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Focusing and the person-centred way
Clive Perraton Mountford
Therapy Today
The Japanese Journal of Humanistic Psychology, 2011, Vol.29, No.2, 55-60
1. More hybrid than union
On first
acquaintance, "focusing-oriented counselling" simply seems to mean
"whatever-else-is-in-the-tin plus
focusing". As the name of a way of doing therapy it dates to Gene Gendlin’s
Focusing-Oriented Psychotherapy: A Manual of
the Experiential Method (1996) where he describes how experiential focusing can be allied to any of the main counselling approaches.
Maybe. I'm
sure that focusing can be allied as
Gene suggests, but I anticipate that any counselling approach which is allied to focusing will be so changed
by the partnership that what the tin says will no longer satisfy trade
descriptions law.
Maybe, too,
this power to change is partly why focusing remains an object of suspicion to
many person-centred counsellors. Person-centred counsellors do tend to be
allergic to being co-opted, and we are too familiar with being misunderstood.
Even so—in my experience, at least—the tradition is particularly well placed to
benefit from alliance with
experiential focusing and to deepen
rather than lose its authenticity.
It isn't just a matter of shared historical roots,
or even that the way of being sometimes
characterized as "core conditional" is essential to focusing
accompaniment. Focusing takes person-centred practice in a direction natural to
and consistent with its history and development while making a hitherto largely
implicit aspect of that practice visible
and explicit. At the same time, person-centred practice is changed by relationship with focusing to an extent such that I
no longer think of what I do and teach as "person-centred counselling and focusing". In place of a
double-barrelled marriage of separable individuals they have become one thing.
So, what
does that one thing look like?
2. Start here
A good place
to start is "the standard view" of person-centred counselling and its
emphasis on conditions of worth.[1] The standard view positions the
lifetime experience of conditional acceptance as both the final source of all
client distress and the theoretical
justification for consistently and tenaciously offering a therapeutic
relationship characterized by unconditional positive regard. As Dave Mearns and
Brian Thorne put it: person-centred counselling is about "sabotaging
conditions of worth".[2]
The power
and beauty of this slogan is undeniable, and it resonates with much client and
therapist experience: who doesn't know what it is like to labour under
conditions of worth? However, as Campbell Purton points out—and as I have sometimes
echoed—it seems unlikely that all
client distress originates in conditions of worth. Other factors such as
post-traumatic stress, lose-lose choices, bereavement, and childhood deprivation bring clients to therapy,
and they do not readily collapse into conditions of worth. Yet person-centred
counselling "works" with a very broad range of "client
issues". What is going on?
The short
answer, I think, is that something deeply interesting and important is going on,
and it is best understood partly in "person-centred" terms and partly
in "focusing" terms. The longer answer—and what will help to justify
this claim—involves looking more closely at the standard view.
3. Collapsing the standard
view
The
theoretical basis of the standard view originates in two now-famous papers published
by Carl Rogers in 1957 and 1959.[3]
The keystone of their argument is the notion of conditions of worth, but congruence
is equally essential. According to Rogers, every client who comes to therapy is
incongruent, denying and distorting
their experiencing. This is why they
have come to therapy: the level of denial and distortion is just not
sustainable or compatible with worthwhile living. The client who then engages
with therapy has a direction of travel towards greater congruence,
greater "capacity and tendency to symbolize experiences accurately in
awareness", and greater openness to
experiencing.[4]
Incongruence
is presented in these papers as a consequence
of conditions of worth, and conditions of worth as the sole originator of distress. However, if we deviate a little from
Carl's original theory and reverse the relative standing of conditions of worth
and incongruence, really interesting things begin to happen. Incongruence—accompanied
by distortion and denial—may now be viewed as responding to a wide possible
variety of experiences incompatible with a person's flourishing, sense of
themselves, and even survival. Oppressive conditions of worth will be
significant contributors for many of us, but there is no reason to view them as
the whole story. The standard view of person-centred counselling thus collapses
into a broader theoretical position consistent with the different kinds of
experience that bring clients to counselling.
Of course, once
conditions of worth are no longer central to the theory, there can no longer be
insistence that the six therapeutic conditions advanced by Rogers are
"necessary and sufficient" because that claim depends upon the
centrality of conditions of worth. However, losing necessity and sufficiency is
more advantage than loss: a claim that strong can only lead to trouble and
contradiction.[5]
What is more, if Mearns and Thorne represent the standard view of person-centred
counselling and its evolution,
necessity and sufficiency are fading into history because they are notably
absent from the third edition.
4. A revised job
description
At the risk
of repetition, this broader conception of person-centred practice removes conditions
of worth from its theoretical centre and replaces them with client incongruence and the client’s journey towards congruence. Yes, this is a radical shift of emphasis. However,
it does entail a theory consistent with much of the original and with Rogers's own direction of travel.
Rogers increasingly came to value counsellor congruence—broadly understood—and
to question the therapeutic recipe suggested by the three "counsellor"
or "core" conditions. For example:
I believe it is
the realness of the therapist in the
relationship which is the most important element. It is when the therapist is
natural and spontaneous that he seems to be the most effective.
I am inclined
to think that in my writing perhaps I have stressed too much the three basic
conditions.... Perhaps it is something
around the edges of these conditions that is really the most important element
of therapy - when my self is very clearly, obviously present.[6]
Alongside
this shift of theoretical emphasis,
the job description of the counsellor
and psychotherapist shifts too. We are no longer setting out to sabotage
conditions of worth alone, our purpose is to sabotage incongruence in general.
Therapy exists to help clients move towards greater awareness and acceptance of
themselves, their environment, and their experiencing whatever is deflecting them from that. Of course, the degree and
pace of change must be acceptable to, sustainable by, and determined by the
client because if the destination is greater openness to experiencing then
those things can only be determined
by the client.
5. How does it work?
If the
therapist’s job is to facilitate greater openness to experiencing, we will need
to do broadly two things. Initially and throughout, we must provide an
environment and a relationship characterized by everything likely to contribute
to a person opening to their experiencing, and by the absence of everything
likely to shut them down...absence of judgment, positive regard for the client,
modelled congruence and openness… It is reasonable that we offer a broadly
"person-centred relationship" of the kind associated with the
standard view.
If this is
all we do, however, we can expect to wait a long time for the client to move
towards deep and acceptant awareness of their experiencing. Clients, like
therapists, live in a world where incongruence is the norm and awareness of
experiencing is mostly discouraged. Unlike therapists, most clients will not
have counselling and psychotherapy training and experience and many will not
even recognize the possibility of
openness to experience. Offering them person-centred relationship alone will be
like providing some hitherto unknown materials and tools then waiting while
they invent a wheel. We need to do more.
We need to actively encourage and facilitate—and, yes, "teach"—the
awareness and acceptance of experiencing.
This is
where focusing comes in. Focusing’s origins are in Gene's recognition that some
clients naturally do well in therapy and some clients benefit much less. The
former tend to engage in an immediate and physical way with their experiencing.
The latter don't. Therapeutic focusing began as a way of helping the second
group of clients get more out of counselling.
There is
something here which it is important to be entirely clear about. "Focusing"
does not necessarily mean that the
client places their feet on the floor, closes their eyes, performs some kind of
inventory of their body, moves inwards, "clears a space" etc., and is
thereafter hardly in contact with their focusing companion or therapist.
Focusing is consistent with a variety of presentational modalities which can
involve eye contact and much verbal interaction between the parties involved. It
can be conversational and can occur during rapid "focusing movements"
within a conversation. Focusing is not
about any particular ritual or procedure. Focusing is about accessing and accepting the felt sense of something.[7]
Personally, I would add that beyond that, focusing is a way of relating to what
Gene has called "the implicit" and to the place within us where
awareness moves into being.[8]
In sum, I'm
talking about a kind of therapeutic accompaniment characterized equally and
inseparably by attention paid to the dignity, autonomy, and uniqueness of the
client—to their value as a locus of
experiencing—and by attention paid to what is sometimes called process. By this I mean the ebb and flow
of awareness, the way in which experience comes into being, is related to, has
consequences, and dissipates.
This may seem a million miles from the standard
view of person-centred counselling. However, the modalities mentioned above
reach from the "eyes closed, feet on the floor" kind of focusing
through more subtle, conversational approaches and all the way to the kind of
conversational therapy once practiced by Brian Thorne of "standard
view" fame. Also, and without doubt, Brian is the arch-exponent of what
might be called "loving presence therapy".[9] As
demonstrated by his (1997) demonstration video The Cost of Integrity, Brian does not offer loving presence and acceptant relationship and then leave
the matter there. His interaction with his client is guided by what in focusing
terms would be called his own "felt sense", and he responds to his
client in such a way that they are gently (and not always so gently) encouraged
deeper into their experiencing and
relationship with their felt sense.
No, this isn't heresy. Brian sanctions this characterization. He also agrees
that it applies to much of Carl Rogers’s later work.[10]
6. A clinical example
Caitlin
sought me out as a focusing teacher because she wanted a different, more
acceptant and immediate relationship with her experiencing. Almost as soon as we
started our journey, however, we began to discover the depth and destructive
consequences of denial and distortion practiced in order to make the best of
the hand dealt her early in life, and I was rapidly deployed as "counsellor
and psychotherapist" in addition to "focusing teacher".
We didn't stop focusing—Caitlin has no doubt that
it has been of immense use to her, helping her accomplish a lot in a short time
compared with her other experiences of therapy—but I guess there were times
when she also needed a very "person-centred" presence. Hence this
from an e-mail conversation in which Caitlin has been reflecting upon the
process of therapy:
Shame is the
lens through which I have seen myself. For most of my life. As close as a
second skin, no more visible from the inside than the first, too close to see.
I was given it.
It never belonged to me.
It has harmed me,
and I have harmed myself in fighting what I could not see.
I armed myself
with contrary proofs.
Collected
evidence in my defence, against myself.
Fenced it in,
to minimise the damage.
Railed at it
with bravado, alcohol, will, energy.
It has filtered
other people's gaze, at odds with what I sensed from somewhere deeper,
somewhere where I am unharmed.
It was safer,
less confusing, not to be seen, where I could hang on to at least some of what
I knew without distortion.
But what
happens if you let someone in, so close that you let them see you through your
own lens, throw no dust in their eyes, and yet they love you anyway?
What if that
love, without condition, holds you safe enough while you go diving, into
yourself, where the distortions and dislocations can be felt, stays with you,
not afraid, while you are afraid, while you keep on exploring as everything
shifts, where what you think you know comes painfully apart?
What if you are
still loved when what is underneath shame is sensed, allowed, experienced, your
vulnerability, uncertainty, your very human need for love, compassion,
acceptance, your despair and desolation at being denied and shamed by others,
by yourself, made worthless and wrong in your own eyes? Scarier, your own
unbrokenness...[11]
This seems to
be describing the essence of person-centred relationship, with oneself and with
a therapist, and its capacity to promote healing. At the same time, I know that
the depths of awareness Caitlin is accessing require focusing.
This is
"focusing-oriented counselling and psychotherapy" as I understand it.