The Role of Empathy In Personality Change: What is the role of empathy in personality change during therapy? A Person-Centred Exploration.
The role of empathy in personality change will be explored in this essay. I will examine the relationship that empathy has with the other five “necessary and sufficient conditions” (Rogers 1957, p.95) and the main features of Rogers’ personality theory or his “Nineteen Propositions” (Rogers, 1951). Carl Rogers created client-centred therapy which later became known as person-centred therapy.
Carl Roger’s & ‘The Necessary & Sufficient Conditions of Therapeutic Personality Change’
Carl Roger’s 1957 paper ‘The Necessary and Sufficient Conditions of Therapeutic Personality Change’ presented the first use of this term and formed the basis of his approach to the therapeutic relationship. The six conditions for the basis of person-centred therapy. He proffered the notion that “If these six conditions . . . exist, then constructive personality change . . . will occur in the client . . . If one or more of these conditions is not present, constructive personality change will not occur” (1957, p.99). This captures the essence of the non-directive, ‘cause and effect’ quality of Rogers’ hypothesis, one that some critics such as Farber (2007, p.289) suggest is insufficient and that “while each of the conditions that Rogers postulated has been linked to positive therapeutic outcome, taken together they have never been conclusively proved (nor disproved) to be either necessary or sufficient for positive outcome.” Farber (2007, p.289) further suggests that Rogers’ goal-oriented hypothesis of personality change “seems to be inconsistent with the essential client-centered notion of nondirectiveness; some clients, after all, might well be satisfied with reductions in the intensity of their symptoms while others might feel content with greater self-awareness without any significant shift in their personality structure.”
Nevertheless, Rogers (1959, pp.213-214) makes clear that he considers the six conditions to be intertwined and that “For therapy to occur the wholeness of the therapist in the relationship is primary, but a part of the congruence of the therapist must be the experience of unconditional positive regard and the experience of empathic understanding.” This point is most essential in appreciating the interconnectedness of the six conditions and in my exploration of how empathy contributes to personality change. We cannot understand empathy in this context without respectful attentiveness to the integrated relationship it has with the other conditions. A notion further expanded upon by Bozarth (2001, pp.144-145), who succinctly encapsulates how the interplay of the conditions will then lead to personality change: empathy for Rogers is intertwined with unconditional positive regard . . . he identifies the necessary and sufficient conditions of the therapist as that of striving to ‘experience’ unconditional positive regard towards, and empathic understanding of the client’s frame of reference. Roger’s instructions to the client centred therapist are to experience these two conditions while being congruent in the relationship. When the client perceives the therapist’s experiencing of these two conditions, personality change will ensue.
The client as expert
However, as Eager (2010, p.114) comments of Bozarth, Elliott, Greenberg & Watson’s analysis in her appraisal of critical approaches to the condition of empathy, “[they] believe that empathy may lead to positive outcomes for numerous reasons. Because empathy increases client fulfilment with therapy, it may increase compliance with therapeutic interventions.” The word ‘compliance’ suggests the removal of the client’s agency resulting in an almost manipulative effect or at the very least an undesirable side-effect which requires more analysis. However, as Brodley (1996, p.26) counters “The . . . therapist’s immediate intention when making an empathic response is to check, test or verify the accuracy of his or her subjective empathic understanding . . . The client is viewed as the expert, the authority, about his own intentions, meanings and feelings.”
Psychological Contact
Before continuing with my analysis of how empathy and the other conditions are viewed as a coherent whole. I want to pay attention at this point, to the only condition, I regard to not be as interlinked as the rest but that they depend on it for their very existence. “Psychological contact” is the first of Rogers (1957, p.96) conditions to be listed. He argues that this condition is a pre-requisite of the ensuing conditions. Quite simply, without psychological contact, empathy is not physically, mentally or emotionally possible. Tudor (2000, p.35) comments that “Although Rogers refers to this condition as dichotomous . . .others notably Mearns (1997 cited in Tudor 2000, p.35), argue “the phenomenological reality of psychological contact to both clients and counsellors is that there are degrees of contact.” Tudor (2000, p.35) continues to assert that more recent work within the Person-Centred Approach has identified ‘Pre-therapeutic work in terms of “‘contact reflections’-contact, situational, facial, body, word for word and reiterative reflections-may be necessary in order to help a client to get to a point of therapeutic engagement.” It would appear then that more recent critiques (Tudor, 2000) and (Mearns 1997 cited in Tudor, 2000, p.35) of this first condition assert that it is not as ‘dichotomous’ as Rogers (1957 cited in Tudor 2000, p.35) initially commented but that it exists in varying degrees and forms. In terms of the relationship this condition has with empathy, we can conclude that psychological contact is simply necessary for empathy to exist.
The Actualising Tendency & The Nineteen Propositions
Returning to a focus on the relationship empathy has with congruence and unconditional positive regard, Bozarth (1998, p.52) previously commented on how ‘empathy . . . is integrated with the conditions of congruency and unconditional positive regard . . . and is predicated on the foundation block of the actualising tendency.” A comment which leads us to a consideration of the role empathy plays in Rogers personality theory (1951) in ‘Client Centred Therapy’ via ‘The Nineteen Propositions.’ Rogers’ theory of personality and hypothesis of personality change are indelibly linked. Whilst the conditions are intended to “demystify . . . those aspects of a human relationship which might facilitate constructive personality change” (Sanders 2012, p.6). As, Merry (2012, p.23) suggests “The key to understanding Rogers’ view of the person is his formulation of the theory of actualisation.” He goes on to assert that “organisms . . . tend to develop positively . . . in environments that support such development . . . but hostile or destructive environments . . . tend to inhibit development of constructive potential.” Once self-structure is achieved, the process of self-actualisation begins. However, through the adoption of introjected values and negative conditions of worth via significant others, a person can experience “unfavourable conditions [resulting] in the actualisation of a self that is in conflict with organismic experience.” (Merry 2012, p.26). This is the point at which ‘psychological maladjustment’ occurs in the person and tension, anxiety or incongruence is experienced. This relates directly to the second condition of client incongruence.
According to Rogers (1957, p.95) the second condition requires that the client “is in a state of incongruence, being vulnerable or anxious.” Eager (2010, p.109) comments that “the second condition identifies incongruence as the state of being that compels the client to seek therapeutic intervention.” This is a crucial point in the journey through the six conditions but one that like ‘psychological contact’ is considered to not be of ‘core condition’ value. I feel it is pertinent at this point to emphasise the synergy between this condition and Roger’s (1951, p.510) fifteenth proposition which states how “Psychological maladjustment exists when the organism . . . denies awareness of the self-structure. When this situation exists, there is a basic or psychological tension.” Interestingly, client incongruence (condition two) relates directly to the imbalance and maladjustment described in propositions fifteen and sixteen. Rogers (1957, p.95) continues to explore how inconsistencies of experience are “perceived as a threat” and how this results in a rigidity of how “the self-structure is organised” in proposition sixteen.
Incongruence
To evaluate the role of empathy at this point in both the conditions and propositions would appear to highlight an intersection. Vincent (2005, p.144) comments that “When there is a discrepancy between organismic experiencing and the self as perceived, the individual is in a state of incongruence.” Vincent (2005, p.150) continues with “clients are unlikely even to seek therapy unless they are incongruent.” Vincent’s point here resonates with the ensuing propositions, seventeen to nineteen, where balance is restored through the therapeutic intervention of counsellor congruence, condition three. How the counsellor responds empathically to the client incongruence and maladjustment expressed by Rogers’ second condition and fifteenth and sixteenth propositions is expressed insightfully through Schmid’s notion of empathic resonance “Through self-awareness in therapy the therapist becomes conscious of their experiencing . . . What they experience is resonance to both the client’s world and/or for their own world. Resonance . . . means the echo in the therapist triggered by the relationship with the client.” (Schmid and Mearns 2006, p.181 cited in Mearns 2013, p.107).
My personal understanding of this notion is that empathic understanding of the client’s incongruence is necessary in order to resonate with their experiencing. A crucial part of the therapeutic process. Schmid (2006 cited in Mearns 2013, p.108) continues to distinguish between “concordant empathic resonance” and “complimentary empathic resonance.” This empathic understanding of the client’s incongruent experiencing is crucial and as Mearns (2013, p.108) comments “adds something else to the client’s current expression . . . what is added is also the result of empathy . . .[and] . . . might reflect a dimension of the client’s experiencing at the edge of his awareness.” Empathy provides resonance, familiarity and safety for the anxious and vulnerable client and as Rogers (1980, p.142) himself offers, enables “being sensitive . . .to the changing felt meanings which flow in this other person, to the fear or rage or tenderness or confusion or whatever that he or she is experiencing.”
Critiques of the actualising tendency
All of this is experienced by the person phenomenologically and understood by the Therapist through empathy. Clark (2010, p.348) comments that Rogers did in fact distinguish between three ways of experiencing empathy, “subjective, interpersonal, and objective.” He encapsulates perfectly how empathy is crucial in understanding the person through the lens of their disturbed self-actualisation “Through a relational process . . . a counsellor strives to empathically understand the phenomological experiencing of a client and demonstrate a sensitive attunement to the perceptual field of the individual.” Brodley further highlights (1996, p.26) the importance of empathic understanding of a client’s experiencing “therapist’s acts of empathic understanding . . . stimulate clients to be in touch with the underlying experiential source of their self-disclosures and self-representations.” Roger’s (1951, p.494) comments himself of the seventh proposition that “The best vantage point for understanding behaviour is from the internal frame of reference of the individual.” Cooper (2019, para. 8-10) offers some criticism of the actualising tendency as a “model in itself . . . [to] . . . be limited and lacking in nuance.” He distinguishes between “higher and lower order directions” and believes that some clients would benefit from “guidance and direction . . . on the assumption that wisdom is not always inside.” Lopez (2018, p.94) provides further critique on how it is not, as Rogers (1980, p.121 cited in Lopez, 2018, p.94) states “Only under unusual or perverse circumstances” that the organism might “actualize it’s potentiality for self-destruction.” Lopez (2018, p.94) argues that “perverse circumstances are not as unusual as we would like . . . malnutrition, lack of hygiene . . . the absence of loving parents . . . children are affected by the socio-affective, economic, cultural and political conditions experienced by their parents.” However, the essence of Roger’s theory is essentially non-directive and places faith in the notion that client’s will self-direct.
Empathy & reorganisation of the ‘self’
As previously stated, the six conditions need to be understood as Merry (2012, p.37) describes as “a coherent whole, or gestalt, of interdependent elements.” A Rogers himself describes (1995, p.78) as a “way of being.” This essay requires me to consider the relationship that empathy has with the other conditions, I believe my analysis has demonstrated that they are interlinked. As Merry (2012, p.37) further comments “deep empathic understanding cannot be experienced by a counsellor who is to some significant extent, incongruent or lacking in positive regard.” The relationship this then has to how personality change occurs in relation to the nineteen propositions is that “If the individual finds . . . herself in a relationship where there is little or no threat of negative judgement . . . the person begins to reorganise her self-concept . . . and behave more authentically.” This relates directly to proposition seventeen in Rogers (1951, p.517) which expounds that “Under certain conditions, involving . . . absence of threat . . . experiences . . . inconsistent . . . may be perceived and examined, and the structure of the self revised.” This is the point at which personality change occurs and As Eager (2010, p.27) comments of the role the Therapist’s empathy plays in this phenomological re-examining “we stimulate the other person to attend to . . . herself as a source . . . of wants, feelings, perceptions . . . to attune to . . . her phenomological source.”
Client preferences & different types of empathy
Some critics, notably Hill (2007), Silberschatz, (2007) and Bohart, Elliott, Greenberg and Watson (2018 [as previously quoted]), question the therapeutic effects of empathy according to Roger’s model. Silberschatz (2007, p.266) comments that “Rogers’ point that the client must perceive the therapist’s acceptance and empathy implies that these therapist qualities cannot be assessed in a generic, one-size-fits-all manner.” He argues that the conditions should not just be viewed as “therapist variables” but that “as an example therapist empathy, which is typically understood as a therapist variable that operates in a unidirectional manner” would be better positioned as intersubjective or as a “mutually regulated empathy . . . essential for maintaining a productive therapeutic relationship.” Silberschatz believes that the client’s empathy for the therapist is an equally important factor. He also refers to the “attachment style” (2007, p.266) of the client, as does Hill (2007, p.262) who believes “empathy is not the same for every client . . . preferences for different types of empathy are based on attachment history.” Hill (2007, p.262) goes on to explain how clients with avoidant attachment may prefer a “more distant relationship with a therapist” but insecure clients “might prefer an extremely close therapeutic relationship.” These critiques have generated some thought within me regarding how empathy might operate whilst working with profoundly disordered clients, for example pathological narcissists. Interestingly, some critique is available surrounding this area, as Greenberg (2019, para. 15-16) notes “it is hard to empathize with clients who are callously abusing other people.” She continues to make a distinction between “emotional empathy” and “cognitive empathy” explaining how in difficult process “emotional empathy can cloud our judgement . . . [and] might not challenge our clients’ maladaptive thinking and behaviors.” Whilst this is not a direct critique of Rogers’ model, I feel it has interesting relevance to the evaluation of empathy during therapy.
Conculsion
In conclusion, I feel the following summary of points addresses the question of how to critically evaluate the role empathy plays in personality change during therapy. The unified relationship that empathy has with the other conditions, the importance of how this interplay is crucial for effective congruence, unconditional positive regard, psychological contact and appropriate conveyance of these therapist attitudes. Furthermore, the psychological maladjustment experienced by clients through improper self-actualisation can be addressed through effective empathic understanding of their incongruent experiencing. There are some critical challenges inherent in Rogers’ model, particularly regarding pre-therapeutic work (Tudor, 2000), self-actualisation (Lopez 2018), (Cooper, 2019), non-directiveness (Farber, 2007) and how considerations of empathy (Hill, 2007), (Silberschatz, 2007) may be better understood through client attachment styles and intersubjectivity.
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