Sometimes what hurts isn't a specific problem. It's a bigger question. What's the point? Who am I, really? Am I living the life I want? What happens when the people I love are gone? These questions can show up after a loss, a milestone birthday, a diagnosis or for no clear reason at all. Existential therapy is an approach built for exactly these moments. This article explains what existential therapy is, the big life themes it explores, what sessions look like and who it can help.
Wrestling with meaning isn't a sign that something is wrong with you. It's part of being human, and you don't have to do it alone.
What is existential therapy?
Existential therapy is a type of talk therapy rooted in philosophy. Instead of focusing mainly on symptoms, it looks at how you're living: your choices, your values, your relationships and how you face the hard facts of life that everyone shares.
It draws on thinkers like Viktor Frankl, a psychiatrist who survived Nazi concentration camps and later wrote about the human search for meaning, as well as Rollo May and Irvin Yalom, who helped shape existential psychotherapy in North America.
The core idea is that many kinds of distress, like anxiety, emptiness or feeling stuck, are connected to the basic conditions of human life. When we face those conditions honestly, with support, we can live with more freedom, purpose and courage.
The four big themes
Irvin Yalom described four "givens" of human existence that often sit beneath our struggles.
1. Meaning
Humans look for meaning, but life doesn't hand us a clear script. When old sources of meaning fall away, like a career ending, children leaving home or a loss of faith, you may feel empty or lost. Existential therapy helps you explore what gives your life meaning now, and how to build more of it.
2. Freedom and responsibility
We have a lot of freedom to choose how we live, and with that comes responsibility. That can be exciting, and it can also be frightening. Many people feel stuck because a choice feels too big, or because they're living by others' expectations instead of their own values.
3. Isolation
No matter how close we are to others, there's a part of each of us that no one else can fully share. This can bring loneliness. Therapy explores how to form deep, honest connections while accepting that we are, in some ways, alone.
4. Mortality
Every life has an end. Most of the time, we keep that thought at a distance. But losses, illness or aging can bring it close. Existential therapy doesn't try to make this fear disappear. Instead, it explores how awareness of limited time can help clarify what matters most.
Signs you might be facing existential questions
You might notice:
a sense that life is empty or pointless, even when things look fine on the outside
feeling stuck, restless or like you're drifting
questioning your career, relationships or beliefs
feeling disconnected from yourself or others
wondering who you are without a role you've lost
anxiety about the future or about time passing
grief that raises big questions about life and death
These experiences are sometimes called an "existential crisis."
Common triggers for an existential crisis
Existential questions often come up during turning points, such as:
the death of someone close
a serious diagnosis for you or a loved one
a milestone birthday
retirement, a layoff or a career change
children growing up and leaving home
separation or divorce
graduating and facing "real life"
moving to a new country
changes in religious or spiritual beliefs
world events that shake your sense of safety
What happens in existential therapy?
Existential therapy is less about techniques and more about the relationship and the conversation. Your therapist will likely:
Listen deeply to your experience without rushing to fix or label it.
Ask thoughtful questions like "What would a meaningful life look like to you?" or "What are you choosing, even by not choosing?"
Stay with discomfort rather than pushing it away, so you can understand it.
Help you clarify your values and notice where your life lines up with them, and where it doesn't.
Focus on the present, including what is happening between you and your therapist in the room.
Encourage responsibility and choice, helping you see where you have more freedom than you thought.
Sessions can feel more like a searching conversation than a structured program. Many therapists blend existential ideas with other approaches, such as person-centred therapy, mindfulness, acceptance and commitment therapy (ACT) or narrative therapy. Learn more about person-centred psychotherapy at our clinic.
Who can existential therapy help?
Existential therapy can be helpful for people who:
feel empty, stuck or unsure what they want from life
are grieving
are living with a serious or chronic illness
are going through big life transitions
feel anxious about death, aging or the future
are questioning or rebuilding their faith
have tried symptom-focused therapy and want to explore deeper questions
It's not usually a first choice on its own for conditions like severe depression, panic disorder or OCD, where structured treatments have strong evidence. But existential ideas can be woven into that care. Research on meaning-centred therapies has found benefits for well-being and quality of life, especially for people facing serious illness.
Existential questions and spirituality
For some people, big questions lead to faith. For others, they lead away from it, or toward a more personal kind of spirituality. Existential therapy welcomes all of these paths. Your therapist won't give you answers about the meaning of life. They'll help you find your own. Our spirituality page describes how our therapists support people exploring meaning, faith and spiritual growth.
Small ways to start exploring
Write about what matters. Ask yourself, "If I had one year left, what would I want to spend it on?"
Notice your "shoulds." Whose voice is behind them?
Take one values-based step. Choose a small action that reflects something you care about.
Talk honestly with someone you trust. Big questions feel less heavy when shared.
Spend time in awe. Nature, music or art can reconnect you with a sense of something bigger.
Getting started at Transformation Counselling
Many of our therapists work with existential questions, meaning-making and life transitions, and some draw on humanistic and existential approaches. We offer sessions in person in Waterloo, Kitchener, Cambridge and Ottawa, and online across Ontario. You don't need a referral, and evening and weekend appointments are available.
Sessions with our therapists are $130 to $200, and there is a one-time $50 setup fee. Many workplace benefit plans cover therapy with a registered psychotherapist, social worker or psychologist.
If you feel hopeless or are thinking about suicide, please reach out now. Call or text 9-8-8 at any time. In Waterloo Region you can also call Here 24/7 at 1-844-437-3247. In an emergency, call 911.
Frequently asked questions
Is an existential crisis the same as depression?
Not always. An existential crisis centres on questions of meaning and purpose. Depression involves low mood, loss of interest and other symptoms most days for weeks. They can overlap, so it's worth talking with a professional if you're struggling.
Do I need to know philosophy to do existential therapy?
No. You don't need to have read anything. You just need to be willing to talk about your life and what matters to you.
Is existential therapy religious?
No. It's open to people of any faith or none, and it respects your beliefs.
How long does existential therapy take?
It varies. Some people come for a handful of sessions to work through a specific turning point. Others prefer longer-term work.
Take the first step
Big questions deserve thoughtful company. Book a free 15-minute consultation and we'll help you find a therapist who is comfortable exploring meaning and purpose with you. Or you can book an appointment directly.