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For whom?

What are its characteristics?

What are its indications and its limitations in psychological pathologies

 

 

 

 

1.   Introduction

2.   Who can benefit from the PRH type of helping relationship?

3.   What are the characteristics of PRH helping relationships?

4.   What are its indications and its limitations in psychological pathologies?

5.   Conclusion

6.   References

1.      INTRODUCTION

PRH Education (1) was started by André Rochais toward the end of the 60’s, under the form of workshops for working on oneself, enabling participants to know themselves better, and especially, to explore their personal resources in order to develop them. André Rochais had the intuition of reaching persons in their best selves, in the very depths of their personality in order to trigger a growth dynamism. Right from the beginning, PRH Educators were facilitating group workshops and were having sessions of individual work with people who were asking for these sessions, either to deepen one or several aspects of the content of the workshops or to take the time needed to explore their personal experience, in order to clarify it, with the help of the Educator. These sessions of individual work are called helping relationships.

2.      Who can benefit from the PRH type of helping relationship?

All individuals who are aware of dysfunctions that they cannot resolve on their own, and who want to work on themselves, can benefit from this type of approach. They will specifically be helped to sort out their felt experience so as to clearly name what they are feeling and what they sense as being accurate, which will allow them to come out of ambivalence, to increase their self-confidence, and to develop the positive in themselves.

As a method that aims at the growth of individuals, couples and groups, PRH is situated on the side of the approaches to the human person which are based on persons’ experience, which are the humanistic psychologies among which Carl Rogers is certainly the best known. He affirmed in his book On Becoming a Person: “the core of the person is something positive. Under the surface behaviour that the person controls, and under the bitterness and the scars from the wounds, lives a self that is positive and without hate”. (2) He added that he had eventually understood this “lesson” through his patients, during 25 years of psychotherapy.

It was Edmond Marc who summarized the state of mind of humanistic psychologies: “These approaches tend to dismiss too strong an opposition between health and illness, by addressing themselves to ‘normal’ individuals as well as to ‘neurotic’ individuals; their objective is not so much to treat and to heal an “illness”, but rather to enable individuals to develop and actualize their potentialities, to enrich their lives and experiences, to make their relationships more intense and more harmonious.” (3)

A PRH helping relationship will therefore help individuals requesting it to explore their experience in the presence of a counsellor with the aim of feeling more themselves, existing more, being more coherent, more active in their human relations, becoming more harmonious, from a place of freedom and respect, where they will be able to reflect on their psychological autonomy and responsibility. However, it requires that they want to question their functioning, are able to question themselves and that they allow themselves to be stimulated by the counsellor’s interventions in order to continue to further explore their personal experience.

3.      What are the characteristics of PRH helping relationships?

The two words: relationship and helping are important. It involves a relationship with a person whose role is to listen, to receive the one requesting help as they are, with the difficulties they expose while at the same time perceiving their desire to progress. It is important to allow for the development of a relationship of trust through a warm welcome and through being available at the time of the meeting.

The counsellor sees to the psychological work through questions centred on the client: they help them to enter deeper into what they are feeling and to seek clarity, so that they can become aware of their ways of functioning, and make new discoveries. Space is given to clients so that they can develop their emotional life while integrating it in their global experience, which allows them to situate themselves in a different way. It is important to give oneself some time in a caring ambience; the intellect gets in touch with the sensations in order to identify their various components, to decipher them, and enter deeper into them, to identify the new elements, to evaluate them and to journey toward making decisions according to the material discovered. The helping relationship allows the present emotion to live, instead of containing it or dominating it. It is said that a repressed emotion manifests itself in a different way, at times through somatisations or through omitted actions. A cleansing of emotional life now takes place, individuals feel more relaxed and relieved after a session, and they free themselves from tensions, and are encouraged to continue their work on themselves after the sessions.

A helping relationship can be occasional so as to resolve a specific problem, for example, to make a decision (retiring this year or continuing to work for one more year? Or: how to help a child with their educational or professional orientation?). It can also meet a need for in depth work, be long-term, and involve regular appointments every three weeks or once a month. Such an accompaniment can involve a questioning regarding one’s work, or regarding one’s functioning as a couple, or seeking clarity regarding personal or relational conflicts. Such a request will be motivated by a desire to learn to function differently: sometimes people will say afterwards: “I had to go through this, otherwise, I would have remained stuck”.

Counsellors using the PRH helping relationship situate themselves as educators in the area of human sciences who practice psycho-pedagogical work. It is not psychotherapy, but a complementary approach to it. It proposes tools to help clients look at themselves: they are invited to do a written preparation before coming for an interview. This preparation involves noting down all the elements that contribute to their problem, weighing their relative importance, and representing them visually by making a topography. After visualizing the topography, it is often easier to circumscribe the problem to be looked at. Preparing for the interview saves time, which leaves more space for exploring the emotional experience during the session.

The counsellor intervenes on what they observe regarding the problem at hand, asks what the client is experiencing, shares their diagnostic, that is, what they perceive as being the core of the problem and proposes hypotheses of solutions. The counsellor may use a visual means and themselves make a topography to illustrate their input. The client is free to choose one of the hypotheses, or not. At the end of an interview, it can be important to underscore the new material that resulted: the client sometimes does this spontaneously, or the counsellor mirrors to the client what they have observed.

The client is asked to do an inventory which will allow them to observe how they worked during the interview, in what they progressed, and if they have observed changes in their concrete life: they can send this inventory to the counsellor who will send it back to them with their annotations. It is part of the nature of psycho-pedagogical work to observe oneself at greater depths in daily life; for this reason, the interviews will rather be every three to four weeks, this applies especially when there is communication through the mail.

To practice the PRH helping relationship, counsellors follow a program involving several years of work on themselves, for the purpose of integrating the method and the explanatory system (1). This training includes workshops, the use of helping relationship for themselves, regular personal written work linked to training objectives, and supervision by a pedagogical accompanist. Counsellors in training learn to analyze what they experience in daily life, to evaluate it, to identify their dysfunctions and to develop other ways of functioning that help them engage in a personal growth process. The aim is that they become aware of all their resources, that they overcome the obstacles to their development so as to take on their full stature as men/women operating in their life context, and are happy to be who they are. This corresponds to what Carl Rogers calls “a fully functioning person”. Through supervision, they learn to refine their interventions centred on the clients to help clients to get to know themselves accurately, to resolve their problems, and to journey toward becoming themselves, step by step.

4.      What are its indications and its limitations in psychological pathologies?

The manuals of psychiatry address the question of what is normal and what is pathological; they agree that the boundaries between the two domains are not clear cut. Society models that at times evolve very quickly increasingly influence what is considered normal. About 50 years ago, depression was mostly hidden from others because the individuals and the family members were ashamed of being affected by this illness. Today this illness is widely dealt with in the various media, which allows the affected individuals to be more comfortable with it. The coverage given to other illnesses such as schizophrenia, autism, and obsessive-compulsive disorders is a more recent phenomenon.

Does a dysfunction or a “normal” state of ill-being come under a verbal approach while all psychological pathology is to be treated exclusively by specialists in psychiatry? Reality is not so clear cut. 30 years ago, one could attend passionate debates that opposed biological approaches through medication to exclusively psycho-dynamic approaches. It would happen that psychotherapists would advise their patient against taking medication so that they could work on themselves using their own means and renounce using the “crutch” of a drug treatment.

It is now common for a psychotherapist to refer a patient to a psychiatrist for the purpose of prescribing a treatment, in order to get relief from troublesome symptoms such as persistent insomnia, permanent mental ruminations and tenacious suicidal thoughts. Drug treatment is therefore no longer seen as a comfort which prevents personal work, but as an essential and unavoidable link that fosters work on oneself, provided it removes obstacles to self-reflection. On the other side, prescribing psychiatrists know that drug treatment alone is often insufficient to bring improvement, and even less to bring healing in a patient, and recommend a complementary approach through which patients work on themselves. The two approaches, medical and psychological, are no longer presented as opposites, but are associated with the aim of helping the patient improve.

It is essential to underscore that the PRH helping relationship will not replace being under the care of a psychiatrist or psychotherapist, and it will not replace a specific treatment. It will be a complement while respecting its specific area of competency, which is that of growth.

Where schizophrenia is concerned, it is appropriate to specify that there are a lot of differences between patients, because of the great variety of symptoms that affect the various aspects of the personality in a non homogeneous way, but also because of individual long-term evolution, over the years. The PRH method, which uses the exploration of one’s felt experience, is not adapted for this pathology because of the patients’ incapacity to accurately recognize their feelings/sensations, and because of their unawareness of their illness.

The PRH method is not recommended in cases of delusional paranoia or of personality disorders (pathological personalities). These pathologies are characterized by defensive manifestations on account of which strong aggression and even violence is triggered when defences are weakened; there is also a variant, which is the possibility of a mental breakdown.

Autism is a pathology 10 times less frequent than schizophrenia. Only the high-functioning autistic individuals, who are even much less common, could request to be accompanied through a verbal approach. Because of their difficulties with verbal communication and their great fragility in the emotional area, the PRH helping relationship is not recommended.

Bipolar patients can benefit from an approach using the PRH helping relationship as a complement, between critical periods, that is, after the resolution of a depressive state or of a manic state. They benefit from being accompanied in their reality, from the integration of their history, from becoming aware of their vulnerability in order to accept it, to de-dramatize their difficulties, and to master their emotions. Also, this type of approach helps them search for the resources they can rely upon and the way they can rely upon them.

The same advice can be given to patients suffering from depression or from recurring depression: they benefit from helping relationship during the resolution phase, after an acute depression episode, which can help them regain self-confidence, identify the resources upon which they can rely, and clarify their emotional and relational experience. However, the PRH helping relationship is not recommended when persons are totally depressed, as they cannot work on themselves during that phase. I have dealt with this on several occasions, and more specifically in a paper (4).

The PRH helping relationship is very useful where alcohol dependency is concerned. Individuals can be helped to make the decision to come off this toxic substance by becoming aware of their desire to live. After their coming off, the PRH method can help them to rebuild themselves: the patients themselves speak of “rebirth” when they learn to say “no” to alcohol and “yes” to life. They become able to discern what constructs them by letting go of destructive ways of functioning. They discover how to take on new responsibilities, and how to assume responsibility for their own life. I described this process in a book (5, 6) and I share it regularly in communications and in publications (7).

The PRH helping relationship can have its place as a complement in the treatment of continuous anxiety disorders.

Generalized anxiety disorder: individuals are helped to decipher their experience, especially what involves their positive aspects, in order to develop them. They learn to de-dramatize the situations that trigger anxiety, which helps them to put things into perspective and to work at developing the reflex to rely on a personal resource.

Panic disorder: the PRH helping relationship, like every psychotherapeutic method will be ineffective for managing acute anxiety crises. However, individuals can be helped, between critical periods, to identify personal areas of vulnerability in order to seek clarity, and to develop personal resources.

Phobic disorder: there is a distinction made between situational phobias or simple phobias, agoraphobia (often a complication of panic disorder) and social phobias. Phobias are characterized by a tendency to avoidance, reassuring behaviours, and dependency on one or several people in their surroundings. The PRH helping relationship can be a complement to help individuals become aware of their dysfunctions and to progress toward greater psychological autonomy by gradually facing their discomfort and by getting away from avoidance behaviour.

Obsessive-compulsive disorder: this disorder offers a lot of resistance to many psychotherapeutic approaches because of a very rigid defence system. The PRH helping relationship can be proposed as a complement, which will help individuals to enrol in activities that give them the sensation of feeling alive. However, they also need a directive approach which helps them to structure their daily life in such a way as to let go of their repetitive rituals.

Post-traumatic stress disorder: The PRH helping relationship can be useful in helping individuals to name the elements that contributed to the traumatizing event, in as much as the counsellor helps the client to work on their felt experience: expressing their emotions is encouraged, which allows the client to feel liberated from shackles.

5.      CONCLUSION

The PRH helping relationship intervenes in a specific area: that of growth. Space for work on oneself is proposed for clients to become aware of their felt experience. The counsellors invite clients to decipher and to enter deeper into their experience starting from their sensations: they are centred on the client, they abstain from giving advice regarding the problem presented, they try to encourage clients to themselves find the solution adapted to their problem. This type of work can enable a liberation from obstacles: clients become more themselves and more in charge of their lives. They understand themselves better, have greater self-confidence, and are happier – I have developed this in another paper (8).

This method can be recommended as a complement for various psychological pathologies, in collaboration with specialists of mental health where the PRH helping relationship practitioner can be part of a network around the person. It is very useful for the various parties involved to communicate with one another so as to foster together the person’s progress.

6.      RÉFÉRENCES

(1)  PRH-international: Persons and Their Growth, 1997

(2)  Carl Rogers: On Becoming a Person, Boston, Houghton Mifflin Co. 1961

(3)  Edmond Marc: Le guide pratique des nouvelles thérapies, Edition Retz, Paris, 1992 (The Practical Guide of New Therapies)

(4)  Thomas Wallenhorst: La relation d’aide PRH avec des malades déprimés; in : La relation d’aide, sous la direction d’Alain Gouhier, Presses Universitaires de Nancy, 1992 (The PRH Helping Relationship with Depressed Clients: in: The Helping Relationship under the direction of Alain Gouhier)

(5)  Thomas Wallenhorst: L’alcoolo-dépendance, un chemin de croissance; Collection Vivre et Comprendre, Ellipses, Paris, 2006 (Alcohol-dependency, a Path for Growth; Collection Live and Understand)

(6)  Thomas Wallenhorst: La dependencia del alcohol, un camino de crecimiento; Colección Crecimiento personal, Desclée de Brouwer, Bilbao, 2010

(7)  Thomas Wallenhorst: the PRH Helping Relationship and Alcohol-dependent Persons; input given in French, English and Spanish during the PRH-International AGM, Canada 2004

(8)  Thomas Wallenhorst: Développer son intelligence; Collection Déclic’Psy, Ellipses, Paris, 2009 (Developing One’s Intellect)