Existential Issues In Sex Therapy & Couples Counseling Existential issues are internal conflicts arising from the ongoing, inescapable confrontation with the givens of human existence–isolation, powerlessness, responsibility, death, and the desire for meaning. Most people defend themselves from fully acknowledging such realities. Therapy needs to illuminate how these defenses shape the behavior and thinking that brings people into therapy. We can help patients understand that truths like the following—rather than their presenting problems—are the issues with which they are really grappling: * Loving involves pain and, ultimately, abandonment or separation * We are responsible for how we express our feelings–regardless…