Latin American existential psychotherapy

1. Introduction

Version followed: the ALPE movement as presented in de Castro & Signorelli (eds., 2020), Voces existenciales en América Latina. Clinical procedures come from three national strands whose primary texts are drawn on: the Mexican school (Martínez Robles, 2017), the Argentine/CAPAC strand (Signorelli, 2022 and n.d.), and the Brazilian daseinsanalytic strand (Feijoo & Protasio, 2010). The Colombian strand (de Castro, Uninorte) is covered only through one article and is marked [uncertain] where used.

What it is. This is a regional movement and professional network, not a single manualised therapy. The Asociación Latinoamericana de Psicoterapia Existencial (ALPE) grew out of meetings that began at an international congress in Cartagena, Colombia, in 2003. It was formally constituted in 2010 at the III Latin American Congress in Argentina. Susana Signorelli (Buenos Aires, Fundación CAPAC) was its first president and now holds honorary status. Full member countries are Argentina, Brazil, Colombia, Ecuador, Mexico and Peru, with associates in Chile, Guatemala and Uruguay. ALPE runs congresses, an online course (from 2009), the Revista Latinoamericana de Psicología Existencial (from 2010) and the Premio Pablo Rispo. It co-founded the international Confederation of Existential Therapists in 2015 and hosted the II World Congress in Buenos Aires in 2019. [source: de Castro & Signorelli 2020 front matter; WCET4 speaker pages]

Key people: Alberto de Castro Correa (Colombia, co-editor of the 2020 volume); Yaqui Andrés Martínez Robles (Mexico, Círculo de Estudios en Psicoterapia/Terapia Existencial, training since 2002, ALPE honorary president); Pablo Rispo (Argentina, early collaborator of Signorelli); Ana María López Calvo de Feijoo and Emilio Romero (Brazil); Ana María León (Ecuador). Signorelli is also named as a key person. [source: de Castro & Signorelli 2020; WCET4] The movement prefers the word "terapia", in its own phrase a therapy "no ... de la psiquis sino del ser" (of being rather than of the psyche). [source: de Castro & Signorelli 2020]

How change happens. These authors do not aim to cure symptoms or solve problems directly. The stated aim is to clarify the client's existential situation, and change is expected as a by-product of fuller description and lived encounter. [source: Martínez Robles 2017, p. 319] Anxiety is to be taken up rather than eliminated, so that it can become creative or constructive. [source: de Castro & Salamanca 2007, p. 164; de Castro & Signorelli 2020] The Brazilian strand frames therapy as a space where people reclaim responsibility for their own existence instead of handing it to an expert. [source: Feijoo & Protasio 2010, p. 168] The Argentine strand adds a social and community dimension: the therapist's task includes widening the client's world. [source: Signorelli n.d., pp. 286–287]

2. Framework

No common phase model. None of the primary sources gives a staged protocol, a session count or explicit transition criteria. Martínez Robles describes a set of attitudes and questions, and Feijoo & Protasio reject mapping or steering the client. [source: Martínez Robles 2017; Feijoo & Protasio 2010] The phases below are therefore a practical scaffold built from the sources. [synthesis]

Phase [synthesis]	Goals	Main procedures (see section 4)	Move on when [synthesis]
A. Opening and encuadre (about 1–3 sessions)	Hear the complaint as lived experience; take a whole-person, in-context picture; agree the frame	4.1 description, 4.10 whole-person and context mapping, 4.13 suspension of prior explanations	The client is describing experience rather than only reporting symptoms, and the frame (frequency, fees, contact, risk plan) is agreed
B. Descriptive exploration (open length)	Widen and deepen description; map tensions between where the client is and where they want to be	4.1–4.7	Patterns and what maintains them are visible to the client, and more than one perspective on them is held
C. Encounter and existential themes	Work with moods (anxiety, boredom, fear), finitude, freedom, the relationship itself	4.8, 4.14–4.17, 4.11 if illness	The client voices their own choices and responsibility rather than seeking direction
D. Ending	Review what the client now sees and how they choose to live it	4.8, 4.9	Mutual agreement; ending is explored as an existential theme in its own right

Format. Individual therapy is the default in the sources. Session length and frequency are not specified, so a weekly 50–60-minute session is a reasonable default. [synthesis] [uncertain] The Argentine strand also uses hospital, oncology and community formats: sessions moved outdoors, an open patient film group, and a one-school-year prevention programme (4.12). [source: Signorelli n.d.; Signorelli 2022]

Programa Convivencia (school programme, Argentine strand). The cycle runs as follows: a survey at the start, pupils split into three age bands, cooperative games followed by guided talk about feelings in the first half of the year, solidarity projects in the second half (at home for the youngest, at school for the middle band, in the community for the oldest), and a survey at the end. [source: Signorelli n.d., pp. 296–299]

3. Guiding principles

Describe rather than explain. Ask for richer accounts of how something is lived, not causal theories. Martínez Robles notes that explanation "surge de la certeza" (arises from certainty). [source: Martínez Robles 2017, pp. 321–322]
No moral preference between "point A" and "point B". Do not assume the current state is bad or the desired one better; explore both. [source: Martínez Robles 2017, pp. 322–324]
Relativity of perspectives. Move the conversation from "this or that" to "this and that", since "nadie tiene el ojo de Dios" (nobody has God's eye). [source: Martínez Robles 2017, pp. 324–325]
Respect complexity. Ask what a troublesome pattern protects or prevents before trying to change it. [source: Martínez Robles 2017, p. 325]
Not-knowing. No theory, diagnosis or experience entitles you to know the client's truth or right direction. Hold this as a "disciplina modesta" (modest discipline), which requires training, not improvisation. [source: Martínez Robles 2017, pp. 327–330; citing Spinelli]
Own your interpretations. You cannot be neutral. Notice your readings and, where useful, offer them as one possibility among others. [source: Martínez Robles 2017, p. 326]
Phenomenological horizontalisation. Treat the client's and your own perspectives as initially equal, and explore any ranking that appears. [source: Martínez Robles 2017, p. 326]
Technique serves the relationship. Techniques are allowed but are secondary to the person using them. [source: Martínez Robles 2009, as reviewed in Chávez 2012, p. 111]
Pathology does not define the person. Read a disorder as one way of being-in-the-world. [source: de Castro & Signorelli 2020] In Feijoo's daseinsanalytic reading, neurosis is a narrowed projection of the existential field. [source: Kahlmeyer-Mertens 2012 review of Feijoo]
Suspend prior explanations. Meet the client "tal qual ele se mostra" (as they show themselves), not through a diagnostic category. [source: Feijoo & Protasio 2010, p. 168]
No tutelage. Do not advise, prescribe, choose for or manage the client. The aim is to return care for their existence to them. [source: Feijoo & Protasio 2010, pp. 167–171]
Guardian of the space. Your job is to protect a space where vulnerability and indeterminacy can be faced, not to guide, map or "conscientise". [source: Feijoo & Protasio 2010, p. 171]
Whole person in context. Body, psyche, social and spiritual dimensions belong together. Take the historical, social, economic, cultural, religious and political context of both client and therapist into account. [source: Signorelli 2022, pp. 43–45; Signorelli n.d., pp. 284–286]
Embodiment. Following Marcel, "the body is not only the one I have but also the one I am", so bodily illness is also existential. [source: Signorelli n.d., p. 285; Signorelli 2022, p. 45]
Openness and interdisciplinarity. Take whatever the client brings. Bring in other disciplines, or refer, where you lack expertise. [source: Signorelli n.d., p. 285; Signorelli 2022, p. 54]
Care widens the world. Following Heidegger on care, part of the task is to extend the client's world beyond the consulting room. [source: Signorelli n.d., pp. 286–287]
Face anxiety, do not avoid it. Normal anxiety is proportionate and can be faced consciously. Neurotic anxiety can be transformed into constructive anxiety rather than removed. [source: de Castro & Salamanca 2007, p. 164]
Encounter, presence, here-and-now. The therapeutic relationship is understood as an encounter with an experiential, dialectical and relational character. [source: de Castro & Signorelli 2020]

4. Intervention inventory

The items below are the concrete procedures named in the sources, grouped by national strand. The authors describe these as attitudes and questions rather than scripted techniques. Steps are given in my own wording, and all example language is illustrative unless quoted with a citation. Where a source gives only a principle, the step-by-step version is marked [synthesis].

Mexican school (Martínez Robles)

4.1 Descriptive questioning (describe, don't explain)

Purpose / when: To move the client from causal explanations and labels toward a detailed account of how the experience is lived. Use it throughout, and especially when the client arrives with a ready-made theory such as "it's my childhood" or "I'm just anxious". [source: Martínez Robles 2017, pp. 321–322]
Steps: (1) Take one concrete episode the client mentions. (2) Ask what happened, how it felt, what they noticed in body, emotion and thought, and what it meant to them. (3) When an explanation appears ("because…"), note it neutrally and return to description ("and how was that, in the moment?"). (4) Go deeper over successive sessions, asking how the client links this experience to others and what meaning they give it. [synthesis for sequencing]
Example language (illustrative): "Before we work out why, can you walk me through how it actually was, from the moment you got the message?" / "When you say 'panic', what is that like for you, in your body and in your thoughts?"
Watch for: The therapist sliding into explanation, which the author ties to certainty. A sign it is working: the client's descriptions grow more nuanced and they start noticing aspects they had not put into words.

4.2 Offering observations back

Purpose / when: To widen description by adding what the therapist perceives: non-verbal behaviour, tone of voice, and physiological, emotional or rational responses. [source: Martínez Robles 2017, p. 322]
Steps: (1) Notice a concrete, observable cue. (2) Name it tentatively as your perception, not as a fact about the client. (3) Invite the client to describe what it is for them. (4) Accept a "no" as data. [synthesis for steps]
Example language (illustrative): "I notice your voice drops when you talk about your brother. I may be wrong. What's happening for you there?"
Watch for: Observations that turn into interpretations or accusations. It is working when the client takes the observation and explores it further.

4.3 Point A / Point B exploration

Purpose / when: For any goal of change, such as "I want to stop smoking" or "I want to stop being so shy". The task is to explore the situation of being in tension between the two points, not to push the client to point B. [source: Martínez Robles 2017, pp. 322–324]
Steps: (1) Name point A (the current way of being) and point B (the desired one). (2) Explore A: how it is lived, whether the client fully rejects it, and what keeps it in place. (3) Explore B: what makes it so desirable, and what negative things could happen if the client got there. (4) Explore the tension itself: what it is like to be between A and B. (5) Explore the client's experience of doing this with you. (6) Leave change to arise as a by-product. [source: Martínez Robles 2017, pp. 322–323]
Example language: Author's questions, verbatim: "¿Cómo es la experiencia del 'punto A'?" and "¿Qué hace al 'punto B' tan deseable?" [source: Martínez Robles 2017, pp. 322–323]. Illustrative English: "What would you lose if you stopped smoking tomorrow?" / "What is it like to keep wanting to stop and not stopping?"
Watch for: The therapist adopting point B as their own goal, which the author calls the loss of the "no-moral" stance. It is working when ambivalence becomes speakable and the client reports choosing rather than failing.

4.4 Exploring the complexity that maintains a pattern

Purpose / when: When a pattern persists despite the client's wish to change it. Ask what keeps it going, whether it prevents something worse, and what secondary gains support it. [source: Martínez Robles 2017, p. 325]
Steps: (1) Ask what makes the pattern important. (2) Repeat the question on each answer to uncover the worldview underneath. The author's dieting example repeatedly asks why it matters to keep eating. (3) Summarise the network of meanings found, without judging it. [source: Martínez Robles 2017, p. 325]
Example language (illustrative): "What does eating give you at that moment?" … "And what makes that important?" … "And if you didn't have that, what would be left?"
Watch for: Repetition that feels like interrogation. Slow down and explain why you are asking. It is working when the client sees the pattern as meaningful rather than simply stupid or weak.

4.5 Asking "foolish" questions

Purpose / when: To keep a not-knowing stance by asking questions whose answers seem obvious, for example what "sad" or "family" means to this person. [source: Martínez Robles 2017, p. 325; citing Spinelli 2015]
Steps: (1) Catch yourself assuming a shared meaning. (2) Ask the obvious question openly, with an acknowledgement if needed. (3) Follow the client's own definition. [synthesis for steps]
Example language (illustrative): "This may sound silly, but what does 'being a good son' mean for you?"
Watch for: Clients may feel patronised. It is working when the answer surprises you or the client.

4.6 Offering your interpretation as one possibility (horizontalisation)

Purpose / when: Because the therapist always interprets, interpretations can be shared openly as one option among others. Then explore how the client receives them: with submission, rebellion, resistance or enrichment. [source: Martínez Robles 2017, p. 326]
Steps: (1) Notice your own reading and your preference. (2) Decide whether sharing it serves the client. (3) Offer it explicitly as your view, alongside others. (4) Explore the client's reaction, including deference to you. (5) If either of you ranks one view above the others, explore that ranking. [source: Martínez Robles 2017, p. 326]
Example language (illustrative): "One way I could see it is that you protect your mother. That's just my angle, and there could be others. How does it land?" / "I noticed you agreed with me quickly. What happened there?"
Watch for: Clients who adopt your view out of deference. It is working when the client can disagree, modify your view, or add their own.

4.7 Showing doubt and incomprehension (client as teacher)

Purpose / when: Openly admit interest, doubt and lack of knowledge about the client's context, so that the client describes it precisely and "teaches" the therapist. This is especially useful across differences of culture, class, gender or generation. [source: Martínez Robles 2017, p. 327]
Steps: (1) Say where you do not understand. (2) Ask the client to explain as if to someone from outside their world. (3) Reflect back what you learned and check it. [synthesis for steps]
Example language (illustrative): "I don't know what it's like to grow up in a town where everyone knows your family. Can you teach me?"
Watch for: Feigned ignorance, which clients detect. It is working when the client's explanations sharpen their own understanding, as with the peer-study analogy the author draws.

4.8 Exploring the therapeutic relationship in the here and now

Purpose / when: To make the shared exploration itself a topic, consistent with the movement's view of therapy as encounter, presence and the here-and-now. [source: Martínez Robles 2017, p. 323; de Castro & Signorelli 2020]
Steps: (1) At a natural pause, or when something shifts between you, ask how it is to be exploring this together. (2) Disclose your own experience briefly if relevant. (3) Link it to the client's other relationships only if the client does. [synthesis for 2–3]
Example language: Author's question, verbatim: "¿Cómo es la experiencia de estar explorando y analizando todo esto conmigo?" [source: Martínez Robles 2017, p. 323]
Watch for: Over-use that turns sessions into relationship-talk. It is working when the client can voice discomfort or appreciation directly.

4.9 Self-supervision against the eight implications

Purpose / when: The author proposes his eight implications as a way to check how phenomenological one's practice is. Use it after sessions and in supervision. [source: Martínez Robles 2017, p. 327]
Steps: After a session, ask yourself: Did I explain or describe? Did I favour point B? Did I collapse "and" into "or"? Did I respect complexity? Did I ask the obvious? Did I own my preferences? Did I show my doubts? Did I claim to know the client's right direction? Note one item to attend to next time. [source: list derived from Martínez Robles 2017, pp. 321–330; checklist format synthesis]
Watch for: Perfectionism. The author says full fulfilment of the approach is impossible (p. 320). It is working when supervision discussions shift from "what technique" to "what stance".

Argentine / CAPAC strand (Signorelli, Rispo)

4.10 Whole-person and context mapping

Purpose / when: At intake and whenever the presenting problem seems detached from the client's life. The aim is to understand the person as body, psyche, social being and spiritual being (spirit understood as creative action), within their historical, social, economic, cultural, religious and political circumstances. The therapist's own context also counts. [source: Signorelli 2022, pp. 43–44; Signorelli n.d., pp. 284–285]
Steps: (1) Hear the complaint. (2) Ask about the body, which is lived as well as owned, following Marcel. (3) Ask about relationships, work, money, community, beliefs and current social events. (4) Ask what health and illness mean in the client's milieu. (5) Note where your own context differs or overlaps. (6) Identify topics outside your competence and plan interdisciplinary input. [steps 1–5 from the listed dimensions; ordering synthesis]
Example language (illustrative): "Alongside what you've told me, how is your body these days?" / "How are things at home and with money? Sometimes that shapes everything else."
Watch for: Turning this into a checklist interview. It is working when the client links complaint and context spontaneously.

4.11 Existential accompaniment in serious illness (psycho-oncology)

Purpose / when: With clients who have cancer or another serious illness, and their families. The goal is quality of life and the unfolding of potential, not "winning". [source: Signorelli 2022, pp. 46–55]
Steps:
1. Prepare yourself. Before or early in this work, examine what cancer means to you, your feelings about ill people, your fantasies of falling ill, and your fears. If you are untrained in oncology, referring is the ethical choice. If an existing client becomes ill, take responsibility: train, seek supervision and read. [source: Signorelli 2022, p. 54]
2. Locate the person in the illness. Assess the period and stage of the disease the person is in. Signorelli refers to her earlier staging framework (2009), which is not drawn on here. [source: Signorelli 2022, p. 54] [uncertain: content of the 2009 framework]
3. Speak to the patient. Ask the patient directly about the illness rather than only addressing relatives. [source: Signorelli 2022, p. 50]
4. Listen beyond words and contain. Offer timely words and emotional containment through gaze, gesture and bodily presence, within what the patient allows. [source: Signorelli 2022, p. 54]
5. Explore the existential frame. Explore being-toward-death and amor fati, the four worlds (physical Umwelt, social Mitwelt, personal Eigenwelt, spiritual Überwelt) and lived temporality. Distinguish more authentic from less authentic ways of facing finitude. [source: Signorelli 2022, pp. 48–49]
6. De-stigmatise. Avoid battle and "bet" language, which implies that a patient who dies has lost. Explore the effect of well-meant remarks such as being told how well they look. [source: Signorelli 2022, pp. 50–51]
7. Strengthen the network. If support is thin, encourage support groups and expressive groups (body work, visual arts, writing, music). [source: Signorelli 2022, p. 55]
8. Act as a communication hub between patient, family and care team. [source: Signorelli 2022, p. 54]
9. Stay present at the end. When words run out, presence and touch remain. Signorelli speaks of offering a caress. Touch is always within consent and local professional codes. [source: Signorelli 2022, p. 53; consent caveat synthesis]
Example language (illustrative): "Many people around you are talking about fighting this. What would living well look like for you right now?" / "Since the diagnosis, what has changed in how you see your time?"
Watch for: The therapist's own death anxiety showing up as false cheer or avoidance. It is working when the patient speaks openly about illness and values, and when the family and team communicate better.

4.12 Community and world-widening interventions

Purpose / when: For children, adolescents and families in low-resource settings, and for school-based prevention. The therapist's task is to widen the client's world, following Heidegger's notion of care; Signorelli writes that a being who cares for itself cares for the other. [source: Signorelli n.d., pp. 286–287]
(a) Taking therapy outside. Signorelli and Rispo moved sessions with low-income children from a Greater Buenos Aires hospital into the hospital gardens. They then organised a trip into the city, which families saved for together. Steps: agree the outing with the families, plan it jointly, and debrief the experience afterwards. [source: Signorelli n.d., pp. 286–287; debrief step synthesis]
(b) Cine-debate. Form an open group of current and former patients. The group chooses a mental-health message, then writes, scores, acts and films a short film, with families sometimes acting too. Obtain authorisation through the school authorities, invite parents to a screening, and lead a debate afterwards with therapists and group members. Signorelli describes film as a trigger of emotions with therapeutic effects. [source: Signorelli n.d., pp. 290–293]
(c) Programa Convivencia (school violence prevention). Steps: (1) Run a baseline survey. (2) Split pupils into three age bands. (3) In the first half of the year, play cooperative games, then talk about feelings with guided questions. (4) In the second half, choose and carry out solidarity tasks: at home for the youngest, at school for the middle band, in the community for the oldest. (5) Let each group name itself, make a banner and settle disagreements by vote. (6) Run a closing survey. [source: Signorelli n.d., pp. 296–299] The guided questions themselves are not given in the source. [uncertain]
(d) Other community actions: a Children's Day street festival, a parents' café with non-therapeutic discussion starters, a prize for schools showing solidarity, and a school health expo. [source: Signorelli n.d., pp. 293–294]
Example language (illustrative): "What message about feeling bad would you want other kids your age to hear?"
Watch for: Consent for filming and screening minors (written guardian consent and the right to withdraw footage) and confidentiality in open groups. [synthesis] It is working when participants take initiative. Signorelli reports high pupil satisfaction with the school programme. [source: Signorelli n.d., p. 299]

Brazilian daseinsanalytic strand (Feijoo)

4.13 Suspension of prior explanations

Purpose / when: From the first contact, take an "antinatural" stance: set aside theoretical, diagnostic and common-sense explanations so the phenomenon can show itself. [source: Feijoo & Protasio 2010, pp. 167–168]
Steps: (1) Notice the category that comes to mind, such as "depression". (2) Bracket it deliberately. (3) Ask how this person's experience actually shows itself. (4) Return to the category only when it is needed for practical purposes (records, referral, risk), and keep it separate from your understanding. [steps 1–3 from source; 4 synthesis]
Example language (illustrative): "You said 'depressed'. Leaving the word aside for a moment, how are your days going?"
Watch for: Bracketing becoming a refusal to recognise risk. See section 5.

4.14 Attunement to moods (anxiety, boredom, fear)

Purpose / when: When anguish or boredom appears, help the client stay with it and let it "say what it wants" rather than distract themselves with busyness or amusements. These moods can disrupt the everyday horizon and open possibilities of individuation. Fear is approached as concerning the possible loss of composure. [source: Feijoo & Protasio 2010, pp. 168–171; Kahlmeyer-Mertens 2012, pp. 1073–1074]
Steps: (1) Notice the mood without renaming it as a disorder. (2) Invite the client to describe it slowly: what it is like, and what it takes away or opens. (3) Refrain from reassurance or activity prescriptions. (4) Ask what the mood shows about how the client is living. [synthesis for the sequence]
Example language (illustrative): "Rather than getting rid of this boredom straight away, can we stay with it a little? What does it show you about these days?"
Watch for: Overwhelm. Pace it (section 5). It is working when the client relates to the mood as meaningful rather than only as something to escape.

4.15 Indirect communication

Purpose / when: Following Kierkegaard, speak indirectly so that the client can "hear and judge for themselves", especially when they demand answers. [source: Feijoo & Protasio 2010, p. 168] The literary model the authors use is Kierkegaard's Repetition. The concrete in-session forms below are not specified in the source. [uncertain]
Steps [synthesis]: Reflect the client's own words back, sometimes in sharpened form. Use questions rather than statements. Use stories or images that leave the conclusion open.
Example language (illustrative): "You've said twice now that you 'have to' stay. I'm just noticing the 'have to'."
Watch for: Indirection read as evasiveness. Explain your reasons if asked.

4.16 Differentiating one's own experiences (breaking up the agglomerate)

Purpose / when: When the client's experience feels like a tangled mass of their own and others' meanings. The task Feijoo names is breaking up the cluster of experiences that arise from mixed intentional fields, so the client can grasp which experiences are their own. [source: Feijoo 2011, p. 86, as quoted in Kahlmeyer-Mertens 2012]
Steps [synthesis]: (1) Take a statement such as "I'm a failure". (2) Ask whose voice and whose standard it carries. (3) Separate what the client actually experiences from what they have taken on. (4) Ask which of these they recognise as their own.
Example language (illustrative): "When you say 'failure', whose measure is that, and is it yours?"
Watch for: The therapist supplying the answers. It is working when the client distinguishes "what I am told" from "what I live".

4.17 Refusing tutelage (returning choice)

Purpose / when: When the client seeks advice, a plan or the therapist's verdict. Decline to be their guardian so that they take up their own care. [source: Feijoo & Protasio 2010, pp. 167–171]
Steps: (1) Acknowledge the wish for help and direction. (2) Do not advise or decide. (3) Open the question back: what is at stake for the client in choosing. (4) Remain present while the uncertainty is felt. [steps from source; sequence synthesis]
Example language (illustrative): "I can hear how much you'd like me to tell you whether to leave. If I did, it would be my choice, not yours. What makes this so hard to decide?"
Watch for: Clients experiencing this as abandonment. Name the stance openly. Safety decisions are an exception (section 5).

Colombian strand (de Castro, Uninorte)

4.18 Taking up anxiety

Purpose / when: With anxious clients. Distinguish normal from neurotic anxiety, following May: normal anxiety is proportionate, involves no repression and can be faced consciously. Help the client assume anxiety rather than avoid it, and transform neurotic anxiety into constructive anxiety by integrating expectations and goals with concrete reality. De Castro holds that the person must take on anxiety rather than try to avoid it. [source: de Castro & Salamanca 2007, p. 164]
Steps [synthesis]: (1) Explore whether the anxiety fits the threat. (2) Identify the givens it relates to (death, freedom, isolation, meaninglessness). (3) Invite conscious facing of it. (4) Compare the client's expectations with their concrete situation and revise their life project.
Example language (illustrative): "What would it mean to let this anxiety be here, instead of fighting it, while we look at what it's about?"
Watch for: Disabling anxiety disorders, which need adjunct evidence-based care (section 5). [synthesis] This is the only clinical content for de Castro; his textbook Psicología clínica: fundamentos existenciales (with García, 2011) is not drawn on here. [uncertain]

4.19 Phenomenological case understanding (adapted from research)

Purpose / when: For case formulation or supervision. [synthesis] De Castro's group uses an adapted Giorgi-style phenomenological analysis in research, not as a described clinical tool. [source: de Castro & Salamanca 2007, pp. 159–160]
Steps [synthesis adapting their research steps]: (1) Read session notes as a whole. (2) Mark units of meaning. (3) Group them into themes. (4) Restate them in psychological language. (5) Note your own reactions and prejudices. (6) Write a short person-centred account. (7) Share it with the client for correction.
Watch for: Treating the write-up as the truth about the client. Step 7 guards against this.

5. Handling problems

The sources say little about clinical difficulties. Items marked [source] draw on them; the rest is [synthesis].

Client wants answers or advice and feels short-changed. Name the stance openly at the start: you will explore with them rather than prescribe. When the demand returns, treat the wish for direction as material (4.17), and explore what it would mean to be told. [source: Feijoo & Protasio 2010, pp. 168–170 for the non-tutelage stance; framing synthesis] If the client needs structured skills, such as for panic or OCD, offer a referral or adjunct treatment instead of withholding help on principle. [synthesis]
Stuck: repetitive story, no movement. Shift from content to the tension itself (4.3, step 4). Ask what keeps the pattern in place and what it protects (4.4). Ask the obvious question you have been skipping (4.5). Check your own drift toward point B with the self-supervision list (4.9). [source: Martínez Robles 2017; application synthesis]
"Resistance." Martínez Robles treats resistance, submission or rebellion in response to an interpretation as something to explore, not overcome (4.6). Ask what the client's no protects and whether your view was offered as the only one. [source: Martínez Robles 2017, p. 326]
Rupture. Invite the client to speak about it using the here-and-now question (4.8). Own your part, including any interpretation or preference you imposed. Since the therapeutic relationship carries power (Foucault, cited in Chávez 2012, p. 112), name the power difference explicitly. [synthesis, drawing on these sources]
Overwhelm when staying with anxiety or boredom (4.14, 4.18). Pace it: invite brief contact with the mood, then return to grounding in the present (the room, breath, posture) and to description. Agree a stop signal. Take dissociation, panic or flooding as a cue to switch to stabilisation. Moods are not to be pursued at the cost of safety. [synthesis]
Suicide risk and the non-directive, non-diagnostic stance. Suspending diagnosis (4.13) and refusing tutelage (4.17) do not extend to risk. Carry out a standard risk assessment and collaborative safety planning, including lethal-means counselling on storage and removal, crisis contacts and escalation routes. Explain to the client that safety is the one area where you will act directively. Existential exploration of the wish to die can continue within that safety frame. [synthesis; the sources do not address risk]
Non-adherence. There is no homework protocol in these sources, so "non-adherence" applies mainly to attendance and community programmes. For missed sessions, explore what the absence says about the client's relation to therapy (point A/B). In programmes (4.12), follow the source in letting groups name themselves, choose their tasks and vote on disagreements, so participants own the work. [source: Signorelli n.d., pp. 297–298; rest synthesis]
Illness work: therapist avoidance or false cheer. Return to self-examination (4.11, step 1) and supervision. If the work exceeds your training, refer. [source: Signorelli 2022, p. 54]
Family speaks over the patient. Address the patient directly. Act as the communication hub and hold separate time with the patient if needed. [source: Signorelli 2022, pp. 50, 54; separate time synthesis]
Cultural, class and context gaps. Use client-as-teacher (4.7) and context mapping (4.10). Name your own context. [source: Martínez Robles 2017, p. 327; Signorelli 2022, p. 44]
Language and translation. Most primary texts are in Spanish or Portuguese. Terms such as angustia, tédio and ser-con carry philosophical weight that English renderings can flatten. Use the client's own words rather than imported jargon. [synthesis]
Group and community risks (4.12). In open patient groups and film work with minors, obtain written guardian consent for filming and screening, agree confidentiality rules, give a right to withdraw footage, and screen for clients for whom public exposure could harm. [synthesis]
Physical touch in end-of-life work. Signorelli mentions offering a caress when words run out (Signorelli 2022, p. 53). Only do this with explicit consent, cultural sensitivity and within your professional code, and document it. [synthesis]
Lack of a protocol. The movement offers stance and questions rather than a manual. To avoid drift, keep regular supervision with an existential-trained supervisor. Martínez Robles stresses that not-knowing requires years of training, supervision and philosophical reading. Training is offered through ALPE's member institutes, for example CAPAC in Argentina and the Círculo in Mexico/Colombia. [source: Martínez Robles 2017, pp. 328–329; de Castro & Signorelli 2020; WCET4]

Sources

Sources

Further reading (not drawn on) [uncertain where relied on]

de Castro Correa, A. & Signorelli, S. (comps.) (2020). Voces existenciales en América Latina: contribuciones a la psicología y a la terapia. Barranquilla: Editorial Universidad del Norte.
de Castro Correa, A. & García Chacón, G. (2011). Psicología clínica: fundamentos existenciales (2nd ed.). Barranquilla: Uninorte.
Martínez Robles, Y. A. (2008/2009). Filosofía existencial para terapeutas y uno que otro curioso.
Martínez Robles, Y. A. (2012). Terapia existencial. México.
Feijoo, A. M. L. C. de (2011). A existência para além do sujeito. Rio de Janeiro.
Signorelli, S. & Martínez Robles, Y. A. (2019). Latin American developments. In E. van Deurzen et al. (eds.), The Wiley World Handbook of Existential Therapy, ch. 35. Wiley.
Martínez, Y. & Signorelli, S. (eds.) (2012). Perspectivas en psicoterapia existencial.

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