Abnormal Psychology: Treatment: Humanistic Therapies and Client-Centered Concepts


Humanistic therapies come along, with the development of humanistic
psychology, the third force in psychology as it were, with Abraham Maslow, and we saw Carl Rogers, and a number of other people, a lineage which has led us now to a thing called positive psychology emphasizing the good in people, and what goes right with
people, what people have the capabilities of doing, their full potential to be tapped. So, trying to figure out how we can emphasize our self healing capacities, we
have now a client-centered model that comes along because in the behaviorist model, which
we’ll talk about in a minute, you come and seek out the therapist, and they will analyze the behaviors, and
they will analyze the contingencies, and they will tell you what you need to
do to manipulate the contingencies to change the behavior. It’s a very top-down system, with that kind of deterministic idea behind it that what you are at any given day is the sum total of all
your learning experiences, all your reinforcements, all of your punishment, etc., etc., of which you are no longer aware, but are going to be in probability zones to be more
or less probable to do any given thing, and to change those
probabilities you have to actually alter the environment, or the structure of contingencies, and so it’s this top-down, you go see the
doctor, they diagnose you, they tell you what to do, if you do it, you should have pretty good behavior change results if that’s what you’re after. With the psycho dynamic concepts your issue
started when you were really, really young, and they became more or less ingrained in who you are. So you don’t have a whole lot of hope for change, but also, you’re looking at a model that’s
deterministic, what happened to you then effects who you are now in a way that’s very hard to go back and understand how it affects you, much less change it.
But with the humanistic therapies coming along they said let’s move it from the top-down model to the bottom up model, the person coming to me, I’m gonna now assume has some ability to take care of their own issues, but might
lack the guidance needed to activate their self-healing capacities. Knowing what we know from some research, what we would do is just help clients
train themselves to arm themselves to be better prepared, to help themselves with their own lives, and that’s a very optimistic model, not
so deterministic. Client-centered therapy is a result of that process. You remember we talked about Mr. Rogers way back? Well Dr. Rogers is who we’re talking about, Carl Rogers, he started this off, and he did a program of research that supported his
conclusions, and so whereas psychodynamic therapy arose out of theory, and
predominately originally, Freud’s theory modified by many,
many, many, other psychologist and theorists, Carl Rogers
started off with some premises that he then tested in the actual research paradigm of
having therapy itself studied. Looking at the
processes of therapy, looking at the processes of therapists
interactions with clients to see what worked and what didn’t work. Switching up the paradigm he’s looking
to provide a warm supportive atmosphere to help improve
concept of self and to gain insight about problems. So
it’s a very affirming situation. Automatically you come in with
a lack of judgment of a negative type. The therapist constructs, which are key, are these, active listening. Active
listening matters. It sounds like a cliche, “How does
that make you feel? How does that make you feel? How does
that make you feel?” Therapists don’t do that. But they do ask you how does that make you fee, do you know why? Because they don’t know. Unless they ask you they have no idea.
Some people will be talking and “I got so angry. I just, I was so angry I couldn’t see straight, you know what I mean?” And all of us in conversation go, “yea I hear ya, I know, man, wow, sure.” But I don’t know what that means, and neither does anyone else, that’s just
something you do in social conversation. “Yea, I hear ya.” I would say how angry did it make you and what ways did you exhibit anger? For some people angry is this. Other
people they’re throwing shit and knocking holes in walls, there’s a big
difference. And unless I ask you, I will have no idea, and that is the key. I need to understand what the world
is like from your perspective as the client or
the patient. Not my judgments about that I need to get into your phenomenal logical reality, so I need ask you questions that might
seem innocuous on the surface, but are designed to get at some hidden
emotional content that people just don’t share, and when they
do share other people just kind of blow off without really understanding it. That phenomenal logical reality is
important. Some people ask me, “How do you know somebody’s telling you the truth in therapy?” and I say, “Quite honestly, I don’t.” I don’t know if anybody’s telling me the
truth. All I know is whether I believe they’re telling me what they believe to
be the truth, and what they believe to be the truth is
their reality, and that’s what I have to work with,
objective reality is a very interesting concept. When you get up a couple who comes into therapy, you got one that goes, “man she’s such a bitch, she’s always nagging on me, she’s always giving me all these problems. I can hardly stand
it no more, and blah blah blah blah blah” While that
other person’s in there going, “yea I am a total bitch, I’m always giving him problems and stuff.” Right?
When you switch it over to the other side guess what happens? They’re like, “He’s an asshole! He’s all the time trying to control me and dominate
me.” And then you got two people who have two very different realities, so what matters is not what’s the truth,
well, you’re half an asshole and you’re half a bitch, and together ya’ll make a mess of things right? That ain’t the objective here right? The objective is to understand how two people who were so much in love and attracted
to one another eventually came to hate one another. How
did that happen? In the reality of the world you wouldn’t
predict that, if everybody loves everybody on the front end you would think that would predict good things on the back end, what happens is people interpret reality
for themselves and that becomes their world, their
reality, their truth, and that’s important, and I won’t know
any of that unless I actually ask questions in a very, very systematic way designed to elicit information to help
me better understand what another persons experiencing, not whether I have some kinda truth-ometer, or I have some kind of standard that you should adhere to, because that’s
just not true. We don’t have advice giving as a part of
professional therapy. We might suggest techniques and
strategies you can apply for yourself, but I’m not gonna tell you what you
ought to do with yourself, Genuineness, you need to be genuine, you
need , you need to come there to that
therapeutic relationship as a therapist, being a totally genuine human being and
that is a hard thing to do for some people. You have to learn how to train yourself.
When you spend one hour, they’re like “man, you got a pretty easy job, all you have to do is listen to people talk all day right?” Try to listen to people talk all day, where you focus intensely on, you ever focus intensely another
person’s conversation for fifty minutes straight? It’s hard. Where you’re not thinking already what you’re going to say next. Where you’re actually listening to everything they say, actually trying to understand everything they say, and you’re putting that into a paradigm
of your own training, making hypotheses and trying to conjecture in what ways you might suggest some kinds of techniques, and strategies to help them help themselves. That takes emotional energy and it takes
attention span that most humans don’t have, right? Most
humans we peek out at about 15 minutes, so to focus on somebody you have to train yourself to do it, you
have to leave your problems at the door, right? And believe me, you’ve got problems, ain’t no therapist that don’t have any problems, right? But that’s not my job, my job is not a
be problem-free and show how people can live a problem-free life, that’s unrealistic. My job is to leave my stuff here, and help you focus on you by being a tool with which you examine your own life, and I have to be real about that, and
people can tell when you’re not being real. They can tell when you’re not being sincere. Unconditional positive regard, that goes
back to when we talked about before, providing a space where you
automatically assume the other person is valuable. You wanna see people devalue human beings get on Twitter! Or get on Facebook. It doesn’t take long
for you see people talking shit about everybody and how they ain’t worth this and they ain’t good enough for that, and they got all kinds of judgments. As a therapist, you don’t do that. You don’t do that. You provide a
unconditional positive regard which says basically this, as a human being meeting
a human being, I assume you have inherent value as a
human being, you may have made bad behavioral choices, which I’m going to reserve judgment on,
because my goal is not to judge you, my goal is to help you. And some people say, “man there’s certain people I just couldn’t work with.” I couldn’t work with an abuser of children, or I
couldn’t work with the rapist, and I couldn’t work… Nobody thinks those are good things.
You’re not condoning behavior, by engaging an unconditional positive
regard the goal here is to what? Have people not do that anymore right? And if they walk in the door and say, well yea I did that, and you go, man, you’re a piece of shit. What’s your odds that you’re gonna help
them not do that anymore? Pretty low. So you would say well I don’t
condone that behavior, in fact I find that behavior abhorrent, that would be inside me and my value
judgment, but my value judgment is not to be laid upon people who come in for help. It’s to be reserved for me and my
personal world while I help somebody else realize that they have within them the capacity to be a good and effective
human being, and to figure out how to activate those
positive choices that prevent them from making a mess of
their own lives, or a mess of other people’s lives. Because that is the goal, it’s not to be a
judge, we have a criminal justice
system with judges and juries. That’s their role. I’m not
saying its not an important role, I’m just saying as a therapist, that’s not your job. You need to know what your biases are, and
your values are. You need to be able to… and if you can’t work with somebody because
what they’re dealin with hits home too close to you, you need to
be able to understand that and refer them to somebody else who can work with them. Being non-directive. That’s a client-centered
approach. The psychodynamic approach is pretty directive. I say you’re going this way because you got
resistance to going that way, I say we outta go that way. Behaviorism, pretty directive. You tell
me the behaviors, I’ll tell you how to analyze the contingencies, how to manipulate them and you’ll do
those things but in client centered therapy, you’re the one coming for help, you tell me what you want to do. You tell
me where you wanna go. One of those kind of cliche questions is, if you could wave a magic wand,and you could do this for yourself, if you could wave a magic wand in your life right now, and make all things perfect for you, what would life be like? What would life be like if everything
for you, within the realm of reality, was perfect? Most people are like, god, I dunno. I never even thought about what life would be like if it was good. I’m just so busy dealing with stuff I
think is bad I’ve never really thought about what it would be like if I overcame the stuff that was bad and
plotted a new course for myself and took responsibility and control back. And empathy, empathy seems to be the biggest factor, maybe up to 40 percent of whether therapy is effective or not is
whether the person coming in for therapy believes that their therapist is
actually empathetic with them. Trying to understand who they are, not
judging them, not just dismissing them, but trying to
really understand what’s going on in their lives, and that’s a hard thing to do because
again, we all have our own issues with attention span, biases, values, etc., etc., to be able to provide genuine empathy. I
can do it people are like, ‘man aren’t you just paying for friendship?’ No. Believe me you can’t be friends with your
client, you can’t go hang out, all those movies where you see people
fall in love with their therapist, those therapist would be fired and prosecuted. You can’t do that. You can’t get in
relationships with your therapist. It’s unethical, and illegal. Right? You can’t do it. Do people ever do it? Yes. That’s how we got those ethical
codes to begin with, because its damaging to the person who comes in, and it’s totally inappropriate. So all that
fantasy stuff aside, you gotta look at this and go, “well It’s not a friendship that I’m buying.” It’s a service I am engaging to help me
understand myself better and to do that I need to have somebody who’s trained to help
me work through my issues, because that will help me like a coach
helps an athlete, not because they’re going to work magic, not because they’re going to make you better because they won’t. But they’ll provide a space in which you can help yourself become more effective at living a life
you’d like to live and empathy is key to that. So can I really empathize with anybody who walks in the door? Absolutely. I have a total of philosophy that every human being is valuable. Period. And so my time with them is
valuable. Even if it’s once. I have conversations
with students every semester. Sometimes for one hour or two hours, when
they’re in distress and I help find, help them find resources that might help
them, and then a year goes by, I may not even remember that conversation. Does that make it any less genuine in the two hours I spent with them where I was focused nothing on nothing but them? No. My memory
limitations aside, what I’m saying is anybody who wants to
help other people can be trained to do so in a variety of
professions, in fact any health care profession, people should
have some kinda background in mental health. At least a little bit of training because
guess what you’re going to encounter in the health professional world? Issues. Issues, Issues and they matter.

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