Existentialism and Humanism
6. The communication to the client of the therapist’s empathic understanding and unconditional positive regard is to a minimal degree achieved
Rogers hypothesized that no other conditions were necessary. If the therapeutic core conditions exist over some period of time, constructive personality change will occur. The core conditions do not vary according to client type. Further, they are both necessary andsuffi cient for therapeutic change to occur.
From Rogers’s perspective the client–therapist relationship is character- ized by equality. Therapists do not keep their knowledge a secret or attempt to mystify the therapeutic process. The process of change in the client depends to a large degree on the quality of this equal relationship. As clients experience the therapist listening in an accepting way to them, they gradually learn how to listen acceptingly to themselves. As they fi nd the therapist caring for and valuing them (even the aspects that have been hidden and regarded as nega- tive), clients begin to see worth and value in themselves. As they experience the realness of the therapist, clients drop many of their pretenses and are real with both themselves and the therapist.
This approach is perhaps best characterized as a way of being and as a shared journey in which therapist and client reveal their humanness and participate in a growth experience. The therapist can be a guide on this journey because he or she is usually more experienced and more psychologically mature than the client. This means that therapists are invested in broadening their own life experiences and are willing to do what it takes to deepen their self-knowledge.
Thorne (2002b) delivered this message: “Therapists cannot confi dently invite their clients to travel further than they have journeyed themselves, but for person-centred therapists the quality, depth and continuity of their own expe- riencing becomes the very cornerstone of the competence they bring to their professional activity” (p. 144).
Rogers admitted that his theory was striking and radical. His formulation has generated considerable controversy, for he maintained that many conditions other therapists commonly regard as necessary for effective psychotherapy
were nonessential. The core therapist conditions of congruence, unconditional positive regard, and accurate empathic understanding have been subsequently embraced by many therapeutic schools as essential in facilitating therapeutic change. These core qualities of therapists, along with the therapist’s presence, work holistically to create a safe environment for learning to occur (Cain, 2008).
We now turn to a detailed discussion of how these core conditions are an inte- gral part of the therapeutic relationship.
CONGRUENCE, OR GENUINENESS Congruence implies that therapists are real;
that is, they are genuine, integrated, and authentic during the therapy hour. They are without a false front, their inner experience and outer expression of that ex- perience match, and they can openly express feelings, thoughts, reactions, and attitudes that are present in the relationship with the client. The quality of real presence is at the heart of effective therapy, which Mearns and Cooper (2005) capture thusly: “When two people come together in a wholly genuine, open and engaged way, we can say that they are both fully present” (p. 37).
Through authenticity the therapist serves as a model of a human being struggling toward greater realness. Being congruent might necessitate the ex- pression of anger, frustration, liking, attraction, concern, boredom, annoyance, and a range of other feelings in the relationship. This does not mean that thera- pists should impulsively share all their reactions, for self-disclosure must also be appropriate and well timed. A pitfall is that counselors can try too hard to be genuine. Sharing because one thinks it will be good for the client, without being genuinely moved to express something regarded as personal, can be in- congruent. Person-centered therapy stresses that counseling will be inhibited if the counselor feels one way about the client but acts in a different way. Hence, if the practitioner either dislikes or disapproves of the client but feigns accep- tance, therapy will not work.
Rogers’s concept of congruence does not imply that only a fully self-actualized therapist can be effective in counseling. Because therapists are human, they cannot be expected to be fully authentic. If therapists are congruent in their relationships with clients, however, trust will be generated and the process of therapy will get under way. Congruence exists on a continuum rather than on an all-or-nothing basis, as is true of all three characteristics.
UNCONDITIONAL POSITIVE REGARD AND ACCEPTANCE The second attitude therapists need to communicate is deep and genuine caring for the client as a person, or a condition of unconditional positive regard. The caring is nonpos- sessive and it is not contaminated by evaluation or judgment of the client’s feel- ings, thoughts, and behavior as good or bad. If the therapists’ caring stems from their own need to be liked and appreciated, constructive change in the client is inhibited. Therapists value and warmly accept clients without placing stipu- lations on their acceptance. It is not an attitude of “I’ll accept you when . . .”;
rather, it is one of “I’ll accept you as you are.” Therapists communicate through their behavior that they value their clients as they are and that clients are free to have feelings and experiences without risking the loss of their therapists’
acceptance. Acceptance is the recognition of clients’ rights to have their own
beliefs and feelings; it is not the approval of all behavior. All overt behavior need not be approved of or accepted.
According to Rogers’s (1977) research, the greater the degree of caring, prizing, accepting, and valuing of the client in a nonpossessive way, the greater the chance that therapy will be successful. He also makes it clear that it is not possible for therapists to genuinely feel acceptance and unconditional caring at all times. However, if therapists have little respect for their clients, or an active dislike or disgust, it is not likely that the therapeutic work will be fruitful.
ACCUR ATE EMPATHIC UNDERSTANDING One of the main tasks of the thera- pist is to understand clients’ experience and feelings sensitively and accurately as they are revealed in the moment-to-moment interaction during the therapy session. The therapist strives to sense clients’ subjective experience, particu- larly in the here and now. The aim is to encourage clients to get closer to them- selves, to feel more deeply and intensely, and to recognize and resolve the in- congruity that exists within them.
Empathy is a deep and subjective understanding of the client with the cli- ent. Empathy is not sympathy, or feeling sorry for a client. Therapists are able to share the client’s subjective world by tuning in to their own feelings that are like the client’s feelings. Yet therapists must not lose their own separate- ness. Rogers asserts that when therapists can grasp the client’s private world as the client sees and feels it—without losing the separateness of their own iden- tity—constructive change is likely to occur. Empathy helps clients (1) pay at- tention and value their experiencing; (2) see earlier experiences in new ways;
(3) modify their perceptions of themselves, others, and the world; and (4) in- crease their confi dence in making choices and in pursuing a course of action.
Accurate empathic understanding implies that the therapist will sense cli- ents’ feelings as if they were his or her own without becoming lost in those feelings. It is important to understand that accurate empathy goes beyond rec- ognition of obvious feelings to a sense of the less clearly experienced feelings of clients. Part of empathic understanding is the therapist’s ability to refl ect the experiencing of clients. This empathy results in clients’ self-understanding and clarifi cation of their beliefs and worldviews.
Accurate empathy is the cornerstone of the person-centered approach (Bohart & Greenberg, 1997). It is a way for therapists to hear the meanings expressed by their clients that often lie at the edge of their awareness. Empa- thy that has depth involves more than an intellectual comprehension of what clients are saying. According to Watson (2002), full empathy entails under- standing the meaning and feeling of a client’s experiencing. Empathy is an active ingredient of change that facilitates clients’ cognitive processes and emotional self-regulation. Watson states that 60 years of research has consis- tently demonstrated that empathy is the most powerful determinant of client progress in therapy. She puts the challenge to counselors this way: “Therapists need to be able to be responsively attuned to their clients and to understand them emotionally as well as cognitively. When empathy is operating on all three levels—interpersonal, cognitive, and affective—it is one of the most pow- erful tools therapists have at their disposal” (pp. 463–464).