In Bill’s drawing, the trees were closer together and the larger tree was sheltering the smaller tree from the elements. The larger tree was beaten and worn in comparison to the small tree which Bill said was “in better shape”. Sandy and Bill were able to use this drawing to discuss their differences in perspectives and initiate dialogue. (Lantz & Alford, 1995, p. 340-341)

Because of the deep subject matter it explores, existential therapy can cause some clients to become uncomfortable. It requires them to face their fears and acknowledge their responsibilities. They have to accept the choices they have made in the past, observe how those choices affected their present, and plan choices about how they will shape their future. Existential therapy incorporates interpersonal therapy and is determined by the therapeutic relationship. Clients who do not prefer to interact much with other people will consider this invasive and disturbing. Other clients will prefer a more structured therapeutic approach compared to existentialist therapy. (Capuzzi & Stauffer, 2016, p. 162) If existential therapists want to appeal to these types of clients, they should consider reorganizing the therapy sessions to be less uncomfortable, invasive, and unstructured.

Existentialist therapists need to be aware of multicultural concerns. Unfortunately, existentialist theory, like much of psychological theory, is deeply entrenched in Western and White perspectives. Therapists need to take a step back and make sure they are taking diverse viewpoints into account.

Existential and humanistic psychology both espouse a deep valuing of diversity – racial, cultural, gender, religious, sexual orientation, and other forms of diversity. Yet, an overview of the literature and a quick glance through the perspectives at humanistic and existential conferences illustrates that they are dominated by White, heterosexual male perspectives. This represents a very unfortunate unfulfilled potential. Existential and humanistic psychology would be stronger if more diverse voices were involved in the dialogues. (Alcahé et al., 2008, p. 1)

On the other hand, the focus on the phenomenological perspective in existential thought naturally leads to an openness to the client’s perspective. (Alcahé et al., 2008, p. 4) Existential theorists often consider mental illness diagnoses to be oppressive and believe what others deem as pathological to actually be healthy psychological expressions. Many therapists teach how to deal with and tolerate mental illness, but existentialist therapists go a step further and value neurodiversity in society. (Alcahé et al., 2008, p. 10) Some existentialist counselors value the expression of anger when facing oppressive systems.

To be okay with being mistreated or discriminated against is not a sign of good psychological health in most instances; instead, it often is a sign of internalized self-hate, shame, or apathy. When this occurs, therapists should not enable oppressive systems. Instead, the therapist often will want to encourage the client to express and hold on to the feelings of justified anger and then help the client find a creative outlet. (Alcahé et al., 2008, p. 12)

Existential theory, existential art therapy, and logotherapy have an extended history with a broad philosophical base, confronting deep questions such as the meaning of existence. With techniques like paradoxical intention, it helps people to live authentic lives. Although existential theory can be combined with other theories and art therapy in working with diverse clients, it is important to be aware of the influence of Western culture on existential thought and practice with multicultural humility. In the future, I hope to add to existential theory by effectively integrating it with medical art therapy, trauma therapy, and multicultural practice.

References

Alcahé, A., Hoffman, L., Meija, M., Oumarou, S. (2008) Exploring Diversity Issues in Existential-Integrative Therapy: Embracing Difficult Dialogues. Humanist Psychotherapies Conference, Boston, MA.

Albert Camus. (2012). Lyrical and Critical Essays. Vintage

Capuzzi, D., & Stauffer, M. D. (2016). Counseling and psychotherapy: Theories and interventions. John Wiley & Sons.

Frankl, V. (2006) Man’s Search for Meaning. Beacon Press.

Funch, B. S. (2021). Art, emotion, and existential well-being. Journal of Theoretical and Philosophical Psychology, 41(1), 5-17. 10.1037/teo0000151

Ivey, A. E., Ivey, M. B., & Zalaquett, C. P. (2023). Intentional interviewing and counseling: Facilitating client development in a multicultural society, 10th edition. Cengage.

Lantz, J., & Alford, K. (1995). Art in existential psychotherapy with couples and families. Contemporary Family Therapy: An International Journal, 17(3), 331-342. 10.1007/BF02252670

Meredith L. Story (2007) Existential art therapy. Canadian Art Therapy Association Journal, 20 (2), 22- 34. 10.1080/08322473.2007.11434771

Moon, B. L. (2011) Dialoguing with Dreams In Existential Art Therapy. Journal of the American Art Therapy Association, 24(3). 129-133. https://doi.org/10.1080/07421656.2007.10129428