Person Centred Therapy Dealing with Negative Emotions

Description of Robbie and his Situation

Robbie is a white homosexual male who is sixty-nine-year-old from a working-class background. He grew up in a small town in Scotland, in a period when homosexuality was criminalized and deemed pathological. In his 20’s he went through a difficult patch (feeling low), he had some therapy but didn’t find it helpful. He moved to a big city in the south. He found self-acceptance and friendship through his local gay community and through a long-term loving relationship of 30 years. His life partner died nine years ago from cancer and since then he has been struggling to adjust to being on his own. He moved back to Scotland and is now living in Glasgow. Robbie is now retired from having a high skilled technical job. He hasn’t had a life partner since his partner, but he does want to be in a relationship ‘someone to wake up with’ he says. He used to find friends through gay bars but there are none in the small town where he is now. He’s unsure about finding a community through the internet, he also worries that maybe he is now too old to find love. He didn’t have a father figure. His father was a policeman and was very old school and wouldn’t accept his homosexuality, but he says that he thought his mother might have known about his homosexuality. But he said he had a good childhood but even though was the only child. He says that it would have been nice too if he had a brother or sister. Because of lacking siblings, he was alone most of the time, which was quite lonely. Even though he had friends, he preferred his own company.

Theory (Person-centred Theory)

I will apply the person-centred therapy and relevant research on loneliness and bereavement. Proponents of this theory believed that humans have an innate capacity for maturity and growth and can fulfil their potential under appropriate relational environments (Sims and Malta, 2021, P. 323). Based on this theory, a person can strive for and has the capacity to fulfil their potential to establish positive interpersonal relationships, like finding their love partners, having a good relationship with their parents, siblings, colleagues, or just friends. It improves a person’s ability to move forward and find their own direction in life is essentially the foundation of this theory (Sims and Malta, 2021, P. 328). By using the core conditions of empathy, congruence and unconditional positive regard, the client would feel safe enough to access their own potential. The conditions of congruence (where the therapist gets integrated into the relationship) (condition 3), empathy (where the therapist begins to feel an empathic understanding of his/her patient’s internal frame of endeavours and references and communicates this experience to the patient) (condition 5), unconditional positive regard for the patient by the therapist (condition 4). This process makes the client aware of their anxiety or vulnerability and engages them in therapy by establishing a psychological contact (condition 1). The therapist effectively communicates to their client a positive regard or an empathic understanding) (condition 6), causing a positive personality change (Sims and Malta, 2021, P. 328). The therapist asks three main questions. The first question helps the therapist to determine the cause of the client’s problems. For instance, the loneliness and loss of a loving partner in the case of Robbie which might lead to motional loneliness (when an individual feels lonely because they are missing a particular person (Robbie is missing his partner) and also, he has no one to share his deepest feelings with anymore. The second question helps the therapist to determine the factors maintaining the issues. For instance, in the case of Robbie, returning to a community with no gay community and where it was criminalized and identified as a pathological condition. Additionally, this will help deal with social loneliness, experienced when individuals feel lonely because they don’t have a big circle of friends and acquaintances to share with thought. According to Lundorff et al. (2017) one in ten people who are bereaved experience prolonged or complicated grief. Robbie could be experiencing this emotion since he lost an intimate partner and a long-term relationship. The last question seeks to facilitate change through collaboration between the therapist and the client, based on the six-step approach mentioned above.

Formulation

Description: what happened?

During his first therapy session, Robbie came to counselling because he had been feeling lonely and thought that he was depressed (his self-evaluation). He seemed very agitated and not at ease. He indicated that his life partner, Kenny, had passed away with cancer around nine years ago. Since then, Robbie experienced difficulties adjusting to a life alone. He felt completely empty and could not get used to Kenny not being around. He also noted that he occasionally had suicidal thoughts after losing his partner. Robbie noted that he isolated himself from everyone and he had no one to talk to. He claimed that no one understood him. By establishing a psychological contact with Robbie by listening and showing empathy, I (the therapist) identified that Robbie was experiencing emotional distress or depression, demonstrated by his suicidal tendencies, isolating himself and the feeling that no one was there for him. According to Sims and Malta (2021, P. 323), and based on the person-centred therapy concept, a fully normal or functioning individual comprises of self-concept, a state in which they trust themselves and decision-making abilities. However, after this session, it was evident that he saw a problem that needed to be dealt with (Sims and Malta, 2021, P. 323). When Kenny died, Robbie was distracted by having people around who helped with the burial. These people also called for a while but stopped with time. His neighbours asked if he needed anything from time to time but he felt like he was imposing on them. He did not want to be a burden on anyone. Based on the person-centred therapy theory concept, it is clear that Robbie was not functioning normally because an individual in a normal state of mind should be free of and should not show defensive behaviours (Sims and Malta, 2021). This stage also demonstrated how important it is to have people to talk to and to share with feelings when depressed. Robbie tried to meet new people but said he did not want appear desperate and needy. Robbie said that he needed to adjust by going out more to make new friends but did not know how. He was unsure about finding a community through the internet. He was also worried that maybe he was now too old to find love. Based on the person-centred therapy concept, a normal person should be able to live harmoniously with other people while experiencing unconditional and genuine acceptance (positive self-regard) which was absent in this situation (Sims and Malta, 2021, P.323). To make him feel genuine acceptance, the therapist demonstrated this by communicating empathy and telling him that he still had a chance to find love and it was not too late. Robbie mentioned that when he was younger, he had a bad memory of visiting a relative who was put into an asylum, this scared him. He thought that if he ‘came out’ as gay he would end up in the same place as being gay was seen as being ‘a disease’. He didn’t want to be suspected as gay. He felt like he was hiding, undercover, leading a double life. Didn’t want to get caught with his ‘guilty secret’. He knew it wouldn’t be accepted; he knew enough then that there was nothing he could do about it then. When Robbie was growing up there was no physical affection from his family. He said that they loved each other but didn’t show it. Kenny was a very physical man who showed affection to Robbie, Robbie is now missing physical contact. Robbie felt that the only person who understood him was Kenny. Kenny being more of a father figure than his own father, his protector and guide. By being genuine, authentic and showing empathy, by developing an accurate sense of Robbie’s private world, Robbie felt unconditional acceptance. He felt as though I had entered his shoes and understood what he was going through. As a result, he seems to be more willing to share his emotional and social loneliness and other challenges which he was experiencing. In the eighth session of therapy, after showing him unconditional positive acceptance and non-judgment of his life, challenges and homosexuality, he was more at ease and more positive. He said he was looking forward to coming for further sessions and would try to go out and make some friends, and perhaps get a chance to meet a new lover. He said he had things to look forward to. He said things were not that bad as he had no money problems and managed to stop his drinking problem as he was aware of the fact that he was drinking too much. He wanted more. He wanted a new life. He wanted a solution and to my surprise, he came up with one on his own. He said that he would start working in Archaeology, something that he has been interested in for a long time and where he could meet new people.

Intervention Plan

My aim for Robbie is for him to feel ok within himself and help to facilitate the development of his own self-awareness. My goal was to make him feel human again, and to appreciate himself. I wanted him to know the important role that friends (other people) play in making others feel unconditionally accepted. My goal for counselling Robbie was based on the core humanistic psychology principles which state that all humans exist in a human context, are aware of themselves within the context of others that is they are conscious and can make choices. I wanted to remind Robbie that he could make choices and had the responsibility to do so. My goal was to make him feel that he needed to make goals, seek value and meaning in his life. My tentative therapy plan was to first determine his problem, for instance, to determine whether he was experiencing anxiety or depression. Based on the problem, I was to determine what cause the problems and the factors which maintained the problem. Finally, I was to come up with a way of facilitating change. Based on my approach, Robbie identified his problems and successfully came up with a viable solution, to work in Archaeology which would help him meet new people.

Pluralistic Approach: An Alternative Approach

Another approach of therapy which can be applied in Robbie’s case in pluralistic therapy. It is based on a collaborative approach which is developed upon appreciating varied ways of comprehending and dealing with mental health challenges (McLeod and McLeod, 2021). The main idea behind pluralistic therapy is that a service user attempting to address the issues suggest ideas on what can likely be unhelpful or helpful to that effort. Pluralistic practitioners collaborate with their clients in identifying as well as implementing different therapeutic activities which draw on the experience and knowledge of both the therapist and their client. This allows both the therapist and the client to think of different ways of dealing with the problem. For instance, Robbie can suggest different other ways of overcoming his loneliness and depression besides working in Archaeology. This approach invites clients to think of the challenges they experience through varied theoretical perspectives (lenses). The professional incorporates a client’s perspective and common-sense assumptions in the process of decision-making. Integrative models like contextual /common factors mode, assimilative integration, eclecticism and theoretical integration can be used. For instance, the professional and their client can draw upon different theories (which is theoretical integration) and use a repertoire of solutions or interventions (which follows eclecticism) (McLeod and McLeod, 2021).

Reflection

My experience with Robbie and the use of a person-centred theory approach, as well as looking into other possible theories demonstrated how important it is to put clients at the centre-stage, to show understanding and empathy or to show them that you truly understand their situations and is willing to help them find solutions. I also realize the important role that my values and personality as a therapist play in helping my clients. To help someone like Robbie to find a solution to their emotional difficulties required me to have compassion and at the same time remain impartial (not let my emotions or assumption cloud my ability to provide good counsel).

References

Lundorff, M., Holmgren, H., Zachariae, R., Farver-Vestergaard, I., and O’Connor, M., 2017. Prevalence of Prolonged grief disorder in adult bereavement: A systematic review and meta-analysis. Journal of affective disorders, 212, pp. 138-149.

McLeod, J., and McLeod, J., 2021. The pluralistic approach. Chapter 12 Sims, M., and Malta, D., G., (2021). The humanistic approach. Chapter 11

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