Abstract
Understand, interpret, direct. This statement is an
oversimplification of sorts, but defines the essence of Adlerian
psychotherapy.
From this minimal overview of Adlerian theory, we can begin to elaborate and
explore the intricacies of individual psychology. Adlerians are concerned with
understanding the unique and private beliefs and strategies of the individual
(private logic and mistaken notions) that we create in childhood, and which
serve as a reference for attitudes, private views of self, others and the world,
and behavior (lifestyle). Therapeutic work with clients involves short-term and
intensive work to increase social interest, to encourage a greater sense of
responsibility for behavior, and to support behavioral change. Insight is used
therapeutically as an analytical tool to facilitate deeper self-understanding
and personal growth.
Concept of the Person
Adlerian Psychotherapy employs a holistic approach to understanding the
individual. Adler provides us with an all-encompassing view of the human being,
who is a primarily conscious, rather than unconscious creature. Adlerians
believe that the most important life problems are social and therefore, the
individual must be considered within the social context (Daniels, 1998).
Adlerian theory proposes that a human’s principle motive in life is to strive
for perfection and that his or her opinion of self, and the world, influences
all of the individual’s psychological processes. “Adlerian counseling seeks to
correct mistakes in perception and logic that people make in their effort to fit
into social relationships and to overcome feelings of inferiority” (Brown &
Srebalus 1998). Once the individual has adopted a “mistaken goal”, he or she
will formulate other misconceptions to support the “faulty logic” (Brown &
Srebalus 1998). Adlerian theory studies the whole person and how that person
experiences life.
According to this theory, the individual possesses four
“life-style convictions” (Mosak 1995). These are: “The self-concept – the
convictions I have about who I am; the self-ideal – the convictions of what I
should be or am obliged to be to have a place; the weltbild, or ‘picture of the
world’ – convictions about the not self and what the world demands of me; and
the ethical convictions- personal ‘right-wrong’ code” (Mosak 1995). When there
is conflict between the self-concept and the ideal, inferiority feelings
develop. It is important to note that Adlerians do not believe that these
feelings of inferiority are abnormal. In fact, this theory proposes that, “to
live is to feel inferior” (Mosak 1995). However, when the individual begins to
act inferior rather than feel inferior, the individual is engaging in
“discouragement” or the inferiority complex (Mosak 1995). “To oversimplify, the
inferiority feeling is universal and ‘normal’; the inferiority complex reflects
the discouragement of a limited segment of our society and is usually
‘abnormal’” (Mosak 1995). This theory views the healthy and “ideal” individual
as one who engages in life experiences with confidence and optimism. “There is a
sense of belonging and contributing, the ‘courage to be imperfect,’ and the
serene knowledge that one can be acceptable to others, although imperfect”
(Mosak 1995).
This theory uses subjectivity for understanding the person. In
order to understand the individual, we must understand his or her cognitions.
Harold Mosak (1995) identifies five underlying assumptions to the Adlerian
theory. He states, “a) the individual is unique, b) the individual is
self-consistent, c) the individual is responsible, d) the person is creative, an
actor, a chooser, and e) people in a soft-deterministic way can direct their own
behavior and control their destinies” (Mosak, 1995, p.87). According to Adlerian
theory, people strive to attain goals that provide them with a place in this
world, in turn giving them security and enhancing self- esteem.
“If
strivings are solely for the individual’s greater glory, he (Adler) considers
them socially useless and, in extreme conditions, characteristic of mental
problems. On the other hand, if the strivings are for the purpose of overcoming
life’s problems, the individual is engaged in the striving for self-realization,
in contribution to humanity and in making the world a better place to live”
(Mosak, 1995, p. 53).
Concept of Intervention
Like all therapies it is
assumed that the individual’s present way of living may accord safety but not
happiness, and because there are not any guarantees in life, one must risk some
‘safety’ for the possibility of greater happiness and self-fulfillment. How each
therapy goes about moving the client from a place of ‘safety’ to a place of
relative ‘risk taking’ may differ. Adlerian psychology addresses the complete
range of human experience, from optimal to pathological, and sees the
‘therapeutic’ relationship as a friendly one between equals (Stein, 1996). At
the foundation of Adlerian theory and practice is an optimism about human nature
and the premise that the primacy of a feeling of community (connectedness) is an
index and goal of mental health (Stein, 1996).
The process (intervention) is
really one of life-style investigation. The therapist tries to understand the
patients life-style, how the individual engages his life, and how that
life-style affects the client’s current functioning. The goal of treatment is
not merely symptom relief, but the adoption of a contributing way of living
(Stein, 1996). Adlerians view pain and suffering in a client’s life as the
result of the choices the client has made. This value-based theory of
personality hypothesizes that the values a client holds and lives their life by,
are learned, and when they no longer work (evidenced by suffering or lack of
happiness), the client can re-learn values and life-styles that work more
‘effectively’.
Adler taught that a client’s life-style can be viewed as a
personal mythology. These mythologies are true for the individual and so the
individual acts accordingly. These mythologies are “truths” and “partial
truths,” but they can also be myths that one confuses for truths. Adler calls
these basic mistakes. Overgeneralizations such as ‘people are hostile’, ‘life is
dangerous’ as well as misperceptions of life, ‘life doesn’t give me any breaks’,
are all myths that one confuses for truth. These mythologies or life-styles are
expressed in the client’s physical behavior, language, dreams, interpretations,
etc. The intervention in Adlerian therapy is re-education and reorientation of
the client to myths that work ‘better’. The actual techniques employed are used
to this end. Adlerians are highly action orientated. They believe the concept of
insight is just a proxy for immobility. Insight is not a deep understanding that
one must have before change can occur. For Adlerians, insight is understanding
translated into action. It reflects the client’s understanding of the purposeful
nature of behavior.
Concept of Change/Development
According to Adler\'s
theory of change, the therapist uses a variety of strategies that help the
client to identify his specific needs. The client is unique; therefore, the
technique used must fit the situation of the client. \"Thinking, feeling,
emotion and behavior can only be understood as subordinated to the individual\'s
style of life, or consistent patter of dealing with life\" (Marino, 2000). The
individual is not internally divided or the battleground of conflicting forces.
Adler believed that humans possess the freedom to act, determine our fate,
determine our personality, and affect our style of life. Humans have the
creative power of self to consciously shape our personalities and destinies.
Adler was oriented toward the future and looked to our expectations, rather than
to the past, to explain and modify behavior. The goal of the therapy is to
stimulate cognitive, affective and behavior change. Although the individual is
not always fully aware of their specific goal, through analysis of birth order,
repeated coping patterns and earliest memories, the psychotherapist infers the
goal as a working hypothesis.
The client approaches control of feelings and
emotions. First, the client recognizes what kind of feeling he or she is having
(angriness, sadness, frustration, etc). Once the client sees and knows the
feeling; then he or she will try to imagine or think of something pleasant that
had happened to him or her, replacing the bad feeling for a good one. By doing
this, the client is in control of his or her emotions and can change the mood
only by thinking differently. It is believed by Adlerians that thinking
different thoughts can effectively change mood states (Marino, 2000). The client
is helped by the therapist to see life from another perspective. The client
tries to put him or herself into another role. Change occurs when the client is
able to see his or her problem from another view, so he or she can explore and
practice new behavior. As the therapist explores the thinking, feeling and
acting of the client, he or she directs the client into a new philosophy of
life. Thus, the client is able to think about a new philosophy of life. He or
she makes decisions and conclusions about his or her own life.
Adlerian
psychotherapy can be broken down into three basic phases: 1) Understanding he
specific style of life of the patient, 2) Explaining the patient o himself or
herself, and 3) Strengthening the social interest in the patient (Daniels,
1998). It attempts to bring each individual to an optimal level of personal,
interpersonal, and occupational functioning. The objective of therapy is to
replace exaggerated self-protection, self-enhancement, and self-indulgence with
courageous social contribution. The Therapeutic Spiral, developed by Henry T.
Stein, Ph.D., is a cohesive model of the tasks facing the Adlerian
psychotherapist (attached). It provides a detailed outline of the steps to
attaining self-actualization using Adler’s theory. \"If people have developed
social interest at the affective level, they are likely to feel a deep belonging
to the human race and, as a result, are able to empathize with their fellow
comforts as well as the discomforts of life” (Marino, 2000).
Tools and
Techniques
Once the initial analysis has been completed and goals for
treatment have been set, Adlerians employ a variety of techniques to encourage
individuals to move forward and elicit change. Most of the techniques are
action-oriented, focusing on facilitating life-style changes while working to
help the individual learn to counteract discouragement, enhancing self-efficacy
and increasing self-esteem. Treatment may occur in the form of multiple
psychotherapy (whereby several therapists treat a single patient), individual
psychotherapy, and/or group therapy. Additional settings and treatment
strategies include the Therapeutic Social Club (as found mental hospital
settings), Marriage Counseling, and a focus on broader social problems via
Interindividual and Intergroup Conflict Resolution.
Within the therapeutic
relationship, the therapist is said to represent values the patient may attempt
to imitate. In serving as models for their patients, Adlerian therapists
therefore characterize themselves as “being for real”- genuine, fallible, and
able to laugh at themselves. An emphasis on humor as an important asset is
frequently utilized in treatment since “if one can occasionally joke, things
cannot be so bad (Moreno, 1987)”. Other verbal techniques include giving advice
while taking care to discourage dependency; frequent use of encouragement and
support; and utilizing language that avoids moralizing by referring to behaviors
as “useful” and “useless” as opposed to “good” and “bad”.
Some of the more
action-oriented techniques include creative and dramatic approaches to treatment
such as role-play, the empty-chair, acting “As if”, and psychodrama. Other
techniques include task setting, creating images, catching oneself, and the
Push-Button Technique. Dramatic techniques such as Role-play, the Empty Chair,
and Acting “as if”, are all utilized to help the patient practice useful skills
and behaviors as they “try on” new roles and styles of living. While these
techniques provide valuable opportunities for patients to rehearse new
life-skills, they also allow for the patient to make choices as to which roles
they wish to discard, and which they wish to use in their every day life.
Psychodrama is technique that occurs exclusively in a group setting, whereby the
internal struggles of a single patient (or “protagonist”) are worked though
dramatically. The process occurs with the active participation (and support) of
other members of the group who are employed by the protagonist to represent
challenging aspects of his or her inner life, while he or she attempts to move
“successfully” through it (Moreno, 1987).
A unique approach to Task Setting
has the Adlerian therapist making two suggestions as necessary for the patient
to apply concurrently, outside of the therapeutic setting, over the course of
several weeks. First, “Only do what is agreeable to you”; second, “Consider from
time to time how you can give another person pleasure”. According to Adler,
successful employment of these two tasks are an effective strategy in helping
people feel “useful and worthwhile”, thus enhancing their self-esteem and
improving their quality of life. Another task-oriented technique, called
catching oneself, requires patients to catch themselves “with their hand in the
cookie jar”. The goals of this approach are not only to increase patient
awareness of their “old” behaviors and provide an opportunity to replace them
with new ones, but to learn to anticipate situations before they occur (Moreno,
1987).
Creating images is another technique utilized by Adlerians in
eliciting change. Based on the premise that “one picture is worth a thousand
words”, patients are given (or generate) images to describe themselves. Use of
this technique maintains that remembering this image, the patient can remember
goals, and in later stages, can learn to use the image to laugh at oneself
(Dayton, 1994). The Push-Button Technique also utilizes the patients’ own
imagination in service of therapeutic goals. After being instructed to call upon
two specific life experiences- one pleasant experience, and one unpleasant
experience- patients are encouraged to focus on the feelings each of these
incidents evoke. This process is utilized to teach patients that they can create
whatever feeling they wish by deciding what they think about. As a result, the
patient finds that he is the creator, not the victim of his emotions, and the
power of self-determination is enhanced (Dayton, 1994).
Conclusion
Adlerian psychology is a vigorously optimistic and inspiring approach to
psychotherapy. As a values-oriented psychology, it is more than a collection of
techniques; it establishes philosophical ideals for individual and group
development. Adlerians attempt to capture the absolute uniqueness of each
individual, while teaching individuals to live in harmony with society. To
encourage insight, Adlerians work with early recollections, birth order, dreams
and metaphors. Adlerian counseling and psychotherapy favors a therapeutic
relationship that is cooperative, supportive, empathic, non-dogmatic, and
common-sensical. Through a respectful Socratic dialogue, clients are challenged
to correct mistaken assumptions, attitudes, behaviors, and feelings about
themselves and the world (Stein, 1997). Adlerian psychotherapy is a system of
theory and practice built upon psychodynamic, cognitive-behavioral, existential,
and humanistic principles.
References
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