Running Head: DISABILITY, MEANING, AND EXISTENTIAL THERAPY 1

A Man with a Disability and the Search for Meaning with Existential Therapy

Leanne Stinn

PSYC 406

July 2020

Athabasca University
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 2

Abstract

Therapy is a very personal journey to engage upon. To have the best therapeutic outcome, it is

imperative that the approach chosen is in alignment with the client’s core struggles and personal

preferences. In the case study of Herb, an Albertan man who suffered a paralyzing workplace

injury cutting trees, we see a man who is searching to regain a sense of meaning in his life. This

case study is reviewed to determine the outcome Herb is looking for in therapy. Internal

strengths, possible sources of support, and areas for growth are identified. Through conducting a

thorough literature review analyzing key concepts, therapeutic process, techniques, and

applications, it is determined that existential therapy will be the best therapeutic approach for

Herb. As a person with a disability, reviewing the impact of this new aspect of identity within

Herb, his community, and the counselling relationship will be critical to Herb’s personal

acceptance. The philosophical foundation of existential therapy which acknowledges Herb’s

experiences with disability, while also recognizing the universality of humanity’s search for

meaning, is determined to be a strong fit. Further investigation into an eclectic approach is

recommended to expand upon areas of weakness within existential therapy. This case study

would be of particular interest to therapists searching for concrete applications of existential

therapy applied to a client.

A Man with a Disability and the Search for Meaning with Existential Therapy

“Every therapy must in some way, no matter how restricted, also be Logotherapy”

(Arnold, as cited in Frankl, 2010). The universality of the existential therapeutic approach, also

known as logotherapy, provides a flexible framework, well-suited for exploring the difficult

questions, like “what is the meaning of life?”. In the case study of Herb, a working class

Albertan man who had suffered a workplace injury cutting trees that left him paralyzed, we see a

man at the crossroads, searching to feel worthwhile again. Throughout this essay I will explore

why existential therapy is the optimal therapeutic approach for Herb. I will also explore the

implications of Herb’s disability on his relationship with himself, others, and myself as his

counsellor. This will involve a review of existential therapy’s key concepts, particularly the

fundamental principles of the method, and its view of human nature. This will be followed by the

therapeutic process. The therapeutic process will be comprised of the goals, the therapeutic

relationship, and other influencing factors that will impact Herb’s counselling. Within the

therapeutic process are the existential ‘non-technique’ techniques and their applications, which

will affect Herb through intrapersonal and interpersonal changes. Lastly, existential therapy and

its application to Herb is evaluated for its strengths, fit, and weaknesses. The weaknesses and

alternate therapies are explored for future investigation.

Key Concepts

Each unique client will affect the process of therapy, but the aim would be the same: to

do the best for our client. For Herb, I believe that the best therapeutic approach would be

existential therapy. This section will first explore the reasoning behind this choice by outlining

Herb’s core struggles and the existential themes that align. To do so, key existential concepts of
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 4

self awareness, along with freedom and responsibility, will build toward the ultimate goal of

finding meaning in Herb’s life (Corey, 2011). The existential view of human nature as searching

for meaning, being self-determinant, and reaching for transcendence (Frankl, 2010) will also

shed light on the origins of Herb’s struggles.

Choosing Existential Therapy

To determine the optimal therapy for Herb, I began by identifying his core struggles.

Through Herb’s word choices like “dissatisfied”, “discouraged”, and rhetorical questions like

“why did this happen to me?” there is a tone of pervasive helplessness and a sense that life is

happening to him; he doesn’t feel in control (Corey, 2005). These feelings are culminating into

serious mental health themes, most notably his frequent bouts of depression and past history of

suicidal thoughts (Corey, 2005). The goals Herb has set also betray how he currently feels about

himself. Through noting that he wants to work on his dissatisfaction, that he’s looking for a new

direction in life, and that he’s hoping to find motivation (Corey, 2005) we can infer that he feels

dissatisfied, directionless, and unmotivated. These thoughts are summed up in Herb’s question as

he wonders “what the meaning of life is” (Corey, 2005). The core struggles of helplessness,

depression, and lack of meaning in life were all struggles that existential therapy was best suited

to address.

Existential therapy is also known as Logotherapy, a word which is derived from Greek

roots that quite literally mean “meaning” (Frankl, 2010). With Herb’s ultimate goal of finding

meaning in his life, existential therapy was a natural fit. However, I also chose existential therapy

for more subtle reasons. As noted above, Herb is feeling a lack of control. Existential therapy

posits that once we’re aware and accepting of our circumstances, we also become aware that we
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 5

have the freedom to choose; however, this freedom of choice means that we now have to accept

the responsibility of our choices (Truscott, 2010). The knowledge that we’re not the victims of

our circumstances is a concept that could be both healing and empowering to Herb. Central to

the concepts of existential therapy, I believe that Herb can transcend the mental limitations

around his disability (Scalzo, 2010). I also believe that the depression and dissatisfaction Herb

currently feels will be addressed through one of the paradoxical secondary effects of existential

therapy: that the more we search for self fulfillment, the more we cannot grasp it. Rather, the self

fulfillment that Herb is searching for will organically emerge as he finds value and meaning in

life (Frankl, 2010). Through embracing the existential search for meaning and accepting the

empowering burden of freedom, existential therapy has the tools to directly address Herb’s core

struggles with helplessness, depression, and his search for the reasons of his existence.

Principles of Existential Therapy

Three principles of existential therapy are particularly salient to the case of Herb: self awareness,

freedom and responsibility, and the search for meaning (Corey, 2011).

Every change has a starting point, and to fully appreciate the changes we’ve made, it

helps to understand our starting place. For this reason, self awareness is often the first step

toward change in existential therapy (Truscott, 2010). Aspects of self awareness include our

awareness of our mortality, the valuableness of time, the impact of our actions, loneliness, and

the anxieties of not living authentically (Corey, 2011). This is a first step I would take with Herb.

Through his recognition of his own dissatisfaction in life along with a desire to find meaning

(Corey, 2005) I can see that Herb has some basic tools of self awareness. However, I don’t have

a sense of his values or passions. Without an understanding of his values, Herb would be unable
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 6

to consult his internal compass to confirm if his choices are authentic (Corey, 2011). Through

engaging in dialogue, a process central to the process of existential therapy (Truscott, 2010), I

would work to expand Herb’s awareness, which would further his understanding of freedom as it

applies to himself (Corey, 2011).

Central to existential therapy is an individual’s desire to rise above their circumstances

(Scalzo, 2010). Yet this cannot be achieved without accepting another existential truth: that we

have the freedom of choice (Farber, 2010). This means that we can shape our destiny as we will

it, but that we are equally responsible for the choices we have chosen (or not chosen) to make

(Corey, 2011). This isn’t to say that Herb’s disability is something he chose, but rather that he

gets to chose if the disability will drive his life forward, or if he will be the driver. The

implications of this could be both incredibly difficult for Herb, and incredibly empowering.

Already we can see elements of existential guilt, feelings from having taken a passive stance in

life (Corey, 2011), in the way Herb is simultaneously inspired and discouraged by his friends

with disabilities. Through Herb accepting his freedom, taking an active role in making choices

for himself, and accepting the accompanying responsibility, his existential guilt can be mitigated

and he can live a more authentic life.

Frankl (2010) writes that man’s search for meaning is “the surest sign of being truly

human”. From this we can see that Herb’s struggle is not pathological but rather a common

struggle of mankind. Frankl also defined a lack of meaning to make life worthwhile as an

“existential vacuum” (Frankl, 2010). As Herb had unwittingly described exactly this feeling, this

tells me that existential therapy has the framework to directly address his meaninglessness.

Through existential practices, Herb and I could work with who he is in the present, evaluating a
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 7

value system that would be in alignment with his way of being, to shape his future to be one of

authentic purpose (Corey, 2011).

View of Human Nature

The existential view of human nature states that we are self-determinant, giving us the

freedom to choose and to change, thereby shaping our future (Frankl, 2010). We are also

responsive, and existential therapy brings forth the question of what we are going to dedicate our

existence responding to: what is the meaning we’re searching for that will allow us to transcend

and become genuinely human (Frankl, 2010)? The existential viewpoint also redefines what a

mentally healthy human looks like. Frankl introduces the concept of noo-dynamics to describe

mental health as occupying a state of tension between what a person has achieved, and what they

have yet to become (Frankl, 2010). These viewpoints assume a fair amount of self awareness and

autonomy on the part of the individual. As a result, these views can shed light on some of the

origins of Herb’s challenges.

As noted previously, Herb is currently at a place of limited self awareness and autonomy.

Through this sense of helplessness, I believe that part of Herb’s challenges could be not

embracing his self determinism. By not acknowledging his autonomy he sees his inspirational

friends through a lens of defeat, instead of a goal that he too could achieve through different

choices. To answer Herb’s question of finding the meaning in this life, he’ll also need to

determine what he wants his life to be lived in response to. This will be no easy task. It will

therefore be useful to keep Frankl’s noo-dynamics perspective in mind throughout Herb’s

therapy; as Herb begins to make achievements that align with his authentic self, rather than being
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 8

discouraged with how far he has to go, he can take comfort from being aware that this tension is

healthy and is moving him towards transcendence.

Therapeutic Process

Prior to beginning the therapeutic process, I believe that it would be important to address

Herb’s possible suicidality, given that he can’t identify meaning in his life, that he feels

worthless, and that he has a previous history with suicide (Corey, 2005). If I feel that Herb has

the strength to engage in therapy without personal harm following a discussion with him on his

thoughts and feelings regarding suicide, I can then start the therapeutic process (Corey, 2011).

This section will begin by delving into the therapeutic goals. These goals will include

increasing Herb’s self awareness, working with him to accept both freedom and responsibility,

moving him towards authenticity, and finally gaining insight into his life’s purpose (Corey,

2011). This will largely be achieved through therapeutic rapport. Aspects of the therapeutic

alliance will include the I/Thou relationship, authenticity and self disclosure, and the increasing

amount of responsibility Herb will be expected to take throughout the process (Corey, 2011).

Lastly, other influential factors to consider will be the impact of values and worldview, important

people in Herb’s life, and external systems such as society’s view of the disabled community.

Therapeutic Goals

Increased self awareness, acceptance of freedom and responsibility, striving toward

authenticity, and finding meaning to life are simultaneously therapeutic goals and fundamental

principles of existential therapy (Corey, 2011). While Herb has expressed some of these goals as

his own, such as searching for meaning to life, other goals, such as addressing his dissatisfaction

with life, are notably absent. However, as existential theory posits that other wants such as
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 9

pleasure and happiness are achieved as by-products in a person’s search to finding meaning

(Frankl, 2010), it would be appropriate to focus on the therapeutic goals stated. In line with an

open and honest therapeutic relationship, this is something I should discuss with Herb to confirm

that he also agrees with this approach to the therapeutic goals.

Therapeutic Relationship

Across all therapeutic methods, the greatest predictor of client success is the therapeutic

relationship (Norcross, 2010). The therapeutic relationship is particularly central to the practice

of existential therapy, as the therapist’s own subjectivity becomes the greatest asset to

understanding the client’s subjective emotions and experiences (Farber, 2010). To embrace this

mutual subjectivity, my role as the therapist will need to be as authentic as possible; at my best

when in an I-Thou state. This state is characterized by openness, mutuality, and being fully in the

present (Friedman, 2014). Part of this authenticity will be appropriate self disclosure. When I’m

genuinely impressed with Herb, I’ll let him know; conversely, if I feel like he’s being resistant, I

can observe this and ask for insight. Additionally, if I feel that it will help him be less alone, or to

understand a concept, I can draw from experiences in my own life and share them. In alignment

with being authentic to my own style, I would not be directive. I would work with Herb to

gradually empower him to be active and responsible for his own therapeutic process. In addition

to being more congruent with my personal values of empowerment, this would be an extension

of the existential values of freedom and responsibility (Corey, 2011).

While my role will be one of authenticity and empowerment, Herb’s complementary role

will be similarly authentic, but of increasing responsibility. I would start small by introducing

more manageable responsibilities, such as directing the feelings and anxieties to be discussed in
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 10

the therapeutic session, then encouraging Herb to be responsible for his awareness, and finally

building Herb up to embracing his freedom along with its accompanying responsibility (Corey,

2011). As Herb currently feels like he has little control over his life (Corey, 2005), I anticipate

some resistance to this increase in ownership. There could also be some frustration that I would

not be telling him what to do to fix his problems. However, I believe that my authenticity and

positive regard for Herb would allow him to trust my faith in him to direct our therapeutic

journey. Over time, I would hope that he would see the ways in which this increase in

responsibility is allowing him to grow, and in searching for further growth, that he would come

to embrace increasing responsibility.

Other Influential Factors

As a person with a disability, Herb will face some very real systemic barriers in the form

of discrimination. He may face environmental barriers from the world being designed for able-

bodied persons, institutional barriers from policies and procedures created without consideration

for people with disabilities, and societal barriers of exclusion and isolation from misconceptions

and stereotypical attitudes (Samamyanga & Mafumbate, 2014). These hurtful beliefs often aren’t

explicit, and tend to be unconscious; in fact, they may be beliefs that Herb himself, or his close

friends and family may subconsciously hold (Friedman & Owen, 2017).

Through the therapeutic relationship it will be important for me to understand how Herb

views himself as a person with a disability, and what hurtful beliefs he may be holding against

himself. It’ll therefore be equally important for me to unpack and correct any hurtful beliefs I

may be holding about disability to ensure I counsel him authentically. As a feminist, valuing

every human life equally is a fundamental part of my worldview. However, as Herb doesn’t see
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 11

himself as worthwhile, I suspect that he has a different worldview from mine. Through seeing

the positive regard I’ll model for him and other people with disabilities, in addition to the

personal and community-based research I will need to do to ensure Herb is counselled with the

respect he deserves, Herb’s worldview can be shifted to a more empowering view of himself and

of disability.

Supporting Herb in therapy isn’t something I can do alone. In addition to research, I will

also need to engage Herb’s circle of support and the local community (Samamyanga &

Mafumbate, 2014). I may need to invite Herb’s family into a session to understand their views of

Herb and his disability, and how they’re supporting him physically and emotionally. If they’re

unsupportive, but irreplaceable in Herb’s system of care, outside training in life skills and

support for people with disabilities could be helpful (Samamyanga & Mafumbate, 2014).

Additionally, while some barriers as a result of his disability will remain, Herb can find worth

and self-reliance through a combination of support from others like himself, and through able-

bodied allies who can provide thoughtful accommodations, allowing him to find fulfillment

through employment and volunteering (Samamyanga & Mafumbate, 2014).

Techniques and Application

Existential therapy de-emphasizes techniques, as they often add distance to the

therapeutic relationship when the client is treated for their symptoms, rather than being treated as

a person (Frankl, 2010). That isn’t to say that there are no techniques to existential therapy.

Rather, the techniques are not ‘typical’ compared to other prescriptive techniques seen in

psychotherapy. The therapeutic relationship is one of the core existential techniques (Farber,

2010); however, as this has been discussed in the previous section, this section will provide
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 12

additional insight into the existential techniques of dialogue, the here and now, and change tasks.

Additionally, if therapy proves effective for Herb he is likely to change. Some of the most

effective changes will be his redefinition of health and strength. This change will be both

internal, growing upon his internal resources such as resiliency with therapeutic techniques, and

external, as he confronts barriers from unaccepting friends and family and replaces them

supportive members of the disabled and able-bodied community.

Therapeutic Techniques and Applications

The process of existential therapy is largely one of dialogue (Truscott, 2010). This

technique focuses on the client’s phenomenological experiences for the therapist to gain a deep

understanding of the world as the client experiences it (Truscott, 2010). Queries are used to

direct the conversation to the client’s issues, to expand upon a topic, and to highlight any

discrepancies, such as between the client’s words and their body language (Farber, 2010).

Paraphrasing also generates discussion. Following a summary, language such as “is this

correct?” allows the client to agree or disagree, furthering the discussion and the therapist’s

understanding of the client’s subjective world (Scalzo, 2010). The intentional use of dialogue

will be especially appropriate for Herb in therapy. Through conversation I could gain insight into

why Herb doesn’t feel like his life is worthwhile (Corey, 2005). From Herb’s initial statements

about the meaning of life I believe that this would naturally lead into exploring existential

themes. Additionally, the question-based nature of the discussions would also allow him to direct

the therapeutic process; an early way to give him a small amount of responsibility, and gain back

a sense of control in his life.

A present-centered mentality of the here and now is an existential technique to increase

the intimacy of the therapeutic alliance toward an I/Thou relationship (Yalom & Josselson,

2013). By keeping the process relatively unstructured, the existential and relational problems that

the client is experiencing will reveal themselves through the here and now, provided the therapist

is alert to the client’s subconscious cues (Yalom & Josselson, 2013). This is something I can

engage in with Herb. A particularly effective example is using check-ins (Yalom & Josselson,

2013). At various points in the session I can check in with myself: “am I engaged? Have I

become more or less engaged as the session has progressed? Are there any other feelings that are

emerging in reaction to Herb?”. I can then use my subjective experience to check in with Herb.

Are his session experiences similar to mine? Are any feelings coming up, like resentment or

frustration towards me as I ask him these challenging questions?” As Herb has noted feeling

discouraged and unmotivated, by staying in the here and now I could address any resistances in

the session directly, ensuring that Herb feels both competent and confident in any changes or

perspective shifts discussed. Ideally this will translate into real-world success for Herb, providing

self-fueling motivation for Herb as he progresses in therapy.

Change tasks, best known through Frankl’s dereflection and paradoxical intention, are

tools that create an environment for the client’s self-confrontation (Truscott, 2010). To address

Herb’s rumination on physical activities that “he loved so much that he cannot do any longer”

(Corey, 2005) the intervention of paradoxical intention is likely to be especially effective. While

some of Herb’s beliefs may be physically true due to his disability, negative attitudes, both on

the part of Herb and on the part of others, can often be more disabling that the actual limitations

imposed by the disability (Samamyanga & Mafumbate, 2014). My understanding is that this is

largely caused by anticipatory anxiety. Anticipatory anxiety occurs when something unpleasant
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 14

happens, which makes us upset (Costello, 2019). A person will then develop anticipatory anxiety

about the event happening again, think about it excessively, and increase their insecurities

(Costello, 2019). An example for Herb could be a trip to the dentist in the past, where he arrived

only to find that the entrance to the office didn’t have a curb ramp. He then had to catch the

attention of the receptionist to try and help him into the building, who then required further

assistance to help him up and over the curb. From this experience Herb described feeling like an

inconvenience and ruminated endlessly, adding to his insecurity of worthlessness. To minimize

this anticipatory anxiety, I could apply paradoxical intention, beginning with disidentification

(Costello, 2019). As Costello (2019) notes, “this is the difference between having and being; as

applied to Herb, Herb has a disability, but he is not his disability. Self distancing is the next step.

By taking a stance of how ridiculous our anxiety is, using humour to mock the insecurity, we can

add distance to the symptom (Costello, 2019). As Herb has developed anticipatory anxiety

around asking for help, we could paradoxically get Herb to ask strangers for help more often.

Through asking for help and realizing that he’s usually not an inconvenience, Herb can then feel

silly about how much he used to worry about asking for help, eventually eliminating this anxiety.

Contexts to Therapeutic Change

Successful therapy involves change in the client. Herb appears to have recognized this, as

he’s actively searching for change to feel worthwhile and become similarly motivated to his

inspirational friends with disabilities (Corey, 2005). Some of the greatest changes Herb will

likely experience, with impacts both internally and externally, is redefining for himself what

strength and health looks like.

Coming from a working class background of lower socioeconomic status, coupled with

an Albertan culture that holds traditional views of masculinity, Herb’s definition of strength and

health is someone physically strong, and physically whole. For Herb to accept who he is, feel

worthwhile, and feel like he can contribute in a meaningful way to find purpose in his life, I’ll be

working to change this perspective. Through being more self aware, Herb can notice that he’s

still strong and still healthy; he has survived paralysis, suicide, and has developed an incredible

amount of upper body strength through using his wheelchair. He has also become stronger

mentally. The resilience he’s had to confront his disability and find the will to live again are a

testament to this strength. Additionally, he’s become healthier mentally. Through focusing on the

here and now, Herb can notice that he’s become more aware of his emotions and mental state.

By comparing his current mental awareness to his past mental awareness Herb can redefine

mental health for himself.

Herb’s family and friends from before the accident are likely to hold a similarly narrow

view of physical strength and health. These people would also be part of Herb’s support system.

While some people can respond positively to family and friends who have disabilities, some

react negatively, especially as disability may come with increased caretaking responsibilities and

financial stresses (Samamyanga & Mafumbate, 2014). This can create barriers to Herb’s physical

and therapeutic progress. For example, if Herb is viewing his physical capabilities in a more

positive and independent light, family members could disparagingly remind Herb that he’s a

‘burden on them’, and that he needs to be more ‘realistic about his actual physical abilities’.

Similar to using paradoxical intention to distance himself from his insecurities, if they’re not

open to Herb’s new insight into strength and health, he may need to find ways to distance

himself from their negative influence. These holes in Herb’s support system can be replaced by
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 16

new sources of support. As Herb finds inspiration in his friends with disabilities, their

encouragement can result in Herb relying on them more and more, incorporating them into his

new support system. Through these friendships Herb is likely to see himself as becoming more

physically capable through their example. Herb can grow in confidence to find a job and could

volunteer, where ideally his acceptance for who he his by others can reinforce the sense of worth

Herb is developing in therapy.

Evaluation

In this case study my approach was to choose a therapeutic method that was in alignment

with my values, and select a client for whom this approach would be a good fit. Throughout this

section I elaborate on how the strengths of the therapeutic alliance, choice, and reframing of

symptoms inherent to existential therapy are the optimal choice for Herb. I reinforce this

viewpoint by comparing existential therapy against other therapeutic approaches. I also

acknowledge the weaknesses of existential therapy, particularly its unclear frameworks and an

assumption of a philosophical frame of mind, that may lessen the applicability of this approach

to Herb. Further investigation is required with regard to addressing weaknesses by applying

elements of reality and feminist therapies.

Model Strengths and Fit

My preference for the philosophical and person-centered approach of existential therapy

is a reflection of my values, such as critical thinking and feminism. Having chosen existential

therapy as my therapy of choice for this project, I read through the case studies to determine

which would be the best fit for existential therapy. Herb’s case study was selected due to the
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 17

existential themes present, such as searching for the meaning of life, a focus of personal growth,

and that Herb was at a crossroad, seeking to find motivation and purpose to his existence. As

Corey (2011) identified each of these themes as strong areas of application for existential

therapy, I believe that this approach is a strong fit for Herb, irrespective of my personal

preferences.

Strengths of the existential therapeutic approach include the focus on the human quality

of the therapeutic alliance, personal autonomy to redesign one’s life, and the reframing of

anxiety, frustration, and isolation as a positive force (Corey, 2011). The strengths of this

approach are particularly well-suited for Herb. As human relationships are often a source of

meaning in life, the relational aspect of existential therapy would provide Herb with a model to

build self acceptance from, which would become a starting point to build new relationships

(Farber, 2010). By embracing freedom and responsibility, Herb would learn autonomy, giving

him back a sense of control in his life. Additionally, anxiety, frustration, and isolation are

typically not seen as positive. However through the existential lens, Herb can differentiate

normal from neurotic anxiety, understand real from perceived frustrations to accept his actual

limitations and eliminate imposed ones, and learn to understand and love himself for who he is.

To ensure that my preferential therapeutic selection was also what I genuinely believed

would be the best fit for Herb, I felt that it was my ethical obligation to compare my choice of

existential therapy against other therapeutic models. I first compared existential therapy against

the other ‘existential’ approaches in Corey’s work. However, I found that the directness of the

here and now approach would provide more instruction than the person-centered approach, and

that the emphasis on the human condition over a sense of techniques would provide a more
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 18

empowering and non-judgemental approach to Herb over Gestalt therapy (Corey, 2011). As I

suspect that many people with disabilities are reduced to their disability instead of the person

they are, I steered away from the reductive approaches of the behavioural therapies that focus on

symptoms. In reading Herb’s case study, my impression was that he felt like a victim of

circumstance. I wanted to restore a sense of autonomy within him, and give him back a sense of

control. The emphasis of choice, freedom, and responsibility of existential therapy therefore felt

more appropriate than the deterministic views of Freud’s psychoanalytic therapy (Corey, 2011).

Goal-oriented Adlerian therapy also didn’t feel like an appropriate choice, as one of Herb’s core

struggles was discovering his goal in life. The metatheories of family systems, feminist, and

multicultural therapies felt the most applicable after existential therapy, as they acknowledge the

real barriers systemic oppression can have. However as ableism has its own unique implications,

particularly being so widely prominent that it’s not seen as problematic compared to other civil

movements (Friedman & Owen, 2017), I believed that the more generally-focused existential

therapy would be more applicable. Through this comparison of existential therapy against other

models, I was able to confirm that my preference for existential therapy for Herb remained

grounded in sound judgement.

Model Weaknesses and Alternate Approaches

Weaknesses of existential therapy are a lack of clarity in theoretical framework and that

not all clients are able to frame and discuss their issues from the philosophical background of this

method (Corey, 2011). Without having met Herb, it’s difficult to determine the extent to which

he would be accepting of an unstructured therapy where he’s in charge, as well as how

philosophically minded he is. It’s entirely possible that without a clear process, set goals, and
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 19

defined techniques that Herb could feel like the therapy ‘isn’t going anywhere’, and could

terminate early. He could also feel like the approach is ‘too abstract and fluffy’, and that due to

it’s seeming lack of practicality and empirical research, that it’s out of alignment with his blue-

collar, concrete approach to life. These are valid limitations in the approach, and these

limitations could make a difference to Herb, such that the model is no longer a good fit for him.

For this reason, incorporation of alternate approaches should be explored further.

A lack of framework and the philosophical mentality required for existential therapy

could be compensated for by incorporating alternate methods such as reality therapy and feminist

therapy into an eclectic practice. The importance of choice and accepting responsibility in reality

therapy, and the acknowledgement of real limitations from outside systems in feminist therapy,

would be in alignment with the existential values of choice, freedom and responsibility, and

authenticity. Existential therapy’s weakness of a lack of structure could be counteracted by

principles of reality therapy. Implementation of cycles of counselling, creating the counselling

environment and then determining procedures to create behavioural changes, along with more

structured procedures such as Wubbolding’s WDEP system (Corey, 2011) could lend a

framework to the application of existential therapy. The sense of equality and dismantling of

power structures inherent in feminist therapy could eliminate the pretentiousness of existential

therapy’s philosophical approach, while also using empowerment to give Herb back a sense of

control (Corey, 2011). It could also be helpful to try feminist therapy’s power analysis, but

between able-bodied and disable-bodied people instead of between men and women, to allow

Herb to appreciate himself as he is, gaining self confidence and fulfillment (Corey, 2011).

Feminist therapy practices could also demonstrate to Herb that he’s not alone, particularly

through group therapy with other persons with disabilities. Meeting Herb in person, and an
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 20

expanded analysis of existential therapy with reality and feminist therapies in an eclectic

approach should be pursued further to create the optimal therapeutic outcome for Herb.

Conclusion

Through evaluation of the key concepts, therapeutic process, techniques, and

applications, it is clear that existential therapy is the optimal therapeutic approach for Herb. The

dissatisfaction, lack of worth and direction, and sense of meaninglessness that Herb currently

feels is particularly well addressed through the approach’s strength of using an authentic

therapeutic relationship to instill a sense of purpose in life. However, the lack of structure and

philosophical nature of the approach is not suitable for every client. A meeting with Herb, and

further investigation into these weaknesses in consideration with his preferences is suggested.

Additionally, an eclectic approach based on existential therapy that would incorporate aspects of

reality and feminist therapies could be an alternative to explore. With the thoughtful evaluation

of Herb’s core struggles regarding the application of existential therapy, it is anticipated that

Herb will find satisfaction and purpose to his life upon successfully completing counselling.
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 21

References

Corey, G. (2005). Student manual: Theory and practice of counseling and psychotherapy (Seventh ed.).

Toronto: Nelson Education Ltd.

Corey, G. (2011). Theory and practice of counseling and psychotherapy. Toronto: Nelson Education Ltd.

Costello, S. J. (2019). Paradoxical intention. In S. J. Costello, Applied logotherapy: Victor Frankl's

philosophical psychology (pp. 13-50). Newcastle upon Tyne: Cambridge Scholars Publishing.

Farber, E. (2010). Humanistic-existential psychotherapy competencies and the supervisory process.

Atlanta: American Psychological Association. doi:10.1037/a0018847

Frankl, V. E. (2010). Feeling of meaninglessness: A challenge to psychotherapy and philosophy.

Milwaukee: Marquette University Press.

Friedman, C., & Owen, A. L. (2017). Defining disability: Understandings of and attitudes towards ableism

and disability. Disability Studies Quarterly, 37(1).

Friedman, M. (2014). Therapy as an I-Thou encounter. In J. F. Kirk J. Schneider, The handbook of

humanistic psychology: Theory, research, and practice (pp. 451-456). SAGE Publications.

Norcross, J. C. (2010). The therapeutic relationship. In S. D. B. L. Duncan, The heart and soul of change:

Delivering what works in therapy (pp. 113-141). American Psychological Association.

Samamyanga, I., & Mafumbate, R. (2014). The relevance of counselling in the management of clients

who are physcially disabled at household level: Implications to practicing counsellors.

Organizational Psychology & Educational Studies, 319-326.

Scalzo, C. (2010). Therapy with children: An existential perspective. Taylor & Francis Group.
DISABILITY, MEANING, AND EXISTENTIAL THERAPY 22

Truscott, D. (2010). Becoming an effective psychotherapist: Adopting a theory of psychotherapy that's

right for you and your client. American Psychological Association. doi:10.1037/12064-004

Yalom, I. D., & Josselson, R. (2013). Existential psychotherapy. In D. Wedding, & R. J. Corsini, Current

psychotherapies (pp. 265-298). Nelson Education Ltd.