Person-centred Therapy

I have been told that my approach is person, or client-centred. To some extent this has to be true in the sense that any effective therapist has to demonstrate client-centredness to the person in front of them.

That said, I am not convinced that I am person-centred in the traditional understanding of the ‘person-centred school’. This perspective can be tracked back to the work of Carl Rogers (assuming you do not want to travel back to the Greeks!). You can find a summary account of Rogers’ life and work at:

https://en.wikipedia.org/wiki/Carl_Rogers

The reason why I am reluctant to accept a person-centred label is that I may adopt an humanistic stance in my work, but that’s a rather vague phrase. I am less convinced about the contributions made by the core conditions that emerged from Rogers’ clear and incisive writing. When I say this, I am referring not only to his three core conditions that are well-known, but also the three less well publicised conditions laid down in his texts.

My understanding of the six conditions, in brief, is:

1. that a relationship between client and therapist must exist and that each person’s perception of the other is important.

2. that incongruence exists between the client’s experience and awareness. This is a normal human condition, but one that motivates clients to seek to change.

3. the therapist needs to be congruent within the therapeutic relationship. That means the therapist is not “acting”. They can draw on their own experiences to facilitate the relationship. Traditional therapies were doubtful about therapists’ sharing their own experiences so Rogers was breaking ground here in the mid-20th century.

4.the therapist accepts the client unconditionally, that is, without judgment, disapproval or approval. This facilitates increased self-regard in the client, as they can begin to become aware of experiences in which their view of self-worth was distorted by others.

5. the therapist seeks to experience an empathic understanding of the client’s inner world (or internal frame of reference, as it is termed). The therapist’s accurate empathy helps the client see the therapist’s unconditional regard for them.

6. The client perceives, at least to a minimal degree, that their therapist’s unconditional positive regard and empathic understanding is present.

These conditions have been labelled “necessary and sufficient” for effective therapy. For myself, I regard them as a global basis for working towards being an effective therapist – they are, indeed, necessary but the six conditions are not sufficient.

Why do I think is this? The six core conditions minimise the therapist’s knowledge and understanding. In my experience, clients do expect their therapists to have some skills and to be active in using them. They do not expect knowledge and understanding to be withheld from them in the name of ‘unconditionality’ simply because they have not asked for it. It is difficult for any of us to ask for what we want if we do not know what to ask for!!

Furthermore, the six core conditions do not allow for any incongruence between the therapist’s experience and awareness. In the ‘safe experimental’ method, a therapist will experience small defeats and small victories, as will the client. All need to be identified, discussed and explored in therapy, between sessions and in the process of clinical supervision. Why? It is not reasonable to expect clients to undertake a process if I, as a therapist, am unwilling to do the same thing. It is not simply a question of settling a ‘good example’: it is demonstrating by example.

On one final point, I would say that self-regard in a client is increased not simply by gaining insights into their own current self-worth. They will also be enabled here when their therapist identifies how their own self-worth is distorted by self and others.

I am used to person-centred people saying these three issues I have listed are addressed by the condition of ‘congruence’ within the therapeutic relationship. This gives the impression that the therapist is given permission to speak their mind – discouraged to put on a professional veneer. Would that this were so. What I have observed, in training and in practice, is that modern therapists can swap the ‘professional face’ of older therapists with a reluctance to commit ask questions or offer an opinion.

The truth be told: there is a time for “acting” when being a therapist. If a client appears to say something important, I can mark it with a verbal or a non-verbal response. The latter are often powerful but require a conscious response from me – to a degree that is ‘acting’; that is, not responding with my first impulse. Some of what emerges from Neuro-linguistic Programming (NLP) demonstrates there is an OK side to ‘acting’.

In my view, the person-centred tradition lost the spirit of Rogers’ attitude or a set of ethics. Over time, training and trainers became wedded to the ideas behind the core conditions. in time, ‘person-centredness’ lost its flexibility and became a ‘school’ – a rather ossified tradition.

In doing so, the school became less motivated to follow the client’s own journey. A person-centred therapist is likely to be enraged by this statement. I can appreciate that most therapists want to walk alongside a client on their journey into a changed future; one that is shaped by that client. It is easy to say those words, and easy to stop demonstrating the difficult actions required to keep two people in a negotiated focus.

Linguistic Ethnography

I was introduced to this research method by Jamie Murdoch, Research Fellow, at the University of East Anglia (UEA).

The term sounds rather intimidating so let me say more about it as it will help some readers interested in research and ‘safe experimenting’

The term ‘linguistic ethnography’ is an umbrella term for specific approaches to research. Scholars combine linguistic and ethnographic research traditions to our understanding of the impact of our social world on us. It does not take for granted our ways of communicating on our everyday world (our ‘social context’, as it is labelled). Take a look at:

https://www.researchgate.net/publication/304796765_An_Introduction_to_Linguistic_Ethnography_Interdisciplinary_Explorations

……. for more details.

There is a connection here with the information I have provided about Acceptance and Commitment Therapy (ACT). I’m no great philosopher, but ACT authors have described their approach as based on the philosophy of science called functional contextualism. Put simply, this means focusing on things that work and the context in which they are working. You are likely to be less effective – and invite more small defeats – unless you design your safe experiments paying close attention to the context in which you are living your life.

As I see it, the research into therapy undertaken by Charles Truax and Robert Carkhuff, as well as later work on Neuro-linguistic programming, undertaken by Richard Bandler and John Grinder, emerged to some degree from this way of examining what goes on in our world.

The relevance of linguistic ethnography to ‘safe experiments’ is that this research method serves to help us notice the social context within which we operate – just enough to see what changes might be made and how we might go about designing a suitable experiment.

You cannot do a safe experiment unless you want to do something different and, to notice what might be done differently, we need to notice the everyday impact on us of the world in which we are existing.

So, in practice, pay attention to the language you and others use and notice what impact language has on your understanding. Just as important, return to the Road Map safe experiment in How to Give Yourself a Nudge and notice how change is made difficult by our wider world.

Notice how others around us make it more or less easy to create change or even ‘allow’ us to become aware that change is feasible. Schools and colleges are intended to educate us; have you noticed how, sometimes, those institutions contain and reduce or ability to be different. It is precisely those ‘social contexts’ that may need disrupting before you can initiate a safe experiment effectively.

Do you remember the experiment about messages from our parents and grandparents? Most messages sent to us were meant to be well-meaning (sadly, not all). Go back to your records and notice the unintended consequences arising from some of the messages we received.