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[MUSIC PLAYING][Dave Mearns in conversation]
[with Frank Wills][a programme from the School of Social Studies]
FRANK WILLS: Hello, my name's Frank Wills,and I teach on the post graduate programin counseling here at the University of Wales CollegeNewport.Dave Mearns and his co-author Brian Thornepublished Person Centered Counseling in Action in 1988.At a time when counseling in Britainwas just beginning to find its feet
FRANK WILLS [continued]: but had not yet established a British based literature,this book had an immense impact.It has become one of the bestselling bookson counseling in English, and enjoys massive salesthroughout the whole world.The importance of the book lay in its abilityto present the really core ideas of personcentered counseling in a vital and very reader friendly way.
FRANK WILLS [continued]: Person Centered Counseling is, of course,strongly associated with Carl Rogers.And it is now almost 10 years since Rogers died.It's obviously vital that any approach to counselingshould continue to develop so that it can avoidthe dangers of stagnation.Dave has been a notable therapist and writer
FRANK WILLS [continued]: who has been able to do this, as shown in his morerecent books, such as Developing Person Centered Counselingand Training in Person Centered Counseling,and indeed in the second edition of PersonCentered Counseling in Action which was published in 1999.This interview gives us the chance
FRANK WILLS [continued]: to go back to original ideas, and gives Davethe space to describe his more recent extensionsto those ideas.He's kindly agreed that we can regardthe interview as a dialogue.So I was able to offer some perspectivesfrom my own position as a cognitive therapist.Inevitably we were able to find areas of overlap,
FRANK WILLS [continued]: but we were also able to identify points on which werespectfully differ.OK, so let's have a look at the video.OK, well Dave, welcome to the Universityof Wales College Newport.It really is a great pleasure to have you here.And I'm looking forward to engaging in a dialogue with youabout both our current experiences in counseling
FRANK WILLS [continued]: and therapy.One area which we thought might be useful to come out a bitis the idea of conceptualization,a term that we both used in recent writings.So can I start by asking you to kick off on that one?
DAVE MEARNS: Like conceptualization in termsof how we think about the work?
FRANK WILLS: Yes.
DAVE MEARNS: And how theory applies to work, right?OK.The way I've characterized theory in the personcentered approach, I've really tried to work on this,because sometimes people outside the personcentered approach thinks we run miles from theory.And even some people within personcentered therapy do run miles from theory.But essentially I think that there's two rafts of theory.
DAVE MEARNS [continued]: There's general theory, or normative theory,and there's theory as it applies to the individual client,ideographic theory.And general theory is really, really importantfor helping us as a therapist for helping us to broadenour imagination, broaden our conceptualizationof the different kinds of clients we can meet,
DAVE MEARNS [continued]: and the different issues.So it's really useful that I knowthat in working with severely traumatized clientsthat sometimes you come across a theoretical phenomenonthat this is simultaneously the worst event in their lifeand also the point at which they felt most alive.
DAVE MEARNS [continued]: So that can be a scary thing for the person.And that's useful theory for me to know.Not that I'll be waiting for that in my client,or expect it to be there.But I know in maybe a third of my clients it will be.So I'm ready, and I can deal with that,and hear it, because often the clienttalks only quietly about that.
DAVE MEARNS [continued]: So I can be ready for that, and hear it, and help them.So that's an example of general theory that's useful.But then after a point general theory we have to lay aside,because we're right into the individual theoryof the client, and we find out what their personality is.Like in terms of my configuration theory,
DAVE MEARNS [continued]: we can with a client create a kindof map of the different parts of their selfthat won't be relevant to any other person.So those two levels of theory I think are important.
FRANK WILLS: All right.Can I just ask you a bit more about how that works outin person centered theory, because I guess whatseems to me to be the really central notion that drivesa lot of the conceptualization in person centeredis around the conditions of worth,
FRANK WILLS [continued]: and the way that works out for the person.And so we know that there are certain types, where parentshave very conditional expectations of their children,then it has developmental consequencesto do with their self image and so forth.
FRANK WILLS [continued]: So that would be a general theory notion, as it were.
DAVE MEARNS: Yes.That's right.And the precise way in which it did work out for the individualwould be the individual theory.So it's like in general terms that kind of alerts usto issues and dynamics that may be there for the person.But the precise issues, and the precise dynamicswould be unique.So we can only get at that through empathy, for instance,
DAVE MEARNS [continued]: with a client.So in other words, yes, we might expect conditions of worthto be playing a part there, but whatconditions of worth, and what part,and how does that manifest itself?That's all individual.I suspect that's not so different from the wayother practitioners from other approaches work.
FRANK WILLS: Well, I'm going to say somethinga little bit about going to therapy in a minute,but I'd still like to pursue this a little bit more.So, for example, an example you give in one of your bookswhich I've heard myself many times in the counseling room
FRANK WILLS [continued]: is that for a client who has six grade A levels but the parentsthink they should have had seven.So therefore there's a sense I can neverdo enough to be good enough for these parents, as it were.
FRANK WILLS [continued]: And you can see how that then maybe relatesinto a later sense of that in the selfof the person about them.
DAVE MEARNS: Can I develop that a bit?
FRANK WILLS: Yeah.Sure.
DAVE MEARNS: And this brings in some more recent theoryon parts of the self and configurations,what can happen in that situation-- I'm thinkingof a particular client of mine who wasn't the male child thatwas wanted.So the conditions for her worth were totally impossible.She could never be male.And so she developed a part of herselfthat very much reflected the conditions of worth,
DAVE MEARNS [continued]: that she was only valuable if she could be male,or if she could do male things, or if shecould achieve in a male world.So she became prominent in the first divisionof the civil service, one of the few women,for example, but also of course was deeply unhappy,and couldn't form the relationshipsa woman would want to form.
DAVE MEARNS [continued]: But I think the human being can bemore sophisticated than that.So how I've developed the theory is that, for her for example,there was a part of her that housed that condition of worththat really reflected that, a deeply depressed heart.But also there was a part of her that
DAVE MEARNS [continued]: objected to that, a part that objected to that constraininginfluence.And that part housed quite a lot of selfexperiences that went the other way.And so what actually brought her in to therapywas the dissonance between those two parts.The dissonance between them grew to an extentthat she wasn't holding things together anymore.And both the parts were actually exerting an influence.
DAVE MEARNS [continued]: One part was slashing her wrists,and the other part was actually asking for help.So that's kind of the way I've cometo see it is that it's a bit more complicatedthan Rogers would have had it.Rogers wrote at a kind of unitary time of theory.Now we're in a more dialogical time.And I think we're seeing the dialogical natureof the human being more.
DAVE MEARNS [continued]: So I would say that person is generallynot just driven by those conditions of worthand defined by them.There's often another part, and other partswith a different narrative.And often a big part of therapy iskind of hearing all the other parts, or all the parts.So that's kind of how it developed.
FRANK WILLS: Yeah.I mentioned it though.I'm glad you brought in the points about configurations.That does seem to me one of the new ideas you have definitelyhelpfully added in there.But if we have the conditions of worth, and as you say,that's only one part of it, because I
FRANK WILLS [continued]: guess different people can react in different ways.Some people will go the one down positionand think they have to go around provingthat they're really worth, in a sort of almostover the top way.Whereas other people presumably would think, well, screw you.
FRANK WILLS [continued]: I'm going to do my own thing.In other words, people can react.But what you're also adding in thereis actually that people can have, in a way,different reactions within their own configurations.
DAVE MEARNS: Absolutely.For instance, a client who really, really looked, and Igot a cold chill down my spine, itlooked like he would have to commit suicide.And it was a really, really difficult time, and a difficultsession, because this was a client with a background thatwas close to violence anyway.So he had it all rehearsed.
DAVE MEARNS [continued]: And then in one moment in a sessionhe made just a passing reference to partof him watching himself.And as soon as he said that, because of the general theoryI heard the part of watching, and so I focused on that.And, of course, naturally it was really important.
DAVE MEARNS [continued]: Because I suspect very often it'sa part of a person that kills them.But there can be another voice there as well.So, for instance, with him that other voice was saying,excuse the language but this is literal, you tired old lumpof shit it said.You know, this is always your reaction to things.There's never anything new.You just go into this violence against others or yourself.
DAVE MEARNS [continued]: So that other voice was a part of him.At that point quite a small part in terms of voice,but actually as he contacted that part, really,really important.So it was important in that sense that that part of himwas heard to reestablish the dialogue within himself.Because if there was dialogue within himself, well,from the point of view of suicide that was less likely,
DAVE MEARNS [continued]: never mind anything else.So that was quite a chilling experience that.And research, for instance, just if we're staying on suicide,research shows that, what is it, about 60% of peoplewho survive a suicide attempt, the next dayare pleased about that.And so you wonder how often does one part of a person kill them?
DAVE MEARNS [continued]: So there's that kind of thing, which I thinkis pretty important, pretty interesting.Human beings are more complicated.
FRANK WILLS: That's great.Maybe I can say something now a little bitabout conceptualization in cognitive therapyin particular, which is my own main interest.And I think we might find some cross overs there.But let's see.So I think one of the really big advantages of cognitive theory
FRANK WILLS [continued]: is the fact that people like Beckdid so much research on things like depression and anxiety.And what they did though was they built these,in your terms, general theory about this is how we think,depression, anxiety, all the other kind of thingsthat we've gone into work.
FRANK WILLS [continued]: And what that to me gives is like a treasure house of ideas,and a language too to understand what might be going oninside the person's system, as it were,and various ways in their behavior,in the way they're thinking, and the way they're feeling,
FRANK WILLS [continued]: and so forth.But very importantly that general conceptualizationof what a depression might look like is only part of the storywhen we get to the individual.And it would definitely be a stage in cognitive therapy
FRANK WILLS [continued]: where you would actually write it down.You would draw up a conceptualizationof various things that might be going on,including childhood factors, the core beliefs people have had,and how this feeds down into the negative thoughtsthat they have now.And that would be individual to them.
FRANK WILLS [continued]: And if I can give you an example of this,one of the new researched areas in cognitive therapyhas been to do with social anxiety, social phobia.And what seems to happen is, again talking general theory
FRANK WILLS [continued]: now, people have these kind of beliefs about themselvesthat they're inept, they're boring,and that they won't interest people, and so forth.And when they actually get to be with other peoplethey feel this intense self consciousness whichis very disabling to them.And I had two clients recently in a row with this,
FRANK WILLS [continued]: with this difficulty.And the first one felt it really acutelywhen he was with anyone in authority.So very self conscious.And he said, well, what I do is I start nodding and butting.
FRANK WILLS [continued]: And I asked him, well, what do you mean by that?And he said, well, the boss is talking to me.I'm going yes, yes, yes, yes.And then he gets out of the situationand realizes he hasn't heard a single word the boss has said.And he has to go and ask people, what did the boss tell me?I don't know what to do.And so consequently, got a negative thing.So I had another very similar client almost the next week.
FRANK WILLS [continued]: And I made the mistake of assuming that he wouldfeel this way with his boss.And I said to him, I was trying to bea bit over clever I think it was,suppose you feel this way with your boss or something.He said, well no actually, with my boss I neverfeel that because I know what the expectations are,I know what the line of authority is,
FRANK WILLS [continued]: and I know what I'm supposed to do at work.It's actually at parties, informal things,where I've got no idea what you're supposed to do there.So it was a really good example of a general theorybut needing to be individualized to people.So I'm just wondering how that sort of--
DAVE MEARNS: Absolutely.I'd actually think, I mean although I say thisas a person centered approach to theory,I think it's probably what we all do.And I do think it's useful that we have clarity.I think it helps students this distinctionthat we're making between the general and the individual,the normative and ideographic, because they can even moreeasily have crossovers because they're naturally insecure
DAVE MEARNS [continued]: and they'll want the general to apply more than it does.But if we didn't think this way in our workwe wouldn't be working with individuals.It wouldn't work I don't think.If you couldn't meet that second client quite quicklyafter putting away the general theory, it wouldn't work.
FRANK WILLS: Can I share with younow a slightly more difficult feeling about this?And this is the fact that, we were talkingabout the politics of therapy before,one of the things that so disappoints me a bit in a way,and you might be able to put me right on this,but as you can probably tell I think that in particular Aaron
FRANK WILLS [continued]: Beck's contribution was just such a masterful contribution.And I don't quite understand why other people don't want to knowabout that, and kind of use it.And, in fact, I've been looking through all your booksto prepare myself a bit for this interview.
FRANK WILLS [continued]: And one of the first things I do is I flick through and seeif there's a reference to Beck.And there wasn't in any of your books.And can you help me out.Have I got an unreasonable expectation of you?
DAVE MEARNS: No.I just think another difference, if you like,is the kind of cuts we take in relation to theory.Do we take cuts that are kind of problem centered or problemoriented?So we would have cuts with depression, cuts with anxiety,or cuts with schizophrenia, whatever it is, and the theory
DAVE MEARNS [continued]: would develop that way.Or are different kinds of cuts taken?Because that's the medical model oriented way of cutting things,problem centered.I mean, there's other cuts that youcan take to theory which is much more existential for instance.What happens when people face an existential crisis?
DAVE MEARNS [continued]: What kinds of things can arise there?And so in that, for instance, youcould have an array of bits of theory to do with depression,to do with anxiety, to do with all sorts of different things.But it's a different kind of cut on theory.And I think traditionally and understandably in personcentered approach, we haven't taken a problem centered cut,because that drives you.
DAVE MEARNS [continued]: It drives you far too much down the general theoryapplied to the individual.So I think that's been the history.I don't think it has to continue being that,because I do very much agree that thereare real gems in work that peoplehave done with different cuts that could be useful elsewhere.
FRANK WILLS: So if we wanted to concrete ours out a bit morethen, would you agree, with me really Isuppose I'm asking you to do, we mighthave a person centered therapist who
FRANK WILLS [continued]: opens their work with a client in a very sort of open way,but does actually discover that depressionis a significant part of this picture.And so if I was supervising that person,and as you know in this present day and age
FRANK WILLS [continued]: you do quite often have supervisor issuesfrom different models.And this has happened to me that itwould be legitimate to suggest, well,you could have a look at what Beck says about it.It might give you some useful general ideas just to inform.
DAVE MEARNS: Absolutely.And that could be really useful.And the gem, and the skill of that practitionerfrom the other approach is to be able to distill theory and takethe general from it without it invadingthe specific, the individual.Like for instance, I'll often dipinto transactional analysis, because Ithink it gives a lovely perspective of the human being,
DAVE MEARNS [continued]: and quite a, not a simple one, I don'tmean to be critical in that way, but quite a ready language.And so I'll often dip in to that and the perspectives from that.Yeah.I mean, all these are riches, and the more crossoverswe have the better.But just our own disciplines of working with them.
FRANK WILLS: OK so I think I can segue thatto perhaps another area where I think that maybecognitive therapy probably has learned, but can still learnmore from your writing certainly,and probably from person centered therapy in general.
FRANK WILLS [continued]: And that is the whole issue of the therapeutic relationshipand the way you've now developed these interesting ideasabout relational depth.And if I can start from the CBT angle as it were, as you know,CBT is fairly structured.
FRANK WILLS [continued]: And there's a tradition which is probably going to come in morerather than less of having protocolswhere the structure of the sessionis actually written down beforehand.And I have to say that personally Ithink that I regard those as guidance rather than thou
FRANK WILLS [continued]: must do all those things.
DAVE MEARNS: Yes.They aren't actually car manuals.
FRANK WILLS: Yeah.But the question has been properlyraised I think about whether using these potentiallyformulaic things does interfere with the relationship.And another factor I would like to chuck in
FRANK WILLS [continued]: before I hand it over to you is I was saying to you, in factI was counseling last night myself,and I was partly pondering some of the thingsthat you'd written about relational depthwhile I was conducting the session.And I was aware of the fact that I do often
FRANK WILLS [continued]: take notes during a session.This is a bit of a thing.If you see Beck working he's always taking notes.And students always say, well, he's taking notes.He's not listening to the client, et cetera, et cetera.And I was partly debating in my own mind,I wonder if this is a barrier between me and this person.So I'm interested to know what you think of all that stuff.
DAVE MEARNS: Yes.Well, I don't think I've ever taken notes.But as a matter discipline I audiorecord every single session I have with a client,apart from the first session, and if they agree.And that's been a discipline for, oh, hundreds of years.And part of that is my record of things.
DAVE MEARNS [continued]: As I practiced more it became more important for meto remember the ways my clients expressed things,so if I was dipping back to them Icould dip back to the way they expressed them last.Because they would have structuresthat would change and evolve, but whatbetter if I met them where they were with it.So hence that discipline.I also found that an awful lot of clients
DAVE MEARNS [continued]: used these audiotapes, which is fascinating too, in creatingkind of meta therapy situations, or taking them homefor their partner.So that's kind of how I got around it.I'm not sure if the actual taking of notesthough, although I haven't experimented with it,I'm not sure if that actually need to get in the way.I could envisage a situation where the client really
DAVE MEARNS [continued]: experienced you or whoever was taking the notes very, veryfully, and very fully with them, and the taking of noteswas just another skill that you were able to do alongside.I wouldn't have thought necessarily--But certainly the idea of a depth of relational contact,something I've really tried to focus on.I mean, Rogers' talked about the therapeutic conditions,
DAVE MEARNS [continued]: the core conditions.And often the approach is, particularly from the outside,it's seen in those terms.And so what I've been trying to dois to kind of reunite those conditions.Because what he was really talking aboutit was an incredibly powerful contact.Powerful in the sense not necessarily emotionally,but powerful in the sense that if I was the client,
DAVE MEARNS [continued]: I'd really be feeling you so close to my experiencingthat that made it incredibly safe, or much more safe for me.Incredibly safe is not right, because what it's doingis getting over the fear, the fearI would have in making contact with myself as I see myself,and exposing that to you and to me.
DAVE MEARNS [continued]: And for the client to do that they reallyneed to feel that I'm someone who is in there with them,with their experiencing.Not just understanding, but the actof being in there shows that I'm not judging ittoo creates an enormous amount of safety for them.So very briefly, that's the kind of emphasis person centered
DAVE MEARNS [continued]: approach takes on relationship.What's important too of course is whathappens when you're in there.And of course this hasn't been much writtenabout in person centered work.But I do believe if someone from another traditionactually looked at what happened when you're in there,in their language they would see a lot of cognitive stuffhappening, for example.
DAVE MEARNS [continued]: Although that wouldn't be the frame.It's simply that you're in there and you'reinteracting with a human being as theyare experiencing their world at an existential level.You're with them.You're close to that.You're focusing on the edges of their experience.You're reflecting their symbolizationsthat help them to re-symbolize.So there's a lot happening that's cognitive as well.
DAVE MEARNS [continued]: But that's the start of the working.That's the emphasis of the working.And I just can't see how you wouldget to that if you didn't have that depthof relational contact.I mean, this is a depth of contactthat's far below transference.Transference is a phenomenon that'smuch more superficial in relationships.
DAVE MEARNS [continued]: The person centered worker would be unpackingthat transference, would be tryingnot to be the blank screen.In that sense getting below that level of the person'sexperiencing and relating in the world.So we're talking about something pretty fundamental I think.I got to that inevitably because most of my early work
DAVE MEARNS [continued]: was working with people who were severely traumatized.And if you didn't get to that level with them,the work didn't start.The work just didn't start.
FRANK WILLS: Right.OK.Did I just refer you back to the idea of the protocol?Is that anathema to you?
DAVE MEARNS: The protocol for the session, like the shape?Well, a few of us at an international conferencewere saying, yes, we actually could draw up a manualfor person centered work.But it would be a very different kind of manual,and I'm not sure it would pass the test of a manual.But it would be a manual that emphasized different things.
DAVE MEARNS [continued]: It would very much emphasize the way the therapist enteredthe session.It would be very much emphasizing the therapistgetting themselves in a good placeto meet the client as an individual.It would very much be emphasizing, pay attentionto what the client is saying.But more important than that, pay attention
DAVE MEARNS [continued]: to how the client is saying it, how isthe client expressing himself?Are there edges to the client's experiencethat they're expressing?What are these edges?Can you delicately kind of knock on their door in termsof these edges without invading them?Actually you could write a pretty good manual on that.But it wouldn't be, you do this, this, and this.
DAVE MEARNS [continued]: But it would be, in a sense, these are the kinds of thingsthat you're aware of.And if such and such, then such and such.But it would be a bit like sort of translatingfrom one language to another.I'm not sure it would add very much.I don't think it would particularlyhelp the therapist.But it would be useful in terms of the politicsof the whole thing, of helping other people to see,
DAVE MEARNS [continued]: well, yes, there is a system.It's a different system, but it's a system.
FRANK WILLS: And I don't know whether thisis a good or a bad thing, but theydo seem to be, in America, they are much more advancedin these areas than us.There is, I've read about recently,a manual for "supportive expressive" therapy, whateverquite that is.
DAVE MEARNS: Supportive counseling I think is a term.I read it for years and then I foundit was a term that psycho-dynamic therapists usedfor person centered, or something like that.It's never ever been used in psy--because it characterizes the external viewof that relationship as being actually something superficial.It's often seen as the therapeutic alliance,
DAVE MEARNS [continued]: or something like that.But relational depths are much different from that.
FRANK WILLS: Not a view I at all share, by the way.But I was reading a study of these different typesof manuals, and actually one of the interesting things in linewith what you're saying, one of the main conclusionswas that maybe we do need to havedifferent types of manuals which say different types of things.
DAVE MEARNS: Probably reading different things,but that's been my impression too is that the manualizationphase people are beginning to kind of see, well,this goes so far, but we need to think a bit broader.I've seen the conventional car manualapproach brought into question more than it used to be.So I suspect always a good thing in Europe
DAVE MEARNS [continued]: about being a bit behind America is sometimesyou don't fall into the same holes.So I think we can probably avoid that.
FRANK WILLS: OK.Just thinking a bit about the so-called structure of therapy,I'm sure you're trying to tell me that you don't know verymuch about cognitive therapy.I don't know how true that is.But I'm sure you know that it at least is quite structured,and therefore is quite amenable to these protocol approaches.
FRANK WILLS [continued]: Although, I want to say this every timeI talk about that, that I think people should regard themas guidelines rather than as thingsthey have to slavishly follow.But one perception that I have about thisis, and if I can just say something about our program
FRANK WILLS [continued]: here-- You met Mike and Norma.And you will know that they work on the front endof the program.And I've traditionally worked moreon the back end of the program.So what we've been doing is general counseling and personcentered skills at the start of the program,
FRANK WILLS [continued]: and offering a chance to specialize lateron in the program.And I have to say that I think I reallyvalue the fact that the students have been well groundedin person centered.I think, personally, it makes them much bettercognitive therapists at the end of the day.And once when I was speaking at a CBT conference,
FRANK WILLS [continued]: I was talking about what it was like tryingto get counselors who had been grounded in person centeredto learn CBT.And somewhat jokingly I said, one problem I've hitis that sometimes the students almost listen too much.
FRANK WILLS [continued]: They try to go with everything the client might say.Whereas CBT would be more about listening outfor the salient issues, and really focusing in on them.And somebody came up to me afterwardswho was a trainer in the health service,
FRANK WILLS [continued]: teaching people to do CBT in the health service.And he said, you know what, I've got the exact opposite problemto you.I can't get them to listen.They try and do CBT without listening to the clients.And I actually thought to myself, I'm glad.I like it my way.I like the problem my way around rather than the other wayaround.
FRANK WILLS [continued]: So I'm wondering what you think about structuring therapy.And, again, maybe one justification which I sometimesmake for it is that clients may be quite confused,
FRANK WILLS [continued]: they may feel quite lost, and sometimesa structure can be helpful to them.I certainly had that feedback quite often from clients,they've said, it's nice to know the different things thatare going to come up.And they find that's helpful.I'm just wondering whether you think
FRANK WILLS [continued]: there is a structure in that, or any other sense in personcentered counseling?
DAVE MEARNS: I really think person centeredtherapy does take an opposite track, or a verydifferent track to that.At that stage we were kind of into the ideographic,we were into what it really is for this individual.And so for instance, the issue may be absolutely nothingthat we could ever have in our manual.
DAVE MEARNS [continued]: Not in our manual, but you were sayingyou can pick on the important issues or whatever.Quite often you would have no idea whatthe important issues would be.A case that I've just written up for a chapterin the book, a person who described himself as alcoholic,
DAVE MEARNS [continued]: the real kernel issue, very much at an existential level,was to do with the fact that whenhe was drinking the sadness that that gave him was living.It was the only example we had of the experience of living.Now, you could never have had a frame that would
DAVE MEARNS [continued]: go in expecting to find that.That was so ideographic.In fact, even explaining in great detailit's very difficult to get people to understand it,because you really have to be in his phenomenal worldto see that for him in his world there had never actually beenan experience of being alive and living,
DAVE MEARNS [continued]: and what he got through the drink was that experience,and it was because of the sadness that came.It's like you could never have got that, and expected that.And also too, if you were operating on other things thatdid seem to be important issues, it would keep you awayfrom the ideographical.There's a danger of that.It might come through, but there'd be a danger.
DAVE MEARNS [continued]: So that's kind of how I'd argue thatfrom person centered perspective you're reallytrying to be open to that ideographic so to speak.And that's a different kind of way of going about it.But both our clients in that situation,maybe both our clients could have successful therapies,but they would be about different things.
DAVE MEARNS [continued]: For instance, one of the reasons Idon't criticize other approaches is-- well, two reasons.One is that I never know enough about them.And the other is I firmly accept the research findings whichsuggest that, you know, the mainstream approachesare pretty effective, and there'sno big difference between them.I do think CBT's got a better base for research than others,
DAVE MEARNS [continued]: in that respect.But I suspect that the more important variableis that you find a way of working that fits you,and I find a way of working that fits me.I think we'd both do better for our clients that way.I'm just remembering that early in my behavioras a psychologist, before CBT it was behavior therapy.
DAVE MEARNS [continued]: And I was the worst behavior therapist.I'll never forget how I worked with this patient,and she totally overcame her fear of bridgesin that such wonderful systematic desensitizationprogram, you know, with pictures of bridges.Was going up and looking at this bridge whichwas just a walkway, and was going 20 yards along, and 50
DAVE MEARNS [continued]: yards, and halfway, and all along with me.And then herself.And, oh, the stages were beautiful.And we did all right.When the anxiety built up a couple of timeswe went back a few stages.It was absolutely wonderful.And then about six months later she phoned me up and said,can I have another session.I said fine, come along to the office.Well, I can't really get out of the house anymore.
DAVE MEARNS [continued]: Symptom substitution wasn't to do with the approach.It was to do with that I was a bad behavior therapist.And I firmly believed that, that there arevery different ways of working.And rather than kind of look to be all the sameor to criticize each other, we can actuallylearn a lot from each other in terms of perspective.
DAVE MEARNS [continued]: I think that's true.You were talking about Beck.That intelligence would be really useful.But we should also note our differences,and that we might be working very effectively becauseof our differences as people.
FRANK WILLS: So I can see a sort of early autobiographyof your early period.I was a behaviorist.
DAVE MEARNS: Yes.A bad one.Ha, ha.
FRANK WILLS: OK.I wonder if I can open up with you another couple of things.In a sense you've already raised them,but I'm kind of interested in the different types of clientswe get.And I particularly picked up the interest
FRANK WILLS [continued]: in the new edition of the Developing Person Centered bookon the so-called "personality disorders."I think we would both share a reservation about that therm.But when you're talking about pretty disturbed clients.And you and Elke give examples in that book of that
FRANK WILLS [continued]: which are very interesting.And actually CBT is also addressing those areas,reaching the conclusion by the waythat a much longer term version of therapyis needed for those clients.So it was a bit of learning there.But it's particularly interesting I thinkfor the person centered model.
FRANK WILLS [continued]: It's an old area and a new area.You will know of the Mendota studythat Rogers was involved in, workingwith pretty institutionalized schizophrenicsand so forth back in the sixties.
DAVE MEARNS: The Wisconsin study.
FRANK WILLS: Yeah.The Wisconsin study.Yeah.And I've heard several different accounts of that.Some of which said that it showed that person centeredtherapy could work with those clients,and some which said it didn't.But it did seem to be something that Rogers did backaway from historically, to me.
FRANK WILLS [continued]: I mean, you probably know more of the historical detail.And, of course, we were talking about the extreme prejudiceversions of our own models.And one of the extreme prejudice versions of thiswould be, of course, it's all middle class clients,and university students.
FRANK WILLS [continued]: All Rogers work was done in that context.You're obviously talking about something very different here.And that also flags up for me the issue of classes,something I'd like to discuss with you,because of comments you make about your own social classback then.But can we just stay first on the disturbed--
DAVE MEARNS: Range of clients?Yeah.Some people say I'm very critical of Rogers' early work,and it's actually not true.But what I've tried to do is to reflect on the factthat a lot of his theorizing was 50 years ago.And we need to update that.
DAVE MEARNS [continued]: Rogers paid a lot of attention tothe therapeutic relationship.One of the things I say is that, justas important as the therapeutic relationship, and almosta kind of pre-determinant of it, is the therapeutic context.And I really think this is a big thing we must pay attention,particularly in working with very different clients.For instance, in my early therapeutic work
DAVE MEARNS [continued]: we would work with only three patients a week.But we'd work an hour a day, six days a week.And that was in a hospital contextwhere the rest of the regime was therapy orientated.Even the medication was therapy oriented.People weren't closed off.But often the symptoms or the depression
DAVE MEARNS [continued]: might be contained a bit, things like that.Now, we would never have got anywherewith those patients, some of whomwere mute because they were traumatized.We would never go anywhere if we were seeing themfor an hour a week in a fancy middle class office.Forget it.And interestingly, a lot of these patientsnowadays would be deemed "unsuitable for therapy."
DAVE MEARNS [continued]: And the politics of it is that usually they'renot unsuitable for therapy.They're unsuitable for the therapeutic contextwe're able and prepared to offer them.So I think that's a big variable that all approaches could use.It's such an important thing.If you are very cut off in one way or another, whatever it is,
DAVE MEARNS [continued]: you're only going to open out, or come step out of that,or delicately feel your way out of thatif you feel the context that's being offeredis big enough to contain what you have.So I think that's a big factor.It's very interesting sort of.As time went on more and more of my workwas with, if you're using problem categories,
DAVE MEARNS [continued]: with clients who would be diagnosed certainlywith personality disorder.Probably not more extreme than that, but certainlyvarying degree than that.Although I didn't think that way.And, again, many people would say, well,they're unsuitable for therapy.But I think one thing that was important
DAVE MEARNS [continued]: for me is there is a point at which the dissonancewithin the person becomes big enoughthat they might under certain circumstances engage therapy.And I don't know if this makes much sense theoretically.It's like if you've got somebody who has developed personalitydisorder, and responds to their circumstances, et cetera,
DAVE MEARNS [continued]: they can be so closed off in relation to other people thattherapy would never become a question unless it wasprescribed by the courts, which usually wouldn't work, I think,for any approach.But at other times something's moved on.Like, for instance, one of my clients found himself crying.
DAVE MEARNS [continued]: And this crying was different from the melancholyhe would sometimes go into.It was almost like, in a sense, part of himselfwas really aware of how much he had lost by the very enclosedlifestyle he had given himself.Now, that was an example of the beginningsof a dissonance within him.And often if we get a client at that point,
DAVE MEARNS [continued]: then we can do a lot.But we've got to watch it in our profession,because I think we only appeal to a small proportionof the population.In general we only really are geared upto the kind of mildly neurotic side of the population,or moderately neurotic.And also, again, in the politics of it,I think in general in our profession
DAVE MEARNS [continued]: we are on the neurotic side.People within normal range.But we are on the neurotic side.So it's a lot easier for us to workwith evenly moderately, or even extremely neurotic people,because we've already got a flavor of it.It can be very difficult for us to work with somebody on a morepersonality disordered side, evenif they are near the normal, because we don't
DAVE MEARNS [continued]: have a flavor for it, and counselors are often frightenedby it.Latterly in my practice I only worked with men.And that was a pure accident, because a number of menwould becoming and would say, I thinkI frightened my previous therapist.So I'm thinking of skipping a lot.I probably deviated from what you were saying.But I'm quite excited about the fact that in the profession
DAVE MEARNS [continued]: I think we've got a lot to learn in terms of how can wemake ourselves amenable to a wider range of people,and problems if you like.
FRANK WILLS: I was just saying though, Dave,about the work of Larry Beutler.And he's someone who has looked across the different typesof therapy, and looked at how differenttherapists use different models, and how clientsrespond to different models.And one of his findings was that,
FRANK WILLS [continued]: if you think of therapies as one dimension,and think of them as from the structured end of the continuumto the less structured end, and that there are some clients whoreally can't use structure.And maybe the more disturbed clients I thinkis the idea there.And I'm aware in my own work, sometimes when
FRANK WILLS [continued]: I'm doing CBT, which I don't do 100% of the time,but I might suddenly feel this justisn't working with this client.And I maybe will try it for a bit,but may well eventually back off and dosomething which I would see is much more like personcentered counseling with that client.
FRANK WILLS [continued]: So I'm just wondering if that rings any bells for youin terms of?
DAVE MEARNS: Well, I suppose the bell itrings is of the difference, because my approachin that situation would be totally different in a sensethat, you know, if I'm imagining it right, if I'm with a clientand I sense my client's discomfort with my reflections,or whatever, and in that sense lessstructured way of going about it,
DAVE MEARNS [continued]: suppose I was sensing that, then I would work with that.I would go into that, and my first kind of thingwould be a reflection on that, is this difficult for youor whatever.So we'd go about it that way and see where that went.So it's not sort of changing the way of working because it seems
DAVE MEARNS [continued]: to better fitting for the client,but working with the difficulty, or difference, or whatever itis, and seeing where that went.But I suppose in that situation, if that proved for the clientto be more of the same, and anxiety provoking,or if not anxiety provoking, not relevant,then they probably would not come.So the client would make the judgment.
DAVE MEARNS [continued]: But it would be a different initial response to itto work with it rather than to change the way of working.
FRANK WILLS: How do you feel about the view whichseems to be emerging in some quartersnow about, for example in the BPS,that I think chartered psychologists have to have twomodels that they are good at.
DAVE MEARNS: That's right.And poor counselling psychologistshave to be schooled in about three I think at least.
FRANK WILLS: Right.
DAVE MEARNS: I smile at it, because it's amazinghow down the years psychology and counseling, therapy, havegone different directions over things.For instance, BHCP would say the really important thingis to be thoroughly schooled in one model.Now, if you've got the time and opportunityto be thoroughly schooled in two models, fair enough.
DAVE MEARNS [continued]: But I'd at least to make sure people are absolutelythoroughly grounded and schooled in one,and have coherence to their functioning.I think that's better than partiallyschooled in two or three.Because I think when we're really challenged in our workwith our client, if we have the depth, and the experience,and the comfort, and the ease in a model, whatever the model is,
DAVE MEARNS [continued]: I think in general that'll work out better.That would be my prejudice anyway.
FRANK WILLS: OK.I wonder if I can finish on a more personal note.And it's one comment.I think it was in the first edition of the Person CenteredCounseling in Action.And I'm aware, by the way, how widely throughout the world
FRANK WILLS [continued]: that book is sold.It's printed in Chinese I understand.
DAVE MEARNS: Japanese and Slovanikan.Ha, ha, ha.
FRANK WILLS: Yeah.So obviously an influential book.But I suppose different things speak to different people.The line that really spoke to me in that bookwas, I think I'm right in saying, somewhere along, maybein the introduction there's a comment about, whatare Brian Thorne's, a high Anglican, and Dave
FRANK WILLS [continued]: Mearns, a working class Glaswegian, doingon the same boat, or something.
DAVE MEARNS: Former poacher I think is-- ha, ha, yes.That's right.
FRANK WILLS: And the reason why it really struck a chordfor me was because I'm from a relatively working classbackground myself.And I have occasionally felt that,that we are quite a middle class world in counseling.And I think maybe what our two institutions have in common
FRANK WILLS [continued]: is that we probably, both in Strathclyde and Newport,we tap into a much more socially diverse--
DAVE MEARNS: Absolutely.
FRANK WILLS: Group of students.So I'm wondering, any reflectionson where that's going?
DAVE MEARNS: The main one is that I'vefound that personally as a therapist,I'm not sure if I've really written this anywhere,a great strength is to be able to pick upthe personal language of the client.And in terms of picking up the personal languageof the working class, west of Scotlandmale, for instance, which is stereotypically
DAVE MEARNS [continued]: a difficult one.But that's easy for me.But I'm challenged in other ways.I might be challenged to pick up the personal languageof someone who's very middle class, church goer, or whateverit is.Although Brian's helped me in that regard.Actually one of the strengths of that I think of Brianand I working together is that difference.But also because we worked together for 28, 29 years,
DAVE MEARNS [continued]: something like that, we know each other so deeply that it'sa wonderful example for students of how when you establisha bond at some depth of knowledge of a person, thenit's amazing how two different people canbe very much involved, very much complement each other.He's a person I love very deeply, Brian Thorne,
DAVE MEARNS [continued]: although we are incredibly different.
FRANK WILLS: I mean, speaking of the geographical thingas well, the other aspect is that to some degree counselinghas been quite dominated by southeast Englandreally in many ways, in my view.And we've certainly felt out on the fringeshere in Wales at times.I think maybe in Scotland you've got
FRANK WILLS [continued]: a bit more of your own supportive structure.
DAVE MEARNS: Again, it's that kind of thing.As always, Scotland was a bit behind Englandin developing things.So I think we were able to go in at a different stageonce we did start it.So, for instance, we do a lot now in termsof primary care counseling.In our university we have a big contractwith the health authority to provide counseling servicesin 60 general medical practices.
DAVE MEARNS [continued]: And that for me is wonderful.That's what the whole thing's about.For me what it's about is providing that kind of helpfor people, free at the point of service.Now we've got a project that, if it does get rolled out,it'll be in 60 secondary schools in the Glasgow areafor young people.And, again, that's, in a sense, my mission,although I don't like that word.
DAVE MEARNS [continued]: But that's very much what I'm about, reaching everybody.It's amazing to listen to tapes of ordinary Glasgow folk,not with a well developed language of the emotions,but actually with a very straightforward and directlanguage of the emotions, and to hear themworking in the therapy context.
DAVE MEARNS [continued]: I'm often crying when I listen to someof these tapes from students, because you can reallysee the fantastic use they can make of quitesmall interventions really.And that makes you even more annoyed at the acculturation,the socialization, and the lack of attentionto the emotional and the cognitive side together.
DAVE MEARNS [continued]: You know, the lack of attention to the whole person,and the way, certainly in Scotlandand probably in other parts too, traditionally wehave really ignored so much of the personand done them a great disservice.And I keep coming back to it.Actually very little interventioncan be well used by people.And that's been a big part of my work in Scotland
DAVE MEARNS [continued]: is to really take that out.
FRANK WILLS: I think that's been a really important development,hasn't it, the getting counselors into health centers.
DAVE MEARNS: Absolutely.Sometimes local private practitioners are objecting.Ha, ha, ha, ha, ha.Which is good.
FRANK WILLS: But I guess what often goes with that thoughis shortened interventions.I don't know if it's the same in Scotland,but I think there are usually six to eight sessioncaps on the number of sessions.I think counselors are quite good at finding waysaround that, but nonetheless.
FRANK WILLS [continued]: And it does raise the issue of shorter term work,and how this really looks like quite a strong tide thatis running in our field.And I was interested in the latest editionof the Developing Person Centered Counselingthat there is some discussion of shortened versions of person
FRANK WILLS [continued]: centered.And I think Brian's chapter--
DAVE MEARNS: Yes.Brian's chapter.I think that's true.I think in the approach we had a prejudice against anything thatwould shorten the thing.But I think Brian's investigation and a numberof others have actually found that you can have actuallyquite big dividends for quite short term interventions.In terms of offering a service I absolutely
DAVE MEARNS [continued]: wouldn't entertain a service that was time limit.But I would entertain a service that was short term.So, for instance, in our contractswith health authorities we do not accept time limitation.What we say is, rather than say you'vegot a maximum of eight sessions, whatever it is,I'll work to an average of six.And that's much better for professionals
DAVE MEARNS [continued]: if you say to the counselor, over the year I want youto hit an average of about six.That allows them-- There are peoplewho can very usefully use one or two sessions, or three.There's other people if you stopped after six or eightit'd be ridiculous because they justopened the window so to speak.So they need that 15.Some need the 20.Some need the 25, and very few.
DAVE MEARNS [continued]: But it allows the professional a bit more latitude.What we're actually doing in our service for the systematic useof core with a great number of our patients,we're actually mapping out circumstanceswhere particular clients can usefullyuse a longer term period.And we can justify that evidentially,
DAVE MEARNS [continued]: because core is a wonderful outcomes evaluation for that.So we can justify that to the authority.So that's where we're going, which interesting, of course,really fits the evidence based culture.So I no longer have a prejudice against short term working,but I really like the professionalto have a bit of leeway.
FRANK WILLS: This solution, the averaging idea,we'll take that one on board.Thank you.
DAVE MEARNS: And when you think about it,in terms of the purchaser, the economic unitis the average times the number of people.That's actually then how much service they're getting.Because you've got other dimensions,like I heard of one place where they put a cap on it of 8,and their average went up from 4.6 to 7.2,
DAVE MEARNS [continued]: because the perception was it's 8.And so a lot of people who otherwisecould have made good use of a few went more towards the 8.Uneconomic to cap it.
FRANK WILLS: OK.Well, I want to finish actually now Dave.But something I'd quite like to perhaps pursueoutside this discussion is that I personallywould like to capitalize a bit on today's meeting.
FRANK WILLS [continued]: I think that we've exchanged a lot of interesting ideas.And I suspect you will feel the same.In a sense we need to look at this nowand see where we have gotten.It feels like we've got somewhere.But we'll see.When we view the tape we'll maybeget a better idea of where that is.
FRANK WILLS [continued]: But I'm quite interested in havingsome sort of further exchange between perhaps our students,or something like that where we could just take this further.CBT is action orientated, as you know.We don't want it to be all just about talk.But thank you very much.
DAVE MEARNS: And also judging by yourself CBT's also very warmand engaging.
FRANK WILLS: Thank you.Thanks.That's a good point to finish on.Cheers.[MUSIC PLAYING][Studio Rob Hyde][Music Music from the Mountains]
FRANK WILLS [continued]: [Edited and Produced by Mike Simmons][Copyright 2004]
SPEAKER 1: The School of Health and Social Sciencesat the University of Wales, Newportis developing a wide range of videos and DVDs aimedat counselors, counseling trainers, their students,and anyone interested in developing their useof communication skills.We offer programs demonstrating good practice and bad practice.
SPEAKER 1 [continued]: We give critiques of the use of counseling skills.And we explore the way in which those skillscan be used in a variety of helping settings.
SPEAKER 2: I just had a really terrible day today.
SPEAKER 1: Using a wide range of examplesin an informative but lighthearted manner,we look at the ways in which help, and support,and counseling can be offered, both in face to face workand over the telephone.
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SPEAKER 1: We have also developeda series of programs in which key practitioners discusstheir work and ideas.And this series, in common with our other material,has been welcomed by many counseling trainers.Whether you're a trainer, a counselor, a student,or someone who uses counseling skills as partof their everyday work, we think that we'll
SPEAKER 1 [continued]: have something to interest you.Call for a brochure, or visit our website,and see what we've got to offer.[hss.newport.ac. uk/sas/counselling.htm]
Dave Mearns in Conversation
View Segments Segment :
Dave Mearns discusses his specialty in Person-Centered Therapy and how it differs from Cognitive Behavioral Therapy. In this therapy model, the practitioner explores a client's unique life experiences to understand the impact of specific attitudes and issues on the individual.
Dave Mearns discusses his specialty in Person-Centered Therapy and how it differs from Cognitive Behavioral Therapy. In this therapy model, the practitioner explores a client's unique life experiences to understand the impact of specific attitudes and issues on the individual.