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  • Ernesto L. Brea

Existentialism in therapy for HIV-positive clients


Using existentialism in therapy for HIV patients can be benefitial

The essence of existentialism

In order to understand how existentialism can work as an effective therapy, particularly in the context of HIV counselling, it is necessary to understand the philosophy underlying the concept of existentialism. In essence, existentialism is both optimistic as well as realistic. It does not present an idealistic image of life, nor is it pessimistic. It takes into account the fact that human choices are limited by countless external factors, but also stresses the fact that freedom underpins the condition of human existence.

We are responsible for our own actions and we make choices constantly, and these choices shape our lives. However, it also recognises that there are external circumstances that limit our choices. Therefore, existentialism makes the point that human beings have freedom, but they also have the responsibility of facing up to the choices they make. As such, existentialism tends to view the human condition in a realistic light, while believing positively in our ability to shape our lives. In the context of HIV counselling, this is an important factor as it tends to place importance on personal freedom and responsibility rather than prescribing to a pre-deterministic view of life.

The road to independence

The existentialist position of personal freedom views co-dependency on another person as toxic and teaches independence through self-observation and examination. That existentialism is pessimistic and views life as empty of meaning is a misconception. Indeed, existentialist therapy concerns itself with understanding that only the self can attribute meaning to one’s life, and that there is no inherent meaning that one must live up or down to. It stresses that by living fully and responsibly, one is free to attribute meaning to life. This is a very significant point in the context of HIV counselling, as patients can often feel like they are rejected or stigmatised.

Death can be an incredibly complex concept to discuss during a counselling session

This view of life and the human condition can be significant in HIV counselling also because it helps to develop a sense of purpose in one’s actions and indeed to one’s life. Existentialist philosophy is often associated with the feeling of emptiness and meaninglessness. Existentialist therapy does not, in fact, cultivate a sense of pessimism or emptiness, rather it helps one look at oneself more objectively and understand the significance of one’s own choices, actions and limitations.

Facing the inevitable

HIV nowadays is not a life threatening condition like it was in the 80’s but yet most HIV clients are haunted by this idea and some of them are incredibly frightened of death. For this reason,  an integral part of counselling with any client with a recent positive diagnose, is coming to terms with death. HIV related death still has to be demystify with HIV clients but death, for HIV and not HIV clients can be an incredibly complex concept and most of us can never really come to terms with it. Existentialism does not view death in a negative light, rather the existentialist position views death only as an inevitable human condition. The condition of being dead is viewed as the ‘other’ that signifies the condition of being alive. This aspect of existentialist therapy addresses the anxiety associated with the future, which can often be complex and debilitating.

Unlike some other forms of therapy, existential therapy is a framework through which to understand the condition of human existence, so that one may be able to deal with the realities of being alive. It is not a reductionist philosophy, but rather, the existentialist point of view is that in order to deal with the mundane and day-to-day life, it is necessary to understand life itself. That is, know the big picture in order to appreciate the details.

Cultivating well-being


Counselling in Kennington, 10 minutes from central London.

If you feel affected by HIV or any other issue please feel free to get in touch and talk to a therapist. I offer a friendly, non-judgemental counselling in Waterloo SE1, Kennington and South London, integrating existentialism in my approach.

Images on Creative Commons license courtesy of Vincepal, Moyan_Brenn_BE_BACK_on_10th_OCT, Joe Houghton

#death #sexualhealth #wellbeing #freedom #existentialism #anxiety #counselling #hiv

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