copyright © by Sue Genest, M.Sc., CCC
Email: email@example.com / Phone 204-221-3619
“The impulse to heal is real and powerful and lies within the client. Our job is to evoke that healing power, to meet its tests and needs and to support it in its expression and development. We are not the healers. We are the context in which healing is inspired.”
– Ron Kurtz, Hakomi Psychotherapy Founder
The purpose of my thesis was to further explore the mysteries of healing and life transformation experienced by clients from their perspective. My question acknowledges the complex, rich, and whole experience of feelings, thoughts, values, skills, struggles, attributes, life development, and multifaceted context that make healing possible. This is consistent with humanistic and feminist principles for research and counselling. Phenomenological interviews were used to capture the stories of three individuals and a group of seven women.
There is a severe lack of research highlighting the client’s voice and experience of how counselling contributes to healing. Most of the research on counselling is observational and/or are interpretive accounts by therapists and researchers on components of the therapeutic alliance from their own perspective. Many authors (Bachelor, 1995; Foskett, 2001; Goedde, 2000; Gutheit, 2000; Mohr & Woodhouse, 2001; Sherwood, 2001) agree that we have more to understand about the working alliance in counselling and that the client’s perspective is essential to this advancement. My research has provided a significant step in understanding client perspectives of the healing journey. I have used qualitative heuristic methodology (Moustakas, 1990; 2001) to highlight individuals’ accounts. The purpose of the heuristic inquiry is “to know the essence of some aspect of life through the internal pathways of the self” (Douglas & Moustakas, 1985, p. 39). Heuristics offers an alternative to interpreting client’s stories by involving participants as co-researchers and portraying them as whole persons in their full and rich narratives. Butler and Strupp (cited in Macran & Ross, 1999) write:
Psychotherapy is not a medical technology that can be administered mechanically to a passive patient, and that somehow eradicates an illness or syndrome, leaving the patient cured… Medications, as chemicals, directly influence the biochemical systems of the body. Psychotherapy consists of behaviours and vocalizations whose influence depends on the meanings attributed to those behaviours and vocalization by the participants. (p.329)
Bachelor (1995) writes that the client’s perceptions of the therapeutic relationship have been proven to be consistent predictors of improvement versus evaluative perspectives. Bachelor’s work has contributed to our understanding by showing correspondence between client perspectives and existing theoretical components of the therapeutic alliance. Bachelor was able to illustrate, for example, that clients differentiated the component of counsellor empathy into the variables of listening and understanding. These were described as a quality of felt presence, genuine interest, and a sense of the counsellor being absorbed in their world (not unlike what Carl Rogers expressed in his 1957 article).
Literature highlighting client perspectives contribute to our appreciation of clients’ experiences and provide insight into understanding counselling outcomes. One form in which this research exists is retrospective accounts of therapy by those who are now counsellors (Biaggio, 1996; Davis, 1996; Dworkin, 1996; Leeder, 1996; Levy, 1996; Moss, 1996). Dissertation research such as Gutheit’s (2000) and Goedde’s (2000) also provide insight. Researchers such as Alexandra Bachelor (1995) focused on components of the therapeutic alliance using a phenomenological approach. Other studies I have found used grounded theory including Bolger, 1999; Phillips, 1984; Rennie, 2002; Rhodes, 1994; Schneider, 1985; and Shaul, 1993. Another valuable source of insight and client perspective is that of autobiographies. For example, in 1974, Irvin Yalom, a psychiatrist, and ‘Ginny’, his client, published a book together on their experiences of counselling, ‘Every day gets a little closer: A twice-told therapy’. More recent stories of clients include, Rosie Alexander’s (1995) book ‘Folie a Deux: An Experience of one-to-one therapy’ and Anna Sand’s (2000) book, ‘falling for therapy: psychotherapy from a client’s point of view’ which both elaborate on their experiences and insights into their counselling process. All of these are valuable sources of information for the counsellor wanting to expand their understanding of clients experience and perceptions of counselling.
So, what do you ask did I find in my research? Keep in mind that although a variety of events, people, and new learning can be cited as significant in the direction of one’s life, the whole of her/his journey is complex and interrelated. Outcome and process are not as easily distinguishable as one might suppose (Phillips, 1985) as each of the parts is intertwined in the complexity of richness of the whole.
Co-researchers’ descriptions of the experience of their journeys indicated numerous contributors to healing, self-discovery, and wholeness. One re-occurring category was the catalysts to self-knowledge and change including life transitions, work experience, health issues, tragedy such as deaths and other losses, and blessings such as births and relationships. Numerous other uncontrolled and unforeseen external events also invoked change and healing. Additionally, relational elements, counselling, and complementary and alternative practices also contributed to co-researchers’ journeys both as catalysts and as part of the change process. Process and experience wove together events and relationships as central to each journey. These included building relationship with self, self-awareness, choice, organicity, the appeal to greater meaning or a greater purpose for one’s life, self-actualizing tendencies, the experience and importance of wholism, cultural and developmental factors, and the expressed emotional, spiritual, and metaphoric expressions of the journey.
Coming into a deeper experience of self was key in healing transformations and induced change while also being an outcome. This was facilitated through relationship that spawned awareness, reflection, facing self, and taking responsibility. Essential to relationship with self was connection to others whether friends, family, counsellors, pets, spirit world, or being in nature. Being in relationship with the world in varying ways allowed for self reflection, necessary support, role models, and the sustaining elements of relationship we all long for as humans. Important components of healing relationships included nurturance, acceptance, love, kindness, empathy, comfort, belonging, and emotional closeness.
The co-researchers experienced a longing and need to seek further what was intrinsically tied to indwelling and making sense of the world in relation to their own internal experience of self. The longing and drawing forward in one’s life can be described by two concepts, organicity and self-actualization, while being crucially tied to choice points and in one’s life. It seemed to me that as co-researchers came to know self deeper their unconscious was more accessible and their knowledge of self, the world, and its great mysteries expanded. I see this expansion as bringing individuals closer to meaningful truths that resonate from within to the realities of their life. Dan Scorpio (2005) suggests that the deep insight we gain is beyond normal self-awareness processes and expands our consciousness.
The process of “learning” here comprises an awakening of awareness, attention, observation of the ephemeral, deep insight and readiness such as to permit rendering of that insight into intelligible, conscious form. Once this process has initiated then it transcends the rote of childhood behavioural conditioning. It becomes self-energising and self-directing, as the awakened parallel intelligence spontaneously moves towards dissipation of dissonant noise and integration of the apparently separate, but in reality conjoined, mind-body system. Expanding awareness implies expanding consciousness (para 10-11).
The expansion of consciousness includes the awareness, experience, and interaction with one’s whole self. The whole self is the fuel of organicity both conscious and unconscious. “Organicity refers to the process dynamics of self-organization – the internally directed creation, maintenance and evolution of living systems” (Kurtz, 1990, p.25). The principle of wholeness in Hakomi body psychotherapy suggests that mind, body, and spirit are subsystems of one metasystem all of which are interconnected and can be accessed through one another. Feldenkrais (Kurtz, 1990) explains that the nervous system is believed to spontaneously reorganize in the healing process (p.33). Ken Wilbur suggests this is the reorganization of the psyche (1983). Peter Baylis (2005) writes about the neurological changes associated with an affective supportive therapeutic relationship. Jung (1981) wrote, But since everything living strives for wholeness, the inevitable one-sidedness of our conscious life is continually being corrected and compensated by the universal human being in us, whose goal is the ultimate integration of conscious and unconscious, or better, the assimilation of the ego to a wider personality (p. 292). Organicity then will direct an individual towards his or her own path and purposes that enrich wholeness and fullness. It is a respect for life and faith in the healing power of an individual that is described by some as the intersection of the unique individual who is incarnate divine (Eisman, 2005). This concept is not new. The divine incarnate has existed for centuries in Egyptian mythology and many world religions (Harpur, 2004). Itzhak Bentov (2000) writes, “You are pure consciousness or pure awareness, and that is the supreme SELF that has been guiding you through the long and eventful trip back to itself” (p.84). This truth within and pull forward is something my co-researchers were tapping into as they highlighted the necessity of coming into deeper relationship with self and expanding consciousness. The therapeutic modalities they sought supported these premises and allowed them to connect to deeper truths within.
My research has implications for therapy, the education of counsellors, theoretical frameworks, ethics, health care policy, and current and potential counselling clients. My research highlights specific aspects such as building relationship with self, spiritual wholistic experiences of healing and transformation, and self-actualizing tendencies. The concept of organicity provides counsellors with a map to facilitate client self-understanding. The insights that arose from client experience and knowledge were vast and bring forward client voice and highlights their expertise. My conclusions solidify that need for greater understanding of client knowledge, the importance of the relationship for context of self discovery and expansion of consciousness for change. My findings and further research highlighting client perspective will contribute to helping professionals’ development towards healing practices for the ultimate benefit of clients.
Alexander, R. (1995). Folie A Deux: An experience of one-to-one therapy. London: Free Association Books.
Bachelor, A. (1995). Client’s perception of the therapeutic alliance: A qualitative analysis. Journal of Counseling Psychology, 42, 3, 323-337.
Baylis, P. (2005). The neurobiology of affective interventions: A cross-theoretical model. The Clinical Social Work Journal. http://www.springerlink.com.ezproxy.lib.ucalgary.ca:2048/(m1q0ry55prh0lb45fy0a4z45)/app/home/contribution.asp?referrer=parent&backto=searcharticlesresults,1,1;journal,1,1;linkingpublicationresults,1:104850,1
Bentov, I. (2000). A brief tour of higher consciousness: A cosmic book on the mechanics of creation. Rochester, VT: Destiny Books
Biaggio, M. (1996). Personal therapy of one lesbian therapist: A lesson in power and responsibility. Women and Therapy, 18, 2, 11-17.
Bolger, E. A. (1999). Grounded theory analysis of emotional pain. Psychotherapy Research, 9(3), 342-362.
Davis, N. (1996). The quicksand of boundary violations. Women and Therapy, 18, 2, 25-36.
Douglas, B. & Moustakas, C. (1985). Heuristic inquiry: The internal search to know. Journal of Humanistic Psychology, 25, 3, Summer, 39-55.
Dworkin, S. (1996). From the personal therapy to professional life: Observations of a Jewish, bisexual lesbian therapist and academic. Women and Therapy, 18, 2, 37-46.
Eisman, J. (2005). The re-creation of the self: As an approach to psychotherapy: Self Published.
Fibush, E. & Morgan, M. (1977). Forgive me no longer: The liberation of Martha. NY: Family Service Association of America.
Foskett, J. (2001). What of the client’s eye view? A response to the millennium review. British Journal of Guidance and Counselling, 29, 3, 345-350.
Goedde, C. (2000). A qualitative study of the client’s perspective of discussing spiritual and religious issues in therapy. Unpublished Doctor of Psychology, Psy.D. Clinical Dissertation, Alliant University, United States.
Gutheit, K. (2000). The internal experience of the patient in the psychotherapeutic relationship. Unpublished Doctor of Philosophy, Clinical Psychology, The Union Institute, United States.
Harpur, T. (2004). The Pagan Christ: recovering the lost light. Toronto: Thomas Allen Publishers.
Kurtz, R. (1990). Body-centered psychotherapy: the Hakomi method. Mendocino, CA: LifeRhythm.
Leeder, E. (1996). Reflections of a midlife lesbian feminist therapist. Women and Therapy, 18, 2, 47-60.
Levy, P. l. (1996). From the inside out. Women and Therapy, 18, 2, 19-23.
Macran, S. & Ross, H. (1999). The importance of considering client’s perspective in psychotherapy research.
Journal of Mental Health, 8, 4, August, 325-338.
Mohr, J. J., & Woodhouse, S. S. (2001). Looking inside the therapeutic alliance: Assessing client’s visions of helpful and harmful psychotherapy. The Psychotherapy Bulletin, 36(3), 15-16.
Moss, L. (1996). After the crash: My journey to become a lesbian feminist body psychotherapist. Women and Therapy, 18, 2, 61-70.
Moustakas, C. (1990). Heuristic research: Design methodology and applications. Thousand Oaks, CA: Sage Publications.
Moustakas, C. (2001). Heuristic research: Design and methodology. In K. J. Schneider, J. F. T. Bugental, & J. F. Pierson (Eds.), The Handbook of Humanistic Psychology (pp. 263-274). Thousand Oaks, CA: Sage Publications.
Phillips, J. R. (1985). Influences on personal growth as viewed by former psychotherapy patients. Unpublished Doctoral Dissertation, York University, Toronto.
Rennie, D. (2002). Experiencing psychotherapy: Grounded theory studies. In D. J. Cain & J. Seeman (Eds.),
Humanistic psychotherapies: Handbook of research and practice (pp. 117-144). Washington, D.C.: American Psychological Association.
Rhodes, R. H., Hill, C. E., Thompson, B. J., & Elliott, R. (1994). Client retrospective recall of resolved and unresolved misunderstanding events. Journal of Counseling Psychology, 41(4), 473-483.
Rogers, C. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21(2), 95-103.
Sands, A. (2000). Falling for therapy: Psychotherapy from a client’s point of view. London:Macmillan Press Ltd.
Schneider, K. J. (1985). Clients’ perceptions of the positive and negative characteristics of their counselors. Unpublished Doctoral Dissertation, Saybrook Institute.
Scorpio, D. (2005). Beginnings of Learning and Awareness. Retrieved October 25, 2005, from:
Shaul, A. N. (1993). Therapists’ symbolic visual imagery: A key to empathic understanding. Unpublished Doctoral Dissertation, York University, Toronto, ON.
Sherwood, T. (2001). Client experience in psychotherapy: What heals and what harms? The Indo-Pacific Journal of Phenomenology, 1(2), 1-16.
Wilber, K. (1983). Eye to eye. Garden City, NY: Anchor Press/Doubleday.
Yalom, I. D. & Elkin, G. (1974). Every day gets a little closer: A twice-told therapy. New York: Basic Books.