Person centred therapy
Therapy offers the therapist all that he/she will need to treat clients’. In this essay I will look at the benefits and the disadvantages of person-centred therapy and consider whether it provides sufficient tools for the therapist to be effective in the treatment of the client.
Looking at the underlying theory (self-actualisation, organismic self, conditions of worth etc), and the originators of it, namely Abraham Maslow and Carl Rogers, I shall consider its strengths and weaknesses and look at the way in which Rogers explains and responds to psychological disorders to explore to what extent his approach might be useful in their treatment. Person-centred therapy first came into being in the 1930s and 40s with work by Dr Carl Rogers which he based, in part, on work by Abraham Maslow.
Both were considered to be the founders of humanistic psychology which was also based on phenomenology. Maslow developed the idea of a ‘hierarchy of needs’ that suggested we are motivated by a series of needs that exist from birth.
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Each of these needs, the most basic of which is survival, has to be fulfilled. Our ultimate aim, after our physical needs have been met, and a sense of belonging and esteem achieved, is self actualisation (that is the complete fulfilment of one’s potential). ‘The central truth for Rogers was that the client knows best.
’He believed that it was a counsellor’s task ‘to enable the client to make contact with his own inner resources rather than to guide, advise or in some other way, influence the direction the client should take’. 2 5th November 2013 Essay 1: ‘Evaluate the claim that Person–Centred Therapy offers the therapist all that he/she will need to treat clients’. Many clients seek therapy because they are lost or stuck and they cannot see the way forward.
They have lost all sense of esteem because they behave, unconsciously, according to a set of rules or what we might term ‘conditions of worth’ that were dealt out to them by their parents or carers in their childhood. These are often outdated for the adult self but because the client has not yet recognised this they continue to play out in their everyday life, in the ‘here and now’. If a person considers themselves to be useless, inept, worthless, they will continuously seek out validation for that claim, seeking approval for their actions yet never feeling that they wholly achieve this.
This self-concept of worthlessness has taken hold over the years and is internalised so that it becomes, by the time a client seeks help, something so destructive and hidden it will take a lot of patience and effective listening on the part of the counsellor to enable the client to feel safe enough to begin, and continue, self-disclosing. Such people are not aware of their real selves anymore; they are cut off from what, in person-centred terms is known as the organismic self.
They have become so dependent on approval that they behave in ways that will elicit this in detriment to what is really needed for their psychological well-being and this, in turn, can impact on their physical health. Because the client is so terrified of not gaining positive approval and fears being rejected it can mean that the person-centred approach takes a long time to get 5th November 2013 Essay 1: ‘Evaluate the claim that Person–Centred Therapy offers the therapist all that he/she will need to treat clients’. anywhere.
The ‘conditions of worth’ have been imposed so strictly the time frame of a counselling session, usually 50 minutes, is only long enough to break through a little, and then a counsellor may have to start all over again in the next session as the client has once again retreated into the safer behaviour of the ‘here and now’. What any person-centred counsellor is hoping to do is allow the client to move themselves forward, to self-actualise and determine what their most innate being, their organismic self, the being they were born into before they were conditioned by others values, is saying.
In other words teach the client to learn to listen to their inner self, their intuitive gut feeling. It is hoped that by applying what Rogers termed the three ‘core conditions’ within a counselling session, every time, a climate of growth can exist. These three are known as the elements of unconditional positive regard, congruence and empathy. The counsellor’s aim is to provide the client with absolute and total acceptance; by providing this unconditional positive regard it is hoped to eventually free the client to express themselves in an environment that, no matter what, will remain always non-judgemental and positive.
Secondly, congruence or genuineness should allow the client to feel ok about being their real self. If the counsellor is congruent the client may learn, with time that it is 5th November 2013 Essay 1: ‘Evaluate the claim that Person–Centred Therapy offers the therapist all that he/she will need to treat clients’. totally acceptable to be who they really are and thus they may develop in a way they previously couldn’t. Thirdly, and perhaps the most difficult to describe (because I feel this is just instinctive, an ‘intuitive knowing’, when one senses what a client is feeling), is empathy.
This is the ability to put oneself in the client’s shoes and show that one really does understand, hear and accept, the way in which the client perceives the world. All worthy aims, there may however be problems with all of these elements. It is not always easy to remain non-judgemental and positive. Once a person starts to become more like more like their real self we may find we do not like them as much so it is harder to remain congruent. Also empathy is a quality that can fluctuate from one day to the next or even within one session.
Personal difficulties or one’s own frame of mind may exert an influence. Defensiveness, embarrassment, one’s own expectations – all these may be blocks to empathy with stereotyping, interpreting, projecting, identifying with and reassuring being the resulting behaviour. What is crucial for any person-centred counsellor to understand is that they must, therefore, work on themselves because if they can’t accept themselves with all their own flaws, their restlessness, their lack of contentment, they are not in a position to help someone else.
Evaluate the claim that Person–Centred Therapy offers the therapist all that he/she will need to treat clients’. ‘Not to be self-accepting is to entertain a contradiction at the very centre of the therapeutic enterprise’3 and herein lies a very real weakness of the person-centred approach. A counsellor can only help a client go as far as they have been themselves; they have to be willing to change and grow and often this involves feeling and experiencing a great deal of guilt in facing up to the truth about the self.
Guilt is a complex emotion that masks all sorts of underlying emotions and it can take a lot of unravelling. If the counsellor has not learned about themselves in personal therapy and how their own feelings of guilt may come from the fact that they haven’t lived up to someone else’s (usually their parents) expectations, they themselves can feel worthless, depressed, a failure and then rather than transmit positivity to a client can transfer negativity.
As one reads in Person-Centred Counselling in Action) ‘Counsellors learn to wait patiently for change in their clients but often find it difficult to extend to themselves the same forbearance. And yet the failure to do so makes their acceptance of their clients’ slowness or resistance to change an act at the deepest level, of patronising tolerance. ’ (p25) Indeed in the 1940s there were a lot of criticisms of person-centred therapy on a number of different grounds. As one can read in ‘An introduction to counselling’: 5th November 2013
Evaluate the claim that Person–Centred Therapy offers the therapist all that he/she will need to treat clients’. ‘A special issue of the Journal of Clinical Psychology, published in1948, brought together a collection of critiques of non-directive therapy from leading figures within the profession. ’4 Amongst those ideas contested was that of the ‘non-directive’ approach. Many of those writing said that it just was not possible for one person in a close relationship with another not to influence them slightly one way or another.
At the same time there was a move away from so much emphasis on looking at what the counsellor did to focussing on how the process of self concept existed in the client and thus in the 50s this led to the process being renamed client-centred therapy . In 1957 Rogers set out to test his theories on a new set of people. These were clients who were schizophrenic and he wanted to test specifically whether the ‘core conditions’ and the ‘process’ models worked. The team working with him found many differences and in the end came to the conclusion that ‘the client-centred approach was not particularly effective with this type of client’ as one psychologist Schlien discovered, they ‘were locked in their own private worlds’. (p172) In more recent times, Masson 1988, has been particularly critical of Rogers saying that in no way could the ‘appalling institutionalisation and oppression’ of these patients be genuinely felt or accepted as in the client-centred model. He wrote: 5th November 2013 Essay 1: ‘Evaluate the claim that Person–Centred Therapy offers the therapist all that he/she will need to treat clients’.
‘How could he have come to terms so easily with the coercion and violence that dominated their everyday existence? Nothing [written by Rogers] indicates any genuinely human response to the suffering he encountered in this large state hospital. ’(p172) I think, however, I would need to read some more on this because as it stands this statement seems to be very judgemental with reference to Rogers and I cannot believe that the founding father of person-centred therapy really had no ‘genuinely human response’ to suffering!
Carl Rogers was also fascinated by cultural experience and indeed travelled to all parts of the world but McDougal, writing in 2002, says that ‘the [person-centred approach] inevitably lacks relevance and resonance for other cultural groups’. Whilst the positivity, the focus on the individual self and treating everyone equally no matter what, are things which match really well in American culture they may not have the same influence elsewhere. It can be argued that the therapy doesn’t take into account different cultural values and beliefs e. g.
In Japan the Japanese psychologist Fujio Tomoda said that: ‘envisaging self in terms of the idea of a self concept ran the risk of over-defining an entity that in Japanese culture would be understood in a more ambiguous way as something that can ultimately never be put into words’. 5 5th November 2013 Essay 1: ‘Evaluate the claim that Person–Centred Therapy offers the therapist all that he/she will need to treat clients’. Generally speaking though it does seem that ‘the person-centred approach to counselling represents a philosophically coherent and practically robust approach to therapy that has remained largely unchanged since the 1960s’ (p202) and it has helped a lot of people but, in my opinion it does have its limits. This is where other approaches come into play and can extend the person-centred approach. As I said earlier person-centred therapy may offer positivity and validity for the way a person is feeling in the present but I feel it does not reach far enough by not looking at how the person’s present behaviour has been determined by what has happened in their past.
Some therapists who have also shared my opinion have looked at ways in which it could be integrated with other therapies. Those who work only in a ‘person-centred’ way stick to some basic philosophical assumptions about the nature of the person which I don’t think allow for greater diversity or knowledge about why something has happened and what contribution past upbringing has had on the present.
For example, if one considers psychodynamic counselling, one believes that relationships with parents and one’s upbringing play a significant part in the development of a person and that in any therapy session there is more than just the client and the counsellor in the room. At any different time there can be the mother, the father, the brother, the sister etc present and through the interplay of transference and counter-transference, which is 5th November 2013
Evaluate the claim that Person–Centred Therapy offers the therapist all that he/she will need to treat clients’. acted out all the time between client and counsellor, the latter can gain insights into the client’s behaviour which may prove significant and enlightening to the client. The person-centred approach would disagree with this concept, particularly the power of unconscious drives and instincts, and it would be irrelevant to their method of achieving self- actualisation.
I, however, believe that it is the unconscious that can hold us back and that our relationships with our parents and siblings can have a profound effect on our lives. I think that if we do not realise something about ourselves, where a certain behaviour has come from and why, then we are forced to keep repeating it and it will have a significant influence on us as a person. It is through understanding and making the unconscious conscious that we can liberate ourselves and learn to behave in ways that are more productive for us.
We can learn about ourselves as whole people instead of parts and thus become the ‘fully functioning’ person we are supposed to be. Yes, I believe in this ‘fully functioning’ person as suggested by person-centred therapy but I believe that our method of achieving it must involve so much more than recognised by the former approach. Rogers described the concepts of congruence and incongruence as important ideas in his theory. Congruent people may lead lives that are authentic and genuine whilst incongruent people, on the other hand, lead lives that include falseness and do not
Evaluate the claim that Person–Centred Therapy offers the therapist all that he/she will need to treat clients’. realise their potential. Conditions put on them by others make it necessary for them to give up their genuine, authentic lives to meet with the approval of others. They live lives that are not true to themselves and can suffer as a result. Rogers suggested that the incongruent individual, who is always on the defensive and cannot be open to all experiences, is not functioning ideally.
They work hard at maintaining and protecting their self-concept through defence mechanisms but because their lives are not authentic this is a difficult task and they are under constant threat, becoming neurotic and psychologically vulnerable. Their defences may even stop working altogether with bizarre and irrational behaviour leading to great anxiety. A Rogerian approach would help them learn to adopt a more realistic self-concept by accepting who they are and thus becoming less reliant on the acceptance of others.
To do this there would need to be a genuine, empathic, and nonjudgmental acceptance of the client with active listening, accurate mirroring and reflecting of the thoughts and feelings of the client which would then need clarification by echoing and restating what the client has said. Thus some resolution may be achieved. However, whilst resolution is possible for many people with this approach I have tried to show that it doesn’t go far enough and although it provides some adequate tools for the therapist it is my belief that other therapies can offer so much more.