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Κύρια Person-Centred Therapy: The Focusing-Oriented Approach
Person-Centred Therapy: The Focusing-Oriented ApproachCampbell Purton (auth.)
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Person-Centred Therapy Person-Centred Therapy The Focusing-Oriented Approach CAMPBELL PURTON © Campbell Purton 2004 All rights reserved. No reproduction, copy or transmission of this publication may be made without written permission. No paragraph of this publication may be reproduced, copied or transmitted save with written permission or in accordance with the provisions of the Copyright, Designs and Patents Act 1988, or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1T 4LP. Any person who does any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages. The author has asserted his right to be identified as the author of this work in accordance with the Copyright, Designs and Patents Act 1988. First published 2004 by PALGRAVE MACMILLAN Houndmills, Basingstoke, Hampshire RG21 6XS and 175 Fifth Avenue, New York, N.Y. 10010 Companies and representatives throughout the world PALGRAVE MACMILLAN is the global academic imprint of the Palgrave Macmillan division of St. Martin's Press, LLC and of Palgrave Macmillan Ltd. Macmillan® is a registered trademark in the United States, United Kingdom and other countries. Palgrave is a registered trademark in the European Union and other countries. ISBN 978-0-333-96916-8 ISBN 978-0-230-21456-9 (eBook) DOI 10.1007/978-0-230-21456-9 This book is printed on paper suitable for recycling and made from fully managed and sustained forest sources. A catalogue record for this book is available from the British Library. A catalog record for this book is available from the Library of Congress. 10 13 9 12 8 7 11 10 6 09 5 08 4 3 07 06 2 05 1 04 For Val, Dinah and Tom Contents Acknowledgements viii Terminological Note x Introduction 1 1. Rogers and the Development of Person-Centred Therapy 11 2. Fault-Lines in Person-Centred Theory 31 3. The Origins of Focusing 54 4. Focusing as a Taught Procedure 82 5. Focusing-Oriented Psychotherapy 96 6. Objections: Issues of Principle and Empirical Issues 143 7. Training and Supervision 163 8. Towards a Theory of Psychotherapy 175 Conclusion 207 Appendix A: The Wider Context 210 Appendix B: Resources 236 References 237 Index 250 vii Acknowledgements I would like to thank Yoshihiko Morotomi for drawing my attention to the work of Fujio Tomoda. It was from that spark that my interest in focusing developed. Barbara McGavin was my first Focusing teacher, followed later by Rob Foxcroft. I owe much to both of them. My understanding of focusing has also been helped by attendance at Eugene Gendlin's 'Thinking at the Edge' workshop in New York, and by workshops run by Maarten Aalberse and Kevin McEvenue. I am grateful to Rose Battye, Paul Cassell, Ann Weiser Cornell, Sarah Hawtin, Dave Mearns, Judy Moore and two anonymous publishers' readers, who kindly read and commented on parts of, or drafts of, the book. They have helped to make the book better than it would otherwise have been. I would also like to thank my Palgrave editors Alison Caunt and Andrew McAleer for their patient support during the writing of the book. The 'Focusing and the Power of Philosophy' courses, on the Isle of Cumbrae, which I have taught with Rob Foxcroft, Barbara McGavin and Kye Nelson, helped a lot in clarifying my own understanding of Gendlin's thinking. I benefited from the opportunity to discuss parts of the book – over wine and cake – at the UEA Counselling Service 'Writing and Research Group'; also from teaching focusing on the UEA counselling diploma course. I have learned a lot from our trainees, and I have very much valued the support of my colleagues, Caroline Brown, Ian Draper, Judy Moore, Eamonn O'Mahony and Louise Young, on the course. My understanding of focusing has been helped greatly by my counselling clients; I hope that they have benefited as much from my involvement in focusing as I have from working with them. I am grateful to Brian Thorne, with whom I have worked for so many years, for his initial encouragement to write the book and for his continuing interest in it; to Muriel Frankl, who helped me see that focusing, in spite of its being a way of helping people find their own path, can get in the way of precisely that; to Mary Hendricks, indefatigable Director of the Focusing Institute, for all her help along the way; and to Gene Gendlin himself. Gendlin has not read this book, though we have had helpful email discussions about some of viii Acknowledgements ix the material. I am sure that in some places I will have unintentionally misrepresented his ideas, and I apologise to him in advance for that. I will have to leave it to the reader to assess how well I have done in this regard, after they have consulted Gendlin's own writings. I very much hope that readers will do this. My daughter Dinah (now working on a PhD on existential themes) and my son Tom (now completing a Masters degree in psychoanalysis) have helped to make me feel that it is all worthwhile. Finally, my thanks to Val, who shares with me the pains and pleasures of trying to write in spite of the pressures of our over-busy lives. Terminological Note I have for the most part chosen to use the pronouns 'they', 'them', 'their' and 'themself ' as singular forms in place of the gender-specific 'he', 'him', and 'his' and 'himself '. This is because I find that the consistent use of 'he or she', 'him or her' and so on often leads to impossibly contorted sentences (how, for example, could one live with such a rendering of 'He himself might feel that he would like his work to be more congenial to him'?). 'S/he' is unpronounceable, and the device of alternating the use of feminine and masculine pronouns runs into difficulties in contexts where gender-specific pronouns are required, and the distinction between a gender-specific 'him' and a gender-neutral 'him' is lost. There can be awkwardnesses in the singular use of the grammatically plural forms; for example, I have preferred forms such as 'while they themself think' to the grammatically correct 'while they themselves think' (though my word-processor keeps 'correcting' this); however, I find I can live with these awkwardnesses more comfortably than with any of the alternative ways around the problem. Singular uses of grammatical plurals are not unknown, although some readers may echo Queen Victoria's apocryphal 'We are not amused'. x Introduction Person-centred therapy occupies a unique position within the wide range of psychological therapies available today. Just what its uniqueness consists in is one thing which I hope to show in the course of this book, through an exploration of the work of Carl Rogers' close colleague Eugene Gendlin. I hope that the book will be of interest to counsellors, trainees, and anyone who is involved in person-centred therapy, or who is interested in looking at the ideas of Carl Rogers in a new way. Rogers himself always saw theories – including his own – as tentative constructions which were liable to modification in the light of further experience. Gendlin's work can be seen as one way in which Rogers' ideas can be carried forward. However, although Gendlin's approach grew out of his work with Rogers, it is deeply relevant to any form of counselling or psychotherapy. It provides a way of thinking about therapy which should be of interest to those who see themselves as working in 'eclectic' or 'integrationist' ways because it provides a plausible view of how such a way of working can avoid being superficial or incoherent. I hope also that the book will be of interest to people who are primarily interested in Gendlin's well-known 'Focusing' procedure, but who have not yet fully appreciated the richness of thought which lies behind the procedure. Finally, I hope the book will be of interest to anyone who would like to glimpse a genuinely novel way of approaching a range of issues which lie at the borders of psychotherapy – issues involving ethics, creativity, spirituality, and the relationship of psychotherapy to science and contemporary culture. My aim is to take Carl Rogers' 'person-centred therapy' and to view it from the perspective developed by Gendlin. Gendlin's work is less known than that of Rogers, but I hope to show that it provides 1 2 Person-Centred Therapy a solid, and much-needed, grounding for the practice of personcentred therapy. Although Gendlin's perspective does not entail radical changes in person-centred practice, it does present that practice in a new light. It also suggests a new way of seeing the relationships between the various 'schools' of therapy, and explains the remarkably persistent research finding that the practices of all the schools are equally effective. Person-centred therapy centres the therapeutic work on the individual client in a way which is quite distinctive but not entirely easy to articulate. Carl Rogers initially characterised the form of therapy which he was developing as 'non-directive'. This term catches the idea that in this form of therapy the therapist's task is not to direct the client towards ends which the therapist sees as good or fulfilling, but to facilitate the client's efforts to determine their own goals, based on their own experiencing. Nor is it the therapist's task to direct the client along a path which the therapist sees as likely to lead to the client's goals, but to facilitate the client's movement along their own chosen path. Further, the task of the therapist is not to provide the client with ways of thinking about their situation, but to facilitate the development of the client's own ways of thinking about that situation. These were revolutionary ideas when Rogers formulated them, and while there are many quarters in which they have still not been absorbed, there can be little doubt that Rogers' influence has been pervasive. 'Person-centred therapy' has, for many years, been one of the major approaches to counselling and psychotherapy in Britain. In the United States it is no longer prominent under that name, but the fourth edition of the American Handbook of Psychotherapy and Behaviour Change (Bergin and Garfield, 1996) now accords 'experiential psychotherapy' – that is, those forms of therapy which take 'the client's ongoing awareness of his or her own experience as the primary datum for therapy' (p. 509) – the status of a 'major approach', along with cognitive, behavioural and psychodynamic approaches. I think that the principles of therapy which Rogers formulated are of enduring importance, but they have a simplicity which can be mistaken for a lack of depth. Person-centred therapy is often seen as lacking in theoretical sophistication, and while some practitioners delight in this, others are concerned about it and may seek to integrate person-centred ideas with theoretical principles drawn from other schools of therapy. However, there is already within the personcentred approach a developed body of theory. It is the theory of experiencing developed by Gendlin which I believe can provide Introduction 3 a solid foundation for person-centred practice. This book is concerned more with practice than with theory, but I hope to show something of the relevance of the theory to the practice. In the early days of the development of his approach, Rogers found that one simple and effective way of facilitating the client's process of change was simply to reflect back to the client what they had said. For Rogers this was a way of checking whether he had understood the client's meaning, although another aspect of this procedure – emphasised more by Gendlin – was that in hearing their words back the client can check whether their words really say what they meant to say. Then, having expressed what they were previously unable to express, the client can move on a step. This simple procedure of listening and reflecting, which Barrett-Lennard (1998) calls 'nondirective reflective psychotherapy', has remained important in the person-centred approach ever since Rogers introduced it. It is clear that in listening and reflecting, the therapist is in an important way influencing what happens in the session. Whatever the therapist does will have an influence on the client, and person-centred therapists, like all therapists, do what they do in the expectation of having an influence which will be helpful to the client. Whether such conscious influence on the process of therapy should be called 'direction' is something we will need to address later. I think it is fair to say that there is in person-centred therapy at least some encouragement of a certain sort of process, that is, the sort of process which involves the client finding their own way forward. The person-centred therapist believes that it is in this particular sort of process that the client 'finds themself', so that it would be absurd for the therapist not to do things that help to bring about this sort of process. So it seems that the term 'non-directive' is not entirely accurate as a description of Rogers' practice, and he himself later came to prefer the phrase 'client-centred'. The import of this new term was that the therapist should not try to formulate the client's experience or goals in terms of any external theory. What is important for the therapist is to be with the client in their own frame of reference, and to help the client to articulate their concerns in their own way. 'Client-centred' contrasts essentially with 'theory-centred', though it is important to see that this does not entail any disparagement of theory: if the client should formulate their experience in terms of concepts drawn, say, from Freud, and these concepts should have experiential meaning for the client, then the client-centred therapist should do their best to enter into the client's Freudian world. 'Client-centred' does not 4 Person-Centred Therapy mean rejection of theories (after all, theories of all sorts are embodied in all our experiencing, even in what we call 'common sense'), but it does mean centring on the client's theories rather than on the therapist's theory. One further terminological change in the development of Rogers' work was the shift from 'client-centred' to 'person-centred'. This change was primarily to allow for the fact that Rogers' approach to human problems came to be employed beyond the limits of psychotherapy. For example, Rogers came to think that in large groups the basic listening procedures of client-centred therapy could be helpful in facilitating mutual understanding. In this kind of context it would be inappropriate to speak of 'clients', so the term 'person-centred' is used to convey that the listener stays with the other person's way of being and experiencing. The person-centred/client-centred distinction marks a difference in the range of application of Rogers' ideas, not in their essential content. One curious development has been that in spite of the approach being referred to as 'client-centred', Rogers and his successors have given far more attention to the attitudes of the therapist than to the experiencing of the client. This anomaly has begun to be noticed (Mearns and Thorne, 2000, p. 193), and Gendlin's work could be seen, in part, as a thoroughgoing effort to redress the balance. Rogers came to see the therapist attitudes of empathy, acceptance and genuineness – what came to be known as the 'core conditions' of therapy – as the crucial ingredients in what made his non-directive reflective procedure effective. He went on to elaborate a theory of why this procedure was effective. This was, in brief, that psychological disturbance arises from the introjection of the values of significant others. He saw human beings as having a deep need for the respect and appreciation of others, a need which often conflicts with the other felt needs a person has. Such conflict does not itself constitute psychological disturbance, according to Rogers; there is such disturbance only when the person denies or distorts their own felt needs so as to develop a self-concept which fits the 'conditions of worth' of those around them. The process of therapy then consists in the undoing of the conditions of worth: in the situation where the therapist genuinely and empathically accepts the client for who they are, the conditions of worth dissolve. Beginning from the observed effectiveness of the non-directive reflective approach, Gendlin's thought moved in a rather different direction. Before he became involved with Rogers' group in Chicago, Introduction 5 Gendlin had been working on a philosophical theory of experiencing. Essential to this theory is the idea that lived experiencing is distinct from the concepts through which we make sense of our experiencing. The ways in which we experience the world are determined in part by the conceptual patterns of the culture in which we are brought up, but at the same time, Gendlin insists, a human being is not a blank slate upon which just any old patterns can be drawn. The concepts and principles which we acquire from our culture are often modified by our own experiencing. We are not entirely trapped in the ways of seeing the world which are handed down to us; there is something in us which engages with the concepts and which determines whether these concepts are useful to us or not. This – our lived experiencing of the world – is something on which we can focus our attention, and to which all our ideas and thoughts are answerable. I will discuss Gendlin's basic ideas later; for the present we need just to get a glimpse of them in order to see how it was that on encountering Rogers' work at the University of Chicago Counselling Center, Gendlin was struck by the fact that there was a group of people who were actually working in just that borderland between lived experiencing and conceptual understanding, which so deeply interested him. For, in client-centred therapy there are so often moments when the client is trying to find ways of expressing what they are experiencing. The stock concepts often will not do. For example: What I feel when I am with him is not exactly embarrassment, but there is a sort of awkwardness – there is something about how I am with him that is sort of 'pulled in', so I can't quite be myself . . . it is a quite specific feeling that goes with this situation . . . yet it is sort of familiar . . . a bit like I used to be with my uncle when he offered to help me when I was making those model planes . . . yes, that feeling. Aaah. [Takes a deeper breath]. Here there is an attempt to articulate, to find a form for, the feeling. And when the form is found there is a sense of release – 'Yes, that's what it is' – followed perhaps by a slightly deeper breath, or a sigh, or the shedding of a few tears. This is what Rogers (1956, 1961, p. 130) calls a 'moment of movement', and Gendlin (1996, p. 20) a 'shift' or 'change-step'. In such moments, something physically shifts a little, and in some sense the person 'moves on'. Gendlin and Rogers see such movements as characteristic of the therapy process although, of course, they also occur in non-therapeutic contexts. It is important to realise that what is being described is 6 Person-Centred Therapy something quite familiar. Novelists sometimes portray it. For example, in The Glass Palace (Ghosh, 2001, p. 328) Alison reflects as she is driving with Dinu: Now, when I wake up in the morning those things come back to me in just that way – I have to do this or that, for Mummy or for Daddy. Then I remember, No, I don't have to do any of those things; there's no reason to. And in an odd way, what you feel at those moments is not exactly sadness but a kind of disappointment. And that's awful too, for you to say to yourself – is this the best I can do? No: this isn't good enough. I should cry – everyone says it's good to cry. But the feeling inside doesn't have an easy name: it's not exactly pain or sorrow – not right then. It feels more like the sensation you have when you sit down very heavily in a chair: the breath rushes out of your body and you find yourself gagging. It's hard to make sense of it – any of it. You want the pain to be simple, straightforward – you don't want it to ambush you in these roundabout ways, each morning, when you're getting up to do something else – brush your teeth or eat your breakfast . . . The car veered suddenly towards the side of the road. Dinu snatched at the wheel to steady it. 'Alison! Slow down – careful.' She ran the car on to the grassy verge that flanked the road and stopped under a tree. Raising her hands, she touched her cheeks in a gesture of disbelief. 'Look,' she said, 'I'm crying'. On the basis of the empirical studies with which he was involved as a member of Rogers' group, Gendlin came to believe that the kind of process that went on in client-centred therapy was in principle no different from that which went on in other forms of therapy when they were therapeutically effective. In all forms of therapy the crucial factor seemed to be whether the client was able to relate effectively to their own experiencing. Clients who spent their sessions in discussing external events tended not to make much progress. Nor did those who approached their problems in a purely intellectual way, and nor did those who simply allowed their feelings to take them over. The way of talking which did seem to be therapeutically effective was that which is encouraged by Rogers' listening-and-reflecting procedure. It is a way of talking in which the client gives attention to what is going on inside them and seeks to give expression to that experiencing. We will encounter many examples of this way of talking in the course of this book. The differences between Rogers and Gendlin lie less in clinical practice than in the theory which underpins the practice. For Rogers Introduction 7 the crucial point is that through embodying the core conditions the therapist provides a receptive, non-judging ambience which functions as an antidote to the conditions of worth which the client has absorbed. Rogers pictures therapy in terms of an agricultural metaphor: people are like plants which can flourish only if they are provided with suitable conditions for growth. Just as plants require sunlight and water, people require genuine acceptance and understanding. We will consider the aptness of this metaphor later, but it is by now well-recognised in person-centred thinking that there is another aspect of Rogers' thought which does not sit entirely comfortable with the agricultural metaphor. This second theme is Rogers' emphasis on the therapeutic relationship. In practice, person-centred therapists do not simply provide a receptive ambience of genuine empathy and acceptance. They interact with the client, reflecting what the client says, sometimes asking questions, and sometimes expressing their own feelings. As we will see later, the practice of person-centred therapy changed significantly in the mid-1960s following the experience which Rogers and his colleagues had of working with schizophrenic patients in the large-scale Wisconsin Project. Instead of the emphasis on non-directive reflection there came to be an emphasis on how the therapist interacts with the client. The core conditions came to be seen more as ways of relating than simply as attitudes. For Gendlin, who had directed the Wisconsin Project, this emphasis on the interaction between client and therapist tied in closely with his understanding of human life as always an interaction between the felt flow of experiencing and something else. The 'something else' could be what someone else said or did, or it might be something which one had read, or the impact of a dream on waking experience, or of reading one's diary, or of watching a sunset, or of hearing a piece of music and so on. For Gendlin, human living is always a process of interaction between felt experiencing and all that which has an impact on our experiencing. It is through such interaction that our experiencing changes. Gendlin sees psychological disturbance as due to difficulties which have arisen in the interaction process which constitutes human living. Such difficulties often arise through our spontaneous responses being blocked through our fear of what other people will think, but the crucial point is that there is a block in the ongoing interaction process. Provision of the core conditions often helps to free up the blocked process, but from his experience of schizophrenic patients, Gendlin became convinced that more than this may be needed. Even in cases of less-extreme disturbance it seems true that some clients are helped 8 Person-Centred Therapy by empathic listening much more than others, and it is important to know why this is so. Gendlin's view is that a lot depends on the client, a view which has been confirmed by much psychotherapy outcome research (for instance Orlinsky et al., 1994). Some clients start from a place where they can respond to the therapist's interventions in a way which frees up their blocked process. These are rewarding clients for the therapist. But there are others who seem unable to make effective use of what is offered to them. For example, they may use the session to talk about the events of their week without referring to how these events struck them, or how they felt about the events, or what meaning these events had for them. Other clients speculate about the causes of their problems, perhaps analysing their difficulties in terms of some psychological theory. Still others simply remain immersed in their anxiety or depression and cannot relate to it. In the years following the Wisconsin project, Gendlin and his colleagues studied thousands of recordings of client sessions and were often able to identify at the start those clients who would be unlikely to make significant progress. This was a disturbing development because it meant that much therapeutic effort was quite likely to be unhelpful. As a result of these studies Gendlin and his colleagues looked at the possibility of developing ways of reaching out to clients who would otherwise not be reached. The 'focusing' procedure was one possibility: clients could be taught to engage with their own experiencing in the way that successful clients did naturally. On the other hand, if the therapist assumes the role of a teacher this can have bad consequences for the client. The person-centred approach is premised on clients discovering their own resources, rather than relying on the knowledge of 'experts'. There is a tension here which I will explore in various contexts in this book. It is the tension between knowing that therapeutic change is likely to follow from the client's relating to their own experiencing, and the need in many cases to help the client to realise that this is so. In person-centred therapy we do not direct the client along a path which we think is best for them; we facilitate their following their own path. But what if the client is not on any path of their own? What if they are following rules laid down by other people, or tracks laid down by long irrelevant events, or generalised theoretical notions? Can we then in effect say to them 'Listen to yourself, listen to your own experiencing now. Don't even listen to me unless what I say resonates with you'? Whether this very particular kind of therapist Introduction 9 directivity is alien to the person-centred approach will be one of the themes of this book. In Chapter 1 I outline the theory of person-centred therapy as developed by Rogers, and the main developments in the years since Rogers ceased to write about the theory of therapy. In Chapter 2 I discuss some areas of person-centred theory which are problematic. Later in the book I hope to show how many of these difficulties can be resolved if we adopt Gendlin's view of therapy. In Chapter 3 we will look at how focusing developed in relation to the early development of client-centred therapy. Then in Chapter 4 I give a short account of 'Focusing' as a taught procedure. (I will always capitalise 'Focusing' when I am referring to this procedure.) Focusing understood in this way is the part of Gendlin's work which is best known, and it would be eccentric not to include this chapter. However, as will become clear in the course of the book, I think it is important to see that Focusing as a taught procedure is just one application of a whole way of thinking about therapy, and about many other aspects of human life. In Chapter 5 I discuss in some detail how Gendlin's ideas can inform therapeutic practice. This chapter is not in itself a manual for practice, but I hope it will provide enough material to entice some therapists to explore further how Gendlin's approach could enrich what they already do. These chapters will inevitably give rise to questions and objections in some readers' minds, and in Chapter 6 I deal with what I take to be the main difficulties in Gendlin's approach, especially as seen through the eyes of more orthodox person-centred practitioners. The implications of Gendlin's approach for training and supervision are explored in Chapter 7, at least in connection with training which remains fairly close to the standard forms of person-centred therapist training. As we shall see, Gendlin's view of therapy involves a radical rethinking of the relationship between the person-centred approach and other schools of therapy. In brief, what is central to person-centred therapy belongs in any kind of effective therapy. The procedures of any school of therapy can be 'experientialised' or oriented towards the principles involved in focusing, so that Gendlin's work is relevant to all the schools of therapy. However, in this book I will, for the most part, restrict the discussion to the relationship between focusingoriented therapy and the more standard person-centred approach. In Chapter 8 I attempt to lay out the philosophical underpinnings of Gendlin's views. It has often been said that the person-centred approach is 'thin on theory', but I do not think anyone who has read 10 Person-Centred Therapy Gendlin will be likely to retain such an opinion. Gendlin's views are rooted in philosophical considerations which involve a thoroughgoing rethinking of many of the assumptions underlying our modern 'scientific' world view. Because of this, his thinking has implications far beyond the field of psychotherapy. This aspect of Gendlin's work will not be of interest to every reader, so I have relegated it to an appendix (Appendix A). However, I think myself that these further implications have an important bearing on therapy – for, if support for Gendlin's general approach can be found in how it illuminates these other areas, we will have extra reason to take his views more seriously when we turn our attention to psychotherapy itself. While up to now Gendlin's contribution has usually been seen as the development of his Focusing procedure, I hope that this book will show how focusing-oriented psychotherapy embodies very deeply the spirit of the person-centred approach. I also hope that the book may whet the reader's appetite for further exploration of a deeply original view of the world which goes far beyond the realm of psychotherapy, while offering an explanation of just what psychotherapy is, and why it can be effective. 1 Rogers and the Development of Person-Centred Therapy Rogers' work In his book Counselling and Psychotherapy: Newer Concepts in Practice, published in 1942, Carl Rogers presents what he sees as a new method of therapy 'in which warmth of acceptance and absence of any form of coercion or personal pressure on the part of the counsellor permits the maximum expression of feelings, attitudes, and problems by the counsellee ...In this unique experience of complete emotional freedom within a well-defined framework the client is free to recognise and understand his impulses and patterns, positive and negative, as in no other relationship' (Rogers, 1942, p. 113). The book contains the first complete recorded transcript of a series of therapy sessions, with a commentary by Rogers on how the therapist's responses in the session embodied the non-directive principles which Rogers was advocating. During the following few years, while Rogers was based at Ohio State University, he and other therapists applied the principles of non-directive responding in a variety of contexts, including work with the adjustment problems of servicemen returning from wartime activities. It was in his next book (co-authored with John Wallen) Counselling with Returned Servicemen (1946) that Rogers first used the term 'client-centred', along with 'non-directive', as characterising his approach. It is the client's frame of reference which is emphasised, while '[i]t is the counsellor's function to provide an atmosphere in which the client, through the exploration of his situation, comes to see himself and his reactions more clearly and to accept his attitudes more fully' (Rogers and Wallen, 1946, p. 5). What the counsellor actually did in the sessions was mainly to accompany the client with 11 12 Person-Centred Therapy reflective restatement and clarification of what the client said, without judgement, comment or interpretation. This work became widely known, and in 1945 Rogers accepted an invitation to a senior appointment at the prestigious University of Chicago, where he proceeded to set up a Counselling Centre which incorporated both clinical and research activities. In the following years Rogers and his colleagues continued to refine their theory and practice of 'non-directive reflective' psychotherapy, and in 1951 Rogers published Client-Centred Therapy. As Barrett-Lennard (1998, p. 60) points out, there are, in this work, incipient changes of emphasis in Rogers' account. The emphasis on the therapist targeting the client's frame of reference is still there, but this mode of responding is now seen less as a technique than as the embodiment of certain attitudes. Also in this book Rogers begins to develop a theory of the self which was needed to explain why the client-centred approach was therapeutically effective. The essentials of this theory were that as a child develops, a 'self-structure' or 'self-concept' forms in which what is valued arises partly from immediate experiencing and partly from values introjected from others, which are experienced as if they were the child's own experience (Rogers, 1951, p. 500). As the child continues to develop, new experiences are assimilated into the selfstructure or, if they are incompatible with it, are denied or distorted. Psychological disturbance is constituted by such denial or distortion. By contrast, psychological adjustment exists 'when the concept of self is at least roughly congruent with all the experiences of the organism' (p. 513). Any experience which is inconsistent with the self-structure is likely to be perceived as a threat, but the therapeutic situation provides a safe setting in which all the client's experiences can be examined, and the structure of the self then becomes re-organised so as to assimilate these experiences. Two further important concepts in client-centred therapy were developed in the mid-1950s. Rogers took up Standal's (1954) notion of unconditional positive regard as a crucial element in effective therapy, and at the same time came to emphasise the importance of therapist 'congruence'. The 'congruence' involved was that between the self as it actually is and the self as perceived. 'Congruence' soon came to be used rather more broadly as a synonym for 'genuineness', which was seen as having two aspects: those of (a) consistency between experiencing and awareness, and (b) consistency between awareness and expression. Roughly speaking, people are fully congruent if they deceive neither themselves nor others. Rogers and the Development of Person-Centred Therapy 13 In 1957 Rogers published his paper 'The necessary and sufficient conditions of therapeutic personality change'. In this he claims that just six conditions need to be obtained if there is to be therapeutic change. Three of these conditions have subsequently come to be known in client-centred writing as the 'core conditions' of therapy, namely the therapist conditions of empathic understanding, unconditional positive regard and congruence. The other conditions are that client and therapist are in psychological contact, that the client 'is in a state of incongruence, being vulnerable or anxious' (Rogers, 1957, p. 96), and that the client must register the therapist's empathy and unconditional positive regard. I will refer to the full set of six conditions as the 'therapeutic conditions', and to the three conditions which the therapist needs to embody as the 'therapist conditions'. (I prefer this latter phrase to the more familiar 'core conditions', since it does not misleadingly suggest that the therapist conditions are more central to therapy than the other three conditions.) In subsequent years, much research effort was devoted to exploring the validity of Rogers' 'necessary and sufficient' claim, which was a claim about not just client-centred therapy but psychotherapy in general. Prior to 1957, Fiedler's research (Barrett-Lennard, 1998, p. 262) had already suggested that therapeutic effectiveness was correlated more with how experienced the therapists were than with their theoretical orientation. Further, work by Quinn (ibid., p. 262) suggested what seemed to characterise the experienced therapists was essentially their receptive and sensitive attitude towards their clients. Heine (ibid., p. 263) found that, regardless of the theoretical orientation of the therapist, what clients themselves found helpful were such things as 'assisting the patient by asking questions which have the effect of clarifying feelings or attitudes', 'expressing for the client straight-forwardly feelings which the client approaches hesitantly and hazily' and 'feelings of trust, of being understood, and of independence in reaching solutions to problems'. Further, at least some of the studies conducted around this time indicated that there was a correlation between therapeutic movement and how effectively the therapist embodied the therapist conditions (ibid., pp. 82, 264–7). In 1959 Rogers published his major theoretical paper, which explains in greater detail why the six therapeutic conditions are to be seen as causally effective. In brief, Roger's view is that human beings have, amongst their other needs, a deep need for the positive regard of others. This need can give rise to conflict in situations where the positive regard of others is conditional upon the individual having 14 Person-Centred Therapy feelings or attitudes which they do not in fact have. The individual is then in effect faced with the choice of satisfying their own 'organismic' needs while losing the positive regard of significant others, or of retaining the positive regard while giving up their organismic needs. The latter option, however, is not really possible since the organismic needs are there. What is possible for the individual is to deny or distort their awareness of their needs. In this way a view of themselves, a selfconcept, is set up which is congruent with the 'conditions of worth' set by others, but incongruent with their actual experiencing. Subsequently, when life situations arise which make it difficult to maintain the distortion or denial, the person will become anxious or behave defensively, and generally exhibit some degree of psychological disturbance. Further, because greater awareness of their own experiencing will render the person liable to anxiety, he or she will be disinclined to give much attention to their experiencing. Instead of looking within to determine what they really feel or value, they will look outwards to what other people are thinking or valuing; in Rogers' terminology they will have an 'external locus of evaluation'. This, while reducing anxiety, undermines the person's sense of themself as 'solid' and trustworthy, thus increasing the person's sense of vulnerability. In Rogers' view, client-centred therapy is effective because it provides an antidote to the introjected conditions of worth: in their relationship with the therapist, the client has the experience of being seen as they are (the therapist is empathic), and of being unconditionally accepted for what they are. Further, the client experiences this empathic acceptance as being fully genuine on the therapist's part – it is not a pretence. In these circumstances the client no longer needs to deny or distort their experiencing, so that their self-concept can return to a state of congruence with their experiencing. As a result the client's psychological disturbance is relieved. In the background of this account is Rogers' notion of the 'actualising tendency'. He held that the primary motivation of all human behaviour is the actualisation of the person's potentialities. However, once a concept of self is set up which is at variance with the person's organismic experiencing, self-actualisation becomes problematic. The person is torn between actualising that 'self ' (self-concept) which is constituted by the conditions of worth (that is, becoming what one 'should be' in the eyes of others) and actualising their organismic potential. Rogers sees the actualising tendency as common to all living beings. Given the right environmental conditions, an organism will grow – Rogers and the Development of Person-Centred Therapy 15 actualise its potentials – without the need of any outside assistance. If the environmental conditions are less favourable then the organism will still grow, but perhaps in a bizarre way. Rogers (1980, p. 118) refers to the example of potatoes which, stored in his family's basement several feet below a small window, grew long, pale spindly sprouts as if they were seeking the light. This is not the 'natural' form of a potato plant; it is not the form the plant has in its natural environment. However even this distorted kind of potato is the result of the actualising tendency which moves the potato sprout to seek the light. Rogers sees this not just as an analogy for what happens in human lives, but as another example of the way in which organisms move towards actualising their potential. For human beings, as for potatoes, the environmental conditions may not be favourable or nurturing, and in that case the organism may develop an unusual form. For Rogers even the most bizarre and seemingly inappropriate forms of human behaviour are the results of the organism coping as best as it can with noxious environmental conditions. As with the potato an unnatural form of development renders the organism more vulnerable (the long potato spindles are easily broken), and there may be no way of reversing what has already happened. However, once the environmental conditions are changed (in the human case, once the conditions of worth are withdrawn) the organism will from there on be able to develop its potential more fully. To summarise, Rogers first proposed a hypothesis, that therapeutic change will take place if and only if the six therapeutic conditions are present. I will call this the Therapeutic Conditions Hypothesis. Secondly he offered a theoretical explanation of why his hypothesis is likely to hold true, namely the Conditions of Worth Theory. The Conditions of Worth Theory came relatively late in the evolution of client-centred therapy, some years after the client-centred practice had been established. It can look as though the theory simply emerged from the practice, but this seems unlikely, given modern views on the way scientific theories develop. In fact, Rogers' views were deeply influenced by his knowledge of Freudian psychotherapy. He does not use the word 'repression', but the 'distortion and denial of experience' of which he speaks are recognisably close to what Freudians mean by 'repression'. Indeed, Rogers (1951, pp. 498–503) himself makes this explicit. In connection with the internalisation of conditions of worth, Rogers uses the psychoanalytic terminology of 'introjection'. He avoids speaking of 'unconscious thoughts and feelings' but this is more an avoidance of the terminology, than of the concepts. 16 Person-Centred Therapy This is not to criticise Rogers; it is often worthwhile to say old things in new ways, and in addition there were many unwanted connotations of the Freudian terminology which Rogers wished to avoid. In particular, I suspect, Rogers wanted to get away from the Freudian idea that there is 'an unconscious' about which the therapist – armed with his theory – could know more than the client; for that idea runs counter to Rogers' fundamental belief that the therapist's aim should be to help the client articulate their experience in the client's terms. Rather than seeing Roger's theory as simply growing out of his clinical experience I think we should see it arising from the interplay of that experience with Freudian ideas, with notions drawn from his knowledge of scientific agriculture, with ideas taken from many other thinkers. Nevertheless, it is true that Rogers' own theory emerged only some years after the practice of what Barrett-Lennard calls 'non-directive reflective therapy' had evolved. This is important for one of the themes of the present book, which is that while person-centred therapy is a demonstrably effective form of therapy, there are difficulties in its theoretical formulation which have some implications for clinical practice. It is important to be able to separate the practice of non-directive reflective therapy as it evolved in the 1940s and 1950s from the theoretical explanation of its effectiveness in terms of the Conditions of Worth Theory, which Rogers presented in a fully fledged form in 1959. I will say more about the development of Rogers' theoretical ideas in Chapter 3, but two important points need to be made here about the later development of his thinking. One is that from the early 1960s, following his involvement in the Wisconsin schizophrenia project, Rogers came more and more to emphasise the importance of therapists being real and spontaneous in their relationships with their clients. One might say that the balance between the Therapist Conditions shifted from an emphasis on empathy and acceptance to an emphasis on genuineness. In practice this meant that client-centred practitioners were less restricted in the forms of response they might make. While previously questions, counsellor self-revelations, interpretations, suggestions and so forth were prohibited, such forms of response were now allowed so long as they were made in a way which still embodied the therapist conditions. The emphasis shifted from particular kinds of response (non-directive reflective responses) to the embodiment of particular attitudes (the therapist conditions) in whatever kinds of response came to the therapist spontaneously in the moment. The other important aspect of Rogers' later thinking is that from the mid-1960s he became very much involved in working with Rogers and the Development of Person-Centred Therapy 17 groups. It was the time at which 'encounter groups' were becoming very popular in North America, and Rogers' interest was caught by the fact that the conditions which facilitated group understanding and co-operation seemed to be very much the same as the conditions which were facilitative in individual therapy. In the succeeding years nearly all of Rogers' professional energy was devoted to this new interest, and he wrote nothing significantly new in connection with counselling theory. Rogers' own enthusiasm for groups, together perhaps with something in the spirit of the times, led to a strong emphasis on unstructured group-work in the world of person-centred counselling, regardless of whether it was appropriate to the context. Mearns (1997, p. 11) recalls some of the more extreme examples of this trend, such as the trainer who 'began his weekend introductory course in person-centred counselling skills with a time-unlimited, unstructured encounter group without giving any warning or explanation'. Such episodes are less common today, although many people become interested in 'the person-centred approach' through encounter with person-centred group-work, and are sometimes surprised to learn that it was not in this context that Rogers' ideas originated. Paths of development in PCT In the years following the establishment of client-centred therapy as a distinctive school, several lines of development can be traced. I will briefly discuss each of these, with a view to seeing later how focusingoriented therapy fits into the wider picture. Some of these alternative views within the broad spectrum of the person-centred tradition will be familiar to readers who come to person-centred therapy in what might be called the standard way, that is, through the writings of Rogers, and the experience of training courses which emphasise the centrality of the therapist conditions. Other views may be less familiar, and I will devote more space to some of these. In Britain, especially, there has been little awareness of how many distinct 'tribes' there are in the person-centred 'nation' (Warner, 2000a), although this situation is now beginning to change (Sanders, 2004). The standard view By 'the standard view' I mean the view of person-centred therapy which is set out in widely read books which frequently appear as 'recommended reading' on person-centred training courses. Examples of such 18 Person-Centred Therapy books are Dave Mearns' and Brian Thorne's Person-Centred Counselling in Action (1988; second edition 1999), Tony Merry's Learning and Being in Person-Centred Counselling (1999) and Mearns' Developing PersonCentred Counselling (1994). The 'standard view' follows closely what I have called Rogers' Conditions of Worth Theory. It sees psychological disturbance as originating through the imposition of conditions of worth which alienate the person from his or her 'organismic valuing process', and sees the role of the therapist as providing 'conditions for growth' in the form of the therapist conditions of empathy, acceptance and congruence. Psychologically healthy persons are seen as those whose relationships with others have enabled them to develop self-concepts which allow them to be in touch with their own experiencing, and to trust in their own experiencing rather than in the judgements of others. Mearns (2003) puts it in Rogers' terminology: 'an implicit aim of person-centred working is to help the client to internalise his locus of evaluation'. Since the role of the therapist is seen as one of embodying the therapist conditions as a means of undoing restrictive conditions of worth, and encouraging the client to internalise their locus of evaluation, the main emphasis in the standard view of counsellor training is on the development of the core attitudes of congruence, empathy and acceptance in prospective counsellors. Hence on counselling training courses, 'personal development', in the sense of developing these attitudes, is seen as the most important aspect of training (Mearns and Thorne, 1988, p. 57; Mearns, 2003). The standard view echoes Rogers' early concern about the imposition of theoretical categories on the client's experiencing. Mearns (2003), for example, speaks of 'the importance of centring the work in the experience of the client rather than in terms of other people's experience of the client issue'. The standard view opposes the introduction of diagnostic categories into counselling sessions, but allows that some general knowledge of conditions such as depression or post-traumatic stress can help the counsellor in understanding the client. Psychopathology is discussed largely in terms of conflict between conditions of worth and organismic experiencing (Lambers, in Mearns, 2003), and different therapist conditions are held to be especially important in connection with different pathologies: for example, congruence is emphasised in connection with psychotic clients (p. 114), and acceptance in connection with clients who have personality disorders (p. 120). The standard view thus allows for Rogers and the Development of Person-Centred Therapy 19 a differential emphasis in the therapist conditions depending on the nature of the client's difficulties. Following Rogers, the standard view is wary of introducing specific therapeutic techniques. On the whole it remains committed to the view that the presence of the six therapeutic conditions is sufficient for therapeutic change. However, it does not insist that procedures which are employed in other therapeutic traditions are always inappropriate. It is rather that the bringing in of specialised techniques is seen as running into the grave danger that the client may come to trust in the expertise of the therapist rather than in their own experiencing. On the whole, the standard view discourages therapeutic moves which aim to teach or direct the client, but in the end the context and the therapist's own spontaneous feelings about what is appropriate to do at the moment are held to be paramount. The introduction of specific procedures does not necessarily go against the notion that the therapeutic conditions are sufficient; the employment of specific procedures can be seen as a manifestation of the therapist's congruent response to what the situation requires. In this respect the standard approach tends to take a pragmatic view of what is helpful, as against the 'purists' who would ban any kind of directivity on the part of the therapist. Brian Thorne (1992, p. 94) writes: I had always considered myself to be somewhat of a 'purist' until a member of the 'purist camp' walked out of a video demonstration of my work when he witnessed what was clearly, for him, a directive response from me to my client, even if delivered with extreme respect and tentativeness. At that moment, in his eyes, I had ceased to practice client-centred therapy. I sense that Carl Rogers would have stayed to see what happened next. Thus the standard view follows the later development of Roger's thinking in that it allows the therapist to be active in the relationship so long as nothing is imposed on the client (Mearns, 2003, Chapter 19). Standard person-centred counselling training usually begins with an emphasis on listening and empathic tracking, but the trainees are later encouraged to develop their own individual ways of embodying the therapist conditions. The importance of the counsellor's presence in the relationship is emphasised. This reflects the development in Rogers' views to which I referred in the last section, that is, his increasing emphasis on therapist genuineness. Such genuineness involves the therapist in trusting, and where appropriate expressing, their natural 20 Person-Centred Therapy responses to the client (Mearns, 2003). This is often referred to as 'use of the self in therapy', and it clearly requires a high level of self-awareness, if it is to be facilitative. Hence the growing emphasis on being genuine in relation to the client further reinforces the stress placed on personal development in counsellor training. If Focusing procedures are discussed in training, they will normally be introduced as unobtrusive invitations to the client to move towards or remain in contact with what Gendlin calls the 'edge of awareness'. It is the counsellor's presence with the client at the edge of awareness that is emphasised, rather than Focusing as a matter of 'techniques' (Mearns, 2003; Mearns and Thorne, 1988, pp. 47–51). The standard view has maintained something of Rogers' later enthusiasm for group-work, while letting go of any dogmatic assertion that such work is the only possible context for training in personcentred therapy. It is recognised that while personal development groups can provide experiences which are unattainable in one-to-one sessions, the converse is also true (Mearns, 1997, p. 102). In sum, the standard view stays close to Rogers' principle of 'clientcentredness' without taking this term in a completely literal way. The literalist or 'purist' approach, which I discuss below, would involve asserting that the person-centred approach has no goals for the client beyond those which the client has for themself. Mearns (2003) explicitly opposes the literal interpretation, asserting that personcentred therapists are at least committed to the goal of helping a client 'to find and exercise more of his own personal power with regard to understanding and evaluating his actions'. Integrationists Richard Worsley (2004) draws attention to two distinct ways in which person-centred therapists have sought to integrate their approach with ideas and procedures taken from other approaches. One way involves the attempt to integrate Rogers' theoretical concepts with those of other schools, through the development of a variant theory. The other is rather a matter of the individual practitioner assessing to what extent they can integrate ideas and procedures taken from other schools of therapy into their own conception of what it is to be person-centred. An example of the first approach would be that of Wijngaarden (1990), who sees human beings as having destructive potentials which cannot be accounted for simply as the frustration of funda- Rogers and the Development of Person-Centred Therapy 21 mentally positive impulses, and draws on Jung's work in elaborating a variation on Rogers' theory. Examples of people who adopt the second approach include Worsley himself, Reinhard Tausch (1990), who advocates supplementing person-centred therapy with such procedures as relaxation techniques and behavioural counselling, and Rose Battye (2003), whose subtle position is hard to classify as either clearly person-centred or clearly integrationist. There is something congenial to this second kind of integrationist approach in Rogers' thought itself. Rogers held that neither the theoretical orientation of the therapist, nor the techniques used, matter very much. So long as the therapeutic conditions are present, therapeutic change will occur regardless of the theoretical orientation of the practitioner 'whether we are thinking of classical psychoanalysis, or any of its modern offshoots, or Adlerian psychotherapy, or any other' (Rogers, 1957, p. 101). Similarly Warner (2000a) quotes Rogers as saying '[i]f a therapist has the attitudes we have come to regard as essential, probably he or she can use a variety of techniques'. But if it is unimportant what theoretical notions or techniques are employed by a therapist, then presumably a wide variety of notions and techniques can be brought together without detracting from the efficacy of the therapy. There are two reservations which may be felt here. One is centred around the question of whether it really is compatible to use 'techniques' such as relaxation procedures or the Gestalt two-chair procedure with the person-centred approach. Many person-centred therapists would say that for the therapist to introduce such techniques is to go against the principle that the client knows best what will be helpful; others, including it would seem Rogers himself, have no objection to the use of special techniques so long as their use does not interfere with the person-centred therapeutic attitudes. The second reservation centres around the question of whether the theoretical concepts of other schools can be employed along with the concepts of Rogers, but without going so far as to set up a variant theory as in the first kind of integrationist position. It would seem that to employ different and perhaps incompatible conceptual schemes at the same time can only lead to confusion, unless there is some meta-position which shows how the different schemes can all be used. As we shall see, Gendlin's account can be seen as just such a metaposition, which allows for the possibility that almost any theory of psychotherapy, and almost any procedure, can be practised in a person-centred way. For Gendlin the person-centred approach does 22 Person-Centred Therapy not exist on the same level as the theories and procedures of the other schools. I hope to show that it is in that way fundamentally different from all the other approaches. Process-experientialists Another path of development is that found in the work of Laura Rice, Leslie Greenberg and Robert Elliotz. Here the emphasis is on the micro-processes of therapy, and the development of particular forms of therapist intervention which are thought to be appropriate in different circumstances. The therapeutic conditions remain, but they are now more in the background. This kind of development in client-centred therapy is often now referred to as 'experiential psychotherapy' or 'process-experiential psychotherapy'. Gendlin's own approach is sometimes regarded as belonging here, and Gendlin (1973b) himself at one time used the term 'experiential psychotherapy' to characterise what he was doing. The development of the processexperiential approach can be briefly sketched as follows. Laura Rice, who completed her doctorate at Rogers' Counselling Centre in Chicago, drew attention to a common kind of therapeutic event in which clients described and explored an incident in which they found themselves reacting in an inappropriate or unexpected way (Rice, 1974). She found that when clients were describing such 'problematic reaction points', it was often therapeutically helpful if the therapist encouraged the client to become more vividly aware of the detail of the incident. If the therapist did this, the client would often become aware that they were construing the incident in a way that did not adequately reflect their experience of what happened. For example, a client is unhappy about how he reacts when entering a room full of people, and they turn to look at him: he freezes or rushes out. The therapist reflects back what the client has been saying in a vivid way, such as 'You open the door, walk into the room and all the heads swivel. The eyes focus on you, they get big and terrifying.' This 'evocative reflection' gets the client back into his experiencing of the situation, and he may then notice things which are not part of his construal, for example, that the people are actually looking at him with indifference or even interest. In the therapy session the experiencing as a whole is recalled and reprocessed. There is no need for the therapist to give any interpretation of the situation; the client's own experiencing provides the corrective elements which enable the reprocessing to take place. Of course, if a client is to go back into Rogers and the Development of Person-Centred Therapy 23 frightening or painful experiences in this way, it is essential that they feel safe and supported. The therapist conditions are thus very important in maintaining that safe atmosphere, but the more evocative reflections go beyond this in helping the client to get into his or her own experiencing, so that the experiencing can be reconstrued in a more appropriate way. Rice acknowledges that there is an element of therapist directivity in this; the therapist is directing the client towards their own experiencing, but in all other ways the non-directive nature of the client-centred approach is maintained. A little later Leslie Greenberg (1979), who also began his therapeutic career within the client-centred approach, drew attention to a kind of change event which is often referred to in Gestalt therapy. When a client is experiencing an inner conflict the Gestalt therapist may use a two-chair technique in which the client speaks from each 'part' of themself while sitting first in one chair and then in the other. This brings the two parts more into awareness, and the resulting dialogue between the two often reduces the differences between them, so that the inner conflict is ameliorated. Greenberg presents evidence that the two-chair procedure can be more therapeutically effective than the procedure of staying empathically with the conflict, but whether or not this is generally so we have an example here of another kind of therapeutic procedure, marked this time by what Greenberg calls a 'conflict split'. It should be emphasised that Rice and Greenberg see Rogers' therapeutic conditions as providing an essential setting for procedures such as evocative reflection and two-chair work, and that the procedures are suggested to clients as possible ways of working which the client may prefer not to use. In that case the process-experiential therapist returns to a client-centred baseline of empathic responding. Another type of therapeutic situation is marked by the client having 'unfinished business' with some significant person in their life. Here a helpful form of therapeutic intervention might be the suggestion that the client should imagine the significant other in an empty chair and express to him or her what the client needs to express. Of especial interest in the context of this book is the kind of therapeutic situation in which a client has a vague sense of a problem, but is unable to articulate it. Here the most appropriate form of intervention might be Gendlin's Focusing procedure, which Greenberg and Rice (Greenberg et al., 1993) see as one example of an 'experiential search' procedure. Greenberg and Rice (joined later by Robert Elliott and others) have thus developed a form of therapy in which the provision of the 24 Person-Centred Therapy therapist conditions is supplemented by attention to the kind of 'process difficulty' which the client is having. By 'process difficulty' they mean such things as the client being in conflict, finding themself responding to situations in problematic ways, not being able to 'let go' of something in their experiencing and so on. These difficulties are not content-specific: what the conflict is about or what the situation is, is another matter, and only the client can speak with authority about that content. In classical client-centred therapy the client is the expert on what they are experiencing; however in process-experiential therapy the therapist is seen as having special expertise in ways of working with one's experiencing. The importance of the therapeutic conditions is not denied, and the process-experientialists emphasise that the conditions can be directly effective in therapy (where for instance the client's main need is to be understood or valued). However, they add that the conditions may also provide a setting for work with specific difficulties which are arising in the client's processing of their experiencing. There is a diagnosis of process difficulties in processexperiential therapy, and the therapist assumes a directive role in suggesting procedures which may help with the difficulties. The therapist makes no diagnosis in connection with the content of the client's experiencing (there is no 'interpretation'), and does not in any way direct or suggest ways in which the client might view their situation. The slogan of the process-experiential school is 'Direct the process but not the content'. One further development in process-experiential theory has been the work of Greenberg and his associates on the nature of emotion (Greenberg and Safran, 1987; Greenberg et al., 1993; Greenberg, 2002). In their view it is therapeutically important to target those places where the client's experiencing is constrained or distorted by construals that are inappropriate to the full range of the client's experiencing. These construals should not be seen, as they tend to be seen in some other forms of therapy, as essentially cognitive. They are, rather, emotional schemes, and the function of procedures such as Focusing or Two-chair work is to access, and hence allow the restructuring of, these emotional schemes. The theory of emotion and hence of psychotherapy which Greenberg and his associates have developed is rather different from that of Gendlin, but the details lie beyond the scope of the present book. Process-experiential therapy is not widely known in Britain, although this situation is beginning to change with the recent publications of Worsley (2002) and Baker (2004). However, in Europe Rogers and the Development of Person-Centred Therapy 25 and in the United States it has become a quite widely researched form of therapy, with its own literature, clinical handbooks and training courses. In addition to Greenberg, Rice and Elliott, who have been the central figures in this approach, there are others who are more or less closely aligned with it, such as Alvin Mahrer (1996) and David Rennie (1998). All these workers see themselves as operating within the broadly client-centred tradition, emphasising the centrality of the client's conceptualising of their experiencing, as opposed to a conceptualisation based on the categories of a psychotherapeutic theory. They differ from many client-centred therapists in that they see the client as needing context-sensitive therapeutic help in working effectively with their own experiencing. The client is the ultimate authority on what they are experiencing, and on what that experiencing means to them, but a client may need very specific forms of help from the therapist in getting to know what that experiencing and meaning are. Within the process-experiential tradition, Focusing is seen as a procedure which is appropriate in connection with certain specific client problems, which are marked by the fact that the client has a vague sense of something which they are currently unable to articulate. Gendlin's view of the place of focusing in psychotherapy is rather different, as we shall see, but there is much in the work of the process-experientialists which is relevant to focusing-oriented psychotherapy. 'Purists' The development of 'integrationist' and 'experiential' approaches within the broad sweep of person-centred therapy has led to a reaction from those who think that such developments undermine the crucial insights of Rogers. These theorists hold that the therapist should have no goal but to follow the client's goals. Barbara Brodley has for several decades resisted what she sees as distortions of the person-centred approach. She writes (Brodley, 1991, her emphasis): Any specific goal for a client, systematically pursued by a therapist for a client, functions and communicates as an expression of authority over the client. It is an expression of knowing what is good for the client. Having specific goals for clients, including process goals, expresses a conception of the therapeutic relationship that assumes the capability and the right of the 26 Person-Centred Therapy therapist to constructively direct the client. I believe that these are deluded assumptions. And: the client-centred therapist, guided by his non-directive attitude, has no directive intentions in relation to the client. The therapist's intentions are distinctly and only to experience and to manifest the attitudinal conditions in such a way that unconditional positive regard and empathic understanding can be perceived by the client. (Brodley, 1990, p. 90) Very similarly, Jerold Bozarth (1998, p. 12) writes The therapist's intent is not to promote feelings or to help the client become more independent or 'to get' the client anywhere. The goal is not self-actualization, actualization, independence, or to help the client become a 'fully functioning' person. The only therapist goal is to be a certain way and by being that way a natural growth process is promoted in the client. Bozarth grounds his view in his understanding of Rogers' theory: Rogers' view of psychological dysfunction is that individuals are thwarted in their natural growth by conditions of worth being introjected by significant others. Psychological growth results from the individual being freed from these introjections. When the individual experiences unconditional positive regard from a significant other, the person begins to develop unconditional positive self-regard. As this occurs, the individual becomes increasingly able to deal with problems and life. If the therapist is congruent in the person-centered relationship, experiences unconditional positive regard and empathic understanding towards the client, and if these attitudes are, at least minimally, perceived by the client, then therapeutic change will occur. (p. 117) Bozarth's understanding of Rogers' theory makes the client's 'actualising tendency' the cornerstone of therapeutic change. The therapist's task is simply to create the conditions under which the actualising tendency can operate effectively. Interestingly, Bozarth (pp. 41–2) concludes from this that the therapist conditions are not strictly necessary; other things may elicit self-regard, and the actualising tendency will make use of whatever is available for constructive change: Rogers and the Development of Person-Centred Therapy 27 There are certainly individuals who report significant change and improved function from experiencing a religious conversion, a sunset, a smile, a traumatic experience, and so on . . . The remarkable resiliency of humans in terms of the actualising tendency leads me to conclude that the conditions may not necessarily be necessary. What Bozarth does insist on is that the therapeutic conditions are sufficient. He sees the 'fundamental curative factor' as the client's perception of the therapist's unconditional positive regard. Empathy is seen as 'the purest way to communicate unconditional positive regard' (p. 51), and congruence is entwined with empathy in that the therapist's awareness of their own experiencing is bound up with their openness to the client's experiencing (p. 80). The therapist conditions are aspects of a way of being in which the therapist is fully receptive of the client, and it is that full presence and receptivity which dissolves the conditions of worth. Bozarth notes that late in his life Rogers himself remarked: I recognize that when I am intensely focused on a client, just my presence seems to be healing . . . (and) I am inclined to think that in my writing perhaps I have stressed too much the three basic conditions (congruence, unconditional positive regard, and empathic understanding). Perhaps it is something around the edges of these conditions that is really the most important element of therapy – when my self is clearly, obviously present. (Rogers cited in Baldwin, 1987, p. 45) So far as the use of specific procedures such as 'reflection of feeling' are concerned, Bozarth sees these as possible vehicles for communicating the therapist's positive regard and empathy. Bozarth follows Rogers in holding that other procedures (even such things as interpretations and advice) are acceptable if they communicate the crucial attitudes. What matters is not what the therapist does, but whether what is done conveys the healing attitude. Tomoda Another development in person-centred therapy lies in the work of the Japanese therapist Fujio Tomoda, who was a major figure in the introduction of client-centred therapy to Japan. Tomoda had been having deep doubts about the value of advice-giving in student counselling sessions, when in 1948 he was given a copy of the book to which I referred at the start of this chapter, Rogers' Counselling and 28 Person-Centred Therapy Psychotherapy. He was deeply impressed by Rogers' approach, and proceeded to translate the book into Japanese. In 1955 he published a translation of Client-Centered Therapy, followed a year later by his own major work in Japanese. He continued to play a major role in translating Rogers, and the Complete Works of C.R. Rogers was published in Japanese, in twenty-three volumes, in 1969. While much of person-centred therapy in Japan has subsequently followed the 'standard' path, Tomoda has a distinctive perspective which emphasises the role of the therapist in helping the client to be alone with their own experiencing (Hayashi et al., 1998). Tomoda was very struck by an episode in the earliest published transcription of a complete series of psychotherapy sessions, which was included in Rogers' Counselling and Psychotherapy as 'The case of Herbert Bryan'. The therapist is not identified, but is widely understood to be Rogers himself. The central passages which struck Tomoda are (Rogers, 1942, pp. 393, 412): In Session Six: Bryan: So the ideal for me would be to – well, perhaps it's too yogi-istic or something, but I want to sort of effect a cure by myself, apart from the environmental problem. Then after the cure, why, I'll go out and tackle the problem. Therapist: You feel that growth can sort of take place in a vacuum, and then once you have developed the growth, then you would be capable of dealing with the situation. Bryan: Well, growth hasn't occurred in the environment, so perhaps it could occur by some sort of solitary meditation or whatever you'd want to call it. That doesn't sound so good, does it? Therapist: Well, I don't know of growth taking place that way, but I can understand your feeling in regard to it. Bryan: You know certain religious mystics will meditate in solitude for a long time. Then that seems to gird their loins, as it were. Then they go out and make achievements. So there must be some sort of building up of power there while they're in their solitude. In Session 7: Bryan: . . . a person can resolve in a vacuum when they really sincerely mean it, but it's too hard to keep meaning it in a vacuum. Rogers and the Development of Person-Centred Therapy 29 Tomoda comments: 'The true leap or growth of a person occurs when he is utterly alone. It is in human relationships or in the actual world that he makes sure of his own leap or growth. But it is not in the actual human relationship that true growth occurs.' This helped Tomoda to 'grasp the significance of the Zen ascetic standing under a waterfall on a mountain or sitting in religious meditation in solitude. In regard to counselling, the true meaning of the Rogerian techniques is that these techniques help the client to be in a state of being utterly alone' (Hayashi et al., 1998). As Hayashi et al. put it, 'Rogers' core conditions . . . have crucial importance and are absolutely necessary, but they are themselves not the sufficient conditions for therapeutic personality change. They are, in fact, prerequisites for the vacuum state . . . The essential meaning of client-centred therapy is in the paradoxical relationship in which a person becomes "utterly alone" through another person's empathic understanding' (p. 113). The way in which this happens is, briefly, that when we sit down with our troubles by ourselves we tend to remain caught in them. We are physically but not psychologically alone (p. 114). The presence of the therapist helps to create a safe space, a 'vacuum', within which we can be with ourselves without being distracted by what Tomoda calls the 'inner strangers', all those parts of ourselves which criticise, undermine and distract us from being who we really are. This kind of view, as Hayashi et al. point out, is very closely paralleled in some of Gendlin's concepts, such as those of 'clearing a space' and 'the client's client'. Tomoda's work gives us a different perspective on person-centred therapy, a perspective which connects in a fascinating cross-cultural way with that which Gendlin has quite independently developed. Rennie David Rennie's (1998) approach 'fits between the person-centred and experiential genres' (p. vi). Rennie follows Rice (see Chapter 5) in emphasising the value of 'evocative reflection' and the use by the counsellor of metaphor and imagery. He follows the processexperientialists generally in seeing a need for process identification and process direction (Chapter 7) in certain circumstances. However, he does not emphasise the use of specific techniques (such as two-chair work) in response to 'markers' of process difficulties (such as 'inner conflict'). Rather, he sees clients as sometimes needing help in dealing with themselves, which can take the form of either process identification 30 Person-Centred Therapy or process direction. In process identification the counsellor draws the client's attention to what they are doing, such as 'remembering' or 'telling a story' or 'complaining'. One function of such process identifications is to facilitate the client's awareness of what they are doing, thus opening up the possibility that they may not wish to be doing it. In process direction the counsellor suggests that the client might do something different from what they are currently doing, for example, by suggesting that the client give some attention to a feeling, or asking the client if they can identify what it is about their situation which is so threatening. Rennie's approach emphasises throughout the self-reflexive aspect of human experiencing. We not only have our experiences, but also reflect upon them, and this self-reflection is crucial to our sense of ourselves as active agents in the world. As Rennie acknowledges (p. 143), the ideal form of living may be one of non-reflective 'flow', but when the flow is blocked, or is in some way unsatisfactory, we need to stop and reflect, to turn our attention to our experiencing. 'Process identification' is involved in the reflexive awareness of what we are doing, such as 'I am experiencing fear' in contrast to the non-reflexive awareness of simply being afraid. As Rennie (pp. 4, 12) remarks, while Rogers' theory has nothing to say about reflexivity, his practice suggests otherwise. Fred Zimring (1990, p. 442) in effect draws attention to this when he concludes from his analysis that 'Rogers's focus was on the person's present reaction to and interest in his or her problem or concern, as well as on the problem or concern itself.' Rogers did not respond just to the problem or to the feeling; he responded to the client's response to the problem or the feeling. As we shall see, this separation of the immediate experiencing from the awareness of the experiencing (the creation of a space between me and my fears, for example) is something that is central also in Gendlin's approach. Like Rogers, Gendlin relates to the client in a way that will help the client to relate to their experiencing. 2 Fault-Lines in Person-Centred Theory Any theory has its weak spots or 'fault-lines' – those places where it is not fully consistent, or where what it predicts does not entirely fit with actual experience. These fault-lines are places from which the theory can grow. In this chapter I will discuss several such fault-lines in the theory of person-centred therapy, and later in the book we will see how Gendlin's work suggests ways in which the theory can be re-structured in ways that eliminate these fault-lines. Of course, new fault-lines may then develop! The agricultural metaphor The picture of human beings as organisms which actualise themselves in environments which may be more or less favourable is central to Carl Rogers' thought. However, as Brian Thorne points out, it is not altogether consistent with Rogers' emphasis on the importance of the client's relationship with the therapist. It seems, as Thorne (1992, p. 88) puts it, that the therapist 'only has to provide a particular psychological environment and the therapeutic process will unfold spontaneously and inevitably'. Thorne remarks that Rogers' 'tendency to employ images culled from agriculture and his emphasis on the actualising tendency and the wisdom of the organism can lead to a highly positive view of the human being but one which is strangely non-relational'. Thorne simply acknowledges 'the inconsistencies and, at times, the logical contradictions in Rogers' point of view' (p. 89), but I think we see here a fault-line in client-centred theory which needs to be taken seriously. 31 32 Person-Centred Therapy Rogers uses the life of plants as an analogy for human life. He sees a plant as an organism which has certain innate developmental tendencies, which will be realised if 'environmental conditions' are favourable, 'environmental conditions' being such things as adequate air, warmth, sunlight and water. The analogy is that human beings have an innate actualising tendency which will be fulfilled if their environment contains the favourable interpersonal conditions of genuine empathy and acceptance. However, even in the case of plants, to think in this way is a serious oversimplification. In order to live fully, a plant needs not only background conditions such as air and sunlight, but specific interactions with elements in its environment. It needs insects to come and pollinate it, and it needs its flowers to be open at the time when the insects are abroad. It needs birds to come and eat its fruit so that its seeds can be distributed. A plant has, or rather is, a set of complex interactions with elements of its environment. The same is true for human beings. In order to live fully, a human being needs not only favourable environmental conditions such as understanding and respect, but a whole range of interactions with other people, animals and material objects. Consider for example the learning of language which is so crucial to being human. A child learns one particular language through detailed ongoing interactions with other people. It is not that the child is ready-programmed with its language (although some aspects may be innate), and only requires the favourable environmental conditions for speech to emerge. And what is true for language is true for everything that involves the child's initiation into its culture, and that culture's ways of seeing and doing things. The background conditions of empathy and respect are crucial, but much detailed interaction needs to go on in the foreground if the child is to develop normally. The picture of a human being as an organism which will flourish so long as its natural growth process is not interfered with has a deep appeal, but I would like to probe it a little more. A picture may help our understanding, but if pressed too far it may mislead. A religious person may say, and mean, that 'the eye of God sees everything' but if someone then insists on asking about God's eyebrows, we know that they have misunderstood the use of the picture. It was not meant to be developed along those lines (Wittgenstein, 1966, p. 71). Let us press Rogers' picture of the biological organism a little bit. First, it is clear that that the natural growth and behaviour patterns of organisms are not oriented entirely towards the survival and flourishing Fault-Lines in Person-Centred Theory 33 of the individual. Think of the bee that dies as a result of its stinging behaviour. Bees are 'programmed' to sting intruders and it is generally to the benefit of the species that this should be done, even if the individual bee dies. Human beings also may well be 'programmed' with instinctive tendencies that involve self-sacrifice. The human mother who will risk her life for her children can be seen as motivated in the same way as the bird mother who makes herself visible to a predator in order to lure the predator away from her nest. Tennyson (In Memoriam, Lyric LV), reflecting on the death of his friend Hallam in relation to Darwin's theory, wrote of Nature as 'So careful of the type she seems/So careless of the single life.' In the background of biological thought is the principle not of the flourishing of the individual but of the species (or, in modern biology, of the genes involved). This is not altogether consonant with Rogers' ideas. But also, according to Darwinian principles, there is no 'goal' or 'general tendency' towards the evolution of the species. It is just that, under the pressure of competition for resources, organisms which are structured in certain ways survive better and leave more offspring than the others. In circumstances where there is no competition for resources, the form and behaviour of organisms (e.g. trilobites) can remain unchanged for millions of years. What was so distinctive, and disturbing, about Darwinian biology was that it eliminated any need for the notion of 'purpose' or 'inherent tendency' in the formation of the organic world. In terms of the evolutionary process we can see how it is that the structure and instinctive behaviour of organisms are oriented towards the occurrence of certain states or the activation of certain processes. There are indeed these specific tendencies, but there is no overall tendency oriented towards the survival or flourishing of either the individual or the species. In other words there is no single 'potential' to be 'actualised'. This way of rethinking (or eliminating) the notion of the actualising tendency is similar to that suggested by Seeman (1988) and by Greenberg and Van Balen (1998, p. 46). The latter suggest that 'it is the biologically adaptive emotion system which provides the scientific basis for the actualising tendency and the associated organismic valuing process'. They accept the actualising tendency as a tendency towards increased complexity which results in greater adaptive flexibility, but reject the notion that it involves the actualisation of potential, or the 'becoming of all that one can be'. However, we do not have to take what Rogers says about 'the organism' as literally as this. Instead we can take what he says as a metaphor for what he knows about certain aspects of human life. 34 Person-Centred Therapy If we follow that line of thought, the notion of human life can be illuminated by the notion of organic life, rather than reduced to it. Our hopes and fears, and our needs and tendencies can be seen as the many interacting processes which go on in a living organism. Our plans develop and come to fruition. We take time to digest a surprising experience. We hear a new idea, and a seed is planted in us which later develops. Overall, our lives involve the growth of experience, maturity, and then the autumn of our days in which we can allow the leaves to fall away. There is an overall pattern in our lives to which all the particular events and processes contribute. Our life is the life of a living whole and we can, if we give attention, become aware of what this living whole needs at any particular time. The metaphor of a human being as an organism seems a very apt one. Indeed, we may now feel unsure again about whether it really is just a metaphor – for, surely we are living things, as well as being conscious animals and rational thinkers. We really do grow, breathe, feed, reproduce and decline in the same way as plants and animals do. We are alive in those ways, as well as 'having a life' in the way that only a human being has a life. If it is said that human beings are different because they are social beings, and that they exist only in interaction with a whole social context, it could be replied that, as I suggested above, plants too exist only in interaction with a whole environmental context. There is no doubt that we really are living things and that therefore our sense of ourselves as actualising wholes must in some way be embodied in our organic nature. Gendlin (1997a) argues that what this shows is that the concepts of modern biology themselves need to be re-thought to allow for creatures like ourselves to be in the world. I will touch on this matter later in the book (in Appendix A), but here I just want to suggest that while it may not be useful to tie Rogers' notions to the scientific concepts of evolutionary biology, there is every reason to relate them to our everyday notion of a living thing. The issue which then remains is not one which relates especially to Rogers or to psychotherapy; it is the issue of how modern biology can connect with our ordinary sense of the distinctive nature of living things. Gendlin has much to say about this in his more philosophical work. 'Being oneself' and 'social restraint' The notion that the nature of human life is essentially social and interactional is very widely accepted today. However, as a number of Fault-Lines in Person-Centred Theory 35 commentators (e.g. Thorne, 1992, p. 88; Holdstock, 1996; Schmid, 2000) have pointed out, this notion seems not to fit well with some aspects of Rogers' thinking. Rogers tends to see human beings as individual organisms which would develop happily, and flourish, if only other human organisms did not come along and impose conditions of worth on them. It can seem, at least, that in Rogers' scheme society comes into the life of the individual in an inhibiting and potentially damaging way. Conflicts are set up between the 'actualising tendency' which is rooted in the organism's biological needs and the requirements – the 'oughts' and 'shoulds' – of society. In the 1960s and 1970s this aspect of Rogers' thought was warmly welcomed by those involved in the 'human potential' movement. It provided support for a counter-culture which, as Mearns and Thorne (2000, p. 178) put it, had a strong preference for 'feelings' over 'thoughts'; for non-self-conscious 'being' over considered action; for 'free expression' over 'censoring'; for 'radical' choices over 'conservative' choices and for 'volume-up' expression of feeling over 'volume-down' expression of feeling. In short, Rogers was seen as advocating 'following one's feelings' rather than 'adapting to society'. In response to this, Mearns and Thorne (pp. 177–86) suggest a reformulation of Rogers' theory which replaces the notion of the actualising tendency with the notion of a balanced interaction between actualising tendency and social restraint. They see human beings as social beings in whom the actualising tendency generates a reaction of concern for the impact of one's action on one's social relationships. Their examples include such cases as 'I fought my way out of a relationship previously, and I lost more than I ever imagined' or 'Everything seemed to point in the direction of leaving the job – I needed to be free of it. But my family would have lost too much – and that would mean me losing too much. So I rolled up my sleeves and made the best of it.' These are examples in which there is a pull towards doing something which one wants to do, which is counteracted by a concern for the impact on other people and on one's relationships with them. However, I think that without any modification to his theory, Rogers can (and did) allow that people have social impulses as well as purely individual impulses. A man both wants to get out of his job and wants his family to be secure. Both these impulses can be seen as aspects of his actualising tendency, just as an animal may have an 36 Person-Centred Therapy impulse to protect its young as well as an impulse to seek its own safety. The examples which Mearns and Thorne give are not obviously examples of conflict between actualising tendency and conditions of worth; they seem rather to be examples of conflict between wanting to promote one's own well-being and wanting to promote the wellbeing of others. I think that the distinction between impulses which come from the actualising tendency and impulses which come from conditions of worth is not a distinction which can be specified (a) in terms of the content of the impulses or (b) in terms of where the impulses come from. (a) I think that it is not simply that the person's actualising tendency favours the welfare of that person, while what comes from the conditions of worth favours the welfare of others. It is often that way, but it need not be: imagine a residential community which is devoted to self-development principles which include the principle of living out one's own needs and not being drawn into 'rescuing' others when they get into emotional difficulties. Everyone agrees that during their time together they will resolutely 'look after themselves'. Then there comes a day when one participant is deeply touched by someone else's pain. Her spontaneous feeling is to put aside her own very real concerns and reach out to this person, but the conditions of worth which she has internalised in the group are very strong, and they prevent her from doing what is natural for her to do. Here her actualising tendency is directed towards the welfare of the other person, while the conditions of worth are directed towards her own welfare. (And situations similar to this really can arise in person-centred training courses.) The distinction between actualising tendency and conditions of worth needs to be made in a quite different way. To act from the actualising tendency should be seen as a matter of acting authentically, which is a matter of giving attention to one's whole sense of the situation one is in, noticing the conflicting impulses, being aware of the moral and prudential principles which seem to apply, and acting from one's felt sense of all that. To act from conditions of worth, by contrast, is to act from some general rule, such as 'You don't reach out to people in this group', without checking the appropriateness of following the rule against everything else which one thinks and feels. The actualising tendency is a tendency that gives expression to the whole person's experiencing of a particular situation, and only that person in that situation can know what the appropriate expression Fault-Lines in Person-Centred Theory 37 will be. Conditions of worth, by contrast, embody general rules which it is important to take into account, but which cannot possibly do justice to the intricacy of the lived situation. The important distinction, then, is not between impulses which will benefit self and impulses which will benefit others, but between impulses which come from deep down in one's whole felt sense of a situation (which takes into account the needs of both self and others), and impulses which arise directly from general principles or rules without any sensing of whether, or how, the rules apply in this situation. The relevant distinction is not that between 'my needs' and 'the requirements of society', but that between 'what I deeply sense is best, taking everything into account' and 'what the rules say'. It is very easy to run these two distinctions together, and then we get caught in the equally unsatisfactory positions of either 'We need to follow our feelings and set aside the rules of society' or 'We need to follow the rules, and set aside our personal feelings.' Part of the confusion here comes from the ambiguity of the word 'feelings' (Gendlin, 1959; Moore, 2002). I think that what Rogers meant when he advocated following one's feelings was what Gendlin means when he says we should be guided by our felt sense of situations. Following feelings is not a matter of indulging emotions or ignoring the needs of others or setting aside moral principles. It is a matter of getting a bodily sense of what the whole situation requires, a feeling which implicitly takes into account one's own emotions and needs, those of others, one's past experience, various principles of morality and so on. Acting from feeling means acting from what Gendlin calls the 'felt sense', rather than acting simply from some strong emotion, or out of habit, or in deference to 'the rules'. (b) A second confusion which complicates the discussion of 'conditions of worth' is that it can look as if conditions of worth are bad because they come from outside us, whereas the actualising impulses are good because they come from inside. This again fuels the idea that if we are to be ourselves, if we are to be authentic, we should always go by our feelings, in the sense of what we want, and take no notice of what anyone else says. It is true that some of our feelings and attitudes seem to come from inside us, and others seem to come more from what we have learned from others. But it is often hard to know which feelings come from where. A child may develop a strong feeling that people should always be truthful, and we might trace this to certain strongly held principles in their family. But the fact that the child has in this way 38 Person-Centred Therapy learned to be truthful does not mean that they have 'introjected a value' which is not theirs. When they grow up they may be genuinely grateful to their parents for having taught them the value of truthfulness. It is a value to which they can authentically and wholeheartedly assent. The fact that it 'came from their parents' does not challenge its authenticity any more than the fact that our knowledge that water is H2O is invalidated by the fact that it 'came from our teachers'. Whether an attitude or value is 'ours' is not a matter of where it came from but that of whether we now can give it our full assent, whether it resonates for us so that we can live it. Of course, some of our feelings and attitudes which 'come from other people' are not authentic. We have taken them in and maybe even act from them, without feeling their validity. But what makes this undesirable is not that the feelings or attitudes have 'come from others' but that they have come from others without our checking whether they are right for us. Much of what is valuable to us 'comes from others' (otherwise education would be impossible); the point is that if our feelings and attitudes are to be authentic, we must not skip the step of checking what has 'come from others' against our own felt experiencing. One final point is that there are cases where we cannot yet feel what other people say is good and valuable, though we can sense that we might come to feel it if only some other things in our makeup could shift. We can sometimes sense, after the matter has been brought to our notice, that it would be a good thing to feel a certain way (for instance