Philip Berman is more than the sum of his psychological conflicts, learned behaviors, or cognitions. Being human, he also has the ability to pursue philosophical goals such as self-awareness, strong values, a sense of meaning in life, and freedom of choice. According to humanistic and existential theorists, Philip’s problems can be understood only in the light of such complex goals. Humanistic and existential theorists are often grouped together—in an approach known as the humanistic-existential model—because of their common focus on these broader dimensions of human existence. At the same time, there are important differences between them.

Humanists, the more optimistic of the two groups, believe that human beings are born with a natural tendency to be friendly, cooperative, and constructive. People, these theorists propose, are driven to self-actualize—that is, to fulfill this potential for goodness and growth. They can do so, however, only if they honestly recognize and accept their weaknesses as well as their strengths and establish satisfying personal values to live by. Humanists further suggest that self-actualization leads naturally to a concern for the welfare of others and to behavior that is loving, courageous, spontaneous, and independent (Maslow, 1970).

Existentialists agree that human beings must have an accurate awareness of themselves and live meaningful—they say “authentic”—lives in order to be psychologically well adjusted. These theorists do not believe, however, that people are naturally inclined to live positively. They believe that from birth we have total freedom, either to face up to our existence and give meaning to our lives or to shrink from that responsibility. Those who choose to “hide” from responsibility and choice will view themselves as helpless and may live empty, inauthentic, and dysfunctional lives as a result.

The humanistic and existential views of abnormality both date back to the 1940s. At that time Carl Rogers (1902–1987), often considered the pioneer of the humanistic perspective, developed client-centered therapy, a warm and supportive approach that contrasted sharply with the psychodynamic techniques of the day. He also proposed a theory of personality that paid little attention to irrational instincts and conflicts.

The existential view of personality and abnormality appeared during this same period. Many of its principles came from the ideas of nineteenth-century European existential philosophers who held that human beings are constantly defining and so giving meaning to their existence through their actions (Yalom, 2014).

The humanistic and existential theories, and their uplifting implications, were extremely popular during the 1960s and 1970s, years of considerable soul-searching and social upheaval in Western society. They have since lost some of their popularity, but they continue to influence the ideas and work of many clinicians. In particular, humanistic principles are apparent throughout positive psychology (the study and enhancement of positive feelings, traits, abilities, and selfless virtues), an area of psychology that, as you read in Chapter 1, has gained much momentum in recent years (see pages 16–17).

According to Carl Rogers, the road to dysfunction begins in infancy (Raskin, Rogers, & Witty, 2014; Rogers, 1987, 1951). We all have a basic need to receive positive regard from the important people in our lives (primarily our parents). Those who receive unconditional (nonjudgmental) positive regard early in life are likely to develop unconditional self-regard. That is, they come to recognize their worth as persons, even while recognizing that they are not perfect. Such people are in a good position to actualize their positive potential.

Unfortunately, some children repeatedly are made to feel that they are not worthy of positive regard. As a result, they acquire conditions of worth, standards that tell them they are lovable and acceptable only when they conform to certain guidelines. To maintain positive self-regard, these people have to look at themselves very selectively, denying or distorting thoughts and actions that do not measure up to their conditions of worth. They thus acquire a distorted view of themselves and their experiences. They do not know what they are truly feeling, what they genuinely need, or what values and goals would be meaningful for them. Problems in functioning are then inevitable.

Rogers might view Philip Berman as a man who has gone astray. Rather than striving to fulfill his positive human potential, he drifts from job to job and relationship to relationship. In every interaction he is defending himself, trying to interpret events in ways he can live with, usually blaming his problems on other people. Nevertheless, his basic negative self-image continually reveals itself. Rogers would probably link this problem to the critical ways Philip was treated by his mother throughout his childhood.

Clinicians who practice Rogers’ client-centered therapy try to create a supportive climate in which clients feel able to look at themselves honestly and acceptingly (Raskin et al., 2014). The therapist must display three important qualities throughout the therapy—unconditional positive regard (full and warm acceptance for the client), accurate empathy (skillful listening and restating), and genuineness (sincere communication). In the following classic case, the therapist uses all these qualities to move the client toward greater self-awareness:

In such an atmosphere, clients are expected to feel accepted by their therapists. They then may be able to look at themselves with honesty and acceptance. They begin to value their own emotions, thoughts, and behaviors, and so they are freed from the insecurities and doubts that prevent self-actualization.

Client-centered therapy has not fared very well in research (Prochaska & Norcross, 2013). Although some studies show that participants who receive this therapy improve more than control participants, many other studies have failed to find any such advantage. All the same, Rogers’ therapy has had a positive influence on clinical practice (Raskin et al., 2014). It was one of the first major alternatives to psychodynamic therapy, and it helped open up the clinical field to new approaches. Rogers also helped pave the way for psychologists to practice psychotherapy, which had previously been considered the exclusive territory of psychiatrists. And his commitment to clinical research helped promote the systematic study of treatment. Approximately 2 percent of today’s clinical psychologists, 1 percent of social workers, and 3 percent of counseling psychologists report that they employ the client-centered approach (Prochaska & Norcross, 2013).

Gestalt therapy, another humanistic approach, was developed in the 1950s by a charismatic clinician named Frederick (Fritz) Perls (1893–1970). Gestalt therapists, like client-centered therapists, guide their clients toward self-recognition and self-acceptance (Yontef & Jacobs, 2014). But unlike client-centered therapists, they often try to achieve this goal by challenging and even frustrating their clients. Some of Perls’ favorite techniques were skillful frustration, role playing, and employing numerous rules and exercises.

In the technique of skillful frustration, gestalt therapists refuse to meet their clients’ expectations or demands. This use of frustration is meant to help people see how often they try to manipulate others into meeting their needs. In the technique of role playing, the therapists instruct clients to act out various roles. A person may be told to be another person, an object, an alternative self, or even a part of the body. Role playing can become intense, as individuals are encouraged to express emotions fully. Many cry out, scream, kick, or pound. Through this experience they may come to “own” (accept) feelings that previously made them uncomfortable.

Perls also developed a list of rules to ensure that clients will look at themselves more closely. In some versions of gestalt therapy, for example, clients may be required to use “I” language rather than “it” language. They must say, “I am frightened” rather than “The situation is frightening.” Yet another common rule requires clients to stay in the here and now. They have needs now, are hiding their needs now, and must observe them now.

Approximately 1 percent of clinical psychologists and other kinds of clinicians describe themselves as gestalt therapists (Prochaska & Norcross, 2013). Because they believe that subjective experiences and self-awareness cannot be measured objectively, proponents of gestalt therapy have not often performed controlled research on this approach (Yontef & Jacobs, 2014; Leung, Leung, & Ng, 2013).

For most of the twentieth century, clinical scientists viewed religion as a negative—or at best neutral—factor in mental health (Bonelli & Koenig, 2013; Van Praag, 2011). In the early 1900s, for example, Freud argued that religious beliefs were defense mechanisms, “born from man’s need to make his helplessness tolerable” (1961, p. 23). This negative view of religion now seems to be ending, however. During the past decade, many articles and books linking spiritual issues to clinical treatment have been published, and the ethical codes of psychologists, psychiatrists, and counselors have each concluded that religion is a type of diversity that mental health professionals must respect (Peteet, Lu, & Narrow, 2011).

Researchers have learned that spirituality does, in fact, often correlate with psychological health. In particular, studies have examined the mental health of people who are devout and who view God as warm, caring, helpful, and dependable. Repeatedly, these individuals are found to be less lonely, pessimistic, depressed, or anxious than people without any religious beliefs or those who view God as cold and unresponsive (Koenig, 2015; Day, 2010; Loewenthal, 2007). Such people also seem to cope better with major life stressors—from illness to war—and to attempt suicide less often. In addition, they are less likely to abuse drugs.

Do such correlations indicate that spirituality helps produce greater mental health? Not necessarily. As you’ll recall from Chapter 1, correlations do not indicate causation. It may be, for example, that a sense of optimism leads to more spirituality and that, independently, optimism contributes to greater mental health. Whatever the proper interpretation, many therapists now make a point of including spiritual issues when they treat religious clients, and some further encourage clients to use their spiritual resources to help them cope with current stressors (Gonçalves et al., 2015; Koenig, 2015). Similarly, a number of religious institutions offer counseling services to their members (see MediaSpeak below).

Like humanists, existentialists believe that psychological dysfunctioning is caused by self-deception; existentialists, however, are talking about a kind of self-deception in which people hide from life’s responsibilities and fail to recognize that it is up to them to give meaning to their lives. According to existentialists, many people become overwhelmed by the pressures of present-day society and so look to others for explanations, guidance, and authority. They overlook their personal freedom of choice and avoid responsibility for their lives and decisions (Yalom, 2014). Such people are left with empty, inauthentic lives. Their dominant emotions are anxiety, frustration, boredom, alienation, and depression.

Existentialists might view Philip Berman as a man who feels overwhelmed by the forces of society. He sees his parents as “rich, powerful, and selfish,” and he perceives teachers, acquaintances, and employers as oppressing. He fails to appreciate his choices in life and his capacity for finding meaning and direction. Quitting becomes a habit with him—he leaves job after job, ends every romantic relationship, and flees difficult situations.

In existential therapy, people are encouraged to accept responsibility for their lives and for their problems. Therapists try to help clients recognize their freedom so that they may choose a different course and live with greater meaning (Yalom, 2014; van Deurzen, 2012; Schneider & Krug, 2010). The precise techniques used in existential therapy vary from clinician to clinician. At the same time, most existential therapists place great emphasis on the relationship between therapist and client and try to create an atmosphere of honesty, hard work, and shared learning and growth.

Existential therapists do not believe that experimental methods can adequately test the effectiveness of their treatments. To them, research dehumanizes individuals by reducing them to test measures. Not surprisingly, then, very little controlled research has been devoted to the effectiveness of this approach (Vos et al., 2015; Schneider & Krug, 2010). Nevertheless, around 1 percent of today’s clinical psychologists use an approach that is primarily existential (Prochaska & Norcross, 2013).

The humanistic-existential model appeals to many people in and out of the clinical field. In recognizing the special challenges of human existence, humanistic and existential theorists tap into an aspect of psychological life that typically is missing from the other models (Watson et al., 2011). Moreover, the factors that they say are essential to effective functioning—self-acceptance, personal values, personal meaning, and personal choice—are certainly lacking in many people with psychological disturbances.

The optimistic tone of the humanistic-existential model is also an attraction. Such optimism meshes quite well with the goals and principles of positive psychology (Rashid & Seligman, 2014). Theorists who follow the principles of the humanistic-existential model offer great hope when they assert that, despite past and present events, we can make our own choices, determine our own destiny, and accomplish much. Still another attractive feature of the model is its emphasis on health. Unlike clinicians from some of the other models who see individuals as patients with psychological illnesses, humanists and existentialists view them simply as people who have yet to fulfill their potential.

At the same time, the humanistic-existential focus on abstract issues of human fulfillment gives rise to a major problem from a scientific point of view: these issues are difficult to research. In fact, with the notable exception of Rogers, who tried to investigate his clinical methods carefully, humanists and existentialists have traditionally rejected the use of empirical research. This antiresearch position is just now beginning to change among some humanistic and existential researchers—a change that may lead to important insights about the merits of this model in the coming years (Vos et al., 2015; Schneider & Krug, 2010; Strumpfel, 2006).