I’ve never considered having psychotherapy, but if I did, there is no doubt which therapy would be my first choice. Ever since I first read that one of the key features of the approach developed by Carl Rogers is that the therapist treats the client with “unconditional positive regard” I have felt that person-centred psychotherapy, as his therapy is known, would suit me just fine.
Rogers’s ideas rose to prominence in the US in the 1940s and 1950s and it is easy to see them as a reaction against the prevailing psychological orthodoxies of Freudian psychoanalysis on the one hand and behaviourism on the other.
These two schools were radically opposed to each other. Psychoanalysts sneered at behaviourists for dealing only with measurable and observable facts of behaviour and ignoring the richness of the inner mental world. Behaviourists scoffed at psychoanalysts for weaving fanciful and untestable theories about repressed conflicts in the unconscious mind from the mundane recollections of their clients.
Despite their mutual antipathy, psychoanalysts and behaviourists tended to agree on one point: the client has the problem and the therapist has the solution. Rogers’s view was more optimistic. He felt that we all have the resources to solve our own psychological problems and a natural tendency to deploy those resources appropriately. Rogers referred to this as the “actualising tendency”.
Of course, circumstances may prevent us from following this tendency. We can tie ourselves in psychological knots, for example, if we are forced to behave in particular ways to gain the approval of our parents, friends or lovers.
This can make us confused about our own wants and feelings. The goal of therapy is to allow the client to revisit and unravel these knots.
The relationship between therapist and client is the key to the therapeutic process, says Sarah Hawtin of the University of East Anglia. The therapist’s unconditional positive regard for the client is an important aspect: it enables the client to express his true feelings without worrying whether they may bring disapproval.
However there are two other qualities that the therapist must also bring to the relationship. The first is empathy in the sense of understanding how the client feels. Only by being aware of that – rather than how she would feel in his position – can she help him to explore his feelings.
Second, even while empathising with the client the therapist must retain a clear sense of how she feels about herself and about him. When appropriate, she must be able to communicate this honestly, although without distracting him from his main purpose which is to explore his own feelings in the framework of a supportive relationship. Only if the therapist retains her sense of her own identity can the client have the sense that he has a relationship with another person.
The detailed arrangements for therapy are kept fairly free in order not to constrain the warmth and supportiveness of the therapeutic relationship. Therapist and client usually sit face to face and the client is free to choose what to discuss. Sessions usually last 50 minutes to an hour and are mostly repeated weekly for as long as the client requires, which can be as short as a few weeks or extend for months or even years.
The effect of exploring his problems in the context of a warm and supportive relationship with the therapist enables the client to develop a stronger sense of self – an understanding of his own needs, wants and feelings. This can enable him to see solutions to problems and also to understand and accept ways in which his needs differ from, and even conflict with, those of people close to him.
Person-centred therapy can be applied to a very wide range of problems. “The theory says there’s no limit,” says Hawtin, “although it may not suit somebody who definitely wants a therapist to give them a structure or to tell them the answer to their problems.”
My wife tells me that it would be no good to me either, but for a different reason. She says that as far as unconditional positive regard is concerned, my problem is that I’ve had too much, rather than too little!
Availability & contacts: Person-centred therapy is widely practised in Europe and the US. In the UK, it is often available through general practitioners in the National Health Service and as a counselling service in large organisations such as universities. The cost of private therapy is similar to the cost of other mainstream therapies.
There is no practical difference between therapy and counselling. In the UK, there is no legal requirement that therapists be registered. Use a reliable referral service such as the Council for Psychotherapy in the UK or the American Psychological Association in the US. The British Association for Counselling (tel: 01788-550899) is also a good source.
Addresses, phones & web sites US: APA tel: 1 800 964 2000, or go to http://helping.apa.org/
UK: UKCP tel: 0207-436 3002 or go to http:// www.psychotherapy.org.uk/
* Psych Yourself Up appears fortnightly.