The Development of Nondirective Therapy

Nathaniel J. Raskin University of Chicago Orignally published in the Journal of Consulting Psychology, 1948, 12, 92-110

 


The term "nondirective therapy" is today commonly identified with the method and views of Carl R. Rogers and his students and associates. For some, nondirective therapy is just a new name for Jessie Taft's "relationship therapy" and Otto Rank's "will therapy". Regardless of how the phrase is interpreted, it is one which now has some meaning for almost all workers in psychology, orthopsychiatry, mental hygiene, and counseling. Fifteen, ten, or even five years ago, advocates of "passive", "relationship", "client-centered", or "nondirective" therapy represented a point of view which was not well known and exerted little influence on the work of psychiatrists, psychologists, and social workers. Today, while the number of therapists or counselors who utilize a consistent nondirective approach is still quite small, it is one which is growing rapidly. Just as significant is the fact that there are few treatment interviewers of any orientation who have not taken cognizance of and considered, however briefly, this newer philosophy, and changed or justified their own procedures in the light of it.

Whenever interest in an idea spreads, curiosity as to the history of it grows as well, and the purpose of this paper is to help satisfy that curiosity. For the writer, "nondirective therapy" may well stand for the philosophy and technique of the Rogers' school of therapy. But, in tracing the development of this philosophy and technique, he has made no attempt to take the ideas of this school and trace them back to their origin. The development of an idea in an individual is a complicated process, often too complicated even for the individual him-self to understand or trace, and the writer does not feel qualified to attempt it in this instance.

The alternative method, which has been chosen, represents a cross-sectional rather than a longitudinal type of study. The work of Freud, Rank, Taft, Allen, and Rogers has been examined here, not with the aim of causally relating the views of any one of them to the others, but with the goal rather of a logical comparison of their ideas. Prominent throughout has been the question, "How does this view relate to nondirective thought?"

As a result of such treatment, and rather uniquely, it is believed, the nondirective aspects of Freud's technique have been stressed here, while conversely, attention has been focused on the directive features of the work of Rank, Taft, and Allen. Generally, Freud's therapeutic methods have been accepted as subordinate to and within the framework of his own theories of personality development and of psychotherapy. With attention centered on client content, there has been little recognition of the degree to which Freud came to compromise with client attitudes in the course of psychoanalysis. With respect to Rank, Taft, and Allen, there has been, heretofore, a rather superficial acceptance of the general "client-centered" nature of their approach, with no critical evaluation of the extent of therapist-direction in their work. Furthermore, the tendency to group Rogers' name with these three has served to obscure what are perhaps the most significant features of the former's work.

Thus, while the effect of our comparative treatment has been to give a different emphasis to the ideas of Freud, Rank, Taft, and Allen than that provided by these therapists at the time they made their contributions, it has left us in a better position to understand and evaluate the significant features of nondirective therapy as it stands today and more important, perhaps, the direction in which it is going.

Sigmund Freud

Freud's orientation to therapy was so completely "physician-directed" that he would not appear to belong in any history of nondirective thought. On the other hand, a great debt is owed to Freud by all schools of psychotherapy for the work he did in establishing the interview (regardless of the therapist's orientation) as a recognized therapeutic measure and, of course, for his theoretical contributions in the fields of unconscious mechanisms, childhood, and the emotions, which have made human behavior far more understandable. [Footnote #1] A more specific reason for including Freud in this paper has been the close relation which Otto Rank held to him. As one of Freud's closest disciples for approximately twenty years, and his favorite for at least ten, Rank's theory and practice, opposed as they were to his teacher's, grew out of his experience with orthodox psychoanalysis [28].

But the most cogent reason for examining Freud's work here lies in the relationship between his therapeutic aim and the techniques he utilized to accomplish this end. Freud's goal in treatment, as is well known, was to have the patient recall as much as possible about his past, in order that the analyst might be given the means to afford him insight into his behavior, in terms of "repressed infantile sexuality." It is interesting to note that Freud, in order to achieve this aim, utilized procedures which are in accord with present-day nondirective philosophy. This is true from the very beginning of the analysis. The following excerpt, brief as it is, shows Freud's use of a nondirective technique while demonstrating, at the same time, his "physician-directed" orientation.

What subject-matter the treatment begins with is on the whole immaterial, whether with the patient's life-story, with a history of the illness or with recollections of childhood; but in any case the patient must be left to talk, and the choice of subject left to him. One says to him, therefore, "Before I can say anything to you, I must know a great deal about you; please tell me what you know about yourself." [12]

Freud continues to be nondirective with the patient who finds it difficult to begin: "One must accede this first time as little as at any other to their request that one should propose something for them to speak of" [12]. But his bent for nondirection soon weakens. There is "emphatic and repeated assurance that the absence of all ideas at the beginning is an impossibility." And if this does not work,

....pressure will constrain him to acknowledge that he has neglected certain thoughts which are occupying his mind. He was thinking of the treatment itself but not in a definite way, or else the appearance of the room he is in occupied him, or he found himself thinking of the objects round him in the consulting room, or of the fact that he is lying on a sofa; for all of which thoughts he has substituted "nothing." These indications are surely intelligible; everything connected with the situation of the moment represents a transference to the physician which proves suitable for use as resistance. It is necessary then to begin by uncovering this transference; thence the way leads rapidly to penetration of the pathogenic material in the case. [12]

But we are not yet ready to leave Freud, the employer of nondirective techniques. He states that while the first aim of the treatment consists in attaching the patient to the treatment and to the person of the physician, " .... it is possible to forfeit this primary success if one takes up from the start any standpoint other than that of understanding, such as a moralizing attitude ...." [12]

In the field of interpretation Freud most clearly tends towards nondirection as a result of bad luck with directive techniques:

This answer of course involves a condemnation of that mode of procedure which consists in communicating to the patient the interpretation of the symptoms as soon as one perceives it oneself, or of that attitude which would account it a special triumph to hurl these "solutions" in his face at the first interview. . . Such conduct brings both the man and the treatment into discredit and arouses the most violent opposition, whether the interpretations be correct or not; yes, and the truer they are actually the more violent is the resistance they arouse. Usually the therapeutic effect at the moment is nothing; the resulting horror of analysis, however, is ineradicable. Even in later stages of the analysis one must be careful not to communicate the meaning of a symptom or the interpretation of a wish until the patient is already close upon it, so that he has only a short step to take in order to grasp the explanation himself. In former years I often found that premature communication of interpretations brought the treatment to an untimely end, both on account of the resistances suddenly aroused thereby and also because of the relief resulting from the insight so obtained. [12]

Freud had a similar experience in the matter of communicating repressed material to patients:

In the early days of analytic technique it is true that we regarded the matter intellectually and set a high value on the patient's knowledge of that which had been forgotten, so that we hardly made a distinction between our knowledge and his in these matters. We accounted it specially fortunate if it were possible to obtain information of the forgotten traumas of childhood from external sources, from parents or nurses, for instance, or from the seducer himself, as occurred occasionally; and we hastened to convey the information and proofs of its correctness to the patient, in the certain expectation of bringing the neurosis and the treatment to a rapid end by this means. It was a bitter disappointment when the expected success was not forthcoming. [12]

Freud's treatment of the problem of overcoming resistance, which is closely connected with the problems of interpretation and of communicating repressed material, is similarly nondirective in its development:

The first step in overcoming the resistance is made, as we know, by the analyst's discovering the resistance, which is never recognized by the patient, and acquainting him with it. Now it seems that beginners in analytic practice are inclined to look upon this as the end of the work. I have often been asked to advise upon cases in which the physician complained that he had pointed out his resistance to the patient and that all the same no change has set in; in fact, the resistance had only then become more obscure than ever. The treatment seemed to make no progress. This gloomy foreboding always proved mistaken. The treatment was as a rule progressing quite satisfactorily; only the analyst had forgotten that naming the resistance could not result in its immediate suspension. One must allow the patient time to get to know this resistance of which he is ignorant, to "work through it," to overcome it, by continuing the work according to the analytic rule in defiance of it. Only when it has come to its height can one, with the patient's cooperation, discover the repressed instinctual trends which are feeding the resistance; and only by living them through in this way will the patient be convinced of their existence and their power.

This "working through" of the resistances may in practice amount to an arduous task for the patient and a trial of patience for the analyst. Nevertheless, it is the part of the work that effects the greatest changes in the patient and that distinguishes analytic treatment from every kind of suggestive treatment. [13]

The intent of the above quotations is not to make Freud out as a nondirective therapist but to demonstrate that a therapist with his fundamentally authoritative orientation found it necessary to reckon more and more with the attitudes of the patient and to depend less and less upon the will of the analyst, in order to make therapeutic progress.

Before leaving Freud, one other point will be cited which shows him as being closer to the nondirective point of view than may be popularly supposed. This relates to the nature of the unconscious. It is widely held that nondirective methods are superficial and fail to bring to light material which is deeply buried in the patient's unconscious. But Freud writes:

The forgetting of impressions, scenes, events, nearly always reduces itself to "dissociation" of them. When the patient talks about these "forgotten" matters he seldom fails to add: "In a way I have always known that, only I never thought of it." [13]

This passage fits very closely the experience of clients in nondirective therapy. On the same topic, Freud writes further:

The "forgotten" material is still further circumscribed when we estimate at their true value the screen-memories which are so generally present. In many cases I have had the impression that the familiar childhood-amnesia, which is theoretically so important to us, is entirely outweighed by the screen-memories. Not merely is much that is essential in childhood preserved in them, but actually all that is essential. [13]

 

Otto Rank

Rank, long Freud's closest associate and disciple [28], first rebelled openly against classical Freudian theory and practice in 1924 with the publication of The Trauma of Birth. In this work, birth replaced castration as the original trauma and the breast took precedence over the penis as the first libido object. In addition, Rank identified the origin of fear with the birth process.

Having done this, Jessie Taft writes, "he had pursued the Freudian path to its inevitable conclusion and after trying out the final biological bases theoretically and practically, was finally able to abandon content as in itself unimportant and devote himself to the technical utilization of the dynamics of the therapeutic process, with the patient's will as the central force." [21]

Rank is responsible for the initiation in psychotherapy of several extremely significant ideas:

  1. The individual seeking help is not simply a battleground of impersonal forces such as id and superego, but has creative powers of his own, a will. When the individual is threatened, when a strange will is forced on him, this positive will becomes counter-will.
  2. Because of the dangers involved in living and the fear of dying, all people experience a basic ambivalence, which may be viewed in various aspects. Thus, there is a conflict between will-to-health and will-to-illness, between self-determination and acceptance of fate, between being different and being like others, etc. This ambivalence is characteristic not just of neurotics, but is an integral part of life.
  3. The distinguishing characteristic of the neurotic is that he is "ego-bound", both his destructive and productive tendencies are directed toward the self, his will is frozen and denied in a dissatisfied concentration on these ambivalences of living.
  4. The aim of therapy, in the light of the above, becomes the acceptance by the individual of himself as unique and self-reliant, with all his ambivalences, and the freeing of the positive will through the elimination of the temporary blocking which consists of the concentration of creative energies on the ego.
  5. In order to achieve this goal, the patient rather than the therapist must become the central figure in the therapeutic process. The patient is his own therapist, he has within him forces of self-creation as well as of self-destruction, and the former can be brought into play if the therapist will play the role, not of authority, but of ego-helper or assistant ego, not of positive will but of counter-will to strengthen the patient's positive will, not of total ego but of any part of the ego felt by the patient to be disturbing and against which he may battle; in sum, the therapist "becomes in the course of treatment a dumping ground on which the patient deposits his old neurotic ego and in successful cases finally leaves it behind him." [21] The therapist can be neither an instrument of love, which would make the patient more dependent, nor of education, which attempts to alter the individual, and so would inhibit the positive will by arousing the counter-will.
  6. The goals of therapy are achieved by the patient not through an explanation of the past, which he would resist if interpreted to him, and which, even if accepted by him, would serve to lessen his responsibility for his present adjustment, but rather through the experiencing of the present in the therapeutic situation, in which he learns to will in reaction to the therapist's counter-will, in which he is using all of his earlier reaction patterns plus the present, in which the will conflict which is present in his total life situation, the denial of the will for independence and self-reliance, is most immediately felt and can therefore most easily be brought home to him. The neurotic is hamstrung not by any particular content of his past, but by the way he is utilizing material in the present; thus, his help must come through an understanding of present dynamics, rather than of past content.
  7. The ending of therapy, the separation of patient from therapist, is a symbol of all separations in life, starting with the separation of foetus from womb in birth, and if the patient can be made to understand the will conflict present here, the conflict over growth towards independence and self-reliance, and if he can exercise the separation as something which he wills himself, despite the pain of it, then it can symbolize the birth of the new individual.

By setting the time of ending in advance, the therapist can early bring in the one situation in which he must act as positive will and thus arouse the patient's counter-will, and allows, without shock, a gradual growth of the patient's ability to give up the therapist as assistant ego, to take over his own self, and face reality.

These seven points seem to constitute the basis of Rank's "will therapy." They are not given systematically by Rank, but are ideas which are presented by him in various relationships to each other; we may regard them as the threads which are used to make up the complicated pattern of Will Therapy, the book, and the therapeutic method itself.

The following passage will serve to illustrate the manner in which Rank contrasts his own method with Freud's ideological therapy, also to illustrate the manner in which Rank interrelates some of the points outlined above, and finally to highlight Rank's skepticism regarding the possibility of a therapy with technical rules:

In contrast to this ideological therapy, the therapeutic utilization of the analytic situation itself has led me to a dynamic therapy which in every single case, yes in every individual hour of the same case, is different, because it is derived momentarily from the play of forces given in the situation and immediately applied. My technique consists essentially in having no technique, but in utilizing as much as possible experience and understanding that are constantly converted into skill but never crystallized into technical rules which would be applicable ideologically. There is a technique on]y in an ideological therapy where technique is identical with theory and the chief task of the analyst is interpretation (ideological), not the bringing to pass and granting of experience. This method effaces also the sharp boundary between patient and therapist to the extent that the latter sinks to the level of assistant ego and no longer rules the scene as chief actor. It is not merely that the patient is ill and weak and the therapist the model of health and strength, but the patient has been and still is, even in the analysis, his own therapist, while the analyst can become a destructive hindrance to cure. If this occurs, not merely as incidental resistance, but threatens to establish itself as a situation, the therapist must possess the superior insight to let the patient go free, even if he is still not adjusted in terms of the analytic ideology in its role as a substitute for reality. For real psychotherapy is not concerned primarily with adaptation to any kind of reality, but with the adjustment of the patient to himself, that is, with his acceptance of his own individuality or of that part of his personality which he has formerly denied. [21]

Much of Rank's theory of psychology and psychotherapy is speculative and difficult, but the most obscure area of his work is the manner in which he practiced psychotherapy, as the above quotation (and point 5 above) might indicate. The aspect which is most inscrutable is the amount and manner of activity of the therapist in the treatment hour. Our clues to this activity lie in rather unsystematic references to it in Will Therapy. We find, despite all the venom heaped by Rank; on the techniques of education and interpretation and despite all the emphasis placed on the autotherapeutic abilities of the patient, that "I [Rank] unmask all the reactions of the patient even if they apparently refer to the analyst, as projections of his own inner conflict and bring them back to his own ego," that "interpretation on the part of the analyst is worthless as long as it does not lead to the understanding of this denial mechanism itself and its relation to the yielding of the will under emotion," and that "here is the place [the therapeutic hour] to show him how he tries to destroy the connections with this experience just as he does with the past." [21]

As an illustration of the same point, the following passage demonstrates the clear use of interpretation in the Rankian method, despite the statement at the end which plays down the value of the technique:

All that the therapist can do is to take over with understanding the role falling to his lot, and to make clear to the patient the universal meaning of this experience which comprehends in itself the whole man, yes, almost the whole of humanness. This explanation, however, can be given only in the individual terminology of the particular patient and not in a general ideology which cannot give him understanding, but at most, knowledge. Knowledge alone does not liberate but freeing through experience can bring the insight afterwards, although even this is not essential to the result. [21]

Finally, we see a completely unambiguous managing of the therapeutic situation by Rank in the following account of end-setting:

I make use of various means in the final situation in order to meet the inner dynamic of the patient, which already functions freely, sometimes too intensively, by a dynamic of the external situation which corresponds better to reality. According to the type of person and the situation, through postponing, leaving out, lengthening or shortening of the regular treatment hour, as well as through other alterations of the customary therapeutic situation, I bring an outer dynamic to bear upon the inner conflict which perhaps may irritate the patient, but is still perceived by him as an unburdening of his ambivalence and is utilized in terms of adaptation to reality. [21]

All of this might be summed up with the comment that while Rank's desertion of content for dynamics, and of past for present, was complete, his renunciation of educative, interpretive, and other directive techniques was less so, and while it was totally wrong in his view to interpret content, it might be pardonable to interpret dynamics. To use the terms of his own simile, the patient is the author of this play, but the therapist retains the role of producer.

Jessie Taft

Taft, Rank's translator and later, for a short time, his associate at the Pennsylvania School of Social Work, for the main part has carried into her own work the features of Rankian theory described above. She has made some contributions of her own to Rankian theory and practice, however, which should be noted in an account of the development of the nondirective approach.

Perhaps her unique theoretical contribution has been the emphasis she places on time as representing the whole problem of living and of therapy. It would be a loss to abstract the views of one who writes such poetic prose. The deep feeling which is present in all of Taft's writing is especially present in her views on this subject, and a few quotations will reveal them concisely while allowing us to retain the feeling tone:

Time represents more vividly than any other category the necessity of accepting limitation as well as the inability to do so, and symbolizes therefore the whole problem of living. The reaction of each individual to limited or unlimited time betrays his deepest and most fundamental life pattern, his relation to the growth process itself, to beginnings and endings, to being born and to dying. [35]

The basis for believing that life can be thus accepted (as a changing, finite, limited affair to be seized at the moment if at all), beyond the fact that all of us do more or less accept it if we continue to exist, lies in this: that we are, after all, part and parcel of the life process; that we do naturally abhor not only ending but also never ending, that we not only fear change but the unchanging. [35]

Time in itself is a purely arbitrary category of man's invention, but since it is a projection of his innermost being, it represents so truly his inherent psychological conflict, that to be able to accept it, to learn to admit its likeness to one's very self, its perfect adaptation to one's deepest and most contradictory impulses, is already to be healed, as far as healing is possible or applicable, since in accepting time, one accepts the self and life with their inevitable defects and limitations. This does not mean a passive resignation but a willingness to live, work and create as mortals within the confines of the finite. [35]

And finally, this most poignant passage of all:

....one might fairly define relationship therapy as a process in which the individual finally learns to utilize the allotted hour from beginning to end without undue fear, resistance, resentment or greediness. When he can take it and also leave it without denying its value, without trying to escape it completely or keep it forever because of this very value, in so far he has learned to live, to accept this fragment of time in and for itself, and strange as it may seem, if he can live this hour he has in his grasp the secret of all hours, he has conquered life and time for the moment and in principle. [35]

Taft reveals a keen appreciation of the separateness of the will of the therapist from that of the client by recognizing the necessity for therapists to accept the limitation on the help which it is possible to give others:

I know in advance that no one is going to experience change, call it growth or progress if you have the courage, because I think it would be good for society, good for his family and friends or even good for himself....

This means not only a limit put upon those seeking help but a genuine limitation in myself, an impotence which I am forced to accept even when it is painful, as it frequently is. There is a beloved child to be saved, a family unity to be preserved, an important teacher to be enlightened. Before all these problems in which one's reputation, one's pleasure in utilizing professional skill, as well as one's real feeling for the person in distress are perhaps painfully involved, one must accept one's final limitation and the right of the other, perhaps his necessity, to refuse help or to take help in his own terms, not as therapist, friends or society might choose. My knowledge and my skill avail nothing, unless they are accepted and used by the other. Over that acceptance and possible use, I have no control beyond the genuineness of my understanding of the difficulty with which anyone takes or seeks help, my respect for the strength of the patient, however negatively expressed, and the reality of my acceptance of my function as helper not ruler. If my conviction is real, born of emotional experience too deep to be shaken, then at least I am not an obstacle to the person who needs help but fears domination. He can now approach me without the added fear and resistance which active designs for his cure would surely produce and can find within the limitation which I accept thus sincerely, a safety which permits him to utilize and me to exercise all the professional skill and wisdom at my command. On the other hand, the person who seeks the domination of another in order to project his conflict and avoid himself and his own development by resisting the efforts of the other to save him, is finally brought to a realization of the futility of his striving, as he cannot force upon me a goal which I have long since recognized to be outside my province and power. Whether such a person will ultimately succeed in taking over his own problem, since I cannot relieve him of it, can be determined only by what actually happens. There are those who are unwilling or unable to go further, an outcome every therapist must stand ready to admit and respect, no matter how much his professional ego is hurt or his therapeutic or economic aim defeated. [35]

We are not surprised to find her writing later on that

. . . . therapy in the sense of socially desirable behavior can never be the goal of this type of analytic relationship. It is a purely individual affair and can be measured only in terms of its meaning to the person, child or adult; of its value, not for happiness, not for virtue, not for social adjustment but for growth and development in terms of a purely individual norm. [35]

One of Taft's major contributions has been to record very completely two treatment cases with children. These appear in The Dynamics of Therapy in a Controlled Relationship and are valuable for the purposes of this paper because they give us the first definite indication of how a Rankian functions in a therapeutic situation. But before discussing them, it way be well to examine Taft's general views on the role of the therapist in a "controlled relationship". She does not care for the name "passive therapy" which sometimes has been identified with her method of treatment:

As I conceive it, the therapeutic function involves the most intense activity but it is an activity of attention, of identification and understanding, of adaptation to the individual's need and pattern, combined with an unflagging preservation of one's-own limitation and difference. [35]

In describing her role in the case of Helen P., which appears first in her book, she writes:

The contacts .... were carried through, as far as I was humanly able, in terms of the child as she actually was at the moment, and my recognition of her immediate will, feeling or meaning. Everything centered in her, was oriented with regard to her. This does not mean that there were no checks but that even when my response was a prohibition, it was also a seeing of her, never a denial of the nature of her impulse or her right to have it. Where my own curiosity as to her behavior symptoms or my interest in bringing out certain material got the better of me, as it did occasionally, I abandoned it, as soon as I became conscious of my folly .... Interpretation there was none, except a verbalization on my part of what the child seemed to be feeling and doing, a comparatively spontaneous response to her words or actions which should clarify or make more conscious the self of the moment whatever it might be. [35]

The comments on Taft's case material are made with the following in mind:

  1. A transcript of the words spoken in a contact is not an entirely adequate reproduction of it. Even records such as Taft's, which are descriptive in addition to containing a record of the conversation, lose much of the feeling tone which is present in the contact and which may be very important for therapy. This would be especially true of contacts in which an individual such as Miss Taft took part; her deep feeling of respect for the strengths and the individuality of the other would come through even if her statements were sometimes neutral (in the sense of not responding to feeling), or interrogative, or went beyond the expressed feeling.
  2. Children do not verbalize as well as adults, and sometimes show clearly what they are feeling, even though they have not verbalized the attitude.

With these points in mind, the cases of Helen P. and of John as handled by Taft seem to be characterized by the following:

1. There is only incidental attempt on the part of the therapist to bring out content material.
2. There are leading questions as to past feelings and warnings as to future feelings.
E.g., during the third hour with Helen P., Helen is drawing a picture of a lady holding an umbrella:

"That's you," she says laughingly.

"Helen, were you mad at me last week?"

"No."

"Weren't you mad -- just a little? I should have been in your place -- because I wouldn't let you take the crayons home."

"I wasn't mad. I like to come here to draw." [35]

It may be said that Taft's "acceptance" of the child is displayed here as an attempt to show her that bad feelings as well as good ones are acceptable in this situation. It should be noted that acceptance is lacking here, however, in the sense of accepting the kind of feeling the child is able to give expression to at the moment.

The same type of dynamic appears in the second case, that of Jackie (fourth hour):

He goes over to the steam pipes which he has found hot before, and shows extreme caution and fear. Can hardly bring himself to touch the pipe which burned him. Finally does so after much effort, and finds it cold.

"You decided to stay home on Thursday, didn't you, Jack?"

"Yes." No further comment. "It's hot here." [35]

Similarly future feelings are anticipated and introduced into the contact by the therapist with no indication that they form part of the present attitude of the child.

Helen P. (end of third hour):

"I like to come," she says.

"Yes, I know you do, but you may feel differently some day." [35]

Jackie (second hour):

He runs out quickly to see if the broom is there. When he comes back the story has grown. "We took the broom away from her and chased her. She was going to chase us but we chased her."

"And that's what you'll be doing to me some day. I see I have to look out." [35]

In the above two excerpts, there is displayed the therapist's need to prepare the child for the inevitable separation. Insofar as this is true, there is a lack of acceptance of the child's own capacities.

3. The therapist sometimes takes the lead in bringing out attitudes on the time element and on other aspects of the dynamics of the therapeutic situation.
E.g., Jack is brought in 15 minutes late for the fifth hour, after Miss Taft had been late for the third hour:

Jack comes in very cheerful and cold. "Feel my ear. See how cold it is."

"You are even with me now. You kept me waiting fifteen minutes."

Quick as a flash, he answers, "Are you mad at me?" [35]

4. The main resource of the therapist here is her general attitude of understanding and respect for the child. In the absence of any specific techniques the therapist appears to respond on an intuitive emotional basis.

Before leaving Taft, it might be well to note first, her feeling, like Rank's, that therapy is "purely individual, non-moral, non-scientific, non-intellectual." [35] Also, that "therapy is non-scientific .... and not open to research at the moment." [35]

Secondly, it is revealing to note her view that relationship therapy is not equally suited for all people and that for some children, it may not do at all:

.... The less able the individual is to bear the pain of his own humanity, the less willing he is to sacrifice a partial unwilled response in favor of a consciousness which permits a choice by the whole self; in other words the less able he is to become emotionally self-conscious, the less suited will he prove for a kind of therapy which depends on the possibility of substituting feeling, emotion, thoughtful voluntary behavior for unconscious irresponsible projection. [35]

.... the over-impulsive child, especially if he is old enough to be classed as delinquent, may be too unable or too slow to reach the point of feeling and self-inhibition of impulse which is essential to forming a new relation to the object, and will perhaps require a discipline which is incompatible with a strictly therapeutic relationship. With such a child there is always the problem of how far he will have to carry the destructive behavior patterns before he is able to face and bear in himself, the need, pain, and fear which they seek to relieve. [35]

 

Frederick H. Allen

In Allen's work at the Philadelphia Child Guidance Clinic we see continued the Rankian emphases on the dynamics of the therapeutic situation, the importance of the relationship between client and therapist, the capacity of the client to effect his own changes, the need for the therapist to be aware of the use which the client is making of him, the notion that during therapy the client casts off his "neurotic selves" on the therapist, leaving him an individuated, unified person at the conclusion of successful therapy, and the importance of the ending phase of therapy.

It may be recalled that in evaluating Rank's contribution, it was stated that while his renunciation of the past for the present and of therapeutic content for dynamics was complete, his abandonment of the Freudian techniques of therapist-direction and interpretation was not, at least where the dynamics of will in the therapeutic situation were concerned.

The same comment may be made in regard to Allen, but with more certainty, since we have a much clearer record of his therapeutic technique [1].

One of Allen's most complete accounts of his method is the report of the ninth hour of "a fearful child in therapy" [1]. In order to bring out more clearly what transpired in the therapeutic hour, the writer has taken the liberty of separating: (1) the remarks made by the therapist during the treatment session (Th.), (2) the statements and actions of the child ( 10-year-old ) during the hour (Ch.), and (3) Dr. Allen's evaluative comments (Com.). The account follows:

(Com.) The ninth hour was a climactic interview which brought to a focus all that had gone into the preceding weeks. Solomon looked languid and worried, but maintained his customary rigorous control of feeling.

(Th.) The therapist commented on his worried appearance

(Ch.) but he was evasive and withdrew into a corner with a few toys.

(Th.) When this need to escape was mentioned,

(Ch.) he shrugged his shoulders saying, "I just know I come here."

(Com.) Knowing how important it was for him to face and experience the pain of this immediate reality, if he were to move beyond this protective barrier,

(Th.) the therapist again opened the discussion of what he was doing and how he was feeling about coming.

(Ch.) "I think there is nothing to it -- it doesn't make sense."

(Th.) The therapist agreed with this if Solomon had to continue putting the whole job of getting well on the doctor.

(Ch.) With more anxiety he said, "I don't know how to get well."

(Th.) At this point the therapist reversed the emphasis and said: "The harder job is being well and you are frightened now because you are closer to being well."

(Com.) It was true that this new responsibility he was taking for himself meant a breaking up of the dependent bond to his mother, which he had maintained through sickness. Each step he made away from sickness meant a step toward a more mature relationship with the mother; it also meant establishing his relationship with his therapist on the basis of getting well and not by remaining sick.

(Ch.) As Solomon withdrew into solitary play

(Th.) the therapist discussed the tenacious way in which he clung to the idea of sickness. To be sick was to be safe as long as others would do the worrying.

(Ch.) He almost agreed with this,

(Th.) and the therapist then commented on how he was finding this experience different in that it gave him a chance to do part of the job, not just to take a bottle of medicine.

(Ch.) "That didn't do any good," Solomon said.

(Th.) The therapist agreed and added that Solomon was frightened at the moment because "this was doing him some good."

(Com.) The mother reported a great deal of change in her son but added that his tics were as bad as ever. Through these difficult therapeutic hours very few tics were noticeable.

(Ch.) Solomon was silent after this,

(Th.) and the therapist withdrew saying that he was there to help him further when he was ready for it.

(Com.) The directness of this discussion had pushed Solomon momentarily further into his shell.

(Ch.) But his play had more purpose and much more feeling and he made a vehement attack on the soldiers.

(Th.) The therapist commented on "those soldiers getting a real punishing" and added that probably some of that anger was meant for him.

(Com.) That touched off the explosion and the barrier he had established to hold back his feeling melted.

(Ch.) In angry crying he blurted: "I would rather be like I was than go through this."

(Com.) He summed up so much in this statement, and showed how aware he was of change in himself and of the amount of anxiety that was stir red by his movement away from his tight and undifferentiated way of living. His anxiety was now concerned with a new responsibility for himself which sprang directly from his growing relationship with the therapist.

(Ch.) As the boy continued his angry outbursts of "What's the use of all this"

(Th.) the therapist was very gentle in his support.

(Ch.) Then suddenly in a tone that was more grieved than angry, Solomon remarked: "You said you didn't care whether I went to bed alone or not."

(Com.) This had happened in an earlier interview when he was trying to prove that by going to bed alone he was doing what the therapist wanted him to do. He was trying at that time to avoid any self-initiated responsibility in that change.

(Th.) The therapist replied: "You are quite right, Solomon. I said that and meant it. I also said I did care about what you wanted and were ready to do about that -- so if you are going to bed alone it is because you are ready and want to do it."

(Ch.) He nodded agreement but maintained this struggle against his part in the changes that had been occurring. He repeated: "I'd rather be the way I was. People told me coming here would make me well."

(Com.) The fact that he was finding some truth in this but not on the pattern he had planned activated a more significant anxiety that emerged from his change. No doubt he was baffled, as anyone would be, who, in fighting against change, found he was participating in bringing it about. 
The force Solomon had put into these interviews was clearly revealed toward the end of this dramatic hour.

(Ch.) Again he said he didn't know how to get well,

(Th.) and we discussed the more important and harder task of knowing how to be well.

(Ch.) Following this he said: "What do I have here that I don't have at home?"

(Th.) The therapist said: "Your relation with me."

(Com.) For a boy who had no attachment to anyone but his mother, this was too much and he let go with a final blast of his determination:

(Ch.) "I will always be sick, nothing can make me well."

(Com.) In effect, he was trying to deny his growing relationship with the therapist and to assert his desire to recapture the safer and undifferentiated relationship with the mother from which both he and his mother were moving away.

(Th.) His divided feeling about being well was discussed and it was brought out that he was ready for something different but that he had to fight against that readiness at the same time.

(Com.) Solomon really suffered in this hour. He was cringing in a corner and hardly moved an inch, but he could share his anger and fear and it had real meaning to him when at the end of the hour,

(Th.) the therapist said: "Solomon, I think you and I are beginning to get somewhere."

END OF NINTH HOUR.

The writer would evaluate this account as follows:

  1. The therapist may be accepting Solomon as an individual who can help himself get well, but he is not accepting the boy's capacity to arrive at that insight himself; he is not accepting the expressed feeling that he does not know how to get well and needs the therapist to help him.
  2. The therapist plays the role of interpreter of the dynamics of the child's will-conflict, and of the relationship of the child to the therapist and to the therapeutic situation in general.
  3. Solomon resists all these attempts at interpretation, and in being forced to express his counter-will against the therapist's will, is given no opportunity to assert the positive will which would make for growth.
  4. Any progress made by Solomon is dependent upon the therapist's interpretation (under Comments above) and is not apparent from the boy's statements and actions themselves. In this connection, the last statements of the boy and of the therapist may be contrasted.

The same lack of acceptance on the part of the therapist is demonstrated by the handling of the ending phase of treatment with this same boy. Allen apparently does not believe in Solomon's capacity to take the initiative in an explicit manner in the matter of discontinuing contacts. At the same time, the following quotation indicates that little progress has been made between the ninth and this, the fourteenth hour, in regard to whether the boy or the therapist will effect the cure:

In the fourteenth hour, Solomon continued to emphasize that he came to be cured and "there is nothing to do here." In this hour he took less initiative, and the therapist commented that he seemed to be about through coming to the clinic. [1]

The same pattern of interpretation is repeated during the next hour:

In the fifteenth hour Solomon was ready to discuss a plan for ending but he approached this negatively. He wanted to paint but said "There are no paints," and "There is no paper." To this the therapist commented: "Sounds as if you don't think there is much here you want and you probably are about finished." [1]

We soon observe that initiative-taking by the therapist leads to difficulties. We are told that the fifteenth hour concluded with Solomon's decision to use the next time to settle on a definite ending date. But in the sixteenth hour, the therapist finds that he must remind him of "last week's decision to get something important settled today." Solomon stalled and asked "what?"

The therapist suggested he answer that and he made two totally irrelevant guesses. The therapist commented that Solomon was finding it hard to settle down and act on his readiness to end. He said nothing more but he played two good games of checkers.

The question of termination was reopened by the therapist who commented on Solomon's anxiety in facing this question. He tried to reassure himself and asked: "What is there to be afraid of?" The therapist replied: "Because you are not quite sure you can hold the feeling of being well that you have gained right here." He assented, saying, "I wouldn't he sure I would be well." The therapist agreed to the risk involved, and that ending would and did activate that uncertainty. With some help Solomon then settled on four more appointments. He was intrigued and relieved with this decision and talked about what he had missed at school through coming here. When the therapist suggested, "Suppose you call your mother on the telephone and tell her of your decision," his first impulse was to do this. As he made the move to pick up the telephone, however, he retreated from this daring act. With a little encouragement he went ahead, asking for his mother, and before she answered he exclaimed: "Gee -- I'm scared." When his mother answered, timidly he asked: "Mother, how much longer shall I come?" The therapist broke in and said: "Solomon, you're just trying to get your mother to decide what you have really decided." So he blurted out: "I am coming four more times." She thought that was fine, and a look of the most intense relief was on Solomon's face as he hung up, saying in a surprised tone, "She said it was all right." [1]

Thus we see the therapist talking an active role throughout, always staying close enough to Solomon to be able to push him up the next step.

In the nineteenth and closing hour, Solomon states that he is all over his fears, but that he is still a little afraid of stopping, and "he talked of the possibility of returning sometime 'for a visit'." [1]

Carl R. Rogers

Rogers is the first individual in the line of therapists we are considering -- Freud, Rank, Taft, Allen, Rogers -- who did not experience a personal working relationship with his predecessor. This may help to account for the fresh advances in nondirective theory and practice which we see in his work.

(1) He introduced into therapy the systematic use of the "recognition of feeling" response, [24] . In so doing, (2) he cut through the maze of mystery which had surrounded the work of psychotherapists in general, regardless of orientation, and gave to the Rankian "client-as-central-figure" philosophy a definite technique, which Rank, Taft, and Allen had pronounced impossible. (3) At the same time, he gave a new, more exact, and deeper meaning to the concept of "acceptance" of the client. [Footnote #2] The following quotation from Rogers is pertinent here:

There has, of course, been lip service paid to the strength of the client and the need of utilizing the urge toward independence which exists in the client. Psychiatrists, analysts, and especially social case workers have stressed this point. Yet it is clear from what is said, and even more from the case material cited, that this confidence is a very limited confidence. It is a confidence that the client can take over, if guided by the expert, a confidence that the client can assimilate insight if it is first given to him by the expert, can make choices providing guidance is given at crucial points. It is, in short, the same sort of attitude which the mother has toward the adolescent, that she believes in his capacity to make his own decisions and guide his own life, providing he takes the directions of which she approves.

This is very evident in the latest book on psychoanalysis by Alexander and French. [25]

This quotation seems applicable to the work of Rank, and Allen, and to a lesser degree, Taft, as well as to that of the modern analysts. Rogers' greatest contribution, it is believed, lies in the fact that he made acceptance over from a concept which was tenuous and incomplete to one which is clear and total. It is an acceptance not only of the individual's capacity for growth, but of his ambivalence over growth and perhaps incapacity for growth at any given time. It is an acceptance of his feelings at the moment without the need for showing him the origin of these feelings (Freud), and without the need for showing him the use which he is making of them (Rank). It is a "nondirective acceptance".

(4) As a corollary, the function of the therapist, with Rogers, becomes in contrast to the Freudian who seeks first to discover and then interprets to the patient patterns of behavior related to repressed infantile sexuality, and to the Rankian, who alerts himself to the manner in which the patient is relating to the therapeutic situation and then responds on that basis simply to recognize and accept the attitudes of the client at the moment. Rogers writes:

We have come to recognize that if we can provide understanding of the way the client seems to himself at this moment, he can do the rest. The therapist must lay aside his preoccupation with diagnosis and his diagnostic shrewdness, must discard his tendency to make professional evaluations, must cease his endeavors to formulate an accurate prognosis, must give up the temptation subtly to guide the individual, and must concentrate on one purpose only; that of providing deep understanding and acceptance of the attitudes consciously held at this moment by the client as he explores step by step into the dangerous areas which he has been denying to consciousness. [25]

(5) The result of therapists' functioning in this manner, of their putting into practice this new concept of "acceptance", has been a growing accumulation of evidence that clients can achieve insights and a happier, better integrated adjustment to living, without guidance. "The individual is capable of discovering and perceiving truly and spontaneously the interrelationships between his own attitudes and the relationship of himself to reality." [25] Here in a sentence is Rogers' distinctive contribution, with the word "spontaneously" signifying the difference between him and the Rankians. [Footnote #3]

With this growing evidence of people's capacity for self-help, and with the participation by Rogers and by his students and associates in more and more experiences in which clients have shown their capacity for self-help, the original philosophy that gave rise to the method of nondirective acceptance has steadily deepened into a conviction that people in mental turmoil need no more than to be accepted as they are. And with this growing conviction have come significant changes in the approach of the Rogers' school, even in its short history. There is now a tendency to get away from an atomistic relating of client statement to the counselor response which immediately precedes it and to evaluate instead the genuineness of the counselor's accepting attitude; structuring, the intellectual explanation to the client of the nondirective counseling relationship, is recognized as undesirable; the list of criteria for acceptance of "cases" for therapy [24] has given way to the belief that in all people there is a degree of capacity for spontaneous self-help; the client's concept of self is now believed to be the most central factor in his adjustment and perhaps the best measure of his progress in therapy.

Current Trends In Nondirective Therapy

The client-centered attitude. Most of the significant changes within the movement of nondirective therapy during the past five years center around a growing appreciation of the importance of the client's internal frame of reference, for counseling and for the study of personality. This has been reflected in the increased application of the term "client-centered" to nondirective therapy, a tendency which has been criticized by exponents of other methods on the grounds that all psychotherapies center their interest in the client and are thus "client-centered". The nondirective point of view on this issue is that to the extent that some other frame of reference than the client's is introduced into the therapeutic situation, the therapy is not client-centered. The Freudian introduces his own frame of reference into the therapeutic hour by virtue of his belief that he has a knowledge of the unconscious which is superior to that of his patient and which must be utilized in understanding him. The Rankian brings his own frame of reference into therapy with his belief that he has a superior knowledge of the dynamics of the therapeutic situation which must govern his behavior in it; this is carried to the point of not accepting certain attitudes which the client may express, and of not accepting the nonexpression of other attitudes. The nondirective therapist believes that where the counselor is concerned with his own frame of reference, he will be unable to provide a full and deep understanding of the client's feelings and perceptions.

Because this latter fact has been more and more clearly understood, there has been a de-emphasis on nondirective techniques, together with an increased appreciation of the importance of a nondirective attitude. Once we center our attention on the client's frame of reference, we cannot stop with counselor techniques, but must study the manner in which they are perceived by the client. Experience indicates that clients will pick up attitudes such as the desire of the counselor that a certain area be explored, and will react defensively as a result. This type of attitude may be conveyed through a "loaded," and thus inaccurate "reflection of feeling" type of response. As the counselor learns, through increased experience, that clients can progress when they are not guided, he comes to have a more genuine nondirective attitude. He then is better able to concentrate on understanding the way things appear to his clients, and to forget about the employment of techniques. As long as the attitude is not genuine, not only will "reflections of feeling" tend to be inaccurate, but directive techniques will creep into the counselor responses, so that even when the goal of the counselor is to be nondirective, recordings of his interviews will show that he is making interpretations, giving support, and utilizing other directive techniques.

The self-concept. Inevitably, with attention centered on the internal frame of reference, has come an appreciation of the significance of the most central portion of that frame of reference, the concept of self, for understanding personality and the changes in personality which occur in therapy. The self, as viewed both externally and internally, has at various times in the history of thought been in the forefront of philosophical and psychological discussion. Today, nondirective psychotherapists, as well as many other psychologists and sociologists devoted to the study of personality, are giving increased emphasis to the internal view of the self in explaining adjustment and behavior. Using modern methods of studying personality, including recorded psychotherapeutic interviews, it is possible that theories of the self, which have formerly died in discussion, may be tested against objective clinical data, and either pass into the realm of useful knowledge, or be discarded as unsupportable belief.

A recent comprehensive treatment of the concept of self, which is little known outside of the field of nondirective counseling, is an unpublished dissertation by Raimy [20] entitled The Self-Concept as a Factor in Counseling and Personality Organization. The experimental aspect of the study has been summarized in the literature [32] . Turning to his theory, we may list some of the hypotheses advanced by Raimy to indicate how far he went beyond older and more orthodox theories of the self:

  1. The self-concept is a learned perceptual system which is governed by the same principles of organization which govern other perceptual objects.
  2. The self-concept regulates behavior. The awareness of a different self in counseling results in changes in behavior.
  3. A person's awareness of himself may bear little relation to external reality, as in the case of psychotic individuals. Logical conflicts may exist in the self-concept for the external observer, but these are not necessarily psychological conflicts for the person.
  4. The self-concept is a differentiated but organized system, so that even negatively valued aspects of it may be defended by the individual in order to maintain his individuality. The self-concept may be more highly valued than the physical organism, as in the case of the soldier who sacrifices himself in battle in order to preserve the positively valued aspects of his self-concept, courage and bravery.
  5. The total framework of the self-concept determines how stimuli are to be perceived, and whether old stimuli are to be remembered or forgotten. If the total framework is changed, repressed material may be recalled.
  6. The self-concept is exceedingly sensitive in yielding to rapid restructuring if the conditions are sufficient, yet it may also remain unaltered under conditions which, to the external observer, are violent conditions of stress. In counseling, the counselor tries to create a permissive atmosphere in which the client can drop his guard and look at the parts of the self-concept which are causing difficulty.

For some time before Raimy began to formulate his theory, Prescott Lecky [16] at Columbia University had been quietly developing and applying a theory of self-consistency to explain human behavior. In evaluating what the self-concept theory cannot do, Raimy [20] wrote that "it provides primarily an 'anatomy' to personality and not a physiology. The self-concept in itself is only a perceptual object and cannot be used to explain behavior. . . " Lecky, with his self-consistency principle, would appear to be supplying a "physiological" formula which could complement the "anatomical" self-concept. This principle is implicit in much of Raimy's dissertation. Used in a much more explicit way by Lecky, we are helped to see more clearly how the self-concept maintains and changes its structure, how it regulates behavior, and so on. Raimy's emphasis is on answering the question "what" in personality, while Lecky stresses the "how."

Rogers early realized the importance for therapy of the client's view of himself. For example, in 1940, he wrote: "In the rapport situation, where he is accepted rather than criticized, the individual is free to see himself without defensiveness, and gradually to recognize and admit his real self with its childish patterns, its aggressive feelings, and its ambivalences, as well as its mature impulses, and rationalized exterior." [23]

Stimulated particularly by Raimy, Lecky, Snygg [33], and Snygg and Combs [34], and through seeing the process of therapy with increasing clarity himself, the concept of self has assumed a place of central significance in psychology for Rogers [26].

Research. Research has always been a significant part of the nondirective picture. Many of Roger's students [4, 5, 6, 7, 8, 9, 10, 11, 14, 15, 17, 18, 19, 20, 22, 27, 28, 30, 31] have made research contributions to the understanding of the therapeutic process and of the dynamics of personality. In his comprehensive article interpreting the present status of psychotherapeutic counseling, Snyder [32] outlines the following principles which had been subjected to investigation by nondirective counselors up to July, 1947:

  1. The recorded content of counseling interviews can be reliably analyzed by certain methods of categorization.
  2. Counseling can be a systematic, orderly process rather than a casual or intuitive one.
  3. The client's feelings change in a consistent fashion during nondirective counseling.
  4. Various types of counselor activity precede and apparently cause certain client responses.
  5. Investigators can study the personality of the client through analysis of the statements he makes during counseling.
  6. Interrelationships between the various problems of the client is an important factor related to the outcome of counseling.
  7. It is feasible to compare different counseling techniques.
  8. An experimenter can compare the responses of various counselors to a particular speech by the client.
  9. The reasons for lack of success of a treatment method can be studied experimentally.
  10. The follow-up is important as an indication of measurable personality changes brought about by counseling.
  11. The group therapy process may be subjected to research analysis.

Important as its role has been in the past, research has a much bigger place within the field of nondirective therapy today than ever before. An examination of the present research activity reveals that much if it constitutes a beginning test of the usefulness of the internal frame of reference as a basis for studying psychological data. The analytic method used by Raimy in his dissertation was an example of this type of investigation and proved fruitful. The reliance on the internal frame of reference in nondirective therapy and the accumulation of therapeutic material based on it has led to the hypothesis that this may be the most substantial foundation upon which to build knowledge about people. Rogers [26] stated the issue clearly:

If we take first the tentative proposition that the specific determinant of behavior is the perceptual field of the individual, would this not lead, if regarded as a working hypothesis, to a radically different approach in clinical psychology and personality research? It would seem to mean that instead of elaborate case histories full of information about the person as an object, we would endeavor to develop ways of seeing his situation, his past, and himself as these objects appear to him. We would try to see with him, rather than to evaluate him. It might mean the minimizing of the elaborate psychometric procedures by which we have endeavored to measure or value this individual from our own frame of reference. It might mean the minimizing or discarding of all the vast series of labels which we have painstakingly built up over the years. Paranoid, preschizophrenic, compulsive, restricted-terms such as these might become irrelevant because they are all based in thinking which takes an external frame of reference. They are not the ways in which this individual experiences himself. If we consistently studied each individual from the internal frame of reference of that individual, from within his own perceptual field, it seems probable that we should find generalizations which could be made, and principles which were operative, but we may be very sure that they would be of a different order from these externally based judgments about individuals.

This hypothesis received its first comprehensive formulation by Snygg [33] in 1940, and is presently being elaborated by Snygg and Combs [34]. It is being tested in many of the research studies being carried on or recently completed by students of nondirective therapy. Some of these investigations, on the other hand, utilize an external frame of reference while a special research project being coordinated by the University of Chicago Counseling Center combines both external and internal measures of a group of ten completely recorded cases with pre- and post- test data and with follow-up information. There are presently about forty individual studies, in the following areas: analyses of the individual therapeutic process through the classification of client responses, analyses of changes produced in therapy through objective measures of the client before and after, evaluation of the counseling experience by the client, studies of counselor methodology, counselor personality, and the effect of training on counselors, studies which objectify group situations, and the application of nondirective principles to other fields.

Application to other fields. The usefulness of being able to see things from another's point of view obviously transcends the field of psychotherapy. Covner [9] has recently described a systematic approach to the problems of an industrial psychologist which is based on an awareness of the attitudes of both management personnel and workers. The extension of the client-centered principle to the classroom, making for "student-centered" teaching, represents an applied situation of extreme interest to nondirective people. Blocksma and Porter [3] have described a training program for personal counselors which relied heavily on student initiative and on a continual awareness of student attitudes on the part of the instructors.

These are illustrations of how individuals who have been trained in nondirective therapy have been stimulated to transfer some of their attitudes to other situations in which human interrelationships are a factor. Much difficulty is encountered in carrying through this transfer because of the different factors operating in these "applied" areas. But the conviction that the principle of recognition and acceptance of another's point of view is a potentially powerful one for the betterment of human relations supplies the motivation for continuing to seek the answers to the puzzling questions which surround application.

Summary

A cross-sectional study of the development of nondirective therapy has been attempted. Freud, within a fundamentally authoritarian framework, found it necessary to respect client attitudes to an increasing degree in order to make progress in therapy. Rank focused his attention on the phenomenon of resistance, and developed a theory of will and dynamics which completely displaced Freudian content as the factor of importance in psychotherapy, At the same time, Rank utilized directive methods in an effort to impress the dynamics of the therapeutic situation on the client. Taft and Allen have carried on the Rankian tradition in this country, and have published clear accounts of their therapeutic method. Rogers has given Rank's client-centered philosophy a definite technique and has made it more meaningful and complete by accepting the client's expressed feelings at the moment in therapy and eliminating directive features of the Rankian method. Accompanying this more complete acceptance has been a greater concentration on the client's internal frame of reference. This has led to an increased emphasis on a nondirective attitude as opposed to nondirective techniques, to an appreciation of the importance of the self-concept as a factor in adjustment, to a greater stress on phenomenological methods of studying personality, and to the application of nondirective principles to other areas of human interrelationships.

Footnotes

1. Rogers has cited the indebtedness of the client-centered approach to Freud for his concepts of repression, release, catharsis and insight [25].

2. The work of Axline [2] in play therapy has helped to define the concept of acceptance. While Rogers' principles have been derived primarily through experience with adult clients, Axline's work furnishes a direct comparison with that of Taft and Allen.

3. The writer has not mentioned Rogers' pioneering work in making psychotherapy objective and amenable to research, but this contribution follows from his more basic discoveries, which are not as widely recognized.

References

  1. Allen, F. H. Psychotherapy with children. New York: Norton, 1942.
  2. Axline, Virginia Play therapy. Boston: Houghton Mifflin, 1947.
  3. Blocksma, D. D., and Porter, E. H., Jr. A short-term training program in client-centered counseling. J. consult. Psychol., 1947, 11, 55-60.
  4. Combs, A. W. Follow-up of a counseling case treated by the nondirective method J. clin. Psychol., 1945, 1, 145-154.
  5. Covner, B. J. Studies in phonographic recordings of verbal material: I. The use of phonographic recordings in counseling practice and research. J. consult. Psychol., 1942, 6, 105-113.
  6. Covner, B. J. Studies in phonographic recordings of verbal material: II. A device for transcribing phonographic recordings of verbal material. J. consult. Psychol., 1942, 6, 149-153.
  7. Covner, B. J. Studies in phonographic recordings of verbal material: III. The completeness and accuracy of counseling interview reports. J. gen. Psychol., 1944, 30, 181-203.
  8. Covner, B. J. Studies in phonographic recordings of verbal material: IV. Written reports of interviews. J. appl. Psychol., 1944, 28, 89-98.
  9. Covner, B. J. Principles for psychological consulting with client organizations. J. consult. Psychol., 1947, 11, 227-244.
  10. Curran, C. A. Personality factors in counseling. New York: Grune and Stratton, 1945.
  11. Fleming, Louise and Snyder, W. U. Social and personal changes following nondirective group play therapy. Amer. J. Orthopsychiat., 1947, 17, 101-116.
  12. Freud, S. Further recommendations In the technique of psychoanalysis. Chap. XXXI in Collected papers. London: Hogarth Press, 1924.
  13. Freud, S. Further recommendations in the technique of psychoanalysis. Chap. XXXII in Collected papers. London: Hogarth Press, 1924.
  14. Gump, P. V. A statistical investigation of one psychoanalytic approach and a comparison of it with nondirective therapy. Unpublished Master's thesis, Ohio State Univ., 1944.
  15. Hobbs, N. and Pascal, G. R. A method for the quantitative analysis of group psychotherapy. Amer. Psychologist, 1946, 1, 297. (Abstract.)
  16. Lecky, P. Self-consistency: A theory of personality. New York: Island Press, 1945.
  17. Muench, G. A. An evaluation of nondirective psychotherapy by means of the Rorschach and other tests. Appl. Psychol. Monogr., No. 13, 1947.
  18. Peres, Hadassah. An investigation of nondirective group therapy. J. consul t. Psychol., 1947, 11, 159-172.
  19. Porter, E. H., Jr. The development and evaluation of a measure of counseling interview procedures. Educ. psychol. Measmt., 1943, 3, 105-126, 215-238.
  20. Raimy, V. C. The self-concept as a factor in counseling and personality organization. Unpublished Doctor's thesis, Ohio State Univ. ,1943.
  21. Rank, O. Will therapy, and truth and reality. New York: Knopf, 1945.
  22. Reid, Dorothy and Snyder, W. U. Experiment in "recognition of feeling" in nondirective psychotherapy. J. clin. Psychol., 1947, 3, 128-135.
  23. Rogers, C. R. The processes of therapy. J. consult. Psychol., 1940, 4, 161-164.
  24. Rogers, C. R. Counseling and psychotherapy. Boston: Houghton Mifflin, 1942.
  25. Rogers, C. R. Significant aspects of client-centered therapy. Amer. Psychologist, 1946, 1, 415-422.
  26. Rogers, C. R. Some observations on the organization of personality. Amer. Psychologist, 1947, 2, 358-368.
  27. Royer, Anne. An analysis of counseling procedures in a nondirective approach. Unpublished Master's thesis, Ohio State Univ., 1943.
  28. Sachs, H. Freud, master and friend. Cambridge: Harvard Univ. Press, 1946.
  29. Sherman, Dorothy. An analysis of the dynamic relationship between counselor techniques and outcomes in larger units of the interview situation. Unpublished Doctor's thesis, Ohio State Univ., 1945.
  30. Snyder, W. U. An investigation of the nature of nondirective psychotherapy. J. gen. Psychol., 1945, 33, 193-223.
  31. Snyder, W. U. A comparison of one unsuccessful with four successful nondirectively counseled cases. J. consult. Psychol., 1947, 11, 38-42.
  32. Snyder, W. U. The present status of psychotherapeutic counseling. Psychol. Bull., 1947, 44, 297-3S6.
  33. Snygg, D. The need for a phenomenological system of psychology. Psychol. Rev., 1941, 48, 404-424.
  34. Snygg, D. and Combs, A.W. Book manuscript. In process of publication. New York: Harper.
  35. Taft, Jessie. The dynamics of therapy in a controlled relationship. New York: Macmillan, 1933.

Copyright 1948 Nathaniel J. Raskin. 
Permission granted to distribute freely with copyright intact.