Alfred Adler Institute of Northwestern Washngton

Questions and Answers
About Classical Adlerian Psychotherapy

Developed by Henry T. Stein, Ph.D.


The following questions and answers about Classical Adlerian psychology have been excerpted from discussion forums, newsgroups, and e-mail correspondence. Text has been edited for clarity and readability. All of this material is protected by copyright and may not be reproduced without the expressed consent of Dr. Stein, (e-mail: htstein@att.net).

Select a Topic

1. Contributions to Contemporary Practice 2. Diagnosis: Initial Evaluation 3. Frequently Used Interventions
4. The Dark Side of Human Nature 5. Emotions and Feelings 6. Treatment of Criminality
7. Undivided Self 8. Self Esteem 9. Main Tools in Therapy
10. Metaphors in Therapy 11. Gestalt and Adlerian Theory 12. Simplified Typologies
13. Birth Order 14. Evolution of Adlerian Theory 15. Striving for Superiority
16. Existentialism, Minus Feeling 17. Dreikurs and Adler 18. Social Comparison
19. The Place of Values 20. Dreikursian and Adlerian Approaches 21. Classroom Management
22. “Doing a Lifestyle” 23. Social Comparison and Depreciation 24. The Place of Values
25. Dreikurs' and Adler's Approaches 26. Child's Goal 27. Suicidal Adolescent
28. Treatment of Sexual Offenders 29. Use of Early Recollections 30. Stages of Therapy Matrix
31. Self Esteem in Teens 32. Treating Symptoms 33. Treating Trauma
34. Treating Addiction 35. Software for Case Analysis 36. Genetics
37. Group Techniques 38. Treatment of OCD 39. Repetition Compulsion
40. Mass Psychology 41. Is Adler a Psychoanalyst? 42. Step-Families
43. Spiritual Assessment 44. Negative Attitudes in Customer Service 45. Teleoanalysis
46. PTSD and Disassociation 47. As If 48. ERs of the Blind
49. Dreams 50. Stress, Tension, and Motivation 51. Narcissism and Aggression
52. Negative Effects of Praise 53. Maslow's Hierarchy of Needs 54. Birth Order and Sulloway Book
55. More on Birth Order 56. Being Godlike 57. Research on IP
58. Greed, Materialism, and War 59. Quote About Self Esteem 60. Case Studies
61. Empathy Scale 62. Marketing Research 63. Cloning
64. Hypnotism and Imagery 65. Striving and Compensation 66. Psychobiographies
67. Sand Tray Therapy 68. Studying Self Concepts 69. Stanislavksi and Adler
70. Congruence 71. Testing 72. Narcissism
73. Writing Therapy 74. Consequences 75. Client Resistance
76. Multiculturalism 77. Counselor Supervision 78. Grief and Loss
79. Transference 80. Disorders 81. Existential Anxiety
82. Adler and Rogers 83. Emotional Intelligence 84. Photoanalysis
85. Statistics 86. Birth Order and Development 87. Measuring Social Interest
88. Christian Counseling and IP 89. Effect of Divorce 90. ERs and Vocational Choice
91. Teen Violence 92. Narcissistic Personality Disorder 93. Group Exercise
94. No Cook Book 95. By Heart? 96. Life Style Assessment
97. Fritz Kunkel 98. Autism 99. Predicting Career Success
100. Narcissism and Aggression 101. Praising Effort 102. Art Therapy
103. Sexual Therapy 104. New Adlerian Publications 105. Making Changes Permanent
106. Applying Theory in Practice 107. Fictional Finalism 108. Gender Bias?
109. Missing Material in Book 110. Laziness 111. Concentration Problems
112. Stages of Psychotherapy

***

Questions and Answers

1. Adlerian Contribution to Contemporary Practice

Question from Gil Levin (BOL): Alfred Adler's name is better known to today's therapists than are his ideas and methods. Your dedication to this body of work must be based on the belief that contemporary practice is diminished because Adler's contributions are not fully enough understood or used currently. What are the key elements of the Adlerian contribution to contemporary practice?
Dr. Stein: Adler has much to offer not only to the practice of psychology but also to society in general. Our democratic way of life has eroded badly into widespread self-interest and indifference. Improvement must come not only from the top down, but mainly from the bottom up. We need individual citizens who are capable of carrying out democracy in their daily lives. Adler's theory can be used to guide this work--to foster the development of a democratic character structure in the individual, and to prevent many of our social problems. Adlerian psychology was developed to realize the values of social equality, cooperation, and responsibility for the welfare of others. It can help re-vitalize our democracy.

Adler's primary index for mental health is the person's feeling of community and connectedness with all of life. This sense of embeddedness provides the real key to the individual's genuine feeling of security and happiness. When adequately developed, it leads to an attitude of cooperative interdependency and a desire to contribute. These qualities are essential for building a healthy democracy. Adlerian child guidance and psychotherapy strengthen this feeling of community.

An Adlerian diagnosis is based on the assumptions of the unity and self-consistency of the personality, and an orientation toward an unconscious fictional goal. It re-directs understanding away from "past cause" to purpose, or "future cause." We gradually help the client understand, evaluate, and modify this goal, as well as the consistent pattern of dealing with life that supports it. Our belief in the creative power of the individual, to freely make choices and correct them, offers an encouraging perspective on responsibility and change.

Classical Adlerian psychotherapy is characterized by a diplomatic, cooperative working relationship that establishes the feeling of equality. Through Socratic questioning, the client is respectfully guided through cognitive change: clarifying thinking and feeling, making conclusions, and coming to decisions. Guided or eidetic imagery may be used to promote affective change. Role-playing and marathon group techniques can support behavioral change. A twelve-stage therapeutic structure provides a guideline for planning strategies and evaluating progress. This foundation also acts as a springboard for creative improvising and inventing. Each therapy is different, adapting to the uniqueness of the individual.

Adler's vigorous optimism, his vision of optimal human functioning, and his humanistic philosophy of life can provide constant inspiration for a behavioral scientist.



2. Diagnosis - Initial Evaluation

Question from Gil Levin: In order to appreciate the texture of the Adlerian approach, let's talk a little about Adlerian "diagnosis." With a 'modal' actual or imagined patient/client in mind, could you walk me through an initial evaluation of a patient's problem?
Dr. Stein: My preliminary evaluation starts when I first meet the patient in the waiting room, since Adler suggested that everyone will express his or her style of life most clearly in a new situation. I look for the degree of contact in the eyes and greeting, the level of activity and posture in the short walk to the office, the initiative in choosing a seat, and the posture when seated. Anything unusual, over- or under-done, is of particular interest. Many people very eloquently express their attitude toward life in that brief episode.

After some preliminary questions about health problems, medication, and drug/alcohol use, I ask about the patient's difficulties. As the problem or symptom unfolds, I am especially interested in when the difficulty began and what else was happening at the time. This may reveal where and when the person's courage or ability to cooperate faltered. Present circumstances may also be denying the person the subjective success, significance, or pleasure they expect.

I want to see the patient's problem in the context of their main life tasks,so I ask about their work, love/sexual life, family, and friendships. This provides an overview of their level of functioning and what they value.

Within the first hour, I try to elicit a preliminary sketch of their early childhood situation, including: descriptions of each family member, relationships, attitudes, feelings, family atmosphere, and earliest childhood memories. I make notes of these descriptions, including the feelings and body language expressed.

I am especially interested in the difficulties that the individual has struggled with and overcome. These conquests often provide strengths to build on. What they have avoided in life may reveal their felt deficiencies.

After the first interview, I review my notes and try to imagine a line of psychological movement leading from the patient's memories of childhood, through the present situation and difficulties, to a future goal of ultimate compensation, significance, and security. I try to connect to this line all of the patient's thinking , feeling, and actions, including their attitude toward me and the task of therapy.

For example, a man in his mid 40's was referred to me after completing an out-patient alcohol treatment program. He was very frustrated with his career as a criminal investigator, experienced very little intimacy with his wife, and had no friends. Although he conducted extremely thorough investigations that resulted in convictions, sentences rarely included jail time.

His cold and isolated childhood left him very bitter: an unhappy mother; a remote father; and a hell-raising older brother whom he hated, but who was the center of the parents' attention and frequently got away with illegal behavior. By contrast, he was a compliant child who didn't make any trouble, and was ignored.

The felt neglect of his father and lack of love from his mother were at the roots of his inferiority feelings. His life style was catching many "bad guys" and seeing that they were locked up. Since many were not, he was perpetually frustrated. He also viewed his parents and brother as unpunished criminals. His unconscious goal was to secure compensation and revenge for his miserable childhood. Revenge was not working out to his satisfaction, but he did look forward to the compensation of a comfortable retirement, a symbol of what he felt entitled to.

His attitude toward me was guarded and minimally expressive. What made him competent in surveillance work, observing others without being seen, was a handicap in making a personal relationship. Two strengths could be built on -- he had conquered both alcohol and nicotine dependencies.

In general, my early guesses are either confirmed or modified in subsequent sessions as I gain more detailed information, which includes a written questionnaire. Frequently, a binocular view of oral and written information is very useful.

A more refined evaluation emerges within the first few weeks, since I spend a good deal of time organizing, analyzing, and synthesizing the case material. This process is facilitated by the use of computer software programs, resulting in a series of conceptual maps: a multi-generational genogram that clarifies family member descriptions and relationships; a time-line diagram that highlights significant positive and negative events; and a matrix that organizes my conclusions about the patient's style of life, including: inferiority feelings, compensatory fictional goal, level and radius of activity, use of symptoms and emotions, degree of community feeling, private logic, earliest recollections, and the antithetical scheme of apperception. These maps provide an on-going guide for treatment planning.



3. Frequently Used Interventions

Question from Gil Levin: Your vignette makes the Adlerian assessment process crystal clear. I know from what you have said elsewhere that you view therapeutic intervention as an "art" and therefore it must be a harder to characterize briefly. I am struggling to frame a question that will get at this...... How about this: Could you spell out a couple of frequently used interventions and indicate the circumstances in the therapy that would signal you when to use them? (If you feel that a different question would take us to the heart of the matter, please answer it instead.)
Dr. Stein: At the first meeting, I frequently ask Adler's favorite diagnostic Question from Forum: "If you no longer had your symptoms, what would you do?" In their answers, patients frequently reveal the problems or responsibilities that they are trying to avoid.

In the early stages of treatment, after establishing an empathic connection, I use a therapeutic adaptation of Socratic questioning to help patients clarify meanings and feelings, recognize the purpose of emotions and actions, identify the consequences of behavior, and generate alternative solutions to problems. There are over fifty Socratic strategies that utilize a series of leading questions to help patients reach their own conclusions. To illustrate one, testing the validity of behavior by multiplying it, I asked a man who liked speeding and running red lights, "What would happen if everyone did the same thing?"

In the middle stages of therapy, after patients achieve more confidence through a series of encouraging new successes, I gradually unfold an interpretation of their style of life and fictional final goal. Earliest childhood recollections offer fertile opportunities for discussing the concrete situations, feelings, and actions that embody the life style. They can also provide effective spring boards for launching new attitudes and behaviors.

A very passive, pampered patient recalled a memory of early childhood that vividly expressed his demanding, expectant attitude. He remembered lying in bed on a cold winter morning, refusing to get up until his grandmother warmed his underwear in the oven. We first discussed the meaning of this memory, and then he tried to imagine several alternative scenarios, including one of getting up early to help his grandmother build a fire. He gradually realized that simply being cute and sad would not bring another pampering grandmother into his life, and that there was a new form of reciprocal gratification more suitable to an adult man.

I frequently have to invent strategies that fit the uniqueness of the patient and the moment. A severely depressed young man came to me after seeing many psychiatrists over a period of fifteen years. After working with him for nearly a year, he complained, "No has ever understood me!" Knowing that he had an appreciation for drama, I proposed that I play him and recite a soliloquy of his inner thoughts. He was intrigued and agreed to have me do it. For about five minutes, I expressed his private logic, attitudes, and feelings about his family, then concluded with his opinion of me. He was very adept at denying the more traditional therapeutic expressions of empathy and insight, but this unexpected form got through to him.

Another case may help illustrate the potential variety in presenting interpretation. A young boy had killed a small pet at school. He lived in a very aggressive, competitive family. His deep anger could not be openly expressed at home. Hand puppets permitted him to express a great deal of murderous rage safely in my office. He selected "Dracula" to kill my collection of thirty puppets. Over a period of weeks, he gradually selected less aggressive characters, who first protected each other, and later on played together. When I felt he was ready to understand why he had killed the animal, I selected a "Wise Old Owl" puppet to Socratically guide him into insight. His appreciation for my help was expressed through a very affectionate "Puppy Dog" puppet.

The most effective Adlerian interventions are creative applications of Adler's basic principles. To achieve significant cognitive, affective, and behavioral change, we do not follow any by-the-numbers procedures. We have to invent the means of accomplishing many therapeutic tasks that include: providing constant encouragement, reducing inferiority feelings, increasing the feeling of community, re-directing the striving for superiority, promoting the feeling of equality, interpreting the purpose of behavior, and stimulating social contribution.

Comment: What you have said so far is very interesting. Let's include others by continuing our conversation on the Behavior OnLine Forum.




4. The Dark Side of Human Nature

Question from Forum: In reviewing our your conversation elsewhere in Behavior OnLine and reading your comments in this Forum, I am struck again and again about what a thoughtful, 'decent' and respectful approach it is. I do wonder though if Adler had anything to say about the darker side of human nature. Most theorists seem to emphasize this. For Freud there's repressed impulses, for Jung there's the shadow. Even contemporary 'schools' touch on this to a degree. Cognitive therapists are concerned with negative self-attributions and constuctivists with dysfunctional narratives. Did Adler have much to say about the darker side?
Dr. Stein: Adlerian psychology addresses the complete range of human experience, from optimal to pathological. The ideal of a fully functioning individual, with a highly developed of feeling of community is posited as a benchmark, from which all deviations are evaluated. Adler considered the darker side of human nature as a potential that could develop in individuals if their feeling of community was not sufficiently developed. He saw this darker side, not as an inevitable characteristic of all people, but as a probable reaction to early childhood neglect, abuse, or pampering. These overburdening influences inhibit the development of the feeling of community and frequently lead to mistaken conclusions about oneself and life. In these cases, the generic striving for significance may deteriorate into destructive striving for power over others. However, it is not the original childhood circumstances that "cause" the dark side to emerge in adults -- it is their unchanged, mistaken opinions of themselves and others, as well as their unchanged, unconscious, fictional goals (the choice of wrong directions).

Therapeutically, the challenge of Adlerian psychotherapy is not to merely uncover or integrate this dark side but to overcome it mentally, emotionally, and behaviorally. In this respect, Adlerian theory and practice is more optimistic about human nature and therapeutic change than many other approaches. Adler believed that an increase in the feeling of community was the primary key to the prevention and cure of mental illness, addiction, and criminal behavior.

(Additional Comments About Inferiority and Aggression)

Parental neglect, rejection, or abuse can easily provoke deep, painful feelings of insecurity or worthlessness in children. Many grow up yearning for revenge. However, pampering, overprotection and indulgence can also set the stage for intensified inferiority feelings. Pampered children may "feel humiliated" when they are not the center of attention or given everything they want. Spoiled children can become very aggressive or abusive toward parents if they eventually discontinue their indulgence. Very ambitious, competitive children, who have accomplished or preferred siblings, may feel painfully inferior by comparison, and harbor "dark thoughts" about their rivals.

Children, as well as adults, can temporarily mask or relieve their inferiority feelings with high activity, anger, and aggression. They can get "high" on this volatile mixture and often have the illusion of being very powerful. By dominating, hurting, frightening, or exploiting others they indulge in pretenses of victory. Their shallow conquests frequently involve the perverse satisfaction of defeating someone. This "dark side" strategy can become very addictive and result in a progressive indifference to the pain of others.

Question from Forum: Your additional comment like many of your contributions is a wise one and seems animated by a kind of 'radical' environmentalism. When I raised the question of the dark side I neglected to make this consideration explicit. The nature/nurture pendulum nowadays has swung (too far?) toward the nature pole, reflecting developments in biology and perhaps the political sphere. Do you/Adler believe that personality development is solely a function of the environment?
Dr. Stein: Personality development is influenced somewhat by the training and challenges of the environment as well as the assets and liabilities of heredity; however, the strongest influence is the creative power of the individual. This premise is reflected in the potential of Classical Adlerian psychotherapy to stimulate a client into choosing a new direction in life (giving up a life style and compensatory fictional goal originally chosen in childhood).

In the early 1900's Adler recognized the impact of organ inferiority on the formation of the personality. He even hypothesized an inferiority of the CNS in most cases of schizophrenia. Yet he also pointed out the potential of productive over-compensation in certain organ deficiencies, (i.e. Beethoven's deafness and Demosthenes' stuttering).

A negative environment does not always lead to problem children, nor does a positive environment guarantee happy, cooperative children. The decisive factor is what the child makes of his situation when, after trial and error, a choice is made that seems to promise security and significance. Without the critical capacity to foresee later consequences, many errors are possible.

In Adler's own words: "It is neither heredity nor environment which determines the individual's relationship to the outside world. Heredity only endows him with certain abilities. Environment only gives him certain impressions. These abilities and impressions, and the manner in which he "experiences" them-- that is to say, the interpretation he makes of these experiences--are the bricks which he uses in his own "creative" way in building up his attitude toward life. It is his individual way of using these bricks--or in other words, it is his attitude toward life--which determines his relationship to the outside world."

At the beginning of Adler's first book, THE NEUROTIC CONSTITUTION, we find one of his favorite aphorisms: "Omina ex opinione suspensa sunt." (Everything is subject to one's opinion of it).



5. Emotions and Feelings

Question from Forum: What I am learning about the importance of values and the social responsibility is interesting, though sometimes it seems rather 'heady", what about the heart?
The feeling side of the Adlerian approach is very important, but often not sufficiently emphasized in the available literature. The personality ideal of "Gemienshaftsgefuhl" (the feeling of community) is a deep "feeling" of being connected, and embedded in all of life, past, present, and future. It begins with the infant's feeling of being positively connected to the mother, may extend to the father and siblings, and hopefully, develop beyond the family in ever-widening circles. Fundamentally, it is a feeling of being at home on this earth, yet this feeling can grow as wide as the cosmos.

By approaching our patients with warm, friendly understanding, we provide the beginning correction for their missing or deficient feeling of connectedness. First, we empathize with their emotional distress, and then gradually help them realize that most of their thoughts, feelings, and actions are consequences of their immediate or future (unconscious) goals. Patients may frequently understand the logic of trying a new direction, but their familiar feelings and emotions do not provide a sufficient spark to move in that unfamiliar direction. At that point, we may try eidetic or guided imagery to promote an emotional breakthrough. Providing corrective "missing experiences" in group therapy may also be effective.

We try to balance our therapeutic interventions so that the head and the heart are equally stimulated.



6. Treatment of Criminality

Question from Forum: What is the Adlerian approach to the treatment of criminality?
Dr. Stein: I've read the Samenow and Yochelson volumes on "The Criminal Personality," and they've created a compelling view of criminal thinking and feeling patterns, including many concepts that paralleled Adler's theory (energy level, zero state, power thrust, perfectionism). However, there are significant differences, particularly in treatment. Their approach to treatment tends to be nomothetic, systematic, and directive. The Classical Adlerian approach to treatment is more idiographic, creative, and Socratic.

We do not have special strategies for depression, anxiety, criminal behavior, or other disorders. Our challenge is to invent a unique therapeutic intervention for each "individual" who may be using symptoms or disruptive behavior in the service of a hidden goal. Initially, using a therapeutic adaptation of the Socratic method, question the client's mistaken thinking. Later on, we may use eidetic and guided imagery to generate conjunctive feelings. If needed, we may use role-playing to practice new, cooperative behavior. However, unless we also uncover and dissolve the hidden fictional goal, the mental, emotional, and behavioral changes may be superficial or temporary.

For Adler's thinking about the private logic of criminals, early childhood influences, and treatment recommendations, read "Crime and Related Disorders (Chapter 17) in THE INDIVIDUAL PSYCHOLOGY OF ALFRED ADLER, edited by Heinz and Rowena Ansbacher. Edward Hoffman, in his new biography of Adler, THE DRIVE FOR SELF: ALFRED ADLER AND THE FOUNDING OF INDIVIDUAL PSYCHOLOGY, offers some brief comments.

(Quoting Hoffman) "...Adler described most criminals, regardless of socioeconomic background, as dominated by a sense of inferiority and a lack of social feeling. Ultimately, he emphasized, they are cowards with "a cheap superiority complex," overcoming their victims through darkness, surprise, formidable weaponry, or sheer numbers.

Quite optimistically, Adler asserted that his approach could "change every single criminal," but acknowledged that such a goal was unrealistic, especially since "we find that in hard times, the number of criminals always increases." Rather, Adler offered several concrete recommendations for preventing a further escalation of crime. These included establishing programs to eliminate unemployment through job training, reducing the ostentatious display of wealth that "can act as a challenge to the criminal," and instituting group sessions with prison inmates to heighten their self esteem and social feeling. Interestingly, Adler also suggested that the mass media "not mention the names of criminals or give them so much publicity," and commented that, "We should not imagine that criminals can be terrified by the thought of capital punishment, [which] sometimes only adds to the excitement of the game."



7. Undivided Self

Question from Forum: It seems to me to that Adler, through his insistence on dynamic unity, both acknowledges 'the dark side' and puts it in perspective. Both 'the dark side' and the conscious self are dedicated to the pursuit of the fictional goal. Any comment?
Dr. Stein: Adler did not make a sharp distinction between conscious and unconscious, nor did he assume internal conflicting forces. He did not believe that everyone had a hidden dark side. Consequently, his model of the personality does not include anything similar to Jung's 'shadow' or Freud's 'Id'.

Adler's conceptions of the unity and self consistency of the personality suggest that any 'dark side' is an invention of the individual--a devise that may be useful in the pursuit of an aggressive or defensive goal.



8. Self Esteem

Question from Forum: You mentioned that one of Adler's suggestions for preventing crime was "instituting group sessions with prison inmates to heighten their self esteem". At this time in our profession, this term is used to mean many different things by different persons. Would you elaborate on Adler's conception of 'self esteem'?
Dr. Stein: An early feeling of belonging gives children the foundation for building self esteem, one that is rooted in being content with who they are, and strengthened by being accepted and liked by parents, siblings, and friends. If children have enough activity and courage, and use their creative power to find ways of conquering what is bothering them, and struggle to overcome the difficulties they face, they can develop normal self esteem.

Self esteem is not given to children by their parents. It comes from the feeling that they can do things on their own, that they don’t always need help. It comes from trying, failing, and trying repeatedly until they succeed. Encouragement is generally necessary when they begin to feel discouraged. If children are always criticized for their mistakes, or they are helped too much, they may be prevented from developing genuine self esteem.. Aspiring to goals that are too high or unrealistic for their age, or intense competitiveness with older or accomplished siblings may deny children any feelings of success and pride in their accomplishment. They may then deviate into fantasy, or rely on the opinion or behavior of others for the illusion of an exaggerated self esteem.

Adults can also set mistaken benchmarks for their self esteem. Money, power, possessions, and fame are seductive substitutes for the feeling of personal value in our culture. Most people have the opportunity of doing the best they can with what they have inherited, to improve their living situations, and to develop their interests and capacities. Satisfaction and pride in one’s progressive improvement, and the willingness to share what one has developed for the benefit of others can provide not only life-long self esteem, but earn the esteem and appreciation of others.

(Additional comments about inferiority and aggression.)
Parental neglect, rejection, or abuse can easily provoke deep, painful feelings of insecurity or worthlessness in children. Many grow up yearning for revenge. However, pampering, overprotection and indulgence can also set the stage for intensified inferiority feelings. Pampered children may "feel humiliated" when they are not the center of attention or given everything they want. Spoiled children can become very aggressive or abusive toward parents if they eventually discontinue their indulgence. Very ambitious, competitive children, who have accomplished or preferred siblings, may feel painfully inferior by comparison, and harbor "dark thoughts" about their rivals.

Children, as well as adults, can temporarily mask or relieve their inferiority feelings with high activity, anger, and aggression. They can get "high" on this volatile mixture and often have the illusion of being very powerful. By dominating, hurting, frightening, or exploiting others they indulge in pretenses of victory. Their shallow conquests frequently involve the perverse satisfaction of defeating someone. This "dark side" strategy can become very addictive and result in a progressive indifference to the pain of others.



9. Main Tools in Therapy

Question from Forum: Adler used two main tools in therapy; were they the family constellation and life-style?
Dr. Stein: The main “tools” in Adlerian therapy are encouragement and the feeling of community. Some constructs, like family constellation, birth order, style of life, inferiority feeling, striving for superiority, fictional final goal, antithetical scheme of apperception, private logic, and earliest recollections, may emerge as more important than others in a particular case or at a specific stage of psychotherapy.



10. Metaphors in Therapy

Question from Forum: How did Adler use metaphor therapy?
Dr. Stein: Alfred Adler did not use "metaphor therapy," if by that term you mean the use of metaphors as the primary focus in diagnostic and treatment strategies. He was very creative in treatment and used whatever technique seemed appropriate to each client. Being "creative" implies the invention of strategies that can capture the uniqueness of each individual, and that facilitate each stage of treatment. For this reason, in the Classical Adlerian approach, we use a variety of cognitive, affective, and behavioral strategies that might include: the Socratic method, eidetic and guided imagery, role-playing, bibliotherapy, dream and daydream analysis, as well as metaphors.

Metaphors can frequently be used by clients to intensify negative feelings and avoid common sense. Countering a negative metaphor with a positive one, usually offers some encouragement, but unless the underlying goal and style of life are modified, any affective or behavioral changes may be superficial and temporary.



11. Gestalt and Adlerian Theory

Question from Forum: Is there any relationship between Adlerian Theory and Gestalt Therapy?
Dr. Stein: In The Individual Psychology of Alfred Adler, p. 11-12, Heinz Ansbacher points out the similarities between Individual Psychology and Gestalt psychology: "emphasis on the whole rather than elements, the interaction between the whole and parts, and the importance of man's social context." On page 149, he also comments about the "close theoretical relationship between the Gestalt school and Adler in the area of intelligence."

My mentor, Sophia de Vries, who studied with Adler, believes that Adlerian psychology has more in common with the early European Gestalt theorists, rather than with later American practitioners like Fritz Perls.

To my knowledge, there is not much of a dialogue today, in the United States, between the Adlerian and Gestalt advocates. Constructs like the fictional final goal and the feeling of community seem to differentiate us from many other approaches that have some limited similarity.

Several years ago, I read Creative Process in Gestalt Therapy by Paul Zinker. I found the first third of the book, about the therapist as an artist, most stimulating and consistent with the Classical Adlerian style of treatment. However, the balance of the book described Gestalt therapeutic strategies that I found less adaptable to the Adlerian model.



12. Simplified Typologies

Question from Forum: Several years ago I began work on an instrument to measure the personality priorities set out by Kefir and also Langenfeld. There work was based on Adler's discussion of common types (along with others). I have found this an interesting research vein. However, while my program advisor was strongly Adlerian, I have not kept close to the purists in the area. I was wondering how personality priorities are viewed today?
Dr. Stein: Simplified typologies, like the "personality priorities" are often appealing to students because they seem to provide a relatively easy way to identify a client's style of life. However, they do not do justice to Adler's principle of the uniqueness of each individual. After mastering Adlerian theory, it takes many years of supervised case analysis, with an expert clinician, to learn the art of capturing that uniqueness diagnostically.

A comprehensive case analysis would include precise descriptions of the client’s: type and depth of inferiority feelings; degree and radius of activity; level of community feeling; compensatory fictional final goal; attitudes toward work, friendship and love; antithetical scheme of apperception; and private logic. These diagnostic constructs provide very useful guidelines for the course of therapy and the potential dissolution of the style of life.

Question from Forum: I was caught off guard the other day when a student at the local university mentioned that her professor had stated that Adler believed that there were four major typologies: The dominant or ruling attitude; the "expectant attitude"; the "avoidant attitude"; and the "solution oriented attitude". It had been my belief that Adler had mentioned these types as examples of potential types. In Ansbacher's "Superiority and Social Interest" (pg 68), Adler states that these four types are presented for "...teaching purposes only." How do you understand this passage?
Dr. Stein: Simplified typologies are useful as preliminary (and temporary) schemes for orienting students at the beginning of their training. However, if we wish to do justice to Adler's view of the uniqueness of each individual, in clinical practice we must eventually abandon all typologies and learn to capture a dynamic picture of each individual's actual movements in relation to external problems and an internal, fictional final goal.

A complete style of life analysis embraces many of Adler's constructs, including: childhood prototype; primary and secondary inferiority feelings; compensatory, fictional final goal; attitudes toward the three life tasks; antithetical scheme of apperception; and private logic. It generally takes several years of weekly case consultation with an experienced clinician to master this creative art.

Although it may be tempting to use simplified typologies in practice, they never capture the uniqueness of the individual sufficiently to help clients feel deeply understood, nor do they provide adequate reference points for precise, effective treatment planning.



13. Birth Order

Question from Forum: I am in a research science class in high school. My project is on birth order and how effects an individual's personality. I have read that Adler was the first to acknowledge this idea. I would appreciate some more information on this subject.
Dr. Stein: Read Alfred Adler's What Life Could Mean to You,Chapter 6, "Family Influences, for a good overview. Also look at Lydia Sicher: An Adlerian Perspective, edited by Adele Davidson, Chapter 17, "Family Constellation."

For a contemporary view of birth order influence, check out Robert Boynton's article, "The Birth of an Idea," in the latest issue of The New Yorker magazine. He discusses Frank Sulloway's research and new book, Born to Rebel.



14. Evolution of Adlerian Theory

Question from Forum: It seems to me that current cognitive-behavioral/ constructivist/narrativist approaches to therapy are an evolution of Adler's observations...

And further, that (in contrast to something in an earlier thread) it is not that current theory is becoming more Adlerian, but that current theory stands on Adler's shoulders, (as well as those of others.)

Do you think Adlerian theory has evolved? If so, where is it today?

Dr. Stein: For more than twenty years I have studied and re-studied Adler's original writings, and have compared them to other and "newer" theories in psychology. Generally, I find that Adler has grasped a "totality" of the human condition unequaled by any other theoretician. He embraces a vision of the human being in the widest social context, including the perspectives of the past and future. I find many other theories that seem parallel to fragments of Adler's theory lacking in the unique totality that he provides.

For the past five years, with the generous help of Kurt Adler, I have been managing and editing the Adlerian ` Project. It has been quite extraordinary to read a steady flow of translated journal articles and unpublished manuscripts. Unlike any other author, Adler consistently penetrates to the core of the human mind and heart.

Our most recent project, a re-translation of The Neurotic Constitution (adding all the new material from the fourth edition) has provided continually profound insights into psychopathology. One unique quality that emerges is a consistent impression of "the whole" of Adler's model, no matter which paragraph one reads (like the structure of a hologram, wherein each piece is a small reflection of the entire image).

I, like my mentor, Sophia de Vries, believe that Adler's theory is complete, like a work of art. I have yet to see anyone "improve" it, although it is possible to elaborate on various aspects of his theory as long as the totality is retained. (Although Adler suggested an ideal for personality development, Abraham Maslow described optimal functioning more comprehensively. Adler, however, provided the therapeutic tools for realizing this goal.) In my teaching and writing, I have explored elaborations of: creative power; dissolving a style of life; childhood developmental scheme; levels of functioning; and private logic.

The evolution of Adlerian psychology will more likely take place in its practice. Adler's writings do not document the technique of psychotherapy in a step-by-step manner because he conceived it as a creative process. A few of his followers have contributed insights into the host of strategies and techniques that can be generated from his theory. Anthony Bruck mastered the art of brief therapy and created a set of graphics for teaching Adlerian theory. Sophia de Vries adapted and refined the Socratic method for promoting cognitive insight and change. Working together, we developed a twelve-stage therapeutic model to guide and evaluate the progress of treatment. I have explored the use of eidetic and guided imagery for providing "missing developmental experiences." It has been difficult to gain a full appreciation of Adler's remarkable contribution, since so much of his work has been out of print, partly translated, or untranslated. We intend to publish The Collected Clinical Works of Alfred Adler once we have completed the massive job of translating and editing. It will then be possible for anyone to fully access and evaluate Adler's theory.

In your message, you expressed your perspective that "current cognitive-behavioral/constructivist/narrativist approaches to therapy are an evolution of Adler's observations" and that "current theory stands on Adler's shoulders." It would be helpful if you could be more specific and illustrate your point with examples.

Comment: I agree with the person who commented about the commonality and seeming evolution from Adler to constructivist/narative/ cognitive psychotherapy. One commonality that comes readily to mind is that both Adler and these investigators see the person as constructing their own concepts of the world and not being passive reactors to external stimuli. Also, treatment considerations may have the same process in mind. Adler talks about "dissolving the lifestyle" while constructivists talk about "re-authoring the narrative." While using different terminology the similarities seem evident. Michael Mahoney tome, Human Change Processes, summarizes the constructivist cognitive psychotherapy position. Art Freeman who is president of AABT will be presenting at the 1997 NASAP conference. His topic - The Adlerian roots of cognitive therapy - may provide further insights.

Comment: Thank you for responding to my post.I had in mind some of what was commented on, as well as other commonalities between Adlerian theory and cognitive/cognitive-behavioral/ constructivist models.

In addition to a creative, ego-centered approach to apprehending reality, I see commonalities between methods. For instance, in acting "as if", a person is "testing out" their hypotheses about self, others, and the world... as well as alternative hypotheses. In looking at early recollections, the therapist assesses the person's learning history and core belief system. (I know that ERs are not veridical, in the sense of stimulus-response theory, but I look at learning theory from a social-learning perspective.)

There is some social psychology research that supports and expands upon the concepts of early recollections. Social psychologists Miller, Potts, Fung, Hoogstra, and Mintz (1990) described cross-cultural research into the social construction of self-concept or personal narrative that both supports Adlerian theory, and provides insight into specific mechanisms by which beliefs about self and other come to be what they do. This kind of basic research could, I think, be put to good use by Adlerians, as empirical validation of Adlerian constructs.

Similarly, there is research in cognitive neuroscience that supports information-processing models that fit well with CBT, constructivist, and Adlerian theories. (I don't have the references in front of me at the moment, but it's not even terribly new research... certainly at least 4-6 years old.)

However, most areas within psychology seems reluctant to look to other areas of the field for verification of basic constructs... it's hard to read broadly enough, for one thing. And then there's an inherent territoriality in what we do, particularly when we create something that has a new twist and we want to call it ours.

At APA a couple of years ago, I wandered into a session that was on cognitive neuroscience. At first, my inclination was to leave... not the place for a practitioner, I thought. But I stayed, because it was a fun and quirky thing to do. And I discovered that the neuroscientists were "discovering" things that clinicians -- particularly Adlerian and Cognitive clinicians -- could have told them, or at least contributed to... and I realized that the lack of communication was reciprocal.We'd all support the profession of psychology better if we paid attention to our more scientific peers.

Dr. Stein: I would extend your suggestion, about paying more attention to other psychology disciplines, to the other sciences. The following excerpt, from "Classical Adlerian Theory and Practice," comments on some fascinating parallels.

Over the half century since Alfred Adler articulated his theory of personality and system of psychotherapy, his ideas have gradually and persistently permeated the whole of contemporary psychology (Ellenberger 1970, 645-648). The shift of psychoanalysis to ego psychology reflected Adler's original thinking and Adler was "hailed by certain psychoanalysts as a precursor of the later developments of psychoanalysis" (Ellenberger 1970, 638). Adler's observation that "human beings live in the realm of meanings" reflects the social constructivist view of human behavior. An early feminist, he held that both men and women suffered from our society's overvaluing of men and undervaluing of women, and he believed the only positive relationship between men and women was one of equality. His earliest work in which he argued for the unity of mind and body was a precursor of psychosomatic medicine.

Even the findings of anthropologists, biologists, and physicists parallel Adlerian concepts. Adler's view of the interconnectedness of all living beings and their natural proclivities toward cooperation has been echoed by anthropologists (Ho 1993; Kim and Berry 1993; Maybury-Lewis 1972), and biologists (Augros and Stancui 1988; Hamilton 1964; Simon 1990; Trivers 1971; Wilson 1975). His concept of the style of life, where one central theme is reflected in every psychological expression, suggests the concept in physics of the hologram, wherein each part of a whole is an enfolded image of that whole (Briggs and Peat 1989). His concept of the final goal, a fictional future reference point that pulls all movements in the same direction, is similar to that of a strange attractor in chaos theory, a magnetic end point that pulls on and sets limits for a process (Nelson 1991). He believed in the fundamental creative power of individuals and their freedom to choose and change their direction in life; this is very similar to the biological process called autopoesis which is the autonomous, self-renewing, and self-directing nature of all life forms (Nelson 1991).

When sociologists, anthropologists, biologists, mathematicians, physicists, and psychotherapists begin describing remarkably similar dynamics, one wonders if we are on the brink of a new unified field theory. Forty years ago, Alexander Müller frequently referred to Adler's body of work as "philosophical anthropology," and held that it had the potential for providing the magnetic center that would draw other disciplines together (Müller 1992).

The scientific paradigm shift and intellectual climate of the 1990's might well be ripe for a re-discovery of Adler's original and full contribution to an understanding of human beings and their relationship to the world. He created an exquisitely integrated, holistic theory of human nature and psychopathology, a set of principles and techniques of psychotherapy, a world view, and a philosophy of living.

(For the complete paper, including references, see: http://www.Adlerian.us/theoprac.htm .)



15. Striving for Superiority

Question from Forum: Could you please discuss what Adler means by "striving for superiority." I find so many people (and clinicians) do not completely understand what Adler was trying to say.
Dr. Stein: A complete understanding of any of Adler's terms requires considerable in-depth study. Publications that attempt to simplify Adler's ideas appeal to the casual reader but mislead many, including clinicians, into thinking that his ideas are easy to assimilate. Many misconceptions are constantly repeated in textbooks and encyclopedias. Since, most of Adler's clinical writings are not yet readily available, it is not easy to find reliable sources. The work of Heinz and Rowena Ansbacher has been very helpful (see "Reading and Study Sources" in the ALFRED ADLER INSTITUTE OF SAN FRANCISCO link of the BOL home page)

The fundamental dynamic of human striving is a constant movement from a felt "minus" to an imagined "plus". The striving is influenced by: the type and intensity of the "minus" feeling (inferiority or insecurity); the degree of activity; the strength of the feeling of community; and the particular goal of an imagined "plus". The character of this movement is not easy to capture in a short phrase--it may erroneously suggest a static "snapshot" rather than a dynamic "moving picture". Also, the generalized, abstract concept of striving must be tailored to reflect the quality and direction of that striving in each individual's life.

It is helpful to consider a palette of terms to describe the variety of directions that individuals could take. People may strive for: superiority over difficulties, superiority over others, significance, completion, compensation, perfection, improvement, achievement, fulfillment, power, prestige, connection, recognition, security, adaptation, or overcoming. Generally, we evaluate each variation as either positive or negative (for the individual as well as society). The overuse of the phrases "striving for superiority" and "striving for power" in the literature implies that Adler saw all social relationship as fundamentally unequal and aggressive. In fact, he used these terms to describe only the negative or pathological variation. The desire to "be perfect, without flaw" can lead to socially useless activities, discouragement, and retreat into fantasy. The striving for godlike supremacy can lead to psychosis.

Adler's terms "striving for completion", "striving to overcome difficulties", and "striving to improve life for all people" reflect more of the positive potential of striving. At an optimal level, he talked about aligning ones striving "in the stream of evolution". He considered the active "striving for perfection" a potentially inspiring ideal, if it led to courageous improvement, correction, and refinement as well as useful social contribution. The striving to "actualize one's potential" was later echoed by Abraham Maslow.

In a spiritual/psychological context, Alexander Mueller used the phrase "striving to become one's best self" in his book YOU SHALL BE A BLESSING. Kurt Adler has talked about "striving for a better adaptation to the environment". Sophia de Vries often referred to a "striving for overcoming obstacles". Lydia Sicher wrote about "striving after some personal truth". Anthony Bruck suggested a "striving for personal significance". All of these expressions try to suggest the general upward striving of human beings. The direction of each person's striving is greatly influenced by the strength of that individual's feeling of community.



16. Existentialism, Minus Feeling, and Adler

Question from Forum: In "Denial of Death" Becker promotes Otto Rank's idea that the truth of our insignificance overwhelms us as youths (and adults I guess). Thus the felt minus begins. Becker then trivializes Adler in a few sentences. It is helpful to me, though, to think of the striving as a story the individual makes up about what it means to "be" someone or overcome an also made up "weakness." When I listen I'm listening for the "validation" story. I'm wondering if anyone else has put an existential twist to the "striving" idea? It seems Adler clearly did not as I have never seen him quoted concerning Heidegger or other existentialists. Thus the overcoming or striving concept seems to be taken as a given - its source or cause not explored so there are many discussions like the above. What is it? What's it really mean, etc.
Dr. Stein: Heinz Ansbacher has commented on existentialism and Heidegger in THE INDIVIDUAL PSYCHOLOGY OF ALFRED ADLER (p.16) and SUPERIORITY AND SOCIAL INTEREST (p.7-9). For another "twist" on the roots of striving, read the following excerpts from Alexander Müller's unpublished manuscript "Principles of Individual Psychology." ---(beginning of Müller quote)--- To what extent is the feeling of inferiority a part of the normal development of a child and of human beings in general? According to a formulation by Adler: "to be human means to have a feeling of inferiority." "The historical progression of mankind is to be seen as the history of the feeling of inferiority, and man's attempt to resolve it." "Who can seriously doubt that the pitiful individual human being was given as a blessing a strong feeling of inferiority that strives for positiveness, security, and overcoming?" Adler, therefore, sees the development of mankind as the result of the surmounting of an inferiority feeling that, for better or for worse, is part of human nature. According to our view, the inferiority feeling, in the broad sense of the remarks above, is a very strong incentive, a trigger mechanism, but not the sole cause of man's evolution. We believe that the primary impetus for the development and unfolding of man has its roots in his immanent creative power.

Perhaps "creative power" can be described as something that we experience, but is not accessible to reason. If one considers character as not innate or fixed, then the question arises: who or what shapes character? Is it education or the environment and people close by, or is it what a person experiences in earliest childhood? Are events decisive or is it how we experience them? On what do how one relates to one's environment and to personal experiences and how the person assimilates them depend? These are questions to which no conclusive answers can be given. However, the following seems important to us: if one does not adhere clearly to determinism, then there remains a question mark with regard to the manner of human behavior. Neither predisposition nor the environmental effect necessarily explain a person's basic behavior. The unique individual character entails an X-factor that can be traced back to nothing else but what we attempt to describe as "creative power." ---(end of Müller quote)---



17. Dreikurs and Adler

Question from Forum: You mentioned Heinz Ansbacher, and this reminds me of the diversity of interpretations of Adler’s principles. I know that you have said that Adlerian’s psychology can be interpreted in different ways, and that Adler himself did not wanted Individual psychology to be a rigid doctrine. But when you have to bring the right answer in front of 2 examiners, you want to be sure. I am reading Ansbacher’s Superiority and Social Interest, a great book for finding the roots of IP… if the information is accurate. Who was closer to Adler? I understand that although Dreikurs made a terrific contribution to Adlerian’s theory, he might have strayed a bit further away from IP than some other Adlerians. What’s the difference between their theories?
Dr. Stein: Heinz and Rowena Ansbacher's books, "The Individual Psychology of Alfred Adler," and "Superiority and Social Interest," are excellent, reliable sources of Adler's ideas in an organized, edited format. For the most complete and accurate information, one would have to read Adler's books and journal articles in their entirety.

For several years, the Adlerian Translation Project has been collecting, translating, and editing all of Alfred Adler's untranslated journal articles, lectures, and unpublished manuscripts. We are also re-translating several books, like "The Neurotic Constitution," that were poorly translated many years ago. "The Collected Works of Alfred Adler" will provide a more comprehensive resource for study and research.

An understanding of Adlerian theory and practice can be enriched by reading other Classical Adlerians. "The Collected Works of Lydia Sicher: An Adlerian Perspective," by Adele Davidson is a valuable book that is currently available. The writings of Alexander Müller, Sophia de Vries, and Anthony Bruck will be published in the near future.

Rudolf Dreikurs began working with Adler in Europe, but after Adler's death, he eventually developed his own approach which should be called "Dreikursian Psychology," since he declared his own theoretical position to be "between that of Adler and that of Karen Horney." Dreikurs attempted to simplify and popularize Adlerian ideas, and eventually became well known for his contributions to child guidance and parent education.

The major differences between Classical Adlerian and Dreikursian are in the style and technique of treatment. Classical Adlerian psychotherapy is creative, diplomatic, and Socratic. Insight is unfolded gradually, after substantial encouragement. The twelve stages of treatment have the potential for dissolving the client's inferiority feelings, style of life, and fictional goal.

The Dreikursian approach is more systematic, directive, and didactic. Insight is offered very early in the form of a summary. Four stages of treatment focus on a positive re-direction of the existing style of life.

For additional information, please read "The Twelve Stages of Classical Adlerian Psychotherapy" and "Adler and Socrates: Similarities and Differences," on the Alfred Adler Institute of San Francisco home page, at http://www.Adlerian.us.



18. Downward Social Comparison

Question from Forum: Reading about the universality of inferiority feelings caused me to wonder if you were familiar with the concept of 'downward social comparison'--a topic of some interest now among academic social psychologists such as Tom Wills. One of the implications of the theory is that people like bad news (as in TV news) because it improves their own self-assessment by comparison with the worse circumstances of others.
Dr. Stein: I was not aware of the current topic of 'downward social comparison' in academic social psychology.

In 1911, Adler wrote about the neurotic tendency to depreciate others as well as over-value one's own achievements. He mentioned several strategies for enhancing one's self esteem by disparaging others.

"The depreciation of the partner is the most usual phenomenon in neurotics. In some cases this may be obvious. In others this may be deeply hidden."

"Idealization is one of the most effective attitudes of the neurotic to measure thumbs down, so to speak, a real person by an ideal, since in doing so he can depreciate him as much as he wishes."

"I have found a further interesting kind of disparagement among neurotic patients in their solicitude, their anxious behavior, and their fears for the fate of other persons. They act as if without their aid the others would be incapable of caring for themselves."

Depreciation of the partner, idealization, and solicitude are very common dynamics that lead to distance and resentment in couples and families. At a larger scale, a cleaning compulsion may provide the bearer with a massive 'downward social comparison' to everyone in the world who is "dirtier".

Alexander Müller has also written on the topic of depreciation.

"The tendency toward depreciation can be described as the passive form of striving for superiority; the attempt to overtake everyone else in whatever capacity. Where there exists a high degree of striving for self-enhancement a person cannot accept the idea that another could be more talented, capable, or superior, that is more "worthy," than he. If he should doubt his ability to overtake another then he can resort to trickery: denigrating the other. A giant is made to appear as a midget."

Do the academic social psychologists recognize and credit the early Adlerian contributions?

Comment: Interesting. As to your question of whether Adler is cited as a source, I don't know, though I doubt it. Maybe others here can help with this. It's worth noting that downward comparison is not seen as neurotic, but as a general characteristic of people.




19. The Place of Values

Question from Forum: Adlerian psychology is very much a values-oriented psychology. However, values have had a somewhat tenuous place in much of psychology. Therapists in a post-modern tradition often talk about therapy being non-judgmental, non-hierarchical, non-instructive (as much as possible), with no assumption of objectivity or truth. Some therapists argue that the therapist has no right to impose his or her values on the client. (My view, however, is that values shape much of what these therapists do even though they might not espouse this in their discussions of theory or practice.) Where do you see the place of values in Adlerian therapy? What if the therapist's values clash with the client's values?
Dr. Stein: Very clear, explicit values are at the core of Adlerian theory, philosophy, and practice, providing personal and professional orientation, direction, and inspiration. The client's values may also be explicit, but are more often only implicit in their interests, actions, and feelings. Consequently, we frequently gain clearer impressions of clients' values from what they do, rather than from what they say, especially if there are contradictions between the two.

Metaphorically, values are like a personal compass on a private map of life. Both may have varying degrees of error, leading the traveler in the wrong direction and providing faulty pictures of what will probably be found. A new "map of probability" can be co-constructed by client and therapist through a series of Socratic questions. Socrates and his students searched for universal truths -- Classical Adlerians and their clients search for common sense. "North" for Adler represented the feeling of community, cooperation, and contribution to social improvement. "South" led to egocentricity, domination, and exploitation. Each of these directions have somewhat predictable psychological and social consequences.

Some values, like, prestige, power, wealth, pleasure, and security, if embraced without a sufficient concern for the welfare of others, may eventually lead to mutual isolation, unhappiness, and hostility. By contrast, the pursuit of higher values like truth, beauty, or justice, when combined with an interest in the well-being of others, may lead to mutual fulfillment and significant social progress.

In a somewhat dialectical fashion, the "cost/benefit ratio" of different directions can be explored and compared in psychotherapy. The client is always free to choose and sustain any direction. There will be no clash of values between client and therapist as long as we do not try to persuade the client to think the way we do. The clash will be between the client's values and their inevitable consequences in life.

Comment: I am glad you posted more some information about the Socratic Method. I was not sure what it was, but once I read your explanation, I could picture Adler talking to a "nasty" adolescent who used to throw objects at his teacher. I am sure you know about this incident, but I do not have the references with me. Well, Adler watched the adolescent for a while (creative therapy?), and then he told the child that he appeared to be short for his age. To the angry response from the adolescent, he told him, that, well… he was small too, and small people try to feel superior by acting up. And he went up and down on his toes, to mark his statement.




20. Dreikursian and Adlerian Approaches

Question from Forum: I read your article about Classical Adlerian psychotherapy posted on The Alfred Adler Institute of San Francisco home page. As a student Adlerian who has studied mainly though the writings of Dreikurs', I though it is stimulating, because this can be one of the major differences between "Classical" and "Dreikursian" approaches.

Dreikurs frequently pointed out the usefulness of confronting the hidden goal by guessing. He reasoned that this method is good because 1) when confronted in an appropriate way, wrong guess does not harm the client, 2) client are often unable to realize the hidden goal. Indeed I saw several psychotherapy shows on TV or radio in which the therapists force the clients to reach the conclusion because they want to finish the show in certain time. In these shows, although the therapists do not to give the clients any answer, the clients reach unsatisfactory conclusion because of lack of the time. I think in these occasions the therapists should have been successful if they utilized the Dreikurs' method.

My question here is whether you think the Dreikurs' method of guessing and confronting is useful to save the time to let the clients acknowledge their hidden goal. To me, it seems foolish not to use a tool which is available to a therapist.

Dr. Stein: Utilizing the Dreikurs method of "guessing and confronting," as soon as possible in therapy, may seem to save time; however, confronting clients with guesses about their hidden goals before they are ready or open may actually be a waste of time. Premature disclosure, especially if presented too bluntly, might be very painful; it could inhibit the client's willingness to accept and use the insight.

Client receptivity depends on several therapeutic accomplishments prior to interpretation: establishing a cooperative working relationship; expressing empathy; communicating understanding; generating hope; and providing encouragement. Initially, the therapist only uses the client’s hidden goal as a guideline to promote new client movements in a more positive direction. After the client has moved in this direction, and built a series of successes, more confidence, and new courage, he is then able and willing to look back at and evaluate his old, underlying goal. At this point, he is more likely to accept the therapist's interpretation and use the insight for deeper change. This process tasks take time and cannot be rushed.

The hidden goal is only one part of a complete picture that may need to be gradually unfolded to the client. The therapist must also be prepared to show the interrelatedness of the inferiority feelings, childhood prototype, style of life, fictional goal, purposive symptoms and emotions, private logic, and scheme of apperception. For the client to recognize his own experience, a precise, convincing portrait must be drawn. How and why this goal was originally formed may need to be explained.

Classical Adlerian psychotherapy is an art, and must be practiced creatively and patiently, with sensitive diplomacy. The uniqueness of each client should be mirrored with a unique treatment strategy that would suggest how and when to offer interpretation. It takes several years of case supervision from an expert therapist to learn this skill. Any attempt to systematize therapy into a fast by the numbers procedure turns it into a dry technology.



Comment: I, too, was a student of Dr. D. in the latter part of his career. My sense, from what he said at that time was he would have trouble with the term, "Dreikursian". He always considered himself and "Adlerian". I agree with Dr. Stein's comments about "guessing." Dr. D. would always say, what a patient doesn't agree with is "threatening", and he would always couch his "guesses" with the phrase "Could it be.....?" He felt, from what I recall, that the patient should always be in a position to disagree with our hypotheses, and s/he should always take them as such. I recall him saying, "When I see a gold mine, I am likely to dig it," or words to that effect. However, his acumen or "Menschenkenntnis" was such that he, more often than not, hit the mark, and when he did so, and with the rapport he had, the patient was able to understand and feel "understood" by him.
Dr. Stein: In the March 1996 issue of "Individual Psychology," (1994 NASAP Convention Keynote Speech) Powers and Griffin declare that "... Dreikurs had once publicly declared his own theoretical position to be between that of Adler and that of Karen Horney." They go on to state that "...Dreikurs was an independent thinker, with original theoretical ideas, and that not all of Dreikurs' ideas were in agreement with Adler's ideas."

Sophia de Vries and Anthony Bruck, both of whom studied with Adler, recognized Dreikurs as an outstanding diagnostician and parent educator, but they believed that his therapeutic technique and style deviated sharply from Adler's original approach. They recommended that students and clinicians rely primarily on Adler's original writings to gain the clearest and deepest understanding of Adlerian theory and practice.



21. Classroom Management

Question from Forum: I am a university student from Perth, Western Australia. I am currently in my second year of a bachelor in secondary education. My dilemma is this.....I am to present a tutorial on Dreikurs and his methods of classroom management. All information that is currently available to me is of little help, and I am hoping you may be able to take a little time to share some of your knowledge with me.
Dr. Stein: Read "Maintaining Sanity in the Classroom," by Grunwald, Dreikurs, and Pepper. You could also look at: "The Education of Children," by Alfred Adler. "The Problem Child," by Alfred Adler. "Guiding the Child," by Alfred Adler and associates.

Several other Adlerian have made significant contributions to working with teachers and students: Alexander Mueller, Anthony Bruck, Oscar Spiel, Ferdinand Birnnbaum, and Ida Lowy. You may have difficulty finding their works, but their ideas are excellent.



22. “Doing a Lifestyle”

Question from Forum: I learned academic lifestyle from Mosak who learned it from Dreikurs. Mosak explained that he was taught over many years by having Dreikurs as mentor. His own method of teaching was to help speed up the process and make it easier. I learned the most by having Mim Pew "do" my lifestyle over a series of ten sessions. This is required at the Minneapolis Adler institute (not with Mim but with some experienced Adlerian.) I would like to hear anyone else's views on requiring this? Does the San Francisco school? Any other school? Being a psychologist now I understand that there could be ethical problems. I would say it was the most beneficial part of my training, easily.
Dr. Stein: We do not use the Dreikursian technique of "doing a lifestyle" at the Alfred Adler Institute of San Francisco. Our mentor, Sophia de Vries, who studied with Adler, believed that this procedure, as well as other Dreikurs attempts to simplify, systematize, and speed up training and treatment had lost the depth, diplomacy, and creativity that characterized Adler's approach.

We believe that students and clinicians need the experience of a complete study-analysis, not only to identify their life style limitations, but to overcome them. In this format, the creative aspect of every stage of psychotherapy is demonstrated and explained. Our goal is to inspire each individual toward optimal personal as well as professional development. The character of the therapist must become congruent with Adlerian philosophy, theory, and practice.



Comment: I agree. I learned the most being engaged with my own lifestyle with Mim Pew and then being supervised for 2 years by an Adlerian. It sounds like I would have been a happy camper at your institute. I wonder at your concept of "overcoming" your lifestyle. It is hard (maybe impossible) for me to understand what that would mean. The concept of lifestyle includes overcoming so to overcome your overcoming seems to get redundant. Recognizing limitations or problems implied by my lifestyle is a different matter. I'm going to think about that a while.
Dr. Stein: Perhaps the phrase “dissolving the style of life” will suggest the process more vividly. First, a few assumptions.

In early childhood, after a period of trial, error, and practice, a way of dealing with life’s challenges becomes fixed as a law of movement As compensation for a felt inferiority, a fictional goal is imagined that seems to promise security and significance. This direction, and way of getting there, become the repetitive pattern of the style of life. This compensatory pattern, which is rooted in a felt deficiency in one or more of the basic physiological, safety, belonging, or esteem needs, was identified by Abraham Maslow as “deficiency motivation.”

Maslow also described a higher level of motivation, within a needs hierarchy, called “growth motivation” or “meta-motivation.” He believed that the individual would have to satisfy the basic or lower needs first, in sequence, before they could become motivated by the higher needs. An Adlerian view of the basic needs would suggest that a mistaken fictional goal would prevent the fulfillment of these needs, or create the illusion of exaggerated needs. Consequently, a positive change in the client’s goal and style of life could potentially satisfy the basic needs.

Most Adlerian therapists identify this style of life for their clients, and try to encourage them to pursue their compensatory goals in a more positive way. This generally leads to a worthwhile improvement; however, there is more that can be done therapeutically. It is possible, although not very common, to “dissolve”a clients’ inferiority feelings, style of life, and fictional goal. This process opens the door to the “meta-motivation’ that Abraham Maslow described -- wherein an individual no longer pursues a final goal, but is motivated by higher values. The symptoms of letting go of one’s style of life are: an initial feeling of disorientation, followed by a sense of a widening psychological horizon, leading to an exploration of a new direction in life. Maslow referred to this exploration as “meta-therapy.” The result is a very high level of creative living that could be called “self/other/task-actualization.” (I have taken the liberty of modifying Maslow’s term to embrace the importance of not only actualizing one’s potential, but also helping others develop fully, and finding a mission in life.)

“Dissolving the style of life” and meta-therapy are not taught at many training institutes; consequently, few therapists have personally experienced their benefits. For an amplification of these methods, in the context of the entire therapeutic process, it would be helpful to read the material on “The Twelve Stages of Psychotherapy” in the document “Classical Adlerian Theory and Practice” at http://ourworld.com/homepages/hstein/theoprac.htm (AAISF Web site).



23. Social Comparison and Depreciation

Question from Forum: Reading about the universality of inferiority feelings caused me to wonder if you were familiar with the concept of 'downward social comparison'--a topic of some interest now among academic social psychologists such as Tom Wills. One of the implications of the theory is that people like bad news (as in TV news) because it improves their own self-assessment by comparison with the worse circumstances of others.
Dr. Stein: I was not aware of the current topic of 'downward social comparison' in academic social psychology.

In 1911, Adler wrote about the neurotic tendency to depreciate others as well as over-value one's own achievements. He mentioned several strategies for enhancing one's self esteem by disparaging others.

"The depreciation of the partner is the most usual phenomenon in neurotics. In some cases this may be obvious. In others this may be deeply hidden."

"Idealization is one of the most effective attitudes of the neurotic to measure thumbs down, so to speak, a real person by an ideal, since in doing so he can depreciate him as much as he wishes."

"I have found a further interesting kind of disparagement among neurotic patients in their solicitude, their anxious behavior, and their fears for the fate of other persons. They act as if without their aid the others would be incapable of caring for themselves."

Depreciation of the partner, idealization, and solicitude are very common dynamics that lead to distance and resentment in couples and families. At a larger scale, a cleaning compulsion may provide the bearer with a massive 'downward social comparison' to everyone in the world who is "dirtier".

Alexander Müller has also written on the topic of depreciation.

"The tendency toward depreciation can be described as the passive form of striving for superiority; the attempt to overtake everyone else in whatever capacity. Where there exists a high degree of striving for self-enhancement a person cannot accept the idea that another could be more talented, capable, or superior, that is more "worthy," than he. If he should doubt his ability to overtake another then he can resort to trickery: denigrating the other. A giant is made to appear as a midget."

Do the academic social psychologists recognize and credit the early Adlerian contributions?



Comment: Interesting. As to your question of whether Adler is cited as a source, I don't know, though I doubt it. Maybe others here can help with this.

It's worth noting that downward comparison is not seen as neurotic, but as a general characteristic of people.

24. The Place of Values

Question from Forum: Adlerian psychology is very much a values-oriented psychology. However, values have had a somewhat tenuous place in much of psychology. Therapists in a post-modern tradition often talk about therapy being non-judgmental, non-hierarchical, non-instructive (as much as possible), with no assumption of objectivity or truth. Some therapists argue that the therapist has no right to impose his or her values on the client. (My view, however, is that values shape much of what these therapists do even though they might not espouse this in their discussions of theory or practice.) Where do you see the place of values in Adlerian therapy? What if the therapist's values clash with the client's values?
Dr. Stein: Very clear, explicit values are at the core of Adlerian theory, philosophy, and practice, providing personal and professional orientation, direction, and inspiration. The client's values may also be explicit, but are more often only implicit in their interests, actions, and feelings. Consequently, we frequently gain clearer impressions of clients' values from what they do, rather than from what they say, especially if there are contradictions between the two.

Metaphorically, values are like a personal compass on a private map of life. Both may have varying degrees of error, leading the traveler in the wrong direction and providing faulty pictures of what will probably be found. A new "map of probability" can be co-constructed by client and therapist through a series of Socratic questions. Socrates and his students searched for universal truths -- Classical Adlerians and their clients search for common sense. "North" for Adler represented the feeling of community, cooperation, and contribution to social improvement. "South" led to egocentricity, domination, and exploitation. Each of these directions have somewhat predictable psychological and social consequences.

Some values, like, prestige, power, wealth, pleasure, and security, if embraced without a sufficient concern for the welfare of others, may eventually lead to mutual isolation, unhappiness, and hostility. By contrast, the pursuit of higher values like truth, beauty, or justice, when combined with an interest in the well-being of others, may lead to mutual fulfillment and significant social progress.

In a somewhat dialectical fashion, the "cost/benefit ratio" of different directions can be explored and compared in psychotherapy. The client is always free to choose and sustain any direction. There will be no clash of values between client and therapist as long as we do not try to persuade the client to think the way we do. The clash will be between the client's values and their inevitable consequences in life.

Comment: I am glad you posted more some information about the Socratic Method. I was not sure what it was, but once I read your explanation, I could picture Adler talking to a "nasty" adolescent who used to throw objects at his teacher. I am sure you know about this incident, but I do not have the references with me. Well, Adler watched the adolescent for a while (creative therapy?), and then he told the child that he appeared to be short for his age. To the angry response from the adolescent, he told him, that, well… he was small too, and small people try to feel superior by acting up. And he went up and down on his toes, to mark his statement.

25. Dreikurs' and Adler's Aproaches

Question from Forum: I read your article about Classical Adlerian psychoytherapy posted on The Alfred Adler Institute of San Francisco home page. As a student Adlerian who has studied mainly though the writings of Dreikurs', I though it is stimulating, because this can be one of the major differences between "Classical" and "Dreikursian" approaches.

Dreikurs frequently pointed out the usefulness of confronting the hidden goal by guessing. He reasoned that this method is good because 1) when confronted in an appropriate way, wrong guess does not harm the client, 2) client are often unable to realize the hidden goal. Indeed I saw several psychotherapy shows on TV or radio in which the therapists force the clients to reach the conclusion because they want to finish the show in certain time. In these shows, although the therapists do not to give the clients any answer, the clients reach unsatisfactory conclusion because of lack of the time. I think in these occasions the therapists should have been successful if they utilized the Dreikurs' method.

My question here is whether you think the Dreikurs' method of guessing and confronting is useful to save the time to let the clients acknowledge their hidden goal. To me, it seems foolish not to use a tool which is available to a therapist.

Dr. Stein: Utilizing the Dreikurs method of "guessing and confronting," as soon as possible in therapy, may seem to save time; however, confronting clients with guesses about their hidden goals before they are ready or open may actually be a waste of time. Premature disclosure, especially if presented too bluntly, might be very painful; it could inhibit the client's willingness to accept and use the insight.

Client receptivity depends on several therapeutic accomplishments prior to interpretation: establishing a cooperative working relationship; expressing empathy; communicating understanding; generating hope; and providing encouragement. Initially, the therapist only uses the client’s hidden goal as a guideline to promote new client movements in a more positive direction. After the client has moved in this direction, and built a series of successes, more confidence, and new courage, he is then able and willing to look back at and evaluate his old, underlying goal. At this point, he is more likely to accept the therapist's interpretation and use the insight for deeper change. This process tasks take time and cannot be rushed.

The hidden goal is only one part of a complete picture that may need to be gradually unfolded to the client. The therapist must also be prepared to show the interrelatedness of the inferiority feelings, childhood prototype, style of life, fictional goal, purposive symptoms and emotions, private logic, and scheme of apperception. For the client to recognize his own experience, a precise, convincing portrait must be drawn. How and why this goal was originally formed may need to be explained.

Classical Adlerian psychotherapy is an art, and must be practiced creatively and patiently, with sensitive diplomacy. The uniqueness of each client should be mirrored with a unique treatment strategy that would suggest how and when to offer interpretation. It takes several years of case supervision from an expert therapist to learn this skill. Any attempt to systematize therapy into a fast by the numbers procedure turns it into a dry technology.



Comment: I, too, was a student of Dr. D. in the latter part of his career. My sense, from what he said at that time was he would have trouble with the term, "Dreikursian". He always considered himself and "Adlerian". I agree with Dr. Stein's comments about "guessing." Dr. D. would always say, what a patient doesn't agree with is "threatening", and he would always couch his "guesses" with the phrase "Could it be.....?" He felt, from what I recall, that the patient should always be in a position to disagree with our hypotheses, and s/he should always take them as such. I recall him saying, "When I see a gold mine, I am likely to dig it," or words to that effect. However, his acumen or "Menschenkenntnis" was such that he, more often than not, hit the mark, and when he did so, and with the rapport he had, the patient was able to understand and feel "understood" by him.
Dr. Stein: In the March 1996 issue of "Individual Psychology," (1994 NASAP Convention Keynote Speech) Powers and Griffin declare that "... Dreikurs had once publicly declared his own theoretical position to be between that of Adler and that of Karen Horney." They go on to state that "...Dreikurs was an independent thinker, with original theoretical ideas, and that not all of Dreikurs' ideas were in agreement with Adler's ideas."

Sophia de Vries and Anthony Bruck, both of whom studied with Adler, recognized Dreikurs as an outstanding diagnostician and parent educator, but they believed that his therapeutic technique and style deviated sharply from Adler's original approach. They recommended that students and clinicians rely primarily on Adler's original writings to gain the clearest and deepest understanding of Adlerian theory and practice.



26. Child's Goal

Question from Forum: I observed a child's behaviour the other day but I can't decide what was the goal of the behaviour? I believe Dreikurs suggests that most misbehaviour is performed with a goal of gaining something from an adult, such as power, attention, etc. The other day I observed a seven-year-old in a classroom. Three times in a period, he hit different students and then when they went to tell the teacher, he told them "remember no tattling" and they stopped. He did not know that I ohserved him and no other adult found out about it. What would you suspect is the goal of the misbehaviour? How would you deal with a child like this?
Dr. Stein: I suspect that the goals of his misbehavior might be "to outsmart others" and " to get away with whatever he can." Dreikurs' four goals are useful as an introduction to goal-oriented interpretation of behavior. However, in practice, we must try to capture the unique movements of the individual. (I would not, however, recommend confronting the child with a guess about his goal.)

Before considering an intervention, it would be helpful to know more about this child. Adlerian insight is best achieved by examining a series of movements and looking for the common denominators. Does he do anything else that is disruptive? What is the quality of his intelligence and his class work? What are his assets? Is anything known about his family life? Is he being abused? Depending on the degree of the perceived problem, an intervention by the teacher might be sufficient, or a counselor may need to talk to the child and family.

One useful resource for educators is "Maintaining Sanity in the Classroom," by Grunwald, Dreikurs, & Pepper. Another interesting book that deals more with early delinquent behavior is "Before It's Too Late," by Stanton Samenow.



27. Suicidal Adolescent

Question from Forum: What Adlerian techniques would be the most beneficial when counselling a suicidal pre-adolescent? And how receptive are youth to Adler's Socratic questioning?
Dr. Stein: Adlerian counseling does not focus on symptoms, but on the style of life and goal of the individual. (Our job is not to merely blow away smoke, but to put our the fire.) Consequently, we do not generally have recommended “techniques” for dealing with suicidal clients. We try to find out what problem or goal might be causing the symptom. We also consider the impact of the symptom on family members. Is this impact valuable to the client?

Socratic questioning can work effectively with anyone of normal intelligence, regardless of age. Young children respond quite well to this approach. They like the experience of a very diplomatic adult approaching them with a feeling of equality and respect for their intelligence.



28. Treatment of Sexual Offenders

Question from Forum: Adler views sexual offenders as lacking social interest and tending towards a pampered lifestyle. I have been working with offenders for a number of years from an Adlerian perspective and have come to believe that whether a sex offender reoffends or not is directly related to social interest. However, because of the danger they represent to society they are often treated as undesirables and unredeemable. I believe this kind of hopelessness discourages social interest. I have advocated both a clear set of boundaries in conjunction with emotional honesty and compassion. Any ideas about how to encourage social interest and promote a sense of social equality while protecting the society from sexual aggression?

I'm doing a presentation on social equality and the treatment of sex offenders at NASAP this Spring and would like some dialogue on the subject, I am interested both in balancing the therapeutic need for the sex offender to enter into a social world of mutual respect and connectedness while at the same time recognizing the potential dangers.

I also am interested in looking at the issue of social embededness as it relates to the whole issue of why some people cross sexual boundaries in our society and others don't. I am concerned that as our culture becomes less personally connected that social interest while decline and sex offending will increase. Does that make sense? Let me know your thoughts on this subject.

Dr. Stein: Encouraging social interest and promoting a sense of social equality are certainly parts of a general treament strategy for rehabilitating sexual offenders. However, unless the style of life is actually "dissolved" there is still the risk of repeated offending. See the Stages of Psychotherapy section of "Classical Adlerian Theory and Practice" at http://www.Adlerian.us/theoprac.htm for an overview of therapeutic stages and strategies. From an Adlerian perspective, the best way to fully protect society from any individual's acts of aggression, exploitation, or destruction is to change that individual's fictional final goal of dominance, superiority, and revenge. This may take more time and skill than is actually available.

Our culture seems to be drifting toward people becoming "less personally connected." This can certainly contribute to an increase in sexual offending as well as other forms of exploitation. Another factor that may be influential is the uncertainty of sexual roles. In periods of transition, from the dominance of one sex, to equality, or to the dominance of the other sex, many people become insecure and confused about their sexual role. The experience of "social embeddedness" may become more difficult to attain, especially if one is simply trying to figure out, and then fit into, the shifting social expectations.

If a psychologically rooted "feeling of equality" is not promoted in a culture, it is possible, over long periods of time, for norms to alternate between male and female dominance, passing briefly through periods of "superficial social equality."



29. Use of Early Recollections

Question from Forum: I don't know if it would be possible, but I think many people (including myself) would find it interesting to have additional information regarding Early Recollections (ER) and their use as a projective technique.

Would it be possible to reprint Mosak's article from "On Purpose" pg 60-75 - at your website? I haven't read it but came across the reference and would be very interested in seeing the complete piece.

What are your own feelings about the use of ER as a projective technique. Anyone out there have any ER's that are particularly interesting that they want to share?

Dr. Stein: An eloquent and concise statement about the value of earliest recollections, is provided by Alfred Adler:

"When rightly understood in relation to the rest of an individual's life, his early recollections are found always to have a bearing on the central interests of that person's life. Early recollections give us hints and clues which are most valuable to follow when attempting the task of finding the direction of a person's striving. They are most helpful in revealing what one regards as values to be aimed for and what one senses as dangers to be avoided. They help us to see the kind of world which a particular person feels he is living in, and the early ways he found of meeting that world. They illuminate the origins of the style of life. The basic attitudes which have guided an individual throughout his life and which prevail, likewise, in his present situation, are reflected in those fragments which he has selected to epitomize his feeling about life, and to cherish in his memory as reminders. He has preserved these as his early recollections." (From "Significance of Earliest Recollections," International Journal of Individual Psychology, (1937) Vol. 3.

I plan to post some additional information about early recollections, on the AAISF web site, in the near future. The book you mentioned, "On Purpose," is protected by copyright and may be ordered from a bookstore.

Earliest recollections provide an elegant projective tool for gaining useful therapeutic insight. When used creatively and diplomatically, they also offer opportunities to promote cognitive, affective, and behavioral change in the middle and later stages of psychotherapy.

I usually elicit both oral and written recollections from a client; even though they may appear similar, some differences are often revealing. When eliciting oral recollections, it is important to notice the client's attitude, expression, posture, gestures, and feeling while giving the memory. Written recollections, embedded in a comprehensive questionnaire, may suggest clues from handwriting, spelling, grammar, word choice, and punctuation.

Interpreting earliest recollections accurately, requires the context of comprehensive case information. See "Suggestions for Presenting or Discussing a Case" at http://www.Adlerian.us/pres-cas.htm . Guesses about the meaning of recollections should be checked carefully against the background of the presenting problem and all available case information.

Posting and discussing clients' or personal recollections on this public forum, although potentially interesting, does not seem appropriate. Not only is there a confidentiality issue, but there is always the possibility that forum comments about the recollections might be uncomfortable or even painful for that individual to read.

Interpreting earliest recollections, as well as the style of life, is a fine art. In addition to the skills of analysis and synthesis, it requires a sensitivity to images, metaphors, and the nuances of feelings. Some of my students have found it initially helpful to structure their case study work according to the stages of the creative process, as well as the discipline of qualitative analysis. (See the course outline for "Case Analysis and Treatment Planning" at http://www.Adlerian.us/dt301.htm .)



30. Stages of Therapy Matrix

Question from Forum: Regarding your matrix: Stages of Classical Adlerian Psycholtherapy All-in-all, great! I look forward to your homepage's additions... What follows are some thoughts that your matrix generated: The perspective that you use in the matrix, is that of the therapist (or an objective third party). What would the stages be from the counselee's point of view? In-other-words, what are THE STAGES OF ADLERIAN CLASSICAL PSYCHOTHERAPY that I (as a counselee) pass through? I've tried looking at your matrix from this perspective, but -alas- in some cases, it just doesn't work. Any thoughts on this? Also, where does "Client Education" fit? I imagine that it is important to teach the client the concept of Life Style. Enrolling him/her in the concept would certainly be part of the Insight Stage. Correct?
Dr. Stein: For a clarification of the purpose of the matrix, please read "The Stages of Psychotherapy" section of Classical Adlerian Theory and Practice at http://www.Adlerian.us/theoprac.htm . (A segment is quoted below.)

For teaching purposes, Adlerian psychotherapy can be divided into twelve stages, and within each stage, cognitive, affective, and behavioral changes are gradually promoted. ...... The stages reflect progressive strategies for awakening a client's underdeveloped feeling of community. What we must remember, however, is that the actual therapy is very spontaneous and creative and cannot be systematized into steps to which we rigidly adhere. Empathy and encouragement, although emphasized at certain points, are present in every stage of effective psychotherapy.

Clients do not generally experience distinct "stages." They gradually gain courage to do what they have been avoiding in their lives. As they conquer old obstables and experience new successes, their feelings of competence, pride, and gratification increase. The better feeling of self can then be extended to making more reciprocal and satisfying contact with others. (Insight about the inferiority feeling, style of life, and goal can be unfolded gradually at this time.) As clients progressively correct their style of life mistakes and begin to function more fully in life, their growing feeling of interconnectedness leads to greater cooperation and contribution. The most dramatic experience for some clients is usually at the Goal Redirection Stage (after minimizing or dissolving the style of life) when a new psychological horizon opens up--as their view of the world changes.

In the Classical Adlerian approach, we do not usually teach clients about the concept of life style or any other Adlerian construct. We use these tools as guidelines for our own understanding and landmarks to focus encouragement. Also, we try to express our interpretion of the client's movements and intentions in the simplest way possible, free of any professional jargon. Instead of inserting a stage of "client education," we prefer to lead a client to insight with Socratic questioning, throughout the entire therapeutic process. It sounds like you may have been trained in a more didactic and systematic style of treatment.

If clients express an interest in learning more about Adlerian psychology, we generally suggest that they first read Adler's What Life Could Mean to You; then we discuss their reactions and questions.



31. Self Esteem in Teens

Question from Forum: I am a grad student in Counseling looking for specific measurable objectives for a counseling model. The population is 11-13 year old male students having low self esteem. I am looking for a goal, and specific objectives to reach that goal. For each objective, I am also looking for specific strategies to attain the desired goal. Any and all help will be appreciated.
Dr. Stein: The main goals, in Adlerian interventions are:
•reducing the feeling of inferiority
•re-directing the striving for significance
•increasing the feeling of community
Because Adlerian treatment addresses the uniqueness of the individual, any objectives and strategies would be created to fit the specific style of life of each client, not an age, gender, or symptom group. We do not generally focus on a symptom, like "low self esteem," but rather on the hidden fictional final goal that is the root cause of the symptom. We prefer to "put out the fire" instead of "blowing away smoke."

The "measurement" of Adlerian personality constructs, and their change in treatment, is best achieved with artistic empathy rather than quantitative scales.

If you would like to gain an overview of Adlerian psychology, read Classical Adlerian Theory and Practice, at http://www.themall.net/~adler/theoprac.htm . Also look at the first six stages of Stages of Classical Adlerian Psychotherapy, at http://www.themall.net/~adler/stages2.htm . If, after reading this material, you have other questions, you may return to this forum and post them.

It is possible that you will find more of what you are looking for in behavioral approaches.



32. Treating Symptoms

Question from Forum: I have been thinking about the issue of "treating symptoms" and am confused. Isn't it "disrespectful" to ignore a client's request for help with their symptoms? For example, I was recently reffered, a 68 year old woman for treatment for panic and anxiety symptoms. She was particularly concerned that her symptoms signaled some horrible illness. However, as she was incapcitated by theses symptoms she could not have a doctor examine her. For the first three sessions I accepted her claim of the importance of her symptoms. We collaborated on hte design of several cognitive behavioral techniques which she tried and reported no success. Her experimentation with the techniques and our growing relationship (I did not insist that she carry out assignments I would only agree that this technique was not for her.) Soon she began to tell me what was immediately bothering her - her relationship with her daughters. After a sessio or two of exploring this matter she agreed that she needed to experiment with new ways of relating to her daughters. When this issue developed momentum she herself had the insight that her symptoms evolved due to the brutalizing she received from her first husband. Her anxiety grew as she tried to protect her daughters from his brutality. When her daughters left she continued to need to protect them and they rejected her "overprotections." Her still needing the symptoms allows us to continue exploring why she uses the symptom that she has chosen while honoring her self-selected goals.

It seems that if I honor the patient initial request to treat their symptom, I demonstrate the flexibility, collaboration, problem solving and effort the client will need to meet life's challenges. I understand the idea that it is better to "put out the fire" rather than "blow the smoke away", but don't you first have to "see where the fire is ?" My "behaviorist-within" reminds me of the power of shaping procedures (helping a person to gradually and systematically reach their goals).

Dr. Stein: We do not ignore the client's request for help with symptoms. First, however, we should determine if the symptom has an organic cause, by suggesting a medical checkup. (For example, anxiety may be related to a thyroid problem.) We can then proceed to check for a psychological influence. After responding empathically to the clients distress, we usually try to find out the genesis of their symptoms: when they started, and what was happening at the time. Generally, symptoms begin when an individual is not prepared to meet a life task, and begins to feel the shock of his anticipated failure. Sensitive or inferior may organs reflect the increased psychological vibration of acute or chronic negative feelings and emotions. Often, we can trace the prototype of an adult's symptoms back to childhood (i.e., the use of crying to secure attention and service).

Clients are often ambivalent about giving up their symptoms. On one hand, they may be suffering more intensely compared to a previously tolerable level of distress (the benefits of the symptom are no longer worth the price); on the other hand, if they give up the symptomn entirely, they may feel obligated to face a challenge that the are not prepared to meet. The trap, for the therapist, could be focusing on managing or reducing the symptom to the exclusion of addressing the challenging task or responsibility. It is not too difficult for a client to declare war with two sides of himself, wage a heroic "side-show" battle with a symptom that he has created, and emerge an exhausted warrior who has no energy left for the events in the main arena of life (work, love, friendship).

Alfred Adler expressed the purpose of symptoms succinctly:

The neurotic symptom has to fulfil three very important functions: It has to serve as an alibi for failing to accomplish what would bring about the craved triumph. It makes it possible to postpone decisions. It permits greater expectation of appreciation for smaller achievements, as these had to be worked against the impediment of suffering.

Lydia Sicher also offered useful insights:

The moment that an individual approaches his problems with the feeling that, "If it were not for my symptom I could do this or that," the purpose of the symptom is quite evident. The symptom itself may affect the body (functional neuroses) and lead through chronic abuse of the organ to real diseases. Or it can lie in the field of thinking, expressing itself in doubts, scruples, fears (obsessions), in the realm of feeling with emotional outbreaks in anger, self-pity, despair, (moods). Or it can be in the sphere of action as raptus, fugues, rituals (compulsions).

Whatever the symptom, it always proves that there is fire burning under the surface of which the visible smoke is the symptom. The problem that the individual fears to face can often be unveiled with the question, "What would you do, if you did not suffer from this trouble?" The answer mostly indicates which situation in the individual's life is menacing his self esteem, or at least so in his own estimation.

If the individual would produce his symptoms voluntarily, he would not be neurotic but a swindler. But he does not know about the deep inner fight that is going on within himself although the faulty attitudes are constantly trained in apperception, dreams, memories.

A cure of the symptom alone without the treatment of the whole person will be necessarily unsatisfactory and mostly bring relief for some time only.

Medication can sometimes reduce a disabling symptom sufficiently for therapy to proceed; however, it may also mask a problem and reduce the incentive to discover and dissolve the root of the problem. Reducing the client's distress is often a priority, but some level of that distress can be used to promote a change in behavior and attitude. We must also consider the negative impact of the client's behavior on others.

Unless the therapist eventually perceives the purpose of the symptom, the reduction of one symptom may lead to the creation of another one. (Adler suggested that either manic or depressive behavior could be used for the same purpose of annoying people.) I had one client who studied psychology texts and developed a remarkable sequence of symptoms. He was intent on proving that no therapist would be able to cure him. (He had already "defeated" several therapists.) As soon as one symptom seemed to subside, a new one would emerge. When I told him that I didn't think that I could do anything about his symptoms, but that I could teach him some new ones, he looked quite surpised and started laughing.



Comment: If I understand the idea: The symptom may be a clue that is important in its own right. It is the context or meaning the person give to the symptom that is most important. The symptom is not what drove the person to treatment (even though they suffer from it). What dives the person to treatment is their difficulty with social reality and its requirements and demands. The symptom could be a "creative fiction" to mask the conflict with social reality. It is the non-acceptance of social reality that leads the person to create a mistaken style of living. When the person begins to understand the purpose of their ficitional goal they can begin to re-adjust their course.
Dr. Stein: You're basically on the right track, but let me add some clarifications. The client does not actually give meaning to a symptom in a conscious, cognitive sense; the meaning is implied in the purpose of the symtom, which is conveniently kept out of consciousness. What drives a client into therapy may be a felt difficulty with a life task, but it may also be the intolerable discomfort of the symptom, or even the pressure of a family member. Understanding one's fictional final goal, is not enough to influence a person to readjust his direction in life. We must also reduce his inferiority feeling, build his courage and confidence, increase his feeling of community, and help him conclude (through Socratic questioning) that a new direction would lead to a happier life. It is difficult to convince a person to give up his symptoms, if there are too many perceieved benefits that are achieved at modest emotional or physical cost.

Significant change takes more than insight; it requires intellectual, emotional, and social risk-taking experiments that slowly build a climate of persistent, creative problem-solving that leads to new successes.



33. Treating Trauma

Question from Forum: I am a practicing cognitive therapist (now an Adlerian oriented cognitive therapist). In a recent list of cogntiive therapists there is a discussion about the treatment of trauma victims using techniques such as prolonged exposure, EMDR and cognitive processing therapy. The focus of each of these modalities is to have the person re-experience the traumatic memories under safe (and guided) conditions. By the therapist taking on the role of "avoidance buster" it is assumed that the traumatic memory will lose its "sting" and the person can integrate the traumatic expereince and move on. Of course, as with the cognitive model in general, there are numerous studies supporting this approach. My problem with the approach is that the implementation of these procedures would require a client who is extraordinarily courageous or depserate for relief. I am not saying that these procedures are ineffective but that they are not likely to be beneficial for all clients. I am not so sure they are for all therapists (even when suitably trained) either.

My question is how would a classical Adlerian approach someone who has been tramuatized and has become incapacitated from their recollections of the experience?

Dr. Stein: In Classical Adlerian treatment of an "incapacity due to trauma", an important factor to consider would be the style of life that was established before the trauma took place. How the individual experiences, digests, and deals with the painful event, is strongly influenced by his preexisting fictional final goal. Knowledge of this mental structure, would offer the therapist a clue regarding the tendency of that client to cooperate with treatment, or exploit the "trauma" as an excuse for avoiding a challenge that would "threaten" the fictional goal.

If the therapist is able to offer deep empathy and understanding that invites the client to share the burden of the remembered experience, a full, cathartic, emotional expression may be elicited. Healing can gradually take place by exploring alternative, imagined scenarios of justice, forgiveness, or other "resolutions" that might provide closure for the client. If the client genuinely wants to overcome the chronic, painful, and disabling recollections, and return to normal functioning, he would need to cooperate with the therapist by intellectually and emotionally accepting one of the co-invented resolutions.

A client who has been exploiting a trauma for attention, sympathy, support, or as an excuse for avoiding responsibility, may resist any therapeutic intervention, and feel a secret victory over that therapist's inability to diminish their continuing anguish.

Some of the best clues to the style of life (that existed prior to the trauma) are usually embedded in the client's earliest childhood recollections. The issue of courage is intimately connected to the vision of the world that is represented in those memories. If a client has a devastating, negative world view, one that would take a heroic degree of courage to survive, we probably would have to alter that client's world view in order to generate a normal level of courage for daily living.







34. Treating Addiction

Question from Forum: I'm looking for ideas on the Adlerian approach to treating addiction. My understanding of Adlerian psychology is that the key to treatment can be found in the "life style" developed in the first few years of life.

Is it likely therefore that this will also hold the key to treating addiction? Would an Adlerian approach consider it possible that the addiction might be compensating for something lacking from the early life style?

My interest is whether addiction can be treated in the same fundamental way as other experiences, eg. trauma.

Dr. Stein: You are quite correct that the key to the Adlerian treatment of all disorders is found in an understanding of the "style of life" of the individual (his way of dealing with the challenges of life) that was originally formed in early childhood.

In this respect, the psychotherapeutic treatment of addiction is similar to the treatment of trauma and most symptoms. However, in order to evaluate the severity of an addiction and provide for a reliable strategy for control of a substance, I generally refer clients first to a physician (if needed) for a check of metabolic or digestive disorders, and then to an Adlerian chemical abuse specialist for an initial consultation and review of resources. Then I discuss the options with the client, explaining that psychotherapy can only be effective if he is willing to take steps to stop the use of the substance. Frequently, regular participation in AA can provide the structure and support that some clients need to stop the substance abuse. Sometimes, an in-patient hospital program is the first step in recovery.

Many people suffering from addiction feel a vague sense of emptiness that can be traced back to an absence of the feeling of belonging in early childhood. Instead of facing and conquering this painful feeling of having been neglected, rejected, or abused, they have found relief in intoxication and illusion. Others have been pampered so outrageously as children, that they cannot tolerate struggling with normal difficulties, or the frustration of their self-indulgent demands. Although, mistakes may have been made by their parents, they too may have responded with a mistaken attitude toward life that has never been corrected.

Insight into a client's hidden, personal ideal (fictional final goal) is essential for a permanent solution. Unless an overblown ideal is discovered and dissolved, there will always be a temptation to intoxicate oneself with fantasy, an activity that is easily facilitated by substance abuse. The deep inferiority that many addicts feel or fear is caused by the great distance they experience from a impossible high goal of personal superiority. Other people are often seen as obstacles or enemies, and the real, normal challenges of life are viewed as threatening tests, interruptions of personal fun and pleasure, or distractions from personal glory. Within this perspective of life, withdrawing and "getting high" can be very seductive, and the addiction can be used as a persuasive excuse for avoiding reponsibility.

For some clients, a series of "missing developmental experiences" must be offered to fill the emotional emptiness that they feel (see http://www.themall.net/~adler/stages2.htm ). Eventually, in treatment, the client's neglected responsibilities, as well as the impact of the addiction on others, have to be faced. The most effective therapeutic solution for any client's disorder is the development of "the feeling of community"-- recognizing and accepting the encouragement of those who are currently willing and able to help, and then becoming a person who helps others.



Comment: I recognise and accept the processes you have described in treating addiction where addiction involves substance or alcohol abuse.

I am interested however in whether the problem of obesity in the Western world could be considered to a large part as addiction to food and whether there are any lessons which might be learnt from treatment of other addictions. I am obviously assuming here that we are not dealing with obesity as a result of specific medical problems. I wonder if it could be true to say that overeating in many cases is an attempt to fill a sense of emptiness, similar to that experienced by other additions, where the client has attempted to replace an emotional emptiness with a perceived physical emptiness. It is generally recognised that there is a "comfort" factor attained from certain foods which seems to lend credance to my theory.

Adlerian counselling seems to me to be a good discipline for this firstly because it deals with the whole individual and his relation to the "community" and secondly it works not through blame but primarily through encouragement.

Whilst I accept that the most effective therapeutic solution for any disorder is the sense of "feeling of community" - of accepting the encouragement of others and then becoming a person who helps others, I must say that I don’t think this can be achieved before a person has a concrete sense of "self" and acceptance of "self".

Dr. Stein: Overeating may have other "symbolic" value besides "replacing an emotional emptiness." The "comfort" factor may be primary in many cases, but I can recall a case where eating an abundance of sweets represented a compensation for the bitterness of life that was deeply felt. In another case, a child who was eating massive amounts of food, believed that it would help him grow up faster and catch up in size with his older brother. I would always look for the individual, unique root of an unusual eating habit.

Developing a "concrete sense of self" and an "acceptance of self" is indeed a prerequisite to increasing the feeling of community. In order to achieve this, the push of the inferiority feeling and the pull of the fictional final goal must be progressively diminished. A genuine sense of self is discovered after the artificial role, dictated by the style of life and fictional goal (designed to relieve a dreaded fear of inferiority) is dissolved.

An examination of the stages of Classical Adlerian psychotherapy can clarify the sequence of strategies that lead up to the development of a feeling of community.



35. Software for Case Analysis

Question from Forum: I came across your posting to the BOL Computing Group in which you stated: P<> "To help students visualize the totality of Classical Adlerian theory and practice, as a preparation for the rigors of case analysis, I have experimented with "mind-mapping" programs like Visimap and the Axon Idea Processor."

I am very excited about the uses of "mind mapping", and have played around with both Visimap and the Axion Idea Processor. Could you go into a little more detail as to the various ways that you have used these programs to"prepare them for the rigors of case analysis."?

Dr. Stein: I have explored the use of several "mind mapping," "concept mapping," and "flow-charting" software programs, to gain a graphic perspective on the inter- relationship of Adler's theoretical constructs. With these programs, I have experimented with some preliminary charts that I plan to offer to my students so that they may be used as "road maps" of the Adlerian terrain. These graphic guides will serve as general, global reminders of "the totality" of Adlerian theory, philosophy, and practice.

The discipline of case analysis requires a somewhat different set of tools. I tried using mindmaps to facilitate the process, but found their structure too confining and awkward at the early stages of organization, guessing, and analysis.

In the organization phase of case analysis, the information that I get from clients, which normally includes a comprehensive history (both oral and written), is initially transferred to a sophisticated outliner, Ecco Professional. This program permits not only a chronological order of client supplied information and therapists's notes, but a re-grouping of information into categories. I also use ABC Flowcharter to create a dynamic, multi- generational Genogram that organizes a condensation of the client's impressions of self, family members, and significant people.

In the analysis phase, using Ecco, a matrix is constructed adjacent to the outline, providing a space to record comments, guesses about dynamics, and questions to be pursued. This matrix structure challenges the student and clinician to come up with guesses about various theoretical constructs. (This approach is similar to the strategies used in qualitative analysis.)

In the synthesis phase, the matrix of categories, comments, and guesses is studied for patterns and progressively higher order principles of the individual's "law of movement." At this point, I generally print out the outline/matrix and work with colored pens marking connections and patterns, Feelings and images that arise spontaneously are also recorded since frequently offer valuable clues to finding the "totality" of a case. Eventually, the task is to boil down all of the impressions into a few core guidelines: the client's unique inferiority feeling(s), style of life, compensatory fictional goal, antithetical scheme of apperception, and private logic.

Having achieved this diagnostic result, the dynamics may be illustrated graphically for convenience and teaching. A mindmap may serve this purpose, but other, more flexible graphic forms are often better. (Axon and ABC Flowcharter offer this variety.) A fascinating program that creates circular, hierarchical, symmetric, and orthogonal layouts is the Graph Layout Toolkit-- however, it is only available to programmers.

Recently, I have been experimenting with Atlas-ti, a program that was designed for research in qualitative analysis. (It facilitates the processes of data collection, reduction, display, and conclusion drawing.) One advantage of the program is the automatic generation of a graphic network that illustrates the connections between text segments, codes, memos, and comments.

Although the process of case analysis can become very intuititve after many years of training and practice, the path to gaining that expertise can be enhanced with the use of some excellent computer programs that facilitate the organization, analysis, and synthesis of case material.

For more information about the use of computer programs in case analysis, see the AAISF distance training course, "Case Analysis and Treatment Planning," at http://www.Adlerian.us/dt301.htm .



36. Genetics

Question from Forum: Im a senior in highschool taking physcology, and I wonder if Behavioral genetics is external or internal, or even both? Im confused about the subject. I believe physical characterisics come from genetics but behavior comes from who you are around most of your life. Like family and friends.
Dr. Stein: Please read an article titled Classical Adlerian Theory and Practice at http://www.Adlerian.us/theoprac.htm . The section on "Development of Personality" explains the early influences on the style of life, including organ inferiority and family dynamics. After reading the material, if you have any additional questions, post them on this forum.



37. Group Techniques

Question from Forum: What are some of the recommended resources regarding the use of Adlerian concepts and techniques in group counseling environments? Are there any specific techniques that are especially usefull with groups?
Dr. Stein: For a recent innovation in Adlerian group treatment, check Providing the “Missing Developmental Experience in Classical Adlerian Psychotherapy at http://www.Adlerian.us/provid.htm . The role-playing technique is generally conducted in an all-day (6-9 hour) marathon group.

A BIBLIOGRAPHY FOR ADLERIAN PSYCHOLOGY, by Harold and Birdie Mosak, contains about 15 references (to articles and books) about "group counseling" and about 80 references to "group psychotherapy."

PSYCHODRAMA: REHEARSAL FOR LIVING, by Adeline Starr, has an Adlerian flavor.



38. Treatment of OCD

Question from Forum: Recently I have found myself with several OCD clients. I have usually used an approach of support and acceptance, followed by reframing of thoughts, education about Sympathetic Nervous System issues, and training in body awareness and control. I would like to have some feedback about how experienced Adlerians treat OCD. I suspect there are some ideas and perspectives I need to add to my collection.
Dr. Stein: A Classical Adlerian psychotherapist does not focus primarily on the control of obsessive-compulsive symptoms, but on the unique individual who may be using those symptoms (or any other symptoms) in the service of a fictional final goal. Consequently, we would expect such symptoms (or even newly created symptoms) to persist until the individual gains sufficient insight and courage to pursue a new direction in life. Many hidden goals are impossible to achieve in the "main arenas" of life, provoking the bearers into imaginary "secondary arenas." Obsessive-compulsive behavior can provide relief from the perceived failure to succeed, as well as an excuse for avoiding a task that does not fit the hidden goal.

As long as the hidden goal and style of life (means of getting there) are not changed, there is a strong probability, that fighting symptoms will eat up a considerable amount of therapeutic time. Retaining the symptom, can even be used to gain an imagined victory over the therapist. It is also fascinating to look at the social impact of symptoms and see who is most affected. If symptoms change, it is frequently because the new one can be used as a more effective weapon in a conflict.

For additional information about Adler's view of compulsive behavior, read chapters 10 and 12 in The Individual Psychology of Alfred Adler, and chapters 7 and 10 in Superiority and Social Interest, edited by Heinz and Rowena Ansbacher. Also, read Classical Adlerian Theory and Practice at http://www.Adlerian.us/theoprac.htm and Stages of Classical Adlerian Psychotherapy at http://www.Adlerian.us/stages2.htm for an overview of the Classical Adlerian therapeutic process.



39. Repetition Compulsion

Question from Forum: Would you please address the theory of Repitition Compulsion as it is understood using an Adlerian perspective?
Dr. Stein: The Adlerian view of a symptom is mainly focused on the purpose that it serves the individual. If two people perform a similar repetition compulsion, each may give it different meaning, and use it for a somewhat different, specific end (mentally, emotionally, or behaviorally). However, the common denominator may be an avoidance of some external demand or expectation.

In Obssession as a Means for the Enhancement of Self- esteem,(1913) Adler states: "In a general way I might claim that in every compulsion-neurotic there inheres the function of withdrawing from external compulsion, so that he may obey only his own compulsion. In other words, the compulsion-neurotic struggles so definitely against the will of another and against every foreign influence, that, in his fight against these, he comes to the point of positing his own will as sacred and irresistible."

In New Principles for the Practice of Individual Psychology,(1913) he comments: "Thus the neurosis and the psyche represent an attempt to free oneself from all the constraints of the community by establishing a counter-compulsion. This latter is so constituted that it effectively faces the peculiar nature of the surroundings and their demands. Both of these convincing inferences can be drawn from the manner in which this counter-compulsion manifests itself and from the neuroses selected.

..... The counter-compulsion takes on the nature of a revolt, gathers its material either from favorable affective experiences or from observations. It permits thoughts and affects to become preoccupied either with the above-mentioned stirrings or with unimportant details, as long as they at least serve the purpose of directing the eye and the attention of the patient away from his life-problems. In this manner, depending upon the needs of the situation, he prepares anxiety-and compulsion-situations, sleeplessness, swooning, perversions, hallucinations, slightly pathological affects, neurasthenic and hypochondriacal complexes and psychotic pictures of his actual condition, all of which are to serve him as excuses."

Lydia Sicher, in The Collected Works of Lydia Sicher: An Adlerian Perspective, writes: "No two people have the same compulsion, even if they feel compelled to perform the same ritual. Nothing is so intimate a property of a person as his outlook on life. This makes the problem 'individual' so fascinating and intriguing because there is no formula for the understanding the one from knowing the other. Only the world as a whole can serve as a starting point for the unravelling of a neurotic personality."

I recall a case where a very disturbed young man would line up the contents of his pockets on the floor, in various patterns, before he would talk to the therapist. He did this to minimize the influence of the other person.



40. Mass Psychology

Question from Forum: I'm asking for help ! I'm actually writing about a French historian, Jean-Baptiste Duroselle who seems to be influenced by Alfred Adler. Duroselle contends that even a people, for instance the French people during the French Revolution 1789, aspires to exert power on the condition it is frustrated. I do not believe that this historical hypothesis stems originally from Adler's theories. In my opinion Duroselle transformed Adler's idea so that it fits into his personal theory of International Relations. But looking for confirmation by a specialist I ask the following Question from Forum: does Adler imply that a whole people - and not only individual beings - being frustrated by social or economic circumstances may try to impose its will on other peoples ?
Dr. Stein: Does Duroselle actually quote or make reference to Adler?

When many people seem to be moving in a similar direction, and act in a similar manner, it is possible that they each have a similar style of life that responds in parallel fashion to common circumstances. Political, philosophical, and religious movements, often mobilized by charismatic, articulate leaders, provide groups of people with the opportunities and reinforcements, on a large scale, for what they had already been doing on a small scale (since childhood). Alice Miller, in For Your Own Good, offers a compelling illumination of this dynamic.

In "Mass Psychology," (International Journal of Individual Psychology, 1937, Volume 3,) Alfred Adler discusses the interplay between mass movements and the style of life of individuals within those movements. He makes reference to: implict agreements about "the meaning of life;" individuals responding to econominc and political conditions according to their "previously acquired style of life;" adults pampered in childhood often seeking leaders to assume all responsibility; and the three hundred year history of witch-burning as a mass effort to force women into a subordinate position.

Adler also offers opinions about significant personalities in the French Revolution, in "Danton, Marat, Robespierre: a Character Study," Arbeiter-Zeitung (Vienna, 1923). Regarding Marat, Adler wrote: "His guiding thought was the victory of the poor over the wealthy and powerful. He found common cause with anyone who complained about suppression, injustice, abuses of the rights of others, as well as with anyone who testified against those who betrayed the people. His boundless hatred of the rulers and exploiters knew no limits."

Another reference may be helpful to you. In "Salvaging Mankind by Psychology" (IZIP, volume 3), Adler wrote about how individuals and groups attempt to erase their sense of inferiority, and about mass movements utilizing destructive means to gain release from situations that are felt to be intolerable. Oliver Brachfield, in Inferiority Feelings in the Individual and the Group, may have addressed similar issues.

It is important to note that, in his later writings, Adler de-emphasized the motivational significance of inferiority feelings, and focused instead on the primacy of the striving for significance.



41. Is Adler a Psychoanalyst?

Question from Forum: Why is Adler still referred to as a Psychoanalyst, I know he and other Neo-Freudians are called Psychoanalyst but most of their theories are about the unconscious, Adler on the other hand does not refer to the unconscious. Is he called a Psychoanalyst just because of his connection to Freud or can you give me another reason. I am doing this research for my Clinical Psychology class.
Dr. Stein: Your comments reflect several misconceptions about Alfred Adler appear frequency in college texts, as well as other superficial overviews of the history of psychology.

1) It is a mistake to consider Adler a Psychoanalyst. His view of human nature, theory of personality, and approach to treatment were almost antithetical to Freud's.

2) It is also a mistake to consider him a Neo-Freudian. He was never a student of Freud, nor did he adapt or modify Freudian theory. There is some evidence that Freud modified his later theory to incorporate Adler's ideas. Indeed, many Neo-Freudians today are beginning to lean gradually in the direction of Adler's thinking.

3) Adler does refer to the unconscious, but does not invest it with the same significance or purpose as Freud. Adler considered the unconscious as the "not quite understood." He was quite explicit about the purpose of keeping the fictional final goal in the unconscious -- keeping it out of the spotlight of critical thinking.

I encourage you to read Alfred Adler's writings directly, not the simplifications of his philosophy, theory, and practice that rarely do him justice. Start with What Life Could Mean to You, by Alfred Adler; then read The Individual Psychology of Alfred Adler, edited be Heinz and Rowena Ansbacher. If you would like an in-depth comparison of Freud and Adler, read The Discovery of the Unconscious, by Henri Ellenberger.



42. Step-Families

Question from Forum: I am aware that Adler did not touch on relationships between established families joined by marriage. Specifically, the relationship between step-parent and step-child. Would you be able to apply Adler's theories to conflicts within the "new" family? For example, the step-father will insult anyone to make it clear that he is in control. He feels a need to assert his power over everyone.
Dr. Stein: Adlerian principles for resolving conflict and eliciting cooperation between any family members, can simply be extended to step-parents and step-children. Parental dominance and depreciation are usually rooted in personal insecurities and mistaken ideas of authority and superiority. It is often difficult to convince parents or step-parents to change their dysfunctional parenting style as long as it relieves their own feelings of inferiority. If a therapist can empathically gain their confidence, they might be willing to examine the real consequences of their style, and then explore the potential benefits of a more democratic style.

Adler emphasized a child's preparation for dealing with new, difficult situations. Generally, a pampered, neglected, or abused child will have, and make difficulties, when a family situation changes and step-parents are introduced. However, a cooperative child may be able to deal with a new, even less favorable situation, more successfully. Look at The Education of Children, by Alfred Adler, Chapter 9, "New Situations as a Test of Preparation," and Our Children in a Changing World, by Erwin Wexberg (may be hard to find).

Two other books that might be helpful to read are: Children: The Challenge, by Rudolf Dreikurs and Vicki Soltz, and Your Inner Child of the Past, by Hugh Misseldine. The first deals with the principles of Adlerian child guidance, the second (not explicitly Adlerian) explores the short and long-term consequences of dysfunctional parenting.



43. Spiritiual Assessment

Question from Forum: I'm seeking a non-secular spiritual inventory assessment tool (or questionaire) to be used along with the Life-Style Assessment. The purpose for this spiritual assessment tool is to get a good picture of how clients are meeting Life Task #4, ( "dealing with the spiritual self in reaction to the universe, God, and similar concepts").
Dr. Stein: Although this material does not technically provide a spiritual assessment tool, it may be of some value. The following passages are from an unpublished manuscript, Principles of Individual Psychology, by Alexander Mueller.

(Quoting Mueller) .....Here we must emphasize a primary function of the human consciousness. The consciousness entails the ability to reflect, to question, and to search for answers. Man is not only capable of thinking, but he also has the need to ask questions and to seek answers to how he can master a given situation, and then conduct himself under certain conditions.

When faced by things, creatures, or a situation, man above all will ask the Question from Forum: how and what is that? This is only the beginning of questions. The correct questioning is a process that can be suppressed, but there is a tendency to take the following steps:

What and how is that?
Does it have to be so?
Can it be otherwise?
Should it be otherwise?
How should it be?
What can I do?

Beginning with the second, every following question contains something special. Man is capable of not accepting facts, the world as it is. He can test the possible or the necessity to change the given situation, that is, he can look at the given as a challenge. To question oneself and given circumstances and to want to make changes is a characteristic of the human being.

The ways and means by which a person lives his life is key to whether his search for its essence is self-centered, or for mainly an intellectual discourse with the world and with himself.

In responding to the Question from Forum: "How should it be?" he makes a significant decision. His response can be: the world should be fashioned so that we can live in it well; or: the world should be, and become, as it should be. The second response expresses something significantly new. The world is not only for me, for us, but also for itself. All living matter have not only meaning relative to us, they have within them a sense and purpose for their existence. It should become as it should be. With that response I can still mean my wellbeing, but also that of the world as well. In the latter, the assumption is included that the world originally had meaning and served not only human purposes.

The world is unfinished and incomplete. It is for man to continue to shape and complete it. How it is to be formed, and what is to become of it is something man himself has to find out while constantly in danger of going astray. He can always approach more closely the deeper purpose of the world, or he can spoil it. Man can ask the questions that have been presented of the world, of other forms of life, of his own situation and of events; he can ask them with reference to himself. .....

For more information about Mueller, visit our web site at http://www.Adlerian.us and follow the "To Read" link.



44. Negative Attitudes in Customer Service

Question from Forum: I am writing a series of articles on customer service and have no explanation for the rampant phenomena of the "No People".

I read several of your responses and found one, in particluar, to hit the nail on the head!

"When adequately developed, ... leads to an attitude of cooperative interdepency and a desire to contribute."

Why is this feeling of community and connectedness missing in so many people?

The "No People" are those clerks, customer service reps, salespeople, secretaries, etc. who are intent on answering every question with a "No." The best customer service training programs are ineffective given the proclivity of so many people to want to say, "No" instead of "Yes."

So, I have started researching the behavioral side of this phenomena. I am an absolute neophyte but in my prelimary research have 'stumbled' upon quotes and articles from Adler and students. I have thought it was some kind of power and control issue. But why can't the power and control be positive instead of always negative?

Has he ever addressed this issue?

Situation:

I call UPS to track a package. I've seen all the great TV ads about package tracking. The customer service agent on the phone immediately tells me why my particular package can't be tracked. I ask to speak to a supervisor. UPS's supervisors are called Universal Agents. My package is Earthbound only but I speak with the UA anyway.

The Universal Agent easily tracks my package. Why did the customer service agent tell me no? What was his gain? Why couldn't he experience his 'power' through the successful resolution of my problem?

Everyday, I and the rest of the America experience these same reactions. The knee-jerk no response. Is there a behavioral reason?

Any comment, suggested reading, etc. would be greatly appreciated.

Dr. Stein: The feeling of community is very weak or missing in many people because it was either never sufficiently modeled or encouraged by their parents, or never consciously developed, as a desired personality trait, by them as adults. Early parental neglect, rejection, abuse, domination, coercion, and perfection inhibit the feeling of connection and community in children. However, an equally damaging culprit that hampers the feeling of community in children is parental pampering.

The eventual results of early childhood pampering or neglect are often quite similar. As adults, victims of any of the parental mistakes mentioned above may become self-pampering and choose either passively expectant or actively demanding attitudes toward others. In either case, the level of feeling of community is very low or quite superficial and conditional. They can be pleasant to those who indulge them or give in to their demands; however, they can become uncooperative or negative to anyone who asks them to help or do their fair share of work. (Adler stated that every pampered child eventually becomes a hated child.)

One can imagine a self-pampering adult who resentfully has to work for a living, stuck in a job where he has to "serve the needs " of customers. As someone who is unfamiliar with "giving" and addicted to "taking", he can easily be tempted to answer "no" to any request that requires extra effort.

Children frequently discover the feeling of power that comes from denying any adult what they want. (It is seductive to use negativity as a self-indulgent substitute for the more difficult path of building social competence.) Many adults carry this negative power of "no" into relationships and work. Social reality sets limits on how far they can go without paying a price, so they often push this strategy of refusal just up to the brink of suffering major consequences.

The desire to say "no" can develop into a complex or style of life. (Adler refers to the "no complex" in Superiority and Social Interest, and the neurotic distancing and self-elevating purposes of "no" in The Neurotic Constitution.) Usually, the individual is not fully conscious of this tendency (yet everyone else around him is) and overcoming this style of life generally requires therapeutic insight and patient encouragement.



45. Teleoanalysis

Question from Forum: This WEB is very interestful. If nobody speaks french I would try to explane my question. I try to elaborate the concept of teleo-analyse, which is for myself, a conjonction of orthodox psychoanalysis and the teleological conceptions of the phenomenologists (for instance Husserl or Paul Ricoeur). I remember that Adler described something as "the teleological position". Did he write on teleoanalysis? If it's true what is exactly the meaning of "teleoanalysis" for Adler?
Dr. Stein: Adler 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."

You mention the term "teleoanalyse." Could you tell me more about this approach. I visited your web page but cannot read any of the articles since they are all in French.



46. PTSD and Disassociation

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? Any assistance would be greatly appreciated.
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://www.Adlerian.us/stages2.htm .



47. 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://www.Adlerian.us/demo1.htm .



48. ERs of the Blind

Question from Forum: I am curious about whether anyone knows of any research or if anyone has had clinical experience with collecting early recollections (ERs) from people who have been blind either since birth or from a very young age (i.e. 2-4). Specifically, I am wondering about how the collection of ERs has to be modified for such clients. My understanding is that when collecting the most vivid moment, for example, a question to be asked is, "What one IMAGE stands out the most?" I doubt such a visually-oriented question would have much meaning to someone who does not use vision. So how is this approach used with such clients, then?
Dr. Stein: I am not aware of any research on this topic. In the Classical Adlerian approach, we do not ask for a "vivid moment" or for an "image that stands out." To keep the projective quality as pure as possible, we simply ask for "the earliest recollection." In this way, auditory or other sensory memories can be easily accessed.



49. Dreams

Question from Forum: Looking for references for understanding/using dreams from an Adlerian perspective. Recommendations/pointers?
Dr. Stein: The following excerpt is from a journal article, On the Interpretation of Dreams, by Alfred Adler.

If we are really to discover the purpose of dreams, we must find what purpose is served by forgetting dreams or by not understanding them. This was the most vexing problem before me when I started, some quarter of a century ago, to try to find the meaning of dreams. It occurred to me one day that perhaps the real significance of a dream is that it is not to be understood; perhaps there is a dynamism of the mind working to baffle us. This idea furnished me with the first real clue to an adequate dream interpretation. Searching further, I asked myself, "For what purpose are we "fooling" ourselves?" In answer, another clue then came to me from ordinary social intercourse. We all know people, including ourselves, who purposely speak so as not to be understood for the purpose of concealing the truth, or they speak to themselves in a way which common sense would not allow. Here, then, is a very close analogy to dreams-in fact more than an analogy since it can be shown that they are both the product of the same mental dynamism. It is not in the thoughts that we "fool" ourselves, but in the emotions and feelings aroused by the thoughts and pictures of a dream. The purpose of the dream is achieved by the use of emotion and mood rather than reason and judgement. Reasoning alone could not purposely deceive us. Thoughts may give rise to errors in judgment, but this would be due to inadequate factual data. When our style of life comes into conflict with reality and common sense, we find it necessary, in order to preserve the style, to arouse feelings and emotions by means of the ideas and pictures of a dream which we do not understand.

For additional reading, check:

What Life Could Mean to You, by Alfred Adler, pages 86-106.
Understanding Life, by Alfred Adler, pages 86-99.
Social Interest, by Alfred Adler, pages 178-196.
Individual Psychology of Alfred Adler, edited by Heinz and Rowena Ansbacher, pages 357-365.

For more information about Classical Adlerian psychology, visit the Alfred Adler Institute of San Francisco web site at http://www.Adlerian.us .



50. Stress, Tension, and Motivation

Question from Forum: In the "incessant striving" of an individual towards a goal of superiority is it possible to determine what part tension plays (e.g. is tension or stress necessary to push the person toward his/her goal of superiority or does constant pushing of oneself cause exhaustion and nervousness)?

Also, how does one maintain a balance in life with this constant striving (i.e. not become a "workaholic")?

Dr. Stein: When the striving of an individual is characterized by a "deficiency motivated" sense of inferiority, and is directed toward an over-blown, compensatory superiority over others, there is indeed a chronic, resulting tension. This tension, stress, or anxiety is the gap that he feels between the dreaded (usually hidden)feeling of inferiority and the compulsive demand for an excessive proof of superiority, or a condition of security (one that reality cannot offer). There is a constant "push" from the feeling of inferiority, and a "pull" from the fictional final goal. This is the dilemma of a self-centered style of life that has never been recognized and overcome.

On the other hand, when striving is characterized by "growth motivation," and is no longer pushed by a feeling of deficiency, but guided by a "higher value (see Maslow on self-actualization), there is no longer a painful gap, but a genuine self-acceptance and the gratification of continual improvement. One may gain a "superiority" over one's previous level of functioning, but there is no irrational urge to relieve a feared feeling of inferiority and prove (or imagine) one's superiority over others.

Exhaustion and nervousness may reflect a willingness to sacrifice one's health (as well as the health of others) in the service of a fictional goal that promises relief of inferiority and the "high" of superiority.

A balance in life, between work, love, family, and friendship is best achieved by developing a stronger feeling of community that embraces the well-being of all, including oneself. You can be considerate of and helpful to others, but you also know when to stop, when to rest, and when to ask for help. Taking care of oneself is an essential part of the feeling of community. Self-care should embrace physical, mental, emotional, and spiritual health. Many "workaholics" make generous financial contributions to their families but ignore the impact of their limited family time and pervasive negative feelings.

Achieving a balance in life is related to the kind of person you want to become. If professional or financial success, power, and prestige is primarily driving a person, balance may be superfluous. However, if becoming a fully functioning human being, and helping others do the same, becomes a primary goal, then balance is a logical necessity. Often, the issue of character is overlooked when one is in the grip of burning ambition.

An imbalance may also reflect an unconscious strategy for minimizing or avoiding activities that one is unprepared to engage in, or that do not feed an excessive demand for prestige. Cutting a big deal, or soaking up the admiration of an audience may overshadow the experience of providing understanding and empathy to a spouse or child.

A well-developed feeling of community is the most reliable path to achieving a balanced life. Common sense must be combined with a sensitivity to feeling (one's own and others'), and an openness to feedback from those we have regular contact with.

Daniel Goleman, in his new book Working With Emotional Intelligence, draws some similar conclusions.

For additional information about "the feeling of community" read Classical Adlerian Theory and Practice at http:/www.Adlerian.us/theoprac.htm .



Comment: Thank you very much for your response.

Would you please provide an example which would help me to clarify the differences between "deficiency" and "growth" motivations. Does "growth motivation" make the tasks feel more effortless?

Dr. Stein: The following two examples might help clarifiy the differences between deficiency and growth motivation.

Example of Deficiency Motivation
(Excerpted from the BOL interview w/ Gil Levin)
A man in his mid 40's was referred to me after completing an out-patient alcohol treatment program. He was very frustrated with his career as a criminal investigator, experienced very little intimacy with his wife, and had no friends. Although he conducted extremely thorough investigations that resulted in convictions, sentences rarely included jail time.

His cold and isolated childhood left him very bitter: an unhappy mother; a remote father; and a hell-raising older brother whom he hated, but who was the center of the parents' attention and frequently got away with illegal behavior. By contrast, he was a compliant child who didn't make any trouble, and was ignored.

The felt neglect of his father and lack of love from his mother were at the roots of his inferiority feelings. His life style was catching many "bad guys" and seeing that they were locked up. Since many were not, he was perpetually frustrated. He also viewed his parents and brother as unpunished criminals. His unconscious goal was to secure compensation and revenge for his miserable childhood. Revenge was not working out to his satisfaction, but he did look forward to the compensation of a comfortable retirement, a symbol of what he felt entitled to.

Example of Growth Motivation
A woman who had felt the pain of rejection as a child because of her parents'preference of her prettier and brighter older sister, eventually, through depth psychotherapy, overcame her feelings of inferiority (not as pretty and not as smart). She came to realize that her sense of value could come from her ability to empathize with and help the underdog, instead of wishing that she could outdo her sister in her parents' eyes. As her inferiority feelings diminished, and her feeling of community increased, she began to experience the motivational pull of "seeking justice" (one of the higher values described by Abraham Maslow). She developed a keen sensitivity to the injustice experienced by others, and helped them legally as an attorney. She was no longer driven by a desire to compensate for her childhood distress (deficiency motivation) by pursuing an endless series of "proofs" of her superiority to her sister. Her new direction became a constantly expanding commitment of improving her ability to benefit the lives of other people (growth motivation).

The "effortlessness" that you refer to is a frequent symptom of growth motivation. However, not all tasks, or stages of development can yield this experience. Becoming a skilled Adlerian diagnostician, for example, usually requires many years of struggling to understand the style of life, fictional final goal, inferiority feelings, private logic, and antithetical scheme of apperception of hundreds of cases, under the guidance of an experienced mentor. One has to study the theory deeper and deeper, often experiencing the frustration of not being able to understand what appears to come so effortlessly from one's mentor. Eventually, after you have really mastered the theory, digested the hundreds of case examples, and overcome the limits of your own style of life in a study-analysis, you discover the marvelous feeling of "effortlessness" in uncovering the hidden dynamics of each new case.

For more information about deficiency motivation, growth motivation, and higher values, read The Farther Reaches of Human Nature, by Abraham Maslow.



51. Narcissism and Aggression

For an interesting study on the roots of aggression, read http://www.drkoop.com/healthnews/rhn0723/t072302.asp

Titled, "Narcissists Most Prone to Aggesstion," it begins: "A surprising new study suggests that the psychological profile of an aggressive person may be more likely to include narcissism -- an exaggerated sense of one's superiority -- rather than low self esteem. ...."

Several conclusions are quite conistent with Adler's ideas about aggression resulting from threats to one's fictional goal of superiority.



52. Negative Effects of Praise

Read http://www.drkoop.com/healthnews/rhn0714/t071402.asp for a summary of a report about the effect of praising a child's good grades. The article begins: "Surprising as it sounds, praising children for their ability or intelligence may actually have a negative effect on a child's academic performance, a study suggests. Such praise may make a youngster feel pressured to get good grades or reach certain goals, and may make them less able to cope with failure, according to a report in the Journal of Personality and Social Psychology. Instead, praising a child for their effort may spur them to try harder in the face of adversity, according to psychologists Drs. Claudia Mueller and Carol Dweck of Columbia University in New York. ..."

The conclusions stated in the report are consistent with Adler's principles of encouragement.



53. Maslows Hierarchy of Needs

Question from Newsgroup: How does Maslow's hierarchy of needs relate to Adlerian theory
Dr. Stein: From a Classical Adlerian perspective, Maslow's "needs" could be seen, not as a hierarchy, but as a flat group. Depending on the individual's unconscious, fictional final goal, and feeling of inferiority, one need would be pursued "as if" it were primary.

An exaggerated goal of personal superiority security and significance (originally adopted in childhood) could intoxicate an individual with the illusion of an intensified "need" that they believe could only be satisfied in a specific, concrete form. Classical Adlerian psychotherapy attempts to trace these mistaken ideas, about security and significance, back to childhood, and then correct them.

In psychotherapy, it is fascinating to see how clients' "felt needs" change after they recognize and give up a dysfunctional goal.

See http://www.Adlerian.us for more details about Adler's teleological constructs.



54. Birth Order and Sulloway Book

Question from Newsgroup: I was wondering if you have a reaction to the new book by Frank Sulloway (MIT) named, "Born to Rebel: Birth Order, Family Dynamics, and Creative Lives." >

Dr. Sulloway was on Charlie Rose tonight and made a compelling case that birth order is the predominant predictor of personality with First Borns seeking parental approval and Later Borns as rebelling against established authority.

Dr. Stein: According to Alfred Adler, who first delineated birth order influences, the ordinal position of the child in the family is only one of five major influences on the formation of the personality. The other four are: organic inferiority & illness; parental attitudes; social, religious, cultural & economic factors; and gender role.

Adler also stated that the differences in personality attributed to birth order, are often due to highly competitive family environments . He predicted, that these personality differences would vanish in more cooperative families.

Just as one would not use a hammer for every woodworking task, the birth order construct is only used when needed in Classical Adlerian psychotherapy.



55. More on Birth Order

Question from Newsgroup: I am doing an article on sibling relationships and whether or not birth order affects personality. More specifically, for example, if the first child is an ace in school or if they tend to be a trouble maker, how does that affect the younger siblings? Also, how are their relationships played out over the course of their lives? Are they the most important relationships they've got, relying on each other for support and guidance; or do friendships rank higher? How do sibling relationships change in regard to gender?
Dr. Stein: Hopefully, the home page provided you with helpful generaL information. Here are some specific answers to your questions.

1. From an Adlerian point of view, birth order is only one of five major influences on personality development. The other four are: physical constitution (healthy/sick) and appearance (beauty/ugliness); formative education (parenting attitudes); social/economic situation; and gender roles. Any factor may be most influential in a particular case.

2. The contrast in character traits between siblings, is usually related to the degree of competition within a family. As each child seeks a place of significance, they may choose an "unoccupied" slot if it seems to promise the result they want (i.e., attention....). Adler predicted that the differences in siblings' personalities and interests would gradually diminish as families became more cooperative and less competitive.

3. Once a "style of life" (repetitive pattern of behaving) is adopted in childhood, it is unconsciously repeated throughout life unless a therapeutic intervention provides insight. Significant people (friends, spouse...) may be chosen to facilitate an "acting out" of the familiar roles. The "antagonists" may be shadows of siblings or parents.

4. Sibling relationships may or may not be the most important later in life (see paragraph above). Frequently, family members stay most important in an adult's life in order to facilitate avoiding close, cooperative relationships with spouses. If parents have pampered a child, it is improbable that anyone else, later on, will do the same without exacting some reciprocation.

5. Once a "style of life" and "fictional final goal" is established, anyone who seems to feeds the specific yearning for security and significance will become most significant. It could be a parent, sibling, friend, spouse, children, or even strangers.

6. Gender can become an issue between siblings, depending on the value given (an perceived) in that family to one gender.

Good luck with your article.



56. Being Godlike

Question from Newsgroup: What about the belief that one is or should be a God? Is it about control?
Dr. Stein: Alfred Adler believed that the more intense an individual (as a child) experiences a feeling of inferioirty or inadequacy, the more likely it is that he or she will unconsciously adopt a very high, almost godlike goal of power and control over others. This unconsicous goal directs all thinking, feeling, and behavior, and remains unchanged without depth psychotherapy.

The dilemma of the psychotic, may be that a goal of being God could be taken literally, and the only way to experience success is to withdraw from reality into fantasy.



57. Research on IP

Question From Newsgroup: I'm a grad student and am working on a research paper on Adlerian theory. Could you please e-mail back answers or research references on the following questions?

Of all counseling theories, what place does Adler's psychotherapy take? How frequently is it used today? By whom? What research studies are forming the basis for its continued use?

Dr. Stein: For a statement about Adler's place in psychology today, read the opening articles in http://www.Adlerian.us .

Also look at "Classical Adlerian Theory and Practice" under the "Readings" heading.

There are three main versions of "Adlerian" practice today:

1. Classical Adlerians follow Alfred Adler's original teachings and his Socratic, creative style of treatment. Probably, a few hundred psychotherapists in the United States have been trained in this tradition.

2. Dreikursians follow the teachings of Rudolf Dreikurs, who deviated from Adler's approach, and whose style of treatment is more directive and systematic. There are probably a few thousand therapists, counselors, and parent educator trained in this style.

3. Neo-Adlerians are quite eclectic, freely mixing Adler with cognitve and other theories and styles of practice. There may be even more therapists who follow this direction.

Many other disciplines have borrowed fragments of Adler's theory, without giving adequate recognition to the source.

The reasearch is not very vigorous. It also would be a mistake to combine the above three approaches for research purposes. It would be better to compare them to each other.

For some references on research, check "A Bibliography for Adlerian Psychology" by Mosak, and "Theory and Measurement od Social Interest" by Crandall.



58. Greed, Materialism, and War

Question From Newsgroup: There is a great tendency toward much greediness in this world. What can Adlerians do about this?
Dr. Stein: What you say about a great tendency for people to be greedy is correct. However, even if this is the way many people are, Adler and Mueller point out that we have the choice of becoming different.

Adler suggested the feeling of community was a critical development in the life of every child. When this is not developed, it is probable that the child will become an egocentric adult. Classical Adlerian psychotherapy attempts to re-build this feeling of community and overcome the egocentricity.

The larger social issues are not just greed, but inequality and domination. Have you visited our home page (listed below) and read the article "Adlerian Psychology and Democracy?" For another interesting perspective, read Philip Slater's "Wealth Addiction" and "A Dream Deferred."

Also, Alice Miller, in "For Your Own Good," traces the behavior of a generation to the child rearing methods of their parents.

The appeal of Adler and Mueller is in their vigorous optimism of what people could and should become, even in the midst of discouraging evidence of how they are at the moment.



59. Quote About Self Esteem

Question From E-mail: I'm trying to remember a quote from Adler that had something to do with "will to power", and not letting others crush your self-esteem (or at least that was the context with which he wanted to use the quote). I know that's really vague, but maybe you would know what he's referring to. I'd sure appreciate it if you could help me out.
Dr. Stein: I cannot identify the quote you are seeking from the general topics you stated. However, here are two excerpts from Adler's writings that may be of some interest to you.

"Every accomplishment that is not in the framework of being commonly beneficial diminishes the feeling of self-worth in the individual, imbues him with a feeling of his own inferiority, and puts him in conflict with the continuous social demands and connections of life. He will always experience everyone's opposition as well as all the problems and penalties that necessarily arise from harming the logic of human social relationships. He will find that his life will not become easier, as he might have presumed, but more difficult. He will not experience being a part of the whole, but will live as if in enemy territory. The value of one's own life, worthwhile accomplishments, can only be found by benefitting the community. "

"Nature provides the individual with strengths, abilities, drives, desires, and the possibilities for development. He is bound to nature to the extent that he uses it to fulfill his life tasks. How he makes use of it, how he allows it to flourish or decline, in particular, however, what direction he gives it, is revealed in the broadest sense in his outlook on life. This philosophy of life, how he relates to life, is the individual's own creative achievement for which in his self-esteem he finds either his reward or punishment."



60. Case Studies

Question From E-mail: Does anyone have any suggestions on reading material regarding pschotherapy sessions/cases, along the lines of Yalom's "Love's Executioner" or "Behind the Couch" (don't remember author). I thoroughly enjoy this type of reading.
Dr. Stein: For an Adlerian perspective on case study, read:

THE PATTERN OF LIFE, by Alfred Adler
THE CASE OF MRS. A, by Alfred Adler
THE CASE OF MRS. R, by Alfred Adler



61. Empathy Scale

Question From E-mail: In an effort to examine clients' and therapists' perspectives on therapeutic interactions, I am seeking a standardized scale that measures the level of empathy perceived in the therapeutic relationship. I have conducted a search of both Psych.Lit and Social Work Abstracts and have also consulted several compendia of tests and measures. These efforts have not produced anything beyond the Hogan Empathy Scale which does not assess the perceived empathy of the relationship.

Does anyone have any suggestions where else I might look or, better yet, know the name and source of such a scale?

Dr. Stein: This is not exactly what you are looking for, but you could check out "Theory and Measurement of Social Interest" by James Crandall. On page 32 he refers to the SIS (Social Interest Scale) and an article published 1972 by Mehrabian and Epstein, "A Measure of Emotional Empathy," in THE JOURNAL OF PERSONALITY, 40:523-43.

Alfred Adler considered empathy a major component of his construct "social interest" (or the feeling of community).



62. Marketing Research

Question From E-mail: A friend of mine has to give a talk about the psycology of advertisment. She asked me to try to get some materials from the Usenet. Can you please post me some addresses or material via PM ?
Dr. Stein: Using a search engine, check the "Censydiam Institute" for a quasi-Adlerian/Freudian/Jungian perspective on marketing research. They also publish a book, "The Naked Consumer," describing their theory.



63. Cloning

Question From E-mail: I have been asked to consider the issue of how cloning would impact the family in relation to the birth order theory.

I have an M.A. in Human Development Counseling, and have been in private practice as a therapist for over 17 years.

This request came from a Methodist Sunday School class, lead by an internist and comprised of a bunch of us eggheads.

We have a stock broker dealing with the financial impact of cloning, etc.

Please send me a brief response to your impressions of the impact of cloning on child development with regard to birth order theory.

Obviously, any response is quite speculative. From an Adlerian perspective, cloning would probably have a similar psychological effect as having twins in a family. If one is aware of being born a few minutes earlier, he or she may act like an older child.

Dr. Stein: A more interesting factor than cloning, is the degree of cooperation or competition in a family. Birth order differences are accentuated in a competitive family atmosphere, and minimized in a cooperative atmosphere. Theoretically, if a family were to become very cooperative and democratic, the traditional birth order tendencies would disappear, and more unique individual development would emerge.



64. Hypnotism and imagery

Question From E-mail: Do Adlerians use hypnotism, porgressive relaxation, and imagery?
Dr. Stein: Adler did not use hypnotism or progressive relaxation, nor do most current Classical Adlerians. Alexander Mueller, an early Adlerian, suggested the use of imagery, and I integrate guided and eidetic imagery into the therapeutic process (see http://www.Adlerian.us/provid.htm for details).



65. Striving and Compensation

Question From E-mail: Could you clarify the concept of "striving for superiority?" Is compensation always negative?"
Dr. Stein: Adler expressed the concept of human striving with many different nuances throughout his writings ( I have found over a dozen terms) . The "striving for significance" or "striving for completion" suggest the general forms. "Striving for superiority" over other people represents a mistaken compensatory striving to relieve a haunting feeling of inferiority. The result is often only an illusion, but the movement is repeated somewhat compulsively as the individual alternates between both poles. Kurt Adler suggested that the "striving for superiority" over one's past achievement was a more productive direction.

Compensation, and even over-compensation do not have to lead in a negative direction. The degree of an individual's feeling of community colors the direction of the compensation.

If, in psychotherapy, one is able to dissolve an inferiority feeling as well as the compensatory goal, it is possible to achieve a level of meta-motivation (motivated by higher values) that is no longer compensatory.



66. Psychobiograpies

Question From E-mail: I have read a paper which offers an interpretation of the actions of Lee Harvey Oswald from an Adlerian perspective (by Ansbacher, Ansbacher, Shiverick and Shiverick). I have not however, encountered any other such studies utilizing Individual Psychology.
Dr. Stein: Heinz Ansbacher did a study of Marilyn Monroe in the magazine Psychology Today, several years ago.

A graduate student wrote a dissertation on "An Adlerian Interpretation of Ann Richards," who was the governor of Texas. Alfred Adler commented on the dancer Nijinsky, in an issue of the journal Individual Psychology.

On different web sites, comments on the life of Albert Einstein and Brian Wilson have been posted.

To gain an idea of how Adler thought about cases, read "The Case of Mrs. A" and "the Case of Mrs R."



67. Sand Tray Therapy

Question From E-mail: I am interested in finding a workshop in the use of Sandtray Therapy.
Dr. Stein: You might also be interested in the "World Test" by Charlotte Buhler. It is similar to the Lowenfeld use of miniatures, but does not include sand, and can be used for assessment as well as therapy. The format and results are very compatable with the Adlerian approach. Check the course outline for "Distance Training in Classical Adlerian Psychotherapy: Child and Family Therapy," at http:/www.Adlerian.us/dt304.htm .



68. Studying Self Concepts

Question From E-mail: I'm looking for certain types of studies on self concept. Surely somewhere, some time, somebody must have put together a study something like this:

A group of subjects is given a questionnaire that asks them to rate their own abilities at a broad range of different skills. After that, their actual abilities at those skills are measured using various tests, and the results compared with the questionnaires. The idea is to measure how accurate a person's self-concept is.

A variation would be to use a group of people suffering from feelings of inferiority and measure their abilities in various areas against some kind of relevant norms, to see whether their feelings are justifiable or not. Of course, there could be a problem in that someone who feels inferior may not try as hard as he/she could, thereby skewing the results. However, I can think of some remedies for that: the subject could be "teased" into a higher level of self-confidence by being given easy tests prior to the ones actually used for measurement. And the actual tests could be designed such that it is difficult for the subject to assess how well he/she was doing on them.

My motivation in all this is the feeling that a lot of therapy is less effective than it could be because it makes certain invalid assumptions, such as: 1.) Feelings of inferiority are always pathological and always inaccurate. 2.) Self concept affects performance but not vice-versa. 3.) Reality doesn't matter; perception is all that counts.

Thank you for any help you can give on this.

Dr. Stein: I'm not sure how intimate your knowledge of Adlerian theory is. Adler does address these issues with his constructs of: private logic; the antithetical scheme of apperception; opinion of self, others, life, and difficulites; and common sense.

Clients generally will "overshoot," "undershoot," or distort their opinion of their capaciites, and their estimate of the difficulites they are facing, in line with their fictional final goal. In therapy, we gradually coach the client to gain a more realistic view of themselves and the world. You always find a world view that fits the self concept.

Adler said that inferioirty feelings, if they were not profound, were a blessing. In therapy we try to use them as a stimulus for struggling in a new direction. Sophia de Vries, my mentor, used to say: "you can put your feelings of inferiorty in front of you like a wall and grind to a halt, or put them behind you and use them to push you ahead."

Reality and common sense matter a great deal in the Adlerian approach. Similar to Maslow's ideal of self-actualization, we help the client progressively gain a more efficient perception of reality. To do this, we often have to dissolve a rigid scheme of apperception. A therapeutic adaptation of the Socratic method is very effective in this quest.

Performance in a new direction, coupled with therapeutic insight and encouragement can change a self concept.

For more information, look at : "Stages of Classical Adlerian Psychotherapy" (Table) at http:/www.Adlerian.us/stages2.htm

"Classical Adlerian Theory and Practice" at http://www.Adlerian.us/theoprac.htm

"Providing the Missing Developmental Experience" at http://www.Adlerian.us/provid.htm



69. Stanislavski and Adler

Question From E-mail: Is there any connection between the ideas of Stanislavski and Adler?
Dr. Stein: I first discovered Adler's writings when I was working on my Master's degree in theater arts during the late 1950's in San Francisco. At that time, my interest was in stage directing and training actors, and I developed an independent study project to explore more effective strategies for analyzing the characters in plays. The writings of Constantin Stanislavski, the great Russian theater director, were considered seminal to character analysis, but I wanted to dig deeper, so I explored the writings of Freud, Jung, and Adler for clues.

My first readings of Adler were quite exciting, since they offered remarkable parallels (studying real people) to Stanislavski's concepts (studying fictional character). For example, they both believed in the unity of the personality, and Adler's "fictional final goal" mirrored Stanislavski's "super-objective."

I read all of Adler's available writings and eventually studied with Sophia de Vries, who was trained by Alfred Adler. At first, I applied Adlerian theory to my work as stage director. Gradually, I became more interested in applying Adlerian psychology to the lives of real people, rather than the fictional characters in plays. I went back to school in the early 1970's, earned my master's degree in counseling, and later my doctoral degree in psychology.



70. Congruence

Question From E-mail: I had a chat with a psychologist today who remarked that each therapy is effective only if it truly reflects the personality and style of the individual therapist. Thus a thinking/introvert type might prefer cognitive therapies. And a person who prefers to advise or direct a person might find it uncomfortable to practice Client-Centred Therapy.
Dr. Stein: The congruence of therapists or trainers with their underlying philosophical premises is an important issue for clients and students. To be trusted, therapists and trainers should model what they advocate. Adler expected those who adopted his approach to go through a personal study/analysis designed to correct any incongruence of personality and Adlerian philosophy.

Anthony Bruck, who was trained by Adler, used to say: "You can go through training in many psychological disciplines and come out the same person you were when you started. However, good Adlerian training changes you."

An upcoming book that may illuminate some aspects of this topic is "Psychoanalytic Versions of the Human Condition: Philosophies of Life and Their Impact on Practice," NYU Press, New York. It is scheduled to be published in May or June of 1998. "Classical Adlerian Theory and Practice" http://www.Adlerian.us/theoprac.htm is one of 17 chapters by representatives of different psychological disciplines.



71. Testing

Question From E-mail: I am currently discussing with a client writing a series of patient teaching materials on the diagnostic testing for psychiatric patients. Obviously, things like Thyroid Functions, CAT Scans, EEGs, etc. that are used in other areas are used for psych.

I would appreciate any leads on tests that are solely psych in nature. They can be either structural (like the above) or other methods (the MMPI comes to mind..any others??)

Dr. Stein: The Adlerian analysis of "Earliest Childhood Recollections" is a very useful projective testing technique. It can augment a standard intelligence and psychological test battery that usually includes tests like the WAIS, Rorschach, MMPI, TAT, Bender Gestalt, Sentence Completion, and Draw-a-Person.



72. Narcissism

Question From E-mail: What a wonderful selection you have provided for us internet users. Thankyou.! I am a 2nd year Counseling Student at Fullerton, Cal-State. I am very interested in Adlerian therapy. It seems to fit with my personality and belief system.

To the point, right now I am working on a paper involving Narcisism. I am curious about an Adler's approach to this personality disorder. If you have time, please forward me some info. If not, thanks so much for all the helpful information at your site. I'll pass it on to the others in my Master's program.

Dr. Stein: The Adlerian treatment of all personality disorders is similar. Regardless of the interesting variety of symptoms, in every case, the goal and style of life must be changed, and the feeling of community increased. See "Classical Adlerian Theory and Practice" at http://www.Adlerian.us/theoprac.htm .

Essentially, we do not treat a symptom or disorder, but the unique individual, with his mistaken style of life and fictional goal.

For more information, read "The Unity and Diversity of Mental Disorders" in THE INDIVIDUAL PSYCHOLOGY OF ALFRED ADLER, edited by Heinz and Rowena Ansbacher.



73. Writing Therapy

Question From E-mail: I wish to know more about writing therapy and the power of writing in general.
Dr. Stein: Take a look at "A Questionnaire to Save Interview Time in Adlerian Brief Therapy" at http://www.Adlerian.us/quest-br.htm .

This focused approach provides very useful information to an Adlerian therapist and might be helpful to others.



113. Consequences

Question From E-mail: I'm looking for information about natural and logical consequential responses to classroom behavioral problems.

I would appreciate any professional journal articles or books that might offer some information.

Dr. Stein: Read "Maintaining Sanity in the Classroom," by Grunwald, Dreikurs, & Pepper. "Logical Consequences," by Loren Grey may have some examples related to classroom behavior. Also read "The Challenge of Kindergarten" at http://www.Adlerian.us/chall.htm .



75. Client Resistance

Question From E-mail: I am inquiring as to how Adlerian therapists see the function of resistance in therapy and how they would work through the resistance on the clients part?
Dr. Stein: Read THE INDIVIDUAL PSYCHOLOGY OF ALFRED ADLER, Edited by Heinz and Rowena Ansbacher, pages 336-38.

"It is the depreciation tendency which underlies the phenomenon Freud described as resistance..."

"The so-called resistance is only a lack of courage to return to the useful side of life."

Also look at THE PRACTICE AND THEORY OF INDIVIDUAL PSYCHOLOGY, by Alfred Adler, chapter 10, "The Concept of Resistance in Treatment."

Briefly, resistance is gradually overcome by winning the client's trust, making an empathic connection, building up the client's self esteem and courage to face tasks that have been avoided, and Socratically interpreting the repeated deviations from cooperation. Ultimately, the fictional final goal must be changed to eliminate resistance. Check "Classical Adlerian Theory and Practice" at http://www.Adlerian.us/theoprac.htm for details on the stages of treatment.



76. Multiculturalism

Question From E-mail: Why doesn't Adlerian Therapy deal much with multicultural issues? What info can you give me on Adlerian Therapy and Multiculturalism.
Dr. Stein: Adlerian psychology considers the impact of culture as one of several factors in the formation of the personality (birth order, parental attitudes, organ inferiority, etc. In practice, we evaluate the way clients interpret or misinterpret their cultural influences, and whether they use those influences in an encouraging or discouraging way for themselves and others. Consequently, any cultural influences that promote feelings of superiority of one group (or individual) and the depreciation of another group (or individual), instead of fostering equality and appreciation, would be considered psychologically suspect. The main focus of Adlerian therapy is the emergence of the socially beneficial uniqueness of each individual, regardless of cultural influences. Adler's definition of "the feeling of community" (Gemeinshaftsgefeuhl), ideally, extended one's identification to "all of mankind."



77. Counselor Supervision

Question From E-mail: I am currently involved with some research in the area of counselor supervision. Of particular interest to me is how Adlerian theory and principles have been formally incorporated into the supervision of counselors in training. As of yet, I have found very little in the way of supervision literature pertaining directly to this matter.

Given your experience in the training of Adlerian therapists, I am quite interested in your perspective on this question. Additionally, I was hoping that you might be able to send me or direct me to some additional resources.

Dr. Stein: There is no "formal" incorporation of principles into training. Each institute has its own character and style of supervision.

My approach is mentor-oriented; I work with a limited number of professionals or students at one time, in order to maintain a close one-to-one relationship throughout the study of theory, practice, study-analysis, and case supervision. In this way, the uniqueness of each student is fully considered.

One unique aspect of our approach, is that we expect our therapists to develop their character in a way that is congruent with Adler's philosophy. Any aspect of an individual's style of life that would inhibit effective treatment, would have to be corrected in a study-analysis. Not all Adlerian institutes expect this.



78. Grief and Loss

Question From E-mail: How would the Adlerian psychotherapist approach grief and loss?
Dr. Stein: A Classical Adlerian psychotherapist would deal with a client's unique style of life in relation to the circumstances of loss. A courageous, active, giving individual would respond to loss quite differently than a passive, expectant, pampered person.

Initially, an empathic, supportive connection would be established to facilitate a full emotional catharsis. Next, we would explore Socratically, the meaning of the loss and the role that the person served in the client's life. Eventually, a resolution and plan of action would be contemplated to provide a useful, meaningful direction. (This could be an opportunity to correct relevant mistakes in the style o life.) Certainly, any philosophical or spiritual issues would also be addressed.

If you are not familiar with Adlerian principles, read "Classical Adlerian Theory and Practice" at http://www.Adlerian.us/theoprac.htm .



79. Transference

Question From E-mail: I am a graduate student studying school psychology and I was wondering where I can find information about Adlerian veiws on the transference process in psychotherapy!
Dr. Stein: Adler considered transference to be a mistaken attitude of clients that needed to be corrected. In essence, clients attempt to draw therapists into familar roles that they have attempted to recreate with many other important figures. Consequently, "counter-transference" is a mistaken attitude of the therapist that should have been overcome during a study-analysis. There isn't much about transference in Adler's writings.



80. Disorders

Question From E-mail: I have been reading your comments at various web sites and am very interested in how problems such as the following disorders are approached in the Adlerian method when dealing with adolescent behavioral problems:

ADHD

Oppositional Defiance

Bipolar mood disorder

Dr. Stein: The Classical Adlerian therapeutic approach does not focus on symptoms or diagnostic categories, but on the style of life of each unique undividual. Consequently, we do not have a "cook book" of technqiues for various disorders. To formultate an effective treatment strategy, the therapist would have to discover the individual's feeling of inferiority, style of life, and fictional final goal.
Comment: Thank you for your response. I'm not a therapist; just a mother; so your words are a little bit lost on me. "Fictional final goal"?

I'm researching this because of my son who has a high IQ, is miserable, is failing in school, and has been diagnosed since 6 with ADHD. Because he developed severe mood swings he also shows symptoms of bipolar mood disorder. We have tried behavior modification (which I hate and agree that the reward/punishment style is ineffective, at least in this setting) and have been with different psychologist and psychiatrists over the years. My aunt suggested I find an Adlerian therapist. I'm going to try to do that. But my reason for writing was to ask------ do you know if classical Adlerian therapy has been known to be successfull with helping discouraged kids who have the "lifestyle" of ADHD, ODD, and BMPD? Or are those problems beyond the scope of this therapy.

This child is on 5 different kinds of medication; and I would really like to find help for all of us -

May I say that to the credit of all the Adlerians who publish on the Web, and in the libraries and stores, since we began intensively trying to work with the principles of this theory within the past week at our house, we have a lot of new hope, and I can imagine lasting, peaceful coexistence.

Dr. Stein: The term "fictional final goal" refers to an unconscious ideal, normally formed in childhood, and is explained in greater detail on my web site.

It sounds like you may need an integrated team approach involving a psychiatrist who can deal with medical/medication issues, and an Adlerian family therapist who can help all members of your family.

Classical Adlerian therapy can be effective with the problems you describe, but success also depends on the experience and skill of the particular clinician as well as the cooperation of the family.

Unfortunately, I do not have the name of a Classical Adlerian in your city. However, when I checked my national directory of Adlerians, I found a name in ____ You could contact _____ at ____ and ask her for referral to someone in your vicinity.

A book that might be of some value is "Helping Your Hyperactive/Add Child," by John F. Taylor, Ph.D. I believe that is written from an Adlerian perspective. You can order it from Amazon books at http://www.amazon.com .

Adlerian ideas have helped many families -- you are on the right track.



81. Existential Anxiety

Question From E-mail: I`m working on some theories about existential anxiety. What are normal experience of existential anxiety, when meeting the challenge of working in a group ?"
Dr. Stein: One perspective on existential anxiety would be to examine it as an inferioirty feeling with an impressive label.



82. Adler and Rogers

Question From E-mail: I'm taking a graduate counseling class. Is there a major difference between the Adlerian approach to therapy and person-centered therapy? I've found much that is similar between the two, but not much different.
Dr. Stein: Read "Classical Adlerian Theory and Practice" at http://www.Adlerian.us/theoprac.htm , and pay close attention to the 12 stages of Classical Adlerian psychotherapy. I think you'll find a considerable difference after the fifth or sixth stage, especially the changing of a style of life and fictional final goal.



83. Emotional Intelligence

Question From E-mail: I am in the early part of reading "Emotional Intelligence: Why it can matter more than IQ" by Daniel Goleman and I was wondering, and this may be a illy question, if emotional intelligence is a given quality at birth or if a person who exhibits low emotional intelligence can be taught to be wise emotionally? Any theories or opinions on this subject would be appreciated.
Dr. Stein: Alfred Adler believed that "feeling of community" (awareness of feelings, empathy, compassion, etc.) is an innate potential which has to be consciously developed by training into skill and ability. It is innately so small that it must benefit from social understanding to develop. After becoming an ability, it may then acquire secondary dynamic characteristics of attitude and motivation. Read "Developmental Sequence of The Feeling of Community" at http:/www.Adlerian.us/dev-si.htm



84. Photoanalysis

Question From E-mail: Does anyone know about literature that deals with how to analyse pictures and metaphors (i.e. the stories that belong to that picture).
Dr. Stein: For a psychological perspective, check:

Photoanalysis; How to Interpret the Hidden Psychological Meaning of Personal and Public Photographs, Robert U., Akeret, Published 1973.



85. Statistics

Question From E-mail: Im very interested in adlerian therapy and use bits of it already but i would like to know (for funding) is there any statistics on out comes? If so, where do I get them?
Dr. Stein: I do not know of any reliable statistics on the outcome of Adlerian therapy. Any meaningful research would have to distinguish between Classical Adlerian and Dreikursian (usually called Adlerian) approaches to treatment.



86. Birth Order and Development

Question From E-mail: I would like to get information about the effects of birth order on development.
Dr. Stein: According to Alfred Adler, who first delineated birth order influences, the ordinal position of the child in the family is only one of five major influences on the formation of the personality. The other four are: organic inferiority & illness; parental attitudes; social, religious, cultural & economic factors; and gender role. Adler also stated that the differences in personality attributed to birth order, are often due to highly competitive family environments . He predicted, that these personality differences would vanish in more cooperative families. Just as one would not use a hammer for every woodworking task, the birth order construct is only used when needed in Classical Adlerian psychotherapy. First, take a look at "An Adlerian Overview of Birth Order Characteristics" http://ourworld.compserve.com/homepages/hstein/birthord.htm Then, for additional information about Classical Adlerian theory and practice visit: http://www.Adlerian.us . For another, rather Darwinian (non-Adlerian) point of view about birth order, with a great deal of historical material, see "Born to Rebel" by Frank Sulloway. He also refers to many earlier studies.



87. Measuring Social Interest

Question From E-mail: I am conducting research on college student binge drinking and am searching for an instrument to measure social interest. Do you have any suggestions?
Dr. Stein: Social interest, or the feeling of community (a better term), cannot be adequately measured with an instrument. It is a complex construct that requires artistic empathy to determine its depth and range. Check "Developmental Sequence of The Feeling of Community" at http:/www.Adlerian.us/dev-si.htm .



88. Christian Counseling and IP

Question From E-mail: I am very interested in the Adlerian Theory. I am a Masters level student at a university. My goal is to incorporate Christian counseling with Adlerian.
Dr. Stein: There are several articles in the Readings|Philosophy and Theology section of our web site. Also consider ordering a book mentioned in one of the artilcles, "You Shall be a Blessing" by Alexander Mueller.



89. Effect of Divorce

Question From E-mail: Are there any Adlerian research papers that have been done on the effects of divorce on children?
Dr. Stein: From an Adlerian perspective, the effect of a divorce depends largely on the pre-existing style of life of the child.



90. ERs and Vocational Choice

Question From E-mail: I am a graduate student and busy with my graduate project at the moment. My topic is: "Early recollections and Vocational Choice".

Early recollections refer to the Adlerian technique which is used by Adlerian counsellors as a diagnostic tool. More specifically I'm interested in researching how early recollections reflect vocational choice in later life.

Dr. Stein: You might find some information by an author named Watkins in some older issues of the Adlerian journal "Individual Psychology." We cover that topic in our distance training course "Career Assessment and Guidance" http://www.Adlerian.us/dt501.htm



91. Teen Violence

Question From E-mail: I am working on a project for a graduate course in adolescent development. We are to design a poster about teen violence -- in particular, teen school shootings. I have found many articles about social interest and printed out some of the information from the Adler Institute web page. I am hoping I can use some of it on my poster (with appropriate referencing of course) -- ? I also wondered if you might have any comments or thoughts about how this issue interfaces with social interest?
Dr. Stein: Although it is generally understood that parental brutality can lead to teen violence, a lack of connection, pampering, or parental indifference can also result in an aggressive, exploitive atttitude in young people. A lack of "the feeling of community" is quite dangerous in the formative period of adolescence, expecially when individuals are trying to prove that they are "adults" and no longer "children." At that point, many mistaken ideas of "power over others" can emerge.



92. Narcissistic Personality Disorder

Question From E-mail: I am presently doing a paper on psychopathology (Narcissistic Personality Disorder) and am interested in what the Adlerian view is of this disorder. Would anyone there be willing to give me a brief answer to this? I would very much appreciate it.
Dr. Stein: A Classcial Adlerian view would be to focus on the unique, fictional final goal and private logic of each individual, rather than on the generalized typology of a "disorder". Consequently, we prefer to minimize the use of the common "personality disorder" terms in our case discussions, since they offer very little valuable insight or clues for effective treatment planning. The usual descriptions of the NPD fit Adler's generic picture of the neurotic personality, which he vividly presented in THE NEUROTIC CONSITUTION. We will be published a new translation of this book in the near future.



93. Group Exercise

Question From E-mail: I am an undergrad currently studying towards a B.S. in psychology and a B.A. in biology. I am a senior and in one of my summer school classes, personality and theories we are studying Adler. I have a partner and we are required to come up with activities to engage the class. We are required to be guest lecturers and have a 45 min. time frame. I would like to ask for your input: any suggestions? Short exercises would be nice..
Dr. Stein: Divide the group by birth order (only, oldest, middle, youngest) and ask the members of each group to compare early experiences (both advantages and disadvantages) that related to that birth order position. Ask one person in each group to record and summarize comments, then report back to the entire class after the exercise.



94. No Cook Book

Question From E-mail: I am in a group theories course and out of ten therapies I chose Adlerian to write about. We all have the same requirements to cover. I am not finding specifics concerning best suited problems or people - when it concerns Adlerian Psychotherapy. I have browsed the internet most of today and am not finding info related to this question.
Dr. Stein: Although that question might be quite relevant to some other therapeutic approaches, it is not as relevant to Classical Adlerian psychotherapy. There are no "cook book" recommendations for types of people or problems. The real issue is the skill, sensitivity, and creativity of the particular Adlerian therapist.

My mentor, Sophia de Vries, who was trained by Adler, demonstrated the expertise of working effectively with a remarkable range of people, problems, and levels of pathology. There are some Adlerians whose training only prepares them to do a modest form of counseling.

Take a look at the "Stages of Classical Adlerian Psychotherapy" table at http://www.Adlerian.us/table2.htm for an overview of the therapeutic process.



95. By Heart?

Question From E-mail: I have a question: Do you work Adlers theory by heart or with a new understanding of it?. What I mean is, are you classical or progressive, to call it in a way?.
Dr. Stein: As a Classical Adlerian, I look to Adler's original theory and principles of treatment for guidance and inspiration. His work is so rich and deep that it requires a lifetime of study to master. In my opinion, to date, no one has improved upon it. However, I do find the ideas of Abraham Malsow generally consistent with Adler's theory. Since the practice of psychotherapy needs to be creative, I constantly explore, experiment, and invent new strategies (based on Adler's theoretical foundation)for helping clients . For example, take a look at my paper on "Providing the Missing Developmental Experience" at http://www.Adlerian.us/provid.htm .



96. Life Style Assessment

Question From E-mail: I would like to understand the idea/concept that when conducting a Life Style Assessment we look to interfering attitudes and basic mistakes to find strengths and assets (in the summary of a life style)
Dr. Stein: Conducting a "Life Style Assessment," which involves providing a summary to the client, is a Dreikursian procedure that deviates significantly from Adler's original style of treatment, and is not used in Classical Adlerian psychotherapy. For an overview of my approach to individual adult treatment, check "The Stages of Classical Adlerian Psychotherapy" at http://www.Adlerian.us/stages2.htm .



97. Fritz Kunkel

Question From E-mail: I am looking for information about one of Adler's students, Dr. fritz Kunkel. Do you perhaps know where to look for information about him?
Dr. Stein: Try finding a book, "Fritz Kunkel: Selected Writings," by John Sanford, Paulist Press, New York, 1984. You could also look for Kunkel's books, "How Character Develops" and "In Search of Maturity."



98. Autism

Question From E-mail: I just visited your website and am curious to know if this type of psychology deals with autism?
Dr. Stein: I have not found any Adlerian information specifically for the treatment for autism. However, you might try getting a copy of "Lifestyle Counseling for Adjustment to Disability," edited by Warren Rule, published in 1983--it may contain some Adlerian information on the subject. Unfortunately, It is out of print, but Amazon books can do a search for you, or check with http://www.bibliofind.com .



99. Predicting Career Success

Question From E-mail: Is there any sort of assessment type of test to be able to establish whether one would be a good or great psychologist?
Dr. Stein: There is no instrument that can predict success in a field. However, an interest inventory can usually reflect potential satisfaction. The Jackson Vocational Interest Survey or the Strong-Campbell Interest Inventory are good choices--they are best administered and interpreted by a career counselor. My approach to career assessment also includes trait inventories like the Personality Research Form and the Jackson Personality Inventory, as well as a series of earliest childhood recollections. An integration of all of these sources provides a useful perspective for career counseling. The interest and trait inventories describe and compare these factors; the earliest recollections may help explain the roots of these factors.



100. Narcissism and Aggression

Dr. Stein: For an interesting study on the roots of aggression, read http://www.drkoop.com/healthnews/rhn0723/t072302.asp

Titled, "Narcissists Most Prone to Aggesstion," it begins: "A surprising new study suggests that the psychological profile of an aggressive person may be more likely to include narcissism -- an exaggerated sense of one's superiority -- rather than low self esteem. ...."

Several conclusions are quite conistent with Adler's ideas about aggression resulting from threats to one's fictional goal of superiority.



101. Praising Effort

Dr. Stein: Read http://www.drkoop.com/healthnews/rhn0714/t071402.asp for a summary of a report about the effect of praising a child's good grades. The article begins: "Surprising as it sounds, praising children for their ability or intelligence may actually have a negative effect on a child's academic performance, a study suggests. Such praise may make a youngster feel pressured to get good grades or reach certain goals, and may make them less able to cope with failure, according to a report in the Journal of Personality and Social Psychology. Instead, praising a child for their effort may spur them to try harder in the face of adversity, according to psychologists Drs. Claudia Mueller and Carol Dweck of Columbia University in New York. ..."

The conclusions stated in the report are consistent with Adler's principles of encouragement.



102. Art Therapy

Question From E-mail: I am currently a graduate student looking for information about Adlerian Art Therapy.
Dr. Stein: Read "Cows Can Be Purple : My Life and Art Therapy" by Sadie E. Dreikurs available through Amazon Books at http://www.amazon.com .



103. Sexual Therapy

Question From E-mail: I need a study dealing with any aspect of human sexuality/sexual identity (preferably male homosexuality, but at this point, I'm not going to be too picky) where the patient was treated from an Adlerian perspective. The case can be fairly superficial and brief as long as it has a good description of the presenting issue/problem.
Dr. Stein: Adler describes an interesting case on pages 56-61 of "Cooperation Between the Sexes," edited by Heinz and Rowena Ansbacher.



104. New Adlerian Publications

Dr. Stein: New Adlerian publications from Oneworld Press in England:
"Social Interest: Adler's Key to the Meaning of Life," by Alfred Adler (Edited version of previous translation.)

"The Freud-Adler Controversy," by Bernard Handlbauer (Translated from the German edition)

"Understanding Human Nature," by Alfred Adler (New translation)

"What Life Could Mean to You," by Alfred Adler (New translation)

"Understanding Life," by Alfred Adler (Edited version of previous translation)

All books may be ordered from Amazon books http://www.amazon.com



105. Making Changes Permanent

Question From E-mail: I am writing to you to ask you your view on the importance of insight in Adlerian psychotherapy in making "changes" permanent.
Dr. Stein: Insight into the dynamics of a style of life, including the fictional final goal, private logic, and the antithetical scheme of apperception, are central to Classical Adlerian psychotherapy and promoting permanent change. Check http://www.Adlerian.us/theoprac.htm for an overview of Classical Adlerian theory and practice.



106. Applying Theory in Practice

Question From E-mail: How does one master the art of diagnosis and treatment. Alhtough I understand the basic theory, applying it to cases seem quite difficult.
Dr. Stein: Finding an expert therapist for supervision, after builidng a solid theoretical base, is the only way to master the art of psychotherapy. The exposure to hundreds of examples of life style analysis and treatment planning builds a solid foundation for practice.



107. Fictional Finalism

Question From E-mail: Please send me anything on Fictional Finalization. I am in the midst of a paper and need as much info as possible.
Dr. Stein: Read "The Development of Personality" section of Classical Adlerian Theory and Practice" at http:/www.Adlerian.us/theoprac.htm .

For more comprehnsive information, look at the chapter on fictional finalism in "Alfred Adler's Individual Psychology,'" edited by Heinz and Rowena Ansbacher.

Are you familar with the seminal work on fictional constructs, Hans Vaihinger's "The Philosphy of As If"?



108. Gender Bias?

Question From E-mail: Why are your articles, as well as the articles in the Adlerian Homepage so gender-biased?
Dr. Stein: I find your opinion quite surprising. If you base your conclusion on the mere counting of pronouns, you have missed the deeper philosophy of Adlerian psychology, which reflects a profound respect for the equality of both sexes.



109. Missing Material in Book

Question From E-mail: Why is the second edition of "Cooperation Between the Sexes" so much shorter than the first edition?
Dr. Stein: That's a good question. I suspect that the editors chose to eliminate all of the material on homosexuality by Adler and Ansbacher, and the result is a reduction of over 200 pages. Marketing may have attempted to be "politically correct," but in that process, scholarship has suffered.



110. Laziness

Question From E-mail: I am a student and am writing a paper on how various personality psychologists would classify or describe someone that is lazy and procrastinating. I was just wondering if you could me some advice on which personal works of Adler I should look at to get the most and best information as to what makes a lazy person and perhaps an explanation of why they are lazy? Also any info you could give on Adlers thoughts on this would be most appreciated.
Dr. Stein: The following material can give you a perspective on Adler's thinking about both issues.
THE LAZY CHILD

(An unpublished manuscript by Alfred Adler - date unknown)

[This material is protected by copyright and may not be reproduced without the expressed consent of Henry T. Stein, Ph.D.]

What are the motives of the lazy child? First we will exclude children with organic deficiencies, children who suffer from anemia, for example, from tuberculosis, deficiencies of the thyroid gland and other such conditions. We will exclude also those children whose laziness is a direct attack on their parents and teachers. Laziness can sometimes be a revenge. It is a very good weapon for disappointing others and causing them trouble.

In all other cases we should look for a fear of defeat in work, games or school activities. A fear of defeat always brings about a lack of interest. When a child thinks he can solve a problem, he is interested in it. Interest in a subject is the strongest stimulus to master it. If he is interested, he will like to learn. But where he is afraid that he cannot succeed, he will gradually distract his interest from the subject.

Success is a word differently understood by everybody. Sometimes it is astonishing to find out what a child regards as a defeat. There are many people who think it a defeat if they are not ahead of all others. Even if they are successful, they consider it a defeat if someone does still better.

But where does the striving for superiority and completeness show itself in laziness? A lazy child never experiences the feeling of defeat because he never faces a test. He excludes the problem before him, and postpones the decision whether he could compete with others. Moreover, everybody else is more or less sure that if only he were less lazy he could meet his difficulties. He takes refuge in the satisfying thought, "If only I were not lazy, I could do everything." Whenever he fails, he can diminish the fact of his failure and keep his self-esteem. He can say, "It is only laziness, not lack of capacity."

Sometimes teachers will say to a lazy pupil, "If you would work harder, you could be the most brilliant pupil in the form." If he can keep such a reputation without working, why should he do any work? Perhaps if he stopped being lazy, his reputation for concealed brilliance would come to an end. He would be judged on his accomplishments, not on what he might have done.

There is another personal advantage to his laziness. If he does the least bit of work, he is praised for it. From a more industrious child, it would never even have been noticed. One lazy boy was asked by his teacher why did no work. "I know I'm the laziest boy in the class," he answered, "but you are always paying attention to me. The boy next to me is the best pupil among us, but you never even give him a look."

A lazy child considers only his own interest. He is not trying to contribute. He is looking for the easiest way in life. He occupies the attention of others and makes them help and support him. In all this we can see the egotistical attitude of the lazy child.

We can hardly blame him, however. A healthy child is not naturally lazy. He has been artificially made lazy. Because of the pampering attitude of his parents, he has trained himself from his babyhood to expect everything from the efforts of others.

You could also look at some of Adler's books:

"What Life Could Mean to You," by Alfred Adler (New translation by Colin Brett).

"Understanding Human Nature," by Alfred Adler (New translation by Colin Brett).

"Understanding Life," by Alfred Adler (Colin Bretts' edited version of a previous translation)

Good luck with your paper.



111. Concetration Problems

Question From E-mail: Is there a general Adlerian view on concentration problems?
Dr. Stein: Assuming that the concentration is not due to an organic problem or substance abuse, the Adlerian would explore the purpose of a lack of concentration. In school children, it may reflect a lack of interest in a teacher or subject. Or, it may be the symptom of a pampered child who does not wish to cooperate in a situation that he feels to be unfavorable to him. "Poor concentration" can be used to defeat an overly directive or coercive adult. Improperly diagnosed hearing or visual problems can also contribute to the symptom.

What we include and exclude from concentration is quite revealing. Generally, the degree and quality of concentration can best be understood is relation to the individual's unconscious fictional final goal. It is a convenient way to avoid anything that does not wish to think about.



112. Stages of Psychotherapy

Compuserve
Question/Comment Thread from Health Professionals Forum: What re the stages of psychotherapy that you refer to on your web site?
Dr. Stein: The twelve stages of Classical Adlerian psychotherapy are:
1. Empathy & Relationship
2. Information
3. Clarification
4. Encouragement
5. Interpretation - Recognition
6. Knowing
7. Emotional Breakthrough - Missing Experience
8. Doing Differently
9. Reinforcement
10. Social Interest
11. Goal Redirection
12. Support & Launching
These stages are described in a table at http://www.Adlerian.us/stages2.htm and in a more comprehensive article at http:/www.Adlerian.us/theoprac.htm .
Comment: That would seem to be more effective for the patient rather than a structured, logical approach that does not allow for flexible and creative spontaneity. What is your cure rate, is that the way you refer to the healing process for the patient? In Freudian I have heard there is no cure, but only an ongoing process of visits for a lifetime. Is that correct?
Dr. Stein: From a Classical Adlerian perspective, the road to client improvement can be viewed progressively as: cognitive change, behavioral change, affective change, attitude change, and ultimately dissolving the faulty style of life. "Cure" is a controversial topic; most HMO's consider symptom relief to be sufficient. Our 12 Stage model (see 12stages.txt in Library 13) of psychotherapy clarifies the Classical Adlerian position. In brief therapy, many clients are satisfied after the 3rd or 4th stage of treatment; most depth therapies bring clients to the 5th or 6th stages and consider therapy completed; only a limited number of clients have the emotional courage to risk working through the 7th and 8th stages of treatment. The Classical Adlerian approach considers a full "cure" only when the style of life and fictional final goal have been dissolved. This facilitates a significant shift from deficiency motivation (attempting to relieve an unconscious inferiority feeling) to growth motivation (the pursuit of higher values). In this respect, Adler vision of human potential is parallel to Maslow's.

The traditional Freudian approach to treatment did have the reputation for going on endlessly, with a rather pessimistic view of personality change. However, many of the current, Neo-Freudian approaches to treatment involve a more modest period of treatment, and have moved in quite an Adlerian direction.

Comment: After the fifth or sixth stage, do they consider themselves 'well' enough to resume a healthy lifestyle, or were these client's ever in a 'healthy' state, were they the chronically mentally ill?
Dr. Stein: Frequently, its not a matter of perceived "health", but of motivation and economics. What brings many clients into therapy is the imbalance of the "cost/benefit" ratio of their way of living. From an interpersonal perspective, most clients do not cooperate that well with the people around them, they either dominate, hurt, exploit, or lean on others to varying degrees. They eventually pay a price for this (others rebel, seek revenge, reject them, etc.). As long as the consequences are not too painful, they are usually not yet motivated to seek help. If they can find a way to continue what they have been doing (with minor compromises) at a lower social and emotional cost, they may be satisfied. From an Adlerian perspective, they are not technically "mentally ill", they may not yet be very cooperative.
Comment: Why do most clients only go to 7th or 8th stage? What lifestyle change are they hoping to effect when they begin the therapy in the first place? Do they want to go into life as a happy, healthy individual, or do they secretly harbor a desire to remain a mentally ill cripple? Sometimes I wonder if mentally ill persons hide in their illnesses in order not to face life's challenges.
Dr. Stein: Clients usually enter therapy with an unconscious dilemma: they wish to pursue a fictional final goal (an idealized image of success, superiority, and security) and style of life (repetitive way of approaching life's tasks, that started in childhood) without paying the unexpected price that they are now faced with. Yes, a few may desire to stay "mentally crippled" if it will bring them sufficient attention, support, and relief from responsibilities.
Comment: It seems to me that Freud was not a mentally healthy person to begin with, was he? Seemed he dwelled on the mother fixation too much as in, Methinks the Lady doth protest too much. Is that a valid impression on my part?
Dr. Stein: Adler considered many of Freud's assumptions about human nature to be based on the narrow perspective of the "pampered child". Read E. Fuller Torrey's "Freudian Fraud" for a scathing critique of the man, his theory, and its impact on our culture.
Comment: Regarding the uncooperativeness of most patients, are you saying that most people who come to see therapists do not feel they have a problem, do they feel it is the other fellow who is mistreating them?
Dr. Stein: Some clients do recognize their own responsibility for creating problems, but many believe that they are justified in their aggressive or dependent behavior. Although they expect others to be helpful and considerate, they ignore their own lack of these qualities. This is especially vivid when working with couples.
Comment: But if these people did cooperate with others around them, would they need the services of a therapist, isn't that what brings them in to see you in the first place? Not adjusting in their World View of others?
Dr. Stein: A person who is truly cooperative (not just when it benefits them) probably does not usually need extensive psychotherapy. They might need counseling or psychotherapy to clarify some confusion, temporary empathic support to deal with a great disappointment or loss, or help to overcome a discouragement in onr area of thier life.
Comment: In one of my nursing classes as a student, my instructor stated that was the ideal way for one to live, with lower standards and expectations.
Dr. Stein: An Adlerian view would be to promote "less egocentric" standards and expectations. Higher ideals and expectations of oneself can be very inspiring if they include a strong feeling of community. Maslow explored the "higher values" that are characteristic of self-actualizing people.
Comment: So in the Adlerian perspective is anyone ever mentally ill, or are they considered unadjusted to the vissitudes of life?
Dr. Stein: Of course there are people who are mentally ill (schizophrenia, psychosis, paranoia, etc.), yet, except for organically caused symptoms, many disorders reflect a evasion of life's tasks that do not enhance (or threaten) the person's hidden, unconscious, fictional final goal.
Comment: And clients who come in are still living their childhood fantasies not having adjusted to the realities of adulthood?
Dr. Stein: Quite true. This is most apparent when you examine their earliest recollections of childhood, and you discover that they are still trying to deal with life by primitive analogies to old, subjective, victories and defeats.
Comment: So what you are saying is that one's being inherently Selfish have the problems? Do you think the ME generation of the 60s-80s are responsible for this phenomena? And how do you feel about Dr. Benjamin Spock and his recommendations to parents?
Dr. Stein: E. Fuller Torrey, in his book "Freudian Fraud," discusses the social, political, legal, and child guidance influences that Freud's thinking had on this country. He claims that "Benjamin Spock probably did more than any single individual to disseminate the theory of Freud in America," and that "Spock's Freudian teachings produced guilty mothers with spoiled children".

The impact on the intellectual, artistic community was considerable. According to Torrey, "The New York intellectual community, especially those in the theatre world, utilized psychoanalysis in their personal lives and Freudian concepts in their professional lives...... Driven toward psychoanalysis by the events of WWII and at the same time forced to repudiate their Marxist ideology by events of an emerging cold war (and Macarthy), many New York intellectuals moved closer to Freud. Freud became the intellectual substitute for Marx".

Torrey quoted the playwright Arthur Miller: "psychoanalysis was a form of alienation that was being used as a substitute not only for Marxism but for social activism of any kind. .....The challenge was not to join a picket line or a Spanish brigade but to confess to having been a selfish bastard who had never known how to love."

Torrey believed that the Freudian impact on our legal system was also considerable. "Clarence Darrow argued that Leopold and Loeb were not responsible for their actions because particular events in their childhood led to emotional immaturity. The effect of the case was to legitimize Freudian theory in American courts." ..... "Insanity, in the broad Freudian sense, became increasingly used as a defense for crimes." ..... "Freudian treatment of juvenile offenders actually led to an increase of crime. They were taught that they were not responsible for their acts, consequently they became less troubled by conscience."

Torrey concludes his analysis with: "The core of Freud's theory and therapy are both fundamentally narcissistic in assuming that ones happiness is the greatest good."

Comment: Are the high normal, self-actualizing, people less likely to be selfish, me dominated, and more likely to give to the community than the less motivated person?
Dr. Stein: Yes, according to Maslow, one characteristic of self-actualizing people is their "older brotherly feeling" toward others (he also used Adler's term "Gemeinshaftsgefeuhl" -- a deep feeling of connectedness and community).
Comment: Are pampered children more prone to mental and emotional aberrations than those who learned life's lessons from understanding, caring parents who took the time to teach the child?
Dr. Stein: Pampered children may not show signs of disorder as long as they are in situations that meet their demands. However, once they are expected to cooperate and contribute, symptoms and excuses usually begin to emerge. Many "loving" parents give their children a great deal of attention, affection, and material goods, but, mistakenly, do not encourage their children to become considerate and giving toward others.
Comment: Therefore, what we have now is a world full of what we once called, Sociopaths, in truth...Criminals without morals or respect for authority.

In your opinion, are these ideas Freudian concepts actually responsible for the amoralist culture we now live in?

Dr. Stein: Good question. "Responsible" is perhaps too strong an accusation. It would appear that a Freudian "influence" has contributed to this situation. An interesting sidelight is the "white collar" crime practiced by many CEO's who brutally drain money from a corporation while putting employees out of work.
Comment: Do you see a method for this country to return to this legacy Adler and Maslow left us before we self destruct?
Dr. Stein: I agree with Vaclav Havel, William Greider ("The Betrayal of American Democracy"), and Philip Slater ("A Dream Deferred")--the problem is basically philosophical, psychological, and spiritual. We need a new American dream that acknowledges the need for developing people of "democratic character" in order to build a true, functioning democracy. You can never bring out the best in children or adults within autocratic families, organizations, and relationships. Adler believed that it would be most effective to focus on providing parents and teachers with the knowledge and skill to guide children in a psychologically democratic direction. Consequently, I, like many Adlerians, have included parent and teacher education workshops as part of my practice. (I have also conducted workshops for business organizations.)



For permission to copy or reproduce any of this material, please contact:
Henry T. Stein, Ph.D., Director
Alfred Adler Institute of Northwestern Washington
Phone: (360) 647-5670
E-mail: HTStein@att.net

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