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"It is a relationship," humanistic therapists tell the apprentice, "no techniques, no manipulation, certainly no advice-giving, and by choice no behavior-modifying." The questions that arise are "But what do you do?" "How does it work?" "What do you say?"

Historically, the humanistic-existential therapist has evaded such questions with responses such as "You create a climate where the client feels safe. You prize the client. The client has a natural drive toward health. We are self-correcting organisms. The relationship you create is what heals." This turns off many psychology assistants or therapist interns who can then go find a behavioral technique with a spelled-out procedure. So how do we remain loyal to a humanistic philosophy and how do we communicate its efficacy to others?

Why Humanistic Therapy?

I grew up in East Los Angeles where gangs flourished: Happy Valley, Hazard, Downey. And girls participated as well as boys; one of my classmates called herself the Black Widow. There was conflict, and there were feuds. On rare occasions, even death. But there were no guns, and teenagers were too poor for automobiles. So, no drive-by shootings, stray bullets killing nearby children, or news bulletins announcing "the death was gang-related."

Now our culture is in trouble. Deadly weapons are in the hands of children. Compounding the problem: frustration is high, and parenting is deficient.

By parenting I do not mean solely the guidance provided by a mother or father. The culture is parent to the children. Today we are culturally lacking in our parenting skills and attitudes. Children grow up outside instead of inside, feeling alienated and bitter. Those attitudes, paired with easy access to weapons of death, create a dangerous society.

We are on the brink of losing our humanity. Children are parented neither to respect each other nor the sanctity of human life.

William Glasser applauds the 20th century as the century of technological triumph and deplores it as the century of social flat-lining. Our children can reach out to the cosmos, but we do not know how to nurture each other. For Glasser, a prime culprit in this disparity is the notion of "stimulus-response." He believes that no one truly responds to a stimulus; one responds out of personal choice. All behavior is chosen. Therefore, one is responsible for all one does.

While not everyone would agree that behavior modificationexternal stimulus-response treatmentis the bad guy in our present state of alienation, one surely would concur that something is missing in our young peoples ability to make healthy, life-affirming choices. A hefty percentage of our children are growing up de-humanized.

In a sociological framework, arguments are made that the family unit as an American bulwark is in tatters. Broken homes breed broken hearts, and broken hearts have a diminished capacity to love others. Yet some argue differently, such as Stephanie Coontz in her book The Way We Never Were. Her thesis is that Life With Father and The Brady Bunch and other pop cultural icons were largely myths, and that it is more likely that drugs, alienation, violence, disloyalty, and crime contribute to the breakup of a family, rather than the other way around. Humanism as a psychology can only flourish in a culture that values humanism as a philosophy. Everyone has a responsibility (choice) in a society that values freedomto perpetuate the cultures human face. The exhortation to "love thy neighbor" means in a practical, everyday way.

Just as two decades ago neurologists devised a system of "patterning" that taught injured children to walk, where repeated manipulation of the injured limbs seemed to train the brain in a reversal of the normal sequential order, so might Humanistic psychologists, through modeling and attitudinal integrity, re-turn the culture toward its built-in Humanistic bent. Humans come packaged with a natural drive toward health.

As Carl Rogers repeatedly expressed, a plant is neither good nor bad but rather grows to its healthy maturity given a nurturing environment of water, sun, and soil. Humans are not good or bad, and will strive toward organismic health in a nurturing climate.

Humanistic therapy has a crucial opportunity to lead our troubled culture back to its own healthy path. More than any other therapy, Humanistic-Existential therapy models democracy. It imposes upon the client least of all. Freedom to choose is maximized. We validate our clients human potential.

We can be the quintessential ele-ment in the obligations of our culture to effectively parent the young.

AN OPERATIONAL GUIDE

1. Be Present

William Offman called it H-E, Humanistic-Existentialism, and he believed that the personal encounter between him and his client was to be a microcosm of life. Be Present was the essence of his approach. What the client was willing to do in the therapy moment would be an appliqué on that clients life. Risks taken with the therapist were practice moments for risks to be taken later with others.

Perhaps equally important is an awareness that the healthiest per sonalities have the capacity to live fully in the present. In my own experiences as a therapist, I have observed my clients debilitating anxiety mushroom when they get ahead of themselves or flounder in the past. Fritz Perls phrase "Anxiety is any time you leave the present," has proven valid time and again in my therapeutic contacts.

More than once I have recited the succint wisdom of pianist/comedian Oscar Levant: "The trouble with most Americans is that happiness is something we remember, not something we experience."

The Humanistic therapist is present and in the moment, energetically and philosophically, with each client.

2. Act Responsibly.

The existentialist view is that there is absolutely no escape from personal responsibility. Clients sometimes hear this as a warning or admonition, reminiscent of parental fiat, to be eluded rather than obeyed.

The Humanistic therapist models responsibilityis responsible to be honest and confront the client in a non-threatening yet unambiguous way. Rather than lecturing, the therapist presumes and encourages responsibility.

Responsibility is the antithesis of blame or fault. We are responsible for our life decisions, for our part in a partnership that decays for example, and for choosing the means to get on with our lives after disappointments and setbacks.

3. Provide a Stimulating Environment.

Freud stressed the use of a barren external environment to allow a patient to go deep within, to encourage transference uncontaminated by extraneous stimuli.

I once had a young woman client who stayed with me for only four sessions. I asked her why she wanted to cut off therapy. "Because," she said almost apologetically, "in New York where I am from I was in analysis for three years and the analysts office was bare and austere. I got used to no distractions. Your office is filled with posters and sayings and stimulating thoughts. I cant concentrate. Its not your fault, its just what Im used to." I assured her that I did not take it to be my fault and that I understood and wished her well.

My contention is that, in a humanistic sense, everything is part of life: color, music, noise, even unavoidable interruptions. I do not set out to distract my clients, but I use everything that happens as part of the therapy. One of my favorite posters has a quote from the philosopher Albert Camus that reads: "In the midst of winter I finally learned that there was in me an invincible summer." One can imagine the therapeutic material that bit of wisdom can trigger.

4. Look for Client Code-Words

A thirty-four-year-old client of mine (well call him Martin) was convinced he was ill and had some dreadful, incurable disease and would die young. His father had died at forty, but was three times Martins size, obese and inactive.

Martin would sit (in my stimulating office), look around, and say, "It is so alive here, so comfortable." Then he would say, "Oh God, how I dread that forty-five minute drive home." "Where did you go," I would ask him. "You were fully present, then you were an hour ahead of yourself."

One time he missed an appointment, and when I called his home his wife said in a frantic tone, "He is in the hospital. They arent sure what it is. He has trouble breathing." A week later he returned and told me, "It might be adult onset diabetes." I think I remember saying (foolishly) "Good." He had wanted something so badly, it was almost a relief to have it named.

Two weeks later he came in and said, "We were going to hear Helen Reddy and I got sick in the parking lot. Began choking. My wife said, Okay, lets go home. But I took a deep breath and answered her No. Lets go in. Fuck it. If I die, I die. It worked. I sat through the concert and felt pretty good."

"Well," I told him, "it looks as if youve landed a code-word for yourself." We both laughed, and from that session on, whenever he began to moan about his lot in life, I would catch him with, "Remember, Martin, fuck it!" His code-word, not mine. Thats the key. Look for the clients own remedy.

5. Provide a Safe Environment.

In Humanistic therapy, the clients feelings of safety are paramount. It is often the case that a clients reasons for being in therapy are at least influenced by feeling threatened, having a sense of fear or impending lossof a person, health, freedom, love. Fear is likely the culprit in depression as well as anxiety, and certainly plays a role in what has come to be called bi-polar disorder.

I learned from a former student of mine that we can enhance our clients safety by having them visualize a familiar safe place in their personal history. By having them go there for a moment, a mood may be set that provides a climate for deeper, safer exploration. In group therapy, the facilitator often offers a moment of "centering," where members breathe deeply and clear their thoughts before group work begins.

Again, the key is voluntary accession to the activity. It defeats the idea of safety if the therapist gets into the role of controller and prescriber. As Rogers reminded us, we must prize our clients as unique and capable individuals. Or, as Pablo Casals, the cellist, once wrote, we are all "...one-of-a-kind marvels."

6. Respect a Developmental Base.

One need not presume that because existential theory (and Gestalt therapy) promote a present-time focus that a developmental history is to be ignored. Our history got us to where we are. Are we trapped in our history? Not according to Alan Wheelis, who tells us in How People Change that our awareness cuts the chains that bind us to our causative issues. What, then, does the Humanistic therapist strive toward as perhaps the only expressed, specific goal for our clients? Their enhanced awareness.

It was a non-therapist who taught me much about a Humanistic developmental theory that counteracts the complaint that Humanistic-Existential philosophy ignores our childhoods. Harvey Jackins, in a stimulating little book The Human Side of Human Beings, points out that we are all born zestful for life, spontaneous in demeanor, and supremely intelligent potentially (assuming no forebrain damage). What goes wrong can be expressed in three little words, we get hurt. We get hurt and our zest shuts down, our spontaneity is blocked, our intelligence is thwarted by patterned reactions to old hurts. Jackins claims that healing occurs through the discharge of tensions, naturally done by children as they cry when hurt, stomp and yell when angry, shiver and shake when frightened, all of which is culturally suppressed in adults.

7. Respect that Affective Discharge Precedes Cognitive Restructuring.

Ah, theres the rub. The HMO-preferred approach to therapy is cognitive/behavioral, since it can be done speedily and with measureable outcomes, as yet unproven as to durability and side effects.

Cognitive therapists argue that a changed way of thinking will drag along with it emotional detritus. Humanistic therapists argue the opposite: that our thoughts are scrambled because of affective dis-sonance, and we can only think straight after our blocking emotions are discharged. Indeed, Jackins cites many instances of this sequential order, where someone has wept and raged and trembled and sweated, and then says in a calm voice, "Now I know what I have to do."

I like Jackins notion that feelings are to be felt and displayed, but deci-sions in life are to be made with the best intelligence possible. The rub comes with the realization that until old hurt patterns are flushed out through emotional discharge, our full intelligence is unavailable to us.

8. Be Willing to Be Vulnerable.

Since therapeutic growth is a product of the existential encounter, both parties are open, self-disclosing, vulnerable. I have said to my students, "It is not like a cocktail party where everyone plays a can you top this game, besting each others juicy stories. Yet, self-revelation by the therapist provides a genuineness and says to the client, "I am a person, too, and have experienced hurt."

As noted under the heading Be Present, the willingness of the therapist to disclose takes the form of inviting a present-time encounter. "What do you think of me?" or "What are you thinking right now?" may be questions a therapist asks. Remarkable self-confidence can be created if a client successfully confronts his/her own therapist.

Such an encounter rests upon the risk-taking ability of both parties. One can imagine that such a willingness on the part of the therapist is a product of her/his own emotional health. "Can I handle my clients encounter openly, without resentment, without harsh judgment, and with a spirit of mutuality that ultimately benefits both of us?" One way to say it is that the humanistic ther-apist needs "margins of good health" like the self-actualizing people Abraham Maslow has described.

9. Recognize That All Choice is for Self-Enhancement.

To say that everyone always chooses what she/he perceives as most self-enhancing is not to say that we are all monuments to selfishness. If my daugher were in the street with a car bearing down on her, I might instantly decide to throw myself into her, pushing her to safety, while being hit by the car myself. Or, one might seem selfless and generous to a fault by methodically giving away huge sums of money, yet in private reality be im-measurably rewarded by such acts.

By understanding this phenomenon, the Humanistic therapist honors all client behavior as chosen, and in fact chosen for perceived, solid personal reasons.

Even the ultimate, desperate act of suicide is perceived by the person as self-enhancing, since everything elserelationships, work, activities, LIFEare seen as intolerable.

Glassers newest notion of all, be-havior as choice, fits perfectly here. Even more important, it exquisitely dispels the "victim" status we sometimes embrace. If we always choose behavior that enhances us, then we are responsible for our life condition.

This is not, of course, to be taken to an extreme, as some therapeutic groups have done over the past twenty years ago: we are not responsible for the many toxins that invade our bodies, for acts of nature, accidents, or some misguided leaders misdirected bombs.

OUTCOMES

It is not only that Humanistic therapy treats clients in a respectful and democratic manner; it is also that an integrated level of functioning and a truly Humanistic attitude will emerge as the final outcome of such an approach.

Walter Anderson, in his important book Politics and the New Humanism, noted that the goal of therapy ought not to be "adjustment." Indeed, one might adjust to an inhumane situation, such as society in Nazi Germany, or a household decimated by alcoholism and physical abuse. Instead, the goal must be an "integrated person."

Integrated people, such as Thoreau, Gandhi, Chavez, are capable of independent choices, of evaluating the panorama of human events confronting them with clear eyes and incisive choiceseven when they go against the established order or current law. They see through to the heart of an issue. They take appropriate emotional risks, guided by an unwavering appreciation for humankind and the planet for which we are custodians.

Finally, an enhancing outcome of a Humanistic therapy must include the steady, incremental building of a society that respects and even relishes human differences. It is not that we are all the same, but rather, we are all different, and isnt that wonderful!

Not everyone comes to therapy. Yet, we need not limit our Humanistic influences to those who do. We do not learn to be therapeutic only for the hour we sit with clients; we become therapeutic in all our transactions. We may then live our lives so that those we touch in all our encounters feel respected, appreciated, and honored. Even (grand challenge) in our automobiles.

Stan Charnofsky is past president of AHP, professor of Educational Psychology and Counseling at California State University, Northridge; and author of Educating the Powerless and When Women Leave Men.