caso loretta

7/24/2019 Caso Loretta

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o,F LORE' ITA

(1959)

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TRANSCRIPT,'

carl

Rogers

c.R.

)

(

s

creaming

n

the

bachground)

' mcarr

Rogers.

This musr

seem

confusing

and

odd,

and

so

on, but I,

I felt

really sorry

that the

interview

had

been

kind

of cut short

'cause

I sort

of

felt

maybe

there

wereother thingsyou wanted o say.

Loretta:

I

don't know,

I'm

being

moved

all right,

transferred..

nd

I

was

just

wondering

f

I'm

quite

ready

or a

transfer.

've mentioned

hat-it's

annoying,

that

woman

talking,

uh,

she's

been

yelling like

that

(referring

tc patient

uko

keeps

creaming

n thebachground).

realiy

rather like

it

on

my

ward. (C.R,:

M-hm,

m-hm,)

And

I have

been helping

.

. . I had

thought

maybe

I could

go

home from

rhere.

(C.R.:

M-hm,

m-hm.)

I

know

being

transferred

means

I'll

probably

be

put to

work in the

laundry all

day.

s*eaming

in

thebachground)

And

I don't feel

quite up

to that.

C.R,: M-hm,

m-hm.

So

hat'sone

mmediate

hing

of concern.

Am

I ready

to

face

whatever's

nvolved

n

moving

away

rom

the

spot where 've-?"

Loretta:

You

get kind

of oriented

to

one

place

when you're

here.

C.R.:

M-hm,

you

get sort

of used

o

it and-

Loretta: oh, I meant o correctone thing.when I said no" before, didn't

*This

interview

with

Loretta

s Tape

Number

one in the Audiotape

Library

of the

American

Academy

of

Psychotherapists.

his

transcripr

was

prepared

by lv{arco

Temaner

and emended

by NathanielJ.

Raskin.

3 3


2/24

sd

a{

10

w

vr!

w(

Ra

i , n

34

\'IE\fS

FRONI

WITHIN

mean

I was

tired

of

talking

to that

cloctor'

just

meant'

"no"'

that

I

was

ready

to,

that

I

wondered

rvhy

I couldn't

go

home'

C.R.: Yeah, yeah.That you felt he didn't quite under-stand ou on that

(screaming

n

th'e

background),

hat

really'-

Loretta:

Maybe

he

thought

I was

being

blunt

(loud screaming

n the

back'

ground).

.

. a.td

that

I meant

"no,"

I didn't

rvant

to

talk

to

him

angnore'

(Loud

screaming)

c.R.:

LTtr-huh

(scteaming

continues

ntennittentl\.)

lrnd

if

l, if

I

sense

some

of

your

feeling

now,

i1

is, uh,

a

little

tenseness

hat'

that'

uh'

maybe

he

dijn't

really

g:et

hat.

Maybe

he thought

you

were'

sort

of-

Loretta:

I thought

he

thought

I-

C.R.:

Shutting

him

off,

or

something'

Loretta:

Yesl

That's

what

I

had

thought'

(C'R': Lrh-huh')

And

that

isn't

what

I meant-

(C'R.: tlh-huh')

tlh,1

don't

know'

I'm

u'ondering

if that

transfer

is

a good

thing.

I

mean,

they

make

you

feel

so

mportant

around

here,

arrd

rtilt

i',ru

arJn't,

but-

(C'R':

irn-hm'

nhm')

Then

when

I go

over

to

Two,

I

knorv

that's

an

open

r'vard,

hat's

[a]

dormitory'

and

I're

been

wearing

not

so

many

of

my

own

clothes

'cause

I don't

like

to

launder

them.

Just

wonder

if

I'm

re

ady

for

that

change'

C.R. M-hm, and that-

Loretta:

'Cause

my

father

and

that

don't

come

to

visit

me or

anything'

so

I don't

get

out

at

all

on

weekends

or

anything'

C.R.:

M'hm.

. .

. And

I'm

not

quite

sure

about

this'

Is it

in

the

ward

where

you

are

now

that

you

feel,

yeah,

they

seeT

,to

make

you

so

important'

tut then

really

you're

not'

lScreaming

n the

background)

s

that-?

Loretta:

That's

really

t.

I'm

important,

but

I'm

really

not'

(C'R':

M hm')

I

probably

wouldn'i

b.

on

the

other

ward,

either'

Well

I

knorv

that'

you're

not very important when you move

to that

ward'

C.R:

I see.

So

that

if

you're

not

very

important

where

you

are

right

norv'

you

feel

then

if

you

rvere

transferred,

even

less

so'

Loretta:

Even

ess

mPortant'

C.R.:

So

that's

something

that

concerns

you'

Loretta:

I think

it

means

working

all

da,v

n the

laundry'

too'

and

I'm

not

quite

ready

for

that.

I mention!d

earlier

that

I had

this

tickling

sensation

inmvkneeswhen lwasonSLxCwhen l rvasget t i ngReserp ineanda

tranouilizer- ( ,. R.: t-hm, m-hm') I tlrink itl'as' And I askcd he doctor


3/24

t

n

The

Case

f

Loreta:

tanscript

35

at

that

time

if he

lrould

move

me,

so I could go

to'work

and

work in

the

laundry.

(C.R.:

M-hm,

m-hm.)

And

the

r.u.rrf.r.u.n"

today.

didn,t

ask

to

be

transferred,

hough,

this

time.

C.R.:

M-hm,

m-hm.

But

it troubles

you

as o

tvhether

you,re

eally

ready

o

face

some

of

the things

that

rvould

be

involved.

Loretta: I don't knorv, there isn,t much to face, t's kind of confusing,

I

think.

c.R.:

I

see'

It's

more

a question

of

facing

trre

uncertainties,

s

that

what

1'OU

mean?

Loreth:

I

don't

know

nhar

I

mean

(tittte

augh).

.

. I

jusr

know

that_

C.R.:

Right

now

you

feel kind

of mixed

up?

Loretta:

\vell,

I knolv

there's

Anita

on

*rat

rvard

that I

did.n't

trust

verv

far

(banging

in tlrc

backgrortnd)

becausc

she,s

the

one

that

ort

-"

on

shock reatment.

C.R.: I

see.

Loretta:

Or I

think

she did,

anyway. C.R.:

M-hm,

m-hm.)

And

srill

she

put

her arm

around

my shoulder

when

I

came

back,

but it

.

. . sh.

was

^the

one that

told

me I

had

to

go

on it

and

I had

done nothing

that

I knerv

of to be

put

on

that

kind

of

treatment.

c.R.:

So

that

there's

somerhing

that's

rear

confusing.

t

would

be

putting

you next

to a

person

who

seemed

to

like

you

and

put

her

arm

"ror.rJ

you and, by gosh, was responsible for shock trearmenr.

Loretta:

.That's

right'

.

. .

of course

she

said

t rvas

doctor's

orders,

but

I

hadn't

talked

to a

doctor

that

I knew

of ar

the

time.

(C,R:

M-hm,

m_hm.)

And.

I

tnow

that

they

gave them

to

. . .

even

though

that

wa, a

work

ward

they

had

them

go over

to the

treatment

ward

and

then

back

to

the

rvork

ward.

(C.R:

N{-hm,

m-hm.) (Screaming

n

the bachground,)

nd

then

to

work.

C.R.:

M-hm,

sure

you heard,

the explanation

was

doctor's

orders

and

al l

that,

but

you

can't

help

but

feel,

,Is

she eally

rustworthy?,,

Cause

here

sheseemed o-

Loretta:

No,

I don't

trust

people

anyway,

an)rrnore. C.R.:

M-hm,

m-hm.)

That's

why I

don't

rvant

hem

to rrust

me.

I

either

berieve

n

them

or i

don't

believe

n

them.

C.R.:

M-hm,

and

all

or none.

Loretta:

And

I don't

quite

think

I

believe

n

her

rery

much.


4/24

36

\'IE\qS

FROM

\VITHIN

C.R.:

M-hm,

m-hm.

Ancl

really

rvith

most

people

you

feel,

"I

don't

think

I

rusL

'em."

Lore t ta :That 's the t ru th , Idon ' t t r t l s t ' er r t ' (Screaming in thebackgrou

Eitherbelieve

em,

or

I clon't

believe

em

or

I don't'

I'm

not

quite

certain

rvhether

I believe

them

yet or

not'

(C'R': M-hm,

m-hm')

But

I don't

believe

n,

trust

anYmore.

C.R.:

M-hm,

m-hm.

That's

one

thing

that

you

feel

has

really

dropped

ottt

for

you,

that

ust

to trust

people'

Not

for

you'

Loretta:

No,

I

don't

trust

'em.

. . .

You

can

get

hurt

much

too

easily

by

trusting

PeoPle.

C.R.: NI-hm, n-hm. If you rcally believe n someonc,and let your trust go

out

to then-r,

hen-

Loretta:

I

don't

have

any

trust,

that's

vhy

can't

ct any

rust

go

out

to

'em'

C.R.:

M-hm,

but

eviclently

our

feeling

s that

when

that

has

happened

n

the

past-

Loretta:

Youjust

get

hurt

bY

t.

C.R.:

That's

thc

rvayyou

can

gct

htu

t'

Loretta: That's the way haaebeen hurt'

C.R.:

That's

the

way

you

zaue

een

hurt'

Loretta:

I don't

mind

being

moved.

I

mean

if

it's,

uh

(pounning

!7

the

bachground),

h,

anothei

thing

toward

going

horne'

(C'R':

Mhm')

(Scriaming

n the

background')

ut

I clon't

get

out

arLy\iay

arrd-I

don't'

I

don't

know

that

he,

my

brother,

I

rvrote

a letter'

but

I didn't

get

any

ansrver

rom

him.

(Screaming

n the

backgrouncl)

C'P.': M-hm'

m-hm')

He

never

calne.

C.R.: M-hm. It isn't that, at eastwhat I understandvou

to

be

saying,

s that

it

isn't the

practical

question

of

the move

so

much

that'

uh'

but

it's

the

question

of-

Loretta:

If

I'm quite

ready

for that'

C.R.:

Yeah,

are you,

are

you

ready

or

a next

step,

s that

it?

Loretta:

I don't

think

I'm going

to like

rvorking

in the

laundry'

that

I know'

'Cause

I didn't

like

it

either

[ofl

the

other

nvo

times'

(Announcenwnt

n

PA

system

n the

bachgrowzdl

A.nd'

I don't

think

I care

too

much

[for]

*o.kirrg on [thel

f.,oi

center

over

there,

either,

because

worked

there


5/24

' .1

i reCasc

. ,1 orc t ta :

l ranscr ip t

) ,

beforc,

and I didn't

care or it.

(C.R.:

M-hn.r,

m-hm.)

\'!'ell, didn't

have

anything

. . . I

. . . the

first day I rvorked

all

right, the second

day

I s'orked

about a

half an hour,

and I blacked

out, and

I tried

it 3 more

days,

and

I

blacked

out each

day,so .

. . Ijust quit trying

to

work

there.

There

was

too much electricity

or

something.

C.R.:

M-hm, m-hm.

You feel

something

was lvrong

over there?

Too much

electricit)'or

something,

that reallyhad abad effect on me'when lvas

working there."

Loreth:

It did. I blacked

out, completely.

f I

l.radn'tgone

to sit

dorvn,

I

would

have

fainted.

C.R.: M-hm,

m-hm. You

feel really

you

wcre

in, in kind of

a desperate

rvay,

at those

points?

Loretta:

No, I didn't

feel desperate.

just,

I

didn't

undcrstand

it,

I didn't

knou,

'lvhy

I blacked

out.

C.R.:

I

sec.

Loretta:

It did frighten

me, though.

I

just

couldn't

work, so-

C.R.: It was

ust

something

very odd happening

to you.

Loretta:

'Cause

I don't have

epilepsy

seizuresor

anything

like

that,

so I

couldn't

imagine

rvhat it was.

I don't,

I'm not,

I don't

usually

have

fainting

spells.

C.R.:

N{-hm.

tjust

made you

feel

real

puzzled.

What

is rappening

o me?"

Loretta: \\rhat

it was,

yeah,

cried,

but

I couldn't work,

and

they

rvanted

me to

rvork, so

. . . sometimes

I

think

yor-lget

put

back on

treatment

if

you

refuse to

work.

C.R.:

lJh-huh.

\\'e11,ma1'be,

maybe

shock

treatmcnt

is really

something

they

may use

for

punishment

if you

don't do the

things

the lvay

they

rvant

you

to do?

Loretta: l\Iell,

it rvould appear

that

way

from rvhat everybody

says,

but

I

don't

rhink I

rvaseven, don't

knorv

wl-ry hey even gave

t to ne

in

the

first p1ace. rvasjustbeginning to come to, enough to realizc hat I rvas

in an

institution,

I think.

(C.R.:

M-hm,

rn-hm

)

And the

next

thing

I

knerv,

the,v

said,

"You're

reaclv,you're on

treatrnent."

(C.R.:

M-hm,

m-hm.)

And I

said,

"Why?

I didn't

do anything.

I

haven't

had any

ight

or an.ything

with an,r'bod,v."

C.R.:

M-hm,

mJrrn.)

And they said,

"\Vell,

doctor's

orders." And

I

said,

"Well,

I haven't even

talked

to a

doctor."


6/24

3 8

VIE\(/S

FROM

\?ITHIN

Because hadn't

talkcd to one.

(C.R.:

M-hm, m-hm.)

At least I didn't

know it if I had.

(C.R.:

M-hm,

m-hm, m-hm.)

And so-

C.R.: So to you it seemed,

Hcre

I rvasust beginning to comc to life a

little, really to knorv

a little bit

lvhat

rvasgoing on."

Loretta:

I

was

ust

begimring to

realize I was in the

hospital-

(C.R.:

Uh-huh.

When they put me on

it, and they put

me to rvork the same

duy'

C.R.:

And then you fccl that

for no reasonyou could

discern,

zingo,

,vou

were-

Lorelta: And

I

began talking very

badly and everything, and

I still

havcn't

forgotten

some of

the things

I

said.

C.R.: M-hm, m-hm, nrhrn.

It feels

hat,

that sort

of brought out the

t'orst

in

you,

is that whal

you mean?

Loretta: If I had a rvorstpart.

It was ike it wasn't even

me talking.

C.R.: I-rh-huh.

Almost seemed as though this-

Loretta: And then

I

went

home weekends, and

I

got

in

trouble

there,

because talked so

much.

Of

course, rvas

getting Sodium

Amytal,

too, so

it might have been

the combination of the

two,

not

just

the

one thing.

C.R.:

But there, too, I guess get the

feeling hat you're

wishing you could

understand

that part of yourself;

was

it

something

that

$'as not

you

talking, or lvas it

just

the effect

of the drugs,

or u'hat

was it

that

made

you-?

Loretta:

It

rvas

he combination,

I think.

(C.R.:

Uh-huh.)

f you notice,

my

. . . I m o v e m y f e e t .

C.R.:

Yes, did

notice.

Loretta: As I said, my knees tickle. (C.R.: Ivl-hm,m-hm.) And I, I don't

know if it's the drugs

'm getting

or l'hat, but it's sometlting

can't

helP.

It isn't *rat I'm so terribly nervous ha t

I can't

sit still, that isn't it.

I do

that at group meetings

or anything,

and I can't control them.

It's

rather

embarrassing

(

ktughsnnuow\

).

C.R.:

And you rvould ike me to understand

that

it isn'tjust tenseness

r

somethilg,

it's,

uh-

Loretta: No.

C.R.:

It's sinrply he-


7/24

I i t e

t ' . t r e

( r l

L - ( ' l

L L ' l :

I r ' r r l s ! '

r l ' '

Lorerta:

Somerhing

can't

control.

C.R.:

Uncontrollablc

tickling

sensations.

Screarningn

thebachground)

LoretLa:

In

my knees

anrl that

far up,

and

my

feet

ust

move'

If

I'm

sitting

uDthereinthecorneralone,that isn,tsonruch,butmykneesst i l l t ickle.

(i.n,

Ht-t.r-,

m-hrn.)

But rr'hen

get

in

a

grouP,

and

that,

my, I

don't

know, they

ust

move.

C.R.:

It scems

as

hough

being

in a group

makes

his

$'orse'

I-oretta:

\Vell,

I have

it rvhen

I'm alone

sometimes,

too'

(C'R: M-hm'

m-hm.)

I think

it's

the

medication

I'm

getting'

C.R.:

\Vell,

probably

Cs

ust

the drugs?

Loretta:

I think

it's the

green

mcdication

I'm getting'

I don't

even

know

what

t is,

cause

I haven't

askecl,

ut

then-

(C'R': M-hm')

(Parue)

think

these

meetings

are

\'ry

enlightening

(little laugh)

C.R.:

Do you?

Loretta:

Wel1,

f you

can't

think

quite

clear

at the

timc,

you

can

think about

it later.

C.R.:

N't-hm,

m-hm.

And

in

that

sense

hey,

they're

somelhat

helpful

in

(hangzngn

the backgrourzzl)

aking

you

think

morc

clearly

afterwards?

Loretra:

I think

I've

been

helped

a lot

ity, more

by

talking

than

I have

by

the pills,

and

that.

C.R.:

N{-hm,

m-hm.

It really,

t seems

as

hough

getting

things

out

to some

degree

n talk-

Loretta:

Seems

o

alleviate

vhatcver

he

situation

s

(C'R

: M-hm,

m-hm')

If it's created

a situatior-r

hat

seems

o

alleviate

. .

I w ish that

$'oman

would

quit

screaming.

C.R.:

"\\rhy

doesn't

she

stop?"

Loretta:

She

can't

stoP

holrgh,

that's

the

lvorst

of

it

' ' '

That gives

you

a

terrible

feeling,

uhut't

goittg

to

happen

to you

if you

end

up

in

a'

like

that.

C.R.:

Yeah,

yeah, part

of the, pirrt of the disturbanceof that noise is the

feeling,

"\{y

god,

could

this

}'rappen

o

me?"

Loretta:

\'es.

(C.R.:

r{-hm,

m-hm.)

Exactly.

And

you

tl-rink

you

could

ust

about

go out

of your

head

ust

from

hearing

that

ail

the

time'

That's

b...,

g"oing

on

for 3

da1's

now,

and

rvhy

did they

give

her

that

much'

she,

f

it's t'ho

I think

it

is, she

$'as up

on

the

rvard

for

one

of those

QIM


8/24

40

\TEWS FROMVITIIIN

clinics,and I satnext to her, and

shesaidsomcthing abor-rt

iking

to talk,

and all

of a sudden she rvas, he

ust

began talking and didn't quit.

C.R.:

So this seems ind of arvful, hat here is this

person

and-

Loretta: She rvasall . . . perfectly all right then, calm; she rvasn't alking

or

arlything-

C.R.: Next to you and so on, and no'w'here Cs

ust

going

on and on-

Loretta:

You

should tirink,

I

tliought they could relieve hose, not make

them worse.

C,R.: It's kind of

discouraging

n

a scnsc o fcel that thc,v,

t seems

o you,

that

they aren't

helping

her.

Loretta:

Yes, considering t's

an admission rvard, and they shouldn't be

that far out of their heads. t's more like the drugs thev're giving after

they're

here are doing it to them.

C.R.: Almost makes

you feel,

"Ar'e

they making her worse

with

their

drugs?" s that-?

Loretta: That's right.

C.R.: And that's kind of a disturbins-

Loretta:

I think it is.

C.R.: Thought, too-

Loretta: Becauseafter all, I'm

getting drugs, too,

and I

wouldn't want

to

end

up like that.

C.R.: M-hm, m-hm. It can't help but raise he question n

you,

"\{buld

the

drugs

they're

giving me make

me

like

that?"

Loretta: That's right. And

then once you're

that wa1',what

can you

do

about it? Only, only I know u'ha t they're like and I can see t, so I have

enough control to hang on to myself, enough to keep from

just

batting

my

head

against he wall, like, uh. . , . Some of them

had

that

feeling,

ard theyjust can't control it. They . . . I've seenso much of

it

and

heard

so much of it that I can hang on to myself a little bit.

C.R.: Those things are kind of--

Loretta: I think

that's

why,

pardon

me, I

think that's whv

m1'knees tingle,

though, because ather than batting my head against he wa1l,

have

tiat t)?e of reaction.

C.R.: M-hm, m-hm. So

n

a sense,

vou

an hold yourself r-r nough so

vou'rc

c

d '

. $

tr

il


9/24

Thc

Cese

of Lorct ta :

I ianscr ip t

not

going

to bat

your

head against he rvall,and yet t's as hough

it

has

to come out someu'here. nd it. uh-

l,oreta:

Comes

out in the

tickling.

It's terrible!.

C.R.: Comesout

in

the

t ickl ingof

your

knees.

Loretta: Because . . well, I've seenon dre outside, oo, so

I mean I know

that

. . . iCs

ust

futile

to

bat

1'or-rr

ead.

Why

anylvay, tirink

my head's too

valuable to bat against thc wall

(Iaughs).It's

my orvn head, and I

like it.

C.R.: \bu feel by gosh,

"I'm

not going to smasirmy

head

against

valls."

Loretta: That's right. After all, God gaveme that head, that's

the iiead I

rvant. I'm not

going to bang

it against the

rvall,

even if I like to, which

I

really rvouldn't like

to

do, anyrvay. . .

\{ell,

rv}ry,how does

that help

that

girl

to be in . . . locked up like that and screaming ike that?

What,

I mean rvhat . . . beneficial aid

is

she getting

out

of

tl-rat? nything?

C.R.: I guess that's the question you'rc asking yourself, "What earthly

sooct-:

Loretta: No, I'm asking

1ozr.

C.R.:

You're asking me.

\Vell,

I'm not on the liospital staff,

and I really

guess

rvouldn't

try to answer because

don't knorv heq and

I don't

know anything about it.

But rvhat I

can understand

s, is the way

that

affects

you

and the feclings that it stirs up in

you.

'Cause

it sounds

as

though with you

that,

that

is

disturbing

not

only

from

the

noise frorn

hcr but the things that it

(screaming

n the bachground) tirs

up in you.

I-oretta: I don't know. I'm all mlxed up. I

rvant

to

(loud

screaming

n the

bachground)o to

Ruilding

One, but I knon'Building One's

not the next

to homc. . . . But if.I could

go

home from

One,

I'd be happy.

. . . But

I'r,ebeen there before. know it's going to be a great change

rom this

building. I hate to leave his building,

'cause

it's quite beautiful.

. .

. But

still,

it,

maybe it's better than

listening

to that girl

screamingall day,

every day.

C.R.:

It's

a rea l touglr choice to make.

Loretta: But I hate to think tl-rat 'm going to have to go to rvork in the

laundry room. I 'd rather. . . and there sn't asmuch to do

arouncl

hat

rvard

as thcrc is here,

that

much I knor.v.

C.R.:

Ir{-hm,m-hm. You feel

that, uh-

Loretta: lbu can relax and.justsleep,because ou do havebeds,

but I don't

think they

do.

I

think rhey expect you to

work if you can.

(C.R:

N{-hm,

4 1


10/24

42

VIEWSFROM V'ITHIN

m-hm.)

They don't

go tha t far as to

just

let

you rest like you're in a

hospital for a rest.

(Screaming

n the bachground)Keep

you

rvorking all

the

time.

C.R.: If it, if

it representeda chance o rest,

then you

rnight

like it,

but

if

it's a chancejust o rvork all the time, uh, then you're not sure hat that's

rvhat

you

want.

Loretta:

I don't think l'm ready

for it.

(C.R:

Uh-huh.) Bccause

my knees

tickle, maybe

that's. . . . I

rvorked

n

the

laundry

before, and

I know.

I

got along

all right. I knorv I

can gecalong norv,but-

C.R.:

"I

cor.rld

o

it,

but, uh, am I

really ready or it?"

Loretta: Though

why?

C.R.:

"Why?"

M-hnr.

Loretta: I packed my o1r'ngrip, so I'm all ready to go. I didn't say, No, I

won't go,"

because 'm always

putting

up a

big fight about it.

(C.R.:

M-hm,

m-hm.) If it's an improvement,

well, I'm willing

to go along with

ir.

C.R.:

NI-hm.

A chanceyou're rvilling

to take although within

yourself,you

feel

a

lot

of qi;estion about it.

Loretta: I rather like

seeing them admitted, although

I can't say hat I like

to

see

em

Bet

worse. But when they improve it's

quitc a

oy

to, to be

where they're all

coming in and going

out.

C.R.: It kind

of helps you inside,when

they, when they'-

Loretta: To know

that otlers

get well

and

can go home.

C.R.: M-hm, m-hm.

So that you're sort

of

discouraged

and encouragedby

what happens

o others.

Loretta:

I had

thought, I had thought that I'd go home from

here because

I hadn't

done anything very

serious-

(C.R.:

M-hm.) I hadn 't, uh, had

any violent

struggle with

anybody,

or anything like

that.

C.R.: That's part of your feeling all the *'ay through, "I haven't done

anything wrong, I've hcld

myself in, you know, I really

have

not

been

violent,

I haven't broken many ru1es."

Loretta:

I haven't broken any, I

don't think.

C.R.: You haven't

broken any-

Loretta: And half

the time

you

have

o

find

outwhat the rules are,because

thev

don't tell va.


11/24

t

hc

Casc

of Lo; .e t t . r :

r

r i rscr ipr

4

C.R.:

M-hm,

m-hm.

But

your

feeling

s,

,,I,ve

been

good.,,

Loretta:

But

I

haven't

been

roa

good,

though,

(screaming

n the

background,)

You

shouldn't

go overboard

about

being

good,

oo.

1C.R.:

M_h-.

lI

do.,.'t

believe

n

that,

either.

(C.R.:

M-hm.) I've

been

as

good as I

know

horv

to

be.

(C.R.:

M-hm)

And

I'm

nor

letter-perfect.

rvoulcl

ike

to be,

but

I 'm

not.

C.R.:

But

in

terms

of

.rvhat

you

can do,

you

feel

you've

d.one

he

best you

can

do.

Loretta:

I'm

doing

as

good

as

know

how.

C.R.:

M-hm.

Loretra,

know

that

some

of

these

people

have

got

to go, and

I

expect

we've

gor

to

call it

quits,

I appreciate

his

chance

o tJk

wirh

yoll.

Loretta:

And

thank

you

very

much.

I

knorv

that

you're

very important

people.

That's

what

I've

heard,

anyhorv.


12/24

COMMENTARY

THE

CASE,

F

LORETTA

A Psychiatric

npatient

Nathaniel

J.

Raskin

THE

INTERVIEIT

AND ITS

CONTEXT

'I'm

Carl

Rogers.

This

must

seem

confusing

and

odd,

and

so on,

but I,

I

felt reaily sorry that the interview had been kind of . . . cut short 'causeI

sort

of felt

maybe

there

were other

thinqs

you

wanted

to say.,'

Thus

does

Carl Rogers

open

his

interview

uith

LJretta,

a ,rute

hospital

inpatient,

diagnosed

as

paranoid

schizophrenic,

n

the

summer

of

lg5B. The

Ameri-

can

Academy

of Psychotherapists

was in

the middle

of its

4dav

Second

Annual

Workshop

ar

the University

of

Wisconsin

n

l\Iadison.

The

30 or

so

participating

therapists

were

gathered

in

a

small auditorium

of

the

hospital

to observe

one another

in actual

practice.

Loretta

had been

previously

nterviewed

by

Albert

Ellis

ro

demonstrare

his

rational-emotive

approach

and

by

psychiatrist

Richard

l'elder

to demonstrate

the experien_

tial method of his Atlanta group, rvhich inclucled Carl \{hitakei Tom

Malone,

and

John

\A'arkenti

.

F,llis and

Felder

had

had

a difficult

time

rvirh

Lorerta,

and there

was

1..ll"o:

in

th-isdiverse

group

of

experier.rced

herapists

for

Rogers

ro rry

his

hand

*'ith

her. He

was

only

too willing,

as he

hadsuffered

thiough

two

interviews

n

which,

from

his

point

of view,

his

woman's

expressed

Jelings

and

attitudes

had

nor been

responded

o

empathicalll'.

Ellis,

he clay

efori,

had

tried

to help

Loretta

to see he irrationalitv

ofher

behavior,

and Felder,

earlier

on

this

day, had

attempted

ro engage

her in

a

person_rGperson

dialogue

about,

among

other

things,

a

dream

he har_l

acl

about

her

thc


13/24

1 he

Cascof

l -orc tca;

Cornmercary

4.t

I i lgsht

belore.

the interviclv

with

Felder

rvhich

'gnr

oerore.

rt

was

tne rntervrcw

with

,telder

to

rvhich Rogers

referred

when

he

said

he thought

Loretta

might

have

elt

cut short.

Lfter

Rogers

agreed

to the intervierv,

Loretta,

wl-rohad

returned

to her

rvard, was

askcd

how

she

fek

about

rerurning

to

tark

to

still another

psychotherapist;

cr

response

was

positive.

Aside

from

attending

this

rvorkshop

as

the first

president

of the

American

Academy of Psychotherapists,Rogers had moved from the

university

of

chicago

to the

university

of

wisconsin

the

year before

for

a

joint

professorship

n Psychology

nd

psychiarry.

This bears

directly

on the

intervierv

with

Loretta,

because

Rogers

sawhis

appointment

at

wisconsin

as

providing

an

opportunity

to

test the

hipotl-resis

hat clientrentered

therapy

would

rvork

with

a schizophrenic

population.

This

woutd

be

explored

comprehensively

in

a large-scale

esearch

project (Rogers,

Gendlin,

Kiesler,

& Truzx,

1967);

he inrervierv

with

Loietta

was

a si-ngle

clinical

test

of Rogers'

h1'pothesis.

THE

SIGNIFICANCE

OF THE

INTERVIETJT

The

case

of

Loretta

is

significant

n

at least

rvo

ways.

First,

t is

one of

the

few

verbatin

recordings

of a thcrapeutic

nterview,

ndthin

any orientation,

with

a

psychotic

patient.

Second,

t

provides

a concrete

example

of the

application

of clicnt-centercd

herapy

to

a psychiatric

npatient

diagnosed

as

paranoid

schizophrenic.

The

interview

shows

how

a

deeply

disturbed

individual

ma1'

espond

positively

to

the therapist-offered

onditions

of

empathy,

congruence,

and unconditional

positive

regard.

One stereotypeof client-centercd

herapy is

that it is

a superficial

approach

that

works

primarilv

rvith

,,normal

people,

for

example,

college

students

with

minor

problems.

Rogers

.nay

huu.

contributed

to

this

belief

in

counseling

antl

pslchotherapl

e942)

his

first

book-lenqth

exposition

of his

approach,

in

rvhich

he

statecl,

as one

of

the tentat]ve

criteria

for

attempting

psychotherapy

of any

kind,

rhat

rhe individuar

be

"reasonably

free

from

excessive

nstabilities',

(p.

77). His

position

was

radically

different

in

his

next

book,

Ctient-Centei,retl

herapy

tgS

t;.

H...

he rvrote:

Present

opinion

on

applicability

must

fake

nto account

our experlence.

A

client-centered

pproach

has

bccn used

u'ith

trvo-year-orcl

hirdren

and adr-rrts

of

65, rvith

mild

adjustmenr

prob)cms.

such

as

student

study

habits,

and

the

most

severe

isorders

ofdiagnosed

psychotics.

. . An

atmosphere

ofaccep-

tance

and respect,

of

deep

understanding,

s

a good

climate

for p"..o.,"I

growth,

and

as

such

applies

o our child ren,

our

colleagues,

ur

students,

as

well

as o our

clients,

vhethcr

he-se

e

,,normal,',

neurotic,

or

psvchotic.

his


14/24

+ b

\.IEWS FROM

\!TTIIIN

doesnol

mean

hat t

rvillcure very

sychological

ondition,

nd

ndeed

he

concept

f

cure s

quite oreign

o the

approach'

pp'

229-230)

The interview with

Loretta

lasted

about

30

minutes.

Some

of

the

notervorthy

occurrences

n this brief

encounter,

each

of which

s amplified,

indude:

1. Loretta's

explanation

of

her side

of the

process

of

ending

the

just{ompleted interview

with Dr.

Felder.

It rvas

clear

that

the

opportunity

to

clarify this

was

important

to

her.

2.

Her

exploration

of the problem

of

an impending

transfer

to

another

ward.

This was

her

"presenting

probleln,"

a reai

one'

3.

The

transition

from

this specific

ssue

o the question

of

rvhether

she was

able to trust

people

in general

and whethcr

she could

trust

the

hospital

staff

in her

treatment.

4.

Her expressions

f disffess

and confusion

about

the

treatment

of

a patient

heard

screaming

in the

background

continually

through'

out

the

interview'

5. Her descriptions

of

peculiar

sensations

f tickling

n her

knees

and

of

a feeling

of

electricity

in the

air

when

she

had

rvorked

in the

hospital

laundrY.

6. Heiemerging

positive

self-regard

s

he

interview

progresscd'

Lorettaexplninshn sideof theprocess f ending he

ust-completednteruiey'

After introducing

the

subject of

her

impending

transfer

to

another

ward,

Loretta wishes

to clear

up

a possible

misunderstanding

of

her

attitude

about

ending

the

interview

just

concluded

with

Dr.

Richard Felder'

She

makes

t ciear

that

the opportunity

to

clarify

this

is important

to her:

"Oh,

I

meant to correct

one thin8.

When

I said

'no'

before,

I didn't

mean

I

was

tired of

talking

to that

doctor.

I

just

meant

'no,'

that

I was

ready

to,

that

I

wondered

why I couldn't

go home."

Rogers

empathizes:

"Yeah,

yeah'

That

you

felt he didn't

quite understand

you

on

that really."

At

*ris point,

screaming

can

be

heard

in the

background,

but

Loretta

responds to Rogers' comment:

"Muybe

he thought I was being blunt and

thal

I meant,

'no,'

I

didn't

want to

talk

to

him anlT

nore

"

To rvhich

Rogers

responds:

"tlh-huh.

And

if,

if I sense

some

of

your

feeling

norv,

it is,

uh, a

littie tenseness

hat,

that,

uh, maybe

he didn't

really get

that'

Maybe

he

thought

you

were,

sort

of . .

. shutting

him

off,

or somcthing

"

Loretta

agrees:

Yesl

That's

what

I had

thought."

Rogers'

emPathic

esPonses

n this

dialogue

facilitate

Loretta's

expla-

nation,

and,

apparently

satisfied

hat

she has

clarified

her

position,

she

then

returns to

the

issue

of the

ward transfer'


15/24

I l.re

Caseof

Lorerta:Comrnentary

Loretta explores he

problenr

of

an impending

transfn to another

uard.

Loretta norv begins

to explain

her

concern,

her presenting

problem:

"I

don't

knorv. 'm being

moved all right, transferred.

And I was

ust

wonder-

ing

if

I'm

quite ready or a transfer.

.

.

It's annoving, hat

$'oman . . . yelling

like that

(refering

o

patient

uho

keeps creaming n the bachground).

really

rather like

it

on

my

ward."

The ward transfer is clearlyan issucof great importance to Loretta,

She devotes

about one

quarter

of the

interview lvith

Rogers to it.

To

summarize some of

her

attitudes

about it:

I don't kno'w'if I'm ready for the work

that would

be involved

n

the

transfer.

I'd hate to work

in the laundry room; I'm

not

even

kecping up rvith my orvn laundry

now. And when

I rvorked

in

the

food center

in that rvard,

had real

physical

trouble.

I bla&ed

out.

Even though the

hospital makes

a

pretense

that the

Patients

are

.

important, I'm not really important on

Iny present

ward and

rvould be lessso on the new one.

At

one time I wanted the transfer,

but I didn't ask

for it riqht

now.

I 'm confused.

If the transfer

s a

step closer

o my discharge

rom the hospital,

that

lvould make me falor it more.

I like the building

I'm in,

because

t's beautifui,

and there's

more to

do

here,

but

it

rr'ould

be nice to gct

away rom that screaming

girl.

I

rvouldn't

mind going to the

new ward if they

let

you

rest there,

but

they keep you working all

the time.

I lvas able to

work

in the

laundrv when

I

'!vas

there before.

I know

I

can do it now, but I'm not sure

I'm ready for it.

I rvon't

refuse o

go.

I've evenpacked

my own grip.

If it's an improve-

ment,

I'm rvilling

to

go

along with the

move.

Rogerscommunicates

his

empathic

undcrstanding

of theseattitudes.

Specificalll',

he recognizes Loretta's

feelings of confusion

and uncertainty

about whether

she is ready for this change

n her life.

He

acknowledges

that it is a tough choice

to make and articulates

Loretta's feeling

that

it

might not be what she

reallv

wants.

This seems o

have he

effect

of

helping

Loretta,

after considerableexploration,

come to a

resolution of

a very

difficult and troubling

issue:

She

would be

willing to give

the transfera try,

even hough she

s not sure she

s ready for it.

Loretta'sexploration

f the snLe f theward ransfer

eads er nto

the

qttestion

of uhethershe s able o trust

people

n general.After

Rogers empathizes

with

Loretta's

feeling

of

confusion

("Right

now

,vou

eel

kind of mixed up?"),


16/24

48

\TE\?S

FRON{

q]THIN

she

moves

o

a new issue:

Well,

I

know

there's

Anita on

that

u'ard that

I

didl't

uust

very far

because

she's

the

one that

Put

me

on

shock

treatment."

Later in

this

segment,

esponding

to

Rogers'

understanding

and acceptance f her distrust

of

one person,

Loretta

sharcs

with

him

the

breadth

of

her disuust:

"I

don't

trust

people

any\\'ay

anymore"'

A little

Iater,she

adds,

"You

can

get

hurt

much

too easily

by trusting

people'"

The

attitudes

she

expresses

n this

segment

can be

summarized

as

follorvs:

I clon't

rust

the staff

person

who

I think

was

esponsible

or my

Setting

shock

therapy.

She

acted

friendly

and

said it was

done

on

"doctor's

orders,"

but

as ar

as

knolv l

hadn't

talked

to a doctor'

ln a very

general

way,

I don't trust

people

anymore'

I've

been

hurt

when

I

did.

I don't understand

why

they

suddenly

ordered

shock

therapy

for me'

I wonder

if it was because

said

couldn't

work

and

they

didn't

believe

me.

All

of a sudden,

I n'as given

shock

and

assigned

to work'

Rogers

deals

with

Loretta's

difficulties

in trusting

people

by

consis-

tendy

ulng

to

appreciate

her feelings

and percePtions'

For

example,

when

Loretta'expre.r.r

h..

lack of

trust

about

the

staff

member

who orches-

trated

her shock

trea[ment,

Rogers

replies,

"So

that

there's

something

that's

real

confusing.

It would

be putting

you

next

to

a person

who

seem,ed

to like you and put her arm around 1'ou

and, by

gosh,

was

responsible

for

shock

treatment."

He also

empathizes

with

her

feeling

that

the

shock

tleatment

is used to

get

her to

perform

her duties:

"\4'ell,

maybe,

maybe

shock

treatment

is really

something

they

may

use

for

punishment

if you

don't

do

the things

the

way

they

$'ant you

to do?"

Implicitly,

in the

way

he responds,

Rogers

nvites

Loretta

to

correct

him when

he has

not gotten

her feelings

exactly

right.

This

is cxemplified

when

she

begins

to discuss

her

inability

to

trust

PeoPle

because

t inevitably

leads

to get;ing

hurt.

When

Rogers

responds

with

rvhat

appears

to be

accurate

i*putttyt

"That's

the

way you

can

get

hurt,"

Loretta

goes

urther

and states:

That's

the way I haaebeen hurt." Whereupon Rogersaccepts

her clarification:

"That's

the

way

you haue

been

hurt"'

Loretta

exprasa

distras

and

confiuion

about

the

treatment

of a

patient

frequzntl2

heari screaming

n

the

bachground

uring

the

nterttieu.

A dramatic

aspect

of

the

audiotape

recording

of this

nterview

s the sound

of another

female

patient

screaming

in the

background.

After

mentioning

it in her

hrst staiement,

Loretta

does

not bring

up the

subject

again

until

more

than

halfway

into

her dialogue

with

Rogers,

even

though

the sound

is piercing

and

rather

constant:

"I

*ish

that

lvoman

would quit

screarning

Rogers'

''.:

r

!

f

I

I

!.

t-

t .

:1 -

i :

.:.

I

i _


17/24

The L.rsc

i Loretra: olnluentary

empathic response

s in the form

of a question:

"Why

doesn't

she stop?"

Loretta'sanswer

akesher into a personal

concern:

"She

can't stop though,

that's the rvorst

of it. . . . That

gives you

a

terrible

feeling,

.rvhat's

going

to

happen o

you if you end

up in a , like that."

Some of the

attitudes

expressed v Loretta in

this

section are:

That ll'oman's screaming really bothers me. You could go out of your

head hearing

that aII

the time.

I'm worried

that I could

end up like that.

I sat

next to her, and

she seemed

perfectly all right.

She was calm and

not talking.

You

rvould

hink the hospital

could help somebodl,

ike that, not make

her lvorse.

I think maybe

t's the drugs

thcy're giving

her.

I'm

getting

drugs, and I'm

worried I could end up like

that.

In his usualway,Rogers espondswith explicit empathic understandit-rg

to these

concerns. He

verbalizes Loretta's

fear that

what

happened

to this

screaming

woman

could also happen

to her, as

lvell as her suspicion that

the hospital staff had

caused her

disturbance rather

than

relieved

it. Note,

for example,

he following

empathic responsc:

Almost

makesyou

feel,

Are

thcy making

hcr worse

with their drugs?'

On the basis of Loretta's

participation

in the dialogue,

one may reasonably

conclude that she feels

understood regarding

her misgivings

about the treatrnent

of the screaming

patient and her fear

that she could end up

the same

vay.

Loretta describesensations f tichling n her hnea and a

feeling

of electricie

in the

air.

Loretta

explains her expcricnces

as follorvs:

I

don't think I'm

going to

like

working in

the laundry, that

I know.

'Cause

I

didn't like it

either

the other tt'o

times.

..

.

And I don't think I

care oo much working

on

food

center over

there, either,

because

rvorkcd there before, and I

di{n't care or

it.

(C.R.:

Mh-m, m-hm.)

Wcll, I didn't have

anything. . . I . . .

..'the

first day, I

'rvorked

all right,

the second day I

worked abour a

half

an

hour, and I

blacked out, and I

tried it

3 more days, arrd I blacked out each

day,so , . . I

just

quit trfng

to work there. There

was oo

much

electricity

or something."

To this,Rogers eplies: NI-trrn,m-hm. You feel something \'aswrong

over here?Too

much elcctricity

or something,

that

really had a bad effect

on me when

I was rvorking

there."' And

:rller Loretta describes horv

frightened

she felt

by

her

blackouts,Rogers responds,

"It

was

ust

some-

thing very odd happening

to

you," and then,

"M-hm.

It

ust

made you feel

real

puzzled.

What

is happening

to me?'

"

A

little later,

Loretta describes

another s)Tnptom:

If

you

notice, my

49


18/24

50 \4EViS

FROM W]THIN

.

.

. I

move

my

feet." To

'lvhich

Rogers esponds:

Yes,

I did notice."

And

Loretta

further explains:

As

I

said,

my knees tickle.

(C.R.:

M-hm,

m-hm.)

And I, I don't know if it's the drugs

I'm getting or rvhat,

but it's something

I can't help. It isn't that I'm so terribly nervous

hat I

can't

sit still,

that isn't

it. I do that at

group

mectings or anything, and

I

can't

control them. It's

rather embarr assing

laughs

neraousll)."

Rogers istens espectfully o Loretta's experience hat

the sensations

are specific to

particular

situations:

It

seems

as though be ing

in a group

ma-kes his

worse."

He is also responsive

o Loretta's

belief that her

symptoms are caused by her

medication:

"Well,

probably

it's

just

the

drugs?" Later

Loretta comes up

with

another

explanation for the

sensa-

tions

in

her knees.She has been discussing

he patient

$'ho screams:

And

rhen once

you're that way, what

can you do

about it? Only, only

I knorv

what they're like and I can see t, so

I have enough control

to hang on

to

myself,enough to keep rom

just

batting

my head against he wall, ike,uh .

. . .

Some of them

had

that

feeling and they

ust

can't

control

it. They .

. .

I've seenso much o f it and heard so

much of it that I can

hang on to

myself

a little bit. . . . I think that's why

my knces tingle, though, becausc

ather

than

batting

my head against he wall,

I have hat tlpe of reaction."

Rogers then responds:

"M-hm,

m-hm. So

in a sense,

vou

can

hold

yourself n enough so you're not go ing

to bat your

head against he

wall,

and

yet

t's as hough it has o come out somewhere,

nd

it, uh . . .

"

Loretta

finishes Rogers'sentence:

Comes

out in thc

tickling." Rogersaccepts

her

way of putting it:

"Comes

out

in the tickling of your knees."

The striking feature of the interaction

bettveen

Loretta and Rogers

on

the topic of her odd sensations

s that he is

ust

as respectful

of this

kind

of experience on the part of

a hospitalized schizophrenic

as he

would

be

of the everydayexperienceof

a

"normal"

client.

His unconditional

positive

regard for Loretta, together with

his

empathy

and

genuineness,

pPear

o

facilitate

her

movement

toward

a rational

explanation of

what initially

appeared to be bizarre symptoms.

Loretta expruses

reatn

positiue

egard

for

herself s

the nteraieu

progresses.

The interview with Loretta illustrates

a dynamic observed

by

Rogers from

the earliest days of client-centered therapy:

If

the

therapist conveys

an

empathic understanding

and

acceptance

f the client's

negative

eelings,

the client is freed to experience positive aspects

of self

and others.

For

example, immediately after the dialogue

about

the tickling in her

knees,

Loretta says:

it'sjust

futile to bat your

head. Why anyway,

think

my head's

too valuable to bat against the wall

(laughs).

t's my own

head, and I like

it."

Here is a dramatic expressionof Loretta's belief

that

she s a

worthwhile

person. Similarly, in her next exchange

with Rogers,

she says:

That's

right.

After a1l,God

gave

me

that

head, hat's the

head I rvant. 'm

not

going

to


19/24

i l r e , r se

f Lo re t r . r :

on r r r r cn ta r . i

bang

it against

he

u'all,

cvcn

if I

like to,

lvhich

I really

wouldn,t

like to

do.

?.:ryway..

.

Well, 'h1',

how does

har

help that

girl

to be n

. . . locked

up

like

that

and

screaming

ike

that?

What, mcan

what . .

. beneficial

id s

shegetting

out

of that?

Anyrhing?"

Rogers

eply

here

s,

I

guess

hat's he

question

ou're

asking ourself,

'tr\'hat

earthly

good .

. . ?'

"

Lorerra

nrerrupts

Rogers

at this

poini

and says,

"No,

I'm asking.yorr.Here, hen,we seeLor.etta tanding p to thisnoted

psychologist,

etting

him

know

what

she

meanr:

She

wants o know

whatDe

thin-ks

of

the treatment

of

the screaming

patient.

There

are

other exarnples

in

the intervierv

of Lore

ta's nsistence

on bcing

understood

exactiy.

One

such instance

occurs

rvhen

Loretta

is

descr.ibine

her

blackouts.

One of

Rogers'

responses

s

"N.{-hm,

m-hm.

you

feel

really you

were in, in kind.

of

a

desperate

way,

at those

points?"

Loretta

corrects

Rogers'

statement:

,No,

I

didn't

feel

desperare.

just,

I didn't

understand

it. I

didn,r knorv

why I

blacked

out."

These

examples

of

Loretta's

insistence

on being

understood

exactly

are the second ndication of her emerging self-regard n this interview.A

thircl,

somelvhat

more

indirect,

expression

s

reflected

n her

assertion

hat

therapy

has

been helplul

to her:

"I

think

these neetings

are

very

enlight-

ening

(little

laugh).

. .

. I think

I've

been

helped

a lot

by, more

by talking

than I have

by the

pills,

and that.

. .

seems o

alleviate

whatever

he

situado;

is."

Loretta's

statemenr

hat

talking to

professionals

s

more

helpfirl

than

medication

suggests

hat

her

participation

in the

treatment

process s

valuable.

The

intervierv

with Rogers

provides

an example

of her

active

stance

n

such

a situation.

It is notelvorrhy,

oo,

thar

rvhile talking

to Rogers,

Loretta

expresses

concern that others may perccive her as not being good or as acting

antisocially,

n

some

wav.

Thc first

instance

occurs

soon after

the intervierv

begins,

$'hen

Loretta

notes

that she

vants to correct

an impression

she mav

have

made:

"Oh,

I meant

to correct

one

thing.

When

I rr-id

'r-ro'

before.

i

didn't

mean

I rvas

ired

of

talking

to that

doctor.

Ijust

meant,

.no,'

that

I

was readv

to, that

I rvondered

why

I couldn't

go home.,'

She

explains

that

her

intention

rvas

not

to be

blunt,

that she dicln't

mean

to

be insr-rlting,

nd

that

she

did not

want to

be

perceived

hat

wav.

Another

instance

of hei

rr

sh to be

perceir,,ed

s

someone

who behaves

in

an

acceptable

hanner

occurs

during

her

discussion

of having

received

shock tl-rerapy. he says: I had done nothing that I knew of to be put on

that

kind

of

trearment."

mplicitly

she

is expressing

a concern

thai

she is

being

perceived

as

having

done

something

,,bad."

This

hypothesis

is

confirmed

by rvhat

she says

felv

minutes

ater:

.And

the

next thing I

knew,

they

said,

You're

reaciy,

ou're

on

trearmenr.'

. . And

I said,

WhyiI

dian't

do

anything.

haven'c

had

any fight

or anyrhing

with

anybody.'

'

Later

in

the intervierv,

Loretta

brings

out

her perception

that

the

5 1


20/24

52

\4EV'S

FROM

\{'ITHIN

decision

about

her release

s related to

whcther

she

has

acted out:

"I

had

thought

that

I'd

go

home

from

here because

hadn't

done

anything

very

serious. . . I

hadn't,

uh, had any

violent

struggle

vith

anybodl',

or

anything

like

that." In his responsc,

Rogers ecognizes

hat this

is

an issue

hat

has

run

throughout

the

interviov:

"That's

part of your

feeling

all the

rval'

through,

'I

haven't done

anything

wrong,

l've

held myself

in, you

kr-ro'iv,

really

have

not been violent,

haven'tbroken

many

rules.'

"

Loretta

replies:

"I

haven't broken

any,

I don't think."

And then she

adds,

And

half

the

time

you

have to

find out

ra'hat he

rules

are, because

they don't

teil ya'"

Rogers

then reflects

her underll-ing

asscrtion:

"Mllm,

m-hm. But

your

feeling

is,

I've

been good.'

"

Loretta's

response

at this point

is interesting

and significant:

"But

I

haven't been

too

good,

though.

. . . You shouldn't

go

overboard

about

being

too

good. .

.

.

I don't believe

n that, either.

. .'

I 've bebn

as good

as

knorv

how to

be. . . .

And I'm not

letter-Perfect.

'rvor-rld

like to be,

but I'm not."

Rogers

eplies:

"But

in terms

of what

you can

do, you

feel

you've

done

the

best you can do."

And

Loretta

affirms this

comment,

"I'm

doing

as

good

as I

know

how."

Here

is an

issue mportant

to Loretta

that

she resolves

n

a way that

e.{presses

ositive

self-regard.

he

articulates

an

impressive

acceptance

f

self:She

s

only

as good as

she

really s, hat

shc

s not perfec t,

and that

she

does

not believe

n going

"overboard

about

being

good."

ROGERS'BEHAVIORN THE INTERVIEW

In

the courseof demonstrating

how

Loretta

dealt with

sir

areasof

concern

during

this

intervielv, many

illustrations

have

been given

of thc

wav

Rogers

interacted

with

her. An

examination

of

the entire

interview

reveais

a

remarkable

consistency

of empathic

responsiveness

n

Rogers'

Part.

Of all

of

his responses,

here

are

perhaps only

one

or two

in which

Rogers

did

something

other than

try

to convey o

Loretta

his understanding

of

what

she

was sharing

with

him.

Loretta wasresponsive o this emPathic approach' Sheadvanced

from

one

area

of discussion

o another

(e.g.,

rom

the presenting

problem

of a

oossible ward

transfer

to the

issue of

her lack of

trust

in the

institution

and

in

people

irr

general),

and

she

made

progress

t'ithin specific

areas

(e'g',

resolving

her conflict

about

moving by deciding

that

the

transfer

might

be

an

improvement and

that

she would

not fight

it). In

addition,

Rogers'

empathic

approach

seemed

to facilitate

increased

self-understanding

and

acceptance

aswell asa

greater

ability to

view problems

more

clearly.

Finally,

Loretta's

responsiveness

o

Rogers'

therapeutic

style is evident

in

the

comments

she

makes mmediarely

olloltine

some

oF

his responscs;

tate-


21/24

L rc Lasc

of Lore rrrr:

(,onlrnentary

.)

ments

such

as

"That's

really

it,"

"Yes,

that's

what I thought"

and

,,That's

the

truth,"

all indicate

that

she

truly felt

understood.

In addition

to a high

degree

of empathy,

Rogers

provided

trvo

other

therapist

characteristics

ncluded

in his classic

ormulation

of

"necessary

and

sufficient

conditions

of therapeutic

personality

change": uncond!

tional

positive

egard and

congruence.

He

accordedLoretta

the same

kind

of respecthe rvould any client; his motive for intervieu-ing herwas his sense

that her

feelings

had

been insufficiently

understood

and respected

n

the

first

wvodemonstrations.

He

displayed

nconditional

regard

or her

belief

that

there rvas

electricity

in rhe

atmosphere

of the laundry

and for the

tickling

sensations

he

exlceriencedn

her

knees.He respected

her

choice

of topic, her

manner

of

exploring

each

one, and her dec isions

o switch o

other issues.

count

24

times

n

this short intervier.v

hat Loretta

took the

initiative

in introducing

a new

subject,

going back

to one

she had been

exploring earlier,

coming up

with an insight

or nel\i

attitude,

or exercising

someorher

form

of self-direct ion.

Another index of the client-centeredness f tl-ris ntervietv is the

number

of lines

n

the

printed

transcript taken

up

by Loretta's

starements

(218)

and the nunber

raken up

by Rogers'

(131).

Many psychotherapists

pay lip

service

to respecting

the strength

of their clients.

However,

an

examination

of

typescripts,

when

they

are available,

haracteristicallv

how

Adlerians,

Jungians,

Gestalt herapists,

cognitive

therapists,

amily thera-

pists,and

others

dominating

the interaction

between

client

and therapist.

This is

often true

of

psychoanalytically

riented tl-rerapists,

s

weli. Client-

centered

herapists,

ecause

hey

eschet'the role

ofexpert,

areconsistently

lessverbose,

n

spite of

the

usual reliance

on

lvords to convey

empathic

understanding

Some

support

for these

assertions

comes from

an analysis

of the

interview

materialin

Case

tudies

n Pslchotherapy

\'!'edding

&

Corsini, lgBg).

This

book includes

cases eated

by therapists

from

a variety

ofapproaches.

AI1

cases hat included

verbatim

intervieu's

lvere tallied

for the number

of

lines

spoken

by

the therapist

and

the number

spoken

by the client

or

patient.

As Table

2.1 ndicates,

he

Adlerian,

rational-emotive,

and

cognitive hera-

pists outtalked

their clients

or patients

by a

significant

margrn.

eualitatively,

they are

also

quite

directive. This

is

tme, for example,

of Friu

perls,

the

Gestalt herapist.

Even hough

he

doesnot dominate

n the number

ofwords

spoken, is ntervierv s repletenith comments ike,"Saythis to them,,' ,Now

play the bedroom,"

"Nor.v

be the

kitchen

again,"

"Stay

ltith

rvhat

you

experience

ow,"

"Be

phony."Peggy

Papp,

he family

therapist, s

alsoquite

directive;

she speaks

or

a

"Greek

chorus"

of observing

herapists

who are

rvatching

through

a one-wa,v

mirror.

(The

325 client lines in

rhe

table

represent

he output

of all fii'e members

of the family

being treated

by

papp.

)

By

contrasr,

Rogers s

consistently

mpathic

vith

"tr{rs.

Oal," a client


22/24

54

\4EWS

FROI4

\\,'ITHIN

Table

.1.

Number

of fl

t Lines

ken

by

Ther

ts

and

Clients

Orientation

Therapist(s)

Therapist

ines

Client

ines

Adlerian

Client-centered

Rational-emotive

Cognitive

Gesta.lt

Family

N{osak

and

N{aniacci

Carl

Rogers

Albcrt

Ellis

Aaron

Beck

Fritz

Perls

Peggy

Papp

268

l t)5

554

398

204

253

227

401

290

182

540

325

-A/ote.

ased

on

yerbatim

inrerview

material

contained

in

Wedding

and

Cor.sini

19g9).

he

saw

over

a

long

period

of t ime

in

the

1950s

s

saw

over

a tong

perrod

ot tlme

in

the

early

1950s

and.lvhose nterview*'ith Rogcrs

was

rhe

one

included

n

\A'edding

nd

Corsini

(

1989).

Further_

more,

Brodley

(1991),

in classifying

Rogers,

responses

n

34 interviell,s

between

1940

and

1986,

ound

1,65b

empathi.

...po.r..,

out

of a

total

of

1,928

responses

of all

kinds,

for

an

,,ernpathy

percentage,,

f

g6.

And, if

Brodley's

(1991)

thr-ee

1940

nterviews

iom

ilie

case

oi..Herberr

Bryan,,

(the

eight'interview

case

hat

took

up approximatery

tv.'o-fifths

cf counser-

ing

and

PsychothnaNry

[Rogers,

1942])

arc

ornirred,

Rogers'

empathic

re_

sponses

ise

to a

remarkable

902o.

Rogers

came

to

vierv

congruence

or

genuineness

as

,,the

most

basic

of

the attitudinal

conditions

that

foster

herapeuricgrowrh" (Rogcrs,1980,

p.

2158).

I

grant

rhar

the

judgment

of

genuineniss

is very

iublective.

However,

I

was

present

at Rogers,

inter;ielv

with

Loretta

and

I

have

carefrrlly

reread

the

tJpescript.

From

this

I find

Rogers

to have

been verv

much

up front

with Loretta

and trury

interested

in f,er.

He

meant

what

he

said,

and

he

responded

o

her

on

the level

of another

human

being

rather

than

from

the

pedestal

ofan

expert.

As

.consistently

emparhic

is

he was,

I

noted

one

lapse

in Rogers,

responsiveness

o Loretta.

Loretta

referred

to her

famiry

t'

u

co,rpi.

of

occasions.

arly

n

the interview,

shesays:

'cause

my

father

and that'don,t

come.to

r,,isitme or anything, so I don,t get.out at all on weekendsor

anything."

Then,

a few

minutes

later,

Loretta

remarks:

"I

clon't

mincl

being

moved,

mean

if

it's,

uh,

. . .

uh,

another

thing

rolvard

going

home. (C.Rl

t-1-.)-

.

. But

I

don't

get our

anyway,

and

I

don't,

I

don't-knorv

that he,

my

brotheq

I wrote

a letter,

but I

didn't

get anv

answer

rom

him.

. .

.

(C.R.:

M-hm.)

He

never

came."

While

Rogers

esponds,

,M-hm"

to Loretta,s

eferences

o

going

home

and

to her

brother's

nonresponse,

by returning

to the

issue

of the

move

he does

not

add

the

explicit

recognition

he

gen-erally

ccords

o

Loretta,s


23/24

I l l i J

U J S e

( ) l

L r ) i c l t t ;

C ( , r t r i l | l r l l t a l f

J )

feelingsar-rd

ttitudes.

If

I-oretta

l-rad

pursued

the

topic, it is likely

that

Rogers

would

have

come

around,

but at this

point

he failed

to facilitate

I

oretta's

going further

wirh her

disappointment

about

not seeing

or

hearing

from

her

father

and

brother,

and

lvhat appears

to

be a strong

interest n

being

discharged

rom

the

hospital

and

going home.

Is this

a significant

failure

in

empathy?

When

one listens

to

the

audiotape

of this intervierv,

as

distinguished

from reading the transcript,

this and

other

errors

do

not appear

so glaring.

This

is supported

by the

recorded

discussion

hat

follorved

Rogers'

nterview

rvith

Loretta.

About

30 members

of the American

Academy

of

psychotherapists.

most

of

whom werc

nor

cl ienr-centcred

herapisis,

observed

his

nrerview

and

attended

a question-and-ansrver

ession

with

Rogers immediately

after

Loretta left.

While

the reactions

were

polite,

rhey

were largely

critical.

Why

had

Rogers

ailed

to

supporr

the

staff

of the hospital?

Why had

he

not

pointed

out

connect ions

among

some

of the

things

Loretta

had

talked about?

There

lvere

many

other

remarks

of this sort,

but nobody

in this audience, which included a number of noted psychoanalysti,

commented

on Rogers'

failure

to respond

to

Loretta,s

references

o her

brother

and father.

_._

This

said, t

still may

be rvorth

speculating

on

the reasons

hat

Rogers

did not

pursue

his

particular

topic.

Was here

something

n

Rogers,

ife-in

his

background-that

made him

disinclined

to

follow

up I_oretta's

efer-

ences

o

her iamily?

In Kirschcnbaum's

(1979)

biography

of Rogcrs, he

notes

he following:

In

my

first interview

with

Rogers

he told

me,

,,I

hate

old people

who

reminisce."He has requentlymade comments ike, ,,We

could

count

on t}te

fingers

ofone

hand

the

people

ofour

own age

we really

enjoy.

The rest

are

all

coo stuffy."

When he

worke

d on his

.,autobiography;'

in I

g65

for a

collection

of autobiographical

essays y

well-knorvn

sychologists,

e

said t

took

him

and Helen

[his

wife]

monrhs

to recover

rom

spending

hat much

time looking

in

the

past. Both

the

scientist

and

the artist

in him

were

operating

here;

both

sides

needed

new

challenges

nd could

not be content

with

pastaccomplishments.

eyond

his, or Rolers,

an

interest

n

the future

also

went hand

n

hand rvith

his

association

ith

young

people.

He had always

valued

his

contact

with graduate

students,

and

this

continued

after

he left

the

university

setting.

As he

described

it,

"probably

the major

factor in

keepingme aliveasa growing therapist

s a continuing

association

ith young

people

on a

thoroughlv

equalitarian

basis.

have

always

worked

with

younf

staff

members;

have

never ound

people

my

own

agestimulating

exccpt o;

rare and

fortunate

exceptions.

find

that

)'ounger

people

are

full

of new

ideas,

xploring

he boundaries

ofour

disciplines

nd raising

questions

bout

anvsacred

colvs

which

I hold

rlear.

This keeps

me

stimulated,

moving,

and I

hope

grorr'ing.

(p.

396)


24/24

55

\TEWS

FRO]\4 TITHIN

Rogers' amily

rclationships

seem o be consistenr

.r'ith

heseattitudes.

He was

closest

o

Helen,

his wife

of 55

years,

his

children, David and Natalic,

and his

sk grandchildren.

His interest

in some of his owrr

siblings appeared

to

decline with the

years,

probably becauscof a lack

of

sharedvaluesand

interests.

It may

be, then, that in respondit'rg

o Loretta, Rogcrs'otr'n issues

influenced

his

"overlooking"

I-oretta's

caso loretta

Documents