in my haphazard dive into critiquing care work and wanting to learn about alternatives took me to reading carl rogers on personal power: inner strength and its revolutionary impact. this is not theory, or economics, or political economy, or any of that, but an approach to understanding the dynamics of hierarchy and control in therapeutic professions. here rogers maps out his person-centered approach and its implications.

the person-centered approach relies on a fundamental belief and “a view of man as at core a trustworthy organism.” This approach sees the therapist as a facilitator, with the goal not to solve problems but to assist someone to grow.

“The therapist becomes the “midwife” of change, not its originator. She places the final authority in the hands of the client, whether in small things such as the correctness of a therapist response, or large decisions like the course of one’s life direct. The locus of evaluation, of decision, rests clearly in the client’s hands.”

The client-centered approach is radically democratic, abolishing the hierarchy of caregiver-care receiver relationship. For this same reason though, Rogers recognizes here “the politics of helping professions”, which is the first chapter’s title.

“It has taken me years to recognize that the violent opposition to client-centered therapy sprang not only from its newness, and the fact that it came from a psychologist rather than a psychiatrist, but primarily because it struct such an outrageous blow to the therapist’s power. It was in its politics that it was most threatening.”

In describing the person-centered approach, he lists three conditions for promoting the growth of the individual in the therapeutic relationship: genuiness or congruence, acceptance or unconditional positive recard, and empathetic understanding.

There are examples of the effectiveness of this approach, including at Twin Oaks (to some extent) and at Diabasis House with Dr John Weir Perry, of abolishing the hierarchy of care and creating a cooperative therapeutic caring relationship. “Essential power and control thus flow upward from the psychotic person and her needs, to the dedicated house staff, to the nurses and psychiatrists. It is a complete reversal of traditional hierarchical, psychiatric treatment.” This is reminiscent of Francesc Tosquelles’s approach at Saint-Alban where patients developed their own expertise, research, and creativity in the therapeutic process.

For Perry, psychic breaks are seen as crucial attempts at healing and self-actualization, and “altered states of consciousness are respected as valid ways of being” leading to individuals taking the lead in their process and clinic staff acting as companions. Refers to this democratic approach to care, Perry describes “Democracy can be recognized as a state of psychic development in which the ordering and ruling principle is realized as belonging essentially within the psychic life of the individual.” read more about Perry and Diabasis here.

Rogers concludes in the first chapter of his book, “To psychiatrists relinquishing control of “patients” and staff, to see them serving only as successful facilitators of personal growth for deeply troubled “insane” persons rather than being in charge of these people is, I am sad to say, a very frightening scene to psychiatrists, psychologists, and other mental health professionals. Revolutionaries are seen as dangerous — and there is no doubt that they are dangerous to the established order.”

As I read this I saw parallels within our social theories and experiences, particularly those of Autonomism and anarchism and the notions of working-class self-activity and self-valorization- how new social relations come into being through self-activity, everyday resistance, and mutual aid. In Kroptokin’s mutual aid , he writes, “In other words, there is the self-assertion of the individual taken as a progressive element.” Similarly in person-centered therapy, it’s the person’s own propensity towards growth and development, along with the person-centered environment, that frees the person to develop for themselves.