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Humanistic Therapy

If all the theories I draw from were like different sections of an orchestra or band, perhaps humanistic therapy would be the percussion section – always present in the background, keeping the rest of the sections on beat and serving as the foundation of the performance. This is because humanistic therapy more than any other theory emphasizes the therapeutic relationship over techniques or concepts, and all therapy techniques take place within the therapy relationship.

I am borrowing heavily from Carl Roger’s work in this post, but other well-known therapists who could be considered classified largely as humanistic therapists include Rollo May, Carl Whittaker, Irvin Yalom, Virginia Satir, Harry Stack-Sullivan, and Erich Fromm.

Goals of humanistic therapy

  1. Self-awareness; a more complete and full understanding of oneself and one’s experience
  2. Growth; becoming more similar to the person he/she wishes to be
  3. Self-confidence; openness to experience
  4. Self-directedness; trust in one’s own experience
  5. Creativity, unique self-expression
  6. Empathy for, and genuine contact with, oneself and others

Assumptions of humanistic therapy

  1. The therapeutic relationship (between the therapist and the client) is the “agent of change”.  The therapist is emotionally and genuinely invested in the relationship with the client.
  2. Withholding ourselves creates sickness, and revealing ourselves creates health.
  3. Human beings are fundamentally, and generally, good.  All people naturally and continuously move toward growth, fulfillment and self-actualization, even if that growth is not always obvious.
  4. Curiosity and acceptance of how we are leads to change.
  5. Feeling precedes, and is more foundational for change, than thinking.  Experience is primary, intellect is secondary.

A healing relationship 

“How can I provide a relationship which this person may use for his own personal growth?”

Carl Rogers

The primary assumption of humanistic therapy (sometimes called relational therapy) is that change for the client takes place as they have a significant interpersonal relationship with the therapist.  Change is not assumed to come from being taught something at an intellectual or cognitive level, receiving the right information, or even having something within them fixed.  Change comes from what is co-created between the therapist and client, and certain aspects of the therapists way of being (e.g. congruence, empathy, acceptance, positive regard) are transmitted to the client through their relationship.

Stated another way, the client “learns” experientially about himself and about relationship to self and others (the primary domain of psychotherapy) by entering into a “zone of proximal development” (Vygotsky) with the therapist.  

Congruence / genuineness

“In my relationships with persons I have found that it does not help, in the long run, to act as though I were something that I am not (…) It is only by providing the genuine reality which is in me, that the other person can successfully seek for the reality in him.”

Carl Rogers

Congruence is another term for genuineness.  I suppose I slightly prefer the word congruence over genuineness, perhaps because it is used less often and less tied to preconceived ideas then genuineness.  

Congruence means that we are being real.  That what is showing on the outside (words, actions, nonverbals) matches what is on the inside (our thoughts and emotions).

In geometry, two angles are congruent if they are the same.  The angles match.  In therapy, congruence refers to how our inner landscape matches our outer landscape, especially how we present ourselves and appear in the world.

A main endeavor of therapy is to integrate the inner child with the inner parent – what our instincts want and what the world wants of us.  Often what makes people mentally sick is this split, which often manifests as a personality front or outside representative in the world (based on our perceptions of the world’s expectations of us) and a restless, anxious, scared, or rebellious inner child within.  It’s not healthy to 1) squash the inner child or 2) let the inner child to have total reign over us.  We need to get to the point that we take the world’s input into account, and decide for ourselves which societal rules we are going to follow and which ones we’re not going to go along with.  The result is that our outside behavior matches our inside emotions.  We are congruent.  Before we go through that process, we’re going to be torn in two directions: what WE want and what THEY want.  Usually this involves some amount of (often unintentional and unconscious) deception and manipulation.  We send mixed signals.  We say what we don’t mean and don’t mean what we say.  We withhold our true intentions lest they give others the means to walk away from us or make a decision based on the full truth.  We try to have our cake and eat it too, strategizing how to cater to our inner children and the world at the same time, when that tends to dissolution both at the same time in the long run, as the truth leaks out over time.  Congruence involves letting go of some of the wants of both, by simply being fully honest and open to the world.  It requires the maturity of facing tradeoffs, and realizing that we’re not going to get everything we want, and neither are we going to forfeit everything we want, which means that others are free to give us less in turn.  

The benefit of congruence is less game playing, and therefore less anxiety.  As Mark Twain said, “if you tell the truth then you don’t have to remember anything.”  It means not stacking up piles of social debts by pretending we are one way or want one thing, influencing others to act according to those inaccurate representations, and then expecting us to respond sensibly to them and to continue behaving in the unnatural way we’ve been behaving.  

It also means that we’re free from the burden of not knowing why people even bother to affiliate with us.  As long as we’re showing something different on the outside, we never know if people are responding well to us due to that mask we’re wearing, or if they genuinely like us for who we are on the inside.  How could they know, if they’re not seeing what’s on the inside by experiencing it on the outside (words, actions, and nonverbal behavior)?

Humanistic therapy involves the therapist transmitting congruence by modeling it, and also by encouraging it.  Carl Rogers said that the therapist should be “dependably real”, expressive, consistent, and unambiguous.

It involves commending a client when they take steps to be interdependent rather than codependent, and when they walk away from the perks of mixed messages and sending false signals to obtain a short-term reward, instead boldly telling the truth to the other people in their lives, and facing the blowback from making those changes.  Becoming congruent can thus be a challenging process, as some of the support rugs can be pulled out from under us, as they were previously based on inaccurate mental models of us, held in others’ minds.  Therapy can help assist in this “hero’s journey”, the treasure of which is a peace and ease of knowing that we are ourselves and that is good enough.

I have found that the more that I can be genuine in the relationship, the more helpful it will be. This means that I need to be aware of my own feelings, in so far as possible, rather than presenting an outward façade of one attitude, while actually holding another attitude at a deeper or unconscious level. Being genuine also involves the willingness to be and to express, in my words and my behavior, the various feelings and attitudes which exist in me.

Carl Rogers

Acceptance / empathy / curiosity

“Acceptance does not mean much until it involves understanding. It is only as I understand the feelings and thoughts which seem so horrible to you, or so weak, or so sentimental, or so bizarre—it is only as I see them as you see them, and accept them and you, that you feel really free to explore all the hidden nooks and frightening crannies of your inner and often buried experience.”

Carl Rogers

Empathy is a word that carries a lot of different meanings. In Humanistic Therapy, empathy is more than caring or compassion.  It means continuously working towards gaining a greater understanding of another person.  Before we can do this, we must first become proficient at continuous deepening of understanding of ourselves.  In the therapy session, the therapist is simultaneously learning about himself and about the client, through the interaction, and observing what impacts each have on the other, as they exchange words, emotions, and energy.

I tend to think that curiosity precedes compassion, since we need to deeply understand another person in order to genuinely feel compassion for what they are actually going through.

Humanistic Therapy then, involves a process of the therapist modeling empathy for herself and for the client simultaneously, to allow life to reveal itself, and be as nonjudgemental as possible about it.  Therapy is fundamentally about change, and change tends to occur when change is not the immediate agenda, rather the goal is simply seeing deeply and clearly what is.

Humanistic Therapy then is a human encounter in which not only the client changes, but so too does the therapist.  The therapist is not an educator or diagnostic expert, but more of a co-traveller on a journey with twists and turns that will be unexpected to both.  Both the experience of the therapist and the client will be important to discover and share on this journey.  

“Our first reaction to most of the statements which we hear from other people is an immediate evaluation, or judgment, rather than an understanding of it (…) Understanding is risky. If I let myself really understand another person, I might be changed by that understanding. And we all fear change. So as I say, it is not an easy thing to permit oneself to understand an individual, to enter thoroughly and completely and empathically into his frame of reference. It is also a rare thing.”

Carl Rogers

Experience over intellect / egalitarian relationship

One dimension of psychotherapy is the degree to which the therapist is considered the expert (by both the therapist and the client). 

On one extreme end of the spectrum, the client is in therapy to explain a problem, and get a solution or prescription from the expert therapist, who is supposed to have the answers.

On the other end, we have pure humanistic therapy, in which the therapist is a “midwife” of the client’s unfolding and developing personality and insight.  The therapist is only an expert (if at all) at this process of listening, seeking to understand, and guiding the client to delve deep within herself.  The therapist can be just as surprised as the client at what may be found.  The therapist does not question real revelations that come from the client’s experience.

I find this type of therapy very rewarding, typically more so than being a prescriber of solutions to problems that are superficially explained and conceptualized.  When I’ve been a therapy client myself, I’ve experienced both the disappointment of realizing that even the best therapists don’t typically have quick and easy answers at the ready, and also the excitement of being allowed and encouraged to explore my own experience (with a guide / witness) and discover my own answers within.

It logically follows that a humanistic therapist isn’t going to take a hierarchical position over the client, because she doesn’t claim to have any expert intellectual knowledge that can be of any use to the client.  Instead, she’ll offer presence, attention, curiosity, genuineness, and a safe relationship of positive regard so that the client can relax, accept what is, and see herself more clearly than he could before the session.  

“I cannot be of help to this troubled person by means of any intellectual or training procedure. No approach which relies upon knowledge, upon training, upon the acceptance of something that is taught, is of any use (…) It is possible to explain a person to himself, to prescribe steps which should lead him forward, to train him in knowledge about a more satisfying mode of life. But such methods are, in my experience, futile and inconsequential.

Carl Rogers

Universality (what is most personal is most general)

“I have almost invariably found that the very feeling which has seemed to me most private, most personal, and hence most incomprehensible by others, has turned out to be an expression for which there is a resonance in many other people.”

Carl Rogers

A humanistic therapist tends to assume that our pain and private, shameful secrets are actually quite ubiquitous, commonplace, and universal.  

“We are only as sick as the secrets we keep” is a humanist refrain, often cited in AA, that implies that we suffer unnecessarily to the extent that we assume that our problems are defects unique to us and thus feel that we have to hide those parts of ourselves from the world, and live in fear that they’ll be discovered.  This is the opposite of congruence, which is to confidently and bravely express what is true and trust that the world will generally accept us, even love us, for it.

Universality is one of seven curative factors of group psychotherapy, listed by Irvin Yalom.  Group therapy members obtain great relief simply from sharing their “shameful” stories with the group, only to hear several other members respond acceptingly with some version of “me too!”  In individual therapy, clients feel similar relief “confessing” to the therapist, who can normalize the experience and assure the client it is okay in the unique position of a professional who has heard many such similar confessions, and even as a fellow human being who can relate on a personal level.

Growth orientation

Humanistic therapists assume that a client is growth oriented.  It is assumed that “dysfunctional” behavior or psychopathology (if the client has received a medical diagnosis) is in fact a symptomatic reaction that overlies a fundamental instinct of self-preservation and self-actualization.  Anxiety would likely be viewed as a desire to be safe, relationship conflict would be viewed as an attempt at connection, and depression might be viewed as conservation of energy or a psychological anesthetic for protecting against high stress.

A metaphor for the growth assumption is a bonsai tree.  The tree wants to grow tall and expand as high as possible.  If wires are placed around it, it will be stunted.  A humanistic therapist does not confuse the wires with the tree, which only wants to grow.  There is a fundamental difference between trying to make the tree want to grow and removing the inhibiting wires.  The “wires” that restrict clients’ growth are typically some amount of shame, stemming from some type of past, often chronic, psychological injury.

Many clients have described themselves as feeling “broken”, and I like to reframe this as being wounded, which implies that healing has already begun taking place, and that what they are is not the injury, but the being that has begun healing.

It has been my experience that persons have a basically positive direction (…) The individual has within himself the capacity and the tendency, latent if not evident, to move forward toward maturity. In a suitable psychological climate this tendency is released, and becomes actual rather than potential (…)I have come to feel that the more fully the individual is understood and accepted, the more he tends to drop the false fronts with which he has been meeting life, and the more he tends to move in a direction which is forward (…) Whether one calls it a growth tendency, a drive toward self-actualization, or a forward-moving directional tendency, it is the mainspring of life, and is, in the last analysis, the tendency upon which all psychotherapy depends. It is the urge which is evident in all organic and human life—to expand, extend, become autonomous, develop, mature—the tendency to express and activate all the capacities of the organism, to the extent that such activation enhances the organism or the self.”

Carl Rogers

Positive regard

Positive regard is the underlying basic attitude of love and respect toward the client.  It’s not enough to be congruent and curious, if there isn’t a genuine liking of the client.

Does this mean that a therapist is always going to like everything about a client, or everything that a client says or does?  No.  We therapists are human beings, after all.  But, it means that we try our best to separate the client’s core essence from any difficult characteristics or behavioral patterns.  We always strive to see these as having a rhyme and reason to them, assuming that they have served a function at some point, maybe even still, and were developed with the intention of the client’s self-preservation and growth.  We know that shining an accepting light on all experience will be fruitful and lead to some sort of greater understanding and movement.  

I do believe it is sometimes the case that a therapist and client magically vibe well without much effort and, other times, simply don’t.  When it doesn’t happen, it can have to do with the therapist and client having different values and past experiences, such that the therapist cannot easily relate to the client, or vice versa.  When this happens it may be better for the client to find a therapist with which he has more natural common ground and chemistry. That said, therapists who gravitate towards humanistic orientations will likely tend to have “wide arms” that can stretch to accept and empathize with a high variety of individuals, because they are in love with the process of self-discovery, and that is what they most focus on within a client.

“The more acceptance and liking I feel toward this individual, the more I will be creating a relationship which he can use. By acceptance I mean a warm regard for him as a person of unconditional self-worth—of value no matter what his condition, his behavior, or his feelings. It means a respect and liking for him as a separate person, a willingness for him to possess his own feelings in his own way. It means an acceptance of and regard for his attitudes of the moment, no matter how negative or positive, no matter how much they may contradict other attitudes he has held in the past.” 

Carl Rogers

A general view of human relationships

I’ll sometimes hear from friends or acquaintances that they are concerned that they will be “analyzed” or receive some sneaky, smuggled in therapy during our conversations.

I’m not sure what to say sometimes, because I don’t see that much of a division between therapy relationships and non-therapy relationships, other than that therapy relationships receive one-way care (from me) and in non-therapy relationships, the care goes both ways.  My sense is that many humanistic-oriented therapists tend to feel this way.  I wouldn’t want personal relationships that lacked the core conditions of humanistic therapy, such as genuineness, curiosity, empathy, acceptance, respect, and positive regard.  These are, I think, ingredients that are important for all human relationships, whether they are consistently directed one-way, as in a professional therapy relationship, or both ways, as in other healthy relationships.

The book titles of Carl Rogers, such as A Way of Being, and On Becoming a Person, point at this general view of human relationships.  The basic idea is that there is a way of being that is conducive to life, connection, and aliveness, and that way of being is developed within relationships, and the therapist has developed that way of being enough to usefully transmit some of that to her clients within the container of the therapy relationship.

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