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

Empathy &
1
Relationship
Support

2 Information

3 Clarification

Encouragement

4 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
 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?