Unconditional positive regard

How can unconditional positive regard be authentic? It is by definition an act. Authenticity means expressing what you really think and what you really feel. Putting on a particular face as a means to produce some effect in another person, that's not authentic, it's an affectation.

My experience with this as a client is mainly about feeling deceived. I paid someone, they played a role, they did not disclose what their methods or intentions were, and it was decidedly unhealthy.

Often it is because once they start the marijuanna they crone psycotic. When they are psychotic all ability to reason goes out the window so they don't think the need medication and stop. When they are on medication there is some help them understand.

I see unconditional positive regard as my T respecting me as an individual and accepting me as I am. I don't have to say or do certain things for him to think I am a valuable person; he thinks that no matter what.

I was thinking more about cases where marijuana is *not* involved when someone stops taking medication and then self-medicates after that.

It depends on what you understand by unconditional positive regard. The definition that other members have given here (respecting the other as a different human being, not trying to impose our own morals, accepting the client as he/she is, etc.) isn't an act and can be authentic. As I said this doesn't mean not getting or repressing "negative" emotions and thoughts in the relationship with the client, but acknowledging them and dealing with them in a way that doesn't harm the client or the therapeutic relationship. Of course there will be client-therapist relationship where this isn't possible and in those cases an ethical therapist will try to solve the issues and if it's not possible client and therapist will have to talk about the possibility of ending the relationship.

Of course there is some kind of role because the therapeutic relationship isn't the same as the relationship that happens with friends, for example. But this isn't the same as playing an act, it's not how I see it and feel it.

I dont do illegal drugs, it was just something i was thinking of doing at the spur of the moment. I thought it might be fun.

Id imagine the patients you speak do it to feel better to mitigate the horrible side effects of the drugs they take. Antipsychotics can make a person apathetic, vegatative, and deadened.

Psychiatry is one of the worst fields of medicine compared to others. They are way behind the times and it doesnt surprise me people turn to other drugs to self medicate.

I will give an example but know I know this is probably not the case for you but an issue we deal with. We have patients who suffer from depression and psychosis. They will come into the hospital so sick because they have not been on their medication because it doesn't help them only marijuanna does. Mj makes psychosis worse. So they come into the hospital for a few days gets stabilized on their medications and do not use mj. They feel good. Then shortly after discharge they start smioking again and then stop their meds because they still feel good. So do in a short time they are back in the hospital and the cycle repeats itself over and over. Now some of our clinicians will just remind them how how song their meds is contributing to their issues. The clinician who velieves in saying it as it is will say if marijuanna works so wonderful for you why do you keep coming back for tratmebt?[/QUOTE]

I'm not convinced that unconditional positive regard has anything to do with how blunt or gentle a clinician is. I think perhaps these are separate issues that are easy to conflate. That's why the conversation in the OP sort of confused me.

Couldn't one say, "Well, if The Reefer works so well for you, why do you keep coming back for treatment?" without being a **** about it? Or, even if one is a **** about it, does that dickishness really need to touch the core of who the client/patient is?

I think one can be frustrated with a behavior while still believing that the client is, at his or her core, a good and valuable person. To me, that's what unconditional positive regard is. That, whatever a person does, you maintain a core belief that they are worthy, valuable, etc.

Maybe that seems disingenuous to some--it's certainly different than the more natural, spontaneous thing that is affection or genuinely liking someone. Liking may or may not co-exist with unconditional positive regard, or it may wax and wane.

I like some of my students better than others, for reasons that have more to do with me than them. I make the decision to hold all students in positive regard, and I'm mostly successful. How blunt/gentle I am with them has to do with what I think they'll respond best to, not how much I like them or whether I hold them in positive regard.

Mostly. Sometimes I get snappish. No one's perfect.

I always figured it was more or less the same way with T's. But I could be wrong.

Yes, I agree. In my professional life, I do like some people better than others. That IMO is true of just about everybody. But I still choose to see people as having basic worth and being loved by their creator. (Sorry if that got too religious). But it is not fake on my part. I believe that to be true. In acting on that belief, sometimes it is harder than others.

And as it relates to therapy, I have a part that was very angry, very defiant, hostile. When t1 encountered her, he didn't freak out or confront or back away. He was just curious. His curiousity rather than fear or condemnation was amazing to me, and allowed that part to deal with some of her stuff. She became cooperative instead of rebellious. And she is now very helpful to me and to the therapy process. I experienced that as unconditional positive regard. He believed that she had a useful purpose and that she was doing the best she could to be helpful.

My personal view is that I don't like when a therapist does not express observations about negative things and is never critical. I like when they challenge me. If I disagree, we can discuss it. Otherwise I don't really see why I pay them and spend my time with the appointments, I want to learn about myself. Definitely depends on the client though.

I realized that in my previous comment I didn't actually give my take on UPR, I mostly talked about different kinds of judgment and when and where it could be helpful.

So, to take it further to UPR, first, I'd like to share a classic didactic teaching material about UPR often used in psychology programs.
This is one of the famous Gloria tapes that demonstrates how UPR is done in practice by the person who invented the approach - Carl Rogers.

Now, to be honest, I don't believe that what he is doing in that video can realistically be done with vast majority of people. Gloria, in my view, is a perfect client for that type of demonstration - very introspective, not visibly struggling with severe trauma of any kind, as well as poverty and other socio-economic stresses many people struggle with these days. Her problems of a middle-income, comfortably living divorcee from the 60-s cannot even closely be compared to someone who, for instance, goes from crisis to crisis, struggles with self-harming behavior, heavy additions, makes suicidal attempts, lives near or below poverty line, gets beaten up by husband or BF and all other heavy karmic stuff like that. That's why what worked for her in that tape wouldn't work for the majority of people IMO.

That's the reason I don't take UPR approach literally as it's demonstrated in the video. I have my own interpretation of it, which works for me just fine. I see UPR as respectful non-engagement in the client's choices. That is to say that I don't see it as my responsibility as a therapist to "navigate" the client towards the "right" choices. That does NOT mean that I would hesitate to say something if I see that something the client is choosing to do can get them into serious trouble. I would say it as I see it but to me it has nothing to do with "challenging" people, just giving them information to consider. But the choice is always theirs and, whatever the choice is, I respect it because my belief is that every human being deserves such respect even if I don't particularly like them as a person. This is a very short description of how I see UPR but in reality it's more complicated than just that. I just don't have time to describe it fully here.

Generally speaking, I don't like the word "challenge" when it's applied to working with people in therapy. I prefer the expression "honest feedback". "Challenging" someone implies to me that they shouldn't be doing what they are doing, and, as I said, it's not my place to make that determination for them (which is by the way part of UPR theory), but I can give my opinion on what could be the consequences of their choices.

The value of UPR idea is that it's much more important to help people come to their own understanding of why they do what they do instead of feeding them the therapist's interpretations, which may be and often are wrong, and the therapist's personal beliefs of what is and isn't healthy, which may also not be true for a particular client as well as in general. Only from that place of self-understanding that comes from within the person rather than from somebody else (the therapist) and self-compassion and self-acceptance that come as a result, the person will be able to come to their own conclusions as to what choices are best for them.

This detail is helpful to understand the concept but now im confused--ive never known a therapist to not do this. Is it the DBT therapists who dont practice this way? Those who treat substance use disorders? Eclectic therapists?

What Ididitmyway describes is very much the way I've always found my therapists to be and practice. My therapists have leaned more eclectic and behavioral.

Thank you for this. I have had the very same experience, with more than one part. The first time, I was not in any kind of agreement with my therapist and had expected her/wanted her to be on my side in dealing harshly with them, but her approach--the acceptance and understanding, not judgement and punishment--proved to be the thing that helped me get there myself in working with those parts.

Maybe some of this is the difference between an authoritarian clinical setting and a private setting, which at least has more chance of finding a humanistic type therapist.

I think im going to go with your explanation AA, it makes the most sense to me.

I personally feel that a therapist who is always accepting and positive in their interactions with me is not encouraging progress much more than I can do alone. I think it also depends what sort of treatment and attitude someone has found helpful and inspiring historically... I have a history of being surrounded by smart, kind, independent and outspoken significant people who like to say what they think. When I say "challenging", it indeed means honest feedback and providing an opinion (even if it's not very accurate), not so much claiming that what I do is wrong and I should not be doing it. But also, when I engage in self-destructive behaviors that defeat my goals and only cause problems, I do appreciate pointing it out, especially if I am in denial. I like when someone engages with me dissecting what my thoughts, feelings and actions mean and provides perspectives that make me think more deeply and in a fresh way. Perhaps we often associate challenge with aggression, but to me, it's more about confidence and constructive criticism, which is a big difference. Of course telling people what's wrong with them and what they should do is hardly very effective except when it's an emergency with someone who presents danger to themselves and others, which require direct interference or when someone is seriously lost and lacks confidence severely. What I really like is when someone uses reasoning to probe into my thought processes and reactions and makes me revise them.

I watched the video Ididitmyway linked and other Gloria videos (with different therapists) before and thought she was perhaps not the best representation of many clients in therapy as she seems to have quite a strong sense of self and confidence.

I like this, too:
I think there is a big difference between criticizing someone's behavior and their self worth or identity. My first therapist used a similar concept when discriminating between "ego-oriented" vs "object-oriented" questions and comments, the latter approach being more protective of the person's self and the first often being shaming.

My second T had an approach to constructive criticism that I liked very much and found very familiar and effective. He is very interactive in sessions and would often share things from his own life that related to my experiences and way of thinking, pointing out both positive and limitations in these rather than in my way of dealing with stuff alone and separately. There was nothing authoritarian in it. It was very effective for me in creating respect and seeing his comments as valuable. I think I found it effective because it's also how I like to relate to others and help, with my students and supervisees, for example... But it does not work with everyone and some people do want/need a more authoritarian approach.

To me the those three words are unambiguous in terms of meaning. Seems like people are talking more about some form of withholding judgement.

I find the UPR concept to be emblematic of therapy, in terms of the centrality of calculated behavior as an alleged tool for healing. I see it as requiring a kind of doublethink -- knowing the therapist is not being their true self nor spontaneous, but putting this aside and pretending they are. Also I found that in practice this kind of role playing just caused a relational mess.

The distinction between "asking questions" and "pointing out" is pretty subtle, and may be meaningless.

"Do you realise that stuff is going to kill you?"

To which I would think the only reply is "Yes, of course I do. I am not a complete idiot. But I did not hire you to point out the obvious"