Person Centred Counselling in Action
Contents
Introduction
Chapter 1 The person
centred approach: a contemporary review and basic theory
The self-concept
Conditions of worth
The Organismic valuing
process
The locus of evaluation
Creating the conditions
for growth
Chapter 2 Recent
developments in Person Centred Theory
Ego syntonic processes
(strange use of syntonic!)
Difficult Process
Fragile Process
Disassociated Process:
Self-Dialogues
Chapter 3 The counsellors
use of self
The experience of
relational Depth
Chapter 4 Empathy
Blocks to empathy
Blocks to empathy
Empathising with
different parts of the client
Chapter 5 Unconditional
Positive Regard
Why is Unconditional
positive regard so important?
Personal Languages
But what do I do when I
don’t accept my client
Focus on warmth
Focus on Conditionality
Unconditional positive
regard is not about being nice
Chapter 6 Congruence
Why is congruence
important
Resonance
Self-resonance
Empathic resonance
Personal resonance
Met
communication
Incongruence
Guidelines for congruence
How can the therapist
learn congruence
The Three conditions in
combination
Chapter 7 Beginnings
The Power Game
Disguises and clues
The end of the beginning
Chapter 8 Middles
The development of the
therapeutic relationship.
Client process
Person Centred Therapist Process
Chapter 9 Endings
Introduction
Central truth for Rogers is the client knows best: they know
where the problem is and where the solution is. The aim of the therapist is to
be a companion that can help the client access their own wisdom. The therapist
is non directive, so client centred.
Chapter 1 The person centred approach: a contemporary review and basic theory
Basic theory: assiduous attention to process, &
uniqueness of the client. Context: an increasingly depersonalised, mechanised
culture, of short term goals, technical upgrades and advancements and experts.
The self-concept
Distrust of experts runs deep among person centred
practitioners. Experts are authoritative, and issue guidance. Experts with humans
can cause difficulties, where a person’s inability to fulfil the expectations
of others, their expertise, leads low self-esteem.
Therapists offer clients self-acceptance, this is in
contrast to previous clients thoughts of my self-perception low, perception of
experts high. A low self-esteem can be his expectation someone has of being
rejected and disapproved of.
Client’s behaviours are understood as an acting out of self-concepts
and our beliefs about the world.
Conditions of worth
People with LSE have conditions of worth, i.e. if I do x,y,z
then I will get approval, if not I will be disapproved on.
The Organismic valuing process
Rogers believe in the actualising tendency, that every
individual strives to grow towards their fulfilment of their potential. People
who have been loved in the early years, would trust their thoughts and
feelings, and it would help them to actualise their potential and provide
satisfaction and fulfilment. Thus their organismic valuing process was in good
condition. People who had imposed conditions of worth, have a large need for
positive regards. However a need for a positive regard then takes precedence
over the actualising tendency and creates dissonance with the organismic
valuing process.
The locus of evaluation
People who have been surrounded by critical and judgemental
people have to resort to strategies to achieve approval. This can result in a progressive alienation
from self-trust, self-worth and self-wisdom. When this is the case an
individual has difficulty knowing what he thinks or feels and a reliance on
external authority to know what they want or feel.
To develop an accepting self-concept, leads to the ability
to access your deepest thoughts, experiences and desires. These people can
listen without feeling threatened. They can listen to themselves or others as
there is a stable I’m ok core. They have trust and confidence in their organismic
valuing process. So their locus of evaluation is themselves no other people.
Creating the conditions for growth
Development of a person is blocked where their basic
positive self-regard has been trampled on. Their self-concept has been created
as a protection against attack and disapproval. The counsellor’s job is to
create the soil in which this basic positive self-regard can grow. This
requires from the therapist:
1.
Congruence or genuineness: this shows its
permissible to be yourself
2.
Unconditional positive regard: this will help in
terms of self-acceptance
3.
Empathic understanding: a counsellor tracks and
accurately assessing the feelings and personal meaning of the client, to know
what it is like to be them, to validate them.
This restores connection to the alienated.
Chapter 2 Recent developments in Person Centred Theory
Rogers stated the actualising tendency is: to achieve goal
of self-maintenance, even when the usual pathway is blocked. We more in the
direction of maturation. Thus Rogers
sees there as one drive, the motivation for humans to maintain, develop and
enhance their functionality, this he sees as the fundamental life force. The
actualising tendency is to make the best for yourself given the circumstances.
In the 1960’s Rogers saw social influence as a restriction
on the actualising tendency. Meanrs and Thorne introduce the concept of social
mediation, where the actualising tendency is mediated by social relations Thus whilst the individual is actualised it
is done so within the social context, which needs to be looked after in the
same way, maintained, developed and enhanced. The social context provides the base
for the actualising tendency of the self.
Ego syntonic processes (strange use of syntonic!)
If you grew up where the primary care giver was
unpredictable and you experienced negative experiences from them then you might
respond by:
1.
Withdraw emotional attachment
2.
Seek to control the relationship
3.
Find ways to control yourself in relationship
Mearns sees the individual as self-actualising and the
social mediation as restraining
Disorder is defined as rigidity in the actualising process,
such that it doesn’t respond to changing circumstances. So the idea being you
develop defences for difficult situations then when the difficult situations go
the defences don’t go.
Difficult Process
Warner writes of growing up in difficult environments
Fragile Process:
where in development insufficient empathy is given. This can lead to
experiencing at very high or low levels of intensity. Their emotions have
difficulty starting or stopping. They may also have difficulty with empathy.
Disassociated Process:
Seen with people who have been traumatised by physical or
sexual abuse pre 7.
These difficult processes put the disorder as the client’s
best attempt to solve a problem
Self-Dialogues
People have different selves, seen in DID so how do you work
with the whole person? Also apart from DID people describe different selves,
how do you work with the whole person which is a person centred mantra. The
approach is to use person centred family therapy. Different selves may develop
due to contradictory introjects being held which can’t or won’t be synthesised.
Configurations allow contradictory positions to be held and
for a schema to construct around them,
Two central themes of configurations are self-protection and
self-expression
There is the existential processes a client has, this would
be the real me, what they consider the heart of themselves. Then there is the
presentational layer, the configurations and process that they present to the
world and sometimes also to themselves.
Chapter 3 The counsellors use of self
Avoid barriers to intimacy:
1.
Being the expert
2.
Using technique
3.
Using theory
Involvement, Intimacy and
emotional risk are the three aspects a counsellor needs.
A counsellor believes in the deep
wisdom and potential of their client and their work is to connect them with it.
However this will be groundless if they do not regard their own being in the
same light. Likewise they can’t offer
the core conditions unless they offer them to themselves, so looking at
yourself with unconditional positive regard, with empathy and congruence.
The world is full of helpers who
do this as a strategy to avoid confronting themselves. Helping is on the basis
of subordinating your needs to the others, and therefore leads to a sense of
martyrdom. The person centred therapist needs to accept and affirm themselves.
Self-acceptance is fostered on
the basis of time, attention and care.
There can be guilt fostered by a
failure to live up to the rules of others, i.e. the conditions of worth. Then
there can be the guilt you feel for a failure to live up to your own values,
your own purpose for existence.
Empathy is powered by imagination
You need the core conditions in
your life as much as in therapy
Congruence, genuineness is more
difficult with unpleasant feelings
A Person centred counsellor is
not responsible for their client but responsible to him to create a relationship
where they can explore their concerns. A
PCC doesn’t know what is good for their client.
Whilst a PCC counsellor doesn’t manipulate a client to ensure
progress, so a ~PCC therapist allows themselves to be manipulated by their
clients. PCC have a basic trust in human nature to seek the truth and constructive
social interaction. PCCs believe that a client, is given the circumstances
going their best to grow and to care for themselves. This ties up with the ~PCC
not trying to catch out the client, with their motives
A PCC therapist will fight for the relationship with their
client through thick and thin. This is a good antidote to people who expect
rejection and fickleness in relationship who have attachment difficulties.
Acceptance
I can act against my values or interests and I can understand
this without punishing myself
I can fail to have my desires fulfilled (e.g. client to
recovery) without considering this is a deficit in me that needs to be remedied
by hard work. In other words I \things would be ok if only I changed myself.
Finishing therapy when it is
right is important, letting go, changing things, not staying on because, not
feeling trapped, not continuing resentfully.
The experience of relational Depth
We present ourselves in different ways depending on the
context. A lot of psychological wisdom is about analysing these presentational
selves. In counselling as the counsellor doesn’t ask for reciprocal attention,
then the hope is that the more existential self, the non-presentational self is
shown, Sometimes in therapy the client gives the presentation of themselves
that they think is acceptable. The PCC therapist wants to create a safe enough
relationship for the client to dare to relate in new ways, to relate in their
existential self. The aim is for relational depth, a state where each is fully
real with the other and in full contact. In other words a reciprocal I’m ok you’re
ok.
Aim to work with the client where they don’t feel they have
to put on any mask to be with you, or more strictly the greater ranger of their
possible expression is allowed.
Chapter 4 Empathy
Empathy is the process of understanding the client’s world
from their perspective, it is not a singular intervention where you can show
empathy. The more you take their frame of reference the more that you can
engage intimately with what they are saying and why they are saying it. This
means that you can see when there is a gap between what they are saying and
what they are meaning. Or what they overtly feel and what is closer to
themselves. So empathy can be both to understand the clients current frame of
reference, and when it is working really well, then it can step slightly past
it, so can predict see omissions, etc. Ideally you want to reflect back to the client
the things that are just out of their awareness, not so much so that it is
overwhelming but enough to be stimulating and attractive.
Internal locus of evaluation: I evaluate myself and the
world: I say what’s right for me
External locus of evaluation: Others evaluate myself and the
world: Other say what’s right for me.
There is evidence for the significance of empathy.
Why is this?
1.
As a counsellor struggles to understand the
other they value their perspective.
2.
You can see the unspoken, unfelt, the things
just outside the frame of reference.
3.
As you focus on understanding their perspective,
so the client focusses more on their perspective and their understanding
increases
4.
As a therapist has empathy for the client, the
client tends to present even deeper things to the therapist.
Handle words a la Gendlin, can be very useful in empathy.
These being the words that represent the felt sense of something, the handle
may be an image or a phrase or a word.
This is the felt sense of a something, it encapsulates a whole thing, it’s
the nexus for a certain way of being or problem. When you get a felt sense then there is often
a release of tension. You may see this by a big sigh, or a spoken release of
tension. If something doesn’t fit then this can be experienced as sudden tension
or just a sense of wrongness.
Pre therapy work is for people with severed communication
problems, it is done by concrete empathy. This can also be used by therapists
when their client becomes stuck.
It is easier to stay in your frame of reference with the
client and pronounce rather than work from their frame of reference.
The more a therapist is sensitive to their own lives, their
emotions and thoughts and behaviours, by therapy, then the more empathic they
can be to their client.
Blocks to empathy
The biggest block to empathy is the therapist’s theories of
human behaviour. Theories cannot predict
the behaviour of an individual. In the
same way personal expectations of how someone should behave can also get in the
way of experiencing the client.
False empathy is where you know what your client’s situation
would feel like for you.
Blocks to empathy
Troubled people can’t empathise. Sympathy or antipathy to
clients can be blocks to empathy as can the need to see improvement each
session. If the counsellor has needs to be liked or needed by the client again
that can block empathy. It is harder to have empathy or listen to someone you
are involved with as their change can affect you. Empathic sensitivity is
giving a mirror to your client. When the therapist is troubled they can become self-protective
which can reduce empathy as they close themselves, it is an art to be troubled
and not self-protective.
Empathising with different parts of the client
Clients can have conflicting parts, some parts of them might
be suicidal. But still empathise with both sides, with the conflict. The
responsibility to empathise is to the whole person and not just to the loudest
voice.
Chapter 5 Unconditional Positive Regard
This is manifest within the therapist’s acceptance and
warmth to their client. The client is viewed as a person of worth even if their
behaviour is not that that the therapist values. A clients behaviours is one
part of their being, a client’s behaviour is the outcome of their experience, a
client was a baby once.
Why is Unconditional positive regard so important?
It’s an antidote to conditions of worth and breaks into the
cycle of I have no value=> I act in a self-protective manner=> I push
people away and confirm I have no value
Personal Languages
The particular way in which an individual protects his
vulnerability is just one aspect of his personal language. The best way that
you can work with people is assume everyone is from a foreign country whose
language you don’t speak, and you need to learn it, so look to establish their
meanings over time.
But what do I do when I don’t accept my client
·
Focus on empathising
·
Ask yourself what you don’t know about this
client
·
focus on the therapeutic relationship
o
When I consider my client what sensations do I
get
o
What are their beautiful bits
o
What do I experience when I focus on that
o
What does he need most from me
o
What do I most want to give him
o
Who am I in our relationship
Focus on warmth
Simply feeling accepting towards the client is not enough
this has to be communicated
Focus on Conditionality
Most liking in everyday relationships is conditional. Liking
can be increased according to certain rules. Indeed this applies to self like
as well. How do you accept your client
if you client breaks your values, is your acceptance conditional? How easy is
it to give Unconditional Positive Regard to a client who has different values
to the institution you see them in?
Unconditional positive regard is not about being nice
Unconditional positive regard is about being genuine and
valuing the person and how they attempt to make the best for themselves, you
can understand them, value them.
Chapter 6 Congruence
Rogers towards the end of his life thought congruence is the
most important quality in a therapist. This means that therapists will be
different in how they operate and how they are effective. Therapists deemed to
be professional can operate to professional mannerisms, this is standardly
incongruent. If we are client suffers
from not being congruent, how can they possibly achieve it, if there therapist
isn’t.
Children learn certain emotions e.g. sadness aren’t approved
of, so they change them into something that is, e.g. Anger. Being incongruent in our society
allows us to play certain roles with each other, to have a smooth interaction,
even when there might be something else going on for us.
UNCONDITIONAL POSITIVE REGARD=Attitude
Empathy=Process
Congruence=state of being, when outward responses match
inner responses
Pretence is when your outside doesn’t match your inside as
you don’t like your inner experience. Defence is when your outside doesn’t
match your inside and you think the other person doesn’t like your inner
experience. Pretence is more playful and imaginative, defence is more
aggressive. Pretend can also include trying to show yourself as a certain
something, e.g. clever or strong. Showing as, is trying to tell the other
person that you are a certain type of person, when in reality your are both
this at times and its opposite, Any definition of yourself as I am an...Is a
pretence.
Congruence can be difficult with therapists around their
needs and their fears. So fearing I’m incompetent, would mean I may pretend to
be clever. Needing to be liked I may pretend to be caring.
Congruence=transparency=genuineness=authenticity
Of course congruence does presuppose there is a real
objective human experience. I guess it would need to be objectively dictated.
But then again it does seem on a continuum, when with self-awareness you know
what you feel inside and you can judge how you behave accordingly.
Congruence defined in this book, is both the awareness of
inner experience and the willingness to communicate this.
Why is congruence important
Develops trust, as if a client asks a question, they know
they will get a straight answer. Mystery evokes a sense of power, transparency
reduces it. There is a call with interventions to show your workings.
With congruence you can, if you don’t express it, “stamp
collect”, then let it all out at once as a vent.
Therapists will get it wrong, Sometimes direct
misunderstand, mis presume, sometimes it’s their own lives that get in the way.
Resonance
Resonance=echo in the therapist of the clients world
Self-resonance
Therapist’s private experience, thoughts, emotions,
memories, etc. triggered by the client
Empathic resonance
Picking up the sense of the client and what it’s like for
them. There are different forms of expressed empathic resonance, one is accurate,
where you reflect, one is complementary when you extend
Personal resonance
So this is resonance within the relationship that you have
with your client, a here and now thing
Met communication
Within a relationship there is the spoken and the unspoken
element and there is usually more of the latter.
Clients can have a strongly externalised locus of control,
so look for very subtle signs of indication where they think the therapists
wants the relationship to go
Incongruence
Incongruence is often not an obvious thing but a creeping
thing that changes the relational dynamic. Incongruence can be seen when the
therapist says one thing but means another. Incongruence can either be because
you are unaware of your feelings, or that you are aware but choose not to say.
Guidelines for congruence
For a therapist to come out with all their private
experiences would mean the sessions were about them and not their client
3 Guidelines
1.
Congruence is only relevant when it is a genuine
response to a clients presentation
2.
Congruence must be relevant to a clients
concerns
3.
You should only express congruence for those things
which are persistent or striking
How can the therapist learn congruence
As the therapist learns to trust themselves they distinguish
their private experiences that are empathic, and congruent, and those that come
from their own needs and fears.
The Three conditions in combination
Unconditional positive regard, empathy and congruence equals
relational depth. Empathy is Unconditional positive regard as if I fully appreciate
the client and why they might choose the way they do, it can only be that I
value them as looking after themselves in some way.
Unconditional positive regard and congruence go together as
if you value and accept the client you will feel free to be congruent.
Chapter 7 Beginnings
The Power Game
The Person Centred Therapist seeks to share power and
authority with their client as much as possible. How do you receive the client
with an open mind, when you have information prior to meeting them? To do this
you need to distil fact from opinion.
The Person Centred Therapist aims in all their communication
with clients, i.e. phone, web, session to convey warmth not authority.
An unhurried session can give relaxation and space to
breathe. Person Centred Therapist opening statement: we have 50mins how can I
be of help?
For the Person Centred Therapist it is vital show a sense of
equality with the client, to engage with them as someone who is capable of
dealing with the things they bring in therapy as much as you are. Task of Person
Centred Therapist is to help the client get clearer about themselves and their
life.
The level of trust between client and Person Centred
Therapist determines what work can take place.
Small talk aims to put people at ease but can heighten anxiety.
5 Elements of non-readiness for counselling
1.
No responsibility for problem: it’s their fault
2.
No responsibility for counselling: you need to
fix me
3.
High cost of change, I don’t want to change if
it upsets me
4.
Not trusting when people try to help that it can
be of help
5.
Unwillingness to look at bad feelings
A client in crisis [needs above all to know their feelings
are received and understood, i.e. empathy. The greater the empathy, the greater
the trust. There is however levels of engagement if you engage with too much
intimacy too soon, then a client may recoil.
When clients reject themselves, are self-critical probably
as a result of having experience this from others, then UPR is a positive
antidote.
Disguises and clues
The inner world of humans is a sanctuary and is only granted
admission after much deliberation.
A client does not know if their inner world will be handled
by the Person Centred Therapist appropriately. One strategy they have for
managing this is to use disguises. So when you get ambiguous messages humour
and seriousness this might be a disguise for something important.
Sometimes messages may be diluted, they give a clue to what’s
significant but don’t state it. Both dilution and disguise offer escape routes
so inner sensitivities aren’t exposed and leave the client feeling vulnerable.
Again clues can be offered in body language, or changes of
tone, long pauses glances and the like.
The end of the beginning
The beginning ends when there is trust, such that the client
can explore at the edge of their awareness or in the sanctum of their awareness
with their PERSON CENTRED THERAPIST.
If there is trust without relational depth then this trust
may well be based on a projection, or a childlike acceptance of the
trustworthiness of authorities. The relationship is thoroughly adult-adult.
Sometimes clients can tell their story quickly as it gives
no time to stop and reflect and feel. It also gives the Person Centred
Therapist no time to engage with it, which could be a defensive aspect, this is
a sensitive story I can’t have anyone ride rough shod over it.
Chapter 8 Middles
If stuckness exists in therapy, if it’s in the relationship
or the Person Centred Therapist then there is a problem, if it’s in the client
then its fine, as they can get a sense of themselves in this. Person Centred
Therapist stuckness would be an outcome of withholding yourself. Presumably
stuckness in the relationship is when you need to go somewhere but you fear it.
If a Person Centred Therapist realises something between sessions, he would
wait to see if within session it is relevant, and only then introduce it.
Accepting someone in their stuckness, exploring stuckness,
can intensify feeling that can be the precursor to coming out of it.
It can sometimes be helpful to understand a person as a
configuration, made up of separate parts. This allows focussing on an
experience that “belongs” to a certain part.
The development of the therapeutic relationship.
Some people are suspicious of relational depth and guard
against it, intimacy may be seen as something to be guarded against.
Client process
Person centred therapy aims to free the natural healing process
within the client.
Person Centred Therapist Process
Aim to have relational depth with all clients, watershed
moment when there is movement from self-criticism to self-curiosity and
acceptance. Vilification leads to avoidance and a defensive attitude, so you can’t
learn, and won’t expose yourself as it hurts.
Chapter 9 Endings
The aim as I see if of person centred therapy is to get the
client to accept themselves and to provide a mirror to their lives to aid in
understanding.
When you see the ending coming ask if there is any
unfinished business for the client, for you, for the relationship. This will be
the final intervention.
The end
