What Is Existential Anxiety? Understanding Deeper Roots of Fear and How Therapy Can Help

Anxiety is often seen as something to be managed, treated, or eliminated. But what if some forms of anxiety aren’t simply disorders but are signals of something deeper? Existential anxiety goes beyond everyday worry. It emerges from our confrontation with core human truths: death, freedom, isolation, and meaning.

Rather than being pathological, existential anxiety may hold the key to a more meaningful, authentic life—if we learn how to listen to it.

In this post, we’ll explore existential anxiety and therapy through the lens of major existential thinkers like Sartre, Camus, Kierkegaard, Heidegger, and Spinelli. We’ll also discuss how therapy—especially when combining existential insights with CBT and exposure work—can help clients move from fear to freedom.

What Is Existential Anxiety?

Existential anxiety is the deep, sometimes disorienting unease that arises when we confront the ultimate concerns of existence:

• Death: The knowledge that life is finite
• Freedom: The responsibility that comes with choice
• Isolation: The reality that no one can fully share our inner world
• Meaning: The awareness that life has no pre-given purpose

Unlike clinical anxiety, which often centres on specific, tangible fears, existential anxiety is more abstract. It’s the anxiety of being itself.

Kierkegaard described it as “the dizziness of freedom.” Sartre saw it as the inevitable outcome of radical freedom—if nothing defines us but ourselves, we are responsible for all we become.

How Is Existential Anxiety Different from Everyday Anxiety?

Existential anxiety isn’t a flaw in the psyche—it’s a core part of human consciousness. As Heidegger wrote, it “discloses nothing,” but in doing so, reveals the potential for authentic living.

Existential anxiety prompts deep questions such as:

• Am I living in alignment with my true values?
• What legacy will I leave behind?
• How can I find meaning in a world full of uncertainty?

What Can Existential Anxiety Teach Us?

Though uncomfortable, existential anxiety can be a catalyst for personal growth. It may indicate a need to reflect more deeply on life’s purpose and our place in the world.

Camus, in The Myth of Sisyphus, argued that facing life’s absurdity can allow us to live with courage and creativity. We may not find fixed meaning, but we can create our own.

From an existential therapy perspective, anxiety isn’t the enemy—it’s a compass pointing us toward the parts of life we’ve avoided or misunderstood.

Existential Therapy: Working With, Not Against, Anxiety

Existential psychotherapy doesn’t pathologize anxiety. It supports clients in reflecting on freedom, responsibility, and authenticity.

According to Ernesto Spinelli, therapy can help clients:

• Recognize anxiety as a normal human experience
• Make conscious, values-aligned choices
• Accept uncertainty as part of a meaningful life
• Move from fear to engaged living

Spinelli describes anxiety as “the most human of experiences”—a call to face the unknown. Therapy becomes a collaborative exploration of what it means to be alive.

Combining CBT and Existential Therapy for Anxiety Treatment

While existential therapy is rich and reflective, it may feel abstract for those facing intense panic, compulsions, or avoidance. This is where CBT (cognitive behavioural therapy) and exposure work can complement the process.

CBT helps clients to:

• Recognize and challenge anxious thinking
• Reduce avoidance and safety behaviours
• Build emotional resilience

But CBT alone may not address deeper existential questions—like the fear of failure tied to identity or mortality. Combining CBT and existential therapy helps clients:

• Explore the meaning behind their anxiety
• Reduce avoidance while honouring deeper questions
• Use practical tools alongside reflective inquiry

A Holistic Model for Treating Existential Anxiety

In Understanding and Treating Anxiety Disorders (2005), clinical psychologist Barry E. Wolfe offers a two-phase treatment model:

1. Symptom Stabilization and Skills Building

This phase uses evidence-based CBT approaches—exposure therapy, thought restructuring, emotion regulation—to help reduce symptoms and build a sense of safety and control.

2. Deeper Existential Work on the Self

Once stabilized, clients explore deeper fears and wounds:

• Core concerns around identity, death, or meaninglessness
• Early attachment injuries and unmet needs
• Existential reflection and value-driven action

Wolfe views anxiety as a message from the self—a signal that something essential needs to be addressed. His approach echoes the insights of existential philosophers.

Who Can Benefit From Existential Anxiety Therapy?

This approach may resonate with you if you:

• Feel a chronic sense of unease or emptiness
• Struggle with purpose, identity, or fear of death
• Find CBT alone too surface-level
• Are drawn to deeper life questions
• Believe your anxiety is pointing to something meaningful

Existential therapy is especially helpful during life transitions, grief, identity changes, burnout, or a sense of being “stuck.”

Final Thoughts: Anxiety as an Invitation to Live Authentically

Though painful, anxiety shows we’re alive and aware. Instead of avoiding it, existential therapy invites us to listen.

As Camus said, “The struggle itself… is enough to fill a man’s heart.” Therapy can help you make meaning from that struggle—and live more fully because of it.

Take the Next Step in Understanding Your Anxiety

If you’re ready to explore your anxiety on a deeper level, you’re not alone. Therapy can help you move from fear to freedom.

I offer an integrative approach that combines evidence-based tools like CBT and exposure therapy with deep existential reflection. Together, we’ll not only manage anxiety—we’ll understand it and use it as a path to growth and clarity.

References

• Camus, A. (1942). The Myth of Sisyphus.
• Heidegger, M. (1927). Being and Time.
• Kierkegaard, S. (1844). The Concept of Anxiety.
• Sartre, J.-P. (1943). Being and Nothingness.
• Spinelli, E. (2007). Practising Existential Psychotherapy: The Relational World.
• Woolf, P. (2022). Anxiety and the Existential Client (lecture materials and personal writings).