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.
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