|
Paper Psychotherapy |
|
Peter F. Schmid
The
necessary and sufficient conditions of being person-centered” |
Semiplenary paper given at the
Vth ICCCEP, Chicago, June 24, 2000
(c) 2000 by Peter F. Schmid
revised
version printed in:
Watson, Jeanne C. / Goldmann, Rhonda N. / Warner,
Margaret S. (Eds.),
Client-centered and experiential psychotherapy
in the 21st century: Advances in theory,
research and practice
Ross-on-Wye (PCCS) 2002, 36-51
Overview, contents
Abstract, keywords
Paper
Endnotes
References
Review
Overview
•
Being addressed to respond and response–ability:
The foundations of person–centered acting establish an ethical position
•
The human being as a person:
From knowledge to acknowledgment in psychotherapy
•
The
relation person to person as encounter:
From
diagnosis and abstinence to im–media–te presence
Abstract
A
wide variety of persons, associations and methods call themselves person- or
client-centered. Is it possible to define what it really means to be
person-centered? Or is it a („postmodern“) question of what you like and
what you believe? Where are the limits? Is it possible to indicate a core? And
if so, what is it? Is everybody person-centered who claims to be or are just
those who repeat what Carl Rogers already said? Is the experiential approach
developing the paradigm or is it an aberration? Is it possible to combine
orientations, to integrate methods and add techniques? Is there actually a „Beyond
Carl Rogers“? Or is an exegesis of his “holy scriptures” what it is all
about? What are the prospects of the development and influence of what once was
regarded a radical paradigm? And, last but not least: Is a person-centered world
association endangering the integrity and genuineness of the approach?
A
clear stance is hold that it is indeed possible to name the necessary and
sufficient conditions of being person-centered. The subject is discussed
from an anthropological, epistemological, technical and political perspective.
Furthermore, naming the “core conditions” of a person-centered
point of view has tremendous practical consequences. And the question of
being person-centered ultimately turns out to be an ethical one.
Keywords
Foundations of PCT and PCA, ethics, anthropology, epistemology, theory of personality, theory of therapy, theory development, World Association, core conditions, person, encounter, sub-orientations, compatibility, methods.
Ladies and gentlemen, dear colleagues!
First of all I have to apologize that I have to read this paper. English is not my mother tongue and I regret very much that I cannot express myself as differentiatedly in this language as I am used to do in my own and that I cannot speak without notes. Secondly I want to thank for the honor of being offered to speak to such a large and outstanding audience.
I am also aware that I am here somewhat in the lion’s den with the subject I’ve chosen. But where else should these questions be discussed if not at the place of their origin.
A variety of persons, institutes and associations and methods or even techniques call and consider themselves as person–centered. Thus the question arises: Is it possible to define what person–centered really means? Or is it a question of personal belief and of what you like? Are there any limits? Is it possible to name central and crucial points? And if so, what are they?
Is everybody person–centered who claims to be? Or only those who repeat what Carl Rogers already voiced. Are the various directions which evolved, e.g. focusing or experiential psychotherapy, a development of the approach or a deviation? Are they suborientations of a general paradigm or are they betraying the original intention and radical paradigm shift? Can one combine orientations, integrate methods and add techniques? Is there something like a „Beyond Carl Rogers?” Or is an exegesis of his „holy scriptures” what it is all about?
Is it inadmissible orthodoxy or even fundamentalism to look for the „core conditions of the approach”? Or even worse: Is only to raise the question evidence enough to prove one’s rigidity? Does one have to reckon with being accused of offending the principles of openness, individuality, democracy, development etc. if such questions are raised? And on the other hand: Is it pure eclecticism and a lack of a clear point of view violating the integrity of the therapeutic relationship offered and incompatible with the image of the human being to integrate ideas and methods from other schools? Isn’t it even necessary e. g. to supplement systemic ideas in order to keep the approach up to date?
These and many more questions are often raised and heavily discussed. Some of the so called „Carl sayers” are accused to play the role of moral guards, others are blamed for destroying the original power of the approach for the sake of appreciation by fashion–oriented tendencies in order to increase their reputation or income or recognition by health insurance companies or even worse: the zeitgeist.
Some of these questions also came up in the course of the building of the World Association: How broad should it be? Who should be invited for membership? Is such an association endangering the integrity and genuineness of the approach? Is the idea of an association person-centered at all? Is it finally the grave for the paradigm because it would mix up too many different approaches? Will it serve as a means to those who want to use the name „person-centered” in order to promote their own ideas? Or will it be a necessary way to give more p. r. and public interest to a paradigm which no longer is as strong and influential as it used to be?
As told before, I am aware that it is of high risk to deal with these issues and that it is not very likely that you make a lot of friends by doing so. But I am convinced that it may be worse to avoid a clear discussion. And I think Chicago is the right place to consider the essentials.
Thus I will try, from my personal point of view, to name some ideas relating to these questions — not from a pragmatic or a superficial point of view, but in principle and from a fundamental point of view. For the first time I here publicly present my view of a foundation of person–centered therapy and of the person–centered approach in general as rooted in ethics and the consequences of this as far as to the possibility and meaningfulness of cooperation in a worldwide person–centered association — ethics as the foundations and not as a consequence of anthropology or practice. I hope it will stimulate exchange and I am looking forward to hearing your opinions on the matter and to discussing it.
Obviously Carl Rogers was fully aware of what he was claiming in stating the hypotheses of the „necessary and sufficient conditions of therapeutic personality change” in 1957. This is the impression the reader gets, when he or she takes a look at the carefully written article in which each word is weighed precisely.
Today almost nobody doubts that these conditions, especially the so called core conditions, are necessary. But the whole point — and after half a century the still revolutionary crux of the matter — is the statement that they are sufficient. Rogers emphasized this from the very beginning and kept the conviction, which he himself called „rigorous” (1959a) for his whole lifetime (Rogers/Heppner/Rogers, M./Lee 1984).
The „formula”, although emphasizing that its assertions are a meta–theory applying to psychotherapy in general not to client–centered therapy only, is the fundament for everything which may justly call itself person–centered, historically as well as theoretically and systematically. In its nucleus this statement comprises everything which is essential for person–centered theory, at least implicitly.
The article also expresses the ideas which do not fit into the theory. In his provocative statement Carl Rogers (1957a, 178–181) specifies a number of ideas and practices which on the basis of the hypothesis formulated prove to be not necessary for psychotherapy. As „significant omissions” he gives e.g. client typologies in order to offer different conditions to different groups of clients or psychological diagnosis as a precondition for therapy or the idea psychotherapy could be essentially different from personal relationships in everyday life or therapy training might be something especially related to intellectual qualities instead of experience.
Many implications of this theory were only later elaborated by Rogers and others. And as a parallel to explicating more and more precisely the anthropological foundations (e. g. Schmid 1991; 1994; 1996) the practice of the theory was also developed further (cf. Farber/Brink/Raskin 1996).
This is no coincidence. It is conspicuous that in Rogers’ basic statement almost nothing is said about the practical therapeutic procedure and the behavior of the therapist. Rogers did not formulate instructions how to act. Of course, there is the principle of non–directivity in this claim, of course, there is an underlying image of the human being which includes some and excludes other ways of acting, but on the whole the statement is a set of principles formulated on a quite abstract level. Concrete action which derives from it and the according theory of acting is left open.
The conditions e.g. do say nothing about how communication between therapist and client should take place. To give an example: verbal communication is not preferred to other ways of interacting, e.g. with the body or by playing or by artistic means. Later Rogers (1975j; 1970a) stated that a variety of personal techniques are compatible with the basic attitudes.
Thus there is a wide room for genuine person–centered work. But this does not mean that whatever someone does is person–centered as long as he or she calls it “person–centered” or as long as he or she is convinced of being person–centered.
Being
addressed to respond and response–ability:
The foundations of person–centered acting establish an ethical position
Rogers elaborated his approach out of his experiences in relationships. His theory is drawn out of phenomenology and is formulated close to experience. Also in later refinements it stays near to experience. What Rogers observed in therapies and where he drew his hypotheses from were no indifferent data but „facts” out of experience, out of being touched and moved personally. They imply a distinct value judgment.
Already doing psychotherapy at all and to reflect this theoretically derives from the decision to respond to the misery, to the grief, to the life of another person, to share one’s joys and sorrows. It derives from being addressed by the other, from being touched, from being asked, being called, from being appealed to, from a demand. This means that psychotherapy is responding, is answering to a demand. (In German: Psychotherapeutisches Handeln entsteht aus dem Angesprochen–Werden, und gründet daher in einem An–Spruch.) Thus it has its origin in the other who – in the sense of encounter philosophy – is an Other on principle.
It sees him or her as a call and a provocation. In doing so the fellow being is the one strange to me, who surprises me, and who I find myself opposed to, who I have to face — neither monopolizing nor rejecting him or her — face to face. The presence of the Other which always „comes first“ is a call for a respond which I cannot escape because nobody can respond in my place. We are obliged and responsible to the Other and owe him an answer. This causes a „priority“ of the Other. From that follows a new — non–individualistic — understanding of self–realization as realization in and out of the relations, in which the individual lives — which is never possible without the realization of the Other.
The point is: Especially starting from a phenomenological consideration, as Carl Rogers did — and not out of morals! — psychotherapy must be regarded as an ethical phenomenon.
Taking a closer look at the core of person–centered theory, i.e. Rogers’ statement in 1957, you’ll find out that the ethical foundation is already included here: Psychotherapy means responding to incongruence, to a vulnerable or anxious person. Even more: If these six conditions are necessary and sufficient for a constructive development of the person by means of psychotherapy, then it is an obligation for the therapist to take them into account (contact, client’s incongruence, communication of therapist’s attitudes) or to offer them respectively (congruence, unconditional positive regard, empathy).
The therapist is seen as somebody responding to the needs of another person and therefore responsible, responsible in the communication. (In German: Der Therapeut ist ein auf die Not Antwortender und daher Ver–Antwort–licher in einer Kommunikation.) In a word: Psychotherapy is ethically founded. (And please don’t misunderstand this in a moralistical way.)
The philosophical basis — ethics denotes moral philosophy, not casuistry or moralizing — the philosophical basis for this understanding of psychotherapy can among others be found, very well developed, in the thinking of the Lithuanian encounter philosopher Emmanuel Levinas (1905–1995), what I have pointed out and described in detail earlier (Schmid 1994; 1998a; 1998b; 1998c). Even more radical than Buber, Levinas (1983; 1987; 1992) describes the interconnectedness of the person, because his thinking really begins with the Other. The starting point of his anthropology is the absolute being different, the otherness of the Other: According to Levinas the fundament of self consciousness is not the reflection (of the I through the Thou) but the experience of relationship, which — think of developmental psychology, e.g., of the child, „conceived” and born into relations! — which always comes first and has its origin in the Other. This marks a shift from the „I–Thou”–relationship to a „Thou–I”–relationship (and thus managing to get closer to the verge of the „We“). The Other is here beforehand. Thus a fellow being is no longer degraded as an alter ego but truly respected as an other one, an absolute different person, an enigma: „Encountering a human being means being kept awake by an enigma“ states Lévinas (1959, 120). For the Other he uses the metaphor of „visage” which reminds of the origin of the term person (coming from the Greek „prosopon” and meaning „face”). This face addresses us, speaks to us, even demands and his needs challenge us. Thus response–abilty is the basic category of being a person: Out of encounter rises the obligation to respond.
Accordingly, psychotherapy means engaged and solidary service to the fellow person. The suffering person demands. This corresponds with the duty of response–ability. The commitment towards the Other — here I want to point to the commitment–concept of my colleagues Ute Binder and her husband Johannes (1981, 179–274), which deserves more attention and appreciation — means a responsibility which originates in the basic dependency of the human being on his fellow beings.
Levinas, professor at the Sorbonne in Paris who lost his whole family in the holocaust, a thinker of tremendous importance who has hardly been discovered for the person–centered approach yet, again and again points out that all of the occidental philosophy (and this also applies for psychology as its „daughter“ and psychotherapy as its „grand–daughter“) including its so–called humanistic orientation in the 20th century has remained „egology“. And, indeed, this fixation on the I is clearly predominant in the terminology of the numerous self–terms in Humanistic Psychology and despite all positioning against an objectivation and instrumentalization it finally indicates a reduction of the Other, of what the Other means to me. In this connection even a well–known sentence by Martin Buber (1923, 18) like „I become through the Thou“ all of a sudden sounds quite differently: even here, as is to be suspected, everything is still focused on me. This, however, presents the ideals of the humanistic movement as such in a new light. And according to Levinas the following applies: „What once seemed to be a distinctive human quality, the absolute desire to determine and realize oneself, „self–determination“ and „self–realization“, has proved the reason of violence against the other human being. Not the enforcement of the ego’s objectives must become the basis [...] but the perception of the other. This is an ethical relation.“ (Waldschütz 1993)
In this perspective psychotherapy (and all psychosocial, pedagogic, political, pastoral etc. acting) receives a socio–ethical dimension leading from the categories „response“ and „responsibility“ to a new understanding of self–realization which can only become reality in what Levinas called „diakonia [diakony]“ — a term with the same meaning as „therapy“, i.e. „service“. In the interpersonal encounter, which we call therapy, addressed and asked to respond, we assume a deep responsibility, an obligation in which our fellow man expects us to render the service we owe to each other. By responding we only fulfil our duty. What we owe each other is nothing else but love. Thus, encounter in dialogue turns out to be a condition for self–consciousness, to be an in–finity, a common transcendence of the (totalitarian) status quo („Totalité et infini” is the title of his major work), to be a start without return: Abraham, who starts his journey to an unknown country without return, and not Ulysses, who at the end returns to his starting point, is to be seen as the symbolic character.
While Buber starts to explore the question of what man is by understanding him as the dialogical nature of being–two and thus relatively contained, Levinas pushes on: from the Other to the Others. I and the Other, my fellow–man, are not an isolated entity, there is also „the Third One“, who himself is a fellow–man; there are the Others. Therefore how to act is no longer obvious, and among others the question of justice and the necessity of judgement arise. A new understanding of We emerges: not anymore the We of the two of us, but rather of the three of us — where two — lovingly — include a third one in their community (as Richard of St. Victor’s term „condilectio” indicates). In such a way instead of duality, the pair, I and Thou, now the tri–unity turns out to be the foundation of interpersonality. Therefore duality does not exclude the Third One, but rather includes him, because it is predisposed to transcend itself towards the group.
The person–centered approach includes a number of ethic implications which definitely prepare for getting beyond „egology“. In doing so ethics cannot be deduced from anthropology but we have to realize that person–centered anthropology has always been ethics at first. Traditional ethics orients acting by principles which are deduced from philosophic ideas. However, a philosophy orienting itself by experience, as it undoubtedly corresponds to the person–centered approach, realizes from the experience in the encounter, which is taken seriously down to the roots, ethics as the first philosophy. Especially out of the personal experience of encounter — being addressed and thus encouraged by the Other — a legitimate claim to an answer and to acting in the kairos is derived — and this is what person–centered ethics as dialogical ethics is about.
There is no doubt that the paradigm shift of Levinas and Rogers — an understanding of the human being quite fundamentally focusing the other’s view — is to be seen as a parallel: the principal precedence of the Other corresponds with the client–centeredness of psychotherapy.
Above all it requires to understand psychotherapy from an ethical point of view. Therapy is giving response to a suffering human being’s cry for help, a response–ability rooting in fundamental ethics.
The
human being as a person:
from knowledge to acknowledgment in psychotherapy
Rogers’ article, published in 1957, implies two essential dimensions of an image of the human being: The first condition already deals with the interpersonal relation — Rogers himself said that he originally wanted to use the term „relation” instead of „psychological contact” but was afraid of academic recognition — and the five others define the characteristics of such a relation. All of them include that the human being has the possibility and tendency to develop in a constructive way on the basis of his or her resources, if a certain form of relationship is provided. In other words, the six conditions presuppose that a human being develops constructively out of his or her own, if he or she finds him– or herself in a facilitative relationship. Without hypothesizing an actualizing tendency, which rests on both, the individual resources and the ability of relating, the conditions two to six would make no sense.
With that exactly those two dialectic dimensions of being human are denoted, for which in the occidential history of theology and philosophy the term „person” was coined: Autonomy and interconnectedness (or relationality), independence and interdependence, self–reliance and commitment, sovereignty and solidarity. Whatever other motives might have been important to introduce the term „person–centered” — it is obvious and clear that this was done consciously and on purpose to denote an anthropology central for the „person”–centered approach.[1]
Thus the fundamental hypothesis of the actualizing tendency which Rogers consistently indicates to be the only axiom must be seen in the dialectical tension of these two dimensions. Seen from a historical perspective the focal point was on the individual aspect — this can be understood as necessary out of historical reasons, especially in rejecting the psychiatric, psychoanalytic and behavioristic model, and quite often led to the reproach of an individualistic approach, of being „typical US–American”. But the relational dimension was formulated from the very beginning (see the first condition in the 1957 statement about the principle of contact) and it was taken for granted in acting in a non–directive, client–centered way, even if its theoretical conzeptualization as encounter and its practical differentiation in multiple forms of acting was elaborated only in later periods of the development of the paradigm.
In his precise description of person–centered psychotherapy in the textbook by Koch (Rogers 1980b, Germ. p.187) Rogers explicitly puts these two dimensions at the beginning of his article.
In short: Person–centered psychotherapy is the practice of an image of the human being which understands the human being as a person and thus encounters him or her personally acknowledging him or her as the Other (in Rogers’ terms: with unconditional positive regard and empathy out of a congruent attitude or: in authentic presence out of a way of being with him or her) instead of objectifying him or her by trying to know him or her, to get knowledge over him or her.
The relation person to person as encounter:
From diagnosis and abstinence to im–media–te presence
This also means that an essential trust in the experiential world of the client and its centrality for psychotherapy is unrenounceable for a truly person–centered approach.
Such an approach quite fundamentally rules out any conception of oneself on part of the therapist or helper or teacher or social worker or pastoral worker etc. as an expert on the problems or on the person of the partner in counseling, therapy, education, supervision or any other helpful relation whatsoever. Such an approach also rules out that the therapist considers himself as an expert in the correct usage of methods and means, and even excludes any preconceived use of methods and techniques, a use which is not rooted in the immediate experience of the relationship. The only „means“ or „instrument“ employed is the person of the therapist him– or herself. And only where „any means has fallen apart“ encounter takes place, as Martin Buber (1923,19) stated unsurpassably and precisely also grasping the process of such a relationship.
Therefore the person–centered approach differs radically from all other approaches which in the meantime have all more or less found their way to the core conditions. However, these approaches consider Rogers’ conditions, attitudes and definitions only as preparatory design of relations meant to establish a certain climate or rapport, as obviously–human preconditions so to speak, upon which the actual therapeutic work still has to be constructed. From a person–centered stance the basic attitudes need no supplementation by specific methods reserved for the expert. „Expertism“, if it has to be described, lies exactly in the ability to resist the temptation of behaving like an expert (even against the client’s wishes) — that means, solving problems with the help of techniques rather than facing them as persons.
In Carl Rogers' words: To work as a person–centered therapist is not only „a way of being“, but „a way of being with“ — in German, according to Ludwig Binswanger e.g., we use the term „Miteinandersein“, not only „Mitsein“ to describe this philosophy of life.
The existential and im–media–te presence as understood by encounter philosophy, the personal being–with which leads to a togetherness means that, in his or her psychophysical presence, the person who offers a person–centered relation opens up to his partner(s) the possibility to concentrate on the fertile instant and thus on oneself and his or her relations. In the „kairos“ (which the very instant is called according to the Greek god of „the favorable opportunity“, who had to be seized by his mop of hair, when hurrying past — in the back he was close–cropped — in the German language we have the phrase „eine Gelegenheit beim Schopf packen“) — in the kairos it is important to take advantage of fallow potential and to seize the opportunity. A person–centered „way of being with“ is applied kairology.
In spite of all inflation the term „encounter“ in general and in the person–centered approach in special has undergone, it has to be stated that the essential element of encounter consists in the fact that the human being meets a reality which moves him or her deeply, which is counter him or her. Encounter is not simply an experience, it is an „experience counter“ which opposes the affected one. En–counter is an essentially different experience from what an idealistic and subjectivistic understanding of (solely intrinsic development) presupposes, from an understanding of development or fulfillment coming completely from itself. However, it is an alien, an Other, another reality, another person, which or who en–counters my reality, which or who encounters me. This makes up the existential dimension and unavoidability of an encounter.
Thus the person–centered relationship is to be regarded as a process providing room, valuing spontaneity and creativity, a process in which both client(s) and therapist(s) develop towards a personal encounter. Where the person of the therapist or/and of the client expose himself or herself to the given Other, he or she can enter in a dialogue — even more so, he or she is called to do so.
To sum it up: Ethics out of phenomenology and the anthropology and epistemology which evolve from it form a unity — a way of encountering the Other.
II.
The core:
the necessary and sufficient conditions of being person–centered
On this basis I now would like to formulate what I consider to be the essential points for being person–centered in psychotherapy (in one–on–one therapy as well as in group psychotherapy). (And one easily can translate this for other professional work.)
Ethics
It is unrenounceable that ethics is grounded in the experience of encounter. This means being addressed to respond by other persons in need and thus responding out of response–ability and solidarity — as stated before. This also characterizes person–centered acting, psychotherapy included, always as a political action, not only a private or individual way of acting.
Anthropology
It is unrenounceable that the image of the human being underlying the understanding of him or her in psychotherapy is based on the view of men and women as persons, denoting the dialectics of autonomy and interconnectedness — as stated before. This implies the centrality of the trust in the actualizing tendency as the motivational force which constructively can „work” in facilitative relationships. And it implies that the necessary and sufficient conditions for such relationships in psychotherapy described by Carl Rogers are crucial for this endeavor and that they are in no way to be understood as techniques or methods but as a way of being with the client by the person of the therapist — a way of being which can truly be called an encounter person to person. (Unless you take the original Greek notion of the term „method” [„meta hodos”], which incidentally means: „to be on the way with somebody, to follow somebody”, or the original meaning of „technique” [„techne” which means „art”]. In his or her presence the therapist takes the person as a whole as he or she is in his or her moment–by–moment process (including the becoming in the past and the possibilities of further developing in the future) without a specific intention for the other. (By the way this implies also to pay attention to the fact and to conceptualize that persons are men and women and are not neutral and therefore are different — an important fact for overcoming a one–sided male perspective, not only on specific gender issues but general in philosophy and psychotherapy — but this would be a separate subject.) To take the person as a whole also means not to solely concentrate on feelings or on verbal interaction but also give room and pay attention to the body and the spirit, to cognitions and ideas etc
Epistemology
It is unrenounceable that epistemology is based on empowerment — as stated before. The person–centered approach is committed to an epistemology oriented on phenomenology, a variety of possibilities to understand (thus it is constructivistic) and a variety of possibilities to approach (thus it is pluralistic), on the person as a whole (personal), and therefore is oriented on dialogical and empathic and hermeneutic communication („hermeneutic” in the broader sense of understanding the meaning of personal communications not in the meaning of interpreting them by an expert, pretending to know better what the author of a statement meant than the author himself — as the term „hermeneutic empathy” is used by some authors).
Theory of personality and developmental psychology
Psychotherapy is considered to be a special form of personality development and interpersonal relationship. Thus consequences can be drawn for other forms of relationship and fields of life. This corresponds to an approach which is oriented more on the process of the development of a so called „healthy” person and not on a personality theory arising from a theory of disease. The basic principles apply to all persons independently of categories like „neurotics”, „psychotics”, „borderliners” or „normals”. Instead of a theory of diseases or illness in the sense this is commonly used in psychotherapy only a theory of the suffering persons is consistent with the essentials, since the approach is person– and not problem– or goal– or solution–oriented.
Personality development brings about an increasing capability to fully live in the moment and to more and more be able to perceive both, phenomena and changes, less distortedly or selectively and to live relationships more realistically. (Person–centered theory is much more interested in processes than in structures.) This coincides with more self–determination and self–responsibility.
Also a genuine training, or better: education of psychotherapists — the German word „Ausbildung” is more exact, because it denotes the process of becoming —, consistent with the approach, is oriented on the development of the personality of the trainee and not on the training and practicing of skills.
Theory and practice of therapy
The therapist focuses on the inner world of the person of the client as it appears to the client and as it is experienced, understood and evaluated by him or her and follows him or her in this inner world wherever the client moves to. In this sense it is an experiential and phenomenological approach. The therapist is available for the client as a living person and not only in his or her function as a therapist. It is crucial for the development of both, client and therapist, that both direct their attention as free of judgments and interpretations as possible to the immediate present experiencing in the relationship. The attitudes of authenticity, unconditional acceptance and sensitive empathic understanding play a decisive role in this process. This implies a radical counterposition to expert–oriented approaches (in terms of the contents as well as the process) emphasizing that the person as such and not techniques, methods or skills are the changing factor. The therapist offers a way of being with the client making possible a process of communication and encounter which moves towards mutuality and dialogue.
Naming the „core conditions” of a person–centered point of view has tremendous practical consequences: On the basis of the stated convictions the concrete design, arrangement and setting of the therapy orientates and adjusts to the needs and possibilities of the client and the possibilities of the therapist. The therapeutic relationship can express itself in multiple ways, verbally, bodily, with the help of creative or artistic means and the like.
Research and development of theory
Philosophical reflections arising from therapeutic work are an important part of the development of psychotherapy, in the single case as well as in terms of psychotherapy as a whole. Continued research, including empirical studies, are necessary in order to improve the quality of and to further develop psychotherapy. Concerning the theory of science an adequate and thus independent understanding of science and research (replacing the traditional paradigms of medicine, natural science and research) including the persons engaged into the process is needed and still has to be developed. Theory has continuously to be revised according to experience and research (and not the other way round).
Practitioners, theoreticians and researchers are invited, even urged to find their own and independent ways on the basis of these convictions and attitudes which represent a philosophy of life, to experiment in a responsible way and to support each other. This points to a world–wide psychological, social, cultural, political and – first of all – ethical challenge which gives neither room to orthodoxy or fundamentalism, nor to an unreflected eclecticism or an attitude of „do what you like as long as you do it congruently” (in German: Beliebigkeit). The person–centered approach, beyond psychotherapy, is an attitude, a way of being in many fields of life and interpersonal work, which stands counter to many streams of the zeitgeist, e.g. those of efficiency which only think in categories how to eliminate problems as quickly, inexpensively and painlessly as possible.[2]
To come to an end.
It is obvious: There is not the way of acting in a person–centered manner. Rogers himself acted differently in the span of his lifetime and he encouraged others explicitly to find their own ways in therapy and practice (e.g. Rogers 1959a, 16). It is a wide range from Virginia Axline’s play therapy to the therapeutic implications in the work of Carl Rogers and his colleagues with large groups and to their intercultural activities towards the end of his life, from the early case studies to the late demonstration interviews, from counseling students to the clinical work with hospitalized, so called psychotic clients. And it is a wide range from Rogers’ work to the various theories and ways of doing practice today.
On the other hand not everything can be called person–centered, if the term should mean anything. Not only because somebody calls himself or herself a person–centered therapist regardless of the consistency with what he or she does with the person–centered image of the human being and the compatibility with person–centered principles. If the convictions or actions of somebody do not stand comparison with these principles, it is only fair to name them differently. This does not say anything about being better or worse. It just calls different things differently.
The image of the human being underlying person–centered acting can be clearly conceptualized. Thus a person–centered way of relating cannot be combined with other orientations in what way ever. It has distinct anthropological, epistemological, developmental psychological etc. positions including a theory of motivation of personality and relationship and a theory of the suffering person and his or her therapy. It coincides with certain views of theories of science and methodologies of research and does not coincide with others. But foremost, as I tried to show, it is an ethical position (Schmid 1988b; 1999a).
There is no proof that the theory and practice initiated by Rogers and others is right. There are other assumptions and they also have good arguments. The difference lies in the different ethical and philosophical basis and therefore leads to different consequences. It is of no use to have an argument about the image of the human being which always is a matter of belief, of „basic beliefs”. Thus it makes no sense to judge other approaches out of the person–centered theory set or to quarrel who is right. But it is of use to enter into dialogue and to be questioned in one’s own convictions (cf. Schmid 1998a, 115f; Slunecko 1996).
This is neither an orthodox–rigid or dogmatic or excluding but a clearing position aiming at mutual understanding. To distinguish is simply a matter of reason and honesty. To adhere to a position does not judge the efficiency, the correctness or the quality of the work of others. Respectfully and critically dealing with differences helps each approach to develop its own theory and practice.
Thus integrating other positions, adding methods, developing new points, combining approaches etc. is always a matter of compatibility of the basic beliefs — especially for ethical reasons, since the client has a right to be offered a responsible and consistent relationship.
• Approaches which are convinced that Rogers’ conditions are not sufficient, have to be complemented or modified, orientations which think there is evidence that the therapist should have a more or less guiding function, stimulating experience, influencing the process in a certain way or direction, making interventions in order to …, instruct the client, focus on certain aspects, levels, feelings, subjects or ways of proceeding, have intentions for the client,
• training programs who aim at teaching skills, giving tools to the trainee, a set of preconceived techniques to make use of, instruments to diagnose upon the other (instead of a common diagnostic process out of the relationship),
• differentiations of so called sub–orientations to be used with different clients or applied on groups of diseases, orientations which prefer one condition to the others, attitudes which stress either the substantial or the relational aspect of being and becoming a person more than the other, which prefer either the intra– or the interpersonal dimension of therapy
— all these positions may have good arguments but they are different from the approach which Carl Rogers and others called „person–centered”. From a person–centered point of view they often may appear to be a reduction to an aspect, what Garry Prouty (1999, 4) calls a „phenomenological reduction”, the reduction of the person to a part of it, the process, or the instrumentalization of the relationship, the intentional use of empathy or selective listening to certain aspects fostering them instead of the person as a whole. (But, as stated before, is does not make sense, to judge another point of view with other foundations.)
Naming the differences and working together
But they — or most of them at least — are closer to the “original” or “genuine” person–centered understanding than many others. Germain Lietaer (personal communication, June 19, 2000) is right: On a broader level it makes sense to distinct between psychodynamic, cognitive–behavioral, systemic orientations and our orientation which in this view can be summarized as “person–centered and experiential” and may include some other humanistic approaches. Their roots are in the theory of Carl Rogers and they derive from him.
I am convinced that it is necessary both, to work together and to clearly be aware and name the differences. Therefore, no doubt, such common conferences (like the ICCCEP, now PCE Conference) are of use. In terms of the World Association this seems to be crucial. An ongoing dialogue makes more sense than splitting up, it enriches instead of fostering ideas of excommunication and fantasies of purity and — not the least — it makes us stronger at a time when the approaches deserve co–operation in order to be influential in therapy, philosophy and health politics.
Person–oriented or goal–oriented — the ethical decision of the therapist
The decision for a certain therapy or a certain therapeutic acting is — that’s what I’ve tried to show — an ethical one as it is the decision for psychotherapy as such. After all it will not come as a surprise to you if I state that therapy understood as personal encounter is the realization of an ethical stance which holds the conviction of the kairotical empowerment of the client instead of the egological power of the therapist.
Carl Rogers gave such a decisive impulse and left us such a rich legacy that a concrete realization of a number of consequences is yet to come. The fundamental positions of Rogers are not at all out–dated — on the contrary they are not yet sounded out by far, in their radicalism, their profound humanism, and their critical potential.
The approach, claiming to be an overall philosophy of culture, is challenged to no less than increasingly understanding the conditio humana, the being human in general. (By the way, this needs to deal with ecological questions as well.)
Obviously a paradigm shift within the approach announces itself in all that. The person–centered approach may well face a turning–point of its self–understanding. If ethics and the underlying image of the human being are taken seriously it becomes obvious that the approach needs further development to a truly dialogical and social approach (also in psychotherapy), a creative, flexible and kairotical approach.
In respect to an ethically founded anthropology — the step from the individual to the person, from relation to encounter will be made as a step from the view of the person–centered relationship as an I–Thou–relationship to a view as a We–relationship as well and therefore finally towards a social therapy as well. Then the I will not only be found as a respond to a Thou, but the I will also be a respond to a We
Then the approach will consequently be seen as a social approach. Sociotherapy besides psychotherapy will be ranked highly in the frame of an overall therapeutic point of view implying the communities man lives in. Thus the political significance becomes obvious.
A dialogical understanding of therapy and group work, really carrying out the paradigm shift from treatment, caretaking and counseling to encounter, transcends models which concentrate on the individualistic self as well as models which exclusively concentrate on a simply systemic–oriented approach. As soon as this step is truly taken not the schools are the issue any more, but the issue is to really understand and practice therapy and group work as dialogue. Or expressed in a more provoking way: the person–centered approach must intend and aim at making itself superfluous just as a good therapist has to do.
In order to reach that goal a lot still has to be done.
If the approach is taken seriously as an “approach“ (and not as a ready–made doctrine), “not as a ‘school’ or dogma but as a set of tentative principles“, to quote Carl Rogers and John Wood (1974, Germ. 213), then it still is the emancipatory approach par excellence.
Almost half a century after Rogers’ revolutionary statement in 1957, at a time when goal– and method–oriented approaches of psychotherapy are booming, a genuine person–oriented conviction might be even more necessary. Even if in various orientations, e.g. in newer psychoanalytic or systemic schools, personal concepts and the real relationship in therapy gain a growing influence — undoubtedly an impact of person–centered therapy — the approach radically and solely centered on the person remains not caught up with.
To oppose the temptation of technification and one–sided orientation towards efficiency (which is a characteristic of our days) is an ethical challenge as well, one that might be more acute than ever.
Thank you.
Endnotes
[1] Only recently I was given a manuscript by Rogers from 1955 (!), in which Rogers already gives a process definition to the question he asked himself „What is a person?“: A „fluid process, potentiality, a continually changing constellation, configuration, matrix, of feelings, thoughts, sensations, behaviors. The structure of the process seems configurational, not additive. [...] Another way of stating this is that a person is a human process of becoming“; Rogers 1955h, 1). He goes on — in the following sequence: „The person as process seems to me most deeply revealed in a relationship of the most ultimate and complete acceptance; a real I–Thou relationship“ (ibd. 2) and „In my experience, the deepest contacts I have with persons reveal them, without exception, to be directional in process, and my experience of that direction is contained in such terms as positive, constructive, creative, toward autonomy, toward maturity, toward socialization, in the direction of growth, toward greater richness or differentiation.“ (Ibd.) Already here relationality and individuality can be found as the two characteristics of the person. — (More material can be found in Schmid 1994, 107).
[2] In short, person–centered therapy can be described as follows: It is a way of relating to other persons, be it one on one, be it in groups, which fosters personality development through personal encounter. It assumes that each person is given the capability and tendency to make use of his or her immense resources in a constructive way. A human being is able to live the own life and living together with others in a satisfying way by trying to understand him– or herself more and more accurate and opening up to the continuous flow of his or her experiencing with less and less defence. This tendency towards the actualisation of one’s own possibilities is encouraged and facilitated by an encounter person to person — a relationship whose quality is characterized by a respect for the individually being different of the client. The therapist is present to him or her in an authentic, congruent way, experiencing unconditional positive regard in a deeply empathic and non–judgmental way and both, client and therapist, develop their personalities together in this relationship (cf. Schmid 1999b).
The
World Association requires a commitment to the following principles:
• the primary importance of the relationship between client and therapist in
psychotherapy and counselling
• to hold as central to the therapeutic endeavor the client's actualizing
process and phenomenological world
• to embody in one’s work those conditions and attitudes conducive to
therapeutic movement first postulated by Carl Rogers
• to have a commitment to an understanding of both
clients and therapists as persons, who are at the same time individuals and in
relationship with others and their diverse environments and cultures
• to
have an openness to the development and elaboration of person-centered and
experiential theory in light of current and future practice and research.
References
see revised version in: Watson, Jeanne C. / Goldmann, Rhonda N. / Warner, Margaret S. (Eds.), Client-centered and experiential psychotherapy in the 21st century: Advances in theory, research and practice, Ross-on-Wye (PCCS) 2002, 36-51
Reviews
I read your ICCCEP paper and think it is
terrific.
What struck me in my memory at the ICCCEP conference, was that Peter, spiritual or not, is speaking as a client-centered therapist who springs from an ethical point of departure, as do I, while accepting and subsuming the actualizing tendency within his personal therapeutic framework. I deeply appreciated Peter's presentation at Chicago 2000, such that I felt a real fondness for him...
Kathy Moon, USA
A variety of papers search into and freshly
unfold ideas and issues, including the
contribution by Schmid, In centering on personal therapy and related thought, papers in this book mostly give little attention to the connective tissue of human life – beyond valuable, close attention to the therapy interaction and relationship. I was glad to see at least a few brief mentions (by Gaylin, van Kalmthout, Lovering and Proctor) of connection, social context and culture as influences to reckon with, and one colleague (Schmid) used the term sociotherapy. The reader might well suppose that ‘we’ view well-functioning persons as self-contained and autonomous beings. The book affirms me in the concern that we tend to decontextualise and treat the therapist-client microcosm as though it was a closed system, and that in honoring the self and fixing our sights so single-mindedly on the inside flow of each person we de-emphasize the essentially relational nature of human being. Few authors mention the community, cultural, organizational or other large-system contexts in the embrace of which we largely live our lives, and that are involved in the generation and maintenance of the difficulties clients come to us with – not to mention in our own motivation and stance as therapists. These ‘missing’ features worry me. Godfrey T. Barrett-Lennard, PCEP 2,1 (2003)
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The paper in Spanish: Preguntándose para responder. La posición ética y el reto de la terapia centrada en la persona y sus "condiciones necesarias y suficientes".
Chicago
2000: Vth International Conference on Client-Centered and Experiential
Psychotherapy (ICCCEP)
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