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.

An existential–spiritual model for coping during and after COVID-19.

“…Numerous factors have made COVID-19 potentially traumatic for individuals that are different from facing life-threatening medical conditions and chronic illness. These unique aspects include persistent anxiety about being either the agent spreading the virus or the victim of it, the prolonged state of vulnerability and uncertainty of when the virus will end, the enormous death toll, social isolation, unprocessed collective loss and grief, and the disruption of daily life (Gordon et al, 2021). In addition, COVID-19 has also highlighted the impact of health care disparities.…”

“…Utilize self-reflective questions including “What have you discovered about yourself through the pandemic?” and “What are your feelings of vulnerability, anxiety, and uncertainty trying to teach you?” to construct a more flexible and self-compassionate narrative (Gordon et al, 2021).…”

“…and "What are your feelings of vulnerability, anxiety, and uncertainty trying to teach you?" to construct a more flexible and self-compassionate narrative (Gordon et al, 2021). • Have the client practice gratitude by thinking of one thing they are grateful for every day, such as their family, job, health, etc.…”

“…This includes other life-threatening illnesses, such as certain types of cancer and neurodegenerative conditions (e.g., amyotrophic lateral sclerosis, multiple sclerosis), as well as future pandemics. Therapists have also gained awareness of what it feels like to experience trauma, fear, and helplessness, as well as an awareness of the preciousness of life and the random nature of events in life (Gordon et al, 2021).…”