Person-centred and Experiential Therapies: a remarkable variety Symposium PCE Europe Prague April, 27, 2014 Gerhard Stumm, Vienna Gerhard Stumm Paradigms in psychotherapy humanistic psycho- dynamic existential CBT systemic integrative PCT 2 Pluralistic tradition in history of PCT • psychoanalytic roots: Otto Rank, Jessie Taft (“relationship therapy“), Frederick Allen, Virginia Robinson, (Elizabeth Davies), (Karen Horney) • cathartic and expressive aspect: play therapy, (Psychodrama) • pragmatism: James, Dewey • phenomenology: Snygg, Combs • Gestalt psychology: Wertheimer, Köhler, Koffka • Humanistic psychology: Maslow • organismic theories: Goldstein, Angyal • encounter philosophy: Buber • existential philosophy: Kierkegaard, Sartre, Tillich Gerhard Stumm 3 orthodox/traditional client-centred/person- centred orientation various sub- orientations experiential orientation Classical Client- Centred Therapy (CCT) (‘non-directive’) relational / dialogic orientation (incl. Relational Depth) interactional (interpersonal) existential disorder specific (incl. Pre-Therapy) creative (Expressive Arts) integrative (Motivational Interviewing) Focusing- oriented Therapy Emotion-Focused Therapy (EFT) Overview of Person-centred and Experiential Therapies Gerhard Stumm 4 Tribes of the Family Gerhard Stumm CCT RD FOT EFT MI existen- tial. Pre- Therapy integrative disorder- specific PCEAT IP FOT= Focusing- oriented Therapy EFT= Emotion Focused Therapy MI= Motivational Interviewing CCT=Classical Client-centred Therapy PCEAT=Personcentred Expressive Arts Therapy RD=Relational Depth IP=Interpersonal 5 Classical Client-centered Therapy (CCT) • trust in the client‘s self-governing and growth capacity (actualising tendency) • ethically based  non-authoritarian, no coercion and power over the client • (principled) non-directivity (non-experiential) • “non-diagnostic mindset“ (Brodley) method: core conditions and their implementation & perception by the client are sufficient for constructive change of the client  relational climate counts Gerhard Stumm 6 PCT as dialogical approach • a tradition that has started with the late Rogers • from a “de-personalized“ therapist (Rogers, 1951) to one who involves and expresses him-/herself transparently (e.g. Rogers, 1980) • from therapist as “alter-ego“ to being the “other“  being with and being counter to the client  “twoperson-centred therapy“ (co-presence) Gerhard Stumm 7 Peter Schmid (*1950) Wolfgang Pfeiffer (1919-2011) Dave Mearns (*1947) Mick Cooper (*1966) Relational Depth • term coined by Dave Mearns (1996) • “A state of profound contact and engagement between two people, in which each person is fully real with the Other, and able to understand and value the Other’s experiences at a high level’’ (Mearns & Cooper, 2005, p. xii). • based on the fundamental need for relating deeply (more than need for UPR) • method: spontaneous and active participation of the therapist to foster an intense meeting and connection with the client  more than actualising core conditions  self of the therapist as “developmental agenda” Mearns, C. & Cooper, M. (2005). Working at relational depth in counselling and psychotherapy. London: Sage. Gerhard Stumm 8 Critique of RD • Sue Wilders: missing unintentionality  directive • Keith Tudor: depreciation for “superficial’’ experiencing  offending the principle of horizontalisation (all phenomena are equally to be regarded positively and unconditionally) what is depth and what is surface?  diagnostic expertise Gerhard Stumm 9 Existential Existential Humanistic/person-centred • struggle between polarities: limitations and tragic side growth and optimism of existence (e.g. death, transitoriness) and potential • freedom to … freedom from … • permanent choices trust in the actualizing tendency • immanent tensions and contin- conditions of worth gency (“there is no cure for life“) • future bound here and now • meaning self-actualisation • challenging/confronting facilitating Gerhard Stumm 10 Interpersonal orientation • van der Linden, van Kessel, Lietaer • reason for incongruence: interpersonal level • exploration of the client‘s relational patterns is primary (vs. self-exploration) method: • non-complementary (“a-social“) responses of therapist • meta-communication about the client-therapist interaction goal: corrective relational experiences Gerhard Stumm 11 disorder-specific • mainly in the Netherlands, Belgium, Germany, Austria, Switzerland • differentiated clinical knowledge & “disorder specific understanding“ is thought to be necessary, especially when working with severely disturbed clients  as cornerstone for empathy and UPR Teusch, Speierer, Binder, Greenberg, also Prouty‘s Pre-Therapy Gerhard Stumm 12 Jobst Finke (*1937) Hans Swildens (*1924) Pre-Therapy • work with contact impaired people (psychotic, autistic, dissociated, dementia, mentally retarded, brain injury, …) = pre-experiencing, pre-expressive • method: contact reflections of concrete client behaviour and his environment: Word for Word, Facial, Body, Situational, Reiterative Reflections to develop or restore awareness of phenomenal field (world, self and others)  contact functions: reality, affective & communicative contact Gerhard Stumm 13 Garry Prouty Jill Prouty (1936-2009) Creative Therapy • Expressive Arts Therapy by Natalie Rogers drawing from theory of creativity“ by her father specific method: “Creative Connection“: dancing, (Authentic) movement, music, sound, drawing, painting, journal writing, meditation, … as channels of the healing process  intermodal approach • Liesl Silverstone (England) • Norbert Groddeck (Germany) five steps: Felt Sense, “invitation to action“, reflecting the product, felt shift, transfer Gerhard Stumm 14 Natalie Rogers (*1928) N. Groddeck (*1946) Focusing-Oriented Therapy • Experiential therapy • relationship quality and experiencing • Felt Sense as compass: “whatever is said and done must be checked against the concretely felt experiencing“ (= direct reference, implicit, pre-conceptual, intricate)  felt shift • self as process  structure bound • Listening, Guiding, Response (more than 6 steps-modell) • process-directivity (Focusing “instructions“ = invitations) Gerhard Stumm Gene Gendlin (*1926) 15 Emotion Focused Therapy • elaborated by Leslie Greenberg (drawing from Laura Rice), Robert Elliott, Jeanne Watson (former: process-experiential) • combination of PC, Gestalt, Focusing, existential • emotion theories & dialectic constructivism • emotions are primary (not experiences, as Rogers and Gendlin have assumed): „You can‘t leave a place before you haven‘t arrived there“ • primary adaptive vs. maladaptive emotions • modification (transformation) of emotional schemata • markers and tasks (process-directive) Gerhard Stumm 16 Les Greenberg *1945 Emotion Focused Therapy Greenberg, L. S. (2011). Emotion-focused therapy. Washington, DC: American Psychological Association. Gerhard Stumm 17 Motivational Interviewing (MI) • focus is on the motivation for change (“80% Rogers”), clients are always motivated for something (natural process) • humanistic philosophy • dealing with ambivalence (change vs. resistance) • empathic listening  change talk (urgency, ability & commitment for change) • motivation-centred, change-centred, problemcentred, directive in terms of facilitating change Miller, W.R. & Rollnick, S. (2002). Motivational Interviewing. Preparing people for change. 2nd ed. New York: Guilford. Gerhard Stumm 18 integrative Gerhard Stumm • The questions are: what is integrated? How systematically is this done? On what level? Consistent? • first vs. second order integration: integration of elements of different suborientations, above all person-centred and experiential vs. integration of elements of other schools 19 Germain Lietaer (*1939) Wolfgang Keil (*1937) Art Bohart (*1943) Mick Cooper (*1966)