It’s a skill because it doesn’t come naturally.
I once asked a friend of mine who is a senior mental health worker, and almost universally liked by everyone: ‘Isn’t the idea of “unconditional positive regard” totally unrealistic - it implies you can like anyone who walks through the door?’ He then claimed that he did like almost every client. I think he was fooling himself, and what he meant with the benefit of hindsight, was that he came to like almost every client - that the more he understood someone the more he liked them.
Carl Rogers started it when he asserted the possibility of unconditional positive regard towards others, built on the idea of accepting oneself:
‘I find I am more effective when I can listen acceptantly to myself, and can be myself.’ (Roger 1967:17)
‘…the curious paradox is that when I accept myself as I am, then I change.’
‘If I can accept the fact that I am annoyed at or bored with this client or this student, then I am also much more likely to be able to accept his feelings in response.’ (p.18)
‘I have found it highly rewarding when I can accept another person.’ (p.20)
The post-war humanist perspective in psychology lost touch with the biology of the human animal - as indeed did the cognitive revolution that followed it. Anxiety should rise when meeting strangers or outsiders, they are a potential threat, you should be cautiously testing each other. We do have very strong first impressions; it is called intuition, and relies on fast emotional responses - it is what keeps us alive. The only question on first meeting someone is: ‘Do I feel safe with this person?’ So the effective helper knows that they must appear safe and non-threatening, but what if you don‘t feel that? We can all be aggressive and violent, if we need to be. It’s not a matter of accepting people as they are, it’s about creating useful encounters where mutual learning can take place and that depends on establishing a relationship of trust. Sometimes it can happen very fast if there is a mutual liking, if there isn’t then it will never happen.
When asked, people self-report that what makes the best first impression is a sense of ‘warmth’ and ‘competence’ in the other person ( www.scientificamerican.com/article.cfm?id=mixed-impressions ), but I think what they really mean is someone who is non-threatening and can deliver something they need. Because first impressions are emotional responses they have very little to do with what is actually said, more with how it is said and the rest of our non-verbal behaviour. We trust those emotions displayed through facial expression much more than the accepting words.
The client is present because they know there is something wrong with them, whether they state it or not, something that stops them functioning in the social world as they would wish. That is why they are seeking help, they’re not looking for acceptance but action, on the assumption that they are meeting with someone with skills and expertise.
But what of Rogers’ underlying point that accepting oneself and others as we are now, is in some sense a precondition of change? Wrong. The preconditions are self-awareness and a willingness to learn new things! And the speed at which it can be done depends on the rapport between the people involved.
One barrier to rapport (effective communication) is the myth that the helper can be accepting as part of their professional role, setting aside their personal feelings. This is obviously ridiculous because feelings always leak-out through facial expression and tone of voice. This first becomes apparent when a prospective helper is still a student and at some point becomes aware of a conflict between their developing intellectual understanding and their emotional response in a given situation. The trick is integrating the two. If I believe in the knowledge I have acquired then I must live that way, the mistake is thinking that one is work and the other a private concern. The answer comes in two parts, firstly in terms of organisation there has to be proper team working - teams purposefully constructed of different kinds of people with different skills, hence giving the client choice!
Secondly, any kind of therapy is the learning of new social and psychological skills and the helper is the model. Acceptance is the skill of tolerating what we cannot change. Now if either or both, client and worker have it in their heads that the client is suffering an illness for which there is no cure… Even the Recovery approach leaves the medical model in place, telling the client to expect occasional relapse. So often both client and worker set each other up to fail. But if your model is one of adaptation in a particular social environment you have two choices, neither of which require acceptance of anything. Either you change yourself (learn new skills) to fit the environment you find yourself in, or you move on and live in a new environment.
It is a belief in people‘s lack of capacity to change which makes acceptance, so unnatural as it is, such a hard skill to learn - requiring decades of practice by the helper!
(See also my post, The ‘therapeutic relationship’ explained - Jan 2010)
Rogers, C (1967) On Becoming a Person: A Therapist’s View of Psychotherapy (Constable: London)
