I presented a workshop at the 2011 American Counseling Association Annual Conference in New Orleans at which I demonstrated some of the main theoretically based techniques that Adlerian counselors use with clients. Adlerian psychology, or individual psychology as it is also known, refers to the theory that Alfred Adler developed at the turn of the 20th century. The strategies I covered in the workshop included life style interpretation, early recollections and social interest. Many of the participants shared that they had always believed in the importance of personality traits, sibling relationships, early memories and using a strengths-based model. What they really appreciated was revisiting the theory behind these techniques because they said it reminded them of how to conceptualize their clients from a holistic perspective. The purpose of this article, however, is not to provide a thorough review of the theory (for that, counselors should read Adlerian Therapy: Theory and Practice by Jon Carlson, Richard Watts and Michael Maniacci, published in 2005). Instead, I’d like to share some of those Adlerian ideas and strategies that counselors can use with clients in a variety of settings.
In my opinion, what distinguishes Adlerian practitioners from other counselors is the emphasis on the purposefulness of behavior. This isn’t necessarily a true technique that one needs to rehearse or practice, like learning how to collect early recollections. Rather, it is a philosophy about the root of the problems clients present with in counseling. We, as Adlerians, do not focus on the symptoms and behaviors that a client experiences, but rather on what underlying purpose those symptoms serve in that client’s life. The only way for a client to truly understand the problem and bring about lasting change is to see the deeper meaning of the situation. So, as the client narrates his or her story, the counselor is listening for the purpose behind the symptom — the “benefit” the client experiences in continuing the behavior.
For instance, a client discussing a struggle with anxiety states, “I would love to go on a date with this person, but every time I get the chance to ask, I get nauseous and feel like I’m going to be sick, so then I don’t ask.” An Adlerian counselor will explore and listen for the reason behind the symptom. In this instance, it may be that feeling nauseous keeps the client safe from possible rejection. Through the course of a therapy session or sessions, a counselor can use questions and other methods to help the client gain insight into the purpose of the symptom. The counselor might ask the client, “What purpose does the nausea have?” or “If your stomach could talk to you about dating, what would it say?” (For more information on Adler’s concept of organ jargon, see the 2006 book Readings in the Theory of Individual Psychology, edited by Steve Slavik and Jon Carlson.)
Upon the client’s recognition that the fear is keeping him or her from a potential opportunity, the client can decide, in collaboration with the counselor, how to rid himself or herself of that fear. It may be that at the heart of the problem, the client views himself or herself as unworthy of love, and the anxiety is an outward sign of that core belief. The goal in counseling may then be to dismantle that self-perception, allowing the client to move toward a love relationship rather than remaining stuck in an inferiority complex. So the point is to listen for the music behind the words rather than focusing solely on alleviating symptoms. If the counselor and client superficially alleviate the symptom without addressing the underlying purpose, then a new symptom will take the place of the old one. In his book Understanding Human Nature, Adler said we must never neglect the client’s own use of his or her symptoms.
From this understanding, counselors can view clients as creative problem-solvers whose coping skills are no longer working the way they used to. This is more encouraging for clients because they begin to see themselves as capable of handling the situation rather than as slaves to their symptoms. This philosophy underlies all of the techniques that Adlerian counselors use. Individual psychology is not about what traits, memories, experiences, cultural backgrounds or beliefs a client possesses, but rather how the client uses these things to accomplish the tasks of daily living.
Life style assessment
One of the main tools Adlerian counselors use to examine how a client is functioning is a life style assessment. Life style refers to an individual’s subjective view of oneself, others and the world that develops based on childhood experiences and perceptions of those experiences; it does not equate to contemporary uses of the word lifestyle (Lifestyles of the Rich and Famous, for example). Life style assessments can take many forms, from paper-and-pencil questionnaires such as the BASIS-A Inventory to a series of questions that seems more like a conversation than an assessment. The goal of any life style assessment is to explore the client’s perceptions of his or her childhood experiences to discover the influence those perceptions have on the client’s current functioning.
One very basic life style assessment involves asking clients to complete the following statements: I am ______________. Others are ______________. The world is ______________. Therefore, in order to have a place to belong, I _______________________.
The client’s answers give some indication of his or her unique thumbprint, those views he or she applies to almost every situation in life. For example, using this particular assessment, a client answers, “I am stupid. Others are better than me. The world is a scary place. Therefore, in order to have a place to belong, I should try to make other people like me.”
How might this client be moving through life? Do you think the client feels capable of successfully meeting life’s demands, or is a better guess that the client approaches life with some anxiety, self-doubt and fear about how to fit in? From Adlerian theory, we know that life style develops based on our perceptions of childhood, so a smart next step with the client (assuming we have not done so already) would be to ask about sibling relationships, family values and beliefs, and other family dynamics. A more thorough picture of when, where, how and with whom these beliefs developed will provide the client with a deeper understanding of himself or herself.
Although we cannot change a client’s past, we can support and encourage the client to evaluate what beliefs he or she wants to retain and what mistaken self-conclusions he or she wants to discard. As the client takes baby steps toward new thoughts and behaviors, the counselor’s role remains one of support and encouragement, both of which are crucial in effective Adlerian counseling.
Early recollections are a great accompaniment to life style assessment. In fact, many Adlerians would say that a life style assessment is incomplete without them. Of all the memories we have, why is it that when someone asks us about our childhood, certain memories quickly come to mind? In his 1937 article “Significance of Early Recollections,” Adler discussed early recollections as a means for uncovering “valuable hints and clues in finding the direction of a person’s striving. They help reveal values to be aimed for and dangers to be avoided. They help us see the kind of world a particular person feels he lives in, and the early ways he found of dealing with that world” (excerpted from Henry Stein’s The Collected Clinical Works of Alfred Adler, Volume 7).
Adlerian counselors collect early recollections, or ERs, because they offer corroborating evidence of a client’s life style. The basic technique involves asking a client to think back before the age of 10 — preferably before the age of 7 — and to verbally share a memory that comes to mind that plays like a video, with a beginning, middle and end, and that has a feeling connected to it. The counselor’s job is to write down the memory as the client shares it, using as many of the client’s words as possible. When the client is finished recalling the memory, the counselor asks, “If you could assign a feeling to that entire memory, what feeling would you give it?” After writing down that overall feeling, the counselor asks a second question: “If you could take a picture or freeze a certain frame of the most vivid part of that memory, what would it be?” Once the counselor notes that information, a final question is posed to the client: “What feeling would you give to just that snapshot of the most vivid part?” The last step is to write down the feeling associated with the most vivid part of that memory. (This process is fully explained in a 2004 article titled “Early Recollections: A Guide for Practitioners” that I wrote with Roy Kern and Daniel Eckstein and that was published in The Journal of Individual Psychology.)
Counselors need to collect a minimum of three ERs to have enough data in which to look for themes. These themes will most likely reinforce life style information, but even more important, they may offer insight into the presenting concern. There are many ways to interpret themes from ERs. Arthur Clark wrote a book in 2002 titled Early Recollections: Theory and Practice in Counseling and Psychotherapy in which he explains in detail how to interpret ERs. The most important thing for counselors to remember is that the feedback process must be collaborative. Therefore, counselors should be tentative about sharing the themes they see or hear and instead invite clients to share their suggestions on possible themes. Some basic interpretation ideas include noticing who is (and who is not) included in the ERs, how many people are present in the ERs, the level of detail included and which parts are emphasized (for example, nonverbal behavior, somatic complaints or physical movement).
Another significant point when using ERs is deciphering whether clients are sharing a true memory or whether it is a report of a memory that someone previously told them. True memories will play like a movie and have a feeling attached to them, while reports typically do not have vivid feelings connected to them because clients only recall the memory on the basis of what someone told them. From developmental psychology, we know that we tend to remember and more easily recount events that hold meaning for us and, typically, our most meaningful life events are emotional in nature. So, having a definite feeling attached to a memory is a clue that the memory is true rather than a report.
ERs can also be adapted to the age or developmental level of a client. When working with children, counselors can ask about favorite storybook or cartoon characters, favorite Bible stories or favorite fairytales. The key is to ask why that story or character is their favorite because their answer reveals a glimpse of how they see the world. If a child shares that her favorite story is Cinderella and the reason why is because Cinderella is no longer being picked on by her family at the end, then the counselor may have a sense of the child’s current struggle in life (feeling picked on or bullied) and her hopes for the future (she sees that life can be different). The counselor should ask for other favorite stories or characters to more clearly identify themes and strengths.
ERs are useful in uncovering life style themes connected to the presenting concern as well as strengths that can be used to encourage clients as they try out new thoughts and behaviors.
Adlerian practitioners believe that Alfred Adler was ahead of his time when he proposed the concept of Gemeinschaftsgefühl, which means a feeling for and an active part in shaping one’s community. Heinz and Rowena Ansbacher, in an effort to simplify this concept, translated it as “social interest” in their 1956 book titled The Individual Psychology of Alfred Adler: A Systematic Presentation in Selections From His Writings. Adler said that our mental health is epitomized by our connection to others and our supportive contributions to society. When we feel good about ourselves, we tend to do good for other people, which usually leaves us feeling good about ourselves and more inclined to repeat that pattern. I consider social interest to be an outward expression of an inner self-evaluation or feeling. If we feel worthless, we will probably convince ourselves that we are beyond help and therefore unable to help anyone else. In contrast, if we feel capable of handling life, we may be more inclined to reach out to others.
What does social interest look like as a strategy? Simply put, counselors will encourage clients to volunteer or contribute to their communities. This could include helping a neighbor with something or volunteering at a soup kitchen or animal shelter. The purpose is to help clients reconnect with the outside world in a way that will leave them feeling better about themselves while also helping others.
For me, this process starts in the first session or two by asking clients what their hobbies are or what they like to do. If this is hard for some clients to answer, rephrase the question to focus on a time when they felt good in life. What things did they do then, or what do they hope to do again in the future? The next step is for the client to choose one thing from his or her list to explore as a possible volunteer activity (find a location, identify someone in need of help, search the Internet for local shelters and so on). Gradually, as the client feels ready or shows progress toward counseling goals, the counselor encourages the client to try engaging in the identified activity just once between sessions and explains the potential benefits the client may receive.
As is the case with any homework, counselors need to inquire about the outcome of the activity and process it with clients. If the activity went well, the counselor uses encouragement to acknowledge the client’s effort and then establishes a new goal (for example, doing the activity two times) for the next week. If it did not go well, explore what happened, acknowledge the client for trying something new and gauge the possibility of choosing a different activity.
In my experience, clients — particularly those who are depressed or anxious — are hesitant at first, but once they start exploring the possibility of helping others, their mood becomes more positive, which fosters confidence toward completing the activity. I have also used this technique with clients struggling with eating disorders, and the results have typically been positive as well.
Counselors must use their discretion before implementing this strategy and guide clients toward interests that are more likely to produce a positive outcome, especially in light of the purposefulness of the symptoms and presenting concern. For instance, I might not encourage a client with a history of eating disorders to volunteer at a soup kitchen because that could trigger a return of symptoms or unhealthy behaviors. Knowing your client and what he or she can handle is always a good place to start.
Putting it all together
These strategies serve me well with every client I see. They provide structure for developing a strong rapport and a comprehensive assessment of how the client approaches life’s demands. Most clients enjoy discussing life style and early memories because they gain a new perspective on how their early years still influence and affect them today. Adlerian theory is quite useful, and I would be glad to answer questions about Adlerian psychology or how to apply these ideas with specific clients.
“Knowledge Share” articles are based on sessions presented at past ACA Conferences.
Susan Belangee is a licensed professional counselor in Collegeville, Pa. She continues to learn about Adlerian psychology through her involvement with the North American Society of Adlerian Psychology (NASAP; alfredadler.org). She coordinates NASAP’s Emerging Leader Program and also teaches online courses for the Adler Graduate School in Minneapolis. Contact her at email@example.com.
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