The Person-Centred Approach to Therapeutic Change

Michael McMillan

• Publisher: SAGE Publications Ltd
• Year: 2004
• Print ISBN: 9780761948698, 9780761948681
• eBook ISBN: 9781446232576
• Edition: 1
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

From the Foreword

`It is an honour to be asked to write a foreword for this new book by Michael McMillan. I have been excited about this book ever since I read early drafts of its first two chapters some time ago at the birth of the project. At different times thereafter I have read other parts and my consistent impression has been that this is an author who has both a sophisticated academic understanding of the material and a great skill in communicating that widely. Those two qualities do not often go together!

The book is about change. After a first chapter in which the author introduces us to the person-centred concept of the person, chapter two is devoted to the change process within the client, including a very accessible description of Rogers? process model. Chapter three goes on to explore why and how change occurs in the human being, while chapter four introduces the most up-to-date person-centred theory in relation to the nature of the self concept and its changing process. Chapters five and six explore why change occurs in therapy and the conditions that facilitate that change, while chapter seven looks beyond the core conditions to focus on the particular quality of presence, begging the question as to whether this is a transpersonal/transcendental quality or an intense experiencing of the core conditions themselves.

This is an intensely modern book particularly in its postmodern emphasis. Rogers is sometimes characterised as coming from modernist times but he can also be seen as one of the early post modernists in his emphasis on process more than outcome and relationship more than personal striving. The modern nature of the book is also emphasised by a superb analysis of the relationship between focussing and person-centred therapy in Chapter five, linking also with Polanyi?s notion of indwelling in this and other chapters. In suggesting that in both focussing and person-centred therapy the therapist is inviting the client to ?indwell? himself or herself, the author provides a framework for considering many modern perceptions of the approach including notions such as ?presence? and ? relational depth?. Also, the link with focussing is modern in the sense that the present World Association for the approach covers a fairly broad family including traditional person-centred therapists, experiential therapists, focussing-oriented therapists and process-guiding therapists. Important in this development is the kind of dialogue encouraged by the present book? - Dave Mearns, Strathclyde University

The belief that change occurs during the therapeutic process is central to all counselling and psychotherapy. The Person-Centred Approach to Therapeutic Change examines how change can be facilitated by the counsellor offering empathy, unconditional positive regard and congruence.

The Person-Centred Approach to Therapeutic Change outlines the main theoretical cornerstones of the person-centred approach and then, applying these, describes why change occurs as a result of a person-centred therapeutic encounter. The author explores the counselling relationship as an environment in which clients can open themselves up to experiences they have previously found difficult to acknowledge and to move forward.

Integral to the person-centred approach is Carl Rogers? radical view that change should be seen as an ongoing process rather than an alteration from one fixed state to another. In Rogers? view psychological health is best achieved by the person who is able to remain in a state of continual change. Such a person is open to all experiences and is therefore able to assimilate and adapt to new experiences, whether ?good? or ?bad?.

By focusing explicitly on how change is theorized and facilitated in counselling, this book goes to the heart of person-centred theory and practice, making it essential reading for trainees and practitioners alike.

1 The Concept of the Person: Vulnerable, yet Fundamentally Trustworthy

The person-centred approach is often criticised for being somewhat lacking in theoretical complexity. Carl Rogers, the founder of person-centred (originally ‘client-centred’) therapy, is dismissed by many as being too simplistic or just plain naive in his attempts to describe and explain the psychological development of the person (for example, Masson, 1989). Indeed, the person-centred approach has sometimes been caricatured as being at the ‘tea and sympathy’ end of the psychotherapy spectrum. Such caricature is somewhat surprising given that Rogers, particularly in his earlier work, writes in an exact and scientific language. People are ‘organisms’; terminology is painstakingly categorised and described; complex diagrams meticulously delineate psychological relationships. Rogers’ use of language did change as he grew older, with a decrease in the use of terms common to scientific psychology, perhaps reflecting the fading of the influences he experienced early on in his life and career (Thorne, 1992). But despite this change he remained consistent with his original statements of theory regarding the person and their development, seemingly not feeling the need for any major revisions.

His exposition of relatively simple ideas is not necessarily one that is insubstantial and he would no doubt agree with the statement that ‘simplicity is not a goal, but one arrives at simplicity in spite of oneself, as one approaches the real meaning of things’ (Lewis, 1974: 20). Any suggestion that his theory is lightweight, however, would seem misplaced; his theory of psychological maladjustment has at its centre a simple hypothesis but this does not mean it is lacking in substance and rigorous analysis. Indeed, Rogers describes his ideas in quite some detail and many other writers have commented on and revised his work as well (see the Further Reading sections at the end of each chapter). A lengthy investigation of his theoretical framework, therefore, is not required here, although a summary of the fundamental principles of his theory is essential to the consideration of how change occurs as a result of the counselling process.

The actualising tendency

At the centre of Rogers’ theory is the notion of an actualising tendency. He postulates that ‘there is a formative directional tendency in the universe, which can be traced and observed in stellar space, in crystals, in micro-organisms, in more complex organic life, and in human beings’ (Rogers, 1980: 133). The actualising tendency, the term most often used when referring to this formative tendency in human beings, is ‘the inherent tendency of the organism to develop all its capacities in ways which serve to maintain or enhance the organism’ (Rogers, 1959: 198). It is absolutely fundamental to life, to the extent that Rogers remarks, ‘only the presence or absence of this total directional process enables us to tell whether a given organism is alive or dead’ (Rogers, 1980: 118). Crucially it is the only motive that Rogers presents in his understanding of human life; it incorporates all other motivational concepts such as tension or drive-reductions that are often differentiated in other theories. The actualising tendency is, however, concerned with increasing tension, as the organism is in a constant state of enhancement (Bozarth and Brodley, 1991); in any case, all directional motives are incorporated in this one tendency.

For Rogers, this inherent and unceasing tendency for all organisms to fulfil and enhance their potential is encapsulated in a memory he has about potatoes. Potatoes would not seem to be the most dynamic example to elucidate the central thesis of a theory on human development but these potatoes proved to Rogers that the actualising tendency would remain present even under the most adverse of circumstances. Interestingly, he observed, it would not be extinguished but it could be distorted:

I remember that in my boyhood, the bin in which we stored our winter’s supply of potatoes was in the basement, several feet below a small window. The conditions were unfavorable, but the potatoes would begin to sprout – pale white sprouts, so unlike the healthy green shoots they sent up when planted in the soil in the spring. But these sad, spindly sprouts would grow 2 or 3 feet in length as they reached toward the distant light of the window. The sprouts were, in their bizarre, futile growth, a sort of desperate expression of the directional tendency I have been describing. They would never become plants, never mature, never fulfill their real potential. But under the most adverse circumstances, they were striving to become. (Rogers, 1980: 118)

Thus this memory highlights two important factors: the tendency towards enhancement cannot be destroyed unless the organism itself is destroyed because it simply exists within it; but the organism’s tendency towards enhancement can be distorted under adverse conditions. This first aspect is fundamental to the whole ethos of the person-centred approach and is integral to any consideration of how change occurs: the actualising tendency is innate and permeates the whole organism, not just one or other part of it. It is continually trying to maintain and enhance the organism as a whole and as it wants for nothing but the maintenance and enhancement of the organism, it is entirely trustworthy. It is not something that requires anything ‘doing’ to it in order for it to work – it just is. The second aspect is also important, as will become clear in this chapter, because it underlines the fact that the tendency is susceptible to adverse conditions and so growth and development can become distorted.

Trusting the organismic valuing process

Rogers thought of this tendency within living beings as a kind of organismic valuing process and found evidence of its existence in babies in the way they acted upon their instinctual needs (Rogers, 1973). He found that in experiments where babies were allowed to choose between a variety of foods on offer, the infants made choices based on what they needed to maintain and enhance their own well-being and growth. They would balance their intake of proteins, carbohydrates and vitamins to match their body’s needs; if they ate too much of something they would soon stop and counteract the effect by eating a different food group. Rogers thought that the babies could not have learned this – it was evidence of their innate internal valuing process occurring uninhibitedly.

With reference to the therapeutic setting, Rogers believes that trusting in this innate valuing process is central to the activity of counselling. Thus it ‘is not a matter of doing something to the individual, or of inducing him to do something about himself. It is instead a matter of freeing him for normal growth and development’ (Rogers, 1942: 29). Rogers’ memory of the potato sprouts is, for him, comparable to his work with clients whose lives have been ‘warped’ by adverse circumstances (1980: 118). Although some of these people’s behaviours may seem ‘abnormal, twisted, scarcely human’, Rogers views these people as striving to enhance themselves in the best ways that are available to them (1980: 119). Even though this may produce somewhat distorted results, the actualising tendency is clearly still present within them and can continue to be trusted. This fundamental trust in the person is a startlingly different stance from that taken by many other therapies, where the emphasis is on in some way constraining rather than liberating the essence of human nature. In these therapies the essence is viewed as at least partly destructive as opposed to wholly constructive.

Rogers has come under criticism for what many believe to be his naive view of human nature (for example, Masson, 1989; Spinelli, 2000; and perhaps most famously, May, 1990). May (1990) described in some detail why he thought Rogers’ view of an essentially ‘good’ human nature was misconceived, arguing in a similar way to Buber (Buber and Rogers, 1960) that there must be both good and evil present within all human beings. Rogers’ response to May was emphatic: ‘I feel that the tendency toward actualization is inherent. In this, man is like all other organisms. I can count on it being present … I find in my experience no such tendency toward destructiveness, toward evil. I cannot count on the certainty that this individual is striving consciously or unconsciously to fulfill an evil nature’ (Rogers, 1990b: 253). As Spinelli (2000) comments, Rogers may have subsequently wanted to add to the answer he gave to May at that time because it was in some ways inadequate, but Rogers’ fundamental view of the actualising tendency being the enhancing source of human nature did not alter. Even as late as 1986 Rogers, when reflecting on the significant elements of a counselling session with a client, Jan, wrote of ‘a trust in the “wisdom of the organism” to lead us to the core of her problems …when trusted, her organism, her nonconscious mind – call it what you will – can follow the path that leads to the crucial issues’ (Rogers, 1990a: 151). Implicit within this was his belief that once identified, Jan would also be able to address ‘the crucial issues’ in the best possible way for herself. Thus his trust in the person remained an integral element of the therapeutic relationship: change may occur, not because of what the counsellor does to the client but rather as a result of the counsellor liberating what already exists within the client.

This is exemplified by three filmed interviews conducted by Rogers and other leading therapists of the time (Fritz Perls and Albert Ellis) with a client called Gloria (Shostrom, 1964). Immediately after the sessions, Gloria comments that if she were beginning therapy she would choose to work with Rogers, but in her current state she thought the challenging style of Perls would be of most help. However, Rogers actually met Gloria a year or so after the filmed interviews had taken place, when she came to a conference he was running at which the participants watched the film of Gloria’s sessions. Rogers reports that on seeing the session of herself with Perls she was clearly distressed, exclaiming ‘Why did I do all those things that he asked me to do! Why did I let him do that to me!’ (Rogers, 1984: 424). Rogers comments: ‘She felt that she had somehow given over her power and this enraged her’ (1984: 424). Rogers, of course, had not ‘asked’ Gloria to do anything in his session with her, he had simply trusted her to lead the way in their exploration of her situation, believing in the client’s ability to find her own ways and means of overcoming her difficulties. It seems that ultimately his way of being with her was of greater value. Thus, the person-centred counsellor, with their trust firmly in the capabilities of the client and their capacity for change, can perhaps best be thought of as attempting to facilitate a reunion: the re-connection of the self with the client’s inherent capabilities.

The self and unconditional positive regard

How, then, does this actualising tendency become distorted in people – how is the internal valuing process affected when subjected to adverse circumstances? This is another aspect that is central to Rogers’ theory and involves two key concepts: the self and unconditional positive regard. Rogers (1951), in an attempt to clarify his thinking about personality and behaviour, presented his hypotheses at the time in the form of 19 propositions, and number nine offers a succinct description of his understanding of the ‘self’:

As a result of interaction with the environment, and particularly as a result of evaluational interaction with others, the structure of self is formed – an organized, fluid, but consistent conceptual pattern of perceptions of characteristics and relationships of the ‘I’ or the ‘me,’ together with values attached to these concepts. (Rogers, 1951: 498)

Here, Rogers hypothesises that due to a child’s interaction with their environment, and particularly through their interaction with other people, they develop a sense of their own ‘self’. Within the child there now exists the actualising tendency as before, which the child experiences (without consciously thinking about it) through their own organismic valuing process. But there is also an element of awareness that is conceptualised as ‘self’, which is, at its simplest, an awareness of being in existence. As this concept of self gradually develops, the child increasingly comes to be valued by (and in relation to) the other people around them and the child wants to actualise this self-concept as well as continuing to have their own organismic valuing process. This is a major shift in the child’s development as now, in effect, there is a sub-system of the actualising tendency: self-actualisation.

Distortions in the actualising tendency

Once this differentiation exists within a person it is possible to consider how the actualising tendency could become distorted. If self-actualisation is in no way different from the actualising tendency, then the actualising tendency will function uninhibitedly and the person will naturally continue to maintain and enhance themselves as before. But if there is any discrepancy between the two, then one may begin to function at cross-purposes to the other: the greater the discrepancy, the greater the counter-functioning.

Returning to the babies of the experiment that Rogers referred to, at this stage of their development the actualising tendency functions uninhibitedly within them. Through their own organismic valuing process they function in ways that maintain and enhance themselves. They eat the right types of food in the correct quantities in order to keep themselves nicely balanced. Children generally at this stage of development seem to have a clear sense of what they need and do not need, what they like and dislike. A child does not like the experience of hunger unfulfilled and so will eat. A child enjoys a sense of security and so will value being hugged and caressed. A child enjoys new experiences for the simple sense of discovery that comes with them, such as discovering they can reach and feel their toes for the first time (Rogers, 1973). All of these examples show the actualising tendency at work within the child. The child does not like or value pain, though, or loud and unexpected sounds and this is consistent with the notion that the actualising tendency is concerned with the maintenance and development of life, not the sabotage or destruction of it (Rogers, 1980).

As the child begins to develop a sense of self they become aware of their interaction with others and this brings a new type of sensation. Now, in addition to their own internal valuing process they begin to process their experience in relation to external values. The child needs love and places great value on it, to the extent that they are prepared to adapt their behaviour in order to receive it, even if this contradicts their own internal valuing process. Whether or not this is a learned or inherent need is, for Rogers, somewhat irrelevant – what is important is that the child tends to try to elicit love from significant others (usually parents) by behaving in ways that they hope will achieve this outcome.

While this perceived positive value (the feeling of being loved by the significant other) is in accordance with their own internal values, there is little cause for concern as the two experiences are congruent. But problems start where these two experiences are not the same, where they are incongruent. For example, the child enjoys the moment of experiencing the taste of what grown-ups call ‘dirt’ but is chastised by the mother, who shrieks, ‘Get that out of your mouth, it’s disgusting’. Or the child wriggles and screams in a desperate attempt to avoid eating the yukky green stuff that his father is convinced will be good for him: ‘Come on, eat it up now like a good boy.’ The internal valuing process says one thing yet the other individuals, from whom the child needs love, say the opposite. Because the need for love is so strong it often overrides the child’s internal valuing process. Thus the child denies himself the pleasurable sensation of the delight and the disgust of the taste of the stuff called dirt; he tries to force down a little bit of that yukky green food that makes him feel sick. He does this in an attempt to win the love or positive regard, as Rogers called it, of the other person (Rogers, 1959). Indeed, this need to receive positive regard is so strong that it can potentially become more powerful than the actualising tendency. Thus, although not a motivational drive (the actualising tendency is the only one in Rogers’ theoretical system, as mentioned earlier), ultimately it can be the more dominant force.

Conditions of worth

In the two examples just presented, the positive regard on offer could be described as conditional: the other people (the parents) display displeasure in relation to the child’s actions – they clearly value one type of behaviour more positively than another. Rogers believes that the result of this over time is for the child to introject these values and adopt them as if they are their own. Thus the child deserts their own valuing system, which has the actualising tendency as its trustworthy base, and takes on the values of others in an attempt to maintain the positive regard they provide. For Rogers, this is the root cause of distortion in the otherwise healthy and life-enhancing development of the person. Once the child’s valuing system moves from an internal to an external source they can be described as having acquired conditions of worth, as their sense of worth is dependent on how others regard them. The only way for distortion not to occur is if the positive regard offered is unconditional – if the person can ‘perceive that of one’s self-experiences none can be discriminated by the other individual as more or less worthy of positive regard’ (Rogers, 1959: 208). Rogers believes that such a situation does not exist in real life because everyone experiences some conditions of worth. In theory, though, if unconditional positive regard is always experienced, self-actualisation will be congruent with actualisation and the person will exist in a state of continual self-maintenance and enhancement.

The introjection of conditions of worth starts almost as soon as a sense of self emerges but can continue throughout a person’s life. Conditions of worth are not just present between the child and their parents (or significant others) during a certain developmental period, a period that some theories of the person suggest defines the type of person that will emerge into adulthood. A person can continue to be affected by the same or different conditions at any stage of their life. In addition, conditions of worth tend to be communicated in an implicit as well as explicit manner, which perhaps makes it more difficult for a person to realise that the process is...

Table of contents

• Cover Page
• Title
• Copyright
• Contents
• Foreword by Dave Mearns
• Preface
• 1 The Concept of the Person: Vulnerable, yet Fundamentally Trustworthy
• 2 Personal Change Through Counselling: an Overview of the Process
• 3 The Evaluation of Experience
• 4 The Complex Nature of the Self-Concept
• 5 Experiencing and Psychological Movement: Why Change Occurs
• 6 The ‘Necessary and Sufficient Conditions’ for Facilitating Change
• 7 Beyond the ‘Necessary and Sufficient Conditions’: the Notion of Presence
• 8 The Challenge Facing the Client: Being Yourself in the Twenty-First Century
• References
• Index