Existentially informed person-centred therapy

1. Introduction

Version followed: Mick Cooper's existentially informed person-centred therapy as he sets it out in "Between freedom and despair" (Cooper, 2003, Person-Centered & Experiential Psychotherapies 2(1), 43–56). His book chapter of the same name (Cooper, in Sanders (ed.), The Tribes of the Person-Centred Nation, PCCS; 2nd ed. 2012, pp. 131–160) and its updated 3rd-edition version (Vanhooren & Cooper, ch. 8) are not drawn on [uncertain]. Concrete in-session procedures come from Vanhooren's experiential–existential psychotherapy (EEP): a 2019 case study, a 2026 training study co-authored with Cooper (abstract only) and the contents page of Vanhooren's 2026 book. Where guidance is EEP-specific it is tagged [source: Vanhooren].

What it is. This is not a manualised therapy. It is a person-centred practice (core conditions, a non-directive client-led process) re-informed by existential philosophy: Kierkegaard, Heidegger, Sartre, Buber, Laing, and existential therapists such as May, Yalom, van Deurzen and Spinelli. Cooper presents existential thought as a corrective to biases he finds in person-centred theory: optimism about growth, an "automatic" actualising process that downplays agency, individualism, and a quasi-medical reading of anxiety as incongruence. He argues that existential ideas let the therapist be more accepting and less directive, not more prescriptive [source: Cooper 2003]. Cooper also notes that existential practitioners often see systematising or manualising as contrary to the approach [source: Cooper 2017, Introduction].

How change happens. Clients are free, choosing beings who are always also limited (by death, chance, their history and culture) and always embedded in relationships. Change comes from:

being met, accepted and confirmed by a therapist who does not push them in a predetermined "growthful" direction;
facing their freedom, limits and meanings, including despair and dread, rather than having these treated as symptoms;
owning the choices and meanings available to them, including future possibilities [source: Cooper 2003].

In EEP terms, existential concerns are first felt bodily, then storied, then related to ultimate concerns. Shifts at the felt level change conceptual meaning, and vice versa [source: Vanhooren 2019].

2. Framework

No fixed phases in Cooper's version. Cooper describes a stance and areas of exploration (freedom and choice, limitations, relatedness, meaning), not a staged protocol [source: Cooper 2003]. He places his own practice at the gentler, more descriptive, less structured end of the existential spectrum [source: Cooper 2017, Introduction]. The process below is taken from EEP and offered as one workable map [source: Vanhooren 2019; Vanhooren 2026 contents page]. Vanhooren treats his three levels as a lens for choosing responses, not a checklist.

Format. Individual, open-ended, client-led sessions. The 2019 EEP case ran 18 sessions. Session length and frequency are not specified in the sources; weekly 50-minute sessions are an assumption [uncertain]. In Cooper's pluralistic framing, check with the client what they want from therapy and adjust [source: Cooper 2017, Introduction].

Stage (EEP)	Goals	Typical span	Move on when
1. Searching for authentic contact (goal and relationship)	Build a relationship the client experiences as safe and real; assess risk; name the client's existential concern explicitly and agree it as the therapy goal and task	Sessions 1–3 in the 2019 case	The concern is named and shared, and the client can stay with their experience in the room [source: Vanhooren 2019; stage name from Vanhooren 2026 contents page]
2. Death, meaninglessness and responsibility (mainly micro work, with meso material)	Contact, symbolise and stay with the bodily felt sense of the concern (e.g. meaninglessness); let stuck experience shift; bring in history and relationships as they show up in the body	Sessions 4–12 in the 2019 case	The client can reliably reach bodily meaning and has a more accepting "I–I" relation to their experience. Macro questions now land rather than being intellectualised [source: Vanhooren 2019]
3. Living the full life (meso and macro)	Reflect on narratives, values and ultimate concerns (what matters in the end, what is asked of the client now); name existential guilt; support concrete steps on unlived projects	Sessions 13–18 in the 2019 case	Ending is agreed with the client; the process is non-linear, so expect returns to earlier work [source: Vanhooren 2019; Vanhooren 2026 contents page]

The three meaning levels used throughout [source: Vanhooren 2019]:

Micro: the bodily felt sense of here-and-now experience.
Meso: narratives, self-concept, cherished beliefs and assumptions about the world.
Macro: ultimate concerns and existential givens such as death, meaninglessness, guilt, isolation and freedom.

3. Guiding principles

[source: Cooper 2003 unless tagged otherwise]

Radical acceptance of the client as they are now. Accept the client as they are, not as who they might become once they have "worked through" their difficulties. Do not quietly wait for them to improve.
De-pathologising. Intense anxiety, regret, helplessness or despair may be accurate contact with the realities of existence, not incongruence. Treat them as understandable responses before treating them as problems. Cooper's summary aim is a therapy that is "radically accepting, radically de-pathologising and radically humanistic".
No prescribed direction ("un-knowing"). Drawing on Spinelli and Schmid, hold open what is best for this client. Notice your own culturally shaped ideas about where clients "should" go, and keep them out of your responses.
Life as crossroads, not conveyor belt. Choices are real dilemmas with no guaranteed right answer, after van Deurzen. Do not assume that following one's "process" or self-interest is always best; explore the dilemma itself.
Agency is real. From the inside, choice is part of being. Reflect the client's choosing and willing, not only their feelings, and avoid language that makes change sound automatic.
Freedom has costs. Choosing one option rules others out (Yalom), and choice brings responsibility and guilt. Expect anxiety and guilt as companions of choice, not as signs of failure.
Limits are real. Death, chance and "thrownness" (the circumstances one was born into) shape every life. Be willing to talk about death, loss and unfairness. Cooper notes that Rogers tended to avoid these topics.
Dialogical presence. Be a real, distinct other in an I–Thou meeting (Buber, Schmid), not a neutral mirror. Be open to being changed while keeping your own otherness.
Confirmation is a basic need. With Buber, Cooper treats the need to be confirmed by others as fundamental, not just a learned need. Confirm the person explicitly; do not pathologise their wish to be confirmed.
Persons-in-the-world. Clients are embedded in relationships, culture and language. Locate difficulties between people and in context, not only "inside" the client.
Respect the client's worldview. The assumption that accessing and symbolising feelings is always helpful is one worldview among others. If a client rejects emotion work, do not press it.
Future as well as past. Attend to possibilities, projects and meanings ahead, not only to causes behind.
Humility. Before life's largest questions, technique and knowledge have limits; let that show.
Hope without imposing growth. Cooper acknowledges that therapist hope has real value, but hope must not become a demand that the client improve in the "right" way.
Core conditions retained. Empathy, unconditional positive regard and congruence remain the base. The client in the 2019 EEP case experienced them as feeling "at home" [source: Vanhooren 2019].
Existential empathy. This is the capacity to stay present with a client's existential concerns, resonate with them and convey that resonance [source: Frediani, Cooper, … Vanhooren 2026, abstract].
Presence over technique. Be present as a living person, without letting techniques stand between you and the client. Notice your own urge to fix things [source: Vanhooren 2019].
Ask the client. Clients need different things at different times; the best way to find out is to ask them (Cooper's pluralistic stance) [source: Cooper 2017, Introduction].
Therapist's own existential work. Training that builds existential empathy combines theory with personal engagement with one's own existential issues [source: Frediani et al. 2026, abstract].

4. Intervention inventory

Cooper does not set out formal, step-by-step interventions. He gives practice implications in general terms [source: Cooper 2003]. Items A1–B8 below turn those implications into in-session steps. The steps are my operationalisation [synthesis] of practices Cooper states or implies; each item names its source. Items C1–C12 are procedures described in the EEP case study [source: Vanhooren 2019]. All example language is illustrative and not quoted from the sources.

A. Relational and stance-level interventions

A1. Accepting and empathising with despair (de-pathologising response)

Purpose / when: whenever the client brings hopelessness, emptiness, dread, meaninglessness or relational frustration. Use it especially when you feel the pull to "move them on" [source: Cooper 2003].
Steps: (1) Reflect the despair at its full weight, without softening it or adding a silver lining. (2) Where it fits, acknowledge that the experience may be a clear-sighted response to something real: loss, uncertainty, mortality, unfairness. (3) Leave out any implied "so that you can get past it". (4) Stay with it; let the client decide whether and when to move.
Example language (illustrative): "It sounds like, when you look at your life honestly, it really does feel like there's no point. That's not something you're getting wrong; it's where you are."
Watch for: your own reassurance reflexes and hurry. It is working if the client goes further into the experience, feels less ashamed of it, and stops apologising for being "negative" [synthesis].

A2. "Un-knowing": holding the direction open

Purpose / when: throughout, and above all when a client faces a choice or seems to be moving "the wrong way" by your lights [source: Cooper 2003, drawing on Spinelli and Schmid].
Steps: (1) Before or after sessions, name to yourself which outcome you are hoping for (leaving the partner, expressing anger, "growing"). (2) Treat that hope as your own culturally shaped preference. (3) In session, reflect all sides the client voices with equal care. (4) If you notice you have leaned one way, say so openly and re-balance.
Example language (illustrative): "I realise I've been asking more about leaving than staying. I don't actually know which is right for you. What's it like to stay with both?"
Watch for: subtle steering through which statements you reflect. It is working if the client owns their decision as theirs, whichever it is [synthesis].

A3. Phenomenological description (bracketing, describing rather than interpreting)

Purpose / when: the default way of exploring experience. It helps the client unpack how something is actually lived. The source here is secondary: a summary of a Cooper lecture listing bracketing, description over interpretation, open questions and helping clients unpack their experiencing [source: Counselling Tutor summary; Husserl's method as cited in Cooper 2003].
Steps: (1) Set aside your theories and assumptions about what this experience means. (2) Invite concrete description of what happens, when, and how it feels and looks. (3) Use open questions; avoid "why" and avoid offering explanations. (4) Stay with the particular rather than generalising.
Example language (illustrative): "Can you take me into one of those mornings: what's the first thing you notice when you wake?"
Watch for: sliding into interpretation or diagnosis. It is working if the description becomes richer and more specific, and the client discovers aspects they had not noticed.

A4. Dialogical (I–Thou) presence and confirmation

Purpose / when: throughout. Use it particularly with clients who have been objectified, denied or not believed (Laing), or who long for recognition [source: Cooper 2003, drawing on Buber and Schmid].
Steps: (1) Meet the client as a unique other, not as a case or diagnosis. (2) Let yourself be affected, and where helpful show it congruently. (3) Keep your own distinctness: offer your own perspective when it serves the dialogue, while respecting theirs. (4) Confirm the person explicitly, both their existence and their struggle. (5) Treat their wish for confirmation from others as a legitimate need.
Example language (illustrative): "I want to say that what you've just told me matters to me. I'm really with you in this."
Watch for: self-disclosure that shifts the focus to you. It is working if the client feels met as a person and risks saying more [synthesis].

A5. Exploring the here-and-now encounter

Purpose / when: when relational patterns show up between you and the client, or the relationship itself feels stuck. Source: a lecture summary listing "exploring the here-and-now encounter" and dialogue among Cooper's demonstrated skills [source: Counselling Tutor summary; secondary].
Steps: (1) Notice what is happening between you right now. (2) Name it tentatively, as your own experience. (3) Invite the client's experience of the same moment. (4) Explore it together without assigning blame.
Example language (illustrative): "Right now I notice I'm working hard and you've gone quiet. How is it for you, here with me, at this moment?"
Watch for: clients who hear this as criticism. It is working if the relational pattern becomes speakable and the contact deepens [synthesis].

A6. Existential empathy

Purpose / when: when existential concerns surface, explicitly (death, meaning, loneliness, choice) or as cues in other material [source: Frediani et al. 2026, abstract; Vanhooren 2026 contents page].
Steps: (1) Listen for existential cues beneath everyday content: a remark about time running out, "what's the point", feeling utterly alone. (2) Stay with the concern rather than steering back to safer topics. (3) Let it resonate in you. (4) Convey that resonance empathically, human to human.
Example language (illustrative): "When you said 'I'm forty and nothing has happened yet', I felt a kind of ache. Is there something there about time?"
Watch for: your own avoidance. The study suggests therapists build this capacity partly by engaging with their own existential issues. It is working if existential themes become speakable rather than hinted at [synthesis].

B. Thematic explorations (Cooper's four areas)

B1. Exploring freedom and choice

Purpose / when: when the client describes themselves as stuck, driven or without options, or speaks of change as something that will just "happen" to them [source: Cooper 2003, drawing on Farber's distinction between automatic willing and deliberate choosing, and May's intentionality, wishing and willing].
Steps: (1) Listen for the choices already present in what the client describes, including choosing not to choose. (2) Reflect agency as well as feeling. (3) Gently separate wishing (what they long for) from willing (what they are prepared to do). (4) Do not supply which choice to make.
Example language (illustrative): "You say you 'can't' leave; you've also said you choose each morning to stay. What's that choosing like?"
Watch for: blaming the client ("it's your choice" said as a reproach), and ignoring real constraints (see B4). It is working if the client starts to speak in the first person about decisions [synthesis].

B2. Exploring dilemmas without prescribing

Purpose / when: at genuine crossroads: career, relationship, caring duties, values in conflict [source: Cooper 2003, drawing on van Deurzen's "dilemmas of existence"].
Steps: (1) Map each option as the client lives it: what it opens up and what it closes off. (2) Explore what is lost either way. (3) Resist resolving the tension for them. (4) Accept that there may be no right answer.
Example language (illustrative): "Both paths cost you something real. Can we look at what each one asks you to give up?"
Watch for: the client pressing you to decide (see section 5). It is working if the client can hold the dilemma with less panic and choose knowingly [synthesis].

B3. Working with anxiety, guilt and regret that come with choosing

Purpose / when: when choice brings anxiety (choosing excludes alternatives, after Yalom), guilt about the effects on others, or regret about paths not taken [source: Cooper 2003].
Steps: (1) Normalise these feelings as part of choosing, not as evidence of choosing wrongly. (2) Explore the specific losses and responsibilities involved. (3) Separate guilt about real effects on others from global self-condemnation. (4) Let regret be grieved rather than argued away.
Example language (illustrative): "Feeling anxious may not mean it's the wrong choice; it may mean it's a real one, with something at stake."
Watch for: reassurance that skips the loss. It is working if the client stays with the feeling and still acts [synthesis].

B4. Facing limitations and givens (death, chance, thrownness)

Purpose / when: around loss, illness, ageing, injustice, or circumstances the client did not choose: family, class, body, events [source: Cooper 2003, drawing on Heidegger's thrownness, Jaspers' "boundary situations" and the tide of accident, and van Deurzen].
Steps: (1) Be willing to name death, unfairness and chance plainly when the client approaches them. (2) Acknowledge what cannot be changed, without rushing to what can. (3) Explore what the client makes of the limit and how it bears on what still matters. (4) Hold freedom and limitation together: clients choose within real constraints.
Example language (illustrative): "Some of what happened to you wasn't fair and wasn't chosen. I don't want to skip past that."
Watch for: recently bereaved or acutely traumatised clients, for whom pacing matters; keep it client-led [synthesis]. It is working if the client speaks more openly about the limit and their responses to it.

B5. Future-oriented empathy: exploring possibilities

Purpose / when: when the work has become purely backward-looking, or the client glimpses a want or project [source: Cooper 2003, citing Bohart's future-oriented empathy responses].
Steps: (1) Reflect what the client is reaching towards as well as what they feel now. (2) Explore the possibilities and meanings that lie ahead. (3) Keep it the client's future, not your plan.
Example language (illustrative): "Underneath the frustration, it sounds like you're reaching for something: a life where your work is yours. Is that close?"
Watch for: turning this into goal-setting pressure. It is working if the client articulates possibilities in their own words [synthesis].

B6. Exploring interpersonal perceptions and metaperceptions

Purpose / when: in relationship conflicts and escalating cycles, or when the client feels objectified, unseen or disbelieved [source: Cooper 2003, drawing on Laing and Sartre].
Steps: (1) Ask how the client sees the other person. (2) Ask how they think the other sees them (metaperception). (3) Ask how they think the other believes the client sees them. (4) Trace where misreadings feed escalation. (5) Explore experiences of having their own perceptions denied.
Example language (illustrative): "When she goes quiet, what do you think she's thinking about you? And what do you imagine she thinks you're thinking?"
Watch for: siding with the client against the absent other. It is working if the client sees the spiral and their part in it with less blame [synthesis].

B7. Exploring meaning and meaninglessness

Purpose / when: when the client voices pointlessness, loss of purpose or emptiness, or questions what their life is for [source: Cooper 2003].
Steps: (1) Accept meaninglessness as a legitimate experience (A1). (2) Explore which meanings the client has lived by and where they came from: family, culture, roles. (3) Explore which meanings they would choose now, knowing these are made rather than given, and transitory. (4) Do not supply meanings. Cooper contrasts Frankl's more didactic meaning-centred approach with the stance that there are no given ultimate meanings.
Example language (illustrative): "If nobody else's expectations counted, what, if anything, would feel worth your time?"
Watch for: meaninglessness accompanied by suicidal thoughts, which needs a risk check (C12). It is working if the client tentatively claims something that matters to them [synthesis].

B8. Working within the client's worldview (not imposing emotion work)

Purpose / when: when a client resists "getting in touch with feelings" or does not share person-centred assumptions about emotion and self [source: Cooper 2003].
Steps: (1) Notice resistance to emotion-focused invitations. (2) Treat it as a worldview, not as defence. (3) Ask the client what way of working fits them. (4) Work in their terms: practical, narrative, philosophical, spiritual.
Example language (illustrative): "I keep asking about feelings and it doesn't seem to be helping. How would you prefer we go about this?"
Watch for: labelling the client "defended". It is working if engagement rises once you work in the client's terms [synthesis].

C. Experiential–existential procedures (EEP)

[source: Vanhooren 2019 for C1–C12 unless tagged otherwise. Step wording is paraphrased and organised by me.]

C1. Naming the existential concern as the shared goal

Purpose / when: sessions 1–3. Make the client's ultimate concern explicit and agree it as the goal and task; revisit it regularly. Vanhooren treats linking the goal to the existential concern as itself a macro-level intervention.
Steps: (1) Listen for the concern beneath the presenting problem (e.g. meaninglessness beneath low mood). (2) Name it tentatively in the client's own words. (3) Agree together that this is what you will work on, and how. (4) Return to it at intervals to check it still fits.
Example language (illustrative): "It sounds like the heart of it is that life has lost its point for you. Is that what you'd want us to work with?"
Watch for: imposing an existential label the client does not recognise. It is working if the client confirms the concern and feels understood at depth.

C2. Focusing on the felt sense of an existential concern (micro level)

Purpose / when: once the relationship is safe enough, to contact and symbolise how the concern is lived in the body. Use it especially when talk stays abstract.
Steps: (1) Invite attention to where in the body the feeling sits. (2) Ask for its qualities: weight, direction, movement, texture. (3) Offer back or invite a word or image for it. (4) Check whether the symbol fits. If the client hedges ("maybe"), gently return to the body rather than moving on. (5) Allow pauses.
Example language (illustrative): "When you say 'empty', where do you feel that right now? … What's it like: heavy, hollow, still? … Does 'hollow' fit, or not quite?"
Watch for: reaching the edge of what the client can attend to; then shift to a related macro theme rather than pushing. It is working if the felt sense becomes clearer and begins to move or change.
Note: this draws on focusing (Gendlin). The steps follow Vanhooren's case, not a full focusing protocol.

C3. Staying with "frozen wholes"

Purpose / when: when stuck, repetitive experiences recur (the same despair, the same flat heaviness).
Steps: (1) Do not try to change or solve the stuck state. (2) Help the client feel and symbolise it fully, staying with it session after session if needed. (3) Wait for it to begin to shift. Vanhooren describes it often changing on its own once fully felt and symbolised. He calls this willingness on the therapist's part a "leap of faith".
Example language (illustrative): "Let's not try to get rid of it. Can we just keep it company for a bit and see what it's like?"
Watch for: your own frustration. It is working if small shifts appear: new words, images or bodily changes.

C4. Asking the felt sense what it needs

Purpose / when: once a difficult felt sense (e.g. a darkness) is well contacted.
Steps: (1) Invite the client to turn towards the felt sense with kindness. (2) Ask it what it needs. (3) Wait for an answer from the body rather than the head. (4) Receive whatever comes, which may point to a new direction.
Example language (illustrative): "If that darkness could tell you what it needs, what might it say?"
Watch for: answers that sound like "shoulds". Return to the body if so. It is working if a fresh, felt answer arrives with some relief or energy.

C5. Attending to both poles

Purpose / when: when despair co-exists with another part, such as a life-affirming, rebellious pull.
Steps: (1) Notice and name both sides. (2) Give each its full attention in turn. (3) Do not side with the "healthy" one.
Example language (illustrative): "There's the part that says 'what's the point', and there's also something in you that won't give up. Can we hear both?"
Watch for: favouring the hopeful side, which can collude with avoidance. It is working if both sides can be felt without one silencing the other.

C6. Meso-level exploration: narratives, relationships, values

Purpose / when: when history, family and relationships come up, mainly through how they show up in the body.
Steps: (1) Explore how the concern shows up in relationships and life history. (2) Notice "un-storied" emotions, feelings not yet linked to life events, and help connect them. (3) Reflect differences between the client's values and their family's. Vanhooren reports this can shift self-concept and bring relief.
Example language (illustrative): "It sounds like 'success' was your father's measure. I'm not sure it's yours."
Watch for: drifting into intellectual life review; keep it anchored in felt sense. It is working if the client separates inherited expectations from their own.

C7. Empty-chair dialogue for unfinished business

Purpose / when: unfinished business with a significant other, e.g. a deceased parent, whose expectations still weigh on the client. In the case, switching chairs to voice the parent's perspective helped the client recognise inherited expectations.
Steps: (1) Offer the exercise as optional, with a brief rationale. (2) Invite the client to imagine the person in an empty chair and speak to them. (3) Where useful, invite them to switch chairs and speak as the other. (4) Track feeling and reflect what emerges. (5) Debrief afterwards.
Example language (illustrative): "Would you be willing to try something? Imagine your father in that chair. What would you want to say to him?"
Watch for: overwhelm, especially in recent or traumatic grief. Do not press if the client declines [synthesis]. This technique comes from emotion-focused and Gestalt practice; Vanhooren uses it within EEP. Cooper's 2003 paper does not discuss it [uncertain whether Cooper's own version includes it].

C8. Macro questions: what is asked of the client, what matters in the end

Purpose / when: later stages, after micro and meso groundwork. Vanhooren found macro interventions powerful only once the client could reach bodily meaning.
Steps: (1) Ask what life is asking of the client now. (2) Reflect back what seems to matter "in the end". (3) Let the answer be felt, not just thought. In the case, the emerging meaning, connection, was itself bodily felt.
Example language (illustrative): "Looking at your life as a whole, what do you sense is being asked of you now?"
Watch for: asking too early, which tends to produce intellectualising, and a micro question that pulls the client out of a macro moment; return to the macro level if that happens. It is working if the client's energy rises and a sense of meaning appears.

C9. Naming existential guilt

Purpose / when: when the client expresses a sense of not having lived, or of having betrayed their own possibilities.
Steps: (1) Name the guilt gently as guilt towards one's own life. (2) Distinguish it from moral guilt towards others. (3) Explore what it points to.
Example language (illustrative): "There's a kind of guilt in what you're saying. Not about hurting anyone, but about not having lived the life you could have."
Watch for: the guilt turning into self-attack. It is working if the guilt becomes a pointer towards what matters [synthesis on the distinction; see Cooper 2003 on guilt and responsibility].

C10. Supporting concrete steps on unlived projects

Purpose / when: when a meaning or project has emerged and the client wants to take ownership of it.
Steps: (1) Ask what a first concrete step would be. (2) Let the client choose and pace it. (3) Review later what happened, without judging.
Example language (illustrative): "What would be one small way of honouring that this week, if you wanted to?"
Watch for: the step becoming your agenda. It is working if the client acts and reports feeling more alive.

C11. Existential reading, ideas and worldview-fitting metaphors

Purpose / when: when existential ideas may validate the client's experience. The client in the case found existential reading on choice and meaning validating.
Steps: (1) Offer an idea or reading tentatively, and only if it fits the client. (2) Choose metaphors from the client's own worldview. With a religious client, Vanhooren used an image of an exodus through the desert. (3) Check how it landed. A lecture summary also lists symbols and metaphors among Cooper's skills [source: Counselling Tutor summary].
Example language (illustrative): "Some philosophers have written that feeling the emptiness you describe is part of seeing life clearly. Does that speak to you at all?"
Watch for: lecturing, which is Frankl-like didacticism (Cooper 2003 contrasts it with his approach). It is working if the client feels less alone or less 'crazy'.

C12. Therapist self-monitoring: being affected, the urge to fix

Purpose / when: continuously, especially with heavy despair or meaninglessness that pulls you in.
Steps: (1) Notice when you are being drawn into the client's despair or paralysed by it. (2) Notice the urge to find quick solutions. Quick solutions can collude with the client's avoidance of distressing experience. (3) Use what you notice to stay present rather than act it out. (4) Bring it to supervision.
Example language (illustrative, to yourself): "I want to cheer her up right now. Whose need is that?"
Watch for: in the case, the work improved once the therapist stayed with the heaviness.

D1. Checking risk when despair or meaninglessness is present

Purpose / when: at intake and whenever hopelessness, meaninglessness or suicidal thoughts are voiced. In Cooper's teaching case (Siân, a composite client with past suicidal thoughts), he first confirms she is not currently at risk, then explores what brought her [source: Cooper 2017, Introduction].
Steps: (1) Ask directly and calmly about suicidal thoughts, intent, plans and protective factors, following your service's standard risk-assessment procedure. (2) Where there is risk, agree a safety plan, include lethal-means counselling (safe storage or removal), and involve others as your protocol requires [synthesis; standard practice]. (3) Then return to an accepting, exploratory stance. Accepting despair (A1) does not mean leaving risk unassessed.
Example language (illustrative): "When life feels this pointless, some people think about ending it. Has that been in your mind?"
Watch for: de-pathologising becoming a reason not to ask [synthesis].

5. Handling problems

Client stuck in the same despair week after week. Cooper's stance: accept it as where the client is now. Do not treat lack of movement as failure; he notes trainees often become frustrated or anxious when clients do not improve in the "right" direction [source: Cooper 2003]. EEP response: stay with the frozen whole and help the client feel and symbolise it more fully (C3). Vanhooren reports such states often shift on their own once fully felt [source: Vanhooren 2019]. If many weeks pass without any shift, ask the client how they experience therapy and whether something different would help, in line with the pluralistic stance [source: Cooper 2017, Introduction; synthesis].
Therapist pulled into despair, paralysed, or rushing to fix. Name the pull to yourself, and recognise that quick solutions can collude with the client's avoidance. Then stay with the heaviness; in the 2019 case the work improved once the therapist did so (C12) [source: Vanhooren 2019]. Take your own death anxiety and meaning questions to supervision or personal therapy. Training research suggests personal engagement with one's own existential issues builds the capacity to stay present [source: Frediani et al. 2026, abstract].
Intellectualising and abstract talk about "the meaning of life". Bring attention back to the body and the here and now (C2). Hold macro questions until the client can reach bodily meaning [source: Vanhooren 2019].
Overwhelm, or the client at the edge of what they can attend to. Do not push micro work; shift to a related macro or meso theme, slow down, and ground [source: Vanhooren 2019]. For trauma-related overwhelm, apply standard grounding and stabilisation, and pace any confrontation with death or loss according to the client's capacity [synthesis].
Relapse after progress. Expect a non-linear course. In the case, a self-critical inner voice undid a good period; the gain came when the client recognised that voice and distanced from it. Treat setbacks as material, not failure [source: Vanhooren 2019].
Client rejects emotion or feeling work. Treat this as a worldview, not as resistance. Ask how they would like to work and follow their lead (B8) [source: Cooper 2003].
"Resistance" in general. Cooper's stance argues against reading the client's direction as defence. First check whether you are steering (A2). Then name the pattern in the here and now and ask the client about it (A5) [source: Cooper 2003; synthesis].
Client demands advice or wants you to decide. Acknowledge the wish and the anxiety behind it. Explore the dilemma and its costs (B2, B3). Be open that you cannot know what is right for them, and offer your own view as one perspective only if dialogue calls for it [synthesis, based on Cooper 2003 on un-knowing and dialogical presence]. If the client repeatedly wants more structure, discuss whether another approach, or a more directive existential approach, would suit them better [synthesis; Cooper 2017 notes the range from gentler to more structured existential practice].
Non-adherence. The approach sets no homework, so classic non-adherence does not arise. If concrete steps agreed in C10 are not taken, explore what happened with curiosity: what the step meant, and what stood in the way, including real limits. Do not set the step again by default [synthesis].
Ruptures (client feels misunderstood, pushed or judged). Name the rupture openly, own your part, and ask for the client's experience. This fits the dialogical, non-defensive I–Thou stance [synthesis, based on Cooper 2003 on dialogue]. Check whether a premature existential label (C1) or a de-pathologising reflection was heard as "you're telling me to just accept it" [synthesis].
De-pathologising misheard as resignation. Some clients may hear acceptance of despair as you giving up on them. Make clear that accepting where they are does not mean you think nothing can change; you are leaving the direction to them [synthesis; Cooper 2003 notes the real value of hope].
Suicidal ideation in the context of meaninglessness. Run a full risk assessment (D1); de-pathologising is never a reason to skip it. Agree a safety plan and lethal-means counselling where needed, and increase contact or refer according to protocol [synthesis; standard practice; Cooper 2017 Introduction models a first-session risk check].
Talking about death with dying or bereaved clients. Let the client lead. Give their actual circumstances full weight before any reflection on meaning. Avoid consoling philosophies [synthesis].
Religious or spiritual clients. Work within their worldview. Use metaphors and meanings drawn from their own tradition (C11) rather than secular existential framings that may feel alien [source: Vanhooren 2019; Cooper 2003 on worldview].
Cultural difference. Cooper notes that the autonomous, inward self of person-centred theory is a Western construction. Explore the client's relational, family and community embeddedness, and do not frame "independence" as the goal [source: Cooper 2003].
Premature macro questions disrupting the process, or a micro question breaking a macro moment. Notice the drop in contact and return to the level where the client was [source: Vanhooren 2019].
Empty-chair work overwhelms the client. Stop, ground, debrief, and return to empathic following. Offer the exercise again only with explicit consent [synthesis].

Sources

Sources:

Further reading (not drawn on) [uncertain where relied on]:

Cooper, M. (2012). Existentially-informed person-centred therapy. In P. Sanders (Ed.), The Tribes of the Person-Centred Nation (2nd ed., pp. 131–160). PCCS Books.
Vanhooren, S., & Cooper, M. Existentially informed person-centred therapy. In M. Cooper (Ed.), The Tribes of the Person-Centred Nation (3rd ed., ch. 8). PCCS Books.
Cooper, M. (2003; 2nd ed. 2017). Existential Therapies. SAGE. (Ch. 8 "Dimensions of existential therapeutic practice" not drawn on.)
Cooper, M. (2015). Existential Psychotherapy and Counselling: Contributions to a Pluralistic Practice. SAGE.
Cooper, M. (2012; 2nd ed.). The Existential Counselling Primer. PCCS Books.
Vanhooren, S. (2026). Carrying Existence Forward: Introducing Experiential–Existential Psychotherapy. University Professors Press.

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