Tag: client-centered therapy

The Gloria sessions

Posted in Humanistic Psychology, psychology, psychotherapy, rational thinkingLeave a comment

I’ve written posts about my education as a psychotherapist in the humanistic psychology program at the University of West Georgia, and my exposure to a variety of therapeutic modalities. These included Rogerian (client-centered), gestalt, and cognitive behavioral therapy. I remember watching a videotaped film titled “Three Approaches to Psychotherapy” that I’ve always thought of as “the Gloria sessions.” For many years this film was only available for viewing by professional therapists, faculty, and students of psychotherapy; but now all three sessions can be viewed on YouTube.

In 1965 a courageous young woman named Gloria – a divorced single mother – agreed to be videotaped in brief therapy sessions with three of the most influential American psychotherapists of the twentieth century: Dr. Carl Rogers (client-centered therapy), Dr. Fritz Perls (gestalt therapy), and Dr. Albert Ellis (cognitive behavioral therapy). Watching the sessions again, I was reminded of Gloria’s courage and candor. The production quality isn’t always good and following the Perls  session takes concentration, due both to poor sound quality and Perls’ thick German accent. But if you want to see three masters of psychotherapy at work, this film is a treasure trove. Their approaches to working with Gloria are very different.

In each segment, the therapist briefly describes his approach to therapy, then works with Gloria, then comments on the session. In the first segment Carl Rogers says that if the therapist can establish certain conditions in relating to the client, “therapeutic movement” will predictably occur. The first condition is genuineness, and the second is congruence – meaning that your non-verbal communication is congruent with your verbalizations. The third condition is transparency , meaning that the therapist hides nothing and can be easily “seen through.” Rogers states that if these three conditions exist, and the therapist can be in tune with the client’s “inner world” (how she experiences herself in the world) insights and growth will follow.

During the session Gloria keeps trying to get Dr. Rogers to give her advice about making a decision, and dealing with guilt feelings related to the decision. He never accedes to her request, but keeps accurately reflecting on what she’s saying, allowing her to eventually take ownership of the issue, and to trust her own judgment. (Contrary to popular belief, good therapists seldom or never give advice.) Rogers is comfortable with silences, and at one point asks, “What do you wish I’d say to you?” She gets it. In his commentary, he remarks on how her “then-and-there” orientation at the start of the session quickly becomes a “here-and-now” focus. He highlights the “I-Thou” quality of their experience, rejecting Freud’s intellectual concept of transference/counter-transference in favor of Martin Buber’s term for authentic relating. He concludes, “Gloria and I really encountered each other” and says he thinks that both of them benefitted from their brief encounter. Watching again, I can’t help but agree.

Perls puffs on a cigarette while he describes gestalt therapy, and Gloria lights up at the beginning of the session, admitting that it’s a response to anxiety. In his introduction Perls, like Rogers, endorses the I-Thou relating essential to the therapeutic relationship, and the idea that therapy should not dwell on the then-and-there, but should always focus on the here-and-now of direct experience. He states that a gestalt therapist never offers interpretations, but provides clients with experiential opportunities to discover things about themselves, often by interrupting the client’s verbalizations and calling attention to automatic behaviors that the client is usually unaware of. Early in the session Perls labels some of Gloria’s behaviors as “phony” – which has a specific meaning in gestalt therapy. She’s initially bewildered and angry, feeling judged. She’s very defensive, but Perls doesn’t back off, and Gloria appears to catch on to what he’s saying by the end of the session. He was never judging her; he was giving her an experiential lesson in her automatic, typical defenses. It’s known in gestalt therapy as “being on the hot seat.” It was Perls who wrote what became known as the Gestalt Prayer, which starts with: “I am not in this world to live up to your expectations and you are not in this world to live up to mine.”

In his introduction, Albert Ellis expounds upon the notion that – contrary to Freudian psychodynamic theory – the past isn’t the primary determinant of present-day distress or dysfunction. The past may have a role in its formation, but it’s present behaviors that maintain the problem – specifically, the irrational things we tell ourselves about our experiences and their consequences. As I’d remembered, Ellis came across like the  stereotypical pushy, fast-talking New Yorker, but his words were precise and logical. In his short session with Gloria he manages to convey the principles of rational thinking, by applying them to Gloria’s anxieties about dating and seeking a life partner. She appears to grasp the notion that she makes undesirable situations worse by catastrophizing. “Don’t beat yourself over the head or convince yourself you’re a no-goodnik, just because you didn’t get the outcome you wanted.” He explained how he gives his clients behavioral homework assignments to complete between sessions, and suggests that Gloria should set up opportunities to take some small risks, instead of holding back in social situations. Its a behavioral technique called exposure, and Ellis was one of its early proponents.

When I first saw “Three Approaches to Psychotherapy,” I remember that there was a brief interview with Gloria after the sessions; but I wasn’t able to find it online. As I recall, Gloria said that she liked Carl Rogers the best, and learned some valuable things from Albert Ellis; but her session with Fritz Perls was the one she most benefitted from. If you don’t understand the basics of gestalt therapy, what Perls says and does in the session won’t make much sense. It shook Gloria up; but that’s what good gestalt therapists do, and Perls was one of the best. I highly recommend the Gloria sessions to social science students, psychotherapists in training or practice, and people who want to know more about psychotherapy.

Little did I know when I first watched the film that I’d actually meet Rogers and Ellis. I’ve already written about my brief meeting with Carl Rogers. In a later post I’ll describe my encounter with Albert Ellis.

Client-centered therapy and active listening

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Dr. Carl Rogers’ client-centered therapy was one of the major therapies within the human potential movement. I had the good fortune to meet him briefly when he was the keynote speaker at a convocation of the Association for Humanistic Education, held at West Georgia College (now the University of West Georgia) in 1976. I’d just listened to his address and then joined my ex-wife, Doris, who was selling her hand-crafted jewelry from a blanket on the lawn outside the education building. Dr. Rogers came out of the building and Doris’ display caught his eye. He was being escorted by a faculty member, but stopped to look. I can’t remember anything that was said between the three of us, but I was in awe of the man and couldn’t believe I was actually talking to him. He bought a piece of Doris’ jewelry as a gift, so I’ve subsequently made the claim that Carl Rogers helped put me through grad school.

Rogerian therapists don’t make analytic interpretations, or provoke authentic responses, or recommend goals to the client. Goals are established by the client, who does a lot more talking than listening in therapy sessions. A good Rogerian therapist is an active listener, who strives to understand the client’s sense of self, interpersonal boundaries, and experience of being-in-the-world by carefully listening to his words. The therapist might ask clarifying questions, but mostly listens. Actively.

After listening to a detailed account of a client’s issues with her dominating mother, the therapist doesn’t respond with an interpretation, but reflects on his understanding of her experience. “It sounds like every time you’re around your mother you end up feeling angry and worthless. I also heard you say that you keep having intrusive thoughts about your mother dying in an accident, and you feel terribly guilty about having these thoughts.” If the therapist has accurately and non-judgmentally reflected the essence of what the client was trying to express, this usually promotes increased trust and a fuller disclosure on the subject at hand. When the therapist is on the mark, the client knows that the therapist cares, listens carefully, doesn’t judge him, and seems to understand. If the therapist misses the mark, the client will usually let him know right away.

Often in everyday life we only give part of our attention to what others tell us, or are distracted by our own thoughts or reactions. Listening is often a passive act. Active listening means giving our full attention to what we’re being told, without allowing our thoughts to distract us. It’s a kind of mindfulness. In a different arena, music appreciation, certain kinds of music demand more of the listener than others. To fully appreciate chamber music, or a sitar raga, or jazz by Coltrane, you have to quiet your own thoughts and give your full attention to the music. In the interpersonal arena, sometimes we need someone who cares enough to listen actively when we have something important to say, whether that person is a therapist, a pastor, a spouse, a family member, or a trusted friend.

Active listening is a learnable skill. I started learning it in grad school. Even when I was working in a therapeutic mode other than client-centered therapy, I was an active listener. I’ve always believed that I owed it to each client to give them my full attention. Sometimes I’d do a brief meditation between clients, to clear my head. Like most things, you learn active listening by practicing it. You have to learn to suspend your own thoughts, and you do that by simply noticing any thought that intrudes on your active listening. Like a stray cat, if you don’t feed it, it goes away. Focus on listening without judging. You can practice listening actively to classical music or jazz, too. Learning to listen actively to complex music is its own reward. Active listening gets easier with practice.

When a parent would come in complaining that their child used to confide in them, but stopped, I’d coach them in active listening and non-judgmental reflection. When a child feels understood and validated, she develops higher levels of  trust and is more willing to talk about what’s important in her life. Learning to be an active listener will give you a tool that some therapists use to establish trust and encourage disclosure. It will make you a better parent, friend or spouse. When you listen carefully and reflect back what you’ve heard accurately and non-judgmentally, the person you’ve been listening to knows that (1) you care enough to (2) really hear them (3) without judging them and (4) you seem to understand and accept what they’re going through. Everyone (other than sociopaths) wants to be understood and validated, and you can help people you care about feel accepted as the unique person they are. In terms of personal growth, Carl Rogers  taught that self-acceptance is the fertile ground in which the seeds of growth can flourish.