The theoretical principles of Person-Centred theory and it’s application in practice. The work shall emphasise the significance of the six necessary and sufficient conditions for therapeutic change in particular, the three core conditions. A critical analysis of the efficacy of the approach will be carried out with some critical evaluation of the researched arguments for and against the effectiveness of Person Centred Counselling. The common conception of human beings sees them as unsocialized, irrational and destructive to themselves and others.
The client-centred point of view sees people as basically forward thinking, rational and social. Antisocial emotions such as hostility and jealousy are not seen as aspects of human nature which are spontaneous outbursts which need to be controlled but rather as reactions to more basic impulses such as love, belonging and security being frustrated. The person centred perspective sees people as basically cooperative, trustworthy and constructive when freed from defensive behaviours.
Individuals are considered to have the capacity to become aware of the factors of their psychological maladjustment and will tend to move towards a state of adjustment. Person Centred Counselling concentrates on qualities of attitudes and relationships, particularly, between therapist and client. Knowledge of key concepts of person centred theory Organismic self The organismic self is the true self before it becomes corrupted by the self concept. This true self is only completely intact for a small space of time as infants.
An infant’s experience puts them self at the centre of reality Rogers believed that the developing organism strives to make the very best of their existence and responds to the world in an organised way because of their need to become “actualized” this is known as the “actualizing tendency”. Rogers considers that organisms know what is good for them. If we are hungry we find food and we make sure the food tastes good (bad tasting food is likely to be rotten and bad for us). Our evolutionary journey having made clear how to distinguish what taste is good and what is bad.
Examples to demonstrate organismic valuing is that Rogers believed if animals are left to their own devices you will find that they eat and drink what is good for them in moderate proportion and you will also generally find that babies tend to like the things that are good for them. We have however created an environment significantly different from the one in which we evolved in this new environment we have refined sugars, chocolate and fizzy drinks to name but a few. All of these things appeal to our organismic valuing but do not serve our “actualization well”.
Self concept The self concept is the term used to describe outside influences on the organismic self. At a certain point in the infant’s development she will differentiate a portion of her world as being experienced separate from herself. This portion of experience is accepted into awareness as the self concept and is composed of perceptions of the characteristics “I” or “me”. The picture of the self concept is built as the infant experiences the world in particular the time spent with others and the way others evaluate her. Positive Regard
With the infants self awareness and the need for satisfaction “the actualizing tendency” comes the need for the “positive regard” from others; when a self-experience of another has a positive impact upon one’s own experiential field resulting in positive regard. Positive Regard is the umbrella term used by Rogers with regards to love, attention, affection and nurturance. This need for the positive regard from others is potent as it is connected to the enhancement of the actualizing organislm. The need for positive regard thus becomes more compelling than the organismic valuing.
Introjected values The evaluations given by others are taken into the forming self concept as if they were organismically valued rather that introjected by others. These are “introjected values”. Conditions of worth When the infant is compelled to accept or avoid self experiences based on whether or not she receives positive regard from others “conditions of worth” are developed. Conditions of worth are imposed upon us by society. The individual will value experience a s positive or negative solely because of the conditions of worth that have been imposed upon them and not because f whether or not the experience enhances the organism . The developing self will grow and actualize itself but because the self contains the introjected evaluations of others it may grow in a different direction from the organism. Positive self regard A Positive self image which is no longer dependant on the attitudes of others. Internal and external locus of evaluation This refers to how much you value yourself from the inside “internal locus of evaluation” and how much you need to be valued by others “external locus of evaluation”. The six necessary and sufficient conditions
Rogers emphasised six necessary and sufficient conditions of therapeutic personality change. Rogers(1957) writes: “For constructive personality change to occur, it is necessary that these conditions exist and continue to exist over a period of time: (1) Two persons are in psychological contact. (2) The first who we shall term the client, is in a state on incongruence, being vulnerable or anxious. (3) The second person whom we shall term the therapist, is congruent or integrated in the relationship. (4) The therapist experiences unconditional positive regard for the client. 5) The therapist experiences an empathtic understanding of the clients internal frame and reference and endeavours to communicate this to the client. (6). The communication to the client of the therapists empathic understanding and unconditional positive regard is to a minimal degree achieved. “ Thus we find Rogers six conditions for therapeutic change. Firstly, the baseline feature that there must be ‘psychological contact’ between the client and therapist. Thus the client and therapist being in each other’s experiential field.
Rogers considered this condition as more of an assumption or pre-condition. Secondly the client must be emotionally vulnerable and in a state of incongruence. Incongruence centres on the discrepancy found between the primary experience of a person and the self image they have acquired. Even if the discrepancy is avoided in consciousness it may still ‘leak out’ in behaviours leading to the possible breakdown of the sense of self. (Rogers 1959: 203-204). Thirdly the therapist must be congruent and at ease within their own selves at least as far as their relationship with their client is concerned.
The condition of congruence permits that that the experiential connection be genuine. To be absorbed in the client’s world of experiences and meanings is to share on a much deeper level. The therapist who is congruent neither hides nor gives a primary focus to their own experience in the helping context. The responses given by the therapist to client’s experiences and issues have a transparent quality. The fourth condition ‘unconditional positive regard’ refers to the warmth and acceptance the therapist is to feel for the clients experiencing self.
Ideally the client should not feel that the way they think or feel are being judged. Thus the therapist does not offer reinforcement to the clients self judging ‘conditions of worth’ (Rogers,1959:209-210). The helping encounter becomes more relaxed and open as a consequence of this and other qualities. The therapist does not offer judgments of either approval or disproval. The fifth condition is that of empathy. This refers to the deep connection that the therapist is to have with the content and qualities of the others experiencing.
The empathic listener must firstly experience’s an inner process of recognition or ‘resonation’ with regards to what the other is feeling meaning and going through (Barrett-Lennard, 1993; Scmid and Mearns, 2006). The sixth condition requires that the conveyance of this empathic awareness is a necessary step so that the client is aware of its presence and also clients perception of the therapists unconditional positive regard. Of primary focus are the ‘core conditions’ of experienced therapist congruence, unconditional positive regard and empathic understanding.
Describe how the three core conditions are communicated and what the barriers to communicating them are. Empathy “If clients feel the counsellor’s understanding consistently he will feel involved in a process of empathy with the counsellor… empathy is not a technique of responding to the client but a way of being in relation to the client. ” Mearns,D. & Thorne,B. (2007). Empathy has to be communicated to the client and the client must feel understood by the counsellor for the response to be empathic. The empathy must be “received”. According to Nelson Jones,R. 2006) empathy is communicated through the counsellor’s attitude, non-verbal communication, para-verbal communication, accurate listening and verbal responding. The counsellor’s attitude must be explored. What are the counsellor’s feelings and values about the counselling process and does the counsellor have an opinion about who should and shouldn’t get access to counselling. It is important to be aware of the Non-verbal and para-verbal communication of empathy. It is of importance that agreement is not communicated para-verbally, Nelson-Jones, R. (2006).
Active and accurate listening must be employed for the counsellor to accurately understand the internal frame of reference of the client and this understanding must be communicated to the client. By referring to their own frame of reference counsellors may hinder their ability to listen to the clients. A response given from the counsellors own frame of reference may be communicated as questions or factual statements about the counsellor’s feelings. The verbal response of the counsellor should reflect back both the content and underlying feelings of the client.
The counsellor shows empathic understanding by their summary of the overt or underlying feelings of what the client is saying. Research into the therapeutic outcome of giving empathy has shown there to be a correlative connection to outcomes of therapy, however clients did not all respond positively to empathy, Bohart et al (2002). Paulson and Worth (2002) research on suicidal behaviours rated counsellors empathic understanding as 1 of the 4 aspects of their therapy they found to be significant (out of a possible 65).
When making an empathic response the intention of the client-centred therapist is to check, test or verify whether the therapist empathic response is accurate. The therapist thus makes a statement which represents their inner understanding. Two examples follow: (1)Client: He called me at work again and said that he would like to see me (pause) finally (pause)I was really busy and couldn’t talk for long, but I found it difficult to concentrate for the rest of the afternoon, my emotions were all over the place. I’m such an idiot! He is such a pig, but I just want to see him.
Therapist: You feel foolish that you want this person who makes you upset….. but you still want him. (2)Client: I feel like the way I am is in some way wrong, like I’ve never really fitted in. Therapist: You feel like no one really understands you. Only the client can confirm to the therapist whether the above statement is correct, however, the statement is still a communication of the therapist sincere intention to try to understand. Congruence Congruence is communicated by the therapist by being completely honest and transparent to the client not by hiding behind a need to look professional.
For example: Client: I feel there is a distance between us today, have I done something wrong? Therapist: Not at all I didn’t sleep well last night and may be a little distracted my apologies. Congruence helps develop trust, shows the therapist’s humanness and openness, it enhances the responses given to the client and mirrors what we hope to see in the client. Congruence without respect is attack therefore the therapist must be mindful of what they are saying. People pick up on congruence more by body language than they do words.
The communication of congruence is generally a non-verbal by-product of being internally congruent. However, there may also be times were the communication of congruence is verbal and more deliberate. Rogers writes of the therapist that if they are”persistently focused on his (sic) own feelings rather than those of the client, thus greatly reducing or eliminating any experience of empathic understanding, or unconditional positive regard “, that in this situation a therapist should express their feelings (1959: 214). Disciplined spontaneity is another way to realize congruence.
Rogers writes, ‘I believe it is the realness… when the therapist is natural and spontaneous that he (sic) seems to be the most effective` (1967: 185). What follows is an example of a disciplined spontaneous and congruent therapist response to an explicit client question. Client: Do you feel disgusted by what I’ve have just told you? Therapist: My feelings toward you haven’t changed and I do not feel in any way disgusted. I only feel very sad that you want to hurt yourself. Bodily felt congruence is also very important as our bodies communicate congruence 23 times more strongly than our words.
Unconditional Positive Regard A multi-dimensional view of unconditional positive regard offered by Lietaer (2001: 92-3) in Bozarth,J,(2007), is Positive attitude towards the client, non-manipulation of the client and consistently accepting and valuing the client. Unconditional positive regard is communicated through warmth (verbally and non-verbally), by giving the client acceptance and seeing them as of worth regardless of who they are, what they say or what they have done, by not giving moral or value judgements of the client emanating from the therapists own belief system, and by being genuine and caring.
Dependence on the therapist should be discouraged the client must be respected in their ability to be their own experts. Two examples of UPR follow the first is an example of respecting the client to be their own experts and the second is giving warmth and acceptance. Client: I don’t know what to do, what do you think I should do? Therapist: I wish I could give you the answer. Client: I feel close to you, I wish my father had been like you Therapist: Well you seem like a lovely daughter to me.
The behaviour of the client should not sway the therapist. No censorship of the client’s content should take place either verbal or non-verbal both consistency and inconsistencies should be accepted. Client: I wish I could walk around the office shooting them all, killing them all, blood everywhere. Therapist: Blood all over their white shirts! In the above example the therapist is entering the frame of reference of the client without censorship or moral judgements. The therapist is experiencing the clients wish to rid herself of her critics.
The therapist must have an accepting attitude to themselves and the client. The therapist must make sure they are not trying to satisfy their own needs by confusing UPR with friendliness. There must be no conditions attached to acceptance of the client. UPR is seen as an ideal to work towards rather than something that can be present at all times. The therapist may accept the client but this does not mean they like or agree with all aspects of client behaviour. Therapist must be able to separate their own views and values from the clients. Limitations
In person-centred therapy lived experiences are taken to be the starting point for understanding the person and are also taken as the starting point for therapeutic practice. There are some difficulties and limitations to a therapeutic approach which is founded on experiential principles. Firstly behaviour may have more determinants than those which can be perceived and experienced. For example in the psychodynamic field of thought what drives human behaviour is libidinal and aggressive drives which lie far deeper that the realm of experience. Such drives are inaccessible to the agent just as e cannot become aware of the underlying biological forces taking place when our muscles generate lactic acid. Jungian psychotherapists would similarly argue that the archetypal forces which form our thoughts, feelings and behaviours cannot be brought into the realm of awareness. Such forces are the ‘blueprints’ for action found behind everyday experience. The person-centred perspective thus could be considered to disregard many other key determinants to behaviour by on focusing of the experiential and also could be charged with failure to explain to explain why we experience the world in the way we do.
The experiential therapists themselves and in particular Les Greenberg propose forceful challenges to the phenomenological orientation. Les Greenberg suggests that : ”experiencing can be understood as the synthesized product of a variety of sensorimotor responses and emotion schemes, tinged with conceptual memories, all activated in a situation”(Greenberg and Van Balen,1998:45) Experience here is given as an epiphenomenon formed by deeper forces of which the subject does not have access.
The experienceing ‘self ’thus is not considered to be a primary phenomenon in its own right but the agent that organises experiences and unites them to create a coherent sense of self . The classical person-centred perspective on experiencing offered by Rogers (1951, 1959) sees experience as something subjective, internal and private to the individual. However, it could be argued that experience is not such a ‘within` the person experience but instead exists on an ‘inter-subjective` plane.
Rather than experience taking place entirely in the subjects own head it could be argued that experience takes places ‘between people’` and that even the thoughts in our own heads are thought using language which originates from socio-cultural context. Thus every element of the way we experience is infused with the thoughts, ideas and communications of others. Experience is not here devalued but perhaps should be placed on a more inter-personal plane.
Possible dangers of ‘phenomenological reductionism`are pointed out by Prouty (1999:9), whereby “The process of experiencing rather that the existential whole being of the self is related to by the therapist”. From my own perspective the theory has far more strengths than it does weaknesses. No other therapy provides as good an environment for UPR, empathy, understanding and deconditioning. Every therapist should have the fundamentals of the person centred approach incorporated into their treatment models.
The main difficulty that has arisen for me has been the concept of UPR. Rogers meant his conditions of worth to be used not only in therapy but in day to day life. I have tried to live by the three core conditions of empathy, congruence and UPR and became very emotionally unbalanced in a situation of conflict with a family member when I tried to give UPR. I asked myself why? Because I was so focused on giving UPR “I am going to feel warmth and acceptance for your experiencing self” that I forgot to use my defence mechanisms.
I did not want to be in a conflict with the family member and was happy with the outcome; I had calmed her down and had not let myself become angry but, after this I still felt lost. Why ? I later realised that I had been unable to use my defence mechanism of “anticipation”. Anticipation is a defence mechanism which enhances pleasure and feelings of control. It helps integrate conflicting emotions and thoughts, while still remaining effective. And those who have these mechanisms are usually considered virtuous.
Therefore I could never offer UPR to anyone other than someone I really loved and trusted. I could offer unconditional positive regard in the moment but it would be offered only because either it was a client who I would only share a finite amount of time with or because I was planning how I would deal with potential future discomfort. “Planning for future discomfort infers that I am applying conditions to our relationship”. Also UPR seems to contradict with congruence when having negative emotions about someone.