Theory Research Paper- Adlerian Therapy

Author- Khushboo Gupta

Overview  

Individual Psychology by Alfred Adler is a comprehensive theory that seeks to explain human behaviour by focusing on holistic growth that spans the past, present and the future. According to Adler, one of the main motivation for an individual is a feeling of belongingness. He describes social interest as the inherent capacity of an individual to connect and add value to the society and community that they are a part of. Adler believed that by cultivating social interest , an individual can move beyond their own self-centred interests and contribute to society. Adler believed that everyone is born with an inferiority and people strive to become successful by overcoming this inferiority, he called this as striving for perfection. Sometimes however when a person is not able to overcome the inferiority, they may develop an inferiority complex or alternatively they may compensate for the inferiority by striving to become better at some other area in life. To protect their self-esteem , an individual may use safe guarding techniques like making excuses, aggression etc.

Early experiences of an individual guide the formation of a consistent worldview, attitudes and beliefs that persist even in adulthood, Adler called them lifestyle. Significant importance has been given to the birth order of an individual. Development of many key attitudes is believed to be due to the order in which a child is born. Individuals have life goals which include work, intimate relationship, spirituality and social connection. If any of the life goals are not being met, person may feel unfulfilled. He also said that individuals develop their own narratives to make sense of their experiences. He called them fictions. When these narratives define what the person wants to achieve in the future , they are called fictional finalism. Fictional finalism is not rooted in the current reality or past experiences of a person’s life, rather it is dependent on the ideal life that a person seeks to create for oneself.

Techniques and Interventions 

Adlerian therapy uses many techniques and interventions to help the person feel wholesome and complete. Goal setting in Adlerian is about supporting the person in setting meaningful and realistic goals for themselves which the person can follow. Goal setting is a very collaborative process in Adlerian therapy and involves changing the faulty fictions of the person, helping the person develop social interest, work on the close relationships by seeking common goals, identifying inferiorities and working towards a more wholesome and meaning full life.

One of the most important technique is lifestyle assessment, where a therapist tries to decode the perceptions and beliefs of the person by taking into account the early childhood memories and impact of socio-cultural environment. This includes working on the family constellation and identifying the kind of relationship the person has with all members of the primary family. Many of the life patterns are believed to emerge as a result of early childhood experiences, hence understanding the effect of the birth order in which the person is born also gives valuable insights about the person. Life style assessment also includes understanding of person’s inferiority and coping mechanisms.

Understanding the current social interest and helping the person develop it further is another valuable technique. Therapist may focus on challenging the self-centred beliefs and encouraging the client to engage in kind behaviours towards other people. This can be done by collaborating with people and developing common goals with people who share closer relationships with the person. Depending on the acceptability , one may be advised to engage in volunteer work and work for community. 

Dream analysis, is also an important technique which focuses on understanding the unconscious thoughts, desires and conflicts within a person. It focuses on analysing the personal symbols and what it means to the individual. It further will take into account the subjective interpretation of the dream by the person themselves. This is done to understand the person’s unconscious desires as well as a perceived shortcomings. 

Understanding the faulty fictions of the person will help to understand the maintaining factors for the problem. Once the goals of therapy are identified by keeping in mind the information received by person which will include fictional finalism, the therapist can use “as If” technique, where a client is asked to behave in a manner that he would have behaved if everything was as he wanted. This helps the person to gradually internalise  the traits that they consider desirable.

Catching oneself is another technique which is used to make a person more aware about their automatic thoughts. It requires self-observation and awareness by the person and consists of catching oneself when any maladaptive or unhelpful though crosses one’s mind. Person is encouraged to step back and analyse that thought in real time to understand if the thought is in fact helpful. If not, one is encouraged to choose more constructive thought. It’s a method to pause and reflect on the negative thought patterns and replace them to more productive ones.

Adlerian often use ‘Socratic Dialogue’ to gently and empathetically help the client reflect on their personal beliefs and attitudes. These are open ended questions which the therapist and person try to analyse and answer together after reflection and thought. It helps the person to rethink about the behaviours in a safe space and possibly change them after introspection.

Overall, techniques and interventions in Adlerian therapy focus on increasing the person’s social interest and develop a sense of completeness and belongingness by helping the client achieve their life goals and strive for perfection 

Literature Review 

Introduction

In 1970, Maslow is known to have said that “Adler becomes more and more correct year by year. As the facts come in, they give stronger and stronger support to his image of man” (Miller & Taylor, 2016, p13).

In this section I want to explore the ways in which Adlerian therapy is relevant in today’s world by investigating the latest research in neurobiology and also trying to understand the various ways in which Adlerian therapy can be used within a cultural backdrop specially since most available literature is based on individualistic setups. This will help me to explore the use case scenario for collectivist cultures such as India.

I would also like to understand how can Adlerian therapy be used with other therapies like play therapy, music therapy etc. and seek to assess the various applications of Adlerian therapy particularly those that benefit children and adolescents.

Neurobiological assessment 

Latest research in neurobiology supports the use of Adlerian therapy in varied populations. In the case of developing social interest which is central to Adlerian therapy, neurobiological research asserts that when people engage in caregiving and bonding with people in their communities, the brain releases oxytocin which helps in reversing the damage done by phycological problems such as stress (Poulin & Holman, qtd Miller and Taylor 2016 ). 

Adlerian theory believes that early childhood has a very lopsided impact on the development of a person throughout the life. It shapes their perspectives, their relationships and their interpretation of future and past experiences. Researchers believe that the  essential framework of the regulatory circuits of the brain is formed in the first five years of life (Andersen et al., 2008; Perry, 2009 qtd Miller and Taylor 2016). Children taken on the neural circuitry of those people that are closest to them in their growing up years and while they are born with some proclivities, many of the traits are acquired from the environment that they are a part of ( Miller and Taylor 2016).

Adler’s method of Early recollections is a way to understand the lifestyle of a person, it is not of consequence that the memory is real or fake. When the person recalls that memory, it becomes predisposed to modification. At this moment, if new information is incorporated in the retrieved memory and the process is repeated several times, it will bring about a re-consolidation of the memory and this will lead to a transformative shift in the perception of that memory.(Lavon and Shifron 2020).

One basic tenet of Adlerian philosophy is striving for perfection which can be looked upon as moving from a state of unpleasantness to pleasantness. At present many Adlerian therapist consider a person’s felt significance and feeling of belongingness when they collaborate to develop goals for therapy.( Kottman & Meany-Walen, 2015; Mosak & Maniacci, 1999 qtd Lavon and Shifron 2020). Neuroscience also looks at behaviour from the lens of moving from  unpleasantness to pleasantness. The most important goal is survival of a person and it is best accomplished when there is some level of group membership and by extension belongingness. Hence feelings of belongingness are not just required for mental health but are actually a core survival requirement.

According to the neuroscience research, a therapist must address all facets of an individual to increase his/her neuroplasticity. This may include working with the person on thoughts, emotions, relationships, etc. (Miller and Taylor 2016). Hence, its safe to conclude that Adlerian therapy has strong roots in neuroscience 

Cultural Orientation

There is a general understanding that Adlerian therapy is more useful for western cultures with their focus on the “individual self”. (Aslinia ,Rasheed, etall 2011). The fact that  Adlerian Psychology is often called “individual psychology” also does not help the cause. However, Aslinia, Rasheed et all in 2011 clarify that the name is sort of a misnomer, since the root of the word individual which was taken from German and has Latin roots implies “indivisible”. Adler focused on a person being complete or whole only within the social and environmental context. This co-relates to the definition of collectivism which also means “part of a whole”. Hence, one can conclude that holism and collectivism are in fact related.

Often times when a person is working with a counsellor from a dominant class/caste, the counsellor may not understand the finer details of the community that the person is a part of and this may hinder the therapeutic process for the client. Many supervisees feel hesitant in asking culture or caste related questions and one reason as postulated by  Aslinia, Rasheed et all in 2011 is because a lack of understanding on behalf of the counsellor interferes in the need to come across as an expert. Another reason could be that there is an expectation from the person to acknowledge and accept the new culture that they are a part of (this may be especially relevant in cases of caste based marriages, immigration to different cities or countries  for work or education).

Adler himself was strongly opposed to marginalisation of any social group and vehemently advocated for social equality

Adlerian believe that regardless of the culture , there is a strong need in all people to move from a position of inferiority to superiority. However, this makes sense only when we inculcate the effect of culture within therapy. If the focus on therapy is on encouraging the client to make individual goals and in the process treat the interconnected way of life of the client as a hindrance, then the client may not respond to the counsellor’s call for self-exploration. (Aslinia, Rasheed, etall 2011). For e.g. while counselling a young adult in a individualistic culture, an adolescent may not want to share anything with the parents and the parents may also feel comfortable with this but in a collectivist culture this may not work.

Hence as a therapist one needs to take this into account and take the parents onboard so they all work as a team for the benefit of the young adult.

Understanding the impact of birth order and gender in diverse cultural populations will help to explore and ultimately improve upon the current approach to mental health. Simultaneously it will also help to add to the existing literature on Adlerian therapy’s application in a more international context. 

In many cultures the life outcome of the first born child folds nicely with the Adlerian concept of birth order. In collectivist cultures, family will have higher expectation from the eldest son because the decision making for the family is bestowed upon him. Hartshorne, Salem-Hartshorne & Hartshorne in 2009 provided evidence that people born in a particular birth order are more likely to seek romantic relationships with people of same order. Some researchers have tried to explore if the birth order and gender can be the used to explore both positive and negative outcomes for adolescents and children specially in collectivist cultures (Horner, Andrade et all 2012). While, Specific studies have not been undertaken for Indian population, I have tried to explore the same using studies done amongst Latin American youth because both Latin America and India can be considered as collectivist cultures even when significant other differences may exist.

In a recent research concluded by Horner, Andrade et all in 2012 to study the impact of birth order and gender on negative outcomes ( e.g. substance abuse) in adolescents in Latin America, It was found out that children who were born as the only child, 2^nd born, middle children or are the youngest in the family are more prone to negative outcomes when compared to the 1^st born child. The only difference is the gender, 1^st born girl child are more prone than other birth orders to have tried substance. This study adds some insight to the application of Adler’s birth order in assessing both positive and negative outcomes for children. Being a first born adds more protection to negative outcomes and at the same time, it gives an educational advantage to children in the collectivist countries. (Horner, Andrade et all 2012). One important reason that the could be that most of the collectivist countries are still developing and being the first born may have added bonus of extra financial assistance and as the number of children increase in the family there are less resources to share.

Application and linkage with other therapies

Adlerian therapy is usable across many different formats of therapy and while it has far reaching impact on many populations, its effect on children is most studies. Adlerian theory corelates with the attachment theory (McCluskey M. 2021) and makes a case for use for parent education. Understanding attachment styles from the frame of Adlerian therapy can help therapist to address Parent-child issues and exploring family dynamics as both theories pay attention on developing supportive relationships.

Another theory which aligns with both Adlerian and attachment theory is objects relation theory (McCluskey M. 2021). These theories can be used alongside to understand and explore the impact of relationships on a person. Within their ambit, therapist can work with the individual as well as family system and bring about positive change.  In 2005, Farooq et al conducted a study with Adlerian video based parental training for minority groups in United states. They found out that people engaged in this training were more empathetic towards their kids and developed authoritative styles of parenting with time. Engaging in Adlerian parent training programme can bring about transformation in family communication , create more equitable roles within family and cultivate more respect amongst family members. (McCluskey M. 2021).

Adlerian Play therapy, developed in 1980 by Kottman is based on evidence and being used extensively in treating children with externalizing behaviour issues. (Meany K &Walen S.,2016). Externalizing behaviours are often indicative of deeper emotional issues that the child may be facing. Hence, if the teachers or parents can relook at the behaviour, their perspective of the child seeking help from councillor may change and this will have a direct positive bearing on the child as well. This therapy has shown good results in both group and individual setting. In group, children get an opportunity to develop better social interest and in individual, they get the opportunity to understand their underlying emotions better. (Meany K &Walen S.,2016). Adlerian therapy is also found to be useful in helping parents with child education of children with social needs Adler referred to this as organ inferiority and laid the responsibility on caregivers to help the child develop useful and helpful fictions. It can also be used along with Music therapy in cases where the person is not engaging verbally. Music is essentially the language of social integration and has the potential to link people together while reverberating with each individual in a unique manner. ( Ericsson C. 2017).

Reflections and observations

It seems like many theories and therapies have borrowed from Adler and yet it’s not as well-known as some other theories of his time.  It however, appears that the interest in this theory is on the rise since it being used across different layouts of therapy. It overlaps with many currently prominent theories of our time, finding takers even in the strict discipline of neuroscience. Research available to see the impact and usage of this theory on different minority groups was minimal and I did not come across many research papers for its usage in Indian context. Since associating with groups and developing belongingness is central to Indian culture, I would like to explore later how this theory works with the idea of the Individual in a collectivist setting. 

The therapy model can be applied to children in different settings, The only kind that Adler believed were at serious risk of developing inferiority and difficult to help were children who were pampered by their caregivers. According to Adler, knowing that one doesn’t deserve something and still getting it develops inferiority and inadequacy in children.

Another aspect that I would like to explore more is usage in group therapy. It  has been used in schools in both group and individual formats on children with externalizing symptoms and I believe that it will be equally effective in dealing with preventive and promotive healthcare for children and adult both. The focus on social interest also works to build stronger communities and creating spaces that foster interpersonal cooperation and harmony within citizens.

One way in which the therapy can be made more effective is by neuro-education, explaining how it works from a neuroscience perspective.  Explaining how our brain works when we are engaging in this kind of therapy model will generate deeper trust in the person that this will work for them

While, the therapy works for many different models , its limited usage may be because it is difficult to implement . There is a lack of a straight-forward process and technique that therapist can use and a lot is left for subjective interpretation especially in techniques like dream analysis. I also found it limited in its approach to integrate the intersectionality of a person in terms of impact of race, culture , caste, sexuality etc.

Overall, while there may be some criticism for Adlerian therapy, the benefits outweigh the disadvantages. Like all therapies, this will work on some individuals more than the others and will appeal to some therapists and not to others. I believe when taken as a whole it is a complete theory and is suitable for a very wide range of issues that we face on a day to day basis.

References

1. Kristin K. Meany-Walen and Sunny Teeling (2016). Adlerian Play Therapy with Students with Externalizing Behaviours and Poor Social Skills , International Journal of Play Therapy, Vol 25, 64-77.

2. Horner P, Andrade F et all (1998), Birth Order and Gender with Academic Standing and Substance Use Among Youth In Latin America, Journal of Individual Psychology Vol 68(1),19-37

3. Qu, X., & Luke, M. (2022). A critical review of Adlerian supervision: Illuminating the untapped potential. Journal of Counsellor Preparation and Supervision, 15(2). Retrieved from https://digitalcommons.sacredheart.edu/jcps/vol15/iss2/4 

4. Mc. Cluskey, (2022),Revitalizing Alfred Adler: An Echo for Equality, Clinical Social Work Journal. 2022; Vol 50(4): 387–399. Published online 2021 Mar 5. Digital Object Identifier: 10.1007/s10615-021-00793-0

5. Miller R. ,Taylor D. (2016), Does Adlerian Theory Stand the Test of Time: Examining Individual Psychology from a Neuroscience Perspective,  The Journal of Humanistic Counselling Volume 55, Issue 2 p. 111-128.

6.  Aslinia S. Rasheed, M. & Simpson C. (2011), Individual Psychology (Adlerian) Applied to International Collectivist Cultures: Compatibility, Effectiveness, and Impact ,Journal of International Counsellor Education, Vol 3,1-12, Retrieved from http://digitalcomms.library.unlv.edu/jice

7. Iris L, Rachel S. The Use of Early Recollections in Adlerian Psychotherapy: Evidence in Neuroscience Research. Psychol Behav Sci Int J .2020; 15(2): 555908. DOI:  10.19080/PBSIJ.2019.10.555908.

8. Farooq D, Jefferson J, Fleming J.(2005), The Effect of an Adlerian Video-Based Parent Education Program on Parent’s Perception of Children’s Behaviour: A study of African American Parents. Journal of Professional Counselling, Vol 33(1),21-34,DOI: https://doi.org/10.1080/15566382.2005.12033810