what is humanistic psychotherapy?

HUMANISTIC PSYCHOTHERAPY

What is Humanistic Psychotherapy?

John Rowan

ABSTRACT. This paper attempts to outline the identity of the humanistic approach topsychotherapy. It does this by laying out certain characteristic themes of humanisticpsychology as background, and then going on to discuss the person-centred approach,psychodrama and Gestalt therapy, experiential psychotherapy, body work, catharsis, thetranspersonal, integration and training and development. It ends by stating theboundaries with neighbouring disciplines.

The first humanistic psychotherapist was J L Moreno, who was working in Viennaabout the same time as Freud. His work was taken up by other humanisticpyschotherapists from the 1950s onwards (Brazier 1991) and integrated into the field asa major influence. But most of present-day humanistic psychotherapy owes as much tothe more general theory of humanistic psychology developed by A H Maslow andothers. It may not be appreciated that the first journal (Journal of HumanisticPsychology) came before the first encounter groups (Schutz 1973) - so it will beworthwhile to step back a couple of paces to see what humanistic psychology is, andwhere it comes from. It started as a world movement in the 1940s and reached its fullflowering in the 1970s. This was the time when the literature and the group work, socharacteristic of the humanistic approach, became most prevalent. It was in 1973 thatthe journal The Humanistic Psychologist was launched by Division 32 of the AmericanPsychological Association, and in Britain Self & Society started to appear.

Today it is consolidating itself and becoming more widely accepted. For example, inthis country the Humanistic and Integrative Psychotherapy Section is the second largestin the UK Standing Conference for Psychotherapy, with fifteen members in 1991 andanother four due to be added in 1992. In this and other ways it is now part of the mainstream rather than being something new and unfamiliar (Rowan 1988). It has changedits name several times, having been called `third force psychology' (Goble 1971) - theother two being psychoanalysis and the behavioural-cognitive approach; the `self-awareness movement'; the `human potential movement'; and `personal growth'. Today itis less of a movement and more of a tendency or approach within the broader context ofpsychology. Its strongest value was and is the full actualisation of the self. Its best-known theorist was A H Maslow (Maslow 1987), an academic psychologist who laterbecame President of the American Psychological Association. Later came C R Rogers (Rogers 1990), another President of the APA, C Buhler, R Assagioli, F S Perls, V Satir,K Goldstein, S Jourard, R May, C Moustakas, I Progoff, J Houston and others.

A characteristic of this approach to psychology is the stress upon personalexperience and upon reflexivity - that is, that the practitioner needs to have beenthrough the same experiences which he or she is explaining or offering to others. It isnot enough to know something at a head level; whatever we know needs to be known at

John Rowan is an Independent Practitioner. Address for correspondence: 79 Pembroke Road,Walthamstow Village, London E17 9BB.

British Journal of Psychotherapy, Vol 9(1), 1992© The author

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a heart level and a gut level as well, if the knowledge is to be fully human. So there is anemphasis on experiential learning, not only at the level of words, but at nonverbal levelsas well. Because it is not enough to read about this in books, a unique kind of institutionwas set up, called a growth centre. This is not a training centre but a place where people,whether or not they are sick or troubled, are encouraged to meet others and meetthemselves (particularly through group work) in an atmosphere which enables them toopen up and be trusting enough to leap forward in self-understanding and humanrelationships. Today there are fewer growth centres because experiential learning andreflexivity have entered more into the main stream, in counselling courses (Nelson-Jones1982), educational initiatives (Hammond et al 1990), management training (Huczynski1983) and so forth. Most courses which teach about communicating with other peoplenow include some emphasis on understanding oneself, and humanistic psychology isparticularly suitable here, because of its very direct way of dealing with such matters.

Because the pioneers of humanistic psychology were independent people, there is nosingle theory, though there are consistent themes which run through all of them.

Being All Right

This is the first theme. Deep down, underneath it all, where it really counts, peopleare all right. (Some would say OK, or fine, or neutral, though not good, because thatexcludes the idea of evil and therefore goes too far.) This contrasts with those theories (Freud with his Id, Skinner with his innate susceptibility to reinforcement, Christianismwith its Old Adam) which say that people are fundamentally bad, or untrustworthy, likebad animals. It hardly seems necessary to quote references for this point since the basicdualism of these theories is well known to all of us.

This does not mean that people are not sometimes destructive, or that there is no evilin the world. It means that if someone will agree to work on his or her destructive actionsor evil wishes, in an atmosphere of trust and acceptance, that person will discover thattheir personal evil and destructiveness are just as phony and forgettable as the personalniceness of other people, which apparently causes no problems. In other words, personalnastiness and personal niceness are most often masks and illusions, put on for reasonswhich seemed good at the time, but which have become stuck, rigid, and out of ourcontrol. By working on ourselves to unstick the rigidities and compulsions, and loosenthe mask, we may eventually learn how to live without needing masks at all - though itmay still be useful to put one on occasionally, like a dress suit or an evening gown. Thisis very different from any theory which says that we must always retain our defences ingood working order, because underneath we are uncivilised and primitive.

This point is sometimes misunderstood and misheard so that it sounds as ifsomething too optimistic is being said. But some, such as Lake (1986), Grof (1988) andBoadella (1987), work at very deep levels of the unconscious mind, where the enormousweight of feelings such as hate, spite, envy, revenge and rage sometimes seemsoverwhelming and not to be underestimated.

Some psychoanalysts, such as Winnicott, Fairbairn, Guntrip, Balint and Horney, hadsimilar views. They influenced Lake, for example, in his work on the schizoid andhysteric positions, and depression. His independent discovery of some of the Kleinianfindings gives strength to both sides.

76 British Journal of Psychotherapy

Emphasis on the Whole Person

It is said (Valle & von Eckartsberg 1981, Vaughan 1986) that human beings exist onat least five levels - body, feelings, intellect, soul and spirit. We have to do justice to allfive in all our efforts at realising human potential. If I want to be that self which I trulyam, then I have to be it on all five of. those levels - I must not leave any one out. Todaythere is more interest in the body - diet, exercise and so on - but much of that interestseems external. It is as if we were supposed to be outside our bodies, disciplining themand making them do things, sometimes under protest. The humanistic approach is to saythat I am my body. If you touch my hand, you are touching me. So I am just asresponsible for my body as I am for my thoughts, feelings, desires, mental pictures orwhatever - it is me doing it. This total responsibility for our own bodies, perceptions,feelings, desires, ideas and intuitions is characteristic of humanistic psychology, andtheoreticians like A R Mahrer (1989), F S Perls (Clarkson 1989) and W C Schutz (1979)have made it clear how this works. This is similar in some respects to the thinking ofJung and some of his followers, (e.g. J Hillman, M Watkins, R Johnson, A Samuels),who are concerned with the whole person in this sense.

Emphasis on Change and Development

Human beings are seen not as static victims or villains, but as people in a process ofgrowth, which is natural and needful. All through infancy, childhood and adolescencewe undergo substantial changes, involving our most basic attitudes and how we seeourselves. Maslow (1987) said that we grow through six levels of development, and hisrather speculative theory has now been confirmed through the work of people likeKohlberg (1984), Alderfer (1972) and Loevinger (1976). This process can continue, ifwe let it, into adulthood, too. We have all seen people we recognise as being furtherahead than us, more complete, more evolved, more themselves. Humanistic psychologysays that we could all continue to grow if we did not limit ourselves and sell ourselvesshort. All the methods used are part of a process of unhindering and unfolding, designedto enable us to take off our self-imposed and society-imposed limitations, and continueto grow into our full potential as human beings. The way in which this differs from otherapproaches is mainly in the higher ceiling which the humanistic approach postulates.Instead of simply aiming at enabling people to love and to work, or to make theunconscious conscious, or to exchange hysterical misery for ordinary unhappiness, or tocorrect aberrant behaviour or automatic thoughts, humanistic psychotherapy envisagesthe possibility of becoming a fully functioning person, along the lines suggested byMaslow (1987). (People are sometimes damaged in ways which have to be dealt with ontheir own account before the person can open up enough to start growing again.) Thiscomes close to the Jungian idea of individuation (von Franz 1964), which says many ofthe same things, and has warnings about such things as ego inflation.

Abundance Motivation

Most other psychologies say that our actions are motivated by deficiency. We maylack food and look for it, or lack safety and look for it, or lack company and look for it.This is to treat people as if they were something like a thermostat, only acting whensomething moves them outside their proper limits. We also have a need for varied

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experience (Fiske & Maddi 1961), a need to satisfy our curiosity (Krech et al 1969) anda need for achievement (McClelland 1961). We have a creativity which takes us out ofthis deficiency-oriented realm into an adundance-oriented one. When we seek to realiseour potential, we are not repairing some deficiency, we are entering a world where beingcan sometimes be more important than having or doing.

The Spiritual

This begins to sound almost religious, and it is one of the characteristics ofhumanistic psychology which distinguishes it from secular humanism, that it has a placefor the spiritual. This is important to understand, because humanistic practitioners areoften loosely called `humanists', and the confusion is quite understandable. Secularhumanism, as represented, for example, by the British Humanist Association, is milesaway from humanistic psychology, having no place in it for spirituality. Maslow (1970)laid great stress on peak experiences and the experience of transcendence. A peakexperience is one of those times, experienced by many millions of people (Hay 1990),when pretence and fear seem to drop away, and we seem to be in touch with the wholeuniverse. It is a timeless and ecstatic moment of intense feeling, which comes to somepeople when they see a sunrise on a mountain, or hear great music, or look at a child, ormake love, or experience a religious ceremony. Freud calls one version of it the `oceanicexperience'. It is more correctly called casual extraverted mysticism (Horne 1978), and iswithin the reach of all of us. Humanistic psychology is interested in studying this kind ofphenomenon and seeing how it can sometimes change a person's life. Some humanisticpsychologists became so interested in the transpersonal - the more spiritual aspects ofpsychology- that a separate Journal of Transpersonal Psychology was set up.Transpersonal psychology is sometimes now called the `fourth force'. There are fourtraining organisations now in London alone for teaching this form of psychotherapy.

Humanistic Psychotherapy

Person-centred

Virtually every course in psychotherapy or counselling nowadays makes copious useof the work of C R Rogers (1990), particularly his idea that there are certain `coreconditions' of successful psychotherapy, which have to be observed by anyone - of anyschool - who wants to work with people. There is now a great deal of research (Truax &Mitchell 1971, Gelso & Carter 1985) to support this view, which is perhaps one of thereasons for its wide acceptance. This person-centred approach, as it is now called, iscentrally humanistic. Recent books such as Kahn (1991) are saying that this can beintegrated with psychoanalysis, or at least with the work of such analysts as H Kohut andM Gill.

Rogers pioneered the use of tape recorders in psychotherapy. In general, humanistictherapists are happy to use both audio and video tapes, particularly for training purposes,but also for continuing feedback on their own effectiveness, and this has contributed tothe spread of the research effort. Psychoanalysts like Gill (1954) and Console (1978)have also argued for this, on the grounds that there are many things going on in thesession which never appear on process notes, and which are of vital importance. Videorecordings are of course of general use in family therapy.


Psychodrama and Gestalt therapy

A characteristic form of humanistic therapy, coming from the work of J L Moreno, ispsychodrama. This is usually known as a group method, and Moreno (Gale 1990), beingan extrovert, preferred to work in groups himself, but everything in it can be adapted toone-to-one work (Badaines 1988). Its characteristic feature is that it is active. Instead oftalking about people or events, those people and events are talked to in the present in adirect way. The person does not talk about the mother, but talks to her, does not talkabout the argument with the boss, but talks to the boss, and then talks back as the boss,exploring both sides of the question. Moreno was too independent ever to align himselfwith other humanistic psychotherapists, but many of them adopt his orientation.Encounter groups (Wibberley 1988) use this approach a great deal. One specificderivation of this has become even more prominent than the original: gestalt therapy,developed by F S Perls and others (Clarkson 1989), is concerned with inner conflicts anddramas rather than with external ones. The reason that a later text is cited, rather than theoriginal, is that much has been added to the theory and practice of gestalt therapy sincePerls died in 1970. This active approach leads to humanistic psychotherapists talkingmore about making interventions than about making interpretations. The difference is thatthere are far more possible interventions than interpretations (both verbal and nonverbal),and therefore there is a wider range of possibilities open to the therapist. This is dauntingin one way and leads to humanistic training courses having a major skills component. Inthis they resemble behavioural approaches rather than psychoanalytic approaches.

It is important to stress at this point that such therapy shares completely withpsychoanalysis an appreciation of the necessity of re-experiencing old pain or oldimpulses. As M Kahn (1991) has recently pointed out: `each school has its own way oftrying to bring this about'. In psychoanalytically-oriented psychotherapy, the hereand-now quality is brought about in the transference; in gestalt therapy it is brought about byputting the parental figure on to an empty chair; in psychodrama someone enacts the roleof the other. In all cases the aim is the same: to bring to life in the consulting room thesignificant relationships and the significant moments in those relationships. It is only inthis way that the repressed material can be brought to the surface and dealt with afresh.

Gestalt therapy emphasises how very often a phrase or gesture holds an emotion, andthat repeating the phrase or movement can bring out the emotion, and its accompanyingmemories, very directly and dramatically.

Experiential psychotherapy

It is not that humanistic psychotherapy denies the existence of transference andcountertransference; it recognises that these things do exist and are important,particularly in long-term work (Rowan 1983). It is more that transference is just one ofthe things going on at a given time: it may sometimes be more important, sometimes less.This means that such statements as - `countertransference includes all feelings andattitudes about the client that occur in the therapist' - are seen as quite wrongheaded andinappropriate.

Many humanistic psychotherapists love working with dreams and have a variety ofmethods for doing this. Freud, Klein, Jung, Perls, Mahrer (1989a) and Hillman are allmajor sources of inspiration here, and Mindell's (1985) work on the dreaming body isparticularly interesting.

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Experiential psychotherapy, as worked out by such people as E Gendlin (1986) andA R Mahrer (1989b), is an important part of humanistic psychotherapy, and is muchpurer than the active approaches just mentioned. It involves the therapist gettingmentally closer to the client than in most forms of therapy, in a way which Samuels (1989) has called `embodied countertransference' and actually speaking on behalf of innerconflicts and inner forces within the person. This is an approach which is growing fast atthe moment and goes beyond empathy as usually understood. Empathy enables thetherapist to work as if he or she could get inside the client's world, but this approachenables the therapist to get inside the client's world completely, and for the moment bethe client.

Body work

Because of their intense concern with the whole person, and their desire not to leaveout the body, most humanistic psychotherapists do some body work. This may extendfrom the minimal ('What does your left hand want to say?') to the maximal ('Whathappens when I work on these rigid muscles?'). Often it takes the form of observing thebody language of the client and using that to help decide what intervention to make next.Sometimes it takes the form of setting up a dialogue between the client and a part of thebody ('Talk to your neck'), or a sensation ('Talk to your pain'). To some people this isreminiscent of Jung's `active imagination' as developed and extended by A Mindell (1985) and his followers in Zurich, and R A Johnson (1986) in San Diego.

It may involve drawing or painting a picture of the body, or physical exercises tobring out buried material. Much of this work stems from W Reich (Boadella 1985), whohas been another major influence, both direct and indirect, on humanistic psychotherapy.Boadella is cited rather than Reich himself because again there have been manyimportant developments since Reich died, some of them due to the work of A Lowen (1976) on bioenergetics. Reich was concerned with resistance as a block to the naturalflow of energy, and the humanistic psychotherapist now has many ways of working onand with resistance. Therapists who need to touch the client's body are advised to take abasic massage qualification first. It is a strange fact that some of the best courses inmassage give out, at the end, a certificate in 'physiatry', which is an embarrassment tomost serious practitioners because of its pretentiousness and misplaced medicalemphasis.

Some of the better organised courses are in bioenergetics (Whitfield 1988), whereexisting practitioners can experience the work themselves before they do it to others (thisis of course a general humanistic value), and can learn of the sometimes difficult ethicalquestions involved here. Direct body work tends to bring up primal emotions, and thefully equipped humanistic psychotherapist is expected to have worked through areassuch as foetal life and the birth experience. This is deep work which is experienced aschallenging by all those involved in it, but necessary if the lowest layers of theunconscious are to be reached.

Many humanistic psychotherapists are just as interested in exploring the past as anypsychoanalyst. They use regression methods which have been worked out over the yearsby people like S Grof (1988) and F Lake (1981). Some of these methods, which aredifferent from the psychoanalytic approach in being more direct, have re-made many ofthe psychoanalytic discoveries, particularly in the area of infant phantasy. This doubleconfirmation is impressive when it happens.


CatharsisOne of the things which tends to happen in body work (but also in gestalt,

psychodrama and so forth) is catharsis. This approach was rejected by Freud (after hisoriginal enthusiasm with Breuer), and so has been excluded from most psychoanalytictrainings. This seems a pity because it can be so effective. In a full discussion of thematter, Grof says (1988, p. 224):

The reason why abreaction (as used by Freud and Breuer in 1875) did not bring lastingtherapeutic changes was that in most cases it was not deep and radical enough. For abreaction tobe fully effective, the therapist has to encourage its full development.

He points out that because catharsis can be so dramatic, the therapist must haveexperienced it and seen it at firsthand in the process of training.

Many psychoanalysts avoid anything like catharsis because they have a fear that theego is fragile and that decompensation of repressed material might take place quitesuddenly, so that the person is plunged into a psychotic episode, but practitioners whowork with catharsis do not find this happening at all. The standard work on catharsis (Nichols & Zax 1978) says (p. 153):

Patients, sensing the turbulence of many of their own internal forces, feel threatened by themadness which they fear might result from a loss of control. The cathartic therapist, on theother hand, holds that the experience of relinquishing control and the opportunity to learn thatthe self, underlying the defences, is worthwhile and solid is an enormously reassuringexperience. Having such an experience may confirm a patient's earlier faith in himself or it maybe a dramatic revelation having a conversion quality to it. In either case the emotive therapistwould see the experience as being a constructive, strengthening one.

So there is quite a clear difference of opinion here, which it would seem could beopen to quantitative testing.

TranspersonalAgain in line with the idea of working with the whole person, humanistic

psychotherapists usually pay attention to the spiritual aspects of the person and to theirown spiritual development. Here the significant name is R Assagioli (Ferucci 1982), thefounder of psychosynthesis, who developed many ways of handling this material (particularly through guided fantasy), and who many people believe went beyond Jung inhis appreciation of what he called the superconscious. This he also sometimes called thehigher unconscious as distinct from the lower unconscious, which is similar to theFreudian `system Ucs'. After his death, his work has been carried on by some very ablepeople in Psychosynthesis Institutes in several different countries, all of whom arecommitted to training people to work with the whole person (Whitmore 1991). There areother schools, too, which take a transpersonal approach (GordonBrown & Somers 1988)from slightly different roots, and pay attention to the future, and the person's directionand purpose in life, as well as what went on in the past, or is going on in the present.

It seems that those disciplines which go deepest into the unconscious also findthemselves making discoveries at the spiritual level (Rowan 1991). There seems to besome connection between depth and height, so to speak. Someone gave the analogy of aspiral staircase standing on a mirror floor so that every step upward is also a stepdownward, in the mirror. The connection with some of the Jungian ideas is inescapablehere, and there is a great deal of overlap between the two schools at this point.

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Integration

There is a strong integrative thrust in humanistic psychotherapy generally, which isperhaps most easily visible in open Encounter (Wibberley 1988) and in PrimalIntegration (Rowan 1988). All those techniques, approaches or methods which centrethemselves on liberation and have some concept of a real self are seen as compatible.Methods which limit themselves to adjustment and role-playing, however, are notalways compatible. There is such an emphasis on the client's freedom (andaccompanying de-emphasis on the client's limitations) that humanistic psychotherapistsfind themselves constantly inventing new ways of dealing with problems as they arise inthe session. This again has to do with the wide choice of interventions mentioned earlier.

Training and development

In training, it is regarded as of the greatest importance that humanisticpsychotherapists should have therapy as intense, as frequent and as long as that whichthey intend to practise. No one should do to others what they have not been through intheir own experience.

It is not always realised that most humanistic psychotherapists have their owntherapist and their own supervisor. These are arrangements which they feel to be bothnecessary and desirable for anyone who is working in depth with others. Those who arefully trained in individual psychotherapy but who are not in one-to-one therapy at themoment often go to intensive groups instead, to work on themselves further, and to pickup new ideas. The belief is that no one is finished and no one is complete when it comesto working as a psychotherapist, no matter what type of training or therapy they mayhave had. So important is this felt to be that accreditation as a humanisticpsychotherapist (whether by a training institute or by a separate accrediting body) is notsomething given for always, but is renewable at intervals - sometimes yearly, sometimesthree yearly and sometimes five yearly.

Not all humanistic psychotherapists are feminists (Chaplin 1988), but most havesome social and political awareness and activity. The social conscience - and here AAdler had some early influence - is usually well developed. Maslow (1987) laysparticular stress on this aspect.

Names and Schools Which Have Not Been Mentioned

Jungian psychotherapy This is very sympathetic in a number of ways, as is evidentfrom the comments made above. Some humanistic psychotherapists have Jungiananalysts. In practice, the Jungian approaches have been influences rather than directsources. These ideas are of great interest these days: not so much Jung himself, though there is much to discover there, but later Jungians such as J Hillman (1989), M Watkins (1986), R Johnson (1986) and A Samuels (1989), and some Jung-derived offshoots like AMindell (1985) and the H Stone - S Winkelman team (1989).

Transactional analysis This was developed by E Berne (Clarkson & Gilbert 1990)Mid swiftly proliferated into management, education, salesmanship and other spheres,because of the simplicity of its language. It can be taught and practised in a humanisticway, but often becomes more mechanistic and needs to be approached with care. It is aparticularly interesting cane because nowadays there arc several centres which teach it


in a genuinely humanistic fashion, and bring out ways in which Berne was morehumanistic than might sometimes appear. In reality Transactional Analysis is a broadapproach which can diversify into a number of specialised areas, some of which maybecome distant from one another.

Rational Emotive Therapy One of the cognitive therapies, though A Ellis (Dryden &Ellis 1986) has sometimes described himself (unjustifiably) as humanistic.

Personal Construct Therapy Another cognitive therapy. Again G Kelly didoccasionally describe himself as humanistic, but this is not the case. Some of the peoplefrom this camp, such as D Bannister, D Rowe and F Fransella, are interesting (Fransella& Dalton 1990).

Rebirthing In the form originated and popularised by L Orr, this is a semi-religiousdiscipline, not therapy at all. It is often practised by people who are not well trained intherapy generally, and it could therefore be dangerous, in the sense of arousing moredeep unconscious material than the client or the practitioner can handle at the moment.For a full discussion (see Albery 1985).

Adlerian therapy There are some historical connections but little present overlap.Quite sympathetic on the whole.

Logotherapy This approach of V Frankl is quite sympathetic but there is littlepractical connection.

Existential analysis Existentialism has had a big impact on humanistic psychologybut as a form of therapy it has remained closer to psychoanalysis (see van Deurzen-Smith 1988).

Co-counselling Very sympathetic in a lot of ways but too specialised to havebecome incorporated into the humanistic therapy scene. Has split into a number offactions. Politically very defensible and interesting, and many humanistic practitionershave been involved with it over the years (see Evison & Horobin 1988).

It is hoped that this will be at least the beginning of a better understanding of whathumanistic psychotherapy is and is not.

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