Carl Rogers Hated Empathic Listening Skills
The father of humanistic psychotherapy was appalled by the word “reflections”
As a training therapist, there was a magical reverence for Carl Rogers- the father of humanistic psychotherapy. He is credited for having defined what are now taken-for-granted ingredients in good therapy, like alliance and unconditional positive regard. His dedication to empathy and conflict resolution was so expansive that Rogers was nominated for the Nobel Prize in 1987. He lost to Mother Teresa. (Reminds me of the year that The Lord of the Rings Trilogy and Lost in Translation were nominated for Best Picture at the Oscars. Kind of unfair really.)
In graduate school, we were required to watch the infamous Gloria sessions in which Rogers embodied his signature non-judgemental empathic listening. The recorded therapy session showcased Rogers’s belief that the patient is the author of her own experience — she will resolve her problem when provided non-judgemental human connection.
“The curious paradox is that when I accept myself just as I am, then I can change.”
- Carl Rogers, On Becoming a Person
Around the same time I studied Rogers, I was also learning about therapy “microskills.” Microskills are small interventions or therapist behaviors like a single step in a choreographed dance. One evidence-based form of therapy that emphasizes microskills is Motivational Interviewing (MI). MI draws heavily from Rogers's work. A core MI microskill is paraphrasing otherwise known as “reflections,” or reflective listening, to show the patient that you understand them.
I learned that reflections were incredibly powerful conversational tools. Good MI therapists are supposed to provide a minimum ratio of two reflections to every question, but ideally four or more per question. I loved reflections. I thought reflections were so great, that I designed years of therapy training and eventually an entire company around teaching people to provide them.
So imagine my surprise when I came across this article from 1975 written by Carl Rogers where he totally rejects understanding empathy as a collection of micro-techniques.
And he especially hates on reflections. He wrote that his approach to empathy had been distorted by other therapists into a grab bag of microskills like reflections, that missed the point of human empathic connection.
Rodgers said, and I quote:
“reflect [became] a word that made me cringe. […] I was so shocked by these complete distortions of our approach that for a number of years I said almost nothing about empathic listening…”
Wow. Speaking of Lost in Translation! The man who practically defined empathic listening for a field stopped speaking about it for years because he was disgusted by reflections.
Rogers was even more disturbed by the implications of behavior modification using reflective listening. He noticed how delighted the field was to have found a form of listening technology in which a person’s behavior could be shaped, with or without their knowledge, to a specific goal. He disliked listening protocols that described reflective listening in a technicist way, especially the idea that therapists could use reflections to selectively reinforce behaviors.
Keep in mind in 1975, Rogers was writing when mind control, cults, and brainwashing were being analyzed in detail by scholars like Robert Jay Lifton and others in the wake of the Vietnam War. I shudder to think what Rogers would make of today’s behavioral economics on social media and advertising.
Rogers continued on to say that it was the time to take a fresh look at empathy; that the tides were turning away from seeing the therapist as an expert on the patient. Rather patients were the experts on themselves.
So if not reflective listening skills, then what makes therapists empathic?
Rogers's original definition of empathy (1959) centered on the idea that therapists should understand another person without ever losing the “as if” condition or else fall into what is known as over-identification. I’ve referred to this idea as a form of unhelpful empathy called “Shoe Stealing.” Shoe stealing therapists demonstrate empathic failures because they are no longer acting as if they are in your shoes, they really try to take those shoes and try them on.
The problem with over-identification from Rogers’s perspective was that the connection between two people is lost. Therapy becomes the therapist projecting their problems and issues onto the patient to the extent that the patient is no longer the driver of their experience and the therapist no longer the witness.
“Being empathic is a complex, demanding, strong yet subtle and gentle way of being.” — Carl Rogers, 1975
Empathy for Rogers was about therapists making themselves at home in the client's experience without leaving a trace. He described empathy as a process in which the therapist would temporarily live in the patient’s world, “moving about in it delicately without making judgments […] not trying to uncover feelings of which the person is totally unaware since this would be too threatening…” (Rodgers, 1975).
Following Roger’s approach, as the therapist explores their patients’ world, frequent check-ins are required to assess if the therapist is understanding this world correctly. Thus, an important function of the therapist's reflective capacity was to help the patient focus on exploring the meanings of these observations- to help the patient move deeper or forward into their life.
When reading his article I couldn’t help but think of the million-dollar question for the field of psychotherapy.
If we assume that somehow the core of empathy is lost when we break it down into technical skills, then how can you train a person to become empathic? We know that empathy and feeling cared for are integral to therapeutic success. But can you train someone in the active process of desiring to know and understand the subjective experience of the other?
What Rogers would say is that the primary way empathy can be trained is through experiencing it first hand. Accurate empathy can only be fostered in training psychotherapists, parents, and teachers if their teachers and supervisors are empathic. Thus, it isn’t just what skills therapists learn, but how empathic their teacher is while they teach them. If a trainee therapist is provided empathic non-judgemental feedback and understanding during their training, we can expect they will integrate and perform empathy with their patients with greater success.
Thankfully this means empathy is not something that you are just born with but rather being in relation to another caring person makes you more empathic. When Rodgers wrote this article critiquing microskills, he cited over 20 studies showing how therapist’s empathic connection leads to the patients themselves being more empathic and less symptomatic. For example, therapists ranked as the most empathic by unbiased judges demonstrated the sharpest reduction in psychopathology for patients, even in those with schizophrenia and personality disorders (Rodgers et al., 1967, p. 85). Now there are hundreds of studies demonstrating the effect of empathic relationships on improving symptoms.
The take-home point here is this:
When a person feels understood by and cared for by another, they start to care for and understand themselves.
This is the deceptively simple core of humanistic therapy — it’s not about a technique. It’s about you. Not as I want you to be, but as you are.
x Dr. Lord
Thanks to Alex Gomez, PsyD, LMHC for his review and feedback on this article and for the many nights of 90s karaoke that supported our humanistic therapy habits.