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