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Talking about counseling: a plea to return to humanistic language.

Multiple linguistic systems have emerged to describe the counseling process. In contemporary mental health culture, humanistic lexicons have generally been displaced by technical, experience-removed descriptors. The author argues that humanistic language should be adopted by counselors because it has far greater utility than technical linguistic systems for describing counseling processes.

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Two people meet to talk on a regular basis with the understanding that the troubles of one of the participants might be alleviated by their ongoing conversations. This simple, one-sentence description of the counseling scenario arguably applies to every individual counseling session that has taken place over the past century. Remarkably, though, simple descriptions are hard to find in the literature of the helping professions. With the exception of the language of humanism, the counseling profession has historically been dominated by complex, technical descriptors. Libidinal cathexis, developmental arrest, cognitive processes, neuropathways, stimulus-response contingencies, countertransference, systematic desensitization, and trichotillomania are just a small sampling of the highly technical and extraordinarily counterintuitive language that has been used regularly to describe the counseling scenario and its participants.

The dominance of technical language has arguably suppressed ways of talking about counseling processes that are relational, intuitive, and obvious. Indeed, upon hearing the usual language of the helping professions, an outside listener might assume that this language was intended to describe sophisticated medical interventions or the repair of complex mechanical devices. This listener would probably never guess that these descriptors were intended to describe two people engaged in conversation.

Of course, whether certain uses of language are considered technical or not varies according to historical periods, cultural differences, and individual judgment. A term may be regarded as technical at one point in history, subsequently become widely adopted, and then evolve into a common way of speaking. For instance, A. Freud (1966) used the technical term "defense" (p. 30) to describe a psychological mechanism that protects the psyche from anxiety. This word later became popularly adopted, and it is now common usage to say that someone is being defensive. When I refer to technical or commonsensical language, then, I do not mean that certain words are locked into these categories. However, to provide a foundation for the thesis of this article, it is necessary for me to refer to gross historical trends about language usage rather than to focus on the minute usage patterns of particular words or phrases.

With the previously mentioned caveat in mind, humanistic language is arguably a standout exception to the technocratic descriptors that have historically dominated the helping professions. Humanists use common, intuitive language (e.g., empathy, counseling relationship, positive regard) to describe counseling processes. An outside listener would probably have no trouble guessing that the language of humanism is intended to describe human interaction.

The purpose of this article is to address some interesting questions that are suggested by the history of language in the helping professions: Why has the language of humanism fallen out of favor in contemporary mental health culture? Is the humanistic language system worth saving? Have technical ways of describing counseling processes become dominant because they are superior? What criteria should be used to determine whether one language system is superior to another? To address these questions, I discuss the history of language in counseling and philosophical assumptions about language.

BRIEF HISTORY OF FANGUAGE IN COUNSELING

The linguistic history of the helping professions involves the initial introduction of highly technical lexicons in the early 20th century, a brief, midcentury interruption of this technical trend by relational, humanistic language, and the resumption of technical ways of describing the helping encounter, which have persisted to contemporary times. At the beginning of the helping professions, S. Freud (1900/1953, 1915/1957) invented an esoteric lexicon to describe his clients and the conversations he was having with them. Transference, libidinal cathexis, oedipal complex, and castration anxiety are just a small sampling from the highly technical language system that Freud created. Meanwhile, behaviorists, such as Watson (1919) and Skinner (1974), developed their own technical lexicons, which contained terms such as classical and operant conditioning, variable interval reinforcement, and systematic desensitization. At first, behaviorists generally applied this terminology to their work with animals. Over time, however, these terms were applied to the behavioral counseling situation (Fancher, 1995).

The introduction of the humanistic language system was a refreshing break from the esoteric terminology that was invented by psychoanalysts and behaviorists. Indeed, psychological humanism was a direct, "third force" (DeCarvalho, 1990, p. 22) reaction to the reductionist ideologies of psychoanalysis and behaviorism (i.e., the first two forces; Hansen, 2012). Quintessential examples of the language of humanism were popularized by Rogers (1957) with phrases such as "genuineness in the relationship" (p. 97) and "empathic understanding" (p. 99), as well as the idea that counselors should try to achieve a "warm acceptance of each aspect of the client's experience" (p. 98) by deliberately maintaining an attitude of "unconditional positive regard for the client" (p. 96). Folksy and relational, the humanistic lexicon is a striking departure from the technical descriptors of psychoanalysis and behaviorism.

Beginning in the early 1980s with the new, descriptive Diagnostic and Statistical Manual of Mental Disorders (3rd ed.; DSM-III; American Psychiatric Association [APA], 1980; Mayes & Horwitz, 2005) and the rise of biological psychiatry (Murray, 2009; Shorter, 1997), the language of helping again became flooded with technical descriptors. Esoteric diagnostic terminology began to dominate mental health culture. New systems of therapy, such as eye-movement desensitization and reprocessing (Shapiro, 1995), dialectical behavior therapy (Linehan, 1993), and cognitive behavior therapy (Beck, 1976) each had specialized, technical names and associated lexicons that were far removed from the relational language of humanism.

Although the preceding overview is brief, it is sufficient to make the point that the linguistic history of counseling began with the introduction of highly technical lexicons; was interrupted by the commonsensical, relational language of humanism; and then returned to esoteric and experience-removed ways of describing counseling processes. Consider that all of the multiple language systems developed throughout the history of the helping professions simply represent various ways of describing what most people would identify as an ostensibly unremarkable situation--two people engaged in conversation. Because it is a clear, relatively jargon-free way of describing the counseling situation that is centered on the relational experience of the participants, humanistic language is a standout exception to the technical, esoteric lexicons of virtually all of the other theoretical orientations that have emerged over the past century.

This historical analysis of language begs some interesting questions: Is there a benefit to technically orientated lexicons? Which way of describing two people engaged in conversation is superior? What criteria should be used to determine whether a language system is superior? To address these questions, one must consider philosophical assumptions about language.

PHILOSOPHICAL ASSUMPTIONS ABOUT LANGUAGE

One of the hallmark features of 20th-century philosophy was an intense intellectual focus on theories of language (Hansen, 2006; Rorty, 1967). For purposes of this discussion, I consider two ways of conceptualizing language: (a) the correspondence theory of language and (b) postmodernist conceptualizations of language, which reject the correspondence theory.

The correspondence theory of language presumes that language, like a picture, is capable of accurately portraying the objects to which it refers (Gergen, 1999; Hansen, 2006). That is, discrete bits of reality can be directly tied to discrete bits of language. The overall goal of language usage within the correspondence theory is to adopt linguistic descriptions that match (i.e., accurately correspond to) reality. For instance, most contemporary Westerners would consider the phrase "infections are caused by bacteria" to have a higher degree of correspondence to the reality of infectious processes than the phrase "infections are caused by evil spirits." Proponents of the correspondence theory would argue that the first phrase is a linguistic replica or picture of the phenomenon that occurs in the reality beyond language, whereas the second phrase is an inaccurate depiction of reality.

As applied to the language of counseling, advocates of the correspondence theory would argue that the language used to describe counseling processes should mirror, or accurately correspond to, those processes. If there are a number of competing lexicons to describe the helping encounter, the one that is closest to the actual reality of the encounter should be adopted. From this perspective, professional progress is defined as the gradual adoption of increasingly accurate descriptors and the concomitant abandonment of inaccurate linguistic systems. For example, helping professionals formerly used the language of phrenology (i.e., bumps on the head) to describe clients. Because the language of phrenology presumably does not correspond to any real client phenomena, this linguistic system has been replaced by lexicons that supposedly have a higher degree of correspondence to the actual reality of clients.

Although the correspondence theory is commonsensical and probably represents the way that most people informally think about language, it has been severely critiqued, and largely rejected, by 20th-century postmodernist philosophers (Chessick, 1987; Gergen, 1999; McNamee, 1996; Shotter, 1992). These philosophical critiques have taken multiple forms. However, there are three critiques of the correspondence theory that are particularly compelling.

First, with regard to counseling, there are numerous, perhaps infinite, ways to describe the helping encounter. For instance, counseling could be described as two people meeting to talk, a person who has unresolved unconscious conflicts establishing a neurotic transference with a neutral psychoanalyst, or a patient suffering from borderline personality disorder being helped by a dialectical behavior therapist. To widen the descriptive process to other disciplinary communities, one could also describe counseling as a sociocultural phenomenon, in terms of the physiological properties of the participants, or as the collision of various atomic particles that results in the illusion of two separate entities. Depending on the community of the perceiver, each of these descriptions might be considered accurate. With regard to the postmodernist critique of the correspondence theory of language, critics maintain that it is impossible to determine which of these numerous descriptions is most highly correspondent to the intrinsic nature of counseling for at least two reasons: (a) there is no neutral authority who could arbitrate the various descriptions and determine which one is most correspondent (Anderson, 1990; Hansen, 2004, 2007, 2008b; Muran, 2001) and (b) the hypothetical true reality of counseling is not something that can be apprehended. To appraise the relative correspondence of various descriptors to the supposed true reality of counseling, one must know both the descriptors and the true reality so that their degree of match can be determined (Rorty, 2000b). Because the extralinguistic essence of counseling is not something that can be apprehended, determining the degree to which certain descriptors match this hypothetical essence is analogous to the task of identifying pictures of something that has never been seen.

Second, language, and the various assumptions about reality inherent in linguistic systems, is a human invention (Baudrillard, 1995; Rorty, 1989, 1999). The objects of reality do not name themselves; humans superimpose their descriptors and categorical systems onto the stuff of the universe. It is logically impossible, then, to get outside of language and apprehend a hypothetical reality that exists beyond linguistic constructions. Therefore, as a human-created superimposition, language can never be considered an accurate (i.e., correspondent) depiction of some hypothetical reality that exists beyond language (Baudrillard, 1995; Rorty, 1989,1999).

The third critique of the correspondence theory draws from a Darwinian perspective. That is, the process of natural selection is responsible for the ability of humans to use language, because language helped humans cope with environmental pressures (Dennett, 1995). Language, then, like any other selected characteristic, is a tool to cope with reality. As a mere tool for coping, language cannot possibly transform into a "media for copying" (Rorty, 2000a, p. 185) reality (Hansen, 2008a). Just as it would be absurd to suppose that a fork, as a tool for eating, could somehow copy the true essence of eating, it is just as absurd to suppose that language, as a tool, could ever copy (i.e., correspond to) some essential reality.

To summarize, the correspondence theory of language maintains that language is capable of accurately mirroring or picturing a transcendent reality that exists beyond language. The language that is the closest match to the transcendent reality is the most desirable language to adopt. According to the correspondence theory, counselors should adopt lexicons that are the most highly correspondent to the actual processes of counseling. However, if postmodernist philosophical critiques are taken seriously, correspondence to a true reality cannot possibly serve as the basis for selecting one system of language over another. It makes no sense, according to these critiques, to conceptualize linguistic systems as being in various degrees of proximity to some hypothetical extralinguistic reality. Language is merely a means of coping with reality; as a mere tool, language can never copy reality. Given this postmodernist critique, what criteria should be used to select counseling lexicons, if degree of correspondence is no longer an option?

UTILITY OF HUMANISTIC LANGUAGE

If the correspondence theory is rejected, linguistic systems cannot be judged by their degree of correspondence to some reality that exists outside of language. Instead, lexicons should be judged by their utility (Hansen, 2007; Rorty, 1999,2000a). To illustrate this point, the phrase "infections are caused by evil spirits" should be rejected by modern medicine. However, this phrase should not be rejected because it fails to correspond to the intrinsic nature of some medical reality (a criterion that makes no sense if the correspondence theory is abandoned). Rather, it should be rejected because it does not have utility to advance the practice of medicine. In other words, linguistic systems should be judged exclusively by whether, as tools, they advance the interests of particular language users, not by whether they correspond to some hypothetical reality beyond language (an impossible judgment to make if the correspondence theory of language is rejected; Hansen, 2007; Rorty, 1999, 2000a).

As tools, then, linguistic systems are analogous to hammers. It would be absurd to ask whether a hammer corresponds to reality or whether it is intrinsically good or bad. A hammer should be judged by its utility in particular situations; it is useful for pounding nails, but not for solving math problems. Correspondence with reality has nothing to do with evaluating hammers or language; the potential utility to facilitate a particular task is the only criterion that can reasonably be used to judge the worthiness of any tool, including language.

Given that utility should be the criterion for selecting tools (including linguistic ones), which language tool should counselors adopt? In other words, which linguistic system has the most utility to advance the work of counselors? The answer to this question depends on the factors that make counseling effective.

The within-treatment factor that accounts for the majority of the variance in counseling outcomes is the quality of the counseling relationship (Wampold, 2001). This finding has been remarkably consistent throughout meta-analytic studies and over decades of outcome research (Wampold, 2001); therefore, given this finding, the language system that highlights the relational factors of counseling is arguably the most desirable lexicon for counselors to adopt. As mentioned previously, the language of humanism, with its emphasis on empathy, genuineness, and positive regard, is the sole counseling lexicon that vividly describes the rich, relational moments in the counseling encounter. This relational, humanistic language does not describe people in esoteric, mechanical terms. Rather, it highlights the elements of counseling that have proven to be the most helpful.

Because relational factors are highly associated with counseling outcomes, the relational language system of humanism arguably has far more utility for describing counseling processes than the technical lexicons that have historically dominated the helping professions. Ironically, however, humanistic descriptors have been largely suppressed by technical linguistic systems, which de-emphasize relational factors in the helping encounter. Although these dominant technical lexicons have virtually no utility for depicting the relational factors of counseling, technical descriptors must have some type of utility; otherwise, they would not have dominated the history of the helping professions. If relational factors are the most important determinant of outcomes in the counseling encounter, why have humanistic, relational language systems been regularly displaced (throughout the history of mental health culture) by nonrelational, highly technical ways of describing counseling processes?

UTILITY OF TECHNICAL LANGUAGE SYSTEMS

When my wife asks me about my day, I could respond by saying, "I participated in a culturally sanctioned midday acquisition of nutrients with a bipedal primate." Alternatively, I could simply say, "I had lunch with Bob." The former response, although arguably accurate, has virtually no utility within the context of a relational exchange with my wife. Because of this lack of utility, I choose the latter response.

With regard to the helping professions, a goal of counseling with a particular client could be stated as "the utilization of cognitive reframing as part of a treatment plan to alleviate the symptoms of generalized anxiety disorder." Alternatively, this goal could be stated as "the development of an empathic, helping relationship with someone who is troubled and tends to worry a lot." As in the example with my wife, the latter response has far greater relational utility. An experiential, humanistic depiction of counseling processes as a relational exchange is reflective of the factors that promote positive outcomes, whereas the former, technical response altogether ignores the relational ingredients that are known to be the largest determinants of client change. Again, however, the former, technical way of describing counseling has dominated mental health culture for over a century, a trend indicating that technical descriptors must have some utility (otherwise, they would not have become dominant). However, if these language systems do not have utility for describing counseling processes, then what is their utility?

I maintain that the utility of these technical descriptors is in their ability to increase the power, prestige, and financial status of the helping professions. Esoteric lexicons have virtually no utility for describing counseling processes, but they have excellent utility for advancing the interests of professional counselors.

Regarding power, the use of technical linguistic systems to describe counseling processes creates a power imbalance between counselors and clients. When counselors speak in esoteric lexicons, they automatically put

themselves in the role of skilled technicians, which relegates clients to the status of passive recipients of professional direction. In this regard, Elkins (2009) noted that humanistic theory is unique among counseling approaches, because (by being client-centered) it empowers clients, not helping professionals. This egalitarian view of the helping encounter, Elkins maintained, is precisely what led to the downfall of humanism in contemporary mental health culture. Ultimately, professionals wanted power, not equality.

Status and prestige are also bestowed upon professionals who speak in technical tongues. For instance, I cannot think of anything that the current trend toward describing counseling processes in the language of neuroscience (e.g., Makinson & Young, 2012) can contribute to the relational process during the helping exchange. Since the dawn of time, humans have established deep, intimate relationships with one another, remarkably, without the help of neuroscience descriptors. Although neuroscience-speak has no more potential to enhance relationships in counseling than it does in marriages or friendships, this technical way of talking has tremendous potential to elevate the status of the counseling profession. In this technocratic age, the public is far more impressed by professionals who speak the language of neuroscience than by those who talk about helping relationships.

In this regard, Flax (1990), a feminist scholar, has an interesting perspective about the issue of status in the helping professions. Flax characterized the relational language of helping as fundamentally passive and feminine. Feminine language systems are devalued in the culture of work, whereas masculine, technical lexicons are highly valued. For instance, a preschool teacher who develops relationships with and is acutely sensitive to the needs of the children under her care receives only a miniscule proportion of the status and financial rewards of a surgeon, who penetrates bodies to repair or rip out dysfunctional hunks of flesh. The teacher is operating from a prototypical feminine model of passive, relational engagement, which is not valued as work in contemporary culture. The surgeon is penetrating and dominating, prototypical masculine activities that are highly valued. The helping professions have adopted technical, masculinized ways of describing their work, Flax maintained, not because these masculine, technical lexicons are accurate or useful accounts of the work of counselors, but because feminine relational modes of operating are devalued in contemporary work culture.

Along with status, financial rewards come to professionals who describe their work in technical lexicons. In terms of the helping professions, the 1980s were a linguistic turning point for counselors. During the 1980s, the new descriptive version of the DSM (APA, 1980; Mayes & Horwitz, 2005) was introduced, managed care began to reimburse for counseling services (Hansen, 1997), and biological psychiatry came into dominance in mental health culture (Shorter, 1997). The combination of these forces resulted in a highly technical and medicalized vision of the helping relationship, which was fortified during the 1990s by the emergence of various empirically supported treatment movements (Wampold, 2001). Although techniques have consistently been found to account for less than 1% of the variance in counseling outcomes (Wampold, 2001), counselors acquiesced to the technical, medical mental health culture and began talking like technicians during the last 2 decades of the 20th century (a trend that has only accelerated to the present day). This technical talk may, indeed, have been important for the financial success of the counseling profession, but it was completely irrelevant (and arguably quite damaging) to the helping process.

To be fair, perhaps in our current technocratic culture, professionals who speak in technical lexicons inspire confidence in clients. Client expectations of obtaining help are undoubtedly an important factor in treatment outcomes (Frank & Frank, 1991; Torrey, 1972; Wampold, 2001). Perhaps quasimedical talking counselors heighten client expectations more than do counselors who use the language of relational humanism. While this may be the case, counselors should find an alternative way to heighten client expectations rather than simply adopting the currently fashionable way of talking. Technical descriptions of counseling are so far removed from the factors that actually contribute to the helping process that it is arguably quite damaging to describe counseling as a quasimedical procedure.

In summary, because decades of research have consistently demonstrated that technical expertise has virtually nothing to do with counseling outcomes (Wampold, 2001), the use of technical language systems by counselors is transparently motivated by professional advancement, not client betterment. Language shapes realities (Gergen, 1999; Hansen, 2007). Describing counseling in highly technical terms risks creating counseling realities that are sterile, mechanical, and devoid of the relational elements that are responsible for client change. With the use of technical lexicons, counselors become experts and clients are defined by deficiency and disorder. Technical descriptors also suppress the humanistic, relational ways of describing counseling processes that have consistently proven to be responsible for client change.

CONCLUSION

It is remarkable that so many systems of language have been invented over the past century to describe the act of two people engaged in conversation. If the correspondence theory of language is rejected (as I have argued that it should be), a decision about which of the many counseling lexicons to adopt cannot possibly be based on judgments about the relative correspondence of the various lexicons to the intrinsic nature of counseling. Pragmatic utility is the only criterion that can be used to choose which lexicon to adopt. Because relational elements are the most important factors within the counseling scenario for client change (Wampold, 2001), the humanistic lexicon, which emphasizes experiential/relational processes, is the most pragmatic linguistic system for counselors to adopt. The technical lexicons that have historically dominated the history of the helping professions are useful for professional advancement, but virtually useless (and arguably quite harmful) for linguistically shaping the realities of the counseling situation.

The language, therefore, that advances professionalism is inherently opposed to the language that advances counseling processes, at least in our current technocratic culture (Hansen, 2010). This situation might not be problematic if counselors simply used technical, medicalized language with legislators and humanistic language with their clients and colleagues. However, any wall that separated these lexicons toppled long ago. Technical, medical descriptors have flooded graduate training programs, with demands from accrediting bodies that counselors learn DSM-speak and other, related antihumanistic lexicons (Hansen, 2003). The intermixture of technical and relational, humanistic language systems in graduate programs leaves counselors-in-training confused about the factors that actually promote client change (Hansen, 2003).

For example, I train advanced counseling students and new graduates from counseling programs. When I first encounter these trainees, many of them speak about counseling in highly technical terms. They talk about diagnosis, treatment plans, and technical interventions. When I tell them that none of what they are talking about is particularly important or useful, they are often stunned and taken aback. Unfortunately, they have confused the language of professional advancement with the language of helping (no doubt the people who trained them were also confused about this). The language of relational humanism would be a far more pragmatic lexicon for them to adopt. Indeed, one of my goals with trainees is to get them to stop uttering phrases like "I am applying cognitive-behavioral methods to treat my client with major depressive disorder" and to start saying things like "I am trying to develop an empathic, helping relationship with a person who is very sad."

Sometimes, I feel like a language instructor rather than a counseling professor or a supervisor. Language shapes realities, though. The way that people speak about counseling is the way that counseling becomes. Talking about counseling in highly technical terms runs the risk of creating counseling environments that minimize humanistic/relational elements. Because it promotes helping relationships, the humanistic lexicon is arguably the greatest linguistic achievement in the history of the helping professions. Humanistic language, then, should be the native tongue of the counseling profession.

Received 10/08/12

Revised 12/18/12

Accepted 01/23/13

DOI: 10.1002/j.2161-1939.2014.00047.x

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James T. Hansen, Department of Counseling, Oakland University. Correspondence concerning this article should be addressed to James T. Hansen, Department of Counseling, Oakland University, 450E Pazvley Hall, Rochester, MI 48309 (e-mail: jthansen@oakland.edu).
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