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T 
I 
WHAT PSYCHOLOGICAL HEALTH MEANS TO THE 
HELPING RELATIONSHIP IN PRODUCING 
CONDITIONS FOR GROWTH. AND CHANGE 
by 
RODGER LEE ^LINE 
A professional paper submitted to the Graduate Faculty 
in partial fulfillment of the requirements for the degree 
of 
MASTER OF EDUCATION 
with concentration in •' 
j 
Counseling 
Approved: 
Committee 
Graduate Dean /y 
MONTANA STATE UNIVERSITY 
Bozeman, Montana 
June, 197^ 
ill 
ACKNOWLEDGMENT 
Sincere appreciation is extended to Dr. Richard 
K. Horswill for his suggestions, continual support, and 
encouragement throughout my graduate work. 
A special thanks to my wife and ray little girl, 
for without their love, patience, and perseverance to 
indure, none of this would have been possible. Who can 
help but cherish their presence in my life? 
And my humble thanks to Jesus Christ for the 
strength to overcome, and for the many people whose 
heart has touched my own, for they became the inspiration 
of my years in school. 
TABLE OF CONTENTS 
Chapter Page 
I INTRODUCTION   . 1 
Statement of the Problem  3 
Purpose of the Study  3 
General Questions to be Answered   6 
General Procedure  *  7 
Definition of Terms  7 
Summary   • .   8 
II REVIEW OF RELATED LITERATURE   . 9 
Introduction  9 
Psychological Health  10 
Counseling Relationship  24 
Experience vs. Theoretical Orientation. . 27 
Facilitative Conditions  ... 32 
Manipulating Therapist-offered 
Conditions  43 
Summary ••••••   46 
III DISCUSSION  50 
Formulation of a Theory  50 
Psychological Health  51 
Counseling Relationship  . 65 
IV SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS . . 76 
Summary • •    • 76 
V 
Chapter Page 
Conclusions   . ♦ ,   83 
Recommendations • •   85 
LIST OF SELECTED REFERENCES   8? 
APPENDIX  97 
vi 
ABSTRACT 
A review of literature was conducted in the area 
of counseling and psychology to determine: 1) if there is 
sone general agreement as to what positive growth and 
psychological health is, and 2) what conditions must 
exist in interpersonal or counseling relationships before 
positive growth and change can occur. 
The research available in the area of psycho¬ 
logical health is limited and tends to be subjective. 
There is, never-the-less, a strong general agreement as 
to what constitutes optimum psychological health, but very 
limited understanding as to it’s nature. The research 
reviewed also suggests a strong general agreement among 
counseling psychologists from various theoretical 
orientations, that facilitative conditions do exist which 
are necessary for positive growth and change; however, 
these conditions are not seen as being sufficient in 
themselves to produce this growth and change. Research 
suggests that these facilitative conditions are a part 
of being optimally psychologically healthy and therefore 
a part of the counselor's personality, not a part of 
some theoretical orientation or techniaue. 
CHAPTER I 
INTRODUCTION 
This age has become the age of mental health, 
with government funded programs being established 
throughout the country. Society is putting much effort 
into attempting to translate into concrete terms the 
concept of the whole man functioning within his 
environment. 
Since 1965, under the National Mental Health 
program there has been millions of dollars spent and 
nearly one thousand community mental health centers 
established throughout the country. Under these new 
programs people will no longer be isolated from their 
communities, families, and friends; they will be treated 
promptly in mental health centers. The center will be a 
part of community life, just as is the drug store or 
health clinic. These programs will seek to give services 
that will treat the whole man in the midst of life instead 
of in the unreal confinement of a mental institution. 
The purpose of the centers is to intervene in, and help 
prevent, what could be mentally and emotionally disabling 
conditions. 
Today’s trends in mental and emotional health 
2 
suggest changes in the way people and society as a whole 
look at such problems, and how much problems can be 
prevented or treated. Since 1955 the trend has been to 
break away from the large custodial institutions, with 
greater emphasis on community treatment of emotional 
problems. Congress, in passing the Mental Health Study 
Act of 1955* authorized an appropriation to the Joint 
Commission on Mental Illness and Health to study and make 
recommendations concerning various aspects of mental 
health policy. In 1961 the commission published its 
well known report, ‘'Action for Mental Health," which 
argued strongly for an increase in health research. It 
recommended that expenditures in the mental health field 
be doubled in five years and tripled in ten years. It 
argued for new and better recruitment and training 
programs for mental health workers. It suggested the 
expansion of treatment programs for acutely ill patients 
in all facilities including community mental health 
clinics, general hospitals, and mental hospitals. It 
attacked the large state mental hospitals and suggested 
that these be converted to smaller regional intensive 
treatment centers. The commission and President John F. 
Kennedy endorsed the viewpoint that mental illness is not 
5 
inherently different from the larger range of day to day 
psychological difficulties common to the community 
environment (Mechanic, 1969; Klein, 1968). 
At a time when mental health is growing in 
importance, there seems to be sparse agreement in the 
professional community as to what mental health is and 
how it can be professionally best facilitated. 
STATEMENT OF THE PROBLEM 
The problem of this study will be to examine 
research and literature in the area of counseling and 
psychology to: 1) come to some general agreement as to 
what positive ‘growth and psychological health is, and 
2) determine what conditions must exist in interpersonal 
or counseling relationships before positive growth and 
change can occur. 
PURPOSE OP THE STUDY 
Many investigators have attempted to isolate 
indispensable aspects of the client-therapist 
relationship. Three crucial characteristics, or 
conditions, were cited by Rogers (1957) as necessary to 
attain a ''psychological climate" wherein a client could 
4 
reorganize himself. These characteristics, or conditions, 
were described as: genuineness or congruence in the 
relationship, acceptance or unconditional positive 
regard, and accurate empathic understanding of the 
client’s phenomenal world. Many persons have studied the 
effects of genuineness, empathy, acceptance and non- 
possessive warmth, and the relationship of these 
variables with change resulting from therapy (Rogers, 
1957; Truax, 1963; Truax and Carkhuff, 1966; Abeles and 
Mullen, 1971)* These variables have been considered to 
be separate but interrelated. Findings in several other 
studies (Bergin, 1967; Truax, 1963; Truax and Carkhuff, 
1966) suggest that the variables are separate and can be 
measured independently. 
In studies similar to those mentioned in the 
previous paragraph many authors have focused on the 
combination of warmth and empathy, or some other 
combination of Rogers' characteristics, as well as 
focusing on each one separately. Bergin (1967) refers 
to the need for training in empathy for counselors and 
therapists in contrast to training in warmth, which he 
does not view as "trainable." Carkhuff and Berenson 
(1967) found that therapists function at a level little 
5 
better than that of the general public in facilitating 
these conditions (congruence, acceptance, and empathy) 
and therefore need better training. 
Since approximately 1950 there has been much 
disagreement as to whether positive growth and change in 
a cli.ent are reliant on the awareness of certain 
conditions in the counseling session: What is the desired 
growth and change that a counselor looks for in a 
counseling relationship? Is there some optimum level of 
living that people strive for in psychological health? 
What are these conditions, if any, that must be present in 
a relationship before growth and change can occur? The 
author has found only two attempts, out of hundreds of 
research articles written during this time, to try to 
draw together the research in this area in a systematic 
way, enabling a person to weigh the findings. 
This is sufficient evidence to warrant a review 
of the research and relating literature in this area to 
see if any conclusive evidence exists that might allow a 
person: 1) to support or reject the theory that 
psychological growth and health is not just a counseling 
illusion but actually does exist, and 2) to support or 
reject the idea that there are conditions in counseling 
6 
which must be met oefore this positive growth and change 
does occur in a client. 
GENERAL QUESTIONS TO BE ANSWERED 
The general questions to be answered in this 
study, based on the review of literature, are: 
1. Is there agreement in research and literature, 
on specific conditions which must be met by a counselor 
in a counselor-client relationship before positive growth 
and change can occur? 
2. Does the counselor’s personality, theoretical 
orientation, and amount of expertise (that which he 
brings with him to the session) affect the level or 
degree of presence of these conditions in the session? 
3. What basic personality changes, or factors 
which could be considered desirable or growth-producing, 
occur in the clients during successful counseling? 
4. Does there seem to be a certain combination 
of these conditions which is more effective, or less 
effective, in producing positive personality growth and 
change as each session progresses? 
3* Does the client's personality and type of 
mental or emotional problem (that which he brings with 
7 
him to the session) affect the level or degree of 
presence of these conditions in the session? 
GENERAL PROCEDURE 
A review of related literature will be used as a 
basis for obtaining information needed in this study. 
The material will be selected from professional journals, 
books, and unpublished papers written in the fields of 
counseling and psychology. The material gathered will 
then be used as a basis for a subjective analysis by the 
author. 
DEFINITION OF TERMS 
Conditions refers to those factors which are 
found to have significant effect on positive or negative 
growth in the counseling session. 
Positive growth refers to the client’s move 
toward a more effective or healthy personality; negative 
growth refers to the client's move away from a more 
effective or healthy personality. 
No distinction will be made between the titles 
of counselor and psychotherapist since the study could 
apply to types of clients that either a counselor or 
8 
psychotherapist could encounter; therefore, the titles 
will be used interchangeably* 
SUMMARY 
Society is in a period when mental health is 
seen as an important commodity to the inhabitants of 
this country, yet there have been complaints that 
little satisfactory research has been done to support 
programs which are desired to meet the needs of either 
the community or the individual. Psychologists, 
sociologists, counselors, social workers, religionists, 
etc., still argue over the question, "What is mental 
health?" How does one know when a person has it, how 
does one facilitate it, and can persons be trained to 
facilitate it? 
It is the purpose of this paper, through a 
review of literature, to explore some of these areas of 
doubts and arguments and try to facilitate a better 
understanding of their importance, or lack of importance, 
in the process of defining and facilitating mental 
health. 
CHAPTER II 
REVIEW OF RELATED LITERATURE 
INTRODUCTION 
In order for one to facilitate effective human 
growth and development in another, one must have seme 
understanding of what is an effective personality, or 
human being* What does a counselor work towards in a 
counseling relationship? What kind of meaning or purpose 
is derived from this relationship? How can the processes 
in this relationship be best facilitated? What happens 
in this relationship that causes a person to want to 
change and grow? What makes this relationship differ 
from any other, and how does what the individual brings 
to the relationship affect its outcome? 
It is the purpose of this review of literature 
tc discuss: 1) What is human effectiveness, or 
psychological health, and what meaning does it have for 
the counselor in determining positive growth and change in 
a client? 2) Are there central ingredients in this 
counselor-client relationship which must be present 
before this positive growth and change can occur, and how, 
or in what way, do these ingredients change as the 
10 
relationship grows and changes until time of termination? 
There is an enormous amount of literature in this 
area which has not been presented due to limited time and 
to the nature of this study. Therefore, the literature 
deemed most significant and appropriate to the author 
will be presented, and thus will undoubtedly reflect the 
author*s biases as a researcher and counselor. 
PSYCHOLOGICAL HEALTH 
Clarifying the meaning of psychological health is 
of interest to counseling psychologists for several 
reasons: 1) It is the basic commitment of the counselor 
to help persons achieve even higher levels of personal 
effectiveness. 2) It is believed that the assessment and 
integration of personal strengths have direct relevance 
to outcome studies. 3) Psychological health should be 
just as important to the counselor as mental illness is 
to the clinician. 4) The counselor's knowledge of 
psychological health is so limited that he is forced to 
use as his conceptual model his belief of how he would 
behave, or would like to behave, in various situations. 
Every counselor or psychologist devoted to 
facilitating human effectiveness must have some kind of 
11 
typology of human effectiveness available to himself for 
conceptualizing it's end points. History has shown, 
time and time again, that it is with goals that man 
strives for what he sees as being right. It is with 
these goals that man achieves meaning and purpose in life, 
and without these goals there is no purpose or will to 
change, A review of the literature in this area reveals 
that the meaning of psychological health remains vague and 
clouded. 
Dr. Bernard Saper, writing in Mental Hygiene, 
January 1967, says positive mental health is "an 
adjustive process characterized simply by a normal zest 
for living and a reasonable ability to adjust without 
relying on professional mental health workers for help.” 
This sounds good, but what does he mean by the word 
normal? By whose standards could behavior be assessed as 
normal? Also, what does he mean by the phrase reasonable 
ability to adjust? What is reasonable? Reasonable to 
whom? Reasonable by what standards? These words 
generally go undefined and keep us from a clear 
understanding of what mental health really is. Can it be 
said that what is normal and reasonable for one person is 
not for another, or are we focusing on professional 
12 
cliches which only lead people astray, or are left to be 
defined in any way a person sees fit? Maybe the words to 
understand are not normal and reasonable, but the words 
zest and adjust. 
Mowrer (1954) and Scott (1958) attempted to 
clarify the concept of psychological health by reviewing 
the definitions of psychological health. They concluded 
that the concept was a statement of values, and that the 
formulation of a generally acceptable definition was 
unlikely. As an alternative, Allport (1961) and Maslow 
(1954;1962) proposed to measure a large number of 
positively valued characteristics as multidimensions of 
psychological health with the hope that such dimensions 
may be integrated eventually into a unified body of 
knowledge. 
Maslow saw human development as the process 
through which these basic human tendencies are actualized 
and full human potentialities fulfilled. He sees human 
personality as basically growing from within, rather than 
being shaped from without. Psychopathology, on the other 
hand, is seen largely as the result of frustrating, or 
twisting, man's essential nature from without. 
From his study Maslow listed fifteen 
13 
characteristics of the self-actualized person. They are: 
1. Realistic orientation. Self-actualizers are 
efficient perceivers of reality and are relatively 
unthreatened and unfrightened by the unknown. 
They do not show an over-powering need for 
certainty, safety, definiteness, and order. 
Acceptance of self, others, and the world. Self- 
act uaTTzers^EenH”to acceppTHem seTvesT^H e i r 
fellow human beings, and the natural world without 
shame, disgust, or hostility. 
3. Spontaneity. Self-actualizers tend to possess a 
zest and enthusiasm for living. They are able to 
capture "peak experiences" of living and to savor 
those without being weighed down by conventional 
cares and responsibilities. 
4. Problem-centeredness. not self-centeredness. 
Self-actualizers tend to focus on real problems 
and solutions. They work effectively and 
persistently at problem situations. They are not 
preoccupied with self-pity or inescapable 
circumstances. 
5. Detachment. They have an air of detachment and a 
need for privacy. They have a quality of self- 
sufficiency, and their interpersonal relationships 
are not characterized by possessiveness, 
dependency, and intrusiveness. 
6. Autonomy and independence. They are not 
overconforming or other-directed. They are 
not unduly affected by fads or crazes of the 
moment. They are relatively unaffected by either 
flattery or criticism. 
7. Appreciation. They have a wholesome, fresh 
appreciation for people and things. They are not 
rigid or stereotyped in their responses. 
8. Spontaneity of experience. Most self-actualizers 
have experienced some sort of deep mystical or 
"oceanic" experience. 
9. Identification with mankind. They have a basic 
feeling of caring'and belonging to humanity. They 
experience genuine sympathy, compassion, and 
affection for their fellow man. 
10. Deepness of interpersonal relationships. They 
share intimate relationships with a few specially 
loved people. They are selective in the 
14 
establishment of such close relationships, but 
also handle more superficial relationships 
smoothly and effectively. 
11. Democratic values and attitudes. They show 
religious, racial,"and e'B&nic acceptance rather 
than intolerance. 
12. Differentiation of ends and means. They are able 
to distinguish Between ends and means and pursue 
ethical ends with firmness and certainty. 
13* Philosophical humor. They possess a spontaneous, 
philosophical sense of humor. Their humor is not 
hostile or degrading to others. 
14. Creativeness. They are creative, original, and 
divergent in thinking. 
15* Resistant to conformity. They are resistant to 
blind conformity to the culture. They exercise 
individuality and thoughtful responses to cultural 
patterns. 
Gordon Allport (1955)i in describing the nature 
of psychological maturity, lists six ma^jor character¬ 
istics; 
Extension of self. The mature person is able to 
extend bis concept of self through feelings of 
caring and belonging to other individuals," 
causes, and institutions and even to mankind 
itself. Through this process of self-extension, 
the welfare of others becomes as important as the 
welfare of self.... 
2. Warm relating of self to others. The mature 
person is capable of intimacy and love. His 
interpersonal relationships are characterized by 
empathy and compassion, rather than possessiveness 
and hostility. The mature person is able to give 
love, while the immature person wants to be loved. 
• • • 
3. Emotional security. For the mature personality, 
emotional security arises out of acceptance of 
self. This security allows him to tolerate 
frustration and avoid overreaction to disturbing, 
but relatively inconsequential, situations. This 
security is reflected in self-control and the 
15 
ability to defer gratifications or adjust to the 
inevitable.... 
4. Realistic perceptions, skills, and assignments. 
5?!ie "mature person is able to function efficiently 
in the areas of perception and cognition. He is 
capable of accurate and realistic intellectual 
behavior. He also has a repertory of effective 
problem-solving skills and techniques. 
5. Self-objectification, insight, and humor. The 
maiure personaii'fcy has realistic self-insight. 
He understands himself. He has a corresponding 
sense of humor. He is able to laugh at himself. 
These characteristics are a result of his ability 
to put himself in perspective without distortion.. 
• • 
6. A unifying philosophy of life. The mature 
personality has worked out some type of unifying 
approach to life that gives consistence and 
meaning to his behavior.... 
Carl Rogers sees the effective human personality 
as a fully functioning person always in the process of 
becoming. Rogers (1961) lists three major characteristics 
of this hypothetical personality: 
1. This person would be open to his experiences; 
that is, he is not defensive or resistant to 
those aspects of his environment that might 
produce change. All the aspects of his environ¬ 
ment are available to him in the form of accurate, 
realistic perceptions. There are no built-in 
barriers that shut out the possibility of fully 
experiencing his environment. 
2. This person will live in an existential way; 
that is, he experiences life in terms of an 
ongoing, becoming process. He lives in a fluid 
stream of experience rather than in a rigid or 
stereotyped way. There is an absence of tight 
organization or imposed structure. 
5* This person trusts himself. He is willing to do 
that which “feels right”, and finds his feelings 
a trustworthy guide to behavior. He has the 
16 
feeling of direction and consistency that flows 
out of him rather than feeding in from his 
environment. 
Rogers* writings, as well as those of Maslow and Allport, 
reflect the same idea, and all of these authors suggest 
that such a person might be seen as the end-product of 
the process of psychotherapy. 
Everett Shostrom (1964) did a study for the 
purpose of developing an inventory for the measurement 
of self-actualization. After reliability coefficients of 
.91 and .93 were established by test-retest methods, 
validation studies were initiated. The following 
adjectives were found to describe persons nominated by 
psychologists as "non-self-actualized** and "self- 
actualized" at the .01 level of significance: 
I. Adjectives used to describe persons 
nominated by psychologists as "Non-Self- 
Actualized" 
bigoted, biased 
puritanical 
rigid, compulsive 
frustrated, blocked, seeking, unfulfilled, empty, 
unsatisfied 
cold, frigid 
frightened, fearful 
constricted, inhibited, limited 
anxious, worried, apprehensive, tense 
insecure, unsure 
uncomfortable, disturbed 
egocentric, self-pitying 
reticent, timid, shy, cautious 
17 
self-conscious, sensitive 
forlorn, depressed, unhappy, pessimistic 
passive, lethargic 
flattened, flat 
unaware, unrealistic 
non-risking, non-committing 
pleasant, Msweet" 
immature, infantile, dependent, other-centered, 
pseudo-independent 
withdrawn, alone, isolated, sex-avoidant 
self-disparaging, self-depreciating 
guilty 
inauthentic 
symptom-ridden, anorexic 
ambivalent, confused, scattered, disoriented, 
schizoid, unorganized, moody, inconsistent, 
indecisive, inefficient, aimless, mood- 
dominated 
hostile, angry, embittered, hypercritical, sarcastic, 
harsh, critical, self-critical 
projecting 
acting-out 
suspicious 
dominating 
II* Adjectives used to describe persons nominated 
by psychologists as MSelf-Actualized” 
active, busy, involved, participant, energetic 
motivated, concerned, hard-working 
constructive, productive, creative, enterprising, 
alert, imaginative 
giving, helpful, generous 
eager, life-appetitive, enthusiastic, adventurous, 
sensual 
optimistic, confident 
enriched 
happy, warm 
responsible, stable, mature, self-assured, 
independent, reliable, dependable, self¬ 
directing 
balanced, moral, adjusted, honest 
realistic 
conscientious, dedicated, thoughtful, discriminating 
patient, aware, empathetic, kind, sensitive, 
18 
sympathetic 
feeling 
non-defensive, open, self-exploring, out-going, 
direct, spontaneous, non-threatened, responsive, 
non-threatening 
seeking, searching, still-learning 
democratic 
social, friendly, personable, gracious, appreciative, 
delightful, humorous, loving, sincere 
adaptable, flexible 
content, satisfied 
accepting, calm, quiet, unassuming, tolerant 
modest, humble 
organized, efficient, integrated, well-functioning 
competent, capable, intelligent 
successful 
Milton E. Foreman (1966) did a study on "Some 
Empirical Correlates of Psychological Health” using 
eleven highly valued characteristics as the selected 
dimensions of psychological health. His findings 
strongly suggest that subjects nominated as optimally 
healthy behave in a manner very different than subjects 
presumed to be of normal psychological health. The 
optimally healthy subjects showed more active involvement 
with their immediate environment than normal subjects. 
They were also more open in their admission of personal 
problems and limitations, and in spontaneous and diverse 
expression of both their positive and negative feelings. 
Finally, the zestful subjects demonstrated their higher 
level of psychological health to the Judges through the 
19 
manner in which they related to others in small 
discussion groups. 
Frank Barron (1954) used the concept of 
"soundness" to study the effective personality. 
Soundness was defined as one’s maturity and effectiveness 
in interpersonal relationships. This study discriminated 
oetween those students rated as sound and those rated as 
less sound on the basis of four characteristicsj 
1. Effective organization of work. The highly rated 
subjects tended to be more adaptable and 
resourceful and to have greater energy and 
resistance tc stress. 
2. Accurate perceptions. The highly rated group 
scored higher on tests of perceptual accuracy. 
They also seemed to have greater insight and 
understanding about themselves. 
5* Ethical integrity. The higher rated group was 
described as more dependable and to have strong, 
internalized, moral principles. 
4. Adjustment to self and others. The "sound" 
group was considered less defensive, distrustful, 
and egotistical. They described themselves as 
happier. 
Roy Heath (1959)* who investigated the problem of 
typologies in normal personalities, found that of the 
thirty-six college students he followed, a few of them 
seemed to function on a level different from all the 
others. He referred to these men as the "Reasonable 
Adventurers." Their characteristics included: 
20 
1. Contact between inner and outer selves 
2. Initiative coupled with reflection 
3. Curiosity coupled with critical thinking 
4. Close interpersonal relationships but independence 
of judgment 
5. Tolerance of ambiguity 
6. Sense of humor 
...Thus, his Reasonable Adventurer is...a 
striving human being who achieves a high level of 
functioning through his own unique pattern of 
individual development. 
There are several studies (Golden, Mandel, Glueck, and 
Feder, 1962; Barron, 195^; Thorne, 1958) which have 
described the characteristics of normal persons who 
possessed neither outstandingly healthy nor unhealthy 
features, while there are other studies which describe 
some of the measured attributes of adjudged 
psychologically healthy persons (Mehlman and Kaplan, 
1958; Schultz, 1958; Heath, 1959). 
Still others have compared the characteristics of 
subjects representing higher levels of mental health 
with those of essentially normal subjects who possessed 
either negatively valued characteristics or were rated 
low on the criteria of selection (Barron, 1954; Bond, 
1952; Bonney, 1962; Seeman, 1959; Foreman, 1966). 
Authority and peer ratings, membership in special groups, 
sociometric data, interviews, personality testing, and 
21 
case history reports were the primary methods used to 
identify psychologically healthy subjects. 
Hart and Tomlinson, in their book New Directions 
in Client Centered Therapy (1970), state that 
psychological functioning can be located on a continuum 
which at one end is rigid, fixed, and static, and at the 
other end is flexible, flowing, and changing. This 
dimension applies to our inner experience and to the 
meanings this experience has for us. If our experience 
is in the process of changing, and is flowing and 
continually meaningful, we are psychologically healthy. 
But if our experience is in the process of being static, 
repetitious, and unresponsive, we are psychologically 
maladjusted. At the low end on the continuum the client 
does not see problems, or sees them as completely outside 
himself. He does not discuss personal relevant material 
and is distrustful, closed, and feels an impersonal 
relationship with the therapist. In the middle part of 
the continuum he recognizes his own contributions to the 
problem and makes attempts to understand what is going on 
inside. At the high end of the continuum he is resolving 
the problem through self-exploration and understanding. 
He expresses himself fully in a spontaneous and open 
22 
fashion, and is very trustful and open to a personal 
relationship with the therapist. 
Salter (1961), in his hook Conditioned Reflex 
Therapy, would describe this continuum of psychological 
health as representing degrees of excitation or 
inhibition. Salter sees excitation as the basic law of 
life, and neurosis as the result of inhibition of 
natural impulses (spontaneity, outgoing feelings, etc.). 
Every human would fall somewhere on a line between pure 
excitation and pure inhibition. 
Rudolph Dreikurs (1968), in his writings on 
personality theory and human growth and development, 
speaks of something very similar when he describes the 
pitfalls of man's striving to be superior to others, as 
opposed to feeling inferior. To Dreikurs, personality 
can be described in terms of the way a person moves. 
People apply themselves in two ways, and these two ways 
of applying one's self can be described in terms of a 
horizontal plane and a vertical plane. Those people on 
the horizontal plane are continually moving toward others, 
and are genuinely interested in people. This is clearly 
distinguishable from the vertical plane, in that 
whatever those people on the vertical plane do, it is 
23 
because they want to be higher on the plane, or better 
than others. 
When a person moves on the vertical plane, he 
is constantly moving up and down. This person can never 
be sure that he is high enough on the plane, nor that 
he can stay there; therefore he lives in tension, fear, 
and anxiety. He is in constant fear of making a mistake 
and is continually defending himself. Because of this he 
adapts slowly, is very rigid in his movements, and will 
rarely look inside himself in self-exploration and admit 
there is something wrong. He dreads change unless he 
has complete control over it. 
Quite different is a movement on the horizontal 
plane. A person who moves on this plane is constantly 
moving ahead in the direction he wants to move. He does 
not move up but he moves ahead. If something goes wrong, 
he is flexible and adapts by considering what is going 
on and trying to find ways around it, or ways of remedying 
it. He is more spontaneous and is motivated by personal 
interest and curiosity. If his motivations are very 
strong he may even have enthusiasm and a sense of 
excitment, but he does not think about his own self¬ 
elevation. He is more interested in functioning instead 
24 
of being concerned with status or prestige. He encourages 
and is not threatened by self-exploration and personal 
change. Life becomes a constant process of becoming and 
growth, with each day being a little bit different and 
generally met with hope and anticipation. 
COUNSELING RELATIONSHIP 
In what way is this growth process, this process 
of becoming, facilitated in a counseling relationship? 
Are there conditions beyond one's theoretical orientation 
which must be met to insure a growth-producing 
relationship? 
Whitaker and Malone (1953)i in their book The 
Roots of Psychotherapy, defined counseling as an 
interpersonal relationship that accelerates growth of 
one or both participants. It was during the period of 
1950 to 1%3 that Carl Rogers presented to the 
professional world a host of published studies, articles, 
and books on what he saw as the necessary and sufficient 
conditions for human growth in a helping relationship. 
During this period (approximately 1950 to 1970) scores of 
researchers, desiring to know whether Rogers' process 
equation was valid and reliable, took parts of his 
25 
theory and put them through a series of objective and 
scientific test procedures. 
Carl Rogers (1958), as well as other client- 
centered counselors, has written extensively about the 
nature of helping relationships. Rogers believes very 
strongly that the formation of helping relationships 
depends not upon any set of techniques that the counselor 
may or may not have mastered, but rather upon the kinds 
of attitudes that the counselor holds about himself, 
his client, and the nature of their interaction. Rogers' 
approach to the nature of the helping relationship can 
partially be summarized by paraphrasing a number of 
questions that he says counselors might ask themselves 
as they approach the counseling relationship. These 
questions include: 
1. Can I be, in some way that will be perceived 
by the other person, dependable or consistent in some 
deep sense? 
2. Can I be expressive enough as a person that 
what I communicate will be communicated unambiguously? 
3. Can I let myself experience positive attitudes 
toward the person-attitudes of warmth, caring, liking, 
interest, and respect? 
26 
Can I be strong enough as a person to be 
separate from the other self? Can I be a sturdy respecter 
of my own needs as well as his? 
5. Arc I secure enough within myself to permit 
him his separateness? 
6. Can I let myself enter fully into the world 
of his feelings and personal meaning and see these as 
he does? 
7. Can I be accepting of each facet of his other 
person that he presents to me? 
8. Can I act with sufficient sensitivity in the 
relationship that my behavior will not be perceived as 
a threat? 
9. Can I free him from the threat of external 
evaluation? 
10. Can I meet this other individual as a person 
who is in the process of becoming, or will I be bound 
by his past and by my past? 
In other writings Rogers distilled these questions 
further into a theoretical equation which states that if 
certain therapist behavioral conditions are obtained 
(empathy, positive regard, unconditionality, congruence), 
then certain other responses would be observed in the 
27 
client (increased self-awareness, autonomy, movement from 
rigidity to flow, etc*)* Rogers* theory, as quoted by 
Hart and Tomlinson (1970:175)» holds that 
.♦•certain conditions are necessary and sufficient 
to produce productive personality change in the client, 
and that the amount of process change is proportional 
to the degree to which the therapist provided the 
conditions and the degree to which the client is aware 
of their presence. If the client perceived the 
presence of conditions of empathy, etc. and those 
conditions are present in optimum degree then the 
client should grow along predicted lines. To the 
degree the client failed to perceive the conditions, 
or if they were not optimumly provided, the client’s 
progress would be proportionately retarded. 
Experience vs. Theoretical Orientation 
One study quoted most often in this area is that 
done by Fiedler (1950), who attempted, basically, to 
answer two questions: 1) Do therapists with divergent 
theoretical views differ in their concept of an ideal 
therapeutic relationship? 2) Is the concept of an ideal 
human relationship unique to psychotherapy, or does it 
simply represent a general view of good interpersonal 
relationships? 
In attempting to answer the first question 
Fiedler had groups of experienced and inexperienced 
therapists from several theoretical orientations 
(psychoanalytic, nondirective, Adlerian, and eclectic) 
28 
sort a set of statements describing the ideal therapeutic 
relationship. In analyzing the data, Fiedler (1950:241) 
found that the 
...psychoanalytically oriented therapist 
correlated with the nondirective therapist, who is 
considered an expert, .77 and .72, while they 
correlated with psychoanalytically oriented inexpert 
therapists, .61 and .57* The differences between 
these correlations are significant at the .05 
level or above. The nondirective expert, who had 
correlated with the psychoanalytical therapists 
•77 and .72, correlated only .64 with the less well 
trained nondirective therapist, a difference also 
significant at the .05 level or above. 
In answering the second question, Fiedler 
compared the results of non-psychologically trained 
raters with those of the therapists. Ke found that 
non-psychologically trained raters had very high agreement 
with therapists in describing the nature of an ideal 
therapeutic relationship. The overall correlation for the 
second question was .92. 
Fiedler concluded that therapists of different 
orientations do not differ from each other or from 
laymen in describing the nature of an ideal therapeutic 
relationship. There were five areas in which Fiedler 
(1950:259-245) found a generally high agreement. These 
areas are: 
1. The therapist is able to participate completely 
29 
in the patient's communications# 
2# The therapist's comments are always right in line 
with what the patient is trying to convey. 
3* The therapist is able to understand the patient's 
feelings. 
4. The therapist really tries to understand the 
patient's feelings. 
5. The therapist always follows the patient's line 
of thought. 
Fiedler found evidence in his study that 
experienced psychoanalytic, client-centered, and Adlerian 
therapists were more alike in their behavior than were 
the experienced versus inexperienced therapists within 
any one of these orientations. Although Strupp (1955a) 
reported differences in the types of responses used by 
client-centered and psychoanalytically oriented 
therapists, his results showed that the more experienced 
the client-centered therapist is, the more similar his 
responses are to those of the psychoanalysts. In another 
study, Strupp (1955b) concluded that "...professional 
affiliation exerts a relatively minor influence upon 
the kinds of techniques used by psychiatrists, 
psychologists, and psychiatric social workers." 
Wrenn (I960) found that greater differences 
occurred among the situations studied than between 
30 
theoretical groups, and possibly in situations which 
place an implicit pressure upon the counselor to make a 
socially conventional response. A year later Grigg (1%1) 
found, from a study of three different levels of 
professional development in counseling psychologists, 
that as a counselor acquires more clinical experience 
his behavior shifts from being more active, more verbal, 
more prone tc give forth with interpretations and 
advice, to being more of a careful listener and partner 
with the client in assisting the client to work through 
the problem. 
Genyea (1963), in a study of 208 clients of the 
University of Texas Testing and Counseling Center and 
eight counselor-interns, found by using the quality of 
therapeutic relationship, as defined by Fiedler (see 
page 28), that therapeutic effectiveness and quality of 
therapeutic relationship are both correlated with 
therapist experience, but not with each other. 
On the other hand, in more recent studies 
Watley (1967) found a difference between the counseling 
philosophy of the trait-factor counselors and client- 
centered' counselors, and that of the counselor's 
predictive skills. 
31 
The counselor's predictive skills were based on 
freshman grades and whether students would persist and 
be scholastically successful in the educational programs 
selected at the time of admission to college. The 
trait-factor counselor predicted both of these outcome 
criteria more accurately than the client-centered 
counselors at the .05 level of significance. Watley's 
findings suggest that the counselor's philosophy, or 
theoretical orientation, does make a difference. 
Pepyne and Zimmer (1971) found that a difference 
exists among counselors' (Rogers, Ellis, and Peris) 
manifest style of intervention. This was shown to be 
directly related to their respective theoretical 
orientations, suggesting that theoretical orientation 
and style cf intervention are significant variables 
among "well experienced counselors." 
Truax and Carkhuff (1966) have identified 
counselor conditions which are common regardless of the 
theoretical orientation espoused by the counselor. These 
conditions are referred to as the core of facilitative 
conditions and have been labeled empathic understanding, 
positive regard (warmth), and genuineness. Truax and 
Carkhuff's (1964) efforts suggested that the level of the 
32 
facilitative conditions offered by the counselor is 
related closely and positively to growth on the part of 
the client. Implicit in this conjecture* as is similarly 
suggested by Regers, is that counseling can be for the 
better when high-facilitative conditions exist, or for 
the worse when low-facilitative conditions exist. 
Facilitative Conditions 
Carkhuff and Berenson (1967), in their book 
Beyond Counseling and Therapy, present a five-point scale 
which they used to assess the facilitative dimensions 
related to improved functioning in interpersonal 
relationships. This scale measures the presence of or the 
lack of presence of, and the degree of their presence in 
or lack of presence in: 1) empathic understanding, 2) 
respect or positive regard, 3) facilitative genuineness 
or congruence, 4) personally relevant concreteness 
(terminology), and 5) self-exploration. 
On all scales, level three was defined as the 
minimally facilitative level of interpersonal 
functioning. Levels four and five were most desirable 
and levels one and two were least desirable. In their 
results they found that lay helpers, college freshmen, 
33 
the general public, and outpatients functioned, on the 
average, between 1*49 and 1*59* At the other extreme 
of those measured they found experienced counselors and 
therapists, graduate students (psychology), and teachers 
functioning between 2*10 and 2*35* In all of those 
measured there were very few who functioned at a three or 
above level. 
Carkhuff and Berenson also found, in two other 
studies using this same measurement of facilitative 
interpersonal functioning, that clients of those 
counselors offering the highest levels of facilitative 
dimensions improve, while those of counselors offering 
the lowest levels deteriorate. They also found evidence 
in their studies to support the idea that in seeking 
help from nonprofessional sources the patient stood an 
excellent chance of receiving functionally the same 
levels of facilitative dimensions as they might receive 
from professional helpers (Eysenck, 1952; Levitt, 1957)* 
Ruth Dombrow (1965) suggests, in a study of 
twenty-nine bothers at a child guidance clinic and 
fourteen social workers as therapists, that empathy on 
the part of the therapist was a significant (.05 level) 
factor in changes in the patient’s self-concept during 
3^ 
therapy. 
Mickelson and Stevie (1971)» in a study of the 
differential effects of facilitative and non-facilitative 
behavioral counselors, found that behavioral counselors 
who were facilitative (high in their offerings of warmth, 
empathy, and genuineness) were more effective than 
non-facilitative behavioral counselors (low in their 
offerings of warmth, empathy, and genuineness). The 
results demonstrated that facilitative counselors were 
able to engage their clients in a significantly (.01 
level of significance) greater amount of verbal 
information-seeking behavior. 
The crucial variable affecting the response 
pattern of clients seems to be the quality of the 
relationship created by the facilitative counselor. The 
lack of between-group differences in the frequency with 
which counselors make rewarding phrases or statements 
emphasizes this point. Verbal reinforcement, by itself, 
is not an effective technique in engaging the client in 
information-seeking behavior. The reinforcing value of 
the relationship proposed by Truax (1966a) significantly 
affected the acceptance by the client of the reinforcing 
stimuli. The facilitative counselor emerged as a more 
35 
potent reinforcer* 
In another recent study, Abeles and Mullen (1971) 
found, using tape recordings representing samples of 3% 
recorded interviews from the completed cases of 36 
clients scored for accurate empathy and liking, that high 
empathy and high liking together did not predict 
successful outcome* But by taking a separate look at the 
variable of empathy, significant relationships were found 
between high conditions of empathy over any stage of 
therapy and successful outcome. They also found a clear 
relationship between low conditions of empathy throughout 
all stages of therapy and outcome categorized as 
unsuccessful* These results were significant at the 
•01 level. 
Abeles and Mullen’s results also indicate at the 
.04 level of significance that inexperienced therapists 
are generally less empathic than experienced therapists, 
suggesting that because of their greater experience and/or 
training, they are generally more aware of all levels of 
the client's feelings throughout therapy. These findings 
tend to support the idea that high levels of empathy are 
necessary but not necessarily sufficient in itself for 
success in therapy. 
36 
A study done by Blackman, Smith, Brockman, and 
Stern (1938) in male schizophrenics found the absence of 
empathy as the most important feature in psychotics, and 
the improvement of their capacity for empathic 
understanding as the key development in their over-all 
improvement. Implicit in their theorizing is the 
assumption that the person, in his relations with others, 
shows the way he feels about himself. Cnly to the degree 
that he understands and respects a full range of 
experiences in himself can he understand and respect a 
full range of experiences in others. 
More recently, Melvin Foulds (1969)$ in a study 
on "Self-Actualization and the Communication of 
Facilitative Conditions During Counseling," found a 
significant (.03 level) relationship between self- 
actualization, as measured by a Personal Orientation 
Inventory, and the ability to communicate "empathy" 
and"genuineness," therefore supporting the idea that 
empathy and genuineness are more than just two terms 
used to describe a counseling process. They are two 
vital, interdependent parts of the way persons 
communicate with themselves as well as with each other. 
Lesser (1961), in a study comparing the 
37 
relationship between counseling progress and empathic 
understanding, found that maximum empathic understanding 
is not necessarily most conducive to counseling 
progress; it is only when the counselor correctly 
perceives the degree of similarity between himself and 
his client that he apparently perceives more correctly 
what the client is saying and feeling than when he merely 
feels similar to the client, or further, overestimates 
their similarity. Lesser is suggesting that there is a 
difference between just empathy and accurate empathy; 
that it is only when the counselor correctly or accurately 
perceives the similarity between himself and the client 
that progress or growth may occur; that under or over- 
estimation of these similarities may actually hinder any 
progress. Truax and Carkhuff (1964) suggest something 
similar when they found a positive correlation between 
concreteness and depth, or patient intrapersonal 
exploration. They define concreteness as the ability of ■ 
the therapist to: 1) ensure emotional proximity; 2) 
enhance the accuracy of the therapists response; 3) 
be able to encourage specificity in the client’s efforts. 
A study by Combs and Soper (1963) was done to 
determine what counselor personality characteristics 
38 
were associated with counseling effectiveness, as 
fudged by a counselor education staff. They evaluated 
protocols obtained from twenty-nine counselors in 
training. These protocols were obrained from papers 
submitted by students describing a human relations 
incident. The protocols were scored by judges on the 
basis of twelve perceptual constructs based on how the 
subject perceived himself and others and how he perceived 
the nature of counseling. Scores on these constructs 
were then correlated about the effectiveness of the 
counseling students at the end of training. Ten of the 
twelve correlations were significant at the .01 level. 
Five of these significant correlations are presented here 
because of their similarity to the findings of other 
researchers: 
1. Sees people as able rather than unable 
2. Sees counseling as freeing rather than controlling 
3. Sees people as friendly rather than unfriendly 
4. Sees self as identified rather than unidentified 
5. Sees self as revealing rather than unrevealing 
Combs and Soper interpreted their results as indicating 
that counselor attitudes and perceptual processes are the 
important determinants of counselor effectiveness. 
Halkides (1938) studied the relationship of the 
following conditions to success in therapy: 
39 
1. the degree of empathetic understanding of the 
client manifested by the therapist, 
2. the degree of positive affective attitude 
(unconditional positive regard) manifested by the 
therapist toward the client, 
3- the extent to which the therapist is genuine 
or congruent, his words matching his own internal 
feelings, and 
4. the extent to which the therapists response 
matches the client's statements in the intensity of 
affective expression. 
When she had Judges rate the degree of these conditions 
in the recordings of interviews of ten cases found to be 
successful on multiple criteria, and ten unsuccessful 
cases, she found that all these conditions were 
significantly associated with the more successful cases. 
An associated study done a year later by Barrett 
and Linnard (1939) also investigated the effects of the 
client's experiences of these conditions, but it was done 
by having clients themselves, not Judges, complete a 
relationship inventory. They found that clients improve 
in their adjustment according to the extent they perceive 
their therapist fulfilled these conditions (understanding, 
40 
congruence, and positive and unconditional regard). 
Truax (1963) reported a series of studies that 
analyzed interviews of clients ranging from college 
students to hospitalized schizophrenics. Personality 
test results were used as criteria of improvement or 
deterioration. When interviews were analyzed, those 
subjects who were Judged as improved were found to be in 
counseling relationships with therapists whose behavior 
was rated significantly higher on empathy, unconditional 
positive regard, and self-congruence. Patients who were 
judged as deteriorated were correspondingly found in 
relationships with therapists Judged low on all three 
variables. The level of significance of Truax* findings 
is between .01 and .03. 
Truax (1963:263) came to four basic conclusions 
as to what the role of the therapist is. These conclusions 
are: 
1. As therapists, we might aim toward a more 
clear and sensitive awareness of the patient's 
inner being; towards a greater ability to deeply 
understand the patient's moment-to-moment feelings 
and experiencings....It would mean that as ther¬ 
apists we would concentrate less upon developing 
skill at highly intellectualized diagnostic 
formulations and more upon developing skill at the 
moment-to-moment-diagnosis of the patient's 
"being." 
41 
2* As therapists we could allow ourselves to express 
more openly our deep caring for the person who 
comes to us for help: to do this unconditionally 
would be to set no conditions on the prizing of the 
person. 
3* As therapists we can afford risking confrontation 
with the patient as a person rather than as an 
institution. Cur open or nondefensive intactness, 
our human genuineness encourages the patient to 
also deeply ,,beM himself within the relationship. 
4. Finally as a therapist, that if we are not able to 
offer these therapeutic conditions to a particular 
patient, then we would best serve the interest of 
that patient by helping him to find another 
therapist. 
In a study aimed at cross-validating research 
done in 1963 Truax (1966b) found that high levels of 
therapeutic conditions not only tend to produce a greater 
degree of patient improvement but also seem tc be an 
important factor in minimizing patient deterioration 
during psychotherapy. This is consistent with the 
hypothesis that psychotherapy can be for better or for 
worse, depending upon the levels of conditions provided 
during treatment. 
The findings from the analysis of the effects of 
nonpossessive warmth raise a question about its separate 
contribution to outcome (apart from its contribution in 
association with empathy and genuineness). Contrary to 
Truax*s original hypothesis, the findings suggested that 
42 
warmth, by itself, tended to have no effect or a negative 
effect. It was also found that, in the present sample 
of therapists, warmth was negatively related to 
genuineness and empathy. In several prior studies 
empathy, warmth, ana genuineness have all been highly 
intercorrelated (Earrett-Lennard, 1959; Halkides, 1956; 
Truax, 19bl, 19b5). One of the aspects of this study 
suggests that empathy, warmth, and genuineness, though 
usually highly intercorrelated, can vary independently 
across different samples of therapists. In another 
study by Truax, Carkhuff, and Kodman (1965), which 
focused on the relationship between therapeutic conditions 
and patient out;come in group psychotherapy, it was found 
that in that sample of therapists, accurate empathy and 
warmth were highly intercorrelated and both were 
negatively associated with genuineness. In that study, 
empathy and warmth were positively associated with patient 
outcome, while genuineness was negatively related to 
outcome. (See also a study by Truax and Carkhuff, 1965a.) 
Two studies in group psychotherapy (Truax, 
Carkhuff, and Kodman, 1965; Dickenson and Truax, 1966) 
suggest also that these therapist-offered conditions are 
significantly related to patient constructive personality 
43 
change within the group. This is true with both 
outpatient counseling cases and hospitalized schizo¬ 
phrenics, and with college underachievers. 
Lewis Stoffer (1%8), in his doctoral thesis, 
studied the relationship of thirty-five elementary school 
children who were experiencing academic and behavioral 
problems, and rhirty-five untrained adult volunteer 
helpers who saw them twice a week for three months. His 
findings generally support those of Rogers, Carkhuff, 
Truax and others, that those helpers who were Judged as 
having provided high levels of nonpossessive warmth, 
accurate empathy and genuineness were more successful in 
bringing about gains in achievement, reduction in 
behavioral problems, and gains reflected by the combined 
outcome index. 
Manipulating Therapist-offered Conditions 
Considerable evidence has been presented, up to 
this point, that therapists may be divided into high and 
low-functioning groups (Truax, Wargo, and Silber, 1%6; 
Carkhuff, 1967; Carkhuff and Berenson, 196?; Truax and 
Carkhuff, 1963b; Truax,. 1963; Truax and Carkhuff, 1964, 
1967; Mickelson and Stovic, 1971; etc.). In several more 
44 
studies self-exploration by the client was shown to be a 
significant factor in successful therapeutic outcome 
(Rogers, 1964; Truax and Carkhuff, 1964, 1967). To be 
even more specific, a number of studies demonstrate 
differential effects of manipulating therapist-offered 
conditions of empathy, positive regard, genuineness, and 
concreteness by high- and low-functioning therapists upon 
the level of self-exploration of high- and low-functioning 
patients (Holder, Carkhuff, and Berenson, 1967; Pagell, 
Berenson, and Carkhuff, 1967; Truax and Carkhuff, 1965). 
Anderson (1966) reported that high-level 
therapists not only confront their patients more 
frequently but confront them more constructively. A study 
done a year later by Carkhuff and Alexik (1967) 
demonstrated that counselors who function at a low level 
tend to be manipulated by the degree of client self¬ 
exploration and client behavior, while high-level 
functioning counselors are not adversely affected by the 
lowering of client conditions but would instead continue 
to function at high levels of facilitative conditions 
independently of client behavior. Another published 
study by Kratochvil, Aspy, and Carkhuff (1967) suggested 
that high-level counselors who might, for a variety of 
45 
reasons such as personally stressful circumstances, 
deteriorate in the level of conditions which they offer, 
may have a negative effect upon the client's level of 
functioning. Similarly, initially low-functioning 
counselors, growing in a constructive direction, may have 
constructive effects upon the clients. Berenson, 
Mitchell, and Moravec (1968) in a similar study found 
that low-functioning therapists tend to have a much 
greater proportion of low self-exploring patients than do 
high-level therapists but that neither high nor low 
therapists were influenced by the level of self¬ 
exploration of the patient. 
More recently Hountras and Anderson (1969) 
found a significant relationship between counselor- 
offered conditions, as presented by Carkhuff and Berenson 
(1967)» and self-exploration in each problem category for 
counseling center clients of both sexes of fifty-four 
college students from the University of North Dakota. 
Recently, Joyce Pattison (1973) found a significant 
(at the .01 level) relationship between touch and self- 
exploration. Touch, she feels, is closely related to 
warmth, which has been found to be positively correlated 
with positive outcome and self-exploration (Truax and 
46 
Carkhuff, 1965a)* Patriscn raised two questions which she 
felt needed to be answered: What does touch or warmth 
provide for a client, and, as suggested by earlier 
research done by Truax (see page 56), does the degree or 
the presence of touch and warmth have to be the same 
throughout the counseling relationship? 
SUMMARY 
The review of literature was presented in such a 
way as to describe some of the major research concerning 
the nature of what growth and development is in the 
helping relationship, and in what ways it can best be 
facilitated by the counselor. 
Since 1950 a number of professionals have told 
the helping professions that there are conditions in the 
counseling relationship which must be met before growth 
and change can occur* During this time there has been an 
enormous amount of research and writings directed towards 
the two problem areas of what positive growth and 
psychological health is, and what conditions must exist 
in counseling relationships before positive growth and 
change can occur. 
The arguments and the discussions linger on 
47 
Authors draw from their own personal and past experiences 
as well as the experiences of others for the purpose of 
understanding human growth and development. Personal 
viewpoints are published and set before the eyes of other 
professionals to gain strength and assurance from one*s 
own peer group. So it is today with the problems of 
discovering what psychological health is and how it can 
best be facilitated. Recent articles in professional 
magazines make us aware of the yet unsettled conditions 
of these problems. To quote only a few, Robert Couchman 
(1974) says: 
The fact that 15 percent of our child and 
adolescent population suffers from serious mental 
health problems requires that we reexamine our 
traditional system for delivering services. Since the 
majority of troubled young people are not receiving 
help from specialists, the couselor should be con¬ 
sidered as a primary mental health resource. If this 
role is to be undertaken, however, counselors will 
require more adequate training than that which is now 
being provided. 
Hans Strupp (1973a), writing on the basic 
ingredients of psychotherapy, states: 
This article presents a parsimonious statement 
of essential conditions for psychotherapeutic change: 
(a) a helping relationship patterned after the parent- 
child relationship; (b) the creation of a power base 
from which the therapist influences the client 
through common psychological techniques; and (c) a 
client who has the capacity to profit from the 
experience. It is asserted that the full range of 
48 
common influencing techniques is inevitably brought 
to bear on any psychotherapeutic relationship, 
and this indeed constitutes one of its defining 
characteristics. These conditions are equally 
applicable to psychoanalytic psychotherapy and 
behavior therapy. 
In reply, Sol Garfield (1973) writes: 
Strupp has presented and discussed what he 
considers to be the essential and necessary conditions 
for positive change in psychotherapy, regardless of 
school. This attempt, which in part resembles and 
draws upon the views of Rogers...and Frank...appears 
to be an entirely reasonable and thoughtful one. 
However.... 
and he proceeds to develop a counter-argument. Then, in 
answer to Garfield's article, Strupp (1973b) makes the 
statement: 
This response to Garfield underscores the fact 
that the operations of psychotherapists share 
important processes with those of other influencers. 
Thus, psychotherapy is a special instance of a 
broader problem. There is more to modern psycho¬ 
therapy than "the relationship," but the latter 
typically serves as a powerful framework for 
therapeutic change. Within that framework, various 
"techniques" are potentiated. Conversely, it seems 
unlikely that "pure" techniques can be developed, nor 
would such techniaues be desirable from the human 
standpoint. 
and on and on goes the dialogue. Those who believe in 
Strupp's argument and the research based much earlier, 
will inevitably follow with research providing for scales 
to measure these basic ingredients, as well as people 
using the scales, and so on. Therefore^ it is in the 
49 
spirit of furthering the dialogue and gaining a greater 
personal understanding and insight into these two 
problems that this review of literature is presented. 
CHAPTER III 
DISCUSSION 
FORMULATION OF A THEORY 
The word theory is defined in the dictionary as 
a statement of general principles supported by data 
offered as an explanation of a phenomenon. Generally 
speaking, it is a statement of the relationship of 
factors Delieved to prevail among a comprehensive body 
of facts. 
Shertzer and Stone (1968) suggest the following 
about theories and the theorist: 
Theory is not generated in isolation but has 
personal, historical, sociological, and philosophical 
basis. It reflects the personality of its builder, 
his needs, and is a product of the time in which it 
appears and is used. 
Stefflre and Matheny (1968) have cited five 
formal attributes which should be present in a theory: 
1. A good theory is clear. It is understandable, 
and it's general principles are not self¬ 
contradictory. 
2. A good theory is comprehensive. A theory 
which explains the most phenomena is preferred 
over the one which explains a single phenomenon. 
3* A good theory is explicit. Precision is evident 
in it's terms and relationships and it's rightness 
or wrongness can be tested. 
4. A good theory is parsimonious. It explains 
data simply and clearly without unnecessary 
diversions. 
51 
5. A good theory generates useful research. 
The author will draw together that literature 
which has been presented, with the idea of developing 
the basis for a theory. The literature and it’s core 
ideas will be presented in this chapter in such a way 
as to make the two problems of this study (1. What is 
psychological health and growth, and 2. how can it best 
be facilitated?) more clear and understandable, and the 
solution a closer reality. It is in this chapter that 
the ideas and experiences of the author, as well as those 
of many other authors, will be refined, and a framework 
built from which these ideas may be better understood 
and the research and evaluation of them more easily 
generated. 
Psychological Health 
In developing a theory of psychological health, 
a framework of common factors of psychological health 
must be decided upon. This will, in turn, be used as a 
guideline for either developing a typological theory or 
judging other typological theories which are already 
available. 
The most obvious factors focused on by the 
52 
review of literature are: 1) The human being has a very 
complex and intricate nervous system which is affected 
by physiological, psychological, and sociological 
factors. 2) The person who is living at an optimum 
level of mental health is the one most often described. 
If a theory of psychological health is going to 
be developed or formulated, then, it must encompass the 
whole person: those factors which are considered most 
healthy as well as those factors considered most 
unhealthy. One must ask if there are central ingredients 
present which may be related readily to both healthy and 
unhealthy behavior. Every human being demonstrates 
essentially two types of behavior to some decree, which 
are usually described by the words rational and irrational 
(emotional). If a person's behavior is at one extreme or 
the other, then there must occur in that person's life 
some psychological and sociological adjustments. If this 
behavior is not accepted or approved by the society in 
which he lives, then it is generally labeled as mal¬ 
adjusted or unhealthy behavior. The converse is also 
true for healthy behavior. 
The key component is the word behavior. When one 
speaks of behavior one is generally describing some 
53 
muscular and/or glandular response of the body which is 
integrated into a form of action, conduct, or mannerism 
that is observable. Basic to understanding any behavior 
is an understanding of the feelings, emotions, and 
attitudes underlying that behavior, and the basic 
ingredient in understanding any feelings, emotions, 
and attitudes is an understanding of the language one 
uses to communicate and define them to oneself. 
Feelings, as defined by the dictionary, refer to 
any of the subjective reactions, pleasurable or unpleasur- 
able, that one may have to a situation. Feelings 
generally connote an absence of reasoning. Emotions, 
on the other hand, imply an intense, strong feeling with 
physical as well as mental manifestation of a specific 
feeling, or a number of feelings. Feelings are, in 
general, more subtle experiences than emotions and many 
times escape one's attention. 
Feelings are described by Meyers (1969) as being 
the aesthetic content of introspective experience. They 
can be attended to and savored for their own sake. 
Unlike emotions, they do not necessarily demand behavioral 
outlet. Feelings are immensely important in shaping the 
personality, and are the neurological base for most 
emotions. Feelings underlie our attitudes, and in 
attitudes lies much of our day-to-day behavior. If 
feelings are then ignored and left to themselves, they 
tend to cluster on the principle that "like seeks 
like." The feeling of indifference can invite the . 
feeling of futility, which Joins with that of 
resignation, and so on. This suggests that introspective 
attention to such feelings is important. One should note 
the strength of those feelings, the degree of their 
recurrence, the tendency of their associations, etc. 
Such attention may provide a basis for their alleviation 
or elimination. Desirable feelings may need cultivating; 
neglected, they wither on the vine. The tendency of 
feelings to recur is a normal response to approving 
attention (reinforcement). The importance of feelings 
is obvious once we understand that our attitudes towards 
self and others are largely dependent upon our 
experiencing desirable feelings. 
When discussing rational behavior, as opposed to 
emotional behavior, one is generally referring to that 
behavior which is sensible, logical, and cased on or 
derived from reasoning. This statement raises some 
rather interesting questions about reason and emotions. 
55 
Can all behavior which is thought through with reason be 
considered to be sensible, and conversely, can all 
emotional behavior be considered to lack sense and 
reasoning? In both cases the author suggests the answer 
is no. Thought and reason, as well as our emotional 
processes, are intertwined in our attitudes, which are 
directly supported by feelings, the neurological system, 
and it's perception of the environment in which it lives. 
Suggesting that one is necessarily more sensible or 
logical than the other is preposterous. 
Rogers (1962) suggests, in his theory of a fully 
functioning person, that a person must be able to trust 
his feelings and use them as a guide to behavior. It 
is in these feelings that man has consistancy of 
behavior and is more spontaneous, less anxious, and less 
rigid. Rogers, Maslow, and Salter would all agree that 
psychopathology is the result of the environment 
frustrating, confusing, and twisting man’s essential 
nature (feelings, emotions, and attitudes). 
Therapeutically, if one can come to know the 
nature of one's feelings and emotions, and in turn learn 
to identify and classify them, then by doing so one can 
change what seems to be irrational or emotional behavior. 
56 
By suggesting this the impression is left that becoming 
acquainted with one's feelings and emotions is a 
straightforward affair. In practice, people find that 
it is not. If requested to identify or articulate one's 
present feelings, people may respond hesitantly and 
confusedly. Perhaps the most important fact about 
feelings is that they often seem elusive and hard to pin 
down for identification. Of course this is not always 
true when feeling annoyed, sad, appreciative, 
affectionate, etc.; there may be no sense of elusiveness 
at all about these feelings, nor doubts about how to label 
them. Peelings can be as frank as one could wish. 
Every emotion has some effect on our functioning. 
There is a continual stream of feelings and emotions 
aroused by our dealings with the world around us. 
Perception ordinarily leads to an immediate intuitive 
appraisal, and that automatically results in emotions. 
Cnee feelings are aroused, it leads spontaneously to 
emotional expression. The emotional impulse urges a 
person not only to action but also to a preoccupation 
with the situation that has precipitated the emotion. 
It coerces attention and thus reinforces the emotion. 
When an emotion recurs persistently, the emotional 
57 
attitude that develops from it will eventually stand out 
among others and will dominate the person’s outlook as 
well as influence his bodily functions* 
The author is suggesting, then, that accurately 
expressed, understood, and accepted feelings may be the 
key to understanding one's behavior, which in turn may 
be the key to psychological health and growth* Such 
communication is a necessary ingredient in psychological 
health, and'facilitating this communication becomes a 
primary goal of most counseling psychologists* Blackman, 
Smith, Brockman, and Stern (1958) stated this very 
accurately when they said that only to the degree that one 
understands and respects a full range of experiences in 
oneself can he understand and respect a full range of 
experiences in others. This is the heart of our 
counseling problems. The counselor first must understand, 
accept, and respect a full range of experiences in himself 
then he must be able to develop a relationship that will 
allow the client to do the same. This will be discussed 
further in the subdivision Counseling Relationship. 
Joel Davitz (1969) did a series of studies on the 
language of emotions for the purpose of developing an 
instrument of measurement for explaining or defining 
58 
human emotions. His studies bring out the difficulty 
in describing and understanding one’s own feelings, or 
the feelings of a client. His study also serves as a 
typology for measuring and describing the actual 
movement of a client, and his feelings or emotions as 
he moves on the continuum (plane) of psychologically 
unhealthy to that of being psychologically healthy. 
Davitz does this by using the client’s own language of 
communication, perceptions, attitudes, feelings, and 
emotions to describe where he is at. This typology is 
clear, it is presented simply, and it reaches across 
and touches a broad range of theoretical orientations. 
It could be a useful tool (with testing and clarification) 
for looking at man's behavior in it's totality, ror 
these reasons the important parts of his studies will be 
brought out here to draw together that which has already 
been presented into an understandable and more concise 
theory of what psychological health is, and how it can 
best be facilitated. 
Davitz had fifty subjects describe, from their own 
experiences, fifty different emotional experiences which 
commonly occur in life. The subjects were given a 
checklist of 556 items referring to emotional feelings, 
59 
physical sensations, perceptions, and behavior concerning 
one’s self and one's’ relations to others, and were to 
use this checklist in describing their emotional 
experiences, Davitz then did a cluster analysis of these 
fifty emotional experiences using a phi coefficient at a 
,05 level of significance to determine to what degree 
each item followed similar patterns of presence and 
absence. Thus, over the fifty definitions of emotional 
experiences described, if a particular item in a given 
cluster appears in the definition of an emotional state, 
other items in that cluster also tend to appear in that 
definition. Similarly, if the item is absent from the 
definition, other items in the cluster tend to be absent 
from that definition. Twelve clusters were identified, 
and each cluster named according to the content and 
commonality of the items listed in the cluster. For 
example, in the cluster named Activation the word 
activation would seem to reflect the central meaning of 
feelings such as sense of vitality, aliveness, vibrancy, 
etc., while the word hypoactivation reflects feelings such 
as feeling empty, drained, hollow, or feeling heavy, 
lo&^y* sluggish, etc. The rest of the clusters are 
similarly named. (Samples of the clusters can be found 
60 
in Table I of the appendix.) 
Davitz also found that in the inspection of the 
definitions of emotional states, not only do specific 
items tend to occur together but also, clusters appear 
to be consistently related to each other. For example, 
scanning the definition of emotional states commonly 
viewed as pleasant indicates that activation and comfort 
both are present in the definition of many of these 
emotions, though with varying degrees of emphasis. 
By further combining the twelve clusters Davitz found 
two factors which accounted for most of the variance 
between clusters. The first factor is bipolar, defined 
by four clusters at one end (activation, moving toward, 
comfort, and enhancement) and the other eight clusters 
at the other end. This factor clearly involves a 
pleasant-unpleasant or positive-negative connotation. 
The four clusters of activation, moving towards, comfort, 
and enhancement define those emotional states commonly 
viewed as pleasant or positive, and the other eight 
clusters define emotional states commonly viewed as 
unpleasant or negative. 
Davitz described the second factor as involving 
a furtner clarification of the negative factors. He 
J 
61 
suggests that there are two types of negative clusterings, 
with type 1 involving hypoactivation, moving away, 
discomfort, and incompetenceidissatisfaction, while type 2 
involves hyperactivation, moving against, tension, and 
inadequacy. He suggests, from this, that there are three 
groups of clusters underlying the definition of emotional 
states. The first group is called Positive, and consists 
of activation, moving toward, comfort, and enhancement. 
The second group is called Negative: Type 1, and consists 
of hypoactivation, moving away, discomfort, and 
incompetencejdissatisfaction. The third group is called 
Negative: Type 2, and consists of hyperactivation, 
moving against, tension, and inadequacy. (Samples of 
these clusters can be found in Tables II, III, IV, and V 
in the appendix). 
The first group, called Positive, represents the 
high end of the continuum (that group which could be 
considerea optimumly healthy); the Negative: Type 1 group 
represents the middle of the continuum, and the Negative: 
Type 2 group represents the low end of the continuum 
(that group which could be considered unhealthy). 
Davitz, as well as Rogers, Maslow, Salter, and 
others, suggests that there are major dimensions of 
62 
emotional meaning which reflect unlearned, innate 
responses. 
The individual doesn’t have to learn to be 
activated, to move towards or away from others, to 
experience comfort or a sense of inadequacy or 
enhancement. However, in any given emotional state, 
the individual's reaction in terms of these four 
dimensions is undoubtedly influenced by previous 
learning. 
Thus, a previously neutral stimulus, as a consequence 
of learning, may acquire the capacity to elicit 
hyperactivation, the impulse to move away from others, 
tension, or a sense of inadequacy. 
The underlying key to psychological health and 
growth is the person's capacity to describe, verbally, 
a series of non-verbal phenomena for which there are 
no readily available, conventional labels; the capacity 
to shift perspectives, enabling one to experience 
emotions fully and directly without mediating labels 
(that is, without a constant process of self-conscious 
labeling, such as, "Now I'm happy; now I'm sad."), 
while still being able to view these emotions later 
with enough perspective to permit a full verbal 
report of the experience. When such feelings become 
inhibited and are not accurately described, understood, 
and accepted, they then become a hindrance to one's 
63 
psychological health or well being. 
The author is not suggesting that through this 
measurement or typology of Davitz', or through the 
review of literature, that a representative sample exists 
of the viewpoints on psychological health and growth; 
what is being suggested is that a significant relationship 
exists between Davitz' measure of emotions and the 
literature. The main focus of the review of literature 
is on that which is optimumly healthy human functioning. 
Davitz refers to that person by a simple measure of 
positive emotions called activation, moving towards, 
comfort, and enhancement. Within these categories are 
groups of emotions expressing in many different ways those 
feelings and attitudes that an optimumly healthy person 
would have. This includes those feelings and attitudes 
expressed by Maslow, Rogers, Allport, etc. in the review 
of literature. 
Davitz' study goes a little further, however, 
and discusses that person who may be considered in either 
category and is described by the emotional categories 
of hypoactivation, moving away, discomfort, incompetence, 
and dissatisfaction. The person who is described in 
terms of hyperactivation, moving against, tension and t 
64 
inadequacy would be considered to be revealing unhealthy 
emotional behavior or responses. These emotions would 
keep the person from a healthy adjustment to himself 
and his environment. This theory also seems to suggest 
that the road to mental or psychological health and 
growth, with one's self and one's environment, would have 
to progress along a continuum, one end representing 
Positive, the middle representing Negative: Type 1, and 
the other end representing Negative: Type 2, A person 
then could logically be located at any one point on the 
continuum, or a combination of any number of these three 
points. It also seems possible that a person could be 
located in one area with one kind of behavior and in 
another area with another kind of behavior. These are 
only a few of the many combinations which need to be 
tested by further research. This theory, or typology, 
could also suggest to a counselor which way a client 
might be moving by describing the person's feelings or 
attitudes about certain behavior, therefore giving the 
counselor an indication as to what he may need to do for 
that client, and what probable difficulties he may run 
into in achieving success. One of possibly many fallicies 
in this particular theory is that in working with humans, 
65 
people, through language, may say one thing about 
themselves (their feelings and attitudes) and their 
behavior demonstrates something entirely different. Only 
with use and much research can these problems be worked 
out. 
When measured by the criteria presented in the 
introduction, on the formulation of a theory by Stefflre 
and Matheny, the theory formulated in this paper offers 
the following: 
1. A clear and understandable principle which is 
not self-contradictory. 
2. A comprehensive theory which explains a 
broad range of phenomenon. 
3. An explicit and testable approach. 
4. A theory without a lot of diversions and 
language which is hard to understand. 
5. A theory which can generate a lot of useful 
research. 
This theory is therefore an acceptable framework from 
which to look at psychological health and growth. 
Counseling Relationship 
Carl Bogers (1957) stated over twenty years ago 
66 
what he thought were the key ingredients necessary for 
psychological change in the counseling relationship* 
Psychological growth or deterioration would occur in the 
counseling relationship to the degree that the client is 
aware of the presence of accurate empathy, genuineness 
or congruence, and unconditional positive regard or 
acceptance. 
Since that time these conditions have been 
included in many research studies, being described and 
measured in every way conceivable* In content these 
conditions are accepted by most counseling psychologists 
as being necessary (not necessarily sufficient in 
themselves, however) but there are many who still argue 
and reject them as being irrelevant, or minor factors. 
In describing the functions of Eogers* three 
conditions, and their relationship to counseling, one 
finds that the word congruence, or genuineness, refers 
to those conditions within the person in which his 
feelings, his awareness of his feelings, and his 
expression of them all correspond, or are congruent, with 
one another. In counseling it means to be continually 
working toward a more equal, full-sharing relationship. 
The word acceptance, or unconditional positive 
67 
regard (respect), means to value or prize all aspects 
of the client, including the parts that are hateful to 
himself or that appear wrong in the eyes of society. It 
means that the counselor does not attach "conditions of 
worth" to the client and does not manipulate the client 
into behaving in a way the therapist values; instead, 
he cares for the client without strings attached. It 
does net, however, necessarily mean that the therapist 
makes the client*s values part of his own values. 
The definition of empathy, or empathic 
understanding, as defined by Truax (1961:2-3) has 
generally been the most widely used definition in 
measuring it*s presence in a counseling relationship. 
Truax states that: 
Empathy involves both a sensitivity to current 
feelings and a verbal facility to communicate this 
understanding (of these feelings) in a language 
attuned to the client's current feelings. The 
therapist's responses...serve to clarify and expand 
the client's awareness of his own feelings or 
experiences. This is communicated...by the total 
voice qualities which reflect the seriousness, the 
intentness, and the depth of feeling. The therapist 
may be accurately describing psychodynamics to the 
patient but a lack of empathy would be indicated by 
such description being in a language not that of the 
client, or by being presented at a time when these 
dynamics are far removed from the current feelings 
of the client. 
Empathic understanding, then, involves the therapist's 
68 
ability, on a moment-to-moment basis, to allow himself 
to merge in the experience of the client, reflect upon 
this experience while suspending his own judgments, 
tolerate his own anxiety, and communicate his 
understanding clearly to the client. 
What has been described in these definitions is 
much like what Rogers, Maslow, Allport, Heath, and the 
others have described as what they consider to be 
optimum psychological health in people. Is this what we 
are suggesting, then, as the necessary conditions for 
facilitating psychological health and growth in others? 
Carkhuff and Berenson (1967) suggested that 
counseling is as effective as the counselor is living 
effectively. They then proceeded to develop a scale for 
counseling effectiveness, using the ingredients of: 
1) empathic understanding, 2) respect or positive regard, 
3) facilitative genuineness or congruence, 4) personally 
relevant concreteness (terminology), and 5) self- 
exploration. Since that time Carkhuff, Berenson, Truax, 
and others have done dozens of research projects, and 
have found success, using this scale and testing it's 
validity. 
The study done by Carkhuff and Berenson is 
69 
reinforced by the study done by Melvin Foulds (1969) 
when he compared self-actualization with the ability to 
comnunicate facilitative conditions during counseling. 
His findings suggest that self-actualization is 
significantly related to the ability to communicate 
empathic understanding and facilitative genuineness or 
congruence at the .09 level of significance. 
Foulds found that the ability of counselors to 
communicate empathic understanding seems to be related 
to the following personality characteristics: 
1. the feelings or attitudes of personal freedom 
or independence and internal direction based 
upon inner motivations rather than upon 
external expectations and influences, thus, the 
opposite of behavioral compliance; 
2. affirmation of the values associated with self- 
actualization and growth rather than conformity 
and "frczenness”; 
3* flexibility in the application of values rather 
than compulsivity or dogmatism; 
4. awareness of and sensitivity to one's own needs 
and feelings rather than estrangement from 
one's inner world of experience; 
3. the ability to accept one's natural agressiveness 
as opposed to defensiveness, denial, and 
repression of aggression; 
6. the ability to develop intimate and meaningful 
relationships with other human beings which are 
unencumbered by expectations and obligations, 
to develop "I-thou" relationships in the here 
and now, to contact the authentic "being" of 
another person, to invite intense involvement 
in human encounters, to enter in communion 
with another human being. 
70 
He found that the ability of counselors to 
communicate facilitative genuineness appears to be 
related to the six personality characteristics just 
mentioned, plus the four following personality 
characteristics: 
1. the ability to oe open and disclosing, to express 
feelings in spontaneous action; k 
2. the ability to like one's self because of one's 
strength as a person as opposed to feelings of 
low self-worth; 
3. acceptance of one's self in spite of one's 
weaknesses or deficiencies rather than inability 
to accept one's weaknesses; 
4. the ability to be synergistic, to transcend 
dichotomies, to see opposites of life as 
meaningfully related. 
The third condition (unconditional positive 
regard) was not found to be significant. Foulds offers 
this explanation: 
Cne interpretation of this finding is that people 
who perceive themselves as "helping" persons and plan 
to enter a helping profession such as counseling 
generally value highly human life and the dignity 
and worth of human beings. Therefore, this self¬ 
selection process tends to result in a relatively 
homogeneous group with respect to the facilitative 
attitude of respect or positive regard for clients. 
The validity of this explanation is not of 
concern at the moment. The fact that two of Rogers' 
three conditions appear on a scale to measure self- 
actualization and that all three appear to fall at the 
71 
positive end of Davitz' scale, as well as being closely 
related to all definitions presented on psychological 
health, is significant. Something other than theoretical 
orientation and technique is being discussed at this 
point; it is that which has to do with effective living, 
or optimum psychological health. 
Optimum psychological health is something 
different from what Pepyne and Zimmer (1971) and 
Watley (1967) were measuring. The argument is not 
necessarily whether theoretical orientation makes a 
difference, but whether there is something beyond these 
learned theories and techniques that allows the 
therapist to use himself and his personal repertoire 
of learning and experience most effectively. It is 
reasonable to assume that if the therapist has many 
feelings, emotions, and attitudes that he has not accur¬ 
ately described, understood, and accepted, then it is 
unlikely that he can use them effectively, and they may 
work against him rather than for him. These feelings, 
emotions and attitudes may come forth at any time in a 
counseling relationship, and if they are ineffectively 
dealt with, or cannot be used in a positive way in the 
relationship, then they may be harmful to the counseling 
72 
process. As suggested by most of the research presented 
in the review of literature, time and experience can be a 
prime factor in helping a counselor to overcome these 
factors. Learned techniques and theoretical orientation 
dees not seem to be of great importance in changing this 
or facilitating these conditions. 
McGreevy and Daane (1967)* in a study to determine 
the effects of counseling on the counselor by using a 
semantic differencial, suggest that counselors may alter 
their perceptions as a result of a counseling experience, 
and improve their judgments of their clients as a result 
of repeated experience with them. 
Lesser (1961), as well as Truax and Carkhuff 
(1964), alludes to the necessity of accurate description 
of the emotions by the therapist through accurate 
empathy, emotional proximity, response, specificity 
in the client's efforts, and concreteness. Blackman, 
Smith, Brockman, and Sterns conclude that only to the 
t 
degree that a person understands and respects a full 
mage of experiences in himself can he understand and 
respect a full range of experiences in others. 
Intervention, in the absence of empathy, may be overly 
intellectual and remote from any feelings the patient 
73 
might have; the patient may feel he is being ignored, 
interrupted, criticized and thwarted with regard to 
further communication. 
A high facilitative therapist tends to expect 
success in his interpersonal encounters.. Ke generally 
confronts his clients often and is more willing to take 
risks and move into "unknown territory." A high 
facilitative therapist is more, apt to trust his immediate 
experiences and act upon them, and because of his feel¬ 
ings of success and accurate sense of empathy he is more 
likely to confront the client with his experience of 
a situation without great concern for being "right" or 
"wrong." These therapists also tend to be motivated 
forward due to both their success in their relationships 
and their true concern for others; therefore, they make 
more of an active effort to know their clients. 
Low facilitative therapists tend to confront 
clients more often with their limitations than with their 
resources, possibly due to a lack of sensitivity to the 
strengths and resources of their clients, the low 
facilitative counselor may also be simply less skilled 
at describing communicatively with himself and others; he 
may feel conflicts from feelings he himself has not 
74 
described or raised during; the counseling relationship. 
In studies done by Truax, Mickelson, and Stevie, 
it has been argued in behavioral terms that Rogers' 
therapeutic conditions are reinforcing, rewarding, and 
somehow encouraging. Types of client behavior 
(presumably more adaptive ones) that are followed by 
high levels of these therapeutic conditions will 
consequently increase during the course of therapy, 
which opens this theory to behavioral interpretation. 
Verbal reinforcement by itself is not an effective 
technique in engaging the client in information¬ 
seeking behavior; what makes the facilitative counselor 
so effective is that he is able to discern when to be a 
stimulator and when to be empathic and supportive. 
Behavioral techniques may be necessary in helping clients 
but they are not sufficient to predict counselee change. 
Theoretical orientation and techniques are not 
enough to insure counselee change or success. They 
become a useful tool only to that person who is already 
labeled as optimumly psychologically healthy. This 
health has been defined, or described, by words such 
as empathic, congruent, genuine, acceptant, warm, 
facilitative, etc. Optimum health comes through 
75 
experience in communicating with one's self and one's 
environment through understanding, description, 
acceptance, etc. Man essentially communicates with 
himself and with others in two ways; through the 
language of a vocabulary and through the language of 
the body. Both are essential in communicating with the 
mind and with the emotions, and this is where the basis 
of mental health lies. 
CHAPTER IV 
SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS 
SUMMARY 
We are in a time known for it's application 
of scientific knowledge and advanced technology. The 
main focus is upon automation and computerization of 
equipment in communication, industry, defense, govern¬ 
ment, and education. Yet the methods used for aiding 
people to live together on this alarmingly shrinking 
planet are still rudimentary. This combination of factors 
confronts society with a fantastic and frightening 
paradox: we are able to control and improve everything 
except the one element that may spell the doom of the 
human race. We have employed unprecedented amounts of 
money and talent to enable people to live better and 
longer, to enjoy leisure, and to take full advantage of 
brilliant technological breakthroughs, but whether 
people survive and improve depends upon the resolution 
of man*s differences with himself and his fellowman. 
Even though man's attention is directed to the machine, 
hopefully change will occur which will fundamentally 
enrich his relationships with himself and his fellow- 
77 
man and permit the genuine betterment of life. For in 
spite of man's technological progress, his essential 
problems remain: Who am I? How did I become the way I 
am? Am I normal? What is good? What is reality? Of 
what value is life? How can I be more productive, 
more sensitive, moie sensible, more alive? Man's dreams, 
drives, concerns, and humanness can be observed in a 
bewildering variety of behavioral situations. 
This paper concerns this bewilderment. How can 
one facilitate in a person those conditions which would 
enrich his life with himself and his fellowman? Too 
often when counselors or psychologists talk about mental 
or psychological health they are discussing or referring 
to a select group of people: that group of people or 
clientel which he chooses to work with. It is within 
that group that he describes what the process of psycho¬ 
logical health and growth is, many times taking for 
granted that since it describes tnis group of people it 
must be the same, or similar, for most people in society. 
Professionals throughout the helping professions have 
made similar assumptions about various ideas. 
The main questions which are hounding counselors 
today are: Is there really anything such as optimum psycho 
78 
logical or mental health? Can it be measured and 
facilitated or is it different for every human being? Is 
there a difference between psychological or mental health 
and the ability to cope with life, and if there is, which 
one is it that we are trying to facilitate in the counsel¬ 
ing relationship? Is optimum psychological health just 
for a select few who feel it is an important attainment in 
life, or is it something which we are trying to instill 
in everyone who will accept it because it is important 
for the continual existence of this society? These are 
only a few of many such questions that must be asked when 
formulating a theory as to what psychological health and 
growth is and how it can best be facilitated. 
The objective of this research was to develop, 
as a broad base theory, an approach as to what the 
nature of psychological health is and how it can best be 
facilitated in the counseling process. The approach was 
to look at literature that concerns itself witn the 
optimumly healthy (as opposed to the more accepted 
approach of looking at the unhealthy) and try to find a 
cure. The argument for taking this approach is that if 
a person is already psychologically unhealthy, then he 
has gained and/or lost something that has caused him to 
79 
be the way he is* Most of our counseling research is 
based on these results and not on the nature of 
psychological health. It is by working with a person 
that the counselor tries to describe the gain or loss 
in such a way that will help both the counselor and the 
client to understand the nature of the problem in order 
to remedy it. It is in the area of interpretation that 
the professional's own feelings and attitudes about 
psychological health are interjected into the client, 
and what the client really gained or lost in causing him 
to be as he is, is possibly distorted. 
Another major argument in favor of the approach 
of looking at a psychologically healthy person for a cure 
is that very little in-depth and systematic research has 
been done by counseling psychologists on the nature of . 
psychological health; consequently very few theories 
about the counseling process and the dynamics of the 
counseling relationship have been based on such a 
theoretical viewpoint. Physiological psychologists have, 
for many years, written about the nervous system, how 
it works, and the physical processes and changes the 
body gees through in memory, thought, feelings, emotions, 
etc. The author has seen no comprehensive theories on 
80 
the process of counseling and psychology based on the 
physical nature of man*s nervous system, 
Davitz, who proclaims to .be a phenomenologist, 
has made a beginning research attempt at drawing together 
the physical nature of man and his nervous system and 
the process of counseling psychology. This approach is 
based on the nature of man's nervous system and the means 
man uses to communicate with it, and vise versa (the 
means the nervous system uses to communicate with the 
man). This communication system is defined by the 
physical body in terms of feelings, emotions, attitudes, 
and perceptions which are, in turn, passed through the 
central nervous center (the mind) and interpreted into a 
form of code which we call language. Through this 
language we communicate with the innermost expressions 
of the body. This is the point where counseling psycho¬ 
logists such as Rogers, Maslow, Heath, Allport, Salter, 
and many others begin to talk about the need for man to 
communicate with his innermost feelings and experiences. 
Unless they are expressed through description, understand¬ 
ing, and acceptance they will cause psychological 
proolems. Only through this process mentioned is 
spontaneity, consistancy, flexibility, responsibility, and 
81 
other healthy behavior demonstrated. At the core of this 
healthy behavior is empathy and acceptance towards 
oneself and others, and an internal hope in the nature of 
man and his capabilities. 
Through this language of the body Davitz developed 
his typology, describing those expressions of man's 
innermost being, and tnen further clarifying those 
clusters of man's expressions in terms of the body's 
natural functions and various behavioral responses. 
He suggested four ways to cluster these inner expressions: 
1) by the twelve clusters of Activation, Hypoactivation, 
Hyperactivation, Koving towards, Moving away, Moving 
against, Comfort, Discomfort, Tension, Enhancement, 
Inccrrpetenceidissatisfaction, Inadequacy; 2) by putting 
them in categories of Positive, Negative: Type 1, 
ana Negative: Type 2; 3) by putting them in categories 
of Activation (relating to physical and emotional 
movement), Relatedness (relating to the environment), 
Hedonic tone (relating to the tone and type of emotional 
expression), and Competence (relating to the environment); 
4) by putting them in categories of Sensations, Physical 
symptoms, Punctioning, Expressive behavior, Interpersonal 
responses, Attitudes, Control, Sense of time, and Arousal 
82 
of other emotions. (For further clarification see Tables 
I-VI in the appendix.) 
We can best understand the nature of psychological 
or mental health with a typology such as Davitz’, based 
on the nature of man and his expression of self and the 
way that self relates to the world around him. Through 
a systematic comparison of this approach, with what we 
knew about psychological problems and hew they have been 
alleviated or may be alleviated, we can better understand 
the nature of the counseling relationship and how it is 
related to the process of growth and change. 
Davitz' typology, as well as those of other 
therapists, has been used in this paper to try to compare 
these facilitative conditions required in a counseling 
relationsnip for psychological growth with those 
conditions cf the nature of optimum psychological health. 
In this comparison nc difference was found between these 
conditions. The words empathy, congruence, genuineness, 
concreteness, exploration, acceptance, etc. all seem, to 
be related to an optimumly psychologically healthy human 
being. Fiedler, Strupp, Truax, and many others have 
shown through research that these facilitative conditions 
exist to a greater degree in most experienced counselors 
83 
crossing various theoretical lines than in counselors from 
the same theoretical background but with less experience. 
Techniques and theoretical orientation become a tool 
which complements that which is, or should already be, 
there (optimum psychological health), but do not, in 
themselves, produce these necessary conditions or this 
optimum level of health. 'It is only within this optimum 
level of living that such tools can be properly described 
and integrated for effective use. 
CONCLUSIONS 
The following are the conclusions yielded by 
this study: 
1. There is general agreement as to what 
constitutes optimum psychological health. 
2. There is only sparse evidence or research that 
measures and/or describes the process which occurs in 
counseling called positive growth. For example: What 
change occurs in a client who at first does not feel a 
need for change, then desires change and works at 
changing? 
3. There is a general agreement about when a 
client is ready to change, but little understanding about 
84 
what causes a person to want to change (fear, anxiety, 
frustration, love, concern, etc.)* Do the righu factors 
just happen to come together at the right time? 
4. There is limited understanding as to the 
nature of psychological health, and little evidence 
supporting it in the articles of those counseling 
psychologists reviewed by the author. Most references 
to it are generally very subjective. Physiological 
psychologists have done some objective research in this 
area. 
5* Of the research reviewed by the author there 
is an over-all general agreement that necessary conditions 
exist in a counseling relationship which help facilitate 
psychological growth. These conditions are not, however, 
generally agreed upon as being sufficient in themselves. 
If these conditions are not necessary in some cases, 
then they are at least desirable. 
6. The facilitative conditions mentioned in the 
paper generally cross theoretical lines and usually 
exist with those therapists who have more experience 
than with those of lesser experience. 
?. These facilitative conditions are a part of 
being optimumly psychologically healthy, and therefore 
85 
are a part of the counselor's personality. Therefore, 
the counselor's personality does affect the counseling 
process. 
RECOMMENDATIONS 
The following recommendations are made as a 
result of this study: 
1. More research should be done to show how these 
facilitative conditions vary in the counselor during the 
growth of the counseling relationship. Research should 
also be dene to show how the counselee, his personality, 
and his psychological problems affect these facilitative 
conditions in the process of the counseling relationship. 
2. In relation to Davitz' studies, more research 
needs to be done inquiring about the nature and develop¬ 
ment cf language (written, verbal, gestures, etc.) to 
determine it's role in psychological, or personality, 
change. 
3. More counselors need to cross theoretical and 
professional lines to see what other professionals have 
to offer in the way of clarifying and refining the 
counselor's approach to helping people. 
4. Davitz' study needs to be used in research by 
86 
men from various theoretical orientations to clarify it's 
validity and it's usefulness as a guide for measuring 
the movement in the counseling relationship. 
5. Counselors and psychologists need to take a 
more critical look at themselves and their professional 
ranks, and spend more time determining what personality 
characteristics in people lay the foundation for making 
the best counselor. Less time should be spent teaching 
theory and technique, and more time spent determining 
what it is to be a psychologically healthy human being. 
6. More honest and open communication needs to 
take place between professionals of various backgrounds 
and theoretical orientations so that a more complete and 
total view of man can be achieved. 
7. The counseling profession must take a better 
look at it's role in the area of mental health and the 
society as a whole to determine whether or not it fits 
the role, and whether or not it wants to change that 
role. 
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APPENDIX 
Table I 
Clusters of Items Appearing in the Definitions of $0 Emotional States 
CLUSTER 1: ACTIVATION 
Sense of vitality, alive ness, vibrancy, an extra spurt of energy or drive 
A special lift in everything I do and sayj I feel bouncy, springy 
Pm excited in a calm way 
There*s an Inner buoyancy 
I feel effervescent, bubbly 
Warm excitement 
I seem more alert 
A sense of being more alive 
I feel wide awake 
A sense of lightness, buoyancy and upsurge of the body 
I seem to be immediately in touch with the world; a sense of being very 
open, receptive, with no separation between me and the world 
Particularly acute awareness of pleasurable things, their sounds, 
their colors, and textures-everything seems more beautiful, 
natural, and desirable 
There*s an intense awareness of everything; I seem to experience things 
with greater clarity; colors seem brighter, sounds clearer, movements 
more vivid 
I seem to sense everything and experience everything immediately 
A sense that I*m experiencing everything fully, completely, thoroughly; 
that I*m feeling all the way 
A strong sense of interest and involvement in things around me 
I feel like singing 
CLUSTER 2: HYPOACTIVATION 
I feel empty, drained, hollow 
I feel heavy, logy sluggish 
I feel understiraulated, undercharged 
All excitement, vitality is gone 
I feel tired, sleepy 
feelings seem dulled 
Ify body seems to slow down 
A sense of being dead inside 
I feel let down 
I feel mentally dull 
99 
TABLE I (continued) 
CLUSTER 3: HYPERACTIVATION 
My blood pressure goes up; blood seems to rush through mgr body 
Ify body seems to speed up 
There*s an excitement, a sense of being keyed up, overstimulated, 
supercharged 
There*s a quickening of heartbeat 
Ify heart pounds 
% pulse quickens 
The feeling begins with a sharp sudden onset 
CLUSTER 1; : MOVING TOWARD 
There is an intense positive relationship with another person or with 
other people; a communion, a unity, a closeness, friendliness and 
freedom, mutual respect and interdependence 
I want to help, protect, please another person 
A sense of empathic harmony with another person; in tune, sharing and 
experiencing the same feelings and thoughts 
There *s a sense of complete understanding of the other person 
I want to feel with the other person, experience with the other person 
with every sense; to be psychologically in touch with another person 
Realization that someone else is more important to me than I am to 
nyself 
I want to touch, hold, be close physically to the other person 
I want to be tender and gentle with another person 
I want to communicate freely, share my thoughts and feelings with 
everyone around 
A sense of giving, doing something for another person 
I want to make others happy 
A sense of being wanted, needed 
I feel soft and firm 
A sense of trust and appreciation of another person 
Sense of confidence in being with another person 
There*s a desire to give of nyself to another person 
CLUSTER MOVING AWAY 
I want to withdraw, disappear, draw back, be alone, away from others, 
crawl into nyself 
A sense of unrelatedness to others; everyone seems far away; I am out 
of contact, can*t reach others 
100 
TABLE I (continued) 
There*s a lack of involvement and not caring about anything that goes 
on around me 
A feeling of a certain distance from others; everyone seems far away 
There is a sense of aloneness, being cut off, coiqpletely by nyself 
I feel aimless 
As if I*m out of touch, seeing things from far away 
A sense of wandering, lost in space with nothing solid to grab onto 
A sense of being incomplete; as if part of me is missing 
CLUSTER 6: MOVING AGAINST 
There is an impulse to strike out, to pound, or smash, or kick, or 
bitef to do something that will hurt 
I want to strike out, explode, but I hold back, control nyself 
I want to say something nasty, something that will hurt someone 
Fists are clenched 
I keep thinking of getting even, of revenge 
CLUSTER 7? COMFORT 
There’s mellow comfort 
A sense of well-being 
A sense of harmony and peace within 
I am free of conflict 
A feeling of warmth all over 
I am peaceful, tranquil, quiet 
There is an inner warm glow, a radiant sensation 
Sense of "rightness” with oneself and the world; nothing can go wrong 
A sense of being very integrated and at ease with myself, in harmony 
with myself 
I’m loose, relaxed 
There is a general release, a lessening of tension 
Everything-breathing, moving, thinking-seems easier 
A sense of being carefree but within balance 
I’m optimistic and cheerful; the world seems basically good and 
beautiful; men are essentially kind; life is worth living 
I’m optimistic about the future; the future seems bright 
I’m in tune with the world 
Ify movements are graceful and easy, I feel especially well coordinated 
I feel I can really be nyself 
Everything is going right for roe 
A sense of smiling at myself 
101 
TABLE I (continued) 
Nothing is a burdenj problems fade away and Pm free from worry 
I think about beautiful things 
There*s a renewed appreciation of life 
I’m completely free from worry 
I feel like smiling 
I feel safe and secure 
I’m at peace with the world 
It’s a state of release 
CLUSTER 8: DISCOMFORT 
There is a clutching, sinking feeling in the middle of ny chest 
There’s a lump in ny throat 
A gnawing feeling in the pit of uy stomach 
An inner ache you can’t locate 
% heart seems to ache 
There is a heavy feeling in ny stomach 
There’s a heaviness in ny chest 
I have no appetite; I can’t eat 
There is a sense of loss, of deprivation 
I can’t smile or laugh 
I feel as if I’m under a heavy burden 
CLUSTER 9: TENSION 
Ify whole body is tense 
There’s tension across ny back, ny neck, and shoulders 
I’m wound up inside 
Mjr face and mouth are tight, tense, hard 
A tight knotted feeling in ny stomach 
I’m hypersensitive 
I'm easily irritated, ready to snap 
I have a sense of being trapped, closed up, boxed, fenced in, tied 
down, inhibited 
CLUSTER 10: ENHANCEMENT 
I feel taller, stronger, bigger 
I have a sense of sureness 
A sense of being exceptionally strong or energetic 
I'm really functioning as a unit 
102 
TABLE I (continued) 
Muscle tone is suddenly enhanced 
I feel strong inside 
A sense of more confidence in nyself; a feeling that I can do anything 
A sepse of being important and worthwhile 
I seem to be functioning intellectually at a higher level 
There is a sense of accomplishment, fulfillment 
There are moments of tremendous strength 
CLUSTER 11: INCOMPETENCE ^DISSATISFACTION 
Seems that nothing I do is right 
I get mad at nyself for rry feelings or thoughts or for what I've done 
I keep blaming Byself for the situation 
There is a yearning, a desire for change; I want things to hurry up 
and begin to change 
A longing to have things the same as before 
I begin to think about what I can do to change the situation 
There is a sense of regret 
There's a sense of weakness 
CLUSTER 12: INADEQUACY 
A sense of being totally unable to cope with the situation 
There's a sense of not knowing where to go, what to do 
I feel vulnerable and totally helpless 
A sense that I have no control over the situation 
I seem to be caught up and overwhelmed by the feeling 
Sense of being gripped by the situation 
I want to be comforted, helped by someone 
* Davitz (1969:110-113) 
103 
TABLE II 
A Structural Analysis of Emotional Meaning 
CLUSTERS 
Dimension Positive Negative: Type 1 Negative: ‘Fype 2 
ACTIVATION Activation Hypoactivation Hyperactivation 
RELATEDNESS Moving Toward Moving Away Moving Against 
HEDONIC TONE Comfort Discomfort Tension 
COMPETENCE Enhancement Incompetence: Inadequacy 
Dissatisfaction 
TABLE III 
Primary Clusters in Definitions of Positive Emotions 
Activation Moving Toward Comfort Enhancement 
Admiration Affection Contentment Confidence 
Amusement Love Determination Inspiration 
Awe Friendliness Pride 
Cheerfulness Gratitude 
Delight Reverence 
Elation Serenity • 
Enjoyment 
Gaiety 
Happiness 
Hope 
104 
TABLE IV 
Primary Clusters in Definitions of Negative: Type 1 Emotions 
Hypoactivation Moving Away Discomfort Incompetence :Dissatisfaction 
Boredom Apathy Grief Guilt 
Depression Pity Remorse 
Sadness Shame 
TABLE V 
Primary Clusters in Definitions of Negative: Type 2 Emotions 
Hyperactivation Moving Against Tension Inadequacy 
Anger Contempt Disgust Anxiety 
Fear Dislike Frustration 
Panic Hate Impatience 
Irritation 
Jealousy 
Nervousness 
Resentment 
* Davits (1969:125) 
105 
TABLE VI 
Categories for Content Analysis of Descriptions of Emotional Experiences 
SENSATIONS: This general classification includes any references to 
awareness of immediate stimulations from the body# 
SI# Tension, agitation, trembling# 
Sla# General (e#g., I feel tense all over)# 
Sib# Specific (e*g#, ny stomach feels jumpy)# 
S2# Discomfort, pain, hurt. 
S2a. General (e.g., I feel achy)# 
S2b. Specific (e.g., I have a pain in my stomach)# 
S3. Tingling, throbbing# 
S3a. Tingling (e.g., I can feel my skin tingling). 
S3b. Throbbing (e.g#, head throbs)# 
SU. Softness, weakness# 
SUa# Softness (e.g., I just feel soft all over)# 
Shb. Weakness (e.g., I feel very weak inside). 
S5# Weight. 
S5a. Heaviness (e.g., I feel heavy, sinking, pulled down)# 
S£b. Lightness (e.g#, I feel very weak inside)# 
S6# Fullness, emptiness. 
S6a. Fullness (e.g., I feel very full, stuffed)# 
S6b# Emptiness (e#g«, I feel very empty, hollow)# 
S7# Tenperature. 
S7a# Hot (e#g., it feels hot, red, burning inside)# 
S7b. Warm (e#g#, I feel warm, there*s a glow)# 
S7c# Cold (e#g., it feels cold inside, a chill goes through me)# 
S8# Lack of or low tension. 
S8a# General (e#g., iry body feels completely relaxed) 
S8b# Specific (e.g#, ny legs, ny neck just feels loose, relaxed). 
S9. Pressure. 
Spa. General (e#g., I feel I will burst or explode)# 
89b. Specific (e.g., uy head feels as if it were in a vise). 
106 
TABLE VI (continued) 
S10* Energy level* 
SlOa* High (e.g*. I'm full of energy, all charged up)* 
SlOb* Low (e*g*, I feel sluggish, tired, drowsy, no drive, 
lazy). 
PHYSICAL SYMPTIONS: This general classification includes directly 
experienced sensations that are part of an organized body system or 
the description of the working of such a system* 
PS1* Cardiovascular. 
PSla. Heightened (e.g., iry heart beats faster, pounds, blood 
rushes). 
PSlb. Depressed (e.g*, ny heart almost stops). 
PSlc. Disfunction (e.g., I felt the blood rushing to ny 
stomach). 
PS2. Respiratory. 
PS2a. Heightened (e.g., I start to breathe faster and faster). 
PS2b. Depressed (e.g., I just sigh, breathe very slowly). 
PS2c. Disfunction (e.g., I*m breathless, choking, grasping, 
suffocating). 
PS3. Digestive. 
PS3a. Heightened (e.gf, I'm ravenous, have a big appetite, 
want to eat). 
FUNCTIONING: This general classification includes all responses which 
essentially describe the individual's functioning or changes in func¬ 
tioning during the emotional experience in general, perceptual, motor, 
emotional, and cognitive areas. It differs from sensations and physical 
synptoms in that the responses are more the Sfs interactional response 
to enironmental stimulation, rather than aspects of physiological 
functioning* 
FI. General functioning and experiencing. 
Fla. Heightened (e.g., I feel alert, ready to do things, 
looking forward to it). 
Fib. Enhanced (e.g., I feel I've achieved something, 
enjoyed it, it was fun). 
Flc. Depressed (e.g., I don't feel like doing much, I'm slower). 
Fid. Disfunction (e.g., I feel blocked, paralyzed, frustrated). 
10? 
TABLE VI (continued) 
F2. Sensory functioning. 
F2a. Heightened (e.g.# I see, hear more acutely, clearly, 
v quickly, sensitive). 
F2b. Enhanced (e.g., I perceive things better, more easily). 
F2c. Depressed (e.g., ny sense of sight is duller, harder to 
see, focus). 
F2d. Disfunction (e.g., I just can*t sense things right, 
normally, etc.). 
F2e. Other. 
F3. Motor functioning. 
F3a. Heightened (e.g.. I want to run, jump, dance, play, 
move around fast). 
F3b. Enhanced (e.g., I can move more easily, play sports 
better, balanced). 
F3c. Depressed (e.g., I don*t feel like moving, move slowly, 
cautiously). 
F3d. Disfunction (e.g.. Pm off balance, clumsy, can*t move, 
I freeze, fall). 
F3e. Other. 
Fii. Emotional functioning. 
Fha. Heightened (e.g,, I feel excited, strongly moved, 
boiling inside). 
Fl|b. Enhanced (e.g., I feel gay, glad, pleased, good inside, 
joyful, positive). 
F^c. Depressed (e.g., I feel dull, gloomy, moody, depressed, 
let down, blue). 
Fljd. Disfunction (e.g., I feel numb, stunned, upset, disrupted 
emotionally, panicky). 
Fhe. Other. 
EXPRESSIVE BEHAVIOR: This general classification includes any extremely 
emotional motoric and nonverbal responses, as well as unique verbal or 
vocal responses that do not fall naturally into other functioning or 
interpersonal categories. 
EB1. Laughing. 
EB2. Crying, moaning, sobbing. 
EB3. Shouting, yelling, screaming (noninterpersonal). 
EBU. Singing. 
108 
TABLE VI (continued) 
EB£* Facial expressions (e.g., smiling, grimacing, etc.)# 
EB6. Gestures (e#g., wringing hands, waving, kicking, etc#)# 
EB7. Other# 
INTERPERSONAL: This general classification includes all responses which 
explicitly or implicitly describe an actual or desired relationship 
with another person which is a focal part of the emotional experience, 
or evoked by it* Responses are groined according to whether they 
reflect a moving toward, moving away from, or moving against people# 
11# Moving toward or close to people# Any positive form of rela- 
tedneas# 
lla. Actual or desired general positive feeling toward others 
(©•g«* I fool very friendly, acceptant, liking, good 
toward them, positive)# 
llb. Actual or desired strong identification with others (e#g#, 
includes desire to be with or close to another emotion¬ 
ally; fuse, merge, share feelings; admire, identify, 
become strongly attached to them)# 
11c# Actual or desired communication of feeling with or to 
others (e#g#, want to talk with them, call up, tell 
what happened)# 
lid# Actual or desired joint activity with others (e.g., 
includes desire to be with or near others, do things 
with them rather than for them, play together, go 
with them)# 
lie. Actual or desired helping, pleasing, or protection of 
others (e#g., I want to do things for persons, be nice, 
kind, help them, please them)# 
Ilf# Actual or desired physical contact with others (e.g., I 
want to kiss, hug, touch, caress, cuddle the person)# 
12# Moving away from people# Avoidance, withdrawal. Isolation 
responses# 
12a# Actual or desired lack of identification with others (e# 
g#, includes responses which establish distance without 
moving against; expressing doubt, skepticism, lack of 
agreement, separateness, mild criticism)# 
12b# Actual or desired avoidance of interaction with others 
(without physical withdrawal) (e#g#, not wanting to 
join in activity with others or to interact with them, 
communicate, or acknowledge them)# 
109 
TABLE VI (continued) 
12c• Actual or desired physcial withdrawal or escape (e#g*# 
I felt like running, leaving the room, walk out, hide 
from them, go away, etc.)* 
12d. Actual or desired feelings of isolation, loneliness, or 
rejection (e.g., feel alone, lonely, walled off, 
rejected, outside the group;. 
13# Moving against people. 
13a. Actual or desired general negativism toward others (e.g., 
I feel annoyed, irritated, despleased, want to get 
even, mean, angry at everyone, etc.). 
13b. Actual or desired passive negativism or oppositionalism 
(e.g., I want to pout, sulk, not cooperate, be stubborn, 
ignore, don*t share, etc.). 
13c. Actual or desired verbal aggression toward others (e.g., 
I want to yell at them, complain, growl, scream at 
them, be sarcastic, say shut up). 
13d. Actual or desired indirect or displaced aggression (e.g., 
includes such indirect attacks as damaging possessions 
of the other person, or being angxy at someone else or 
a pet). 
13e. Actual or desired direct physical attack on others (e.g., 
I felt like hitting, punching, slapping, kicking, 
hurting them physically, fighting and charging them). 
ATTITUDES: This general classification includes all responses which 
reflect a system of beliefs, feelings, or dispositions to respond, 
usually bound to an object and involving evaluation of it. Attitudes 
may be expressed toward the self or the world in general. 
Atl. Attitudes toward the self. 
Atla. Positive (e.g., I feel important, strong, confident, 
worthwhile, secure). 
Atlb. Negative (e.g., I feel worthless, self-conscious, 
inadequate, stupid). 
Atlc. Heightening of specific feelings toward the self (e.g., 
hostility, love, pity, shame, guilt, etc.). 
Atld. Self-detachment (e.g., I feel removed, detached, 
outside myself, bored). 
Atle. Other. 
110 
TABLE VI (continued) 
At2# General attitudes# 
At2a# Positive (e.g## includes enhancement of the world or 
sense of positive feeling about the world, optism, 
etc.)* 
At2b. Negative (e.g#, includes responses reflecting pessimistic 
outlook, things look bad, nothing is going right, 
something bad will happen)# 
At2c# Lack of involvement (e.g., not caring about anything, 
detached or removed from the world, uninvolved)# 
At2d# Other# 
CONTROL: This general classification includes responses which pertain 
to loss of or recognition of the need for emotional control, or lack 
of concern about it# 
Cl# Loss of control of behavior, feelings or thoughts (e#g#, I 
feel unable to control my feelings, ny thoughts ran wild, 
I felt out of control)# 
C2# Lack of concern over emotional control (e.g#, I couldnH 
care less what happened. I feel carefree, no need to hold 
back, I say what I feel)# 
C3. Recognition that control or the need for it exists (e.g#, I 
know I shouldn^ do it though I want to, I stop uyself, 
have to be careful). 
SENSE OF TIME: This general classification includes responses which 
make reference to awareness or lack of awareness of the passage of 
time. 
Tl# Sense of expanding time (e.g., time seems infinite, endless, 
could go on forever, the time passed in a flash)# 
T2# Sense of slowing time (e.g., time seemed to stand still, I had 
no sense of the passage of time, I thought it would never 
be over, the minutes passed like hours)# 
AROUSAL OF CITHER EMOTIONS: This general classification includes responses 
which indicate that the feeling gives rise to another emotion, usually 
related to the initial state or reaction. 
Arl# Positive (e.g., I feel happy, joyous). 
Ar2# Negative (e.g., I get angry, sad, disgusted)# 
* Davitz (1969:152-156)