The severe limitations of rogerians approach to therapy

The severe limitations of rogerians approach to therapy This essay reflects on the above statement, and begins by defining what we mean by supportive and reconstructive, when relating these to the subject of counselling and psychotherapy. In then identifying the key theories of the Rogerian approach, and exploring some of these theories in greater detail, this leads to a deeper discussion and consideration of the question. Feeling supported in the therapeutic environment is a key element to how successful and effective therapy can be. Having an open, equal, honest relationship between client and therapist is the ideal situation, and where this kind of relationship exists it can greatly enhance the healing process. When the therapist is able to offer a safe space, the client feels able to express himself freely, without fear of being judged. If supportiveness is lacking, this negatively impacts the client. Feeling judged, fearful of what the therapist might be thinking, creates barriers and an atmosphere that feels unsafe and not conducive to effective therapy. The term reconstructive can be used to describe the process where major changes occur for the client during therapy. For clients suffering from post-traumatic conditions, including complex grief reactions, reconstructive therapy focuses on facilitating the client to recognise, understand and accept their feelings and reactions. Deeper self understanding can enable clients to see they have choices, and to regain responsibility for themselves and their reactions. The concept of being supportive can be clearly identified within several Rogerian theories, namely: The Core Conditions, The Self Actualising Tendency, and the Organismic Valuing process. The connections to supportive, seen in Rogers theories are explored and discussed in more detail later. Other key Rogerian theories considered in more detail include the idea of Phenomenology, The Self-Concept (or self), and Conditions of Worth. I observe the supportive tendency towards growth as being strongly embedded within the Rogerian approach. I also identify Rogers approach as reconstructive in the sense that major positives shifts and changes often occur during therapy. Considering the question of limitations this is harder to answer. As is the case with all psychological theories there will always be limitations and exceptions to effectiveness. For a great many clients and therapists the Rogerian way of working offers both a gentle and powerful therapy, that has stood the test of time. The Rogerian approach is also known as Person Centred counselling or Client Centred therapy. It originated from the pioneering work beginning in the 1930s which continued through six decades, of American psychologist and writer, Dr Carl Ransom Rogers (1902 1987). ( Mearns and Thorne 1999). Rogers talked about client centred or person centred therapy as not just a therapeutic way of working, but more as a way of being. Being real, genuine and true to himself. (Rogers, 1980) Rogers belief was that the client knows best. His approach was a radical move away from the analytical approaches of the time, where the therapist was thought of as the expert. Rogers was convinced that we each have within us the knowledge and resources to move forward, and that the role of the therapist is to offer the conditions that facilitate clients to help themselves. (Mearns and Thorne 1999). A helpful description of the Person Centred approach is offered by J K Wood: .. it is neither a psychotherapy nor a psychology. It is not a school à ¢Ã¢â€š ¬Ã‚ ¦ itself, it is not a movement à ¢Ã¢â€š ¬Ã‚ ¦it is not a philosophy. Nor is it any number of other things frequently imagined. It is merely, as its name implies, an approach, nothing more, nothing less. It is a psychological posture, if you like, from which thought or action may arise and experience be organised. It is a way of being. (Wood 1996, cited in Embleton Tudor, Keemar, Tudor, Valentine, Worrall, 2004) Phenomenology comes from the work of Edmund Husseri (1859 1938), Martin Heidegger (1889 1976), and Maurice Merleau-Ponty (1907 1961). (cited in Embleton Tudor, Keemar, Tudor, Valentine, Worrall, 2004, pp 18 24). Phenomenology is based around the idea that reality is not fixed. We each perceive our own reality, which is informed by our life experiences, biases, prejudices, and perceptual filters. We all experience reality in our own unique way. (Embleton Tudor, Keemar, Tudor, Valentine, Worrall, 2004) Rogers said: I do not react to some absolute reality, but to my perception of this reality. It is this perception which for me is reality. (Rogers, 1951) Empathic understanding can be described as a process of attending phenomenologically to the phenomenological world of another. From phenomenological thinking comes the phenomenological method, which contains three steps enabling us to be as open as possible to each new experience. The first step is to bracket all our pre-conceptions that we have taken on board and tend to automatically believe. Our challenge is to set these beliefs to the side on the basis that they are limiting and unhelpful and likely to impede our experience of this moment now. The next step is for us to describe rather than judge our experience. Our tendency is to analyse, evaluate and judge. The challenge here is to describe what we observe, rather than put our pre-conceived interpretation and judgement onto the experience. By staying close to felt senses we can be more open to accurately describing what we experience. The last step is to avoid putting a hierarchy on what we notice and experience. To be open to valuing everything we have noticed equally. These three steps combined, encourage non judgemental openness to experiencing, which sits well within Rogers Person Centred approach. Rogers believed that all human beings have within them an inherent tendency towards growth and fulfilment. He called this directional process in life the actualising tendency. (Rogers, 1980). Rogers saw life as an active process, and that regardless of the environment living things can be counted on to move towards maintaining and enhancing themselves. He recognised that the actualising tendency can be frustrated by adverse circumstances and events, but saw that this striving for growth always remains even in the most difficult of conditions. An example he gives is of the potatoes kept in the cellar of his childhood home that still grew in the semi-darkness, desperate to live, growing sad spindly sprouts towards the distant light in little cellar window. (Rogers, 1980). According to Rogers, humans have the ability within themselves to know what is good for them. He termed this ability organismic valuing. Trusting in our inner knowledge and intuition supports our self actualising tendency. The self actualising tendency becomes suppressed when organismic valuing gets lost through negative introjects and limiting beliefs. This usually stems from childhood, as a result of taking on conditions of worth from significant close others (for example parents, siblings, teachers). When worth or love is only expressed if we conform to certain conditions imposed by others, we take on board negative and distorted beliefs, often carrying them throughout our lives. Our locus of evaluation becomes external, constantly seeking direction, approval and reassurance of others. The Rogerian ideal is to have an internal locus of evaluation. With an internal locus of evaluation we are able to trust our own judgement, rely on our gut feelings, and have confidence in our own ability to know what is right. (Rogers, 1951) The self-concept is a persons conceptual construction of themself. Self-concepts often are not in balance with the actualising tendency and the organisimic valuing process. Self-concepts begin in infancy and develop over time. They are shaped by our perception of the attitudes and behaviours towards us of significant others. The need for positive regard and to feel approved of by others is a fundamental and powerful want. Conflict occurs when this need isnt fulfilled, and negative self-concepts become embedded. (Dryden 2007, pp 149 151). Rogers believed that peoples personalities are made up of two components, the organismic self and the self concept. The organismic self is the self I was born with, the real me. The self concept is the person I have become during my life in order to receive positive self regard from others. Introjects from those close to me, like my parents and others, have forced values inside me that arent in harmony with my organismic self. These become conditions of worth, causing me to behave in certain ways in order to receive the positive self regard from those close to me that I need. Small children have an inbuilt need to be loved by their parents. The child will feel like it is going to die if this need is denied. The locus of evaluation for the organismic self is internal, inside me. The locus of evaluation for the self concept is external approval is sought from outside. An example of organsimic self verses self concept comes from my own life: When I was in my mid teens I came under the influence of a powerful older man. For many years I felt controlled by him. I sought his approval in all areas of my life and my own personality became more and more subdued. He influenced my work, my social life, my romantic / sexual relationships, my family life my opinions and values. I felt I didnt have any of my own opinions any more. When I attempted to break free from his influence, he would react very badly and wear down my self esteem even further, making me feel powerless, worthless and useless. I suffered a lot of anxiety and unhappiness during those years. He also had the power to make me feel very good, if he chose to. His approval was so important to me. It was only in my thirties I managed to fully break free from his influence. I was able to begin returning to the real me, to re-discover my organism self, and accept myself as a worthwhile person with my own views and values. The following two examples illustrate the power of interjects in creating conditions of worth: Jake talked about his experience as a small child where he didnt want to eat and would find any excuse to get out of eating. As a punishment for refusing to eat his parents would shut him out of the flat, leaving him on the landing outside the flat, locked out. Jake described how this made him feel I felt completely rejected, I was thrown out of my house. This example shows how in this case the behaviour of his parents had a very negative effect on the his sense of worth and self concept, as a small child. Jake felt that a minor misdemeanour could take away the love of his parents and the security of his home of which he was not worthy anymore. These events seriously negatively affected Jakes conditions of worth for many years. When I became pregnant in my late teens I felt very frightened and alone and not able to share this traumatic event with my parents. Shortly after having a termination my secret came out. The reaction from my mother was angry and judging, I remember her words how could you do such a thing. I took this to mean how could I have sex, and how could I have an abortion. I felt very ashamed and guilty and bad about myself. This affected my romantic and sexual relationships and my views on sex and pregnancy for many years. This example shows how one sentence from my mother (a negative introjection of her values) had a huge affect on my conditions of worth and had long lasting negative consequences. In contrast, my fathers reaction to the news of my unplanned pregnancy and that Id had a termination was completely different. He was sensitive and supportive, not judgemental and very understanding of my decision. This had a very positive effect on my view of my father, and my relationship with him. It also helped to balance the strong negative reaction I felt to my mothers response. I still look back on this memory as a time when I realised what a wonderful man my father is. My respect and affection for him has only grown since this experience. Looking back it is clear to me that he offered me empathy, congruence and UPR at a time when I really needed it. Rogerian therapy is built around the premise that if certain conditions are present then healing will occur. 1. Psychological contact between the counsellor and the client 2. The client is in a vulnerable or anxious state 3. The counsellor is congruent 4. The client experiences unconditional positive regard and feels accepted by the counsellor 5. Empathic understanding of client by counsellor The client receives the empathy and unconditional positive regard and congruence Rogers claimed that as long as these conditions were there, this was all that was needed. He described them as being necessary and sufficient. (Rogers, 1951) Of the six conditions, three are core, these are Empathy, Unconditional Positive Regard (UPR), and Congruence. These three conditions need only be minimally present, in order for therapeutic personality change to take place. Returning to empathy, I see this as being able to put myself by the side of the client, and to understand their feelings. Phenomenologically I will never be able to fully know how someone else feels, but believe that empathy takes me close enough. Rogerian counsellors demonstrate empathy by active listening in a sensitive way, and reflecting feeling words back to the client, and also by tone of voice, body language and mirroring facial expressions. Paraphrasing can be used to summarise what the client is saying, with clarification whenever there is any confusion about what the client is trying to communicate. (Mearns and Thorne, 1999) Unconditional Positive Regard can be defined as respecting the client as a human being and not judging. It may be that there is sometimes something to do with the clients actions or behaviours which the counsellor doesnt agree with, but this doesnt stop UPR being offered. It is about giving respect to a fellow human being without conditions. From the clients point of view, receiving UPR will improve their own feelings of self-worth. If they have been in a cycle of behaving badly because this has always been what has been expected by others, then the cycle can be broken by UPR being offered by the counsellor. In order to offer UPR, it is important that the counsellor has a high degree of self awareness and has worked through her own issues and is clear about any biases or prejudices, and able to put these to the side. (Mearns and Thorne, 1999) Congruence means being real and genuine, the counsellor being able to be herself and to be open and honest with the client. Being congruent means removing pretence or acting, and being fully present. Receiving congruence and seeing the counsellor isnt perfect and has vulnerabilities, reassures the client that it is ok to be imperfect and vulnerable. (Mearns and Thorne, 1999) Person centred counselling can be an extremely powerful therapy and can have an enormous impact in enabling damaged people to heal themselves. One of the basic criticisms of Person Centred Counselling is around its theory which is based around our built in motivation to self actualise, grow and achieve. The reality of todays world is that there are many people who dont demonstrate this self actualising tendency. What Rogers didnt explain was if everyone is basically good deep down inside, why arent societies better and better as a result? It is also argued by some that person centred counselling is limited. It can be seen as being a passive soft kind of therapy, with the balance of power with the client, and the counsellor not offering the client advice or solutions. Is this a weakness or a strength? My view is that it is a strength and one of the key reasons why person centred counselling is so effective. The counsellors role isnt that of an expert solving the clients problems, but as someone able to reflect back the clients thoughts and feelings, in a respectful and honest manner, enabling the client to begin to heal himself. Taking this further and coming back to the title question, I see that the fact that Rogerian counselling offers a safe and supportive space for the client, this is what then enables the reconstructive process to take place. Clients come to therapy for a variety of reasons, but they all have one thing in common, they are in emotional pain. The gentle yet powerful elements of Rogerian therapy allow the client to be safe enough with the counsellor to express their emotional pain. In order to get to this place of safety, there has to be a strong level of trust between the client and the counsellor. This trust grows, through the counsellor offering empathy, congruence and unconditional positive regard. For major shifts to happen first the client needs to be open and honest and be able to express their distress. The next step is for the client to take the risk of moving out of their comfort zone and challenging themselves. This is when the greatest shifts can occur. In order for either of these steps it is absolutely key that the client trusts and feels secure with the counsellor. The person centred values promote and encourage this by offering an equal non judgemental honest real relationship. To return to the question, in my view and my experience, Rogerian therapy is both supportive and reconstructive. I feel its only limitations lie within individual clients. If a client is not ready to explore themselves honestly, to open up and challenge themselves, then change wont occur. The client has to be ready to engage in what can often be painful self exploration. When a client is ready and wants to do this, working in the Rogerian way can have powerful life changing results. The Rogerian approach is a way of being, and this way of being can be applied to all aspects of life. In terms of therapy, I see this approach being very valuable. Other tools and skills can be offered to clients, in a person centred way, which I see as greatly enhancing the therapeutic process.