Adlerian Psychotherapy

1. Adlerian Psychotherapy Prioritizing social interest

2. History of Adlerian Theory • Inspired by Freudian psychoanalysis, but did not buy into determinism or the primacy of sexual trauma • Some overlap with other neo-Freudians (e.g., Horney) • Anticipated elements of humanistic, cognitive, and systemic approaches • Sought to overcome the superiority of the therapist • Championed in U.S. by Rudolf Dreikurs • Dissemination throughout U.S. elementary schools during the guidance movement by Don Dinkmeyer

3. Alfred Adler 1870-1937 • Born in Vienna • Raised by middle class, Jewish family • Very close to father (no Oedipal need) • 2nd of six children • Felt in shadow of his older brother • Invalid as child (rickets, pneumonia) • Freud’s professional associate and (initially) friend • Converted and became a Christian After World War I • 1921-1934: 30 mental health clinics in schools- closed by Nazis - drop in delinquency at time • Came to USA in 1934 (lived in U.S. until his death)

4. Adler’s Individual Psychology • A phenomenological approach • Social interest is stressed • Birth order and sibling relationships are emphasized • Therapy as teaching, informing and encouraging • Basic mistakes in the client’s private logic • The therapeutic relationship as a collaborative partnership

5. The Phenomenological Approach • Adlerians attempt to view the world from the client’s subjective frame of reference • Reality is less important than how the individual perceives and believes life to be • It is not the childhood experiences that are crucial ~ It is our present interpretation of these events • Unconscious instincts and our past do not determine our behavior • It is not genes • It is not environment • It is not genes and environment • It is how we choose to respond to our genes and environment

6. Social Interest • Adler’s most significant and distinctive concept • Refers to an individual’s attitude toward and awareness of being a part of the human community • Mental health is measured by the degree to which we successfully share with others and are concerned with their welfare • Happiness and success are largely related to social connectedness Gemeinshaftsgefuhl – the state of social connectedness and interest in the well-being of others that characterizes psychological health.

7. Impact of Birth Order Adler’s five psychological positions:

8. Encouragement Encouragement is the most powerful method available for changing a person’s beliefs • Helps build self-confidence and stimulates courage • Discouragement is the basic condition that prevents people from functioning • Clients are encouraged to recognize that they have the power to choose and to act differently Note: Reassurance is not encouragement.

9. Nature of maladjustment • A person has a mistaken opinion of self and world • Inferiority complex: Individual overwhelmed by inadequacy, hopelessness • Superiority Complex: Individual’s very high opinion of self lead him/her to insist that personal solutions to problems are best • A person engages in neurotic behavior to protect own opinion of self (e.g., when threatened with failure and insecurity) • The person becomes self-centered rather than other-centered • Conflict: “one step forward and one step backward movement” which has the net effect of maintaining an individual at a “dead center” point • People 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 goal (e.g., It’s my job to keep the peace in the family) • Family constellation: birth order mediates genetic and constitutional factors • The individual may be unconscious of these events

10. Adlerian Therapy Focus • Importance of the feelings of self (ego) that arise form interactions & conflicts • Sense of self (ego) central core of personality • Start from Psychoanalysis • Emphasis on lifestyle (5 life tasks) • Social interaction • Work • Sex • Spirituality • Coping with ourselves • Courage

11. Other Adlerian Concepts • Organ 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

12. More Adlerian Concepts • Masculine protest: • Men: Become a “real man”, surpass the father • Women: Gain equal status to men • Perfection striving: people who are not neurotically bound to an inferiority complex spend their lives trying to meet their goals. “The life or a human soul is not a ‘being’ but a ‘becoming’” • Elimination of their perceived flaws • Gives motivation and focus • Social Responsibility & Understanding • Occupational task-career-self-worth • Societal task-creating friendship-networks • Love task-life partner • Positive & Goal Oriented Humanity- people striving to overcome weaknesses to function productively-contributing to society

13. Therapeutic Phases and Stages

14. 1. Establishing the relationship • Therapist gets to know the client as a person • Supportive, caring human connection • Warmth, empathy, and acceptance • Hope, reassurance, and encouragement • Love • Therapy is collaborative • Goals established together prior to start • Awareness of goal discrepancies during early phases • Scripts (“Have you ever seen a patient like me before?”) • Games (“My previous therapist said the opposite…”) • Realignment of goals, when necessary

15. 2. Gathering information • Interview • Client tells own story as expert on own life • Presenting problem(s) • Early recollections, influences (earliest memories, vivid memories from early adolescence) • Life tasks • Personality priorities • Lifestyle Assessment -- therapist listens for clues to client’s coping and approach to life, develops therapy goals by identifying major successes and mistakes • “The Question” -- If I had a magic wand that would eliminate your symptom immediately, what would be different in your life?” • Family constellation, other paper-pencil tests • Integration and summary

16. 3. Facilitating Self-Understanding & Insight Insight = Understanding of motivations (the whys) that operate in client’s life • Therapist clarifies vague thinking with Socratic questioning. • Therapist invites evaluation of consequences of ideas and actions. • Therapist gently challenges mistaken ideas about self and others. • 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 interpretation • Of nonverbal behavior: to bring the client’s 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.

17. 4. Encouraging and Reorienting • Encouragement process – “to build courage” Personal change/growth is encouraged and reinforced • Ongoing search for new possibilities • Making a difference through change in behavior, attitude or perception

18. Advantages of Adlerian Theory • Applicable to diverse populations and presenting issues • Does not consider people to be predisposed to anything • Phenomenological • Context-focused • Empowering

19. Disadvantages of Adlerian Theory • Difficult 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 care • Adlerians do not like to make diagnoses • Not compatible with managed care • Difficult to systematically measure efficacy • Challenging to develop problem-specific treatments

20. Adlerian Approaches today • Education • Parent Education • Marriage Counseling • Family Counseling • Group Work

21. Adlerian Therapy Demonstration Session transcript • Can 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 wasn’t? • If it was helpful, what about it made it helpful? • Would you want to work with an Adlerian if you were seeking therapy/counseling?