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“I took a test in Existentialism. I left all the answers blank and got 100.”
― Woody Allen
“Today, however, we are having a hard time living because we are so bent on outwitting death.”
― Simone de Beauvoir, The Ethics of Ambiguity
As a teenager I was obsessed with the likes of Camus, Kierkegaard and Sartre, my attempt to grapple with the big questions; being fundamentally alone in the world, facing the unknown, finding meaning in life, etc. These authors have, for generations, provided both terror and solace to seekers, serving as guides as we ask ourselves the most fundamental questions about life.
Many students of psychology, nowadays, however, do not realise the enormous contribution that existentialism has made to our field over the decades. From R.D Laing (1960) to Frankl (1964), Rollo May (1964) to Yalom (1975), the principles of existentialism were deeply enshrined in phenomenological approaches to psychotherapy.
In contemporary times with the dominance of the scientist-practitioner model, activity-based funding, branded treatments, symptom management and the rise of cybertherapy one might imagine that there is no longer room in our field for these deeper questions. As we risk becoming more superficial, however, there are a group of clinicians and researchers who are bucking this trend.
Once a week I put aside a few hours to trawl the Journals and just see what takes my interest. Today I came across something pretty extraordinary. In a 2014 issue of Clinical Psychology Review Iverach, Menzies & Menzies, provide an overview of the current contribution of existentialism to contemporary clinical psychology in their paper 'Death anxiety and its role in psychopathology: Reviewing the status of a transdiagnostic construct'
Here they provide a comprehensive argument for the role of death anxiety (the persistent fear of ones own death) as a critical underlying construct for a wide range of anxiety disorders, including OCD, panic disorder and PTSD. Like perfectionism and rumination, avoidance and insecure attachment they position the fear of death as a core construct in the development of mental health problems. These types of trans-diagnostic approaches serve as an important critique to the less meaningful compartmentalization of human suffering exemplified in the DSM5.
There are a number of unique and extraordinary things about this paper, that set it apart from much of the drier empirical work in clinical psychology journals
1. Through the lens of 'Terror Management Theory' the authors are able to draw parallels between personal and societal pathology. This theory posits that many of our worldviews and cultural values serve to defend us from death anxiety and that conflicts between religions can be understood as an attempt to regain psychological structure when our beliefs are threatened. Usually we only see an engagement between psychology and sociology in critical and post-structural psychology, but these authors are doing so from the mainstream.
2. The authors engage with the existential questions and the contribution of philosophy by a rigorous and systemic review of the experimental literature. They are convincing in demonstrating how the concept of death anxiety can be studied through traditional empirical means. This is a unique marriage between phenomenology and hard science, one that is often the domain of more qualitative studies.
3. They provide a convincing argument for the integration of cognitive behaviour therapy with existentialist-humanist approaches, allowing CBT to be adapted to grapple with some of life's more archetypal dilemmas. This demonstrates the adaptability of CBT, which has also been integrated with psychodynamic therapy in the form of schema-based work and with Buddhism in the form of acceptance and commitment-based therapies.
I commend this paper to you as an example of the best of what our field can offer.
