The Concept of the Human and Counselling Part III

The theoretical inconsistencies discussed in the previous two posts (here and here) inevitably leave practicing counsellors in a difficult position. If they followed the theoretical frameworks as these are posited, they would not be able to counsel people.

In transactional analysis, if the script is really ready by the early school years and it is so powerful that it directs concrete and distinct behaviours for an entire life, counselling would have very little chance to change the script or counsellors would have to be omnipotent and infallible. Since there are no special mothers to give birth to omnipotent and infallible counsellors, the counsellor has to reject or at least put aside the most fundamental assumptions of transactional analysis (and use it as a communication technique rather than a counselling one).

If the actualising tendency is autonomous and the blockages to it derive from interaction with the society asRogersstated, then the healthy person should withdraw from the society either directly (becoming a hermit) or indirectly (the actualising tendency is in incognito – showing a mask to the society or being a non-conformist). Thus counsellors have to put aside the most fundamental category of person-centred counselling if they want to work with the client.

In Gestalt Therapy if needs have a predetermined hierarchy and these are in conflict with the behaviour displayed by the client, the only answer counselling could have is to change the client’s personality in order to match the hierarchy of needs and then help the person to establish the Gestalt in this new structure. However, this would contradict to the basic assumption of the autonomy and the individuality of the client, hence the counsellor, to work with the client, has to ignore the theoretical foundation of Gestalt Therapy.

Not having a theory as a support to their practice, counsellors have to turn to themselves to find some basis to their practice: their own experiences and their own ethics. While experience is very important as skills have to be at a dexterity level in counselling, the incoherence between theory and practice deprives the skills from the reference point: the systematic, constructed knowledge.

This is how the ethics of the counsellor becomes the basis, the reference point. No doubt that the key attribute of the therapy is the genuine helping intention on the side of the therapist based on empathy, hence ethics is central. However, theoretical inconsistencies could cause confusions even in this. Let us show this on the example of the theory of person-centred counselling.

I want to emphasise that these are the logical outcomes of the carelessness with which Rogers approached theory and not how he actually applied person centred counselling. Nevertheless, it is important as counselling students still have to memorise Rogers’s theoretical framework and as critical reflections on the fundamentals are actively discouraged, it has a latent effect on the practice.

Rogers defined unconditional positive regard in two ways. Firstly as a utilitarian principle:

‘A high degree of unconditional positive regard was likewise associated with the more successful cases.’ (Rogers, 1967, p. 48-49).

Here he acknowledges the possibility of different degrees of unconditional positive regard in the counselling process; and he interpreted it as an effective way to achieve success. However,Rogersgave a very different definition elsewhere:

 ‘The third conditions is that the therapist experiences a warm caring for the client – a caring which is not possessive, which demands no personal gratification… Standal has termed this attitude “unconditional positive regard”, since it has no conditions of worth attached to it.” (Rogers, 1967, pp. 282-283).

Here unconditional positive regard is defined as essential and necessary to the therapy. But what is it? Rogersdescribes unconditional positive regard explicitly as an attitude and not as a method or a technique (Rogers, 1951, p. 25), as a chosen philosophy (Rogers, 1951, p. 22), or to put a proper name to it: a moral, ethical obligation. It is a moral choice made by the counsellor. This then opens Pandora ’s Box:

Why should the counsellor choose this moral stance? Are there other ethical choices? Could those be different, better, more efficient than unconditional positive regard?

What is the relationship between the two definitions of unconditional positive regard? As a moral obligation, it should be unconditional, but as a utilitarian principle it cannot be such. Is it morally right to use unconditional positive regard when there is low level of it?

If unconditional positive regard is utilitarian, it has to be conditional, hence it cannot be a necessary condition of the therapy.

If unconditional positive regard is independent of the goal of the therapy, it cannot be a moral obligation.

These contradictions can be resolved only in one way. As the unconditional positive regard as a moral obligation is independent of the attributes of the therapeutic situation, thus, from the perspective of the therapist, the therapy itself becomes a moral action. It is correct only if it is the interest of the client that the therapist uses unconditional positive regard.

This is unsustainable, because therapy can be unsuccessful. The unconditional positive regard as a moral obligation in unsuccessful therapies is unimportant from the perspective of the therapy as it fails to deliver. The unconditional positive regard is a moral obligation from the point of view of the therapist, but it is immoral from the client’s view as for the client the therapy is defined by its success. If the unconditional positive regard is a utilitarian principle, then success is crucial, consequently it ceases to be a moral obligation on the therapist – it becomes a technique.

When Rogers defined the unconditional positive regard as a necessary and sufficient condition of therapy, he attempted to unify the two aspects: the unconditional positive regard is a moral obligation that delivers results. With this the problem seems to disappear, because the therapy itself is a moral act – unconditional positive regard defines the particular therapeutic relationship. This means that at the deepest level unconditional positive regard and therapy are one and the same.

But the problem only seems to disappear. If therapy is a moral act, then the unconditional regard abolishes the unique characteristics of the particular therapeutic situation, thus it is immoral as it defines the therapy exclusively from the therapist’s perspective, while this perspective is arbitrary because success is not relevant to this. Thus therapy as a moral act becomes immoral. If unconditional positive regard is a utilitarian principle, a method (or using Rogers’s term: as an implementation), unconditional positive regard cannot be regarded as essential to the therapeutic process, it cannot be a moral obligation and if the therapist insists on it, it becomes immoral. The problem is evident in the following passage from Rogers:

‘To me it appears that only as the therapist is completely willing that any outcome, any direction may be chosen – only then does he realize that vital strength of the capacity and potentiality of the individual for constructing action. It is as he is willing for death to be the choice, that life is chosen; for neuroticism to be the choice, that a healthy normality is chosen. (Rogers, 1951, p. 49)

Rogers here ignores the content of the client’s choice – he is interested only in the act of choice and therefore, his attitude (that he allows the client to choose anything) justifies (or can justify) anything. On the other hand Rogersalso defined people by their choice (in particular, the fully functioning person). The theoretical and logical inconsistencies led to an anti-theoretical stance: the therapy depends on the ethics of the therapist and this ethic (the unconditional positive regard) is omnipotent: if the therapist shows unconditional positive regard, the client will choose life, health. This faith becomes now the cornerstone of person-centred therapy and all the theoretical categories of actualising tendency, organismic self, the locus of evaluation are superfluous from the perspective of the therapy – they are communication tools to create respectability in academia.

But because of this faith the noble values and ideals that unconditional positive regard claims to be as the only way for a successful therapy is only a thin veil of haughtiness of the therapist and his moral.

With this the unconditional positive regard destroyed the concrete meaning, the purpose, the content of the therapeutic relationship – now therapy is for the therapist convenience: he is deus ex machina who, hypocritically, finds moral satisfaction in acting as such. With this, person centred counselling turned against its own principles: it is not for the client, but for the therapist, it is not for cultivating the personality of the client, but satisfying the egoistic needs of the therapist. Helping the client is important only as much as it helps the therapist and the approach in the market competition for income against other service providers.

Clearly Rogers and person-centred counsellors do not follow these logical consequences resulting from the incoherence in the construction of Rogers’s theory – in their practice they interpret unconditional positive regard as acceptance of the situation and the client that needs helping.

Here at CTPDC in our courses we follow this latter interpretation of the therapeutic relationship. For us the moral obligation of the therapy derives from the fact that it is a helping profession, its function is healing. The primary aim of the therapy is to reduce the suffering of the client. This is the condition of the healing process, although not necessarily as a separate phase. It is possible that the therapist cannot “cure” the client, but by reducing the suffering the therapist makes humane life possible for the client.

This attitude requires a high degree of consciousness. It requires the therapist to live a life in which he is conscious of his relationships and the tensions of his own life and – even more have to be able to manage these effectively. The counsellor consciously has to give up the urge of coming from the therapeutic relationship to have power over life of the client and he has to suppress the voyeuristic joy coming from the ability of peeping in the deepest secrets of the clients’ life. These conditions will provide stability, honesty, clarity and consciousness for the therapeutic process, or to use the term of person-centred counselling, it will support congruence and open the way to genuine helping.

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The concept of the human and counselling – Part II

The exclusion of practical activity is the major source of the theoretical incoherence in counselling theories because without it they cannot answer two fundamental questions: how do we know things and ourselves and how do we know if our knowledge is correct. To put it bluntly: consciousness is either ignored or depreciated in counselling theories.

They try to avoid this problem in two ways. The first perceives humans as putty on which the external environment leaves clear imprints that triggers predictable behavioural patterns. The second assumes that somehow the self recognises itself, thus the source of knowledge comes from exploring the unaffected internal world. In effect, the first denies the role of the self, of the conscious, while the second one assumes that the self is a born-with attribute, the outside word is unimportant and it dissolves the self into phenomenology. Continue reading

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The concept of the human and counselling – Part I

Some of the counselling approaches are quite explicit about their concept of the human, some are shyer, but either way without the concept of the human, no counselling approach can exist. The logical/theoretical frameworks of the approaches are driven by this and therefore the concepts of the counselling process are also defined on this basis. In this post I will argue that the concept of the human in essentially all counselling approaches is the machine-human. Since, in my view, this concept is flawed from a theoretically point of view and questionable from an ethical point of view, the motivation and the actual practice of the counsellor becomes particularly important. An ethical practice must deviate from the logical consequences of the machine-human concept, although this is not a blank cheque for putting every possible technique and assumption in the counselling process – after all we are not making hotchpotch. Continue reading

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Violence in videogames – aggression in children?

I did not want to post about another Therapy Today article. However, in the October 2011 issue there was a viewpoint article, accompanied again by an endorsing and highly superficial editorial. Both were intellectually so sloppy that I felt I needed to react.

The viewpoint article, in spite of several more nuanced observations in parts of the article, essentially claims that violent and sexualised videogames are responsible for lack of concentration, academic underperformance and lack of impulse control (aggression) in pre-puberty boys.

I will not address the problem of sexualised videogames – this is much more complicated than the article posited (the role model does not have to be male: boys could identify with Lara Croft).

While it is enough to open most of the tabloid newspapers to see the flawed assumption that violent films, computer games (after all, they are film-like) create aggression in the children, it is surprising to see this in Therapy Today.

I put forward two key arguments about this assumption here:

a)      without social conditioning the violent videogames have no enduring impact on children.

b)      consequently, the key issue is not the violent videogames, but the amount of time children spend with videogames irrespective of their content. Consequently, the problem is the family and the lack of socially organised child activities and hence the core assumption in the article actually obstructs us to address the problem of uncontrolled aggression in children. The role of the videogames in the development of antisocial aggression must be assessed in the social context in which the child lives. Continue reading

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Therapy Today and the BACP Ethical Framework

In the issue of March 2010 of Therapy Today a viewpoint article was published – Anger and Forgiveness. The article was on the Hoffman Process and it said: “And I have yet to hear anyone rubbish it”. I wrote a letter to the editor, in which, although did not rubbish it, criticised the therapy but also the editorial policy – not that the article was published, but it was published without any critical commentary. The letter was not published – as a matter of fact, unusually for Therapy Today, no letter was published on this viewpoint article. Here is the slightly edited version of that letter.

The viewpoint article lacks reflections to such an extent that it could be perceived as an advertisement of the Hoffman Process. The article quotes Serena Laurence, one of founders of the Hoffman Institute UK saying that in the institute they are wary that the press presents the Hoffman Process as a miracle cure. Considering the running testimonies on the Institute’s website and the celebrity endorsements (among them Patrick Holford, a so-called nutritionist, in whose book the other founder of Hoffman Institute UK, Tim Laurence, wrote one chapter) on their newsletter page, it is clear that it is not the press, but the Institute that presents the process as a “miracle cure”.

However, there are more important issues than over-marketing a technique. According to BACP’s ethical framework, page 5: “Ensuring that the client’s best interests are achieved requires systematic monitoring of practice and outcomes by the best available means. It is considered important that research and systematic reflection inform practice.”

The article states that the Hoffman Process has been in use for many years, yet it goes on to say on page 15: “while some research has been completed in the US, the UK team are keen to develop an evidence base from work in this country”. This means that this technique, by the standards of BACP, has been unethically used in UK, as there is not the slightest evidence or even peer evaluation of its efficacy and one could have doubts about the stated desire of the institute of evidence-based research for two reasons. Continue reading

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