Nondirective Psychotherapy

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Nondirective psychotherapy was developed by the humanistic psychologist, Carl Rogers, in the 1940s and 1950s. It is used to help a person achieve personal growth and/or come to terms with a specific traumatic event or psychological problem. The method has proved effective and popular, although it has been criticized for its lack of structure. The strength of the approach lies in the emphasis of harmonious relationships, based on respect, congruence, and empathy, in promoting healthy psychological development. However, while ensuring that the counselor is non-judgemental and, therefore, not threatening to the client, there is a concomitant loss of authority and lack of norms, or at least alternative viewpoints, to guide clients in deciding how to change in order to achieve greater psychological health.

Introduction

Carl Rogers developed Nondirective psychotherapy, also called Client-centered therapy and later, the Person-centered approach, reflecting Rogers' belief that his model applied to interactions between all people, not just therapist-client relations. It is also commonly referred to as Rogerian therapy. Along with Abraham Maslow, Rogers was the founder of the humanistic approach to psychology.

He referred to his approach as counseling rather than psychotherapy, and preferred the term "client" over "patient." He also believed that the relationship between the client and the therapist is not a patient-doctor relationship in which the patient passively submits to something that is done to him or her by the healer. On the contrary, it should be a person-to-person relationship in which the therapist talks with the client.

Personality Theory

The person-centered approach was developed by Carl Rogers based on his theory of human personality. He believed that all human beings naturally strive to achieve their potential, so that mental health is actually the process of psychological development; mental disturbance is the result of distortion in this growth process.

Actualizing tendency

Rogers believed that all creatures have a built-in life force, that he called the "actualizing tendency," which functions as motivation to develop one's potential as fully as possible. Abraham Maslow referred to this process in human beings as "self-actualization." Rogers viewed psychological development as the process of a person following the path of actualization and so becoming more fully themselves.

Fully functioning person

The "healthy person", as termed by Rogers, is the one who is clearly on the path of actualization, as "fully functioning," and he identified five qualities that make us healthy:

Openness to experience means that one is able to accurately perceive one's feelings and experiences in the world, and accept that reality. Openness includes feelings, because these are what convey "organismic valuing," or the sense of whether something is good or bad for the person.

Existential living means living in the present rather than the past, which has gone, or the future, which does not yet exist. Rogers did not mean that the past and future do not exist, though, only that they should be recognized as what they are: the past is contained in memories from which we can learn, and the future contains our dreams, hopes, and plans for what we intend to do. The present, however, is the reality that we must deal with now.

Rogers believed that organisms know what is good for them: evolution has provided all living creatures, including plants, animals, and human beings, with senses to discriminate between what is good and what is bad for them. Therefore, people should allow themselves to be guided by this process, trusting their own thoughts and feelings as accurate, and doing what comes naturally. According to this view, what feels right is the right thing for a person to do.

However, it is important to understand that Rogers did not advocate hurting others or ones’ self just because it might feel good. For Rogers, organismic trusting means trusting what one's "real self" feels, the real self-being in touch with what is actually good for the person.

Experiential freedom refers to the feeling of freedom that we have when choices are available to us. Rogers noted that we are not free to do anything we might want, but there are many aspects of life in which we make choices. Acknowledging these choices and taking responsibility for one's actions is how a fully functioning person experiences freedom.

Rogers believed that the healthy, fully functioning person naturally participates in human society, and makes every effort to give their best possible contribution to the world. Such contributions may be through work, social relationships, or creative work in the arts or sciences.

Psychological problems

According to Carl Rogers, although we may be born with organismic valuing and an actualizing tendency, the environment in which we live does not always support our needs, and in fact, often misleads us as to what is really in our best interest. This occurs both on the physical level, as food which tastes good is not necessarily nutritious, and on the social level when our culture values behavior that is counter to our natural disposition, such as the American emphasis on expressiveness and social interaction that is anathema to the more reserved, contemplative, or introverted type, or when teenagers experience pressure to become sexually active while their conscience tells them that maintaining sexual purity until reaching a higher level of maturity is right for them.

Rogers also noted that society often puts conditions on approval, so that we are rewarded with what we need only when we have shown our "worth," and positive regard is withheld from those who do not behave according to society's norms. When these norms are not in our best interest, we lose touch with our organismic valuing and our actualizing tendency, and mold ourselves into "good" people, who may not be happy or healthy. The result of this is that we cease to function according to the nature of our original, real self, and become more and more distant from our goal of being fully functioning, healthy individuals.

The aim of person-centered counseling is to decrease the gap between the client's current way of functioning and the nature of their original, real self.

Incongruity

Rogers called the "real self" that aspect of an individual that is pursuing the actualizing tendency, following organismic valuing, needing and receiving positive regard and self-regard. It is an individual's potential on the way to being realized. On the other hand, due to society imposing conditions of worth that are out of step with organismic valuing, we develop an "ideal self." This ideal self is not realistic, but a standard that cannot be met, an impossible goal to achieve. The gap between this "ideal self" and the "real self" is what Rogers termed "incongruity." The greater the gap, the greater the suffering a person experiences. This suffering, due to the mismatch between one's idealized self and one's true self, is Rogers' understanding of neurosis.

Defenses

Rogers developed the idea of "defenses," similar to the defense mechanisms of Freud, to explain what we do when we experience incongruity between our idealized image of our self and our real self. Such incongruity is threatening, and brings on a feeling of anxiety, which leads us to take defensive action.

For Rogers, there are two psychological defense mechanisms: denial and perceptual distortion. Denial is a refusal to acknowledge the threatening situation, either by ignoring some reality (at least temporarily), or by keeping a memory of an unpleasant situation out of one's awareness, again only temporarily. Thus, it includes both denial and repression in Freud's model. Perceptual distortion is similar to Freud's rationalization, involving a reinterpretation of the situation to make it less threatening. Thus, an individual may blame others or some circumstance beyond their control for their failure, or misinterpret feedback as positive or supportive when in fact it was critical.

The problem with using defense mechanisms is that the gap between the ideal and the real self tends to increase, causing more anxiety, which in turn leads to further use of defenses. The neurotic person becomes unable to free him or herself from this cycle of behavior without outside assistance.

Rogers suggested that psychosis is the extreme result of such a situation, when a person's defenses have become so overwhelmed that they can no longer protect the sense of self. At that point, a "psychotic break" occurs, and the person exhibits bizarre behavior, becomes disoriented, experiences inappropriate emotions, and appears to have lost their sense of identity.

Therapy

Rogers took the position that every individual has, within him or herself, the resources for personal development and growth, and that it is the role of the counselor to provide favorable conditions (namely congruence, empathy, and unconditional positive regard) for personal development to occur naturally. Living in the present, rather than the past or future, with organismic trust, faith in one's thoughts and feelings, and a responsible acknowledgement of one's freedom with a view toward participating fully in the world and contributing to other people's lives, are hallmarks of Rogers' approach to counseling.

According to Bozarth (1998), the basis of Rogers' Client-centered approach can be summarized as follows:

  1. There is one motivating force in a client; i.e., the actualizing tendency.
  2. There is one directive to the therapist; i.e. to embody the attitudinal quality of genuineness, to experience empathic understanding from the client’s internal frame of reference, and to experience unconditional positive regard towards the client.
  3. When the client perceives the therapist’s empathic understanding and unconditional positive regard, the actualizing tendency of the client is promoted.

Requirements of the therapist

Rogers identified three attitudinal requirements for a counselor to be effective: empathetic understanding of the client's emotions and perspective, congruence or genuineness, and unconditional positive regard for the patient. This emphasis contrasts with the dispassionate position that may be advocated for other methods of therapy.

Empathetic understanding

Empathetic understanding means that the counselor accurately understands the client's thoughts, feelings, and meanings from the client's own perspective. When the counselor perceives what the world is like from the client's point of view, it demonstrates not only that their view has value, but also that the client is being accepted as a person. However, the counselor should not become bound up in the client’s emotions; they should be able to recognize that they are experiencing the client's emotions and simultaneously maintain their own perspective.

Congruence

By "congruence," Rogers meant that a counselor should be authentic and genuine; he or she should not present an aloof professional facade, but rather be real and transparent to the client. There should be no air of authority or hidden knowledge. Thus, the client should feel that the counselor is being honest with them, and responding as a true person, not analyzing the client's communication according to some theoretical system.

Unconditional positive regard

To create an atmosphere of psychological safety within the counseling relationship, Rogers believed the therapist should have unconditional positive regard, or respect, for the client—that is, not judge the client’s character or personality. If the client feels that his or her character is being evaluated, he or she will put on a false front or perhaps leave therapy altogether. The client should feel free to explore all thoughts and feelings, positive or negative, without danger of rejection or condemnation. There should be no particular actions, communications, or standards of behavior that must be met to "earn" positive regard from the counselor. By giving unconditional positive regard, the counselor provides a partial antidote to the client's previous experiences in which parents, teachers, and other authority figures acted toward them as if they had no intrinsic value as a person; their value being derived from behaving in the way others say they ought to behave.

Reflection

The main technique Rogers recommended is that of "Reflection," or the mirroring of emotional communication. For example, if a client says, "I hate men!" the therapist responds, "So you hate all men?" By doing so, the therapist is letting the client know that he or she is listening and trying to understand, as well as clarifying what the client is communicating. Clarification occurs when the therapist abstracts the core or the essence of a set of remarks by the client. In this case, the client may well acknowledge that she does not hate all men, certainly not her brother, father, or some others, hopefully including the therapist, if he is a man. Finally, she may realize that it is not hate she feels, but rather a lack of trust toward men, as a result of being hurt by a particular man.

Group therapy

Rogers' approach has been applied not only to individual clients, but also to small groups. He coined the term, "Basic Encounter Group" to identify groups that operated on the principles of the person-centered approach, which he believed offered a unique and effective paradigm for group therapy.

The functional application of the person-centered approach to groups includes: being completely present and totally attending to people; promoting equivalency in people; and not presupposing what people will be like, do, or become, during or after the therapeutic encounter. The person-centered approach in groups does not usually presuppose such considerations as the target population, size of the group, establishment of goals and ground rules, or specific facilitator or participant behaviors (Bozarth 1986).

Rogers (1970) once recommended that the best size for encounter groups was eight to ten people. However, further experience with groups led him and his colleagues to consider ways of working with larger groups, including as many as eight hundred people. The major selection criterion for group members is that each person be willing to attend and participate in the group experience. Participants nearly always select themselves to be in such groups. They are usually from a variety of geographical locations, jobs, and have multiple reasons for attending groups.

Group goals are not defined prior to the group experience, and although the group may develop goals, these are often more in the form of plans, such as scheduling meetings at certain times, and decisions to meet for certain lengths of time. The group will often move in a common direction as though the group is one organism (Rogers, 1970). However, such direction is not in the form of goals.

The role of the facilitator in the person-centered group is that of creating an atmosphere in which members are enabled to discover their own power to heal themselves. The facilitator does not necessarily expect that any particular process will occur, nor will he or she attempt to accelerate any particular process. The facilitator acts on the assumption that participants have the power within themselves to resolve their problems, heal themselves, and move in positive constructive directions.

Rogers describes his facilitator role in the following way:

My hope is gradually to become as much a participant in the group as a facilitator. This is difficult to describe without making it appear that I am consciously playing two different roles. If you watch a group member who is honestly being himself, you will see that at times he expresses feelings, attitudes, and thoughts primarily directed toward facilitating the growth of another member. At other times, with equal genuineness, he will express feelings or concerns that have as their obvious goal the opening of himself to the risk of more growth. This describes me, too, except that I know I am likely to be the second, or risking, kind of person more often in the later than in the early stages of the group. Each facet is a real part of me, not a role.

(Rogers 1970: 48-49).

The fundamental assumption of the person-centered approach in groups is that each individual has the capacity to allow his or her innate potential to develop in order to become personally empowered to move in a constructive direction for self and society. The facilitator perpetuates this growth process by embodying and communicating his or her attitudinal qualities to the group without presupposing what its members should do, be like, or become.

These fundamental assumptions suggest a different paradigm from other theoretical approaches. Many assumptions about groups are altered and the facilitator does not have the intention of creating any particular group behavior. As such, the person-centered Basic Encounter Group is unique (Bozarth 1986).

Criticism

Although popular, and achieving a certain level of success, the person-centered approach has its weaknesses. In particular, the emphasis on counselors' exhibiting congruence, respect, and empathy toward their clients, has led them to become supportive of their clients' situation and viewpoint to such an extent that the clients feel no need to change. Without invoking some standard or norm, or at least presenting alternative viewpoints, the counselor does not have any position of authority from which to guide the client to make constructive changes. While this was in no way Rogers' intention, it has led to counselors validating actions, otherwise deemed unacceptable by society, because their clients experience satisfaction from them.

Another frequent criticism of the person-centered approach is that embodying the three requirements of the therapist is what all good therapists do anyway, before they move on to applying their expertise and doing the real work of "making clients better." However, this criticism reflects a misunderstanding of the real challenges of consistently manifesting unconditional positive regard, empathic understanding, and congruence in the therapeutic situation. Just being able to maintain openness, honesty, empathy, and respect toward a client, while listening to their account of traumatic experiences and subsequent responses, may indeed be a defining attribute of a successful counselor. Beyond this though, it is fair to question whether other attributes of the self that the counselor brings to the relationship, which will be transparent to the client, are relevant to the healing process. The person-centered approach fails to address the issue of whether that self should have developed in any particular way through personal experience or specific training, or should have acquired any particular background knowledge, in order to be qualified and effective as a counselor.

Nevertheless, there is research that indicates that the personality of the therapist is a better predictor of success than the techniques used (Boeree 2006). Thus, Rogers' emphasis on the harmonious relationship between counselor and client should be appreciated as a significant insight into the therapeutic process.

Rogers' theories continue to inspire counselors working with individuals, couples, families, and larger groups.

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External links

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