Bread and Jam and Sparkling Wine? Can I be Person-Centred and Pluralistic?
Ani de la Prida, creative arts counsellor, psychotherapist, founder of the Association for Person Centred Creative Arts, and lecturer at the University of East London
I have been a passionate person-centred therapist and trainer for many years. A couple of years ago I attended the pluralistic conference in London, and something in me changed. I felt like I’d come home. I felt I belonged. It was quite a profound experience. One that challenged my therapist identity and made me question my deeply held philosophies and beliefs about growth and therapy.
Am I pluralistic? Does that mean I am not person-centred? Can I be person-centred and pluralistic, are they compatible? I had been considering these questions for a long while when I came across a paper Unnecessary and incompatible: a critical response to Cooper and McLeod’s conceptualization of a pluralistic framework for person-centred therapy. It states that the pluralistic approach is unnecessary, that the person-centred approach is in effect pluralistic at its heart, and that the pluralistic approach is simply old wine in new bottles. Whilst my blog post isn’t an academic or a critical response to the paper, my very personal response here to this critique has grown in richness from my reading of the paper and from some valuable discussions with the author.
I know that the person-centred approach works, it has been extensively researched and shown to be one, if not the most, effective way of working. More important to me than the research is my experience, and I have worked with a person-centred approach for twenty years and know for myself how powerful and effective it can be.
The person-centred approach comes in for much criticism. Partly I think this stems from its phenomenological philosophy which can translate into a belief that experience trumps research. This is a philosophical view that is often dismissed and devalued in the current positivist climate, which values science over experience and tends towards promoting manualised therapies.
As therapists, our approaches are very tied up with our identities: a therapist often says ‘I am person-centred,’ for example. So, when someone says that the person-centred approach isn’t effective, or that it isn’t enough on its own, it can feel personal. And it seems to me that the person-centred field and its research is caught up (understandably) in defending the approach, in consistently wanting to prove, to a positivist world, that it is effective. This is a position that builds walls and shoots arrows in its defence: that can be critical of other approaches in what feels like a therapy war.
The pluralistic approach seems to have a looser, more inclusive philosophy, one that accepts a diversity of views and positions. Not in the sense of simply tolerating other approaches, but in a genuine spirit of actively valuing diversity. I really like that there isn’t one way to be pluralistic. You may be at the other end of the spectrum to my practice and philosophy, but if we are both pluralistic there is some space perhaps where we can find common ground. For example, if you practice CBT pluralistically and I practice person-centred therapy pluralistically we share some common ground in that we both value the collaborative aspects of therapy.
The person-centred approach holds that the six conditions are necessary and sufficient, nothing else is needed. I agree and, in my experience, I have found that to be true. But—and for me a number of ‘buts’ have emerged—the concept of ‘sufficient’ feels to me to be a little dry. For example, we know we can survive on bread and water, it is sufficient. But… maybe a little jam or marmite would be nice? Jam doesn’t stop the bread being bread, but it does have the effect of enhancing it.
The pluralistic approach seems to be asking the same question, what might enhance the therapeutic process. To be more specific, what might make this therapy with this client more effective. It encourages me to be more actively interested in what each client wants, to ask each client if they prefer jam, or chocolate spread, or marmite. This doesn’t mean that I have discarded my trust in the actualising tendency, but it does encourage me to approach each therapeutic encounter more flexibly. Working in a person-centred way doesn’t feel so flexible.
I originally trained with and was supervised by Liesl Silverstone in using a person-centred approach to arts therapy. In our sessions I often wanted to bring new art materials like glitter to the session. Liesl said ‘no’, glitter isn’t necessary, pencils and pastels are enough. They are sufficient. She felt glitter was superficial and might distract from the essence of the process. True, maybe, some of the time.
Obviously, I did bring glitter to sessions with Liesl, and also to sessions with clients. What I learned is that for some clients glitter makes a difference. Glitter doesn’t necessarily detract from the process; it often enhances it. That is if it is offered congruently without any attachment on my part to the client using it. And therapeutic congruence takes time, and training to develop.
Using glitter doesn’t really sit comfortably within a person-centred approach, if glitter is seen, or used as a technique. But perhaps glitter, or marmite, or actively seeking preferences might actually, some of the time, enhance some clients’ experiences of the six conditions?
That I am able to use glitter, and it can enhance therapy, doesn’t mean that if another therapist brings glitter into their therapy it will have the same effect. It won’t help all clients.
Isn’t that annoying? Wouldn’t it be great if we could manualise therapy and say ‘this works,’ ‘glitter works,’ so let’s just all use glitter? But good therapy isn’t and shouldn’t be like that.
I think good therapy is about asking what will help this client at this time. It’s about being open to—but not attached to—the use of glitter, or marmite, or something new that a client suggests.
In response to clients over the years I have developed how I work to include digital media (texting, emails, iPad, art apps, Google) as well as guided visualisations, breathing techniques, outdoor work, and even occasionally smoothie bowl homework (an exercise I created to therapeutically create, decorate, photograph, and eat healthy bowls of food, you can read more here). Most often these have been introduced at a client’s request, but, and here is another but…sometimes at my suggestion. Always tentatively, always with careful consideration, and always collaboratively negotiated with a client. In that sense I feel I move away from a pure person-centred approach towards a more pluralistic approach in the degree that I introduce ideas of potential ways of working.
In my practice I have always been open to what a client wants to bring: how a client wants to work. Without realising it, I’ve been developing what I now see as a pluralistic approach to therapeutic communication. This is person-centred as its heart: the client at the centre. But I feel a pluralistic approach includes more of what I bring to the mix. What can I can offer to this client? What would support this client? Could glitter help here, for example?
Some in the person-centred field might say what I’m describing is an example of effective person-centred practice. Maybe. But I think it is more accurate to describe it as ‘pluralistic practice’ because I feel freer to be more involved in collaborating with clients. I tell clients that if I have what I think are good ideas I’ll offer them. This distinguishes between a person-centred and a pluralistic approach.
My heart is in the person-centred approach, my practice is person-centred. But there is also now some new space for exploration, for asking about jam or marmite too, the aim of which is not to direct but to enhance how I support the client’s direction. That feels pluralistic. Not either or, but both person-centred and pluralistic.
My therapy contract used to say, ‘I will work to understand you and to provide a non-judgmental relationship where you feel able to explore your issues and feelings openly so that you can find your own answers, inner resources and solutions’. Now I’ve added, ‘My role is to explore with you, and to collaborate so that we can work out what is helpful, and to help you to discover your own inner resources, promote psychological healing, and/or find solutions’. The use of ‘we’ feels important. That subtle difference feels relational, more dynamic, less dry. Interestingly since I have changed my contract and my practice, I find clients feel more empowered, more engaged in the process of therapy.
I opened one of my favourite Carl Rogers books, Client Centred Therapy, hoping to find something from Carl Rogers to use here. The page it fell open at said:
It is about our feeling of tentativeness as we advance theories in the hope that they may strike here and there a spark which will aid in illuminating and advancing this whole area of endeavour. (xii)
I have found this feeling of tentativeness within the pluralistic approach: an approach and developing theory which holds its truths lightly. I see the approach as actively trying to shine a light into therapeutic crevices and therapy battlefields. The approach is new and developing. I don’t agree with all of the pluralistic writers I have read. But I get the sense that is OK and that in fact a critical voice is welcomed.
So, do I think the pluralistic and person-centred approaches are compatible. Yes. I think I can be both person-centred and pluralistic in my practice. There are differences, but I believe they are fundamentally compatible. Is the pluralistic approach old wine in new bottles? Actually, I think the pluralistic approach is neither old wine nor new wine—it is a lovely bubbly, sparkling wine. It feels exciting and fresh.
I hesitated when I wrote that sentence. I could have said Prosecco or Champagne, but that would be hinting at creating a brand, and that is something that I know the pluralistic approach is trying really hard not to do.
I also hesitated when writing this blog post, worried that I might be seen as being critical of the person-centred approach and field, which I am not. I am still passionately person-centred and will stand up and defend its effectiveness. But now I am passionately pluralistic too.
In fact, if Rogers were here now, I think he would be pluralistic. Even if he didn’t describe himself as pluralistic, I am pretty sure he wouldn’t fire any arrows at the approach and that he would be happy to sit and stay awhile and share a glass of lovely bubbly pluralistic wine with us.