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Person-Centered Psychotherapies - Cain, David J...rtf
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Being Authentic, Genuine, Transparent

Being genuine or congruent means that the therapist is what he or she seems to be. What the therapist experiences internally is matched by his or her words, behavior, feelings, and manner of expression. Therapist genuineness lends credibility to everything the therapist does. Congruent therapists are more likely to be perceived as trustworthy and honest and as persons of integrity. When the therapist is transparent, or willing to be known, and without deception of any kind or intent to act like someone he or she is not, the client is likely to feel trusting. Conversely, incongruence on the part of the therapist may cause the client to be cautious or guarded. Congruent therapists do not play the role of therapist or hide behind it but are naturally themselves in relationship to their clients. In simple terms the person-centered therapist eschews any form of deception, phoniness, or manipulative behavior no matter how benign in intent. They have little or no need to hold back anything that is relevant to their clients. At times, the person-centered therapist may invite the client to inquire about the therapist’s comments, behavior, or his or her thoughts or feelings about the client. Such openness is often vital to clients who tend not to trust others or misread others’ intentions. Recently, one of my clients expressed her deep distrust of most people, fearing that they would attempt to take advantage of her. She seemed hypersensitive to some of my physical gestures (e.g., rubbing my brow) and expressed her concern that I may be withholding something from her. I encouraged her to check with me about anything I said or did and assured her that I would let her know my thoughts and reactions to her. She greatly appreciated this opportunity and did inquire a few times about some nonverbal behavior that she feared signaled a lack of interest in her. My willingness to be open with her enabled her to be more trusting of me.

Rogers came to believe that therapist congruence was the most important element in therapy:

It is when the therapist is natural and spontaneous that he seems to be most effective. . . . Our experience has deeply reinforced and extended my view that the person who is able openly to be himself in that moment, as he is at the deepest levels he is able to be, is the effective therapist. Perhaps nothing else is of any importance. (Rogers & Stevens, 1967, pp. 188–189)

Clearly, this was a radical position that challenged the prevailing views of how therapists comport themselves with their clients. Far from the position of classical psychoanalysis where therapists were to remain neutral and unknown so their clients could project interpersonal conflicts onto their therapists via transference reactions, Rogers’s view was that authentic encounter with the client was itself therapeutic.

There are numerous ways the therapist’s congruence contributes to the change process. As mentioned earlier, having a meaningful encounter with a congruent and present therapist often has a therapeutic impact on the client. Clients sometimes learn to be more congruent through authentic engagement with the therapist since realness on the part of the therapist often begets realness in the client. When there is a genuine meeting between therapist and client, both are enriched by the quality of contact. Clients then have the experience that they can engage meaningfully with the therapist and, by extension, other persons. Therapist self-disclosure that is relevant to a client’s experience (e.g., the pain of losing a pet) often helps the client feel understood and less alone in his or her troubling feelings. When therapists are transparently real, clients see that they are persons just like others instead of omnipotent or omniscient beings. This often provides perspective for clients and enables them to become more self-accepting. Although it may not be therapists’ intent, they often serve as models of an authentic manner of being for the client. Through vicarious learning, clients see and experience what it means to be authentic and try out for themselves more transparent ways of engaging with others. Consequently, the quality of their primary and everyday relationships is often enriched. They learn that it can be gratifying to be open with others who, in turn, are more likely to be open with them. Communication is generally enhanced because it is more direct and honest and, therefore, less subject to image management, political correctness, deception, qualification, caution, and the myriad ways that communication can be compromised.

Congruent therapists may use themselves in a variety of ways on behalf of their clients. Although person-centered therapists tend to focus primarily on their clients’ lived experience, there are times when they respond spontaneously as the person they are. By doing so, they often bring forth aspects of themselves that are intended to serve their clients. Clearly, various qualities of the therapist other than empathy and unconditional regard are often therapeutic. In any given course of therapy, the particular relational qualities that may be growth enhancing will inevitably vary. Just as the client can be understood in terms of a variety of selves that may emerge at different moments in varying contexts, so can the therapist. For example, the therapist may engage his or her sense of humor with the client, make affirmative comments, or even challenge the client as long as such behaviors are intended to foster the therapeutic relationship, process, or the client’s goals and well-being.

Being congruent doesn’t mean that person-centered therapists have license to say or do whatever they feel, simply because it is an honest response. It is essential that the therapist’s genuineness be relevant to the client and the current therapeutic situation and be of constructive intent. Congruent expressions of the therapist can be a problematic, and sometimes risky, endeavor. Expressions of congruence may be harmful and damaging to the therapeutic relationship. For example, expressing anger at a client for lack of effort during or between sessions may be authentic but runs a high risk of being harmful and should generally be avoided. In the Gloria series of sessions, Perls was rated high on authenticity but was experienced by Gloria as alienating (Rogers et al., 1965).

Congruent expression of the self of the therapist means that the therapist’s words, actions, feelings, thoughts, and intents are an integrated whole. Since congruent expressions of the self may be for better or worse, such expressions need to be made judiciously. Keep in mind that research indicates that therapist congruent expressions are sometimes negatively related to client outcome. Discriminating expression of self is certainly called for in the therapeutic endeavor. Therefore I offer some guidelines for the congruent expression or use of self in the form of questions therapists might ask themselves.

Guideline 1: Is my authentic expression intended to be in the best interest of my client? An affirmative answer to this question usually indicates that the therapist is of good will and intention. It also suggests that the response is believed to have therapeutic value.

Guideline 2: Is my congruent expression relevant to the immediate therapeutic situation? Therapists sometimes succumb to the impulse to share aspects of their lives, feelings, or thoughts that are not relevant to the immediate therapeutic situation. Thus, therapists should ask themselves, “Does this fit?” or “Is this relevant to the client’s concerns?”

Guideline 3: Is my expression natural, spontaneous, authentic, and without any hidden or manipulative intent? If the therapist feels awkward, hesitant, uncertain, uncomfortable, or in any way incongruent, then he or she would probably be wise to refrain from personal expression. Further, if the therapist has the sense that he or she may be “up to something” that is not clear or is uncertain whether his or her motives may be deceptive, compromised, or possibly manipulative, then the therapist would do well to contain such responses.

Guideline 4: When strains or problems in the therapeutic relationship arise and persist, is my response intended to understand, constructively address, and repair such problems? Strains in the therapeutic relationship are not uncommon and often derail the therapy. Unfortunately, clients often do not share their problematic reactions to the therapist or therapeutic process. Therefore, the burden of addressing such strains or rifts falls to the therapist. At times, when the therapist is having difficulty with a client, he or she may disclose his or her feelings or concerns in an attempt to resolve any problems that may exist in the relationship. Rogers used as a marker any persistent problematic reaction or feeling elicited by the client as an impetus to share his own feelings or perceptions with his client. Therapists need to be aware of their possible contributions to the strains and nondefensive in acknowledging their part in them. When therapists are the main source of the strain, it is appropriate for the therapist to acknowledge this and apologize to the client.

Guideline 5: When I have negative reactions toward my client, do I first consider that such responses may reflect problematic issues of my own? When therapists react negatively to clients, I believe it is valuable to remember that not all therapists or others familiar with the client would have an adverse reaction. Thus, therapists should first look at themselves and consider that their own biases, blind spots, or problems may be at play.

Guideline 6: Would the client be better served by my withholding some of my feelings and reactions, especially if such expressions have the potential to be hurtful to or burden the client or damage our relationship? The psychotherapist’s commitment should be to “first do no harm.” When therapists have moderate to strong doubts about the effects of their disclosure, it is often wise to refrain from or postpone sharing their reactions. If the therapist’s response is likely to elicit defensiveness, hurt the client’s feelings, or damage the relationship, then the therapist should probably refrain from such expression.

Guideline 7: When I decide to share negative or problematic reactions to my client, is my intent clearly to be of therapeutic benefit? There are times when therapists’ reactions to clients are “diagnostic” in the sense that they likely represent responses that would be common to other therapists and other persons who know the client. For example, a client who complains of a lack of intimate relations may disclose relatively little of a personal nature and tend to focus on superficial aspects of her life. The therapist might notice his or her reaction to such a client and share that he or she feels disconnected from the client. In doing so, the therapist’s intent would be to use the immediate situation to explore with the client how his or her manner of relating seems to interfere with the development of closeness. When therapists make such observations and decide to share them, it is essential that the therapist feels benign and constructive in his or her intent.

In sum, each therapist needs to be attuned to the personal characteristics and emerging needs of the client and bring forth aspects of the self that foster relational engagement, deal with conflicts, and address relational strains or ruptures. If therapists consistently ask themselves, “Is my response intended to be in the bests interests of my client?” they will likely make sound decisions most of the time.

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