Adlerian Therapy PDF

Adl e ri an The r apy   113 Introduction Along with Freud and Jung, Alfred Adler was a major contributor to the initial development of the psychodynamic approach...

Adl e ri an The r apy   113 Introduction Along with Freud and Jung, Alfred Adler was a major contributor to the initial development of the psychodynamic approach to therapy. After a decade of collabo- ration, Freud and Adler parted company, with Freud declaring that Adler was a her- etic who had deserted him. Adler resigned as president of the Vienna Psychoanalytic Society in 1911 and founded the Society for Individual Psychology in 1912. Freud then asserted that it was not possible to support Adlerian concepts and still remain in good standing as a psychoanalyst. Later, a number of other psychoanalysts deviated from Freud’s orthodox posi- tion. These Freudian revisionists—including Karen Horney, Erich Fromm, and Harry Stack Sullivan—agreed that relational, social, and cultural factors were of great sig- nificance in shaping personality. Even though these three therapists are typically called neo-Freudians, it would be more appropriate, as Heinz Ansbacher (1979) has suggested, to refer to them as neo-Adlerians because they moved away from Freud’s biological and deterministic point of view and toward Adler’s social-psychological and teleological (or goal-oriented) view of human nature. Adler stressed the unity of personality, contending that people can only be understood as integrated and complete beings. This view also espoused the pur- poseful nature of behavior, emphasizing that where we have come from is not as important as where we are striving to go. Adler believed that we create ourselves rather than merely being shaped by our childhood experiences. After Adler’s death in 1937, Rudolf Dreikurs was the most significant figure in bringing Adlerian psychology to the United States, especially as its principles applied to education, parenting, individual and group therapy, and family coun- seling. ­Dreikurs is credited with giving impetus to the idea of child guidance cen- ters and to training professionals to work with a wide range of clients (Terner & Pew, 1978). Refer to the MindTap for this book to interact with video quizzes and various video programs to expand your knowledge on topics relevant to Chapter 5. LO1 Key Concepts View of Human Nature Adler abandoned Freud’s basic theories because he believed Freud was exces- sively narrow in his emphasis on biological and instinctual determination. Adler believed that the individual begins to form an approach to life somewhere in the first six years of living. He focused on the person’s past as perceived in the pres- ent and how an individual’s interpretation of early events continued to influence that person’s present behavior. According to Adler, humans are motivated primarily by social relatedness rather than by sexual urges; behavior is purposeful and goal- directed; and consciousness, more than the unconscious, is the focus of therapy. Adler stressed choice and responsibility, meaning in life, and striving for success, Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 114   C h a pt e r F ive completion, and perfection. Adler and Freud created very different theories, even though both men grew up in the same city in the same era and were educated as physicians at the same university. Their individual and distinct childhood experi- ences, their personal struggles, and the populations with whom they worked were key factors in the development of their particular views of human nature (Schultz & Schultz, 2013). Goal-Directed Movement Adler did not believe that people had a personality; to be sure, humans had person- ality traits and character, and all of these parts and ways of being were, for him, directed toward and pursuant to a final life goal. In short, everything in human life is goal-directed movement. From birth to death, we are engaged in striving, in overcoming and compensating, in moving from an experienced, perceived, and felt minus to a similarly felt and imagined plus (Adler, 1929/1969). It is that imag- ined plus position that gives individual movement its direction and motivation; we become oriented toward fulfillment in our imagined future. As the child grows, the goal continues to evolve, never really changing its rudi- mentary vision but expanding and refining it, so that movement is adapted to the demands of life. Although each individual’s law of movement is unique, it is possible to gain an initial sense of individual movement by considering it from one or more of four perspectives: movement toward, movement against, movement away from, and ambivalent movement (what Adlerians sometimes call hesitant movement; Sperry & Sperry, 2020). A subcategory of movement against self occurs when individuals work against their own self-interest, even to the point of being self-destructive. The movements of infancy and very early childhood are almost always move- ments toward because survival depends on attachment and connection. The child reaches for the secure attachment to the parent, often to the mother, and in that attachment both are nurtured. Mutuality turns out be true at almost every possible human level, including spirituality and meaning, emotions, and even physical well- ness. Breastfeeding, for example, improves the immune systems of both the child and the mother. Being rocked in a parent’s arms can calm both beings at once. Adler (1931/1958) called such attachments the child’s first experience of cooperation. It is then the job of the primary caregiver to redirect the child’s first connection: first to the other parent if there is one, then to siblings, and later to friends, neighbors, school, and the community. As the child gets older, movements toward another begin to take on many forms, some of which are useful, such as constructive attention-getting (Dreikurs, 1948), and others that are less useful. Disruptive attention-getting, dependency, clutching, shyness, separation anxiety, pleasing to secure safety or to be valued may all be mis- taken forms of moving toward. Such mistaken forms are often the result of parental pampering and overprotection (Adler, 1931/1958). Pampering and overprotection can also lead to ambivalent movement. When things are regularly done for children that they can do for themselves, they lose a sense of being capable; they lose courage and may become discouraged; they hesi- tate, feel anxious, and may even freeze in the face of life’s challenges. Such movement may be characterized by displays of inadequacy (Dreikurs, 1948), in giving up when Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.  Adl e ri an The r apy   115 faced with life tasks and challenges, and with both anxiety and depression becoming everyday life experiences. At the other end of pampering and overprotection are children who have been hated, abused, or neglected. Such children often feel that their survival is threat- ened, and they become skilled at withdrawal or movement away; this movement is a safeguard or protection against loss and hurt. Some children, however, develop a movement against others, reacting with anger and the assertion of power and even seeking revenge (Dreikurs, 1948). In such cases, the movement against is seen as the child’s best hope for survival. Not all of these movements are survival-based. When children can develop a secure attachment with one or more adults, movement is often in the service of con- nection and the feeling of belonging. The various movements aim at helping us to count, to feel capable, and to handle life’s challenges. When life’s challenges and burdens become too much for the individual, however, these four movements can be seen in both clinical and personality disorders. So what do the four general movements look like in relation to mental discour- agement? We know that the movements will be determined by a personal goal of overcoming, and in mental illness that goal involves the desire for safety and secu- rity. We know it is not the problems in the person’s life but rather the individual’s evaluation of self, others, and life that drives movement. And when this evaluation turns stress into distress, the feelings that result communicate both the internal assessment of self and the world and a relational demand that others protect them or take care of them. These movements are most easily seen in what are called per­ sonality disorders (American Psychiatric Association, 2013), but they are also present in clinical disorders. Some of the feelings, behaviors, and disorders described in Table 5.1 can easily reflect more than one movement or be individualized into a combination of move- ments. Although we may find that a single movement is involved—for example, anger as a movement against—we do not yet know the particular use of anger in the individual’s style of living. We merely know that the person feels under threat and feels compelled to fight back and to win at any cost. Mosak and Rasmussen (2002) use dance as a metaphor for the therapeutic encounter. Clients enter the dance of therapy in a multitude of ways, from the bold, assertive, never hesitant posture of the straightforward dancer to the wallflowers who never take the floor and distance themselves. Some dancers appear to go in one direction, but shift, sometimes constantly, to a different destination. Some dancers are passive or hesitate, and others show off. Dancers may ignore the music until it goes away, and others simply demonstrate that they are the worst dancers in the world. Each of these dance partners enters therapy with a style of movement, and they engage the process with what they have commonly relied on in life. It is the counselor who encourages the client “to alter the music [heard] and to dance a new dance” (p. 120). Goal-Orientation and the Unity of the Personality What others might consider an individual personality, Adlerians understand to be the person’s style of living, and each person’s style includes a life aim or goal, a Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 116   C h a pt e r F ive Table 5.1 General Movements by Individuals Movement Emotions, Behaviors, and Possible Disorders Movement toward Emotions: Some forms of shyness; embarrassment; humiliation; shame; envy; lust; guilt. Behaviors: Attention getting; dependency; pleasing and placating; putting others first to the exclusion of self. Disorders: Some uses of separation anxiety; disinhibited social engagement disorder; histrionic personality disorder; dependent personality disorder; some uses of borderline personality disorder. Movement against Emotions: Frustration; disappointment in others; anger; disgust; resentment; contempt. Behaviors: Anger outbursts, rage, and some uses of impulsive behavior; excessive criticism; some forms of stonewalling. Disorders: Selective mutism; conduct disorder and antisocial personality disorder; narcissistic personality disorder; some uses of borderline personality disorder; paranoid personality disorder. Movement against self Emotions: Personal disappointment; (a subcategory) self-contempt. (subcategory of movement Behaviors: Cutting and other forms of self-harm; suicide. against) Disorders: Anorexia, bulimia; body dysmorphic disorder; trichotillomania; excoriation. Movement away from Emotions: Sadness; sorrow and grief; hurt; dread; depression. Behaviors: Depersonalization; insomnia. Disorders: Some forms of attention-deficit/hyperactivity disorder (ADHD); some uses of separation anxiety; reactive attachment disorder; avoidant personality disorder; selective phobias; social anxiety disorder; schizophrenia; schizoid personality disorder; schizotypal personality disorder; schizoaffective disorder; acute stress disorder; and post-traumatic stress disorder (PTSD). Ambivalent movement Emotions: Fear; feeling stuck; anxiety, panic; anguish. Behaviors: Hesitation; some forms of stonewalling; panic attacks; hoarding; insomnia; dissociation or depersonalization. Disorders: Panic disorder; generalized anxiety disorder; dissociative identity disorder; dissociative amnesia; passive aggressive personality disorder; obsessive compulsive personality disorder. personal law of movement, and the individual’s opinion, assessment, and evalua- tion of self and the problems or tasks of life that must be faced. When Adlerians speak of lifestyle or, more specifically of lifestyle assessment, it is the person’s style of movement through life that is being addressed. Adler (1927/1959) believed that the individual’s goal emerged early in childhood, perhaps as early as 4 or 5 years of age, at least as a prototype; the goal is an early formulation of what the child would be like if fully successful, whole or complete: It is the child envisioning perfection. At this young age, it is highly likely that mistakes will be made—errors in judgment, thinking, and perceiving—and these errors may lead to further mistakes in feeling and behaving. Once the life goal is formed, it unifies the personality: With some occasional deviations in pattern, every thought, conviction, belief, feeling or emotion, and certainly our behaviors become directed toward—and oriented to—that final goal. Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.  Adl e ri an The r apy   117 Because we will never reach a goal of perfection, the goal is, of course, fictional, a guiding ideal that serves as a final endpoint off in the distance. This is what Adler (1932) means by the concept of a fictional finalism. Literally, the power of the goal comes from the quality of it being beyond us, more than we are now or ever will be, but envisioned, at least early in life, as possible. LO2 Community Feeling and Social Interest As Paul Rasmussen (2010) suggests, we are all doing the same thing: We are all moving through space, advancing time, and changing circumstances with the goal that our lives will go well. We all want feel good, happy, satisfied, and complete. The problem, of course, is that we keep running into roadblocks, chal- lenges, and events for which we are not prepared. If we can’t feel good, we at least want to feel better, and “better is always better, but better is not always good” (p. 7). It is when we are confronted with life’s challenges that our style of living will be most clearly expressed and revealed. And like everything else internal to the person, feelings communicate the individual’s goals, law of movement, and perceptions of self. It is not the movement, however, that determines the happiness and functional- ity of the individual. It is the degree to which the person’s movement is imbued with community feeling (Adler’s term was Gemeinschaftsgefühl) and enacted with social interest. Community feeling, so central to Adlerian thought, is also one of the least developed concepts in the model. Within Adler’s (1929, 1932, 1938) system, the con- cept grew and developed over time. Community feeling is what connects the individual to all of humankind. Adler’s (1938) community is more than where one lives or the culture within which one is raised. It is the feeling of belonging to the ongoing history of humanity, of being called to make a contribution to the whole. It is the human community beyond time and space. It is the feeling of being at home in the world, of feeling that one matters at least as much as others in the world. It is not so much the feeling of being God- like as it is the feeling of being more fully human, of being good enough, of having something to offer and ultimately leave behind. In this sense, the meaning of life is exactly the contributions to humankind and to life that we make while we are here on earth. Adler’s community feeling is both systemic and relational; personal mental health is derived from the feeling of connection, from being more concerned about others than we are about ourselves. Personal happiness derives from aiding others in the pursuit of their happiness. When we apply this perspective to the individual’s law of movement, it becomes much easier to differentiate useful from useless movements. Let’s take the move- ment against through this differentiation. What does a movement against look like when it is useful? Positive movement against might include taking a stand in social justice movements, speaking up for someone in need, or acts of nonviolent civil dis- obedience for a cause or for people who have been marginalized or experienced dis- crimination. Notice how large the scale of these movements against are. For example, Sam wears a T-shirt that proclaims his war against cars, and he steadfastly refuses Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 118   C h a pt e r F ive to own one. It is one of his many contributions to climate change, to the hope that there will be a planet for humans to inhabit in 100 years. Similarly, movement away from with the spirit of a community feeling can sometimes be seen as withdrawing from a fight or simply choosing to stay calm when being provoked. It may be experienced by giving over leadership that one has had to others who can advance the group. Mahatma Gandhi did this when England left India to be governed by its own people. Some former presidents of the United States do this when they leave office. People who have a community-based social interest are often good leaders, but they can also be good followers. Even ambivalent movement can be useful. All people feel stuck at one time or another. It is not being stuck that counts; rather, it is what is done with the expe- rience. People with a community feeling do not panic. They do not descend into anxiety. What separates them from others is their ability to stay present; to let the experience be what it is; to consider options in stillness; not to move until they are ready. It is possible to freeze and stand still in fear, a law of movement that seeks safety; it is also possible to stand still in peace and contemplation. The Dalai Lama (1998/2009) provides multiple examples of this. The opposite of community feeling is found in Adler’s (1935/1996a, 1935/1996b) descriptions of neurosis. It is here that Adler emphasizes the impact of exaggerated feelings of inferiority and the lack of preparation for living that leads to a retreat from the demands and challenges of life—and specifically, from the tasks of friend- ship, work, and love. It is the inferiority feeling that leads to withdrawal and isola- tion, exaggerated forms of safeguarding, and in cases of depression, the experience of self-absorption. These forms of movement characterize mental illness. Life without problems—life without stress—is impossible. At times. we expe- rience problems, challenges, and burdens that we cannot ignore. Stress, itself, does not lead to dysfunction. Distress is the experience of being overwhelmed, believing that one is not up to facing the challenge or feeling incapable of han- dling a situation. Such an inferiority feeling leads to emotional reactivity: per- haps anger, almost always anxiety, and sometimes depression. The eminent Canadian researcher Hans Selye (1974) echoed Adler’s call to social interest. Selye suggested that people should try to live each day in a manner that would earn the love of others. Private Logic For Adler, those who are unable to connect with their fellow human beings develop a private intelligence, a private logic. It is thinking about self, others, and life as if the only thing that matters is the individual. Private logic often leads to withdrawal and isolation, to self-absorption and maladaptive responses. Everyone is biased toward self, of course, but those with a community feeling can move beyond the conscious and sometime unconscious self-orientation that permeates the private thinking associated with self-survival. Private logic includes all the mistaken beliefs, faulty assumptions and convic- tions, and incomplete knowledge that individuals develop to preserve their sense of worth, and most of these biases are intuitive rather than conscious. The results of such private orientations to life are experienced in maladaptive patterns, Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.  Adl e ri an The r apy   119 interpersonal conflicts, and emotional distress. When stress becomes distress, private logic kicks in along with feelings of inferiority and being overwhelmed. These feelings in turn stimulate other feelings (fear, anxiety, anger, depression), and each of these negative feelings compels action and activities that seek one of those positive feelings that all of us want. These highly desired feelings are what Rasmussen (2010) calls “the Z factor,” the individual’s experience of feeling good (p. 11). There is no Z factor without an overarching life goal of success, achieve- ment, or fulfillment. Both Z-factor positive emotions and the negative compel- ling emotions are markers along the road of life, feedback within one’s style of living, letting the person and others know how the journey is going. Between any- thing an individual experiences (X) and the resulting feeling (Y or Z) is the person’s thoughts and interpretations (T). If the resulting feeling is positive and makes us happy, that is the desired outcome—the Z factor, the validating emotion. If the resulting feeling is negative, it is a compelling emotion (Y) directly related to our private logic or how we think (T) and demanding that we act (A) in an effort to achieve a more desirable outcome (Figure 5.1). Emotions serve the purpose of providing immediate existential feedback as well as communicating to others what the individual wants or needs. Anger, for example, flows from the belief that “I am entitled to a certain outcome.” It communicates that “I will attack; I must win at any cost; I seek victory.” There is an outward ori- entation to anger that suggests the person has strength and will use it to the fullest extent, but that outward strength masks an equally strong feeling of weakness. Now let’s consider anxiety, what does it suggest? Anxiety is a hypervigilance emotion, the feeling that one is at loose ends. Indeed, it informs us of loose ends that need to be tied up. Anxiety calls on the individual to be alert, to pay attention, to get on top of things: “Life is dangerous, and I need someone to bail me out of this danger!” Depression, however, flows from the experience of hopelessness. It is an emotional waving of the white flag, a throwing in of the towel: “It is hopeless, but please bother to reach out: I need someone to take care of me.” Dozens of emotional responses signal stress, and when stress is interpreted as being overwhelming, it becomes distress. Each emotional response reflects the individual’s self-assessment, communicates desired outcomes to others, and compels behaviors that the indi- vidual hopes will restore happiness and well-being. Rasmussen (2010) notes that some feelings can be an end in themselves: the Z factor, the outcome we seek. These feelings include joy, happiness, contentment, love, and pride. They reflect achievement of desired states; nothing else needs to happen. These are feelings that result from common sense when we approach life tasks with a community feeling and social interest. X Y Z Stimulating Compelling Validating Event Emotion Feeling (The Desired State) T A Private Behavioral Logic Action Figure 5.1 The Z Factor Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 120   C h a pt e r F ive LO3 Life Tasks Adler (1964) contends that we must successfully master at least three universal life tasks. All people need to address these life tasks, regardless of age, gender, time in history, culture, or nationality. These tasks are building friendships (social task), establishing intimacy (love/marriage task), and contributing to society (work task). These life tasks are so fundamental to human living that dysfunction in any one of them is often an indicator of a psychological disorder. Each of these tasks requires the development of psychological capacities for friendship and belonging, for con- tribution and self-worth, and for cooperation. For Adler (1927/1959), the meaning of life is contribution. In this sense, our occu- pation is more than the work we do; it is also the recognition that we have a limited amount of time on this earth, and occupation is about how we choose to use the time we have been given. Have we just taken care of ourselves, or have we made a contribu- tion to others—and in a larger sense, to the ongoing development of humankind? Influences on Individual Development We are born with a set of givens, including temperament, inherited genetics, a bio- logical structure and biological predispositions, mental capacities or limitations, and a social and cultural environment poised to shape us into the person that those who love us hope we will become. But none of these building bricks determine how life will go. Rather, it is the manner in which the person experiences them, inter- prets them, and uses them that makes individuals who they are. It is each person’s attitude toward life that fixes one’s relationship to life and to the outside world and results in a style of living (Adler, 1935). Still, there can be no denying that some influences have a very strong impact on personal development. Family Constellation and Family Values Adler was the first systemic therapist and the first to actually practice family counseling—often in front of a live audience (Bitter, 2021). Family constellation was his term for what we now call the family system. During Adler’s lifetime, ideal families were headed by heterosexual couples in which mothers, for the most part, raised the children, and fathers were providers and available to guide their children as often as possible. It was the mother’s job to form the first bond with the newborn, giving the child an experience of safe connection and the child’s first cooperative relationship. As the child grew, the mother’s task was to turn the baby toward the father, then siblings, and finally toward the larger world. Within the family, the ideal parental team treated each other with mutual respect, kindness, and caring, setting a model for how men and women could get along with one another. When both parents share common values, have similar beliefs and convictions, and approach the tasks of life in the same manner, they set a model for the children in everyday life. These shared ways of being become family values, orientations to life that are experienced as givens: They are what our family does; it is who we are. Children almost always accept these values early in life. Later, they may rebel against them or, conversely, promote them, but the values themselves are strong enough that they cannot be ignored. Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.  Adl e ri an The r apy   121 Family Atmosphere Before the first child is even born, the atmosphere into which the child will enter is being set in motion. The child may be welcomed into the world by a single parent, perhaps completely alone, but often with a support system that may include extended family members, friends, or even people hired to provide child care and family support. When two parents head the family, the relationship between the coupled partners sets the tone and the atmosphere for the family. It does not matter whether the couple is heterosexual, same-sex, trans, gender neutral, or gender fluid. These couples are the leadership teams of their families, and their attitudes and feelings for each other provide the child with the first experiences of life and security. The child is constantly watching, observing, and interpreting: What do these parent-people do together? Are they in competition or do they cooperate? How do they talk to one another and to me, the child? Do they stick together or can they be wedged apart? Are they attentive or distracted? Are they present or gone? Do they respond to my needs, and if so, how do they do it? And what do I need to do to gain their attention and support? How do they make decisions? Do they fight and, if so, what about? How do their arguments affect me? Are there things they both agree on or that they always do as if these beliefs and actions were set in concrete, automatic, and not to be questioned? The family atmosphere set by the parents and sometimes the extended family can be nurturing or abusive; it can be like a playground, or it can be a jungle; it can be peaceful or tense, cooperative or competitive, safe or frightening. Parents set the tone in how they respond to each other and to each of the children. Gender Guiding Lines and Gender Identities The families with whom Adler worked were mostly headed by two heterosexual parents. In the early part of the 20th century, only two gender identities were recognized, and one’s gender was assigned at birth based on a doctor’s assessment of anatomy. Parents seldom disagreed with the assignment. In these families, parents served as gender guiding lines for their children; that is, little boys looked at their fathers for a model of what men were like, and little girls did the same with their mothers. In this sense, a child would look at the parent of the same gender and almost always decide that it was inevitable: When the child became an adult, that child would be just like the parent with whom he or she identified. Other adults in the family might offer alternative models for the child to consider, but the parental model held the most power. In heterosexual families of the 21st century, much the same thing happens for children who are cisgendered. In single parent families, children of the same sex as the single parent will also see that parent as a powerful guide for how they will be when they mature. But what about a child raised with two same-sex parents? Even a child who is the same gender as the same-sex parents will be presented with multiple models. In the end, parents are powerful models for how adults are in the world, but when the child experiences same-sex models, interpretation is everything. That child experiences choice differently than a child with a single parent or heterosexual parents. This is also true in children for whom the same-gendered parent is absent or missing and for children who are misassigned at birth or whose gender identity is neutral or fluid. These children are literally co-constructing their identities within the contexts of their lives, and their subjective interpretation of self is what counts. Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 122   C h a pt e r F ive LO4 Birth Order and Sibling Relationships The Adlerian approach is unique in giving special attention to the relationships between siblings and the psychological birth position in one’s family. Adler identi- fied five psychological positions, or vantage points, from which children tend to view life: oldest, second of only two, middle, youngest, and only. Birth order does not determine who a person will be, but it does increase an individual’s probability of having a certain set of experiences. In the end, however, it is the interpretation that one assigns to these experiences that creates the meaning of birth order in the indi- vidual’s life. Adler (1931/1958) observed that many people wonder why children in the same family often differ so widely, and he pointed out that it is a fallacy to assume that children of the same family are formed in the same environment. Although siblings share aspects in common in the family constellation, the psychological situation of each child is different from that of the others due to birth order. The following description of the influence of birth order is based on Ansbacher and Ansbacher (1964), Dreikurs (1953), and Adler (1931/1958). 1. The oldest child generally receives a good deal of attention and focused energy; for a time, the oldest child is an only child, and all the benefits of emotional connection and attunement accrue. When a new sibling arrives on the scene, however, oldest children find themselves ousted from this favored position: They are dethroned, no longer unique or special. Oldest children may readily believe that the newcomer (or intruder) will rob them of the love to which they are accustomed. Most often, the oldest adopts the position of a model child, bossing younger children and exhibiting a high achievement drive. These oldest children tend to be dependable and hard working, building on their advantage of being first and striving to keep ahead. 2. The second child of only two is in a different position. From the moment of birth, second children share the attention of adults with another child. The typical second child behaves as if in a race and is generally under full steam at all times. It is as though this second child were in training to surpass the older child. This competitive struggle between the first two children influences the later course of their lives. The younger child develops a knack for finding out the elder child’s weak spots and proceeds to win praise from both parents and teachers by achieving successes where the older sibling has failed. If one is talented in a given area, the other strives for recognition by developing other abilities. The second-born is often opposite to the firstborn. 3. The middle child often feels squeezed out. This child may become convinced of the unfairness of life and feel cheated. This person may assume a “poor me” attitude and can become a problem child. How- ever, especially in families characterized by conflict, the middle child may become the switchboard and the peacemaker, the person who holds things together. If there are four children in a family, the second child will often feel like a middle child and the third will be more easy- going, more social, and may align with the firstborn. Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.  Adl e ri an The r apy   123 4. The youngest child is always the baby of the family and tends to be the most pampered one. Because of being pampered or spoiled, young- est children may develop helplessness into an art form and become experts at putting others in their service. Youngest children tend to go their own way, often developing in ways no others in the family have attempted; in the end, they may outshine everyone. 5. The only child has another kind of problem. Although sharing some of the characteristics of the oldest child (for example, a high achievement drive), the only child will never be dethroned and may not learn to share or cooperate with other children. What only children do learn is how to deal with adults, because they make up the child’s whole world. Often, the only child is pampered by parents and may become depend- ently tied to one or both of them. Only children often learn more adult language earlier in life, may want to have center stage all of the time, and if their position is challenged, they will feel it is unfair. Birth position is an interpretation, and each of these descriptions may be totally incorrect for any given person. However, birth order and the interpretation of one’s position in the family has a great deal to do with how adults interact in the world. Individuals acquire a certain style of relating to others in childhood and form a defi- nite picture of themselves that they carry into their adult interactions. In Adlerian therapy, working with family dynamics, especially relationships among siblings, assumes a key role. It is important to avoid stereotyping individuals, but certain per- sonality trends that began in childhood because of sibling relationships can influ- ence individuals throughout life. Culture, Race, and Ethnicity: Systemic Holism Like birth order, culture is a vantage point from which individuals view life. If you are born at a specific location on the planet and are raised for 10 years in the culture that dominates and permeates that location, it is highly likely that you will embrace the worldview, values, and social orientations of that culture. Culture is to families within it as families are to family members. There will be individual differences, but the general way of being is a very strong influence. Culture expresses itself in community values, beliefs, and convictions; it is celebrated and reinforced in ritu- als; and it is structured through laws and religion. We can leave our culture, travel the world—indeed, we can become citizens of the world—but nothing feels quite the same as home until we return to where we started life. Some cultures are built around race and ethnicity, especially when one’s race or ethnicity has experienced oppression and marginalization. When any group feels that their members are under attack or challenged or dismissed, banding together is the first line of defense. Groups who have banded together will develop distinct cultures of their own over time. Every part of the world has a dominant culture. In the United States, the dominant culture is male, White, rich, heterosexual, abled, right-handed, relatively young, and Christian. Those who perfectly match the dominant culture experience unearned privilege throughout their lives. To be sure, the dominant culture has real power, and to the extent that one is not part of the dominant culture, there is Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 124   C h a pt e r F ive oppression. The intent of a dominant culture is to reinforce itself and marginalize alternative positions. In the end, it is not the race, ethnicity, gender, socioeconomic level, religion, or culture that determines who a person is; rather, it is the interpre- tation that the individual attaches to these profound influences and to the experi- ences they have. It is impossible to fully understand the individual outside of the full, systemic, social embeddedness of the person’s life. Processes in Adlerian Therapy Therapeutic Goals Adlerian counseling and therapy rests on a collaborative arrangement between the client and the counselor. In general, the therapeutic process includes forming a rela- tionship based on mutual respect; a holistic psychological investigation or lifestyle assessment; and disclosing mistaken goals and faulty assumptions within the per- son’s style of living. This is followed by a reeducation or reorientation of the client toward the useful side of life, and replacement of a maladaptive pattern with an adap- tive one. The main aim of therapy is to develop the client’s sense of belonging and to assist in the adoption of behaviors characterized by community feeling and social interest. The emphasis is on health, well-being, and prevention of problems rather than on remediation. Adlerians favor the growth model of personality and empha- size strengths and resources (Carlson & Englar-Carlson, 2013, 2017; Sweeney, 2019). A key goal is to assist clients in addressing the tasks of life. Adlerians recognize the need to assist clients with first-order change, addressing and managing severe symptoms, but the real aim of therapy is to help people live more adaptive lives, replacing maladaptive patterns of coping and living with more socially useful pat- terns. More adaptive lives are characterized by the development of what Adlerians call psychological muscle (Rasmussen & Schuyler, 2020). Psychological muscle is the exercise of responsibility, cooperation, respect for self and others, and courage in the daily approach to the life tasks. Encouragement is the most powerful method available for changing a person’s beliefs; it helps clients build self-confidence and stimulates courage. Courage is the willingness to act even when fearful in ways that are consistent with social interest. Fear and courage go hand in hand; without fear, there would be no need for courage. The loss of courage, or discouragement, results in mistaken beliefs and dysfunc- tional behavior. Discouraged people tend to act only in line with their perceived self-interest, which often is associated with a lack of social interest. Maniacci and Sackett-Maniacci (2019) suggest working toward these goals dur- ing the educational process of therapy: ◆ Foster social interest and community feeling ◆ Help clients overcome feelings of discouragement and inferiority ◆ Modify clients’ lifestyle in the direction of becoming more adaptive, flexible, and social ◆ Change faulty motivation ◆ Encourage equality and acceptance of self and others ◆ Help individuals become contributing members of the world community Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.  Adl e ri an The r apy   125 LO5 Therapist’s Function and Role The Adlerian therapist’s role is to help clients become aware of their faulty world- view and to provide clients with a new “cognitive map” that enables them to change their feelings and behavior (Carlson & Englar-Carlson, 2017). All clients come to counseling and therapy hoping to feel good, and if they cannot feel good, they at least want to feel better and find a way to manage those events that lead them to feel badly (Rasmussen, 2010). Adlerians operate on the assumption that clients will feel and behave better once they discover and correct their basic mistakes. They tend to look for major mistakes in thinking and evaluating such as mistrust, selfish- ness, unrealistic ambitions, and lack of confidence. In addition to examining basic mistakes, Adlerian therapists often help clients identify and explore their core fears, such as being imperfect, being vulnerable, being disapproved of, or suffering from past regrets (Carlson & Englar-Carlson, 2017). It is precisely these mistakes in the client’s internal assessments that lead to symptomatic presentations. Such symptoms are most often expressed in emotional disturbance, and to be sure, Adlerian counselors will help clients manage their symptoms when they are severe. Addressing emotional disturbance and correcting mistakes, even replacing maladaptive patterns with more adaptive ones, however, is a means to an end, not the end in and of itself. The ultimate role of the therapist is to facilitate the development of a preferred style of living, a coping style in which the life tasks become opportunities for the development of psychological muscle—and a life in which a community feeling and social interest are manifest in the contributions that people make to others. In sup- porting the achievement of this larger goal of therapy, the initial symptoms with which clients present themselves often disappear—simply because they are no longer needed. Client’s Experience in Therapy How do clients maintain their lifestyle, and why do they resist changing it? A per- son’s style of living serves the individual by staying stable and constant. In other words, it is predictable. It is, however, also resistant to change throughout most of one’s life. Generally, people fail to change because they do not recognize the errors in their thinking or the purposes of their behaviors; they do not know what to do differently and are fearful of leaving old patterns for new and unpredictable out- comes. Thus, even though their ways of thinking and behaving are not successful, they tend to cling to familiar patterns (Sweeney, 2019). Clients in Adlerian counsel- ing focus their work on desired outcomes and a resilient lifestyle that can provide a new blueprint for their actions. Clients come to therapy when their unhappiness, often presented as emotional disturbance, is greater than they can stand. Few clients ever start with a concern about their thinking or behaving. Most of the time, clients are unhappy, and they want the counselor to help them feel good—if not good, the client would at least like to feel better. Negative emotions have a purpose. They signal to the individual that some- thing in life is wrong and needs attention. They signal to others that the person is in Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 126   C h a pt e r F ive distress and needs help—often in the form of a desired outcome. And they suggest a way of thinking and approaching life that is maladaptive. Let’s consider a few of the more common emotions with which people present for therapy. Anxiety, for example, is a battle emotion. The person is worried about potential outcomes, but the client is still in the fight, still hoping for “things” to work out. The emotion tells the person to be vigilant, to be on alert, that there is a threat to one’s well-being or integrity. It says to others, “Hey, join the battle with me. We may be in danger. I need your help and support.” Perhaps the emotional presentation is anger. Anger signals that the person feels in danger of losing or not getting what the person wants. It comes from the belief that the person is entitled to a certain outcome. It says to others, “I will not accept what you are saying or doing, and if I have to, I will attack: I am willing to remove you as an obstacle; I am not against seeking revenge.” And then there is depression. Depression comes from a sense of impending defeat or failure. In some cultures, it is recognition of an impending loss of face. It is a retreat from life’s tasks, a withdrawal from the playing field. It says to others, “I need to find hope, help, or relief.” The linking of emotional (symptomatic) presentation to cognitive orientations is essential to understanding the maladaptive pattern of the client. These three emo- tions provide examples, but similar patterns emerge around the feelings of frus- tration, dread, fear, panic, sadness, sorrow, shame, resentment, disgust, contempt, jealousy, greed, and guilt, to name a few others. Think about what these emotions might mean to the individual’s internal sense of self and what the person might be communicating to others. Every presentation in therapy has a precipitating event that is supported by social, familial, and biological predispositions and perpetuated by reinforcers in the person’s environment (Sperry & Sperry, 2020). Precipitating events tell you what pushed the client to seek help, what compelled the person to act. Reinforcers are all the social triggers that keep the maladaptive pattern going. And predispositions are largely revealed through what Adlerians call lifestyle assessment. Lifestyle assessment is a more formal investigation of the individual’s approach to life, including the orientation the person adopted in their family constellation, what the person came to expect in the family’s atmosphere, and the thinking, values, and convictions with which the person was raised. Lifestyle assessment also inves- tigates the experiences and interpretations the individual has in relation to the life tasks of work, friendship, and love. Finally, early recollections are used to verify how the client sees self, others, and life—and to identify patterns that have been with the person for a very long time. To provide a concrete example, think of a chronically depressed middle-aged man who begins therapy. After a lifestyle assessment is completed, these basic mis- takes are identified: ◆ He has convinced himself that nobody could really care about him. ◆ He rejects people before they have a chance to reject him. ◆ He is harshly critical of himself, expecting perfection. ◆ He has expectations that things will rarely work out well. ◆ He burdens himself with guilt because he is convinced he is letting everyone down. Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.  Adl e ri an The r apy   127 Even though this man may have developed these mistaken beliefs about himself and life when he was young, he is still clinging to them as rules for living. His expec- tations, most of which are pessimistic, tend to be fulfilled because, on some level, he is seeking to validate his beliefs. Indeed, his depression will eventually serve the purpose of helping him avoid contact with others, a life task at which he expects to fail. In therapy, this man will learn how to challenge the structure of his private logic. In his case the syllogism goes as follows: ◆ “I am basically unlovable.” ◆ “The world is filled with people who are likely to reject me.” ◆ “Therefore, I must keep to myself so I won’t be hurt.” It is easy to see how depression might follow from this thinking, but Adlerians also know that the depression serves as an excuse for this man’s retreat from life. It is important for the therapist to listen for the underlying purposes of this cli- ent’s behavior. He has isolated himself from any community feeling, so his social interest is low. Through the therapeutic process, clients will discover that they have resources and options to draw on in dealing with significant life issues and life tasks. LO6 Relationship Between Therapist and Client Adlerians consider a good client–therapist relationship to be one between equals that is based on cooperation, mutual trust and respect, confidence, collaboration, and alignment of goals. They place special value on the counselor’s modeling of communi- cation and acting in good faith. From the beginning of therapy, the relationship is col- laborative, characterized by two people working equally toward specific, agreed-upon goals. Adlerian therapists strive to establish and maintain an egalitarian therapeutic alliance, a person-to-person relationship with their clients that is facilitated by empa- thy and support. Developing a strong therapeutic relationship is essential to success- ful outcomes. It is a foundation for both a subjective and an objective psychological investigation, and it provides support for personal transformation and change. In the end, the Adlerian therapist helps the client substitute an adaptive pattern for a mal- adaptive pattern (Sperry & Binensztok, 2019; Sperry & Sperry, 2020). LO7 Application of Therapy: Techniques and Practices Adlerian counseling is structured around four central objectives that correspond to the four phases of the therapeutic process (Dreikurs, 1967). 1. Establish the proper therapeutic relationship. 2. Explore the psychological dynamics operating in the client (an assessment). 3. Encourage the development of self-understanding (insight translated into action). 4. Help the client make new choices (reorientation and reeducation). These phases are not linear and do not progress in rigid steps; rather, they can best be understood as a weaving that leads to a tapestry. Dreikurs (1997) incorporated these phases into what he called minor psychotherapy in the context and service of holistic medicine. This way of working is discussed in the following sections. Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 128   C h a pt e r F ive Phase 1: Establishing the Relationship The Adlerian practitioner works in a collaborative way with clients, and this ­relationship is based on a sense of interest that grows into caring, involvement, and friendship. Therapeutic progress is possible only when there is an alignment of clearly defined goals between therapist and client. To be effective, the counsel- ing process must deal with the personal issues the client recognizes as significant and is willing to explore and change. The therapeutic efficacy in the later phases of ­Adlerian therapy is predicated on the development and continuation of a solid therapeutic relationship during this first phase of therapy (Watts, 2015). Adlerian therapists focus on making person-to-person contact with clients rather than starting with “the problem.” Clients’ concerns may surface rather quickly in therapy, but the initial focus should be on the person, not the problem. One way to create effective contact is for counselors to help clients become aware of their assets and strengths rather than dealing continually with their deficits and liabilities. During the initial phase, a positive relationship is created by listening,