Adlerian Psychotherapy: Prioritizing Social Interest

Adlerian Psychotherapy

Prioritizing social interest

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

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)

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

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

Social Interest Gemeinshaftsgefuhl – the state of social connectedness and interest in the well-being of others that characterizes psychological health.  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

Impact of Birth Order Adler’s five psychological positions: Oldest child

favored, spoiled, center of attention, pseudo-parent, high achiever

Second of two

behaves as if in a race, often opposite to first child (rivalry)

Middle

often feels squeezed out

Youngest

the baby (more pampered), creative, rebellious, revolutionary, avant-garde

Only

may not learn to share or cooperate with other children, learns to deal with adults

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.

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

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

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

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

Therapeutic Phases and Stages Phases

Stage # Stage

1

Empathy & Relationship

2

Information

3

Clarification

4

Encouragement

Support

Encouragement

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

2. Gathering information  Interview 

Client tells own story as expert on own life  

 



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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

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.

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

Advantages of Adlerian Theory  Applicable to diverse populations and presenting issues  Does not consider people to be predisposed to anything

 Phenomenological  Context-focused  Empowering

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

Adlerian Approaches today  Education  Parent Education

 Marriage Counseling  Family Counseling

 Group Work

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?