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3 Core Conditions for Therapeutic Change

3 Core Conditions for Therapeutic Change

The person-centered counseling approach was established in the 1940’s by humanistic psychologist, Carl Rogers. The goal of a person-centered therapy is to create the necessary conditions for clients to engage in meaningful self-exploration of their feelings, beliefs, behavior, and worldview, and to assist clients in their growth process, enabling them to cope with current and future problems.

A major concept of this approach is that people are generally trustworthy, resourceful, capable of self-understanding and self-direction, able to make constructive changes, and able to live effective and productive lives. Another key concept is that the attitudes and characteristics of the therapist, and the quality of the client-therapist relationship are prime determinants of the outcome of the therapeutic process.

Rogers maintains that therapists must have three attributes to create a growth-promoting climate in which individuals can move forward and become capable of becoming their true self: (1) congruence (genuineness or realness), (2) unconditional positive regard (acceptance and caring), and (3) accurate empathic understanding (an ability to deeply grasp the subjective world of another person).

1. CONGRUENCE (GENUINENESS)
Congruence refers to the therapist being real, authentic, and genuine with their clients. It’s called congruence because their inner experience and outward expression match. In being authentic, the therapist shows they are trustworthy, which helps in building a good therapeutic relationship with the client. It also serves as a model for clients, encouraging them to be their true selves, expressing their thoughts and feelings, without any sort of false front.

2. UNCONDITIONAL POSITIVE REGARD and ACCEPTANCE
Unconditional positive regard means the therapist genuinely cares for their clients and does not evaluate or judge their thoughts, feelings, or behaviors as good or bad. Each client is accepted and valued for who they are, as they are, without stipulation. Clients need not fear judgment or rejection from the therapist.

3. ACCURATE EMPATHIC UNDERSTANDING
Accurate empathic understanding means that the therapist understands their client’s experience and feelings in an accurate and compassionate way. The therapist recognizes that each client’s experience is subjective and therefore strives to see things from the client’s unique perspective. An important part of accurate empathic understanding is for the therapist to convey that they “get it” by reflecting the client’s experience back to them. This encourages clients to become more reflective with themselves, which allows for greater understanding of themselves.

If you’ve ever had an experience where you felt like someone just really got you…they completely understood where you were coming from, or could truly relate to the way you felt – that’s accurate empathic understanding.

Rogers asserts that empathy helps clients (1) pay attention and value their experiencing; (2) see earlier experiences in new ways; (3) modify their perceptions of themselves, others, and the world; and (4) increase their confidence in making choices and pursuing a course of action. Jeanne Watson (2002) states that 60 years of research has consistently demonstrated that empathy is the most powerful determinant of client progress in therapy. She puts it this way:

“Therapists need to be able to be responsively attuned to their clients and to understand them emotionally as well as cognitively. When empathy is operating on all three levels – interpersonal, cognitive, and affective – it is one of the most powerful tools therapists have at their disposal.”

 

References:
1. Watson, J. C. (2002). Re-visioning empathy. In D. J. Cain (Ed.), Humanistic psychotherapies: Handbook of research and practice (pp. 445-471). American Psychological Association, Washington, DC.
2. Corey, Gerald. Theory and Practice of Counseling and Psychotherapy. Belmont. Thomas Learning, Inc. 2005.

A Young Woman’s Personal Experience with Anxiety

A Young Woman’s Personal Experience with Anxiety

Anxiety is something that everyone deals with, to some extent, during their life. For some people it’s a passing experience of feeling stressed and overwhelmed. For others, though, anxiety can be crippling. I mean truly, intolerably, despairingly crippling.

You can’t sleep, you can’t eat, you can’t focus. Your work suffers; your relationships suffer.  You question everything you do, and everything you say. Your mind never stops churning things over. You’re filled with feelings of self-doubt and never being good enough. It’s pure agony.

The term “anxiety” gets thrown around for everything, ranging from feeling nervous to experiencing unrelenting, incapacitating panic attacks. Because of this, there are people who equate “feeling stressed” to knowing what having an anxiety disorder feels like. Unfortunately, this attitude feels discrediting and invalidating to the person who truly experiences the wrath and magnitude of anxiety.

Anxiety can manifest itself as a condition, such as a phobia, social, or generalized anxiety; or on a greater level, it can present comorbidly with other conditions, such as Depression, ADHD, Schizophrenia, and so forth. Anxiety is not a character flaw. I repeat: ANXIETY IS NOT A CHARACTER FLAW. Anxiety is a neurological imbalance. It is the result of obtaining some unfortunate genetics and/or exposure to certain life experiences. None of those things are your fault in any way.

I am the youngest child of two girls. Some people believe that being the youngest child makes you “selfish.” I would say that I do, in fact, have a tendency towards selfishness. But my selfishness isn’t due to being the youngest child; rather, it’s a result of having to manage my anxiety.

For instance, I can’t be the person who goes and offers comfort to a friend in the middle of the night because of a break-up, or some other challenging situation. I have to be selfish; I need to sleep. Because altering my routine and extending myself could offset my own mental stability. I need to rest. I need to relax. I need time to myself.

I have to “be selfish” in order to operate in a fast-paced, high-producing, performance-based society. I’m at a disadvantage to others, who function at a higher level, and with more ease. Because of my anxiety, my mental and emotional reserves are easily and quickly depleted.

I want to be there for my friends in the middle of the night, when they are hurting, but the fact of the matter is that I can’t. I have to take care of myself. This doesn’t mean that I don’t care. It doesn’t discredit me as a kind-hearted person. I absolutely want what is best for the people around me. I simply need my time, time when I am off limits, time to recuperate.

I’ve learned from past mistakes of over-extending myself. There have been times when I’ve tried to be everything to everyone. I went out of my way, above and beyond, to be there for people. Even when I did all that I could, I still felt this hankering guilt that it wasn’t enough; that I wasn’t enough.

I have since learned that the care and support I am able and willing to offer others is enough. I have since learned that I am enough. I realize that I owe it to myself (and others) to take care of me. I have to care for myself at least as well as I care for others. Self-care is a requirement for others-care. And when you think about it, there’s really nothing selfish about that.

 

* Special thanks to my considerate, generous, hard-working, and capable niece for sharing her story, in hopes of providing understanding and validation for those who face their own struggles, and in hopes of providing insight for others to develop empathy for such challenges.