PS6014 Person-Centred Therapy - Lecture Notes

Week 7 PS6014 PERSON-CENTRED THERAPY  Barry Christie Summary PS6014 Lecturer Journey started in 1970s - Humanistic Co-Counselling Groups in Biography North London...

Week 7 PS6014 PERSON-CENTRED THERAPY  Barry Christie Summary PS6014 Lecturer Journey started in 1970s - Humanistic Co-Counselling Groups in Biography North London Graduated from LSE 1983 Have been working in counselling and psychotherapy since 2000 Main field Sociology with Psychology & Anthropology Personal therapy: Institute of Psychoanalysis - early 1980s United Kingdom Council for Psychotherapy (UKCP) Starting taught training at CAPP 1999 (now Bowlby Centre) Registered Psychoanalytic Psychotherapist from 2006 Honorary position in Bexley Psychotherapy Service (NHS) 2001-02 Areas of interest Core Counselling Skills Bowlby Centre Trainee Learning & Development Clinical Training Committee Member, Course Tutor & Teacher Attachment Theory & Lifecycle Child Development & Observation UKCP Trauma & Complex PTSD Clinical Member - Ethics & Professional Conduct Committees Narcissism & Narcissistic Abuse Addictions & OCD CPJA (UKCP) College Applied Psychoanalytic Theory Training Standards Committee Member & Organisational Assessor Tavistock Centre Visiting Lecturer - Child / Nursery Observation Private Practice Small number of clients in once-a-week psychotherapy Overvie What is person-centred w therapy? Key theoretical concepts Debates/Criticisms Practice for the assignment: formulating the case of Joe A first definition… Person-centred therapy, also known as client- centred, non-directive, or Rogerian therapy, is an approach to counselling and psychotherapy that places much of the responsibility for the treatment process on the client, while the therapist taking a nondirective role. What is the assumption here? Historical background: Humanistic Psychology Third force in psychology after Behaviourism and Psychoanalysis Emerged in the middle of 20th century Partly as a reaction to previous ways of looking at human nature Psychoanalysis was criticised for portraying humans as merely driven by unconscious sexual and aggressive urges Behaviourism was thought to be objectifying and overly reductionist Humanistic Psychology More optimistic – sees humans as striving for choice, values and purpose Focus on the client’s strive for self-awareness and self- fulfillment Human beings have some choice and, with that, responsibility Holistic stance: humans supersede the sum of their parts Acknowledges spirituality Humanistic therapy Humanistic therapy is an umbrella term Comprises various therapeutic approaches Person-centred Existential-phenomenological Gestalt Transpersonal Transactional  Carl Rogers was a psychologist Carl Rogers Born in Illinois was the fourth of SIX children 1902-1987 Quite a “sick’ child and lived in a conservative (fundamentalist Christian) family Often teased by family and often shared little emotions/ feelings with family members Adopted family motto ‘others act in dubious ways, which we do not approve of in our family’ Studied agriculture, then history and then religion, wanted to be a minister Went to China aged 20, felt free from parental religious influence- which he saw as becoming an independent person. 1924- had internship at Institute of Child Guidance Received PHD in 1928 and published first book The Clinical Treatment of the Problem Child Shift from diagnosis to listening Prolific writer – many journal articles and books Rogers’s Client-centered Therapy: Its Current Practice, Implications and Theory (1951) first outlined his ideas for his therapeutic model Rogers introduced the word ‘client’ in therapy A therapist who engaged with research THEORETICAL CONCEPTS Person-Centred Therapy Main elements/ideas: Self-actualisation The self-concept Conditions of worth The organismic valuing process The locus of evaluation Self-actualisation Or the actualising tendency as Rogers called it: “It is the urge which is evident in all organic and human life – to expand, extend, to become autonomous, develop, mature – the tendency to express and activate all the capacities of the organism, to the extent that such activation enhances the organism or the self.” (Rogers, 1961, p. 35) Seaweed as a metaphor for self-actualisation “Here in this palmlike seaweed was the tenacity of life, the forward thrust of life, the ability to push into an incredibly hostile environment and not only to hold its own but to adapt, develop, become itself.” (Rogers, 1977, p. 237-238) Self-actualisation The self is: Trustworthy Constructive (enhanced effectiveness) So, the self will self-actualise by: Moving away from facades and oughts Moving away from meetings expectations and pleasing others Moving toward trust of self- and self direction Moving toward process and complexity Moving toward openness to experience and acceptance of others Moving toward wholeness and integration Debate: Actualizing tendency Thus, the concept of actualizing tendency describes an inherent tendency within ourselves to grow and reach our full potential. The assumption here might be that we are all born with the ability to develop into the best versions of ourselves. What do you think about this view of human nature? Which considerations could challenge this view? The self The self is the result of individual’s experiences and the awareness of self is what helps a person differentiate him/her from others Rogers differentiates between the real self and the ideal self The more is the gap between the real and ideal self, the more will be the maladjustment - incongruence Crucial to the development of the real self are early experiences of interacting with others: unconditional positive regard conditional positive regard Conditions of worth A condition of worth is a condition we believe we need to meet in order to receive (deserve?) love and respect (REGARD) Those raised in an environment of conditional positive regard feel worthy only if they match conditions - conditions of worth - that have been laid down for them by others Thus, sense of worth is conditional upon winning approval and avoiding disapproval from others Need for approval so great that conditions of worth are accepted and eventually internalised Those raised in an environment of unconditional Unconditional positive regard Unconditional regard (acceptance) from significant others Unconditional self-regard Full functioning and self- actualisation But…conditional positive regard Conditional regard from significant others leads to… Conditional self-regard, which leads to… Psychological problems Congruence Defining feature of psychological health Congruence between experiencing, awareness and communication If I am accurately aware of what I am experiencing, then I will be internally congruent. If I communicate accurately my awareness of my experience to others, then I will be externally congruent. The organismic valuing process Intrinsic ability to make judgements about experiences Human organism capable to provide reliable messages about its needs Helps individual to have a sense of what they need for their enhancement When in conflict with the need for approval, person will develop a self-concept that separates him/her from organismic experience or become distrustful of it Example: Early confusion of the organismic valuing process Child: (Falls over and cuts his knee; runs crying to his mother for comfort or assurance) Mother: What a silly thing to do. Stop crying and don’t be such a baby. It’s hardly bleeding. Child: (Thinks: it’s stupid to fall over; it’s wrong to cry; I shouldn’t want mummy’s support but I need it. But I wanted to cry; I wanted mummy’s cuddle; I wasn’t stupid. I don’t know what to do. Who can I trust? I need mummy’s love but I want to cry.)  The creation of disturbance Due to criticism of others, the person grows more doubtful of the validity and acceptability of own thoughts and feelings In order to obtain approval, s/he has to deny or distort the information provided by the valuing process and pursue an ideal fake self This is a difficult task and self-image is constantly under threat This leads to internal conflict between self- concept and self-experience = disturbance Internal locus of evaluation In Latin ‘locus’ means ‘place’, so the term describes the place from which a person makes a judgment of value Internal locus of evaluation Trusting and following the organismic valuing process Ability to make decisions based on own source of wisdom and without fear of rejection Open to experience and able to listen to themselves and others In other words, how much we trust and value our view or self External locus of evaluation External locus of evaluation Poor self concept Organismic valuing process no longer source of knowledge and guidance Difficulty knowing what s/he thinks or feels Difficulty in making decisions Reliance on external sources for guidance Desperate attempts to please everyone In other words, how much we trust and value others’ views of us Locus of evaluation in the therapy room A common indication that someone is operating from an external locus of evaluation is that they use the word ‘should’ or ‘ought’. For example, a bereaved client might say: ‘It’s six months since my mum died. I should be feeling better by now.’ Or someone whose parents had been emotionally cold towards her might say: ‘I ought to be grateful really, because they weren’t cruel to me, and I was always warm and well-fed.’ Clients with a predominantly external locus of evaluation may try to get the counsellor to say what they think or to provide advice. It is important always to keep the locus of evaluation with the client. This includes not praising the client, ‘which is just as much a judgement as condemning the client’. So, for example, if a client arrived in a session and jubilantly announced, ‘I’ve not had a cigarette all week!’ ‘Well done! I’m so pleased with you’ (reinforces external of evaluation). ‘I can see you’re delighted with that, and so proud of yourself’ (encourages internal of evaluation). Criticisms of PCT Actualising tendency, simply another abstract concept like Freud’s id, ego and superego – impossible to directly observe The approach is hard to empirically evaluate People argue that the person-centred approach is overly optimistic about human nature Too passive an approach – too much nodding and not enough direction! More direct approaches to change cognitions and subsequent behaviours are necessary Too much focus on individual autonomy at the expense of social belonging and environmental resistance In-class practice: the case of Joe