Approaching mindful multicultural case formulation: Rogers, Yalom, and existential phenomenology

ABSTRACT

Narrow or restricted case formulation considerations can limit therapeutic effectiveness, limit the lived base of evidence guiding psychotherapy, and contribute to psychotherapist microaggressions. Notably, Person-Centered Therapy (PCT) and existential phenomenology have, in combination, actively maintained that the cultural landscapes or interconnected world horizons of historical, contextual, and sociocultural matters are inseparable from lived experience. In what can be understood as mindfulness perspectives in their own right, the non-judgmental and presence-centered emphases of PCT and existential phenomenology are suited for mindful and meditative attunement to socioculturally diverse clients. This article sets out to begin providing a basis for person-world centered case formulation themes that are mindfully and meditatively linked with a psychotherapist’s depthful ontological attunement and cultural or contextual pan-experiential attunement to clients. These interdependent forms of Humanistic Existential Psychotherapy (HEP) attunement can open onto multiculturally informed person-world centered themes that may contribute to experiential restructuring and sociocultural self-actualization. As a way to enhance HEP’s sociocultural sensitivity, existential givens, phenomenological themes, and multicultural worldview values are integratively re-visioned as Sociocultural Lifeworld Themes.

Des présentations de cas étroitement ou restrictivement réfléchies peuvent limiter l’efficacité thérapeutique, altérer la prise en compte de l’expérience vécue comme base de la thérapie et contribuer à des microagressions de la part du psychothérapeute. La Thérapie centrée sur la personne (TCP) et la phénoménologie existentielle ont soutenu activement ensemble l’idée que l’expérience vécue est inséparable des paysages culturels et des horizons mondiaux interconnectés dans leurs aspects historiques, contextuels et socioculturels. Dans ce que nous comprenons comme étant des perspectives pleinement conscientes à part entière, l’importance accordée par la TCP et la phénoménologie existentielle au non-jugement et à la présence sont les éléments appropriés d’un accordage méditatif et pleinement conscient avec des clients socioculturellement variés. Cet article se propose de commencer à fournir une base pour des thématiques de formulation de cas centrées sur le monde de la personne qui soient pleinement consciemment et méditativement reliées à l’accordage ontologique profond du thérapeute et à l’accordage culturel ou contextuel pan-expérientiel du client. Ces formes interdépendantes d’accordage en Psychothérapie Existentielle Humaniste (PEH) peuvent ouvrir le champ à des thématiques multiculturellement ancrées propres au monde du client et qui peuvent contribuer à une actualisation de soi socioculturellement et expérientiellement restructurante du client. Pour mettre en valeur la sensitivité socioculturelle de la PEH, les données existentielles, les thématiques phénoménologiques et les visions multiculturelles du monde sont intégrativement revisitées comme étant des thèmes socioculturels inhérents au monde vécu.

Las consideraciones de formulación de casos estrechas o restringidas, pueden limitar la efectividad terapéutica, limitar la base vivida de evidencia de la psicoterapia y contribuir a las micro agresiones del psicoterapeuta. En particular, la Terapia Centrada en la Persona (PCT) y la fenomenología existencial, en combinación, han mantenido activamente que los paisajes culturales o los horizontes mundiales interconectados de contextuales históricos, y socioculturales son inseparables de la experiencia vivida. En lo que puede entenderse como perspectivas de atención plena por derecho propio, los énfasis sin prejuicios y centrados en la presencia del PCT y la fenomenología existencial son adecuados para la sintonía consciente y meditativa con clientes socioculturalmente diversos. Este artículo se propone comenzar a proporcionar una base para los temas de formulación de casos centrados en el mundo de la persona que están vinculados de manera consciente y meditativamente ligados con la profunda sintonización ontológica de un psicoterapeuta y la sintonización cultural o contextual pan-experiencial para los clientes. Estas formas interdependientes de sintonización de psicoterapia existencial humanista (HEP) sintonizadas pueden abrirse a temas centrados en el mundo de personas multiculturalmente informdas que pueden contribuir a la reestructuración experiencial y la autorrealización sociocultural. Como una forma de mejorar la sensibilidad sociocultural de HEP, los conceptos existenciales, los temas fenomenológicos y los valores multiculturales de la cosmovisión se reven integrativamente como Temas Socioculturales del mundo de la Vida.

Las consideraciones de formulación de casos estrechas o restringidas, pueden limitar la efectividad terapéutica, limitar la base vivida de evidencia de la psicoterapia y contribuir a las micro agresiones del psicoterapeuta. En particular, la Terapia Centrada en la Persona (PCT) y la fenomenología existencial, en combinación, han mantenido activamente que los paisajes culturales o los horizontes mundiales interconectados de contextuales históricos, y socioculturales son inseparables de la experiencia vivida. En lo que puede entenderse como perspectivas de atención plena por derecho propio, los énfasis sin prejuicios y centrados en la presencia del PCT y la fenomenología existencial son adecuados para la sintonía consciente y meditativa con clientes socioculturalmente diversos. Este artículo se propone comenzar a proporcionar una base para los temas de formulación de casos centrados en el mundo de la persona que están vinculados de manera consciente y meditativamente ligados con la profunda sintonización ontológica de un psicoterapeuta y la sintonización cultural o contextual pan-experiencial para los clientes. Estas formas interdependientes de sintonización de psicoterapia existencial humanista (HEP) sintonizadas pueden abrirse a temas centrados en el mundo de personas multiculturalmente informdas que pueden contribuir a la reestructuración experiencial y la autorrealización sociocultural. Como una forma de mejorar la sensibilidad sociocultural de HEP, los conceptos existenciales, los temas fenomenológicos y los valores multiculturales de la cosmovisión se reven integrativamente como Temas Socioculturales del mundo de la Vida.

As considerações estritas ou restritivas na formulação de casos podem limitar a eficácia terapêutica e a vivência das evidências que orientam a psicoterapia e contribuir para microagressões do psicoterapeuta. É evidente como, quer a Terapia Centrada na Pessoa (TCP), quer a Fenomenologia Existencial defenderam ativamente que o panorama cultural ou os temas relacionados com os horizontes históricos, contextuais e socioculturais interligados dos indivíduos são inseparáveis da experiência vivida. Naquilo que pode ser entendido como perspetivas de mindfulness de pleno direito, os focos da TCP e da Fenomenologia Existencial – atitude de não fazer juízos de valor e conceito de presença – são adequados à sintonização mindful e meditativa de clientes de meios socioculturais muito distintos. Este artigo destina-se a fornecer uma base para a formulação de casos no mundo centrado na pessoa que se encontre ligada, de forma mindful e meditativa, a uma sintonização profunda e ontológica do psicoterapeuta e a uma sintonização cultural ou pluri-experiencial e contextual dos clientes. Estas formas interdependentes de sintonização pela Psicoterapia Existencial Humanista (PEH) podem dar abertura a temas de inspiração multicultural do mundo centrado na pessoa, os quais podem contribuir para uma reestruturação experiencial e para uma auto-atualização sociocultural. Os pressupostos existenciais, temas fenomenológicos e valores multiculturais de perspetiva do mundo são colocados em perspetiva novamente e de forma integrada, na sua qualidade de Temas Socioculturais de Perspetiva do Mundo, como forma de ativar a sensibilidade sociocultural da PEH.

KEYWORDS:

• Experiential restructuring
• mindfulness meditation
• sociocultural self-actualization
• ontological attunement
• pan-experiential attunement

Disclosure statement

No potential conflict of interest was reported by the authors.

Consent

Client case material has been anonymized.

Notes

1. Presence-centered attunement includes an open-hearted journey from incongruence to lived presence. The therapist–client relationship attends to nonjudgmentally bringing congruent and resonant words to the lived experiences of past and present moments.

2. Ontology involves the study of being. Entering into the ever-changing flow of being – as a way of being – has been a central consideration for PCT, existential phenomenology, and Buddhism.

3. An HEP psychotherapist’s attunement to the panoramic view of client attends to understand client experiences as part of a larger whole or interconnected totality of contexts (e.g., being in the world).

4. In this article, the terms “contemplative” and “mindfulness meditation” are used interchangeably. We suggest that a contemplative HEP psychotherapist nonjudgmentally and empathically engage clients in co-meditation on in-the-moment aspects of experience and their contexts.

5. In existential phenomenology, authentic refection is grounded in moods, senses, and life contexts. Comparatively, Tudor (2011) views authenticity as a level of transparency that a PCT psychotherapist embodies with the client “in the relationship” (p. 169). Singh and Tudor (1997) suggest that a PCT client may begin psychotherapy from a state of incongruence (inauthenticity) that includes divergence from the client’s self-concept and/or a client’s disconnection from lived sociocultural contexts.

6. We are using gender-neutral pronouns to acknowledge non-binary and transgender identities.

7. Yalom’s (1980) description of four existential givens includes an understanding of meaning with respect to the broader meaning of life and the more personal meaning of one’s own life. According to Yalom, defining personal meaning is necessary in the face of a universe that appears to be meaningless or without preordained coherence. As a second existential given, Yalom’s description of “freedom” (p. 216) references the existential design of the universe as one without an inherent moral or ethical structure. Amid this groundless cosmological space of freedom, people hold ultimate responsibility for being the sole author of their lives and existence. It is this jarring realization that occasions an existential anxiety that one is “doomed to freedom” (p. 220). As a third existential given, Yalom contrasts a fundamental “existential isolation” (p. 355) from others over against worldly “interpersonal isolation” (p. 353) from others or “intrapersonal isolation” (p. 354) and disconnection from one’s own experiences. For Yalom, existential isolation becomes apparent when one returns from being lost or absorbed in the world and realizes that an “unbridgeable gulf between oneself and any other being” (p. 355). Finally, Yalom reminds us that death (p. 30) is not only part of life’s facticity during the final moment of one’s existence but rather awareness of death is also an impetus for living fully and authentically while alive. In accord with Heidegger, Yalom maintains that the experience of death awareness is unmatched in its capacity to shake one out of tranquil everydayness into a mindfulness of being.

8. Though we have not specifically referenced the assemblage theory of Deleueze & Guattari, 1987, their dynamic system perspective on how the elements of self-organization assemble in fluid rather than static hierarchies and forms is worth consideration. In their theory, such forms or gestalts are subject to ongoing deterritorialization and reterritorialization.

9. The following summarizes Triandis’ (2000) cultural syndromes: (a) “complexity” (p. 147) in which complex cultures consist of individuals and subgroups with differing attitudes and values, whereas simple cultures tend to exhibit value consensus; (b) “tightness” (p. 147) wherein relatively isolated cultures have numerous rules and prescriptions for behavioral conduct in contrast to loose cultures that are more tolerant of difference and have fewer rules; (c) “individualism and collectivism” (p. 147), in which individualism and autonomy are contrasted with a collectivist emphasis on conformity to socially valued identities and allegiance to family and community; (d) “vertical and horizontal cultures” (p. 148) in which vertically weighted cultures are characterized by hierarchies and horizontally weighted cultures emphasize equality; (e) “active-passive cultures” (p. 148) wherein active orientations focus on changing the environment in order to suit individual and cultural needs in contrast to passive orientations that encourage people to establish harmony by adapting to situations; (f) “universalism-particularism” (p. 148) in which a universalized approach to interacting with others is contrasted with an emphasis on unique forms of engagement with varieties of people and situations; (g) “diffuse-specific” (p. 148) values in which diffuse or generalized reactions to situations and people contrast with specific and differentiated engagement with situations and people; (h) “instrumental-expressive” (p. 148) values in which instrumental relationships place emphasis on functional usefulness of others that contrasts with expressive ways of connecting with others that privilege the importance of the relationship; and (i) “emotional expression or suppression” (p. 148) values that distinguish between cultural codes supporting free expression of emotion and those codes that emphasize controlled expression of emotion.

Additional information

Notes on contributors

Andrew J. Felder

Andrew J. Felder, Ph.D. is the former Clinical Director for the Los Angeles Sexual abuse Treatment Program and is currently a Clinical Psychologist at UCLA’s Counseling and Psychological Services. He previously facilitated dialogs in the U.S. and internationally with cultural groups historically in conflict. He has also facilitated mindfulness groups and taught courses that include existential-phenomenology, intercultural dialogue, and psychotherapeutic listening.

Brent D. Robbins

Brent D. Robbins, Ph.D. is the former President of APA Division 32, Society for Humanistic Psychology. He is also the Chair and Professor of Psychology at Point Park University. He is also the author of The Medicalized Body and Anesthetic Culture (2018, Palgrave Macmillan).