Using Developments from the Broader Field of Psychotherapy

Word count excluding front sheet and references: 4816 Introduction The purpose of this essay is to explore the development of the self in relationship within the person centred approach through drawing on developments within the broader field of psychotherapy.

My principle intention is to explore intra-psychic and intersubjective understandings of self and form a view of a person centred understanding of self in relation to this dichotomy. I will argue that person centred theory was an original, if not revolutionary, approach to psychotherapy, the origins of which are found in phenomenological and existential thought rather than the scientific and medical roots of the psychoanalytic theory dominant at the time. I will describe how the person centred view of the self grew from the experience of how people changed and achieved growth through the therapeutic relationship.

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As such it was a truly relational theory from its inception and moved toward more clearly defined intersubjectivity through the development of therapist congruence, subjectivity and the wider systemic applications of the person centred approach. By contrast, the importance of relationship in psychoanalytic theory emerged over many years through a long revisionist path which led ultimately to a sharing of values between these two paradigms in respect of subjectivity and genuine encounter in which the subjective frame each participant is acknowledged.

Nevertheless I do contend that both traditions inform and enrich one another and further suggest that this process is enhanced by recent developments in neuroscience. I will draw on the work of Carl Rogers in particular and contrast his work with that of theorists from the analytical tradition, including Bowlby, Winnicott and Kohut; from developmental psychology, Stern and Stolorow and from the existential / phenomenological tradition, Spinelli. I will include brief critiques from systemic and cultural perspectives and will also draw on my own practice to illustrate some of these themes.

The Development of Self – A Person Centred Context “This above all, to thine own self be true, and it must follow as the night the day, Thou canst then be false to any man” (Shakespeare Hamlet; Act1:Scene 3) Polonius’s paternal advice to his departing son Laertes suggests that being true to “thine own self” is the most important –“above all” – aspiration in life. The emphasis on “thine own” self implies that there might be other “selves” from which it might need to be distinguished.

As the only organisms with conscious self awareness, understanding and knowing who we are is an exclusively human endeavour and is perhaps the most fundamental of our psychological needs. However, Shakespeare here suggests that for human beings, knowing their “own self” is perhaps more complex than it may seem. Carl Rogers readily acknowledged that, initially, he regarded the notion of “self” as a “vague ambiguous and scientifically meaningless term” (Rogers,1959a: p. 00) only changing his view later when he realised that “when clients were given the opportunity to express their problems and their attitudes in their own terms without any guidance or interpretation they tended to talk in terms of the self”(ibid) (Shakespeare, it seems, was able to recognise this human propensity more readily than Rogers. ) Always a committed empiricist, he began to research with “no reliance on a particular view of the truth” (Barrett-Lennard 1998 p. 61). His readiness to “take the phenomena as given” (May 1961b p. 60) and his “allegiance to processes by which the truth may be gradually approximated” (ibid) reveals his affinity to phenomenological thought. It is this aspect of Rogers’ approach which so fundamentally distinguishes his theory from psychoanalysis. The word “phenomena” is generally taken by philosophers to mean “the appearances of things as contrasted with things themselves as they really are” (Spinelli 1989) As human beings we attempt to make sense of and impose meaning on all our experiences and thus we create a subjective rather than an objective reality (phenomenology even questions whether any objective reality exists).

Rogers came to recognise that the only reality that he should be concerned with was the “inviolable subjectivity of individual experience” (Tudor & Worrall 2006 p. 27). This does not make Rogers, in essence, a phenomenologist but it was the foundation of his view that empathic understanding and therefore relationship formed the context within which the development of the self takes place. Person centred theory was therefore conceived as a truly relational psychology where as psychoanalysis was concerned with intrapsychic drives and therapist interpretations of objective reality.

Although he was primarily interested in change rather than causation (Kahn & Rachman 2000), after many years of observation of change in his practice Rogers gradually became alienated from his traditional psychological training and he found that he needed his own theory of how the self formed and developed. “To explain and adequately connect the events of therapy, a view of human personality was needed. The events themselves were highly suggestive in regard to fundamental aspects of personality…and literal theory building began” (Barrett-Lennard 1988 p. 1) Relationship, especially in infancy, subjectivity, empathy and acceptance of the client’s frame of reference were to be the bedrock themes. Rogers’ Theory of Personality and Behaviour First appearing in 1951 (Rogers 1951), Rogers’ Theory of Personality and Behaviour was presented in the form of nineteen Propositions and reached their final and most comprehensive form in his seminal paper of 1959 (Rogers 1959). At the very heart of Roger’s theory are the organism, which he clearly distinguishes from any notion of “self”, and the actualising tendency.

The self is seen as a conceptual structure that emerges from the organismic context. The actualising tendency is described as the “one central source of energy in the human organism; it is a function of the whole organism rather than of some portion of it; and that it is best conceptualised as a tendency towards fulfilment, toward actualisation, toward the maintenance and enhancement of the organism” (Rogers 1963 cited in Merry 1999 p. 22) All of aspects of Rogers’ theory, both of development and change, rely on this view of the organism.

The phenomenological influence on this theory and the importance of relationship in infancy are clear. The first three propositions in particular evidence his phenomenological perspective as they are sceptical of objective reality, embrace the subjective and delineate the relationship between what we perceive and how we behave (Tudor & Worrall 2006 p. 28) In infancy, the self emerges from the organism as “a portion of the total perceptual field gradually becomes differentiated as the self (Proposition VIII) i. e. n the first few months of life an infant learns to recognise an identity separate from its mother. Continuing development of the self occurs when a part of an “individual’s experience is symbolised in an awareness of being” (Rogers1959 p. 224). These can be described as self experiences. Actualisation is maintained if those experiences which are perceived as enhancing of the organism are symbolised accurately in awareness. However, experiences which are perceived as threatening may be distorted and perceived inaccurately in order to protect the organism.

The continued development of the self will therefore be influenced by both accurate and distorted perceptions of experience. The emergent self develops the need for both positive self regard and the positive regard of others. The need for positive regard from others is so compelling that securing it may be at the expense of experiences which are of positive value in actualising the organism. This is critical for the infant. With an overwhelming need for love and positive regard, a baby may adopt behaviour that is guided not by the need to enhance the organism but by the “likelihood of receiving maternal love. Rogers 1959 p. 225). Rogers describes this process as the development of “conditions of worth” which result in the development of a self concept; an “organised set of characteristics that the individual perceives as peculiar to himself/herself” (Ryckman 1993 cited in Pescitelli 1996). Incongruence occurring at any time between experience and the self as perceived may result in “tensions and inadequate functioning” (ibid p. 226) and psychological distress. The process of mediation between the organism and self concept is lifelong.

There is a danger here, I believe, of seeing these concepts in black and white terms i. e. organism good, self concept bad. “Self actualisation”, the role of the self concept as distinct from “actualisation” of the organism, in fact enables a move toward optimal psychological functioning (Tudor & Worrall 2006 p. 90). It positively serves the organism’s tendency to actualise, by enabling individuals to organise and evaluate experience, mediate social relationships in family and society and balance organismic needs with the needs of others (Tolan 2002 cited in Tudor and Worrall 2006 p. 90).

Merry adds to this argument by reminding us that the organism’s primary need is to survive and that it will “close down” any potentials which threaten survival (Merry 2003 p. 87). Cooper (2000) suggests that different concepts of the self can be formed in response to various individuals conferring positive regard for very different self experiences. Perhaps something like this was in Polonius’ mind with his emphasis on “thine own” self. Mearns (Mearns D 1999) also argues for a plurality of self concepts and points out that individuals often use the word “parts” to describe how they experience different dimensions of themselves.

As new experiences and perceptions occur, or as experiences are differently perceived, the self is constantly open to change, including through therapy. In this sense the self is a process rather than a fixed or constant entity. The development of self in a person centred context therefore rests on the view that, given the right kind of relationship, people have the capacity to grow and achieve their potential through the continuous prompting of the actualising tendency and the mediation of the self concept.

Other Perspectives of Self “The great questions of psychotherapy will never be definitely answered…. Nonetheless, …In spite of continuing sharp controversies and differences even among sympathetic colleagues, there is a growing unity of thought…” (Kahn 1996 p. 19) Revisionists of classical Freudian theory began to put relationship, especially in infancy, rather than instinctual drives at the heart of what it is to be human. In effect, psychoanalysis began a movement toward the point where Rogers began.

Nevertheless much of Rogers’ thinking is richly elaborated by these developments and there is evidence that he was influenced by some of them Melanie Klein(1882-1960), from observations of young children and parental figures saw early infant/mother relationship, to be critical in the development of self. Her theory of Object Relations, in essence contends that a child builds an interpersonal world (of object relations) from what is experienced in relationship, seeing external objects as “an ‘other’ that helps us experience the ‘I’” (Tudor & Worrall 2006 p 88).

Otto Rank (1884-1939), an associate of Freud, saw conscious will and purpose rather than unconscious instincts as being at the heart of humankind with “the client’s consciousness and meanings , (and) awareness of present felt experiencing (as) the vital issues in therapy” (Barrett-Lennard 1988 p. 355). Rank is, I believe, revealing here his own phenomenological position. Viewing creative potential as inherent in the make up of humans, he implied a form of growth principle somewhat analogous to the actualising tendency

The work of Rank’s associate Jessie Taft (1880-1960) is also characterised by relationship with young children (Taft 1933). However, she was anxious to distinguish her approach from psychoanalysis “or any process in which either analytic or intellectual aspect is stressed, or the immediacy of the experience is denied or confused with history” (Taft 1933: xvi in Barrett-Lennard 1988 p 125). Using the term “relational therapy” to describe the essence of her approach, she too reveals here a phenomenological stance with recognition of the centrality of empathy and relationship.

She precedes Rogers by almost a decade. Rogers both met Rank and Taft and read their work and their influence in the later development of his self theory seems clear. In further developing Object Relations theory, the British psychoanalysts Winnicott and Bowlby similarly placed relationship at the heart of human development. They too saw, as did Rogers, the infant – mother relationship as the context for the formation and development of a self identity and further acknowledged that our internal and external experiences affect and are continually affected by each other. (Holmes 1993).

Psychoanalysis was moving from a one person to a two person psychology. Winnicott, hinting at an inter-subjective paradigm, went as far as to say that “there is no such thing as a baby (Embleton Tudor et al p. 88). He meant by this that the baby must be seen and considered in the context of a “whole unit” (ibid) as mother and baby so profoundly and continuously affect one another through sensory experiences such as touch, tone of voice, gaze and holding. Recent developments in neuroscience reveal that identical activity in the form of mirror neurons is triggered in the brains of mother and infant as they gaze at each others faces. Schore 1994; Cozolino 2002) Essentially this is perhaps the beginnings of a scientific explanation of empathy and intersubjectivity. Further developments in this field are likely to lead to a re-examination of other aspects of psychotherapeutic theories and methodologies. “all of the disorders we have thought of as ‘psychological’ need to be reframed to include neurobiological correlates and mechanisms” ( Cozolino 2002 p. 319). Bowlby (1907-1990), developed what I consider to be perhaps the most significant development to have emerged from the analytical tradition in understanding how the self develops.

Having studied, ethnology, anthropology and human bonding and culture, his major formulation of Attachment Theory (Holmes 1993) rests on the need for the close proximity of infant and parent in order for development, exploration and the process of individuation to continue. When the secure base (attachment) of the mother/infant relationship is undermined by an intolerable separation, anxiety is caused in the infant, which, if repeated or continued, can lead to the child becoming insecurely attached.

Always seeking to make the best attachment possible, an insecurely attached child feels angry but does not dare attack the attachment figure for fear of retaliation and pushing the attachment figure even further away. Resultant feelings of both anxiety and rage are suppressed, lack of care becomes an expectation and the expression of any emotion is fraught with danger. These processes that begin in infancy and, if strengthened in later life, can lead to difficulty in establishing intimate relationships and maladaptive behaviour such as aggression, depression, substance abuse and self harm.

This theory, largely rejected by the psychoanalytical establishment of the time as it saw the development of self as an external rather than an internal process (Holmes 1993) has had a worldwide influence in the field of childcare and social policy. It is broadly consistent with Rogers’ view of the nature and importance of the mother infant relationship but greatly enriches it. Rogers describes this process in terms of lack of positive regard leading to a distorting of experience by the self concept and a denial to awareness of organismic needs.

This can lead to greater and greater incongruence and subsequently to delinquent behaviour and psychological distress. Kohut and self psychology is generally seen as offering the most significant revision of psychoanalysis (Kahn 1996) in terms of the move toward relationship and many of his views, radical in psychoanalysis, are consistent with Rogers’ theory. When he replaced interpretation and objectivity in psychoanalysis with empathy and subjectivity, analytical theory “could no longer define healthy functioning as a conformity to some objective reality” (Kahn 1996 p. 0). Kohut describes the infant’s needs in the analytical terms of archaic narcissism but believed they could be met through, what he termed, the “empathic attunement” of the parents to the infant’s experience. In this sense parents become “self objects” and the child begins to acquire other self objects from all its experiences. In Rogers’ theory the infant, through receiving accurate empathic responses, experiences positive regard from the parent and develops positive self regard. Kohut saw the self as developing from and close to a person’s experiencing.

This “experience near” (Kohut 1984) stance compares to Rogers theory of symbolisation of experience. A robust sense of self and capacity for affect regulation is achieved through making “transmuting internalisations” of experiences when narcissistic needs are imperfectly met. This is analogous to the mediation between organism and self concept. It is perhaps surprising that Kohut nowhere acknowledges Rogers’ much earlier identification of the importance of empathic understanding. Nevertheless, both Bowlby and Kohut offer rich elaborations on the processes of early self development.

By his focus on the subjective experience of the client, rather than objective reality, Kohut consolidated the move of psychoanalysis from a one person to a two person psychology. Towards Inter- subjectivity Rogers by this time had advanced the concept of therapist congruence in Person Centred theory which altered the balance of the therapeutic encounter from one characterised by therapist provided attitudes to the mutuality of two subjective worlds meeting in as real a relationship as possible.

Although Kohut had begun to appreciate how therapist subjectivity impacted on the therapeutic encounter by creating a mutuality of reciprocal influence (Kahn 1996 p. 33), a fully intersubjective view on the development of self was yet to emerge from psychoanalysis. “A trend towards mutuality in relationship, towards a dialectic of meaning that had whispered along in the background, suddenly took voice in the work of intersubjectivists” (Sills 2007) The intersubjective “baton” is passed to developmental psychology.

In a decisive move towards the notion of intersubjectivity and away from object theory Stern (Stern 1985) suggested that experiences jointly created in parent child relationships come to be owned by the child to form part of the sense of self. Describing such experiences as “representations of interactions that are generalised” (RIGS), they can be negatively or positively valued, but are jointly created experiences and not objects. Stolorow and Atwood . Stolorow & Atwood 1992) go further and argue for an exclusively intersubjective theory of self. Describing intrapsychic drive theory and its derivatives as the “myth of the isolated mind”, they argue that all human development and experience occurs within an intersubjective context and that a child’s organisation of experience into a self structure “must be seen as a property of the child care giver system of mutual regulation” (ibid p. 23). They describe self regulatory competence as a systems competence.

Invariant principles that unconsciously organise the child’s subsequent experiences are formed within the matrix of the child –caregiver system and become the essential building blocks of personality development. The therapeutic relationship is also seen as a system within the intersubjective field of the therapy where invariant organising principles can be adjusted. Ogden (1994) describes the therapeutic intersubjective field as “intersubjective analytic third” where a third subject is unconsciously co-created by the interaction between client and therapist and which each experiences through their separate personality system.

I find that this concept, where the observer becomes part of the observed, makes a distinction between the truly intersubjective and other models of relational therapy. The two paradigms, psychoanalytic and humanistic, now shared many core principles which had been at the heart of person centred psychotherapy for almost half a century. It is remarkable how far ahead of the psychoanalysts Rogers was in appreciating the validity of the subjectivity of the client (Kahn 1996 p. 32) A Systemic Context

Whilst seeing the infant caregiver relationship as a “system”, Stolorow and Atwood do not go on to explore the significance of all of the other systems to which it is connected. The mother infant relationship is a system within the nuclear family system which is in turn within the extended family system and so on so that society is seen as a structure of systems within systems. Change in one part of a system inevitably changes its other parts which then affect the other systems to which it is connected and so on.

Pioneering systemic work in Italy in the 1980s (Palazzoli et al 1985) with people diagnosed with schizophrenia demonstrated that working with the family as a system of relationships alleviated the symptoms of the family member diagnosed with schizophrenia when more traditional individual approaches were not successful. It seems to me an irony that Rogers, who began to develop his theory of self from his experience of working with families, seems to have paid relatively little attention to the influence of the whole family system.

Ironically, although person centred theory emphasizes empathic unconditional positive regard as the engendering force of psychotherapy, the theory tends not to recognise that force’s kinship with the emotional power of early family dynamics (Gaylin 2001p90) A cultural context A consideration of the systemic context of the development of the self inevitably leads to an awareness of the wider societal systems, national, cultural, political, in which we live and how they may effect the development of self.

Western psychology, including person centred therapy, has developed within predominantly white European and North American cultures that traditionally value individualism. Many non-white cultures and Eastern cultures, by contrast, see the self as an integral part of something greater such as clan or community. It is important to recognise that these values are culturally defined and in predominantly white Western societies it is through the “subtle veil of whiteness” (Cornelius White and Anderson p5) that individualism is presented as an unquestioned norm. the ancestral worldviews of people of color emphasise positive interdependence and have inherent differences to those built on individual actualization”(ibid) The cultural context is therefore a powerful influence in the development of the self but has received little consideration in the theoretical views discussed here. “It was awful to be Negro and have no control over my life. It was brutal to be young and already trained to sit quietly and listen to charges brought against my color with no chance of defense” (Angelou 1984 p 176)

Maya Angelou conveys powerfully here the impact of racism in her young life in the southern American state of Arkansas. In addition to an early separation from her parents she has also to resile against the “brutal” attack on her sense self as a Black child in a dominant white and far from “subtle” racist environment where the political system legislated for the denigration of Black people.

In the latter part of his career Rogers continued to be far ahead of other therapeutic traditions in exploring the boundaries and application of his theories. He worked predominantly with groups and was active in cultural and political contexts such as peace-seeking initiatives in Northern Ireland and South Africa. Though always connected to individual therapy, he could perhaps no longer promote it in alienation from the environmental contexts of peoples’ lives.

In terms of the development of self, he recognised the need to address cultural and religious dimensions as well as the effects of oppression, violence and poverty in society. The name ‘person centred therapy ‘ inadvertently hides a dismissal of the sociological inequities that often offer additional explanations for suffering rather than resting sole credit or blame with individualized conditions of worth (Cornelius-White and Anderson 2007p. 5)

The Formative Tendency (Rogers 1980), formulated towards the end of his career, which takes a systemic view of the universe as a complex of connections and systematic order, can be seen as an “ecological revision” (Cornelius-White and Anderson 2007) of the individualistic actualising tendency thus providing a theoretical base for the wider application of person centred theory, the person centred approach, and it is broadly compatible with established systemic theory Individual or Intersubjective – a person centred view

Stolorow and Atwood argue that as an individual’s world of inner experience is “embedded in an intersubjective context in a continual flow of mutual regulation,.. the gap between the intrapsychic and interpersonal world is closed and the dichotomy between them is rendered obsolete” (Stolorow & Atwood 1992 p18). They view the self as entirely intersubjective in formation and development. However, in person centred theory the actualising tendency, and therefore the separate individual, still exists. This raises the question of how individual and intersubjective understandings of the self can be seen within a person centred context.

I argue for a “both/and” position; a view that I suggest finds support in the phenomenological roots of person centred theory. The existential – phenomenological tradition contends that the self can only be defined in a relational sense (Spinelli 1994). Humans can only exist in the world and cannot exist alone and therefore human existence rests on the principle of relatedness. We cannot therefore understand or make sense of human beings – ourselves included – on their own or in isolation but always and only through their inter-relational context. (Spinelli 2007)

This also is a truly intersubjective view of the self. However, unlike Stolorow, existentialism also embraces a view of the individual self in the context of existential isolation (Spinelli1994) (Yalom 1980). Individuals can only experience the world in a unique way that cannot be completely shared by another. Recognition of our uniqueness inevitably brings an awareness of our aloneness or isolation. When we die we die alone. The moment that we die brings to an end our unique world of meanings, and the world that both defines and is defined by our being ceases to exist. Spinelli 1994). Stolorow & Atwood dismiss such ontological aloneness as part of the “myth of the isolated mind” and as nothing more than a “calming vision” (Stolorow & Atwood 1992 p11) built into the human condition as the common fate of all mankind which offers “reassuring illusions” (ibid) of self sufficiency and autonomy as a defence against interpersonal events over which the individual has only limited control. I do not share this view and see an individual dimension of self arising, not from an intrapsychic process, but from a relationship to the givens of human existence.

Whilst Kohut’s self psychology and Stolorow’s intersubjective position both clearly share the critical core values of person centred theory, the role of the actualising tendency presents a crucial difference which questions Kahn’s view (Kahn 1996) that they are “one at the core”. The actualising tendency is the core of person centred theory. In the person centred context, the intrapsychic and intersubjective dimensions are expressed by such terms as “actualising tendency” and “fully functioning person” (the individual dimension) and “relationship” and “encounter” (the intersubjective dimension) (Schmid 2001).

The individual dimension defines what a person is; the intersubjective dimension describes becoming i. e. how a person becomes a person. Together they form the “distinctive characteristic of all person centred thinking”(ibid). The self in a person centred context must therefore be seen as both intra-psychic and inter-subjective. People are both individuals and relationships. I suggest that the dichotomy of the intersubjective and intrapsychic will never become obsolete as long as human beings continue to understand and express themselves in terms of self. Autonomy and interconnectedness, independence and interdependence, self reliance and commitment, sovereignty and solidarity uniquely characterise the human condition” (ibid). In taking this view, I recognise that I am from a white Western culture. I am not arguing for its universal acceptance and I remain open to the different understandings of others. However, consistent with the phenomenological theme I have outlined, my theoretical view of self arises from my own self experiences which I have attempted to symbolise accurately here. Conclusion

In reviewing various theoretical positions in relation to the development of self, I have described how Carl Rogers created a new psychotherapeutic paradigm that arose from his phenomenological disposition which recognised the primacy of both the phenomena of subjective experience and the centrality of relationship in human development. The contrasting intrapsychic Freudian ego psychology, dominant at the time, and which pre-dated Rogers by many years, was gradually revised to incorporate many of Rogers’ core values in respect of subjectivity and relationship.

Both paradigms subsequently moved towards more fully intersubjective positions. I have contended that systemic and cultural perspectives have been advanced more in person centred theory through the wider applications of the person centred approach but that both traditions have paid relatively little attention to these aspects. Traditional views of psychotherapy maybe either challenged or reinforced by developments in neuroscience as we are now aware that our brains organise the totality of our experience (Cozolino).

It is perhaps an irony that psychotherapy, which has so steadily moved away from Freud’s scientifically driven approach, may now be returning to science for validation of its theories. Whilst fully embracing the concept of intersubjectivity, I have argued that the role of the actualising tendency is an intrapsychic process which must be reconciled with intersubjectivity in a person centred context. I have therefore concluded that self, in a person centred perspective, is both intrapsychic and intersubjective, that these are not mutually exclusive concepts and that this view distinctively characterises person centred thinking.

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