CLIENT-CENTERED THERAPY

Julius Seeman

Introduction note from J.S.

Our statement up to this point has more implications for commonality among therapies than uniqueness, and indeed it is true that many formulations of therapy emphasize drives or tendencies analogous to that of self-actualization. On the other hand, it also seems true that the various therapies differ among themselves with regard to the degree of emphasis given to the foregoing postulates in the actual treatment methods. A plausible explanation of these differences may be found when one examines the position which the concept of ambivalence holds in the various theories—that is, in the importance attached to the countervailing tendencies in the human organism, to those tendencies which make for perpetuation of maladaptive behavior. On this point the analytic therapies give more weight to the fundamental nature of ambivalence in the individual than does client-centered therapy; one example of this difference may be seen in the central position which the concept of resistance holds in analytic therapy, whereas this concept is hardly touched upon as such in client-centered therapy. These differences become reflected clearly in corresponding differences in therapeutic method. This question about the underlying tendencies in personal organization remains as a focal point for the understanding of present differences in theories of therapy.

In this section I should like not so much to set forth the sequence of steps in therapeutic movement as we have observed them in practice and research, but rather to conjecture about the quality of the therapeutic experience itself. In this connection it is instructive to note how certain responses are often described in two-fold terms. Thus we have the distinction between intellectual and emotional, between content and feeling, between the implications of color and form in human expression. Carson McCullers (1951) has stated these distinctions in the direct way that novelists sometimes have of capturing experience when she wrote, "The mind is like a richly woven tapestry in which the colors are distilled from the experiences of the senses, and the design drawn from the convolutions of the intellect." These complementary processes seem to represent two qualities of experience, and they find a direct counterpart in the process of therapy. In psychotherapy, too, we find an experiential-affective process on the one hand and a perceptual-cognitive process on the other; and the core of the process of therapy lies in the blending of the two—that is to say, in the process of experience-with-meaning. For it is precisely this creation of congruence between sensory and cognitive experience that is the essence of the integrative act.

        T: It’s embarrassing to actually feel like a child.

C: Yes. I know I have those feelings and I’ve tried to put them out of my mind, or I         would never pursue them very far.

        T: Is it that they just didn’t seem appropriate feelings to have now?

C: They were too threatening. "Don’t think about it," I’d say. Let’s go out." And I’ve          had certain inklings about them and a certain amount of insight about them. I wasn’t as          blind to them, but I never let it go too far before.

T: It isn’t at all that you were blind to them, it’s just that they never did come as close to         you as last time. I mean really close.

        C: (Slowly) Really close.

What does it mean when the client said that he/she was a witness to his/her own regression? This could be simply a figure of speech, but it is more likely that the client was experiencing in some physiological-emotional sense what it is like to be a child and to feel deserted.

In the foregoing formulation, the concept of therapy as the resolution of conflict is relegated to a position of secondary importance, but rather that it is an outcome, a consequence of the therapeutic experience, and not the process to which the counselor gives his/her attention during the therapeutic hour.

The exposition of the therapeutic process here presented may make good clinical sense; it may even correspond with the experiences and observation of some therapists. But what it does not yet do is to present an argument in testable terms. We should like, therefore, to carry further the ideas presented here to see whether we can move a step further toward operational meaning. In this connection, we may refer again to the earlier statement by Carson McCullers; where she has described two qualities of response we have said that their integration represents the process of therapy. However, Carson McCullers is not only describing processes inherent in therapy but in thinking of them as color and form she is literally naming in Rorschach terms the perceptual modalities through which these processes may be inferred; indeed, in Rorschach terminology the integration of form and color—the FC response--represents the integration of affect and cognition and stands as the perceptual behavior most indicative of emotional maturity. But we have also defined the therapeutic experience in these terms. Thus it may be appropriate to characterize the therapeutic process as an FC experience.

There are lines of evidence sufficiently reasonable to make this analogy a real possibility in thinking about the therapeutic process. For example, Wittenborn (1950) has shown that color responses and form responses are factorially distinct, thus suggesting that when we characterize them as two different qualities of response we are on the right track. With regard to FC as such, Beck showed in 1938 that normal adults have a significantly greater proportion of FC responses than do schizophrenics. This finding was confirmed in another study as yet unpublished. In study of even closer relevance because it dealt with the effect of therapy upon Rorschach responses, Haimowitz (1948) reported a 50% decrease in the number of clients showing impoverished FC records (one FC response or less) on post-therapy as compared with pre-therapy records. No such shift was shown in the control group. These lines of evidence open the possibility that internal aspects of therapy may be studied in terms of an FC concept representative of the forms of the therapeutic experience we have earlier described.

Although we have thus far emphasized the experiential-affective medium of the therapeutic process, one can by no means relegate the perceptual-cognitive factors in therapy to a position of unimportance. These are the ways in which ones sees or understands himself/herself to be, the ways in which one organizes his/her view of the world. As such, they are important in they are important in their influence upon behavior. In terms of the perceptual-cognitive modality, therapy is a process in which one seeks out the troubled and incongruous aspects of the self, and reorders these cognitions-of-self into a pattern more harmonious with total experience.

The Function of the Therapist

If we accept the premise set forth earlier, that therapy is an experiencing-symbolizing process through which a client comes to know himself/herself more fully, then it follows logically that the function of the therapist is to provide the psychological climate in which such a process can take place. Now if we combine this view of therapy with client-centered theory’s emphasis upon the individual’s drive toward self-actualization, we then have the elements which determine the psychological climate in client-centered therapy. As we spell out this climate in terms of the counselor’s behavior, we can define the counselor’s activity in five-fold terms, as follows:

1. The counselor enters into the feeling life of the client.

2. The counselor concentrates upon the internal frame of reference of the client.

3. The counselor attempts to act with empathic understanding of the client.

4. The counselor provides an accepting, non-evaluative atmosphere.

5. The counselor acts in terms of his/her own degree of integration as a person.

All of these activities are highly related, but they can be separated for purposes of clearer analysis. The first two of these aspects of the counselor’s function have to do with the direction of his/her attention. The counselor centers his/her attention upon the feeling life of the client as it is being experienced by the client himself/herself at that moment in time. We might well have combined these first two activities into one, except that we wish to emphasize that it is the "feeling life" aspects of the client’s behavior to which the counselor attends. In this activity both counselor and client are working, as Rogers has put it, at the "cutting edge of awareness." This seems to lead to a fuller development of the feelings which the client and counselor are trying at that moment to understand, and also to make clearer the meanings of these feelings. To use our earlier analogy of color and form, the counselor fosters the development of the color experience and quite often serves also a form-giving function—that is, by his/her very attempt at verbal understanding, he/she helps to lend delineation to tentative, obscure expression.

Let us return then to a psychologically meaningful description of the counselor’s participation in therapy. We have said that the counselor fosters emotional release and also helps to add understanding to the client’s expression. To heighten the point let us examine client-counselor interaction at meaningful points in therapy. In this connection, when we ask the question, "What interaction is taking place at those moments in therapy when the client feels most deeply understood?", our answer is that quite probably the counselor has expressed that symbolization of feeling which is exactly congruent with the client’s emotional experience. In our earlier terminology, this is precisely the process which represents the act of integration and we here imply that the counselor participates in a crucial way in implementing this experience.

A further word is in order about the meaning of empathic understanding. The concept of empathy is part of a larger class of concepts which deal with feeling relationships between individuals, concepts such as sympathy, identification, projection, and the like. The distinguishing feature of empathy, and a factor important for therapy, is that the counselor who acts empathically enters into the feelings of a person, while at the same time being quite clear as to the distinction between the client’s feelings and his/her own.

There is one further aspect of the general relation between counselor personality and therapy which we should like to consider. By and large, therapeutic theory does not have a great deal to say about this question except to state the desirability of emotional maturity in a counselor, and to consider the question in relation to counter-transference. Yet it is also true that therapy, being an interpersonal relationship between counselor and client, brings the personality of the counselor into an inseparable relation to the therapeutic process. We must then raise the question of the harmony between counselor personality and therapeutic method. For it is most likely that therapy will be more effective for any given counselor when his/her own ways of functioning in therapy are in accord with his/her own inner organization--that is, when the methods he/she uses are congruent with his/her own beliefs, attitudes, and values. This is simply another way of saying that the therapist will function most effectively when he/she himself/herself is integrated in his/her behavior as a therapist. What this means is that with regard to the formulation of the therapist’s function and behavior we can assume some degree of variability which can best be understood in terms of the uniquely individual personality organization of the therapist, regardless of the theory and method he/she uses. Stating the case this way does not relieve us from the necessity of arriving ultimately at a point where we can state more clearly which behaviors are helpful to therapy and which are not. At the present, however, our formulation of the therapist’s role must leave room for individual-therapist differences in behavior, even though we cannot yet spell out what the nature of these differences will be.