Abstract

This paper examines the roles of “being” and “doing” in person-centered therapy. The examination consists of : (1) reconsideration of the basis principles of the person-centered approach as espoused by the late Carl R. Rogers, (2) examination of Rogers’ responses to his clients, and (3) consideration of some of the reported research findings concerning the function of the person-centered therapist.

The principles of the approach are well known but often not considered from a functional vantage point. Person-Centered Therapy is essentially, however, the following:

The therapist functions as a genuine person who experiences the attitudes of unconditional positive regard and empathic understanding toward the client and the client perceives these therapist attitudes.

The assumption is that if the therapist can be this way with the other person and that the person of the client, at least, minimally perceives these attitudes then therapeutic personality change will ensue. In therapy, the foundation block of the theory is the actualizing tendency; i.e., the tendency of the organism to grow in a positive and constructive direction; for the person "to become all of his/her potentialities.” (Bozarth & Brodley, 1991). Put another way: When the therapistt can be a certain way, then the client’s actualizing tendency is promoted. In addition, the self-actualizing tendency is promoted in a way that is harmonious with the experiencing of the actualizing organism; thus the self-concept of the individual is altered.

The essence (the basic nature and the basic core) of Client-Centered Therapy is consistent with these principles (Bozarth, 1990). After examining the results of the Bower (1986) study, examining the evolution of Carl Rogers as a therapist (Bozarth, 1988) and from my understanding of Rogers' writings, the essence of the approach was defined as follows:

The essence of CC/PC therapy is the therapist's dedication to going with the client's direction, at the client's pace, and in the client’s unique way of being. (p. 59)

and:

It is the full commitment "to trust in the client's own way of going about dealing with his problems and his life.” (Brodley, 1988, p. 59).

Implications of this theoretical stance are integrally related to the concept of the locus of control. The therapist is promoting a natural individual and general process in the client by the therapist being a certain way; that is, experiencing certain attitudes toward the client. The client is his/her own best expert about him/her self and his/her life. The therapist's intent is not to promote feelings or to help the client to become more independent or to get the client anywhere. The goal is not self-actualization, actualization, independence or to help the client to become a "fully functioning" person. The goal is only to be a certain way and by being that way to promote a natural process.

Rogers' responses to his clients

Several authors (Coulson, 1986; Frankle, 1988; Van Balen, 1990; Van Belle, 1990) have suggested that Rogers changed his thinking and approach to therapy over the years. I consider their points valid in that Rogers'statements over the years were more focused on the principles rather than on the response modes and,

perhaps, the meta-principles as a "way of being" were more important for him to express than the "way of doing" that was often focused upon earlier in his work. He seemed to become more at ease and expressive over the years (Brodley, 1991) and, reportedly, expressed and demonstrated increased involvement with intuition (Bowen, 1991). Rogers, in fact, indicated in an interview with Baldwin (1987) that the presence of the therapist in the therapy session had perhaps not been given enough attention. Rogers stated:

Over time ... I have become more aware of the fact that in therapy I do use myself. I recognize that when I am intensely focused on a client, just my presence seems to be healing ... (and) I am inclined to think that in my writing perhaps I have stressed too much the three basic conditions (congruence, unconditional positive regard, and empathic understanding). Perhaps it is something around the edges of those conditions that is really the most important element of therapy-when my self is clearly, obviously present. (p. 45)

However, my (Bozarth, 1988; 1990) analyses reveal that Rogers did not change either his basic intent or way of working as a therapist. In addition, Brodley's (1988) analysis suggested that he changed little in the way that he worked as a therapist. More recent extensive analysis of Rogers' work (Brody, 1991; Brodley, 1991) further clarifies this issue. Brody reports her analysis of Rogers' articulate verbal responses to clients in ten therapy interviews over a 40-year time span, from 1946 to 1986. Brody's major findings are the following:

(1) Rogers responds 91 % of the time with an Empathic Following Response in which his apparent intention is to check his understanding of the client's meaning." (When eliminating responses to client questions). Almost all of 556 distinct articulate responses were non-directive, empathic following responses. The range of such responses was from 100% with Miss Munn in 1955 to 60% with Mark in 1982.

(2) The average percent of responses for categories (including responses to client questions) were: Empathic Following: 86%; Therapist Comment: 11%; Therapist Interpretation: 1 %; Therapist Agreement: 1 %; Leading Question: 1%.

Brody's general conclusions are also of interest:

(1)... empathic understanding, in Rogers' responses, is a complex and rich expression of the client's subjective meaning. Rogers conveys his understanding of the client's meaning in a varied and deeply personal manner. A focus on feeling, or on simply repeating back what a client has said, is an error in understanding empathic understanding as Rogers use it.

(2) Rogers usually answered questions when asked by the client.

(3) He occasionally makes unelicited, spontaneous comments from his own frame of reference, but always in what seems to be a non-systematic manner.

(4) His verbal behavior in these ten sessions consistently convey the gestalt of the therapeutic attitudes.

Brody concludes that Rogers did do what he said over the four decade span. As she states: "The depth of his involvement in the client's internal world is apparent; he is genuine, a real person presenting himself transparently to the client; and he is unconditionally accepting" (pp.78-80).

"Doing" and "Being"

I think that one of the greatest sources of misunderstanding of the person-centered approach is that of focusing on how to do it. The focus then becomes focused on technical responding and leads to the emphases on such conceptualizations as reflecting,

client-centered listening, client-centered communication and so on. The emphasis meant and practiced by Rogers to achieve empathic understanding is lost as the complex and rich expression of the client’s subjective meaning. The understanding of the client’s meaning in a varied and deeply personal manner as conveyed by Rogers is distorted. In addition, such confusion leads to invalid conclusions such as the statement that client-centered listening may not be sufficient. Tausch's (1990) report of research is a classic example of examining the client-centered approach in this manner. Defining the function of the client-centered therapist as. “client-centered communication" Tausch (1990) concludes that some clients need to have supplemental treatment because of the lack of therapeutic gain when receiving only client-centered communication. Although Tausch notes that to a certain extent the necessity for supplementation occurs when the therapists are unable to provide the attitudinal conditions to the clients and when the therapists attend mainly to the clients' emotions rather than to person-related cognitions, he states that the necessity of supplementation in these instances is “A client-centered necessity” (p. 447). Moreover, determination of the kind of supplementation decided upon (intended to be in harmony with each client) emerges from the therapist asking such questions as: What is helpful for this client? What does he need to facilitate his emotional heafth? Which supplementation is accessible to this client? In my opinion, the focus of the Tausch study upon "doing" "Client-Centered Communication" violates the principles of "being" by casting the therapist in the role of determining what should be proposed to the client. Emphasis upon the way to do client-centered or person-centered therapy leads to confounding of the approach in practice and in research.

Coterminous Interminglings in Practice:

When the therapist is doing something that does not entail “being” his/her experience with clients, then the "person-centeredness is
contaminated. In this sense, the therapist may be as effective with what he/she does not do as with what he/she does. Specifically, for example, contamination occurs when the therapist assumes that he/she knows what is best for the client, what is wrong with the client or what direction the client should go. On the other hand, whatever the therapist does as a therapist that is consistent with these principles is “person-centered.” For example. The question: "How old is your sister?" would probably be external to the client's frame of reference most of the time and usually important to the therapist from some external theoretical frame of reference that the therapist might hold. However, it might be conceivable that within the context of a client's story about being treated a certain way by her sister that the therapist could try to obtain a clearer picture of the client’s story by asking such a question.

The responses of the person-centered therapist may be as conventional as "reflection" or other statements that check the accuracy of the therapist's understanding or the responses may be as diverse as the following:

When I took my Volkswagon engine out, the car rolled down the hill, hit the rabbit pen, etc. etc. (Bozarth, 1984, p.70)

It has been my notion that therapist responses may be idiosyncratic to the client, therapist, and the unique relationship. The content of the remark has to be taken in context. In this instance, the therapist's response was a response to the client's communication of a prolonged, intense and painful struggle. The therapist's response was later viewed as a response to her question, "What have you been doing?" She later identified the statement as one which was hightly consistent with her inner struggle and later volunteered that it enabled her to identify the core of this struggle. The therapist comments offered her respite from her struggle. She reported that this was what she desperately needed at that time, In short, the principles of the approach guide the specific responses of the therapist. Raskin (1988) clarified the concept of idiosyncratic empathy with his conceptualization of unsystematic therapist responses. His conceptualization, I believe, may be the crux of the evolution from the label, Client-Centered Therapy to the label of Person-Centered Therapy. The difference between systematic and unsystematic therapist responses and activities is that systematic approaches have “... a preconceived notion of how they wish to change the client and work at it in systematic fashion, incontrast to the person-centered theapist who starts out being open and remains open to an emerging process orchestrated by the client “(p.3) The differences between the labels of client-centered and person-centered include the attention to the form of the empathic understanding response in client-centered therapy and the emerging process of responses that may occur in person-centered therapy. Person-Centered Therapy may come more out of the therapist's own genuineness while being absorbed in the frame of reference of the client.

Uncontaminated dedication to the frame of reference of the client from a genuine person as the therapist seems to me to be the crucial variable in determining particular responses. The more the therapist can allow his/her "intuitive" responses to arise and his/her presence to be connected to the client, the greater the range of idiosyncratic responses is apt to be. Intuition and the presence of the therapist take on progressively more importance. However, this is only contingent, I surmise, if the therapist is maximally trusting of the client's actualizing tendency and is truly dedicated to the client's frame of reference.

In short, the range and type valid person-centered therapist responses are centered in the centering of the therapist in the world of the client with trust in the client's self-determination.

References

Baldwin, M. (1987). Interview with Carl Rogers on the use of self in therapy. In V. Satir & M. Baldwin (Eds.), The use of self in therapy (pp. 45-52), New York: The Haworth Press.

Bowen, M. V. (1991). Intuition and the person-centered approach. Paper presented at the Second International Conference on Client-Centered and Experiential Therapy, University of Stirling, Scotland.

Bower, D. (1985). Assumptions of the Rogerian person-centered approach to counseling: Implications for pastoral counseling (Research Project), Atlanta: Columbia Theological Seminary.

Bozarth, J. D. (1984). Beyond reflection: Emergent modes of empathy in R. F. Levant & J. M. Shlien (Eds), Client-centered therapy and the person centered approach: New directlons in theory, research, and practice (pp. 59-75), New York: Praeger.

Bozarth, J. D. (1990). The essence of client-centered/person-centered therapy. In G. Lietaer, J. Rombauts, & R. Van Balen (Eds.) (pp. 59-64), Client-Centered and experiential psychotherapy: Toward the nineties. Leuven: Katholieke Universiteit te Leuven

Bozarth, J. D. (1988, August). The evolution of Carl Rogers as a therapist. In F. Zimring (Chair), Re-examination of client-centered therapy using tapes and films. Symposium conducted at the meeting of the American Psychological Association, Atlanta.

Bozarth, J. D. & Brodley, B. T. (1991). Actualization: a functional concept in client-centered therapy. Journal Social Behavior and Personality, 6 6 (5), 45-59.

Brody, A. F. (1991). Understanding client-centered therapy through interviews conducted by Carl Rogers. An unpublished Clinical Research Project, Illinois School of Professional Psychology, Chicago, 111.

Brodley, B. T. (1988, August). Carl Rogers' therapy. In F. Zimring (Chair), Re-examination of client-centered therapy using Rogers' tapes and films.

Symposium conducted at the meeting of the American Psychological Association, Atlanta

Brodley, B. T. (1991). Some observations of Carl Rogers' verbal behavior in therapy interviews. Paper presented at the Second International Conference on Client-Centered and Experiential Therapy, University of Stirling, Stirling, Scotland

Coulson, W. R. (1987). The Californication of Carl Rogers. Fidelity. November, 20-31.

Frankel, M. (1988, May). The category error and the confounding of the therapeutic relationship. Paper presented at the Second Annual Meeting of the Association for the development of the person-centered approach, New York City.

Raskin, N. J. (1988, May). What do we mean by person-centered therapy. Paper presented at the meeting of the Association for the Development of the Person-Centered Approach, New York, New York., N.Y. rleration of client-centered communication therapy with other valid therapeutic methods: "A client-centered necessity, in G. Lietaer, J. Rombauts, & R. Van Balen (Eds.), Client-Centered and experiential psychtotherapy: Toward the nineties, (pp. 447-455). Leuven: Katholieke Universiteit te Leuven.

Van Belle, H. A. (1990). Rogers' later move toward mysticism: Implications for client-centered therapy, in G. Lietaer, J. Rombauts, & R. Van Balen (Eds.), Client-Centered and experiential psychotherapy: Towrard the nineties (pp. 47-57). Leuven: Katholieke Universiteit te Leuven.