A meta-synthesis of five single-case studies reveals how Yalom’s existential givens immerse in sex offender treatment: Life and Death; Connectedness and Existential Isolation; Meaning and Meaninglessness; and Freedom, Responsibility and Guilt. Comparison of different qualitative case studies can aggregate and synthesize findings. It illustrates how existential and experiential psychotherapy can be of value in addition to risk management or a rehabilitation approach. For these five cases, a lack of basic trust in life was rooted in adverse childhood experiences and linked to poor connection to oneself and others. As maladaptive shame was revealed as a shared core emotion scheme, it deserves more attention in sex offender treatment. Based on these case studies, it might be seen as a main driving force behind the abuse, but also as a hindrance for therapeutic growth and taking full responsibility. The meta-synthesis confirms the idea of existential thinkers and attachment theorists that a strong, empathic therapeutic relationship is crucial to rebuild trust in their own inner compass and in connection to others. Experiencing genuine connection and being of significance to others seemed to be of most importance to find meaning in life. This meta-synthesis is clearly an appeal to put more emphasis on therapeutic attunement to improve connection with the bodily felt experience and meaning. It also shows the relevance of exploration of existential givens in forensic treatment.