Video Tape Analysis
For this assignment, I have chosen the Adlerian
Model, need to address model in paper.
Sources include, Video Tape, Power Point Notes (email), and from textbook -Theories and Psychology and Counseling by Richard S. Sharf (4th Edition) pages 112 to 126 (will fax)
Answer questions as follows:
1. What is the main goal of the Adlerian
Model? What are the goals of this approach?
2. What did you observe in video that you liked/agreed with?
3. What did you observe in video that you disliked/disagreed with?
4. What are the benefits and drawbacks of Adlerian Therapy
5. What is the main thing that you learned from writing about Adlerian Therapy
or the Adler Model.
See Video Tape Transcript below
Counseling and Personality Theories
Wednesday, May 14, 2008
and personal centered therapies
tonight and get out of our get a little more out of the past from psychoanalysis and Jungian analysis which are very pathology oriented and very much rooted in the past as well.
I hope you find these approaches from your reading as well I hope you found these to be more enlightening. I think as you see them on videotape, it may be a little clearer.
The video of Carl Rogers is very poor, and so it's a the problem is the video is about 500 bucks, and so we're going to still I still want you to see part of it so you can kind of get a sense of what he was like.
is based on the work of Alfred Adler. And his theory is important to understand. It was based on his earlier experiences in life, and he experienced multiple illnesses and didn't walk until the age of four. He was coddled I guess you could say by his mother because of his illnesses. And so when you start to look at one of the primary approaches of his approach, is the idea of moving from what somebody would call inferiority, and this is organ inferiority, the idea that your body compensates. So for example, if you have an injury to one lung, the other will work harder. That's what your body does. And they call it compensation and Adler believed that people started to compensate when they had a struggle. And it could be emotional or physical. And this is important from our field being in disabilities, because we see that that's what people do. And oftentimes they develop stronger senses or stronger abilities in one area or another when they are struggling in another area. So much of his early experience influenced the way he eventually developed his theory.
He earned a MD. This is the third person through the theorists we've talked about who received a medical degrees and went to the University of Vienna, which is where Freud went.
He was originally an ophthalmologist and worked with in a general practice. And he actually worked in an area where they had carnivals in and out. And which sounds like an odd thing, but because in those days carnivals aren't quite what they are today. So he had a lot of people who were had were sort of put out on the stage as being odd or strange or, you know, like literally put out to make money. And so people would stare at them and, you know, go, What happened to that person? Kind of these sight shows that were very much a part of the late 1800's and early 1900's. And what happened was Adler would see a lot of these people who could come to talk to him. It was off the beaten path of a person who might walk in from a job or family situation. He would see people dealing with another level of adversity in the world and constantly finding himself in a place of finding himself in the how do these people deal with adversity that a lot of people would never experience in their lives. And he found that many of them compensated and developed other skills and abilities.
So very early on he saw this focusing on people's strengths. By the way, he was the first who talked about it. Jung recognized it, but didn't draw it out with them.
His works are "social interest" we'll talk about that, the social interest and the other is individual psychology of Alfred Adler. If you were going to go back to his original writings, you'd go back to that one. There were other people who followed with his work later on.
He was invited by Freud to participate in an informal discussion group. He wasn't a student, but he was invited to be part of these Wednesday night discussion groups so he, in fact, right away saw differences in Freud and himself and had no problems standing up to Freud. Even for that day and age where Freud was seen as a developer of these great ideas. He was very clear that there were limitations to the way Freud saw things versus the way he saw things. He was very much part of the psychoanalytic movement with Freud, but there were differences between their thoughts and modes of thinking.
He became the President of Vienna Psychoanalytic Society in 1910 and just prior to when Jung sort of left Freud's inner circle around 1911 and 1912 and 1914 when they really split actually Adler started to split from Freud before that.
So there were a number of dissenters who really initially were really gravitating toward Freud, and the closer they got to them they went, I don't think so, I don't really see this in the same light. There was quite a bit of dissension in the early years.
Unlike Freud, Adler believed in the social realm, and it's a very important to the development of the person and that you have to understand the social context in which behavior occurs. In other words, if you can't really understand why the person would act the way they would or what would cause the behavior, unless you understand the context the person's in. I think this is clearer as we get deeper in the theory.
He disagreed with the idea of power. And Freud thought it was sexual drive, and he was much more interested in gender and politics as being influences in people's lives.
Interesting. Think about this for a second. What a novel idea that was at that point in time that somebody would stand up and think not primarily biological. The surroundings people are in, including the political things, has an influence on gender and the person's perceptions. And Freud said it contributes to the superego, but it's not that much of an influence in the scope of things. Freud was like, these processes that exist within the id are the primary force in people's lives. He formed the Society of Individual Psychology which is sometimes what his approach is called individual psychology in 1912. And he developed an approach that could be used at a community level. This is very important because Adler's work went later on went to influence schools and what had became known as guidance counseling, in fact. It was very much based on Adler's initial ideas.
If you're looking for roots where this stuff began, look no further, because his original idea of taking toll in the community was important. He worked with community hospitals and social settings where people were dealing with war and dealing with all kinds of threats that, you know, all of human kind is going to face and was very interested in how you needed to participate in an active participant in the level. It's not sufficient enough for the person to change as an individual, it has to be taken out into the world and it has to turn into action somehow.
So again, let's comparatively, thinking about Jung and Freud who were very internally focused, change the internal process and that should be sufficient. But Adler said, it's not just about what you do as an individual in terms of making those psychological changes, you must take it a step further and take it out into the world.
Adler's ideas were further developed by Rudolf Dreikers, if you read his work, and he was the primary developer and Don Dinkmeyer and Jon Carlson that had the haircut you were all admiring. (At the beginning of class he showed a video clip with a therapist who had kind of wild looking hair.) And he died in 1937.
Let's talk a little bit about his theory. Now, I want to I'd like you to think about this in terms of what that might look like. Think about how an Adlerian
might look different than somebody practicing psychoanalysis or Jungian psychology.
Okay, so Adler was a transitional theorist, meaning that he crossed over multiple paradigms, but he was primarily psychological and didn't pay as much attention to biological and viewed people as constantly becoming and moving toward fissional goals that they believe lead to superiority. They use these terms that kind of sound more technical than they were.
What's a fictional goal?
CLASS MEMBER: Like unrealistic.
INSTRUCTOR: Kind of unrealistic. It's kind of a combination between a future that somebody wants for themselves, but oftentimes it's a little bit outside of what most people are going to attain, but it's set pretty early, according to him. There's disagreement.
And I thought about eight or nine, and I don't think I had a goal.
But he said it starts developing back then. It's an idealistic view of things, the way you want things to be. So it's off base. They came too high; I guess you could say or too grandiose.
What is superiority?
CLASS MEMBER: If you believe you're superior, you compare yourselves to others and want to be better than others and better than you were and be superior.
INSTRUCTOR: Let's tweak that the little bit.
Same kind of imprint. So what you'll often see is that people will remember very significant things, but most of the time for most people, before the age of four it's very hit and miss. If they think they remember something, it's often what Adler is saying is someone else's construction. They said you were like this at the age of four and you conjured up your own thought of what you think it was like.
But here's the fact of the matter, you'll never know for a fact what you really remembered at that age and what was part of a construction from a conversation with other people. You're just not going to know. And the fact is that memory, that early shifts and changes significantly over the year, how you remember and what you remember and so on. So it's good news in some ways. That's how the body copes with things and how your psyche is able to cope with things. And you don't feel the same way 20 years later that you felt earlier.
CLASS MEMBER: How about when you're three or 21 or 22? Isn't the idea that the mind has plasticity? And the cells that you had at three are not the same cells?
INSTRUCTOR: Exactly. And the synapses close at ten or twelve. That's why you see a young child learn to play piano like Chopin. And you're like, I can't learn to play that way at an older age. Kids have those open. Their ability to learn and digest information is quick. That's a different ability than something that's imprinted on you. The whole process of learning is easier for children, but the actual remembering of events is a different part of the brain.
So we have to consider when somebody experiences something, how does it imprint on them? If it's too early in life, you're not going to know what was reality. When you have a situation and you thought about it years later and you say, I'm not sure it happened or not, have you had that happen?
CLASS MEMBER: I had an incident that happened this last week, and my older sisters described an event that happened when I was two.
And they said, you know, you couldn't remember. It's funny you brought that up, because we actually we were sitting around the table trying to decide whether or not I could remember this at two years. There were images, but maybe the stories been told so many times.
INSTRUCTOR: And you've seen pictures.
CLASS MEMBER: Yeah, I actually did do that.
INSTRUCTOR: That's a tough it's really tough to know but most people, unless you're extraordinary are just not going to remember but so what Adler's getting at, which is different than Freud, is that it really doesn't matter exactly what the event was. It matters what you experienced with it, what your perception's of it.
Now that has taken hold today. We still again, we talked about trauma theory in the last class and splitting off aspects. It's the same kind of thing. You'll hear people describe they were at the same place at the same time when something happened, and yet their experiences with it are very different. And that has to do with culture and has to do with family and has to do with the person's cognitive ability and whether they're more visual or auditory and so many things. But for us, your best pathway is not to get hung up on that. Your theory will tend to direct you towards one thing or the other. I want to encourage you to stay away from your theory and learn from the person which is what Adler was the first person to really talk about it. He said, You know what, I'm going to set the theory aside or not try to figure out whether this is stored in the unconscious or figure out if it's more this or that. I'm going to ask them to describe it. Because they're living in the reality that's been imprinted. They have their own story about it. That's what they're interested in, the story, not whether it's real or not real or true or not true.
If you came across in your reading you'll come across constructivism. But it's become a bigger sort of thing in psychology and family therapy
and as part of contextual and the reality is constructed. You interact with the world in a certain way and interpret things and you live your world according to your story of the world, and there's nobody has a market cornered on social reality.
So Adler was very interested in social reality and how do people form social realities, which is based on the idea of constructivism. He was interested in the person's perceptions of the past and how this interpretation of the early events has an ongoing influence. He believed the early years did influence how people acted in the present, but based on the perceptions of the early experiences not the experiences themselves and believed that people are primarily motivated by the social aspects rather than sexual urges. Behavior is seen as purposeful and goal directed. It's to get something and achieve something and it's typically in a direction of the fictional goal people were moving towards.
Adler stressed choice and responsibility and meaning in life and striving for success. So he thought it was important, again, for people to take it out in the world, but also there has had to be substance to it because sometimes people ask the big questions. We'll see this with the existentialism. And he thought those things come about at different times in life, but nonetheless, most people deal with them in any culture, but these look a little different.
By the way, we used to do this a lot with kids. I would ask them questions. I'd have a teenager doing whatever and referred by the court and breaking and entering or assault or whatever.
And I'd see them and I'd say, So, what do you think you're on this planet for?
And you knew when you'd get a smart aleck remark like, Take up space.
But for some kids it was the deer in the headlights.
And they'd ask, What am I doing here?
And I'd say, What do you want to get done and accomplish before you become an adult? Because it's going to be here before you know it.
And they start to look at things in a little different way.
And, Wow, there's a period of time when this is going to come.
It's a different way of asking a question. It's about the nature of being. And I've heard people say, I think kids just don't want to live in the present and they don't want to think about tomorrow. And I have to say, I completely disagree that kids don't think about tomorrow. I think it's pretty scary when you turn on CNN. There's a lot of reasons to not want to think about tomorrow. I think it's there, and they don't want to face it. They're aware of it. When you hear it all the time you're thinking about it.
We want to consider the fact that reality is right there to everybody. What do you make of it? It depends on the person. It absolutely depends on the person. So it's, you know, those watching if you've with the two earthquakes, I'm sure more than one of you have seen this. Every time I see it I have, not just feeling for families and so on, but just the terrible tragedy. I want to get on a plane and go there and start digging and do whatever, do whatever you have to do. And I think that's what Adler was getting at in the end was that do more than just for yourself, make the changes because it's good for humankind in general.
Central to his theory was this idea of feelings of inferiority, which I mentioned a minute ago. He saw this as a normal condition. And it sounds like a negative thing. It's like Jung's idea of complexes. If you think of the point of time, they sound extreme. He didn't mean it as, this is necessarily a pathological thing. Everybody feels inferior or less than about something at some point in time. That's okay. There's nothing wrong with it in and of itself. It's not a problem. It's a problem when it's unrealistic for them. Rather than a sign of weakness or abnormality Adler believed such feelings could be a wellspring of creativity.
The existentialists talk about anxiety. If I asked you what anxiety would mean, we have a negative connotation of anxiety in this society. A very negative but the fact of it is, is anxiety can be good as long as it's not neurotic and keeps people indoors and they don't live their lives. Anxiety can be a creative thing because it gets people to think differently about a situation and gets them to expand their way of looking at the world.
If you hear I always it's interesting it's such a I I'm always fascinated. I'd love to see a Saturday Night Live skit on this when they interview athletes. They say the same things over and over.
What do you need to do?
We have to make the fewest mistakes and capitalize on the opportunities.
They say the same things. This is the thing that's interesting to me.
The person says, I'm not nervous about it.
Dude, you need to be nervous about it. That's going to make you perform at a higher level. If you can't get excited and a little bit worried, then are you really are you really getting that last bit of adrenaline? And those who are at the top of the game, they're nervous and they dug a little deeper.
If you're worried about something it means something is meaningful to you and you care about something.
So Adler was saying, it's all right. A little anxiety is okay. It's okay to come in class and say, I don't know if I'm going to understand this. Maybe it will spur you to dig deeper and make sure you do get it.
When I first studied these theories, I have to tell you in all honesty, I understood about 20%. It was a flash for me. And I said to myself, if I'm going to understand what I'm doing, I'm going to have to take a look at these theories and you know, I actually worked backwards. I went and studied theories and studied something that I was interested in. And I studied these different theories and realized they came out of cognitive theory. And I relearned the theories by working backwards. If I had to sit down and learned Adlerian
, I would say I don't get it. I don't understand this. It was a bit of anxiety to push further and be willing to ask the questions that are contributing to your not understanding something. But a little anxiety is okay.
And that's what Adler was saying. You don't want to be overwhelmed, but it's a good thing and use it to make you more creative.
Feelings of inferiority can motivate people to strive for higher levels of mastery.
A little more on the theory. They believe around six years of age people develop fictional visions of themselves as perfect and an overall life goal. This is a point of contention with his approach. Again, a lot of people say, I don't have an overall life goal, but you will hear something interesting that kids will say. Kids will say things like not my daughter is a perfect example. My daughter's nine and so, she says she'll say things like, she wanted to be a teacher before and now she wants to be a veterinarian. But here's the unifying things she talks about. She wants to help other people. That's the thing. That's the life goal that you think about. That's likely to stay there in some form. It's not a specific task or a specific job. You see what I'm saying? So now that it still may shift a little bit. It's likely she'll come back at some point of time. I don't know what it will look like for her. There's too much life left to find out and interests to pursue. You'll see people taking things apart and interested in mechanical sides of things and some like nature. So don't think this as a specific life goal and this is what I'm going to do when I grow up. It's an orientation to the world, I guess you could say.
If you were to think back to yourself at the age of eight, nine, ten years old, and think you can remember some of the things you were interested in at that point in time and see if there's consistency and think about that. You might have to look for loose associations. So when I was a kid, I was going to be a baseball player or I was going to be a rock star. Didn't work out too well.
But you know, if I looked back and think about all the activities I was involved in and what really interested me, then I don't see it as a great step away from what I do now. I think there are plenty things I can find connective tissue around. I knew I wasn't going to work in a financial company, even when I was ten years old. No interest, and have no interest. That has not changed one bit. But the fact of the matter is some things work out and some things don't. Look for the connective thread.
And then what Adler was saying is, what's the motivation that moves people in that direction? And typically it's some sort of mastery that's helping them move toward the vision. What are they trying to accomplish? Obviously at a young age you decide to be this or that. You gravitate to skills or abilities to move to the next level with it.
So like I I had when I was a um a junior in high school. I was Player of the Year in baseball and that was my joke because I played in the same league as Tom Glavins, and he's going to be in the Hall of Fame. I had a better run average and more wins than Tom Glavins, and how does it work out? Life goals unify the personality and becomes the source of motivation. So what you focus on tends to create that reality that you live in, and part of that becomes you over time.
You are a conglomeration of multiple things and who you are as a person. So personality is a construct and not a fixed thing. Number of things go into it and contribute to who you are as a person. And again, that life goal is a source of motivation for people and something they're moving towards.
Here's the present, future orientation. Past events have an effect, but where people are moving towards in the future is important to the person as well, towards that goal. Adlerians
see people as not merely influenced by heredity. And it's a growth, not problem focused approach. I think hopefully you're getting this.
People will come in a can come in with a specific concern; however, most of it is about, where are you going? And what do you want for yourself? And what are you striving for yourself?
And again, if you polled a hundred local therapists, you would find three who call themselves Adlerians
and people would use aspects of this approach, particularly in guidance counseling, and particularly in some of the techniques we're going to see, but the techniques a lot cut across different approaches.
may focus on birth order more than a cognitive therapist, but it's not beyond the cognitive therapist to talk about birth orders.
You see how they cut across multiple disciplines even though they're associated with a particular theory? Because we're starting with the early approaches, a lot of the concepts came out of these approaches. All right.
So let's move on further here.
All right. Last slide of theory here. So basic tenets or if you want to call them assumptions associated with Adlerian
. The driving force is driving from a perceived negative to a hoped for positive situation. And that's the definition of inferiority and superiority. Each person strives for a particular direction for a unique goal or an ideal self and because the goal is and idea is fictional. What is social interest?
CLASS MEMBER: Like politics or the community outside your family.
INSTRUCTOR: Outside of yourself or out of your family or out of the own little comfort zone that you build that's your world. Contribution to something bigger than yourself. That's what it comes down.
The individual perceptions of self and the world and the subsequent interpretation of those perceptions are all aspects of the lifestyle.
You'll hear this term cognitive map. It's the person's construct of the world. And the Adlerians
believe that lifestyle is a big proportion of that: work, love and friendship.
Individuals cannot be seen separate from the social context and all important life problems are social problems according to Adler. If they weren't social problems, we would literally people would stick to themselves and the world would go and not make a difference. But the fact of the matter is something that affects one person in some way affects somebody else. And we just have to consider what those effects are.
Maladjustment is characterized by increased inferiority feelings. The further they get to having negative feelings about their lives and the more inferiority feelings and the more depression and the more substance abuse and the more trouble in their relationships, so it's just skewed. Skewed thinking is what we're getting at here.
CLASS MEMBER: So is this the idea that all our problems are not just ourselves but a part of the social context, that what we do effects somebody else? Is that what started the systems theory?
INSTRUCTOR: No, not really. That came out of something else. He talked about that, but not as a treatment approach, whereas the systems theory is the actual focus on changing relationships. But he was a few years ahead of that. You could look through his writings and you might say, I see a connection here, but it wasn't a precursor. Systems theory came out of biology and social systems theory both of which we'll talk about in here.
The process of counseling for Adlerians
. First of all, use of DSM diagnosis is inconsistent with the Adlerian
approach. They don't do that in that approach.
As with all approaches from here on out, if you're in a climate where a diagnosis is required, you're going to have to assign a diagnosis to get reimbursed and assign a diagnosis for people to get services. What I would encourage you to think about is having people have conversations, and you should be disclosing that to your clients, and you should say a diagnosis is required for reimbursement of services. So you should make that very clear to people and you should make it clear what happens after you assign the diagnosis, meaning that if it stays within your organization, that's one thing. You may have to assign a diagnosis. And if somebody audits your records, prove it. However, if you have to submit a diagnosis, meaning it goes outside of your organization or your practice, you need to inform people of that. Because the fact of the matter is, even though our systems are somewhat improved in terms of confidentiality, there is the possibility that the diagnosis can be accessed by other people, meaning that it all goes into a mainframe computer. So life insurance it's happened with people, and they go to get life insurance. And the person says, Well, you were am I right, you were diagnosed with major depression ten years ago? And the person said, It was ten years ago, and it was situational.
It's a sad thing. It can happen. But I'm here to tell you, it does happen.
Labels are much harder to get rid of than they were to assign. So just be aware of that.
And that's why many people in the same way that they choose to get go and pay for a massage or dental work outside of their insurance will do that. And they pay out of pocket for mental health services. And it's just one of those things that you just you need to let people make the best educated decision they can for themselves. And I would say 97% of the time it's not going to be an issue for them. But in the event it is, you need to let people be aware. That's all.
So, um I again, have a couple of colleagues. Dr. Conway was this way, as well, for those who knew him. I never when I had my private practice and had an office didn't accept insurance. And people knew that up front because I did not want
Several reasons. One was the potential stigma that can occur from it and the other was I didn't want to deal with insurance companies. So it's one of those things. You just have to decide.
But from this perspective, diagnosis doesn't play a role in working with people. So you typically would not gravitate at a time towards that.
Assessment involves the use of interviewing and inventories and questionnaires. You're going to see this on the tape. I'll give you examples in a minute.
Focus on exploring the family constellation. Family is very, very important to the Adlerians
wanting to understand what the early relationships were like. And they're meticulous. Tell me about your relationships with your mother and early memories about your mother. What about your father, and who was he close to? They really are meticulous. You were not close to her or him? They get more involved in mapping out the family.
Sometimes it's inventories, and they'll have a questionnaire. And they'll kind of use it as a guide while interviewing with somebody.
I notice you have six brothers and sisters. What was that like for you growing up in a big family? And move into the order. What did you notice about your relationship with your sister? How close or distant were you from the youngest sibling?
They delve into that family constellation and get into friendships, work, and love, and examples of processes, using lifestyle inventories. And you'll see this in the tape when Jon gets into birth orders.
Dreams. Early on, they might have questions on dreams, but not really a part of the way people work these days. But again, it's another way of understanding how people's perceptions develop over time.
So your focus is getting into conversation with people about different things that happened in their life but not to relive them, but to get a sense of what are the things that influenced their perceptions that are affecting the way they were in the present. There is the belief that those perceptions affect what's going on right now. It's to get a sense of how they were influenced now.
Goal setting. The goal setting is focused on helping people to lead socially useful lifestyles and the challenge of everyday tasks of work, love, and friendship, and ultimately to achieve a higher level of social interest. And again, that involves going and being involved in the world and going beyond just your immediate self and what your immediate needs are, your primary goals.
Let's talk about a couple concepts. Social interest, which we've talked about. If somebody asked you what is the primary components of Adlerian
, one is social interest, being involved in the community and being involved with other people and family constellation and the importance of the early family development that teaches people closeness and how to be in a relationship with one another and teaches social skills. And again, it's based on perception. Lifestyle, work, friendship, and love relationships. This is sort of the overall frame you're looking at.
So whenever you're asking questions they're typically in one or more of the areas. You're gathering information. People will focus more on the other. I had a conflict with my boss, move into the work realm. Chances are the there is significant conflict showing up as a theme. You'll find connective tissue elsewhere and trouble from relationships somewhere, maybe not to the same degree, but somewhere.
Inferiority versus superiority. Moving from a negative situation to a positive one.
Life goal. What are people moving towards in life? And what are they trying to achieve? And what are they hoping for?
And basic mistakes. They are errors in people's thinking. When moving towards a fictional goal, there are errors in thinking. So in other words, they're in the position of feeling, having the feelings of inferiority. And say, they're getting worse and worse and worse, at some point the person starts making errors in their thinking like, you know, the way my dad treated me as a younger child, all men, that's what they do, and that's how treat their kids. When working with men I need to keep this in mind. It's an error in thinking and a dichotomous way of thinking. So look for the errors contributing to people's upset.
Oftentimes from moving from inferiority towards superiority, you start to see distorted thinking and errors in perception.
So what are some of the methods you might use? Restatements, guesses, interpretations.
Restatements are things like restating what somebody has said to you. I'm just feeling really lonely.
So you're describing yourself as being really lonely.
It's a restatement.
A guess is something like, so I'm wondering about. I was just curious about. It's an idea. You're not saying you are. You're saying I'm wondering about. You're asking the person rather than assuming.
Freud would give a literal interpretation and say, You're an angry person. But the Adlerian
would say it sounds like, even if the person didn't use the word.
I'm wondering if you're angry.
And they might say, No, I'm not. Or maybe I am.
It's not interpreting, it's asking. It's a position of curiosity. It's how you frame your questions.
Interpretations are given loosely and given with the approach of the person having the last word. So the person you're working with gets to say, Yeah, that sounds right. Or no, it doesn't.
It's how you deliver the interpretations rather than saying, Clearly it means this. You're saying, I wonder if it could be this? Or have you considered the possibility this might have ... and it's a result of this.
And client says no, yes, maybe.
CLASS MEMBER: How does restating help them? And what is that doing for you?
INSTRUCTOR: Let's them know you're listening. And sometimes it's a good way to summarize what they said. Sometimes hearing what you just said is a different way of experiencing it. I have a friend who says, Let me see what I say so I know what I think.
Once you put it out in the world and you hear it back to you, then it's acknowledging it and normalizing it, because you're not labeling it. You're not saying, the person says, I'm really sad. And you say, So you've been really sad. Sounds like you've been down from what you're describing. You're not saying it's bad. They're not labeling, but they're catching the essence of what you said. So that process of reflection let's people know you're there. When it comes to parroting, it might sound like you're repeating. And we all restate to some degree. You'll see this with Rogers.
Encouragement and encouraging people to take steps in their lives and move forward and use their skills and abilities and be creative about things.
Asking "The question." In the question goes a little bit like this it's a future focused question. If I had a pill to make fill in the blank go away, how would things be better in your life?
When we get to solutions therapy
in the last part of this course, you'll hear the idea of the miracle question. And it's interesting because the miracle question was developed by a couple of people in Milwaukee. And they both passed away in the last couple of years. And they were given credit for this question, but in fact the question, Adler's question proceeded that. And Milton Ericson also has had a variation. And it's the idea of getting a sense of what better is. If you know what better is like for the person, then you can help them to move sort of backwards to make that happen. If they describe how their lives would better if they took a pill, and how can we get to that to happen? And now you know the end point and what they want. So it's a bit of a future focus.
CLASS MEMBER: In the course of therapy
, would you wait a while to ask questions like that? I mean I mean.
INSTRUCTOR: You asking me from this approach or asking me in general?
CLASS MEMBER: First in this approach.
INSTRUCTOR: In this approach, you would wait.
CLASS MEMBER: Would it be automatic after your assessments?
INSTRUCTOR: I would say
CLASS MEMBER: I guess why I ask, I'm wondering how is this a quicker therapy
than like Freudian or Jung or does it is it more processed long term?
INSTRUCTOR: It's shorter term than Jungian analysis and Freudian analysis; however, it depends on the person.
A lot more Adlerians
would ask focused questions and a lot don't get to those questions until further on down the road. It depends stylistically.
The fact of the matter is that most people who practice in this way are off the beaten path a little bit. They're not quite they're not true necessarily to all these ideas, so they it may look different
When you see Jon Carlson, Carlson is a constructivist, and he is a brief therapist and wants to help the person to move forwards.
CLASS MEMBER: He would ask sooner?
INSTRUCTOR: Sooner than someone else. In general, I would encourage you to ask them sooner than later. If you don't know where you're going, you'll end up somewhere else.
The whole point is, I need to know what better is. If I don't know what better is, how am I going to know how therapy
is good for the person and that they don't need to come back and how improvement is made? I argue, and some people say, clients don't really know. They don't know what better is.
INSTRUCTOR: And my response is, that's a problem. I need to work with the client, if they don't know what they're trying to get out of therapy
and don't know what better is, not coming in and saying A, B, and C and I will sleep better at night. Rather than getting two hours of sleep, I'll get six hours of sleep. Great. We have something we can agree to work on. If I don't know what that is in four, five, six sessions and still in the same spot, this is where the research data comes flooding in. The data says most of the change and all metaanalytic studies show the same thing. The trajectory of change is highly predictable in the first handful of sessions. Typically the first three to five sessions they show some kind of response or some kind of movement. If they don't and the therapist fails to recognize that and fails to make adjustments and uses the same approach, the likelihood is this client's going to get worse. And what happens then is that the therapist starts to see the client as resistant, non motivated and not wanting to change and noncompliant.
CLASS MEMBER: You change approaches?
CLASS MEMBER: Keep trying something new?
INSTRUCTOR: So the key is I hope this piece comes out in some way the key is to have a conversation with people and put it out on the table and say, From where I'm standing, I'm struggling to get a sense on how this helping you or how things might be improving or getting worse. Ask the client. The thing therapists struggle is they get in their heads and try to figure it out. Therapists are lousy judges of the strength of the relationship. They don't really know. They look at cues from the client and say, This is a good relationship. You ask the client later, and they say, I don't feel her. I don't feel like the person understands what's going on with me. What we're aiming with is going back in conversation and saying, How are you seeing this? And from the very beginning getting into those kinds of conversations.
And if you look at data on strength of relationship between a effective therapists, most therapists early on see this, that are really effective.
You look at the first sessions, one through five, and look at the trajectory of this is where the therapist and this is how let's say this is a number of sessions, and these are high alliance scores. High, low alliance scores. This is the client's rating of the relationship. Most therapists, what you'll see is the alliance kind of goes like this. (Drawing on the graph. One line shows an increase right away and then a leveling off. The line representing the effective therapist shows a slight increase and then a small dip and then a steady increase.)
Why do you think that effective therapists have lower alliance scores earlier than a therapist who goes like this? Because this doesn't necessarily mean better all the way, always. I'll explain why in a second.
CLASS MEMBER: Maybe not used to the therapist and build trust.
INSTRUCTOR: Why does it improve?
That follows in some ways.
Why a lower score initially and why isn't the person dishonest and you give them a tool and you say I want you to rate how this session went. And many of the -- those therapists get a lower score earlier. Why do you think that is?
CLASS MEMBER: Maybe they take more time to do the assessment and to get to know the client before they before they give them treatment for the specific thing.
INSTRUCTOR: Could be. That's plausible. There's another reason. Okay. Ever put take yourself to a position where you've been take this into a social realm and everyday relationships. What is the first thing men and women do when they meet somebody? To try and everybody does this.
CLASS MEMBER: Impress.
INSTRUCTOR: Impress. Exactly. You want to impress the person right away. You don't want to dare get into that stuff.
And there's another side to that. You could obviously go dump something on somebody and that might push them away as well.
But the key is that people that tend to put something out on the table and show that there is some level of, I'm not perfect kind of. That tends to be a little more endearing in the long run. I can't tell you how much that amount is, but therapists tend to here they don't candy coat and say, I don't really know what it's going to be like for you. But here's the thing, I'm going to check in with you to find out how things are going pretty routinely. And I want you to be honest with me. If something isn't working well, you're not going to hurt my feelings. You're not going to dampen my confidence but I need to know this from the beginning.
So from the beginning, they get feedback that isn't always so good; whereas the other person comes in and paints this picture of, I can absolutely things are going to improve and set the exception that everything's going to be perfect. And the client is scared to give feedback. And what if I say something that makes them feel bad? And they start to rescue the therapist in some way and then what happens? What happens for the person with high scores but didn't feel like they can give feedback? They might rate them high, but not being challenged. So their outcome scores people with these sort of lower dips, their outcome scores are likely to continue up before they flatten out. But here, the scores kind of flatten like this. They still say, I like meeting with the person, but they're not showing any improvement. That's the trouble, is it becomes a little more fused, the relationship, more dependent. There's a not being pushed at any point of time. I mean pushed in confrontation and not challenged in a way that helps them move forward in some way. So the big difference is that the therapists here are just setting it on the table from the beginning and they're saying, Look, you know here's my exception of you, to be honest with me. And I want you to know I think things are going to improve quickly, and it might be a possibility we get stuck points. If you help me, we can make adjustments and figure out what's working and not working. And that's when you change the model or approach. Getting comfortable with saying, Do you feel like we're focusing on what you want to focus on or spending too much time on an area that's not useful for you? When you open those doors for people you'll hear things like, Now that you mention it, I'm not really sure why we're spending time on this. I thought you thought it was important, but that's not really why I'm here. I'm really here because of this. And all we're saying, if you ask the questions, you get a better chance to attend to any ruptures that might be occurring in the relationship and make adjustments and change your model if you need to.
CLASS MEMBER: How often and I hear that and think about this. How often do therapists get offended whenever they try to do that and someone, a client says, Well, I don't really like what you've done here. And I'd like to focus here. Granted we should be thinking okay, you know, it's mainly for the client. How often do the clients get offended by those things and are ineffective the whole rest of the way?
INSTRUCTOR: Let me say this: When you ask questions of when you're asking questions about the strength of the relationship, you're asking about process, not about character. You're not saying, I want you to tell me whether you think I'm a good therapist. Do you think I'm going a good job? You don't ask that to people. That gets into character. Then you ask them to judge your character. That's not your job for the client to judge your character. What you want them to do is judge the process and say, Is the way we're approaching your situation working for you? Are we talking about what you want to talk about? Not am I a good person or therapist? This is a parallel for working with your clients.
You've got to get the personality disorder thing the other day when you start thinking about the person as characterologically flawed, do I have the ability to judge somebody in that way? Even if 3% of the population does the worst thing on the face of the planet and should never be let out of jail and does horrible things, does that give us the right to judge others?
You've heard people say this I've heard parents say this to their kids and he's acting just like a murderer. Acting like a (pausing for effect). Think about the complication. It's a threat to somebody's character, to who they are as a person. But if you're saying, I don't like that you do this. This bothers me when you do this. I don't like the actions or that behavior, you're getting at process level not getting at character.
Do you see this difference? If you work with couples, you have to get past this point.
The minute that people start to attack each other's character and get to the level of intent if one person thinks the other person is trying to hurt them, purposely doing this, that is a completely different level than the person who says I know he does this, he doesn't mean to do it. He does it, but it hurts my feelings. One is act and action and one is about a character issue. when you get into character, you get into intent.
Does this make sense at all? You'll know it when you feel it too and when you feel it from the client. He's trying to hurt me. He's trying.
I did a whole piece on. I don't want to diverge too much. I did a piece on it's in the book. It's called the problematic stories. You cut problems into four areas.
One is that they think things won't change and stories of impossibility.
Another is a story of blame which is about intention. He's doing that on purpose and trying to hurt me. That's a when you hear those stories, you should hear have a buzzer go off in your head.
Stories of invalidation and somewhere somebody says, Don't feel that way. And let it go. And they're not ready to. It feels invalidating to you. You shouldn't feel that way. That's the way I feel. You know that's not the problem. So it feels invalidating.
And the last is stories of non accountability. I can't help it. My mom didn't give me my medication. And if people wouldn't cut my off I wouldn't have to run into them. That's the story of non accountability. And they don't take responsibility for their actions or use an excuse.
Most of what you hear is going to fall into one of those areas. When you're asking for feedback, it's not judging you or talking about who you are as a person but talking about the process and commenting on the process or your approach.
And I think, Ryan, it keeps it out of that area of being personal if that makes sense?
CLASS MEMBER: I understand that. I was curious how often that occurs?
INSTRUCTOR: I think when it's set up from the beginning, it may take a few people to get used to the fact that until you understand what they're asking of them, it can happen. They is say, I don't want to say something that offends you. You have to create that context, you know. My job is to help you to figure out how you can move forward with this. You're not going to in any way offend me if I'm doing something that's not useful. You have to develop a sense of a bit of a thicker skin with this.
Anyway, if you put yourself out there, you have to develop a bit of a thicker skin. Sometimes it's difficult, you know I mean, everybody can be cut in some way. And as long as the intent is not to say they're not trying to put you down but give you a useful comment and you have to sift through that and ask a few more questions.
When I went to seminars, there'd be 200 people and I'd get 195 good evaluations and five that were scathing. And I'd say, Is there something useful I can take away? Or is it something if it's characterological, I dismissed it. It was rare. People don't take an attack on your character, but if they do you have to see through it and go, That's not me. If they don't like the way I presented something or did something, that's one thing. I can learn from that. That's the point of evaluation. You have to be able to
I had somebody say. It happened at this school. It was probably seven, eight years ago. I had a student put on an evaluation, professor didn't always wear socks.
It was like summer. I have I have worn socks every day I've taught here. But I wore loafers or something during the summer. I'm like, that's not really a useful comment on an evaluation.
CLASS MEMBER: Are you serious?
INSTRUCTOR: It was on an evaluation. I mean, what do you
You'll get but you have to kind of that's the same thing with therapy
. You're asking for it at a certain level. You have to be able to step back and say, it's not really about me when it comes to that. So kind of you have to sift your way through it.
Let's get through the last little bit, and we'll take a break and a couple more methods.
Catching oneself. Who you are how are you going to stop yourself from, "Woe is me." And they picture a hand, and they have a keyword that comes up. Some way of stopping that process of continuing down that path of everything's terrible.
Acting as if. What if you were, today, to walk out the door and act as if. Going to have a successful career. What would you do? What would you do that is different. This is an interesting thing. You see a lot of people who
There's a great book came out couple years ago called it's the Cambridge book and after studying business people and studying athletes and all these people who were very successful and interviewing people like Warren Buffet. And he used to say, I'm hard wired that way. That's the way I was born that way.
And in fact, there's nothing that can be further from the truth according to the data. Warren Buffet studied financial documents day and night, market trajectories. And he's the perfect example of somebody who created a lot of his genius by immersing himself. If you find people who are successful as people, it's not a mystery. The top 10% of musicians practice 20% more than others. The top 10% of athletes have certain things that they do that are different than the next 10%. And it's beyond just that ability, you must have been born that. It doesn't ferret out. They learn from other people and practice. And many have the idea of focusing on the future, not where have I been, but where am I going, and not worried about the final end step but taking the steps in between to get there. If you didn't think that, if you if you really, really wanted a master's degree or bachelor's, if it's all you wanted is just that piece of paper, you go get one from some university that's not accredited and take another process.
But the fact of the matter is, you come to a whole bunch of classes that's going to take two years, and probably three for most people and maybe more and complete a whole lot of papers and come to a whole lot of lectures like this and be very tired. If you didn't see that there were steps in between that you could gain from, you wouldn't bother. Now you may not think about it in those terms, but every time you come here and go through one class, you take a step further along. And pretty soon you're at the end of the semester, and you've completed two classes or three and four and build and builds and then you're there. All these people think about is the things in between and breaking it up. If you drive here from California, you wouldn't go, Wow, jeez, we're I'm 1620 miles from where I need to be. You'd go, it's a hundred miles to here. It's 250 miles to Kansas city. You break it down and feel like you're making progress and you do that in your own way.
My point is thinking about that next step forward. And for the clients, rather than saying here's the end point and this is where I have to get, what are the sort of things in between we need to steer them towards. One is to think acting as if.
Spitting in the soup is when you challenge a client and the person's saying, I'm just really exhausted. And you say, You know, I hear that you're exhausted, but it seems to me like as long as you continue to work these ten hour days that that's probably going to be a part of your lifestyle. And wait a minute, I've got to work ten hours a day. It sounds like a choice to me. You're not confronting the person and say, Quit being a cry baby. But there's a choice. And I'm going to challenge you. That's kind of going in there and saying, I'm not disrespecting you or telling you you're wrong, but looking at it through a narrow way. And I'm going to throw a rock in the water and let it go out in ripples. The result is you're going to have to think about things differently. It's not just the way you see it right now. I'm going to challenge you to think about the world slightly different.
So another we'll see this in other approaches, challenging absolutes and so on.
There's a couple more, pushing the button. This is like when you have a person, you can have them envision something positive or an event that they're not feeling strongly one way or the other and have them think about the positive sides and have them think about the negative sides, and emotion that go with that. And they tip the scales for themselves just through the process of experiencing that.
And the one last one is homework and to give them assignments and take them in the world. And most change doesn't occur in the office, it occurs in the world when they go out and live their lives. Most change takes some action on the part of the people. No matter how they talk about it, they give us great lines. And now you've got to go do it and develop plans with people how they can take actions, realistic action and small actions, not overwhelming. But that's often a good starting point for people.
So what I want to do is take a break and come back and see about 20 minutes of video of Jon Carlson doing Adlerian
and give you a sense of what this looks like. So take a break.
INSTRUCTOR: So this is Jon Carlson, and he's pretty prominent in the ACA, American Counseling Association. If you ever get to the conference last year it was Hawaii. And next year it's like Nashville or someplace like that. Usually the conference is a pretty good conference.
He's working with a woman. The guy I was with did this series with family therapy
with the experts, but they're displaying the approaches. These are real clients, not role playing or something. She's come in and kind of ambiguous about what's going on with her. But what he's going to do is demonstrate the theory. And you'll see a lot of the things we talked about. See what you notice. You may want to choose to write your critique of it's up to you. But I think it's pretty I'll make it and stop it at a couple of points, but I think it's mostly self explanatory. Look for the process we talked about and the key things we talked about and the role of the past, and the importance of perceptions. We'll talk about the family constellation and early recollections and so.
Here we go.
CLASS MEMBER: I have a question really quick. This is what our paper's on? We critique the video?
INSTRUCTOR: So the next four videos you see today and next class. I want you to choose one. You may not know until you've seen them all. I want you to choose one to answer those areas I gave you on that paper.
CLASS MEMBER: And use these videos as the basis for our papers, or you know.
INSTRUCTOR: The video is the basis for that paper. Yes, yes. It is. So your responses should be to this. Okay.
JON CARLSON: I've been wanting to meet you for a while. I've watched you come in and out of our set and haven't had the chance to talk to you. I appreciate you filling out the forms.
CLIENT: You're welcome.
JON CARLSON: Let me summarize what I learned from those and see if it makes sense. If I understand things, you're in a transition right now and moving from being married to you've divorced now.
CLIENT: Mm hmm.
JON CARLSON: You're a single mom?
JON CARLSON: Two sons?
JON CARLSON: Okay.
JON CARLSON: And you're moving into the last year of the 30 something's?
CLIENT: Yes. Yes, I am.
JON CARLSON: And you indicated that your family of origin, there were four children and you're the hold oldest?
CLIENT: Yes, I am.
JON CARLSON: Three girls and one boy.
CLIENT: Two girls and two boys.
JON CARLSON: Two girls and two boys.
CLIENT: The two older are girls.
JON CARLSON: And the two youngest are boys?
Coming in today, did you have ideas about what you wanted to talk about right now?
CLIENT: Every day's challenging actually. Nothing really pressing or anything like that. It's just these last couple of weeks I've had conversations with family members and friends and this overwhelming theme of amusement parks and choice of rides. You have people who ride the merry go round and the roller coaster. And my mother told me I ride the roller coaster. And I've been using it the last two weeks, talking with my friend, and it's amazing how it's real true.
JON CARLSON: It's a metaphor?
CLIENT: We were saying is that you can exist in life or live life. Those people that go on merry go rounds go around and around. There's no excitement and challenge. They're existing. But you have people like me that like roller coasters. And you know, they're scary. And you've got that moment where you close your eyes, but yet you kind of expect it and you kind of thrive on it. And each time you go on a roller coaster, it's not the same, more people on, less people. They speed it up or slow it down. And it's more like living.
JON CARLSON: So where are you right now on the roller coaster?
CLIENT: I'm going back on for more rides. I'll keep riding.
JON CARLSON: Are you more up or down.
CLIENT: Up, up, up.
JON CARLSON: Like from a scale from one to ten, one at the bottom and ten at the top?
JON CARLSON: So.
CLIENT: Very up. Very up.
JON CARLSON: So these are good days for you?
DR. BERTOLINO: So people talk in metaphor a lot. It's very common.
CLASS MEMBER: Was she talking about a class she attended when she started talking about the carnival?
CLASS MEMBER: I'm like what the hell's the roller coaster.
CLASS MEMBER: She's talking about family and life.
DR. BERTOLINO: She was having a conversation with her mother and the mother used the metaphor of life is just like a roller coaster. And they just got talking about that.
CLASS MEMBER: She brought it up.
DR. BERTOLINO: Yeah, she brought it. Where would you like to start? She's like my mother and I were having this conversation the other day about life and
CLASS MEMBER: Okay.
INSTRUCTOR: He's tuning into the story. It was kind of random.
Let me make a point about that. There's been a lot of research about the what is the right starting question, and there isn't one. And what I would encourage you to do is to not try and start with your own agenda. I would encourage in other words, I would encourage you to stay away from asking a specific question like, What's your problem? Or you know, what would you like to change? I would leave it open, because when people walk in the door, they want to start wherever they're most comfortable.
It's like if you walked in wherever you live now and you walked in and you live with somebody and first thing out the other person's mouth was something like
CLASS MEMBER: (Unintelligible.)
CLASS MEMBER: What's your problem?
INSTRUCTOR: I wouldn't say that, because that's not a kind of question therapy
. It wouldn't make sense. It really wouldn't make sense.
What would be a question? Walk through the door and the person said, What do you want for dinner? Now that's a reasonable question, but wouldn't you prefer the person saying, How are you doing? How's it going? And really that applies to therapy
. Start general.
What brought you in What would you like to talk about? What's on your mind? How are things going?
You're going to eventually move towards what you need to. If you funnel people in, you're cutting them off and not giving them the opportunity to start.
In subsequent sessions some people start on a thread and they tell you just what happened when they came in and not talking about the problem. They want to tell you and catch you up to speed. And if you check in and, You said you mentioned you had an argument with your son, that's a little different than what we talked about last week. Was it on your mind or is it something you'd like the spend time? I just wanted to tell you about it. Just didn't that's not how I hoped the day will go. What I really want to talk about is this. You're checking in with the person. You should go where the client wants to go, and you can always at more structure in as you need to.
He's just following her and staying on the metaphor. He's tagged on it nicely. He is using scaling. It's not an Adlerian
idea, because it's a constructivism approach and how they construct reality. Scaling makes sense. He wants a sense of how they put reality together. Wow, this will help me better understand. Is she more up or down, ten being the top end and one being not so good? By her rating it, he gets a better idea.
CLASS MEMBER: It's general practice? Before you asked why you're here. He was reiterating a history of her. Is that typical before you go into a problem they get a family history, you know, of where they came to, where they're at, and where are we at?
DR. BERTOLINO: It's part of the conversation and they'll start and say I was going over some of you stuff you filled out. And as we get started, I'm going to start requesting you questions. He's more deliberate. They've only got a certain amount of time. He's more fact of the matter. He's pushing more to show the approach, but I suspect if he weren't being taped and there weren't the kind of pressure, he would start general and filter it in from there.
When she talked about the mom and metap
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