Being-With and Being-Counter: Relational depth: The challenge of fully meeting the client

 

Mearns and Schmid

Person-Centred and Experient©ia Ml Peasyrnchs oatnhde rSacphimesi,d V14o7lu7-m97e 557,/ N06u/0m4b2e5r5 -41 1 255

Dave Mearns University of Strathclyde, Glasgow

Peter F. Schmid Institute for Person-Centred Studies, Vienna; Sigmund Freud University, Vienna; Saybrook Graduate School,

San Francisco

Miteinander-Sein und Gegenüber-Sein: Tiefgehende Beziehungen: Die Herausforderung, dem Klienten wirklich zu begegnen

Estar con y Estar contra la Profundidad Relacional: El desafío de encontrarse plenamente con el consultante Etre-Avec

et Etre-Contre : Rencontrer le client pleinement — Un défi

 

Author note. This paper was presented as the second part of a double keynote lecture to the fourth World Congress of Psychotherapy in Buenos Aires in August 2005.

 

Address correspondence to Dave Mearns: Email: <dave@davemearns.com>.

 

Address correspondence to Peter F. Schmid, A-1120 Vienna, Koflergasse 4, Austria. Email: <pfs@pfs-online.at>.

 

Abstract. Following on from a previous publication (Schmid & Mearns, 2006), this paper continues the authors’ investigation of the relationship emphasis within

person-centred therapy. It explores the concept of relational depth (Mearns & Cooper, 2005), especially in regard to work with hard-to-reach clients, outlining the

particular challenges to the therapist seeking to engage the different parts of the client, even those in self-protective conflict with the therapeutic process. The

ethical boundaries of therapeutic confrontation and dialogue that constitute relational depth are explored as is the developmental agenda for the therapist.

 

 

256 Person-Centred and Experiential Psychotherapies, Volume 5, Number 4 Being-With and Being-Counter

 

Keywords: Person-centred therapy, relational depth, encounter, confrontation, dialogue, developmental agenda, existential touchstones

 

In a previous paper (Schmid & Mearns, 2006) we laid down the basis of person-centred therapy as a relationship therapy. We explored the nature of that relationship, emphasizing that it was both alongside the client and in confrontation with them. We emphasized the notion of achieving relational depth where the client is offered an intensity of human relating that is experienced as affording unique safety and support such that the client might take the risk of going behind their normal portrayal level of self to enter parts that are of particular existential  significance to them. We examined the different kinds of resonance in the therapist: self-resonance, empathic resonance and personal or dialogic resonance and how these can lead to confrontation and dialogue. We pointed out that such a strong relational way of working could be particularly indicated for a range of hard-to-reach clients and illustrated this by brief references to such clients as Dominic the drunk, Bobby the ex-gangster and Rick who had become mute as a response to his traumatization in war. In this paper we will go on to identify the particular challenges to the therapist in working at relational depth — the challenge of engaging the hard-to-reach client and the challenge to the therapist of using their self fully and in a fashion that is professionally boundaried. Furthermore, we develop criteria for person-centred confrontation and dialogue. Lastly, we will outline the developmental agenda for the therapist seeking to work in these ways.

 

CHALLENGES FOR THE PERSON-CENTERED THERAPIST

 

In the struggle to obtain the kind of dialogue we have been describing there are two particular challenges for the person-centred therapist:

 

· Not to be relationally negated by the self-protective processes of the client;

· Struggling to meet the different parts of the client that may have come to personify different facets of the conflict and offer relational depth to all.

 

Not to be relationally negated by the self-protective processes of the client

 

In person-centred therapy discourse we tend not to use terms such as defences or resistances because these have come to connote a battle against the process of the  client. Instead, we more often use the term self-protective processes because this term more accurately reflects the primary function of those processes — to protect the self as it has actualized to that point. If we look at two of the clients mentioned in the previous paper (Schmid & Mearns, 2006) we can see examples of their self-protective processes. One of the functions of Dominic’s drinking (see also Mearns & Cooper, 2005) was that it could always return him to a position of stasis thus staving off any potential threat of change. This is one of the reasons why the person-centred therapist would not focus their work on specific client behaviours or problems. If the work is focused, for example, on the client’s drinking, then it is too easy for the self-protective processes to negate the therapeutic endeavour and recreate stasis by recommencing drinking. The challenge for the person-centred therapist is not to make the therapy vulnerable by placing emphasis on the drinking behaviour. While this seems obvious in theoretical terms it is striking how often the opposite, problem-centred approach is taken. Of course, it is easier to relate to a problem than a person, particularly a hard-to-reach person. Another client from the previous paper, Bobby (see also Mearns & Thorne, 2000; Mearns & Cooper, 2005) exhibited self-protective processes that had been developed over a lifetime of protecting himself against the danger of the loss of control that relationship might bring. He was expert in counteracting growing intimacy with ready suspicion, cynicism and sarcasm. Also, he was outwardly aggressive and threatening towards the therapist and where he saw weakness, he was ready to jump on it with taunting behaviour. Arguably the most violent of his self-protective processes was the hate he would experience and manifest in response to feeling the smallest relational warmth within himself.

 

During the past ten years person-centred therapists have gone a long way towards identifying a range of client processes developed to protect the self as it is actualized to an earlier point of stasis: for example, fragile process and dissociated process (Warner, 2000); psychoticprocess (Prouty, 1994) and ego-syntonic process (Mearns, 2006). One of the main challenges for the person-centred therapist is not to be relationally negated by those processes. Instead, the therapist meets the person engaged in these processes, actively values them and relateswith them, and is as responsively empathic as when the client is manifesting other qualities. The impact of this upon the client is striking — the very strategies they used to protect them from relationship are themselves being encountered in relationship. That confrontation can be so existentially significant for hard-to-reach clients that it opens doors to deeper levels of self-experiencing and self-expression.

 

Struggling to meet the different parts of the client

 

The second main challenge for the person-centred therapist seeking to establish dialogue at an existential level with their client is the struggle to meet the parts of the client that may have come to personify different facets of the conflict and to offer relational depth to all, even those who might seek to destroy the therapy or the therapist. Like many psychotherapeutic theories, person-centred therapy has developed its own understanding of self-pluralism (Cooper, Mearns, Stiles, Warner, & Elliott, 2004). It is interesting to see this same kind of development coming from many different parts of the profession, yielding broadly similar concepts such as the person-centred notion of configurations (Mearns & Thorne, 2000) but also, from other traditions, voices (Hermans & Kempen, 1993), sub personalities (Rowan, 1990), ego states (Berne, 1966) and others.

 

The growth of conflict within the self leading to the possibility of change is described by Carl Rogers in terms of his concept of actualization. In his 1959 revision of his Personality Theory (Rogers, 1959), he spoke about the conflict that arose between the self as it has actualized to this point and the continuing promptings of the actualizing tendency. For example, the action of the actualizing tendency will have prompted the client to achieve the best balance they could between their own enhancement and meeting the conditions of worth imposed upon them. However, while obtaining that resolution will have seemed like an enormous achievement of survival for the client, the promptings of the actualizing tendency do not cease with the winning of that apparent stasis. Having survived childhood conditions of worth, the adult now finds themselves in renewed conflict under the challenge of implicit existential questions such as Is this all there is to my life? Is surviving all I can do? Must I continue to be fearful in relationships?

 

A more generic concept than actualization for examining this process is Leon Festinger’s fifty-year-old concept of dissonance (Festinger, 1957). Most clients come into therapy because the dissonance within their self has reached an intolerable level. In terms of a pluralist conception of the self, the conflict between and among the parts has increased to an extent that the family of the parts is in potential breakdown. In so far as psychotherapy hears all the voices more fully and also (hopefully) equally, therapy initially tends to increase that dissonance, albeit in a well-supported context. Dissonance is uncomfortable but it is also a secondary motivation for change and development.  This is one of the reasons why psychotherapy is a politically radical process. Unlike symptom-reduction treatments it brings dissonant process to the fore and does not reinforce stasis.

 

Within the person-centred system, where we are seeking to achieve the kind of dialogue at a profound existential level described in  our previous paper (Schmid & Mearns, 2006), the challenge to the therapist is to enter the client’s dissonance system and find ways to meet the different parts that have developed to house the various imperatives within that system. So, the person-centred therapist is challenged to meet “Dominic the drunk” as equally as “sober Dominic” even although “Dominic the drunk” is extremely wary of relationship because of its  potential to challenge his imperative of restricting Dominic’s further actualization. As well as Bobby’s self-protective processes already described, he had two main configurations: sad me and frightened me. The challenge of encountering sad me was the pure depth of that sadness. Interestingly, one of the powerful therapeutic experiences for Bobby was his therapist being able to meet his frightened part without,  in turn, feeling fear (Schmid & Mearns, 2006). This simultaneously increased Bobby’s own fear but

also raised his hope. Existentially, fear and hope are often two faces of the same coin.

All the time, while struggling to work within the client’s dissonance system and form therapeutic relationships at depth with all the parts, the person-centred therapist is aware that there are different ways in which the massive dissonance may be reduced. All systems of psychotherapy, including person-centred therapy, tend to hold to the hope that the result of our therapeutic work will be that the  dissonance will tend to be reduced by the client’s changing in a growthful direction. However, there are no such guarantees — dissonance can also be reduced by the client’s beating a retreat to an earlier point of stasis and balancing the movement with a strident negation of the therapy process and the therapist. Such is the radical politics of psychotherapy that we cannot and should not seek to control the client’s outcomes.

 

CRITERIA FOR PERSON-CENTERED CONFRONTATION AND DIALOGUE

 

As outlined at the end of the previous paper (Schmid & Mearns, 2006) we need criteria to determine when confrontation, disclosure of personal resonance and dialogue are person-centred and when they are not. This is necessary not only in order to correctly understand what is meant by these terms but also important in order to have a guideline to check for oneself and to be able to discriminate between  one’s own need for encounter and the client’s (maybe tacit) invitation to enter an encounter relationship in therapy.

 

What confrontation and dialogue are not

 

As a matter of course, confrontation and dialogue have nothing to do with expert behaviour such as “the way I see it is more correct than the way you see it.” They are also different from “you could/should go in this or that direction with your further exploration of your experiencing.” They do not intend process direction or process guidance. Furthermore they are definitely  not for the satisfaction of the needs of the therapist  stemming from outside the therapeutic relationship. They have nothing to do with diagnosis. They must not be mixed up with blaming, reproaching, insinuating or attacking the client’s self-protection (“resistance” or “defence”; Rogers, 1971, pp. 277–278). And not at all have they to do with rude or insensitive behaviour.  It seems particularly necessary to emphasize that confrontation and dialogue are also substantially different from so-called self-disclosure (Carkhuff, 1969) — at least in its common,  widespread meaning and use, or better: excuse, where it is often mixed up  with the idea that everything the therapist says or does can be justified by the idea of congruence. This is a confusion of congruence with  thoughtlessness, lack of empathy, self-portrayal and self performance, selfishness or even coarseness and misuse.

 

Devoting one’s awareness to the service of the Other: Criteria for working at relational depth

 

The overall criterion is: Whatever the therapist does should be towards the assistance and facilitation of the client. This means that the therapist is devoting their whole awareness to the service of the Other. This includes the awareness of self and relationship, the whole consciousness. The general criterion is defined in terms of a number of sub-criteria as follows:

 

Existentiality

 

On an encounter level client and therapist are touching and are being touched. Existentiality denotes a personal quality which has to do with  significant experiences and their interpretations. Dialogue can never be made or produced (see also Barrett-Lennard, 2003, chapter 5); it evolves out of being touched on a personal level and the willingness to share this.

 

Freedom of choice

 

The therapist has the freedom to choose the level of their relationship to the client within the possible spectrum. They are free to choose the existential level or a more presentational one (see Mearns, 1996, p. 308; cf. Schneider & May, 1995). They are not forced to bring themselves into play; they deliberately can decide. The therapist has more than one option to continue. Although the moment of being touched is never  chosen purposefully, the way to proceed in the encounter relationship happens with full consideration.

 

Immediacy

 

Encounter is just the opposite of preconceived techniques, methods and trained skills. True dialogue happens im-media-tely, without media or means. As dialogue is a process, immediacy is a process, too, as Martin Buber (1923, p. 19) states: “Immediacy is born through the fact that all ‘media’ that separate us ‘decay’, become unnecessary, surplus.” (See Schmid, 1994, 2002.) (Apropos true dialogue: at the encounter level, at existential depth a person cannot lie; see Mearns & Cooper, 2005.)

 

Relationship-centeredness

 

Communication in an encounter relationship always more or less explicitly says something about the relationship between those involved. In a communication of this quality the therapist always also communicates — explicitly or implicitly — about how they see their relationship with the client. For example, this can be their personal feeling towards the client that is stirred up by the client’s expressions or their personal acknowledgment of the person of the client, or their deep empathic understanding of the client by referring to a comparable experience of themselves etc.

 

Mutuality

 

The therapist’s communication allows that a mutual exchange can occur, if the client chooses to enter this mode. What the therapist utters shows that it is an invitation (not an obligation) to respond on the same level. Here it is where true dialogue can commence, if the client desires.

 

Openness to risk

 

In the encounter mode there is always a risk (of being touched, surprised, hurt, loved, etc.). Like every personal relationship, psychotherapy at the level of relational depth includes the danger of being misunderstood, hurt, rejected or ignored. This goes for the therapist, but also for the client.

 

Spontaneity

 

Encounter and dialogue happen without calculated intention, they are never “in order to”; they can never be used. They are characterized by a principled non-directiveness or to name it in a positive way, by a cilitative responsiveness (Schmid, 2005). They are answers to given situations. They rest on the belief that it is always the very moment that is the source of change, development and decision (making up the “kairotic quality” of encounter; Schmid, 1994, 2003).

 

Addressing all parts of the self

 

Meeting at relational depth means to encounter and address all visible and sensed parts of the other person, although usually not at the  same time (see above).

 

Co-reflectiveness

 

Since we are talking about personal rather than naïve encounter (Schmid, 2004), the relationship includes the joint reflection of the relationship. Thus co-reflection (or metacommunication or metadialogue) is an essential part of dialogue. This means to view the dialogue from within the dialogue: therapist and client reflect their relationship.

 

Quality

 

The criterion for whether something is personal confrontation or dialogue is not a matter of intensity. The difference is qualitative rather than quantitative. Confrontation and dialogue can be very unspectacular. To encounter a client, to meet them at relational depth, means to touch the client in(side) their experiencing as opposed to an approach from the outside (see Mearns, 1996, p. 309).

 

Contextuality

 

The phenomena and processes we talk about, although precious and maybe rare for a lot of people, happen within the world, not outside of it. It is extremely important to be aware of the context. Personal words may have a specific meaning to a specific client and/or in a specific situation. This implies being aware of who else is listening or involved. For example, it is very important in groups to be conscious of the fact that the person addressed by a statement may well understand it as it was meant and another person, listening and seemingly not involved, can be hurt or can take it the wrong way. To be aware of the context also means to be attentive  to the client’s relational life outside therapy and to the wider socio-economic and cultural context of the enterprise and microcosm of  therapy itself (see Barrett-Lennard, 2005).

 

Awareness of power

 

Last but not least, dealing carefully with the power issue involved is an unrenounceable ethical task for therapeutic confrontation and dialogue. Particularly when at the level of encounter, clients are vulnerable and may be misused. The therapist must keep in mind that psychotherapy is for the client and therefore always carefully reflect on the relationship — in the relationship itself, as just mentioned (partly together with the client) and outside the relationship (most commonly in supervision). If the therapist fails to do so, they might confuse interest with curiosity, being touched with self-therapy, confrontation with correction, sharing with advice, in a word: encounter with abuse.

 

THE DEVELOPMENTAL AGENDA FOR THE PERSON-CENTERED THERAPIST

 

How do person-centred therapists meet these challenges? What is it that makes a therapist the kind of person with whom a client any client — would be prepared to risk an engagement at relational depth where they would enter these areas experienced as Fundamental to their existence? The answer we have been developing is that such a therapist is someone who is not trapped into relating only at the presentational level of self but can respond to the client from their own depths. They can offer empathic resonance  and also personal resonance. They can be both receptive and expressive: they can take people in and they can reach out to eople. In both these activities they are not deterred by clients’ various systems of self-protection. They honour these, but they do not collude with them. They can receive a wide range of others — the client who is ncredibly fragile (Warner, 2000), another who protects himself by seeking to put down the other (e.g. Bobby), and even clients who have essentially retreated from the world (e.g. Rick in chapter 6 of Mearns & Cooper, 2005). As well as being able to receive, this therapist can also reach out to the other. In reaching out they are not deterred by fear — fear of the other; fear of how they are seen; fear of getting it wrong; fear of losing themselves. They are utterly committed to congruence — to being transparent as well as self-aware — to show the other what is going on in the therapist; why they are trying; and the feelings they are experiencing in the act of trying. In all of this, the aim is to offer something truly different to the client, something that the client might begin to accept as moments of relational depth and, as these moments add up, accept  in terms of the continuing relationship where they can more easily dip into material from the depths of their self-experiencing whether that material is already symbolized or is at the dimmest edge of awareness. How can we help therapists to become this kind of person? Certainly, we cannot do it by giving them a manual of interventions, treatment plans and therapeutic tools. The endeavour is so firmly tied to who the therapist is as a person — their personal awareness and security — that it is their self that must be the developmental agenda. We want the therapist to be able to use their self fully, in the sense of personal resonance, with their clients. urthermore, we want them to be able to do this with a wide range of clients, including many that will be hard to reach for a variety of reasons. So, the self of the therapist that is likely to achieve this is one that has both breadth and depth and is accessible to being used by the therapist in the therapeutic endeavour. Many human beings have a considerable breadth and depth of self experiences and self-configurations, but these are not necessarily safe places. The developmental agenda for the therapist is discovering these self-experiences and configurations, gradually integrating them in the sense of overcoming the fear that may initially be associated with them and coming to accept them as actual or potential strengths that may offer breadth and depth in relationship with clients. This developmental agenda may challenge the person-centred therapist to integrate the different configurations within their own self so that these become accessible for use within the therapy room. So, a therapist in their early development might readily employ their confident part, but can they also come to accept their diffident part to the extent that it can potentially be useful in some therapeutic encounters? Many clients will find easy uses for “confident” but there will be some that at times can also benefit from an engagement with “diffident”. Similarly, a therapist will readily find that her “grown-up woman” is a major player in the therapy room but are there also times when her “little girl” is useful too —perhaps for the particular acuity she has for parts of the client that struggle to be grown-up? It is not only full-blown configurations of self that add to the breadth and depth the therapist can offer the client. Each therapist will have a range of self-experiences that potentially can become what we call existential touchstones (Mearns & Cooper, 2005) that can be used to meet clients. The interesting feature of existential touchstones is that some of them may start their life as negative or even damaging experiences for us, but with the process of self-acceptance they become integrated and offer us powerful aspects of our self to use as bridges into the experiencing of our client. For example, a therapist’s earlier intense experience of powerlessness in the face of abuse would not obviously be regarded as a potential strength for her as a therapist. Nor would it be a strength while she was still racked by fear or anger from the experience. But if her development takes her to a point beyond that fear or anger then she has won a potential touchstone that could broaden as well as deepen what she can offer as a therapist. That self-experience of fear or anger could now be a part of her self she can enter as a bridge into her client’s experience of fear or anger. It is not the same as her client’s experiencing but it is in the direction of the client’s experiencing — it has the same flavour. By this means the therapist can more fully enter her client’s world and offer a powerful depth of relating. This phenomenon is qualitatively different from the exercises of projective identification (Rowan & Jacobs, 2002, pp. 41–46) or cognitive social perspective taking as challenged by Binder(1998, pp. 219–220) where there is an effort to imagine the world of the other but it is a purely cognitive reach rather than an affective/cognitive one. This personal resonance — actually going into different aspects of our sense of our own existence as stepping-off points into our client’s experiencing — might seem dangerous to those who are concerned about losing the as if quality of empathy and getting lost in their own self-experiencing. In fact this is the kind of worry that evaporates in the reality of the events. What does “getting lost” actually mean? If it means finding our own tear for ourselves and that being shared with our client while acknowledged as our own, then that can be a most powerful moment in relationship. The developmental challenge to the therapist is to convert earlier self-experiences, many of which would initially have been difficult, into aspects of their self that actually strengthen their spirit and broaden the self they have to offer their clients. In person-centred language we talk about this in terms of increasing self-acceptance. Many self-experiences detract from our relational functioning perhaps because we feel bad about ourselves in relation to them or we have doubts or even fears about ourselves in relation to them. The gradual process of self-acceptance during the person-centred therapist’s development reviews and re-evaluates these self-experiences, gradually removing the fear and doubt and obtaining a realistic appraisal of the self. Initial training in person-centred therapy faces this self-acceptance agenda, creating an intense relational environment where trainees find themselves encountering each other in a climate of shared learning. Gradually, self-doubt is challenged by the review of old self experiences and by new self-experiences reinforced through the challenge and feedback from others. By this process the intrinsic negativity is chipped away under the challenge of reality testing and replaced by a growing self-acceptance. But initial training is only the beginning of the developmental process for the therapist. That development goes on, ideally supported by continuing supervision. Such developmentally

oriented supervision is qualitatively different from casework supervision. Instead of the primary focus being on the client, it is on the therapist and their ongoing development (Lambers, 2006). So many of the clients we meet have become damaged in relationships or by the loss of relationship. So much of our poetry, our music, our drama and our literature is grounded in the centrality of relationship. Yet we have an ambivalence towards our use of relationship in psychotherapy — we sense its value but we also worry about how we can be professional in our use of relationship. That ambivalence is what we have been seeking to challenge in this and our previous paper. Rather than allowing our practice to become ever more relationally detached and reliant on observations, analyses and techniques, might we take up the challenge and explore how we could more fully harness the power of human relationship while simultaneously laying down the ethics for its professionalism?

 

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