CONTINUING EVOLUTION OF THE PERSON-CENTERED APPROACH: CONTINUITY AND CHANGE
Ruth Sanford and Jules Seeman
ADPCA 1995 - Tampa, Florida
I am pleased to be here today in what has been announced as an open forum, particularly our '94 meeting I have keenly felt the importance of face-to-face interchange of our experience in practicing the PCA as it continues to evolve and change.
In my work in South Africa and the Soviet Union I met with frequent references to the western world and the barrier that has risen between us. When the PCA is working in whatever culture its values run contrary to the general value system in the United States or in the western world with its competitiveness and its use of power over rather than power within and so on. But it's many times confused because it comes from the west and has been introduced to other parts of the world by Carl and his colleagues.
I think it came most strongly to me in the work in South Africa. When we went there, there were very few people who had any notion about it excepting immediately around Len Holdstock so that Carl and I were seen pretty much as some people from the west coming to South Africa and bringing this idea, this concept, sitting down with people who were not just in conflict but who really hated each other.
First of all, how to get them together so that the first condition that Carl had mentioned about this is being willing to get together, how to get them together and then what kind of climate do you try to create so that they begin trusting each other enough so that they will talk with a person that in their hearts they feel is the oppressor? The person who is white is therefore an oppressor. The person who is black is therefore inferior, that kind of thing.
Recently I've seen a real evolution taking place and now the indigenous peoples from the various tribes who really are the native South Africans, not just those who speak Afrikaans, or the people who have adopted many of the western ways of thinking - people from tribal roots have now become involved in the government and the people who have been exposed, who were in our workshops in '82 or '86 or later when I went back in '87, they're beginning to say, "It's time now that we draw in people with the tribal backgrounds of the Africans who were originally here and that we sit down together and see how we can appreciate one another in the concept which will evolve in South Africa from the acquaintance with the person-centered approach and still will be understandable and acceptable in the culture of the tribal South Africans. Now that seemed to me like a very real step in the evolution.
It was these things that have brought me to this real interest in what part do we have in this evolutionary process, keeping in mind that it is a way of being. It's not just a way of therapy. It's not just working with groups. It's not just what we understand as relationships in general, significant relationships, but it also is one that needs to be understood by and to be understood.
Those of us who have been deeply involved in the person-centered approach/client-centered therapy as it has evolved so far are trying to keep in mind that it deals with the whole person.
I found that Colin Lago in England has been working on large groups and doing research on large groups. I know that John K. Wood feels that not enough research has been done on groups yet, or at least we don't know about it to call it really a theory like the very careful and thorough and rigorous research that was done on establishing client-centered psychotherapy as a way of therapy on the basis of what really works. And there again comes in the question of research and what part does that have in evolution.
I think I don't want to say anymore about that at this point. I did want to give that background and Jules has another way that he's been thinking about concerning the evolution of what it means to be a fully functioning person.
Jules Seeman: I see this meeting as an invitation, a strong invitation to us to be liberated enough to be visionary about the present and future of the person-centered approach. That's what this is about. How can we think about today but more importantly, how can we think about tomorrow or the tomorrows? That's the way I see the concept of evolution.
A couple of years ago, I wrote a little paper for our RENAISSANCE called "Continuity and Change in the Person-Centered Approach" and that blend is very important to me. I know there will have to be continuity if there is an organic sense of the many ways that we live together in this approach then there will be continuity. There will be change. That's as inevitable as the tides. There's no way to prevent it. There's no way that anyone would want to prevent it, I don't believe. But I think the issue of continuity and change is in our hands.
I know I'm interested in what it can be like. How can we shape it? How would we like to shape it? What directions do we envision? We really don't have to go to a pie in the sky tomorrow. Just look at the program today. Look at the program this time, work with autistic children. That isn't just an application to little children who don't speak well or who don't communicate. It takes some continuity and change to work in that.
Just a half hour ago or less, we had a meeting here on working with persons who are thought to be psychotic. That wasn't just about application. That was about continuity and change because I heard some change. The meeting that Peggy and I had yesterday was about continuity and change when we talked about looking more deeply into the relationship, looking more deeply into the whole person. To me there were new elements to that. I wanted that. I know they're new elements so to me that's the context for me of a way of sitting together and saying, 'Well, that's interesting. Ruth referred to a kind of geographic revolution, more than that of course, evolution into national and international kinds of issues. That' new. You didn't read that in Counseling and Psychotherapy but that's an evolutionary process.
Ruth: Yes and there is a nation now that is at a point of bifurcation. They're having the choice now and it can be transformation. The very fact that it was called a "people's government" means that there's something that's really cooking there.
Jules: Those were the thoughts and then Ruth and I got together and said, "Let's have a meeting," so here we are, thinking about or at least inviting us to think about continuity and change.
Barbara Brodley: I'm not clear what this forum right now is for. It seems to me that anything that any and all of us can do to support interest among ourselves and among the people we come in contact with follow our own particular abilities in the applications, writing about and so on, the approach, is the basic way to contribute to the evolution, to do what we can and give support and encouragement to other people who might be inclined to do it.
What could come from that would be people talking about things they'd like to do or that they would like to try to do, something like. I'm not trying to say what we should do here but I don't understand exactly what you're getting at that's different than that kind of support and encouragement for people to do what they feel able to do.
Jules: The purpose of the meeting is to share. That's what the purpose of the meeting is, this meeting, to share, well, the purpose of many meetings.
Nat Raskin: I was very attracted to the topic but I can see there would be a question about to share what.
Ruth: I would guess that there are people who are finding new ways in which these concepts work, new ways that they hadn't maybe used last year or the year before. Momcilo's presentation on autistic children today was an example of that and it was very interesting that you can't use the same kinds of things that we talk about but the basic principle is there and that was the concept of self, the way in which the concept of self comes about in a human organism and he's applying it here to these babies, these small children who have already shut the world out.
I think the thing that they're working on, as I suggested in South Africa, is saying how can we extend this and make it more practical, more applicable, more acceptable to people who come from a completely different culture? They're thinking about it and they're working on it and I feel that that is definitely an evolution because the person-centered approach did originate in the west. There's no doubt. The question is quite often raised, "how does it affect people who have completely different values in their culture." I don't know that we need some extreme instances of difference for that but I am interested in Colin Lago, for example, in England, who is really working very hard to try to learn more about group process and more research and wanting to get in touch with other people who are doing it. Well now maybe ideas about that would be important and maybe the interchange is going to be a part of a continuing evolution. But unless we communicate, not just in our own little group, how is it going to expand, extend, grow?
Kristin Sturdevant: At this point I feel really like we're almost voices crying in the wilderness. I feel like we are counter-culture, that our interest, concern, care about individuals is not unique to us but there's an awful lot going on in our culture that doesn't value that. I think also that Jules, in developing a model of positive health in a systems way of looking, is another example of how this is evolving and might be another way for people to care.
Ruth: Yes, Jules, your concept of the fully functioning person has been expanded. I mean it's expanding what Carl talked about with a fully functioning person. You are saying that not only the cognitive and the affective are involved, not only brain and feeling, but you are saying the body. That certainly is a step in evolution.
Jules: To me I take that to say there are multiple forms of evolution that can take place. I see that as an evolution inward, an evolution in depth of understanding of what we mean by the fully functioning person. Maybe that does, in fact I think that does add some depth. It adds specificity but that's just an illustration of a form of evolution. I think the meeting earlier on the psychotic person is too. But those are illustrations. To me, this is an invitation to dream, to see where you are in the frontier of your own thinking, what's beyond the frontier? Those are the kinds of things and they may or may not be. It's an invitation that you can accept or decline.
Nat: So far I'm hearing there can be a sharing of new developments or methods, a sharing of dreams. I was thinking of the sharing of problems.
Ruth: I think all of them. If it's in your mind and you are working on it and you'd like to share it, we're here.
Nat: I had a reaction to what we said about communicating. I think we have a lot going on that way. We have our journal; we have this meeting; we have three series of international meetings. I'm evolving. Yesterday Alberto corrected me that the Latin American conference should be included so we have three of those. We have our famous e-mail communicating. I'm impressed (I'd like to see more of course) but there is a lot going on.
Fred Zimring: I don't know that everybody knows about your famous e-mail.
Nat: Well, for those who don't, we have an international e-mail network of 63, actually there's 64 people now because one of the addresses is a couple. (Laughter) I think we have 64 people who are mostly in the United States but we have somebody in Australia. We have people in England, Greece, Sweden, Portugal, Austria. We're all over and it's a very interesting network because it's used in so many different ways to share information. Does anybody know how I can get the Q-sorts or I'm looking for a particular reference on the research on groups maybe. Lately there was sharing of poems which came out of nowhere. It's a very spontaneous changing, takes all kinds of forms. When you check your mail each day or several times a day as I do, you never know what's going to come up.
Jules: Last week Tony Merry from East London jotted a little request to me. It said, "Jules, would you send me a reference?" like he was across the street. Immediately he sent that and there it was. It boggles my mind that a guy in east London can do that instantly.
Nat: And with one click instantly to everybody, to all 64 people.
Alberto Segrera: When you were talking, Ruth, I was trying to organize feelings and thoughts that I had and this question of the evolution of the person-centered approach.
With me I would start by saying I think that for me the person-centered approach is what allows me to have a common umbrella for a lot of things, more than any other expression. That can be different to someone else but like saying, "We have something in common, whatever differences there are." I think that's important that we don't forget that we have a lot of things in common, whatever the differences we have and to see diversity more as richness than as something that divides us or separates us.
And then I would try to ask myself what kind of diversity we have and I got to four kinds of diversity. One is theoretical diversity. I'm just going to mention some examples. Some people say client-centered, some people say person-centered. In French they still use a lot - nondirective for example. Or people about encounter groups, another would speak about group therapy. Those for me are expressions of the diversity in theory.
I think that we can enrich each other if we read each other. We don't have to accept whatever everybody says, that if we take an empathic attitude towards diversity instead of a fighting attitude towards diversity. That's one.
Second, my feeling is that the person-centered approach can't have to give up being a psychological approach and I've said that it's got to become an interdisciplinary approach in which contributions come in from philosophy, from education, from administration, from whatever, and these contributions have as much to contribute to our comprehensive view of human beings as a psychological point of view, something that Jules said would be as important on the physiological level as the psychological aspect of it. So, we need medicine, we need whatever discipline accepted on the same level as psychology and that's a hard thing to do for psychology. But I do think we have to keep on saying, "This is psychology and use whatever you want at whatever you find fit in your field."
Ed Kahn: Did you say the person-centered approach has encompassed medicine?
Alberto: Yes, I do think so. There is a person-centered approach to medicine and there is a contribution to medicine to a person-centered approach.
Ed: What is that?
Alberto: Okay. I think that as a psychologist, I never studied the human body, I mean, as extensively as, to the same depth, as a medical doctor usually does. I never studied as a psychologist society as a sociologist does. I've never studied an organization, administration as an administrator does and it is as important to get those aspects of the human person and the human person in relationship. I prefer person in relationship to human in relationship. Society and the universe, I think that theology has contributed to the person-centered approach also.
The third one being that we recognize diversity in fields of professional and professional application and work. You've said enough about the different things but there is a lot more.
Fourth, is a diversity of cultures and every culture has as much to offer and to contribute to the person-centered approach as American culture did and I hope that we'll go on giving in the future.
Jules: I just wanted to add to Ed's statement, your question, Ed, in relation to medicine. One of the experiences that I had in that regard was a person who came to me who had terminal cancer and he was asking whether there was any contribution that I had in relation to that. I think there were a number of contributions that I could make and did make. What I did was to define myself as a professional companion, not a therapist, as a professional companion, because there were many things that he needed in the way of spiritual help and ways of living more fully for the time that he had. What I'm saying is that a person-centered approach has a contribution to make or contributions. That's just an illustration and it's an answer to your inquiry I think, to your curiosity about the way of doing, a way of applying the person-centered approach in a medical kind of . . .
Ed: Probably the reason I asked the question is I've been interested in self psychology as some people know Kohut's work. Kohut was only interested in subjective experience in mental life and defined this discipline that all we study is introspection and empathy, which is vicarious introspection. He was only interested in the mind and experience in psychology but I guess in order to clarify for myself, the person-centered is not only interested in client-centered therapy in subjective states, it's interested in changing society. It's a much broader domain that goes beyond just mental life.
Kohut called some of the work of Eric Erickson with some social stages and called it sociology, that that was a culture and he was interested in mental life. So there's an aspect of person-centeredness that's concerned with mental life but it's much more than that and Rogers was more interested in resolving cultural conflict.
Carol Wolter-Gustafson: I'd like to add to that what is definite, probably the key word for me and Alberto what you were saying is the interdisciplinary nature of our knowledge and this is happening with a sort of crumbling in every phase. There's a sweet little theory that Public Broadcasting System did on the mind and body. When a top scientific researcher in the country of National Institute of Mental Health was to be interviewed by Bill Moyers, who is a journalist on Long Island, he posed the question about the immunological work in such a way that separated the mind and body. He said, "So your talking about neurotransmitters." He was saying, "So the mind communicating to this neurotransmitter," and she said, "You've already posed the question in your own way. It's not one thing speaking to the other. It is an interpenetration of . ." and she went on to describe. So the interpenetration is something that we already have known about I think from our approach. We understand that these things are separated in some organic way and if this is being replicated in every field and we can be I think pushing that.
For example, pretty much straight research from straight M.D.'s they'll quote the quote that 80% of medical visits are not medically based. They know that. So that 80% of medical illness or medical visits is attributable to somewhere else. The mind and body thing, we should be on the cutting wave of that.
Kevin Kukolek: I really concur with that. I had to read for my History and Systems class and I don't know if you know about this book. It's excellent and it's by Lawrence LeShan and it's called the Dilemma of Psychology. It talks about how we're remiss if we don't integrate history and culture and sociology and art and literature into the understanding of a person as an entire being and unfortunately it's out of print.
Alberto: I would say there is person-centered history and there is the contributions to history in the person-centered approach.
Fred: There's a very nice book out, about two years ago, from the Yale University Press on empathy. It was sponsored by the pharmaceutical companies, etc. so this is already a hot area. I've done some workshops with dentists a day-and-a-half long. This has nothing to do with psychotherapy. It has to do with communication. It has to do with understanding and in preparing for these sometimes I've looked at the literature in health psychology and you would be surprised. Modern research, for example looked at physicians talking to their patients and 80% of the time the physician did not let the patient finish even though there was somebody sitting there checking it off. 65% noncompliance with patients and their medication, because nobody is understanding. And we've got so much to contribute to that. I think we could give up completely psychotherapy and deal with all of these professions and their listening problems.
Alberto: That's part of it. I have a communications student who's now finished my course and might write her thesis. One thing is how much we can contribute to that and that still sounds like how the psychologist can contribute to that even if not intentionally. She might write a thesis on what communications theory has to offer to the concept of empathy which is a contribution from another discipline to a construct or concept that at least as of this moment has mostly been seen from the psychological point of view. What the sociologist has contributed to the concept of empathy, personal or social empathy.
Fred: I agree with you entirely. The linguists as a matter of fact now have a great deal to contribute in terms of what empathy is. There's a whole new thing coming down the pike called "discursive psychology."
Fred: Yes, the next thing beyond that which is going to recast how we think about empathy.
someone: I think they've got a textbook now that's going into corporations. It's called Collaboration of Community. So much of that is client-centered kind of work.
Margaret Warner: What I'm trying to think about how small the client-centered movement is. One way I sometimes console myself, I guess, is to think of us as being a little bit like Quakers, who are often articulating an extreme form of some good principles often to the point that they'll say if you were really a pacifist, you wouldn't have an army at all. It's often taking it to a form that isn't easily integrated in life but also at certain points, translating it into more institutions as they exist, that they historically were the ones that first got prison reform or that first were anti-slavery or that they were often in the forefront of things that society may have caught up with. But I am still impatient with us.
When I was in Austria, we were in the middle of a fight there and I was trying to think, what motivates me? I was thinking what I would really like to see is a society where you could be schizophrenic or an incest survivor and show up in an emergency room and have somebody treat you like a human being. That's an institution.
I guess I would like us to keep honing the pure form of what we do. That isn't very easily translated into how IBM works or how a hospital works but also to keep saying, "How can we get credibility in the everyday world? How can we get it in a form that a moderately ordinary institution could cope with it, to keep doing that?". Because if we don't do that the ordinary person showing up in the emergency room doesn't get listened to.
Ed: If this is the major goal of the person-centered approach, then the majority of the meeting has to do with psychotherapy it seems like. Is that a contradiction that most of the presentations are about the psychotherapy process and what's being said now is that the organization is more interested in bringing about some kind of social reform?
Margaret: I have the same issue on all of Jules' systems levels. I am very admiring of the practicality of this South Africa work, that you can have our community meetings and say well, what would this have to do with the real world? It took a lot of ingenuity to say, "Well, we could go to South Africa and we actually could influence that group of people who are in a key enough position that when there's an opening for some kind of later communication. . ."
Ruth: And that we will let them influence us. The idea that seems to me is a part of the evolution here is that the reciprocation and the empathy for another culture enough that you can enter into the world of that other culture, at least a little way and appreciate it.
I was present in South Africa when we were invited to take part in what the native healer called "throwing the bones." I didn't know what to expect but we went into this room and here was a healer who put down the cloth in front of him, had a handful of what I would call trinkets in the sand - stones, shells, all kinds of things, beads. He threw them on the floor and then he turned to the client whom he had singled out as a troubled spirit and began talking with her and what I saw him doing was to talk with her, to hear what she said and then to ask for a question and he would pick up something from the cloth.
I followed him through into the point where the young woman finally said, "Yes, you really touched on something that I had not dared to speak about and my fiancee is right here. I've never had the courage to tell him that there is a possibility that I won't be able to bear a child and I've been holding that back and it's been between us for a long time." Here he was sitting beside her. She shared it. I said to myself, "There is a person-centered therapist, really." The attention was down here at first but immediately it transferred to the relationship between the healer and the person who had come for help so I think it's that kind of openness which everybody doesn't have the opportunity to observe at close range like that. It's terribly important and it's a terribly hard thing to do when it's outside of your experience.
Margaret: I like holding to the idea that there's something in this client-centered thing that seems to cross at least a lot of cultures and yet that manifestation in our particular culture is not the most important one or that it would be manifested in different ways in other cultures.
Alberto: There's another aspect of it. People speaking about somehow psychological help, whatever way or whatever form it takes. At this moment, for example, I'm a union leader in my university. I want to be a person-centered union leader. I try to be a person-centered union leader. That doesn't have to do with a kind of helping profession. It's a social function. Of course I think that we should help each other. That would be implicit. But I don't think that we're going to try to train people to be disguised psychologists, secret service psychologists working as community leaders. (Laughter) What I want is to be able to see the person-centered approach used, utilizing it, contributing to having person-centered union leaders and I want to have professional union leaders tell us what is bullshit, that we think is person-centered approach. That is one example of going outside the helping professions.
I think it's a way of being so it's not only for helpers, it's for every human being so there's got to be a person-centered way of administrating of a person-centered politician. It is possible.
But then a professional politician is going to come and tell us it won't work that way because this and this and this and this. Instead of saying, "Oh, just because you're not person-centered, hey what a minute! What are you telling us?"
A person-centered theory of politics is not going to be written by any of us. It should have to be written by a politician. That's what I'd like to have.
I mean the idea would be in twenty years I'd like to have an international meeting where psychologists would be the minority, not because they are less but because there are people from every profession, every discipline that would share these basic principles of person-centered approach.
Nat: I think the tendency in unions is for union leaders to assume a lot of power so I think one big contribution would be to learn how to empower the workers themselves and for the leaders to be willing to be part of that kind of organization.
Alberto: By one example, next month for the first time in eighteen years of human history the budget is going to be voted by the general assembly, 800 people. That's giving power to the people.
Margaret: Gene Gendlin had a thing I haven't heard him say before. It was very interesting to me this year. He said, "Any large organization is more stupid and perverse than almost any individual you know." But on the other hand, there are many, many things that you can do more effectively in larger institutions than with 100 individual people doing it on their own. But as soon as you are in an organization you will feel that somehow fate put you in a peculiarly neurotic and perverse group of people because everybody is acting that way and that humans too quickly give up on larger organizations instead of hanging in there, that they too quickly say, "I have to leave and go to a group of two or three or four or five people where I can be consistent with my principles," as opposed to hanging in there with larger organizations.
Alberto: There is something funny that we trust individuals who have that actualizing tendency but we don't trust an organized group of individuals to have that actualizing tendency also.
Nat: Well, maybe that's because it's specifically an organization.
Alberto: It's happened like that. It doesn't have to be like that.
Nat: I agree it doesn't have to be like that and people who've studied good organizations I think typically find that the good organizations, give, distribute power, like Federal Express.
Ruth: I think organizations are learning more that that works.
Jules: I'm mindful of the fact that we do have an obligation to help keep the schedule so that the employees can keep to their hours and that it's high time.