Jungian, Existential, and ACT Therapies: A Case Conceptualization Study
Client History, Presenting Problem, Strengths, and Goals
The client is a 40-year-old Caucasian female. She is married with no children. The client is employed part-time at a nonprofit but will soon lose her job because her organization is closing. She’s in a full-time master’s program for art therapy and counseling and lives with her husband in Santa Fe, New Mexico. The client states she is having difficulty dealing with the loss of her paternal aunt. She states, “My Aunt Sue (my aunt on my dad’s side) passed away this past March of pancreatic cancer. Her death was very unexpected and sudden. She had just found out she had pancreatic cancer a few months prior during a test for a gallbladder issue. She (we all) thought she had more time even after her diagnosis. We were very close. She was in many ways a hero, mentor, and best friend to me, and losing her has been tough.”
The client states she’s decided to enter therapy because she’s struggling with grief due to the loss of her aunt and guilt that she was unable to ease more of her aunt’s suffering during her final days. The client has been dealing with these feelings on and off since last March when her aunt passed away. She has been taking healthy steps to help combat these feelings, like eating a whole food, plant-based, vegan diet, limiting alcohol consumption, regularly exercising, meditating, and expressing emotions through art. She’s also currently seeing a Jungian art therapist.
The client has a variety of strengths to help her combat her feelings of grief and guilt. She leads a healthy lifestyle and utilizes mostly healthy outlets for managing stress, namely exercise, and meditation. She lives with her husband, who is a “huge support.” Additionally, her husband is a psychiatrist, and she says she feels very comfortable expressing her emotions with him. She says her husband is her biggest and most important support system. However, the client also states that she doesn’t have a solid local network of friends as they moved to Santa Fe during the pandemic and will only remain for another year due to health issues she’s battling.
In terms of goals of therapy, the client would like to explore additional healthy ways of working through her grief and guilt. She would also like to investigate her deeper feelings about death and the meaning of life and find ways to use the experience to live a more positive and meaningful life. The client states she is not experiencing debilitating or overwhelming feelings about her aunt’s death. Still, she wants to learn additional tools she can use as she continues to work through the process.
Jungian Theory
The first study model I’ll be using to examine this case is the Jungian Analytical Theory. The main tenants of this theoretical approach as it applies to the client’s presenting problem are that it supports methods of accessing the psyche and bringing parts of the unconscious to the surface of awareness to create a complete sense of the whole self. Additionally, utilizing dream analysis to access the personal and collective unconscious is another foundation of Jungian analysis. Both concepts of opening doors to the unconscious by various means apply to working with the client’s feelings of grief and guilt. Additionally, accessing the psyche can help the client investigate her thoughts on death and the meaning of life. Due to the symbolic nature inherent in Jungian Analytical Theory, working with the client’s existing love of creating art combined with creative dream analysis might help her tap into the collective unconscious to access views about death and dying.
Two goals for treatment utilizing Jungian Analytical Theory are to 1) increase the client’s awareness of her deeper feelings on death and living a meaningful life by bringing to the surface aspects of her personal unconscious as well as the collective unconscious; and 2) give the client specific creative tools she can use in the future to tap into her psyche on her own. At the end of therapy, the client should have an increased sense of the whole self, a deeper awareness of her feelings, and additional tools to help her deal with future hardship. If the client states these three goals have been met, the therapy will be a success.
There are two specific Jungian-style goal-related interventions that I’ll use. The first is utilizing a guided meditation to gain a deeper awareness of the client’s existing accessible feelings of grief and guilt. I plan to implement this technique when the client expresses her feelings about her aunt’s death but has difficulty arriving at the root of the emotions. I expect that she will warmly receive the intervention due to her existing meditation practice. I will then guide her to close her eyes and focus on her breath. I would then ask the client to notice what emotions are surfacing for her and name the prominent emotions. I would invite her to notice where she might feel these emotions in her physical body and ask her to describe them in as much detail as possible. If the client begins to feel too triggered, I will invite her to return to her breath until she feels grounded. I would then invite the client to alternate her focus back and forth from her breath focus and her emotions focus, again describing or naming anything additional that surfaces. Lastly, I would invite her to visualize a healing white light slowly saturating her body and radiating outward. I would then ask her to open her eyes and talk through how the experience was for her.
I’ll use dreams analysis through journaling and art therapy for the second Jungian-style goal-related intervention. Given the client’s love of creative expression, I think she would receive the homework exercises positively. I would invite the client to keep a journal near her bed and to write down everything about her dreams that she can remember immediately after waking, including any associated emotions and bodily sensations. I would then ask her to artistically express her dreams through collage, painting, mandala, or other creative means. I would ask her to bring her journal and art to our next session. If she has trouble remembering her dreams, I will talk about simple techniques to help her, such as avoiding alcohol and sticking to a consistent sleep schedule.
The Jungian modality has a high likelihood of success specific to the client’s therapy goals of harnessing a deeper awareness of her feelings and gaining additional tools she can continue to use in the future. The use of meditation can deepen her understanding of where she is closer to the surface. The use of dream analysis and art therapy can help her access her unconscious and possibly gain wisdom from the collective unconscious about death and dying. Both directly relate to the client’s stated goals.
Existential Theory
The Existential Theory is the second study model I’ll be using to examine this case. One of the central tenants of this theoretical approach as it applies to the client’s presenting problem is the foundational belief inherent in the theory that purpose and meaning are critical to a person’s life and well-being. The importance placed on a sense of meaning correlates with the client’s desire to investigate the deeper meaning of life. In Existential Therapy, there is significantly less emphasis placed on early childhood experiences, which wouldn’t be relevant to the client’s presenting problem. There is also a core belief within this theoretical approach that people can change. This construct could be helpful in terms of the client making adjustments to incorporate more meaning in her life in the aftermath of her aunt’s passing and utilize new tools moving forward. I believe this modality might be helpful to the client because it would directly address her curiosity about meaning, help her find more positive uses for her grief and guilt, and provide her with additional tools.
Two goals for treatment utilizing Existential Theory are to 1) help the client develop her own sense of meaning and attitudes about death, dying, and the purpose of life in a world where inherent purpose and meaning are largely absent; and 2) help the client identify ways she can create more meaning and fulfillment in her life. At the end of therapy, the client should better grasp how to create meaning and fulfillment for herself rather than trying to find it outwardly. If the client arrives at a place where she feels she’s accomplished that, the therapy will be termed a success.
There are two specific Existential-style goal-related interventions that I’ll use. The first involves helping the client shift her perspective as it relates to seeking meaning outwardly to creating meaning for herself in her own life. To do this, I would invite the client into conversations exploring a phenomenological perspective and ask questions that shed light on Umwelt, Mitwelt, Eigenwelt, and Uberwelt. Once I understand the client’s subjective experience about death, dying, and any inherent worldly meaning of life, I would gently challenge her unhelpful thoughts and encourage introspection. Rather than the client seeking to find meaning in her aunt’s death or purpose in her own life out in the world, I would encourage deep reflection on what life and death mean to her and why it matters.
The second intervention would be helping the client establish specific, actionable ways to create more meaning and fulfillment for herself. I would accomplish this by asking her questions like, “Where in your life do you feel more satisfied?” and “What would your ideal life look like?” As we work through those conversations, I could help the client establish a plan to incorporate more of the fulfilling elements unearthed into her life and address ways to tie them to having a meaningful life. I would also encourage her to read The Book of Joy by the 14th Dalai Lama, Desmond Tutu, and Douglas Abrams to educate her on ways to create joy inwardly rather than pursuing happiness outwardly.
The Existential modality has a high likelihood of success specific to the client’s therapy goals of harnessing a deeper understanding of the meaning of life (and death) and finding ways to incorporate more meaning into her life. The exploration of her phenomenological perspective, combined with gentle confrontations, encouragement, and establishing goals to increase fulfillment, would all directly relate to the client’s stated therapy goals. It would also likely shift her worldview in a manner more compatible with living a joyful life.
Acceptance and Commitment (ACT) Theory
The final study model I’ll be using to examine this case is the Acceptance and Commitment (ACT) Theory. One of the main tenants of this theoretical approach, as it applies to the client’s presenting problem, is that her feelings of grief and guilt aren’t inherently problematic; rather, it depends on their context. For example, they will be problematic if the client relates to these feelings from a psychologically inflexible framework. However, if she can approach them from a place of psychological flexibility, she can experience her aunt’s death more healthily. This modality might be helpful to the client because it would directly address her desire to explore healthy ways of working with her grief and guilt. It would also provide her with additional tools she can use in the future.
The ultimate ACT-based goal for treatment would be achieving psychological flexibility. Psychological flexibility encompasses embracing presence, identifying core values, accepting what is, being aware, engaging in mindful thinking, and taking action. The first two facets I would approach with the client during therapy would be acceptance and values. Specifically, if the client allowed herself to sit with her feelings of grief and guilt about her aunt’s death and fully experience them as they are, that would be progress. Additionally, if the client could identify the core values which bring a sense of purpose and meaning to her life, that would put us on the right track in terms of her goals to investigate her deeper feelings about the meaning of life as well as start the process of developing ways (tools) that she could live a more positive and meaningful life. Once these goals are reached, we could continue with the therapeutic process until she has reached psychological flexibility, call the therapy a success, and end treatment.
There are two specific ACT-style goal-related interventions that I’ll use. The first relates to acceptance through mindfulness practice. I would invite the client into a similar practice as the Jungian meditation, beginning with focusing on the breath. I would then ask the client to remember her aunt’s final days, her guilt when she passed, and her grief. As these images and feelings surface, I would invite the client to describe where in her body she feels these emotions––maybe in her chest, stomach, or throat. I would invite her to be with these challenging emotions and accept them as they are. I would explain that accepting feelings as they are, is the first step in processing them and being free to move on.
The second intervention I’ll use is the values wheel exercise, similar to the life wheel, goals wheel, and law of attraction wheel concepts. There are different methods for creating the wheel. I would provide the client with a worksheet of the wheel diagram, including eight pie sections: work, education, relationships, home, finances, personal growth, fun, and health. I’d ask the client to write some specific values relevant to that area of life next to each category. I’d then ask the client to assign a number to each value representing how deeply she’s living that value, with one being not at all and ten being completely living it. I’d invite her to color each pie section to represent that numerical level of current value immersion. This exercise would help the client identify core values that can be more fully integrated into her life so she feels a more profound sense of meaning and joy. It would also tie into other aspects of psychological flexibility, such as providing a structure to incorporate taking action.
The ACT modality has a high likelihood of overall success specific to the client’s therapy goals because achieving all six facets of psychological flexibility would allow her to process her feelings of grief and guilt, solidify her core values and live a more positive and meaningful life, and establish impactful tools she can use in the future. Further, the ACT modality, while not as measurable as CBT due to its inclusion of mindfulness and spirituality constructs, is still more measurable in terms of progress than the Jungian and Existential theoretical approaches. But all three modalities have their own sets of strengths and weaknesses.
References:
Neukrug & Hays, E., & Hays, D. G. (2022). Counseling theory and practice (3rd ed.).
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