Empathy is also an essential core condition required for a successful therapeutic relationship. When the counsellor is empathic it means that the he/she will be able to gain a deeper understanding of the clients world, and “can stand in the clients shoes and perceive things as the client perceives them” (Hough M, 2002:54).
However Hough (2002:54) states that “this can be extremely difficult to accomplish and sustain, not least because it involves a continuous and intense active listening, not just to words but also to the feelings expressed and conveyed when no words are spoken” (Hough 2002:54). Therefore it could be argued whether a heterosexual counsellor could fully understand the deeper meaning and feelings of a gay/lesbian person, if they have not experienced these themselves.
Unconditional positive regard is a core condition that is essential in accepting the client’s experiences and respecting the client as a unique person. Rogers believed that every individual has the motivation and ability to change if they received un-conditional positive regard and the individual is the best person that can decide on what the change should be.
Pietrofesa JJ, (1978:119) highlights the debate over the use of the word ‘unconditional’ in relation to positive regard. He cites Belkin’s (1975) critique of Roger’s theory for using this term as he states that it is impossible not to be influenced by certain conditions relating to the client.
At the initial stage of the helping process it will be necessary to express unconditional positive regard and respect for the client and to accept the client as they are, however Brammer (1973) states that as more knowledge and understanding of the situation becomes available the regard may change from being ‘unconditional’. Hough (2002) states that remaining ‘unconditional’ can lead to the tendency of the counsellor becoming ‘passive’ rather than facilitating change.
This highlights the complexity of the client /counsellor relationship and of maintaining and using the core conditions effectively.
Roger’s developed the self-concept, which is how an individual perceives themselves and their reality; it consists of conscious thoughts and beliefs about his /her self. This self concept can be contrasted with the organismic or ‘real’ self which is how the individual would choose to be. The aim of the inner or real self is to grow and develop, and to reach self actualisation.
Radford and Govier (1991) however criticise Roger’s theory of the self as being naïve, they question whether an individual knows themselves and their problem as well as Rogers claimed.
Rogers stated that the organismic self may be neglected as the self concept is distorted this is particularly relevant for the homosexual individual living in a homophobic society that is saturated with negative stereotypes of homosexuality.
Dryden et al (1993:237) state that a homosexual person
may experience feelings of “self-hate guilt, shame, a lack of self worth, self-doubt, internalized oppression, religious doubts, and fear for the future”, therefore there is a discrepancy between the ideal self and the self concept.
Being functional or dysfunctional human being is particularly relevant to how a gay/lesbian identity and self concept develops, becoming functional human being requires being able to use ones own organismic valuing process, which maximises the potential to grow and become the true self. The dysfunctional human being lives to meet the values of others to acquire love and respect. This is known as conditions of worth. Conditions of worth are relevant to the gay and lesbian people living in a society where homosexuality is stigmatised, a homosexual person may have spent all their lives under conditions of worth at both a social and personal level, where they have developed internalised feelings of low self worth and negativity about their sexuality; and they strive to meet the expectations of a heterosexual society. Coming out as a gay/lesbian therefore is fraught with anxiety and even danger of rejection by family, friends and community.
The previous medical model of therapy often treated homosexuality as a mental illness and therapy was used to try to ‘cure’ homosexual people, through ‘conversion’ therapy.
In 1974 the American Psychiatric Association declassified it, Mcleod J, (1998), and although it is no longer considered a mental illness, it can be argued that it is still considered as a deviation from the ‘norm’ (Davies and Neal, 1996)
Rogers deliberately used the word ‘client’ to replace ‘patient’ because he believed that the client was an ‘expert’ on his or her problem, this is significant in relation to therapy for gay and lesbian people. However it can be argued whether the balance of power has actually shifted towards the recipient from the professional/counsellor.
The issues of ethnicity, culture, race and class are particularly important when there is a difference between the counsellor and the client’s cultural background; for example if the client is black and the counsellor is white, it can be questioned whether cross cultural counselling will be effective? Another important question is that of racism, can a white middle class, heterosexual counsellor, fully understand the impact of racism and on a black gay/lesbian person?
Palmer et al (1996:184) define the ‘imbalance of power’ that a black person may already have experienced in daily life situations and therefore may distrust the professional-client relationship as it may be a ‘mirror-image’ of powerlessness they experience in every day situations.
Neal and Davies(2000) also stress the ‘multiple’ discrimination experienced by black people, when the client is black and gay Neal and Davies state they have to come to terms with “ the additional task of integrating two major aspects of their identity which are generally devalued by society, race and sexuality” (2000:14).
The counsellor therefore not only has to be aware of the impact of racism on their client but also of the homophobic society that the client lives in.
The person centred method and humanistic theory are based on the notion of ‘individualism’ and how the individual perceives him/herself, however Glassman (2000)states that many cultures foster a ‘collectivist’ framework. Therefore an individual may identify themselves in relation to their social position or status, or in relation to family structure.
Glassman (2000) states that in this case social relationships are considered ‘more important than the individual’. This is particularly relevant to clients from black and Asian ethnic backgrounds where the individual depends on support from social and family networks, especially in relation to coping with racism.
It is necessary therefore to realise that clients who are gay or lesbian have different life experience to those that are heterosexual this needs to be recognised and acknowledged in relation to their ethnic and racial background.
Ivey (1986:103) criticises theories such as Rogers Person centred approach, and states that ‘they do not question their own assumptions about reality’ he emphasises the way that such theories automatically separate an individuals problems from their social context and origin. For example ‘coming out’ from a white gay/lesbian Eurocentric community viewpoint is regarded as positive acknowledgment of sexual identity, however Chan (1997 :279) acknowledges that ‘non-western’ cultures, such as East–Asian cultures, may not have concepts of sexual identity , comparable to the concept found in Western cultures therefore a white counsellor may not be able to relate to pressure and need to conform to the traditional gender and role expectation of the client.
Dryden et al (1993:246) also highlight the fact that counsellors may ‘unwittingly and unintentionally display prejudice’ when dealing with homosexual clients, this may be in relation to assumptions about the ‘origins’ of homosexuality, possible explanations about being either genetic or environmental ones. He also states that the counsellor may have assumptions about whether the client is confused about their maleness or femaleness and this is also perpetuated in the media where gay and lesbian people are assumed to play out masculine/feminine roles. Kus (1990) states that one of the most frequent criticism concerning helping professionals is that they get ‘fixated’ upon the homosexual life style and lose sight of the issues the help is being sought for .Therefore rather than building a helping relationship with the client, the counsellor may question the client to satisfy their own curiosity of homosexuality.
Counsellors need to show their acceptance and understanding of their client not only through verbal expression but also through nonverbal means such as body language, Kinsey et al (1948) states that “a minute change of facial expression, a slight tensing of a muscle, the flick of an eye, a trace of change in one’s voice, a slight inflection or change in emphasis………or any of a dozen and one involuntary reactions betray the interviewers emotions’……… cited in Dryden et al (1993:238). Therefore prejudice and ignorance can lead to unconsciously oppressing the gay client both verbally and non-verbally.
The person centred method places great importance on the relationship between counsellor and client. The relationship based on the core conditions will allow the counsellor to enter the client’s world and see it from the client’s perspective.
The advantage of Roger’s person centred approach is that the client is allowed to explore their own thoughts and feelings and determine what they want to discuss in the therapy session.
Lee Ann Hoff (1990:112) states that ‘the quality of the relational bond, listening, and empathy’ are key components to success in therapeutic relationships. Therefore these elements and also the awareness of other environmental factors, such as social and structural impact of stigma associated with homosexuality needs to be considered in the helping process.
A further criticism of the person centred method by Ivey et al (1997) is that it is a ‘highly verbal’ technique, which is over-concerned with the deeper meaning of life rather than tackling problems and finding solutions. Therefore it may not be suited to all clients especially those with mental health problems etc.
Janet Perry (1993:41) states from a feminist perspective that “the theories on which many counselling models are based project both masculine and western cultural images” This is also significant in relation to the development of male role within society where independence and individualisation are notions that are valued and strived for, therefore the humanistic perspective of independence may not have the same value and significance from a feminine perspective. Therefore a lesbian woman may feel that her role as a woman in society is not valued and acknowledged.
‘A primary goal for the person –centred counsellor is to, see feel and experience the world of the client as it is seen, felt and experienced by the client’ (Perry, J,1993:53) however can this be achieved be fully achieved ?
Perry also states the disadvantages of having a same sex counsellor, she states that there is a potential for over-identifying and over-sympathising with the client, as this can cause complications where they will be unable to ‘stand back’ from the experience, and rather than providing empathy this will be replaced by sympathy and both parties will feel powerless .
Bradshaw (1998) has defined the concept of ‘Toxic shame’ in relation to internalised homophobia within the self-concept. This is when the self concept becomes fragile and a false self concept develops, through denial, this may be conscious or unconscious but it will be due to the fear of discovery. Davies and Neal (1996) state that this notion cannot be fully understood without the use of a more eclectic approach to counselling such as gay affirmative therapy which incorporates both psychodynamic and humanistic theoretical models. They also emphasise the need for training counsellors to be aware of issues such as homophobia, gay identity development and reflecting their own values towards homosexuality.
The person centred model has contributed significantly to the therapeutic process of counselling and working with gay and lesbian people, Kus, (1990), highlights the importance of honesty and openness about personal prejudices on behalf of the therapist and that clients should be referred on, in such circumstances.
The person centred model is also useful for other helping professionals from health, social work and education, because it places the individuals needs and experience at the focus of the relationship and it is therefore a useful tool in facilitating the acceptance, respect and valuing relationship between client and counsellor, which will therefore facilitate change and growth.
Reference Page
Perry J, counselling for women(1993) Open University press, Buckingham
Hough M(2002) A Practical Approach To Counselling, 2nd edition,Pearson Education Ltd Essex.
Neal C and Davies D (2000) Issues in Therapy with lesbian, gay, bisexual and transgender clients , Open University Press Buckingham
Pietrofesa JJ et al (1978) Couselling :Theory, Research and Practice Rand McNally College Publishing Company,Chicago, USA
Davies D, Neal C, (1996) Pink Therapy, Open university press, Buckingham
Palmer S,(1989) The Hand Book of Counselling, Tavistock, Routledge, London
Kuss J R,(1990) Keys To Caring ,Assisting Your Gay And Lesbian Clients, Alyson Publications London
Palmer, S and Laungani P et al (1999)
Counselling in a multicultural society, Sage publications Ltd London
Dryden et al (1993) Handbook of Counselling in Britain, Routledge , London
Chan C (1997)
Asian Lesbians : psychological issues in the coming out process, Thousand Oaks Sage , London
