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
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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
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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
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Inferiority complex: Individual
overwhelmed by inadequacy, hopelessness
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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)
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The person becomes self-centered rather than other-centered
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Conflict: “one step forward and one step backward movement” which has the net
effect of maintaining an individual at a “dead center” point
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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)
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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 fictional
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
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Occupational task-career-self-worth
Societal task-creating friendship-networks
Love task-life partner
 Positive & Goal Oriented Humanity- people striving to overcome
weaknesses to function productively-contributing to society
Therapeutic Phases and Stages
Phases
Stage # Stage
1
Empathy &
Relationship
2
Information
3
Clarification
4
Encouragement
Support
Encouragement
1. Establishing the relationship
 Therapist gets to know the client as a person
 Supportive, caring human connection
 Warmth, empathy, and acceptance
 Hope, reassurance, and encouragement
 Love
 Therapy is collaborative
 Goals established together prior to start
 Awareness of goal discrepancies during early phases
 Scripts (“Have you ever seen a patient like me before?”)
 Games (“My previous therapist said the opposite…”)
 Realignment of goals, when necessary
2. Gathering information
 Interview
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Client tells own story as expert on own life
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Presenting problem(s)
Early recollections, influences (earliest memories, vivid memories
from early adolescence)
Life tasks
Personality priorities
Lifestyle Assessment -- therapist listens for clues to client’s
coping and approach to life, develops therapy goals by
identifying major successes and mistakes
“The Question” -- If I had a magic wand that would eliminate
your symptom immediately, what would be different in your life?”
 Family constellation, other paper-pencil tests
 Integration and summary
3. Facilitating Self-Understanding & Insight
Insight = Understanding of motivations (the whys)
that operate in client’s life
 Therapist clarifies vague thinking with Socratic questioning.
 Therapist invites evaluation of consequences of ideas and actions.
 Therapist gently challenges mistaken ideas about self and others.
 Therapist offers open-ended interpretations to:
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bring conscious awareness to unconscious processes
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identify and confront resistance
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explore purposes of symptoms, feelings, behaviors or blocks
 Types of interpretation
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Of nonverbal behavior: to bring the client’s nonverbal behavior to the
attention of the client and interpret it.
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Of the therapeutic process: Dealing with what is in the here and now.
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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?