I remember when I went for therapy some years ago, the therapist didn’t even look up from their desk as I entered the room. I said ‘Hello’, which was met with no response. The rest of the session seemed to be about my reaction to not being greeted and how I had felt ignored and how I had expected some acknowledgement of me as a person.
Sometime later, while training to be a therapist myself, I realised their response must have been from a psychodynamic blank-screen approach. Or, maybe it was just someone having a bad day? It didn’t work for me, whatever it was. I even went back for a second session as I did need help at the time, but the second session was similar. A continuation of what seemed like a battle between what I felt was a reasonable way of being, and the therapist’s response. I didn’t go back again and I would say that clearly we were not in relationship, which was unfortunate.
I would like to consider the relationship between different modalities in therapy, not necessarily the different theories of practice and models, but on the relationship between therapists and counsellors who have different ways of being with their clients, and to wonder if we can be more open and learn from each other. I imagine the recent concept of pluralism in counselling and psychotherapy is an opportunity for different schools of therapy and approaches to meet and have a dialogue and begin to be in relationship.1 The pluralistic perspective on psychotherapy and counselling seems to offer an alternative way of thinking about the client’s needs, and may indeed be a new way of informing therapeutic practice. I believe that even just being aware of different perspectives, approaches and modalities can only enhance more understanding of practice, which will ultimately benefit the client. I also believe that therapy is a collaborative process and is always informed by what we know, what the client knows and what we can both learn together, and offers a space where we can explore what we don’t know. I wonder then if there is a similar way of exploring our practice by having a conversation with colleagues working across modalities. While there may be differences in our approach and even our language at times, I am sure as therapists we all agree that our main goal is to help the client or patient find their way to becoming the person they have the potential to be. An example of the difference in language which I found amusing was when someone at a conference asked what my ‘schema’ was. I had no idea what they were talking about until their colleague said, ‘Oh, you’re person centred, which means conditions of worth?’ I have since explored this further and I can sort of get what they mean, and I can see the parallels.
A word that we all have in common, though, is the simple ‘hello’. I think most, if not all, therapeutic relationships usually start with a hello, and perhaps this is how we can begin to be in relationship with colleagues from other modalities when the opportunity arises; and importantly, not ignore our differences, but be open to something meaningful emerging in exploring our similarities and to find a way of understanding where, I think, we all share the same goals of helping.
I am trained in the person-centred approach and in this article I intend to consider some of the work of Carl Rogers (1902–1987) to help me explore how therapists and counsellors who have different perspectives can start to be in relationship with each other. I will not try to convince anyone to become ‘person centred’ in the way I understand it, but it may be helpful to consider what Rogers called the ‘Necessary and sufficient conditions of therapeutic personality change’ where he proposed six conditions.2 In his research, he discovered that if certain conditions were to some degree perceived by the client, they would experience therapeutic personality change at some level. And whether or not these conditions are viewed as always necessary or enough, I think they are pluralistic in nature in that they aim to cover all aspects of personality change in the therapeutic relationship. Regardless of the therapeutic approach, I believe they show key elements of the interaction between therapist and client or patient which are present whenever there is growth and positive change. While many therapists acknowledge the importance of Rogers’ core conditions of empathy, congruence and unconditional positive regard, I want to offer a slightly wider interpretation of all six conditions in my attempt to find a better way of dialoguing with other modalities. What I aim to present is only an interpretation of course, which I hope will encourage discussion. Considering there are so many therapies out there, with different approaches and ways of being with clients, looking at Rogers’ work may offer a useful framework to make a start. Rogers’ original conditions are listed with my interpretation, in bold, below each one.
- Two persons are in psychological contact.
There is a meeting of two people who can have an impact on each other.
- The first, whom we shall term the client, is in a state of incongruence, being vulnerable or anxious.
The client is either vulnerable or anxious and may or may not know why.
- The second person, whom we shall term the therapist, is congruent or integrated in the relationship.
The therapist genuinely wants to offer an honest response from their experience and is ready and committed to help creatively in an ethically supportive manner.
- The therapist experiences unconditional positive regard for the client.
The therapist accepts and acknowledges the client’s experience so far, and believes they can be helped to find their own resources to cope better in the world.
- The therapist experiences an empathic understanding of the client’s internal frame of reference and endeavours to communicate this experience to the client.
The therapist is able to express in different ways how they have an authentic understanding of the way the client experiences their world.
- The communication to the client of the therapist’s empathic understanding and unconditional positive regard is to a minimal degree achieved.2
The client feels encouraged by what they discover in therapy and can be themselves more freely in the world.
Again, I would like to emphasise that this is merely my attempt to start a conversation and there are other frameworks and steps towards change that are equally valuable. I believe the way that we actually help our clients and patients and experience our practice of being a therapist or counsellor may also help us understand how to begin to be in relationship with other modalities. And I have some questions that may be useful to consider, which were inspired by my reading of Rogers’ book, On Becoming a Person.3 Hopefully, these questions offer the possibility of a new dialogue and start a process of understanding how we may approach some of the differences in our work with colleagues from other modalities.
- Am I open to my experience?
- Do I feel safe enough in my experience as a counsellor or psychotherapist?
- Am I able to take in the evidence from different research rather than rigidly stick to my own experience?
- Can I tolerate ambiguity?
- Can I, by my own attitudes, create safety in my relationship with colleagues of other theoretical approaches and models to make communication possible?
- As I am open to the realities in me and the realities of the other, can I extend the same attitude to other modalities?
- Can I receive conflicting evidence without forcing closure on the situation?
- Am I available not only to what can emerge in therapy but to what is emerging in the psychotherapeutic world at this time?
I recently came across something known as ‘dadirri’, an indigenous Australian way of understanding our way of being and recognising each other in the world. It originates from the Ngan’gikurunggurr and Ngen’giwumirri languages of the Aboriginal peoples of the Daly River region in Australia’s Northern Territory. It has been described as the ‘gift we have been thirsting for’.4 Miriam Rose Ungunmer Bauman, an aboriginal elder in the Northern Territory of Australia, refers to dadirri as an ‘inner deep listening’ where there is a ‘quiet still awareness’ which taps into the ‘deep spring’ inside us and can make us whole again. For many of the clients I have worked with, the notion of being made whole resonates deeply with them. They have experienced parts of themselves that feel empty and are each entering therapy to find wholeness or at least some understanding and meaning in their lives. I am sure this is also true for clients and patients using other counselling or psychotherapeutic approaches. The idea of a greater understanding inside us that we can tap into like a spring, reminds me of Rogers’ notion of the tendency towards growth, which he called the mainspring of life, and which I imagine is like a fountain or a waterfall inside every one of us. ‘Whether one calls it a growth tendency, a drive towards self-actualization, or forward-moving directional tendency, it is the mainspring of life, and is, in the last analysis, the tendency upon which all psychotherapy depends.’3
In dadirri, there is the belief that we are all connected in nature and in the universe, and that everything is being attended to if we live in right relationship with ourselves, with others and with the earth. And by listening to each other with respect, and honouring the earth, we begin our journey home, where we may become whole again. This makes me think of how I can become better at listening to colleagues from other modalities who use different ways of working with people, as there may be a deeper wisdom in the therapeutic approach we have chosen, though seemingly separate, that may actually come from the same source. Regardless of which modality or approach we use in therapy, I believe that what we all have in common is a desire to help our clients and patients find a deeper understanding of themselves and their world, and to feel better and more able to cope with life. And all this can start with a simple ‘hello’.
Here is a message from Miriam Rose Ungunmer Bauman, which is part of a transcript from a video interview with Ken Zulumovski from the Gamarada Indigenous Healing & Life Training project in Australia. I think this message can help us to reflect on aspects of our work more deeply and perhaps find a connectedness in knowing that we all offer something valuable. And perhaps we can integrate our own deep spring inside ourselves and take what we need from it and share this with our clients and colleagues and indeed the world:
Don’t give up in what you are doing. You are doing really well. People out there need you. And without you, their spirit won’t have the awakening that it needs. Knowing that there are people like yourselves who are there for them, to support them and give them strength. And sometimes it can be hurtful when you are working with people who are feeling down and out and depressed and don’t feel that they belong. Just remember that each and every one of those people that you work with has a spirit and you have a spirit too. They have got to be told that they are just as important as you and I and they have a purpose. And also encourage them that they do belong and that the belonging is in relation to what you are doing. That they are made to feel that they belong, that they are important. Dadirri is an important tool to use. It’s not just an aboriginal thing, everyone has dadirri, and it’s just that they haven’t been able to find how to work with dadirri because everyone is running around really busy, doing this and that and having to hand in stuff yesterday. And I think it’s to do with time, and dadirri is being appreciative of who you are, where you are, and to get healing you need to go have some chilling out time as in walking the beach, listening to the waves as they are crashing on the beaches and spending time with yourself. And finding out about yourself. Who are you? What are you doing here? What’s your purpose? Where do you belong? Until you are at peace with yourself through dadirri, you are unable to go and help other people to heal. Keep up the good work.’5,6
Finally, I am reminded of a supervisor who once brought an ornate metal jug into one of our sessions. It became a symbol for pouring and being filled at the same time and it is as if there is a constant flow in any relationship, like an exchange of energy evolving between two people, harnessing the potential for growth and creating something transformative. Perhaps this is a good metaphor of the opportunity we all have to learn from each other by listening deeply and being in relationship, receiving and giving to this flow from a deep spring inside ourselves, which may indeed be the gift that we are thirsting for.
My thanks go to Aunty Miriam-Rose Ungunmer-Bauman and to Ken Zulumovski at Gamarada Indigenous Healing & Life Training for agreement to use a transcript from his video.
Mike Moss has 35 years’ experience working with children and families in Scotland. He has trained in youth and community work, solution-focused brief therapy, systemic family therapy, integrative therapy, person-centred therapy and clinical supervision. He is currently employed full time by West Lothian Council as a counsellor/psychotherapist for children and young people. He also has a small private practice, offering supervision to counsellors.
1. Cooper M, McLeod J. Pluralistic counselling and psychotherapy. London: Sage; 2010.
2. Rogers CR. The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology 1957; 21: 96.
3. Rogers CR. On becoming a person. London: Robinson; 2004.
4. www.miriamrosefoundation.org.au (accessed 17 February 2019).
5. Special Invitation by Daly River Elder Miriam Ungunmer Rose. Dadirri/ Mindfulness. www.gamarada.org.au (accessed 17 February 2019).
6. https://www.youtube.com/ watch?v=Jfe3j9pNB3A (accessed 17 February 2019).