Counseling Theories

Solution-Focused Therapy

A Quick Definition…

“Solution-Focused Brief Therapy (SFBT) is a future oriented, goal-directed approach to brief therapy that uses questions designed to identify exceptions (times when the problem does not occur or could occur less in the client’s life), solutions (a description of what life will be like when the problem is gone or resolved), and scales which are used to measure the client’s current level of progress toward a solution and reveal the behaviors needed to achieve or maintain future progress.” (page 287)

Solution-Focused therapy was developed by Insoo Kim Berg & Steve de Shazer at the Mental Research Institute (Corey, 2015).  It is a brief therapy that represents a postmodern, social constructivist perspective.  This brief, goal-oriented focuses the client’s attention on the solution rather than examining the problem (Metcalf, 2011). Instead of focusing on reliving the past, it focuses on changes to create in the client’s desires for the future.   Since reality is conceived as a constructed, rather than absolute concept, the client is the expert not the therapist. It is for this reason that the therapist’s role is collaborative in nature, and involves redirecting the client toward possibility.   The primary goal of Solution Focused Therapy is empowerment for client in whom emotions are validated in a brief and highly structured context (Metcalf, 2011).

    Focused on the present.

    Postmodern social-constructionist perspective.

    Practical, aimed at uncovering solutions.

    Goal-orientation optimistic perspective.

    Theoretical Assumptions

    Client’s have the resources and capacity to change.
    Problem-focused thinking prevents change
    Change is a continuous process therapists aim to magnify.
    It is unnecessary to know the problem to solve it.
    Clients define the goals.
    Client’s often present one side of themselves in life.
    Rapid change is possible when identifying the “other side of the coin.”
    Client’s can be trusted to solve their own problems.
    There is no right or wrong way of seeing things.

    The Therapeutic Process

    Overview of Steps

    According to a textbook titled “Theory and Practice of Counseling” solution-focused therapy involves the following steps: (1) determine the client’s goals for therapy, (2) figure out what is working in the client’s life, (3) determine new approaches for what isn’t working, (4) keep therapy brief, pragmatic and goal focused, (Corey, 2015, p. 380).   In contrast, my old course textbook, provides the following description of the solution-focused therapy process (Metcalf, 2011):

    STEP #1: BUILD RAPPORT

    “My name is ____. As we begin talking, it would help me to get to know if you would tell me more about yourself and what you appreciate about each other, (Metcalf, 2011, p. 299).”

    STEP #2: UNDERSTANDING THE PROBLEM

    Listen to the client describe their problem and the change they attempt to accomplish.  “How do you explain your ability to ______ during this time? (Metcalf, 2011, p. 299).”

    STEP #3: ASSESSMENT

    In Solution-Focused Therapy, assessment doesn’t involve an examination of the problem, its cause and historical context.  Instead, assessment focuses on actionable solution and the possibility for change. “Could you describe the times when the problem occurred less? (Metcalf, 2011, p. 299).”

    STEP #4: DEFINING GOALS

    The Miracle Question:Suppose tonight while you sleep, a miracle occurs. When you wake up tomorrow, what will be different?, (Metcalf, 2011, p. 299).”  

    STEP #5: AMPLIFY CHANGE

    Whenever you hear exceptions to the problems at hand examine this further in order to develop a clearer understanding of the solution. “What difference did that make for you? (Metcalf, 2011, p. 299).”  

    STEP #6:  TERMINATION

    Each week, ask the clients whether they wish to come back, and if so, when. This puts them in charge of therapy. “What did we do during our time together that you found helpful, if anything? (Metcalf, 2011, p. 299).”  

    How Change Happens

    “Solution-focused therapists view clients as wanting to change, (Sharf, 2015, p. 457).”  Rather than diagnosing or focusing on aspects of the problem, solution-focused therapists aim at making small changes step-by-step.  Change happens through a strategic focus on how to promote solutions to one’s problems.  Helping clients find exceptions to their complaints can help them focus on possibility for change rather than continuing to focus on the problem (Metcalf, 2011).

    Assessment

    “Unlike many other therapies, solution-focused therapy is not concerned with making diagnostic categorizations; rather the therapist assesses openness to change, (Sharf, 2015, p. 457).”  This entails examining the client’s motivations to change as well as any obstacles or barriers that might be present. One tool useful in this assessment are “…mindmaps…diagrams or outlines of…..the goals and solutions to problems, (Sharf, 2015, p. 457).”

    Therapeutic Goals

    “The solution-focused therapist believes people have the ability to define meaningful personal goals and that they have the resources required to solve their problems.  Goals are unique each client and are constructed by the client, (Corey, 2015, p. 381).”   Goals must be, clear, concrete, specific and measurable, (Sharf, 2015).  Techniques useful in defining one’s goals include miracle and exception finding questions. According to solution-focused therapists, well-defined goals have the following characteristics:

    Well-defined goals should be stated positively in client’s language (Sharf, 2015).
    Well-defined goals are action-oriented (Sharf, 2015).
    Well-defined goals are “structured in the here and now, (Sharf, 2015).”
    Well-defined goals are “attainable, concrete & specific, (Sharf, 2015).”  
    Well-define goals entail actions that are controllable by the client (Sharf, 2015).

    Therapist Role

    “Clients are much more likely to fully participate in the therapeutic process if they perceive themselves as determining the direction and purpose of the conversation, (Corey, 2015, p. 382).”  A collaborative relationship develops based on the fact that therapists are experts in the change process while clients act as experts of their own life experiences.   A mutually respectful dialogue develops, involving an open inquiry involving an exploration of goals and solutions.

    Techniques & Procedures

    Questions

    “Questions are designed to help clients focus on exceptions and make presuppositions about future actions while building a positive outlook and encouraging achievement, (Metcalf, 2011, p. 295).”  There are three types of questions:

    Exception Questions

    Solution-Focused Therapy is based on uncovering exceptions to an individual’s experiences of the problem.  These exceptions are times when the problem did not unfold as expected.  Exception questions are utilized in therapy to further understand this powerful exception-related experience.  The goal is to engage in change-talk and develop a clearer view of the solution to one’s problems

    “Tell me about a time when the problems you’re experience don’t happen?”

    The Miracle Question

    With the miracle question the therapist asks: “If a miracle question happened and the problem you have was solved overnight, how would you know it was solved, what would be different?” (Corey, 2015, p. 384).”  The purpose of this question is to allow the client to begin considering hypothetical solutions to their problem.

    “Imagine…a miracle happens and the problems we’ve been talking about disappear….what would the…signs [this] happened? (Sharf, 2015, p. 460).”

    Scaling Questions

    “Scaling questions ask the client where they feel they are on a scale of 1 to 10 (Metcalf, 2011, p. 296).”  These questions are useful in determining a client’s progress towards their goal.  “This kind of assessment offers clients hope that change is inevitable.  It is not a matter of if change will occur, but when it will happen. (Corey, 2011, p. 384).”

    “On a scale of one to ten…where would you say you are today? (Sharf, 2015, p. 460).”

    Interview Techniques

    “Interview techniques serve to validate concerns and assist clients in experiencing significant shifts in their thinking about their situation, (Metcalf, 2011, p. 296).”   The mindset utilized during an interview centers around the idea that the client is the “expert”.  This therapy method has a positive orientation that considers clients willing and capable of change.  It is a problem-free perspective that focuses on promoting change and clarifying solutions to one’s problem.  Corey, (2015) describes compliments as a technique that encourages clients and helps them open up to change.

    The Message

    “Many solution-focused therapists will stop the session 5 to 10 minutes early to give the client a written message as feedback about the session, (Sharf, 2015, p. 462).”  The purpose of this message is to summarize the client’s achievements, while providing an overview of change still needed.

    Strengths & Weaknesses

    One strength of Solution Focused Therapy, is its pragmatic and brief nature. These two qualities are especially attractive in light of the influence of managed care and popularity of brief therapy.   Additionally, as a logical and easy-to-understand approach, it is easy to explain and provides quick solutions for clients.

    The weaknesses associated with Solution Focused Therapy can be understood in terms its one-sided perspective. As Metcalf (2011) explains Solution Focused Therapy sees individuals as creators of their reality, and in this respect the experts. Clients are never viewed as “never pathological or resistant” (Metcalf, 2011, p291) in Solution Focused Therapy. In mental health, pathology refers to the causes and effects of psychological disorder.   As mental health professionals, it seems impossible to do our job if we are unable to attend to the presence of a psychological disorder.

    Additionally, Solutions Focused Therapy has its limits from a cultural perspective. For example, this method may not be a good fit for individuals with a cultural background that includes a collectivist orientation. This is because Solution Focused Therapy excludes generational patterns, family history and past experience as relevant factors to its overall approach (Metcalf, 2011).

    References

    Corey, G. (2015). Theory and practice of counseling and psychotherapy. Retrieved from: http://bk.unesa.ac.id/wp-content/uploads/2015/09/Theory_and_Practice_of_Counseling.pdf
    Metcalf, L, (2011). Marriage and family therapy: A practice oriented approach. New York: Springer Publishing Company
    Rosenthal, H. (2005). Vital Information and Review Questions for the NCE and State Counseling Exams. Routledge.
    Sharf, R. S. (2015). Theories of psychotherapy & counseling: Concepts and cases. Cengage Learning.

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Narrative Therapy

What is Postmodernism???

As I begin wrapping up my review of counseling theories for an NCE exam in April, I’m reviewing two final counseling theories discussed in Rosenthal’s (2005), review: Narrative Therapy & Solution-Focused Therapy.  In two key online resources I’ve used for this review, is a discussion of postmodernism.  Apparently, all theories discussed thus far have held a modernist philosophical viewpoint, whereas narrative therapy and solution-focused therapy, hold a postmodernist perspective.  What the hell does this mean anyway?

“Modernists believe in objective reality that can be observed and systematically known through the scientific method. They further believe reality exists independent of any attempt to observe it. Modernists believe people seek therapy for a problem when they have deviated too far from some objective norm…Postmodernists, in contrast, believe that realities do not exist indepen- dent of observational processes…To social constructionists, reality is based on the use of language and is largely a function of the situations in which people live. Realities are socially constructed. A problem exists when people agree there is a problem that needs to be addressed, (Corey, 2015, p. 376).”
Modernists believe there is an objective reality.
Postmodernists believe reality is a matter of perception
Modernists attempt to systematically understand reality via scientific method.
Postmodernists attempt to understand reality as a social construction.
Modernists define client problems as a deviation from an objective norm.
Postmodernists feel a problem exists when people agree that it needs to be addressed.
Modernists act as experts, scientifically assessing the problem in order to determine a diagnosis.
Postmodernists explore the client’s frame of reference and how this perception defines reality.

Narrative and solution-focused therapy are examples of postmodernist social-construction approaches.  These perspectives both “attend to the client’s way of viewing problems. Neither therapy brings in its own theory of development or personality. (Scarf, 2015, p. 453).”

Narrative Therapy Defined

7772794404_055c289f79_oDeveloped by Michael White & David Epston, narrative therapy focuses on the stories we create out of our life experiences.  These life experiences become like scenes in a plot as they become temporally connected and infused with meaning.  We utilize a constructed meaning in life as an objective truth.  This constructed meaning reflects internalized messages from society.  It acts as a filter through which we edit our life experiences.  Many are edited from our plot-line because they contradict our preferred meaning system. This occurs because of a process of selective attention. Changing the language we use to describe our experiences can lead to the creation of new systems of meaning (Metcalf, 2011). Oftentimes the problem is a matter of a constricted storyline that predefines the outcome of life experiencing. By attend to unique events or subordinate story we produce meaningful change (Metcalf, 2011).  Narrative therapy is aimed at the “re-establishment of personal agency from the oppression of external problems and the dominant stories of larger systems, (Corey, 2015 p. 388).”   The narrative therapist helps clients resolve problems by utilizing the narrative metaphor to examine how our perceptions and interactions create life experiences, (Metcalf, 2011).

Key Concepts

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What are Stories?

We live our lives as a constructed story with a constructed plot line that provides meaning.  Stories provide us a way of imbuing our lives with meaning (Metcalf, 2011).  They are created within a social construct and reflect our perceptions.  In this respect, stories do not reflect objective reality as much as they do our preconceived system of meaning.   The events that are included in our storyline support our system of meaning.  Those that contradicted it are edited out through selective attending.   In this respect, stories shape our reality, providing a social and cultural context.

The Setting

The setting describes where and when our life story takes place.  It acts as a background against which the characters develop and  the plot unfolds.   “The story can occur in an indoor or outdoor setting, or be an actual experience, an image or dream….it can be described in great detail or with broad brushstrokes.  It can take seconds or years, (Sharf, 2015, p. 466).”  It encompasses the sociocultural environment in which we live.

The Characters

“The people (actors) in our story are characters…..the client is the protagonist or central character.  There are also antagonists (the people in conflict with the protagonist)….the personality and motive of the characters can be described by the…narrator (Sharf, 2015, p. 466).”

The Plot

The sequence of events in a story, involve the action of characters in a particular setting.  Understanding the plot involves listening the client’s description of events.  Oftentimes, with each story retelling, new plots develop in a person’s life story and new systems of meaning evolve.

Underlying Themes

“The reasons things happen in the story are referred to as themes…the client’s understanding of the story, (Sharf, 2015, p. 467).”  In other words, when you examine plots and stories in your life, are there any common threads underlying them?  These are the systems of meaning woven through your life.  Here’s an excellent example from my own blog of a theme.

Overview of Therapy Process

6410917039_714c365517_zThe narrative therapy process is based on a collaborative relationship that starts with an examination of the problem.  Examining the components of a client’s life story and examining it from different perspectives, provides a useful opportunity to examine alternate systems of meaning.  Describing stories through a process of externalizing, examining historical evidence and speculating about a new future can allow us to develop support for a new storyline.

Goals of Therapy

“A general goal of narrative therapy is to invite people to describe their experience in new and fresh language (Corey, 2015 p. 390).”  Seeing our life story from a “positive rather than problem saturated (Sharf, 2015, p. 469), is the end goal of therapy.  This happens as clients learn how their meaning system shapes the characters, setting, and plot within their life story.

Assessment

Narrative therapy does not prescribe to a diagnostic perspective.  Instead narrative therapists focus on listening how the client’s life story develops and how they act as the creator and narrator.  Writing down the plot line, and mapping out the sequence of events can allows the cline to recognize underlying themes.  The assessment process simply stats with a determination of the client’s goal for therapy.  Narrowing in on the problematic storyline and its influence throughout an individual’s life, is the initial step in narrative  therapy.

The Therapist’s Role

“Narrative therapists are active facilitators….the not-knowing position…allows therapists to follow, affirm, and be guided by the stories of their clients, (Corey, 2015, p. 469).”  Utilizing a respectful curiosity, the therapist begins by attempting to understand the impact of a problematic storyline.  The end goal is to assist the client in constructing a preferred story line.  This begins when the client can understand how they have identified with the problematic storyline through externalizing conversation.  Detaching and deconstructing the problem story line, can uncover the system of meaning as the core issue.  This process occurs without a strict adherence to traditional diagnosis or specific interventions.  The relationship is collaborative, optimistic, and respectful (Sharf, 2015).

Common Techniques….

While narrative therapy is generally opposed to a technique-driven process, what follows is a list of common approaches utilized in narrative therapy.

Asking Questions

“Narrative therapists use questions as a way to generate experience rather than to gather information, (Corey, 2015, p. 392).”   From a not-knowing perspective, therapists present questions that can aim at reconstructing their life story from an externalized viewpoint.  Deconstructing their problematic life story is the ultimate goal.

Externalizing Conversations

Underlying the concept of externalizing conversations is the notion that: “the person is not the problem. The problem is the problem” (Metcalf, 2011, p317). In other words, Narrative Therapy appears to be mindful of the issue of blame attribution when discussing the underlying problems. Externalizing conversations means discussing the issues from the standpoint that the problem isn’t attributed to a person. Instead it is conceived of as an evil villain, or separate entity altogether (Metcalf, 2011). For example, in such conversations you would not say, “(you/I/they) did this or that thing”. Instead, you might say, “I’ve noticed an underlying interactional dynamic that is developing a life of its own in the family, do you.”  Utilizing techniques such as these can prevent any potential misreading of blame attribution in this discussion.

Mapping the Influence

This involves examining the problem’s influence over one’s life in a systematic fashion.  “When mapping is done carefully, it lays the foundation for co-authoring a new story line for the client,” (Corey, 2015, p. 393).”  Tracing the problem as a thread of meaning woven throughout one’s life, can allow us to understand current problems in a historical context.   It also allows clients to understand the problem’s scope as well as the underlying cause.

Unique Outcomes

“When narrative therapists listen to a story that is full of problems, they look for exceptions to the stories….that are seen as sparkling moments or unique outcomes, (Sharf, 2015, p. 470).”  Since these unique outcomes are not predicted based on our current problematic story line, they are useful in rewriting our life narrative.

Alternative Narratives

An exploration of strengths or unacknowledged aspirations edited out of one’s life can provide evidence of an alternate narrative (Corey, 2015).   Constructing new stories in this manner requires a simultaneously deconstruction process of problematic narratives, (Sharf, 2015).  Reauthoring our life story happens as we examine alternate narratives and examine unique outcomes.

Documenting the Evidence

“New stories take hold only when there is an audience to appreciate and support them, (Corey, 2015, p. 395).”  The sources I used for this post describe letters written by therapists between sessions as useful in documenting the client’s progress (Corey 2015; Sharf, 2015).  Support groups and participation of significant others in the therapy process are also useful in providing evidence to support a new narrative.

Strengths & Weaknesses

Overall, I really enjoyed this theory. It forces us to engage in how we perceive and take in our life experiences and make meaning of them.   What interests me about the application of this theory in Marriage & Family Therapy is the fact that meaning systems in this context are more cultural than perceptual. In other words, the meaning systems that create family plotlines are shared systems of meanings (i.e. culture). From this perspective, Narrative Therapy is especially useful.

One weakness of this theory is related to an insight from an assigned article on bad couples therapy (Doherty, 2002). This article mentions briefly that another beginners mistake in couples therapy is failing to provide a plan for change (Doherty, 2002). Underlying this mistake is a belief that insight alone is adequate in producing change. Doherty, (2002) asserts that sine all empirically supported forms of couples therapy include an active intervention excluding this is a disservice to clients. While this therapy method does have a few activities to produce change, it is heavier on the insight.

Images: 1, 2, 3

References

Corey, G. (2015). Theory and practice of counseling and psychotherapy. Retrieved from: http://bk.unesa.ac.id/wp-content/uploads/2015/09/Theory_and_Practice_of_Counseling.pdf
Doherty, W. (2002). Bad couples therapy: Getting past the myth of therapist neutrality. Washington: Psychotherapy Networker, Inc.
Metcalf, L, (2011). Marriage and family therapy: A practice oriented approach. NewYork: Springer Publishing Company
Rosenthal, H. (2005). Vital Information and Review Questions for the NCE and State Counseling Exams. Routledge.
Sharf, R. S. (2015). Theories of psychotherapy & counseling: Concepts and cases. Cengage Learning.

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Gestalt Therapy

Fritz Perlz(1893 – 1970)

Gestalt Psychology was founded and developed by Fritz Perls, “and collaborators Laura Perls and Paul Goodman.” (Sharf, 2015, p. 241).  Fritz Perls was born in 1893 in Berlin to older Middle-Class German Jewish Parents. He had three siblings, one of whom was killed in the Nazi concentration camps.  He completed a medical degree in 1920 after volunteering as a medic during World War One.    Early on in his medical career Perls worked with brain-damaged soldiers at the Goldestein Institute and met his wife Laura there.  After his wife completed a Phd. in Psychoanalytic training, Perls was motivated to do the same.  He established a Institute of Psychoanalysis in South Africa and New York as well as training centers throughout the united states.  His first book “The Gestalt Approach” was published in 1973 and his second book “Legacy of Fritz” was published in 1975.

An Overview…

Gestalt is a German word which means “The configuration of an organized whole, (Rosenthal, 2005).” Gestalt theory sees individuals as whole and self-regulating.  The focus of Gestalt Therapy is the individual’s way of perceiving reality.  Problems are defined as a a result when we reject or devalue certain aspects of ourselves.  Healing this fragmentation is a goal of treatment and involves helping individuals become aware of all their senses, emotions, observations, beliefs needs, and thoughts (Corsini & Wedding, 2011).

A Quick Definition

“Gestalt therapy enhances awareness, which leads to reintegration and allows the whole person to regulate and be responsible for his life, (Sommers-Flannagan et al, 2004, pg. 143).” It is an “existential and phenomenological process-based approach created on the premise that individuals must be understood in the context of their ongoing relationship with the environment, (Corey, 2015, p. 190).”

Gestalt vs. Other Methods

Freud vs. Fritz

“Although Fritz Perls was influence by psychoanalytic concepts he took issue with Freud’s theory on a number of grounds. Whereas Freud’s view of human beings is basically mechanistic, Perls stressed a holistic approach to personality. Freud focused on repressed intrapsychic conflicts from early childhood, whereas Perls valued examining the present situation, (Corey, 2015, p. 199).”

In psychoanalysis, the client’s thoughts, feelings and beliefs are not considered reliable since they are reflective of unconscious elements. (Corsini & Wedding, 2011).  In contrast, Gestalt therapy holds a phenomenological perspective of reality that does not readily dismiss the legitimacy of a patient’s inner world.  According to Fritz, “the patient’s awareness is not assumed to be merely a cover of some other, deeper motivation, (Corsini & Wedding, 2011, p. 347).” As a result, while Gestalt therapy utilizes the therapeutic relationship to examine an individual’s direct experience, psychoanalysis limits the development of a relationship in order to prevent countertransference.   Finally, while Gestalt focuses on the present, psychoanalysis looks at one’s past.

Rogers vs. Perls

Both Rogers and Perls held a believe in the mans potential for personal growth and utilized the therapeutic relationship as a fulcrum for change.  Additionally, both approaches hold a phenomenological view, by appreciating the subjective nature of a patient’s reality.  However, Rogers approach is non-directive in nature while Perls utilizes a more active approach that involves increasing awareness of one’s experiences.

Ellis vs. Perls

While REBT conceives the problem as a matter of irrational thinking, gestalt therapy conceives problems as matter of fragmentation, due to denial of certain aspects of oneself.   Consequently, REBT utilizes techniques that confront a client’s irrational ideas, while gestalt focuses on the what and how of one’s present experience.  Additionally, the focused awareness experiments utilized in gestalt therapy are useful as an alternative to REBT’s confrontational approach.  In this respect, REBT is conceives the therapist as holding a reality-based perspective, while gestalt rejects the notion that the therapist’s perspective is objective.

Theory Assumptions

The Goal = Creative Adjustment

tumblr_mu6goosrvm1rvkvumo1_500In well-functioning individuals, gestalt theory assumes that they have achieved organismic regulation. Healthy individuals are able to respond to their wants and needs because all the parts of the self are integrated.  They are able to assess their life situation, and initiate actions in agreement with who they are.  They have no problem taking responsibility for their actions and are able to live in the present moment.   Gestalt Therapy calls this healthy functioning creative adjustment.  Corsini & Wedding, (2011), defines it as a byproduct of resolved fragmentation.  It reflects a “creative balance between changing the environment and adjusting to current condition, (Corsini & Wedding, 2011, p. 355).”

The Problem = Stuckness

“an impasse is experienced when a person’s customary supports are not available and new supports have not yet bee mobilized. The experience is existentially one of terror. The person cannot go back and does not know whether he or she can survive going forward.  (Corsini & Wedding, 2011, p. 358).”

1314561Gestalt Theory defines psychopathology as a form of stuckness”.  This stuckness reflects an inability to “identify with one’s moment-to-moment experience (Corsini & Wedding, 2011, p. 355)”.   Symptoms of psychopathology arise as a result of rigid boundaries between the self and environment that cause us to engage in creative editing.  We are fragmented with both accepted and denied aspects of ourselves.  Our ability to engage in creative adjustment is disrupted since our fragmented self produces an incomplete picture of reality.  The solution to stuckness heppens when we work through this resistance and live authentically.  Denial perpetuates our problems since we tend “forget” that any “creative editing” ever took place.   We first deny and then deny to ourselves that we have denied.

Resistance = Causing Stuckness

“In Gestalt Theory, resistance is an awkward but crucially important expression of the organism’s integrity.  Resistance is the process of opposing the formation of [something] that….is judged to be dangerous, (Corsini & Wedding, 2011, p. 356-357).”  In other words, resistance has a protective function, holding out of our awareness aspects of ourselves and our experiences that we prefer to deny.  Gestalt theory asserts that we forget this resistance exists as an adaptive mechanism.  Resistance causes stuckness since it prevents us from “identify[ing] with [our] moment-to-moment experience [fully] (Corsini & Wedding, 2011, p. 355)”.

Unfinished Business

Perls describes unfinished as unacknowledged feelings “emotional debris that clutters present-centered awareness, (Corey, 2o15, p. 204).  According to Gestalt Theory, this unfinished business is like an oppressed negative energy that seeks resolution.  It underlies our self-defeating behaviors, and feelings of stuckness.   Until we face these unresolved emotions, they re-emerge repeatedly throughout our lives like a “monkey wrench” of sorts.

A Process of Reowning

rebornGestalt is a process of “reowning” parts of the self that have been disowned.  When we learn to accept those aspects of ourselves we have rejected, we become strong enough to proceed on a journey of personal growth.  The client needs to be whole in their current position, aware of what and who they are, rather than focusing on what they are not.  Change can only happen once we go of a need to wish for what aren’t.  This allows us to attain wholeness and function more effectively in present day-to-day life events.

A View of the Past & Present

Gestalt theory assumes that our “power” is in the present and the only significant moments are in the present, (Sommers-Flannagan et al, 2004) The past is gone and the future has not arrived yet. In order to be fully aware, a person must live only in the present.  Many people focus on their past mistakes by looking for resolutions, or planning for their future rather than focus on the present. (Sommers-Flannagan et al, 2004).  Since the past often influences our present attitudes and behavior, resolving them is essential for growth.  Feelings associated with past memories and fantasies will linger in background and interfere with effective contact if not dealt with, (Sommers-Flannagan et al, 2004).   Failing to resolve these inner conflicts, self-defeating behaviors, as well as manifesting physical symptoms. (Corsini & Wedding, 2011).

Self-Responsibility

Gestalt theory assumes people are in charge of  how they behave and must take responsibility for what they say and what they do. When we blame something or someone outside yourself, we are deceiving ourselves, (Kirchner, 2000).  Taking responsibility for one’s actions allows us to understand clearly the consequences of our decisions.

View of Human Nature

“Authentic change occurs more from being who we are than from trying to be who we are not, (Corey, 2015, p. 201).”

Gestalt therapy assumes that individuals are able to engage in self-regulation and have an innate desire to work towards self-actualization.  It is a perspective that defines human nature as “rooted in existential philosophy, phenomenology and field theory, (Corey, 2015, p. 200).”  Problems are a byproduct of fragmentation due to disowned parts of our personality.   Overcoming this problem requires us to become fully aware of our environment as well as our inner world.  Claiming ownership of previously denied aspects of ourselves, allows us change to happen.  This involves letting go of who we believe we “should be” and instead accepting fully who we are.   “By becoming aware, clients become able to make informed choices and thus to live a more meaningful existence, (Corey, 2015, p. 200).”

Basic Concepts

Holism

“Holism asserts that humans are inherently self-regulating, that they are growth oriented, and that persons and their symptoms cannot be understood apart from their environment, (Corsini & Wedding, 2p11, p. 343).”

Gestalt Therapy asserts that the whole is not equal to the sum of its parts.  What does this mean? FIRSTLY, it acknowledges the fact that human beings are oriented to exist as as holistic and self-regulating organisms.  SECONDLY, this means clients can only understood in terms of one’s own individual direct experiences.  Symptoms are meaningless apart from the context in which they are occurring.  “Gestalt is a German word that meaning a whole or completion, or a form that cannot be separated into parts without losing its essence, (Corey, 2015, p. 201).”

FIGURES – “Those aspects of the individual’s experience that are most salient at any moment (Corey, 2015, p. 201).”
GROUND – “Those aspects of the client’s presentation that are often out of his or her awareness, (Corey, 2o15, p. 201).”  
FIGURE-FORMATION PROCESS – “tracks how some aspect of the environmental field emerges from the background and becomes the focal point of the individual attention and interest (Corey, 2015, p. 202).”  

Field Theory

The “Field Theory” concept can be found in Einstein’s Theory of Relativity, and describes the nature of reality and our relationship with it (Corsini & Wedding, 2011, p. 343).  Essentially, this concept notes the importance of context as a crucial factor upon which reality is constructed and understood.  In Gestalt Therapy, field theory is a guiding principle that asserts individuals must be understood in the context of their environment and lived experiences.  Fields can be understood as the entire situation including the interaction between an individual and his environment, (Corsini & Wedding, 2011; Corey, 2015).  In this respect, it is an ever-changing concept that exist as a byproduct of this interaction.

In the context of a therapy session, the field comprises “the therapist, the client, and all that goes on between them… (Corey, 2015, p 201).”
In the context of a client’s life story, what you get is not a view of what happened, But it can tell you how the patient experiences his history in the here and now, (Corsini & Wedding, 2011, p. 343).”  

Field theory carries with it key propositions on the way one views and interacts with his world.  What follows are five principles that describe the nature of reality creation according to this theory.

The Principle of Organization

Since everything is in life is interconnected, meaning can be ascertained by looking at the whole situation. For example, rather than examining symptoms, or individual characteristics, gestalt therapy looks at the interdependence between internal and external factors in one’s life situation (Parlet, 1991).

The Principle of Contemporaneity

“This principle points to the fact that it is the constellation of influences in the present field which ‘explains’ present behavior, (Parlet, 1991, p. 5).”  In other words, cause is found in the present field of one’s field of one’s experience.  The past does not determined the present, instead it exists as a reinterpretation of past events.  The future is simply our current anticipations of what we expect to happen.

The Principle of Singularity

“Each situation, and each person-situation field, is unique, (Parlet, 1991, p. 6).”  In other words, Field Theory cautions against developing laws of human nature since each individual and situation are unique.  When we utilize generalizations, we create a premature conceptions of reality. We create findings in the situation that coincide with our generalizations (Parlet, 1991).

The Principle of Changing Process

“While the Principle of Singularity emphasizes the need for unique perspectives for unique occurrences, the Principle of Changing Process refers to the fact that experience is provisional rather than permanent, (Parlet, 1991, p. 7).”  In other words, field theory notes that our constructed reality exists as an ever-changing concept.  It is not a static, inert, or stable concept.

The Principle of Possible Relevance

“Everything in the field is part of the total organization and is potentially meaningful, (Parlet, 1991, p. 7).”  In other words, all elements in the field of one’s experience are important and worthy of examination.

Organismic Self-Regulation

“Organismic self-regulation is a process by which equilibrium is ‘disturbed’ by the emergence of a need, a sensation, or an interest, (Corey, 2015, p. 202).”    This self-regulation can involve changing in response to our environment, or utilizing resources to maintain an equilibrium.  The figure-formation process (discussed earlier) is utilized to help clients increase their ability to engage in self-regulation.  Growth starts with conscious awareness of the complex interdependent relationship between oneself and the environment.

“Individuals move toward wholeness by identifying with ongoing experience, being in contact with what is actually happening, identifying and trusting what one genuinely feels and wants and being honest with self and others about what one is actually able and willing to do, (Corsini & Wedding, 2011, p. 343).”

Phenomenological Inquiry

Gestalt therapy encourages us to live fully in the present moment.   Focusing on past or future events can take us away from the power which can only exist in the present to alter our lives.  “Phenomenological inquiry involves paying attention to what is occurring now…. (Corey, 2015, p. 202).”  Therapists use what and how questions while avoiding why questions in order to promote present awareness.

Theory of Personality

“Gestalt therapy is a radical ecological theory that maintains there is no meaningful way to consider any living organism apart from its interaction with its environment, (Corsini & Wedding, 2011, p. 351).”  In other words, there is no self independent of one’s circumstances.  Additionally, an individual’s circumstances can’t be understand outside of their unique perspective.  Gestalt therapy focuses on the contact we have with others and our environment as essential in the formation of our life experiences and personality, (Sharf, 2015).  The field of our lived experiences are mediated by boundaries that help connect us with others, while providing a sense of separation:

“People grow through contact with and withdrawal from others….by separating and connecting, a person establishes boundary and identity….One identifies with that which is nourishing and rejects that which is harmful.  This kind of differentiated contact leads to growth, (Corsini & Wedding, 2011, p. 352).”

Contact

Contact between oneself, others, and the environment is essential for the creation of life experiences, however often occurs outside our awareness.  “Contact is made by seeing, hearing, smelling, touching, and moving.  Effective contact means interacting with nature and with other people without losing one’se sense of individuality (Corey, 2015, p. 205).”  Moments of contact seem to involve a reciprocal transformation in which one is changed as a result of contact with the outer world while transforming it as well.  “Contact means being in touch with what is emerging here and now, moment-to-moment, (Corsini & Wedding, 2011, p. 344).” It produces a creative adjustment to one’s environment, and often requires moments of “withdrawal to integrate what has been learned, (Corey, 2015, p. 205).”

Awareness

“Conscious awareness is a focusing of attention on what one is in touch with in situations requiring attention. Awareness, or focused attention, is needed in situations that require higher contact ability, situations involving complexity or conflict, and situations in which habitual modes of thinking and acting are not working, (Corsini & Wedding, 2011, p. 344).”

Awareness is a vital aspect of personality development in Gestalt theory. It refers to the quality of one’s attentiveness to the present.   “Gestalt therapy focuses on the awareness process….the continuum of one’s flow of awareness, (Corsini & Wedding, 2011, p. 344).”  Helping clients recognize interruptions in their awareness and what they hold outside it is critical for growth and transformation.  Sharf, (2015) describes “four types of awareness: (1)…awareness of sensations and actions; (2)…awareness of feelings; (3)…awareness of wants; (4)…awareness of values and assessments, (p. 250).”  As I understand it, awareness comprises the moment-to-moment editing process of our experiential reality.  By becoming aware of how we’re aware, we can learn we’ve acted as a creator of our life experiences.

Contact Boundaries

“Contact boundaries are the process of connecting to or separating from other objects, (Sharf, 2015, p. 245).”  Boundaries serve to help us manage our contacts with the outer world.   Guided by our ego’s need for a positive self-evaluation, we identify with that “which is nourishing and reject that which is harmful, (Corsini & Wedding, 2011, p. 352).”  A delicate balance of separation and contact is essential for healthy functioning.  Sharf, (2015) describes several types of boundaries:

Body Boundaries restrict our sensory experiences, such as a sensation to pee or rest, when you’re struggling to complete homework.
Value Boundaries refer to values we hold that are resistant to change, such as the idea that Donald Trump is an asshole and doesn’t deserve to be president.
Familiarity Boundaries refer to things we do automatically and repetitively that go unchallenged.  A convenient example might include my husband’s daily drive to work.
Expressive Boundaries  are learned early and involve limitations on what is appropriate.  In my family of origin stoicism was the norm and I learned to internalize my emotions.

Boundary Disturbances

“Often the boundaries between self and others become vague, disintegrate or…disturbed….causing the individual to keep out nourishing aspects of object and others, (Sharf, 2015, p. 348).”  Unhealthy boundaries between oneself and the outer world include: introjection, projection, reflection, deflection, and confluence.   These unhealthy boundaries exist as a form of resistance tend to operate outside our awareness as deficient coping mechanisms that limit our ability to engage in creative adjustment

Introjection

“Introjection refers to swallowing whole or accepting others’ views without reviewing them, (Sharf, 2015, p. 348).”  This sort of passive acceptance causes us to filter through information in accordance with our personal wants or needs (Corey, 2015).  We fail “to make discriminations about what to take in and what meaning to attach to it, (Corsini & Wedding, 2011, p. 254).”

Projection

“Projection is the reverse of introjection…we disown certain aspects of ourselves by assigning them to the environment, (Corey, 2015, p. 204).”  When we falsely attribute phenomenon that occurs within us to other individuals, we fail to adopt a full awareness of our experiences.  The short term payoff, includes an avoidance of responsibility. However the long-term price we pay for this is that we remain the helpless victim.

Retroflection

“Retroflection consists of doing to ourselves what we want to do to someone else, or it can refer to doing things for ourselves that we want others to do for us, (Sharf, 2015, p. 249).”  This involves inhibit one’s reactions to life experiences out of fear that others might respond negatively.  Corey (2015) uses the example of self-mutilation here as act in which we direct inward expression the anger we feel towards others.

Deflection

Deflection is an unhealthy boundary mechanism that causes us to become easily distracted, or avoiding an sustained sense of contact with others (Corey, 2015).  For example, we can deflect in conversations by beating around the bush and being overly polite.  Deflection can also involve an avoidance of physical contact.

Confluence

“Confluence occurs when the boundary between one’s self and others becomes muted or lessened, (Sharf, 2015, p. 249).”  Healthy confluence can be thought as an empathetic understanding of others.  Unhealthy confluence reflects a strong need of acceptance as we relinquish our true feelings.  Our ability to withdraw is block and we lose a sense of separate identity and become isolated (Corsini & Wedding, 2011).

Assimilation

In contrast to the above unhealthy boundaries, Corsini & Wedding, (2011), describe the concept of assimilation as a “process of experiencing what is to be taken in, deconstructing it, keeping what is useful, and discarding what is not, (p. 354).  It is a healthy boundary in is useful as a comparison to the boundaries described above.

Five Layers of Neurosis

In Gestalt theory, healthy individuals adopt a fluid identity that engages in an ongoing creative adaptation to the outer world.  In contrast unhealthy individuals respond by developing a character that exists as an adaptive response to the expectations of others.  This character becomes an idea of who we think we are, or “should be”, and becomes frozen and resistant to change.   According to Perls, a neurotic personality can be thought of as comprising layers like an onion (Corey, 2015; Sharf, 2015).  In order to achieve personal growth, people must fulfill their potential the  layers of neurosis must be pealed away. There are five layers of neurosis which exist as a levels of contact with the outer world.

THE PHONY LAYER – refers to inauthentic or shallow forms of interaction.  I understand this as involving a “going through the motions” mentality.  We are not fully present.  
THE PHOBIC LAYER – This refers to a form of interaction defined by a desire to avoid psychological pain.  The world becomes a land-mine in which we work to actively avoid what we believe might hurt us.  
THE IMPASSE – is a feeling of stuckness in which we are either afraid or unwilling to change.  I discussed this above in greater detail….
THE IMPLOSIVE LAYER – This point often occurs in therapy and involves an emerging awareness of our feelings and true self, with little knowledge of what to do about it.  
THE EXPLOSIVE LAYER – This level of contact is described as “authentic and without pretense (Sharf, 2015).”  It is the goal of Gestalt Therapy.  

Application of Theory

Goal of Therapy

“Fritz Perls…practiced Gestalt therapy paternalistically. Clients have to grow up, stand on their own two feet, and ‘deal with their life problems themselves’. Perls’s style of doing therapy involved two personal agendas: moving the client from environmental support to self-support and reintegrating the disowned parts of one’s personality, (Corey, 2015, p. 200).”

Perls believed that growth is an inevitable and lifelong process, that is occasionally derailed causing stuckness, resistance and fragmentation.  “The only goal of Gestalt therapy is awareness, (Corsini & Wedding, 2011, p. 359).”  Rosenthal (2005) describes this as a reclaiming of fragmented parts with a “major emphasis on experiential awareness.”  Corsini & Wedding, (2011) describe awareness of awareness as “the patient’s ability to use his or her skills…to rectify disturbances in his or her awareness process, (p. 259).”  The therapy process is engaged as a process of exploration and doesn’t involve a “direct attempt to change behavior, (Corsini & Wedding, 2011, p. 260).”

Best Case Match

Gestalt therapy lacks a clearly defined theory of human development. Because there is no theory on how a person develops into adulthood, there is no clearly defined framework that therapists can use to assist people with the problems that occur during the developmental stage. (Kirchner, 2000)  Client’s must also have a high self-awareness for this mode of therapy to work.   Gestalt therapy would not work well for individuals suffering from more severe disorders, such as psychoses, schizophrenia, personality, or mood disorders,   Clients who are in need of crisis intervention techniques would also not do well with Gestalt therapy.  However, this method works well with individuals who are self-aware and desire to institute change in their lives.

What & How; Here & Now…

Gestalt Therapy avoids “WHY” questions, since they cause us to look to our past to understand why our life is as it is.  Instead, Perls suggests asking clients “WHAT” they do, and “HOW” they do it.  “Direct experience is the primary tool of Gestalt therapy and the focus is always on the here and now, (Corsini & Wedding, 2011, p. 360).”  Perls describes failures to remain present as disturbances in our awareness.  Any exploration of the past is done while anchored in the present, (Corsini & Wedding, 2011).

The Therapist’s Function & Role

“The therapist’s job is to invite clients into an active partnership where they can learn about themselves by adopting an experimental attitude toward life in which they try out new behaviors and notice what happens, (Corey, 2015 p. 207).”  Methods utilized are aimed toward increasing awareness of the present moment.  Gestalt therapists pay close attention to nonverbal cues incongruent with what is being said.  In Gestalt therapy, communication patterns exist as an expression of our feelings, thoughts, and attitudes. Therapists utilizing this approach often call attention to a client’s communication patterns to increase awareness.

Assessment

Gestalt Therapy does not have a specific systematic diagnostic or assessment process.  However, Sharf, (2015), describes a cyclical approach that correlates with the five phases of an experiencing cycle: “sensation/awareness, mobilization, contact, resolution/closure and withdrawal, (p 254).  Essentially this process seems to involve determining where the points of stuckness and resistance lie.  For example, PTSD can be associated difficulty with resolution and closure while phobias might have difficulty mobilizing (or taking action).

Experiments

“Perls, was adamant that awareness in and of itself is curative, (Rosenthal, 2005).”   For this reason, Perls utilized experiments that served the purpose of creating frustration and heightening awareness (Rosenthal, 2005). Experiments serve the purpose of helping clients acting out points of stuckness and internal conflict (Corey, 2015).  It forces clients to express themselves behaviorally and shifts the focus away “from talking about a topic to an activity that will heighten the client’s awareness and understanding, “(Corey, 2015, p. 212).”  The purpose of an experiment is to bring something a client is struggling with to life in the present moment.

The Role of Confrontation

While Perls utilized a highly confrontational approach, this is not representative of Gestalt Therapy as it is currently practiced.  In this therapy method, confrontation tends to involve an “invitation to examine behaviors, thoughts, and attitudes, (Corey, 2015, p. 215).”  By encouraging clients to confront incongruencies while remaining empathetic and supportive, a client can achieve heightened awareness.

A Few Miscellaneous Techniques….

Focusing – Staying with the Feeling

“The most common techniques are the simple interventions of focusing.  Focusing ranges from simple inclusion or empathy to exercise arising largely from the therapist’s experience while being with the client, (Corsini & Wedding, 2011, p. 364).”  My course textbook provides an example of an exchange between a therapist and client.  The client looks sad, and the therapists asks “what are you experiencing right now” (Corsini & Wedding, 2011, p. 365).”  When they respond by noting they feel sad, the therapist asks them to stay with the feeling, and describe everything they are thinking, feeling and experiencing somatically (Corsini & Wedding, 2011).  The goal of this is to increase the awareness of their emotions and what brought it up.

Exaggeration & Repetition Game

Rosenthal, (2005) describes the this technique as useful when the client makes an important statement casually.  “The therapist then asks the client to repeat it, saying it louder with more emotion, (Rosenthal, 2005).”  The goal is to make the client aware of the statement’s significance and take responsibility for their feelings and behaviors (Rosenthal, 2005).

Internal Dialogue Experiments

This exercise is aimed at integrating fragment parts of our psyche.  One example provided in several resources for this post include the Top Dog vs. Underdog Dialogue. “The Top dog is righteous, authoritarian, moralistic, demanding, bossy and manipulative…the underdog manipulates by playing the role of victim, by being defensive, apologetic and helpless, (Corey, 2015, p. 216).”  Introjection exists as the mechanism that causes this fragmentation, (Corey, 2015).  Utilizing an empty chair technique, the client is asked to play both roles and create a dialogue between these two fragment selves (Rosenthal, 2005).

Making the Rounds

This technique is often utilized in Gestalt Therapy groups and involves an experiment with each member of your group.  For example, if you have trouble sharing your honest feelings about people, the therapist would ask you to do so with each group member.  “The purpose is to confront, to risk, to disclose the self, to experiment with a new behavior, (Corey, 2015, p. 217).  This can hopefully create an opportunity for growth or change

The Reversal Exercise

“Certain symptoms and behaviors often represent reversals of underlying or latent impulses.  Thus the therapist could ask a person who claims to suffer from severe inhibitions and excessive timidity to play the role of an exhibitionist, (Corey, 2015, p. 217).”

The Rehersal Exercise

This exercise simply involves rehearsing a new behavior as a means of bolstering our success “in real life”. Through this process of rehearsal, “we become increasingly aware of how to meet the expectations of others, of the degree to which [we] want to be approved, accepted, and liked, and of the extent to which [we] will go to attain acceptance, (Corey, 2015, p. 217).”

Dreamwork

Gestalt therapy does not interpret dreams in order to uncover some aspect of the unconscious.  Instead, the content of one’s dreams are acted out in the goal of becoming part of the dream.  “Each part of the dream is assumed to be a projection of the self, and the character creates scripts for encounters between the various characters or parts, (Corey, 2o15, p. 218).”  Therefore, Perls suggests clients utilize the empty chair technique and play out various roles in our dream.  Rosenthal, (2005), notes that: “dreams are the royal road to integration…contain[ing] existential messages to the self.”

References

Center for Substance Abuse Treatment. Substance Abuse and Mental Health Services Administration (1999). Brief Interventions and Brief Therapies for Substance Abuse.   Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK64939/
Corey, G. (2015). Theory and practice of counseling and psychotherapy. Retrieved from: http://bk.unesa.ac.id/wp-content/uploads/2015/09/Theory_and_Practice_of_Counseling.pdf
Corsini, Raymond J. & Wedding, Danny (2011). Current Psychotherapies. Belmont, Ca: Brooks/Cole, pp. 342-382.
Fall, Kevin A & Holden, Janice. (2004).Theoretical Models of Counseling and Psychotherapy.      New York, NY: Brunner-Routledge, pp. 217-243.
Gestalt Theory: Oneness and Integrated Wholeness (n.d.).Gestalt Theory. personality, psychotherapy, history, Gestalt concepts, applications. Retrieved From:  http://gestalttheory.com/
Kirchner, Maria. (2000). Gestalt Therapy Theory: An Overview. Gestalt!,4, Retrieved from: http://www.g-gej.org/4-3/theoryoverview.html
Lawe, Charles F. & Smith, Edward W. (1986) Gestalt Processes and Family Therapy. The Journal of Adlerian Theory, Research & Practice.42, 537-544.
Parlet, Malcolm. (1991). Reflections on field theory.  Retrieved from:  http://itgt.com.br/wp-content/uploads/2012/10/Reflections-on-Field-Theory-ParlettProfSandra.pdf
Rosenthal, H. (2005). Vital Information and Review Questions for the NCE and State Counseling Exams. Routledge.
Sharf, R. S. (2015). Theories of psychotherapy & counseling: Concepts and cases. Cengage Learning.
Sommers-Flanagan, John & Sommers-Flanagan, Rita. (2004).Counseling and Psychotherapy Theories in Context and Practice. Skills, Strategies, and Techniques.  Hoboken, NJ: John Wiley & Sons, pp. 174-210.

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Existential Psychotherapy

***This post is a study exercise as I prepare for the NCE exam.  It contains excerpts from several paper’s I’ve written***

Because existentialists are sensitive to the ways in which theories may dehumanize people and render them as objects, authentic experience takes precedence over artificial explanations….When experiences are molded into some preexisting theoretical model, they lose their authenticity and become disconnected from the individual who experienced them, Corsini & Wedding, 2011, p311).”

Existentialism is a movement that stresses the, “ . . . existence of the individual person as a free agent who is burdened with personal responsibility and whose existence cannot be investigated objectively, being unrevealed by the reflection on existence in time and space. It tends to disparage scientific methodology and knowledge and to reject objective values” (Coleman, 2009. p.264).  Existential psychotherapy, while not an independent school of thought, works well with other therapy objective empirically based methods of psychotherapy, (Corsini, & Wedding, 2011).

Historical Overview

Founding Fathers

The history of existentialism was born out of philosophical movement that thrived in Europe in the 1940s and 1950s.  Danish philosopher Soren Kierkegaard (1813 – 1855) is often described as the father of existentialism.   Kierkegaard stated, “I exist, therefore I think” compared to Rene Descartes’ famous quote of “I think, therefore I am.” Kierkegaard’s statement swayed a group of European philosophers and psychologists, changing their approach to treatment; however, Kierkegaard’s philosophy was not readily accepted in the United States.

Fredrich Nietzsche (1844 – 1900), is another early founder of existentialism.  Like Kierkegaard, he stressed the importance of subjective experience.  However, Corey, (2015), notes: “where Kierkegaard emphasized the ‘subjective truth’ of an intense concern with God, Nietzsche located values within the individual’s ‘will to power’, (p. 135).”

Still other early influential existentialists worth knowing include Buber & Sartre.  Jean Paul Sartre, (1905–1980) was a French philosopher and novelist described an existential spaces he descrbies as “nothingness—between the whole of our past and the now frees us to choose what we will. Our values are what we chooser, (Corey, 2015, p. 135).”   Martin Buber, (1878–1965), on the other hand has a less individualistic perspective of human existence in his description of the i-thou relationship.  “There is never just an I, but always an other. The I, the person who is the agent, changes depending on whether the other is an it or a Thou, (Corey, 2015, p. 135).

Key Modern Figures

Rollo May (1909-1994), the American psychologist who was an existentialist advocate, credited the introduction of existentialism to the United States psychologist and philosopher, William James. James advocated free will, a key component of existentialism. In the 1920s and 1930s, existentialism was discretely introduced in university classrooms. Other notable philosophers and psychologists, such as Viktor Frankl (1905-1997) were introducing existentialism to the world through their writings. It was not until Rollo May and other psychologists such as, Abraham Maslow and Herman Feifel participated in the American Psychological Association (APA) Symposium on Existential Psychology and Psychotherapy on September 5, 1959, that existential psychology began to reach the forefront of the psychology field (Spear, n.d.).

Assumptions of Existential Models

A Caution Against the Medical Perspective

Existential models caution against utilizing a medical perspective, since it utilizes a diagnostic/disorder perspective with which to examine a client’s issues (Ingram, 2012).  Rather than working to alleviate symptoms, existential therapy is ultimately concerned with the meaning people give to their subjective experiences, (Corsini, & Wedding, 2011). According to existential therapy, underlying our psychological, social, biological, and interpersonal concerns is a greater existential crisis regarding life’s ultimate meaning (Corsini & Wedding, 2011).

A Focus on Intrinsic Meaning.

At the core of human existence is the notion that life contains no intrinsic meaning.  Understanding this inherent meaninglessness can allow clients to realize the freedom they have in choice.  Existential therapy aims at enabling a client to understand themselves as a creator of their own experience (Corsini & Wedding, 2011).   By examining the underlying choices we make to create meaningful lives we can begin to live more authentically. (Corsini & Wedding, 2011).  We are ultimately empowered by an awareness of the choices our make as we assume responsibility for those decisions. In this respect existential theories point out that with freedom comes self-responsibility.

Stresses the I/Thou Relationship

In Existential Psychotherapy client’s aren’t seen as an “it” (constant entity) but a person in the process of change (Rosenthal, 2005).  During therapy, both therapist and client experience change as a result of the relationship.  The above video provides a good summary of the concept, the quote below provides a brief description of the i-thou relationship.

“we humans live in a kind of betweenness; that is, there is never just an I, but always an other. The I, the person who is the agent, changes depending on whether the other is an it or a Thou. But sometimes we make the serious mistake of reducing another person to the status of a mere object, in which case the relationship becomes I/it, (Corey, 2015, p. 135).”

As the above quote notes, a serious mistake often occurs when reduce others as objects of our perception. Acknowledging the other individual and their being, requires us to become present.

Honoring Subjective Experience

Existentialism describes humans as “meaning-makers” and is “sensitive to the ways in which theories may dehumanize people and render them as objects” (Corsini & Wedding, 2010 p. 311).  It is on this basis that Existentialists caution against a medically-based perspective.  In order to honor an individual’s subjective experience, existentialists focuses on issues such as the purpose of life, mortality, meaning, death, freedom, and responsibility (Corsini & Wedding, 2010).

Rejects a Deterministic Perspective

“One of the aims of existential therapy is to challenge people to stop deceiving themselves regarding their lack of responsibility for what is happening to them, (Corey, 2015, p. 134).”

Existential Psychotherapists reject the perspective of behavioral determinism since this conceives individuals as victims to circumstances.  “Psychoanalysis sees freedom as restricted by [the] unconscious…behaviorists see freedom as restricted by sociocultural conditioning, (Corey, 2015, p. 133).” In contrast, existentialism provides an optimistic perspective that stresses self-responsibility and an individual’s ability to choose what we make of our circumstances, (Corey, 2015; Rosenthal, 2005).  Existential Psychotherapy stresses patient autonomy: that we are free and “external circumstances are only seen an excuse that can limits people” (Rosenthal, 2005).”

View of Human Nature

Existentialism provides a theoretical approach to counseling that does not focus on techniques but instead a perspective of human nature, (Corey, 2015).  “Existentialists regard people as meaning-making beings who are both subjects of experience and objects of self-reflection, (Corsini & Wedding, 2010, p. 311).”  On the one hand, existentialism provides a positive and optimistic perspective that stress personal choice, individual autonomy, and self-responsibility (Rosenthal, 2005).  This optimism is balanced with an acknowledgment of the limitations and tragedies that are integral to human existence (Corey, 2015).   Existential psychotherapy is concerned with how we balance the realities of our human existence as an ever-evolving self.  In a textbook titled “Theory & Practice of Psychotherapy” (Corey, 2015), is a list of basic dimensions of human nature:

“The basic dimensions of the human condition, according to the existential approach, include (1) the capacity for self-awareness; (2) freedom and responsibility; (3) creating one’s identity and establishing meaningful relationships with others; (4) the search for meaning, purpose, values, and goals; (5) anxiety as a condition of living; and (6) awareness of death and nonbeing, (Corey, 2015, p. 139).”
Self-Awareness:  Existential approaches are aimed at increasing our self-awareness so we are not prisoner to our identity and past decisions.
Freedom & Responsibility:  Existential approach states we “are the authors of our own lives….and we alone are responsible for our choices, (Corsini & Wedding, 2010, p. 311)  With freedom comes responsibility.
Identity & Relationship with Others: Existential perspectives stress the delicate balance that exists in maintaining our relationships and our sense of identity, (Corey, 2015).
Search for Meaning:  Existential psychotherapy states that humans strive to find meaning in their lives. “We create our own world and have to answer for ourselves why we live and how we shale live, (Corsini & Wedding, 2010, p. 213).”
Existential Anxiety: “Existential anxiety is the unavoidable result of being confronted with the “givens of existence”—death, freedom, choice, isolation, and meaninglessness, (Corey, 2015, p. 148).”
Awareness of Death:  Existential perspectives acknowledge of our eventual demise as a painful and vivid reality we must acknowledge.  Frankl asserts the awareness of our death makes the idea of living each day to its fullest a priority.  

Theory of Personality

Existentialism’s view individuals in a continual process of change.  Personality development is going as we struggle with questions such as: “Who will I be? Who am I? Where do I come from? (Sharf, 2015, p. 166).”   Existentialism is concerned with how we understand ourselves and the world around us.

Being in the World.

“The term…being-in-the-world…refers to the ability of individuals to be able to think about and reflect on events and to attribute meaning to them, (Sharf, 2015, p. 166).” Rollo May adds that this involves being the subject and object of one’s own experience.  “Man’s capacity to stand outside himself, to know he is the subject s well as the object of experience, to see himself as the entity who is acting int he world of others, (Corsini & Wedding, 2010, p. 217).”

Four Ways of Being

“Existentialists identify four ways of being-in-the-world. Human beings exist in the Umwelt, Mitwelt, Eigenwelt, and Überwelt simultaneously. The Umwelt refers to the biological world or the environment. The Mitwelt means “with- world” and concerns the area of human relationships. The Eigenwelt is the “own-world” and refers to the relationship that individuals have to themselves. The Überwelt refers to one’s relationship with spiritual or religious values, (Sharf, 2015, p. 167).”
Umwelt: The umwelt world we are thrown into, or the biological world of self-awareness (Rosenthal, 2005; Sharf, 2015).  As a night-shift worker, getting sleep is concerning. I’m trying to lose weight, and watch my food intake closely.
Mitwelt:  “Mitwelt refers to the world of relationships or encounters with others, (Rosenthal, 2005).”  I worry about the impression I will leave at my next internship.
Überwelt:  Uberwelt refers to our beliefs about the world (Sharf, 2015).  The beliefs we hold about the world influence greatly our experience in it.
Eigenwelt:  “Eigenwelt, one’s ‘own world,’ is more than a subjective, inner experience; it is a self-awareness from which we see the world, (Sharf, 2015, p. 168).”

Factors Influencing Personality Development

Freedom & Responsibilty

Awareness of our personal freedom implies responsibility for our life (Corsini & Wedding, 2010).  With freedom comes self-responsibility.   “They are responsible for creating their own world, which rests not on the ground but on nothingness, (Sharf, 2015, p 171.”  With an awareness of our ability to freely choose, comes the need to accept responsibility for our choices.

Isolation

“Coming to terms with existential isolation..is a second dynamic conflict that structures the personality, (Corsini & Wedding, 2010, p. 219).”  Yalom describes three types of isolation: “Interpersonal isolation refers to distance from others…Intrapersonal isolation occurs when one separates parts of oneself by using defense mechanisms…Existential isolation is even more basic than either personal or intrapersonal isolation. It refers to being separated from the world” (Sharf, 2015 p. 171).”   In order to avoid existential isolation, it is essential to shareoneself with others.   The I-thou concept (mentioned earlier) is important.

Meaninglessness

“How does a being who requires meaning find meaning in a universe that has no meaning? (Corsini & Wedding, 2010, p. 320).”  This question also influences our personality development.  Systems of meaning help us make sense of our world and discover what we value most in it.

Motivations Driving Us

Sharf, (2015) describes three final factors that also influence our personality development: Self-Transcendence & authenticity.  Regarding the issue of self-transcendence: “human beings to transcend their immediate situation and their self-interest to strive toward something above themselves, Sharf, 2015, p. 173).”   In contrast, authenticity simply refers to a striving to live a life that is consistent with our personal value system.

Rollo May: Anxiety & Creativity

A Definition of Anxiety.

In his work titled “The Meaning of Anxiety” Rollo May discusses the concept of anxiety at length (May, 1950). Gathering insights from an array of fields such as Sociology, Religion, and Psychology, Rollo synthesizes them into his own overarching definition of anxiety. With this in mind, May states that “anxiety is apprehension cued off by a threat to some value which the individual holes essential to his existence as a personality….the threat of meaninglessness” (May, 1950, 191-193).   Anything that is a threat to our secure sense of meaning, produces anxiety (May, 1950). For example, May states that a job loss for a person whose identity is invested in that career, can be very anxiety producing (May, 1950).

Overcoming Anxiety – A Creative Experience.

According to Rollo May, the key to overcoming anxiety is to examine existential matters as their root cause (Corsini & Wedding, 2011). This means learning to see beyond our own perspective. Doing so can enable us to examine our lives and create our experiences from within this viewpoint.   It is this ability to know ourselves as “the subject as well as object of our experience” (Corsini, 2011, 312) that lies at the heart of this creative experience.

This capacity to experience a gap between expectations and reality, and with it the capacity to bring one’s experiences into reality are the characteristics of all creative endeavor which Kierkegaard described as conceiving ‘possibility’ and bringing possibility into actuality….Now we have noted that this capacity, however it may be defined is the condition both for anxiety and for creativity…So our discussion now comes full circle: we see that man’s creative abilities and his susceptibility to anxiety are two sides of the same capacity (May, 1950, 356).

Its when we can understand our anxieties as resulting from an existential crisis, that we can develop a greater understanding from which to recreate our lives (May, 1950). By examining how we give our lives meaning, and define possibilities for ourselves we are more aware of the underlying existential choices in life (May, 1950). Aligning these choices in accordance with reality is how we create realities out of possibilities.

Viktor Frankl’s Logotherapy

Biography

Viktor Frankl was born in Vienna, Austria on March 26, 1905. Frankl was an excellent student who was involved in Socialist youth organizations and it was this interest in people that brought him to the field of psychiatry. Frankl worked with both Sigmund Freud and Alfred Adler; however, he disagreed with Freud’s will to pleasure and Adler’s will to power and soon broke his ties and went out on his own. The most notable event that shaped Frankl’s views was his time in concentration camps, which also led him to write his book Man’s Search for Meaning. Frankl stated:

“And throughout his ordeal, he could not help but see, that, among those given a chance for survival, it was those who held on to a vision of the future; whether it be a significant task before them, or a return to their loved ones; that were most likely to survive their suffering. Frankl lost his wife, his parents, and other members of his family to the Holocaust and it was the meaning he found in that suffering that led to the writing of Man’s Search for Meaning (Viktor Frankl’s Biography, 2009. para.9).”

Major Concepts

Viktor Frankl focused on three aspects of the human existence – will of freedom, will to meaning, and the meaning of life. Existential freedom is not the same as political freedom but rather it has more to do with responsibility for what we experience. “Responsibility is inextricably linked to freedom because we are responsible for the sense we make of our world and for all of our actions and our failures to act” (Corsini & Wedding, 2011. p.312). Viktor Frankl talked about freedom of will, which he witnessed during his time in concentration camps. Frankl believed that many things except their ability to look at their situation in a positive manner restrict humans. More specifically, he saw that even people in concentration camps, who suffered the worst atrocities, could find a purpose in their lives – they had the freedom to choose whether to find a purpose and meaning or become victims (Das, 1998). Ultimately, people have the freedom to choose how they perceive their lives and the situations in which they find themselves.

Frankl believed will to meaning was that people did not live for self-actualization but rather they lived to find as much meaning and value in their lives as possible (Das, 1998). Frankl thought we create our own world and have to answer to ourselves about how we live and how we react to life’s suffering (Das, 1998). Frankl writes in Man’s Search for Meaning (2006), “One should not look for an abstract meaning of life. Everyone has his own specific vocation and mission in life to carry out a concrete assignment, which demands fulfillment. Therein he cannot be replaced, nor can his life be repeated. Thus, everyone’s task is as unique as is his specific opportunity to implement it” (p.109). Frankl also believed that man’s search for meaning, although may be unsettling, was in no way a neurosis but rather an achievement because it recognizes that man understands life and that life does have meaning and purpose (Frankl, 2006). Frankl believed in order to find meaning in life one must discover meaning through values, which are discovered through work, love, and through confrontation with our suffering (Frankl, 2006).

According to Frankl, only the prisoners who could find a meaning to their lives and looked forward to fulfilling it were able to sustain the brutalities of the concentration camps. These people had the motivation to live and a reason to overcome the cruel abuse and unspeakable living conditions. Frankl believed everyone needs meaning of life in order to live a fulfilled existence – even in times of suffering. Frankl proposed that the process of trying and fighting for a meaningful goal is what gives man ambition for life and is what affords man with gratification once the goal is accomplished. “This meaning is unique and specific in that it must and can be fulfilled by him alone; only then does it achieve a significance which will satisfy his own will to meaning” (Frankl, 2006. p.99). Frankl suggested that individuals who do not find meaning to life live in an existential vacuum. The existential vacuum, according to Frankl, “ . . . manifests itself mainly in a state of boredom” (Frankl, 2006. p.106). The existential vacuum results from man’s loss of interest and lack of initiative in life. Frankl felt this existential vacuum was associated with industrialization; when neither social tradition or instinct directs man towards what he ought to do, thus, leading man to loose touch with what he wants to do with his life (Frankl, 2006).

“Logos” is a Greek word that means “meaning”. Logotherapy focuses on the meaning of human life as well as man’s search for meaning (Frankl, 2006). Frankl’s logotherapy techniques are paradoxical intention and modification of attitudes to name a few. Paradoxical intention is a way of actually facing the condition head-on, and intentionally trying to make it worse so that it will ultimately get better. For example, if a person has a fear of dogs and becomes panicked whenever he or she sees one, Frankl suggests letting that panic rise and ride it out. The premise is that the anticipatory symptoms are what cause the phobia; therefore, recognizing and attaching oneself to the symptoms will help alleviate the phobia. “Self-attachment enables the patient to adopt a new attitude, to stand back or laugh at the situation or self. In applying paradoxical intention, the therapist tries to mobilize and utilize exclusive human capacity for humor” (Wong, 2007. para.46). Logotherapy also uses a technique that is quite simple in terms but can make an enormous impact on the client, especially those who suffer from depression and addiction. This technique is called modification of attitudes, and it is exactly what the name implies, it helps the client change his or her attitude about a stressful situation in his or her life. “ . . . the emphasis is on reframing attitudes from negative to positive. For example, the client may be asked: ‘Is there anything positive about the situation?’ or ‘What freedom is still available to you in this situation?’” (Wong, 2007. para.56).

At the core of logotherapy is that it teaches patients to transcend his or her negative belief patterns, which hinder personal growth. By letting go of our constrictive thought process, the patient is free to pursue his or her deepest aspirations and achieve a life of fulfillment and purpose. The therapist guides the patient to alternate his or her perception in order to view events differently and receive and embrace what is beyond his or her control. Effective communication and a strong patient-therapist relationship are key to logotherapy because the patient must be able to feel comfortable with communicating his or her deepest thoughts – the meaning of being and the purpose of life. Many say this therapy is more a way of life rather than a way to treat challenging issues (Good Threpay.org, 2012).

Assumptions of Logotherapy

One assumption of Frankl’s theory is man is free, therefore, responsible for his choices. Frankl witnessed much of this in the concentration camps by observing how the prisoners reacted to their situation. As Corsini and Wedding stated, “life is groundless, and we alone are responsible for our choices” (p.311). This is a powerful statement – humans have the ability to think and make choices and this, at times, can be very daunting because we are all responsible for the choices we make. Another assumption of Frankl’s theory is the will to meaning, which assumes that every man strives to find meaning in his life. Frankl states:

As each situation in life represents a challenge to man and presents a problem for him to solve, the question of the meaning of life may actually be reversed. Ultimately, man should not ask what the meaning of his life is, but rather he must recognize that it is he who is asked. In a word, each man is questioned by life; and he can only answer to life by answering for his own life; to life he can only respond by being responsible (Frankl, 2006. p.109).

Another assumption is life has meaning under all circumstances. Again, Frankl learned this by observing his patients and fellow inmates in the concentration camps. Even under stress and suffering life has meaning and purpose – it just takes one’s will to meaning to discover this. One of this author’s favorite quotes by Frankl is: “What is to give light must endure burning” (Frankl, 2011). In suffering, individuals find meaning or at the very least the desire to find meaning in life.

There are situations in which one is cut off from opportunity to do one’s work or enjoy one’s life; but what never can be ruled out is the unavoidability of suffering. In accepting this challenge to suffer bravely, life has a meaning up to the last moment, and it retains this meaning literally to the end. In other words, life’s meaning is an unconditional one, for it even includes the potential meaning of unavoidable suffering (Frankl, 2006. p.114).

Strengths and Weaknesses

One aspect of Frankl’s logotherapy which could be seen as a weakness by some in his field, is that Frankl saw anxiety as a healthy condition rather than problematic. Frankl believed that anxiety was a healthy condition because he felt anxiety was a powerful force behind the human drive to live and finding meaning in life (Frankl, 2006). Therefore, Frankl did not treat anxiety as a disorder, as most counseling theories do, and did not treat this condition accordingly. This may lead to undue suffering from clients who seek this type of therapy.

Another weakness of Frankl’s therapy is that it will only work with highly intelligent people who think rather philosophically. Frankl’s logotherapy is deeply based on philosophical ideas; thus, it may not be for everyone. For example, someone who is mentally challenged would not be able to comprehend this type of therapy. Logotherapy would not be beneficial to patients who are suffering from psychotic episodes for this same reason. Furthermore, with existential therapy there is very little guidance from the counselor; responsibility of treatment lies with the patient. This can be very difficult for certain patients who are not motivated enough to take on all the responsibility for their treatment.

A strength of Frankl’s therapy and existentialism therapy is that it can be integrated into many other forms of therapy. Since logotherapy is mainly a philosophical point of view it can be used with many other forms of therapy such as, cognitive therapy, REBT, and person-centered therapy.

Overview of Approach

A Core Clinical Hypothesis

I dug up another course textbook that provides an interesting perspective, titled “Clinical Case Formulations,” (Ingram, 2012).  It’s purpose is as follows. “A clinical case formulation is a ‘conceptual scheme that organizes, explains, or makes sense of large amounts of data and influences the treatment decisions’ (Ingram, 2012 p. viii).”  What I love about this book is it provides clinical hypotheses that are useful in providing “a single explanatory idea that helps us structure data about a given client (Ingram, 2012 p. 11).”  In chapter eleven of this textbook is a section titled “Existential & Spiritual Models”  In it is are a few clinical hypotheses based on this perspective.  It useful in understand how this theory could be utilized for purposes of case conceptualization…

“By applying the hypotheses in this category, the therapist refuses to pathologize, medicalize, or objectify the patient. Clients do not have a ‘disorder’ but are struggling with inevitable problems of human existence, (Ingram, 2012, p. 257)”

(ES1) Existential Issues Hypothesis

Useful in cases where a person is suffering from a “Crisis of Meaning” in their lives due to death or loss; depression and/or severe anxiety (Ingram, 2012).  Existential therapists addressing these issues by noting that suffering in life is ultimately unavoidable.   Existentialists suggests that we view “painful emotions as useful signals that can help, (Ingram, 2012, p. 259) us live more effectively.  Rather than medication emotions, this approach suggests we clients become aware of these unpleasant emotions and the underlying thought processes (Ingram, 2012).

Application of Hypothesis

The role of the existential therapist is to “facilitate the client’s self-understanding…remove obstacles that are in the way of change and growth…[and] shine a light on blind spots, (Ingram, 2012, p. 263).”  Rather than developing a pragmatic and goal-directed treatment plan existentialists might promote the idea that no change is okay.   I would surmise this approach yields two benefits.  FIRSTLY, it gives clients the feeling they are free to choose since they are no longer held to the standard of showing progress. SECONDLY, sometimes awareness and understanding itself is transformative.  Other unique aspects of existentialism is its phenomenological approach that allows therapists to act as a “fellow pilgrim [that can engage in] philosophical discussions, (Ingram, 2012, p. 265),” with the client.

Best Case Match

Logotherapy and existential therapy would best suit individuals who are facing boundary situations such as, “. . . a confrontation with death, the facing of some important irreversible decision, a sudden thrust of isolation, or milestone that mark passage from one life era into another” (Corsini & Wedding, 2011. p.333). Clients, who view life’s problems as challenges, rather than symptoms of psychopathology, would best be served by logotherapy because logotherapy views anxiety as a healthy aspect of the human condition rather than a problematic symptom. Logotherapy is also suited for individuals who want to find meaning in life and who are concerned with increasing self-awareness and self-examination. This approach is also good for individuals who are questioning their own ideologies and beliefs such as, religion or politics. “ . . . some existential practitioners suggest the approach is particularly appropriate for those who feel at the very edge of existence, including those with terminal illnesses or who are contemplating suicide, or perhaps those who are just beginning a new phase of life in some way” (Malhauser,2012. para.10).

Frankl also believed logotherapy worked well with patients who were suicidal because this type of therapy focuses on one’s will to live or meaning in life. In most therapy sessions the therapist asks the patient if they plan on harming him or herself; however, Frankl devised another question to ask in conjunction with this question to better understand if the patient was truly suicidal or not. This question was to ask the patient “why or why not” in regards to wanting to commit suicide or harm him or herself. If the client could readily explain why they could not commit suicide, then Frankl believed the patient had a meaning to life. If the client could not answer this question then they did not have a meaning to life and that indicated that he or she was deceiving the therapist to thwart off any intervention (Marshall, 2011).

The Role of the Existential Therapist

So what exactly is the role of a therapist when utilizing existential psychotherapy? This is admittedly a tough question, in light of a clear absence of specified training methods and a lack of empirical evidence, (Corsini & Wedding, 2011).    Still some interesting observations about this theory can be made, in helping to differentiate it from other methods.

Existential therapy is aimed at focusing on the subjective experiences of the client, with a unique relationship as “fellow-travelers” (Corsini & Wedding, 2011). Unlike cognitive and behavioral therapies that appear to have an objective scientific approach based on inductive reasoning, this theory is unique (Corsini, & Wedding, 2011). Its utilization alongside other therapy methods seems particularly appealing in light of its subjective and deductive reasoning (Kershen, 2006). In fact, it is the feeling of this author that understanding the difference between deductive and inductive logic, is vital to appreciating this method (Kershen, 2006; Wong, 2010).

On the one hand, inductive logic starts with specified and objective observations, and develops generalities on the basis of this (Inductive Logic, 2006). It is this form of logic that underlies the scientific method and is aimed at critically testing hypotheses (Inductive Logic, 2006). On the other hand, the deductive method starts with general principles such as meanings and beliefs, and moves to specific observations (Deductive Logic, 2006). In contrast to inductive logic it is unique proposition is that of preserving greater truths (Deductive Logic, 2006).

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References

Coleman, A. (2009). Oxford Dictionary of Psychology (3rd ed.). New York, NY: Oxford University Presss.
Corey, G. (2015). Theory and practice of counseling and psychotherapy. Retrieved from: http://bk.unesa.ac.id/wp-content/uploads/2015/09/Theory_and_Practice_of_Counseling.pdf
Corsini, R. J. & Wedding, W. (2011). Current Psychotherapies. Belmont, CA: Brooks/Cole
Deductive Reasoning.  (2006). In Encyclopedia Dictionary Psychology.  Retrieved from: http://www.credoreferences.com.eproxy.bellevue.edu/entry/hodderpsych/deductive_reasoning
Das, A. K. (1998). Frankl and the realm of meaning. Journal of Humanistic Education and Development , 36 (4), 199-212.
Frankl, V. (2011). Man’s Search for Menaing. Boston: Beacon Press.
Good Therapy.org. (2012). Logotherapy. Retrieved April 22, 2012, from Good Therapy.org.
Inductive Reasoning.  (2006). In Encyclopedia Dictionary Psychology.  Retrieved from:  http://www.credoreferences.com.eproxy.bellevue.edu/entry/hodderpsych/inductive_reasoning.
Ingram, B.L. (2012). Clinical Case Formulations: Matching the Integrative Treatment Plan to the Client. (2nd ed.). Hoboken, NJ: Wiley.
Kershen, A. (2006). A new look at existential psychotherapy. American Journal of Psychotherapy. 60(3). 285-298.
Malhauser, G. (2012). The Introduction of Existential Counseling. Retrieved April 10, 2012, from Counseling Resources: http://counsellingresource.com/lib/therapy/types/existential/
May, Rollo. (1950). The Meaning of Anxiety. New York: Roland Press Company.
Rosenthal, H. (2005). Vital Information and Review Questions for the NCE and State Counseling Exams. Routledge.
Sharf, R. S. (2015). Theories of psychotherapy & counseling: Concepts and cases. Cengage Learning.
Spear, J. (n.d.). Existential Psychology: History of the Movemement. Retrieved April 10, 2012,  from Existential Psychology: History of the Movement:   http://psychology.jrank.org/existential-psychology.html
Viktor Frankl Biography. (2009, November 24). Retrieved April 1, 2012, from Viktor Frankl          Institute of South Africa:       http://www.vfisa.co.za/index.php?option=com_content&view=article&id=46:viktor-frankl-biography&catid=34:about-viktor-frankl-and-logotherapy&ltemid=64
Wong, P. (2007). Logotherapy. Retrieved April 6, 2012, from International Network on Personal  Meaning: http://www.meaning.ca/archives/archive/art_logotherapy_P_Wong.htm
Wong, P.T. (2010). Meaning therapy: an integrative and positive existential psychotherapy. Journal of Contemporary Psychotherapy. 40. 85-93. 

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Reality Therapy

Who is William Glasser?

William Glasser was born on May 11th, 1925 in Cleveland Ohio.  He earned an undergraduate degree in chemical engineering, a Masters in Clinical Psychology, and finally his MD.  He completed his Psychiatric training in 1957.  He was married 47 years until his wife’s death and had two children.

What Glasser Believed

“Very early Glasser rejected the Freudian model, partly due to his observation of psychoanalytically trained therapists who did not seem to be implementing Freudian principles. Rather, they tended to hold people responsible for their behavior, (Corey, 2015, p. 315).”  William Glasser developed Reality Therapy to address a key problem with psychoanalysis: that it taught people to blame others for their behaviors (Sharf, 2015, p. 417).  In Glasser’s Reality Therapy, he sought to develop an approach to therapy that  that reflected his  clinical experience.    As a result of this experience, “Glasser became convinced that it was of paramount importance that clients accept personal responsibility for their behavior. (Corey, 2015, p. 315).”  In many respects, Reality Therapy appears to be similar to REBT as a practical cognitive and behavioral approach (Rosenthal, 2005).  However there are a few key differences.  While Glasser focuses on relationships and an awareness of one’s choices, Ellis is focused on irrational beliefs and behavioral change.  Additionally, while it contains techniques that reflect behaviorism, he ultimately disagreed with Skinner.

Criticism & Praise

Rosenthal, (2005) notes that since this theory is practical, straightforward “and not cloaked in theory, it is attractive to social workers, case-workers, teachers, juvenile workers, rehabilitation specialists, (Rosenthal, 2005).”   However, some have also criticized this method is overly simplistic and ignores the unconscious as irrelevant to his approach (Rosenthal, 2005).

Characteristics of Reality Therapy

The Problem & It’s Solution

“Reality therapists believe the underlying problem of most clients is the same: They are either involved in a present unsatisfying relationship or lack what could even be called a relationship…Few clients understand that their problem is the way they are choosing to behave. What they do know is that they feel a great deal of pain or that they are unhappy…(Corey, 2015, p. 316).”

As the above quote states, reality therapists define the goal as unsatisfying relationships and poor behavioral choices that cause unhappiness.  In contrast, REBT focuses on irrational beliefs while psychoanalytic theorists state answers lie in the unconscious.  Consequently, Reality Theorists are not interested in helping client’s gain insight into their irrational behaviors or resolving unconscious conflict. (Wubolding, 2013, p. 293).  Instead Glasser aims to help clients make better behavioral choices since he defines problems as involving poor behavioral choices (Corey, 2015; Wubolding, 2013).   By helping clients make better behavioral choices, they can become more successfully fulfill basic human needs such as love, belonging, freedom, achievement, etc. (Corey, 2015).

Thoughts on Diagnosis…

Glasser’s theory rejects the traditional DSM-based perspective of diagnosis except when absolutely necessary (i.e. insurance coverage purposes), (Corey, 2015).  He rejected the notion of a label that defined someone as mentally ill and that the primary solution involved medication.  Instead, in Glasser’s view, the problems ultimately came down to the behaviors people choose to engage in when attempting “to deal with the pain and frustration that is endemic to unsatisfying present relationships, (Corey, 2015, p. 317).”

Choices Not Symptoms

“Reality therapy helps people examine their wants and needs, evaluate behaviors, and make plans for fulfilling needs (Wubolding, 2013, p. 293).”  Glasser rejected other approaches on the basis that they allowed clients to blame others for their behavior (Sharf, 2015).  Instead, reality therapy is based on the notion that “the only person you can control is yourself, (Corey, 2015, p. 315)”.  Rather than complaining about external circumstances or criticizing others, reality therapy is focused on oneself.  Symptoms of a mental illness are instead conceived as consequences of our behavioral choices.  The symptoms represent the problem while our choices reflect our solution.

Emphasis on Self-Responsibility

“If we choose all we do, we must be responsible for what we choose. This does not mean we should be blamed or punished, unless we break the law, but it does mean the therapist should never lose sight of the fact that clients are responsible for what they do (Corey, 2015, p. 315).”

Click Here To Read My Post Titled: “Accepting Responsibility: “Shame, Blame, Resentment”  

Focused On The Present

While Glasser does believe that we are products of our past history, the solution lies in the present.  If we focus on the past, (Corey, 2015).  In this respect, while Reality Therapy appears to acknowledge our problems are often associated with a multifactorial cause, the workable solutions lie in our behavioral choices.  When we focus on things beyond our control like the past we become a victim.  When we focus on the choices we’ve made, we become empowered with a realistic and remediable solution.

Rejection of Transference

“Glasser contends that transference is a way that both therapist and client avoid being who they are and owning what they are doing right now (Corey, 2015, p. 320).”  In other words, since transference issues pertain to unconscious memories of past events, they aren’t relevant to the solution.  From a reality therapy perspective, focusing on transference issues in order to uncover unresolved issues within our unconscious is a waste of time.  Instead, Glasser believes we can only be what we are in the present (Corey, 2015).

Basic Concepts

Control Theory

Glasser developed Reality Therapy in the 60’s as a result of his years of experience at a “state institution for delinquent adolescent girls, [in which a] focus on friendliness and responsibility was found to be helpful (Sharf, 2015 p. 417).  Later in 1981, Glasser wrote a book titled “Choice Theory” which emphasized the phenomenological pictures we create in our mind.   This phenomenological experience of our world determines our behavioral choices.  Consequently, we”behave to control the world…[it] does not control us (Rosenthal, 2005).”  The solution we desire ultimately lie within.

The Thermostat Analogy

file5331257892459Glasser describes the brain as an internal thermostat, that functions to assess how effective our behaviors are in responding to our environment (Corey, 2015; Wubolding, 2013).  This process begins when we utilize our senses to observe the world outside ourselves.  We choose how to respond based on these perceptions and how they correlate to our basic human needs (Wubolding, 2013).  In other words, the brain assesses the effectiveness of our behavioral responses to our environment. Psychiatric symptoms are best understood from this perspective according to reality therapy.

A picture of reality

img_2878“Glasser (1981, p. 126) makes the point that we do not live ‘to any extent in the real world’ (Sharf, 2015, p. 419).”  In other words, it is ultimately our perception of reality that determines our behavior.  Do we see reality as it is?  Wubolding, (2013) notes “The input desired from the world enters the brain first through the sensory system and then through two filters: the total knowledge filter, by which the perception is first recognized, and the valuing filter, by which the person makes a positive or negative judgment about the perception, (p. 295).  Our innate human drive to fulfill certain elemental needs like love, and belonging, create the motivational force underlying our valuations of the external world.  In this respect, our perceptions often act as self-fulfilling prophecies, until we understand where our choices lie.

A View of Human Nature

“Choice theory posits that we are not born blank slates waiting to be externally motivated by forces in the world around us….Rather, we are born with innate human needs such as survival, love and belonging…that drive us all our lives, (Corey, 2015 p. 317).”  In this respect, reality therapy conceives all behavior as purposeful in nature (Wubolding, 2013).  We are driven by our innate human needs….

…On the surface, this perspective of human behavior sounds much like Skinner’s mechanistic view of human nature.  However, Reality Therapy notes that we respond to this drive by making behavioral choices that correlate with our perceptual understanding of reality (Wubolding, 2013).

Explanation of Human Behavior

According to choice theory, all behaviors are a reflection of the personal choices we make to fill personal needs (Wubolding, 2013).  Additionally, Glasser states that: “behavior is made up of four inseparable but distinct components— acting, thinking, feeling, and physiology—that necessarily accompany all of our actions, thoughts, and feelings, (Corey, 2015, p. 318).”  Wubolding, (2013) adds that behaviors can be thought of a form of communication, wherein we inform others of our underlying motivations.

“Physiology refers to both voluntary and involuntarily bodily mechanisms, (Sharf, 2015, p. 421).”  EXAMPLE: I experience physiological anxiety.
“Thinking includes both voluntary and involuntary thoughts, (Sharf, 2015, p. 421).”  EXAMPLE:  I think about our mounting debt.
Feelings include an endless array of both positive and negative emotions, (Sharf, 2015). EXAMPLE:  I feel frustrated about paying it off.
“Doing refers to active behavior…voluntary or involuntary, (Sharf, 2015, p. 421).”  EXAMPLE:  I bitch and whine endlessly.
“behavior is a language, and that we send messages by what we are doing, (Covey, 2015 p. 319). EXAMPLE:  I communicate a lack in faith that we can get through this.  

Additionally, Glasser utilizes a diagram as an analogy to describe how he conceives human behavior (Sharf, 2015).  Our needs exist as the engine or motivate fuel that drives our behavior while our individual wants are much like a steering wheel by providing us some direction (Sharf, 2015).  Now if we have a front wheel drive car, actions and thoughts are the front wheels, while feelings and physiology are the back wheels (Sharf, 2015).  This analogy is keeping with Glasser’s assertion that innate needs are essential as a point of understanding human behavior, while describing how we can gain control of the vehicle.

Basic Human Needs

Glasser believes that our conceptions of our external world are defined by an innate desire to satisfy our innate human needs (Sharf, 2015).  Consequently, reality as we experience is a subjective creation and not an objective fact.  “For example, a woman with anorexia may have a picture of herself as fat, (Sharf, 2015, p. 420).”   These needs provide motivation for our behavioral choices and are universal in nature since they are innate rather than learned (Wuboldt, 2013).  Glaser describes five basic needs:

SURVIVAL: “Taking care of oneself by eating, drinking, seeking shelter, & resisting illness, (Sharf, 2015, p. 420).
BELONGING:  A basic  desire for love &acceptance from others as well as a feeling of cooperation in significant relationships, (Sharf, 2015).  
POWER:  A need to “be better than others often conflicts with our need for belonging, (Sharf, 2015, p. 420).”  This esteem or feeling worthwhile by achieving our personal goals. 
FREEDOM:  A desire to live life on our own terms and have control over how we choose to express ourselves (Sharf, 2015).  
FUN:  a need to engage in experiences and activities one finds enjoyable (Sharf, 2015). 

The Nature of Choice

“When a person perceives that he or she is getting what is desired from the external world, the five needs are satisfied. But when there is a difference between what is desired and the input one receives by way of the perceptual system, the person is motivated to generate a choice, a behavior in the external world, (Wubolding, 2013, p. 295).”

How does reality therapy address the issue of illogical human behavior? In other words, why would we choose for ourselves a state of being that is displeasurable?  Glasser describes in his theory for reason why a person would choose an unwanted state of being (like anxiety or depression)

FIRSTLY:  Individuals sometimes choose to be anxious or depressed because it is a preferable to displays of anger (Sharf, 2015).  (EX – I vacillate between anger & depression in response to the money issues rather than lashing out in anger.)
SECONDLY:   Individual’s sometimes choose to be angry or depressed because it yields a more helpful response from others.  (EX – when my husband sees me becoming anxious about our debt, he watches the budget closely, and the kids whine less about shopping).
THIRDLY:  “Individuals choose pain and misery to excuse their unwillingness to do something more effective (Sharf, 105, p. 422).”  (EX – For example, I choose to remain in an abusive relationship for promises of acceptance, rather than heal older traumas from my childhood).
FOURTHLY:  Sometimes people opt for anxiety and depression because it can help them gain control of other’s responses (Sharf,  2015).  
In other words, “when people choose misery…it is because these are the best behaviors they are able to devise at the time, and these behaviors often get them what they want. (Corey, 2015 p. 319).”

In this sense, Glasser does not view illogical behavior as a matter of mental illness, but instead as a “creative solution” to a complex problem (Sharf, 2015).  The key question for therapists then would be: What purpose does this behavior serve?  Answering this question will require utilizing Glasser’s Car Metaphor for perspective since individual’s may not directly choose these behaviors.  “People do not choose pain and suffering directly; rather, it is an unchosen part of their total behavior, (Corey, 2015, p. 319).”

EXAMPLE ONE: A person can play victim because it gives them a sense of control over others and they can feel a sense of validation and self-righteousness that their hurt was in fact caused by other people.  An unchosen part of this total behavior is that they become helpless.  Solutions can only be defined in terms of others
EXAMPLE TWO:  When I become depressed I start focusing on regrets from my past (i.e. unforeseen illness and mounting medical bills).  I use these past experiences to predict future events, and see nothing about the same in my future.  This causes heightened anxiety as I begn thinking in terms of worst case scenarios.  This helps me feel prepared for the worse, however renders me helpless.  All I can do is worry and complain.  

A Theory of Personality

“Reality therapy teaches that human beings choose behaviors. When choices are made, people discover that the result attained is desirable or undesirable. They thus discover whether their behaviors are effective or ineffective in satisfying their needs. They also discover whether particular aspects of the external world are pleasurable (need-satisfying), painful (not need-satisfying), or neutral, (Wubolding, 2013, p. 299).”

According to Glasser, personality development begins with a basic understanding of our needs, and how to best fulfill them.  Life experiences accumulate to create a perspective that we utilize to understand our world.  Since all behaviors are designed to fill our needs, our identity is based on how successful we are at meeting them (Wubolding, 2013)….

Success Identity

A success identity can be thought of as “a responsible individual who develops a high degree of self-esteem, personal strength, and [successful in meeting their] needs, (Rosenthal, 2015).”  In order to develop a success identity we need to be willing to develop a “repertoire of skills for meeting the fiveneeds of belonging, power, fun, freedom, and survival in positive ways, (Wubolding, 2013, p 301).”  A resource I found for this post describes three key elements necessary for the development of a successful identity (Wubolding, 2013):

“(1) a desire to fulfill human needs effectively without infringing on the rights of others; (2) elements of a positive life direction include the following positive symptoms such as “altrusim…effective thinking…self-confidence…effective behaviors; (3) and a positive addiction for meditation and noncompetitive exercise (Wubolding, 2013, p. 301).”

Failure Identity

A failure identity “is characterized by faulty perceptions and irresponsible behaviors, (Rosenthal, 2015).” Their behavioral responses are ineffective in meeting their life needs.  In contrast, the development of a failure identity is byproduct of three factors:

“(1) giving up…(2) [engaging in]…ineffective behaviors such as antisocial actions…negative thoughts [and] feelings; (3) and unhealthy addictions, (Wubolding, 2013, p. 301).”

The Reality Therapy Process

Rosenthal (2005), completes his discussion of reality therapy by providing an overview of the process in eight key steps:
“(1) establishing a relationship; (2) Focusing on current behavior; (3) Requesting client participation in evaluation process; (4) developing a plan for change: (5) committing to therapy; (6) accepting responsibility; (7) avoid punishment & while utilizing judgment to ascertain willingness to change; (8) finally, remain persistent, (Rosenthal, 2005).

Facilitators of Change

How does Reality Therapy make change happen?  Wubolding, (2013) states that Reality Therapy provides hope to clients in the form of a realistic solution.  Corey, (2015) states that change happens “when [clients] are convinced that their present behavior is not getting them what they want and (2) when they believe they can choose other behaviors that will get them closer to what they want, (p. 325).”

  1. Reality therapy facilitates change because it helps us understand how we are behaving from moment-to-moment throughout our lives, (Wubolding, 2013).
  2. Reality therapy facilitates change by helping us find effective solutions to gain control over our lives and increase our overall effectiveness in meeting our needs, (Wubolding, 2013). 
  3. The therapeutic relationship facilitates change by [roviding the client a friendly and safe environment in which to examine their total behaviors.
  4. Reality therapy facilitates change by helping improving their ability to engage in honest self-evalaution (Wubolding, 2013).  

Assessment

Reality Therapy does not utilize assessment for diagnostic purposes, but instead as a facilitator of change (Sharf, 2015).  Wubolding (2013) notes that “all change, great and small, is preceded by the client’s judgment that life is not as it could be and that a better, more rewarding future is possible, (p 310).  In other words, helping a client understand how change is possible, itself is a huge step.  Sharf, (2015) notes two key elements focused upon in a Reality Therapy approach include: an assessment of wants and total behaviors:

ASSESSMENT OF WANTS & NEEDS:  What does one want and how do these wants represent the five human needs Glaser has discussed?  How can they describe the need between what they want and what they have?
ASSESSMENT OF TOTAL BEHAVIOR:  Utilizing the metaphor of the car, what are your actions, thoughts, behaviors, and physical symptoms.  How can you describe your responses to difficult life situations, in this matter?  

WDEP System

“the WDEP system…represent[s] a cluster of skills and techniques for assisting clients to take better control of their own lives and thereby fulfill their needs in ways satisfying to them and to society, (Wubolding, 2013, p. 304).”  Each letter represents a different step in the overall therapy process which naturally begins with the establishment of a therapeutic relationship (Sharf, 2015).

“WDEP…refers to W = Wants, D = Direction & Doing, E = evaluation, & P = Planning, (Sharf, 2015, p. 424).”
STEP ONE “As client’s what they want, (Wubolding, 2013, p. 304)” This means examing one’s personal wants and how they influence their perceptions of reality.
STEP TWO“Ask clients what they are doing and their overall direction, (Wubolding, 2013 p. 305).”  This is can help clients examine the motivations underlying their behavior and what changes they can make.
STEP THREE“Ask clients to conduct a searching self-evaluation, (Wubolding, 2013, p. 305).”  For example, how realistic are their needs and are their behaviors taking them in the direction of their goals?
STEP FOUR “Ask clients to make Plans to more effectively fulfill their needs…. The plan should have SAMIC characteristics—i.e., it should be Simple, Attainable, Measurable, Immediate, and Committed to, (Wubolding, 2013, p. 306).”

Therapist Attitudes

“The following are attitudes that counselors adopt when handling difficulties in exploring total behavior, evaluating the behavior, making plans, and committing to plans: (1) No excuses for failure to follow through on plans are accepted…(2) The counselor does not criticize, argue with, or punish the client… (3) The counselor does not give up on the client, but persists, (Sharf 2015 p. 428).”

Therapeutic Strategies

Finally, before I end this post, I think its useful to list a few therapeutic strategies listed in Sharf’s (2015) textbook.  He begins by noting that this method is not “technique focused” (Sharf, 2015, p. 430).”

  1. QUESTIONING:  Developing a variety of ways to ask clients about their inner world is useful in exploring the elements of one’s total behavior.
  2. BEING POSITIVE:  “The reality therapist focuses on what the client can do. Opportunities are taken to reinforce positive actions and constructive planning, (Sharf, 2015, p. 431).”
  3. METAPHORS:  Glasser seems to describe the use of metaphor as a way of utilizing the client’s language to describe their needs and total behaviors.  This can be useful in talking about things in a manner which is congruent with their own experience (Sharf, 2015, p. 432).
  4. CONFRONTATION:  As stated earlier, one essential therapeutic attitude involves the refusal to accept excuses from your clients, (Sharf, 2015).  Confronting the client doesn’t necessarily mean that you’re rejecting the client or being negative.  Instead it means a firm line is drawn that forces the client to accept responsibility.
  5. PARADOXICAL TECHNIQUES:  “Paradoxical techniques are those that give contradictory instructions to the client, (Sharf, 2015, p. 432).”  This method appears similar to Viktor Frankl’s paradoxical intention technique that involves having the client engage in a highly exaggerated and inappropriate level of a specific behavior they hope to extinguish.  For example, this can involve reframing how we think about a topic, or prescribing a schedule for certain maladaptive behaviors in order to control them better (Sharf, 2015).

References

Corey, G. (2015). Theory and practice of counseling and psychotherapy. Retrieved from: http://bk.unesa.ac.id/wp-content/uploads/2015/09/Theory_and_Practice_of_Counseling.pdf
Glasser, W. (1981). Station of the mind: New direction for reality therapy. New York: Harper & Publisher.
Reality Therapy / Choice Theory: Chapter 8. (n.d.) Retrieved from:  http://www.willamette.edu/~regray/cm/CH%208%20Reality%20Therapy.pdf
Rosenthal, H. (2005). Vital Information and Review Questions for the NCE and State Counseling Exams. Routledge.
Sharf, R. S. (2015). Theories of psychotherapy & counseling: Concepts and cases. Cengage Learning.
Wubbolding, R. E. (2013). Reality therapy for the 21st century. Routledge.

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Transactional Analysis

***This post is a study exercise as a I prepare to take the NCE exam.  It contains excerpts from other posts that can be found hereherehere…&… here***

Eric Berne, (1910 – 1970) was born in Canada as Leonard Bernstein.  His father was a physician who died when Eric was young.  His mother was a writer.  In an effort to follow in his father’s footsteps, Eric Berne also became a physician, graduating in 1935.  After completing his internships, and becoming an American citizen, he changed his name to Eric Berne.  He started his practice in Connecticut and married his wife, Ruth in the early 40’s.  They had two children together.

Rosenthal, (2005) states that Transactional Analysis is often referred to as a “Populist Therapy Method”, since it is fun and easy for the laymen to understand.  While developing his approach, he made a point of simplifying the language and wrote several books on the subject including.

An overview of Transactional Analysis….

matryoshka-970943_1920Utilizing insights from this theory, my therapist keeps nesting dolls on the coffee table in her office.  Utilizing them in conversations from time to time, they have been productive tools for reflecting on the opposing ego states underlying my stuckness.  It seems my own “inner critic” and “hurt child” are fighting for “control” and as a result I’m getting nowhere.  Now that I’m a student, and reading Eric Brene’s works, it may be useful to quickly review some essential concepts.

Selfdefinition.org (n.d.) describes transactional analysis as a theory of social intercourse.  According to Eric Berne, “The human brain acts in many ways like a camcorder, vividly recording events.” (ericbrene.com, n.d.).  While not necessarily remaining available for conscious retrieval, the emotive consequences of these events and our experiences of them remain.  It is only when interactions and events, trigger these memories that the effects of these events arise.  This cognitive process is much more complex in an individual with PTSD as you might imagine.  In an effort to provide convenient constructs to discuss the transactional process between these ego states, Eric Brene created several key concepts in this theory.  For example, structural analysis involves an examination of the various mental states I described earlier (“inner critic” vs. “hurt child”).  In contrast, transactional analysis examines the dynamics of social interaction and how these elements of our psyche play their role.  The nesting dolls in my therapy sessions provide a convenient method of illustrating Eric Brene’s concepts of ego states.  Rather than conceiving of these ego states as Freudian structures in the brain, Berne states they are “phenomenological realities” (ericbrene.com, n.d.), that represent consistent patterns of reacting to life events.  Additionally, these phenomenological realities are based on past choices in response to life events.  Therefore, his conception of personality development is less determinstic than Freud.  For example, my own “hurt child”, reflects Eric Brene’s child ego state in which past experiences are experienced from the standpoint of their emotive impact.    In my specific instance, this is where most of my unresolved traumas exist.  In contrast, the Parent ego state, represents my own “critical parent”.  The critical parent’s camcorder provides an overview of early life experiences and the implicit messages they contained.  Finally, as I understand it, Berne’s adult ego state, reflects closely Marsha Linehan’s wise-mind concept.

T.A. Ego States…


529807Ego states refer to experiential realities that also represent a consistent pattern of relating with the world around us (Ingram, 2012)  Analysis of ego states is called Structural Analysis (Rosenthal, 2005).  Since, only one ego state is dominant at any point in time, our communication style and body language often communoicates which ego state we are operating out of (Rosenthal, 2005).

Three primary ego states exist in transactional analysis: parent, adult and child. The parent ego state is a representation of the way parents and other authority figures conduct themselves. The parental ego influences us by echoing the learned rules and morals communicated to us from authority figures throughout our life. Two main forms of parental ego states include the nurturing and critical parent. The child ego state, in contrast, is archaic and emotionally 490629driven. Comprised of our own first-hand early childhood experiences, it reacts impulsively with others on the basis of these deep emotional memories. Two versions of the childlike ego state exist: the rebel and hurt child.  Finally, The adult ego state is much like the wise-minded DBT perspective. In this respect, it is fully present in the moment and is capable of making realistic appraisals based on all perspectives, including thoughts and emotions. As somebody who is trying to lose weight, a funny description of each state is provided in my textbook:

“[rebellious child] I’m going to eat what I want and you can’t stop me…[hurt child] I know I am bad; what’s wrong with me. I’m trying, but just can’t…[nurturing parent]…don’t worry, I know you’re stressed. Go ahead and have some ice cream…[critical parent] you should take those pounds of. What’s wrong with you?! You’re an indulgent loser…[Adult] Lets come up with a plan where I can maintain a steady weight loss of one pound a week yet still eat foods I enjoy and have certain meals where I can disregard the rules.” (Ingram, 2013, p 295)

Basic Concepts….

Defining Transactional Analysis

Transactional analysis can be thought of as an attempt to understand social interactions between individual ego states (Rosenthal, 2005; selfdefinition.org, n.d.).

TRANSACTION – a unit of social intercourse, where two or more individuals interact

TRANSACTION STIMULUS – the actions and/or words from another acknowledging our presence & reacting to our behaviors.

TRANSACTIONAL RESPONSE –  is naturally our chosen manner of responding to transactional stimuli.

Types of Transactions

Berne also classifies types of social transactions in his theory, these include: (1) complimentary transactions; (2) cross-transactions; and (3) gimmicks, (Rosenthal, 2005).

Complementary Transactions

complimentaryAre predictable interactions based on the natural order of a relationship between individuals.  Responses are predictable, parallel and can proceed in this manner as long as all individual respect the parameters of the relationship, (selfdefinition.org, n.d.).   Rosenthal, (2005) describes these as healthy relationships. For example, when interacting with my kids I’m adopting a parent ego state, they can expect when they talk to me.

Cross-Transactions

pac10Rosenthal, (2005) describes these as unhealthy relationships, (i.e. hurt child / critical parent).  Communication that is not complementary creates conflict and causes a breakdown in understanding.  It can be best described as a form of transference.  For example, let’s say I’m talking to my husband about the bills.  I assume I’m talking to an adult.  However, I get a response from his “Hurt Child”, and pouts when I begin discussing our spending this last month.

Gimmicks

Gimmicks are used in games for a payoff – or ulterior motive (Rosenthal, 2005).  Selfdefinition.org, (n.d.) notes that they can involve the activity of more than two ego states are at play during an interaction. Gimmicks are based on our social needs.  In order to meet these social needs, our true feelings psychologically can contradict how we behavior in the social transaction.

In my last internship I received no support or training and was overwhelmed.

I initially engaged in a complementary transaction with my supervisor, and notified them the 70+ hour work week was too much.

However this didn’t work, they were desperately understaffed.

Therefore, I bided my time, appearing appreciative and friendly.

However, I was seething in frustration underneath.

I desired to make a good impression.

This is a gimmick.

Strokes

selfdefinition.org (n.d.) defines as a unit of social interaction that are interpreted as a form of physical or verbal recognition.  They can involve a form of intimate physical contact or include verbal recognition.  Rosenthal, (2005), notes that they can be either positive or negative.

Rituals & Procedures

Typically socially interactions exist as a series of events that are learned as a result of previous interactions.  Procedures are series of complex transactions such as the standard greeting of a casual acquaintance when you ask them about how they’re doing and they say fine in the grocery store.  They serve the purpose of allowing us to folllow social rules while acknowledging others without expending a great deal of mental energy.  In contrast, rituals are byproducts of external social requirements (i.e. scripts, schemas and/or frames).  An excellent example of a formal ritual includes the typical Catholic mass (selfdefinition.org, n.d.).  We all know what’s expected and behave accordingly.

Games

Like rituals and procedures, games exist as a series of typical events in the course of our interaction with others.  However, what makes them unique are that they include a series of gimmicks and can be characterized by an ulterior motives, and concealed motivations.  Rosenthal, (2005) describes them as containing underlying messages that contradict our behaviors, preventing intimacy and honesty.  They are repetitive in nature and color the nature of our unhealthy relationships.

Berne’s Scripts

In his book “Transactional Analysis in Psychotherapy”, Eric Berne, (1961), provides a theory which is useful in analyzing social interactions.  His theory uses the concept of life scripts to describe a set of “unconscious relational patterns” (Erskine, 2010, p. 24).  Developed in childhood, they are relational patterns that reflect our attachment history and are repeated throughout life.  Scripts exist within limbic memory and influence our thoughts, perceptions and behaviors.  Finally, they provide “a generalization of specific experiences and an unconscious anticipation…that will be repeated throughout life” (Erskine, 2010, p. 22).  Berne uses the term “transference phenomena” (Ereskine, 2010, p. 15) to describe this repetitive nature reflected through our relationship history.

Our life script unfolds “like a novel based on messages accepted in childhood.  Therapy is based on creating new decisions and re-writing your own life script.”  A physician by the name of Stephen Karpman, (who studied under Eric Berne)(, has developed a “drama triangle” that builds on this concept.  It consists of the concepts of the concepts persecutor, victim & rescuer.  These roles are described below:

Life Positions…

transa6In the second of his videos (theramin trees, 2010), delves into how our own ego states interact with significant others.  Why is it this endless cycle occurs?  In answer to this question, (theramin trees, 2010), mentions the concept of “life positions”.  In transactional analysis, this concept refers to a consistent belief about ourselves in relation to others.  As a broad stance we take in relation to others, it might convenient to think of “life positions” as self-imposed roles.  We distort our realties through these life positions, and utilize patterns of interaction with others as preferred coping tools.   Naturally, the benefit of a “life position” is its pay-off.  Theramin trees (2010), suggests to viewers, that in addition to desconstructing transactions to gain clarity, we should let go of the payoff that allows these cycles to continue.  Without the payoff (i.e. need fulfillment) the “life position” is no longer a logical choice.

“I’M OKAY YOU’RE OKAY”

Since this position conceives everyone as equals, it promotes well-being in your social interactions  You do not act from a position of superiority or inferiority so are effective in meeting your own social needs in a positive and mutually healthy relationships

“I’M OKAY YOU’RE NOT OKAY”

This life position “causes clients to blame others for their difficulties and cause paranoia and criminal tendencies, (Rosenthal, 2005).”  You place yourself in a dominant or superior position over others and tend to project inadequacies onto others.  Donald Trump Exists Here.  

“I’M NOT OKAY YOU’RE OKAY”

This is my own life position as a result of childhood ostracism. It caused me  to feel inept and inferior to others, and led to feelings of severe depression and suicide ideation during my teens.

NOBODY OKAY

Rosenthal (2005) states people here are often “homicidal, suicidal, both or schizoid”.  Are frequently overwhelmed with feelings of anger or betrayal.  It is characterized by extreme apathy and existential hopelessness.

A Personal Application…

“Transactional analysis often regards the experience of ‘ feeling stuck’ as the manifestation of an impasse or an intrapsychic conflict or interpersonal roadblock…my own aim here is to broaden the theory of impasses, exploring whether and how ‘stuckness’ may constitute a developmental opportunity” (Petriglieri, 2007, p185).

Resistance from this theoretical perspective can be “explained as a battle between inner parts: one part wants to change, while the other does not…” (Ingram, 2013, p 234).   According to transactional analysis, within us exist ego states that represent experiential realities from various stages in life.  Within each ego state is a typical coping style or pattern of relating to those around us. As I recall, two in particular have been engaged in a perpetual lifelong battle….

My Hurt Child

The child ego state can be thought of as an inner mental recording of painful childhood experiences.  When encountering triggers that remind us of these events, we’re sent back in time.  Emotionally, we can re-enact these early experiences with those around us. For example, within me lives a “hurt child” who was bullied kid and had no friends.  This hurt child asks, “I know I am bad; what’s wrong with me” (Ingram, 2013, p. 295).  She is submissive, insecure, with no sense of self.  Filled with a sense of shame, she seeks validation and acceptance from others – wherever she can get it…

My Critical Parent

The parent ego state reflects messages we receive from authority figures in our lives and standards of conduct we were taught.  My own critical parent, consists of messages from my parents that emotions were bad and creativity was a waste of time.   My critical parent consists of message from parents and teachers who ignored and overlooked the bullying.

My critical parent might say “you should take those pounds off. What’s wrong with you?! Your an indulgent loser (Ingram, 2013, p. 295).”  
My hurt child will be filled with feelings of insecurity as a former “ugly duckling”.  Shame takes over in reaction to the random characteristics that happen to define my meatsuit

References

Berne, E. (1961). Transactional analysis in psychotherapy: A systematic individual and social psychiatry.
ericberne.com (n.d.) A description of transactional analysis.  Retrieved from:  http://www.ericberne.com/transactional-analysis/
Erskine, R. G. (2010). Life scripts: A transactional analysis of unconscious relational patterns. London: Karnac.
Ingram, B.L. (2012). Clinical Case Formulations: Matching the Integrative Treatment Plan to the client. (2nd ed.). Hoboken, NJ: Wiley. ISBN: 978-1-118-03822-2
selfdefinition.org (n.d.) Games people play by Eric Berne. Retrieved from:  http://selfdefinition.org/psychology/Eric%20Berne%20-%20Games%20People%20Play.pdf
Theramin trees [screen name] (2010, June, 10) Transactional Analysis 1: ego states & basic transactions  Retrieved from: https://www.youtube.com/watch?v=nKNyFSLJy6o
theramin trees [screen name] (2010, June, 17) Transactional analysis 2: games. Retrieved from:  http://youtu.be/YOqJ4sc9TAc
Petriglieri, G. (2007). Stuck in a moment: A developmental perspective on impasses. Transactional Analysis Journal. 37(3), 185-194.

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Carl Rogers Nondirective Approach

carl-rogers2-1Biography

Carl Rogers was born in Chicago suburb on January 8, 1902, and had five siblings (Boeree, 2006).  His father worked as a civil and his mother was a homemaker (Boeree, 2006). He was raised in a devoutly Christian home and had a strict upbringing.  “Roger’s parents believed in hard work, responsibility, and religious fundamentalism…The family was characterized by closeness and devotion but did not openly display affection” (Corsini & Wedding, 2011, p. 155).  He received his Phd. in clinical psychology from Colombia University in 1931 (Boeree, 2006).  He worked at the University of Ohio and the University of Wisconsin as a Professor before accepting a research position in California during the 60’s (Boeree, 2006).

Characteristics of Approach

“Carl Ransom Rogers…revolutionary theory…has variously been called nondirective therapy, client-centered and the person-centered approach. …Roger’s hypothesis states that a congruent therapist, who expresses attitudes of unconditional positive regard, and empathetic understanding within a genuine relationship will catalyze…personality change in a vulnerable, incongruent client” (Corsini & Wedding, 2011).

A Nondirective Approach

“The nondirective therapist believes that where the counselor is concerned with his own frame of reference he will be unable to provide a full and deep understanding of the client’s feelings” (Raskin, 1984, p105). On the basis of this underlying belief, nondirective approaches stress empathetic listening and allow clients to direct the flow of conversation, (DeSole, 2006; Raskin, 1948).   This perspective is in stark contrast with direct approaches that define the therapist as an “expert” (DeSole, 2006, p69), who exerts greater control of the conversation.

DeSole, (2006) advocates a nondirective approach for new therapists who are developing their professional identity (p 78). The key benefit of this approach for the novice is its ability to challenge one to be open to new ways of doing things. DeSole, (2006) also notes that “new clinicians often underestimate the influence they have on their patients” (p. 79). In this respect a nondirective approach is vital to prevent doing harm to clients, and facilitating a rapport, (DeSole, 2006, p80).

A Person-Centered Perspective

“Based on his experience as a psychotherapist, Rogers postulated that persons possess resources of self-knowledge and self-healing, and that personality change and development are possible if a definable climate of facilitative conditions is present” (Witty, 2007, p. 35).  Therefore, the therapist’s job is to have faith in a clients as “fully capable o articulating and pursuing their own goals” (Corsini & Wedding, 2011).  Several crucial aspects of Roger’s characterization of human nature are worthy of highlighting here:  

Rogers held a positive and trusting perspective of his clients

“Rogers viewed his patients as good, trustworthy, constructive and rational (Rosenthal, 2005)”.  He believed that a natural self-actualizing tendency was an inherent characteristic of human nature (Corsini & Wedding, 2011).  Clint’s could, therefore be trusted to direct the therapy process.

Rogers held a humanistic perspective

Humanistic psychology adheres to the notion that individual’s are to be understood holistically as complex human beings and not simply as his patients.  “The term patient conveyed illness Rogers preferred the word ‘client'” (Rosenthal, 2005).  His approach is unique in this sense and does not “reduce [a] person to diagnostic categories” (Corsini & Wedding, 2011).   Te humanist perspective is a rejects behaviorism since this perspective equates human behavior with animal beHAvior in research (Rosenthal, 2005).  It rejects the perspective of psychoanalysis which states individuals are powerless in controlling their unconscious instincts (Rosenthal, 2005).

Rogers was Phenomenological

“Phenomenology is the study of structures of consciousness as experienced from the first-person point of view (Smith, 2013).”  In other words, phenomenology refers to how we perceive and experience reality.  Rogers was a phenomenologist since he believed a the individual’s perceptions of the things takes precedence over a counselor’s understanding of matters (Rosenthal, 2005). Additionally, Corsini & Wedding, (2011), note that reality and experience are both utilize the individual’s perceptions as a reference point.

The Therapist & Client Relationship

The client-centered therapist trusts the client’s capacity for self-actualization and provides a empathetic and nondirective attitude in therapy (Corsini & Wedding, 2011).  The goal of therapy is to facility the client’s process of personal growth through a collaborative relationship.  The quality of this relationship is critical to the outcome of therapy and is central in Roger’s approach to therapy (Corsini & Wedding, 2011).

The Importance of Congruence

“To me being congruent means that I am aware of and willing to represent the feelings I have in the moment. It is being real and authentic in the moment” – Carl Rogers (Corsini & Wedding, 2011, p. 150).

As the above quote notes, an attitude of congruence simply means we are being authentic and genuine.  We are fully-integrated in the sense that a consistency can be seen between our inner world and external reality.  As a result, we are fully present with the client in fully awareness and clarity minus the “denial and distortion” (Corsini & Wedding, 2011).

Unconditional Positive Regard

“This construct refers to a warm appreciation or prizing of the person.  The client accepts the client’s thoughts, feelings, wishes, intentions, theories and attributions…” (Corsini & Wedding, 2011, p. 150).  In other words, the client provides an unconditional acceptance of who they are, without bias, or judgment.

Roger’s Definition of Empathy

“I have come to believe that empathetic listening is one of the most powerful forces for growth that I know…. (Rutsch, 2015).

“…When I can let myself enter the softly and delicately into the vulnerable inner world of the other person…(Rutsch, 2015).

“…When I can temporarily lay aside my views and values and prejudices…(Rutsch, 2015).

“…When I can let myself be at home in the fright, the concern, the pain, the anger, the tenderness, the confusion that fills their lives…(Rutsch, 2015).

 “…When I can move about in that inner world without making judgment…(Rutsch, 2015).

“…When I can see that world with fresh unfrightened eyes…(Rutsch, 2015).

“…When I can check the accuracy of my acceptance with him or her and be guided by the responses I receive…(Rutsch, 2015).

“…Then I can be a companion to that person, pointing at the felt meanings of what is being experienced.  Then I find myself to be a true helper…(Rutsch, 2015).

 Societal Influences on Development

Growth-Oriented & Self-Actualizing

Rogers presents a “growth-oriented” (Corsini & Wedding, 2011) perspective of human development. Starting in infancy, we are guided by a desire to self-actualize and enhance our life experiences (Rosenthal, 2005).  Additionally, it is interesting to note that Roger’s conception of human nature remains trusting and positive even in infancy.  He describes a process of human development that is guided by our tendency to be guided by desire to self-actualize.

Rogers uses the term “organismic valuing(Boeree, 2006), to describe an individual’s ability to know what is essential for survival.

Rogers also notes that “we instinctively value positive regard (Boeree, 2006), from ourselves in others.  In other words, we all instinctively desire to develop a positive self-image.

Self Actualization is a “basic human drive toward growth, completeness and fulfillment” (Corsini & Wedding, 2011, p. 613). Rogers asserts this is an innate drive in all individuals.

The Effect of Conditional Regard

“As a result of interaction with the environment, and particularly as a result of evaluational interaction with others, the structure of self is formed – an organized, fluid, but consistent conceptual pattern of perceptions of characteristics and relationships of [who we are] together with values attached to these concepts” (Corsini & Wedding, 2011, p. 158).

Starting in infancy infants begin developing concepts of themselves and their social world (Corsini & Wedding, 2011).  As a result of our experience a “self” is formed as an organized conceptualization of who we are.  This concept develops as a result of the feedback we receive from our social world.  In this respect, the direction of our development is highly influenced by the extent to which our environment meets our needs for positive self-regard (Corsini & Wedding, 2011).   Rogers makes a point of distinguishing between the organism and a self.  While “the organism [is a] total range of one’s possible experiences, the self [is the] accepted portion of one’s experience.  What is not denied” (Rosenthal, 2005).  So what happens when we don’t receive the positive regard from others we require and we deny aspects of ourselves???

THE SELF STRUCTURE (Quick Review)…

  1. THE ORGANISM – “The total system of perceptions and meanings make up the individual’s phenomenal field, (Cervone & Pervin, 2015, p. 167).” Rosenthal (2005) describes it as “”the organism [is a] total range of one’s possible experiences.”
  2. THE SELF/ “SELF CONCEPT” “That subset of the phenomenal field that is recognized by the individual as ‘me,’ or ‘I’ is the self…[and] represents [a] consistent pattern of perceptions. Although the self changes, it always retains this patterned, integrated, organized quality, (Cervone & Pervin, 2015, p. 167).”  Rosenthal, (2005), notes that “the self [is the] accepted portion of one’s experience.  What is not denied.”
  3. IDEAL VS. REAL SELVES:  “Rogers thus recognizes that our views of ourselves contain two distinct components: the self that we believe we are now and the self that we ideally see ourselves becoming in the future, (Cervone & Pervin, 2015, p. 167).”  

IDEALLY – “The Real Self”

The process self-actualization towards our real self begins in infancy when we engage in organismic valuing to attain meet our survival needs.  “Like Maslow, Rogers believes that, if left to their own devices, animals will tend to eat and drink things that are good for them, and consume them in balanced proportions,” (Boeree, 2006).  As infants, interact with their environment their self-concept and are guided by a natural tendency toward self-actualization.  “The infant positively values those experiences that are perceived as self-enhancing and places negative values on those that threaten..the self” (Corsini & Wedding, 2011, p. 160). When the person self-enhancing perceptions of oneself, a “Real-self” is allowed to develop:

  1. THE REAL SELF“The aspect of your being that is founded in the actualizing tendency, follows organismic valuing, needs and receives positive regard and self-regard, Rogers calls the real self.  It is the “you” that, if all goes well, you will become,” (Boeree, 2006).
  2. POSITIVE REGARD:  We all instinctively desire positive self-enhancing experiences from our social world.  Boeree, (2006) notes that positive regard is an “umbrella term for things like love, affection, attention, nurturance, and so on.”
  3. POSITIVE SELF-REGARD:  This term is refers to an innate desire to feel good about ourselves.  It is also known as a positive self-esteem or self-image.  “We achieve this positive self-regard by experiencing the positive regard others show us over our years of growing up.(Boeree, 2006).”  

INCONGRUENTLY – “The Ideal Self”

When an individual’s social environment fails to provides an infant’s basic needs then an inner division between our ideal and real self begins to form.  For example, Corsini & Wedding, (2011), note “to hit…a baby sibling may result in the child’s being told that he or she is bad and unlovable” (p. 161).  Confusion and self-doubt as messages of conditional worth in order to gain the acceptance and love we desire innately from others.  These messages are internalized as we begin developing a conditional self-regard that consist of ideas of what “good enough” means.  The end result is a sense of incongruity between our actual and real selves.  To cope, we “edit out” all aspects of ourselves that contradict our idea.  We remain incomplete until these wounds can heal.

  1. CONDITIONS OF WORTH: “As we grow up, our parents, teachers, peers, the media, and others, only give us what we need when we show we are ‘worthy,’ rather than just because we need it (Boeree, 2006).”   Corsini & Wedding, (2011) note these messages can “sow sees about the self” (p. 161).
  2. CONDITIONAL REGARD:  These messages of conditional worth are laden throughout our interactions with others and their conditional approval.  “Parental attitudes are not only introjected, but…experienced..in distorted fashion, as if based on the evidence of one’s own sensory and visceral equipment” (Rogers, 1951, p. 500).
  3. CONDITIONAL SELF-REGARD:  These messages of conditional regard are incorporated into our sense of self since a desire for positive regard is so innate. Living up to these conditions becomes a life-altering goal:  “we bend ourselves into a shape determined, not by our organismic valuing or our actualizing tendency, but (Boeree, 2006)” by these messages of conditional worth.
  4. THE IDEAL SELF:  The ideal self, then, is the self-concept that an individual would most like to possess. It includes the perceptions and meanings that potentially are relevant to the self and that are valued highly by the individual (Cervone & Pervin, 2015, p. 167).”  
  5. INCONGRUENCY – “This gap between the real self and the ideal self, the ‘I am’ and the ‘I should’ is called incongruity (Boeree, 2006).”  It causes us to be threatened of evidence that contradicts our real selves.  In the presence of such evidence we become anxious, and engage in an array of defense mechanisms to deny these aspects of ourselves.  Roger states it often leads to Neurosis.  

The Fully Functioning Person

“Rogers defined those who can readily assimilate organismic experiencing and who are capable of symbolizing these ongoing experiences in awareness as ‘fully-functioning’ persons, able to experience all of their feelings, afraid of none of them, allowing awareness to flow freely in and through through their experiences, (Corsini & Wedding, p. 163).”

Characteristics of “Fully Functioning”

Openness To Experience

Fully-functioning people do not live incongruently with denied aspects of themselves lurking within.  Therefore they are not defensive against evidence that contradicts their idealized self (Covin, 1974). They are able to remain open to life experiences without the unnecessary distortion.

Being Rather than Becoming

Fully-functioning individuals are living in the present rather than mourning the past or worrying about the future (Boeree, 2006).  “The individual moves toward more acceptantly being a process, a fluidity, a changing.  He lives in a more existential fashion, living fully in each moment (Covin, 1974, p.37).”

Trusting Our Own Instincts

Rogers asserts that all individuals have an innate self-actualizing tendency and should have faith in our instincts.  This means trusting our survival instinct – or what Rogers calls “organismic valuing” – in order to attain what we need to thrive.  “We should trust ourselves, do what feels right, what comes natural, (Boeree, 2006)” 

Experiential Freedom & Self-Responsibility

Roger’s conception of fully-functioning individuals implies integration of our real and ideal selves. It also implies a congruent life experience that doesn’t contained denied and lived elements. From this integrated perspective, individuals are able to recognize the freedom choice available to them. Rather than playing victim they are able to engage in self-responsibility and make their choices freely (Boeree, 2006).

Creative Engagement

Fully functioning are able to live creatively: “If you feel free and responsible, you will act accordingly, and participate in the world, (Boeree, 2006).”  Rogers describes creative individuals as “trust[ing] his own experiencing of life, the process of himself, so that he could go on expressing his own unique perceptions (Coven, 1974, p. 42).”  

Barriers to Full Functioning

The above video appears to describe succinctly, the barriers that exist to fully functioning.  As noted earlier in a previous section, if our need for positive regard are not met, we are left feeling a sense of self-doubt.  Messages of conditional worth influence our self-perception.  Living up to this conditional version of self-worth means denying all aspects of ourselves that contradicts this idealized self-image.  In time, we develop defense mechanisms to edit out these unwanted elements:

Denial

In a Freudian sense, we can block unwanted elements of ourselves and our experiences in order to uphold an idealized self-image.  “Denial for Rogers does also include what Freud called repression:  If keeping a memory or an impulse out of your awareness — refuse to perceive it — you may be able to avoid (again, for now!) a threatening situation, (Boeree, 2006).”  

Distortion

“Similar to Freud’s rationalization,” (Boeree, 2006), distortion involves a creative re-interpretation process in order to make information less threatening than it is.  For example, Freud uses the concept of “sour grapes” to downgraded evaluation of experiences we miss out on.  Alternatively, a “Sweet Lemons” perspective means an upgraded valuation of what we have now.

Adjustment vs. Maladjustment

In his book “Client Centered Therapy” (Rogers, 1951), Rogers describes his theory of personality which comprises 19 propositions.  Since I’m trying to study for the NCE exam, l won’t list them here.  However, I list a few here from my course textbook, (Corsini & Wedding, 2011), since they do great job of differentiating between Roger’s conceptualization of maladjustment and adjustment:

  1. PSYCHOLOGICAL MALADJUSTMENT exists when the organism denies to awareness significant sensory and visceral experiences which consequently are not symbolized and organized into the…self structure.  When this situation exists, there is…psychological tension, (Corsini & Wedding, 2011, p. 159).”
  2. PSYCHOLOGICAL ADJUSTMENT exists when the concept of the self is such that all the sensory and visceral experiences of the organism are…are assimilated on a symbolic level into a consistent relationship with the concept of the self, (Corsini & Wedding, 2011, p. 159).”

What Growth Looks Like…

In his work, Rogers conceptualizes growth as a gradual process from moment to moment which he calls “Molecules of Change (Corsini & Wedding, 2011, p. 167).”

“Therapy is made up of a series of such molecules, sometimes strung closely together, sometimes occurring at long intervals, always with periods of preparatory experiences in between, (Rogers, 1959, p. 52).

This view of change appears to occur as a matter of “doing” rather than “thinking.”  In a recent post titled “Stages of Change,” I provide a unique personalized overview of growth and transformation.  It contains insights from Roger’s (2012) work “On Becoming a Person.”  In this work he describes the change process. I will not review it here, but instead include an excerpt of his overview of how change happens:

[the change] process involves a loosening of feelings. At lower end remote and unowned…At the upper end process of experiencing a continually changing flow of feelings becomes characteristic of the individual…from incongruence to congruence…from rigidity to looseness…from failure to acknowledge problems towards self-responsibility, (Rogers, 2012, p.157).”

Criticisms of Roger’s Work

In the 1940’s Roger’s work was somewhat controversial within the counseling field (Rosenthal, 2005).  FIRSTLY, he proposed a non-directive approach to counseling.  SECONDLY, he did not feel diagnosis, interpretation, or giving advice was a necessary part of the counseling process. FINALLY, his conceptualization of human nature was a bit one-sided.  For example, rejects the notion that “The deterministic notion that man cannot be trusted (Rosenthal, 2005).  My thoughts?  I love Rogers’s work since he describes a critical component of therapy that is missing too often.  Understanding patients as they understand themselves is critical.  However, sometimes diagnosis, interpretation and direction are necessary in the counseling process.

A Carl Rogers Lecture on Youtube…

Western, B. [Screen Name]. (2012, December, 10). 01 Carl Rogers on Empathy [Video File] Retrieved from: https://youtu.be/iMi7uY83z-U

Western, B. [Screen Name]. (2012, December, 10). 02 Carl Rogers on Empathy [Video File] Retrieved from: https://youtu.be/idgjD5tir_w

Western, B. [Screen Name]. (2012, December, 10). 03 Carl Rogers on Empathy [Video File] Retrieved from: https://youtu.be/qw_O2Vxzmok

Western, B. [Screen Name]. (2012, December, 10). 04 Carl Rogers on Empathy [Video File] Retrieved from: https://youtu.be/3g2iRmjQsPI

References

Boeree, G. (2006). Carl Rogers. Retrieved from:  http://webspace.ship.edu/cgboer/rogers.html
Corsini, R. J. & Wedding, W. (2011). Current Psychotherapies. Belmont, CA: Brooks/Cole
Covin, T. M. (Ed.). (1974). Readings in human development: A humanistic approach. Ardent Media.
Ingram, B.L. (2012). Clinical Case Formulations: Matching the Integrative Treatment Plan to the Client. (2nd ed.). Hoboken, NJ: Wiley.
Metcalf, L, (2011). Marriage and family therapy: A practice oriented approach. New York: Springer Publishing Company
Cervone, D., & Pervin, L. A. (2015). Personality, Binder Ready Version: Theory and Research. John Wiley & Sons.
Raskin, N. J. (1948). The development of nondirective therapy. Journal of Consulting Psychology,12(2), 92.
Rogers, C. R. (1951). Client-centered therapy. Boston: Houghton Mifflin.
Rogers, C.R. (1959). The essence of psychotherapy: A client-centered view. Annals of Psychotherapy. 1, 51-57.
Rogers, C. (2012). On becoming a person: A therapist’s view of psychotherapy. Houghton Mifflin Harcourt.
Rutsch W. [Screen Name]. (2015, January, 30). Carl Rogers Empathy & Presence. [Video File] Retrieved from:  https://youtu.be/B0Xv6Tb2k0E
Rosenthal, H. (2005). Vital Information and Review Questions for the NCE and State Counseling Exams. Routledge.
Smith, D.W. (2013) Phenomenology.  Retrieved from:  http://plato.stanford.edu/entries/phenomenology/
Witty, M. C. (2007). Client-centered therapy. In Handbook of Homework Assignments in Psychotherapy (pp. 35-50). Springer US.

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Aaron Beck’s Cognitive Behavioral Therapy

History & Overview

“Cognitive behavioral approaches look at how cognitions and/or behaviors have been learned and can be re-learned….They all believe that after identifying problematic behaviors and/or cognitions, one can choose, replace, or reinforce new cognitions and behaviors that result in more effective functioning” (Newkurg, 2009).

“The basis of cognitive approach to emotion can be traced as far back as Aristotle…and Epitectetus” (Metcalf, 2011, p. 92).  These historical of CBT focus on how individual’s we give our life experiences meaning and make sense of them.  Kant’s concept of transcendental idealism, that things cannot be known outside of how they might appear to us, has also greatly influenced CBT (Corsini & Wedding, 2011).

Cognitive Behavioral Therapy (CBT) was developed by Aaron Beck in the 1960’s as a result of his research on depression when he noted their thought process contained a negative bias (Corsini & Wedding, 2011).   It is based on the idea that an individual’s experiences are shaped by core beliefs, which in turn determine thoughts, feelings and behaviors.   The goal of CBT is to alter the cognitive appraisals that produce emotional distress and maladaptive behavioral responses (Chaplin, et al, 2013).  Adjusting our information processing begins in a collaborative process between therapist and client in which maladaptive cognitions can be tested and re-examined (Corsini & Wedding, 2011).

In order to achieve this goal, CBT focuses on cognitive schemas which comprise perceptions about ourselves and others alongside personal expectations, goals, memories, and prior earning experiences (Corsini & Wedding, 2011).  Contemporary CBT perspectives describe these schemas as modes “networks of affective, motivational, and behavioral schemas that compose personality and interpret ongoing situations” (Corsini & Wedding, 2011, p. 277).  CBT defines psychological disorders as maladaptive cognitive schema that create a systematic bias between oneself and the world.  Psychological disorders such as anxiety encompass primal modes which encompass, rigid, automatic, survival-based thinking.  The solution to these issues involve: (1) symptom relief; (2)  an acknowledgment of any cognitive bias, and; (3) the “correct[ion] of  faulty information processing” (Corsini & Wedding, 2011, p. 290).

CBT vs. Other Perspectives

Psychodynamic Therapy vs. CBT

While psychodynamic theory and CBT both conceive belief systems as influencing our behaviors, the prior conceives beliefs as components of our unconscious mind (Corsini & Wedding, 2011). Beck disagreed with this.  Consequently, CBT does not focus on uncovering hidden aspects of our unconscious from early childhood.  Instead it focuses on understanding the links between any psychological disorders, symptoms, beliefs, behaviors, and experiences (Corsini & Wedding, 2011).  Finally, while psychoanalysis is a long-process involving cathartic free-association in therapy, CBT tends to a short-term and structured.

Ellis vs. Beck

REBT and CBT both conceive cognitions as useful in understanding psychological dysfunction and focus on maladaptive systems of belief.  However, there are a few key differences as delineated below.

An Inductive CBT Approach vs a Deductive DBT Approach

Ellis’s REBT is a deductive approach, that involves beginning with a general theoretical prediction as a starting point from which we make specific observations about the world (Corsini & Wedding, 2011).  In this respect, it follows closely with the logical of scientific research which begins with a hypothesis that it tests in an experiment with the hopes of making observations that might support it.  In contrast, CBT is an inductive approach that states we make specific observations about daily life and use these to form generalized belief systems about our world.  For example, in Beck’s research on depression he notes people develop negative biases about their world as a result of a set of symptoms stemming from depression.

Two Divergent Conceptions of Psychological Disorder.

As a result of his research on depression and anxiety, Beck noted variations in that these disorders had general cognitive biases (Corsini & Wedding, 2011).  Beck’s CBT approach utilizes the “cognitive profiles” (Corsini & Wedding, 2011, p. 279), for these disorders as a guide to understanding how we should address the issue.  In contrast, REBT focuses on the absolutist nature of any beliefs or our “Musterbating”.   For example, while a CBT therapist would focus on addressing perceptual errors an REBT therapist would focus on our “should’s”.

Two Divergent Interpretations of Belief Systems

REBT conceives faulty belief systems as a philosophical error of irrational thinking.  As a result, an REBT therapist would challenge belief systems that are “incongruent with reality” (Corsini & Wedding, 2011, p. 279).  In contrast, Beck disliked the idea that a client’s cognitions be characterized as irrational (Metcalf, 2011).  Rather than conceiving our beliefs as irrational he felt they existed as automatic thought processes triggered by feelings and not events (Metcalf, 2011).

Behavioral vs. Cognitive Interventions

Cognitive Interventions

Cognitive interventions focus on the “content and process of” (Ingram, 2012, p197) an individual’s thoughts. The theoretical underpinnings of these interventions come from a diversity of fields including neuroscience, cognitive development, CBT, and even sociology (Ingram, 2012). This is because the manner in which we construct our understanding of the world varies according to our developmental level, cultural perspective, and brain functioning. Examples of cognitive interventions can include addressing dysfunctional self-talk, utilizing a metacognitive perspective, or DBT skills (Ingram, 2012).

Behavioral Interventions

Behavioral interventions are based on the well-known learning principles from the works of Skinner and Pavlov. Additionally, the textbook notes that learning principles can be found in other forms of therapy including the work of Carl Roger (Ingram, 2012). For example, in contrast to cognitive therapy, a behavioral intervention might utilize the process of behavioral analysis. This involves examining the problem, and defining their causes and consequences in order to determine how to utilize interventions like positive and negative reinforcement, or contingency contracting, punishment (Ingram, 2012, p236).   Cognitive therapy, on the other hand, focuses on our thought processes such as the ABC model in which an event produces thoughts and causes our feelings (Ingram, 2012, p210).

CBT on Personality

CBT “views personality as shaped by the interaction between innate disposition and environment” (Corsini & Wedding, 2011, p. 284).  So what makes us who we are?  Our personality is comprised schematic approach towards the world that is comprised of cognitions, emotions, behaviors, and motivations.  Each individual has unique strengths and vulnerabilities related to their own personality structure (Wedding & corsini, 2011).  Psychological disorders and distress are a consequence of both the environment and predisposition.   In this respect, Beck’s view of our developmental history is consistent with social learning theory.

Dimensions of Personality

In his research, Beck was interested in learning how certain aspects of the personality were related to maladaptive emotional responses like anxiety or depression (Corsini & Wedding, 2011). Beck described a continuum-based set of personality dimensions that could help explain an individual’s susceptibility to depression.

Sociotropy

Beck uses the term “Sociotropy” (Corsini & Wedding, 2011, p. 284).  Sociotropic individuals display high levels of social dependence and experience higher levels of depression during instance of relationship disruption.  “The sociotropic dimension is organized around closeneess, nurturance, and dependence” (Corsini & Wedding, 2011, p. 284).

Autonomy

Autonomous people are highly independent and experience depression when they fail to acheive their goals (Corsini & Wedding, 2011).  Autonomous individuals show a preference for “independence, goal setting, self-determination and self-imposed obligations” (Corsini & Wedding, 2011 p. 284).

Cognitive Distortions

As stated earlier, psychological distress is conceived as a byproduct of both innate and environmental factors.  Beck also noted systematic biases in individuals who experience psychological distress (Corsini & Wedding, 2011).  He used the term “cognitive distortion” (Corsini & Wedding, 2011, p 285), to describe many of our systematic biases.  What follows is a list of examples of common cognitive distortions:

  1. ARBITRAY INFERENCE – “Conclusions made in absense of supporting evidence” (Metcalf, 2011, p. 95).  For example, my son believes he is terrible at math because it is hard, when in fact he just earned a B+.
  2. SELECTIVE ABSTRACTIONS – This distortion involves taking information out of context (Corsini & Wedding, 2011).
  3. OVERGENERALIZATION – Overgeneralization involves utilizing single situation as representing all events of this type.
  4. MAGNIFICATION & MINIMIZATION – “Seeing something as more significant or less significant than it actually is” (Corsini & Wedding, 2011, p. 285).
  5. PERSONALIZATION – Personalization happens when we blame ourselves for external events.   We ignore the aspects of the situation that are beyond our control.
  6. DICHOTOMOUS THINKING – This distortion is often called black-and-white thinking and ignores the gray areas.
  7. TUNNEL VISION – This narrowed focus is characterized by a focuses one’s own selfish interests and sacrifices others’ viewpoints.

CBT on Psychological Disorders

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As you can see in the above photo, (Corsini & Wedding, 2011), Beck conceived psychological disorders as evidence of a systematic bias in an individual’s cognitive schema.  In other words, all symptoms are interpreted in terms of their overall view of the world.  For example, depressed individual’s hold a pessimistic cognitive schema and anxious individuals hold exaggerated views of danger.

Beck on Anxiety…

Click here for a Beck’s Anxiety Inventory…

With anxiety disorders, Beck notes that individual’s act on a “worst-case-scenario” basis that involves an overestimation of a potential outcome and underestimates one’s ability to cope (Corsini & Wedding, 2011).  The body is in flight-or-flight mode as physiological responses to a self-perceived threat.  We can tend to create them even when they might not exist.

Beck on Depression…

Click here for Beck’s Depression Inventory…

In his research, Beck noted depressed individuals display negative beliefs about themselves, the world, and the future overall.  These belief systems influence one’s cognitions and emotional states, making it difficult to see beyond our view of things.  The world is experienced through a pessimistic lens, leading to a sense of hopelessness and motivational paralysis.

Beck on Suicidal Behavior…

Click here for Beck’s Suicidal Risk Assessment…

Beck describes the thought processes associated with suicidal individuals as containing two features: hopelessness and cognitive deficit (Corsini & Wedding, 2011).  Additionally, a suicidal individual’s thought process become rigid with suicide appearing as the only alternative (Corsini & Wedding, 2011).

Overview of Counseling Process

Goals of CBT

The goal of CBT is to “correct faulty information and help patients modify assumptions that maintain maladaptive behaviors and emotions” (Corsini & Wedding, 2011, p. 290).  It treats belief systems as hypotheses that can be tested in a therapeutic setting.  Cognitive changes in one’s belief systems, are thought to lead behavioral changes.  Emotions are influenced by our perception of events.

Therapeutic Relationship

Corsini & Wedding, (2011) describe the therapeutic relationship as a “collaborative empiricism” (p. 277).  Client and therapist share responsibility for therapeutic goal setting.  The therapist is a guide who helps the client better understand their attitudes and belief systems.  This reality testing process occurs within an accepting and empathetic setting where beliefs are tested as hypotheses one has about their reality.

Strategies & Techniques

What follows is a “quick and dirty” overview of techniques often utilized in Beck’s Cognitive Behavioral Therapy.

Guided Discovery

Guided discovery involves a gradual process of discovering threads in one’s thinking like links in a chain (Corsini & Wedding, 2011).  “The therapist guides the client through a scenario, enabling them to understand any cognitive distortions” (Metcalf, 2011, p. 114), by linking linking misperceptions to past experience.

Socratic dialogue

CBT involves the use of reality testing methods that are similar in many respects to a socratic dialogue.  This involves deconstructing our current preconceptions of a matter and analyzing any ignorance.  With this ignorance defined, it can then be possible to uncover its solution – a greater knowable truth that was previously invisible.

Validity Testing

Validity testing involves a critical examination of our beliefs and thoughts and requires the establishment of a solid therapeutic relationship to occur.  “If the client cannot defend their beliefs and thoughts they are said to be invalid” (Metcalf, 2011, p. 108).

Modeling

Clients are given role-playing exercises with the therapist in which they can practice new ways of responding to specific situations (Metcalf, 2011).  This technique is often utilized with autism clients in an effort to develop greater effectiveness in social situations.

Approaches to Dysfunctional Schema

“There are three major approaches to treating dysfunctional modes: (1) deactivating them, (2) modifying their content and structure, and (3) constructing more adaptive modes to neutralize them” (Corsini & Wedding, 2011, p. 278).

Exposure Therapy

Utilized frequently in trauma and anxiety-related disorders this involves addressing cognitive distortions and physiological symptoms when presented with anxiety-related objects.  “By dealing directly with a patient’s idiosyncratic thoughts, cognitive therapy is able to focus on that patient’s particular needs.

Treatment Planning

I dug up another course textbook that provides an interesting perspective, titled “Clinical Case Formulations,” (Ingram, 2012).  It’s purpose is as follows. “A clinical case formulation is a ‘conceptual scheme that organizes, explains, or makes sense of large amounts of data and influences the treatment decisions’ (Ingram, 2012 p. viii).”  What I love about this book is it provides clinical hypotheses that are useful in providing “a single explanatory idea that helps us structure data about a given client (Ingram, 2012 p. 11).”  Chapter ten of this textbook discusses “Cognitive Models” (Ingram, 2012), an individual’s cognitive functioning and thought processes.  Several clinical hypotheses are worth mentioning in order to get an idea of how this therapy method can be applied directly to a case.  

(C1) Metacognitive Perspective (Ingram, 2012)

Metacognition is a term which means “thinking about thinking” (Ingram, 2012).  This clinical hypothesis is useful when a person needs to hone their critical thinking skills and gain awareness of their inner experiences.  It is useful in anxiety and trauma-related disorders, or instances in which rumination, and emotional dysregulation are a problem.  However, states five cognitive capacities are critical when using this hypothesis: “(1) nonreactivity to inner experience…(2) able to separate self from thoughts…(3) not giving power or control in thoughts…(4) evaluating one’s thinking in terms of goals…(5) taking the role of executive over one’s own thoughts” (Ingram, 2012, p. 200).

(C2) Limitations of Cognitive Map (Ingram, 2012)

This hypothesis is useful when individuals have maladaptive schemas or self-fulfilling belief systems.  Since these schemas provide a framework of meaning around which they understand their world, it is thought to influence their behaviors, emotions, and experiences (Ingram, 2012).

(C3) Deficiencies in Cognitive Processing (Ingram, 2012)

Useful for clients who display “faulty information processing, poor reality testing, and an inflexible cognitive style (Ingram, 2012, p. 214).  Useful with depression and anxiety disorders, many of Beck’s concepts are discussed here (Ingram, 2012).

Phases of Therapy

Building Rapport

As noted earlier the CBT approach involves a Socratic dialog that includes a collaborative empiricism.  Testing one’s views about the world entails a great deal of vulnerability as an individual’s perceptions are called into question.  For this reason, the initial goal of therapy involves building a solid relationship with the client (Corsini & Wedding, 2011).  “Therapists should be genuine, empathetic, and active listeners” (Metcalf, 2011, p. 114).

WHY SEEKING THERAPY –  “How did you make the decision to come into therapy?…”What are your present concerns in life?” (Ingram, 2012, p. 114).  
UNDERSTANDING THE PRESENTING PROBLEM -“What feelings are you experiencing when you think of these situations…What thoughts make you feel worse? How would you feel if you did not have these thoughts?” (Ingram, 2012, p. 114).

Developing Goals

“In CBT the client’s decide the therapeutic goals” (Ingram, 2912, p. 115).  In this respect, a greater amount of responsibility falls on the shoulders of clients in determining the direction that therapy will take.

Amplifying Change

Corsini & Wedding (2011), notes that change occurs when the client “experiences a problematic situation as a real threat” (p 298).  This is because, when emotions and affective arousal are linked to systems of belief they are easier to access and acknowledge (Corsini & Wedding, 2011).  The therapist is responsible for acting as a guide.  Ingram, (2012) notes that this involves monitoring their improvements and overall functioning.  The therapist notes these changes and inquires about the changes in beliefs and thoughts that coincide with these mood and behavioral alterations (Ingram, 2012).

Termination

CBT is a short-term and goal directed approach to therapy.   In this structured approach, symptom reduction is an initial goal (Godfried, 2002).   Helping clients manage difficult emotions is important in order to begin addressing their underlying causes.   Cognitive therapy helps client’s develop general skills to deal with life’s difficulties. Once the client experiences a reduction in symptoms and has developed skills to address these issues, a new phase of therapy can begin. CBT approaches view “termination as a time of consolidation and preparation for the next phase of independent application” (Prout & Wadkins, 2014, p284). Godfried (2002) describes this as the maintenance phase of therapy. During this phase the therapist monitors a client’s utilization of coping skills when confronted with significant life events. Essentially, in this respect the termination process can be understood as a “relapse prevention model” (Godfried, 2002, p384). The goal is to help clients develop a sense of self-efficacy when utilizing key CBT skills independently in the context of their lives.

References

Charman, T., & Stone, W. (Eds.). (2006). Social and communication development in autism spectrum disorders: Early identification, diagnosis, and intervention. New York, NY, USA: Guilford Press.
Corsini, R. J. & Wedding, W. (2011). Current Psychotherapies. Belmont, CA: Brooks/Cole
Goldfried, M. R. (2002). A cognitive-behavioral perspective on termination. Journal of Psychotherapy Integration, 12(3), 364-372. doi:10.1037/1053-0479.12.3.364
Ingram, B.L. (2012). Clinical Case Formulations: Matching the Integrative Treatment Plan to the Client. (2nd ed.). Hoboken, NJ: Wiley.
Metcalf, L, (2011). Marriage and family therapy: A practice oriented approach. New York: Springer Publishing Company
Newkurg, E. (2009) Assessment of Your View of Human Nature and Conceptual  Orientation. Norfolk, VA: Old Dominion University. Retrieved from: http://ww2.odu.edu/~eneukrug/therapists/survey.html
Prout, T.A. & Wadkins, M.J. (2014).  Essential Interviewing and Counseling Skills.  NewYork, NY: Springer Publishing Company.
Rosenthal, H. (2005). Vital Information and Review Questions for the NCE and State Counseling Exams. Routledge.

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Bandura’s Social Learning Theory…

Alfred Bandura was born on December 4, 1925 in a small town in northern Canada and is the youngest of six children.  His parents immigrated from Poland and the Ukraine.   He graduated from the University of Kentucky with a Phd. in Psychology and is well-known for his research and writing on “Social Learning Theory.”   While, classical and Operant Conditioning focus on reinforcement through the manipulation of antecedents and consequences respectively, Bandura provides a more comprehensive understanding of learning.   For example he uses the “vicarious and self-reinforcement” (Bandura, 1971), to describe how we learn from others.  He uses the term reciprocal determinism to describe how individual’s influence their environment and affected by it in turn….

“Personal and Environmental factors do not function as independent determinants, rather they determine each other. Nor can ‘person’s’ be considered causes independent of their behavior. It is largely through their actions that people produce the environmental conditions that affect their behavior in a reciprocal fashion. The experiences generated by behavior also partly determine what individuals think expect, and can do, which in turn affect their subsequent behavior (Bandura, 1977, p. 345).”

Bandura vs. Skinner & Pavlov

Since this is blog is being completed as a “Study Exercise” for the NCE exam, I would now like to list key differences between Bandura and the behaviorsts discussed here.  Rosenthal, (2005), discusses Bandura with the other behaviorists theorists just briefly.  However, since he diverges from the other classical behviorists in several key aspects, I feel he deserves his own post:

Triadic Reciprocal Interaction

“The social-cognitive approach depends on the the theory that behavior is based on three separate but interacting regulatory systems:  (1) external stimulus events, (2) external reinforcement, and (3) cognitive mediational processes, (Corsini & Wedding, 2011, p. 236).”

Bandura’s approach examines the interaction between between environmental factors, behaviors, and personal factors like motivation and perception (Sharf, 2012).  This is a unique point of divergence from other behaviorists.  For example, Skinner proposes the control of environmental factors in order to adjust maladaptive behaviors (Wolpe & Fraud, 1997).  Pavlov, focuses on reflexive and involuntary processes by adjusting an individual’s behavioral responses to antecedent stimuli.  Essentially, Skinner & Pavlov conceive a one-way relationship between humans and their environment.  We are the dependent variable, and the environment is the dependent variable.  Bandura rejects this idea.

How does Learning Happen?

For Pavlov, learning is a passive process and involves adjusting antecedent stimuli in order to either habituate or extinguish a maladaptive involuntary behavior.  In contrast, Skinner focuses on adjusting the consequences of our behavior in order to address maladaptive responses.  While Pavlov’s view of learning is conceived of as a much more passive process than Skinner, they both only focus on external factors.  In other words, internal factors play no relevancy in learning for both Skinner and Pavlov.  This makes Bandura’s perspective quite unique in comparison.  He believes learning is a social process and involves both reinforcement processes as well as observational and vicarious learning (Sharf, 2012).  Bandura also disagree’s with Skinner’s assertion that feelings and thoughts don’t matter.  Intrapsychic factors act as a mediating factor between an individual and his environment.

Reciprocal Determinism

Skinner, (1971), a proponent of radical determinism, states: “a person does not act upon the world, the world acts upon him” (p. 211).  In his book “What is B.F. Skinner Really Saying?” Nye, (1979) attempts to contextualize Skinner’s statement about radical determinism.  In particular, Nye (1979), states Skinner believes we rely too much on inner abstractions like thoughts, feelings and motivations.  Not only does he feel these are somewhat “unknowable” concepts, they have little relevance to life behaviors or outcomes (Nye, 1979).  Instead, Skinner asserts “ultimately the environment has the control” (Nye, 1997, p. 81).  Therefore we should focus on how we process and respond to information we receive from the external world since this is much more pragmatic.  Bandura, (1978), rejects this idea by noting that in Skinners theory, “the environment thus becomes an autonomous force that automatically shapes, orchestrates, and controls behavior” (p. 344).   Rather than conceiving behavior as occurring independent of an individual’s input, he sees the social learning process as follows:

“In the social learning view of interaction, which is analyzed as a process of reciprocal determinism, behavior, internal personal factors, and environmental factors all operate as interlocking determinants of one another” (Bandura, 1978, p. 346).”

What’s really exciting about Bandura’s inclusion of the individual into the causal equation, is it allows us to examine an array of factors, invisible in Skinner & Pavlov’s approaches.  Bandura, (1978) notes: “Exponents of radical behaviorism have always any construct of self for fear it would usher in psychic agents and divert attention from physical to experiential reality” (p. 348).  He then continues that the self regulatory functions of one’s behavior involve: self-observation, judgment, and response (Bandura, 1978, p. 349).

Self & Vicarious Reinforcement

For Skinner reinforcement is a function of the consequences of one’s behaviors.  In other words, a behavior is reinforced, and more likely to be repeated when the consequences are favorable.  In contrast, Pavlov conceives reinforcement as the strengthening of association between conditioned and unconditioned stimulus.  For example, as Pavlov’s dog begins associating a bell with food, he then responds to the bell by salivating.  What’s important to note about Skinner and Pavlov are that reinforcement is conceived in mechanistic terms. External forces are manipulated to initiate change.  In contrast, Bandura views reinforcement as an interactional process:

“Most human behavior is not controlled by immediate external reinforcement.  Rather, people regulate their own actions to some extent by self-generated anticipatory consequences….Behavior can be self-regulated, not only by anticipated…consequences, but also self-evaluative responses to one’s own behavior (Bandura, 1971, p. 229)”

Self-Efficacy

Traditional behaviorists don’t value highly internal aspects of the self, as relevant to the therapy process.   For example, Skinner asserts that self-knowledge, can’t be directly observed and is therefore difficult to access (Nye, 1979).  Additionally, while behaviorists like Skinner and Pavlov acknowledge intrapsychic processes, they assert they play no causal role in our behaviors.  Bandura again diverges from this line of thinking.  Human beings are not victims to the environment, and do play a role in determining their own behaviors and actions.  For example, he provides the following definition of self-efficacy, a critical intrapsychic component in the social learning process:

“Bandura…describes self-efficacy as ‘people’s judgments of their capabilities organize and execute courses of action required to attain designated types of performances…How individuals view their abilities and capabilities affects academic, career and otherr choices” (Sharf, 2912, p. 196).

Social Learning Theory Overview…

In his book “Social Learning”, Bandura (1977), criticizes the viewpoints of both psychodynamic theories and radical behaviorism as two extreme poles along an explanatory continuum of behavior.  Regarding the psychodynamic perspective, Bandura, (1977) complains that inner processes must be inferred from one’s behavior and that this process is not exactly empirical.  Regarding the issue of radical behaviorism, Bandura, (1977) notes that “in an…effort to eschew spurious inner causes, it neglected determinants of man’s behavior.” (p. 2).  Bandura describes his social learning theory as a perspective that fills in the gaps missing within these theories:

“In the social learning view, man is neither driven by inner forces nor buffeted helplessly by environmental influences.  Rather psychological functioning is best understood in terms of a continuous reciprocal interaction between behavior and its controlling conditions” (Bandura, 1997, p. 3).

Essentially, Bandura (1971), provides a behavioral perspective with three unique components that include: (1) the importance of observational learning; (2) man’s unique cognitive capacity and; (3) our capability to engage in self-regulatory behavior (p. 3).  These three unique additions to Bandura’s behavioral perspective are discussed below.

Observational learning

Bandura’s (1977) social learning theory describes how “new patterns of behavior can be acquired through direct experience or by observing…others” (p 3.)    So how are individuals motivated to observe and learn from others?  Bandura (1977), states that past experiences help us anticipate the consequences of various actions.  Those actions others display which are rewarded become the focus of our efforts to learn via observation (Bower & Hillgard, 1981). Additionally, Bandura’s observational learning process diverges from the antecedent/respondent/consequence model discussed in Skinner’s theory.  Behaviors do not follow an antecedent and are not byproducts of the consequences that follow.  Instead, observational learning consists of four interrelated processes, discussed below:

ATTENTION – Firstly, for an individual to learn a behavior, it has to capture their attention.  A variety of factors determine the attentive value of a behavior including its functional value in terms of one’s past experiences and future goals (Bower & Hilgard, 1981).  
RETENTION – Secondly, an individual’s ability to retain information is critical in determining the extent to which it affects future behavior.  As Bandura, (1971), notes: “A person cannot be much influenced by observation of a model’s behavior if he has no memory of it” (p. 7).   
REPRODUCTION – The third critical factor in observational learning is an indivividual’s ability to reproduce a specific behavior.  This requires not only a cognitive understanding of the modeled behavior but the the skill and ability to replicate it. 
MOTIVATION – In observational learning is reinforced to the extent that an individual believes they might yield rewards or punishments.  In this sense, Bandura (1971), conceives reinforcement as influencing not only the overt expression of behavior but one attentive focus.

Self-Regulatory Processes

“A comprehensive theory of behavior must explain not only how response patterns are required but how their expression is regulated and maintained” (Bandura, 1971, p. 11). In his theory, Bandura describes three self-regulatory processes (Bandura, 1971):

Stimulus Control

Within both operant and classical conditioning, behavior is described as a byproduct of the external environment.  Bandura (1971) adds to these perspectives by noting that individuals are able to anticipate the probable consequences of a behaviors based on past experiences.  Our ability to engage in foresight and anticipation greatly influences the effects of a stimulus on our behavior.

Reinforcement Control

In Skinner’s operant conditioning, behavior is said to be a function of its consequences.  Bandura’s social learning theory appears to provide an alternative view of consequences as not just externalized or environmental factors.  Instead he notes that individuals “aslo regulate their behavio to some extent on the basis of observed consequences, as well as those they create for themselves” (Bandura, 1971, p. 20).

For example, Bandura describes vicarious counterparts to Skinner’s concepts of reinforcement and punishment..  For example vicarious reinforcement is an increase in behaviors after witnessing the consequences of others’ behaviors (Bandura, 1971).  Vicarious punishment is the decrease in a behavior after witnessing the negative consequences of someone else’s behaviors (Bandural, 1971).

Regulatory Processes

“Self-evaluative and self-reinforcing functions assume a prominent role in social learning theory” (Bandura, 1971, p. 30).

SELF REINFORCEMENT

Self-reinforcement is a byproduct of goal-setting and motivation that results when we define our personal standards of behavior.   Goals become a standard against which observational learning takes place.  It also provides a personal reference point with which to assess one’s performance.

SELF-EVALUATION

Self-evaluation in social learning theory is primarily a function of oure efficacy expectations defined as a personal conviction that we will successfully meet our goals.  A person’s evaluation of efficacy is defined by four factors: “(1) past accomplishments…(2) observations of other successes or failures…(3) verbal persuasion by self or others, and (4) changes in one’s emotional arousal” (Bower & Hilgard, 1981, p. 470).

References

Bandura, A. (1971). Vicarious and self-reinforcement processes.  Retrieved from: https://www.uky.edu/~eushe2/Bandura/Bandura1971.pdf
Bandural, A. (1977). Social Learning Theory.  Englewood Cliffs, NJ: Prentice Hall.
Bandura, A. (1978). The self system in reciprocal determinism. Retrieved from: http://web.stanford.edu/dept/psychology/bandura/pajares/Bandura1978AP.pdf
Corsini, R. J. & Wedding, W. (2011). Current Psychotherapies. Belmont, CA: Brooks/Cole
Ingram, B.L. (2012). Clinical Case Formulations: Matching the Integrative Treatment Plan to the Client. (2nd ed.). Hoboken, NJ: Wiley.
Nye, R.D. (1979). What is B.F. Skinner Really Saying?. Englewood, N.J.: Prentice-Hall.
Rosenthal, H. (2005). Vital Information and Review Questions for the NCE and State Counseling Exams. Routledge.
Sharf R.S. (2006). Applying career development theory to counseling. 6th Ed. Belmont CA: Thomson.
Skinner, B. F. (1971). Beyond freedom and dignity. New York: Knopf.

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Operant Conditioning Inspired Models of Therapy

What is Operant Conditioning

“B. F. Skinner and the radical behaviorism that he advocates are very controversial.(Nye, 1979, p. 2).” Skinner’s operant conditioning emphasizes that behavior is a function of behavioral consequences and rejects “mentalistic or cognitive explanations of behavior (Bower & Hillgard, 1981, p. 169).”  Also known as instrumental leaning it has historical roots in Edward Thorndike’s work on Animal Intelligence (Rosenthal, 2005) which describes the law of effect:

“Rewards and nonrewards or successes and failures [are]…proposed as mechanisms for selection of the more adaptive response. (Bower & Hillgard, 1981, p. 24).”

Corsini & Wedding, (2011) describe Applied Behavioral Analysis as a modern extension of Skinners work.  Rosenthal, (2005), describes Behavior therapy (classical conditioning) and Behavior Modification (Instrumental Models) as based on Skinner’s theory.  Treatment procedures are based on altering relationships between overt behaviors and their consequences.  It makes use of “reinforcement, punishment, extinction, stimulus control…(Corsini & Wedding, 2011, p. 236).”  Before providing an overview of Skinner’s work, I’d liked to review insights from another course textbook that provides an interesting perspective, titled “Clinical Case Formulations,” (Ingram, 2012).  This textbook provides an overview of clinical case formulations based on theoretical approaches such as Skinners as away of organiz[ing], explain[ing] or mak[ing] sense of large amounts of data and…treatment decisions (Ingram, 2012 p. viii).”

A Core Clinical Hypothesis

In this section, I’m going to review a clinical hypotheses based on Skinner’s work.  It is useful for case formulation purposes and is useful in determining how Skinner’s work might be utilized in a contemporary therapy setting.

“Hypothesis BL1: Antecedents and Consequences” (Ingram, 2012, p. 227)

“The treatment plan should be based on an analysis of Antecedents (triggers) and Consequences (Rewards and punishments)…lead[ing] to specific hypotheses about contingent relations among variables. Interventions are based on this functional analysis of behavior and use strategies of behavior change developed from studies of operant conditioning (Ingram, 2012, p. 227).”

Clinical Case Example

“[John} is referred by court for anger management therapy after committing assault in a road rage incident.  You help him identify the triggers for his excessive rage reactions:  An external trigger (the driver gave him ‘the finger’) and an internal trigger (the thought: ‘someone is disrespecting me’).(Ingram, 2012, p. 227).”

Potential Problem Areas & Treatment Methods…

Some problem areas in which Applied Behavioral Analysis is useful might include autism, addictive behaviors, overeating (Ingram, 2012). The treatment process begins with a baseline measure of problematic behaviors that are defined in clear operational terms. For example, in the above hypothetical clinical case, the client has trouble controlling his anger.  Next, the antecedents (i.e. triggers) that precede his displays of anger need to be described.  These triggers can include physical symptoms (i.e. hunger), emotional states, or thought processes (Ingram, 2012).  Finally, identifying the consequences and reinforcers of one’s behavior is essential.   Behavioral modification strategies including stimulus control, reinforcement, and contingency contracts are then useful.

Common Criticisms….

In the book “What was B.F. Skinner Really Saying?  Nye, (1979) states the following:  “B.F. Skinner and the radical behaviorism that he advocates are very controversial…for many people there remain misunderstandings….about what Skinner is really saying, (p. 2).”  What follows are responses from this book to common criticisms about Skinner’s Theory:

MISUNDERSTANDING #1: Radical Determinism

One criticism of Skinner’s work rests in the fact that he “denies that our behaviors are self-determined” (Nye, 1979, p. 78).”  Personally, when reading about Skinner’s work, I can’t help but feel he’s describing human beings as mindless automatons.  Nye, (1979) respond by noting that Skinner simply believed we relied too much on inner qualities like motivation to achieve our life goals. Instead he suggested that since “ultimately the environment has the control” (Nye, 1979, p. 81), we utilize information about the external world, since this is far more pragmatic.

MISUNDERSTANDING #2:  The Proposed Nature of Control

Another common misunderstanding regarding Skinner’s work  pertains to the idea that we control environmental factors in order to adjust an individual’s behavior.  Honestly, this seems a little f’d up, doesn’t it?  Nye, (1979) respond by noting: “Skinner’s proposals for controlling behavior advocate the systematic use of positive reinforcement rather than aversive methods of control (p. 86).”

MISUNDERSTANDING #3:  Oversimplified View of Human Nature.

Critics of Skinner’s work, often complain that it ignores many aspects of what makes us human.  For example, while Skinner does acknowledge the presence of thoughts and feelings as components of our inner world, they have no causal role in our behaviors.  Instead thoughts and feelings are controlled by environmental factors along with our behavior.  In response to this question, Nye (1979) ask “Even if SKinner’s approach were judged to be simple, is that necessarily bad?” (p. 94).

MISUNDERSTANDING #4: Skinner’s View of Self-Knowledge

In light of radical determinism, and the utter meaningless of thoughts and feelings, it would seem to me that Skinner suggests self-knowledge and spiritual introspection are meaningless.  In response to this criticism, Nye, (1979), note that his view of self-knowledge is “materialistic” (p 99) in nature.  Self-knowledge under Skinner’s view, knowing oneself “has to do with stimuli, responses and reinforcement” (Nye, 1979, p. 99).

Unique Aspects Of This Behavioral Therapy Approach

Skinner’s approach focuses on the learning process for voluntary behaviors through the manipulation of consequences.  Consequences refer to those events that follow our behaviors. Manipulating the consequences of our behaviors is key to creating change in our lives. In contrast, Pavlov focuses on involuntary reflexive behaviors and emotional responses.  Learning then becomes a matter of readjusting our chosen responses to a specific situation.  Pavlov’s independent variable is the antecedent while Skinner’s is the consequence.  In this sense, Skinner’s approach is conceives the client’s role as more active and participatory while Pavlov’s clients play a passive role in the learning process.

Who is Skinner?

“Burrhus Fredric Skinner…was born on March 20, 1904, in Susquehanna a small railroad town in northeastern Pennsylvania” (Nye, 1979, p. 8).  His father worked as a lawyer was a homemaker.  He had one younger brother who died in childhood.  He received a bachelors in literature from Hamilton College and Phd in Psychology from Harvard in 1931.  “Beginning in the 1930s, Skinner published a series of papers reporting results of laboratory studies with animals in which he identified the various components of operant conditioning. He summarized much of this early work in his influential book, The Behavior of Organisms” (Shunk, 1990, p. 88).   “Skinner was interested in giving a scientific account for behavior…buy found the S–R paradigm insufficient to explain the majority of behavior, especially for those behaviors for which there appeared to be no obvious antecedent environmental causes” (Dixon, 2012, p. 4).  What follows is an overview of his research and perspective.

Fundamental Premises

Essentially, Skinner upheld a biological perspective of human behavior which notes that behavior is a function of consequences.   These consequences are determined by human biology as well as our environment.  In this respect, “behavior is lawful [and] the role of psychology is to discover the ’cause-and effect’ relationships” (Nye, 1979, p. 23) between behavior and their consequences. Understanding this cause and effect can be achieved through experiments that manipulate key environmental conditions associated with the consequences of one’s behavior.   “To pursue his interest in operant behavior, Skinner built a small soundproof chamber…referred to as a Skinner Box” (Nye, 1979, p. 27).  As the above video shows, this involves adjusting environmental conditions in the experiment in order to observe how this influences an animal’s utilization of the food dispenser.  Based on these observations, Skinner developed the following concepts of human behavior in his reinforcement theory.  As stated earlier, Skinner criticized the Stimulus-Response Model of behavior reflected in classical conditioning, because it left out a key component of the puzzle: The consequences of our behavior (Dixon, 2012).

Key Concepts

Respondent vs. Operant Behavior

Bower & Hilgard, (1981), begin their discussion of Skinner’s work by defining clearly the specific types of behaviors that are the focus of his research.  For example, Skinner rejects Watson’s “dictum ‘no stimulus, no response'” (Bower & Hilgard, 1981, p. 169), which states that any behavior must have a stimuli that elicited it.  Naturally, this excludes from one’s examination of human behavior, anything that doesn’t have a clear antecedent stimuli associated with it.  In order to differentiate his work from classical conditioning’s view of behavior Skinner created a classification of two types of responses.  With the classical models behavior is elicited by antecedent stimuli.  Skinner conceives behavior as operant, emitted in response to the perceived consequences of one’s actions.

Types of Behavioral Conditioning

With two different definitions of behavior, there are two unique ideas on how we learn new behavior.  Within the classical conditioning model behavior is reinforced by the close association of an unconditioned stimuli with a conditioned stimuli.  For example, Pavlov taught dogs to drool when they hear a bell, by ringing a bell at feeding time.  Skinner calls this type of behavioral conditioning an “S Type” (Bower & Hillgard, 1981, p. 171).

In contrast, “Type R” (Bower & Hillgard, 1981, p .1971), conditioning reflects Thorndike’s law of effect that states behaviors are a function of their consequences.  In other words, the consequences of one’s behavior are manipulated through the provision of positive and negative reinforcers discussed next…

Discriminative Stimuli

While Skinner classical classical conditioning of its assertion that antecedents play a role in the determination of behavior, it is wrong to assume he eliminates this variable completely.  “Discriminative stimuli change the probability that an operant will be emitted based on an operant in one situation but not in another” (Shunk 1991, p. 84).  In other words, discriminative stimuli are defined by the behaviors that they influence.  Additionally, the influence of this stimuli is determined by an individual’s past experiences with consequences they tend to be associated with.

Learning & Reinforcement

Consequences from the environment that increase the possibility that behaviors will be repeated are called reinforcements (Rosenthal, 2005).  These reinforcers can be positively or negatively valued by the individual.  Here are a few examples

An Example of Positive Reinforcement

Positive reinforcers are positively valued consequences that follow a behavior.  For example, if my son does his homework and completes his nightly chores, I allow him to play for one hour on his xbox before bedtime.

An Example of Negative Reinforcement

Negative reinforcement occurs when a negatively valued consequence is removed for a specific behavior.  Skinner uses the term “aversive stimulus” (Bower & Hillgard, 1981, p. 172) to describe negatively valued stimuli such as electrical shocks, extreme cold, or loud noises.  In negative reinforcement, this aversive stimulus is removed in order to increase one’s behavior.  For example, last quarter when I was putting in about 30+ internship hours a week, my oldest son had to learn how to make dinner in the events.  This helped stave off his own hunger while also prevented my younger brother whining about there being “nothing to eat”.  He was able to eliminate two aversive stimuli: hunger and hearing his brother whine.

Extinction & Punishment

Extinction involves the reduction in frequency of a behavior over time either through the cessation of a reinforcer (described above) or the provision of punishments.  While reinforcers increase the probability of a behavior punishments decrease the occurrence of negative responses (Rosenthal, 2005).  As with reinforcers, punishments can be both positive and negative.

An Example of a Positive Punishment

With positive punishments, negatively valued stimuli are presented after a specific behavior.  For example, if my youngest son brought home a few bad grades home.  Firstly, I made him redo these assignments since his teacher told me he didn’t put in a good effort and “was goofing off in class”.  Secondly, I made him go to bed early and gave him extra chores around the house.

An Example of a Negative Punishment

With negative punishments involve the removal of a positively desired stimulus for a poorly desired behavior.  For example, if my sons get in trouble at school for some reason, I have also utilized my favorite punishment:”eliminating for one week any and all devices that require electricity.  This means he can’t play with his computer, ipad, iphone, or xbox.

Behavioral Modification

Behavioral modification techniques are based upon Skinnerian principles of operant conditioning defined above.  Essentially, it involves replacing negative behaviors for positive ones through the utilization of positive and negative reinforcement.  This approach is based on the “Premak Principle” which basically notes that reinforcers should be based on what individuals valure most (Rosenthal, 2005).  In other words, reinforcers that yield the greatest amount of intrinsic enjoyment, have the greatest influence on one’s responses (Shunk, 1991).  It is for this reason, that Skinner focused so much of his work on the functional relationship between behaviors and environmental consequences.

“the external variables of which behavior is a function provide for what may be called a causal or functional analysis. We undertake to predict and control the behavior of the individual organism” (Skinner, 1953, p. 35).

Intrinsic vs. Extrinsic Motivation

Before discussing Skinner’s reinforcement theory it might help to differentiate between intrinsic and extrinsic motivation:

“The most basic distinction is between intrinsic motivation, which refers to doing something because it is inherently interesting or enjoyable, and extrinsic motivation, which refers to doing something because it leads to a separable outcome.” (Ryan & Deci, 2000, p. 56).

In other words, this definition notes that those things which provide intrinsic motivation are desired for their own sake.  In contrast, extrinsic motivators are desirable because they can lead to something else.

Schedules of Reinforcement

In his research, Skinner learned that the maintenance of a specific behavior required a schedule of reinforcers.  In other words, for my boys, they know that in order to get an allowance they must do their chores and keep up their grades.  For Skinner the utility of a reinforcement schedules is determined by the rate of response of his animal subjects.  In the real world, the enviornment’s natural reinforcers for certain behaviors are not provided in a uniform manner.  In his research, Skinner defines two main types of reinforcement schedules.

Continuous Schedules

With a continuous reinforcement schedule, an individual is rewarded every time after performing a specific task.  Nye, (1979), notes that the real world tends to provide reinforcements in this manner.  For example, my youngest is allowed to have his snack and extra free play-time if he does is schoolwork in a timely manner.  Rosenthal, (2005) notes that continuous reinforcement schedules promote each the establishment of a new habit, but ineffective when working on maintaining the behavior.

Intermittent Schedules

Skinner spent a great deal of time studying intermittent reinforcement schedules in his work.  As the term indicates, this involves providing reinforcements only part of the time, for a specific response.   In his work, Skinner describes two main types:  “interval schedules are based on passage of time and ratio schedules are based on number of responses” (Nye, 1979, p. 59).

Example of Ratio Schedule

Ratio schedules are determined based on the number of positive behavioral responses.  For example, at my son’s school they utilize behavior cards.  Green is good, yellow is okay, and red is when he’s being “naughty”.   If my son is able to get at least three greens in a row during a school week then I take him out to his favorite restaurant.  This is a ratio schedule. “These schedules also can be fixed (FR) and variable (VR)” (Nye, 1979, p. 60).  Rosenthal, (2005) states that “variable ratio schedules are the highest rate of behavioral response and are very hard to extinguish.”

Example of Interval Schedule

Interval schedules are determined based on a time interval.  For example, if my youngest son can sustain 30 minutes of homework time without whining I give him a treat.  Interval schedules can also be on a fixed or variable schedule.  Another example might include the weekly allowance I provide my kids for certain behaviors.  Rosenthal, (2005) notes that while variable rato schedules are most successful, regular interval schedules are the least reliable.

Primary and Secondary Reinforcers

Primary reinforcers provide intrinsic motivation and are – by themselves – highly desirable to clients.  These primary reinforcers tend to be associated with our innate biological drives.  In contrast, secondary reinforcers provide extrinsic motivation.  Also known as conditioned reinforcers they are stimuli that are “originally neutral but gain the power to reinforce through its pairing with one or more primary reinforcers” (Nye, 1979, p. 36).  “Conditioned reinforcement occurs when behavior is strengthened by events that have an effect because of a conditioning history” (Pierce & Cheney, 2013, p. 271).  In other words, past experiences define our expectations of future events.  Secondary reinforcers tend to gain power through their association with primary reinforcers.  Conditioned reinforcement is a process of learning and involves the association between primary and secondary behaviors.  For example, my son at school gets behavior cards that are good for a drawing in class.  He gets an opportunity to either pick an item from the prize jar or gets “first picks” on the toy he wants to play with during free time.

Generalization

“Once a certain response occurs regularly to a given stimulus the response also may occur to other stimuli.  This is called generalization” (Schunk, 1991, p. 97).  For example, oldest son is proud of his academic achievements.  He completes his homework, participates in class, and is mindful of when assignments are due, because these behaviors have been useful in achieving good grades in the past.  Skinner notes, this process of generalization allows us to apply experiences in similar situations to new ones.  “If generalization didn’t occur, we would have to learn each time how to respond in every new situation” (Nye, 1979, p. 50).  In describing this process, Skinner noted the existence of a generalization gradient where responses to specific stimuli decrease in frequency as the stimuli are more dissimilar from what we’ve encountered in the past.  For example, my cat think he’s being fed whenever he hears the sound of the can-opener.  However a dissimilar sound, like the doorbell, does not yield the same response.  The sound of a doorbell is highly dissimilar from a can opener.

Discrimination

The processes of discrimination and generalization each act as a complement to the other.  With discrimination, we learn to discriminate between “different aspects of similar situations and our responses become more finely tuned” (Nye, 1979, p. 51).  Discriminative stimuli refer to those aspects of a situation that allow us to determine the relevance of certain learned behaviors to a specific situation.

Shaping

In everything discussed thus far, many of Skinner’s concepts refer to the learning of simple behaviors in a series of one-shot experimental situations.  However, with behavioral modification, Skinner’s concepts are often utilized to help individuals develop patterns of behavior in a gradual process of evolution or development (Rachlin, 1991).  This process is called shaping (Rachlin, 1991; Schunk, 1981) and involves the gradual improvement of behaviors through the continual reinforcement process.  Bower & Hilgard, (1981) describe this shaping process as involving the following steps:

Identify the client’s current behaviors as well as any antecedents and consequences. 
Identify the desired behavioral changes & define the goal.  
Identify potential reinforcements based on the client’s environment & preferences.  
Break down the desired behavioral change into a realistic step-by-step process.
Utilize a reinforcement schedule to help the client to engage in a successive approxmations and reinfinements towards the defined end goal. 

Chaining

Skinner utilize the term chaining to describe how we learn more complex behaviors like playing the piano.  He describes the process of learning complex behaviors as consisting of several individual responses like links in a chain (Nye, 1979).  Each link in the chain generates consequences that influence the next response (Nye, 1979).

References

Bower, G.H. & Hilgard, E.R. (1981). Theories of Learning, 5th Ed..  Englewood Cliffs, N.J.: Prentice-Hall.
Corsini, R. J. & Wedding, W. (2011). Current Psychotherapies. Belmont, CA: Brooks/Cole
Dixon, D. R., Vogel, T., & Tarbox, J. (2012). A Brief History of Functional Analysis and Applied Behavior Analysis. Functional Assessment for Challenging Behaviors, 3-24.
Ingram, B.L. (2012). Clinical Case Formulations: Matching the Integrative Treatment Plan to the Client. (2nd ed.). Hoboken, NJ: Wiley.
Kazdin, A. E. (2012). Behavior modification in applied settings. Waveland Press.
Nye, R.D. (1979). What is B.F. Skinner Really Saying?. Englewood, N.J.: Prentice-Hall.
Pierce, W. D., & Cheney, C. D. (2013). Behavior analysis and learning. Psychology Press.  Retrieved from: https://scholar.google.com/scholar?cluster=8530085740643864664&hl=en&as_sdt=0,28&as_ylo=2012
Rachlin, H. (1991). Introduction to Modern Behaviorism, 3rd. Ed. New York: Freeman & Company.
Rosenthal, H. (2005). Vital Information and Review Questions for the NCE and State Counseling Exams. Routledge.
Ryan, R. M., & Deci, E. L. (2000). Intrinsic and extrinsic motivations: Classic definitions and new directions. Contemporary educational psychology, 25(1), 54-67.
Schunk, D. H. (1991). Learning theories: An educational perspective. Retrieved from: http://s3.amazonaws.com/academia.edu.documents/44670152/_Dale_H._Schunk__Learning_Theories_An_Educational..pdf?AWSAccessKeyId=AKIAJ56TQJRTWSMTNPEA&Expires=1475602918&Signature=jyd3eErVXh%2F6RaD8I%2B056ea%2FlNw%3D&response-content-disposition=inline%3B%20filename%3DDale_H._Schunk_Learning_Theories_An_Edu.pdf
Skinner, B. F. (1953). Science and human behavior. New York: The Macmillan Company.
Wolpe, J., & Plaud, J. J. (1997). Pavlov’s contributions to behavior therapy: The obvious and the not so obvious. American Psychologist, 52(9), 966-972.

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