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The “existential” in existential psychotherapy: pressing issues of everyday life necessitate intuition informed practice

ABSTRACT It is suggested that intuitive knowing (tacit, relatively swift processing) guiding a clinician’s hands-on behaviour is presently marginalised in favour of a focus upon “reflective practice” (deliberative, relatively slow processing), despite recurrent highlighting that a skilled therapist routinely displays moments of intuitive wisdom, and also the decision-making and moral cognition literatures which, respectively, investigate the importance of tacit judgement. Relatedly, it is further suggested that a skilled clinician’s deft perspicacity, as well as their competency with reflective determinations, are influenced by an evolving, selfhood-based personal philosophy. In this latter regard, existential/humanistic positions are drawn-out to elucidate the commitment possible when selfhood and personal beliefs overlap. In conclusion, building on the assumption that sense-making in life (including clinical practice) relies upon rational (conscious) and non-rational (intuitive) thought processes, attention is given to psychotherapy as an art, and thereby the necessity to cultivate a clinician’s non-rational sensibility to complement their rational analytic thought processes. Key Points What is already known about this topic: Research into intuitive processing is in its infancy. However, the decision-making and moral cognition literatures respectively investigate intuitive judgement. Clinical training in the occurrence and usefulness of intuitive judgement is marginalised in favour of an emphasis upon “reflective practice”. Skilled clinicians are seen to routinely display moments of intuitive wisdom during therapy. What this topic adds: It is suggested that intuitive judgement and reflective practice are both informed by a clinician's personal philosophy. Several existential/humanistic positions are examined to illustrate their ‘sense-making’ qualities, thereby to suggest the conviction with which personal beliefs may be held, and, in this regard, to also suggest that integrity, genuineness and humanity are existential virtues. It is suggested that effective psychotherapy is an art which draws upon rational (conscious) and non-rational (intuitive) processing.