Frank Seems Like an Ideal

Frank seems like an ideal candidate for Carl Roger's person-centered therapy techniques. Rogers' therapy focused not as much on pathological states of behavior, but on normative states, and above all the normative impulse towards a quest for meaning. At present, Frank does not feel fulfilled in his vocational, spiritual, or social life. Although he is not exhibiting substantial deficits in any of these areas -- i.e., he 'has' a job, wife, and a spiritual home -- he does not derive intense pleasure or satisfaction from his experiences. Rogers believed that striving for optimal growth was necessary, rather than merely seeking a state of homeostasis with one's environment. Rogers used non-directive questioning to create a supportive environment during therapy to encourage the patient to explore what made life meaningful for him or herself.

At present, Frank seems to have a very passive way of engaging with his life. He has accepted a job that is dull and unfulfilling, but which he needs to keep to pay his bills. He has had little variety in his sexual or romantic life, and although he is not unhappy with his wife, their relationship does not appear to be moving forward. They have known one another since high school, and seem to have exhibited little emotional growth. Rogers would say that Frank's esteem is overly dependant upon social expectations: Frank is trying not to rock the comfortable 'boat' in which he has found himself, and makes his legitimate but manageable fears (such as the need to pay his credit card bills) into insurmountable obstacles to prevent growth. Rather than trying to find a new job and cutting back his expenses, for example, Frank uses the debt as an excuse to stay in his job.

Frank clearly has a desire for transcendence beyond the mundane. He has sought comfort in spirituality. However, he has not pressed himself into a deeper level of understanding of the divine. Again, he is unfulfilled, but seems unable or unwilling to change. Frank must understand that it is he who must motivate change, and he cannot try to render himself dependant upon others to make crucial changes. Frank must create his own, new reality.

Alfred Bandura once said that human beings model themselves by observing others -- Frank has selected a very conservative model for himself, and he does not seem to have models in any sphere of his life that could propel him engage in some sort of meaningful vocational or spiritual activity. Frank is clearly capable of some change and showing consistency in adhering to a value system -- he has provided a good role model for his children, and undertaken some steps to improve himself through exercise, church membership, and has been faithful to his wife. But Frank seems to have little sense of why taking such meaningful personal steps are good and desirable for him, and so he lacks 'follow-through.'

Gordon Allport's theory of motivation stresses that while human beings, like all animals, are motivated by certain basic needs, such as food, all humans also have higher needs. Frank's higher needs for true self-acceptance and emotional security remain unaddressed, and he lacks a way to fully relate to others in a meaningful way and a true, expansive philosophical understanding of his purpose in the world. Frank does not even seem fully aware that he has such deeper needs, given that his gestures towards self-improvement have been half-hearted at best.

A therapist must help Frank understand why Frank feels so emotionally closed off from others, and why he has difficulty accepting his deeper needs, beyond those of having a job and providing for his children. As well as exploring Frank's needs from a Rogerian perspective, the therapist might also want to set some specific behavioral goals for Frank to undertake (such as to look for a new job, exercise more regularly, attend a spiritual retreat) so Frank can receive some external reinforcement and structure as he strives to improve his life in a concrete fashion. Seeking therapy is a good first step, but given Frank's stunted emotional life, having concrete behavioral goals might be helpful, especially at the beginning of the therapeutic process.

Q2: Integrationist point-of-view

No single personality theory can heal all individuals: every person presents the therapist with unique challenges. Some patients, for example, with personality disorders such as bipolar disorder, obsessive-compulsive disorder, or schizoid personality disorder may benefit from having clear, concrete behavioral goals that they must perform, to help wean them from ineffective coping mechanisms (such as self-injury, obsessive rituals, or isolation). More searching types of 'talk' therapy alone may encourage patients to stall rather than to actively change their life in proactive ways and will not address some of the root, habitual causes of the patient's behavior.

Other patients who feel unfulfilled but have a more structured and healthy lifestyle might benefit from more exploratory types of therapy, including Rogers' self-actualization therapy. This therapy empowers the client through intense questioning, and requires the client to have a certain level of willingness, self-knowledge and stability to be effective. An integrationist will find an ideal balance between the types of approaches offered, as even someone with OCD might benefit from some discussion of the social impact his or her behaviors, while someone seeking fulfillment might benefit from having behavioral goals set by the therapist (such as volunteering in the community, for example). There is no perfect cookbook recipe of therapy that will work with every patient. While every therapist has his or her preference for certain types of therapeutic techniques, every patient presents the therapist with his or her own unique challenges. An overly doctrinaire approach is seldom fruitful and can even be harmful. The patient's stage of life, stage of self-awakening, and what he or she desires from the therapeutic process will all shape the client-therapist relationship.

The patient is often striving to become someone 'new': the same, yet different, and fully actualized. That 'new' envisioned persona will not be the same for every individual, even if the goal for every patient is ultimately to create a more positive and new sense of self. Just as every spiritual figure's path to the divine is different, but ultimately leads to the same end, the same is true with therapy. To achieve a goal will require a different path for every patient, because every patient is operating within a unique social context, and is subject to different biological, social, and familial conditions.