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The Situation

Dsicuss about the Practice of Counselling and Psychotherapy.

The present case is about Joel who is 36 years old and is unsatisfied with his life, He grew up with his father after his mother passed away. His father was a good man but had anger, alcohol and coping with loss issues. Joel was a rebel in his teenage, gave a hard time to his father, and worked hard to get into a university as a means to escape from him.  He is presently working successfully in a corporate law firm, is married to Anna and has a one year old boy named Oliver. His family lives comfortably under his income and they have been planning another child. Despite these positive events, Joel feels unhappy. He feels frustrated and although he loves his family, he feels that the pressure of parenthood is too much for him. He is constantly worried about himself being a good father and a good husband. He is disappointed in himself because he feels that he does not have adequate control over his life. He has therefore come for counseling sessions as he feels unhappy and dissatisfied with himself and the direction towards which his life is moving. According to me, the existential therapy needs to be adopted to deal with Joel’s situation appropriately.

The existential therapy is an exceptional kind of psychotherapy, which explores the difficulties faced in the daily life from a philosophical point of view rather than using fixed techniques. The therapists focus on the human beings as a whole; encourage people to take complete responsibility for the attainment of any form of success in their life (Corey, 2013). The existential theory emphasizes on human experiences, and therefore will focus on Joel rather that the symptoms that he faces. The issues that are being faced by Joel will be viewed as a result of him being unable to make authentic, self-directed and meaningful choices about the way he should live. The theory is named the same way because of its approach to help individuals deal with existential crisis. This is an appropriate approach is present scenario because this helps individuals face a crisis, the development of which is related to a major transition in life, parenthood, in Joel’s case. The existential approach can be beneficial in helping people learn to cope with things like situational anxiety, finding values that one can live by, making sense of their current life scenarios (Friedman, 1964). This approach emphasizes that it is required to have a subjective perspective for viewing a human condition in totality and not in parts. According Corey (2012) Existential therapy helps in providing individuals with a perspective in understanding freedom, guilt, commitment, anxiety, isolation and death. The three major areas of interest in  this therapy are, 1) Freedom- Every individual has the free will to choose their paths in life. 2) Meaning – people need to find the values of their life so that they has a reason to live a meaningful life. 3) Anxiety- therapists while practicing this approach understand that the anxiety, which is supposed to motivate individuals to act, might just be the reason behind them not taking control of their own life (Hoffman, 2004).

Understanding Existential Therapy

The major goals of this approach in working with Joel include 1) helping him realize that he has numerous possibilities and freedom available, 2) challenging him in realizing that he has more control over his life than he thinks and 3) helping him identify the variety of factors that are blocking his freedom to gain control over his circumstances . (Corey 2012). The key concept of this approach is that it does not have a specific or theoretical model; instead, this model stresses that individuals need to focus on their present condition and self-awareness prior to taking actions for shaping oneself. There are no specific techniques in this approach because therapists incorporate a number of techniques from various approaches to address the meaning of responsibility, freedom and the existential issues faced by individuals.  This approach of psychotherapy might not be the most conventional form of counseling, yet it has a certain structure, which is built specifically around the experiences and realities of the client. The therapists while using this approach do not put much emphasis on the events that had taken place in the past, however, the past is taken into consideration when the client is asked to use retrospection to understand what the past events imply towards the happenings of the present (Corey, 2009).

As the therapist, I will have to understand that Joel’s behavior, personality and reactions are shaped by the factors like culture, biology and luck. I will have to explain to him that the problems that he is facing are due to the fact that he does not exercise his choice and judgments in proper direction, to find a direction to his life; he needs to understand that every individual has the responsibility to make their own lives meaningful (McLeod, 2003). As an existential therapist, I need to help Joel know that his life is more about confronting the negative evil forces or environmental factors which are causing a blockage between him and his own life’s control. I have to help Joel in finding a philosophical meaning to his circumstances on the face of his unhappiness, dissatisfaction and anxiety. I need to form a sort of therapeutic alliance in comparison to the modalities which may seem long term. With the help of this therapy, I will need to the address the factors that have lead to Joel’s distance from his family and his inability to feel more enthusiastic about his work. I have to help him in penetrating deeper into the issues that have caused him to feel such discomfort in his life despite numerous positive components to look forward to. This would, in turn act as a catalyst in helping Joel find alternatives to fill the void that he has been feeling. I have to be devoid of any sort of judgments as my acceptance and empathy will be playing a major role in Joel’s recovery from the helplessness that he feels at the moment in his life. As his therapist I would have to help Joel find the opportunities so that he is capable of making existential choices, while making informed decisions about his current situation. With the help of this therapy, I need to help Joel in being capable of finding the dimensions of his newfound self-respect, self-growth and self-motivation. This therapy is accurate for the present case because with the help of this approach I will be able to help Joel be more self aware of his responsibilities, a good father and a good husband. Therefore, he might be able to look beyond the burdened feeling of his current life situations and envision a life where he can reach his full potential. The key aspect of this approach is that I cannot directly address the underlying factors causing him discomfort, rather help him,  step by step to work towards a more positive future. The aspects of this therapy that I will need to incorporate in the short therapy sessions would include empathizing with his situation, reflective listening, encouraging his affective components, accepting the subjective experiences faced by him. This might include therapy sessions involving cognitive-behavior therapy, strategic theories or psychodynamic theories (LeMay & Wilson, 2008).  This approach does not essentially follow any sort of comprehensive techniques, but my personal philosophies as Joel’s therapist must have some sort of congruence with the theoretical bases of this therapy. I have to be very willing to engage Joel in an authentic and genuine conversations, which would help him, make some meaningful changes in his life. It is absolutely essential that I have enough sensitivity towards therapeutic as well as teachable moments. I have to use this therapy effectively so that Joel is capable of accessing his emotional experiences or is able to deal with the obstacles that he needs to overcome. This will be done so that he can enter into the recovery phase, that is, he can act responsibly even though he insists that he is not capable of taking the responsibility of his family.

Goals of the therapy for Joel

Joel is hard working, however, that aspect of him began due to his intense wish to move away from his father who had a number of mental health issues. The tendency to be distant from the family might have begun from the time his mother passed away. Although his father worked hard to raise him, he was unable to support Joel emotionally enough. Joel started working in corporate law, which he genuinely enjoyed, because of which he could achieve the successful position that he presently is in.  Having a baby has been a very recent change in his life, which has caused him to take up a number of new responsibilities. Parenthood is difficult, especially when one is a beginner and this anxiety might be the reason for driving Joel away from his family. He has not been enjoying his work either, due the pressure he feels he has taken up. Another factor that might be causing the amplification of his discomfort, may be the fact that they have been planning another child. As discussed earlier, the existential approach emphasizes on the free will of the individual while nudging him/her to muster the strength to face the consequences and responsibilities of the decisions that has already been taken by them. The opening therapy session is of utmost importance, because this is where I will be building the base of the therapeutic rapport development. I already have a brief history of Joel’s case, but I will need him to delve deeper so that I can put forward my empathy and understanding for his situation. I will then need to emphasize on Joel’s freedom to choose the steps that he would want to take and explain to him the potential that he has in him to bring about a meaningful change in his life. As Joel’s therapist, I will also need to articulate the goals of this therapy. Developing the initial rapport can be a little tricky; however, can be achieved by demonstrating openness, honesty and respect, reflective listening and gradually building his faith. As a therapist, I can facilitate the therapy sessions by sharing my reactions to Joel’s thoughts while sharing similar experiences that I might have faced. I will have to get Joel to express his feelings and then challenge him in seeing the ways he has been avoiding his responsibilities and decisions.  I will have to share with him, that the experiences that he has been having, is essentially a unique human quality.

The Therapist's Role

Two techniques of intervention that I would incorporate in Joel’s situation for facilitating change would include ‘Holding the container’ technique and the ‘everything is everything’ approach (Edelstein, 2018). In the first technique, I will be holding the cup so that Joel is able o take risks of exploring the issues that are unusual for him. This will help him open up about his current life circumstances an d I will also have the opportunity to gain his trust while expressing to him that I will be there to support him despite what he is sharing. This technique will require Joel to experience the inner strength that he has. In order to me to hold the container properly,  I will have to do my personal works which might include committing myself to the psychotherapy, engaging myself to peer or paid consultation or supervision and  investing a large amount of self-care throughout my career. The other technique that I would like to use, would be everything is everything intervention approach.  According to this intervention, I would have to explain that nothing is a coincidence and everything is the result of conscious decisions taken by individuals.  Two other areas of intervention that can be used in the present scenario include ‘universalization’, in which Joel will be explained, he is not alone in the sufferings and ‘acceptance’ which would help Joel is reflect a sense of unconditional positive regard, thereby being capable of handling his own life situations.

References

Breitbart, W., Gibson, C., Poppito, S. R., & Berg, A. (2004). Psychotherapeutic interventions at the end of life: a focus on meaning and spirituality. The Canadian Journal of Psychiatry, 49(6), 366-372.

Corey, G. (2009) Theories and Practice of Counselingand Psychotherapy. (8th ed.) Belmont, CA: Thomson Higher Education.

Corey, G. (2013) Theories and Practice of Counselingand Psychotherapy. (9th ed.) Belmont, CA: Brooks/Cole CENGAGE Learning.

Edelstein, B. (2018). Ehinstitute.org. Retrieved 29 March 2018, from https://www.ehinstitute.org/pdf/Edelstein_TherapeuticInterventions.pdf

Friedman, M. (1964). Existential psychotherapy and the image of man. Journal of Humanistic Psychology.

LeMay, K., & Wilson, K. G. (2008). Treatment of existential distress in life threatening illness: a review of manualized interventions. Clinical psychology review, 28(3), 472-493.

McLeod, J. (2003) An Introduction to Counselling. (3rd ed.) Maidenhead, Berkshire, UK: Open University Press.

Mendelowitz, E. & Schneider, K. (2008) Existential Psychotherapy. In R.J. Corsini& D. Wedding Current Psychotherapies. (8th ed.) Belmont, CA: Thomson Higher Education, pp295-327.

Schneider, KJ 2005, ‘Existential-Humanistic Psychotherapies’ , in AS Gurman& SB Messer, eds., Essential Psychotherapies. New York: Guilford Press.

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