Come as You Are — Become what You Are

Today, I'll shed light on a quiet, composed, yet significant transition that took place in the mental health world in the 20th century. A shift from the term 'patient' to 'client'. You probably didn't notice. This term was first introduced in therapy by Dr. Carl Rogers, transforming the therapeutic dialogue in significant ways. Rogers' belief in the goodness of persons, including those troubled psychologically, was first shared in the 1960s through humanistic psychology (Rogers, 1961; Rogers, 1963), an area of psychology that firmly recognizes each person as a seedling of possibilities, in the right rain and shine. This was a time when therapy was strongly prescriptive. In other words, the predominant approach in therapy at this time entailed a patient seeking help from a therapist who then, almost blindly, followed the 'doctor's advice' to fix their mind. An approach in psychology that is often contrasted with the Rogerian approach is psychoanalysis, which has its own wonders. However, in the psychoanalytic approach, the person seeking help is almost always seen as oblivious to their own problems given the emphasis on the unconscious. Even now, some may argue, what's so wrong with a prescriptive therapeutic dialogue? An expert giving advice to the person in peril makes perfect sense -- for a cold perhaps, not necessarily for knowing the inner impediments and the entire psychological story of another human being.

The therapist's role is mainly to generate a climate of interaction that can make a person express themselves genuinely and without fear, of judgement or of any poor consequences later. For this reason, Rogers used to spend a lot of time listening like a sounding board -- mainly to gather knowledge about the client to learn what they understood about their condition already. Trust followed inevitably because once their inner world was welcome in the space of therapy, as a therapist you knew the problem(s) to address. Even good therapists and those seeking therapy for a long time know, a therapist may be the best in town in intellect and knowledgebase. However, if you don't know where the problem resides, no progress will follow leaving the client and the therapist questioning each other. Both may see each other as stunted in ability. Not to mention the lost lot of some people who lament about how therapy messed them up even more. You'd be surprised how much clients already know about their well and less known psychological issues. They probably just need to visit the right therapist, not necessarily the most knowledgeable one in town.

I'll highlight some of the main strokes of Carl Rogers' Person-Centered approach to therapy, which still hold importance today. To understand some of this in his own words, you can see this video. Some of the key features of Carl Roger's therapeutic environment encourages:

-being transparent and real,

-anticipating feelings that'll come into the conversation,

-introducing compassion whenever apt,

-showing interest without sharp judgement,

-being yourself in the conversation even when just listening, and even if worried, with occasional affirmation of your understanding about the words expressed,

-seeing the client as human as them but still a different person, in their responses, beliefs, feelings, and set of experiences, and

-the possibility of introducing another therapist if you know you won't be able to empathize or even understand the client well.

Once a stage of unconditional positive regard is set, the therapist has won half the battle. Why? Because the therapist's main task is to not complete a checklist in a state of vigilance. The therapist's task is to make the client's world safer to them with acceptance and transparency after which a person becomes a person-in-progress, and the work begins.

References

Rogers, C. R. (1963). Toward a science of the person. Journal of Humanistic Psychology, 3(2), 72-92.

Rogers, C.R. (1961). On becoming a person. Houghton Mifflin.