Unconditional Acceptance in Therapy
Since the early development of psychotherapy, there has been a recognition that one of the principal benefits of the therapeutic process is to provide an opportunity for the sharing and disclosing of otherwise secret and repressed feelings, thoughts, memories and experiences. Carl Jung, one of the early founders of psychoanalysis along with Freud, argued that one of the goals of psychoanalysis was to encourage the sharing of those elements of the psyche that had been repressed. He claimed that the advent of modern psychotherapy filled a gap left by the dissolution of religious conviction in the late 19th century, comparing its role with that once played by confession. He argued that the keeping of secrets and repression of emotions are ‘psychic misdemeanours for which nature finally visits us with sickness’, and that the treatment for such a sickness must involve ‘full confession’. Moreover, he points out that this confessional process ‘must not be a purely intellectual exercise, but must lead to confirmation by the heart and the actual release of the suppressed emotions’ (1) .
It has been a common theme in the ongoing development of various therapeutic models from that point onwards to explore and identify what might be the optimal conditions for sharing of repressed emotions on behalf of the client. One of the core conditions that is commonly identified is that of a non-judgemental attitude on behalf of the therapist towards the client and their experience. The idea here is that one of the main reasons that an individual may withold the sharing of themselves in a full and honest way is due to fear of repurcussion, judgement, and criticism from those around them. These fears often date back to our early childhood development, as we learnt to adapt ourselves to the conditions laid upon us by our parents or other significant care-givers. This process of adaptation and socialisation will more often than not lead to the repression of certain ways of thinking, feeling, and acting, particularly if they resulted in negative attention from the adults on whom we depended for our survival. One of the goals of the therapist can be to provide a space free from such restricting conditions in which the client can be free to know and express themselves in whatever way they want and/or need to, including aspects of themselves they may have repressed or hidden as they were growing up and adapting to their social world.
In his formulation of Transactional Analysis as a therapeutic model, Eric Berne developed his own ideas about the conditions of the therapeutic relationship that might best facilitate positive change. Berne had a particular view of the human individual as being basically good and valuable, and that the distortions which formed in the human personality were largely due to conditions placed on the individual by their environment and upbringing. As Berne himself stated, ‘People are born princes and princesses, and are made into frogs’. This emphasis on the innate human capacity for growth and development was influenced in part by the ancient Greek concept of ‘physis’. As Richard Erskine explains,
‘[physis] describes the source of our internal thrust to grow. The word physis refers to the vitality and psychic energy that is invested in health, creativity, and the expansion of our personal horizons……….Physis is an internal thrust for health and growth, the urge to do something different and novel, the aspiration to be fully our selves, and to have choice about our own destiny’ (2).
It was Berne’s belief that given the right conditions, this natural and innate propensity for growth and expansion could find fulfilment in any individual. However, this natural tendency towards healthy psychological growth is stifled and held back by the social environment that a young child finds themselves thrown into, with the pressures of socialisation and the need to adapt to the expectations of the adults around them leading to a limitation and restriction of certain ways of being in the world in favour of others. One of the main ways in which children limit themselves is in response to parental ‘injunctions’. These injunctions consist of negative messages communicated in early childhood by the parents, often below the level of conscious awareness. These injunctions act as prohibitions against certain types of behaviour. It was the Gouldings who developed this idea further and identified twelve key injunctions that a parent might communicate to their young child, from prohibitions against certain natural functions such as ‘Don’t Feel’ and ‘Don’t Think’, to more profound rejections of the child such as ‘Don’t Be You’ and ‘Don’t Exist’.
As well as internalising injunctions from the parents regarding certain ways of being in the world, the young child, according to Berne, will also develop one of four basic life positions which frame their view of themselves in relation to others;
‘I’m OK, You’re OK’,
‘I’m OK, You’re Not OK’,
‘I’m not OK, You’re OK’,
‘I’m not OK, You’re Not OK’.
These basic life positions, according to Berne, are adopted in early chlidhood in response to attitudes of the primary attachment figures. For example, the child of a withdrawn or depressed mother may take the absence of maternal love as evidence of the fact that they are unloveable, rather than consider the frightening possibility that there might be something wrong with a primary care-giver on whom they are dependent for survival. In this scenario the child would adopt an ‘I’m Not OK, You’re OK’ position, which they will then carry with them into their adult relationships.
In Berne’s view, it is the first of these life positions, ‘I’m OK, You’re OK’, which provides the optimal conditions for children to develop and maintain psychological health and well-being. It implies a recognition of the fundamental goodness at the heart of every individual, and suggests a security in the knowledge of that which is unshaken by the stress of navigating complex and sometimes difficult relationships. In regard to the role of the therapist, it is the maintenance of this attitude in their relationship with the client which can contribute to an optimal environment in which the client can grow, heal, and be in whatever way is necessary for them at any given moment. It can also serve to model a way of being for clients who have adopted one of the other three positions, helping them to move into an ‘I’m OK, You’re OK’ relationship with the therapist which they can hopefully transfer to other areas of their life.
The provision of a relationship in which the client feels unconditionally accepted can be particularly powerful for clients who never experienced such attitudes from their caregivers in childhood. The absence of unconditional love in a child’s social and family environment can produce lasting trauma that has a detrimental impact on an individual’s psychological development into adulthood. Children whose early lives have been characterised by parental abuse and neglect can grow into adults who have very low self-esteem, suffer high levels of generalised anxiety, and experience a global feeling of fear and insecurity. In his book on Complex PTSD, Pete Walker explains that ‘I have seen the unconditional positive regard of the therapist be enough on numerous occasions to significantly repair the damage of not being parentally loved’ (3).
1 Jung, Carl (2001) Modern Man In Search of a Soul, Abingdon and New York, Routledge
2 Erskine, Richard (2011) Attachment, Relational Needs, and Psychotherapeutic Presence,
3 Walker, Pate (2013) Complex PTSD: From Surviving to Thriving, Azure Coyote