Psychoanalysis and Adlerian Therapies Counseling

Psychoanalysis and Adlerian Therapies

Counseling is defined as professional guidance in resolving personal conflicts and emotional problems (Lexicon Publishing LLC 2007). Two of the most common counseling therapies are psychoanalysis and the Adlerian therapy.

Psychoanalysis was developed by Sigmund Freud, a practicing physician in Vienna, Austria, who specialized in neurological disorders (Frey 1999, Encyclopedia of Childhood and Adolescence 1998). The therapist who uses this approach helps the patient better understand himself by guiding his self-examination of deep personal feelings, relationships and events, which have contributed to the development of his motivations and behavior. During his practice in the early 19th and early 20th centuries, Freud had patients who evidenced physical symptoms for psychological disorders. He used hypnosis to get to the cause of these disorders. He discovered that by allowing the patient to talk his problem out, the cause or causes would eventually surface. Through his concept of free association, the patient is encouraged to speak whatever comes to mind un-directed, without narrating, without censorship. This unrestricted and un-directed self-exploration became one of the principles of psychoanalysis. From this discovery, he published "The Interpretation of Dreams" in 1900, "The Psychopathology of Everyday Life" in 1904 and "A Case of Hysteria" and "Three Essays on the Theory of Sexuality" in 1905 (Encyclopedia of Childhood and Adolescence).

Psychoanalysis is the therapy often used by qualified psychotherapists for patients with mild to moderate and chronic psychological problems (Frey 1999). It is applied one-on-one with the patient and not suitable as a group therapy. It is the most intensive psychodynamic therapy, which deals with one's view of the human personality. This view derives from the interactions between the conscious and the unconscious. The goal of this therapy is to bring all unconscious information to full consciousness in order to give the person full control over his life. The discovery or recovery of suppressed information or previous feelings can resolve the person's internal conflict. The therapy also intends to form a strong and intense relationship between the therapist and the patient. The relationship analyzes and deepens the patient's insight into his problems (Frey).

Using psychoanalysis, a therapist sees a patient 4-5 times a week for 45-50 minutes per session (Fine 2003). The patient lies comfortably in a couch. The therapist or analyst sits on a chair behind him and out of his view. She tells him to verbalize whatever comes to mind. This is "free association." The method is considered challenging right way because most people learn at an early stage to restrain or suppress certain thoughts and feelings. By staying out of the patient's view, she prevents eye contact so as to make spontaneous speaking easier for him. She should be non-judgmental towards anything he says. What is important is not what he expresses but her attention and act of listening to him, even if what is says is not important. Her objective and caring attitude is the critical factor. In the process of free association, the unconscious sources of his current problems will come out. The counselor or therapist will notice and connect certain repetitive or similar aspects of behavior. His free talk will include matters, which he will find difficult to verbalize, and those, which he will habitually mention or make reference to. The counselor notes the link and reveals this to the patient in a gradual and considerate manner. He may accept the revelations as correct and helpful or reject, correct or modify them. On the whole, the counselor and the patient work together to change the patient's difficult life patterns. They will soften troubling symptoms and relieve or release pent-up emotions in the unconscious. They can expect a kind of transformation, which can lead to his understanding of himself and others. With this new sense of openness, he will be more productive at work, develop a greater capacity to love and experience more changes within him in satisfying and enduring ways (Fine).

However, not all patients can benefit from psychoanalytic therapy (Frey 1999). Those who will are patients undergoing or experiencing depression, character disorders, neurotic conflicts and chronic relationship problems. It is recommended to those whose conflicts are long-standing or deeply imbedded in the personality. Patients who would opt for the therapy should possess certain qualifications. They should be capable of relating well enough to establish an effective working relationship with the counselor or therapist. This is called a therapeutic alliance. The alliance requires at least average intelligence and some knowledge of psychological theory in the patient. He must be able to take and tolerate frustration, sadness and other difficult and painful emotion. He must be capable of distinguishing between what is real and what is imagined. Psychoanalytic therapy is also costly for most patients who have no insurance coverage. A full therapy runs through 3 to 5 weekly sessions with for 3-5 years. Each session usually costs between $80 and $200, according to the location and the experience of the therapist. Most health management organizations have shown reluctance in paying for long-term therapies like this. It is also uncertain if short-term therapies are more effective for many patients than long-term therapies like psychoanalysis (Frey).

One of Freud's critics was Alfred Adler, who was a former disciple but parted ways with him over a point-of-view (Encyclopedia of Childhood & Adolescence 1998). Freud assumed that infants and children are driven by sexual gratification, but Adler believed that self-affirmation is that driving force. Adler was an Austrian psychiatrist, the founder of the school of individual psychology (UXL Newsmakers 2005). His concept points to the uniqueness of the individual and his relationships in society. From the start, he zealously advocated for social reform, often through his writings published in socialist newspapers. He was invited by Freud to a small discussion group, later to become the prominent Vienna Psychoanalytic Society. During the discussion, Adler disagreed that sex was the main determinant of personality. He did not think that biological factors dominated psychological factors and that biological factors established a compulsive pattern in an individual, who was pleasure-seeking. Freud viewed man as similar to machines and animals, but Adler looked at what precisely makes man different from machines and animals. He held a humanistic view of people. As a result, he resigned from Freud's group and set up his own school. He served at a military hospital during World War I and then organized a child guidance clinic in Vienna in 1919. He could be the first psychiatrist who applied mental hygiene, which he used in his counseling work. He established the first family therapy and community psychiatry on record. Adler was known to be emphatic, deliberate, persuasive and friendly. He was open to people, very sociable and hospitable. The arts asserted much appeal to him. He loved to sing. He worked tirelessly and slept little. In his counseling relationships, he was gentle yet convincing, accepting and encouraging (UXL Newsmakers).

Individual psychology, Adler's theory, deals with simple and observable things in a concrete way (UXL Newsmakers 2005). It is concerned with the healthy as well as the unhealthy aspects of human personality, with individual and group relations, and the physical and the psychological. The components of his theory are as cohesive as his view of the person as an organism or unit. Within that unit, all parts work in cooperation and subordination to the total plan of the whole. The principles of this theory are goal striving, determination, lifestyle, social ties, and social interest. According to the principle of goal striving, a person possesses an intrinsic drive to pursue a goal or purpose. He struggles after it from below to above and does not need prodding, motivating or pushing. He does not need a deeper or more compelling force to drive him to completion. That fundamental impulsion lives within him. His nature directs him towards superiority, overcoming, perfection, success, and importance. The root of one's personality can be found in his goal or goals. In order to understand a person, his goal or goals must be discovered and understood. According to the principle of self-determination, a person may respond to suggested or perceived inferiority from discouragement, compensation or overcompensation. But he is not limited by these. Subjective factors, such as interpretation and opinion are the decisive ones. He described one's degree of self-determination as creative power. It spans one's ability to choose between many ways of reacting or considering and his capability for spontaneity. The principle of lifestyle refers to actions, which characterize him in a unique way and separately from other individuals. The coherence and unity of his individual expressions constitute his lifestyle. As child, he screens his impressions, performances and failures. As he grows up, he learns from the environment, develops perceptions, selects values and arrives at a particular style of life drawn from his authentic and individual thinking, feeling and acting throughout his life. The principle of social ties refers to his social relations. His daily life is inseparable from his communal life. These ties are occupation, associations and love and marriage. His uniqueness are bound to his relations with others and can be interpreted best with reference to the persons who make up his community life. And the principle of social interest refers to an individual's coping with society. Social interest is a transcendence of the self. It is the opposite of self-centeredness. It develops into a trait and the most important one within his lifestyle. Adler identified social interest as the very criterion of mental health, as his experience in psychiatry revealed to him by mentally healthy persons who felt at home on the earth. He viewed neurotics, failures, psychotics and offenders as suffering from intense inferiority, which held them back to themselves. They are unable to cope with life, struggle for personal superiority, according to a private sense. They cushion their existence with a pampered lifestyle wherein they expect to get without giving. Opposite these unfortunate individuals are those who have acquired maturity. They have grown away from a sense of helplessness and into a taking responsibility for others. They have become an asset rather than a burden or liability to the community (UXL Newsmakers).

Adler's view of counseling was for the therapist to discover the error in the patient's lifestyle and, through it, lead him to greater maturity (UXL Newsmakers 2005). For this purpose, he devised diagnostic approaches. Among these were the theory of dreams, the meaning of early childhood recollections, and the role of birth order in the family. The counselor or therapist gains an understanding and experience of the patient, not characterized by depth, but from the context of the larger whole of his collective transactions. In Adler's view, this was how to effect a change in the person's self-view and his view of the world. He would then be reorganized. In addition, the patient could be drawn to appreciate his own power of self-determination and to develop the courage to use it. In order to motivate or incline the person or patient towards or against a goal, the counselor or therapist expresses disinterest or unconcern and thus develops feelings of trust and true fellowship. This openness to each other would make up where one's mother could have failed (UXL Newsmakers).