them with evidence to the contrary and plunge them into a state of confusion or disintegration. Activity and passivity are an important polarity here. Self-affirmation and resolution go with the former and surrender and yielding with the latter. Facing the final dissolution of self that comes with personal loss and the facing of death might bring anxiety and confusion to many who have not yet given up their sense of self-importance. Spiritual dimension On the spiritual dimension (Überwelt) (van Deurzen, 1984), individuals relate to the unknown and thus create a sense of an ideal world, an ideology, and a philosophical outlook. It is there that they find meaning by putting all the pieces of the puzzle together for themselves. For some people, this is done by adhering to a religion or other prescriptive worldview; for others, it is about discovering or attributing meaning in a more secular or personal way. The contradictions that must be faced on this dimension are often related to the tension between purpose and absurdity, hope and despair. People create their values in search of something that matters enough to live or die for, something that may even have ultimate and universal validity. Usually, the aim is the conquest of a soul or something that will substantially surpass mortality (as in having contributed something valuable to humankind). Facing the void and the possibility of nothingness are the indispensable counterparts of this quest for the eternal. Research support There has not been a tremendous amount of research on existential therapy. Much of the research focuses on people receiving therapy who also have medical concerns such as cancer. Despite this, some studies have indicated positive efficacy for existential therapies with certain populations. Qualitative research has shown there is a positive learning outcome of Existential Therapy. Overall, however, more research is needed before definitive scientific claims can be made. An overview of research in Existential and Phenomenological Therapy was provided in the magnum opus on the approach, The Wiley World Handbook of Existential Therapy, edited by Emmy van Deurzen with Erik Craig, Alfried Laengle, Kirk Schneider, Digby Tantam and Simon du Plock. Joel Vos wrote this chapter in which he remarked that Dilthey, and many other phenomenological philosophers and therapists, have tried to turn the scientific paradigm more towards an inside understanding the subjectively lived experiences from clients, therapists and what happens in their relationship and in the therapeutic