Critically analyse the following statement with reference to person centred theory and theories of human growth and

development: There is no substantial evidence to refute Rogers position. Further consideration of the theoretical underpinnings suggests to me that, rather than conclude the conditions are necessary but not sufficient, it is more accurate to conclude that the conditions are not necessarily necessary but always sufficient - (Bozarth 1993) This is a story of absences, power discourses (Foucault 2002, p.37), and the erasure of agency by dominant narratives (Meyers 2008). I view Bozarths' stance via discourses - or 'dividing practices' (Foucault 2001, p.251) - of 'person centered-ness' and 'sufficiency' in research, literature, and (as my sole 'client'), personal experience, drawing on understandings as an 'anxiously attached' survivor of childhood neglect (Bowlby 2005, p.163), a 'transsexual woman' in a discourse of gender, (Irvine 1990, p.266)and a person confronting the 'boundary situation' of a possible cancer diagnosis. (Yalom 1980, p.159) I critique one under-theorised element in Rogers' modernist/humanist theory; and through the 'lens' of postmodern positionings like Narrative Therapy (White & Epston 1990), consider why Bozarth's argument is sufficient but not sufficiently sufficient. To review: with apologies to Sanders & Purton (2003), and following the farmers' son's selfactualising potato (Rogers 1996, p.124) into Mid-Western agrarian metaphor, Bozarth here is sheriff, reconciling two tribes, 'settlers' and 'herders', progeny of the pioneer spirit represented in Rogers' intellectual journey from a backward-facing Freudian/European pessimism about 'Man' in thrall to 'incest, murder, and other crimes' (Rogers 2004, p.91) to the future-facing Californian optimism of the 'good life' (Rogers 2004, p.187); each now contesting a post-Rogerian landscape. The 'settlers' exemplified by Brodley (1993), Patterson (2000) Thorne (1989) and, equivocally, Bozarth, build therapeutic relationships solely from the raw materials of the' six 'necessary and sufficient conditions for therapeutic personality change' (Rogers 1956). Seeing additions to Rogers' canon as 'deviance' (Brodley 1993, p.141), their rationale is clear: "Counselors who have... modified, pure client-centered work because they found it inadequate either did not correctly understand the approach or did not engage in practicing it long enough to develop their capabilities to a level that could be a test of the approach." - (Brodley 1993, p.139) Whilst Patterson (2000, p.225) quotes Thorne (1989): 'I believe... the limitations of the approach are a reflection of the personal limitations of the therapist.' Ranged against them: free-roaming heretics such as Gendlin (1990), Sachse (1990) and Tausch (1988) driven by critiques of 'classical' Rogerianism to depart for new territories of theoretical elaboration - with the risks to 'pure' person centered-ness that implies. Gendlin, for example, saw paradox in Rogerianism: that it was both too hermetic to logically permit change, yet devoted to it - what he called its' 'repression' and 'content' paradigms (Gendlin 1964a). This, and his dissatisfaction with non-directiveness (Rogers 2007) confronting extreme distress (1964b, pp.170-72) saw him seek liberation for the 'moral' value of Person Centered therapy (Grant 2002, p.373) elsewhere, in 'Focusing' (1997) This is the terrain Bozarth (1993) polices. He concludes the six conditions are logically consistent;

reviews pre-1993 research, highlights contradictions, states key elements of Rogerianism have yet to be adequately studied, and differing research definitions prevent meaningful conclusions. He argues for enlarging Rogers' method, without rejecting core values (i.e. the 'actualizing tendency', Rogers, C.R., (2004, p.35).) It is an appeal to absences: Rogers does not talk about whether or not there might be other factors sufficient to induce therapeutic personality change...[but] can a vulnerable person experience the conditions when they are not... provided by a therapist?... It seems to me... people do improve therapeutically without being in relationship with therapists who consistently hold these attitudes. (Bozarth 1993, p.100) Support for Bozarth can be found in the canon like all sacred texts, Rogers' is infinitely interpretable: Cain, quoting Rogers, in rebuttal of Patterson (2000) demonstrates: The approach is paradoxical. It emphasizes shared values, yet encourages uniqueness. It is rooted in a profound regard for the wisdom and constructive capacity inherent in the human organism.... At the same time it encourages those who incorporate these values to develop their own special and unique ways of being, their own ways of implementing this shared philosophy." (Rogers 1986, pp.4-5), in (Cain 1993, p.138)) In Bozarth's view, the 'pure' six conditions, whilst sufficient to achieve therapeutic change are not the only capable therapeutic offer - in his artful construction, is not 'necessarily necessary.' In the politics of therapeutic revolution, he is a Menshevik gradualist, offering one story about efficacy, permitting flexibility, avoiding the 'settlers' intellectual/economic sterility whilst adhering to principals to prevent Rogerianism succumbing to the random wanderings of eclectic 'herders'. Yet his is a partial narrative, significant for what it does not address. Note the minimizing gloss (1993, p.94)) on research (Kirtner & Cartwright 1958) which appeared to show initial client attitude a greater determinant of success than therapist stance perceived as so devastating to the Person Centered project it was a factor in Gendlin's departure, prompting Rogers' famous reassurance, that 'the facts are friendly' (Rogers, C. in Kirschenbaum & Henderson 1990, p.26) Bozarth's defensiveness foregrounds other, antithetical accounts - Krumboltz, (1967), Traux & Carkhuff, (1967), and Patterson, (1969) - which question the completeness of Rogers' (1956) 'necessary and sufficient' conditions. To these might have been added the criticisms of Rogers' contemporaries Carter, Ellis, Hathaway, Hunt, Louttit, Seidenfeld, Thorne et al, (see Hill & Nakayama 2000); or recent commentators (Kensit, (2000); Quinn, (1993); Ryan, (1995)). Taking our lead from this partial narrative, consider two other narrative propositions, metaphorical guides on our uncertain journey into Bozarth's absences : "Before beginning a Hunt, it is wise to ask someone what you are looking for... (attributed to Pooh, Winnie The, in (Milne 1996, p.55)) and: "When people stop believing in God, they don't believe in nothing -- they believe in anything." (attributed to Chesterton, G.K. (Cammaerts & Chesterton 1937, p.211) ) First, the Bear of Little Brain. In cultural representation and children's hands already a real - albeit transitional, or partial - object (Winnicott 2005, p.2), (Klein 1984, pp.1-24)), further objectified as an exemplary neurophysiological link between developmental stresses and psychological ill health (Shea et al. 2000), 'Winnie The Pooh' offers sound advice for those following Bozarth across this

fractured land. As the Bear advises (or appears to... described by his publishers as 'inspired' by Milne, the quote appears nowhere in his original works (Milne 2001) another unreliable narrative) it is as well for us to consider what exactly the aim of this Hunt is before pursuing further. What, then, is uniquely Rogerian, sufficient to mark it a distinct, living therapeutic practice, that Bozarth defend from dwindling into a 'smorgasbord of perspectives' (Lietaer 2002, p.2 , Mearns & Thorne (2000, p.2)) Lietaer notes: "the working alliance [is] the most powerful predictor of therapeutic success in all orientations (Horvath & Greenberg (1994), Gelso & Carter(1994), Orlinsky et al, (1994)", (Lietaer 2002, p.4)) Cooper, in his recent meta-analysis of 'Essential Research Findings' (2008)) agrees but suggests it is Rogers' re-imagining of the alliance born of Freud's notion of the 'analytic pact'. (1970, p.50) that research supports as the singular most effective contribution the Person Centred Approach has made to therapy across modalities. He finds research support for key Rogerian/humanist concepts as '...empathic, accepting, collaborative and genuine therapeutic relationships...[and] the assumption that clients are the principal drivers of therapeutic change.; and capability in dealing with depression in adults and children. (Mick Cooper 2008, pp.162-3). Motschnig-Pitrik and Lux (2008) find empirical support for Rogers' theory of personality - the '19 Propositions' (Rogers 1959) - in Damasio's work on the neurobiology of emotion (1998; 2000; 2003; 2006). Elsewhere Cooper however concludes that whilst evidence suggests any 'talking therapy' is considerably better than none (2008, p.34) - the 'Dodo Verdict' ('all have won, and all must have prizes' -(Carroll 2003, p.26) cited in (Stiles et al. 2006) - and there is some evidence to suggest certain modalities are best for dealing with certain issues (e.g. CBT for anxiety, (2008, p.59)), the orientation of the therapist is largely irrelevant efficacy (2008, p.59); and, echoing Kirtner & Cartwright (1958), ...client factors are some of the strongest predictors of therapeutic outcomes. (2008, p.78). But more is at stake here than 'efficacy'; another absence. Turn to our second guide: The 'Chesterton' quote, pertinent to a world without Rogers-as-reified-godhead in it, is misattributed, its' most likely source, a gloss on unrelated statements, offered by a commentator (Cammaerts, E, 1937: (see Chesterton & Cammaerts, 2009). It is an elision become fallacy, become 'true' narrative. Arguably, something similar happened to Rogers, giving rise to those tribal tensions. As Wilkins says, arguing Masson's (1994, pp.229-47) critique of Rogers 'misunderstands' him: ...[this] sometimes appears to arise from a slight twist in emphasis or the addition or omission of a word... (Wilkins 2002, p.72)) Elisions, in short. Absences which construct 'unreliable narratives'. (see Bortolussi & Dixon 2003, p.83) for a literary/cognitive-psychological perspective.). It is this discourse of (mis)readings of Rogers', pursued with Talmudic exhaustiveness by seekers after 'truth' that Bozarth cannot escape; a failed quest for 'concreteness' (Sachse 1990) , since he operates within the paradigm: in assuming 'givens' a unitary self, that Rogerianism is internally sufficient and complete in engagement with all possible clients Bozarth sacrifices a radical re-imagining of what it might be. Arguable absences include, but are not limited to: Rogers' failure to advance the approach (Cain 1993) lack of sophistication re. ethnic difference (Moodley et al. 2000)) lack of sophistication re gender difference (Lerman 1992) failure to accomodate non-heterosexual sexuality (Galgut 1999)

inadequacy in the face of strong mental disturbance (Gendlin 1964b) a limited concept of self in psychological contact with others (Prouty 2002, pp.54-62) an undertheorised, spiritual/faith-based acceptance of a problematic, Kantian a priori claim of 'self-actualisation' (Mindess 1988; Nelson-Jones 2000) a one-sided belief in 'goodness' (Deurzen 2001, p70; Yalom 1980, p19) a lack of an explicit theory of developmental growth (McLeod & Wheeler 1996 p5-14; Cain 1993, p135-6)

... and so on. There are counters of course e.g. Wilkins, on Rogers' developmental theory (Rogers 1959) considers it, though 'concise', fully sufficient: ...a theory that is simply stated is not necessarily an inconsequential theory. (Wilkins 2002, p.41). But the existence of the objections maps a more complex terrain than Bozarth allows. Thus, in the precise sense of political theorist Labedz, he contributes to Rogers' reification, i.e.: "...a process of simplification through a set of abstractions, in which certain aspects of a given phenomenon are selected and stressed for heuristic purposes."(Labedz 2000, p.742)(Labedz, L, p742, in Bullock et al. 2000) As Thompson (1997)recognises, it is but a short step from reification to 'the fallacy of misplaced concreteness', the phenomenological trap proposed by Whitehead (1967)in consideration of the disjuncture between the world and our apprehension of it via scientific method: "...Thus, nature gets credit which in truth should be reserved for ourselves: the rose for it's scent, the nightingale for his song... The poets are entirely mistaken... Nature is a dull affair, soundless, scentless, colourless, merely the hurrying of material... However you disguise it, this [misplaced concreteness] is the practical outcome of...[historical] scientific philosophy.' (1967, p.54). Rogers himself was conscious of the risk, his equivocal place at the intersection of discourses of 'scientific empiricism' and 'humanism' (Ellingham 2002, p.242). He saw value in methods (tape recording, analysis of technique), which were revolutionary, but rooted in the scientific/empiricist tradition: The work that I and my colleagues have done...made possible the empirical study of highly subjective phenomena. (Carl R. Rogers 1996, p.48) Another defining absence: Rogers' theories were born in opposition, not only to his Freudian past, but to the then-hegemonic success of cognitive behaviourism, that 'elitist technocracy'(Kirschenbaum & Henderson 1990; Carl R. Rogers 1996)(Kirschenbaum & Henderson 1990, p.385; Carl R. Rogers 1996, p.55);Rogers 1996, p.55) which drew heavily on its' research base for its' validity. (A condition incidentally echoed now in the anxious debates around professionalisation of therapy (Proctor 2008) and funding for 'evidence based therapies' occasioned by the 'Layard Report' (Bell et al. 2006).) Rogers had to engage within a science/research paradigm to be persuasive. Yet he also wished to move beyond Whitehead's 'mere hurrying of material'. It is clear that the humanist, unitary conception of 'self' he articulated (Rogers & Koch 1959) was a step away from 'technocracy'. Cooper points out that Rogers also dialogued with many of the great existential thinkers of his day, including Buber, Tillich and May. (Mick Cooper 2003, p.4) [ the 'I-thou' dialogic principle (Buber 1971) being particularly influential.] Similarly, Spinelli (2005, p.170) observes, Rogers' aversion to asking clients questions echoed the phenomenological method, to evoke an individual's noematic and noetic experience of some

'thing', in some way. Or consider Heideggerian 'authenticity' (C. Guignon 1993) alongside Rogers' 'internal locus of evaluation' (Rogers 2003, pp.150-57) and 'conditions of worth' (Kirschenbaum & Henderson 1990, p.246); or consider Proposition 1 of his 'Theory of Personality and behaviour' : Every individual exists in a continually changing world of which he or she is the center...An important truth in regard to this private world of the individual is that it can only be known, in any genuine or complete sense, to the individual himself. (Rogers 2003, p.483) Correspondences, inexact but extant, can also be read across from other elements of Husserl's Phenomenological Method (Husserl 1981, pp.67-74), referenced in (Spinelli 2005, pp.20-22) to Rogers' 'necessary and sufficient conditions of therapeutic personality change' (Rogers, C.R., 1957): the 'bracketing', openness and 'un-knowing' required by the Rule of Epoch, the emphasis on Description, not explanation, and the requirement by the Rule of Horizontalisation to treat all experiencing as equal value, for example, sit well with aspects of both Rogerian 'unconditionality' and 'empathy'; whilst the method in toto equates to Rogers' conception of the counselor's task: ...to assume, in so far as he is able, the internal frame of reference of the client, to perceive the world as the client sees it, to perceive the client himself as he is seen by himself, to lay aside all perceptions from the external frame of reference...(Rogers 2003, p.29) In short, Rogers chafed at the bonds of empiricism. He states: Openness to experiences can be seen as being fully as important a characteristic of the scientist as our understanding of research... truth is pursued in many equally meaningful ways. (Coulson & Rogers 1968, p.8, in Rogers 1996, p.238) Rogers 1996, p.238) Echoing Kant "...a knowledge that is independent of experience and even of all impressions of the senses." (Kant 2007, pp.37-38) - he came also to view a transcendent, spiritual dimension a powerful component in therapy: When I can relax and be close to the transcendental core of me, I may behave in strange and impulsive ways...but these strange behaviours turn out to be right in some way." (Kirschenbaum & Henderson 1990, p.137) And yet... That unitary self remained, the goal of his therapy a (unitary) 'fully functioning person. (Rogers 2004, pp.183-196). And the science of his approach implied crisis, what Bozarth called (1984, p.59) 'operational methods for acting empathic'. In other words, by providing a empiricist template, allied to a tendency in Rogerian researchers to study that which easily could be studied i.e. what was said and done in a session, rather than an elusive 'way of being' - and then replicating this abstracted/reified, partial understanding the theory offered itself to being 'manualised' to technique. Leading to the view that Rogerian therapy was simply 'parroting' client's words; and thus deracinated, could be applied, to any modality, leading to this from Merry (1990) cited in Wilkins, (2002, pp.2-3): I am troubled by two things. One is the way the term 'person-centred' is becoming widely used to describe situations which do not do justice to the spirit or the original meaning of the term 'person centred hypnotherapy' for example. The other... is the growing but mistaken view that client-centred therapy has no distinct...identity but is simply a means of providing a psychological climate in which other techniques, methods and approaches can be applied.

Rogers anticipated this: I am distressed at the manner in which small-caliber minds immediately accept a theory . . . as a dogma of truth. If theory could be seen for what it is - a fallible, changing attempt to construct a network of gossamer threads which will contain the solid facts- then a theory would serve as it should, as a stimulus to further creative thinking. (Rogers 1959, pp.190-91) But he could not prevent it's consequence. As his own theory taught, that which reacts with rigidity in the face of conflict between self concept and organismic experiencing becomes anxious. (Rogers 1978). How like in effect to 'Chesterton's' quotation, then, is this cri de coeur cited by Patterson (2000, p.224): ...some of Rogers' closest colleagues use hypnosis, guided fantasies, paradoxical statements, dream analysis, exercises, give homework assignments and generally follow the latest fads to supply their [Rogers' necessary and sufficient conditions] missing deficiencies. (Wood 1986, p.351) And what is this but a signpost on Bozarth's fractured land, pointing as much back at the strain of maintaining a merely modern theory in a post-modern world, as forward to the ostensible cause? To this existential fear of dissolution (Yalom 1980, p.52)) we may add Cain's (1993) pragmatic concern; a blunt statement of economics: The Person-Centered Review... was published for only five years...because its subscription level was too low... to continue. His prime suspect for client-centered counseling's failure to thrive?: ...Its lack of evolution in theory or practice. Rogers' foresaw the impasse. He offered his ideas for examination (e.g. in relation to one core condition, the Accurate Empathy Scale developed by his colleague Truax (1967) - Rogers 1996, pp.143-144 the Barrett-Lennard Relationship Inventory (1963); and others (1996, p.63)). Nor was he precious about method: There was only one criterion in regard to any method... and that was 'Does it work? Is it effective?' (Rogers, in Burton 1972, pp.46-47) He also modified his positioning, if not content, through experience. Anderson (2008) notes that, in response to 'what works': ...Rogers changed the name of his approach from non-directive to client-centered and then to person-centered. - Signifying, she argues, the move from therapistcentric to client-centric and finally to a view of the 'person' which permitted a spiritual dimension. Cooper (2003, p.8) however captured the continuities and discontinuities of a key absence, what Mearns and Thorne (2000, p.185) called the 'tyranny' of growth: "Rogers places great emphasis on the human capacity for freedom, and the centrality of choice to the process of psychotherapy and personality change....[but] the notion of growth ... and the widespread appropriation of biological and naturalistic metaphors ... tends to portray human development as a spontaneous, automatic process, rather than one that also involves agency, choice and active decision-making. Potatoes in a basement bin, for instance, do not choose to send their sprouts upwards." Similarly, feminists Marecek and Kravetz (1998, p.13)offer this:

"Therapy discourse typically centers on the construct of the private, autonomous self, a self that stands apart from history and culture. It assumes that free choice and self-determination are both possible and desirable. Authenticity and individual self-realization are taken as unproblematic goals of treatment and defining aspects of mental health." And Cain (2002, p.367)speaks of another 'paradox' at the center of the theory: An approach that places enormous emphasis and value on the individual tends to take a 'one approach fits all' stance towards the facilitation of growth. That is, the same basic attitudinal qualities in the therapist...are viewed as necessary and sufficient for all clients... regardless of individual differences in the person, even enormous ones. These criticisms resonate with others (Mearns and Thorne, (2000), van Deurzen, (2001, p.70); that negotiating life is a more faceted affair than simply establishing a single internal locus of evaluation (Rogers 2004, p.119) en route to being a 'fully functioning person' in isolation from culture (something Rogers himself was to acknowledge (1963)); that anxiety might be a realistic appreciation of circumstances, rather than a 'symptom' (Spinelli 2006) ; and that there are certain boundary conditions - like death about which Rogers has relatively little to say (Swildens 2002). Against such tensions the 'settlers' rage. Is this not an echo of the same impulse Foucault found in the Enlightenment's need for the manufacture of madness? The need to define what one is by constructing and condemning what one is not, and in so doing, creating the inadvertent, unavoidable exposure of what one most fears: The constitution of madness as a mental illness... thrusts into oblivion all those stammered imperfect words...in which the exchange between madness and reason was made. The language of psychiatry, which is a monologue of reason about madness, has been established only on the basis of such a silence." (Foucault 2001, p.xii) Bozarth presents us only with a discourse of philosophies of helping between, let us call them practitioners; but definitely not something as anti-Rogerian as 'professionals'. (see: 'Dare we do away with Professionalism?': There are as many certified charlatans and exploiters of people as there are uncertified.(Carl R. Rogers 1996, pp.243-244) Yet this 'practitioners' debate is played out across an implicit landscape of other, competing narratives, voiced or absent, on the narrow stage of late 20th Century Western academic/therapeutic discourse; and simultaneously, on others: of economic power (Tudor & Worrall 2002), culture (Singh & Tudor 1997) models of illness and wellness (Ingleby 1982), of a perceived threat to 'person centered's' positioning in the 'therapeutic marketplace' (Mearns & Thorne 2000, p.217); against other competing modalities (Cain 1990), and, philosophically, in response to other, 'scientific' views of human functioning (Ellis 1995): in short, the 'matrix of concepts and beliefs by which we understand our lives, and the world in which our lives take place' (Payne 2006, p.20); what Foucault called 'Power/Knowledge', the: "...manifold relations of power which permit, characterise and constitute the social body, [which] cannot themselves be established, consolidated nor implemented without the production, accumulation, circulation and functioning of a discourse." (Foucault 1995, p.93)(Foucault tr. Gordon 1995, p.93) This definition of power was my entry into engagement. A 'fishbowl' session with a colleague, I the client. I shared my possible diagnosis, believing I was managing it well through personal therapy. I

spoke calmly. Without awareness, I dominated my colleague. A classmate commented: 'even your back was angry!'. I began thinking about dimensions of power in the therapeutic relationship. At first, in a mundane sense a trained counsellor of any modality would have responded to my anger, I'm sure... But I saw power as one absent dimension in classical Rogerianism. His own writings on it are relatively sparse, outward-facing, and limited to overt power between individuals in which, as Anderson(2008) notes, Rogers seeks to 'empower' the client, as if power was his to grant (Rogers 1996, p.140); or of political power. (Rogers 2004, p.388). As Wilkins (2002, pp.92-96) notes, Rogers would refute this: it is not that this approach gives power to the person; it never takes it away (Rogers 1978, p.289); whilst Mearns & Thorne would later put forward an elaborated notion of power within the therapeutic alliance as 'mutuality' (1999, pp.1269) and Natiello (1990) would offer useful strategies for achieving 'collaborative power'. None of these positions however consider the effect on the client of being a locus of discourses of supra-personal power. My experience as a trans woman, (autobiography is transsexuality;s proferred symptom: Prosser 1998, p.104) conscious of my male past and the deep incongruence it engendered (Lev 2004, pp.87-88), seeking now to create a female positioning, (the self is not something that one finds; it is something one creates - Szasz 1974, p.49) brought into sharp focus for me the discourses of power we are all engaged in of gender, class, sexuality - which are absent from classical Rogerianism. Leading me to Knowledge/Power's critique of humanism: "It is not possible for power to be exercised without knowledge, it is impossible for knowledge not to engender power." (Foucault 1995, p.52). A positioning necessarily reflected in therapy: "Interpreting and understanding... is always a dialogue between therapist and client, and is not the result of predetermined, theoretical narratives that are essential elements of the therapist's world of meaning." (Anderson & Goolishian 1992) Proctor (2002, pp.79-88) explored this further, identifying from a post-structuralist perspective, issues of power in the roles of person-centered therapist and client, personal history, experiences of power, and social positionings; noting Burstow's (1987) observation that the danger of asserting equality where it does not exist can be that the vulnerability of the client is missed ; and exploring inter alia, Starhawks' (1991) elaboration of Rogers' 'power over' (Kirschenbaum & Henderson 1990, p.326) into 'power-from-within' and 'power-with' . This chimed with my stance, and experience. Like others, I suspect, I approached study as selfdiscovery, most new ideas as Manuals to Me. I arrived via therapy, following a 'mid life crisis' (Erikson 1994, p.103) precipitated by a suicide attempt and the subsequent departure of my partner of twenty four years when I chose transition before death. ('Stagnation'? Yes, but 'generativity' and 'genitality' had little to say to an ex-Gay man who chose surgical castration!) My experiences of childhood physical and emotional abuse confirmed in me a world view I called existential. ("Emotion, which is suffering, ceases to be suffering, as soon as we form a clear and precise picture of it." - (Frankl 1985, p.82, translating Spinoza). Reading Spinelli (2005) and Cooper (2003) thus felt like - validation. Then, the first day of my course, I was told I might have cancer, and suddenly found existential theory facing a practical test. Yalom (1980, pp.118-21) and Yalom, (1991, pp.68-86) assisted. Bowlby's description of the parenting conditions which create anxious attachment (2005, pp.162-3)

sounded like the fragments of my childhood I can recall: father's violence, mothers' suicide threats, her lengthy hospitalisation, her oft-stated desire that I not exist. The consequences in adulthood referred to by him (ibid.:165) sounded like most of the ways I contributed to the failure of my relationship with my partner denials of feeling, behaviours to test the limits of his love, and after he left, my inability to handle the loss. The findings of Atkinson & Goldberg (2004, p.8) on the link between insecure childhood attachment and later adult behaviours offered further insight; whilst the review of evidence for these linkages in Dozier, M. et al (2008, p.729) gave pause for thought to a trans woman on 'identity': "According to Main and Hesse (1990) and Liotti (2004) early experiences with a frightened or frightening caregiver cause a child to develop multiple, incompatible models of the self and others." Gerhardt's (2004) accounts of the biochemical consequences - my inability to link strongly felt emotion to cognition at times (ibid:82), the decades of emotional flatness I thought normal (ibid: 80) the inability to regulate stress (ibid:67), and the so-called 'cancer personality' (ibid: 95) made direct and personal sense to me; as did the message of hope I drew from her observation that adult change was still possible (ibid: 53) (I would add that my experience of change from a previous 'self' through trading testosterone for oestrogen has made the inter-relatedness of neurophysiology to emotional states vividly clear.) My experiences also taught me something about living authentically with the consequences of choices even those which I did not call so; something too, about the possibilities of profound and positive change; and that biology, though ultimately Death, is never Destiny. The self-reflection I took from these ideas to personal therapy led me in turn, to consider how the particularly unequal power dialectic of the gender dysphoric and the psychiatric establishment is negotiated through narrative. I found this: In order to achieve the diagnosis necessary to access the medical technology to change sex, one must recount a transsexual narrative (Prosser 1998, p.158). And from that, to my still-evolving engagement with useful ideas such as 'Discursive Empathy' which uses the Foucaultian, post modern perspective of Narrative Therapy as propounded by Epston & White (1992) to introduce an integrated and consistent sociocultural dimension into the therapeutic process not otherwise acknowledged or addressed in contemporary understandings of empathy. (Sinclair & Monk, 2005, p.334), Similarly, some Narrative Therapy ideas such as 'problem saturated stories', 'thin and rich descriptions', and particularly, the strategy of 'externalizing language' (Payne 2006, pp.6-18) do not, it seems to me, pace Bott (2002), do violence to the six conditions; neither are they incompatible with those strains of existential therapy such as Spinelli's (2006) where staying with the client's lived experience is key; whilst the idea of narrative as both a tool in therapy and a metaphor for it also reaches back to the notion of the patient's and the analyst's playing together (sic) (Winnicott 2005, p.51). In sum, I find the linkages between developmental theory and expression in the sole client I have had the opportunity to study convincing; and aspects of the three therapeutic traditions outlined above Rogerian, post modern, and existential - complementary, personally resonant, philosophically congruent, and practically useful in suggesting some ways to negotiate the absences

I find in Rogers alone. I share Bozarth's view that Rogers's original conditions will of themselves be sufficient to provide a baseline of therapy, but as I hope I have outlined, there are good reasons for arguing that this conception may not necessarily be sufficiently sufficient to respect all aspects of a client in this post modern world. I am excited at these possibilities of synthesis, particularly in relation to working with other transgendered people as I hope soon to do, since I believe our particular 'dilemmas of living' (Deurzen & Deurzen-Smith 1997, p.172) will prove exemplary in highlighting both limitations and possibilities in therapy. Finally, speaking of living... I have a voice on a phone saying 'query lymphoma', to thank for my first truly lived understanding of this: They give birth astride of a grave, the light gleams an instant, then it's night once more. ('Waiting for Godot' Act II, Beckett 2006, p.82) Oh, but what a gleam...

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