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).
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.