What Can Carl Rogers Teach Therapists About Trauma?

In recent years, there has been much written about posttraumatic growth. Posttraumatic growth is when people report positive psychological changes following trauma. The term posttraumatic growth was coined in 1995 by Richard Tedeschi and Lawrence Calhoun, two clinical researchers based then at the University of North Carolina. It was an important observation that added to an understanding of trauma that was previously restricted to posttraumatic stress.

Surely this was something we already knew? It was. The pioneers of posttraumatic growth have always acknowledged that it is an idea contained in many philosophical and spiritual writings.

And, as I discovered if one looks back to humanistic psychology, it can also be seen in the writings of Carl Rogers, the founder of client-centered therapy.

In a 2004 paper entitled "Client‐Centred Therapy, Post‐traumatic Stress Disorder and Post‐traumatic Growth," published in the British Psychological Society journal, Psychology and Psychotherapy, I described how Carl Rogers’s theory shows how growth arises out of adversity.

Becoming "Fully Functioning"

Of course, Carl Rogers never actually used the term posttraumatic growth. He was writing decades before the term itself was coined. But what I did was to examine his writings in light of the development of the term posttraumatic growth to show that it was an idea he was familiar with. In essence, Rogers described what he called the process of "breakdown and disorganization," and how this, in turn, can lead to becoming more "fully functioning."

By fully functioning, Rogers was referring to characteristics such as greater openness to experience, more existential living, and the ability to trust in one’s own judgments. When Rogers talks about becoming more fully functioning, he could easily be describing what contemporary researchers call posttraumatic growth.

10 Practical Implications for Therapists

In my paper, I offered 10 practical implications for therapists, which, in summary, are

1. Clients might not want to talk about their trauma, particularly early on before the relationship has developed. The client-centered therapist will not push the client to talk. The client-centered therapist is careful to note the process but without implying that the client should do any differently than what he or she is doing.
2. Clients will likely feel more comfortable in talking about their experiences when the therapeutic relationship has developed and they feel accepted and understood by the therapist. This takes whatever time it takes. Reassurance from the therapist before this trusting relationship has developed that it is acceptable to talk will not speed up this process. Feelings of frustration and of wanting the process to be quicker than it is on the part of the therapist will likely only serve to slow down the formation of the relationship.
3. If a client does begin to talk about their traumatic experiences, it is not the therapist’s task to direct the content of the narrative. The task is purely to try to understand the client’s experience and communicate to him or her that understanding and to stay with the client in his or her experience.
4. Psychological contact is the prerequisite for client-centered therapy to take place. If the contact is not present, client-centered therapy is not taking place, and the therapist needs to use other grounding techniques to regain contact.
5. As the client explores the meaning of his or her experiences, the therapist’s task is to help the client hear his or her own meanings so that he or she can reappraise and re-evaluate for him- or herself. It is not the client-centered therapist’s task to do this for the client.
6. As the client feels intense negative emotions of fear, despair, sadness, and so on, it is not the client-centered therapist’s task to try and remove these feelings: The task is simply to stay with the client’s experiences.
7. It is not the therapist’s task to direct the client to exercises or activities, but if the therapist thinks that something might be useful, the therapist might share this with the client without in any way pushing the client to do the exercise or activity.
8. Although theory states that the client will move in growthful ways given the right social environment, do not set this up as an a priori expectation for the client so that he or she feels he or she is failing if he or she struggles to find positive meaning. Posttraumatic growth can be a gradual and slow process. It is also important to understand that growth is a process rather than an outcome.
9. Although it is useful for therapists to have a knowledge of the trauma literature on the general reactions of people who experience trauma, the therapist should not assume that this knowledge necessarily applies to each and every client.
10. Therapists can help provide clients with the social environment conducive to recovery, but they cannot make them recover. Therapists should endeavor constantly to make sure that, in their interactions with clients, they do not act to take responsibility away from their clients, who must, in the end, take responsibility for the progress of their own therapy. Clinicians can create the therapeutic context conducive to posttraumatic growth, but it is only the client who can achieve growth.

A client-centered approach to posttraumatic growth challenges the trauma industry by offering a nonmedicalized view, putting the person back in the driving seat as the expert on what is best for themselves, and, most of all, offering a hopeful view that overcoming adversity can also mean positive psychological changes.

For client-centered therapists working with traumatized people, this is good news. We don’t need to see our clients as broken, disordered, or needing to be repaired or fixed, but as benefiting from the healing power of empathic and unconditional relationships. In the therapeutic relationship, clients can process their experiences of breakdown and disorganization through learning to listen to themselves, becoming more self-accepting, and finding new directions.

The clock can never go back for people who have experienced trauma, but we can still help our clients live in the most meaningful and fully functioning ways they can.