Existential Psychotherapy Yalom Quotes

To love means to be actively concerned for the life and the growth of another.

Mature love is loving, not being loved.

To care of another individual means to know and to experience the other as fully as possible.

To the extent that one is responsible for one's life, one is alone.

Yalom wrote in Existential Psychotherapy, our awareness of death helps us live more fully—and with less, not more, anxiety.

Someone's got to do some more research, but I would really like to know: when a CBT therapist really gets distressed, who does he go see?

Surely this sense of betrayal is what Robert Frost had in mind when he wrote: "Forgive, O Lord, my little jokes on Thee/And I'll forgive Thy great big one on me." io

she attempted to deal with her terror in a most ineffective and magical mode-a mode that I have seen many patients use: she attempted to elude death by refusing to live.

می‌توان خواندن را اراده کرد ولی نه فهمیدن را

انسان باید بیاموزد با دیگری ارتباط برقرار کند بی‌آنکه با بدل شدن به بخشی از او، به آرزوی فرار از تنهایی پروبال دهد، از سوی دیگر، باید بیاموزد با دیگری ارتباط برقرار کند بی‌آنکه او را تا سطح ابزاری برای دفاع در برابر تنهایی پایین بیاورد.

وحشت مرگ همه‌جایی است و چنان عظمتی دارد که بخش قابل‌ملاحظه از انرژی زندگی صرف انکار آن می‌شود.

Death and life are interdependent: though the physicality of death destroys us, the idea of death saves us.

The same point is made by the Hasidic Rabbi, Susya, who shortly before his death said, "When I get to heaven they will not ask me, 'Why were you not Moses?' Instead they will ask 'Why were you not Susya? Why did you not become what only you could become?

آگاه شدن از این واقعیت که فرد متشکل از خودش است، هیچ مرجع تمام‌عیار خارجی‌ای در کار نیست و فرد معنایی دلبخواه به دنیا می‌بخشد، به این معنا خواهد بود که فرد به بی‌پایگی بنیادین خویش آگاهی می‌یابد.

وقتی فرد به دلیل انجام ندادن کاری که باید انجام می‌داد، احساس گناه می‌کند، این فکر پدید می‌آید که پس کاری می‌شد کرد و فضای حاصل از این فکر، بسیار تسکین‌دهنده‌تر از حقایق اگزیستانسیال طاقت‌فرسای زندگی است.

By keeping death in mind, one passes into a state of gratitude, of appreciation for the countless givens of existence. This is what the Stoics meant when they said, “Contemplate death if you would learn how to live.

بزرگ شدن، انتخاب کردن و جدا کردن خود از دیگران به معنای مواجهه با تنهایی و مرگ هم هست.

مسئولیت‌پذیری موجب می‌شود فرد اعتقادش به وجود نجات‌دهنده‌ی غایی را کنار بگذارد و این کار برای کسی که جهان‌بینی‌اش را حول چنین اعتقادی استوار کرده، بسیار دشوار است.

شر واپسین این است که زمان بی‌وقفه رو به نابودی است و بودن با نابودی دست‌به‌گریبان.

The enemies of conformity are, of course, freedom and self awareness

Life cannot be lived nor can death be faced without anxiety. Anxiety is guide as well as enemy and can point the way to authentic existence. The task of the therapist is to reduce anxiety to comfortable levels and then to use this existing anxiety to increase a patient's awareness and vitality.

درواقع، فقط جهان‌شمولی رنج انسانی است که باعث می‌شود در همه جای دنیا به بیماری (روانی) یکسانی برخورد کنیم.

دانستن و عمل نکردن با ندانستن یکی است.

Wish" gives the warmth, the content, the imagination, the child's play, the freshness, and the richness to "will." "Will" gives the self-direction, the maturity, to "wish." Without "wish," "will" loses its life-blood, its viability, and tends to expire in self-contradiction. If you have only "will" and no "wish," you have the dried-up, Victorian, neopuritan man. If you have only "wish" and no "will," you have the driven, unfree, infantile person who, as an adult-remaining-an-infant, may become the robot man.66

پرسشِ "چه معنایی در زندگی است؟" در درجه اول این فرض را پدید می‌آورد که معنایی در زندگی هست که نتوانسته‌ایم آن را بیابید که با دیدگاه اگزیستانسیال که انسان عامل و فاعل معنا بخش زندگی است، در تعارض است.

هیچ انسانی نیست که همیشه کامیاب شود و همیشه بیافریند، هیچ انسانی نیست که مدام در تلاش‌هایش موفق باشد، ولی حرکت در مسیر درست حتی اگر به کامیابی منجر نشود، شاید معنای زندگی و تنها پاسخ اگزیستانسیال ممکن باشد.

آگاهی از مسئولیت یعنی آگاهی از اینکه خودمان سرنوشت، گرفتاری‌های زندگی، احساسات و درنتیجه رنج‌هایمان را پدید آورده‌ایم.

احساس گناه قبلاً به‌صورت احساسی تعریف می‌شد که درنتیجه تجاوز خیالی یا واقعی به حریم دیگری به وجود می‌آمد، بعدها ما توجه منبع دیگری از احساس گناه نیز شدیم: تجاوز به حریم خویش، ناتوانی در زیستن زندگی‌ای که به فرد اختصاص داده‌شده است.

If parents teach the child that all free impulse expression is undesirable and all counter will is bad, the child suffers two consequences: suppression of his or her entire emotional life, and stunted, guilt-laden will. The child then grows into an adult who suppresses his or her emotions and regards the very act of willing as evil and forbidden.

به عقیده فرانکل، معضل انسان امروزی این است که دیگر غریزه و یا سنت نیست که به او می‌گوید باید چه کند. حتی دیگر خودش هم نمی‌داند چه می‌خواهد بکند و فقط دو واکنش رفتاری نسبت به این بحران ارزش دارد، یا همرنگی با جماعت (آنچه دیگران می‌کنند) و یا تسلیم در برابر استبداد (انجام آنچه دیگران می‌خواهند).

دو شیوه متضاد در رویارویی بشر با مرگ وجود دارد، بشر یا می‌پیوندد یا می‌گسلد، یا در خود جای می‌دهد یا در هم می‌آمیزد، یا بر خودمختاری خویش تأکید می‌کند یا امنیت را در پیوستن به نیرویی دیگر می‌جوید. مطمئناً منظور فروم هم از این جمله که انسان یا در آرزوی سلطه‌پذیری و اطاعت است یا مشتاق قدرت، همین بوده.

Mass consumerism requires that a product be attractive, well packaged, and, most important of all, easily and quickly consumed. Unfortunately these requirements are generally incompatible with the effort and the thoughtfulness that are needed if one is truly to examine and alter one's life and world perspective.

No matter how close each of us becomes to another, there remains a final, unbridgeable gap; each of us enters existence alone and must depart from it alone. The existential conflict is thus the tension between our awareness of our absolute isolation and our wish for contact, for protection, our wish to be part of a larger whole.

آثار بزرگ ادبی ماندگارند، زیرا چیزی در خواننده برمی‌انگیزند که او را مشتاق درک حقیقتشان می‌کند. حقیقت شخصیت‌های داستانی به این دلیل ما را تحت تأثیر قرار می‌دهد که حقیقت خود ماست.

ترس از مرگ نقش عمده‌ای در تجربه درونی ما دارد، ذهنمان را به طرز بی‌بدیلی تسخیر می‌کند، مدام زیرپوستمان در غرش است و حضوری تیره و آشفته در حاشیه خودآگاهی دارد.

as the clinician gains maturity, he or she gradually begins to appreciate that there are staggering problems inherent in an empirical study of psychotherapy.

two beliefs, or delusions, that afford a sense of safety. One is the belief in personal specialness; the other, the belief in an ultimate rescuer.

All of us are creatures of a day; the rememberer and the remembered alike. All is ephemeral—both memory and the object of memory.

Heidegger believed that there are two fundamental modes of existing in the world: (1) a state of forgetfulness of being or (2) a state of mindfulness of being.

پاداش‌ها در پی محبت می‌آیند، در پی محبت نمی‌روند.

We will go to any length to avoid responsibility and to embrace authority even, if necessary, if it requires us to pretend to accept responsibility.

One who does not feel is not sought out by others, but exists in a state of loneliness, cut off not only from one's feelings but from those of others.

در درون هر فرد ترسی اساسی و بدوی هست که گاه به شکل ترس از زندگی و گاه به شکل ترس از مرگ رخ می‌نماید.

death is the condition that makes it possible for us to live life in an authentic fashion.

No matter how close each of us becomes to another, there remains a final, unbridgeable gap; each of us enters existence alone and must depart from it alone.

Significant problems arise in relationships for the alexithymic individual. Others never know how that person feels; he or she seems unspontaneous, wooden, heavy, lifeless, and boring.

is the creation of a psychic world in which one does not experience freedom but exists under the sway of some irresistible ego-alien ("not-me") force. We call this defense "compulsivity.

A denial of death at any level is a denial of one’s basic nature and begets an increasingly pervasive restriction of awareness and experience. The integration of the idea of death saves us; rather than sentence us to existences of terror or bleak pessimism, it acts as a catalyst to plunge us into more authentic life modes, and it enhances our pleasure in the living of life.

Great literature survives, as Freud pointed out in his discussion of Oedipus Rex,18 because something in the reader leaps out to embrace its truth. The truth of fictional characters moves us because it is our own truth.

While the belief in personal specialness provides a sense of safety from within, the other major mechanism of death denial —belief in an ultimate rescuer—permits us to feel forever watched and protected by an outside force.

Existential isolation, a third given, refers to the unbridgeable gap between self and others, a gap that exists even in the presence of deeply gratifying interpersonal relationships. One is isolated not only from other beings but, to the extent that one constitutes one’s world, from world as well. Such isolation is to be distinguished from two other types of isolation: interpersonal and intrapersonal isolation. One experiences interpersonal isolation, or loneliness, if one lacks the social skills or personality style that permit intimate social interactions. Intrapersonal isolation occurs when parts of the self are split off, as when one splits off emotion from the memory of an event. The most extreme, and dramatic, form of splitting, the multiple personality, is relatively rare (though growing more widely recognized); when it does occur, the therapist may be faced (...) with the bewildering dilemma of which personality to cherish.

If two wishes are mutually exclusive, then one must be relinquished. If, for example, a meaningful, loving relationship is a wish, then a host of conflicting interpersonal wishes-such as conquest, power, seduction, or subjugation-must be denied.

Some therapists may attempt to increase therapeutic leverage by accenting the individual's sole responsibility. The therapist helps the patient realize that not only is the individual responsible for his situation but that only he is responsible.

I think my quarry is illusion. I war against magic. I believe that, though illusion often cheers and comforts, it ultimately and invariably weakens and constricts the spirit. But there is timing and judgment. Never take away anything if you have nothing better to offer. Beware of stripping a patient who can’t bear the chill of reality. And don’t exhaust yourself by jousting with religious magic: you’re no match for it. The thirst for religion is too strong, its roots too deep, its cultural reinforcement too powerful.

I think my quarry is illusion. I war against magic. I believe that, though illusion often cheers and comforts, it ultimately and invariably weakens and constricts the spirit. But there is timing and judgment. Never take away anything if you have nothing better to offer. Beware of stripping a patient who can’t bear the chill of reality. And don’t exhaust yourself by jousting with religious magic: you’re no match for it. The thirst for religion is too strong, its roots too deep, its cultural reinforcement too powerful.

Now I can read and get a good night's rest which is what I really wanted all along." In that remarkable phrase-"which is what I really wanted all along"-lies the crux of Bernard's problem. The obvious question is, "Why, Bernard, if this is what you really want, did you not simply do that directly?

It is a matter of no small importance that one be able to explain and order the events in our lives into some coherent and predictable pattern. To name something, to locate its place in a causal sequence, is to begin to experience it as under our control. No longer, then, is our internal experience or behavior frightening, alien or out of control; instead, we behave (or have a particular inner experience) because of something we can name or identify. The "because" offers one mastery (or a sense of mastery that phenomenologically is tantamount to mastery). I believe that the sense of potency that flows from understanding occurs even in the matter of our basic existential situation: each of us feels less futile, less helpless, and less alone, even when, ironically, what we come to understand is the fact that each of us is basically helpless and alone in the face of cosmic indifference.

The wish-blocked individual has enormous social difficulties. Others, too, wish to shout at such persons. They have no opinions, no inclinations, no desires of their own. They become parasitic on the wishes of others, and finally others become bored, drained, or fatigued at having to supply wish and imagination for them.

For some of us the fear of death manifests only indirectly, either as generalized unrest or masqueraded as another psychological symptom; other individuals experience an explicit and conscious stream of anxiety about death; and for some of us the fear of death erupts into terror that negates all happiness and fulfillment.

Recently, for example, I visited my optometrist to complain that my eyeglasses no longer functioned as of yore. He examined me and asked my age. “Forty-eight,” I said, and he replied, “Yep, right on schedule.” From somewhere deep inside the thought welled up and hissed: “What schedule? Who’s on schedule? You or others may be on a schedule, but certainly not I.

I always imagined that you might write something about me. I wanted to leave an imprint on your life. I don’t want to be “just another patient”. I wanted to be “special”. I want to be something, anything. I feel like nothing, no one. If I left an imprint on your life, maybe I would be someone, someone you wouldn’t forget. I’d exist then. (Marge’s letter to Yalom)

The majority of therapists realize, for example, that an apprehension of one’s finiteness can often catalyze a major inner shift of perspective, that it is the relationship that heals, that patients are tormented by choice, that a therapist must catalyze a patient’s “will” to act, and that the majority of patients are bedeviled by a lack of meaning in their lives.

Thought, in and of itself, has no external consequences-although it may be an indispensable overture to action: one may, for example, plan, rehearse, or muster the resolve for action. Action extends one beyond oneself; it involves interaction with one's surrounding physical or interpersonal world. Action need not entail gross, or even observable, movement. A slight gesture or glance toward another may be action of momentous import.

The existential psychotherapy approach posits that the inner conflict bedeviling us issues not only from our struggle with suppressed instinctual strivings or internalized significant adults or shards of forgotten traumatic memories, but also from our confrontation with the “givens” of existence. And what are these “givens” of existence? If we permit our-selves to screen out or “bracket” the everyday concerns of life and reflect deeply upon our situation in the world, we inevitably arrive at the deep structures of existence (the “ultimate concerns,” to use theologian Paul Tillich’s term).

My own odyssey of therapy, over my forty-five-year career, is as follows: a 750-hour, five-time-a-week orthodox Freudian psychoanalysis in my psychiatric residency (with a training analyst in the conservative Baltimore Washington School), a year’s analysis with Charles Rycroft (an analyst in the “middle school” of the British Psychoanalytic Institute), two years with Pat Baumgartner (a gestalt therapist), three years of psychotherapy with Rollo May (an interpersonally and existentially oriented analyst of the William Alanson White Institute), and numerous briefer stints with therapists from a variety of disciplines, including behavioral therapy, bioenergetics, Rolfing, marital-couples work, an ongoing ten-year (at this writing) leaderless support group of male therapists, and, in the 1960s, encounter groups of a whole rainbow of flavors, including a nude marathon group.

This book deals with four ultimate concerns: death, freedom, isolation, and meaninglessness. The individual's confrontation with each of these facts of life constitutes the content of the existential dynamic conflict. Death. The most obvious, the most easily apprehended ultimate concern is death. We exist now, but one day we shall cease to be. Death will come, and there is no escape from it. It is a terrible truth, and we respond to it with mortal terror. "Everything," in Spinoza's words, "endeavors to persist in its own being";3 and a core existential conflict is the tension between the awareness of the inevitability of death and the wish to continue to be. Freedom. Another ultimate concern, a far less accessible one, is freedom. Ordinarily we think of freedom as an unequivocally positive concept. Throughout recorded history has not the human being yearned and striven for freedom? Yet freedom viewed from the perspective of ultimate ground is riveted to dread. In its existential sense "freedom" refers to the absence of external structure. Contrary to everyday experience, the human being does not enter (and leave) a well-structured universe that has an inherent design. Rather, the individual is entirely responsible for-that is, is the author of-his or her own world, life design, choices, and actions. "Freedom" in this sense, has a terrifying implication: it means that beneath us there is no ground-nothing, a void, an abyss. A key existential dynamic, then, is the clash between' our confrontation with groundlessness and our wish for ground and structure. Existential Isolation. A third ultimate concern is isolation-not interpersonal isolation with its attendant loneliness, or intrapersonal isolation (isolation from parts of oneself), but a fundamental isolation-an isolation both from creatures and from world-which cuts beneath other isolation. No matter how close each of us becomes to another, there remains a final, unbridgeable gap; each of us enters existence alone and must depart from it alone. The existential conflict is thus the tension between our awareness of our absolute isolation and our wish for contact, for protection, our wish to be part of a larger whole. Meaninglessness. A fourth ultimate concern or given of existence is meaninglessness. If we must die, if we constitute our own world, if each is ultimately alone in an indifferent universe, then what meaning does life have? Why do we live? How shall we live? If there is no preordained design for us, then each of us must construct' our own meanings in life. Yet can a meaning of one's own creation be sturdy enough to bear one's life? This existential dynamic conflict stems from the dilemma of a meaning-seeking creature who is thrown into a universe that has no meaning.

هرچه بکوشیم تا دنیا را دوبه‌دو طی کنیم، درنهایت، تنهایی بنیادینی هست که باید تاب آوریم، هیچ‌کس قادر نیست با دیگری یا برای دیگری بمیرد.

زمان جاودانی اکنون است نه آینده.

ما نیازمند نظام معنایی هستیم که طرح کلی ارزش‌ها در آن لحاظ شده باشد، ولی جهان چنین چیزی فراهم نمی‌کند، جهان کاملاً نسبت به ما بی‌اعتناست، تنش میان آرمان انسان و بی‌تفاوتی جهان همان چیزی است که آلبر کامو "پوچی" موقعیت انسانی نام نهاده.

هریک از ما سخت نیازمند جاودانگی، استواری، همزیستی و الگویی برای سرمشق قرار دادنیم، و باوجوداین، همگی باید با مرگ ناگزیر، بی‌پایگی، تنهایی و پوچی روبرو شویم.

ما در حسرت خودمختاری هستیم، ولی از پیامد ناگزیر خودمختاری، یعنی تنهایی، طفره می‌رویم.

مردم برای یافتن راه‌های پرهیز از آگاهی نسبت به مسئولیت، زرنگی و ذکاوت خستگی‌ناپذیری از خود نشان می‌دهند.

انسانی که می‌بخشد، چیزی را در دیگری می‌آفریند.

حتی آن زمان که چیزها خارج از کنترل ماست، انسان این قدرت را دارد که نگرش خود را نسبت به سرنوشتش تحت فرمان داشته باشد، آنچه را که قادر به انکارش نیست، از نو تعبیر و تفسیر کند.

همان‌طور که فرد به‌تنهایی مسئول آنچه هست است، به‌تنهایی مسئول تغییر آنچه هست نیز هست.

تا زمانی که فرد معتقد است دیگری یا نیرویی بیرونی مسئول مشکل یا ملال اوست، تعهد به تحول فردی چه معنایی دارد؟

آنان که مأیوسانه نیازمند آرامش و لذت حاصل از یک رابطه اصیل‌اند، درست همان‌هایی هستند که کمتر از هرکسی قادر به برقراری چنین ارتباطی هستند.

A person who reaches mid-life, either without having successfully established himself in marital and occupational life, or having established himself by means of manic activity and denial with consequent emotional impoverishment, is badly prepared for meeting the demands of middle age, and getting enjoyment out of his maturity. In such cases, the mid-life crisis, and the adult encounter with the conception of life to be lived in the setting of an approaching personal death, will likely be experienced as a period of psychological disturbance and depressive breakdown. Or breakdown may be avoided by means of a strengthening of manic defenses, with a warding off of depression and persecution about aging and death, but with an accumulation of persecutory anxiety to be faced when the inevitability of aging and death eventually demands recognition. The compulsive attempts, in many men and women reaching middle age, to remain young, the hypochondriacal concern over health and appearance, the emergence of sexual promiscuity in order to prove youth and potency, the hollowness and lack of genuine enjoyment of life, and the frequency of religious concern are familiar

began this book by observing that death anxiety rarely enters the discourse of psychotherapy. Therapists avoid the topic for a number of reasons: they deny the presence or the relevance of death anxiety; they claim that death anxiety is, in fact, anxiety about something else; they may fear igniting their own fears; or they may feel too perplexed or despairing about mortality. I hope that I have, in these pages, conveyed the necessity and the feasibility of confronting and exploring all fears, even the darkest ones. But we need new tools-a different set of ideas and a different type of therapist-patient relationship. I suggest that we attend to the ideas of great thinkers who have faced death forthrightly and that we build a therapeutic relationship based on the existential facts of life. Everyone is destined to experience both the exhilaration of life and the fear of mortality.

we suffer also from our inevitable confrontation with the human condition-the "givens" of existence. What precisely are these "givens"? The answer is within each of us and readily available. Set aside some time and meditate on your own existence. Screen out diversions, bracket all preexisting theories and beliefs, and reflect on your "situation" in the world. In time you will inevitably arrive at the deep structures of existence or, to use the theologian Paul Tillich's felicitous term, ultimate concerns. In my view, four ultimate concerns are particularly germane to the practice of therapy: death, isolation, meaning in life, and freedom. These four ultimate concerns constitute the spine of my 1980 textbook, Existential Psychotherapy, in which I discuss, in detail, the phenomenology and the therapeutic implications of each of these concerns.

Often we know we need to change, to stop wasting our time and to focus our efforts elsewhere, but we delay and justify our delays with the excuse that in the future conditions will be more ideal. As we become more acutely aware of our mortality we will realize in the words of Seneca that “[j]ust where death is expecting [us] is something we cannot know; so, for [our] part, expect him everywhere”. This recognition can imbue our life with a new sense of urgency and help us realize that with death always approaching “existence cannot be postponed” (Irvin Yalom, Existential Psychotherapy) and that waiting for ideal future conditions is a dangerous game to play.

فردی که رویکردی کاسب‌کارانه دارد، وقتی قرار باشد ببخشد و در مقابل نستاند، حس می‌کند فریب‌خورده ولی برای انسان رشد یافته، بخشش نشانه قدرت، ثروت و وفور است.

شاید حیوانات حس نیاز به چوپان یا جان‌پناه در خود ببینند، ولی انسان که به نفرین خودآگاهی گرفتارشده، باید در جهان هستی بی‌پناه بماند.

بااینکه اقدام به خودکشی به دلیل ترس از مرگ یک پارادوکس است، اما چندان ناشایع نیست. فکر خودکشی تا حدودی به فرد اجازه می‌دهد چیزی را تحت کنترل درآورد که تاکنون او را کنترل می‌کرده است.

ما برای ماشین‌هایی که در وقت صرفه‌جویی می‌کنند، ارزش قائلیم و همین ارزش ماشینی را برای خود نیز به‌کار می‌بریم. بااین‌همه، با وقتی‌که با صرفه‌جویی اندوخته‌ایم چه می‌کنیم جز آنکه هدرش دهیم!

فردیت یافتن مستلزم تنهایی کامل، بنیادین و ابدی است.

As Rank suggested, an individual may have learned early in life that impulse expression is bad, and generalized that verdict of badness to the entire realm of volition.

انسان‌ها همیشه منشی دوسوگرا نسبت به آزادی دارند. بااینکه به پیکاری بی‌امان برای رسیدن به آزادی دست می‌زنند، منتظر فرصتی هستند که از آن صرف‌نظر کنند و به نظامی استبدادی تن دردهند تا از باری که آزادی و تصمیم بر دوششان نهاده بکاهند.

در برابر هر آری، یک نه هست. تصمیم‌گیری درباره یک چیز همیشه به معنای چشم‌پوشی از چیز دیگر است. هر راه چاره، تو را از سایر راه‌ها محروم می‌کند.

برای آنهایی که مردن را زندگی کرده‌اند اشک نریزید، اشک‌هایتان را برای آنهایی بگذارید که در حین زندگی مرده‌اند.

تنهایی عمیق از عمل خود آفرینندگی جدایی‌ناپذیر است، فرد به بی‌تفاوتی عظیم جهان آگاه می‌شود.

آنکه زندگی نمی‌کند، بیش از همه از مرگ می‌هراسد.

The four ultimate concerns are death, isolation, freedom, and meaninglessness. Death, of course, is an instinctive fear that we often repress but that tends to increase as we get older. What we fear isn’t just dying in the literal sense but in the sense of being extinguished, the loss of our very identities, of our younger and more vibrant selves. How do we defend against this fear? Sometimes we refuse to grow up. Sometimes we self-sabotage. And sometimes we flat-out deny our impending deaths. But as Yalom wrote in Existential Psychotherapy, our awareness of death helps us live more fully — and with less, not more, anxiety.

The existential psychotherapy approach posits that the inner conflict bedeviling us issues not only from our struggle with suppressed instinctual strivings or internalized significant adults or shards of forgotten traumatic memories, but also from our confrontation with the "givens" of existence. And what are these "givens" of existence? [...] Four ultimate concerns, to my view, are highly salient to psychotherapy: death, isolation, meaning in life, and freedom.