Humanistic Perspective of Mental Health and Illness
Willie McDonaldSemester A 2007
Aims
Overview of the perspective
Nature of human beings
Nature of psychological normality and development
Preferred methods of treatment
Humanistic Approach
Phenomenology – the lived experience
Subjective experience
Developed in the 1950s – Perceived overly mechanistic qualities of other perspectives and the negative picture presented by psychoanalysis
Key Figures - Maslow, Perls, Rogers, Kelly, Berne, Laing
Humanistic Approach
Reject that behaviour is controlled:
unconscious impulses (psychoanalytic)
external stimuli (behaviourist)
processing info (cognitive)
Focus instead on:
describing inner life and experiences
each person’s unique perspective of the world
their interpretation and conclusions affect actions
Humanistic Approach
Emphasis on distinguishing human qualities
Personality – understanding the person & their situation
Concept of self, growth and self-actualisation
Develop to fullest potential
Progress despite environmental and social barriers
Research relevant to human welfare
Humanistic Psychology
“Humans are not simply objects of study” Association of Humanistic Psychology (1962)
Four Principles
The experiencing person is of primary interest
Human choice, creativity and self-actualisation are the preferred topics of investigation
Meaningfulness must precede objectivity in the selection of research problems
Ultimate value is placed on the dignity of the person
Essential nature ofhuman beings
Essentially constructive
Basically social
Self-regard is a basic human need
Motivated to pursue the truth
Actively interpreting and making sense of their worlds
Carl Rogers
Essential to healthy personal development –Personal growth and self-concept
Two Basic needs - Self-actualisation and Positive Regard
Growth, maturity, positive change
Tendency toward fulfilment, Choice is to grow
Biological needs are subservient
Basis of “Client-centred Therapy” - nondirective
The Self
Self-concept
Consists of all of the ideas, perceptions and values that characterise “I” or “me”
Influences both the person’s perception of the world and their behaviour
Does not necessarily reflect reality
Individuals evaluate every experience in relation to this self-concept
The Ideal self
DevelopmentThrough relationships, usually in childhood
Unconditional Positive Regard -more fully functioningbelieve themselves valuedfree to explore potentialsatisfy need for self-actualisation
Mental illness originates in people’s attempts to cope with a lack of positive regard
Conditional Positive Regard –feeling unlovedstops risk takingunable to satisfy need for self-actualisation
Maslow’s Hierarchy of Needs
Physiological Needs
Safety Needs
Esteem Needs
Cognitive Needs
Aesthetic Needs
Self-actualisation
Needs
Belongingness & Love Needs
Characteristics of Self-actualisers
Perceive reality efficiently, can tolerate uncertainty
Accept themselves and others
Spontaneous in thought and behaviour
Problem centred not self centred
Good sense of humour
Highly creative
Concerned for the welfare of humanity
Deep appreciation of basic life experiences
Deep satisfying interpersonal relationship with a few people, rather than with many
Able to look at life from an objective viewpoint
Behaviours Leading toSelf-actualisation
Experience life as a child does –with full absorption and concentration
Try something new rather than sticking to secure,safe waysListen to own feelings in evaluating experiences,not the voice of authority or the majorityHonest; avoid game playingPrepared to be unpopular if your views are differentfrom most peopleAssume responsibilityWork hard at whatever you doIdentify your defences and have the courage to givethem up
Personal Construct Theory (Kelly 1955)
Role of cognitive processes
Dimensions that had been constructed by psychologists
Rather than dimensions that the individual uses
Their own personal constructs – constructive alternativism
“If you don’t know what’s wrong with the patient –ask him. He may tell you.”
Personal Construct TheoryConstruct as Bi-polar statements –
Good – Bad, Intelligent – Stupid, Kind – Cruel
Constructs are individual –
words may be the same, but meaning entirely different
Explore constructs and consider alternatives -
through more effective interpretation
exploration of implications of views
making and testing new hypotheses
Role play – can help interpretation
Existentialist Therapy (Laing 1965)
To understand human existence we need to understand the choices we make
People are directly responsible for their choices –always free to say “no”
Strong emphasis on free will
Not acceptable to use “illness” as an excuse
Mental illness is seen as a choice on the part of the patient to retreat into illness when reality becomes intolerable
Ontological Insecurity
Ontological security – positive identity and place
Family functioning
Individuals trapped in “double-bind” situations
Unable to develop strong, confident sense of self
May manage undemanding situations, but fragile
Three types of psychological threat:Engulfment, Implosion, Petrification
Depersonalised – not how inner self might choose to act
Schizophrenia
Objective reality isn’t important
How the patient views the problem is
A false self, developed to cope with demands -Alienated from the “real” self
Therefore they felt unreal and lacked contact with reality
The split from reality meant feelings were expressed as hallucinations and delusions
Examine the content of these – insight into problem
Person-centred Counselling
Non-directive approach based on a positive view of human nature and individual perceptions
Creating a warm, positive relationship
Through one-to-one sessions or encounter groups
Focus on here and now
Characterised by three core conditions in the counsellor:CongruenceUnconditional positive regardEmpathic understanding
Core conditions - Congruence
Genuineness, no front, the capacity of the helper to be with the client in an authentic way
Permissible and desirable to be yourself
It develops gradually as the result of a commitment to self-awareness
The practitioner becomes more in touch with his true self
The helper and the client can therefore be seen to be on the same journey
Core conditions - UPR
Offer total acceptance
Non-judgemental
Safe to explore negative feelings
Face themselves honestly, without fear of rejection
Core conditions - Empathy
Empathy is the ability to understand how the other person feels in their own world
It is not the ability to assume how you would feel in the other person’s situation
Nor is it your knowledge of how other people have felt in that situation
Ability to convey this to the client
Other Therapies
• Transactional Analysis
• Gestalt Therapy
• Family Therapy
Transactional Analysis (Berne)
Theory of Human Interaction (Berne)
Individuals – autonomous, responsible, able to make decisions
Four Features:
Ego statesTransactionGamesLife Positions
Ego States
Behave from different facets of personality
A consistent pattern of feelings and experiences,resulting in consistent patterns of behaviour
Offers a way of making sense of these differences
Three ego states:the Parent – controlling, judgemental or nurturing, caringthe Child – enjoyment, creativity or dependency, angerthe Adult – logic, analysis, measured and in control
Transactions
Any unit of human communication
Takes place when a communication is offered and a response given
Social level and Psychological level
Combine with ego states
Analysis of human communication
Games
Orderly series of transactions
Psychological, with the following elements
Plausible complementary transactions
Ulterior transaction, revealing a personal agenda
Negative pay-off – e.g. “Yes but …” game
Strokes – positive units of human recognition
Life Positions and Scripts
I’m OK, You’re OK
I’m OK, You’re not OK
I’m not OK, You’re OK
I’m not OK, You’re not OK
Individuals usually don’t spend all of their time
in one position
It is up to individuals to write their own script
Gestalt Therapy (Perls)
Perceptions of world as whole units, not fragmented parts
The complete form (the Gestalt) is important, not its component features
Organised around satisfaction of needs
Central idea is of awareness
They include thought, feeling and activity
Failure to complete – distress, neurosis
Gestalt Therapy
The Gestalts form the interface between the person and their environment
Teaches people how to experience things fully, forming and completing one Gestalt at a time
Dominant immediate need of the time, what is and what’s not relevant to immediate experience
Denying or distorting situations through defence mechanisms prevents experiencing it fully
Awareness, self-knowledge, self-acceptance
Family Therapy
Schizophrenigenic families
Pseudomutuality - façade of family happiness
“scapegoat” – mentally ill
Double-bind
Major Schools:Object-relations Therapy – early experience
Family Systems Therapy – not just individuals
Structural Family Therapy – boundaries, divisions, subsystems
Strategic Intervention Therapy – immediate presenting problem
Double-bind
Two or more persons
Repeated experience – not a single event
Primary negative injunction –“Don’t do ...” or “If you don’t do …”
Secondary injunction – conflicts with primary injunction often not explicit, hard to pin
down
Tertiary injunction - preventing escape
Learned perceptions –not all elements need be explicitly present
Conclusion
Possible Pros
Focuses on the individual’s unique experience
More holistic thanother approaches
Positive, optimistic view
Important problems
Possible Cons
Lack of direction may not suit passive clients
Doubts over evidence
Built around healthy individuals or focused on neurotic problems
Sanctions selfishness
References and Further Reading
Eyesnck MW (2004) Psychology an International Perspective New York: Psychology Press
Hayes N (2000) Foundations of Psychology London: Routledge
Hewstone M, Finchorn FD, Foster J (2005) Psychology Oxford: Blackwell
Mearns D. (2003) Developing person-centred counselling (2nd ed). London: Sage
Mearns D., Thorne B. (1999) Person-centred counselling in action (2nd ed). London: Sage
Online Sources
http://pandc.ca/?cat=carl_rogers&page=rogerian_theory
http://www.adpca.org/articles.html
http://www.ahpweb.org/rowan_bibliography/
http://www.infed.org/thinkers/et-rogers.htm
http://www.ship.edu/~cgboeree/rogers.html