Adlerian PsychotherapyPrioritizing relationships

Adlerian TheoryHistory of Adlerian Theory

Inspired by Freudian psychoanalysisSome overlap with other neo-Freudians (e.g., Horney)Anticipated elements of humanistic, cognitive, and systemic approachesChampioned in U.S. by Rudolf DreikursDissemination throughout U.S. elementary schools during the guidance movement by Don Dinkmeyer

Alfred Adler 1870-1937Born in ViennaRaised by middle class, Jewish family2nd of six childrenFelt in shadow of his older brotherInvalid as child (rickets, pneumonia)Very close to his father (no oedipal need)Converted and became a Christian After World War I Gemeinshaftsgefuhl deep-seated concern for others and need to associate with them1921-1934: 30 mental health clinics in schools- closed by Nazis - drop in delinquency at timeCame to USA in 1934 (lived in U.S. until his death)

Nature of maladjustmentA person has a mistaken opinion of self and worldInferiority complex: Individual overwhelmed by inadequacy, hopelessnessSuperiority Complex: Individuals very high opinion of self lead him/her to insist that personal solutions to problems are bestA person engages in abnormal behavior to protect own opinion of self (e.g., when threatened with failure and insecurity)The person becomes self-centered rather than other-centeredConflict: one step forward and one step backward movement which has the net effect of maintaining an individual at a dead center pointPeople experience themselves as stuck but actually create the antagonistic feelings, ideas, and values, because they are unwilling to change (if-only)Safeguarding: Symptoms developed to safeguard the fictional goalFamily constellation: birth order mediates genetic and constitutional factors The individual may be unconscious of these events

Adlerian Therapy FocusImportance of the feelings of self (ego) that arise form interactions & conflictsSense of self (ego) central core of personalityStart from PsychoanalysisEmphasis on lifestyle (5 life tasks)Social interactionWorkSexSpiritualityCoping with ourselvesCourage

Alfred Adlers Individual PsychologyA phenomenological approachSocial interest is stressedBirth order and sibling relationships emphasizedTherapy as teaching, informing and encouragingBasic mistakes in the clients private logicThe therapeutic relationship as a collaborative partnership

The Phenomenological ApproachAdlerians attempt to view the world from the clients subjective frame of referenceReality is less important than how the individual perceives and believes life to beIt is not the childhood experiences that are crucial ~ It is our present interpretation of these eventsUnconscious instincts and our past do not determine our behaviorIt is not genesIt is not environmentIt is not genes and environmentIt is how we choose to respond to our genes and environment

Social InterestAdlers most significant and distinctive conceptRefers to an individuals attitude toward and awareness of being a part of the human communityMental health is measured by the degree to which we successfully share with others and are concerned with their welfareHappiness and success are largely related to social connectedness

Impact of Birth OrderAdlers five psychological positions:

Oldest childSecond of twoMiddleYoungestOnly

favored, spoiled, center of attention, pseudo-parent, high achieverbehaves as if in a race, often opposite to first child (rivalry)often feels squeezed outthe baby (more pampered), creative, rebellious, revolutionary, avant-gardedoes not learn to share or cooperate with other children, learns to deal with adults

EncouragementEncouragement is the most powerful method available for changing a persons beliefsHelps build self-confidence and stimulates courageDiscouragement is the basic condition that prevents people from functioningClients are encouraged to recognize that they have the power to choose and to act differently

Other Adlerian ConceptsOrgan Inferiority: everyone is born with some physical weakness, which motivates life choices

Aggression Drive: reaction to perceived helplessness/inferiority lashing out against the inability to achieve or master

More Adlerian ConceptsMasculine protest:Men: Become a real man, surpass the fatherWomen: Gain equal status to men

Perfection striving: people who are not neurotically bound to an inferiority complex spend their lives trying to meet their fictional goals. The life or a human soul is not a being but a becoming Elimination of their perceived flawsGives motivation and focus

Social Responsibility & Understanding Occupational task-career-self-worthSocietal task-creating friendship-networksLove task-life partner

Positive & Goal Oriented Humanity- people striving to overcome weaknesses to function productively-contributing to society

How an Adlerian does TherapyComprehensive Assessment using:Family Constellation-questionnaire-social world assessmentEarly Reflections-single incidents from childhoodLifestyle Assessment-develop targets for therapy by identifying major successes and mistakes in the clients lifeThe Question -- If I had a magic wand that would eliminate your symptom immediately, what would be different in your life?

What Clients do in TherapyExplore private logic-concepts about self, others, & life philosophy lifestyle is basedDiscover purposes of behavior or symptoms and basic mistakes associated with their copingLearning how to correct faulty assumptions & conclusions

Therapeutic Techniques & ProceduresEstablishing the relationshipGathering Information Encouraging development of self-understanding insight into purpose through clarification and correction (of faulty self-concept and reasoning)Helping client make new choices: reorientation & reeducation away from previous lifestyle

PhasesStage #StageTasks to be accomplishedSupport1Empathy & RelationshipProvide warmth, empathy, and acceptance. Generate hope, reassurance, and encouragement. Establish a cooperative, collaborative relationship.2Information Gather relevant information: Elicit details of presenting problem & life tasks. Explore early childhood influences and memories.

Encouragement3ClarificationClarify vague thinking with Socratic questioning. Evaluate consequences of ideas and actions. Correct mistaken ideas about self and others.4EncouragementHelp generate alternatives. Stimulate movement in a new direction, away from life style. Clarifying new feelings about effort and results.

1. Establishing the relationshipTherapist gets to know the client as a person

Therapy is collaborativeGoals established together prior to startAwareness of goal discrepancies duringScripts (Have you ever seen a patient like me before?)Games (My previous therapist said the opposite)Realignment of goals, when necessary

Supportive, caring human connectionFaithHopeLove

2. Gathering informationSubjective interviewClient tells own story as expert on own lifeTherapist listens for clues to clients coping and approach to life The Question: Objective interview ~ Life Style AssessmentFamily constellationEarly recollectionsPersonality prioritiesIntegration and summary

3. Encouraging Self-Understanding & InsightInsight = understanding of motivations (the whys) that operate in clients life

Therapist offers open-ended interpretations to: Bring conscious awareness to unconscious processes Identify and confront resistance Explore purposes of symptoms, feelings, behaviors or blocks

Types of interpretationOf nonverbal behavior: to bring the clients nonverbal behavior to the attention of the client and interpret it.Of the therapeutic process: Dealing with what is in the here and now.Active Wondering: Proposes an alternative to the presenting problem.

4. Reorientation & ReeducationEncouragement process to build courage personal growth is encouraged and reinforcedChange and search for new possibilitiesMaking a difference through change in behavior, attitude or perception

Advantages of Adlerian TheoryCan be used for numerous issues and disordersUses encouragementPhenomenologicalDoes not consider people to be predisposed to anythingApplicable to diverse populations and presenting issues

Disadvantages of Adlerian TheoryDifficult to learn (e.g., making dream interpretations)Works best with highly verbal and intelligent clients. (potentially leaves out many people who do not fit this category)Might be too lengthy for managed careAdlerians do not like to make diagnoses

Adlerian Approaches todayEducationParent EducationMarriage CounselingFamily CounselingGroup Work

Adlerian Therapy demonstrationCan you diagnose Gina using the DSM?What were her strengths?What did she need to work on?What did Carlson do to build the relationship?How was the intervention individualized?Was the therapy helpful to Gina? If not, why do you think it wasnt?If it was helpful, what about it made it helpful?Would you want to work with an Adlerian if you were seeking therapy/counseling?Session transcript

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