The following questions, answers, and comments about Classical Adlerian philosophy, theory, and practice have been excerpted from discussion forums, newsgroups, and e-mail correspondence. The text has been edited minimally for clarity and readability. All of this material is protected by copyright and may not be reproduced without the expressed consent of Dr. Stein at htstein@att.net.
| 45. Teleological Holism | 46. Post-Traumatic Stress Disorder | 47. The Concept of "As If" |
Question from Forum: Adler described his theory as teleological. Could you clarify this concept.Dr. Stein: Adler's theory was indeed teleological (fictional finalism), but also holistic. In his own words:
"The development of man's inner life occurs with the help of a presumed teleology, by which a goal is established under pressure of a teleological apperception. Therefore, we will find in all psychological phenomena the characteristic of goal-striving that incorporates all forces, experiences, judgments, desires and fears, deficiencies and abilities. From this we conclude that a true understanding of a psychological phenomenon, or of a person, can be gained only from a teleological concept of the whole."".....every person acts and endures according to his individual teleology which, to the person who does not understand this, seems like fate . The origins of a person's teleology lead back to earliest childhood and seems almost always to have been under the adverse influence of physical and psychological problems....."
"The fiction of a terminating finale is the answer to the child's feeling of inferiority."
46. Post-Traumatic Stress Disorder
Question from Forum: Question from Forum: I haven't been able to find much on the Adlerian perspective on the treatment of PTSD and Dissociative Disorders. How does an Adlerian explain PTSD/Dissociative Disorders, and what would an appropriate treatment plan?Dr. Stein: Post-traumatic Stress Disorder (PTSD) is described in DSM-IV (309.31) as the reaction of a person who has been exposed to a serious traumatic event, within which they experienced intense fear, helplessness, or horror. That event may be persistently re-experienced as memories, images, thoughts, dreams, illusions, hallucinations, or flash backs. They may also persistently avoid any stimuli associated with the trauma and have persistent symptoms of increased arousal (not present before the trauma).An Adlerian perspective of this disorder acknowledges the comprehensive description of symptoms and the apparent history of the disorder, but goes much further diagnostically by exploring the internal and social purposes of the persistent symtomology. If debilitating symptoms persist, there is a high probability that a "neurotic disposition" existed before the "traumatic event." The choice of symptoms is interesting but not as important as the awareness of the responsibilities that are being avoided. Adler believed that many symptoms are extensions of early childhood "weapons" against the parents, and are retained in adulthood to continue serving the unconscious final goal. Clients may combine or change symptoms, yet retain the same underlying goal. If you want to read more about this, look at "The Unity and Diversity of Disorders" in The Individual Psychology of Alfred Adler, edited by Heinz and Rowena Ansbacher.
Although it is possible for anyone to have a terrible experience and be deeply distressed by it, the ability to digest it and move on depends, in part, on the "style of life" that existed before the experience. Certainly, the empathy, insight, and encouragement of a skilled therapist can help dissolve any residual pain, fear, and bitterness--but only if the client cooperates in the process of changing the core fictional final goal and style of life that may be capitalizing on the retention of symptoms. Treatment planning in Classical Adlerian psychotherapy is not focused on the type of disorder or particular symptoms; it targets the mistaken style of life and fictional final goal (the fire under the smoke).
Regarding dissociative disorder: amnesia, fuge, MPD, and depersonalization; a Classical Adlerian approach would be to first rule out organic etiology or substance abuse; often, a complete psychological/neurological test battery is essential. We would explore which life tasks are being avoided by the symptoms, and what tendencies in early childhood provided the "prototype" that could provide a foundation for the later development of the symptoms. Once again, we do not target the symptoms, but the style of life and fictional final goal beneath them. The treatment plan for any client does not grow out of "disorder categorizations"--it is based on a creative invention that penetrates his unique style of life. For an overview of the therapeutic process, read "The Stages of Classical Adlerian Psychotherapy" at http://ourworld.compuserve.com/homepages/hstein/stages2.htm .
47. The Concept of "As If"
Question from Forum: Would you please explain the concept of "as if?" Also, would you please clarify how a therapist would respect a patient's right to his own feelings and wants while trying to persuade him to exude more effort in life.Dr. Stein: "As if" refers to the picture of life, fictional final goal, scheme of apperception, and private logic that describe and explain the inner world of the client and his attitude toward different aspects of living. He behaves "as if" his perceptions, memories, images, assumptions, and anticipations of the future are all true and justified. In order to find orientation in life, we may develop a guiding "as if" fiction that give meaning to our experiences, and direction to our striving for security and significance.Adler was clearly influenced by the German philosopher Hans Vaihinger who authored "The Philosophy of As If." In his masterful work, Vaihinger catalogues the various scientific, legal, monetary, political, aesthetic, geographic, and psychological fictions that we use to provide orientation and ideals.
With an accepting, empathic, diplomatic, and Socratic approach we help a client see that he has exactly the right feelings for his (unconscious) fictional final goal. However, we stimulate his active thinking about the probable consequences, to himself and others, of pursuing that goal. We help his see that feelings and emotions "are not arguments" for doing or not doing something--they merely facilitate intentions. If you want others to do the work and serve your needs, passivity, depression, even fatigue can be used to intoxicate yourself and impress others. Often, questioning the cost/benefit ratio of symptoms, advantages, and disadvantages helps the individual "persuade himself" to take action in a different direction. The Socratic style of leading a client toward making his own conclusions, minimizes resistance to new ideas and change.
For an illustration of the Socratic method, see A Demonstration of Classical Adlerian Psychotherapy Technique, Using Socratic Questioning in Psychotherapy at http://home.att.net/~Adlerian/demo1.htm .
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