Psychotherapy: Theory, Research, Practice, Training
2007, Vol. 44, No. 3, 279 –284
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Copyright 2007 by the American Psychological Association
0033-3204/07/$12.00 DOI: 10.1037/0033-3204.44.3.279
CARL ROGERS AND THE LARGER CONTEXT OF
THERAPEUTIC THOUGHT
PAUL L. WACHTEL
City College and the Graduate Center of the City University of New York
Carl Rogers’ classic account of the
necessary and sufficient conditions for
therapeutic personality change is exam-
ined in light of developments in theory
and practice since the time he wrote.
Rogers’ ideas, which diverged from and
were very largely a challenge to, the
dominant psychoanalytic ideology of
the era in which he wrote, are consid-
ered in relation to new theoretical de-
velopments in what has come to be
called relational psychoanalysis. They
are also considered in light of the
greatly increased influence of and sub-
stantial evidence supporting behavioral
and cognitive– behavioral approaches.
Points of convergence and divergence
among these approaches are examined.
Keywords: Rogers, relational psycho-
analysis, unconditional positive regard
When Carl Rogers wrote his article on the
necessary and sufficient conditions for therapeu-
tic change, the field of psychotherapy was con-
siderably different from what it is today. The
1950s were the heyday of Freudian hegemony,
and much of the body of Rogers’ work can
clearly be seen as a kind of confrontation with
and the offering of an alternative to the rather
stern practices of psychoanalysis of that era, as
well to its often highly intellectualized mode of
practice. Rogers offered a “kinder and gentler”
exploratory or insight-oriented psychotherapy, as
well as a more experiential approach to the work.
Correspondence concerning this article should be ad-
dressed to Paul L. Wachtel, Department of Psychology, City
College of New York, New York, NY 10031. E-mail:
paul.wachtel@gmail.com
Today, the hegemony of so-called classical
analysis is no more. In the days when Rogers
wrote his “necessary and sufficient conditions”
article, the different “schools” of therapy were
describable in terms such as Adlerian, Jungian,
Rogerian, and so forth. (The classic research of
Fiedler [1950] that Rogers cites, which showed
experienced therapists of different schools as
more like each other than they are to neophytes of
their own school, essentially defined the schools
in this way.) In the present era, these different
schools, including client-centered therapy, can be
seen as rather close cousins, having much in
common with each other compared to their rela-
tion to approaches across what now seem to be
the “real” lines of substantial divergence—the
boundaries between the insight-oriented therapies
and the other two major groupings on the con-
temporary therapeutic scene—the cognitive–
behavioral and the family systems approaches.
There are, of course, many ways to slice the pie,
and some might object to my way of grouping; at
one count, there were over 400 “brands” of ther-
apy on the marketplace (Norcross & Newman,
1992). But close examination of the various ap-
proaches, I believe, lends itself best to an over-
arching three-factor or three-dimensional model.
In placing Rogers’ conceptualization of the
necessary and sufficient conditions in this con-
text, I wish primarily to consider Rogers’ views
in relation to those of other representatives of the
broadly inclusive insight school. I must first offer
a caveat, though, because “insight” was not quite
the aim of Rogers’ approach. Insight, as it was
implied in the era when Rogers was writing, was
something significantly different from the kind of
self-awareness that Rogers was aiming to pro-
mote. As many critics from within the psychoan-
alytic world in recent years have emphasized
(e.g., Aron, 1996; Hoffman, 1998; Mitchell,
1988; Stern, 1997; Stolorow, Orange, & Atwood,
2001a, 2001b), the traditional conception of in-
sight in psychoanalysis was essentially objectiv-
ist in nature. Rogers, in contrast, approached mat-
ters from a more phenomenological vantage
279
 Wachtel
point. His aim was not to help the client to
remember what “really” happened or to discover
what he or she “really” felt and was defensively
distorting but to help the client be freer to expe-
rience whatever his or her inner inclinations
pointed toward. He aimed, in essence, not to
enable the client to see what he or she had been
unconsciously thinking and feeling all along if
only he or she could acknowledge it, but rather to
develop the thoughts and feelings that were in-
cipient but blocked by anxiety and self-
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disparagement. It was very largely the further
This document is copyrighted by the American Psychological Association or one of its allied publishers.
development of the personality, not the discovery
of what was already there, that was at the heart of
his efforts.
In this, Rogers’ thinking converges signifi-
cantly with Stern’s (1997) conception of unfor-
mulated experience. For Stern, the focus of psy-
choanalytic concern is not on contents already
formed but hidden but is on thoughts and feelings
not completed or elaborated because they are
impeded by anxiety, guilt, shame, or self-
loathing. To be sure, there are many important
differences between Stern’s relational psychoan-
alytic conceptualization and Rogers’ client-
centered view; but I believe there is also a sig-
nificant degree of convergence, not just with
Stern’s thinking but with the entire tradition of
relational psychoanalysis—a point of view and
way of thinking psychoanalytically that did not
really exist when Rogers was writing his “neces-
sary and sufficient conditions” article. Rogers’
thinking, which was once at considerable vari-
ance with the main currents of psychoanalysis,
now converges in important ways with what is
perhaps the most influential and important trend
in psychoanalytic thought. Having just completed
a book-length study of the relational point of
view and its implications (Wachtel, in press), I
found, not surprisingly, that it was this compari-
son that was most on my mind as I reread Rogers’
article, and it is this comparison to which I now
turn.
We may note, to begin with, that the very first
condition that Rogers puts forth, which he first
frames as “two persons are in psychological con-
tact,” is one that he restates, in further elaborating
on his ideas, simply as “relationship.” This em-
phasis on the relationship as the grounding con-
dition for therapeutic effect converges not only
with the general thrust of relational psychoanal-
ysis but also with a central theme in psychother-
apy research in recent years. Perhaps in response
280
to the preponderant emphasis on techniques or
methods or procedures that had largely marked
psychotherapy research since the mantle of lead-
ership in that field passed from Rogers and his
followers to the proponents of cognitive–
behavioral therapies, recent research has increas-
ingly been concerned with showing how power-
ful an influence the relationship itself is, over and
above any specific technique or theory differ-
ences (see Norcross, 2002). In contrast to the
almost impersonal emphasis in so much psycho-
therapy research in recent decades on the efficacy
of particular protocols or intervention methods in
the abstract, Rogers, like contemporary relational
thinkers, reminds us that the ground of any ef-
fective therapy is a relationship.
It could be said, indeed, that everything spelled
out in the remaining five conditions Rogers dis-
cusses is an elaboration of what constitutes a
useful and effective therapeutic relationship. That
is, the other five conditions are all about what
kind of relationship is therapeutic. Being in a
relationship with the patient, while a crucial
grounding condition, is necessary but not suffi-
cient. There are good relationships and bad rela-
tionships, therapeutic relationships and relation-
ships that are decidedly countertherapeutic.
The issue of congruence or genuineness is per-
haps the most the most complex and difficult of
the six conditions to understand conceptually and
master in daily practice. It points to vexing ques-
tions with which therapists continue to struggle.
What to do when one is genuinely bored with
what the client is saying (and, especially, if one
feels frequently bored); how to deal with simi-
larly troubling feelings of anger, sexual attrac-
tion, or any of the other powerful human feelings
that, as any practicing therapist knows, are not
excluded by the four walls of the consulting
room—these remain matters with which every
therapist must wrestle. Related issues arise with
regard to when or whether to self-disclose about
such feelings and, if so, how to do so in a way
that is therapeutic. There are still some in our
field who feel that if a therapist has such feelings,
he or she “has a problem,” should go back into
therapy to explore these feelings, and so forth.
For contemporary relational writers, the occur-
rence of such feelings is not only assumed to be
virtually inevitable but, for many, is seen as a
fundamental and invaluable source of the thera-
pist’s understanding and of the therapeutic pro-
cess itself. It might be said that the process of
 Special Section: Carl Rogers and the Context of Therapeutic Thought
therapy is very largely a function of the tensions
between the imperative of genuineness and the
imperative of unconditional positive regard. That
is (before elaborating a bit further on the meaning
and implications of unconditional positive re-
gard), one might depict the effective therapist’s
stance as one of striving for unconditional posi-
tive regard and inevitably failing in some respects
and, therefore, as being confronted with the ques-
tion of how to be genuine about that failure while
still being therapeutic. One of the most important
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things we have learned about the therapeutic pro-
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cess from research conducted in the years since
Rogers wrote is that failure to consistently meet
the standards described in the article under dis-
cussion here is not only inevitable but is probably
one of the essential engines of therapeutic
change. What Safran and Muran (2000) call “re-
pair of ruptures” in the relationship seems to
be one of the crucial factors in the therapeutic
process.
This is in certain respects something that Rogers
himself recognized. He did not expect the therapist
to be perfect, but rather he described the therapist’s
success in meeting the conditions he described as “a
matter of degree.” It is essential, one might say, that
the therapist be good at repairing ruptures in the
relationship, but it is also essential that the ruptures
not be too frequent or too severe.
One place where Rogers seems to me to be
limited in the approach he described 50 years
ago—and I emphasize that half-century time dif-
ference so as not to seem to fault him for not
having benefitted from years of further thinking
and new findings that did not yet exist—is in his
faith in the Q-sort as arbiter. I am actually a great
fan of the Q-sort and still recommend it to some
of my dissertation students, but like any method it
has its limitations. In this article, the particular
way in which Rogers suggests reliance on the
Q-sort seems at times to reflect a retreat to ob-
jectivism and what might be called “operational
definitionism” that is not fully consistent with the
phenomenological and experiential emphasis that
seems to be closer to the heart of his clinical and
theoretical position. I credit Rogers greatly for
trying to link his views about therapy with efforts
to rigorously test those views empirically, espe-
cially because that combination is often unfortu-
nately absent in some of the otherwise most
thoughtful and fertile contributors to the literature
on relational psychoanalysis (Wachtel, in press).
Nonetheless, assessing the therapist’s genuine-
ness by looking at how his Q-sort compares with
those of outside observers tells only that his per-
ceptions differed from theirs not that his was less
genuine.
It could be said that addressing the limita-
tions of how Rogers discusses validating his
hypotheses in this article is unfair. It is, after all,
a short “idea” article, and Rogers conducted an
enormous amount of research on his approach
over the years. But it is nonetheless worth noting
the naively positivistic tone to his discussion of
the Q-sort in this article. Although one of the
strengths of the Q-sort is that it is a method that
permits the subject to express aspects of his or
her subjective world in a manner that also lends
itself to quantitative comparison, Rogers’ discus-
sion virtually treats the judges’ Q-sorts of what
has transpired as an objective criterion to which
the therapist’s subjective sort is compared. This
may be an “operational” definition of congru-
ence, but it does not seem to me to be fully
consistent with the emphasis, both in this article
and in Rogers’ work more generally, on under-
standing the phenomenological world from
within the framework of the experiencing indi-
vidual. Therapists are “persons” also, and a
person-centered approach is marked particularly
by a validating rather than evaluating perspective,
especially an evaluating perspective that takes as
the “real” the experiences and judgments of oth-
ers. Certainly it is difficult to find the best way to
assess the state of someone’s subjectivity, and
Rogers is to be admired for even making the
attempt. But we do the enterprise no favor by
giving it a pass for good intentions.
In contrast, whereas the literature of relational
psychoanalysis is short on efforts at empirical
assessment and validation, it is strong on discus-
sion of the philosophical pitfalls of residual pos-
itivism even in writers who think they have tran-
scended it (e.g., Hoffman, 1998; Mitchell, 1993;
Stern, 1997; Stolorow et al., 2001a, 2001b). Ex-
amination, from the vantage point of these more
contemporary critiques, of the methodologies and
working assumptions of the research of Rogers
and his followers might help to sharpen the meth-
odology further. Although these critiques can be
(and at times have been) used to evade the re-
sponsibility to engage in systematic empirical
inquiry altogether, in the hands of a research
tradition that is already more inclined toward the
study of phenomenology and subjectivity than
281
 Wachtel
the mainstream, these critiques can serve a valu-
able function.
Turning more focally to the dimension of un-
conditional positive regard, I believe it is illumi-
nating to consider it in relation to the traditional
psychoanalytic concept of neutrality. Like neu-
trality, it embodies the idea that the therapist
should not make value judgments or direct the
patient or client to move in a particular direction
but rather should simply aim to understand the
person in his or her own terms. Certainly in
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connotation, there is a rather significant differ-
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ence between being neutral about another person
and unconditionally positive regarding him or
her. To what degree these very clear and obvious
differences in connotation reflect real differences
in the therapist’s attitude toward the patient or
client is a continuing source of debate. Tradi-
tional analysts have continued over the years to
assert that neutrality does not mean coldness or
lack of caring, but precisely what this “non-
neutral” neutrality is remains plagued by ambi-
guities. In 1961, for example, Stone (1961) ar-
gued that the traditional psychoanalytic stance
included what he called “physicianly concern”
and, in general, presented a version of psychoan-
alytic neutrality that did not preclude warmth and
caring. Stone’s argument could be seen as evi-
dence that the image of the cold, distant, “unposi-
tively regarding” psychoanalyst was a caricature,
or it could be seen instead as evidence that a
corrective was needed to a stance that was rather
lacking in warmth and caring—why else did
Stone need to write his book in the first place?
Frequent further statements over the years con-
tending that the concept of neutrality has been
misunderstood by critics of psychoanalysis sim-
ilarly raise the same issue. Why has this much
“misunderstood” concept needed so frequently to
be clarified? As recently as 2007, Hoffman
(2007), in a keynote address to the American
Psychological Association’s Division of Psycho-
analysis, cautioned analytic therapists about “sit-
ting back in that stereotypic, stylized posture of
psychoanalytic hyper-unperturbed calm” (p. 9),
suggesting that the older, problematic form of
neutrality has by no means disappeared.
It seems to me that the concept of neutrality
was problematic from the outset, because it was
built upon a faulty and illusory foundation
(Stolorow & Atwood, 1997; Wachtel, 1987).
Rogers’ concept of unconditional positive regard
seems a much better starting point for establish-
282
ing the proper tone for the therapeutic relation-
ship. It too is in some ways an impossible ideal
(see, e.g., Truax, 1966), but, keeping in mind
Rogers’ caveat that it can only be achieved “to a
degree,” it remains a far more satisfactory guide
to achieving the very stance and tone that con-
temporary advocates of “neutrality” now contend
they seek. The interplay between genuineness
and unconditional positive regard, however, is
now understood to be considerably more com-
plex than it might have seemed in the 1950s.
Rather than representing two separate, more or
less orthogonal dimensions or conditions, genu-
ineness and unconditional positive regard are per-
haps best thought of as being in a dialectical
relationship, in which it is the very tensions be-
tween them and the explicit effort to comment
upon and address those tensions and competing
pulls that are the heart of the therapeutic process
(see, e.g., Aron, 2006; Hoffman, 2007; Mitchell,
1997).
The final two conditions that Rogers notes—
empathic grasp of the client’s experience and
attention to the client’s perception of the thera-
pist’s communications1— seem to me to hold the
key to addressing in therapeutic fashion a signif-
icant source of change that Rogers’ six conditions
do not address (and that makes them, at most, a
description of the necessary and sufficient condi-
tions for therapeutic change within a client-
centered modality). Rogers’ necessary and suffi-
cient conditions, if taken as necessary and
sufficient for all therapy, would seem to imply
that behavior therapy could never benefit people
in significant ways, something that seems diffi-
cult to maintain in 2007. Both broad approaches
to therapeutic change are backed up by strong
evidence, a state of affairs that suggests to me
that it is in the client’s interest to consider how to
bring to bear the strengths of each, just as the
strengths of psychoanalytic and behavioral
approaches—also thought for a long time to be
incompatible— can be synergistically combined
(Wachtel, 1997).
It may seem, if one takes the six conditions
Rogers outlines as absolutes, that such a combi-
nation is a chimera, both monstrous and illusory.
1
Regarding attention to the client’s perception of the ther-
apist’s communications, see Hoffman’s (1983) and Aron’s
(1991) discussions from a relational psychoanalytic view-
point.
 Special Section: Carl Rogers and the Context of Therapeutic Thought
There has long been evidence, however, that even
Rogers was contingent in his responses to clients
and, indeed, contingent not in an arbitrary or
personally self-serving way but in a fashion that,
without explicit acknowledgment, was in the ser-
vice of the very aims that Rogers viewed as being
at the heart of the therapy (Truax, 1966; Wachtel,
1979). Moreover, as I noted earlier, Rogers him-
self acknowledges that these conditions are only
met “to a degree” in any real therapeutic inter-
action. Could it be that if they are met too
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absolutely something is actually lost—that if
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the therapist attempts to foreswear any contin-
gency whatsoever, he or she will be kind and
humane and respectful but ineffective in help-
ing the client overcome what troubles him or
her?
In the psychoanalytic realm, relational analysts
have increasingly acknowledged and begun to
address the analyst’s influence (e.g., Hoffman,
2007; Mitchell, 1997) and how to reconcile that
influence with the value commitments and theo-
retical assumptions that have guided psychoana-
lytic work over the years. Efforts by client-
centered therapists to integrate rather than deny
the role of influence are likely to be equally
illuminating. One key to achieving a reconcilia-
tion of the six conditions Rogers outlines and the
inevitability of influence, contingency, and the
like lies in the final two conditions. If one ap-
proaches any effort to guide, direct, or influence
the client not as a taboo, but rather as a part of
relating to the client that must be guided by an
empathic grasp of the client’s needs, perceptions,
and feelings and that must include paying atten-
tion to and continually discussing how one’s
statements and interventions as a therapist are
experienced by the client, then the various forms
of helping that human beings offer and seek can
be effectively combined in a way that genuinely
is guided by the client’s interests and values.
One of the important points made by Rogers is
that the therapeutic relationship is not something
sui generis but shares much in common with all
good human relationships. The kinds of relation-
ship and the kinds of assistance that people seek
are much broader than tends to be encompassed
by any of the specific schools of therapy, each
with its own ideology and set of blinders. In the
relationships and interactions that populate our
lives, we do frequently seek out being heard and
understood without advice or other direction. But
sometimes, if the person with whom we are in-
teracting truly understands and hears us, he or she
will understand that it is precisely advice or di-
rection that we yearn for or need and that to
interact with us respectfully and helpfully is to
provide what we need or are asking for rather
than what the therapist’s theory says is best. It is
not always client-centered to be nondirective.
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