‘Focusing’ and ‘working at relational depth’ - why do they help?
Centre for Counselling Studies,
Paper presented at
the 7th World Conference for Person-Centered and Experiential
Psychotherapy and Counselling.
In his 1964 paper on ‘A theory of personality change’ Gendlin suggested that the two most central factors in therapeutic personality change are that it (a) ‘involves some sort of intense affective or feeling process occurring in the individual’ and that (b) it ‘occurs nearly always in the context of an ongoing personal relationship’. In this paper I suggest first that much recent research confirms Gendlin’s view. I then relate Gendlin’s ‘feeling process in the context of an ongoing personal relationship’ to the work of Mearns and Cooper on ‘relational depth’, and then, drawing on Gendlin’s later work, consider what theoretical explanation can be given for the effectiveness of working in this way with clients.
Dave Mearns and Mick Cooper (2005) have devoted a recent book to the importance of relating to the client ‘in depth’, but they have little to say about why such relating is helpful, beyond noting that it can in a general sort of way provide corrective experiences, relieve loneliness, and give some hope and encouragement. Of course, these factors – which tend to be common to all modes of therapy - can play a significant role, but Mearns and Cooper (p. 15) themselves remark ‘We still know very little about the actual processes and dynamics that take place between therapist and client, and how these might lead to significant therapeutic change.’ This seems different from the position many person-centred therapists have taken (and which Mearns took with Thorne in Person-centred Counselling in Action). In that earlier work it was asserted that psychological disturbance is caused by the introjection of conditions of worth, and that what leads to therapeutic change is the therapist’s provision of an antidote in the form of empathy, acceptance and congruence.
Conditions of worth are missing from the account of Mearns and Cooper; nor are they given much prominence in Tudor and Worrall’s recent study of person-centred therapy (Tutor & Worrall 2006). I have argued elsewhere (Purton 2004) that not all psychological disturbance is due to the introjection of conditions of worth, so I have no objection to this change of emphasis, but if conditions of worth are thus removed from their traditionally central place then a gap appears in the person-centred account of both the generation of psychological disturbance, and of what is required for therapeutic change.
In an article published over forty years ago Gendlin (1964) suggested that there are two main factors involved in therapeutic personality change. One is that such change involves an engagement with feelings, rather than being a purely cognitive process. The other is that such change usually occurs in the context of an ongoing personal relationship. In therapeutic personality change the client is engaged both with their own felt experiencing, and with the therapist.
Since Gendlin wrote this, much work has been devoted to the assessment of the factors that are conducive to therapeutic change, and my impression is that this subsequent work largely confirms Gendlin’s view. For example, Orlinsky and his collaborators (Orlinsky et al 1994) write that ‘The point has been reached where certain findings about comparative outcomes and the relation of various facets of process to outcome are so well replicated that they can be accorded the status of established facts’ (p. 352). And two of these ‘established facts’ are in effect Gendlin’s two factors, that is, what Orlinsky et al call ‘client self-relatedness’ and ‘the therapeutic bond’ (p. 360).
The ‘therapeutic bond’ is clearly related to what Mearns and Cooper call ‘relational depth’; while ‘client self-relatedness’ is, I believe, closely related to what Gendlin calls ‘focusing’. If we are to understand what happens in psychotherapy we need to understand why these two factors are so important.
I will give two examples, and then discuss them using the theoretical framework developed by Gendlin.
Emma comes to her adviser in connection with her academic work, and it emerges that she is feeling over-pressured in her life. She is thinking of easing this feeling of pressure by ending a relationship which has been taking a lot of her time and energy. But it is the end of term, and the adviser feels that it is a bit odd to end the relationship now, just when she could reasonably devote more time to it. She remarks upon this to Emma, who agrees that it does seem a strange time to do it; nevertheless she really does feel afraid of the pressure which the relationship brings. She is afraid of letting it continue. The adviser suggests that Emma focuses on the uncomfortable pressured feeling a bit, and encourages her to talk a little about the ideas and thoughts which come to mind in connection with it. It emerges that there have been several little incidents recently in which Emma felt rather insecure in the relationship, moments when she felt jealous, though quite irrationally. She comes to acknowledge that the discomfort she feels involves anxiety about the man ending the relationship, leading to the feeling that she would rather do it first. So while she was correct in construing her feeling as some sort of anxiety, she has misconstrued the nature of the anxiety. It is the sort of anxiety that is involved in jealousy and fear of rejection, rather than the sort that is involved in not having enough time. Having realised this, Emma goes off and talks with her boyfriend about the incidents which gave rise to the jealousy, and they work out ways in which similar misunderstandings can be avoided in future. As a result the emotion which she misconstrued as ‘feeling pressured’ dissipates, and the relationship improves.
We have here a situation and a feeling about the situation. Situations and feelings come together: the feeling (which she initially called ‘being over-pressured’) is how Emma is sensing the situation, how it is being registered in her. If she gives it closer attention she may be able to sense the pressured feeling right there in her chest or stomach. Emma’s situation, like any human situation, is indefinitely complex. There are the broad themes of her academic life, her reasons for wanting to be at college, her relationship with her boyfriend and all that has happened between them; and within each theme there is endless detail, such as what she thinks her parents feel about her boyfriend, how she wants to relate to her parents, and on and on. All this is largely implicit in her situation – that is, she would not normally articulate much of it, and clearly it would be impossible to articulate all of it. Nevertheless, there is the situation as a whole, and it can be felt as a whole. When the adviser suggests to Emma that there is something a bit odd about the situation, Emma can give her attention to the feel of all that.
It is an important fact that we can give our attention to the feel of a whole situation in this way. At first, such a feeling may not be there; Emma might at first just have various thoughts and feelings about her course and it being the end of term, about the time which her relationship absorbs, together with a whole range of vague tensions and anxieties. There is a flow of experiencing here, a stream of consciousness, but not a felt sense of the whole situation. However, as she gives her attention to what the advisor says, such a felt sense may form. There is the pressured feeling, and further she senses that there is more in or beneath or around this feeling. She gives her attention to all that, felt as a whole, and now new thoughts and feelings emerge, feelings about her insecurity and jealousy, leading to the thought ‘I need to end it before he does’. At this point she may feel a certain release. Such a release can be felt physically, in the body. At this point she is no longer stuck – the coming of the jealous feeling, although not pleasant, carries her forward. Her situation now feels, and is, different. A new felt sense forms, which is focused in the words ‘I need to talk to my boyfriend’.
The theoretical question is why this change takes place when she gives her attention to her experiencing. She starts in a stuck place, where it is not clear how she should move forward. What exactly does she do next? Well, she tries to formulate or symbolise her experiencing in various ways. One such way is to formulate it as ‘I don’t have time for this relationship’. But when she does this nothing much happens. She may genuinely think this is true, but it does not move anything in her. Or she may say to herself ‘This is really not much of a problem, I don’t need to do anything about it’. But in spite of thinking this, she still feels stuck. In Gendlin’s phrase these formulations don’t carry her forward. In her felt sense of the situation there is a tension, an implying of something; something needs to come, but it has not come yet. As she remains in the stuck place, her mind moves out over areas of her life which connect with the problem, and various ways of formulating it present themselves, but none of them have the feel of what she feels. As we might say, these formulations don’t do anything for her. She then tries out ‘I don’t really want this relationship anyway’ but that doesn’t feel right, either. Nor does ‘It’s OK, but I need a change’. She comes to ‘I need to end it before he does’ and suddenly there is a rush of feeling. Her experiencing shifts dramatically. Quite new thoughts come to her – him talking last night to his ex-girlfriend, her pain over this, her covering up the pain. Then comes ‘I’m jealous, and I feel insecure’. All this flows from the formulation ‘I need to end it before he does’. That formulation was not explicit until now, but now we can say it was implicit all the time. There was something there all the time which implied this formulation. Once the thought actually came it was no longer implied, and the tension of the implying dissipated
If we ask, where the shift came from, there are two parts to the answer. One is that it came from the implying that was inherent in the stuckness, but this is not the whole story, since the implying was there all through. What carried her forward was the occurrence of the thought ‘I must end it before he does’. If she hadn’t hit on that thought then probably nothing much would have happened. The thought came to her partly because it was available to her, in her repertory as it were. That is, she was familiar with the idea of one person ending a relationship before their partner did it. She may have seen this happen with a friend, or read about it in a novel, or just thought about it. If a friend had been in her kind of situation, she might in fact have suggested just that possibility – ‘Maybe you want to end it before he does’. So amongst all the possible perspectives on her situation there was that one. As she stayed with her feelings she was allowing various formulations to come to her, and when she came to that one it carried forward her felt meaning through making that meaning explicit.
Note that to say that this formulation was the ‘right’ one is not to say that the formulation ‘matched’ an explicit feeling that was already there. In Gendlin’s view symbols do not match or represent experiences; they change experiences in a special way. Before it is symbolised the experiencing has the nature of an implying, a tension, a quality of something that is to come. Emma feels this. Various thoughts come to her but they do not change the experiencing. It stays as it is. Then the thought comes that she needs to end the relationship before he does, and the tension, the sense of something that is to come, is no longer there. Not because it has been ignored or suppressed, but because what was to have come now has come. The ‘correct’ formulation of her felt experiencing is a formulation that carries that experiencing forward. It carries it forward because it satisfies and gives expression to the bit of her that can’t bear to be rejected. But then new thoughts and feelings can come… Is she likely to be rejected here….? Does it really feel that he is moving away from her?....There were those things that happened….A new felt sense forms which is focused in the words ‘I need to talk to him about those events’…. Then the action-step of talking to him, and then something new again, no doubt.
In Emma’s case the symbolisation which carried her experiencing forward was a formulation that was already familiar to the client, but often there is no familiar formulation which will carry the person forward. Rather, a new formulation has to be created in the specific situation. Here is an example.
Jade is depressed. She had a family but her husband left her and her children have now grown up and moved away. She provided a protective container for them which was her sole function in life. She did it well, but now she has no role any more. Beyond a sense of heaviness she can’t find words to express what she is experiencing. Her therapist suggests that she might try to stand back a bit from the heaviness, to create a bit of space between her and it, so that she can better sense what it is in it. She is able to do this, and gives her attention to ‘all that heavy thing’, without getting drawn into it again. Suddenly an image comes to her of an empty box. She says with a sigh, ‘That’s it - my life is an empty box’. But then she stays with the metaphor of the box. She feels, there is nothing wrong with a cardboard box that has fulfilled its function. Does it just have to be thrown away? No, it can be recycled, or it can be used for an indefinite range of other things. It can have many functions. Its life can continue in quite new ways, maybe no longer as a box at all. Jade feels a sense of release at this.
This example is different from the previous one in that what comes to the client is not a familiar formulation. It is a new creation out of her own experiencing. It was created out of that experiencing and the familiar words ‘empty box’, but these words were not being employed with their usual meanings. They were employed as an image or metaphor. I do not have time to explain Gendlin’s account of metaphor here, but I hope it will be clear that the symbolisation which carries a client forward may need to be newly created in the session.
What is the role of the therapist?
Could Emma or Jade have done what they did without the help of another person? Possibly: it is possible, on one’s own, to give attention to one’s experiencing, to slow down one’s thinking, to pause with what is there, to let a felt sense form. It is also possible to stand back from one’s feelings, to imagine them being set down at a distance, to touch them, to see what comes. This is what people learn to do in Focusing training; it is the procedure which Gendlin outlined in his first book. But it is often not easy to do it on one’s own. If we are too distant from our feelings we often need another person to help us register them, to pause us where we would skip over them in a cognitive way. We may also need help in allowing good feelings to come. Without a companion it is easy to pass over a sense of release and move on to the next thing. But then we lose what that new good energy could have given us. A companion can say ‘Just take a minute to feel that relief in your body – let it sink in that it feels like that’.
Similarly, when we are caught in our feelings, we may need help in getting and maintaining a distance from them. It can feel that as we get closer to the thing which frightens or hurts us that we are descending into a swamp, and we need to hold on to the rope which connects us to the other person who is standing firmly on the bank. The feelings can easily take us over, so that we cannot properly specify or articulate them. Just as too much involvement in symbols can lead to us skipping over the feelings, so too much involvement in feeling can lead to us skipping over what the feelings are.
Further, it is not always the case that by staying with a thought (such as ‘I need to end this relationship’) the feelings beneath it will open up. Nor is it always the case that through staying with a feeling (such as ‘heaviness’) it will become articulated, and more intricately specified. When we try to stay with thoughts or images they may just go round and round without anything helpful happening. Similarly when we try to stay with a feeling we may simply be pulled into it. We can be so caught either in the symbols or in the feelings that there is no possibility of an interaction between symbols and feelings. Such thoughts or feelings form what Gendlin calls a ‘frozen whole’ in which full experiencing is not going on. The client’s experiencing is not fully alive at these points. If the therapist simply responds to the stuck thoughts or feelings this may simply make things worse.
These situations are the ones which Gendlin calls ‘structure-bound’. What they require is not a response to the stuck thoughts or feelings but to the experiencing which is still taking place around those thoughts or feelings. For example, suppose that the therapist suggests to Jade that she might give her attention to the heavy feeling. Jade does this, and that is all that is there – heaviness. The more attention she gives to it, the more she is drawn into it. This is not helpful. Here the therapist needs to respond not to the heaviness but to what is still alive and functioning in the client’s experiencing. For example, the therapist could ask Jade how she feels about this heaviness, or what impact it has on her life. It might then emerge that she is angry at feeling so heavy all the time, angry at what she is being prevented from doing. This anger is alive, but it is close to the heaviness, connected with the heaviness. A bit of what the heaviness involves emerges here - it is preventing the client from doing many things. How is it when the client allows herself to feel the anger? Does she still feel the heaviness then? No, they seem to be incompatible – the anger can lift the heaviness for a few moments. The client can in these moments get back a bit from the heaviness and perhaps begin to sense a little of what is in it. The heaviness is now no longer frozen, it is beginning to be open to symbolisation. This aspect of the client’s experiencing is coming alive again, or as Gendlin puts it, the client’s experiencing has been reconstituted.
Here again we can see the importance of the interaction with the therapist. On one’s own it is very hard to stay close to a frozen whole without becoming frozen oneself. The client needs the therapist to help her move back from the frozen place a bit (otherwise she will remain caught in it), but not too much (otherwise she will lose touch with it). Then as live experiencing emerges close to the frozen place the client may need the therapist’s help in staying with that experiencing. The therapist can say – ‘Just let yourself feel that anger’ and ‘While you feel the anger, what is happening to the heaviness?’ These are things that the client could say to herself, but it is very hard to provide for oneself such a helping role while at the same time actually struggling with the feelings.
I think there is one further point about the importance of the relationship with the therapist, which is probably the most important point. The simple presence of another person changes the nature of our experiencing in a crucial way. Imagine that you are in a remote place in the mountains, watching the clouds go by. Suddenly you become aware of another person who is watching you. The whole quality of your experiencing shifts as you become the object of their gaze as well as the subject of your own gazing. This kind of experience was famously discussed by Sartre, who saw it in a purely negative way, in which the gaze of the other turns one into an object. However, as we know from person-centred therapy, the other’s presence can also be facilitative. The therapist’s reflective presence can help the client to be more aware of what they are experiencing. What the presence of the other person does is to facilitate reflexivity or self-awareness. But it is just that reflexive attention to one’s own experiencing which is needed if that experiencing is to be carried forward and re-structured in a therapeutic way.
Relating to the therapist helps to create and maintain self-relatedness - it is through our interactions with others that we find – and are - ourselves. Effective therapy involves that facilitation of self-relatedness with which we are familiar in focusing, but such facilitation normally requires a context in which there is ‘relating in depth’.
References and bibliography
(1996) Focusing-oriented Psychotherapy.
Gendlin, E.T. (1962/1997)
Experiencing and the Creation of
(1964/1973) A theory of personality change. In A.R. Mahrer and L.Pearson Creative Developments in Psychotherapy.
Gendlin, E.T. (1997) A Process Model.
Mearns, D. & Cooper, M. (2005) Working at Relational Depth in Counselling
Mearns, D. & Thorne, B. (1999) Person-Centred Counselling in Action. 2nd edition.
Orlinsky, D.E., Grawe, K. & Parks, B.K. (1994) Process
and outcome in psychotherapy – noch
einmal. In S.L. Garfield & A.E.
Bergin (Eds.) Handbook of Psychotherapy and Behavior
Change (4th ed.).
Purton, C. (2004) Person-centred Therapy: The
Sartre, J.-P. Being and Nothingness (1953) Part 3, ch. 1, iv: ‘The look’.
Tudor, K. & Worrall, M. (2006) Person-Centred Therapy: A Clinical Philosophy.