The Humanist Approach to Therapeutic Care
With its belief in the innate goodness of the individual ; the exercise of empathy and its insistence on unqualified positive regard for the other person, humanist therapy has been attractive to, and influential with, those who work in the life space with vulnerable people. This piece is offered as a short introduction to the humanist approach and its relevance to life space work. I hope readers who might wish to pursue further the issues raised here will find the 'further reading' list helpful.
Theorists of humanist psychology do not accept that human social motives are derived from biological motives only. They argue that social motives like biological ones are related to basic human needs. Their view is that the meeting of a human being’s psychological and social needs is necessary for full human development and that though the frustration of these higher needs may not have the dramatic consequences of a lack of food, warmth or shelter, it is profoundly damaging to individual wellbeing in the long term.
One of the principal humanist theorists, Abraham Maslow, suggested that human beings have a hierarchy of needs.
Belongingness and love
At the base of the hierarchy are the physiological needs : food and water and the need to be safe. Once these needs are met, he argued , people move on to feel the need to belong and to be loved and then to the need for esteem. According to Maslow, at the top of the hierarchy is the need for self-actualisation; the human being’s need to develop a capacity to think and feel and to understand the world. He argued that this hierarchy described the relative strengths of the various needs and that a chronic failure to satisfy lower needs leaves the human being unable to focus on higher needs. For instance if people are starving they make take risks with their safety. Or if people are insecure and frightened they will not be concerned about making new friends.
On the face of it, it can appear that Maslow is arguing that people are not capable of altruism. If lower needs are to be met first before people act to satisfy higher needs, it seems they would never give a scrap of food to a loved one. Yet Maslow did believe that the human being has a capacity for altruism and for good. He argued that the basic needs must be met for most of a person’s life, particularly in the earlier years, if the individual is turn to satisfying higher needs. Once a human being has the security that the basic needs will be met, then he or she can begin to function at higher levels by satisfying the higher needs, which includes meeting the needs of others. Maslow pointed out that extreme deprivation in adulthood can lead human beings to focus on basic needs. For example some of the inmates in the Nazi concentration camps stole food from their children and parents, but equally some people were still capable of incredible generosity. According to Maslow, the latter were those people whose lower needs had been consistently met during their early lives (Maslow,1970). Maslow’s ideas here may be seen to harmonise with Winnicott’s notion of the ‘facilitating environment’ and Bowlby’s idea of the ‘secure base’.
Carl Rogers, another major humanistic theorist and therapeutic practitioner believed like Maslow that human beings have an innate tendency to develop and exercise all their capacities. Like Maslow he called this tendency self-actualisation. But where Maslow thought that most people are so busy meeting lower level needs that they can’t even begin to deal with their needs for self-actualisation, Rogers considered that self-concepts - a system of ideas and beliefs about the self - are usually the source of a person’s failure to self-actualise. For Rogers (1951) a positive self-concept was an essential ingredient for a healthy life.
Rogers proposed that people develop self-concepts by observing their own actions and feelings, and that the more accurate their observations were, the healthier they are. According to Rogers the accuracy of these observations is limited by reactions of others. From infancy parents and others impose what Rogers called conditions of worth on children. They tell children - through their words and their actions - that they are more lovable when they act and feel in some ways rather than when they act and feel in other ways. Children in turn are so concerned to have the approval of significant others, that they avoid recognising their own actions and feelings for what they are and so try to adjust their self-concepts to reflect what their parents and others tell them their actions and feelings should be. Here it may be seen that Rogers ideas of ‘self-concepts’ may travel along easily with Bandura’s ‘Social Learning Theory’.
The problem is that many of the acts and feelings rejected by adults are normal and inevitable. For instance the child who sees another child receive something special may be told not to be jealous. The child tries not to be jealous – but since jealousy is a normal reaction - the child still feels jealous without feeling able to acknowledge it or to cope with it. Rogers leaves us to conclude that in the process of the imposition of conditions of worth it becomes developmentally important for children to draw from parenting figures that though behaviours like jealousy may not be socially desirable, they are understandable. According to Rogers, the failure to understand his or her feelings and actions prevents the individual from reaching full potential. It is a failure to self-actualise. For Rogers our adult personalities reflect the compromises between the realities of our true selves and our self-concept (Rogers,1959). Parallels may be seen here with Freud’s constructs, the ‘ego and the superego’.
The Practice of Humanistic Therapy
Rogers (1951) believed the most important aspect of humanity is the tendency towards self-actualisation ; that is the need to mature and the need to enrich our lives. As I’ve already implied, he argued that psychological difficulties emerge when our need to grow is in some way obstructed. These obstructions arise from early childhood onward because other people have approved or haven’t approved of the things we do and since we all want to be liked or loved we try to deny our natural feelings (such as anger or jealousy) because we think others will not like us if we have those feelings. Rogers thought that a consequence of this process is that our experience and our self image become incongruent, to the extent that we experience ourselves as different than we really are. We can feel we are not at one with ourselves.
The goal of humanistic therapy is to help the individual to remove the obstructions that stand in the way of congruence. This is achieved when the self-concept is in line with or ‘congruent to’ the self. Rogers believed that all human beings have within them the resources to develop and improve themselves. Consequently it is not the therapist’s work to change the client but rather to create an environment in which the client can realise his or her potential.
According to Rogers, three major elements must be present in the client-therapist relationship to make it possible for the client to be helped :
• The therapist must have unconditional positive regard for the client. This is an acceptance that is not contingent on the client’s actions, thoughts or feelings.The therapist must be non-judgmental and though the therapist may disapprove of the client’s actions, the therapist must not disapprove of the person.
• The therapist must be genuine, open and honest about his or her feelings, while interacting with the client.
• The therapist must display an accurate, empathic understanding ; that is, he or she must be able to understand the experience and feelings of the client at each moment in therapy. The aim here is to reflect back to the client, not the content, but the feeling (emotion) which underlies each statement the client makes.
For Rogers the moment of change in therapy comes when the client experiences the feelings – the anger, sadness or jealousy – that he or she has been denying in an effort to gain approval from others.
Humanist therapy and life space work children and young people
While the positive tone of the humanist approach – for instance the belief that everyone has the potential within themselves to become a person who is at one with himself or, the practice of offering unqualified positive regard for the recipients of their care - is attractive to life space workers caring for others in one to one work, in family settings and in group living settings, it can often seem that for cultural, economic and other environmental reasons the self-concepts of those who are to be looked after are incongruent with the self-concepts of the life space worker’s personal make up. The question being asked here is can unqualified positive regard together with the belief that everyone has the potential for self-healing, overcome this interpersonal incongruence in order to complete the therapeutic process ?.
In my experience humanist therapy has achieved a powerful if indirect impact on life space work Its underlying tenets of empathy, congruence and unqualified positive regard have become incorporated as underlying principles in group living settings and have thus informed and enriched the provision of a therapeutic milieu.
Charles Sharpe, November, 2007 revised December, 2008
When you are working with the young people you support and look after do you feel you maintain an unqualified positive regard for them ?
Discuss with your colleagues any past experiences when you have felt an incongruence within yourself.
Give an example of your observation of incongruence in a young person you have worked with. How would you deal with it in a humanist way ?
Maslow, A.H. (1970) Motivation and Personality New York : Harper & Row
Rogers, C.R. (1951) Client-centered Therapy : Its Current Practice, Implication and Theory Boston : Houghlin Mifflin
Rogers. C.R. (1959) ‘A theory of therapy, personality and interpersonal relationships, as developed in the client-centered framework’ in S.Koch (ed.), Psychology: a study of a science Vol 3 New York : McGraw-Hill pp.184-256
Rogers, C.R. (1961) On Becoming A Person : a therapist’s view of psychotherapy London : Constable
Rogers,C.R., Gendlin,E.T., Kiesler,D.J., & Truax, C.B. (1967) The Therapeutic Relationship and Its Impact : A study of psychotherapy and schizophrenics : Madison, Wisconsin : University of Wisconsin Press
For Social Learning Theory
Bandura, A. (1977) Social Learning Theory Englewood Cliffs, New Jersey : Prentice Hall
For Milieu Therapy
Bettelheim, B. (1974) A Home for the Heart London : Thames and Hudson.
For Attachment Theory and the Secure Base
Bowlby, J. (1988) A Secure Base: Clinical Applications of Attachment Theory Routledge : London.
Holmes, J. (2001) The Search for the Secure Base : Attachment Theory and Psychotherapy London Routledge
For Ego and Superego
Freud, S. (1923) ‘The Ego and the Id’ in On Metapsychology : Penguin Freud Library Vol.11 London : Penguin Books (1991)
For the Facilitating Environment
Winnicott, D. (1965) The Maturational Processes and the Facilitating Environment London : Karnac Books (2005)
© goodenoughcaring.com and Charles Sharpe