August 2002

Contested questions between client-centered and experiential therapies

Marjorie Witty, Ph.D.

Illinois School of Professional Psychology

A division of Argosy University

The following paper was written as a stimulus for a dialogue between Mary Hendricks, Ph.D. and myself at the British Association for the Person-centered Approach (BAPCA) conference held in Durham, UK in September, 2002.  Proponents of client-centered and experiential therapies have been asked to delineate issues of agreement and disagreement between the two approaches

The theory and practice of client-centered therapy, developed by Carl R. Rogers, is unique among  therapeutic approaches by virtue of the therapist’s commitment to realizing the attitude of principled non-directiveness, while experiencing the core conditions for personality change:  congruence, empathic understanding of the client’s internal frame of reference, and unconditional positive regard - the latter two attitudes necessarily being perceived by the client to some degree.  A non-directive relationship proceeds logically from the view of the client as an autonomous person.  It is an extension of Rogers’ theory of motivation which postulates an actualizing tendency which animates and organizes all activities of  living organisms (Goldstein, 1940; Rogers, 1951).  The actualizing tendency functions holistically and constantly in the lives of  organisms from birth until death.  Human beings may be pictured as evolving processes moving toward greater differentiation and complexity whose aims and purposes, while not random, are unpredictable.  Contrasting with the devolution of closed systems toward maximum entropy or states of increasing probability and disorder, living organisms or open systems develop toward states of higher order, according to a principle termed ‘anamorphosis’ (Bertalanffy, 1981, p.113).  

Further support for Rogers’ motivational theory may be found in the more recent development of Ryan’s and Deci’s Self Determination Theory (Ryan and Deci, 2000). 

Perhaps no single phenomenon reflects the positive potential of human nature as much as intrinsic motivation, the inherent tendency to seek out novelty and challenges, to extend and exercise one’s capacities, to explore, and to learn.....the evidence is now clear that the maintenance and enhancement of this inherent propensity requires supportive conditions, as it can be fairly readily disrupted by various nonsupportive conditions...the study of conditions which facilitate versus undermine intrinsic motivation is an important first step in understanding sources of both alienation and liberation of the positive aspects of human nature (Ryan & Deci, 2000, p. 70).

Interestingly, Ryan and Deci reference neither Kurt Goldstein nor Carl Rogers in their article, raising the question of whether they make some critical distinction between their concept of intrinsic motivation and the actualizing tendency.  If there is a difference, it would seem to me to be a matter of scope rather than kind.  That is, Goldstein’s concept of the actualizing tendency emerges from his philosophical reflection upon the nature of the human organism viewed holistically in the tradition of Gestalt psychology.  Ryan and Deci’s work is more narrowly focused, and emerges from the tradition of American experimental psychology.

The non-directive attitude, then, is consistent with Rogers’ view of organisms’ capacity for self-direction. The attitude is equally well-described as an expression of Rogers’ valuing of  the client’s right to self-direction (Bozarth, 1998; Brodley, 1997, 2002; Grant, 1990; Rogers, 1942).  In attempting to live this ethical position, the client-centered therapist must consider the autonomy and self-regard of the client in every aspect of the therapeutic relationship.  This kind of collaborative practice maximizes the potential for the client to increasingly become the ‘architect of the therapy’ (Raskin, 1947; Rogers, 1951, 1977; Natiello, 2001).  Means and ends must be ethically consistent from a client-centered viewpoint (Brodley, 2002; Grant, 1985; Tomlinson & Whitney, 1970).  

Efficacy in and of itself can never justify psychotherapy.  If one believes that respect for the freedom for the client is fundamental to meeting another person as a person, then one must honor the client’s right to refuse what is efficacious (Grant, 1985; Schmid, 2001).  Any systematic process-directivity, intervention, or procedure which does not emerge from the client’s own creative participation in the relationship violates principled non-directiveness.  From a client-centered point of view, we are constrained by our commitment to an attitude of principled non-directiveness by respect for the voice of the client, the intentions of the client in the therapeutic situation (Grant, 1985).  We are bolstered in this attitude by our belief in the functioning of the actualizing tendency of the client who is seen as having vast, untapped resources for meeting life and life’s difficulties.  But whether or not one accepts the actualizing tendency as the sole motivation in organismic life does not release one from the demands of this ethical commitment to non-directiveness if one wishes to interact with a client as another sovereign human who is at all times an emergent process both capable of and deserving of free expression and representation.

To describe the client-centered approach as a method among other therapeutic methods is to misunderstand it. As Schmid puts it,  ‘In person-centred therapy, the attempt to understand is never used "in order to” ‘ (Schmid, 2001, p. 53).  From a client-centered viewpoint, we are not using a ‘means’ like empathic understanding of the client’s meanings in order to achieve ‘ends’ such as ‘enhancing the client’s self-understanding,’ or ‘deepening the client’s feelings.’  We are not ‘using’ ourselves as therapeutic agents to enhance the client’s experiencing process.  The practice is an expressive therapy co-created by the relational expressive interaction between client and therapist (Brodley, 2002).  Client-centered therapists are not directive of the clients’ ways of being in therapy, in terms of how they go about the relationship or the processes or contents they realize within that context. 

In our reading of the studies assessing the relation of early-in-therapy experiencing levels to outcome, there is insufficient evidence in the literature to support the idea that a particular kind of process, high levels of focused experiencing, necessarily leads to superior psychotherapeutic outcome (Brodley, 1988).  But, importantly, even if evidence accrues in the future to support an optimal mode of clients’ ‘processing’ and an optimal mode of therapists’ functioning, we still would not find ourselves compelled to train that process in clients who did not spontaneously manifest it.  We aim to participate in a relationship with another sovereign being in ways which respect and honor the client’s unique perceptions, meanings and purposes within the therapeutic situation.  We regard directiveness in regard to the client’s internal processes (which we cannot know directly) or expressions of meanings as a presumption and encroachment upon the autonomy of the client which undermines the client’s experience of the validity of her own internal frame of reference.

A client in psychotherapy is (or should be) free to define the experience in any way she wants.  She may feel that she is there to get an ‘objective view’ of her ‘problems.’  She may assert that she needs to be ‘healed.’  Some clients may want to be helped to ‘get in touch with feelings.’  Some clients are quite inarticulate about what brings them to therapy, and why they stay in the situation, even over long periods of time.  We assume that the client wants to be understood when expressing his intentions or hopes or vulnerable feelings, or complaints about us or about the therapy process.  It is the willingness of the client-centered therapist to respond to the client’s expressions of meaning with empathic understanding absent any other intention which distinguishes client-centered therapy from therapies which have a priori notions about what it is ‘good’ to do; notions which have arisen from sources external to the client.  Rogers was keenly aware of environmental influences and constraints.  He was hardly naive about the extent to which some persons must cope with environmental circumstances which limit the extent of the press for actualization.  Our clients come to us with myriad received conceptions about who they are and what they are like, internalized from family, school, media, religion, and sometimes, psychiatry.  The conceptions may help, but often hinder the client’s organismic experiencing and self-creation.  Our work is not to counter or rebut these influences, but to be expert on not being experts.  Schmid states:

For the person working in the person-centered field the realisation of these basic attitudes, which at the time has to be newly put into effect during the process, represents the help which needs no supplementation by specific methods and techniques reserved for the expert.  "Expertism,” if it has be described, lies exactly in the ability to resist the temptation of behaving like an expert (even against the client’s wishes)---that means, solving problems with the help of techniques rather than facing them as persons (Schmid, 2000, p. 15).

Polanyi has pointed out that unlike scientific experiments which aim to be replicable across time and contexts, ‘[A]n art which cannot be specified in detail cannot be transmitted by prescription, since no prescription for it exists.  It can be passed on only by example from master to apprentice....It follows that an art which has fallen into disuse for the period of a generation is altogether lost’ ( Polanyi, 1955, p. 53).  Non-directive client-centered therapy is a practical art which is in danger of being lost.[i] This state of affairs has many determinants---too many to enumerate here, but a major problem is the obfuscation of the approach and the assertion that client-centered therapy has been subsumed within the more ‘evolved’ experiential and process-directive therapies. The term in common use-- ‘client-centered/experiential’-- is an instance of such obfuscation.  Gendlin has argued that experiential therapy is a more highly evolved form of the old, ‘classical’ approach advocated by Rogers, improved on both philosophically with better ‘process’ concepts, and practically with more efficacious, potent ways of stimulating high levels of focused experiencing (Gendlin, 1981, 1996)  Gendlin’s writing has contributed to this obfuscation insofar as he holds ‘listening’ in high regard as the ‘baseline’ to which any therapist of any school should return.  You can do anything as long as you return to the baseline, the client’s experienced ‘felt sense’ (Gendlin,  1974, p. 211).  The implication of describing empathic responses as ‘listening’ or as a ‘baseline’ to return to is that this response form is a tool employed by therapists  (not just client-centered or experiential) so as to remain in contact with an inner, dynamic experiencing process.  Gendlin conceived successful therapeutic personality change as resulting from a particular form of focused experiencing, not as a consequence of a particular kind of human relationship.  As Prouty pointed out in his recent article "Carl Rogers and experiential therapies:  A dissonance?” Rogers clearly viewed the therapist’s provision of a relationship with particular attitudinal qualities, informed by principles of the trustworthiness of persons and respect for persons as the necessary and sufficient conditions for personality change.  The shift in experiential therapy is to locate the cause of change in a particular kind of internal processing on part of the client. The therapist is not absent, not unrelated or impersonal, but the core conditions in Rogers’ theory seem like a backdrop to the action on stage, that is, how well the body is carrying forward the experiencing process.  In his 1974 article,  ‘Client-centered and experiential psychotherapy’, Gendlin states:

The experiential method...is a way of using many of the different therapeutic approaches.   It is a method of methods.  It enables me to show just how client-centered therapy ought to be a part of every therapist’s way of working.  It is a systematic way of using various vocabularies, theories, and procedures, among them client-centered therapy.  When I have offered some details of its theory and practice, it will then become clear how my rendition of client-centered therapy...is really a reformulation of it in experiential terms.  As so reformulated, it ought to be a part of every therapist’s way of working (Gendlin, 1974, p. 211, emphasis added).

It should be clear from this excerpt, that Gendlin construes client-centered therapy as an instance of ‘vocabularies, theories, and procedures.’  He asserts that any therapist, no matter what her orientation, can benefit from incorporating  ‘reformulated’ client-centered therapy as if client-centered therapy were synonymous with accurate empathic responding.  It appears from this statement that Gendlin abandoned the fundamental premise of the approach in favor of a method which fosters focused experiencing in the client.  As Rogers conceived it, client-centered therapy was not a method, and to reduce it to one was to fundamentally lose the practice.  Client-centered therapy was, for Rogers, a philosophy of persons.  This is Rogers in 1951, writing 23 years prior to Gendlin’s published essay in Wexler and Rice’s Innovations in client-centered therapy:

There has been a tendency to regard the nondirective or client-centered approach as something static---a method, a technique, a rather rigid system.  Nothing could be further from the truth.  The group of professional workers in this field are working with dynamic concepts which they are constantly revising in the light of continuing clinical experience and in the light of research findings.  The picture is one of fluid changes in a general approach to problems of human relationships, rather than a situation in which some relatively rigid technique is more or less mechanically applied (Rogers, 1951, p. 6).

To classify non-directive client-centered therapy as ‘purist’ or ‘classical’ is to encourage the belief that the practice is outdated.  Who writes ‘classical’ music?  The repetitive use of words like ‘new,’  ‘paradigm shift,’ etc., is to employ rhetoric which plays on our vulnerability to the belief that whatever is ‘new’ is better, more advanced.  Gendlin claims that experiential therapy is a ‘new’ way, and is an evolution from the ‘old’ way of client-centered therapy, while retaining the basic client-centered attitudes. However, the shift to focusing-oriented therapy is quite clearly a departure which changes the nature of the therapy relation (Brodley, 1990).

On our view, Gendlin departed from the theory of client-centered therapy in 1964 when experiencing level became the independent variable in any therapy, the motor of change.  He innovated a form of response which he called ‘the experiential response,’ whose purpose was to invite attention to the bodily felt sense, which, with the aid of the experiential response provided by the therapist, facilitated a carrying forward of experiencing.  Experiential therapists assert that they are non-directive because they drop the invitation to attend to the bodily sense if it is not wanted by clients.  But we contend that empathic responses which are given along with invitations to focus create a different kind of relation between client and therapist.  Even when invitations are given with utmost respect and sensitivity, the client cannot help but conclude that the focusing-oriented therapist has a conception of what is helpful and what is not—particularly if the client herself is frustrated with her own ways of being in the therapy.  And in fact, process-directive therapies do have a conception of what is effective and ineffective therapy behavior in clients which is not shared by non-directive client-centered therapists.

  For example, in reading transcripts of focusing oriented therapy, there are instances in which the attention of the client is guided away from the relationship with the therapist to the client’s body.  Here is an example from Gendlin’s Focusing-oriented Psychotherapy (1996):

C:  (After he has talked unemotionally for some time, there is a break in the client’s voice.)  I’m so tired of my depression, and other people also get very tired of it.  My friend Nick got tired of it and he doesn’t want to see me now, much.  If I go to his place I try not to complain and ask for care.  And in my group they said I’m passive and all I do is complain.  I do say to myself: ‘I can take care of myself.  I can do that myself.’

T:  You can sense that the depressed feeling is wanting care, and you do kind of give it to yourself.  It scares you, though, that the people are getting tired of you.

C:  And I’m worried that you will too.

T:  And that includes me.  You’re scared I’ll get tired of you being depressed and asking for care.

C:  Yes. (Silence)

T:  I notice something welling up in you when we talk about your needing care.

C:  Yes, it loosened things in my throat.  Mostly I don’t feel anything.

T:  Saying you need care loosens your throat, and you do really feel that wanting, wanting care.

C:  It loosens that locked place. (Eyes tear up)

T:  Do sense that now as clearly as you can in your body; the stuck depressed place is really this need-for-care place.  Is that right?  Can you sense that?

C:  It loosens when I say ‘I need care,’ and if somebody is there to say it to.  And it’s also the connection with all that stuff with my mother that we talked about. (Gendlin,  1996, p. 187 – 188, emphasis in the original, except for the underlined portion). 

At the juncture in which the client has the courage to acknowledge his fear that the therapist will tire of him, the therapist gives an empathic response, but then breaks the silence by making an observation from his/her own frame of reference which has the effect of deflecting the client’s attention from the here-and-now with the therapist to his own bodily state.  It would appear that the therapist in this example has a goal which is clearly exemplified in his/her imperative instruction:  ‘Do sense that now as clearly as you can in your body.’  This instruction is followed with another statement from the therapist’s frame in which he offers the interpretation that the ‘stuck depressed place’ is  ‘really this need for care place.’  The therapist relates caringly, but also authoritatively when he conveys that he knows what the client should do in this moment and what the client’s experience of being depressed is really about.  This interaction is quite different that an imagined one in which after the uninterrupted silence the client could have said ‘I need you to care for me.’  The client may or may not have made such a daringly direct appeal to the therapist, but the point is he was not given the chance because he is diverted into viewing events which are supposedly occurring internally.

Non-directive client-centered therapists believe that the only goals we should have in therapy should be goals for ourselves in learning how to realize the attitudes, not only because the liberty of the other person constrains our developing goals and aims for him or her, but also on the principle that constructs, such as ‘experiencing,’ ‘conditions of worth,’ are most often not expressions of the frame of reference of the client.  We are mindful of how easily clients can take in the views and vocabulary of the therapist, even when the therapist eschews this influence.  Additionally, clients are very often compliant and they appear to be so in some of the transcripts from Focusing-oriented Psychotherapy.

All therapies use a rhetoric of emancipation or liberation of human potential.  That is, they aim to free persons---from ‘incongruence,’ ‘neurosis,’ ‘irrational cognitions,’ ‘phobias,’ ‘addictions,’ ‘mental illness,’ ‘low self-esteem,’ ‘low experiencing level,’ etc.  The definition of success in psychotherapy depends upon being able to claim that the client has changed for the better, and that that change is a consequence of the independent variable of psychotherapy.  Since Eysenck’s famous challenge in the 1950s to the therapy industry in which evidence was brought forward which showed that many clients seemed to decline in the process of therapy,  meta-analytic studies of therapy outcome give us confidence in our practice as providing benefits to clients.  However, non-directive client-centered therapists are leery of accepting treatment effect sizes as the last word on practice.  We believe that the harmful effects of therapy are rarely investigated and reported (a notable exception is the work of Binder and Strupp, 1997). 

Iatrogenic effects of medical treatments, which are regularly discussed at Mortality and Morbidity conferences among physicians, have no formal counterpart in the world of psychotherapy.  We assert that our therapy, even at its most non-directive, can have, and has been observed to have, negative effects on clients.  Sometimes this is the result of momentary loss of discipline by the therapist; sometimes it results from the client’s having misunderstood a communication from the therapist.  But we know that these inadvertent mistakes can have far-reaching consequences.  How much more damaging to the person’s sense of positive self-regard are practices designed to change clients--- either their lack of congruence,  or their ‘stuck’ ways of processing?  Because of this awareness and because of the commitment to the principle of non-malfeasance, we would like to see more research devoted to harm done in the context of therapy relationships

The client’s right to refuse psychological and psychiatric treatment is crucial in warding off harm.  Various authors have made reference to the significance of the human person’s ‘power to refuse.’ (Weil, 1987).  Only our perception of the humanity of another can halt our trajectory of intended action, and allow as Weil puts it, ...‘that interval of hesitation, wherein lies all our consideration for our brothers in humanity.’  Peter Winch’s reading of Weil explains her position. 

To recognize the existence of another human being is to acknowledge a certain sort of obstacle to some projected actions; that is to say, it is to acknowledge that there are some things one must do, and some things one cannot do in dealings with the other which hence constitute a limit to the ways in which we can pursue our projects.  Our recognition of these necessities is internally related to our grasp of the kind of beings we are confronted with (Winch, 1989, p. 107).

Notions of ‘voice,’ self-determination, and personal autonomy imply that a fundamental aspect of humanness is the exercise of one’s own will; to say ‘yes’ and to say ‘no.’  Personal assent or dissent are expressions of freedom.  In a democracy after the election results are in, politicians go before the cameras and exclaim ‘the people have spoken!’  Vox populi is the defining feature of a democratic polity; the voice of the person is the individual expression in a democratic situation for those who live in societies which grant fundamental human rights. Only persons who can refuse can freely assent to enter into a relationship of equals.  Unequal as a therapeutic relationship may be in the structural sense, if the person seeks the relationship voluntarily and maintains at each moment of this relationship the ‘power to refuse,’ there is, to some degree, a meeting of two sovereign persons (Proctor, 2002; Schmid, 2001).  A broken person is one who gives up the attempt to give or withhold consent, and who perceives that he is perceived by others as no longer constituting an obstacle to their plans or actions.

What does the ‘power to refuse’ mean in the context of a client-centered therapy relationship?  This power, first, must mean the freedom to withhold expression, either partially or entirely.  The client cannot be interrogated, probed, encouraged, or induced to speak.  The act of speaking, making contact with the other, should be understood as a free expression, a call from one Person to an Other, not as linguistic production or symbolizing process (at least within the moment of the encounter.) The only appropriate response to the other’s voice is the act of response issuing from my authentic self.  I think that this kind of call and response is what Buber refers to as an ‘I – Thou’ relation, a concept which Rogers valued and referred to over many years. 

One of the first problems the client-centered therapist faces, however, is that many clients come into the relationship from social and familial contexts which have long denied their personal authority.  Compliance with familial norms and obedience to authority figures has been deeply inculcated in most of us.  Thus, we cannot naively assume that the client knows that this is a ‘free’ situation.  Many clients believe that they should not ask questions, and that conversely, they should answer any questions put to them by the authoritative counselor or ‘doctor.’  They need help and feel vulnerable which exacerbates the situational pressures against their grasping their own power to refuse.  That power exists in the abstract, perhaps, and functions as a constraint for the non-directive therapist but is not yet a reality to be grasped and lived by many clients.  The fundamental aim of the client-centered therapist is to offer oneself in a entirely personal way, without professional facade.  We believe that through the practice of empathic understanding of the client’s internal frame of reference, his or her personal power will increase.  This assumption has been borne out in practice with clients over many years (Zimring, 2001).

We claim that our aim is to be of help,  but we cannot know in advance what ‘help’ will mean to any given person.  It must always remain an open-ended question in our work:  ‘Am I helping you?’  The client is the expert on what is or is not ‘help,’ and more radically, when he or she ceases to want ‘help’ in any form.  When this point is reached the therapy relation must be redefined or ended, because its essential structure is that of a therapist who is present in the situation to give ‘help’ and a client who is present in the situation to receive it.

Is it a contradiction to hold this consistent non-directive position to the exclusion of techniques and pedagogy?  Is not this a kind of rigidity which represents a kind of tyranny of non-directiveness imposed on the client?  Cain asserts that the emphasis on the therapist attitudes leads to a ‘one approach fits all’ stance to therapy  He states:

The same basic attitudinal qualities in the therapist or teacher are viewed as necessary and sufficient for all clients (students) regardless of individual differences in the person, even enormous ones.  Not surprisingly, there is generally fairly little variation in the ways person-centered practitioners interact with their clients (Cain, 2002, p.367).

I think that Cain misses the fact that because client-centered therapists are committed to the non-directive realization of the attitudes with no attempt to create effects in their clients, they provide an environment for the emergence of a unique therapeutic relationship with each new client and with each client in successive sessions.  To the contrary, there is a great deal of variation in the ways client-centered practitioners interact with their clients---as much variation as there are persons.

 A staunch commitment on the part of the therapist to non-directivity means that from moment to moment we are attuned to the client as a whole person.  In the mature form of client-centered therapy (meaning practice in which the therapist is freely him or herself in the situation), many possible implementations of the attitudes may emerge.  We are not behaving according to a method or formula, nor are we responding with any systematic intention except to empathically understand whatever the client intends to express.  It is inconceivable that a client-centered therapist would say to a depressed client who wanted to stop coming to therapy, ‘I don’t think that would be wise.  I think you need to stay a little longer until you are feeling less depressed and can think more clearly about the decision.’  This kind of paternalism is a contradiction to non-directiveness because it undermines and ultimately abrogates the client’s power to refuse.  We want to honor the client’s internal frame of reference because it is right and because it is what we want for ourselves.