Existential Concerns and Cognitive-Behavioral Procedures: An Integrative Approach to Mental Health (Hardcover, 2022)

Section 1. Introductory Issues

Chapter 1. Existentialism and the problems of being ? Gerard Kuperis, University of San Francisco.

This opening chapter provides a history and overview of the central ideas of the existential philosophers. A thorough grounding in the theoretical orientation of these thinkers, and the common claims of existentialism, sets the scene for the rest of the volume.

Chapter 2. Existentialism and its place in contemporary cognitive-behavior therapy - Michael Worrell, Regent’s University London and Head of Department, London CBT Training Centre

Chapter 2 examines the way in which existentialism and CBT can be successfully integrated. The education of cognitive behavior therapists has not traditionally included any direct engagement with existential philosophy or existential psychology. This is despite the fact that Beck, and other founding figures in the history of CBT, have highlighted the relevance of existentialism to their thinking. The chapter describes the benefits of experiential practice exercises that ask therapists to ‘just listen’ to their clients and note the presence of ‘existential givens’.

Section 2. Death

Chapter 3. Death awareness and terror management theory ? Ilan Dar-Nimrod, University of Sydney

Terror Management Theory (TMT) is the dominant social psychological theory examining the relationship between death awareness and human behaviour. According to TMT, cultural worldviews and self-esteem are thought to serve an important anxiety-buffering function in order to manage (or ‘tranquilise’) existential fear of death. This chapter will review the evidence for TMT and alternative accounts of the role of death awareness on human behaviour.

Chapter 4. Death fears and their relationship to mental health ? Rachel E. Menzies, University of Sydney

Recent research suggests that death anxiety may be a transdiagnostic construct that mediates a range of mental health symptoms and disorders. It has been linked to OCD, Panic Disorder, Illness Anxiety Disorder and more recently to Somatic Symptom Disorder, PTSD, Depression and even Eating Disorders. This chapter will review the evidence and discuss the implications of these relationships between death anxiety and mental health.

Chapter 5. Creative approaches to treating the dread of death ? David Veale, The Priory Hospital North London and Visiting Professor, Department of Psychology, Kings College London

Building on his work on death anxiety and Illness Anxiety Disorder, Professor Veale will explore contemporary approaches to treating the dread of death. Unlike other phobic reactions (e.g. fear of dogs, spiders, water), which may be characterised as irrational, death anxiety is based on an inevitable event or an ‘existential given’. As such, it requires a more creative and imaginative approach to treatment.

Section 2. Isolation

Chapter 6. Interpersonal, intrapersonal and existential isolation ? Jeff Greenberg, University of Arizona

The existential psychotherapist Irvin Yalom (1980) describes three types of isolation. Interpersonal isolation refers to the loneliness created by social distance. Intrapersonal isolation refers to the dissociation between parts of oneself. Finally, existential isolation refers to the unbridgeable gap between oneself and any other being i.e. the fact that we can only ever experience our own consciousness. Chapter 6 examines the three types of isolation described in existential theory.

Chapter 7. Isolation, loneliness and mental health ? Peter Kelly & Isabella Ingram, University of Wollongong, NSW

Chapter 7 reviews the considerable evidence that interpersonal isolation is strongly associated with poor physical health, mental health and high rates of addictive behaviours. Further, the inability to share phenomenological experience, which is associated with existential isolation, has been found to correlate significantly with depression, purpose in life, and non-specific loneliness in several studies. The relationships between non-specific loneliness, depression and mental health more broadly will be thoroughly explored in this chapter.

Chapter 8. Social prescribing: A review of the literature ? Genevieve Dingle & Leah Sharman, University of Queensland.

Chapter 8 presents a social identity approach to mental health that has been championed by Professor Alex Haslam and colleagues at the University of Queensland (UQ). The growing evidence for social prescribing will be explored, with particular reference to the development of UQs ‘Groups 4 Health’ program (G4H). Their five-module program is the first to specifically target the development of social group relationships to treat psychological distress.

Section 3. Identity

Chapter 9. Identity and the courage to be ? Paul Rhodes, The University of Sydney

Identity is a complex concept that is a relatively recent addition to models of existential concerns. It arises through ‘the courage to be a part of’ an ingroup, or through affirming and participating in the unique self which is typically referred to as ‘the courage to be’. Like each of the existential themes, it is inextricably linked to related concerns like isolation. Chapter 9 reviews the literature on identity from an existentialist perspective.

Chapter 10. The role of identity concerns and the self in psychopathology ? Richard Moulding, Deakin University, Melbourne, Victoria

Chapter 10 reviews the range of mental health disorders that have been associated with the existential construct of identity. The ‘self’, and several overlapping constructs, have been implicated in obsessive compulsive and related disorders as well the anxiety disorders, mood disorders, eating disorders, trauma-related disorders and gender dysphoria.

Chapter 11. Clarifying identity and the self in a CBT context ? Michael Kyrios, Flinders University, South Australia

Professor Kyrios will review the variety of ways that therapists may challenge faulty thoughts, beliefs and attitudes related to identity and the self. Metacognitive strategies, schema work, psychoeducation about the nature of consciousness, rational restructuring and a range of other cognitive and behavioural strategies will be explored.

Section 4. Freedom

Chapter 12. Freedom, responsibility and guilt ? Thomas Heidenreich, Hochschule Esslingen, Esslingen am Neckar, Germany & Alexander Noyan, Hochschule Mannheim, Mannheim, Germany

Humans have the freedom to live in whatever way they choose. However, with freedom comes responsibility, and with responsibility comes ‘ontological guilt’. This was the basis for Tillich’s (1959) third domain of anxiety. Regret may arise as soon as a course of action is chosen, since inevitably one door opening implies that another has been shut. Chapter 12 examines the constructs of freedom, responsibility, guilt and regret and their importance in existential thinking.

Chapter 13. Failed potentialities, regret and their link to depression and related disorders ? Ross Menzies, University of Technology Sydney.

A variety of studies have linked mood disorders to a ruminative style of thinking, particularly involving events and happenings from the past. When an individual’s early expectations of life are not met, depression may follow. In existential terms, depression may be linked to an individual failing to embrace the potentialities afforded by freedom. Post-event rumination, usually involving shorter time frames, has been also been linked to social anxiety disorder. Finally, regret and shame over early happenings can be involved in a range of pure obsessions. All of these relationships will be explored in Chapter 13.

Chapter 14. Reframing the past and the treatment of existential guilt and regret ? Ross Menzies, University of Technology Sydney.

Regret over past actions can haunt sufferers with a range of disorders. At the heart of the CBT response to regret is the stoic practice of letting go of things beyond our control. Stoic philosophers of Ancient Greece and Rome argued that desires for outcomes beyond our control are at the centre of human pain and suffering. Seneca, Marcus Aurelius, Cicero and others urged us to limit our desires to activities and outcomes that fully lie in our own hands. This chapter with explore contemporary CBT for regret and shame through the lens of applied stoicism. Both Ellis and Beck have acknowledged the important role of core stoic concepts in shaping their clinical guidelines.

Section 5. Meaning

Chapter 15. On the need for meaning ? Gerard Kuperis, University of San Francisco

Satre famously declared that “man is nothing else but that which he makes of himself”. Capturing a central thesis of existential thinking, Satre essentially claims that man must determine his nature through his choices. In other words, “existence precedes essence”. Professor Kuperis will examine the claim that man’s search for meaning is an essential part of dealing with the existential confusion that comes from being thrust into an absurd and inherently pointless world.

Chapter 16. Meaninglessness, depression and suicidality: A review of the evidence ? Aliza Werner-Seidler, The Black Dog Institute, Sydney.

Many theorists, beginning with Freud, have proposed that humans need meaning and purpose to maintain psychological wellness. Depression has been linked to an absence of meaning, or a general sense of ‘pointlessness’ to daily activity. Common features of Major Depressive Episodes (e.g. reduced motivation, difficulty initiating behaviours) may be derivatives of a lack of meaning in life. The related concept of hopelessness has been linked to increased suicidal risk. This chapter will explore the relationships between meaninglessness, hopelessness, depression and suicidality.

Chapter 17. Living a meaningful, values-based life: The efficacy and effectiveness of acceptance and commitment therapy ? Joe Ciarrochi, Australian Catholic University

One of the novel contributions of ‘third-wave’ approaches to mental health has been an increased focus on meaning and values-based living. Acceptance and Commitment Therapy (ACT) seeks to identify the values of the individual and encourages living a life based on these values. In this way ACT can be viewed as applying the existentialist idea of creating personal meaning and living authentically. Professor Ciarrochi is an internationally acclaimed author in this space and in Chapter 17 he reviews the evidence supporting the use of ACT in establishing a meaningful existence.