Nearly a quarter of a century ago the groundbreaking psychologist Carl Rogers, then 83, was recorded answering wide-ranging questions from a professional audience. Listening to the recording now, it’s remarkable how little some things have changed over the years.
The conversation hour with Carl Rogers was part of the first Evolution of Psychotherapy conference, which took place in Phoenix, Arizona, in December 1985. The conference organizers, The Milton H. Erikson Foundation made the recording available in connection with their most recent conference in the series last month, and you can listen to it here:
Also participating was Carl Rogers’ close collaborator, Ruth Sanford, whom I do not quote here, but who made a significant contribution to the conversation.
Relationship, understanding and change
Several questions led Rogers to reiterate his core beliefs about the way psychotherapy works. One, right at the start, was about the relationship between understanding — a client being understood by a therapist — and change in the client. Part of Rogers’ reply was to re-state the very basis of his approach to therapy, combining understanding with acceptance (1:50):
Often we go around feeling that, “No one can really understand me — I’m too complex, or I’m in too much trouble, or I’m too different.” And when we find that someone truly understands, and along with that understanding is acceptant…then I think that’s a very releasing feeling, and we’re able then to move ahead.
A later question brought up the contrast between traditional (1940’s in the context of the question) psychotherapy based on techniques applied to the client, and more modern psychotherapy based on the client’s inner process (25:30):
I feel that therapy is a relationship, and the quality of the relationship is what is going to be helpful or not helpful, and that to be “very professional” and use different “techniques” with different clients seems to me goes quite a long ways toward destroying the possibility of a real growthful experience for the client.
Medication, sympathy and behaviour therapy
Some questions concerned treatments that do not necessarily work. One was about the use of medication (9:35):
I personally feel that that is a greatly overrated procedure. I felt that when we were working with schizophrenics in a psychiatric hospital, that medication was very good for the staff [laughter] because it helped keep people calm, and not so troublesome, but I doubt very much that it was of help to the patients.
Another question concerned nurses whose sympathy for patients makes them ‘buy in’ to a patients’ illness, thinking that they are being empathic, when really they are helping to maintain the illness (26:45):
[when] nurses buy in to the patient’s illness, that’s not empathy. That may be sympathy, it may be identification, but it is not empathy, because empathy is entering into the other person’s world and really understanding it — but not losing yourself…
…identifying with the patient, and feeling over-sympathetic and so on, I can well imagine that would keep patients in the hospital when they should be out, would make them dependent when they should be becoming independent. I can think of all kinds of unfortunate results of that.
And another question was about the way psychotherapy is taught to students by academics, who seemed generally to favour behavioural approaches over person-centred approaches (39:18):
Behaviorism, and the behavioristic approach, is very congenial to the American professional mind at the present time…it seems very natural to a lot of people to think that we can have a technology of human beings…
…it takes deep root in universities partly because that’s a very safe kind of approach to use — you don’t risk yourself. You apply a technology to other people, remaining personally remote from them. If you deal with other people as human beings, and enter the relationship as a human being yourself, then you take the risk of being changed. And my experience of academic personnel is that they do not like the risk of being changed. [laughter and applause]
Some questions led to personal disclosure by Rogers. One was from a man who was about to travel to China, and who worried about his ability to be of help there. Instead of specific advice (though Rogers had himself travelled extensively in China), the reply was a much deeper personal philosophy (14:55):
There is one statement, or…it’s almost a sort of a slogan for me, that I developed a number of years ago to help me deal with situations where I felt quite inadequate…”What I am is good enough, if I can only be it openly” …
I think it’s when we try to cover up, when we try to be more than we are, try to put on a front, try to pretend that we’re something we’re not — that’s when I think we make mistakes in dealing with situations…”
And another question concerned Rogers’ experiences and thoughts around the death of his wife, which prompted a very moving story and a statement of personal philosophy that I’ll not try to sum up in a quote, but let you listen to yourself.
What has the profession learned?
For a final quote (though I have by no means cherry-picked all the best bits from this fascinating hour), there was a question half-way through about how things had changed for the profession over the previous 100 years — is there anything we have really learned? (31:30)
As to what we have learned…I don’t know what the profession has learned, I really don’t.
I’ve learned to be more human in the relationship, but I’m not sure that that’s the direction the profession is going.
Looking back over nearly another quarter century since Carl Rogers spoke those words, they seem still to be true. Medication, disempowering sympathy and behavioural approaches to therapy are still failing patients. Academics still promote them.
Learning to be more human is still not the direction the profession is going.