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Person-Centred Practice A n expression of Non- medicalised Mental Health Care. The Person-Centred Approach Carl Rogers 1902–1987. The approach has been in continuous development from circa 1935 to the present day. To be radically nice. Rogers’ approach was radical because
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Person-CentredPracticeAn expression ofNon-medicalisedMental Health Care
The Person-Centred ApproachCarl Rogers 1902–1987 The approach has been in continuous development from circa 1935 to the present day
To be radically nice Rogers’ approach was radical because • it started in entirely the ‘wrong’ place — it started with the client and the primacy of understanding the client’s process • he thought that it was unhelpful to stereotype and categorise the client’s experience: he was set against diagnosis because it was damaging • he thought that it was unhelpful to understand the client’s process as one of ‘sickness’ • he thought it was unhelpful to play the expert, because he believed that it was the client who was the expert in their distress and their healing
To be radically nice • it is helpful to be humble and authentic, to listen, understand and accept rather than judge, interpret and categorise • people are not ‘bad’, ‘dangerous’ or ‘flawed’. As adult human beings we do not have to be protected from ourselves • humans are not limited to change by learning • human beings grow. We live by growing and are constantly changing and adapting by growing. Clients grow in multi-dimensional ways which are frequently mysterious to the therapist
To be radically niceJohn Shlien style ‘Diagnosis is not good, not even neutral, but bad. Let’s be straightforward and flat out about it, it is not only that its predictions are flawed, faulty, and detrimental to the relationship and the client’s self-determination, it is simply a form of evil. It labels and subjugates people in ways that are difficult to contradict or escape.’
To be radically niceJohn Shlien style ‘There is no value in being ‘reasonable’, in wanting to participate in reformulation of the psychodiagnosticendeavor that will generate a universally agreed-upon answer. Why petition to be a partner to reformulation when it is wrong from the beginning? It does not pay to make even temporary concessions to logic you believe to be false, or professional conventions you believe unworthy. They haunt one forever.’
How to be nice Try to understand the other person. Listen to how they experience their world. Help them find meaning in their experience. Feeling understood is helpful in itself. Do not interpret their experience, tell them what it means or impose your own meanings on it. They are the expert. If they ask you to explain their experiences, be straight with them.
How to be nice Accept the other person as a worthwhile human being. You don’t have to approve of their behaviour, but they are a human being of equal value. Some people have been damaged by harsh, heavy-handed opinion, unreasonable judgement or abuse. It’s important that they don’t get more of the same from you. Be positively warm and accepting of ALL aspects of the person, including those parts that want to choose an option that we don’t agree with.
How to be nice Do not have a front or facade, do not act like an ‘expert’, be your real self as a helper; fallible, vulnerable, imperfect, not knowing any of the answers. This goes against some of the training in the ‘helping professions’ which advises people to keep a professional distance, bluff it out, pretend they know what they’re doing (even if they don’t) and close ranks.
How to be nice Be ‘principled’ rather than ‘instrumental’ when you offer this relationship. Mean it, inhabit it, BE nice. Being nice is NOT a treatment or intervention. Understanding, acceptance and genuineness are not tools to get to the bottom of things, extract truths or flesh out symptoms. They are both the means AND the end. You will be found out if you don’t mean it.
Medical metaphors for psychological distress – still think it’s a good idea? ‘Grief is not an illness; it is more usefully thought of as part of being human and a normal response to death of a loved one’ Editorial (unsigned) Lancet 18 Feb 2012 [In response to the BE being removed from DSM-5]
Non-medical metaphors for distress ‘Feeling low is not an illness; it is more usefully thought of as part of being human and a normal response to bad, hurtful or humiliating things happening to you.’ Commonsense (and scientific evidence) … and Person-Centred
Non-medical metaphorsfor distress • Being overwhelmed … • Hearing voices… • Having jumbled thoughts … • Not wanting to get up in the morning, wash or eat regular meals … … not illnesses; they are more usefully thought of as part of being human and normal responses to …
The struggle for meaning in mental health professions …psychological treatments are so effective, only ethics and social action can save us
When everything we do has the same effect … use ethics • Do we choose a helping method that is the cheapest? • Do we choose a way of helping that treats people like machines, or tin cans? • Do we choose a method that boasts the white heat of psycho-geno-neuro technology? • What will youchoose?
When change is in the air … Be on the side of right CURED! • ‘Homosexuality’ • Menstruation, Pregnancy, Premenstrual Dysphoric Disorder Borderline Personality Disorder, Masochistic personality Disorder. (‘Being a woman’) • Learning disability CURED! (Well, almost!) CURED!
