Praxical.Psych
Unit 7 of 20

Existential therapies

Take seriously the possibility that some distress is not a disorder.

Chapter 4Beyond the standard syllabus

What you should be able to do afterwards

  • 1Describe the four ultimate concerns and their clinical presentations
  • 2Distinguish existential from neurotic anxiety
  • 3Explain what presence means technically, and why it is difficult
  • 4State honestly what the evidence supports and what it does not

The reading

This unit asks the question the rest of the curriculum assumes away: is this person disordered, or are they responding accurately to their situation? A framework that can distinguish the two is worth having, and a framework that cannot distinguish them is dangerous in both directions.

What belongs to this unit

Questions to take away

For a seminar, a supervisor, or an argument with yourself.

  1. 1A patient with terminal illness is frightened of dying. What, exactly, is the treatment?
  2. 2When does re-framing distress as existential become a way of not treating a treatable condition?
  3. 3Is the concept of authenticity culturally universal? What would follow if it is not?

Your notes

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Before you begin

What Praxical.Psych is, and is not

Praxical.Psych is an educational tool. It teaches the theory, evidence base and clinical method of psychotherapy at the level of an advanced survey course, and it lets you rehearse a complete session in a simulator.

It is not medical, clinical, psychological or legal advice. It cannot diagnose or treat anyone, and it does not state the law where you practise — requirements differ by jurisdiction and change. Nothing here creates a clinician–patient or solicitor–client relationship.

  • Every patient, transcript and case in this app is fictional — a composite written for teaching. None depicts a real person.
  • Praxical.Psych is not therapy, not a substitute for supervision, and not a credential. Competence to practise comes from training, supervised hours and licensure.
  • Scores from the instruments here are for learning how they behave. They are not a diagnosis and not a risk assessment, and must not inform a decision about a real person.
  • Do not enter real patient information. Everything you type stays in this browser, but that is not the same as a compliant clinical record system.
If you are in crisis

In the US and Canada, call or text 988. In the UK and Ireland, call 116 123 (Samaritans). Elsewhere, find a local line at findahelpline.com. In immediate danger, use your local emergency number.

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