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Counseling Theories Paper Notes

Chapter 5: Adlerian Therapy
- psychodynamic approach
- original student of Freud but deserted him
- founded the psychology for individual psychology in 1912
- a significant contributor to Adler's work is Rudolph Dreikurs
- Adler was developer of individual psych
- individual psych is a term Adler used to describe his emphasis on the
uniqueness and unity of the individual
- Dreikurs, brought Adler's principles to US, applied them to education,
child guidance, and group work
- he moved away from Freud because he disagreed with a biological
and deterministic point of view
- Adler’s point of view is mainly social-psychological, teleological: goal
oriented point of view
- stressed the unity of personality
- we can only be understood as integrated and complete beings
- his theory talks about purposeful nature of behavior
- emphasizes that we were striving to go is more important than where
we come from
- he says we are creators of ourselves rather than being shaped by
childhood experiences
- positive view of human nature
- more social than biological focus
- people are in control of their fate, not victims of it
- individuals create a lifestyle at an early age rather than being shaped
by childhood experience
- lifestyle: tends to remain relatively constant and defines one’s
beliefs about life and how to deal with the tasks of life
Key Concepts:
- view of human nature
- person’s perception of the past and his interpretation of early events
- humans related by social-relatedness rather than sexual urges
- behavior is purposeful and goal-directed
- conscious more than unconscious
- stresses choice and responsibility
Inferiority Feelings: early determining forces in behavior
- source of human striving and creativity
- humans attempt to compensate for both imagined and real
inferiorities, which help them to overcome handicaps
- at around age 6 our fictional vision turns into life goal
- the life goal unifies personality and becomes a source of human
- from Adlerian perspective, human behavior not determined solely by
heredity and environment
-- genetics and heredity not as important as what we choose to do
with our abilities and limitations
a feeling that one is inferior to others in some way. Such feelings can arise from
an imagined or actual inferiority in the afflicted person. It is often subconscious,
and is thought to drive afflicted individuals to overcompensate, resulting either in
spectacular achievement or extremes chizotypal behavior, or both. Unlike a
normal feeling of inferiority, which can act as an incentive for achievement (or
promote discouragement), an inferiority complex is an advanced state of
discouragement, often embedding itself into one's lifestyle, and sometimes
resulting in a retreat from difficulties.
- So the perpetrators have sever inferiority feelings
- probably most likely felt extremely inferior as children themselves to
their parents
- instead of striving to be the best parents they can be, they stay
discouraged and retreat from their personal difficulties by trying to gain
medical attention via their children
- but our limitations can stop us from doing some things
- re-educating individuals and re-educating society
- forerunner of a subjective approach to psychology
- pioneer of a holistic, social, goal-oriented, systematic, and
humanistic approach
- first systemic therapist
- he said it is essential to understand people within the systems they
Phenomenological: clients’ subject frames of reference
- this subjective reality includes individual’s perceptions, thoughts,
feelings, values, beliefs, convictions
- from an Adler perspective, object reality is less important than how
we interpret reality and the meanings we attach to it
- therefore, therapists need to understand the subjective views of
clients with MBPS
Human Personality
- he named his approach individual psychology
- need to understand whole person
- whole person unified by individual’s movement toward a life goal
- more emphasis on interpersonal relationships than individual’s
internal psychodynamics
- Basic assumption of individual psych: we can only think, feel, and act
in relation to our perception of our goal
- Adlerians are interested in the future
- look for continuity by paying attention to themes running through a
person’s life
- MBPS perpetrators have no positive goal for themselves, their life
goal might be getting acceptance in life, something their parents never
gave them
Fictional Finalism: refers to an imagined central goal that guides a
person’s life
- image of what people would be like if they were perfect and secure
- he later replaced the term with Guiding Self Ideal
- perpetrators may have a central goal of being accepted by others,
gaining power...may have a warped sense of what it means to be
perfect and secure
Striving Toward Superiority: a strong inclination toward becoming
competent toward mastering the environment and self improvement
- goes back to early in life, what we would be like if we were
successful and perfect
- applied to human motivation
Guiding Self Ideal: represents an individuals image of goal perfection
Lifestyle: core beliefs and assumptions through which the person
organizes his reality and finds meaning in life
- our perceptions of self, others, and the world
- characteristic way of thinking, acting, feeling
- how we strive towards long term goals
- unique ways in which people develop a style of striving for
- roadmap of life
- we can reframe childhood experiences and consciously create a new
style of living
- their childhood experiences made them feel insecure and unwanted,
so instead of striving for competence and meaning, they strive for
acceptance, care
- their unique childhood events cause them to have lifestyles where
the only way they can deal with life tasks is to keep seeking medical
help via their children who they can have power over
Social Interest and Community Feeling
- Adler’s most significant and distinctive concepts
- refer to individuals’ awareness of being part of the human community
and to the individuals’ attitudes in dealing with social world
Social Interest: individuals’ positive attitudes toward other people in
the world
- capacity to cooperate and contribute
- includes striving for a better future for humanity
- central indicator of mental health
- people express it through shared activity and mutual respect
- MBPS patients do not have social interest...they see other people as
people to gain power over and if they were striving for a better future
for humanity, they would not be inducing sickness in their children
Individual Psychology: central belief that our happiness is largely
related to social connectivity
Community Feeling: individual’s awareness of being part of human
- feeling connected to all humanity
- making the world a better place
- many of the problems we experience are related to fear of not being
accepted by the groups we value
- if our sense of belonging is not fulfilled, anxiety is the result
- we must master 3 life tasks:
1. Building friendships (social task)
2. Intimacy, (love, marriage task)
3. Contributing to society (occupational task)
- Dreikurs added 2 other tasks to lists
- Self acceptance
- Developing our spiritual dimension
- aim of therapy is to assist clients in modifying their lifestyle choices
so that they can more effectively navigate one of these life tasks
- these 3 tasks must never have been accomplished in MBPS
- intimacy is the task that these individuals have certainly never
accomplished since they cannot provide what their children need or
even love their children
Birth Order and Sibling Relationships
- special attention given to relationships between siblings and
psychological birth order
- birth order: one’s position in the family
5 types:
1. Oldest child: receives good amount of attention, hardworking,
strives to get ahead
2. Second child: behave as if they were in a race with first child, can
see competitive struggles, opposite to first born often
3. Middle child: often feels squeezed out, life is unfair, cheated, can
become a problem child, but also can become a peacemaker and try
to hold things together
4. Youngest child: always the baby of the family, tends to be most
pampered, tend to get their own way
5. Only child: shares some of characteristics of oldest child (high
motivation), but may have trouble sharing and cooperating with other
kids, often pampered, and may become dependent on one or both of
- not deterministic, but does increase an individual’s probability of
having a certain set of experiences
- actual birth order is less important than individuals interpretation of
his place in the family
- MPBS perpetrators could be any of these, but they probably felt
more like middle children and not receiving attention or the proper
care they needed
*this is why Adler observed kids in same families
-certain personality traits begin in child as a result of sibling rivalry
Therapeutic Process
- rests on collaborative arrangement between client and counselor
- holistic psychological investigation of lifestyle assessment
- disclosing mistaken goals and faulty assumptions
- followed by re-education of the client toward useful side of life
- aim of therapy is to develop client’s sense of belonging and to assist
in behaviors that promote community feeling and social interest
- accomplished by increasing client’s self-awareness and challenging
or modifying fundamental life goals or basic concepts
- view the client as not being sick
- favor a growth model instead
- counseling process focuses on providing info, teaching, guiding, and
- encouragement is most powerful method available for changing a
person’s beliefs, building self esteem, and building courage
Therapist’s Function and Role
- therapists look for faulty assumptions
- lack of ambition
- non-pathological perception
- do not label clients with diagnosis
- assist clients in changing and understanding “life story”
- major function is to make comprehensive assessment of client’s
Family Constellation: social and psychological structure of family
system, included birth order, individual perception of self, and parental
- each person forms his or her own unique sense of self, others, life
through family constellation
Early Recollections: defined as stories of events that a person says
occurred before he was 10 years of age
- ERs are specific incidents that clients recall about their childhood
- people retain these memories as summaries of their present
philosophy of life
- it is possible to understand mistaken notions, present attitudes,
social interests, and possible future behavior
- makes you feel a certain way about yourself
- after these are summarized, therapist looks at successes and
mistakes in a clients life
- ERs are useful as functional assessment devices
- part of gathering early memories is also part of a lifestyle
- memories of neglect and not feeling loved are the early memories of
MPBS perpetrators so their lifestyle assessment is not strong or
healthy enough to achieve the life tasks
Lifestyle Assessment: learning to understand goals and motivations
of client
- after this assessment, client and therapist have targets for therapy
- Adler viewed dreams as a rehearsal of possible future courses of
- dreams suggest possible answers to client’s problem
Client’s Experience in Therapy
- clients explore Private Logic
Private Logic: basic convictions and assumptions of the individual that
underlie lifestyle pattern
- explains how behaviors fit together to provide consistency
- involves convictions and beliefs that get in way of social interest
- clients problems arise because conclusions based on private logic
often do not conform to requirements of social living
- so their private logic is that nobody cares about them and that they
need to use their kids to get the attention they want
Relationship Between Client and Therapist
- goal alignment: congruence between client and counselor’s goals
and collaborative effort of two persons working together
- good relationship is one based on equals
Therapeutic Techniques and Procedures
- 4 central objectives:
- not linear
- not produced in rigid steps
1. establish proper therapeutic relationship
Phase 1:
- works in collaborative way to define goals
- help clients become aware of assets and strengths rather than only
dealing with liabilities
- positive relationships created by listening, responding, respect
- more attention to subjective experiences of clients than they use
- during initial phase of counseling: attending and listening with
empathy, following objective experience of client as closely as
possible, identifying and clarifying goals, suggesting initial hunches
about purpose in a client’s symptoms and actions
- counselors are generally active especially during initial sessions
- assist clients to define personal goals
Phase 2:
- explore individual’s psychological dynamics
- assessment
- understand individual’s lifestyle
- focus on individual’s social and cultural context
- proceeds from 2 interview forms
a. subjective interview: counselor helps client tell his life story
- treat clients as experts in their own lives
- extract a pattern in person’s life to see what’s going on
- toward end of interview, therapist asks if there is anything else he
should know to understand client’s concerns
- Dreikurs: he calls this The Question
The Question: used in initial assessment to gain understanding of the
purpose that symptoms or actions a person has in one’s life
- how would your life be different and what would you do differently if
you didn’t have this problem
- use The Question to help therapists uncover a life task, faulty
- if client reports nothing would be different, the problem may be
organic and require medical intervention
b. objective interview
- conduct psychological assessments and offer interpretations
- seeks to discover information about how problems began (medical
history, social history, reasons for seeking therapy)
Phase 2 continued:
- counselors interpret person’s early memories to understand meaning
in which they attach life experiences
- lifestyle assessment seeks to develop holistic narrative of person’s
life to make sense with life tasks and to uncover private logic that they
- considered family origin as having central impact on individual’s
- where person formed his unique view of self, others, and life
- ER: assessment of person’s convictions about self, assessment of
client’s stance and relation to counseling sessions, verification of
coping strategies, individual strengths, assets, interfering ideas
- family constellation
- end of second phase: wrap up with integration and summary, looking
for 5 basic mistakes
-- different summaries prepared for the client on strengths, weakness,
and strengths
Basic Mistakes: myths about yourself that are influential in shaping
- people have myths about themselves that they are unloved and
Phase 3: encouraging self, understanding, and insight
- insight, referring to understanding of motivations that operate a
client’s life
- self understanding only possible when hidden purposes of goals and
behaviors are made conscious
- special form of awareness that facilitates meaningful understanding
and acts as a foundation for change
- insight is a means to an end, not an end itself
Interpretation: deals with a client’s underlying motives or behaving the
way they do in the here and now
- in this process, clients eventually come to understand their
motivations and how they are contributing to their behavior
Phase 4: re-orientation and re-education
- final stage of therapeutic process
- putting insights into practice
Reorientation: shifting rules of interaction, process, and motivation
Encouragement: most distinctive Adler procedure, it is central to all
phases of counseling and therapy
-- literally means to build courage
-- entails showing faith in people, expecting them to assume
responsibility for their lives, valuing them for who they are
-- universal therapeutic invention for Adlerian counselors
- fundamental attitude rather than technique
- discouragement is basic condition that prevents people from
- areas of application:
--prevention services in mental health, Adler was advocate for
individual psych in families and schools
-- because it’s growth model, it is very applicable
- Deirkus spread Adlerian theory throughout schools
- application to parent education
- parents are taught how to recognize mistaken goals of children and
to use natural consequences to guide children toward better behavior
- application to couples counseling: designed to assess a couple’s
beliefs and behaviors, educate them to meet relationships goals
-- not who’s at fault, but the interaction of 2 different lifestyles
-- emphasis into given if they want to maintain relationship and if so
what changes need to be made
- application to family counseling: increase awareness of
individuals within the family system
- application to group counseling: Deirkus: unique characteristics of
groups for them to handle change in effective ways
-- Adler created guidance centers in Vienna
- mistaken values can surface in a group
- rationale for group counseling based on premise that our problems
are mainly of a social nature and group provides social community
- multicultural perspective:
-- strengths: importance of multicultural context
--health over pathology, holistic perspective, freedom within social
context, flexible
- shortcomings: can focus too much on self, other cultures have
different concepts, emphasis on self could be problematic
2. explore psychological dynamics operating in client (assessment)
3. encourage development of self understanding (insight into purpose)
4. help client make new choices (re-orientation, re-education)
- Drekuirs: approach has been elaborated into Adlerian Brief Therapy
Chapter 6: Existential Theory
- existential therapy is more a way of thinking than a style of practicing
- neither independent or a separate school of therapy and is not
defined model with specific techniques
- can best be described as philosophical approach that influences a
counselor’s practice
- it rejects deterministic view of human nature
- basic premise: we are not victims of circumstance, we are what we
choose to be
- a major aim of therapy is to encourage clients to reflect on life and
recognize range of alternatives
- another aim: to challenge people to stop deceiving themselves
regarding their lack of responsibility over their life
- it’s not a medical model
- it’s not designed to cure people
- designed to help people develop a greater quest for meaning and
- therapists basic task: to encourage clients to explore their options for
creating a meaningful existence
- we are not passive victims of our circumstances, but instead can
consciously become architects of our lives
Existential Tradition: balance between recognizing the limits and the
dimensions of human experience and the possibilities and
opportunities of human life
MBPS perpetrators do not have any balance, they do not see other
possibilities of how to improve their lives and keep themselves limited
by neglecting their own children
Historical Background
- not founded by any one group
- many thoughts contributed
- came from different parts of Europe
- to resolve dilemmas of contemporary life like alienation, isolation,
and meaninglessness
- early writers focused on individual’s experience of what they called
being alone in world and facing anxiety of that situation
- Soren
- Kierkegaard (1813-1855), Danish philosopher
-- concern around angst: a combo of dread and anxiety
- addressed role of anxiety and uncertainty in life
- without the experience of angst, we may go through life as
- becoming human is a project and our task is to discover who we are
and “create” ourselves
Fredrich Neitzsche (1844-1900)
- German philosopher
- counterpart to Kirky
- emphasized importance of subjectivity
- he wanted to prove that the def. of humans as rational was entirely
- we are more creatures of will than impersonal intellect
- kirky and nitche together: they are the originators of existential
Martin Heidegger (1889-1976)
- developed human experience being phenomenological
- reminds us that we exist IN the world
- we should not try to think of ourselves from being apart from the
- our moods include anxiety and death, are a way of if we are living
authentically or whether we are being inauthentic in constructing our
Phenomenology: uses subjective human experiences to focus
- provides view of human history that does NOT focus on past events,
but motivates individuals to look forward to authentic experiences that
are yet to come
- other believers: Adler, person-centered (Rogers), Gestault
Gene Paul Sartre (1905-1980)
- our values are what we choose
- the existence of space (nothingness) between whole of our past and
the NOW
- the now frees us to choose what we will
- calles excuses “bad faith”
- no matter where we have been, we can make choices
- his view was that at every moment by our actions, we are choosing
who we become
- our existence is never finished, always growing
- MBPS have “bad faith” in that they make excuses
Martin Buber (1878-1965)
- from Israel
- humans live in a kind of “betweeness”
- there is never just an “I”, but always an “other”
- changes depending on whether the “other” is an “it” or “thou”
- we make msitakes and reduce other person to status of mere object,
then relationship becomes an “it”
- importance of presence: 3 functions
1. enables the “I”, “thou”
2. allows for meaning to exist in a situation
3. enables an individual to be responsible in the present
- when this relationship is fully mutual, we become dialogic and have a
human condition
Ludwig Binswanger (1881-1966)
- proposed holistic model of the self that addresses relationship b/w
person and environment
- used phenomenological approach
- accepted Heidegger’s notion of being “thrown” into the world
-- the throwness does not release us from responsibility of our choices
or for planning for the future
Existential Analysis (Dasein Analysis): emphasizes subjective and
spiritual dimensions of existence
- Binswanger said crises in therapy were major choice points for the
- MBPS might consider themselves “thrown”, make excuses that their
children really are sick so that they can continue on inducing sickness
and getting medical attention
- so they have no control and are “thrown” into the situation
Meddard Boss (1903-1991)
- made reference to Dasein
- commonly referred to “being in the world” which pertains to our ability
to reflect on life’s events and attrivute meaning to them
- major professional interest: applying Heidegger’s notions to
therapeutic process
Key Figures in Contemporary Existential Psychotherapy
- all developed therapy approaches from existential and human
Viktor Frankl
- central figure in Europe
- brought it to U.S.
- influenced by Freud and Adler, and Niche (“That which does not kill
me, makes me stronger”)
Logotherapy: therapy through meaning
- philosophical model: what it means to be fully alive
- fully alive: find meaning in suffering
- central theme is life has meaning under all circumstances
- central motivation for living is the “will to meaning”
- the freedom to find meaning in all that we think
- the modern person has the means to live but often has no meaning
to live for
- the therapeutic process is aimed at challenging indivuduals to find
meaning and purpose through suffering, work, and love
- MBPS perpetrators have no meaning in their lives, no purpose, they
try to get attention...they may have suffered bad childhoods, but never
found meaning through their experiences, which has led them to their
mental health issues today
Rolo May
- also influenced by Freud, Adler
- key figure for bring existentialism to U.S. and translating key
concepts into psychotherapeutic process
- book: Existence: A New Dimenson in Psychiatry and Psychology
- it takes courage to “be”
- our choices determine the kind of person we become
- constant struggle within us
- struggle is between security of dependence and delights of pain and
James Bugental
- approach to depth therapy
- based on existential concern with an individuals immediate
- help clients examine how they have answered life’s existential
questions and to revise their answers to live authentically
- illustrates the here and now in the therapeutic relationship
Iriving Yalom
- acknowledges the
- focues on 4 “givens of existence”, or ultimate human concerns
1. death
2. freedom
3. responsibility
4. existential isolation
5. meaninglessness
- all of these themes deal with client’s “being” in the world
View of Human Nature
- cruel significance of existential movement is that it reacts tendency
to use a set of therapeutic techniques
- therapy is based on understanding what meaning “human” means
- stands for respect for the person
- exploring new aspects of human behavior
- methods for understanding people
Existential Tradition: seeks a balance between recognizing the limits
and tragic dimensions of human existence
-- limits and tragic dimensions in one hand, and other hand
possibilities and opportunities of human life
- grew out of dilemma of contemporary life
- current focus is on individual’s experience of being in the world alone
and facing the anxiety of the isolation
- basic dimensions of human condition is:
1) capacity for self awareness,
- as human being capable of self awareness
- as we expand our awareness we increase capacity to live
- we are finite and we have limited time
- we have potential to take action or not to
- we choose our actions and create our own destiny
- meaning: the product of discovering how we are “thrown” or situated
in the world
- we are subject to loneliness, meaninglessness, emptiness, and guilt
and isolation
- we are basically alone, yet we have an opportunity to relate to other
- we can choose to either expand or restrict our consciousness
- expanding= fundamental human growth
Increasing Self Awareness: includes awareness of alternatives,
motivations, and goals is the aim of all counseling
2) freedom and responsibility,
- people are free to choose among alternatives and therefore have a
large role in shaping their destiny
- we all long for freedom and try to escape from our freedom
- possible to avoid choosing freedom by making excuses
- bad faith: Sartre- inauthenticity of not accepting personal
EX: since that’s the way I am made, I can’t help what I did
Freedom: we are responsible for our lives, actions, failures to take
Existential Guilt: being aware of having evaded a commitment or
having chosen not to choose
Authenticity: implies that we are living by being true to our own
evaluation of what is valuable existence for ourselves, be true to
- being free and human are identical
- 2 central tasks of the therapist are inviting clients to recognize how
they have allowed others to decide for them and to encourage them to
step forward in their choices
3) creating one’s identity and establishing meaningful relationships
with others
- we’re concerned about proving our own uniqueness, yet we want to
relate to other people
- each of us wants to discover ourselves and create a personal identity
- we have sought direction and answers from other people’s beliefs,
rather than trust in ourself
- Paul Tillich: the courage to “be”
- part of human condition is experience of loneliness
-- we can get strength from looking into ourselves and sensing
- isolation comes when we recognize that we cannot depend on
anyone else from our own confirmation
- we alone must give a sense of meaning to life
- we alone decide how we will live
- must have relationship with ourselves
Experience of Relatedness
- humans depend on relationships with others
- we want our relationships to be based on fulfillment and not
- a function of therapy is to help clients distinguish between neurotic
dependence attachment
- a therapist points out that you must find your own answers
4) search for meaning, purpose, values, and goals,
- the struggle for a sense of significance and purpose in life
-- why am I here?
- therapy provides framework for helping clients find meaning in their
- one problem in therapy: clients may disgard traditional/imposed
values without finding other ones to replace them
- can lead to emptiness or hollowness
- according to Frankl:
Existential Vacuum: condition is often experienced when people do
not busy themselves with routine or with work
- people feel trapped and empty
Creating new meaning: logotherapy: designed to help clients find
meaning in life
- meaning is created out of an individual’s engagement of what is
valued and this commitment provides the purpose that makes life
5) anxiety as a condition of living, 6) awareness of death and
- anxiety arises from one person’s striving to maintain one’s being
Anxiety: condition that results from having to face choices without
clear guidelines and without knowing what the outcome will be
Existential Anxiety: an unavoidable result of being confronted with the
“givens of existence” (death, freedom, choice, isolation, and
- we experience anxiety as we become increasingly aware of our
freedom and the consequences of accepting or rejecting freedom
- therapists differentiate between normal and neurotic anxiety
- see anxiety as potential source for growth
Normal Anxiety: appropriate response to an event being faced
Neurotic Anxiety: out of proportion to the situation, tends to immobilize
a person
- awareness of death and non-being:
-- does not view death negatively, but holds that awareness of death
as a basic human condition gives significance to living
- the ability to grasp the reality of the future and death
- Frankl: death provides motivation for us to live and take advantage of
- Yalom: therapists should talk to clients about reality of death,
confronting this fear can be factor that helps us transform an
inauthentic mode of living into an authentic one
- explore the degree to which clients are doing things they value
Therapeutic Process
- goals:
- best considered as an invitation to clients to recognize how they are
not living authentically and make choices accordingly
- aim of therapy is to assist clients in moving forward toward
authenticity and learning to recognize when they are deceiving
- no escape from freedom as we will always be held responsible
- if we relinquish our freedom, it is the ultimate inauthenticty
- aims at helping clients face anxiety and engage in action that is
based on authentic purpose of creating worthy existence
May: people come to therapy with self-serving illusions that they are
inwardly enslaved to
- the task of therapy is to teach clients to what they already know
about themselves
Bugental: therapy is process of bringing out latent aliveness
-- identifies 3 main tasks:
1. assist clients in recognizing they are not fully present in the therapy
2. support clients in confronting anxieties that they have sought to
3. help clients redefine themselves and their world so they can foster
greater genuineness of contact of life
- increased awareness is central goal of existential therapy
Therapists Function and Role
- primarily concerned with understanding subjective world of clients to
help them understand and create new options
Restricted Existence: a state of functioning with a limited degree of
awareness of one’s self and being vague about the problem- therapist
may hold up a mirror, so client can see themselves
Client’s Experience in Therapy
- client is encouraged to take seriously their own subjective
experience in the world
- client challenged to take responsibility for how they now choose to
be in the world
- they are expected to go out into world and decide how they will live
- another aspect of experience of being a client: confronting ultimate
concerns rather than coping with immediate problems
Major themes for therapy sessions:
- Anxiety, free, and responsibility
- search for identity
- isolation, alienation, death
- living authentically
Relationship Between Therapist and Client
- quality of person-person encounter in therapeutic situation is
stimulus for positive change
- therapists believe their basic attitudes toward client and their own
personal characteristics are what they have to offer
- I/It (time and space) and I/Thou (connecting to self and spirit): Buber
- create equal, non-distant relationships with client
- core of relationship is respect, and faith in client’s potential to cope
authentically with their troubles
Therapeutic Techniques and Procedures
- unlike most other therapies in that it is not technically oriented
- de-mphasis on technique and priority
- given to understand a client’s world
- philosophical views on basis of human nature and existence
- prefer description, understanding, explanation over diagnosis,
treatment, prognosis
Phases of Existential Counseling
- therapists assist clients in identifying and clarifying their assumptions
about the world
- counselor teaches them how to reflect on their own existence and to
examine their role in their problems in living
Middle: self-exploration
- restructuring of values and attitudes
- learning about themselves and putting that into action
- clients discover their strengths and living a purposeful existence
Client Appropriate for this Approach
- good for people who are coping with developmental crises
- grief and loss, confronting death
- facing major life decision
- suited to individuals experiencing a lack of sense of identity
Application to Brief Therapy
- possible for time-limited approach
- get clients to become involved in therapy
Application to Group Counseling
- existential group can be described as :
1. enabling members to become honest with themselves
2. widening their perspective on themselves to the world around them
3. clarifying what gives meaning to their present and future
- open attitude is essential
- Yalom says the group provides optimal conditions for work on
Multicultural perspective:
- broad perspective, good
- great cross-cultural counseling
- individualistic
- ignore social factors that cause human problems
- highly focused on philosophy
- many clients want structured approach to counseling, not found in
this approach
- counselors need to provide direction, but not run the show
Chapter 4: Psychoanalytic Therapy
- Freud’s psychoanalytic system is a model of personality development
and approach to psychotherapy
- gave psychotherapy a new look, calling attention to psychodynamic
factors that motivate behavior
- unconscious
- developed first therapeutic procedures for understanding and
modifying the structure of one’s basic character
Key Concepts:
- view of humanistic nature : deterministic
- irrational forces, unconscious motivations, biological/instinctual drives,
evolve through psychosexual stages in first 6 years of life
- instincts are key
- libido: refers to sexual energy
-- broadened it to include the energy of all which he termed “life
-- libido is all about gaining pleasure and avoiding pain
- death instincts which account for aggressive drive
- Freud’s view: both sexual and aggressive drives are powerful
determinants of why people act as they do
Structure of Personality
- 3 systems: id, ego, superego
- they all work together as a whole
- id is a biological component, ego is a psychological component, and
superego is a social component
ID: with you when born, relies on pleasure principle
- it never matures and is largely unconscious
EGO: traffic cop, it mediates between the instincts and the surrounding
environment, it is conscious and ruled by the reality principle
reality principle: the ego does realistic and logical thinking and
formulates plans of action for satisfying needs
SUPEREGO: person’s moral code, represents traditional values handed
down from parents to children, related psychologically to rewards and
- consciousness and unconciousness: keys to understanding problems
about personality
- unconscious not studied directly, but can be by:
1. dreams: symbolic representations on needs, wishes, conflicts
2. slips of the tongue and forgetting
3. posthynotic suggestion
4. material derived from free association
5. material derived from projective techniques
6. symbolic content of psychotic symptoms
- unconscious stores all memories, experiences, and repressed material
- aim of psychoanalytic theory is to make unconscious conscious
- unconscious process is at root of all neurotic symptoms and behaviors
- cure is based on uncovering the meaning of symptoms, causes of
behavior, repressed material that interfere with healthy functioning
- note: intellectual insight does not solve the problem
- the clients need to cling to old patterns (repetition) must be confronted
by working through transference distortions
- a feeling of dread that results from repressed feelings, memories,
desires, and experience that emerge to surface of awareness
- it develops out of a conflict among the id, ego, superego
- 3 kinds of anxiety:
1. reality: fear of danger form external world, level of anxiety is
proportionate to degree of real threat
2. neurotic: evoked by threats to balance of power within a person, fear
that instincts will get out of hand and fear that one will be punished
3. moral: evoked by threats to balance of power, fear of one’s on
- when the ego cannot control anxiety, it relies on indirect ones (ego
defense mechanisms)
Ego Defense Mechanisms
- help individual cope with anxiety and prevent the ego from being
- 2 characteristics in common:
a) either deny or distort reality
b) they operate on unconscious level
1. Repression: threatening or painful thoughts are excluded from
-- use of behavior: an involuntary removal of something from
2. Denial: closing one’s eyes to the existence of a threatening aspect of
-- simplest of all defense mechanisms
-- distorts way individual thinks and operates at a preconscious and
conscious level
3. Reactive Formation: actively expressing the opposite impulse when
confronted with threatening impulse
-- developing conscious attitudes and behaviors that are diametrically
opposed to disturbing ideas
-- in this way people do not have to face the anxiety that would result
Ex: individuals conceal hate with facade of love, be nice when they
harbor negative reactions
4. Projection: attributing our own unacceptable thoughts, feelings,
behvaiors, and motives to others
-- mechanism of self-deception
-- Example: Those people are out there, but not me
5. Displacement: directing energy toward another object of person
when original object is absent
-- way of coping with anxiety that involves discharging impulses by
shifting from a threatening object to a safer target
Example: husband hits wife instead of boss
6. Rationalization: manufacturing good reasons to explain a bruised ego
-- helps justify our behaviors and aids in softening the blow connected
with disappointments
7. Sublimation: diverting sexual/aggressive energy into other channels
-- energy diverted into socially acceptable/admirable channels
-- example: athletics
8. Regression: going back to earlier phase of development
-- cling to immature or inappropriate behavior
9. Introjection: taking in and swallowing the values and standards of
-- comes positive (parental values), negative (accepting values of an
10. Identification: identifying with successful causes, organizations, or
people in the hope you will be perceived worthwhile
-- it can enhance self worth
-- children learn gender role behaviors
11. Compensation: masking perceived weaknesses or developing
certain positive traits to make up for limitations
-- direct adjustive value
-- don’t see the ways in which I am inferior, but see me and my
Development of Personality
Psychosexual stages:
- Freudian chronological phase of development
- each characterized by primary way of gaining sensual and sexual
Oral stage: inability to trust one’s self and others, resulting in fear of
loving and forming close relationships
-- the initial phase of psychosexual development where mouth is primary
source of gratification
-- 0-1 years
Anal stage: second stage, pleasure is derived from retaining and
expelling feces
-- inability to recognize and express anger leading to denial of one’s own
power as a person and a lack of a sense of autonomy
-- 1-3 years
Phallic stage: third stage, child gains maximum gratification through
direct experience with genitals
-- inability to fully accept one’s sexual feelings and to accept one’s self
as a man or woman
-- Oedpius: males, mother is love object of boys
-- Elektra: females, father is striving for father’s approval
-- 3-6 years
6-12: latency stage, sexual interests replaced by social activities
Genital stage: old themes of phallic stage are revived
-- 12-18 years
- begins in puberty and lasts through life until senility sets in
Erik Erikson
Psychosocial perspective
- built on Freud’s ideas and extended them
- his theory holds that psychosexual growth and psychosocial growth
take place together
- each stage of life, we face the task of establishing equilibrium between
ourselves and our social world
- development in terms on the entire lifespan, divided by specific crisis
- crisis: equivalent to a turning point in life when we have the potential
to move forward or to regress
- classical psychoanalysis: grounded on ID psychology, holds that
insticnts are intrapsychic conflicts
- contemporary psychoanalysis: based on EGO psychology, which
emphasizes striving for ego mastery and competence throughout human
- Erikson has 8 stages
1. First year of life
- infancy: trust versus mistrust
-- significant others provide basic physical and social needs
-- basic needs not met, get an attitude of mistrust toward the world,
especially interpersonal relationships
2. 1-3 Early Childhood
- autonomy vs. shame and doubt
-- basic struggle between sense of self reliance and sense of self doubt
-- kids test limits
3. 3-6 Preschool Age
- initiative vs. guilt
-- achieve competence and sense of initiative
-- let kids make their own decisions or else they will develop guilt over
taking initiative
4. 6-12 School Age
- industry vs. inferiority
-- child needs to expand understanding of the world
-- develop gender role identity
-- also basics needed for success in school
-- obtaining personal goals
-- failure to do so: sense of inadequacy
5. 12-18 Adolescence
- identity vs. role confusion
-- transition between adulthood and childhood
- life goals and life meaning
6. 18-35 Young Adulthood
- intimacy vs. isolation
-- task is to form intimate relationships
-- failure to do so can lead to isolation
7. 35-60 Middle Age
- generativity vs. stagnation
-- goes beyond self and family in helping next generation
6. Age 60+ Later Life
- integrity vs. despair
-- look back on life
- by combining psychosocial and psychosexual, counselors have
framework for understanding developmental issues
- key needs and developmental tasks along with challenges inherited at
each stage provide model for understanding core conflicts
Therapeutic Goals
- 2 goals of Freudian therapy
1. make unconscious conscious
2. strengthen the ego so that behavior is based more on reality and less
on instinctual cravings
Therapist Function and Role
- classical psychoanalysis: analysts typically assume anonymous stance:
blank screen
- little self disclosure
- transference relationship: client’s unconscious shifting to the
therapist of feelings and fantasies, both positive and negative that are
displacements from reactions to significant others from their past
Client’s Experience in Therapy
- free association: primary technique consisting of spontaneous and
uncensored verbalization by the client which gives clues to the nature of
the client’s unconscious conflicts
-- also known as the “fundamental rule”
- classical psychoanalysis: the traditional Freudian approach to
psychoanalysis based on long term exploration of past conflicts, many of
which are unconscious and an extensive process of working through
earlier wounds
Differences between classical analysis and relational analysis
- classical analyst: therapist stays outside of relationships, comments on
it, offers insight and interpretations
- contemporary relational psychoanalysis: therapist is not detached
-- impact on client in a here and now interaction
- relational model of psychoanalysis: transference is interactive process
between client and therapist
- relational analysis: analytic model based on assumption that therapy is
an interactive process between client and therapist
- interpersonal analyst assumes that countertransference is a source of
- if therapy is to produce change, must have working through
-- working-through: exploration of unconscious material and defenses
originated in early childhood
-- resolving basic conflicts that are manifested in client’s relationship
with the therapist
---achieved by repeating interpretations and by exploring forms of
- countertransference: therapists’ unconscious, emotional response to
client that is likely to interfere with objectivity
-- unresolved conflicts of therapist projected onto client
-- not all countertransference reactions are detrimental
Example: working on yourself may make you understand client deeper
- can be key for helping client gain self-understanding
- psychoanalytically therapy or psychodynamic therapy includes
following features:
1. therapy geared more toward limited perspectives than restructuring
2. less likely to use the couch
3. fewer sessions per week
4. more supportive
5. therapist more self disclosing
6. focus more on pressing, practical concerns rather than fantasy
- therapy proceeds from catharsis: expression of emotion to insight to
working through unconscious material
- 6 basic techniques of psychoanalytic
1. maintain analytic framework: refers to range of procedures where
the analyst remains anonymous as a structure of therapy
2. free association: clients are encouraged to say whatever comes to
mind, basic tool that opens doors to unconscious, often leads to catharsis
3. interpretation: consists of analyst pointing out, explaining, teaching
client’s meanings of behavior from dreams, free association, resistances
-- function is to enable ego to assimilate new material and speed up
process of uncovering unconscious material
4. dream analysis: important for uncovering unconscious material, two
levels: latent and manifest content
-- latent: hidden, symbolic motives and fears
-- manifest: the dream as it appears to the dreamer
5. analysis of resistance: anything that works against process of therapy
and prevents clients from producing unconscious material
-- when handled properly, can be one of most value tools in
understanding a client
6. analysis of transference: central technique
Application for group counseling
- works
- countertransference can me useful tool in group therapy
- coined analytical psych: an elaborate explanation of human nature
that combines ideas from history, mythology, anthropology, religion
- big advances in personal development, esp. middle age
- he places central importance on psychological changes assoc. with
- in midlife we need to let go of many of our values and behaviors that
guided first half of life and confront the unconscious
- developed spiritual approach that places emphasis on being impelled to
find meaning in life, opposite from Freud’s psychological and biological
- Freud more about past, but Jung believed we are shaped by the past as
well as our future
- individuation: harmonious integration of the conscious and
unconscious aspects of personality
- shadow: primitive impulses
- collective unconscious: deepest level of psyche containing
accumulation of inherited experiences of humans
- archetypes: universal experiences contained in collective unconscious
-- important ones: persona (mask or public face we wear), animus/anima
(biological/psychological aspects of masculinity and femininity, coexist
in both sexes), and shadow (our dark side)
- Jung said dreams have 2 purposes
-- are prospective, help people prepare themselves for the future, serve
as a compensatory factor working to bring balance to the opposites
within a person
-- they were an attempt to express
Contemporary trends
Object- Relations Theory/ **More psychoanalytic theory for my
- newer version of psychoanalytic theory which focuses on
developmental sequences
- individuals go through phases of normal symbiosis and separation,
culminating in stage of integration
- object relations: interpersonal relationships as they are represented
- development is seen as individuals separating and differentiating
themselves from others
- based on the notion that at birth there is no difference between others
and self
- others represent objects of need-gratification
- goal here is self individualization, which is achieved over time
- when this process is successful, others are perceived as both separate
and related
Eminson (2000) postulates that many cases are of highly enmeshed
parent-child relationships, which create a gray area in the psychological
boundaries between parent and child.
When the perpetrator’s child arrives at a particular developmental stage,
it will evoke unresolved memories and reactions from the same stage in
a perpetrator’s own development. Eminson relates back to Freud in that
the unresolved conflicts triggered by age-specific developmental signals
from the child can be unbearable for an adult to bring to his or her own
consciousness. In projective identification, an uncontainable feeling is
“placed” onto another person and is experienced as actually emanating
from the other person. Therefore, the parent then confuses his or her
child with him or herself as a child. He or she abuses the child, in
attempts to get the medical care and attention her or she never got from
his or her own parents. This activates the anger and ambivalence he or
she felt toward his or her own parents in the context of their abuse and
this can introduce ambivalence into their current parental behavior. As
a result, the child starts to feel disorganized and truly symptomatic under
the circumstances and that confuses the picture because then the child is
clearly presenting illness to the doctors. Similar to the psychoanalytic
view, Hotchkiss (1997) states that a MBPS caregiver’s ego development
is still merely at a pre-oedipal level, where infantile aggression, the
splitting of the ego, and the need for a transitional object to manage
separation from the mother dominate the clinical picture. Never
mastering the oedipal stage causes the caregiver to not operate on the
reality principle and may not even know what reality is.
Lastly, Rocha (2004) suggests a theory of etiology about the idea
of a false self, which relates to the object-relations theory. The true self
develops in the child out of a genuine and flexible attachment, but when
needs are focused on mother and not the child, an overly compliant false
self will develop. Therefore, it is out of her own needs that the mother
seeks treatment for her child.
Self psychology
- Heinz Kohut
- how we use interpersonal relations to develop our own self
- focuses on the nature of the therapeutic relationship, using empathy as
the main tool
- interactive process between client and therapist
- people search for relationships that match patterns established by
earlier experiences
- Margaret Mahler: influenced contemporary object relations
-- symbiotic relationship with maternal figure toward separation and
-- normal infantile autism: in first 3 or 4 weeks of life, infant doesn’t
know you’re a person (just breast, hands, mouth)
-- symbiosis: third month to 8th month, infant is dependent on mother or
primary caregiver
-- separation-individualization: 4-5 months, child experiences
separation from sig. others, but still turns to them for comfort
- Example of toddler taking steps
- narcissism comes from not separating from parents
- narcissistic personality: grandiose, exaggerated self importance
- borderline personality disorder: rooted in period of
-- moved into separation process, but have been stopped by parental
rejection for their individualization, you can separate from me, but you
can’t be different
-- instability, irritability, impulsive anger, self destructive acts,
occasional euphoria
- Mahler’s final subphase (36 month): involves mood toward
consistency of the self
Treating Borderline/Narcissistic
- rooted in trauma and developmental problems in separation and
individualization phase
- trend toward brief psychodynamic therapy: applies principles of
psychodynamic theory to treating selective disorders with a
pre-established time limit of 10-25 sessions
-- marked use of concepts such as psychosexual, psychosocial, object
-- existence of unconscious process
- usefulness of interpretation
- importance of working through
- therapist assumes active role
- time-limited dynamic therapy: goal is symptom reduction and
changing client’s ingrained, repetitive patterns of interpersonal
-- major goal: client to have new relational experience
- psychoanalytic therapy from a multicultural perspective:
-- Erikson’s psychosocial approach good for people of color
-- psychoanalytic approaches not great for diversity (upper middle class