The Existential Givens in Therapy: Death, Freedom, Isolation and Meaning
Written by the ICPS College Academic Team · Reviewed by ICPS College faculty · Last reviewed: September 2026
Existential therapy approaches human difficulty not primarily as illness but as part of the condition of being alive. Drawing on philosophers such as Kierkegaard, Heidegger, Sartre and Merleau-Ponty, and on clinicians including Rollo May, Viktor Frankl, Emmy van Deurzen and Irvin Yalom, it asks how each person meets the fundamental conditions of existence.
The four existential givens
Yalom described four ultimate concerns that every person must face:
Death: awareness of mortality can generate anxiety, but also urgency and appreciation for life.
Freedom and responsibility: we are, to a large extent, the authors of our choices, which can feel liberating or overwhelming.
Existential isolation: however close our relationships, a gap remains between self and other.
Meaninglessness: life does not come with ready-made meaning, so meaning must be discovered or created.
Clients rarely name these givens directly. They tend to appear within everyday concerns: a midlife crisis, fear after a health scare, loneliness within a relationship, or paralysis in the face of a decision.
The phenomenological method
Phenomenology asks the practitioner to set aside assumptions and attend closely to the client's lived experience as it appears. In practice this involves:
Bracketing: noticing and suspending one's own theories and judgements.
Description: staying with what the client describes rather than rushing to explain it.
Horizontalisation: treating all aspects of experience as potentially significant.
Exploring the four dimensions of existence (physical, social, personal and spiritual), a framework associated with the British school of existential therapy.
Existential therapy in practice
Existential work is less a set of techniques than a way of being with clients. The therapist stays present, curious and honest, and is willing to engage with difficult questions rather than resolving them prematurely. Anxiety is understood not simply as a symptom to be removed but as a signal that something important is at stake. The aim is to help clients live more authentically and take ownership of their choices within the real limits of their situation.
Integrating existential ideas
Many counsellors integrate existential thinking into humanistic, psychodynamic or integrative practice. It is particularly relevant to bereavement, serious illness, ageing, life transitions and questions of identity and purpose. As with any approach, practitioners should work within their competence and use supervision to reflect on how their own relationship with the givens shapes their work.
Further training
The Professional Diploma in Existential Phenomenology for Counselling & Psychotherapy is a live-online programme carrying 60 CPD credits. It introduces existential philosophy, the phenomenological method and applied existential practice for counsellors, psychotherapists and allied professionals.
Related ICPS College courses
References
van Deurzen, E. (2012) Existential Counselling & Psychotherapy in Practice. 3rd edn. London: Sage.
Yalom, I.D. (1980) Existential Psychotherapy. New York: Basic Books.
Important information
This article is educational content for practitioners and learners. It is not a substitute for professional advice, counselling or therapy.
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