ABSTRACT
We see an important place for a discussion of existential life issues in problem formulation since these provide a good balance to any tendency to pathologize. Issues related to death or to loss of all kinds, facing critical life choices, the meaning we make of events and of our lives, facing the freedom of choice to make decisions that will shape our destinies, coming to terms with the consequences of our choices, and facing the challenges of different life stages are frequently at the heart of the problems facing people who present with anxiety and depression. Spinelli (2007) makes the point that `existential anxiety encompasses all responses to the conditions of existence' (p. 28). May et al. (1958/1994) speak of ontological anxiety as `the experience of the threat of imminent non-being' (p. 50) since it `overwhelms the person's awareness of existence, blots out the sense of time, dulls the memory of the past, and erases the future' (p. 51), in this way striking at the heart of one's being in the world. Attempts to suppress or displace ontological anxiety often underpin dysfunctional patterns of relating to self, others and the world.
