Existential therapy is a talk therapy for the questions that sit underneath many other problems: what makes my life meaningful, which choices are really mine, how do I live with uncertainty and loss, and what does it mean that life ends. It does not hand you answers. It gives you a place to face those questions honestly, with someone who will not rush you or look away.
It tends to help people in transitions, people who are grieving, people who feel flat or adrift even when life looks fine on paper, and teens and young adults working out who they are. In most practices it is one thread in a broader, depth-oriented therapy, woven together with other approaches.
The big questions existential therapy works with
Existential therapy grew out of philosophy as much as psychology, and clinicians such as Viktor Frankl, Rollo May and Irvin Yalom shaped it. Different therapists emphasize different themes, but four come up again and again:
- Meaning. What makes life feel worth living, and what to do when old sources of meaning stop working.
- Freedom and responsibility. The choices that are actually yours, including the ones you have been putting off.
- Isolation. The part of experience no one else can fully share, and how to stay connected anyway.
- Mortality. The awareness that time is limited, and what that awareness asks of you.
These can sound heavy. In practice they often show up in ordinary language: "I don't know what I'm doing with my life." "Everyone else seems to have it figured out." "After my dad died, nothing I used to care about feels the same."
What a session looks like
Sessions are conversations. There is usually no fixed agenda, no worksheet and no protocol that runs week by week. Your therapist pays close attention to what you are experiencing in the present, including in the room with them, and asks questions that help you notice your own values, choices and avoidances.
An existential therapist might gently point out that you talk about your career as if someone else chose it, or notice that you change the subject whenever the future comes up. The aim is to help you see your situation more clearly and take ownership of what is yours to decide. The tone is usually warm and direct. You are treated as a capable person facing real questions, and your therapist is willing to sit with those questions alongside you.
Because the work is personal, existential therapists tend to be present and engaged. You may hear more of your therapist's honest reactions than you would expect, always in service of your own thinking.
For a teenager or young adult, existential conversations often sound less philosophical. They might be about whether to stay on a path a parent chose, how to handle a friendship that has changed, or why everything feels pointless right after a big goal is reached. A therapist can take those questions seriously without lecturing, which many young people find a relief. Parents sometimes worry that talking about meaning or death will make a teen more anxious. A skilled therapist approaches these topics carefully, at the young person's pace, and with close attention to safety.
You do not need to have read any philosophy or have your questions neatly worded. Most people arrive with a feeling, something like restlessness, dread or a sense that something is missing, and the words come with time.
Who existential therapy can help
- People in transition. Graduating, leaving home, divorce, retirement, becoming a parent, a move or a career change can all unsettle the story you had about your life.
- People who are grieving. Loss raises questions of meaning very directly. Our post on meaning-centered grief therapy looks at that territory in detail, and finding meaning after loss explores how grief can reshape a sense of self.
- People facing illness. A diagnosis, your own or a loved one's, can bring mortality into sharp focus.
- Teens and young adults. Identity, freedom and what kind of person to become are central questions at this age, and existential conversations take them seriously.
- People who feel empty or stuck. Some people come in saying nothing is exactly wrong, yet life feels hollow or on hold. That feeling deserves attention too.
How existential therapy fits with other approaches
Few therapists practice existential therapy on its own. It often sits alongside narrative therapy, which looks at the stories you tell about your life, and psychodynamic therapy, which looks at how earlier relationships and patterns shape the present. Together these are sometimes called depth-oriented approaches.
Existential work is less suited to being the first or only tool when someone needs fast, practical relief from a specific symptom such as panic attacks or compulsions. In those cases a structured approach like cognitive behavioral therapy (CBT) may come first, with the deeper questions explored later or alongside. A clinician can help you sort out what fits right now.
When the big questions start to feel dangerous
Thinking about meaning and mortality is a normal part of being human. For some people, though, the sense that life has no point blends into hopelessness or thoughts of not wanting to be alive. Those feelings are important to say out loud to a therapist, and they are something a clinician can help with. If you are in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or go to the nearest emergency room. Mind Body Seven is outpatient care.
It can also be hard to tell existential distress apart from depression, since the two can look alike and can happen together. Persistent low mood, changes in sleep or appetite, or losing interest in things you used to enjoy are worth raising with a clinician, who can help sort out what is going on and whether a psychiatric evaluation would be useful.
What existential therapy aims for
Existential therapy does not promise that the hard questions disappear. Its aim is a different relationship with them. Over time, the work is meant to help with:
- A clearer sense of what you value and why
- More willingness to make choices and live with them
- Less time spent waiting for life to start
- More honest relationships, with less fear of what sits underneath
- A steadier way of living with uncertainty, since some of it will always be there
Getting support at Mind Body Seven
- Maria Szabo, MHC-LP, draws on existential, narrative, psychodynamic and IFS work, and has a longstanding interest in how storytelling, reflection and meaning-making support emotional development.
- Mandy Rice, LMSW, is strengths-based and collaborative, helping teens and adults clarify their values and goals around purpose, vocation and well-being, often through narrative and reflective practices.
Our narrative and existential therapy page describes how we approach this work. When you request an appointment, tell us a little about the questions you are carrying, and our team will help you find the right fit.
FAQs
What is existential therapy?
Existential therapy is a talk therapy that focuses on questions of meaning, freedom and responsibility, isolation and mortality. It does not hand you answers. It helps you face these questions honestly and live more deliberately.
Who is existential therapy for?
It can help people in transitions, people who are grieving or facing illness, teens and young adults working out identity and direction, and anyone who feels empty or stuck even when life looks fine from the outside. A clinician can help you decide whether it fits what you are going through.
Is existential therapy depressing?
Most people find it the opposite of bleak. Talking openly about hard questions in a warm, steady relationship often feels like a relief. If thoughts about meaning start to feel like hopelessness, tell your therapist, and in a crisis call or text 988 or go to the nearest emergency room.
How is existential therapy different from CBT?
CBT is structured and focuses on changing specific thoughts and behaviors, often with practice between sessions. Existential therapy is more open-ended and focuses on values, choices and meaning. Some people benefit from using both at different times.
Do I need to know philosophy to do existential therapy?
No. Most people arrive with a feeling, such as restlessness, dread or a sense that something is missing, and the words come with time. Your therapist will meet you where you are.
