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Therapy

What Client-Centered Therapy Gets Wrong (and Right)

Could Carl Rogers' approach reinforce a patient’s egocentric perceptions?

Key points

  • Carl Rogers' client-centered therapy tends to reinforce a patient’s egocentric perceptions of their problems.
  • The retrosplenial cortex mediates between egocentric and allocentric perceptions, which was evolutionarily useful in spatial navigation.
  • The retrosplenial cortex original adaptive function has been exapted (repurposed) to regulate emotional states.

Before my crucifixion, I wish to say that the basic principles of Carl Rogers’ client-entered therapy are practiced more than any other therapy in the world. Among those principles are active listening and positive regard for a client’s (aka patient’s) welfare. However, as the name suggests, it is a person-centered (egocentric) orientation. For example, when a patient says, “I’m depressed,” the therapist’s typical response might be, “Tell me more about that,” or “What do you mean by that?” It is my opinion that these client-centered responses tend to reinforce the patient’s egocentric perceptions of their depression. So, what does the retrosplenial cortex have to do with these perceptions?

It is well established that the corpus callosum transmits information between the two cerebral hemispheres. The posterior (toward the back) portion of the corpus callosum is called the splenium (which is also its thickest part). The cingulate cortex covers the corpus callosum, and its posterior region is called the retrosplenial cortex (RSC). The RSC is well known for its role in spatial orientation and navigation. Evolutionarily, it was advantageous for hominins (all close relatives of Homo sapiens since about 6 million years ago) to be able to explore their environments for water, food, shelter, and other resources and successfully return to their places of origin. The RSC accomplishes this ability by being able to translate and mediate between egocentric perceptions of the environment with allocentric (viewpoints independent of the self) perceptions. Our distant ancestor, Homo erectus, dates to about 1.9 million years ago and was amazingly successful at negotiating their environments. It is estimated that they expanded their territory about 10 times the area of Lucy (Australopithecus afarensis), who evolved about 1 million years earlier. Homo erectus was so adept at navigation that they began leaving Africa about 1.5 million years ago and entered the Middle East, Europe, Asia, India, China, and Indonesia. Therefore, the RSC must not only have been present in Homo erectus but also functioning well.

I hypothesize that the RSC’s original adaptive function of spatial navigation was exapted for a new purpose and that is emotional regulation. Exaptation is the re-purposing of an original function for a new behavior. Although the term is often attributed to Gould and Vrba (1982), Darwin actually first heralded the idea in 1862 when he wrote, “… if a man (sic) were to make a machine for some special purpose, but were to use old wheels, springs, and pulleys, only slightly altered, the whole machine and all its parts, might be said to be specially contrived for its special purpose. Thus, throughout nature almost every part of each living being has probably served, in a slightly modified condition, for diverse purposes…”

So how might the RSC’s exaptive function regulate emotions, and what might Rogers have gotten wrong about client-centered therapy? Imagine if the therapist said (in addition to initially inquiring about the nature of the patient’s depression), “You know, a lot of people get depressed. And a lot of people get over it relatively quickly.” Of course, that advice would go against client-centered prescriptions for never giving direct suggestions, but, as I noted, the latter statements are allocentric perceptions. Is there any evidence that allocentric perceptions might help regulate one’s emotions? Yes. Webb et al. (2012) demonstrated empirically that one successful way of regulating emotions was taking an allocentric perception of that emotion. Additional examples of allocentric perceptions for depression might be, “You are not alone. And most depressions lift quickly and rarely persist. You are going through an experience that most people will have at some point in their lives.” While allocentric perceptions may not be a panacea for all psychological problems, the resistance to giving such advice (allocentric perceptions) in client-centered therapy may actually impede quicker or more efficient positive therapeutic outcomes.

The genetic origins of our species (Homo sapiens) may be traced to the divergence of the lineages of Homo sapiens and Neandertals almost 600,000 years ago. This field of study is called paleogenomics (paleo- meaning old). The earliest fossils of Homo sapiens date to about 300,000 years ago, but truly modern Homo sapiens fossils, and modern behaviors, probably evolved only within the last 100,000 to 80,000 years. These modern behaviors included bow-and-arrow technology, highly ritualized burials, depictive cave paintings, personal ornaments (shell necklaces), depictive figurines (Venus-like), and fantastical (imaginary, i.e., half-person, half-lion) statues. In part, these ultra-modern behaviors have been attributed to a parietal lobe expansion that was unique to Homo sapiens (and not in Neandertals). The brains of Homo sapiens also became rounder and smaller than Neandertals. About this same time, there is archaeological evidence that Homo sapiens began trading long distances (over 600 miles) and trading mates. These modern behaviors, including trading, undoubtedly required diplomatic negotiations (Coolidge & Wynn, 2012), and were probably largely non-verbal, as people now encounter a bewildering number of different languages traveling relatively short distances across Europe or within India.

I hypothesize that diplomatic negotiations required allocentric perceptions combined with egocentric perceptions, not only to imagine what the other person might be thinking (curiously named Theory of Mind) but also to regulate one’s natural anxiety-filled inclinations when encountering strangers (called xenophobia). Thus, the exaptation of the RSC from its original adaptation of spatial navigation (which was preserved) to the regulation of emotions in diplomatic negotiations may have been one the critical components in the evolution of modern human behavior. Further, it may be beneficial for client-centered therapists to consider offering allocentric perceptions of their clients’ problems in addition to exploring the egocentric nature of these problems.

References

Darwin, C. (1862). On the Various Contrivances by which Orchids are Fertilized by Insects. Cambridge Library Collection.

Coolidge, F. L. & Wynn, T. (2012). Cognitive prerequisites for the evolution of indirect speech. In K. R. Gibson & M. Tallerman (Eds.), Oxford handbook of language evolution (pp. 216-223). Oxford University Press.

Webb, T. L., Schweiger Gallo, I., Miles, E., Gollwitzer, P. M., & Sheeran, P. (2012). Effective regulation of affect: An action control perspective on emotion regulation. European Review of Social Psychology, 23(1), 143-186.

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