American psychologist Carl Rogers was one of the founders of the Person-centred Therapeutic Approach in psychology and a founding father of Humanistic Psychotherapy. Rogers was aligned with Maslow’s concept of the self-actualising person and suggested that for a person to recover from internal conflict, they require an environment of genuineness, acceptance and empathy with both themselves and others. He sought to redefine the relationship between the therapist and patient. In doing so, he argued that to bring about a positive personality change, this relationship must be built upon mutual trust and respect. Only then will the environment be conducive to the client bringing about change in themselves. In today's Sunday Letters, we'll explore Rogers' fundamental concepts around this relationship.
Inevitable Suffering
We suffer–every one of us does. It's an inevitable aspect of life on this rock and we must find a way to cope. This doesn't mean that life has to be a constant shit storm, one that we have no choice but to accept. But it does mean that some days will be difficult, some days may be more than difficult, and other days will be almost unbearable. So we must cope. We must uncover a way to bring to the fore in us, a means of dealing with conditions as they are. We've got to manage when things are unmanageable. To be calm when things are hectic and find solutions when there appears to be none.
More often than not, we find a way, but that way can sometimes be destructive to us and the ones we love. Enter the therapist–someone trained and experienced in helping us solve our human problems. Someone who can point the way. Carl Rogers was one of those people, and such were his findings and insights into the nature of the human experience, he heavily influenced psychotherapeutic practices and the broader field of psychology.
About Carl Rogers
Carl Rogers grew up and was educated in a strict Baptist environment and as a young man had considered entering the ministry. However, after a series of significant experiences including time spent in China and a period attending a Christian Seminary, he began questioning his religious convictions and later adopted atheism 1. Through his decades of work and numerous publications on the nature of the self and personality, it's said that he came to recognise a realm of reality beyond the reach of science. To him it was a spiritual realm which he came claimed was indescribable.
Rogers' Early Career
In the 1930s, after completing his Phd., Rogers worked with disadvantaged children and served as director of the Society for the Prevention of Cruelty to Children in New York. In his 1942 book Counselling and Psychotherapy 2, Rogers suggested that the client, by establishing a relationship with an understanding, accepting therapist, can resolve difficulties and gain the insight necessary to restructure their life. He held that positive change was always within the capacity of the client and that change, or resolution of inner conflict, comes about phenomenologically. In other words, it rises in the perceived reality of the client, and therefore could not be taught or brought about through coercion.
This was apparently counter to practices within the Freudian movement, which he claimed objectified the client. This point, on the nature of the therapeutic relationship, is critical to Rogers’ thinking. He saw the therapist as a facilitator, rather than someone with authority, or the person responsible for making change happen.
The Seeking of Congruence
Rogers believed that human beings seek congruence, or balance in the self, across three areas of our lives, and this is achieved through the highest state of being, or self-actualisation [book].
Self-actualisation is possible to the degree to which our idea of self-worth, self-image, and ideal self overlap. Here we achieve congruence, and it is the role of the therapist to facilitate the alignment of these aspects of the self in the client.
Self-worth
Rogers believed that feelings of self-worth (what we think about ourselves) develop in early in our childhood and are formed through our interaction with parents and home life.
Self-image
How we see ourselves in relationship with our peer groups, workplace colleagues, our place within the family and other social groups to which we belong, and society.
Ideal self
This is the concept of ourselves as we wish it to be at some future time. It takes into account our goals, wishes and desires for ourselves and often changes throughout life.
According to Rogers, these three aspects of the self are formed independently. Until all three combine in self-actualisation, difficulties and imbalance exist in the client's relationship with the world. Rogers also insisted that our personalities are unique. He regarded the “cookie-cutter” idea of personality inaccurate and unhelpful to therapeutic work. Instead, he insisted on a person-centric approach. In other words, he believed in the validity of the individual experience.
The Validity of The Unique Self
It is this acknowledgement of the validity of the individual experience and the necessity for one-to-one intervention that draws me to the work of psychologists such as Rogers and Maslow.
The generalisation of conditions and experience that the science of psychology establishes is valuable, no doubt. It teaches us something about human beings as a collective. But it often falls short in bringing about change on an individual level. This is why I hold the view that on its own, a book on this or that subject, a course, a therapy, or some other generalised account of how you and I may find success and happiness, is not enough.
It’s why we never really get to the core of our issue. Every attempt to solve our discordance is simply an avoidance of the problem. It is a substitution of one distraction for another, a wrangle, a gimmick and an unsubstantial and disingenuous attempt at fixing ourselves.
Real transformation happens when we go deep inside in an exploration of the inner-self. Alas, often we are too caught up in our surface-level identity to find a breakthrough.
The Necessary Conditions For Change
The Question
Rogers asked specifically if it were possible to state, in clear definable terms, the psychological conditions necessary and sufficient to bring about constructive personality change in people suffering internal conflict. He wanted to establish a consensus amongst his fellow clinicians. What did it mean for patients to transform internal conflict and achieve greater integration?
He subsequently outlined six conditions which, persisting, were essential to bringing about such change.
- The patient and therapist are in psychological contact
- The patient is in a state of incongruence, vulnerable, anxious and in conflict.
- The therapist is congruent and integrated.
- There is unconditional positive regard for the client.
- The therapist has empathy for the client’s experience and attempts to communicate it.
- The communication of the therapist’s empathy and positive regard are achieved.
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Published in the Journal of Consulting Psychology in 1957, Rogers’ paper titled, The Necessary and Sufficient Conditions of Therapeutic Personality Change 3, formed part of his broader psychological theory of personality and sought to outline the psychological conditions that bring about constructive personality change in sufferers.
What This Means
Rogers said that the therapeutic relationship is key to recovery. As I read, a story a friend shared with me about his recovery from alcohol abuse came to mind. An older friend of mine, let’s call him Joe, went through a tough period. He was addicted to alcohol, and his marriage was falling apart. His business was suffering badly, he had hit rock bottom and was left with little choice but to seek help.
In the treatment centre, they referred Joe to a psychiatrist who he regarded as not much help. In counselling sessions, he felt that the therapist treated him in a very transactional way. He was an object to be dealt with rather than a human being with a complex life situation. Joe told me the therapist would pay more attention to his watch than to what Joe was saying, and as such, he gained little benefit from the exchange.
In contrast, after Joe entered Alcoholics Anonymous and began working with other men who had been where he was, who understood him and had genuine empathy for his experience, things changed. It was difficult for him, and it took time, but eventually, something shifted.
Joe has since been sober, over 30 years now, I think.
1. The Client-Therapist Relationship
Carl Rogers says that a minimal relationship must exist and that significant positive personality change does not occur without it. The following conditions from 2 to 6 are features of the relationship that define the characteristics of each person.
The client may be perhaps catatonic or in some other way, unable to sense a difference in their experience due to the therapist. However, Rogers suggests that at an organic level, they do experience a subtle difference.
It would seem that for there to be progress, the client must see the relationship as safe, and the therapist must be open to them.
Rogers says, the first condition is such a simple one that perhaps it should be labelled an assumption. However, without it, the remaining five conditions would have no meaning.
2. The Client’s State of Mind
Rogers says that the client must be in a state of incongruence, anxious and vulnerable. He suggests further that incongruence refers to a discrepancy between the experience and the self-image of the individual.
Rogers offers the following example;
“A student may experience, at a total or organismic level, a fear of the university and of examinations which are given on the third floor of a certain building, since these may demonstrate a fundamental inadequacy in him. Since such a fear of his inadequacy is decidedly at odds with his concept of himself, this experience is represented (distortedly) in his awareness as an unreasonable fear of climbing stairs in this building, or any building, and soon an unreasonable fear of crossing the open campus. Thus there is a fundamental discrepancy between the experienced meaning of the situation as it registers in his organism and the symbolic representation of that experience in awareness in such a way that it does not conflict with the picture he has of himself”.
A person may have no awareness of the existence of incongruence and be vulnerable to resulting anxiety. They may somewhat know of their incongruence, but cannot associate it with specific conditions of their experience. In therapy, as the person approaches awareness of some element of their experience, anxious states may arise. The therapist may guide the person through this change.
3. The Therapist’s State of Mind
According to Rogers' theory, the third condition requires the therapist to be completely and wholly themselves. They must be congruent, integrated and “deeply himself” as Rogers states. It's unnecessary that the therapist be the epitome of enlightenment across all areas of their life. Rather, for that hour, in that place of trust, the therapist must be completely themselves.
It’s as though the therapist must learn how to switch off their everyday surface-level personality, and be open. From reading Rogers on this aspect, he suggests that the therapist drop their own self-identity as ‘therapist' and just be human.
All preconceived notions of how the relationship is, or should be, must be removed.
4. Unconditional Positive Regard
The therapist must have unconditional positive regard for the client. There is a complete acceptance of the client’s expressions of negativity, pain, fear, defence and abnormal behaviour.
The same applies to that which would be considered good, positive, mature, and confident on the part of the client. The therapist must allow these conditions to exist without internal or external judgement.
In this, Rogers proposes, we allow the client to own their experience. They can attempt to feel their feelings and accept themselves as they are in the safety of the clinical relationship. There must be no approval or disapproval or commentary that may be interpreted as such.
5. Empathy
To adequately feel empathetic towards the client, the therapist must be able to sense the client’s world as if it were their own. Rogers says this must be without losing the “as if” quality. This is essential to therapy and explains it as follows;
To sense the client’s anger, fear, or confusion as if it were your own yet without your own anger, fear or confusion getting bound up in it is the condition we are endeavouring to describe. When the client’s world is this clear to the therapist, and he moves about it freely, then he can both communicate his understanding of what is clearly known to the client and can also voice meanings in the client’s experience of which the client is scarcely aware.
Empathy, it seems to me, is often a misunderstood quality of mind.
Often when I hear people speak of empathy, they are expressing an adoption of, and absorption of, and internalisation of the other person's emotional state.
This is not good, I would suggest, for a therapist. To see it and feel it without becoming it, is the aim.
6. The Client’s Perception of The Therapist
The final condition that Rogers suggests is necessary in the client-therapist relationship, is the client’s perception. To a minimal degree at least, the client must feel the acceptance and empathy that the therapist has for them.
The client receives the therapist’s behaviour and words either consciously or subconsciously. The environment too has an impact, the room and furnishings will influence the exchange, although Rogers doesn’t mention these things.
My understanding is that if the client does not experience a sense of “openness” in the therapist, then little progress will be made until such conditions exist. In Freudian terms, points 5 and 6 would be referred to as “transference“.
Some Final Comments
Rogers hypothesised that; if these six conditions exist in the relationship, as operationally defined, then constructive personality change can occur in the client. If one of these conditions is not present, constructive personality change will not occur.
I have only recently, for this article, read the paper; The Necessary and Sufficient Conditions of Therapeutic Personality Change, and although I am lacking in the extensive clinical experience of Carl Rogers, it seems that there is a significant validity in what he had to say.
Personality change, or a shift towards a more congruent self, is possible I believe without therapy. Although, therapy is perhaps a quicker route to resolution.
Who truly knows?
What iss true, however, is that the psychic life of the person, the world within the dome of the skull and perhaps beyond it, is complex. Many things influence it, often becoming established in childhood, and they escape our conscious awareness.
Sometimes we need help to unravel it. In doing so, the humanistic approach presented by Rogers, and Maslow is valid, I believe.
Article references
- Michael Martin (2007). The Cambridge Companion to Atheism. Cambridge University Press. p. 310
- Rogers, C. R., & Carmichael, L. (1942). Counseling and psychotherapy: Newer concepts in practice.
- Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of consulting psychology, 21(2), 95.
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