Tag Archives: person-centered

On Becoming a Counselor: What’s a Rogerian, Anyway? by Lauren Leslie

carl-rogers

IMHO, more people should read Carl Rogers. But I understand, sometimes there just isn’t enough time in the day to fit in your Yoga class, mindfulness meditation practice, cardio workout, meal prep, work and family-life, and other responsibilities. So here’s an option: Below you’ll find a review of a classic Carl Rogers work: On Becoming a Person. It was written by Lauren Leslie to fulfill an assignment I give in our Counseling Theories class. It’s a fun read and gives you an abbreviated glimpse of the amazing Carl Rogers from the perspective of a first-year graduate student in clinical mental health counseling.

On Becoming a Counselor: What’s a Rogerian, Anyway?

Lauren Leslie
University of Montana

            Carl Rogers’ On Becoming a Person is a collection of essays and edited speeches written between 1951 and 1961, while client-centered humanistic therapy was being simultaneously embraced and challenged by the establishment. Rogers states he intends to write to professional psychologists, members of the counseling profession, and informed laymen, different populations who nonetheless have at least one thing in common:

. . .while the group to which this book speaks meaningfully will…have many wide-ranging interests, a common thread may well be their concern about the person and his  becoming, in a modern world which appears intent upon ignoring or diminishing him. (Rogers, 2012, “To the Reader” para. 8)

Throughout the text, Rogers offers a picture of himself as a person and a therapist. He provides insights into the growth of his theoretical framework as well as therapy transcripts to flesh out central elements of client-centered practice. Ultimately, the text crystallizes the effectiveness of empathy, congruence, and unconditional positive regard within a therapeutic relationship, and it is difficult to argue against Rogers’ persuasive and clear writing. Critics insist Rogers’ model is incomplete or insufficient, but the core tenets remain central to the practice of contemporary psychotherapy.

On Becoming a Person collects texts of varying genres into a sort of holistic catalog of Rogerian thought. Due to this variety of genre, Rogers’ tone and subject matter shifts; he addresses his own personality and life, includes transcripts of counseling sessions, and tries to systematize examples of his practice into stages of client development to analyze effectiveness of treatment. Rogers philosophizes on the human condition and therapeutic practice, Kierkegaard and Buber, and scientific research and personal change. It is a sweeping book which attempts meaningful understanding and data-driven conclusions. At one point, Rogers claims “There is no general agreement as to what constitutes ‘success’ [in psychotherapy]…. The concept of ‘cure’ is entirely inappropriate, since … we are dealing with learned behavior, not with a disease” (Rogers, 2012, p. 227). He consistently moves in opposition to the kind of concrete, experimental thinking favored in certain parts of the psychological community and comes off far more as a philosopher studying existential questions than as a data-driven scientist.

In considering himself, Rogers (2012) states, a client “discovers how much of his life is guided by what he thinks he should be, not by what he is. Often he discovers that he exists only in response to the demands of others…” (p. 109). In the same passage, he muses on the insight of Kierkegaard on this point: “He points out that…the deepest form of despair is to choose ‘to be another than himself.’ On the other hand, ‘…to be that self which one truly is, is indeed the opposite of despair,’” (p. 109). If this isn’t existential philosophy, the reader must ask, what is? In his own practice, Rogers (2012) characterizes a fundamental shift from “How can I treat, or cure, or change this person?” (p. 32) to his later, fuller question “How can I provide a relationship which this person may use for his own personal growth?” (p. 32). From his training in psychology, Rogers claims to have followed his own instincts into client-centered therapy. His writing overtly embraces that exploration.

Despite his philosophical bent, in large sections of his writing, Rogers draws on established scientific structures or language. He writes a whole chapter which tries to formulate a “general law of interpersonal relationships,” then launches into a lengthy and example-laden consideration of the firmness of knowledge and conclusions within the behavioral sciences at the time. His cognitive resting place seems to be that the behavioral sciences are in their infancy, and while practitioners may rely on a lot of interesting information now being discovered, exploration, philosophy, and instinct still hold places of honor within the field. More than fifty years after the book’s first publication, the situation seems to have changed very little, though there is more data in certain areas. Though Rogers seems to have viewed psychotherapy as a scientific practice, his person-centered view showed him countless variables with which to contend. Perhaps in an environment without controls, philosophy and instinct present better-formed or more immediate solutions than experimentation can.

Rogers seems to boil complex situations down to essentials wherever he can: relationship is his central theme, and empathy, congruence, and unconditional positive regard are the three relationship components. This pursuit of simplicity may be attentiveness to the broad audience of On Becoming a Person or may be indicative of Rogers’ own worldview. Whatever its source, it leaves Rogers open to criticism from those who see things as unsimplifiable. In a similar way, the individual variation and client focus implicit in Rogers’ therapy leave him open to criticism from those who see him acting only as a clarifying mirror for clients, not as a truly congruent party to change-spurring relationships. In one example of a common critique, Ralph H. Quinn (1993) contends that “[a] fully person-centered therapist…would feel compelled to stay with the client’s lead…[and] trust that the client knows best” (p. 20) rather than confronting the client in a moment of genuine human response.

Genuineness in psychotherapy…does not mean simply the willingness to confront a client…. More than anything it means that the therapist must strive to be fully present with the client, to bring all of himself or herself to the therapeutic relationship. As therapists, we must be willing to risk as much as we ask our clients to risk, to be as transparent and courageous as they must be, if the therapy is to produce real life change. (Quinn, 1993, p. 20-21)

This section includes the assertion that bold congruence and full presence are not already parts of person-centered therapy, and Rogers was remiss in not addressing them. Quinn (1993) later implies a fully person-centered approach can easily be seen as practicing “Pollyannish optimism and therapeutic passivity” (p. 21). Such criticism is valid enough, and points out elements of Rogers’ work that may be over-simplified. However, the complexity with which Rogers addresses each essay, idea, and client interaction suggests he did not see humanity or psychotherapy as simple, and did not approach them passively. Rogers may not have dwelled enough in his writing on the practice of congruence; perhaps it was an element that seemed also to contain infinite variables and defy simple definition. I tend to think this criticism stems from a misinterpretation of Rogers’ intentions and practices. In the final analysis, even critic Quinn (1993) only suggests practicing more (riskier?) congruence on the part of the therapist, not abandoning Rogers’ principles.

In terms of my own use of this book, its variety in tone and subject matter makes it a uniquely useful text. Each section and each essay can be read independently, and dipping into Rogers’ world is a clarifying and centering experience that could bring me back to the core of therapeutic practice in times of questioning and uncertainty. Reading this book now gave me a window into the complexities inherent in a model that can be seen as very simple (by Rogers’ design, admittedly). Considering this approach in my own attempts to define or grasp client “distress” has been helpful in placing myself in the wide world of this human-helping profession, and has helped me frame my own conception of what I am doing here and what a client might want or need from me in this role. This reading has been one new way of incorporating personal change into myself: deliberately approaching the self I am discovering myself to be.

 

References

Quinn, R.H. (1993). Confronting Carl Rogers: A developmental-interactional approach to

person-centered therapy. Journal of Humanistic Psychology, 33(1), 6-23. doi:

10.1177/0022167893331002

Rogers, C. (2012). On Becoming a Person. [Kindle Voyage version]. Retrieved from

Amazon.com

An Interview with Natalie Rogers (Daughter of Carl Rogers) about Person-Centered Therapy

Of all the counseling and psychotherapy approaches out there, person-centered therapy might be the most quickly dismissed of them all. I’ve had therapists watch or listen to a PCT demonstration and then make dismissive comments like: “Oh yeah. That was just basic listening skills. I know all about that.”

It’s usually hard for me to figure out how to best respond to that sort of statement. What makes it hard to take is that typically, when someone says something like, “I already know all that Rogerian stuff,” it’s a surefire sign that they really don’t get person-centered therapy.

Although this is mostly just my opinion, it’s also the opinion of Natalie Rogers (daughter of Carl Rogers, the person who originally developed person-centered therapy). The following is an edited excerpt of two telephone interviews I did with her way back in 2003. This excerpt is included in our theories textbook: http://www.amazon.com/Counseling-Psychotherapy-Theories-Context-Practice/dp/0470617934/ref=cm_cr_pr_product_top?ie=UTF8

Additional interview material is in an article published in the Journal of Counseling and Development in 2007: http://onlinelibrary.wiley.com/doi/10.1002/j.1556-6678.2007.tb00454.x/abstract

And even more interview material is resting on the hard-drive of my computer.

Other fun and interesting content about person-centered therapy is in our Student Guide: http://www.amazon.com/Counseling-Psychotherapy-Theories-Context-Practice/dp/0470904372/ref=sr_1_fkmr1_1?s=books&ie=UTF8&qid=1438700878&sr=1-1-fkmr1&keywords=sommers-flanagan+student+guide

Here’s what Natalie had to say about the status of Person-Centered Therapy in the U.S.

Why Is the Person-Centered Approach Undervalued in the United States?

In the following excerpt from two telephone interviews, Natalie Rogers discusses why person-centered approaches tend to be undervalued or overlooked in the United States.

John Sommers-Flanagan (JSF): Other than the managed-care focus and an emphasis on quick fixes, can you think of any reasons why more American therapists aren’t practicing PCT?

Natalie Rogers (NR): That’s a good question. Most psychology students I know only get a chapter or two in the academic world, and they don’t really understand in any depth what the person-centered approach is about. And, most importantly, I think they haven’t experienced it. They’ve read [about] it and they’ve talked about it and they’ve analyzed it, but my own belief is that it really takes in-depth experiencing of the client-centered approach to know the healing power of empathy and congruence and unconditional positive regard.

JSF: So it’s almost like students get more of an intellectual understanding, but you’re just not seeing them get the experiential part.

NR: Even the intellectual understanding is very superficial, because they read maybe a chapter and watch the old Gloria film (Rogers, 1965). The fact that there have been 16 books written on client-centered therapy and a lot of other books now that Carl’s passed away and the research that he did is so profound . . . the in-depth research on what actually helps clients go deeper into their feelings and thoughts.

JSF: Right.

NR: You know, [how therapists can help clients go deeper into their feelings and thoughts] is hardly ever mentioned in academia as far as I know.

JSF: And what I remember from our last conversation was that you said you thought it didn’t happen in the U.S. at all and maybe a little bit in Europe?

NR: I think it does happen a lot more in Europe, and most particularly in the United Kingdom, Scotland and England. They have really excellent training programs in the client-centered approach, and the books that are coming out are coming out from there. You know in Germany they have a several-year, very extensive training program that’s also linked in, I believe, to becoming accredited or licensed as a therapist. Things are going that particular route in Europe, but none of that is here in the States.

JSF: That seems to reflect our own emphasis on the surface or the quick fix as well in that people just really haven’t gone deeper and experienced the power of PCT.

NR: Right. And then again I think the other point is that the ego needs of the therapists [appear] to be strong here. Therapists in this country seem to need to have the attitude that “I have the answers” or at least that “I know more,” and it’s . . . the old medical model that we still hold onto in this country a lot. The doctor knows what he needs to diagnose and treat, knows what’s wrong and that there are ten steps to fix it.

JSF: Right, which seems to be the opposite of the person-centered therapy of “trust the individual, trust the person.”

NR: Not just seems to be, it is the opposite. So, to actually believe, to have faith in the individual, to have faith that each person has the answers within himself or herself if given the proper conditions, and that’s a big if. That philosophy takes a great deal of humility on the part of the therapist.

JSF: For us to realize that we don’t have all the answers for another person.

NR: Right. I kind of like the gardener metaphor. That I’m the gardener and I help till the soil and I help water the plants and fertilize the plants, and care for them. And I need to understand what the plant needs, what conditions that plant needs for it to actually grow and become its full potential. That’s very different. That’s what I see as one metaphor for being a therapist. I don’t know all the answers, but I’m a person who creates the conditions for the person to grow.

JSF: Kind of the fertile field metaphor. So . . . what would you tell beginning therapists that would help them see the tremendous value of following person-centered principles?

NR: Well, I always ask my students to examine their own beliefs about psychotherapy and about what it is that creates psychological feelings and growth. I think it’s a philosophical, spiritual belief system that we’re looking at. People are using the words “methods” and “techniques,” which always puts me off, because although there certainly are methods that we use, it’s much bigger than that. It’s a belief system about the connection between mind, body, and emotional spirit. And so I ask them what do they believe creates personal growth, and what have they experienced themselves that creates growth, and we get them to think and talk about their religious experiences, their psychotherapy experiences, their experiences in nature, and their experiences in relationships. I think they’re all profound. And then when we focus in on relationships, which is what psychotherapy is about, then I want them to experience . . . from me or my colleagues in hour-long demonstrations what it means to be client-centered. So then they experience it as witnesses and they can experience it as a client.

JSF: So more students need to directly experience, or at least witness, client-centered therapy.

NR: Let me give an example. I was talking to a colleague once who had some of my training and who said that he was now using brief therapy, brief psychotherapy, and I admitted I didn’t really know what that was. We decided that he’d have to give me some ideas on what that’s like. So I listened to him describe the theory and practice for quite a while and questioned him about it. And as he was describing it, I was wondering, how would I feel if I were in the client’s chair and this was what was being done to me. And so then I felt pretty uncomfortable, and thought, “I guess I wouldn’t like it.” So I asked him, “Have you ever been a client in this kind of brief therapy yourself?” And he said “No,” and I thought that was inexcusable. To practice something on somebody else that you haven’t experienced in-depth yourself. I think it is inexcusable. So that illustrates in a kind of negative way the point that I wanted to make. You really need to have in-depth experience of that which you are going to have other people do.

Listening as Meditation on Psychotherapy.net

Listening in psychotherapy and counseling is partly art and partly science. This week I have the good fortune of having a blog piece I wrote on Listening as Meditation published at psychotherapy.net. You can access this blog piece — and other excellent psychotherapy.net blog pieces — at: http://www.psychotherapy.net/blog

Have an excellent and mindful Wednesday.

John SF

What I’m Writing Today: CI5 Chapter 5

With a February 1 deadline looming, I’m in all out writing and editing mode. Today’s topic: Congruence. Below is an excerpt from the draft of the upcoming 5th edition of Clinical Interviewing. I gotta say, Congruence and Carl Rogers—good stuff—way better than any NFL playoff games:). I know, Empathy would be a little better, but you can’t always get what you want.

Here’s a glimpse of the opening of chapter 5: Evidence-Based Relationships in the Clinical Interview

In 1957, Carl Rogers made a bold declaration that has profoundly shaped research and practice in counseling and psychotherapy. He hypothesized in a Journal of Consulting Psychology article that no techniques or methods were needed, that diagnostic knowledge was “for the most part, a colossal waste of time” (1957, p. 102), and that all that was necessary and sufficient for therapeutic change to occur was a certain type of relationship between therapist and client.

Although we could go back further in time and note that Freud (of course) had originally discussed the potential value of therapeutic relationships, Rogers’s revolutionary statements refocused the profession. Until Rogers, therapy was primarily about theoretically-based methods, techniques, and interventions. After Rogers {{365 Rogers 1961; 690 Rogers 1957; 363 Rogers 1942;}}, we began thinking and talking about the possibility that it might be the relationship between client and therapist—not necessarily the methods and techniques employed—that produced therapeutic change.

For years, a great debate has fulminated within the counseling and psychotherapy disciplines {{499 Wampold 2001;}}. Norcross and Lambert (2011) refer to this debate as “The culture wars in psychotherapy” (p. 3). They describe it as a polarization or dichotomy captured by the question: “Do treatments cure disorders or do relationships heal people?” (p. 3). As academics and professional organizations have engaged in this debate, typically there has been little room for moderation and common sense. There have been assertions about the “rape” of psychotherapy as well as strong criticisms of practitioners who blithely ignore important empirical research {{4453 Baker,Timothy B. 2008; 5969 Fox, Ronald E. 1995;}}. The heat of this controversy continues, in part, because we live in a world with limited health care dollars . . . and the fight to determine which forms of therapy are included as “valid” and therefore reimbursable will likely continue.

But the focus of this chapter is about a part of the controversy that’s really no longer a controversy at all. In the past two decades excellent research and research reviews have settled at least one dimension of the argument. Evidence now overwhelming shows that therapy relationships do contribute to positive outcomes across all forms of therapy and setting {{2241 Goldfried 2007; 285 Sommers-Flanagan 2007; 4074 Norcross 2011;}}. The question is no longer a matter of whether the relationship in counseling and psychotherapy matters, but how much it matters.

This chapter focuses on what has come to be known as “evidence-based therapy relationships” {{5958 Norcross 2011;}}. Although organized around specific theories and supporting research, the chapter also provides clinical examples for how the theories and evidence translate into specific evidence-based relationship facilitating behaviors that occur in the clinical interview.

Carl Rogers’s Core Conditions

Carl Rogers (1942) believed that the necessary and sufficient therapeutic relationship consisted of three core conditions: (a) congruence, (b) unconditional positive regard, and (c) empathic understanding. In his words:

Thus, the relationship which I have found helpful is characterized by a sort of transparency on my part, in which my real feelings are evident; by an acceptance of this other person as a separate person with value in his own right; and by a deep empathic understanding which enables me to see his private world through his eyes. When these conditions are achieved, I become a companion to my client, accompanying him in the frightening search for himself, which he now feels free to undertake. (Rogers, 1961, p. 34)

Congruence

Congruence means that a person’s thoughts, feelings, and behaviors match. Based on person-centered theory and therapy, congruence is less a skill and more an experience. Congruent therapists are described as genuine, authentic, and comfortable with themselves. Congruence includes spontaneity and honesty; it’s usually associated with the clinical skill of immediacy and involves some degree of self-disclosure (see Chapter 4).

Congruence is complex and has been described as “abstract and elusive” {{5961 Kolden, Gregory G. 2011;}} (p. 187). The ability to be congruent includes an internal dimension that involves clients being in touch with their inner feelings or real self plus an external or expressive dimension that involves therapists’ being able to articulate their internal experiences in ways that clients can understand. The following excerpt from Rogers’s work illustrates these internal and external dimensions of experiencing and expressing congruence:

We tend to express the outer edges of our feelings. That leaves us protected and makes the other person unsafe. We say, “This and this (which you did) hurt me.” We do not say, “This and this weakness of mine made me be hurt when you did this and this.”

To find this inward edge of my feelings, I need only ask myself, “Why?” When I find myself bored, angry, tense, hurt, at a loss, or worried, I ask myself, “Why?” Then, instead of “You bore me,” or “this makes me mad,” I find the “why” in me which makes it so. That is always more personal and positive, and much safer to express. Instead of “You bore me,” I find, “I want to hear more personally from you,” or, “You tell me what happened, but I want to hear also what it all meant to you.” (pp. 390-391)

Rogers also emphasized that congruent expression is important even if it consists of attitudes, thoughts, or feelings that don’t, on the surface, appear conducive to a good relationship. He’s suggesting that it’s acceptable—and even good—to speak about things that are difficult to talk about. However, as you can see from the preceding example, Rogers expected therapists to look inward and transform their negative feelings into more positive external expressions of congruence.

Guidelines for Using Congruence

When discussing congruence, students often wonder how this concept is manifest. Common questions include:

  • Does congruence mean I say what I’m really thinking in the session?
  • If I feel sexually attracted to a client, should I be “congruent” and share my feelings?
  • If I feel like touching a client, should I go ahead and touch?
  • What if I don’t like something a client does? Am I being incongruent if I don’t express my dislike?

These are important questions. Watson, Greenberg, & Lietaer {{4387 Greenberg,Leslie S. 1998;}} provided one way for determining the appropriateness of therapist transparency or congruence. They wrote: “. . . it is not necessary to share every aspect of [your] experience but only those that [you] feel would be facilitative of [your] clients’ work” (p. 9). This is a good initial guideline: Would the disclosure be facilitative? In fact, sometimes, too much self-disclosure—even in the service of congruence or authenticity—can muddy the assessment or therapeutic focus. Perhaps the key point is to maintain balance; the old psychoanalytic model of therapist as a blank screen can foster distrust, reluctance, and resistance, while too much self-disclosure can distort and degrade the therapeutic focus {{2454 Farber 2006;}}.

Rogers also suggested limits on congruence. He directly stated that therapy wasn’t a time for clinicians to talk about their own feelings:

Certainly the aim is not for the therapist to express or talk about his own feelings, but primarily that he should not be deceiving the client as to himself. At times he may need to talk about some of his own feelings (either to the client, or to a colleague or superior) if they are standing in the way. (pp. 133–134) {{760 Rogers 1958;}}

Let’s say you’re working with a client and you feel the impulse to congruently self-disclose in the moment. If you’re not sure your comment will be facilitative or whether it will keep the focus on the client (where the therapy focus belongs), then you shouldn’t disclose. Additionally, you should discuss ongoing struggles with self-disclosure with your peers or supervisors because by so doing, you’ll deepen your learning about how best to be congruent with clients.

Since the 1960s, feminist therapists have strongly advocated congruence or authenticity in interviewer-client relations. Brody {{331 Brody 1984;}} described the range of responses that an authentic therapist might use:

To be involved, to use myself as a variable in the process, entails using, from time to time, mimicry, provocation, joking, annoyance, analogies, or brief lectures. It also means utilizing my own and others’ physical behavior, sensations, emotional states, and reactions to me and others, and sharing a variety of intuitive responses. This is being authentic. (p. 17)

Brody is advocating many sophisticated and advanced therapeutic strategies; but keep in mind that she’s an experienced clinician. Authentic or congruent approaches to interviewing are best if combined with good clinical judgment, which is obtained, in part, through clinical experience.