Birth Order and Sibling Relationships
Phase 2: Explore the Individual’s Psychological Dynamics
The aim of the second phase of Adlerian counseling is to get a deeper understand-ing of an individual’s lifestyle. Durunderstand-ing this assessment phase, the focus is on the individual’s social and cultural context. Rather than attempting to fi t clients into a preconceived model, Adlerian practitioners allow salient cultural identity concepts to emerge in the therapy process, and these issues are then addressed (Carlson &
Englar-Carlson, 2008). This assessment phase proceeds from two interview forms:
the subjective interview and the objective interview (Dreikurs, 1997). In the subjective interview, the counselor helps the client to tell his or her life story as completely as possible. This process is facilitated by a generous use of empathic listening and responding. Active listening, however, is not enough. The subjective interview must follow from a sense of wonder, fascination, and interest. What the client says will spark an interest in the counselor and lead, naturally, to the next most signifi cant question or inquiry about the client and his or her life story. Indeed, the best subjective interviews treat clients as experts in their own lives, allowing clients to feel completely heard. Throughout the subjective interview, the Adlerian counselor is listening for clues to the purposive aspects of the client’s coping and approaches to life. “The subjective interview should extract patterns in the person’s life, develop hypotheses about what works for the person, and determine what accounts for the various concerns in the client’s life” (Bitter et al., 1998, p. 98).
Toward the end of this part of the interview, Adlerian brief therapists ask, “Is there anything else you think I should know to understand you and your concerns?”
An initial assessment of the purpose that symptoms, actions, or diffi culties serve in a person’s life can be gained from what Dreikurs (1997) calls “The Ques-tion.” Adlerians often end a subjective interview with this question: “How would your life be different, and what would you be doing differently, if you did not have this symptom or problem?” Adlerians use this question to help with differential diagnosis. More often, the symptoms or problems experienced by the client help the client avoid something that is perceived as necessary but from which the per-son wishes to retreat, usually a life task: “If it weren’t for my depression, I would get out more and see my friends.” Such a statement betrays the client’s concern about the possibility of being a good friend or being welcomed by his or her friends.
“I need to get married, but how can I with these panic attacks?” indicates the per-son’s worry about being a partner in a marriage. Depression can serve as the cli-ent’s solution when faced with problems in relationships. If a client reports that nothing would be different, especially with physical symptoms, Adlerians suspect that the problem may be organic and require medical intervention.
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The objective interview seeks to discover information about (a) how problems in the client’s life began; (b) any precipitating events; (c) a medical history, includ-ing current and past medications; (d) a social history; (e) the reasons the client chose therapy at this time; (f) the person’s coping with life tasks; and (g) a lifestyle assessment. Mozdzierz and his colleagues (1986) describe the counselor as a “life-style investigator” during this phase of therapy. Based on interview approaches developed by Adler and Dreikurs, the lifestyle assessment starts with an investiga-tion of the person’s family constellainvestiga-tion and early childhood history (Powers &
Griffi th, 1987; Shulman & Mosak, 1988). Counselors also interpret the person’s early memories, seeking to understand the meaning that she or he has attached to life experiences. They operate on the assumption that it is the interpretations people develop about themselves, others, the world, and life that govern what they do. Lifestyle assessment seeks to develop a holistic narrative of the person’s life, to make sense of the way the person copes with life tasks, and to uncover the private interpretations and logic involved in that coping. For example, if Jenny has lived most of her life in a critical environment, and now she believes she must be perfect to avoid even the appearance of failure, the assessment process will highlight the restricted living that fl ows from this perspective.
t h e fa m i ly c o n s t e l l at i o n
Adler considered the family of origin as having a central impact on an individual’s personality. Adler suggested that it was through the family constellation that each person forms his or her unique view of self, others, and life. Factors such as cultural and familial values, gender-role expectations, and the nature of interpersonal relationships are all infl uenced by a child’s observation of the interactional patterns within the family. Adlerian assessment relies heavily on an exploration of the client’s family constellation, including the client’s evaluation of conditions that prevailed in the family when the person was a young child (family atmosphere), birth order, parental relationship and family values, and extended fam-ily and culture. Some of these questions are almost always explored:• Who was the favorite child?
• What was your father’s relationship with the children? Your mother’s?
• Which child was most like your father? Your mother? In what respects?
• Who among the siblings was most different from you? In what ways?
• Who among the siblings was most like you? In what ways?
• What were you like as a child?
• How did your parents get along? In what did they both agree? How did they handle disagreements? How did they discipline the children?
An investigation of family constellation is far more comprehensive than these few questions, but these questions give an idea of the type of information the counselor is seeking. The questions are always tailored to the individual client with the goal of eliciting the client’s perceptions of self and others, of development, and of the experiences that have affected that development.
e a r ly r e c o l l e c t i o n s
As you will recall, another assessment procedure used by Adlerians is to ask the client to provide his or her earliest memories, including the age of the person at the time of the remembered events and the feelings or reactions116
CHAPTER FIVE
associated with the recollections. Early recollections are one-time occurrences, usu-ally before the age of 9, pictured by the client in clear detail. Adler reasoned that out of the millions of early memories we might have we select those special memories that project the essential convictions and even the basic mistakes of our lives. Early recollections are a series of small mysteries that can be woven together into a tapes-try that leads to an understanding of how we view ourselves, how we see the world, what our life goals are, what motivates us, what we value and believe in, and what we anticipate for our future (Clark, 2002; Mosak & Di Pietro, 2006).
Early memories cast light on the “story of our life” because they represent met-aphors for our current views. From the thousands of experiences we have before the age of 9, we tend to remember only 6 to 12 memories. By understanding why we retain these memories and what they tell us about how we see ourselves, others, and life in the present, it is possible to get a clear sense of our mistaken notions, present attitudes, social interests, and possible future behavior. Early recollections are specifi c instances that clients tell therapists, and they are very useful in under-standing those who are sharing a story (Mosak & Di Pietro, 2006). Exploring early recollections involves discovering how mistaken notions based on faulty goals and values continue to create problems in a client’s life.
To tap such recollections, the counselor might proceed as follows: “I would like to hear about your early memories. Think back to when you were very young, as early as you can remember (before the age of 10), and tell me something that hap-pened one time.” After receiving each memory, the counselor might also ask: “What part stands out to you? What was the most vivid part of your early memory? If you played the whole memory like a movie and stopped it at one frame, what would be happening? Putting yourself in that moment, what are you feeling? What’s your reaction?” Three memories are usually considered a minimum to assess a pattern, and some counselors ask for as many as a dozen memories.
Adlerian therapists use early recollections as a projective technique (Clark, 2002;
Hood & Johnson, 2007) and to (a) assess the client’s convictions about self, others, life, and ethics; (b) assess the client’s stance in relation to the counseling session and the counseling relationship; (c) verify the client’s coping patterns; and (d) assess individual strengths, assets, and interfering ideas (Bitter et al., 1998, p. 99).
In interpreting these early recollections, Adlerians may consider questions such as these:
• What part does the client take in the memory? Is the client an observer or a participant?
• Who else is in the memory? What position do others take in relation to the client?
• What are the dominant themes and overall patterns of the memories?
• What feelings are expressed in the memories?
• Why does the client choose to remember this event? What is the client trying to convey?
i n t e g r at i o n a n d s u m m a r y
Once material has been gathered from both subjective and objective interviews with the client, integrated summaries of the data are developed. Different summaries are prepared for different clients, but117
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common ones are a narrative summary of the person’s subjective experience and life story; a summary of family constellation and developmental data; a summa-ry of early recollections, personal strengths or assets, and interfering ideas; and a summary of coping strategies. The summaries are presented to the client and discussed in the session, with the client and the counselor together refi ning specifi c points. This information provides the client with the chance to discuss specifi c topics and to raise questions.
Mosak and Maniacci (2011) believe lifestyle can be conceived of as a personal mythology. People behave as if the myths were true because, for them, they are true. Mosak and Maniacci list fi ve basic mistakes in what is essentially an integra-tion of Adlerian psychology and cognitive behavioral theory: overgeneralizaintegra-tions, false or impossible goals of security, misperceptions of life and life’s demands, minimization or denial of one’s basic worth, and faulty values.
In addition to the concept of basic mistakes, Adlerian theory is useful in as-sisting clients to identify and examine some of their common fears. These fears include being imperfect, being vulnerable, being disapproved of, and suffering from past regrets (Carlson & Englar-Carlson, 2008).
The Student Manual that accompanies this textbook includes a concrete example of the lifestyle assessment as it is applied to the case of Stan. In Case Approach to Counseling and Psychotherapy (Corey, 2013, chap. 3), Drs. Jim Bitter and Bill Nicoll present a lifestyle assessment of another hypothetical client, Ruth.