What do family therapists experience when clients raise existential themes in therapy? A qualitative study

The last decade the evidence that existential concerns are intertwined with the struggles clients bring to the therapy room has been growing. Existential concerns have for example been associated with several forms of psychopathology, including eating disorders, depression, anxiety disorders, addiction, and psychosomatic illnesses (Fuchs, 2013; Glaw et al., 2017; Iverach et al., 2014; van Bruggen et al., 2014). Accordingly, different psychotherapy models have underlined the need for mental health professionals to address the existential experiences of their clients (Cooper, 2017). This recommendation raises the question how we can train mental health professionals to work with their clients existential concerns adequately. In the literature a start has been made to explore questions that, directly and indirectly, address this issue. Examples include: How therapist experience working with clients’ existential concerns (Frediani et al., 2022); Which challenges therapists experience when confronted with clients’ existential suffering (Hill, 2017; Lundvall et al., 2018; Sundström et al., 2018; Ulland & DeMarinis, 2014; Vanhooren, 2019); How the concept of existential empathy may be of importance in addressing clients’ existential concerns (Vanhooren, 2022). These studies all focus on the client as an individual human being and on therapists who have been trained to engage with a single client at a time. The literature however informs us that when facing existential struggles, people do not only attune to their own experiencing, but also to the experiencing of other family members. In the first conversation with the family about a family member’s death, the family for example tends to only disclose the information the most vulnerable family member is ready to hear (Rober & Rosenblatt, 2013). Also some couples who have suffered the loss of a child choose to not talk about their own existential pain with their partner as a way to search for a bearable distance from their own grief and their partner’s grief and as a way of attuning to their relational context (Hooghe et al., 2018). Hooghe and colleagues (2018) argue that the couples’ intrapersonal process of emotional regulation rests on an interpersonal process of attunement. These studies thus teach us that relating to one’s existential struggles, which is often considered as a very personal and lonely experience, is nevertheless often interwoven and influenced by complex interpersonal processes. This leads to the question how family therapists deal with these complex dynamics when a family member raises existential concerns in the session. Family therapists are at that moment required to not only attune the individual family member’s existential suffering, but to each family member’s suffering and also to the family’s suffering as a whole. Do family therapists therefore encounter different challenges than individual therapists when relating to the existential layer of the family members’ concerns? What do family therapists experience when they are confronted with a family’s existential suffering? Do family therapists maybe even identity different themes as existential than individual therapists do? To our knowledge, these research questions have not been addressed yet. They are however valuable questions to explore as they could inform us on how the help train family therapists to deal with existential concerns that arise in the context of family therapy. Our research aims to explore this topic. References: Cooper, M. (2017). Existential Therapies. Sage. Frediani, G., Krieckemans, L., Seijnaeve, A., & Vanhooren, S. 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