Why person-centred therapy was the original anti-oppressive therapy
Person-centred therapy is one of the most popular forms of therapy in the UK, but it is also widely misunderstood and misrepresented. When it was initially developed in the 1940’s by Carl Rogers, it was a really radical change from the other therapies around at the time such as Freudian psychoanalysis and behaviourism. I think that one reason it has become somewhat misunderstood is actually because a lot of the ‘core conditions’ (empathy, genuineness and positive regard) are now considered essential qualities for most therapists these days, so the fact that it was Rogers who originally spent his whole life advocating for these very basic human qualities to be a central part of therapy has been somewhat lost to time.
I am really glad that these relational qualities have been so broadly embraced. This only improves the therapy world overall, but I do wish the person-centred approach was given the credit it deserves for being the original promoter (at least in western schools of psychotherapy) of this type of therapeutic relationship.
I am not an expert in the other modalities. I have a decent enough broad understanding of the overall profession, but I have focused my career more on getting a really deep understanding, skill and appreciation of one modality. I know that there are many people practicing a variety of types of therapy who are doing great work to make them less oppressive to marginalised people, however I think I can make the case that person-centred therapy actually lends itself better than most approaches to being an anti-oppressive approach at its core, and therefore very relevant to current and future generations of therapists.
Sadly a brief glance at the history of the medical model, (e.g. the DSM), psychology, and various therapy modalities will show that they have openly categorised marginalised people (queer, trans, disabled, neurodivergent, people of colour) as ill, deviant or otherwise not ‘normal’ and as such actively contributed (and in some cases are still contributing) to the oppression and harm of members of these groups in therapy. Whilst there is no doubt that individuals practicing person-centred therapy could hold oppressive views, this is not ‘baked in’ to the approach itself and instead runs contrary to its fundamental principles.
These core principles include a respect and appreciation of the diversity of individuals, and a willingness to believe people’s accounts of their own experience. It is much easier to be anti-oppressive when you believe that difference is a good thing, and that people should be believed and centred as the experts on their own experiencing. These values are shared across other ‘humanistic’ schools of therapy. However, the person-centred approach places the most emphasis on individual autonomy and doesn’t seek to fit people into models or predetermined structures. This makes therapists less likely to impose their own theories and expectations onto clients and means that they are open to listening to clients when they express that something is harmful to them, in a way that say a medical model based approach is not (these often blame the client when the therapy doesn't’ work, e.g. by describing someone as ‘resistant’ to the treatment).
This sets up person-centred therapists to believe marginalised people’s accounts of themselves and continually adapt therapy to meet a wider array of access needs. It is open to the way therapy can inadvertently harm (because we believe people when we hear about harm, and don’t dismiss them) and works to reduce the amount this happens especially as a result of failing to meet individuals’ needs around accessibility or cultural sensitivity.
Person-centred therapy tends to be more flexible in how it offers itself. If something doesn’t work for somebody, we are more likely to listen and flex what we offer to meet the needs of the individual. This often includes a willingness to change the length, frequency or location of appointments. Some modalities and the therapists practicing them require people to have weekly sessions or maintain that ‘real therapy’ can’t take place in shorter or less frequent appointments, or do not accept any kind of between session contact or won’t work with camera’s off. This kind of flexibility means that person-centred working is readily set up to meet a wider range of access needs making it overall more inclusive as an approach.
It has also been used to great effect to make therapeutic contact with people with various degrees of difficulty engaging due to cognitive differences and psychosis (a form of person-centred therapy referred to as ‘pre-therapy), which means it is more accessible to people who may not be deemed ‘suitable’ for other kinds of therapy.
Unfortunately in a world where freedom, autonomy and diversity are not centred (despite superficial lip-service to these values) and hierarchy, power and the medical model still prevail, person-centred therapy is both too radical because it sets itself up in opposition to those things and also gets misunderstood and portrayed as weak because western culture unfortunately is built on the assumption that strength equates to aggression, dominance and control of self and others. This can show up in say the NHS’s and other official bodies lack of valuing of the approach because it rests on an entirely different paradigm which is deeply incompatible with the one they are based on. (I deeply value the NHS but it is incredibly hierarchical and is not a natural home for or appreciator of the person-centred approach).
Given the great social changes that have happened and are continuing to happen since the origins of person-centred therapy and psychotherapy more generally, there is a need for all approaches to listen to, learn from and incorporate the best from a range of social movements and anti-oppressive practices outside of the field. I find person-centred therapy very compatible with other anti-oppressive practices because they share some fundamental values that I mentioned earlier - intersectional feminism, LGBTQ+ rights, the neurodiversity paradigm and movement, the social model of disability, disability justice, the intuitive eating and health at every size movements, anti-racist, anti-colonial and liberation movements, to name a few.
In practice, many therapists are integrative or pluralistic and blend or adapt approaches to suit the individual client. This is often offered on a ‘base’ of person-centred practice that prioritises client autonomy and choice and many do offer wonderfully accepting and accessible therapy, but I think it is the person-centred principles that mostly enable this, as well as the therapists’ personal values and a desire to better serve the people they work with.
Ultimately, person-centred relationships are ones where there is genuine participation, care, non-hierarchical, non-coercive power dynamics, a respect and welcoming of difference and genuine curiosity and willingness to really learn about each other without any agenda. Although rare to find expressed fully, these are fundamental human qualities, the person-centred approach doesn’t ‘own’ them. However, given how the therapy field is mapped out currently, the person-centred approach is often appropriated, misunderstood and undervalued, and I think in doing so we miss both its power and its relevance within and beyond the world of therapy.
(Photo credit Duncan Shaffer 2020 and shows protestors in Seattle)