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Psychoanalysis is fundamentally a theory of how human psychological existence comes into being and is sustained. This “existential dimension” is organically embedded within the psychoanalytic theory of mental development and is not the same as nor derived from the “existentialism” of existential philosophy or existential analysis. Unlike “existentialism,” the “existential dimension of psychoanalysis” involves how the need for psychic survival and the fear of psychic death (nonbeing) motivate the separation—individuation process and the development of the defensive organization as well as the internal world of self and object representations, in order to create a sense of being. In light of this profound influence on psychological functioning, it would seem that a viewpoint that includes listening for the underlying existential throughline of patient material would deepen clinical understanding for effective therapeutic interventions.
The main purpose of this article, therefore, is to prod the existential skeleton out of the psychoanalytic closet. According to Freud (1914, 1920), the infant is born into an essentially Godless, chaotic, meaningless world in an overwhelmingly dead (inorganic) universe in which everything that is alive eventually dies, including itself. Obviously the infant is not aware of its mortality until well into childhood. Instead of preserving its physical existence, the infant's primary psychological struggle involves the growth, development, and survival of its ego—its archaic, emerging sense of self—as well as the creation, strengthening, and maintenance of its internal objects, which represent its vital connections to others. The infant derives its experience of existence