Excerpts from Psychotherapy and the Fully Functioning Person (click an item to read excerpt)

In this book I present an account of my work and my thinking in the area of psychotherapy and the fully functioning person. While I emphasize the professional and scientific aspects of my work, I do this in a personal way, so that the book stands most clearly as a professional autobiography. It is a personal narrative and has the phenomenological emphasis that befits such a narrative.

The content of my work has centered on two closely related phenomena. My first intention has been to evolve a framework for characterizing and defining the psychotherapeutic process. From the beginning, it was clear to me that in order to deal adequately with the whole domain of psychotherapy, particularly from a research perspective, I would have to give specific consideration to the issue of psychotherapy outcome. That goal pointed me to the task of investigating attributes that might characterize persons who completed an experience in psychotherapy. And so I spent many years in investigating what I have called "organismic integration" and what Rogers has called the "fully functioning person,” for that is the logical direction of a person's development through psychotherapy.

This book then is a two-fold venture. It is about my evolving ideas concerning psychotherapy theory and practice and about the investigations that my students and I have done in our efforts to understand the fully functioning person. I have implemented my twin objectives by organizing the book into two major sections. The first section of the book deals chiefly with some of my ideas about theory and practice of the psychotherapeutic process, and the second section reports the research that my student- colleagues and I have done in learning about the fully functioning person. The interrelationship between these two themes will be amply evident, I am sure, and the overlap between these two major themes will also be evident.

As I think about the research that I have done and that I summarize in this book, I am grateful that I chose the path of research as part of my career. It has turned out to be a precious part of my experience and learning. It has brought me closer to an understanding of the mainsprings of personal development and it has deepened my understanding of psychotherapy as a process that enriches human functioning.  

Because this book is a kind of personal history, I will represent my work across time. Accordingly, I will offer work that I have done over a fifty- seven year period, and include in the book both recent papers and selections that I have written many years ago but which speak to issues that are still relevant today.  
  On rare occasions in my experience as a therapist I noted that very brief therapeutic encounters resulted in profound positive changes that far exceeded ordinary experience or expectations. I noted also that in a few of the single demonstration therapy sessions that Rogers conducted, the positive outcomes were far out of proportion to the brevity of the experience. In this respect, I was also moved by Jessie Taft's respect for each single therapy hour (Taft, 1933/1973).The concept of strong effects of brief experiences aroused my curiosity and I decided to investigate this phenomenon. The following paper is the result.

It has been my experience as a therapist that on occasions, infrequent but recurrent, a brief encounter with a client results in deep and meaningful personal changes. These experiences appear to be life-changing experiences that are telescoped within the compass of one, two, or three meetings. This view of deep changes within a very brief time span offers some challenge to the normative concept of the therapeutic process. It is in this spirit of inquiry that I have chosen several illustrations of brief but impactful psychotherapy experiences from my own practice and from that of Carl Rogers and subjected them to analysis. In all cases there were follow-up statements from the clients after their experiences, and these statements form the basis of the data analysis. At this point I will describe the brief therapeutic encounters.

MARK

When Rogers was in South Africa he arranged to do a demonstration therapy session with a young white South African government worker. It turned out to be a complex interview. Rogers expressed personal disappointment and dissatisfaction with the session and the client likewise expressed dissatisfaction. The experience, however, took on a special turn in that Rogers and Mark stayed in touch with each other by correspondence. Mark in particular integrated the experience over a period of at least three years and found a great deal of food for thought. The experience came to mean far more to him as time deepened its meaning. There was much evidence that the experience gradually took on a profound meaning, as evidenced by his statements sixteen months later and again three years after the experience. Brief excerpts are given here: “Coming into personal contact with you brought to the fore deep and painful issues regarding the meaning of my life . . . I have recognized my dilemma about the world about me and my circumstances, as a projection of my inner turmoil. Consequently, because it is ‘my own’ I am not helpless in the face of it, but can work through it.”

Three Years Later

Some excerpts from a letter by Mark: “That encounter I had with you had a profound effect upon me . . . With my vulnerability and tenderness came a feeling of aliveness. . . . It is a feeling of remembering who I really am. It is like moving from strange unfamiliar terrain into the well loved precincts of home.” It is evident that time has the capacity to deepen the meanings of therapies long completed. Such an experience seems to have come to Mark.      
  It is far from unusual in the behavioral sciences to find that there is a kinship between professional conceptualization and personal dispositions. In this respect I have had the opportunity to follow the work of Rogers over many years, and it appeared to be the case that Rogers's personal growth and change was in consonance with his conceptual development. I wrote the article, not because this idea is surprising (it is not) but more as an affectional testament to his personhood.

This paper examines the thesis that Rogers's theoretical formulations evolved in close relationship to his development as a person-- in short, that his conceptual formulations may be seen as an approximation of his professional autobiography. The paper examines samples of Rogers's writings in the three domains of personality theory, therapy theory, and research philosophy and shows how these writings mirrored his more general development. The paper concludes that clinical theory by its nature contains elements of professional and personal autobiography.

It should come as no surprise that clinical theories, far from being intellective abstractions, are living theories shaped by the observations and experiences of the theorist. It can be no other way. The very subject matter of clinical theory concerns the core of human experience. The theorist who chooses to observe these experiences and to frame them in a conceptual structure cannot stand aside and escape personal involvement, for it is through his or her person that these observations must filter. Thus, the  the question is not whether the theorist as a person is involved in the theory. The question rather has to do with the nature of that involvement.

It is this question that I will address here, and concretely, through an examination of the life and writings of Carl Rogers. The two parts of the title above convey the directions that this examination will take. First, I will explore the continuities between the writings of Rogers the theorist and Rogers the person. Second, I will examine Rogers's work from a longitudinal perspective, on the ground that his work reveals strong developmental trends in the growth and richness of his theory and his person. Thus, to understand Rogers the person and Rogers the theorist, we must look at the course of his development.

But the conception of theory development that I have propounded here brings new questions in its train. Theories were never intended to be private reflections. They are on the contrary intended as public statements, general in application and subject to the discipline of public verification. The validity issue thus needs to be addressed, and will be in its appropriate context.  
The human system framework that I evolved as a way of unifying our diverse organismic processes has helped also to provide a unifying perspective on individual personal characteristics and high functioning. A good illustration turned out to be a perspective on the growing feminist movement, a movement that began to flourish in the 1960s after the publication of Betty Friedan's book The Feminine Mystique (1963). The following article undertakes to comment on this movement through the use of the human system model. A detailed description of the human system model itself will be presented shortly.

One of the manifest byproducts of the women's movement has been a heightened accent on assertiveness. Books on assertiveness have come out at an increasing rate, and workshops on assertiveness training have been offered with increasing frequency.

There is a logical explanation for the emergence of this interest. The traditional roles of women have embodied a one-down position of subservience and compliance. Any movement looking toward a revision of these roles required a modification of the very stance that signaled women's inferior social status in the first place. There has been no other way to go but up, and many women are choosing to move in that direction.

There is, however, a good deal more to assertiveness than the foregoing synopsis suggests. It is a phenomenon deeply imbedded in the very fabric of personal effectiveness and psychological well-being. Colleagues and I have been working on studies in personality integration that help trace this link between psychological maturity and assertive behavior. Other personality theories too are in striking agreement as to these connections.

Let us look at the evidence. We can begin by constructing a model of effective human functioning. Toward this end I have suggested a concept that I have called organismic integration. The outline of this concept can be stated simply. All of us as human beings have behavioral subsystems. Each of us has a biochemical subsystem, a physiological subsystem, a perceptual subsystem, a cognitive subsystem, and an interpersonal subsystem. In the psychologically integrated person, these subsystems function in harmony with each other, without blockage or disruption. There is a free and unhampered flow of information within the subsystems of the person, across these subsystems, and at the contact boundary between person and environment. The psychologically integrated person is a “together" person.

This model of psychological integration leads to certain predictable consequences: a free-flowing human communication system will be more open to experience. We can thus receive more reality data, that is, the basic data that come to us through our sensory and perceptual processes. The amount of data that persons can generate is directly related to the effectiveness of response. The more data a person generates as a basis for judgment and decision, the greater is the likelihood of effective action. Reality data are the basic stuff of experience, the primordial raw material by which we maintain a connection with our world--so much so that I would characterize reality data as psychological nutrition, just as important to the psychological well-being of persons as food is to biological well-being. Both represent the sustenance necessary for effective living.

Colleagues and I have done studies that have turned up lawful patterns of effective behavior compatible with the foregoing theory. In a study that I coauthored with Rebecca Cooley (Cooley & Seeman, 1982), we compared biofeedback behavior of highly integrated persons with the behavior of persons less fully integrated. In a biofeedback study, persons are given information about some internal physiological function and asked to modify that function in specific ways. We reasoned that if we were right about the ability of high integration persons to maintain a free flow of communication and to utilize incoming information maximally, they would be able to modify their physiological subsystem more effectively than would be the case for less highly integrated persons. In two separate studies, one with women and one with men, we requested our participants to modify their surface skin temperature in accordance with instructions. An audible tone provided feedback as to their temperature level, so that the participant could tell whether or not she or he was modifying the skin temperature in accordance with instructions. In both studies we found that high integration persons were significantly more effective in modifying their skin temperature than was the case for persons who functioned quite satisfactorily but who were not in the very top range of personality integration. This result is compatible with the theory. We theorized that the feedback constituted perceptual/cognitive data that high integration persons could use to modify their physiological subsystem responses.

Other studies done with similar experimental designs investigated other subsystem functions. For example, we have found that high-integration persons have greater cognitive effectiveness (Lewis, 1959). They have more concepts at their disposal for comprehending and describing their world than is the case for equally intelligent but less highly integrated persons. In studies more closely related to the phenomenon of assertiveness, we have found repeatedly that one of the defining characteristics of high-integration persons is their high environmental contact, their tendency to relate actively to both their physical and interpersonal environment.
It is at this point that we can begin making more direct connection between integration and assertiveness. We may now inquire as to the quality and character of the interpersonal contact that high integration persons make. Our studies throw light on this question. In one of the early studies carried out by Edyth Barry, Charlotte Ellinwood, and myself (Seeman, Barry, & Ellinwood, 1963), we found that children as young as 7 and 8 years old showed pronounced differences in the quality of their interpersonal relationships, depending on their level of psychological maturity. In that study we observed the play behavior of high and low integration children. A therapist was in the playroom with the child, so that the child had the option of relating to the therapist or playing with the materials. Each child had 10 individual play sessions. We found that the low-adjustment children had clearly defined relationship patterns: They displayed either highly dominating behavior or highly obsequious and dependent behavior. In either case the relationship was both controlling and hierarchical, that is, the children acted out relationships in which they continually attempted to structure the behavior of the adult and to define the relationships in vertical one-up or one-down terms.

In striking contrast, the high integration children displayed almost no controlling behavior and made virtually no attempts to structure the behavior of the adult. These 7-and 8-year-olds established a remarkably peerlike relationship that involved high sharing and low demand.

 
This chapter is designed to explore possibilities for further development of humanistic psychotherapy. In particular, the concept of the fully functioning person provides a foothold for potentially important directions of development. The concept contains in it both the whole-person idea and the fulfillment of personal potentialities that mark the goals of humanistic psychotherapy.

The direction in which my own thinking has evolved has been in the growing awareness that a human system model has promise because of its power both to organize complex structures and also to account for their underlying unity. It is, further, a design that is itself sufficiently structured to be helpful in generating empirical inquiry. Indeed, the human system model that I will present here was itself fostered by some twenty-five or more empirical studies that contributed to the validation of the model (Seeman, 1983).

THE HUMAN SYSTEM MODEL




Figure 8 - The Human System Health Model   Figure 8 depicts the model. The figure displays in a molecular-molar sequence the major behavioral subsystems that constitute the human system. Starting at the base with the biochemical subsystem, we move upward toward the more molar subsystems, capped by the most molar dimension, the person-environment transaction.

The horizontal and vertical arrows convey vital information about the model. The bidirectional vertical arrows are intended to depict the imbedded connections among the behavioral subsystems. These connections have a transactional quality--that is to say, the subsystems are so intimately linked and mutually imbedded that their function and their very definitions are interwoven with each other.

It is necessary to a true understanding of organismic processes that we grasp the full meaning of this transactional quality. Bohm (1981), for example, has said, "Each part grows in the context of the whole, so that it does not exist independently, nor can it be said that it merely 'interacts' with the other, without itself being essentially affected in this relationship" (p. 173).

Angyal (1941) has utilized what is probably the most simple and elegant definition of a system when he used the term unitas multiplex. In this term he captured both the existence of multiple subsystems or components of a system, together with its underlying unity.

Turning again to Figure 8, we note now the horizontal plane. This plane with its accompanying arrows is where the action takes place across time. The plane depicts the ongoing behavior, history, and development of the person. The bidirectional arrow immediately below the term Horizontal Dimension is designed to emphasize the continuity of past, present, and future in a well functioning human system.

There is one subsystem that requires special description. While most of the behavioral subsystems listed in Figure 8 have descriptive titles that are self-evident, the precognitive subsystem presents at once an important and less well understood aspect of the human system. By precognitive I am referring to those aspects of our behavior that are less fully organized and conceptualized. They occur to us as fragmentary and ambiguous impressions; they include dreams, affectively toned sensations, "intuitive" fragments, and the like. Their importance in psychotherapy stems from the fact that these precognitive bits of awareness furnish the client and therapist with avenues of access to potential blocks in connectedness and integration. They are less formed but vital emergent sources of information to client and therapist.

To say that these precognitive sources of information are less well understood is in no way to say that they are mysterious or unexplainable. Indeed, the organismic aspects of precognitive functioning have been the object of intensive interest at the biological level in recent years. What is now increasingly understood is the neural circuitry that connects the cortex with the lower levels of brain structure and function, and that provides evidence of the connectedness that characterizes a system. On this point, Gray (1981) has stated that

Improvement of methodology of study of fiber tract connections within the brain has led to the interesting finding that there are very extensive fiber connections between the two [the limbic system and the neocortex], and even to the discovery that all impulses entering the cortex or leaving it are routed through the limbic system and other subcortical structures. (p. 303)

Findings from another laboratory were concerned with the avenue through which information was integrated (Foote, 1988). Foote proposed that interactions within the neocortex were facilitated by subcortical structures that provide cortical "activation" or "implementation." Here we note again that precognitive activity from subcortical regions may be made available for further processing as a consequence of neural linkages from subcortical to cortical regions of the brain. An integral part of the task of psychotherapy is to pay attention to these precognitive signals, for they carry vital information often not fully available to the client. In such instances the therapist facilitates integration by fostering fuller awareness and symbolization, thus facilitating cognitive mastery of this information by the client.

It will be useful here to comment on another aspect of the model. You will note that the emotion subsystem cuts through all of the  subsystems. My rationale for placing emotion across the subsystem spectrum comes from the broad span with which emotion engages all of the other subsystems. An emotion might begin with a particular perception or with an interpersonal event, transfer rapidly to the biochemical and physiological subsystem, engage then with a cognitive response, and circle back to a revised interpersonal response. Such a broad response spectrum might not be unique, for I have argued that these transactional intersystem responses inhere in the very nature of the human system. What might be different is the breadth of coverage that characterizes the emotion system.

Emotion theory lends some support for this notion of breadth of span. For example, Tomkins (1962) put forth many years ago the notion that emotion in the human system functions as an amplifier of responses, serving to promote added energy to virtually the entire human system. Izard (1993) has identified four systems for emotion activation, including both cognitive and noncognitive points of origin. More recently, Smith and Kirby (2000) summarized some of the literature with an equally broad definitional span, thus: "The emotional reactions themselves are commonly conceptualized as having multiple response components, including a distinctive subjective feeling state, an organized pattern of skeletomuscular, autonomic, and endocrine activity, and a felt urge to respond to the situation in a particular way . . ." (p. 85). It was the cumulative weight of all of the foregoing comments that prompted for me the vertical placement of the emotion subsystem.
This chapter reports and analyses the first decade of therapy process research conducted by Rogers and his students. The report refers to both published and unpublished papers. Because this chapter is the most intensive and detailed record of that first decade of research in client-centered therapy, it is a precious record of an exciting decade of innovation in psychotherapy, a record that might otherwise be lost if it is not presented here. Originally published in 1953, there could be no such prior report for any other therapy method, since there were no prior verbatim recordings available like those used in this extensive collection. As an added bonus, the report reveals an intriguing variety of concepts that were the objects of study. The report was first published by J. Seeman and N. J. Raskin, as indicated in the acknowledgments.

In the decade or more since the appearance of Rogers's book Counseling and Psychotherapy (Rogers, 1942), a considerable body of research literature on client-centered therapy has come into being. This body of literature is the subject matter of the present chapter. What I will do here is to consider this research from a historical-developmental perspective, as the case history of a research program in being. In this period of interest and ferment regarding ways of looking at the phenomenon of therapy, such an approach may be useful not only as a stock-taking enterprise in its own right, but also in terms of the models it may provide for research in any form of therapy. In this connection I should like to indicate the research directions that have thus far been roughed out in client-centered therapy and to extrapolate from these into areas still to be explored. In so doing, I shall be talking about not only the contributions of research in client-centered therapy, but also its problems and unfinished business. Because other reviews have discussed the literature of play therapy (Dorfman, 1951) and group therapy (Hobbs, 1951), I shall confine our discussion to research in individual adult counseling.

As a way of defining the present task, I suggest two frameworks within which to organize our thinking about therapy. The first pertains to the bidimensional nature of research in therapy, and the second relates to the role of theory in shaping research plans and directions. With reference to the dimensions of therapy research, we can take our cue from the dimensions of psychological research in general. Here we can see two dimensions---first, the dimension of internal events or processes and, second, the external dimension that seeks to find correlates ("outcomes") to help explain the processes we are interested in studying. The internal dimension exists whether we are studying the process of therapy, the process of concept formation, or the process of maze learning in rats. In therapy research we may arbitrarily define the internal dimension as the interview behavior of client and therapist. Within this dimension of internal observation we can look either through the eyes of the subject (the internal frame of reference) or utilize concepts that interpret the events from some other frame of reference. In any event, we are seeking through this dimension to discover the orderly and lawful relationships inherent in the data of the therapeutic process.

The second dimension of therapy research turns to the correlates of the process of therapy; its main task is to teach us more about the process of therapy by teaching us about the concomitant behaviors associated with therapy. This second and external dimension of therapy research has the double task of discovery and demonstration. Its search for independent measures of therapeutic process and outcome leads not only to discovery of new facts about therapy, but also to the classical validation function of verifying hypotheses about therapy.

We started the organization of our thinking about therapy by suggesting two frameworks, one of which was the dual aspect of research in this field. The second framework, the consideration of the role of theory, we can best discuss as we consider the specific research studies. However, it may be well here to restate what this book already presumes, namely, that a structure of theory is a powerful force both for the organization of existing knowledge and for the structuring of directions in which to search out new knowledge. The inexorable direction of science is relatedness; a theory simply cooperates with nature in this respect.
This paper presents some findings and views as to the noxious impact that the use of deception can produce in the research process. An interesting sidelight with respect to this paper is that it was honored by a committee of the American Psychological Association. Their task was to select one paper from each year's papers in the American Psychologist, a paper that could represent the quality papers for that year. The research deception paper that follows was selected to represent the year 1969.

Since the development of psychology as a behavioral science, the issue of experimental controls has been a central one. In the early history of psychology, when attention was centered on studies of sensation, perception, and learning, the problem of controls was readily managed. In recent years, however, psychologists have turned to the study of more complex phenomena, including attitudes, motivational states, expectancies, anxiety, dissonance, and stress. The study of these variables imposes more difficult demands on the control of the experimental setting.

One of the ways that psychologists have sought to construct relevant experimental controls is to devise what I shall call fictional environments--that is to say, environments that appear to have certain properties but that in fact do not have these properties. These fictional environments are designed to induce specified sets or expectancies in the subject. Illustrations of such fictional environments are, for example, the use of false verbal instructions, or the use of nonfunctional visual props such as electronic gear and wires, and the creation of fictional social norms through the use of confederates. One of the distinguishing characteristics of these fictional environments is that they typically involve the use of deception. This article will focus on the issue of deception in research and consider four aspects of the problem: the frequency with which deception is employed in research, the pragmatic complications that result from the use of deception, the public policy issues inherent in the problem, and the ethical issues involved.

With respect to the incidence of deception, it may be useful to note the frequency with which deception appears in the published literature and to determine whether any long-term trends are evident. For this purpose, the total published literature in several journals was analyzed for the years 1948 and 1963. Journals were chosen to reflect different fields within psychology.  
The reports that follow all allude to the program of research that I undertook to learn more about the fully functioning person. The specific research task that was before me at the outset was to devise a program that was whole-person in spirit and intent, and yet detailed enough to scrutinize as many specific aspects of the fully functioning person as was feasible. At the outset I could not have predicted that my search would lead to the development of a human system model of human functioning, yet in retrospect that outcome was inevitable.

I will not try to describe all of the thirty studies that my student-colleagues and I did, but I will present enough studies in each major human subsystem so that you will have a clear picture of the outcome patterns that the studies revealed. In presenting these studies I am aware that many of my readers are likely to be most interested in what the studies have revealed to us, and to be less concerned with the technological aspects of the study. Consequently I will discuss these studies in an informal conversational way. For those readers who are interested in the study's technical details, I refer you to my 1983 book, Personality Integration.
The literature reported in this book is diverse along many dimensions. It spans four decades in time, it is international in scope, it covers a variety of theories, and its empirical literature includes many different samples and research designs. Yet within this striking diversity there emerge themes of equally striking consistency, so much so that we are entitled to conclude that here we have knowledge about human effectiveness, knowledge in the Dewey sense of warranted assertions (Dewey & Bentley, 1949).

I want to identify and set forth here the recurrent themes that emerge from this review, omitting for now the findings of our own research that I reported earlier. But first, a caveat: While there is meaning in such enumeration, I do not wish in this process to lose sight of a powerful message implicit in the literature, namely, that the fullest understanding of these themes will involve a comprehension of the structure and organization of the system as a whole.

It is in the foregoing connection that we can best understand the one theme that recurs more often than any other. The most frequently mentioned aspect of personal effectiveness centered on conceptual frameworks that emphasized synthesis and integration. There was wide agreement that special qualities of organization and function of the individual as a whole characterized the phenomenon of personal effectiveness. The individual's capacity to regulate the total personal system, the harmonious interplay of part processes, and the existence of adequate communication channels were all required as conditions of effective functioning and optimal utilization of personal resources.

Coincident with this structural perspective, two substantive themes emerged as the two most widely cited elements of personal effectiveness. These two themes involved the capacity to experience and perceive self. The capacity to experience not only represents a phenomenon in its own right, but is a process linked to significant derivative qualities. The associated qualities include active awareness of environment, high ability to receive and process new information, an ability to deal with complexity and ambiguity, a resilience in the management of stress and conflict, and an accompanying capacity for environmental mastery.

A concurrent cluster of qualities involved self-regarding attitudes. What stands out clearly in this respect is confident trust in self. Equally prominent are clarity in self-definition and sense of identity, coherence of self-definition, and sense of autonomy deriving from belief in self and differentiation in self-other relationships.

On the issue of self-other relationships, the themes were very evident. There is a capacity for going beyond self, a commitment to awareness of and concern for others. Intimacy, warmth, and empathy are accompanying elements of this orientation.

Finally, consistent with the foregoing portrait, are the qualities of energy, vitality, and good physical health.

As a final note, I should like to synthesize all of the findings, ours and others, by constructing a portrait of the psychologically integrated person. Such a synthesis may remind us that we are talking about real people who function in real life. It is a portrait that may not fit any one person but that cumulatively defines human effectiveness as we have come to know it in this book.

I start here where I have begun before: Psychologically integrated persons affirm themselves. They have a core sense of self which they like, respect, and trust. And that makes all the difference, for that one central fact connects with all the rest. Persons who understand and trust their basic organismic self can listen to their own signals. They do not have the same need to screen, shut out, deflect, or distort signals in a way that characterizes more vulnerable persons. For the integrated person this ability to receive and process the data of their immediate experience results in the optimal receipt of information both quantitatively and qualitatively--quantitatively because they can literally receive more information through an open, uncluttered communication system, and qualitatively because they can process and integrate the information more fully as their behavioral subsystems function congruently, in a harmonized and undistorted rhythm.

This capacity that I have just described, this ability to receive and process the reality data of their world, has portentous effects for the integrated person. Reality data serve as psychological nutrition, fully as important to the psychological organism as food is to the biological organism. The ability to take in and assimilate reality data serves to maintain, to regulate, and to nourish the organism in its transactions with the environment. When the reality data are adequate and comprehensive, the person has the best chance for psychological development. When the reality data are diminished or distorted, the person's chances for development or even survival are minimized. Reality data, in short, constitute the fundamental building blocks of psychological life. The person with maximal access to such data is quite simply more alive.