Death is the ultimate truth, both in myth and in reality; it is ever present. "Our existence is forever shadowed by the knowledge that we will grow, blossom, and inevitably, diminish and die" (Yalom, 2009, p. 1). How a person has accepted this mortal condition – or found ways to ignore it – determines his or her psychological well-being. Death is encountered in all counseling or psychotherapeutic experiences. Existential issues reflect grief needing to be addressed and also involve letting go of the unhealthy or dysfunctional parts of self in relation to oneself, others, and a potentially meaningless world.
Drawing from Karen Horney's notion of idealized and despised images of self, Bugental (1978) asserted that both images are false and must die for the real person to emerge:
But there is a fearful wrenching involved in that relinquishment. The nakedness seems, and indeed is, so terribly vulnerable and so truly mortal. Suicidal and homicidal feelings are common as clients watch a part of themselves die. Usually the "killing" of the old self occurs in some kind of break out experience, (p. 79)
Death anxiety can cause a person to connect as well as cause feelings of isolation and despair. A confrontation with death signals the rebirth of a more aware, honest, and authentic being. According to an existential approach, most people experience tragedy, but in equal proportion, they experience joy (Maslow, 1998). Through finding meaning, people can transcend any pain of existence (Nye, 2008).
Freedom comes after one's confrontation with one's inaccurate representation of oneself. It emerges only after one realizes that the world is an arbitrary construction of one's awareness.
Hence, people can make each moment the way they wish, and make their future different from any moments in their past. Although a person can choose each thought, there are costs and benefits for each decision. Frankl (1984) outlined his existential approach, called logotherapy, and described how people may have tragedies in life but it is their ability to choose their reactions that gives them freedom. Courage to be and to do is existential. The emotional readiness to make decisions and the choice of reactions to them are keys to the meaning gleaned from the encounter. Freedom is silhouetted by responsibility.