Thursday, June 19, 2008

Idling With Ivor 8

The Essence of Psychotherapy

Carl Rogers, a pioneer in counselling and psychotherapy maintained that therapists, counsellors or helpers need to communicate to the client/patient  three basic qualities, viz., Empathy, Warmth and Genuineness. The first quality is hard to define, but the person being helped will pick up very quickly whether the therapist is able to show real empathy - the ability to place oneself as near as possible "into the shoes" of the client as it were. Empathy, says Rogers, is the ability to enter the world of another person "as if" it were your own so that you can better understand what it is like to be that person in need of your help.  The second quality warmth is a little easier to explain. Rogers also called this quality "unconditional positive regard," and by this he meant that he wished that all counsellors and helpers to "prize the person" seated before them - to respect people for who and what they are, for their uniqueness and for their individuality.  In short the counsellor or therapist shows a warmth that indicates an acceptance of them.  Lastly he stressed the quality of genuineness.  Some writers refer to this quality by two other terms called "authenticity" or "congruence."  The best way to describe this last quality is  to regard it as open communication.  The posture and body language of the therapist or counsellor reflects what he is saying or communicating.  The counsellor is truly himself or herself - "what you see is what you get" or "it does as it says on the tin" would be appropriate metaphors for this quality.

Returning to Ivor Browne's wonderful memoir the first three chapters of Part 6 are three scientific or intellectually phrased and argued chapters - more like chapters from a university extended essay than from a memoir.  Nevertheless, they are significant and important as they explain the intellectual base for his growing understanding of a new living system's approach.  This meant a holistic approach to everything and everybody as we are all part of a nexus of interrelated beings: "...we are formed out of the matrix of relationships and environmental influences that we absorb from the moment of conception onwards." (Op. cit., 254)  In these three chapters Ivor rails against the pure impersonal thrust of all modern sciences, namely that of reductionism. (Ibid., 228-254 passim).  Chapters 30 and 31 are wonderful as they deal with (i) his considered thoughts on therapeutic practice and (ii) the Phyllis Hamilton and Father Cleary debacle respectively.

Once again at the beginning of his chapter on his therapeutic practice Ivor nails his colours to the mast.  One can only respect his enthusiasm and commitment to improving the lot of everybody whom it was his privilege to serve:

Back in 1962 when I returned from the States and started the psychiatric clinic in Ballyfermot, I had reached an existential point.  Either I would have to put my head down and just dish out tranquillisers to all and sundry, or else I would have to address the manifold social problems that were having a devastating effect on people's lives.  I became convinced that, behind the presenting symptoms of anxiety, depression and so on, lay the tortured traumatic life histories of the persons concerned and the environmental problems generated by poverty and social disorganisation.  (Op. cit., 255)

I find Ivor brilliant on the "therapeutic relationship" between psychotherapist and the patient:

...this is a real relationship, like any other, between two human beings.  But it is not simply that; it is a relationship established with a purpose, which is to help a client with their problems.  Therefore, there also has to be objectivity and the relationship has to be managed.  I feel there is considerable confusion about this amongst psychotherapists.  When it is said that therapy should be non-directive, this is essentially correct.  It is generally useless to tell a person what to do, or to do it for them.

Nevertheless, the therapy has to be managed.  If the client is left to feel and behave as they have always done, they will control the therapy and there will be no change.  There is an apparent paradox here.  What is often misunderstood is that it is the task of the therapist to manage the context of the therapy; that is to manage the boundary of the relationship...  (Ibid., 272)

This quotation merely gives a flavour of Ivor's insights into the psychotherapeutic relationship and I must direct you to read in full  Chapter 30 to understand what he means by "managing the boundary of the relationship."

Another scene from Donabate Beach - this time a rather ominous cloud!

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