September Membership Meeting Write-Up — Madeline Taylor, LMFT

Existential Issues During the Pandemic

Presented by Rena Pollak, LMFT

It’s easy to understand why existential issues might be high in therapists’ minds these days. California has been in lockdown since the middle of March, 2020, due to the COVID-19 pandemic. Therapists are not seeing patients in-person as a rule, and we’ve been forced to learn how to treat our patients online. We have suddenly been thrown into an existential crisis along with our patients. We are threatened by a virus and we all want to live.

Rena Pollak, Licensed Marriage and Family Therapist and esteemed member of our chapter, “held” us through a discussion of some of the major issues which may be affecting us and our patients during this unusually stressful time . . . issues like isolation, meaninglessness, freedom, and death. One by one, Rena walked us through some of the ways that these issues might be manifesting in patients (and in ourselves) during the current crisis.

The existential approach to psychological treatment takes as its central, organizing belief that life is fraught with inescapable realities, issues related to existence. These are universally experienced, yet each of us experiences them in our own way. The belief which forms the methodology of the treatment is that these givens are tolerated better when we can acknowledge them to a sympathetic other and, in those brief moments of human encounter, find the strength to face them better in our own lives.

A fundamental tenet of existential philosophy, originating with Edmund Husserl in the late 19th Century, is that the way to understand human nature is to study human consciousness directly. By exploring the inner world of subjective experience, Husserl suggested that we could come as close as possible to understanding the nature of human existence. He called this, phenomenology; the study of phenomena occurring at the subjective level deep within each of us.

This perspective was gradually adopted by philosophers like Sartre and Heidegger, and by psychoanalysts such as Rollo May, Viktor Frankl, and Irvin Yalom. Today these precepts are part of the warp and woof of the humanistic-existential stream within the field of psychotherapy, establishing a third force between the earliest Freudian/Kleinian theories of psychoanalysis and the hyper-rational approach of the behaviorists.

It is in this stream of thought that most of us find our basic, theoretical home. We may not call ourselves existential therapists per se, and we might branch off into areas of specialization with approaches such as EMDR, DBT, CBT, EFT, contemporary psychoanalyis, etc. But, nonetheless, it’s safe to assume that none of what Rena spoke to us about was foreign or unfamiliar.

Presently, we can really hear the issues of isolation, meaninglessness, and death echoing in our patients’ concerns. In existential theory the issue of “freedom” encompasses our mixed feelings regarding taking responsibility for our lives and wishing to be relived of it. Most of us chronically teeter somewhere between these two poles as if on a see-saw. The stress we’re all under regarding life and death issues related to COVID, financial stress, relational stress, etc. bring up these issues, around which there is much ambivalence.

Rena drew our attention to the myriad ways that any of these existential issues might show up in any given client’s material. Some may speak of these issues directly, consciously. In that case, the therapist’s role is to acknowledge these realities with sober and somber compassion, maybe inquiring a little further about the specific situation the client finds him/herself in. From Rena’s existential point-of-view, nothing therapeutic can happen until the therapist acknowledges both the patient’s subjective reality (his/her unique, inner feelings and deep-seated beliefs) and the literal reality presented by the pandemic. When we recognize the subjective legitimacy of the patient’s lived experience and acknowledge the objective reality, in which we are all embedded, the patient might feel less isolated and more accepting of him/herself. The purpose is not to comfort the patient, but he/she might feel comforted, nonetheless.

More subtly, however, are the myriad ways these concerns show up in less-than-conscious ways. A client might express a general malaise, an indistinct dread, or a vague feeling of disconnection from his/her feelings. A patient may feel a general sense of anxiety for which he/she can find no explanation. Others might describe a longing for an idealized protector, a manic-y focus on work, or an intense need to control people and situations. Yet another patient might appear “above it all,” as if nothing affects him/her. Overtly aggressive feelings or behaviors might cover over feelings of powerlessness and vulnerability too unbearable to admit to consciousness.

Rena pointed out that we are also embedded in a culture, which is generally uncomfortable with death, dying, and I would add, with distressing emotions in general. Conscious or unconscious concerns about death may also be connected to the feeling of not being thoroughly alive, or of feeling threatened in some related way.

I have a patient who, as a child, had a recurring nightmare where a witch on a broomstick wearing a large, black cape was coming after her. In the dream she is running out the back door to escape envelopment by the witch but she never succeeds. This patient’s mother was a deeply depressed woman. Together, my patient and I discovered that she desperately needed to escape the “black, enveloping cape” of her mother’s depression. This dream didn’t signal so much a fear of physical death as a kind of emotional suffocation. As a child she experienced the death of hope, joy, emotional safety, and her sense of autonomous individuality. She feared that loss of selfhood, which amounts to spiritual death. These are existential concerns, for sure.

Ernest Hemingway wasn’t a therapist but he said: “The world breaks everyone, and afterward, many are strong at the broken places.” To me, this is existentialism with a little hope, and a statement with which I think Rena and the rest of us could agree.

Madeline Taylor, PhD, LMFT, has been in practice for 40 years. She is associated with the Institute of Contemporary Psychoanalysis and has taught attachment theory, self-psychology, and intersubjectivity theory for 30 years. She has offices in Santa Monica and Calabasas, seeing adolescents, adults, and couples. “Nothing is as powerful as human understanding.” (George Atwood)