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Gendlin, E.T. (1969). Focusing. Psychotherapy: Theory, Research and Practice, 6(1), 4-15. From http://www.focusing.org/gendlin/docs/gol_2048.html

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FOCUSING

EUGENE T. GENDLIN

University of Chicago

Experiential focusing is a therapeutic procedure. As I will explain later, it is not alone sufficient for psychotherapy. Rather, I view it as one essential sub-process. I will first describe the focusing procedure, and will then discuss how the procedure may fit in with therapeutic interaction. Finally I will present the research background which gave rise to this therapeutic procedure.

Much of psychotherapy consists of talking on the surface of an individual's troubles, hoping very gradually to get more deeply into them.

Recently therapists use a number of methods to begin working right in the midst of the trouble, to reach a concrete bodily level of working, after only some initial interviewing. For example, those using behavior therapy and desensitization attempt this (whether always effectively or not, is another issue). Once a problem has been chosen, the desensitization patient (Wolpe & Lazarus, 1966) is asked to imagine and tolerate successive anxiety-arousing versions of it. Patients begin working almost immediately with the bodily concreteness of their difficulty. Certain role-playing methods similarly attempt to involve the concrete organism of the individual, not only what he says and thinks.

Many patients can't easily get into the bodily version of their troubles. Some do struggle from the start toward something more real than just talking, and do achieve a concrete change process. But others never seem to try or attain it.

The method of focusing which I will now outline, can be taught and used in the context of any therapy. It is a bodily method.

First of all, the method involves a sharp and complete shift in direction. One must cease talking at oneself inside; one must ask: "What"s wrong?" and then keep quiet, and refrain from answering oneself.

It is understood that everyone knows a great deal about what is wrong, nevertheless it is a totally different matter to wait and listen, than to be telling oneself about it.

Usually one thinks from the outside in, at oneself. In "focusing" one shifts to "from the inside out, from oneself." Rather than trying to say or think what the trouble is, what the answer is, one must keep quiet and listen. Then the bodily felt version of what the trouble is, makes itself felt clearly enough.

It is important to emphasize the sharpness of the difference in set. Everyone knows the experience of being "in a stew" and trying to say something useful at oneself, usually succeeding but little and in an unclear way. Focusing is a dramatic stop to this, and instead, a shutting up.

Secondly, one must understand before one starts, that words can come from a feeling. Words come anyway, one can't shut up for long. But there is a way of letting all words that come go by, except for such words as [Page 5] 'come from" the feeling. Another way to phrase this (since "come from" is mysterious), is that some rare words have a felt effect. I call it an experiential effect. As these rare words come, one senses a sharpened feeling, or a felt relief, a felt shift, usually before one can say what this shift is. Sometimes such words are not in themselves very impressive or novel, but just these words have an experiential effect, and no others do. (For example: 'I"m scared . . ." might not be new, but when the words arise from one's quietly listening, they often have the effect of: "Yeah, that's what it is allright, (long exhale breath), (shakes head), yeah, boy, I didn't know how true that was.") Yet, perhaps he has been saying for days, among other things, that he was scared. In a little introductory discussion the therapist first explains how words can come from a feeling. Then the patient is invited to give examples, which usually show that he hasn't understood yet. More discussion follows. When he comes up with an example that is right, we are convinced that he understands, and only then. (For example: the patient knew what is meant by words coming from a feeling when he said: "When you don't like someone, there is what you criticize objectively, but it is different when what you say comes from your feeling of how you don't like him. That might not be objective, but it's from what you feel.")

Thirdly, and lastly, one must explain in advance that it is possible to sense a problem as a whole and let what is important come up from that bodily sensing. People rarely let the crux of the problem come freshly to them from their feel of the problem as a whole. They already know what the crux is, or they decide what it is. Therefore, before we begin, we instruct the patient on this third point: 'When you have a feel of the whole problem, don"t decide what is so important about it. Feel it all and don't decide anything. Wait and let the main crux come to you freshly."

In summary, these three preliminaries are discussed until the patient's own description convinces the interviewer that the patient grasps them: (1) One must wait about 30 seconds without talking at oneself, letting words go by if they come, until one freshly senses one's bodily feelings of the problem. (2) Words can come from a feeling and such words have a special power, a sensed effect, other words don't have. (3) When you have a feel of the whole problem, don't decide what's most important about it. Ask: "What's the crux of it?" and let that come freshly to you from how the whole problem feels.

In research we give exactly the focusing instructions below. For therapy it is better to give them informally in one's own language, to vary their order, and to work repeatedly on steps where difficulty arises. The initial portion may be omitted after the first time.

FOCUSING MANUAL [1]

This is going to be just to yourself. What I will ask you to do will be silent, just to yourself. Take a moment just to relax..... 5 seconds. All right—now, just to yourself, inside you, I would like you to pay attention to a very special part of you..... Pay attention to that part where you usually feel sad glad or scared. 5 seconds. Pay attention to that area in you and see how you are now.

See what comes to you when you ask yourself, "How am I now?" "How do I feel?" "what is the main thing for me right now?"

Let it come, in whatever way it comes to you, and see how it is.

30 second or less

If, among the things that you have just thought of, there was a major personal problem which felt important, continue with it. Otherwise, select a meaningful personal problem to think about. Make sure you have chosen some personal problem of real importance in your life. Choose the thing which seems most meaningful to you.

10 seconds

1. Of course, there are many parts to that one thing you are thinking about—too many to think of each one alone. But, you can feel all of these things together. Pay attention there where you usually feel things, and in there you can get a sense of what all of the problem feels like. Let yourself feel all of that.

30 seconds or less

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2. As you pay attention to the whole feeling of it, you may find that one special feeling comes up. Let yourself pay attention to that one feeling.

1 minute

3. Keep following one feeling. Don't let it be just words or pictures—wait and let words or pictures come from the feeling.

1 minute

4. If this one feeling changes, or moves, let it do that. Whatever it does, follow the feeling and pay attention to it.

1 minute

5. Now, take what is fresh, or new, in the feel of it now...... and go very easy.

Just as you feel it, try to find some new words or pictures to capture what your present feeling is all about. There doesn't have to be anything that you didn't know before. New words are best but old words might fit just as well. As long as you now find words or pictures to say what is fresh to you now.

1 minute

6. If the words or pictures that you now have make some fresh difference, see what that is. Let the words or pictures change until they feel just right in capturing your feelings.

1 minute

Now I will give you a little while to use in any way you want to, and then we will stop.

When successfully taught, the patient may be struck by the fact that he could actually focus and sometimes even have an experiential effect from doing so. But often the difficulty he encounters in trying to focus is also striking (and unique to him, usually.) Perhaps he no sooner focused, then he doubted, blocked, found his extreme unwillingness, or whatever. Why conduct several years of surface interviews, when this barrier to an experiential process is right here, and is probably what we most want to work on?

The way to work on this difficulty is, again, by focusing on it. There is a "turning upon that," which makes the block, flatness, or unwillingness itself the object of focusing. "This unwillingness, what is that?" "Again, don't explain, think, talk at yourself, just feel 'all that' and ask what, about it, is the crux of it, and let that come."

Whenever the patient is unsure about what he has found (explaining or doubting) the way to deal with it is always again with a fresh start. One needn't decide the verbal issues that arise. "Focus freshly on it instead, let it come freshly again"—this is almost always the answer to whatever the issue now seems to be. ("But I don't know if what came is really mine, or if that's what people have drilled into me . . . ?" Answer: "Well, see freshly now what comes; never mind your doubts about what you just got to, let it come another fresh step, all new.")

Alternatively, if the doubt won't allow a fresh start: "All right, try to focus on that whole doubt business. What's the crux of all that? But wait, and let the whole doubt business come fresh."

When one attempts to teach someone how to get into the concretely felt version of his troubles (instead of talking about them), the difficulties encountered are themselves worth working on. The patient can experience what it is to refer to and feel his own bodily sense of the trouble he is up against. He can usually do so on some topics, but not on others. ("What's your whole impression of me? See—there you have it. Don't say anything. That's just an example.") This makes it very clear what he must strive to do, and the time can be spent heading straight into the concrete, even if one doesn't get there with ease.

Sometimes it may be hard for the patient to keep quiet, he may have so much to say. It is perfectly allright for him to say it all for a while, since the therapist's responses are, of course, another essential dimension of psychotherapy. But sometime soon again, after some minutes, (after he is satisfied he has the therapist with him) he ought again to focus freshly, and let the experiential body process move another concrete step.

In this experiential therapy, it is important that the therapist respond to what is directly felt even while it isn't yet conceptually clear. What patients sense in focusing is often conceptually vague. The patient feels the felt meaning distinctly enough, but if he talks, he often begins by complaining that it isn't possible to think about it clearly. "There's something funny there, about the way I pull out of relationships . . . (He has talked about the [Page 7] problem before, but not about what is "funny" here, he just focused and encountered that) . . . but I can't describe it. It's . . . ah . . . funny, there." The therapist must be able to talk to that, even without knowing what it is: "You got something there, but you don't what it is, yet. It's a funny something that you find, right there in how you pull out. It's something about how you pull out."

More talking and interaction may now help, or be just a rest from focusing. However, focusing is much easier when another person responds at times. The far out and fuzzy character of focusing on this "funny" feeling is very much mitigated, when the therapist talks of it. The patient's last furthest step becomes interpersonally anchored. It will then be easier for him to focus further.

Even though therapists are an introspective lot, I find that I and my colleagues do not do this sharply distinct focusing even in our own introspections, unless we set ourselves to do so specifically. I am as likely to go about in a stew as anyone else, until I specifically bring myself to focusing and say: "All right, now. Shut up," and then wait gently as I ask my body sense: "What's wrong?"

The key phrase in which focusing can be summed up is "What's wrong?", understood that one then waits without inwardly talking at oneself.

When one's mind has wandered, (one doesn't know that, until one catches it and then it has already wandered) one brings it back gently: "Where was I, oh yes, on that, uh, and, oh yes, what's really wrong?"

The deliberate almost forced character of this must be stressed. It isn't letting oneself go, but very intently keeping quiet, zeroing one's attention in, and then—within this deliberately made focus and quiet—only then and there, letting come what comes.

Another special qualification concerns borderline psychotics, or generally people to whom voices and other "weird" experiences can happen. It is important to emphasize that focusing concerns "how you now feel." It is not a matter of letting just anything come, but only "how you now feel" (about some problem of living). Focusing on how one now feels has a sane-making effect. The "weird" experiences do not come from how one now feels, but from out of space, from somewhere to the left of one's head. Once it is clear that present feeling is what one is focusing on, focusing is helpful also to people who are trying to control weirdness and rightly want to keep that from coming. Feeling is a safe and different "place" in oneself, than psychotic experiences.

The "feelings" one focuses on are not emotions as such, (though one may have emotions about and with them). Emotions are emotional tonalities such as anger, fear, hate, depression, joy, satisfaction, excitement. If one focuses ones attention only on the emotional tonality, nothing happens, or the tonality simply increases. For example, by focusing on the feel of being depressed, one gets more and more depressed. Instead, what I mean by "feeling" is really felt meaning, a preconceptual richness, implicitly "that whole situation," or "everything that has to do with. . . ."

Any difficulty involves our past, other people, situations, self-hates, past attempts, and many more facets that are not known. But one can feel the undifferentiated mass of "all that" in a bodily way. Such a "feeling" isn't only an emotional tonality (say depression), but rather, all that which has happened and makes life and me "the way it is now."

To focus on such a preconceptual body-sense of "all that," one must sometimes push past a specific emotional tonality. One can do so (especially if another person is present, even while that person is silent,) by moving as it were, through it. ("Yes, I am very depressed, yea, ugh . . . whew, what a heavy feeling . . . but freshly now, what is all that?" or another example: "Yes, I am very ashamed of it all, granted, yes, uhunh, but now, what's the crux of all that, that I am ashamed of?") Felt meaning is always an as yet undifferentiated mass of many aspects, but can be bodily felt as a whole.

Theory

I have now outlined the practical procedure of experiential focusing. I also employed the words felt meaning and experiential effect.

The following three theoretical propositions may briefly state 1) why a felt meaning, although felt as one, is a body sense of the many complexities of a problem; 2) why an experi- [Page 8]ential effect is a bit of body resolution of a problem; 3) why words, images, and interactions can have experiential effects.

1) A person is a bodily interaction with others and with his environment, much as breathing is a bodily interaction with an environment. How one lives and reacts is a bodily process going on in situations. When someone is about to jump at you, you feel it in your "gut." When someone is in complicated ways going to hurt you, again you feel it in your gut. Just as a golfer feels in his body, in the position of his feet, and in the muscular sense of his swing, the whole scene in front of him, so do we bodily experience the complexity of our situations and interactions.

2) A body-sense of a problem or situation is pre-verbal and pre-conceptual, it is structured in very many ways but not in just one way, and is not equivalent to any one verbal or conceptual pattern. To attend to it or speak from it is a further living and therefore a further structuring, a "carrying forward." When this bodily further living occurs, one senses an experiential effect.

3) Experiential body process is carried forward by action and feedback. As one acts, one perceives ones own acting. This is then a new experiencing which can again lead to an action which is again experienced and leads to another action. This "zig-zag" between body sense and visible action is such that each carries the other forward: the action is itself experienced again, and this experiencing again leads into a new action.

Words, images, dance steps, roles played, other people's reactions, all these are perceived as feedback, and can have the carrying forward zig-zag effect, which action has. (I say "can have," because most often, they don't. Only some words and some people's reactions carry one's felt sense forward. Usually they do not. They arouse new reactions but fail to release or carry forward the felt meaning one just then had.)

Although focusing, in the procedure here presented, uses words ("let words come from the feeling"), some individuals prefer imagery. Therefore the instructions sometimes say "words or a picture." What counts isn't whether words or pictures are used, but whether there is again and again a genuine fresh start from the feeling. People who use words tend to remain in the words, thinking and talking, rather than making again and again a fresh start from the feeling. Similarly, people who use images tend to be fascinated with one image, when they ought again and again to let a fresh start from the body feeling change the image for them.

Any sort of perceivable objectification (words, images, actions, interpersonal responses) can perform the same function, provided one constantly moves back to the feeling, and freshly from out of it again to new words, images, responses, etc.

We do not yet know if these different modes of carrying experiencing forward are equally effective for everyone, and whether exactly the same effects are produced, by all these modes. Only this we know: any of these can be effective when consistently remade by fresh steps from feeling, and any of them can fail when one gets involved in them and forgets fresh starts from felt experiencing.

Synthesis Based on Experiential Principles

To try out a new method, one must put first the patient's present immediately felt sense of what is going on. If this is put first, if the therapist always attends to it and asks about it, then any method can be tried without damage. One must honestly tell the patient: "Here is a method which I know of. It may help us, it may not. I'd like to try it with you, and then we can talk about how it seems to you." With this open approach and primary interest in the patient's own feelings, one will never inhumanly impose something wrong. Rather one will hear about what is going wrong, and in working on that, the method will have helped, at least indirectly.

Synthesizing is not the same as eclecticism. To put different methods together, one must first see exactly what specific therapeutic processes each engenders in the patient. Methods may sound very different, yet engender the same patient processes. Conversely, two therapists may say and think they practice alike, yet engender very different patient processes. This shows that current methods are not yet specifically defined in terms of the consequences [Page 9] they produce. We must define each method by the specific experiential steps and momentary effects in the patient, which they produce. To do so, we must define much more exactly what the therapist actually does, which has these experiential effects. Such a specific redefinition what I call "experientializing" a method. Once we have done that, we can see what specific procedures from one method we might want to use, what these can do, what they lack, and consequently what specific procedures from other methods we might need to put together with them.

In the following I will briefly "experientialize" several methods, just sufficiently to show what aspects of them are included in the focusing procedure. In each case, please notice that what I specify experientially is something many practitioners of the given method do, but also something many of them don't do. The older conceptualizations lack a way of pin-pointing the essential process of experiential focusing.

I view focusing as one essential of psychotherapy, desensitization, Jungian imagery, hypnotherapy, free association, and other methods. In most cases I believe the focusing procedure has specified what is valuable and eliminated what makes for failure in this essential process. For example, free association is like focusing only when it is done experientially. Most often it isn't. Most often, free association is a means for informing the analyst about the patient. The patient's associating may be only mind-wandering. The analyst's inferences may be correct but generate no immediate body process in the patient. On the other hand, free association in Freud's original mode was intended to let the patient arrive at directly encountered blockage. Then the analyst's interpretations are aimed at that concrete blockage, and are called effective only if they succeed in dissolving that blockage and engendering a concrete change process (in analytic language, a "dynamic shift.")

Just as I have specified two sorts of "free association" above, so also one can be more specific about the Jungian daydream technique: Does the patient freshly re-imagine, or does the therapy get itself stuck in analyzing a given image however fascinating it may be? Does the therapist focus the patient's attention on his concrete feeling so that images change in interplay with the body sense of the problem, or do images march independently as mind-wandering does in free association? (Jung emphasized that the patient must be "active" with the imagery, and must not just observe.) Many patients have frightening run-away imagery because they are not sufficiently focused on their concrete feelings. Imagery therapy without such a focus can reinforce patients' tendencies to push feelings back, and lead them toward psychotic-like experiences.

Experiential focusing (as Weitzman, 1967, has commented) is very like systematic desensitization. However, the behavior therapist picks the scenes to be imagined, the steps and the pacing. In focusing, the patient lets these develop. He usually holds himself to a problem rather than a single situation (because, quite often, as focusing proceeds, what the trouble is becomes transformed.)

Focusing also differs from desensitization in that the patient isn't given a "hierarchy" of images to feel, but lets the next specific troublesome feeling arise directly from his body sense of the trouble. However, the content flow in focusing (when later described) is often similar to reports after desensitization.

The distinct experiential shift one feels when there is an "experiential effect" is very like what desensitization aims at.

When one attempts to focus, one relaxes. This is quite natural (one shuts out externals, takes a deep breath, and one says "now let me see . . . "). Focusing is helped by introducing relaxation instructions just before, an innovation contributed by Weitzman (1967.) However, these relaxation instructions must be brief, ("just tense your arms and then let them drop. That's right. Now your legs, tense them, now let them drop.") otherwise relaxation is too deep and focusing doesn't occur. Focusing oscillates across the line (if we may draw one) between full waking and slight relaxation. It requires enough relaxation to focus on felt meaning, but immediately again full awakeness in response to what comes, then again a fresh descent into the body feeling of the problem and again a fully awake coping with what has come. If relaxation is too deep, there is content flow but no concrete experiential shifts.

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Many other methods—when they work—involve the same experiential process as focusing. This is because therapy must involve a body process of experiencing.

The body change process we seek is becoming clearer to us, and seems to be the same one, whether with words, images, or role-playing, whether by imagining the situations the therapist assigns, or by direct bodily sensing as a source of words and images.

We are just beginning to define precise steps of instruction. Without more precise steps and definitions, therapy methods are vague and the differences between methods are less than the differences among practitioners of the same method.

There are surely other specific steps which other therapists are finding, and which the method of focusing so far fails to include. These can and should be added if they can be made specific and instructable. Experiential focusing makes specific and synthesizes the steps of those therapeutic methods which systematically seek to engender body change process. But this is only one main dimension of therapy. The other main dimension is interpersonal interaction.

Therapist Interaction

Focusing, as deliberate silent instructed effort, must occur in the wider context of a therapeutic relationship. In presenting focusing I would not like to give rise to its being practiced exclusively, but only in the context of one's preferred broader method of therapy.

However, currently most methods that systematically engender concrete body process ignore the interpersonal relationship (although this is less and less the case in behavior therapy, Levin et al., 1968; D'Alessio, 1968; Lazarus, 1968.) Conversely, relationship therapies tend to have no systematic way to make therapy a bodily concerete process, in cases where that is not so for the patient already. Why not use both these dimensions of therapy?

For too long, each therapeutic method advertised itself as the only effective one, and as all that one needs. Where experiential specificity reveals that two methods do not make for the same process steps, anything of value that they offer should be put together. We know that interpersonal interaction provides the patient with processes of reliving and new living which he cannot have alone.

How can a specific deliberate instruction method be put together with a therapeutic interaction method? As I have already indicated, the therapist should make responsiveness to the patient his overriding rule. That alone guarantees that there won't be a mechanical and exclusive application of focusing. There will be many periods of more ordinary therapeutic interaction, into which focusing can fit, often or rarely, as seems best.

We must now turn to this other major dimension of the therapies, the interaction between two people. I will indicate only briefly some aspects of interaction which, along with focusing, go to make up experiential psychotherapy.

The therapist responses (both verbal and in the way in which he interacts, expresses himself, interprets, and argues, or lives toward the patient, . . .) are also a type of objectification, just as words, images, and actions are. Therapist responses can carry the patient's experiencing forward, into experiential effects and bodily release, or they can leave his experiential body process stuck where it was stuck. (Of course, it is easy to arouse all sorts of other reactions in the patient, but "carrying forward" is that very special reaction of finding his experiential process living further from just how it was stuck.)

Focusing and interaction are both effective via the same basic experiential carrying forward, which in focusing is provided by bodily attention and words, or images. The only difference is that we know, in the case of interpersonal responses, that they have effects no other sort of feedback can have.

While I cannot discuss it in detail in this article, fresh self-expressive relating by the therapist, is one of the best ways to assure carrying forward. However, such relating must consistently leave room for focusing, and welcome and prize the patient's side of whatever interaction patient and therapist engender. Without this overriding rule, much current expressive relating by therapists fails. Therapists are not superior human beings. When they relate spontaneously, it is often not better than when the others in the patient's life [Page 11] do so. What makes it better is the fact that the therapist has an overriding interest in welcoming and making room for whatever experiencing he has engendered in his patient. If he teaches his patient to focus, and makes room for that process, then even seemingly bad patient-therapist interactions will have therapeutic results. This is again the rule that what happens in the patient always takes precedence over anything else.

The rule means that I may spontaneously express myself regarding him—but then, soon, I will want him to focus and speak from what has happened in him. Just as the patient should not get "stuck" with the one set of words, or one image, he also shouldn't get stuck with one way I am toward him. Rather, a fresh start from his feelings is always again necessary.

Experiential interaction comes spontaneously from both persons. As therapist I often don't teach or help with focusing, I often express myself instead of responding receptively. But very soon, I will do just that latter, and only because I will, am I free to believe that my spontaneous interacting can be therapeutic. Whatever I create or stir, there will be room for the patient to live that forward in ways most people won't help or let him do.

The repetitive self-defeating patterns some patients bring to therapy are the most difficult obstacles to progress. Every major writer in the field has cited them, whether called transference, counter-will, opposite, etc. With focusing they are discovered to be positive efforts at completing what I call ego-formation. Of course such modes disrupt adult interpersonal relations, and of course they don't fit adult situations which presuppose finished egos, persons, or selves (use any word for it.) In those respects in which each of us is still struggling to become a person, in those respects he cannot respond well to other persons. What I am asserting is no more than an experiential reformulation of the Oedipus Complex, Separation Anxiety, the Great Mother, or generally, the "family drama" one reenacts. Focusing reveals that the imminent felt meaning of these patterns is positive. One attempts to express or assert oneself, to identify with a figure of one's own sex, to have one's sexuality established and valued, to be really loved or close, etc. On the other hand, one is still forming oneself and one is still at issue in such repetitive patterns. In real situations these positive ego-forming needs make for behavior which alienates others and defeats the felt aim. Experiential interaction (both in focusing, and in personally spontaneous interaction) must intensely involve, and carry forward, such felt aims. This often cannot be done without periods of battle, but it requires as well, periods of welcoming, and responding so as to complete the positive aim positively, even though the behavior would not, in the world, lead to positive results. The patient must be able to perceive the response as carrying forward, that is, as embodying just that which he just then is and feels. If his obnoxious behavior is a self-assertion, the therapist's response (whether it is blowing up or giving in) must visibly complete the patient's having asserted himself. If the patient's behavior is passive, he must sometimes live passively successfully with the therapist, in a peaceful togetherness, in an identifying identity-building way. The ego-forming pattern must succeed, and yet it must also be expanded and elaborated and intruded upon by the real other person of the therapist. To put it in reverse order, first the therapist responds spontaneously as a real person, then moments later, he helps the patient successfully form himself to meet, tolerate, and live in the adult relationship he was as yet unable to live in.

Theoretically, we can summarize: words, imagery, actions, and other people's responses can carry forward an individual's bodily experiential process. When that happens, there is experienced feedback. What objectively feeds back is experienced as continuous with the previous moment—yet always, such experiencing is more, it carries further. While focusing attention and words are very powerful in being both continuous and carrying the body process further, interpersonal interactions are even more powerful. Another person's living toward me is "feedback" of a kind that can constitute much more further living than focusing alone can do. But the principle is the same: words, images, and interactions do not have the purpose of saying what the [Page 12] patient feels or is, but to provide a further experiencing continuous with, but carrying forward, where he has been concretely blocked, autistic, or self-defeating.

By putting together our methods for engendering body process with our methods for spontaneous human interaction we can provide the needed further bodily experiencing.

The Research Background

In a sequence of studies (van der Veen & Stoler 1965; Tomlinson & Hart 1962; Rogers 1967; Gendlin 1966, 1967, 1968) we have now found that successful outcomes measured on psychometric tests before and after therapy correlate with the "experiential level." Interviews are tape-recorded and analyzed on the Experiencing Scale (Gendlin and Tomlinson, 1963). Failure on the outcome measures is highly correlated with a low experiential level during interviews. Therapists' outcome ratings and patients' own ratings parallel these findings on the psychometric instruments. The relation of outcome measures to each other is somewhat irregular, but the main finding consistently stands out in these studies. High experiential level (during interviews) is significantly correlated with positive outcome (before and after measures).

The Experiencing Scale is used by independent raters listening to randomly selected and re-recorded bits of psychotherapy interviews. The Scale has many detailed descriptions of what a rater must hear on the tape in order to score that bit of tape in any one of the seven scores. While these descriptions are not so specific as to preclude all doubt whether they apply or not, the scale is close to that aim. It does not use subjective impressions of the rater. Undergraduates as raters are more reliable at using the scale than sensitive clinicians—because the latter refuse to go by the scale and use their subjective judgment instead. This shows that the scale descriptions, not the bias of the rater, does at least some of the discriminating.

From research one can conclude only that two variables are associated, not that one is the result of the other. Outcome, and experiential manner during interviews may both be the results of some third, as yet unknown variable. However, the experiential indices were derived from a theory of experiential change process.

The scale was intended to define the sorts of verbal behavior occurring in therapy interviews when a patient uses his freshly ongoing experiential process as a basis for what he says, thinks, and does in the interview (Gendlin, 1956, 1961, 1962). The kind of references he makes, how he comes from one thing he says to the next, is quite different in a directly referred to feeling process, than when he is merely intellectualizing, moving from concept to concept, or merely reporting on situations, or merely emoting.

Psychotherapists have always held what these findings show: intellectualizing, event-reporting, or mere catharting makes for failure, while concrete "working through" makes for success. But what successful "working through" really is has never been well defined, or measured before.

We now have a measurable index applicable to any given interview or bits from interviews, telling us validly whether psychotherapy is going on therein or not (if we mean by psychotherapy the here measured process).

Of course all of this is still a bit new, but assuming further consistency, this measure allows us, at last, to begin the sort of research we have always looked forward to: to measure the differential effects of specific techniques, (or of anything else you think might improve therapy.) You can now institute any experimental factor and then measure whether it has raised or lowered the experiential level in the subsequent interviews.

You might want to test what you do, that you consider crucially effective. The same research paradigm can say whether, after you do that, the experiential level increases, or not, (and, separately, whether the outcomes again correlate with that level).

We have chosen to test the effect of "focusing instructions." We now teach patients how to focus, and then measure whether, indeed, the teaching has raised the experiential levels of the subsequent interviews. The reason we chose to devise such teaching (the focusing instructions) and to test its effects on the experiential level is as follows:

In the earlier research there was not only [Page 13] the good finding that the experiential level correlates with eventual success. Unfortunately there was also, in the same sequence of studies, a very unwelcome and unpredicted finding: the experiential level predicts success and failure significantly, whether you analyze interviews from the end of therapy, the middle, or the beginning! One can predict success or failure quite significantly even from very early interviews. If the experiential level in the early interviews is low, it does not usually rise. Failure results. In only five out of one group of 38 cases (Gendlin, et al., 1968) was there a sufficient increase during therapy to make for a success in initially low cases. Perhaps today it happens more often, as hopefully our current research will show.

We had predicted that over the course of therapy, the experiential level would rise. Patients would begin low, closed, defensive, and therapy would make them more able to focus on their directly experienced felt meanings. We were mistaken. Therapy as usually practiced does not teach the patient how to do therapy. Our earlier prediction was circular. By not doing anything therapeutic, we thought, a patient could learn to do something therapeutic. (Of course, we wouldn't have put it that way at that time.) We thought that therapists could make the process happen even when it isn't happening initially. The experiential level can be viewed as the "motor" of therapy. No matter how much time is spent with the motor off, that doesn't turn it on. If it is sufficiently on, progress is made. If it is off, nothing change-effective happens. But we still think that therapists should turn this "motor" on, and that is what our use of focusing attempts.

The motor need not be on at extremely high levels, 3.5 on the scale is sufficient. But at 2 no therapy happens, as defined by our process and outcome measures.

We had predicted that successful patients would move up the scale over the course of therapy. It happens, but minimally. Successful patients move half a scale position, a change which is statistically, but not psychologically, significant. If the motor is on, the patient moves successfully, and doesn't necessarily increase in how "on" the motor is. Using this analogy, say you drive from Chicago to New York, you don't necessarily go faster and faster as you get closer to the end. You might go only 40 mph all the way but you still get there. If the motor is off, you are sitting in the parking lot and no matter how long you sit, you will still be there.

This finding says simply that much of what we call "psychotherapy" is not psychotherapy. It says also, that when therapists are confronted by a patient who does not focus experientially, does not concretely work at anything, therapists have not been effective (in our data at least) at making something therapeutic happen.

There are research implications to this finding: let us stop testing a "therapy" group against a "control" group, by defining "therapy" as nothing more than the wishful intent of the therapist. With our still weak measures, a control group that does no therapy should not be compared to a "therapy" group more than half of whom are not doing therapy either! Whenever we have first used our experiencing measure to define those who are engaged in therapy process, (a high level on that scale) we then always found significant differences in outcome between them and the control group.

The question for clinical practice posed by these findings is, of course: Is it responsible to let the failure-predicted patients simply continue for some years to their predicted failures? When we can measure now that the interviews are not of the change-effective sort, should we let them go on and on that way? Or shall we teach the effective therapy process? And does success then result from such taught behavior, as it has in these studies resulted from such behavior when not taught?

Of course we can argue that psychotherapy is indicated for some types of people and not for others. But the history of psychotherapy is one of adapting and extending it to populations that were at first held untreatable. What is more, psychotherapy was improved by these adaptations and extensions. For example, some of the main developments of all psychotherapy have come from work with children and with psychotics. Each time the untreatable population is one which isn't good at using [Page 14] words and thoughts as therapeutic tools, and each time psychotherapy as a whole became more interactional and experiential as a result of being adapted to these populations. Perhaps a step of this sort is happening again, as we attempt to learn how to make an experiential process begin, how to make overly verbal therapy bodily and experiential.

Rather than thinking of focusing ability as associated with a personality type, I prefer to think of it as a skill. Perhaps some types of people have this skill naturally, while others must learn it. But if it is a skill basic to personal problem-solving and health, we would want to teach it to those who don't generally have it. For example, some are natural athletes, others not, but some calisthenics are important for everyone's health, not only for athletic types.

We do have some beginnings of research which show that those who are initially good at focusing are a type. Some Cattell variables correlate with focusing ability as measured by a questionnaire taken after focusing instructions (Gendlin, et al., 1968). Interesting questions open: at what age do children develop focusing ability? At what age is it lost again by many of them? Or do some never have it? Does it vary with cultures and our sub-cultures? Does it vary with economic class? Focusing instructions take ten minutes, and the introductory discussion need not be long. It is best administered twice, with clarifying discussion between. We have administered it to groups at one time. The questions asked by a group between the two administrations often clarify a great deal. The questionnaire still leaves much to be desired, but is a reliable measure.

POST-FOCUSING QUESTIONNAIRE:

1. Without saying what you thought about, describe in two or three sentences what was happening for you during this time.

2. How is this different from what you normally do?

3. What about this was the best thing for you?

4. What was the worst thing about it?

5. What surprised you most about doing this?

6. Did the feeling change or move?

7. Describe what happened for you when I said: "Try to get a sense of what all the problem feels like. Let yourself feel all of that."

8. What happened for you when I said: "As you pay attention to the whole feeling you may find that one special feeling comes up"?

9. Describe what happened when I said: "Wait and let words or pictures come from the feeling."

Independent scorers reliably score the questionnaire on a four point scale: (1) did not focus; (2) did stay with the problem, but it is not clear that he focused on a felt meaning; (3) did focus on a specific felt meaning but with no reported effects; (4) focused with an experiential effect of some kind.

Of course, one can argue that those who cannot focus are a type. But, as therapists in such cases we have failed at something that we have not even fairly tried: to show the patient how to do therapy. Most therapists were trained in the view that showing the patient how to do therapy is impossible. Therapists hint, they say "have you thought why that might be . . . ?" or "perhaps you feel . . . ," and then they are often patiently dismayed week after week, when there is never any concrete, bodily, experiential, live, physically felt change.

Therefore we embarked on the direct teaching and working with focusing.

Focusing is not a matter of degree, as was the experiential level we measured in therapy interviews. Rather, it is a direct and abrupt turn from talking and thinking to the felt body version of a problem.

Footnotes

[1] The language of this manual is objectionable in many ways. For example, the phrase "part of you" is theoretically wrong. Also, felt meanings are not really "inside" a person, but are his body sense of his external life and situations. Better phrasing can no doubt be devised. This phrasing arose from a great many revisions made in discussions with subjects after focusing, and seems to communicate quickly.

References

D'Alessio, "The Concurrent Use of Behavior Modification and Psychotherapy," Psychotherapy., 5, 3, 1968.

Gendlin, E. T., "Experiencing: A Variable in the Process of Psychotherapeutic Change," Am. J. Psychother., 15, 233, 1961.

Gendlin, E. T., Experiencing and the Creation of Meaning, New York: Free Press, 1962.

Gendlin, E. T., "A Theory of Personality Change," In Personality Change. Worchel, P. and Byrne, D. (Eds.), New York: John Wiley, 1964.

Gendlin, E. T., "Research in Psychotherapy with Schizophrenic Patients and the nature of that 'Illness'," Amer. J. Psychother., XX, 1, 4-16, 1966.

Gendlin, E. T., Jenny, R., & Shlien, J., "Counselor Ratings of Process and Outcomes in Client-centered Therapy," Report to the American Psychological Association Convention, 1956.

Gendlin, E. T., & Tomlinson, T. M. "The Experiencing Scale," Mathieu-Klein revision, unpublished manual, 1963

Gendlin, E. T., Beebe, J. III, Cassens, J., Klein, M., & Oberlander, M., "Focusing Ability in Psychotherapy, Personality, and Creativity," In Shlien, [Page 15] J. M. (Ed.) Research in Psychotherapy, Vol. III, Washington: American Psychological Association, 1968.

Lazarus, A. A., "Variations in Desensitization Therapy," Psychotherapy, 5, 1, 1968.

Levin, S. M., Hirsch, I. S., Shugar, G., & Kapche, R. "Treatment of Homosexuality and Heterosexual Anxiety with Avoidance Conditioning and Systematic Desensitization: Data and Case Report," Psychotherapy, 5, 3, 1968.

Rogers, C. R., Gendlin, E. T., Kiesler D. & Truax, C.B. Eds., The Therapeutic Relationship and its Impact: A Study of Psychotherapy with Schizophrenics, University of Wisconsin Press, 1967.

Tomlinson, T. M. & Hart, J. T., "A Validation of the Process Scale," J. Consult. Psychol., 26, 74, 1962.

van der Veen, F. & Stoler, N., "Therapists Judgment, Interview Behavior and Case Outcome," Psychotherapy, 2, 158, 1965.

Weitzman, B., "Behavior Therapy and Psychotherapy," Psych. Rev., 1967.

Wolpe, J. & Lazarus, A. A., Behavior Therapy Techniques, Oxford: Pergamon, 1968.

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  • Biographic Note: Eugene T. Gendlin is a seminal American philosopher and psychologist. He received his Ph.D. in philosophy from the University of Chicago and taught there from 1963 to 1995. His philosophical work is concerned especially with the relationship between logic and implicit intricacy. Philosophy books include Experiencing and the Creation of Meaning, Language Beyond Post-Modernism: Saying and Thinking in Gendlin's Philosophy edited by David Michael Levin, (fourteen commentaries and Gendlin’s replies), and A Process Model. There is a world wide network of applications and practices (http://www.focusing.org) stemming from this philosophy. Gendlin has been honored three times by the American Psychological Association for his development of Experiential Psychotherapy. He was a founder and editor for many years of the Association’s Clinical Division Journal, Psychotherapy: Theory, Research and Practice. His book Focusing has sold over half a million copies and has appeared in seventeen languages. His psychology-related books are Let Your Body Interpret Your Dreams and Focusing-Oriented Psychotherapy.
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