“What is Existential Therapy?”: The relational, ontological and phenomenological dimensions of existential work

In the everyday language of psychotherapy, we often talk about symptoms, diagnoses, coping skills, behavior change, and measurable outcomes. These are valuable and necessary conversations — yet they represent only one layer of what it means to live a human life. For those drawn to depth work — work that honours the full complexity of our lived experience, our uncertainty, our choices, and our relations with others — existential therapy offers a distinct and potent approach. Rather than treating psychological distress as something to be “fixed,” existential psychotherapy invites a different kind of inquiry: What does it mean to be a human being, here, now, in relation to others and to oneself?

Existential therapy is not merely a set of techniques or interventions. It’s a stance, an orientation toward the person’s lived world, shaped by philosophical inquiry as much as clinical practice. At its core it acknowledges that humans are beings in the world — always already enmeshed in relationships, meanings, possibilities, limitations, and anxieties that arise from the very structure of existence itself. To explore this, I want to foreground three dimensions that lie at the heart of existential therapy: relationality, phenomenology, and ontology.

These are not abstract academic categories. They are lived dimensions of every psychotherapy session, every moment of self-reflection, every encounter between therapist and client. To understand them is to appreciate what existential therapy is at its deepest level.

I. Relationality: Being-With in the Therapeutic Encounter

If you ask someone what they most remember from a meaningful therapeutic experience, it’s rarely a particular tool or technique. More often it’s how they felt with their therapist — seen, understood, challenged, accompanied. This is the terrain of relationality.

Relationality in existential therapy refers to the fact that our very existence is in relation to others. We do not come into the world as isolated, self-contained entities. From the moment we are born we are in a network of relations — with caregivers, with culture, with language, with expectations, and ultimately with other human beings who reflect back to us something of who we are. This is not a metaphor or a theory; it’s a lived experience that shapes how we understand ourselves and our possibilities for living.

Martin Heidegger, whose existential phenomenology profoundly influenced modern existential therapy, insisted that human existence is Being-in-the-world (In-der-Welt-sein). For Heidegger, to be human is to be inherently situated among others and in relation to the world around us — not a detached observer but an engaged participant. This is inherently relational. Our identity, our cares, our choices are shaped in connection with others and with our situation in the world.

In therapy, relationality shows up in the therapeutic relationship itself. It is not an add-on or optional extra; it is the ground of the work. A therapist’s presence — attuned, reflective, responsive — matters deeply. It creates a field in which the client can explore not just what they feel, but how they are in relation to another human being. This mirrors the way we live outside the therapy room: our pattern of relating to others — intimate partners, family members, friends, colleagues — often reflects deeper structural patterns of being-with. When someone says, “I always feel unseen” or “I can’t trust people,” they are speaking not just about isolated feelings, but about their relational mode of Being in the world.

Existential therapy, therefore, does not treat the relationship as merely supportive or facilitative. Instead, the therapeutic encounter becomes a space where the fundamental structure of relational existence can be explored and understood. In this way, relationality isn’t just a context; it’s an existential stake — part of what it means to be human, to be known, and to know others.

II. Phenomenology: First-Person Experience as the Starting Point

If relationality describes how we exist with others, phenomenology describes how we experience our own existence. In existential therapy, we begin not with general theories or diagnostic categories, but with the person’s first-person experience — the felt, lived texture of their reality.

Phenomenology is a philosophical method — originally developed by Edmund Husserl and later expanded by Heidegger, Merleau-Ponty, and others — that seeks to describe experience as it is lived, before it is theorized, categorized, or interpreted. It teaches us to hold our assumptions in abeyance so that we can attend to how things show up for the person in their experience. In therapy, this means slowing down our impulse to explain, diagnose, interpret, or fix, and instead cultivating deep openness to another’s subjective world.

In practice, phenomenological listening is subtle and demanding. It requires us to ask: What is it like for this person to experience their anxiety, their grief, their sense of meaninglessness? What does fear feel like when it’s not yet named? When someone says, “I feel numb,” what does that numbness mean to them in the context of their life? It’s a matter of description more than diagnosis — an invitation into the texture of experience before conclusions are drawn.

This orientation shifts therapy away from reducing experience to symptoms and toward understanding the way experience is structured. Unlike more technique-driven approaches that emphasize behavior change or symptom reduction as primary goals, phenomenology invites us into the complexity and ambiguity of human experience.

A phenomenological stance also respects the uniqueness of each person’s world. Two people may both struggle with anxiety, but their experience of “anxiety” can be radically different in its qualities, meanings, and implications for their life. Phenomenology helps us remain attentive to these differences, rather than collapsing them into a single category. This stance deepens our curiosity and expands the therapeutic space from “What is wrong?” to “What is this like for you?”

III. Ontology: The Question of Being

If relationality invites us to consider who we are in relation to others, and phenomenology invites us to consider how we experience our world, then ontology asks the deeper question: What does it mean to be? Ontology is the philosophical study of Being itself — not just facts about existence, but the structure of existence in all its complexity.

Existential therapy is fundamentally ontological because it takes seriously the question of what it means to be a human being. This does not mean abstract speculation divorced from lived life; rather, it means that therapy is a space to investigate — with genuine curiosity — the fundamental conditions of our existence: freedom, responsibility, mortality, isolation, meaning, and authenticity.

Ontology in existential therapy invites us to consider how these conditions shape the way we live. Are we living in ways that align with our values and choices, or are we avoiding the hard questions, deferring to the script of others, or clinging to illusions of certainty? These questions are not easily resolved, and they are rarely the kind that can be fully answered in one session. But raising them — acknowledging them — creates a therapeutic space that is both intellectually honest and emotionally rich.

Ontology also brings into view the possibilities inherent in human life. Human beings are always in a situation of becoming. We can choose (to some degree) how we relate to our conditions. We can choose to avoid, deny, embrace, or explore the uncertainties of our existence. This is not therapeutic optimism in the sense of forcing positivity; rather, it is the sober recognition that we are agents in our own lives, and that our choices — even when limited — shape the texture of our being.

Interweaving the Three Dimensions

Relationality, phenomenology, and ontology may seem like distinct concepts, but in existential therapy they are deeply intertwined. Consider a session where a client speaks about their sense of isolation. In a relational frame, we attend to how the client relates to others and to the therapist. In a phenomenological frame, we explore how isolation feels and shows up in their experience. In an ontological frame, we reflect on what it means to be isolated as a condition of existence and how that awareness shapes the life lived.

These dimensions do not operate in isolation; they inform one another and deepen the therapeutic encounter. The therapist’s presence is not neutral; it is an invitation into the relational world of the client. The therapist’s listening is not detached; it is phenomenological, oriented toward the live experience of the person before them. And the work is not merely technical; it is ontological, asking and holding open questions about the structure of existence itself.

Existential therapy — with its emphasis on relationality, phenomenology, and ontology — does not offer quick answers or sterile formulas. Instead, it offers space for thinking and feeling deeply about one’s life.

Clients may come seeking relief from anxiety, a way through grief, or a clearer sense of direction. But beneath these concerns often lie more fundamental questions about who they are, how they relate to others, and what it means to live in the world with all its ambiguity and possibility. Existential therapy gives voice to these questions. It treats distress not as a defect or failure, but as a natural response to the conditions of existence — an opportunity for inquiry, reflection, and ultimately, greater self-understanding.