As human beings we have an "idea" or concept of who we are and what we really should be, hence we create an Ideal Self that we constantly strive for, often in vain. If the perceived self, our own self-image, is not aligned with the actual self, how we really are, there will always be personality problems and dysfunction as one relates to one's self and the rest of the world. (Kail & Wicks 1993) In Carl's case this is certainly exacerbated by his TBI.
In some sense if a human being grows in a very healthy and psychological and socially secure and protected environment, congruence should naturally be achieved. If he or she has felt the unconditional positive reinforcement that Rogers advocates, than congruence should be an outcome of certainty. (Vander Zanden 2003) However, even with the best of growth comes change and the self you are today may be different that the self you will be tomorrow, with perhaps different plans and goals. The human being's ability to adapt and change is one of the species greatest strength, but may also keep total congruence just a little out of reach. In Carl's case achieving congruence will require a great deal of adaptation to a new way of living with this TBI.
During the course of our therapy I realized that Carl had several organic as well as psychological issues that needed to be addressed. I knew it was imperative that I not only address these issues but also find a way for Carl to embrace his new self and, after a mourning period, release his concept of his old ideal self so that he may more appropriately address his issues of congruence and self-actualization. Our first interviews went slowly as we not only got to know each other but this also allowed Carl to actually begin to remember me as his short-term memory was reinforced with repetition of my presence. Afterward we worked on addressing what his ideal self had been and where his new ideal...
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