Existential–Humanistic and Relational Psychotherapy During COVID-19 With Patients With Preexisting Medical Conditions

Abstract

Unexpected traumatic events, including life-threatening medical conditions, brain injuries, and pandemics, can be catalysts for patients and clinicians to consider existential issues, including meaning in life. The existential–humanistic and relational perspectives on therapeutic interventions emphasize creating meaning, taking responsibility for one’s own life and self-narratives, choosing and actualizing ways of being in the world that are consistent with values, and expanding the capacity for agency, commitment, and action. Myriad factors have made the COVID-19 pandemic upsetting and potentially traumatic for individuals, including the novel experience of self and other as possibly infectious and dangerous, a sense that anyone is vulnerable, and protracted uncertainty about the duration of the crisis and its consequences. The vignettes included in this article explore risk and reliance factors relevant to patients with preexisting medical conditions during COVID-19 and highlight the benefits of exploring values, priorities, and assumptions, asking open-ended questions about meaning in life and posttraumatic growth, learning for each emotion, and interpretation of dreams. The existential–humanistic and relational approaches offer unique insights into how practitioners might help their patients to reflect on the unanticipated changes and anxieties ignited by COVID-19, while reinforcing the potential to live with greater purpose and intention.

Keywords

existential psychotherapy meaning in life relational psychotherapy

Get full access to this article

View all access options for this article.

References

Auerbach

(2000). Trauma shatters the self and the world. NYS Psychologist, 12(1), 7-10.

Breitbart

Gibson

Poppito

S. R.

Berg

B. S.

(2004). Psychotherapeutic interventions at the end of life: A focus on meaning and spirituality. Canadian Journal of Psychiatry, 49(6), 366-372. https://doi.org/10.1177/070674370404900605

Breitbart

W. S.

Poppito

S. R.

(2014a). Individual meaning-centered psychotherapy for patients with advanced cancer: A treatment manual. Oxford University Press. http://doi.org/10.1093/med/9780199837243.001.0001

Breitbart

W. S.

Poppito

S. R.

(2014b). Meaning- group psychotherapy for patients with advanced cancer: A treatment manual. Oxford University Press. http://doi.org/10.1093/med/9780199837250.001.0001

Bromberg

P. M.

(1980). Sullivan’s concept of consensual validation and the therapeutic action of psychoanalysis. Contemporary Psychoanalysis, 16(2), 237-248. https://doi.org/10.1080/00107530.1980.10745621

Buechler

(2004). Clinical values: Emotions that guide psychoanalytic treatment. The Analytic Press.

Chochinov

H. M.

Kristjanson

L. J.

Breitbart

McClement

Hack

T. F.

Hassard

Harlos

(2011). Effects of dignity therapy on distress and end-of-life experience in terminally ill patients: A randomized controlled trial. Lancet: Oncology, 12, 753-762. https://doi.org/10.1016/S1470-2045(11)70153-X

Dahan

J. F.

Auerbach

C. F.

(2006). A qualitative study of the trauma and posttraumatic growth of multiple myeloma patients treated with peripheral blood stem cell transplant. Palliative & Supportive Care, 4(4), 365-387. https://doi.org/10.1017/S1478951506060470

Fiscalini

(1995). The clinical analysis of transference. In: Lionells

Fiscalini

Mann

C. H.

Stern

D. B.

(Eds.): The handbook of interpersonal psychoanalysis (pp. 617-642). The Analytic Press.

10.

Frankl

V. E.

(1986). The doctor and the soul: From psychotherapy to logotherapy. Vintage Books.

11.

Frankl

V. E.

(1992). Man’s search for meaning (4th ed.). Beacon Press.

12.

Frankl

V. E.

(2019). Yes to life: In spite of everything. Beacon Press.

13.

Gans

J. S.

(1983). Hate in the rehabilitation setting. Archives of Physical Medicine and Rehabilitation, 64, 76-79.

14.

Goldman

Rosenbach

Gensler

Goldman

D. S.

Prince

Gordon

R. M.

(2002). Voices from New York: September 11, 2001. Contemporary Psychoanalysis, 38(1), 77-99. http://doi.org/10.1080/00107530.2002.10745807

15.

Gordon

R. M.

Aron

Mitchell

Davies

J. M.

(1998). Relational psychoanalysis. In Langs

(Ed.), Current theories of psychoanalysis (pp. 31-58). International Universities Press.

16.

Greenberg

Mitchell

(1983). Object relations in psychoanalysis. Harvard Universities Press.

17.

Gunther

M. S.

(1987). Catastrophic illness and the caregivers: Real burdens and solutions with respect to the role of the behavioral sciences. In Kaplan

(Ed.), The rehabilitation desk reference (pp. 219-243). Aspen.

18.

Hill

C. E.

(2018). Meaning in life: A therapist’s guide. American Psychological Association. http://doi.org/10.1037/0000083-000

19.

Hirsch

(1994). Countertransference love and theoretical model. Psychoanalytic Dialogues, 4(2), 171-192. https://doi.org/10.1080/10481889409539012

20.

Janoff-Bulman

(1989). Assumptive worlds and the stress of traumatic events: Applications of the schema construct. Social Cognition, 7(2), 111-136. https://doi.org/10.1521/soco.1989.7.2.113

21.

Janoff-Bulman

(1992). Shattered assumptions: Toward a new psychology of trauma. The Free Press.

22.

Jennings

(1993). Healing the self: The moral meanings of relationships in rehabilitation. American Journal of Physical Medicine and Rehabilitation, 72(6), 401-404.

23.

Lippmann

(2000). On listening to dreams. The Analytic Press.

24.

McWilliams

(2020). The future of psychoanalysis: Preserving Jeremy Safran’s integrative vision. Psychoanalytic Psychology, 37(2), 98-107. http://doi.org/10.1037/pap0000275

25.

Mitchell

(1988). Relational concepts in psychoanalysis. Harvard Universities Press. https://doi/org/10.2307/j.ctvk12rmv

26.

Proulx

Markham

K. D.

Lindberg

M. J.

(2013). Introduction: The new science of meaning. In: Markman

K. D.

Proulx

Lindberg

M. J.

(Eds.), The psychology of meaning (pp. 3-14). American Psychological Association. https://doi.org/10.1037/14040-001

27.

Schneider

K. J.

Krug

O. T.

(2017). Existential-humanistic therapy (2nd ed.). American Psychological Association. https://doi.org/10.1037/0000042-000

28.

Strachey

(1934). The nature of therapeutic action of psycho-analysis. International Journal of Psycho-Analysis, 15, 127-159.

29.

Tedeschi

R. G.

Shakespeare-Finch Taku

Taku

Calhoun

L. G.

(2018). Posttraumatic growth: Theory, research, and applications. Routledge. https://doi.org/10.4324/9781315527451

30.

Thomson

G. A.

(2020). COVID-19: Leaving lockdown–of Schrödinger cats, testing, and masks. International Journal of Clinical Practice, 74(8), Article e13519. https://doi.org/10.1111/ijcp.13519

31.

van der Kolk

. (2020). Bessel van der Kolk, MD, on the global coronavirus: Steering ourselves and our clients through new & developing traumas [Webinar]. PESI. https://catalogue.pesi.com/item/bessel-van-der-kolk-md-global-coronavirus-crisis-steering-clients-developing-traumas-credit-57744

32.

Yalom

I. D.

(1980). Existential psychotherapy. Basic Books.

33.

Yalom

I. D.

(1996). Lying on the couch. Basic Books.