EXISTENTIALLY-INFORMED PSYCHOTHERAPY

Travis J. Pashak is a clinical psychologist from Michigan. He works as an Associate Professor at Saginaw Valley State University, and also has a small private practice conducting outpatient psychotherapy. He earned his B.A. in Psychology at the University of Michigan in 2008 and his Ph.D. in Clinical Psychology at Saint Louis University in 2014. His interests include existential psychotherapy as well as other dynamic and relational models, death anxiety research and scholarship on other existential concerns and terror management issues, and student development including mentorship and supervision of research and clinical skills. Outside of work, he’s a dad to three awesome kids and enjoys pizza (with pineapple), metalcore music, and stand-up comedy. He wants to thank you for reading this and encourage you to connect with him (@ProfPash on Twitter, by name on ResearchGate and PsyArXiv). Memento mori!

When, how, and why did you start incorporating EBF/TMT into your work?

My initial reaction to the terror management literature was dismissive actually! I remember first learning about the theory in undergrad, probably around 2006, and thinking it seemed completely bogus. In retrospect, I suppose my knee-jerk denial was a perfect illustration of proximal defenses in the TMT model! I later returned to the topic of death anxiety with more of an open mind in grad school, as it was an area of interest for my dissertation advisor and clinical supervisor, Dr. Paul Handal. It would have been around 2013 that I first started conducting any legitimate research on the topic, and it’s been a growing theme in my scholarship since then. Paul’s fascination with the topic helped change how I view both research and psychotherapy. He was (and continues to be) a wonderful mentor who expanded my perspective in many ways.

Other influencing factors came from personal life. For instance, my family faced some challenging medical issues which made salient death’s loom. My mother was first diagnosed with breast cancer when I was a young child, and her journey with the disease included five cycles of remission and recurrence between 1993 and 2021 when she finally passed. I also experienced an acute episode of a rare autoimmune disorder, Guillain-Barré Syndrome, in my late teens which could have been fatal or permanently disabling were it not caught and addressed so efficiently. Lastly, I think it’s relevant that I experienced a significant worldview transition in my early twenties, from very religious to agnostic, which forced much reflection upon the meaning of mortality. While I’m not implying that these experiences are unique, I think they led me to face existential questions with increasing curiosity despite the initial discomfort. This all made me want to understand how these phenomena function in others, and to explore how they can contribute to the therapeutic relationship. Although morbid, it’s been fun and interesting! I’m glad to be in this niche.

What is existentially-informed psychotherapy and what’s an example of the effective use of an existentially-informed lens in clinical practice?

I had the distinct pleasure to do some writing on this topic recently! With a team of my psychology research students and two faculty colleagues in philosophy, we built an argumentative literature review paper on the integration of existentialism with clinical psychology’s teaching, scholarship, and applied practice, calling for the field to more robustly intertwine some previously disparate threads of inquiry. Check it out here or here. Our article ends with a brief set of recommendations, so I’ll quote the ones specific to therapy here: “Embrace clients’ subjectivities and de-essentialize conceptualizations of their suffering.” “Incorporate existential themes across modalities, contexts, populations, and presenting problems.” And finally, “explore existential topics (including death but also many others), in a non-prescribed flexible manner.”

What does all that mean? Concisely, existentially-informed psychotherapy is about seeking a deeply empathic connection with one’s clients—understanding them subjectively, phenomenologically, through their own eyes—while suspending the assumptions and structures often applied by society, external narratives, or even diagnostic frameworks. Mental health professionals of many titles, specialties, and orientations can adopt an existential mindset insofar as dialogue about meaning and limitations in life are invited into the clinical space, while always pursuing growth of the client’s authenticity and acceptance. When this is done effectively, I believe clients feel more truly seen and understood—more able to see and understand themselves, and more tolerant of the existential threats/truths we all face together, including but not limited to death.

Do you see Becker/TMT having a bigger role in psychotherapy in the future? How and why?

Yes! My impression lately is that clinicians are increasingly fascinated to imbue their work with a clearer philosophical basis of some kind, and that the existential topics of meaning and mortality among others are appealing. Folks like Emmy van Deurzen, Joël Vos, Rachel Menzies, Mick Cooper, and Irvin Yalom have been producing a massive and inspiring anthology of existential clinical literature in recent years for helpers to draw from, and I believe we are seeing it really develop traction in trainees and early-career professionals especially. I would have to imagine that our culturally shared experiences of threat and loss over the past few years (e.g., global pandemic, political polarization, climate change) are informing this trend toward interest in the existential, and that therapists are finding value in how it aids their work. I am certainly grateful for these ideas and approaches—not only for ways they have enhanced growth in my clients and students, but also for ways they have been healing to me!