Developing Person-Centred Counselling
Publication Year: 2003
Subject: Person Centered Counseling
‘This is a useful book for those who use person-centred counselling in their practice, or who are training to become person-centred counsellors’ - Counselling and Psychotherapy, the Journal of the British Association for Counselling and Psychotherapy
Developing Person-Centred Counselling
Second Edition is designed to help counsellors improve their skills within the person-centred approach. Written by Dave Mearns, leading person-centred expert and bestselling author, the Second Edition has been fully revised and updated taking account of developments in person-centred practice.
With new chapters on growth and transference, the book covers the subjects which are central to person-centred training:
the core conditions; therapeutic alliance; development of the counsellor; therapeutic process; the person-centred approach in relation to psychopathology.
Supported by case material and examples from practice, each part of the book presents the ...
- Front Matter
- Back Matter
- Subject Index
Part I: Extending the Therapeutic Conditions
- Chapter 1: Don't Confuse Unconditional Positive Regard with ‘Liking’
- Chapter 2: Offering the Client an Engagement at ‘Relational Depth’
- Chapter 3: What is Involved in Offering Wider Contracts to Clients?
- Chapter 4: Extend the Core Conditions to the Whole of Your Client – Introducing ‘Configurations’ of Self
- Chapter 5: Don't Get ‘Hooked on Growth’
Part II: The Development of the Counsellor
- Chapter 6: Counsellor ‘Paralysis’: Diagnosis and Treatment
- Chapter 7: Beware the Need to Appear ‘Clever’
- Chapter 8: ‘Burn-Out’ and How to Avoid it
- Chapter 9: Personal Therapy is Not Enough
- Chapter 10: What to Do if You are Not Perfect
- Chapter 11: Using the Large Unstructured Group to Develop Congruence in Person-Centred Training
- Chapter 12: Developing a Spiritual Discipline
Part III: The Therapeutic Alliance
- Chapter 13: You Do Not Need to Be an ‘Expert’ on the Client Group or Issue to Work Expertly with the Client
- Chapter 14: Be ‘Beside’ the Client but Not ‘on the Side of’ the Client
- Chapter 15: Getting beyond ‘Transference’
- Chapter 16: Brief Companionship
- Chapter 17: Becoming Aware of the ‘Unspoken Relationship’ between Counsellor and Client
- Chapter 18: Tapping the ‘Unspoken Relationship’ between Counsellor and Client
Part IV: The Therapeutic Process
- Chapter 19: Getting the ‘Power Dynamic’ Right
- Chapter 20: Let the Client's Locus of Evaluation Be the Guide to Your Working
- Chapter 21: Assisting the Client's Focusing
- Chapter 22: Be Aware of and Beware the Dynamics of Self-Concept Change
- Chapter 23: Confronting the Client
- Chapter 24: Trouble-Shooting ‘Stuckness’ within the Therapeutic Process
Part V: Person-Centred Psychopathology
- Chapter 25: The Person-Centred Perspective on Psychopathology: The Neurotic Client
- Chapter 26: Borderline Personality Disorder
- Chapter 27: Psychosis
- Chapter 28: Personality Disorder
- Chapter 29: An Introduction to Client-Centred Pre-Therapy
- Chapter 30: Dealing with the Possibility of Psychotic Content in a Seemingly Congruent Communication
Developing Counselling Series
Developing Counselling, edited by Windy Dryden, is an innovative series of books which provides counsellors and counselling trainees with practical hints and guidelines on the problems they face in the counselling process. The books assume that readers have a working knowledge of the approach in question, and, in a clear and accessible fashion show how the counsellor can more effectively translate that knowledge into everyday practice.
Books in the series include:
Developing the Practice of Counselling Windy Dryden and Colin Feltham
Developing Counsellor Supervision Colin Feltham and Windy Dryden
Developing Counsellor Training Windy Dryden and Colin Feltham
Developing Psychodynamic Counselling Brendan McLoughlin
Developing Rational Emotive Behavioural Counselling Windy Dryden and Joseph Yankura
Developing Cognitive-Behavioural Counselling Michael J. Scott, Stephen G. Stradling and Windy Dryden
Developing Transactional Analysis Counselling Ian Stewart
Developing Gestalt Counselling Jennifer Mackewn
© Dave Mearns 2003
First edition published 1994. Reprinted 1996 (twice), 1998, 2000, 2002
Second edition first published 2003
Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, this publication may be reproduced, stored or transmitted in any form, or by any means, only with the prior permission in writing of the publishers, or in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency. Inquiries concerning reproduction outside those terms should be sent to the publishers.
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British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
ISBN 0 7619 4968 2
ISBN 0 7619 4969 0 (pbk)
Library of Congress Control Number available
Typeset by M Rules
Printed and bound in Great Britain by TJ International Ltd, Padstow, Cornwall
Maria Villas Bowen[Page v]
This book is dedicated to Maria Bowen. Maria was a Brazilian psychologist who became an integral member of the Center for Studies of the Person in La Jolla during Carl Rogers' years there. Indeed, Maria was one of Carl's most valued friends and colleagues – someone with whom he loved to engage in theoretical debate. Maria was also a therapist who had a considerable reputation – one of her clients said ‘She had such a huge personality that there was room for everyone’.
I knew Maria from 1971 to 1994 when she died of AIDS. A year later her husband Jack Bowen, another of my friends, died similarly.[Page vi]
Preface to the Second Edition[Page ix]
Historically, the first edition of Developing Person-Centred Counselling (1994) was positioned after Person-Centred Counselling in Action (1998 and 1999, co-authored with Brian Thorne) and just before Person-Centred Counselling Training (1997). The intention was to offer an extension to thinking about person-centred counselling beyond the introduction offered in Person-Centred Counselling in Action. Thereafter, Person-Centred Counselling Training deepened exposition on the development of the person-centred specialist. More recently Person-Centred Therapy Today (2000, with Brian Thorne) seeks to reflect its title and introduce the very edges of the approach including work on ‘Configuration Theory’ and the revision of Rogers' Self Theory. These four texts do not duplicate one another – each has a place sequentially in the development of the person-centred counsellor.
This second edition retains most of the sections from the original book, though all have been revised, some extensively, to reflect developments in the past eight years. Only two sections have been completely dropped. The section ‘How to work with a couple?’ has been superseded by two good books on person-centred couple and family therapy by Charles O'Leary (1999) and Ned Gaylin (2001). The section ‘How much of your “self” can you use therapeutically with your client?’ is dropped because similar material now appears in chapter 7 of Person-Centred Therapy Today (Mearns and Thorne, 2000). These sections have been replaced by ‘Don't get “hooked on growth”’ and ‘Getting beyond “transference”’. The first has proved to be of great practical value to counsellors – it shows how easy it is to miss the parts of the client whose impetus appears to be oppositely directed to ‘growth’. The ‘transference’ section gives a modern appraisal of ‘transference process’ and its place in person-centred counselling.
In total, 6000 words and 50 references have been added to the book in this second edition, but it is still written as a thoroughly practical text – one which offers 30 focused seminars to help the person-centred counsellor to develop her practice.
[Page x]The first edition sold 15 000 copies, considerably more than were expected by the publisher. Part of this popularity is its positioning in the sequence of four, but a lot has to do with the style of writing which attempts to communicate complex ideas simply and also to retain in its writing that most important ingredient of person-centred counselling – its attention to the humanity of the endeavour.April, 2002
The person-centred counsellor must always remember that she is a guest within the client's world of experience. This first sentence encapsulates the ‘essence’ of person-centred counselling. Most other approaches to counselling and therapy are much more exciting for the counsellor and perhaps also for the client with the practitioner playing a dashing role exhibiting mastery of sophisticated skills of analysis, interpretation and near mystical insight into the client's condition and requirements for change. Compared to this exciting portrayal the person-centred counsellor presents a somewhat quieter image.
In many ways person-centred counselling does not fit so-called Western culture where the notion of being helped to heal oneself is attractive only in the margins of society and where expertness in the pursuit of authority over others is a goal at every level of societal functioning from commerce through academia to the criminal fraternity.
It is commonly supposed that the person-centred approach has no goals for the client beyond that which the client has for himself. This is of course nonsense. There is at least an implicit aim behind all person-centred working: that, under certain conditions, the ‘client’ will be helped to find and to exercise more of his own personal power with regard to understanding and evaluating his actions in the past and present and in making decisions for the future. Furthermore, it is expected that this gain will, in some degree, carry forward to be exercised by the client in his future life. This implicit aim of the person-centred approach renders it unsuitable and even dangerous in contexts where the authority is seeking to develop and maintain a ‘social control’ function over the client.
Perhaps the most central concept in the person-centred approach is conditions of worth. Throughout the socialisation of the child he is faced with the fact that his worth as defined by other people is dependent on whether he measures up to particular conditions. If these conditions for his worth are particularly oppressive, inconsistent or ambiguous the roots will be laid for difficulty in adulthood as he attempts valiantly but in vain to live up to the conditions. Sometimes the difficulty which the [Page xii]person experiences in adulthood is only indirectly related to the conditions of worth but more to do with the way the young person adjusted his or her living to exist within the constraints of the conditions. In other words, the very adjustments which the person made to survive difficult early circumstances might become the source of later problems as those adjustments fail to work effectively in adult life. In a sense, he is struggling to ‘survive his survival’. These two factors: the conditions of worth and the ways in which the person has adjusted to the conditions of worth are the main ways in which ‘maladjustment’ is understood within the person-centred approach.
Another central concept which follows on from conditions of worth is locus of evaluation: the degree to which the person can be his own locus of evaluation or whether that locus of evaluation is externalised with the person unable to make judgements about himself but reliant on the judgements of others. The way a person-centred counsellor works will vary considerably according to the extent to which the client's locus of evaluation is externalised or internalised (see Sections 19 and 20). As mentioned earlier, an implicit aim of person-centred working is to help the client to internalise his locus of evaluation. Helping another person to internalise his locus of evaluation is not achieved by exercising power over him but by creating a relationship in which the client may take responsibility for himself. The singular genius of Carl Rogers, the founder of the approach, was in enunciating and evaluating the relationship conditions in which that client empowerment might be optimised. Rogers laid down six such therapeutic conditions. Currently the most accessible account of these conditions is presented in Kirschenbaum and Henderson (1989: 221).
For constructive personality change to occur, it is necessary that these conditions exist and continue over a period of time:
- Two persons are in psychological contact.
- The first, whom we shall term the client, is in a state of incongruence, being vulnerable or anxious.
- The second person, whom we shall term the therapist, is congruent or integrated in the relationship.
- The therapist experiences unconditional positive regard for the client.
- The therapist experiences an empathic understanding of the client's internal frame of reference and endeavours to communicate this experience to the client.
- The communication to the client of the therapist's empathic understanding and unconditional positive regard is to a minimal degree achieved.
[Page xiii]The strength of Rogers' theory was in this clear statement of the central hypotheses, and considerable research ensued to confirm the importance of the third, fourth and fifth conditions on the congruence, unconditional positive regard and empathy offered by the counsellor (Mearns, 1993a) as well as the relevance of the sixth condition on the communication of these to the client. It must be said that the first condition was largely taken for granted until the work of Garry Prouty and Dion Van Werde pointed out that psychological ‘contact’ could not be presumed with clients whose difficulties were more profound. This observation led to the more recent development of client-centred ‘pre-therapy’ for work with clients whose ‘contact’ with their affect and with other people is impaired (see Sections 29 and 30 of this book).
The strength of Rogers' theory in presenting clear hypotheses has, paradoxically, led to a difficulty of interpretation. Because empathy and unconditional positive regard could be clearly defined, the naive presumption has developed that a simple portrayal of these conditions is what is required of the person-centred counsellor. New students of person-centred counselling and those who are trained by non-specialists in the approach often labour under the misapprehension that all they need to do is to exhibit empathy and unconditional positive regard. The student in these circumstances is thrown into some degree of chaos by the simultaneous demand for congruence. The problem is that conditions such as empathy and unconditional positive regard cannot be ‘portrayed’ towards a client with any degree of effectiveness: clients are not so easily fooled by incongruent portrayal. The task then for the developing person-centred counsellor is quite momentous – she has to become the kind of counsellor who genuinely feels a deep valuing and interest towards her clients, no matter how varied the clients may be. This heralds the true challenge of person-centred training: the enormous personal development work which is necessary to win a sufficient degree of self-acceptance to allow the counsellor to feel consistently unthreatened, accepting and open to the experiencing of her clients.
This book does not go into detail on any of the above aspects of person-centred theory and practice but assumes that the reader will have familiarity with these basics. The reader is referred to the earlier Sage publication: Person-Centred Counselling in Action, second edition (Mearns and Thorne, 1999) for a thorough grounding in the approach. The present book has been compiled in such a way as to offer no duplication with that earlier text but to invite the reader to explore the middle reaches of the approach.
The first part of the book, ‘Extending the Therapeutic Conditions’, offers thoughts and practical examples of ways in which the experienced [Page xiv]person-centred counsellor can function fully as a person in the therapeutic endeavour. Much of this section presumes considerable personal and professional development on the part of the counsellor. Some aspects of that development are explored in the second part of the book, ‘The Development of the Counsellor’, including the crises which commonly hit person-centred counsellors during training like ‘paralysis’ and the need to feel ‘clever’. Highly practical advice is also given on the handling of difficult personal material aroused during training. Part III, entitled ‘The Therapeutic Alliance’, includes fairly detailed exploration of the intricacies and depths of the therapeutic relationship, even the ‘unspoken’ tracts of that relationship. One of the chief areas of interest for the author is the exploration of ‘The Therapeutic Process’ within person-centred working. This forms Part IV of the book with a contribution by Brian Thorne on short-term person-centred counselling and other sections exploring the centrality of the ‘power dynamic’ and ‘locus of evaluation’ in person-centred work. Part IV also includes theoretical suggestions on the nature of self-concept change and how that may induce apparent ‘stuckness’ and regression in the therapeutic process. The fifth and final part of the book is perhaps the most important in offering areas for future development: ‘Person-Centred Psychopathology’ has been a very neglected dimension for person-centred work but this section offers considerable new thinking in four chapters by Elke Lambers, who was set the task of addressing traditional psychodiagnostic categories in terms of person-centred theory. The person-centred approach has long had an uneasy relationship with psychodiagnostic terms, which it rightly regards as unnecessary and even somewhat obtrusive in relating to the individual client. However, it is important for the person-centred counsellor to be able to relate with these terms if she is to function within a clinical setting. The last two sections of the book are provided by Dion Van Werde on client-centred ‘pre-therapy’ developed initially by Garry Prouty as a way of working with clients who have severe problems in maintaining ‘contact’ with their own affect and with other people. Pre-therapy is one of the most important developments in the last twenty years of person-centred work, offering as it does a meaningful basis for working with largely neglected client groups. The other major development, the work of Margaret Warner on ‘fragile’ and ‘dissociated’ processes is not included in this text because it is well-described elsewhere (Warner, 2000; Warner, 2002b)
This introduction needs to contain some paragraphs on language. Frequent mention during the book is given to ‘the training period’ without that term ever being defined. The author considers that the training period for a person-centred counsellor is somewhere between [Page xv]three and five years, regardless of the length of the actual training course, which tends to vary from one year full-time to three years part-time. Whether that basic training is completed within one year of completely intensive work or three years during which the work can be better integrated with practice, there should still follow some years during which the counsellor is in an embryonic phase as a person-centred practitioner.
This book tends to use the term ‘person-centred counsellor’ rather than the more common ‘person-centred therapist’. The reason for this choice is simply one of maintaining consistency within the series. The training of the person-centred practitioner seeks to equip her to function at whatever depths are required by each new client. Whether that work should be called ‘counselling’, ‘therapy’ or ‘psychotherapy’ is largely irrelevant. While the term ‘counsellor’ is predominantly used in this text, Sections 29 and 30 respect the convention of the author's cultural context by using ‘therapist’.
The same policy is adopted for the use of pronouns as that which has been well received in Person-Centred Counselling in Action, second edition (Mearns and Thorne, 1999): within the general text the counsellor is ‘she’ and the client is ‘he’. Obvious exceptions to this exist in some of the reproduced case material, where to change the sex of the client or the counsellor might radically alter the material. Also, the female pronoun is used for the client in Section 26 on ‘borderline personality disorder’ simply because this experience is only rarely found in men.
This text does not seek to be politically correct in terms of the choice of material or the language which is currently prevalent in Britain. The reader should note that political correctness is very much tied to specific cultures, and language which would not be ‘correct’ in Britain might be the norm elsewhere. This particularly applies to some of the terms used in the pre-therapy sections (29 and 30). It was deemed to be disrespectful to change language which was perfectly appropriate in the culture from which it originated. This issue of political correctness was also considered in relation to the material presented in Section 20. Some consultations suggested that the client material described in this section should not be published lest it give the impression that accounts of the sexual abuse of infants and ritualised sexual abuse are over-emphasised. The author decided not to censor this material on those grounds but wishes to make it clear that he is of the opinion that these abuses are if anything under-estimated rather than over-estimated in modern society
The book contains a considerable amount of client material. Extreme care has been taken to preserve both the confidentiality and the anonymity of the clients. Permission has been obtained to reproduce any parts which could have been identifiable by the client himself and [Page xvi]changes have also been made to ensure that there are no features which might be identified by other persons. Furthermore, a strict policy has been observed of not using material from clients with whom work was current at the time of writing. Although clients are usually quite happy that such material be used, it can have unforeseen effects upon the therapeutic relationship.
With all these introductions and cautions expressed, let us embark upon a journey round thirty critical and at times controversial issues at the forefront of thinking in the practice of person-centred counselling – where better to begin than with the perhaps controversial suggestion that ‘unconditional positive regard’ has little to do with ‘liking’!
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