Subsequently there now appears to be a lot more assessment and diagnoses happening. This could be primarily because of external pressures which are ultimately financial. Both the NHS and insurance companies demand diagnoses of pathology in order to approve (pay for) therapeutic work, and this is also becoming the norm in voluntary organisations (Sanders, 2005). Since they, alongside voluntary organisations who’s funders have largely adopted the same approach and are the main sources of subsidy for therapy, this demand for a medical definition has largely been accepted and therapy’s heritage of medico-pathological labels has been dusted off. The difficulty for humanistic therapist is thus consequently finding a comfortable balance between acknowledging that practitioners of course recognise patterns to the issues that clients bring whilst being able to maintain as a core position that each person is unique and that the authority about a person rests in the person rather than the outside experience (Bozarth, 1998).
As a result many humanistic therapists are developing their own versions of conventional diagnostic categories, primarily those used in DMS IV (American Psychiatric Associations, 1994). For example; A System of Gestalt Diagnoses of Borderline, Narcissistic and Schizoid Adaptations (Greenberg, 2003) and not forgetting another very influential paper which discusses how the traditional pathologies- schizophrenia, hysteria etc can be understood in terms of Transactional Analysis (Ware, 1983). But it is the Rogerians Person Centred Theory (PCT) – also highly criticised for its lack of empirical research and scientific findings, that has held out most strongly against pathology and diagnoses since such concepts are directly inimical to their whole approach (Sanders, 2006).
Person centred theory has therefore been criticised for being ‘profoundly simple’ (Totten, 2010) and that is concerned with presence rather the theology and therefore lacking in skill. But interestingly there has been a strong emphasis in humanistic therapies on the use of experiential groups (Berne, 1966, Perls, 1971; Rogers 1973; Whitton 2003 and Berkow 2005). Carl Rogers was the originator of the encounter group model and both TA and Gestalt have traditionally done a lot of work in groups rather than one to one and continue to do so. Of course other modalities use groups and in contrast within psychodynamic traditions they tend to perceive groups as specialism requiring separate training; while in humanistic circles practitioners have spent a significant amount of time in groups and therefore will often be regarded as inherently competent to lead them.
Consequently it is rarely possible to make absolute distinction and oppositions between modality. Unlike most CBT and medical model therapies, humanistic practise is orientated towards growth not cure and unlike most psychoanalytical therapies; humanistic practise is actively relational and unrestricted. These differences are basis to the unique identity of humanistic therapy. If humanistic, psychoanalytical and CBT theory was to be subsumed into a generic version of therapeutic practise then the essence of individual practise would be lost.
The existence of different modalities and approaches therefore benefit not only the client, but also the practitioner. Certainly clients need different approaches which best suit their needs, issues, life situation and personality. But it is also important for the practitioner to work in a style that suits their personality and hence enables them to give their best. If modality was therefore integrated without careful care or consideration given to the core concepts of each, then it is possible that either practitioner or their clients would be dissatisfied with the result. Give this, there is still an authentic need to strengthen the interconnection between modalities and for each to learn from the others so as to improve overall practise, while still recognising and preserving the real differences of approach. (Lapworth and Sills, 2010).
Thus, one can sometimes feel that psychoanalytical practitioners at times convey behaviour which suggests that they don’t like their clients, often treating their clients as patients, a specimen of theology perhaps. Humanistic therapy therefore offers a style which is rooted in an appreciation of human beings and there innate tendency to heal and grow- a style which fosters the valuing, the individual quirks and foibles, a principled willingness to follow where the client leads and an optimism which is itself conducive to therapeutic success.
The finest practitioners in each modality I believe have therefore already incorporated all or much or what they need from other modality. However I believe at times practitioners can be ignorant, perhaps believing that they are staying ‘true’ to their theoretical background, but none the less, possibly secluding themselves from what is going on elsewhere in the world of counselling and psychotherapy and consequently are not equipped to invent for themselves what is missing or underemphasised in their own training.
In conclusion it may not pay to think of psychoanalytical and humanistic as competing schools of thought- but to consider that each branch of theory has contributed to our understanding of the human mind and behaviour. Humanistic theory added yet another dimension that takes a more holistic view of the individual and there are many groups of individual practitioners that working with a combination of some or all modality often including psychodynamic input. This comes to no surprise as although heavily criticised- both Freud’s seduction theory and work relating to traumatic neurosis have heavily influenced all fields of counselling and psychotherapy today.
I may even argue that his work is the fundamental basis of theoretical thinking. Although differences still stand with both schools of thought, where humanistic theory gives way to the potential for growth and psychoanalytical theory offers insight into our unconscious thoughts, I feel that when both these elements are brought together, true therapeutic change can take place. Consequently, regardless of the chosen theoretical background, when engage in therapeutic relation, the main focus should be the client and their interest alone. Therefore to avoid labelling and to work within the context of the client I believe working via a humanistic approach which is therefore integrated with other modality can provide a harmonious blend of both presence and theology.