caso loretta
TRANSCRIPT
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ASL
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
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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
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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.
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\'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
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' .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."
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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-
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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
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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
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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
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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.
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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.
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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
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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
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7/24/2019 Caso Loretta
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+ 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'
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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?"),
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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 _
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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
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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
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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
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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-
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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
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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
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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)
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55
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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