PSY 245
CLINICAL PSYCHOLOGY
 Assoc. Prof. Dr. BAHAR BAŞTUĞ
 Clinical Psychologist
Individual Psychology &
Adlerian Therapy
Alfred Adler (1870 – 1937), founder
of individual psychology
Welcome
 Today we’ll be focusing on individual
psychology which is a theory and therapy
approach developed by Alfred Adler.
 This approach is typically referred to as
Adlerian therapy.
 Although some people still refer to Adler as
one of Freud’s students, he was Freud’s
contemporary and developed his own, very
different, approach to counseling and
psychotherapy.
 He’s like a man from the future.
 Some labels Adler as a neo-Freudian.???
 Adler’s Individual Psychology is a
psychoeducational, present/future oriented,
and brief approach.
 Adler’s psychology was far ahead of its
time. He’s known as the father of CBT.
Alfred Adler
 was born to a Jewish family, second of six
children, in Vienna.
 had a sickly childhood. He suffered from
rickets. His physician told his father: «your
boy is lost.»
 His father encouraged Adler.
Alfred Adler
 obtained medical degree from University of
Vienna.
 married Raissa Timofeyewna Epstein, an
early socialist and feminist.
Alfred Adler
 met Freud in 1902. Adler attended “Wednesday
evenings”.
 He defended Freud’s “Interpretation of Dreams”
and then was invited to what became the Vienna
Psychoanalytic Society
 was man with his own ideas before meeting Freud.
 In 1911, as president of Vienna’s Psychoanalytic
Society, Adler read a highly controversial paper
(the masculine protest) at odds with Freudian
theory. Adler emphasized the power of culture and
socialization.
 He noted that some women who reacted to
this cultural situation by choosing to dress
and act like men were suffering not from
penis envy, but from a social-psychological
condition he referred to as the masculine
protest. In extreme cases, males who
suffered from the masculine protest began
dressing and acting like girls or women.
Alfred Adler
After this presentation, Adler left the Vienna
Psychoanalytic Society. He and his
colleagues established The Society for
Individual Psychology.
According to Individual psychology, human
functioning was not only biologically based,
but also powerfully influenced by social,
familial, and cultural factors.
The key to psychological health and wellbeing was encouragement.
THEORETICAL PRINCIPLES
The Whole Person: Adler didn’t believe in
dichotomies the individual into different
functional parts. He emphasized unity of
thinking, feeling, acting, attitudes, values, the
conscious mind, and the unconscious mind.
 Adler avoided reductionism. Freud was
reductionist.
 Reductionism X Holism
 Adlerian holism: Humans are a single
complete unit; a whole that cannot and
should not be divided into separate parts
(id, ego, superego).
Striving with Purpose
According to individual psychology, humans
actively shape themselves and their
environments. There is a third element—
beyond biology and the environment—that
influences and directs behavior; Adler referred
to this third force as “attitude toward life”
Attitude toward life is composed of a
combination of individual human choice and
purpose.
Striving with Purpose
Human behavior is purposeful. We move
toward specific goals in life. Humans are
driven by hopes for the future, rather than
instinctual forces from the past.
Adler referred to the endpoint of our future
purposeful striving as fictional finalism
because the endpoint is each individual’s
subjective fiction.
Striving with Purpose
 Everyday behavior can be analyzed with
respect to its purpose. When an Adlerian
therapist notices a maladaptive quality to
the client’s behavior patterns, threapist
wonders why that behavior occurs.
 For Adler, the question was neither ‘How
does mind affect body?’ nor ‘How does
body affect mind?’ but rather ‘How does
the individual use body and mind in the
pursuit of goals?”
Striving with Purpose
 Striving with purpose is helpful in child psy
and parenting. Dreikurs identified «the four
goals of misbehavior» to understand of
children misbehavior.
 To get attention
 To get power or control
 To get revenge
 To display inadequacy
Social Interest and Community Feeling
Humans are born into an interpersonal context. As
a consequence, the development of individual
personality is shaped by interpersonal factors.
When an individual experiences a deep sense of
connection to others, he or she is experiencing
community feeling.
Social Interest and Community Feeling
 Social interest is community feeling in
action.Social interest or a sense of social
responsibility is a goal of therapy. As an
individual’s social interest develops, so
does the capacity for empathy.
Psychologically healthy individuals feel a
sense of communion with others.
 Social interest is positively related to
spirituality,positive psychology &
attachment.
Striving for Superiority
The most basic human motive is striving for
superiority. Individuals strive for a
perceived plus in themselves and their lives.
Within the individual there is opportunity for
both interpersonal gain and individual
developmental gain.
Adler is neutral. He doesn’t believe in the
innate goodness or innate destructiveness of
humans. He believes we are what we make
ourselves; we have within us the potential
for goodness and evil.
Striving for Superiority (cont.)
Adler viewed individualistic superiority striving as a
sign of psychopathology.
The basic striving is the striving for completeness.
Even a flower that grows strives to reach its
completeness. The fundamental law of life is to
overcome one’s deficiencies.
Humans strive; we are active, creative, and persistent
in our drive to move toward completion and
excellence. We can become discouraged and
resigned due to unfortunate life circumstances, but
our natural state is forward moving.
Phenomenology
Adler was an early existentialist; the concept
of phenomenology is a central assumption
of individual psy.
Individual experience is a subjective fiction
based on each individual’s perception. The
individual actively creates and adapts
personal reality.
Adler had an influence on Victor Frankl and
Rollo May.
An Idiographic Approach
For Adler, general statements about humans and
human psychology are helpful, but of limited use.
A human being cannot be typified or classified.
Every individual is unique. To really understand
an individual, a couple,or a family, you must work
with that individual, couple or family. Meeting
and spending time with clients are more important
than providing a diagnostic label.
Individual psy is about the psy of the single, unique,
whole individual.
Soft Determinism
Individual psychology is not deterministic approach.
Adler didn’t emphasize the causal determinants of
human behavior.
Soft determinism is the midpoint between deterministic,
cause-and-effect thinking and nondeterminism which
assumes no causal connections.
Soft Determinism
From the individual psychology perspective,
human behavior is a function of a
combination of influences. There is no
single, direct causal factor that produces a
single behavior. There are many influences
or contributing factors.
Adler believed every individual is responsible
for his/her behavior.
Adlerian theory is hopeful and optimistic.
Lifestyle: The Early Cognitive Map
Adler was deeply influenced by Hans Vaihinger.
According to Vaihinger, we each create our own
world and then live by the rules we’ve created.
Vaihinger’s philosophy is based on a cognitive
psychological model. Vaihinger’s book was “The
Philosophy of «As If»”
Adler referred to a client’s fictional goals or
fictional finalism as a future-oriented concept that
influences an individual’s present behavior.
An individual’s lifestyle is both conscious and
unconscious. It is a subjective cognitive map of
how the world works.
Lifestyle: The Early Cognitive Map
The future is now. This is because the future strongly
influence your everyday behavior. In addition, the
future is then. This means that your future was
established by your early childhood experiences.
Humans are characterized by continuity; the past,
present, and future are all closely intertwined.
An individual’s personal continuity or lifestyle may
be more or less adaptive. Some people hold onto
beliefs about the self, world, and others that cause
them emotional pain and distress. Adler has
referred to these beliefs as basic mistakes, and
these cognitive mistakes are an obvious target of
therapy.
 Adler is hopeful and optimistic about the
possibility for helping individuals change
their cognitive maps through therapy.
Tasks of Life
Adler believed all humans face 3 life tasks:
 Work, or occupation
 Love and marriage
 Social Relationships
Later, other Adlerians added 3 more tasks:
 Self
 Spirituality
 Parenting and Family
These six tasks constitute the challenges of life.
The clients come to therapy because they have
had difficulty with one or more basic life
tasks. The difficulties arise from mistakes
and maladaptive perceptions associated
with their lifestyle. The goal of therapy is to
help clients adjust or modify their lifestyles
in ways that help them more effectively
complete their life tasks.
Work or Occupation
This is a life demand that we all must face and
work through.
Adler believed the best way to solve the life
task of work or occupation was by solving
the second life task, social relationships,
through “friendship, social feeling, and
cooperation”.
Social Relationships
Adler proposed positive social relationships.
Establishing healthy social relationships was the
key to solving the work or occupational problem.
Humans are interdependent. Everyone needs to
belong to some social group.
Humans need to belong and are interdependent and
must also face the life task of dealing with
relationships. Some clients come to therapy
because they have social relationship problems.
From the Adlerian perspective, clients’ social
problems arise from inappropriate expectations,
beliefs, and interpersonal habits.
Love and Marriage
Adler viewed marriage as a partnership.
Many clients come to therapy with intimacy
problems, both sexual and nonsexual.
Road to recovery: modify the lifestyle and
develop empathy (community feeling).
Self
This task emphasizes that everyone has a relationship with
himself or herself. The nature of your relationship with
yourself is established during childhood.
Mosak and Maniacci describe four dimensions of the self life
task:
 Survival of self: Am I taking good care of my physical
self? Am I taking good care of my psychological self ? Am
I taking good care of my social self ?
 Body image: Is my perception of my body reasonable and
congruent with my actual body?
Self
 Opinion: What is my opinion of me? To
evaluate this in an interview, Adlerians
often ask clients to complete the incomplete
sentence, “I ....me”.
 Evaluation: Some clients have various
extreme perspectives of the self. From the
object relations perspective, the question
would be “Am I good or am I bad?”
Spirituality
Mosak and Maniacci describe five specific issues
related to the spirituality task. As individuals grow
up and face life, they must approach and deal with
each of these issues:
 Relationship to God:
 Religion:
 Relationship to the universe:
 Metaphysical issues:
 Meaning of life:
Parenting and Family
Giving birth to, raising a child & functioning
as a family are extensions of love and
marriage task. Some individuals function as
single parents and raise children outside
marriage. Individual parents also develop
strong feelings and beliefs about how children
should be raised. How individuals face the
parenting and family task is both a function of
and a challenge to the lifestyle.
Parenting and Family
Adlerian parenting approach has some core
characteristics:
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Democratic-authoritative
Autocratic/authoritarian or permissive
Responsive
Problem-solving
Encouragement
Punishment
Contemporary parenting authorities
Theory of Psychopathology
Psychopathology is often defined as
“discouragement”. The discouraged
individual is unable or unwilling to
approach and deal with essential life tasks.
In the case of mental disorder, one or more of
the life tasks have become overwhelming.
The person struggling to adequately face a
life task becomes discouraged. He or she
feels inferior or unable to successfully
manage the life task demands, and therefore
symptoms arise.
Psychopathology and Human Change
Patients are suffering from the effects of their
inaccurate or mistaken lifestyles. Symptoms
become an answer to the question “What shall I do
if I cannot successfully manage this life task?”
From an Adlerian perspective, symptoms have a
purpose and help individuals avoid facing life
tasks.
For example “If I become anxious, I will not have to
approach one or more of the basic life tasks.
Perhaps I can avoid marriage or work.”
Although feelings of inferiority are
natural, they can also become
pathological.
The Practice of Adlerian Therapy
 In the practice of Adlerian therapy, there are
four phases:
1. Forming the therapeutic relationship
2. Lifestyle assessment and analysis
3. Interpretation and insight
4. Reorientation
The Practice of Adlerian Therapy II
 Forming the therapeutic relationship
– The relationship is equalitarian and characterized
by listening and caring.
– The therapist is like a friendly teacher or business
consultant. Therapist and client sit on chairs of
equal status and look more or less directly at one
another. Therapy is conducted collaboratively.
“What do you want me to know about you?
– Clients are encouraged to be active participants in
therapy.
The Practice of Adlerian Therapy III
• Therapist-client goal alignment is important;
sample goals include:
– Fostering client social interest or community feeling
– Helping clients overcome feelings of inferiority and
discouragement.
– Helping clients change the basic mistakes embedded in
their lifestyle.
– Shifting client motivation from self-focused superiority to
a community focus.
– Helping clients believe and feel as equals in their
relationships.
– Helping clients become contributing members to society.
The Practice of Adlerian Therapy IV
 The therapist focuses mostly on positives
and not pathology.
– Focus on client strengths.
– There is also sometimes a focus on client
problems.
Adlerians focus on the person and strengths as
well as problems.
The goal is to establish an environment
characterized by encouragement.
Initial Lifestyle Interpretations
“Tell your client something you’ve learned
about him toward the end of the first
session”
The purpose of this early interpretation is to
further the connection between therapist and
client and begin the process of a deeper
analysis.
Lifestyle Assessment and Analysis
Several approaches to lifestyle assessment are
available. The main assessment strategies
are:
 The family constellation interview
 The question
 Earliest recollections (memories)
The Family Constellation Interview
is a particular approach to obtaining information about the
client’s childhood experiences. Topics covered include
descriptions of each family member, descriptions of how
family members interacted with one another, how each
family member was viewed by the client, who fought,
who didn’t fight, and more.
Adler considered birth order to be a strong contributor of
lifestyle. He emphasized that every individual is born
into a different family; this is because with the addition
of a new family member, the family dynamics change
and a new family is born.
Birth order
 We shouldn’t use birth order like astrology
to describe personality and to predict human
behavior.
 Birth order is psychological, not
chronological. If a first-born child has
illnesses, a second-born may adopt
personality characteristics associated with
first-borns.
 Oldest: may be spoiled, later dethroned,
may be bossy, authoritarian; Oldest child
may feel responsible for others, identify
with father.
 Middle: may have trouble finding her place
in life.
 Youngest: may feel she/he should be treated
like royalty. She/he dreams of being bigger
and more powerful, learns to manipulate
others.
 Only: takes attention from both parents,
feels special, may have problems with peer
relationships due to lack of sharing
experience.
 Only boy among girls: may need to prove
he’s a man, is to be sensitive to feminine
issues.
 Only girl among boys: may become
feminine, tries to compete with her brothers.
The Question
In order to obtain information about the
purpose of the client’s symptoms, the
therapist asks the client “the Question.”
How would your life be different if you were well?
What would you be doing in your life if you no longer
had your symptoms?
This question is a method to look for
underlying motivations or secondary gain
(remember: all behavior is purposeful).
Earliest Recollections
This is a method for understanding the client’s lifestyle.
It helps clarify the self ideal.
The early recollection is a message from the past, still
active in the client’s present life, a forecast of the
future. The accuracy of the memory is much less
important than the existence of the memory. The
memory is an active expression of the client’s living
lifestyle. If the memory was not important in the
present, there would be no purpose for the client to
remember it.
Basic Mistakes
An Adlerian becomes able to identify a
client’s basic mistakes:
 1.Overgeneralization
 2.False or impossible goals
 3.Misperception of life and life’s demands
 4.Denial of one’s basic worth
 5.Faulty values
Interpretation and Insight
Insight is central to Adlerian therapy. There’s a
strong link between insight, motivation, and
action. Insight stimulates motivation, motivation
stimulates action.
Insight is generally achieved through interpretation.
Collaboratively «Could this be true?»
The purpose of interpretation is to demonstrate
continuity of an inaccurate, maladaptive lifestyle;
it’s not important to show a causal connection
between past and present.
The Practice of Adlerian Therapy X
 Reorientation is the final phase of Adlerian
therapy.
 This is where many specific teaching and
learning strategies are employed, including:
– The future autobiography
– Creating new images
– Acting “as if.”
Reorientation: Specific Therapy Techniques
 The Future Autobiography: The future guides and
shapes everyday behavior. This technique is for helping
clients reshape their view of the future. This technique
is especially useful for clients who like to write, draw or
tell stories.
 First, this technique can be used as an assessment tool.
 The future autobiography can help identify the client’s
fictional life goals (self-ideal). A discussion of the
client’s future autobiography can help the client take
greater conscious responsibility for directing and
shaping life.
 The future autobiography can be used in a
therapeutic manner. You can use it after
gathering information about client’s past
and lifestyle. You can help the client to
write a realistic and adaptive future
autobiography.
Creating New Images
Clients have images of themselves in the past,
present, and future. This procedure can be used in
many different ways. In some cases, the therapist
may try to use a short phrase to visually and
metaphorically capture a client’s behavior,
attitude, or value.
This technique can also be used to encourage clients
to actively develop new and more adaptive selfimages.
Acting “as If”
Clients often wish for traits they don’t have.
The “acting as if ” technique is used when
clients express a desire to be different.
«What if you were self-confident?»
This technique is primarily experimental.
Clients gain new perspectives and
motivation for behaving in different, more
adaptive ways.
Reflecting As If
There are 3 stages:
– Reflecting: therapists ask clients to reflect on
how they wish they might act differently.
– Planning: building a hierarchy of specific
behaviors linked to the ideal-self.
– Implementing: the client identifies one or two
as if behaviors that would be easiest to
implement.
RAI can be used with adults, children & couples.
The Push-Button Technique
Adler believed that under every feeling there is a
cognition. The technique is designed to help
clients have greater emotional control.
The push-button technique is an ABA reversal
experimental design that teaches clients the power
of thoughts and images over feelings. “Depressed
people feel depressed. It’s because they’re
consistently thinking depressing thoughts.”
This technique can be used with depressed people.
Spitting in the Client’s Soup
Clients avoid demands & responsibilities of basic life
tasks. Spitting in the client’s soup is a metaphor and
technique for destroying the client’s avoidance strategy.
Its purpose is to increase client awareness and destroy the
use of the maladaptive behavior pattern in the future.
– Develop a friendly and supportive relationship with the
client characterized by good listening and
encouragement.
– Identify a repeating and unhelpful behavior or thinking
pattern (basic mistake) that the client uses repeatedly
and plans to use in the future.
– Ask and get the client’s permission to share an insight.
– Share the repeating and unhelpful pattern that the client
is planning to continue using.
– Be open to discussing the client’s reaction to having
his/her soup spat in.
Catching Oneself
Self-awareness and self-control
is designed to help clients become aware of
their maladaptive behavior patterns and
goals. The therapist coaches the client on
how to catch himself when he or she slips
into old, unhelpful behaviors.
The technique of catching oneself is a
historical precursor of CBT’s selfmonitoring and thought stopping.
Paradoxical Strategies
 Paradox in therapy involves prescribing the
symptom. If the client is self-critical,
therapist might suggest that she negatively
analyze and criticize herself at a higher rate.
Advice, Suggestion, and Direction
Adlerian therapists offer advice within the
context of a friendly, collaborative, positive
relationship.
• I’ll Betcha
Case Analysis and Treatment Planning
• The Problem List
– Inferiority feelings or low self-esteem
– A range of different maladaptive behaviors
and cognition.
• Problem Formulation
• Interventions
• Outcomes Measurements
Outcomes Measurements
Assessment is integrated into the treatment process
and assessment via lifestyle analysis.
A primary goal is to develop client social interest. It
focuses on the ability of clients to face and
complete the tasks of life. These goals are
measurable and relevant to treatment outcomes.
Research shows that higher self-interest scores are
associated with fewer symptoms and lower
diagnostic rates.
– Sulliman Social Interest Scale
– Social Interest Index
– Social Interest Scale
Cultural and Gender Considerations
 Adlerian theory and therapy is not value-
free. One value is social equality.
 His feminist perspective is, of course,
welcomed by feminists. He stated that
women’s psychopathology is shaped by a
prejudiced society.
 His emphasis on family and family
dynamics as influencing the individual also
plays well in multicultural counseling.
Evidence-Based Status
Professionals and teachers have applied the principles of
individual psy within educational settings, for parent
education, and for group, family, couple, and individual
therapy. Numerous contemporary approaches such as CBT,
existential and reality therapy borrow from individual psy.
Despite the prominent use of Adler’s concepts, empirical
research confirming to the efficacy of Adlerian therapy is
little. Perhaps the greatest reason for this is the fact that Adler
found nomothetic research that compares group outcomes to
be relatively useless. Consequently, the Adlerian focus
continues to be idiographic case studies.
Evidence-Based Status
Early research reviews, based on only four empirical studies
of Adlerian psychotherapy, indicate that the procedures are
slightly more effective than placebo treatment and have
efficacy similar to psychoanalytic and person-centered
therapy.
Birth order and social interest have studied. The relationship
of birth order to specific personality traits have been
mixed.
Positive correlation between positive psy & social interest
Positive correlation between spirituality & social interest
Higher social interest is associated with fewer symptoms and
increased well-being.
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