1. The document discusses time-limited existential therapy, including its history, key characteristics, and the researcher's study on clients' experiences of this approach. 2. The study found that existential time-limited therapy was effective in helping clients with issues like isolation, low self-worth, and fear of judgment to achieve greater self-acceptance and empowerment. 3. Clients felt the 12-session time limit allowed for engaged, focused exploration of deep issues. The early therapeutic alliance and meaningful ending process also positively impacted clients.

1. Time and Existential Therapy
HowWeLive,NSPCConference,BritishLibrary,9th July2016
Dr Neil Lamont, CPsychol, HCPC & UKCP regd.

2. Workshop Agenda
o Time and temporality
o Overview of existential time-limited therapy
o My research
o Group exercise

3. Time and Temporality

4. A Brief History of Temporality
E. Husserl (1859-1938):
Lived time is three-dimensional -
a ‘retentive’ (past) and ‘protentive’ (future)
influences how we experience the current

5. A Brief History of Temporality
Martin Heidegger, 1962
‘the phenomena of the future, the character of
having been, and the Present’ together
constitute the ‘ecstases of
temporality’

6. ‘A unity of the ecstasies’
So we experience an amalgam of all three tenses – time is three dimensional and
transient:
‘the unity of a future which makes present in the process of having been; we designate
it as ‘temporality’ (Heidegger, 1962. p.326)
We are unique in having the ability to
transcend the present and project towards
the future where our possibilities,
and the certainty of our death, reside.

7. My choice…
1. confront and embrace this transience > purposeful living
2. avoid and deny - the ‘never me’ strategy:
‘dominates everydayness so stubbornly that in Being with one another, the ‘neighbours’
often still keep talking the ‘dying person’ into the belief that he will escape death and
soon return to the tranquillized everydayness of the world of his concern’ (ibid.p253)

8. Being towards Death
‘When Dasein concerns itself with time, then the less time it has to lose,
the more ‘precious’ does that time become, and the handier the clock
must be’ (ibid. p.418).

9. Relevance to Existential Therapy

10. Time-limited therapies

11. Defining characteristics
 Collaborative endeavour – ‘positive, strong, collaborative working alliance’ (Bor, 04)
 Brief practitioner should actively challenge their client from the outset
 Fundamental intention is for the client’s resourcefulness and autonomy to be
encouraged and nurtured – instil self-reliance and self-confidence
 Small changes both a realistic aspiration and, crucially, sufficient to instigate a larger
process of change which the client will continue once the therapy has ended

12. Defining characteristics
 Clear explicit contract re number of sessions (usu. 6-12)
 Ending should always be present and discussed
 Acknowledged as not suitable for all presenting issues (early life trauma/abuse)

13. Existential time-limited therapy
Limited literature e.g. Bugental (1995) and Strasser & Strasser (1997) – seminal:
 ‘the one important distinguishing feature…is the limitation of time itself. So although the
goal is to achieve the same kind of awareness as outlined in an open-ended approach, the
aspect of time becomes a tool in itself’ (ibid, p.13)
 a ‘pressure’ is created for both client and therapist to become mindful of the limitations
that they face and the objectives they aspire to meet
 ‘…the simple fact of knowing that there is an ending tends to evoke stronger
emotions…such as fear, anger, sadness and the recollection of previous losses and rejections
help clients to identify their value and coping strategies’ (Strasser & Strasser)

14. Existential time-limited therapy
as with open-ended ET, clients values explored within the context of a life lived within
the paradox of possibilities, limitations and choice; ‘to distinguish them from the
limitations that they impose on themselves’
encouraging an engagement with the key existential concepts of responsibility,
choice, temporality, the embracing of our limitations, possibilities and death within
this particular context can facilitate a unique opportunity for a meaningful exploration
of problems with living

15. Myresearch
Is Time of the essence? Experiential accounts from existential
time-limited therapy at an HIV counselling service

16. Existentialtime-limitedtherapy
My existential
vantage point
client work
Prevalence of
time-ltd therapy
What role for
ETLT?

17. Researchrationaleandassociatedquestions
Little knowledge
of how ETLT is
experienced by
clients.
Lack of ET
practice
evidence-base.
Prevalence of
time-ltd therapy.
Is ETLT an
effective therapy
option for this
client group?
1. Presenting issues and objectives – what were your hopes and expectations
when you began ETLT?
2. What actually happened during the ETLT?
3. Therapy outcomes – what was taken from the process, if anything?
4. Therapeutic relationship – how was this experienced?
5. Time-limited frame – did this influence the process and if so, how?

18. Researchdesign
 Semi-structured interviews
 Follow-up interviews – why?

19. Participantdemographics
Alias Age Ethnicity HIV status Sessions
attended
John 38 White Irish HIV+
(<1yr)
12
Oliver 34 White British unknown 12
Jawaad 43 Zimbabwean
British
HIV+
(>2yr)
12
Michael 36 White British HIV+
(>3yr)
12

20. Threekeyperiods:

21. 1. Beginningatime-limitedexistentialjourney:
• ‘the tragedy of being a gay person – you’ll party hard, you’ll get
HIV…and you’ll die. I just felt like such a cliché…it represented
punishment and oh judgment and fear of your own sexual
desires’ (John)
A quest for
acceptance and
understanding
• ‘I may not be able to talk candidly about sex….because she is a
woman she may not understand as well as say a gay male
counsellor’ (Michael)
Obstacles en route to
trust
• ‘I said I needed interaction…and I got a whole explanation
about ET…all this nonsense…it is not going to make any
difference to me’ (Jawaad)
Therapeutic substance
over style

22. 2. Atime-limitedexistentialexploration
• ‘She asked me ‘when you think of love, what does it mean?’
and I said ‘unhappiness’…it was very useful…I realised that I
am afraid of letting myself go because loving or being loved
equates to being hurt’ (Jawaad)
A meaning revealing
journey
• ‘Her personality, her manner, her warmth, her presence…her
ability to relate to what I was saying and what I was
feeling…sometimes she drew on personal experiences...It
built the trust.’ (Michael)
How relational
alliance is conduit for
change
• ‘I think that if you want to kind of explore a problem and look
at it, examine it…to me (12 weeks) feels like the right amount
of time…to open something up, look at it and deal with it’
(Oliver)
The opportunity of
the time-limited
setting

23. 2. Atime-limitedexistentialexploration
Challenging, confronting fears:
I think (counsellor) always *pause* always asking the question ‘well what do you think
will happen if you do something you are frightened of doing?’ or ‘what will happen if
you don’t do something you are frightened of doing?’. Making me articulate things
and to focus on these different scenarios and and and erm cos I think everyone knows,
you know the answers to those questions but it’s one thing to know it and another to
say it, and get it out! Erm and really *pause* examine it, you know, looking right at it.
Oliver, (II104)
Confronting fears:

24. This processof describingand meaning makingengenderedanearly
andwelcome shift in his mood and attitude:
I went from a place of such isolation and loneliness and just ...terror in a way... I felt I
was just breaking down and I just needed somewhere to go with that. And just to
have that space and do that, describing how I felt, making sense of it, I quite quickly
kind of started getting more happy again...and positive again, and felt much healthier
and you know OK about myself and that probably happened in the first four to five
weeks. (II67, Michael)

25. Early relationship…
Something has happened definitely. Because in the first 2 sessions I remember being
in that desperate state and almost scared of (counsellor) in a way, not knowing, and
almost apologising for me being there. But as the weeks progressed I became more
and more animated and it was...it was a confidence building thing and maybe that
was the relationship that was helping with that. (II199)

26. Substance and depth…
(It) did feel like a substantial bit of work, and I suppose in a way it did make me focus
more...and after twelve weeks it would have gone deeper but we went quite deep
anyway, it wasn’t on the surface. I've faced some painful and difficult things in the
twelve weeks. (II138)

27. Value of good ending
You know this is a relationship in the way that is ending in a way that I didn't want it to
end and I quite enjoyed and looked forward to and now I won't have. So you know to
have the sense of loss of that, that space. Yeah it's sad...I feel sad. But it's tolerable
cos you know I can contain that and know that but it's kinda like I'd made a friend and
they have moved on but I'm happy I had that time while I had it. That's what it feels
like. (II55-7)

28. 3. Leavingatime-limitedexistentialjourney:
• ‘You’re faced with your own mortality basically…but I can
now see that how – and this will sound absolutely atrocious –
but it has actually been my saving grace…I realise that now’
(Michael)
Purposeful living from
adversity
• ‘This is…the conversation I wanted to have with the
counsellor, but I avoided it because I thought ‘I shouldn’t
really…don’t get too analytical…just go with it’’ (Oliver)
The value in taking
stock
• ‘I think it has kicked-off something which I am continuing
myself. I’ve really felt that – it hasn’t just stopped’ (John)
The beginning in the
ending

29. Post therapy follow-up
And there was stumbling blocks which I was really challenged by since the
therapy that have really rocked me and I feared would put me back in that
same place again...but they haven’t. And I suppose again it has challenged me
to now make the changes that I am now aware that I need to make. I need to
do it slowly but I will do it, the judgement has been removed I suppose, I’m not
as judgemental on myself. John (FU14-15)

30. Value of post therapy review
I am glad this has happened (interview), because it has kind of
crystallised the whole process. But had you not been doing this…you are
just left to get on with your life and it’s not... and it is that uncertainty,
you know ‘what the hell just happened *laughs* for twelve weeks?!’
‘What have I actually achieved if anything, what have I actually
covered? Have I covered this, have I done this?!’ Michael (II143)

31. Beginning in the ending
I think it (counselling) has erm kicked-off something which I am
continuing myself. I've really felt that - it hasn’t just stopped…It's there
with me and that's something that’s changed in me and that’s
something I want to keep. I don’t want to lose that...I found something
here in me that I want to keep. Oliver (FU143-4)

32. 1.Relevanceoftheexistentialapproach
• Isolation, low self-worth, fear of judgement and
rejection
• Shadow of HIV
• Crises of being-in-the-world – perception of
unacceptability
Presenting issues
• Accepting relationship with self
• More meaningful relationships with othersObjectives
• Acknowledgement, Understanding, Respect
• Interaction and engagement
Therapist

33. 1.Relevanceoftheexistentialapproach(contd)
Session features: descriptive, conversational,
clarifying
Understanding emotions, deriving meaning
Outcome: enabling, empowering,
purposeful living

34. 3.Theinfluenceofthetime-limitedframe
Potential of a time-limited contract
• Sense of urgency > engaged, focussed explorations – but not ‘single issue’
• Early establishment of alliance pivotal
• Evidenced in potency of ending
Potential of post-therapy review
• Sense of ‘after-care’, tailored
• Opportunity to explore experience of ending and loss
• Importance of this being external
Time-ltd setting as change initiator
• This was beginning of journey, work-in-progress – equipping and empowering

35. Someconclusions
ETLT in action
Presenting issues – existential
engagement effective: self-
acceptance and empowering
Time-limited can be non-
specific and achieve depth
12 sessions were enough for all
– no plans to re-apply
Relational attitude was key –
insight into specifics
Taking stock – much value in
time-limited setting (external
reviewer esp valuable)
Practitioners should be mindful
of context of minorities (BPS)
and alert to triggers

36. Conclusion:
ETLT
deserves a
place
Client-centric
and
empowering
Reflects
human
condition
Pluralism
and client
choice