Alfred Adler Individual Psychology case study

Madhura

21020

Abstract

The subsequent report adapts an Individual Psychodynamic approach to discuss the case of
Louise, a 20 years old university student who has self-referred to the counselling service due
to anxiety and stress over her academic work. Louise’s personality was looked at in depth in
relation to her family and scrutinized her family’s behavior. According to the Adlerian theory
people strive for superiority which was clearly seen in Louise’s family. The interactions she
had with her family members and with her bullies in her early life, made Louise feel inferior.
Parental style and birth order was also examined, to see how these played a part in Louise’s
feeling of inferiority. The types of inferiority which Louise showed signs of was discusses as
well as her life style. The report highlights the importance of encouragement in the therapy,
whilst focusing on the therapeutic relationship.

Case history

Louise is the younger of 2 daughters in a family with mother and father. Having gone through
a chaotic childhood which was had lasting impacts on her in her later life, she was struggling
physically, academically and emotionally at University. She comes from a family who have
high expectations and has lot of pressure on her to do well, particularly from her father. This
was partly due to her high attaining sister, creating competition between the 2, which in turn
caused the 2 to distance. They rarely spent time together and increasingly argued with each
other.

The parents explicitly encouraged the girls to try out new experiences and take part in
extracurricular activities such as tennis practice and swimming, creating competition in the
activities she took part in, alongside the competition she had with her sister. She was also
bullied at bullied at school which caused her to have anxiety, which led to hair loss. This was
a cynical issue as the hair loss led to more anxiety. Louise’s relationship with her mother was
fine but her controlling father spoke to his wife and daughters in a belittling manner, treating
his family the same as his work colleagues. He worked at an interior design company as a
senior manager. Perhaps his job had an impact on the way he viewed his life in general- an
interior designer trying to design a perfect child. Louise’s father said he did not want her to
rely on the family as she is less than perfect, making Louise unwanted. The constant criticism
from her father made a negative impact on her. She found academic work increasingly
challenging. She missed lessons at school due to the recurring episodes of anxiety and as a
result her A- levels, which knocked back her confidence. Her parents then paid to resit her A-
levels so that she could go to University, which she did not appear to enjoy. Since being there
she was constantly worried about achieving the grades she needs for a good job which again
resulted in anxiety and hair loss.

Applied Therapeutic Orientation

The Adlerian approach states that people strive for superiority, which was clearly seen in
Louise’s family, due to her father’s behavior. He has high expectations of his elder daughter
Sophia and would frequently compare her achievements against Louise. He asked Louise
“Why can’t you be more like your sister. You need to work harder!” The constant
comparison between Louise and Sophia caused the 2 to distance and created a lot of jealousy
and arguments. Not only did Louise struggle with relationships in her family, but she was
also bullied at school, causing a great deal of anxiety for Louise and leaving her with no safe
haven to escape to. As a result of these in her early life, led Louise to feel inferior. There are
different kinds of inferiority in the Adlerian approach; Louise appears to display biological
and personal inferiority.

According to Adler’s analysis, ‘the inferiority reaction appears in individuals who start life
with some organ inferiority’ which can be seen in Louise by her hair falling out in large
clumps.

The main type of inferiority which Louise appears to display is personal inferiority. This is
where the individual feels undervalued, powerless and not part of the community. It also
inhibits social interest. Louise shows two responses to personal inferiority; positive and
negative. She showed a positive response by striving to be valued; working hard in school,
joining local swimming team and attending tennis lessons and piano class. She showed a
negative response to personal inferiority by avoiding effort and connection with others. She
did not seem good at socializing. This suggests that the life style which Louise most
prominently displays is the avoiding type, displaying psychotic symptoms by avoiding life
and social connection. Louise also shows evidence of the learning style life, which is when
people are too dependent on others. It could be seen that Louise depended on her parents for
her education, as when she found it increasingly difficult to be seen in the public, her parents
paid for home schooling, and when she failed her A- levels, her parents paid for her to resit
them. Louise’s father worried that she would always be reliant on the family. This life style
could contribute to Louise’s anxiety.

Adler also suggested that birth order in the family has an effect on personality. They youngest
child in the family would have high dependency needs and feels the need to excel and
achieve, which could also be explained by the early parenting styles and over encouragement
to do everything. Louise saw her elder sister as competition and her development depended
on the way Sophia treated. Sophia did not treat Louise nicely.

Sulloway (1996) stated that first born children hold positions of dominance and parental
favor in comparison to later born children and as a consequence, develop personality
characteristics that correspond the parental interests. Contradicting Sulloway’s findings
Michalski and Shakelford (2002) find no relationships between firstborn status and
conscientiousness or emotional stability. More recent research also contradicts lay beliefs and
prominent scientific theories about birth order effects on personality, and only finds relation
between birth order and intelligence, which has convincingly documented that performance
on performance on psychometric intelligence tests decline slightly from firstborns to later-
born (Rohrer et al, 2015). This could explain why Louise struggled academically in
comparison to her Sophia. The early parenting styles had led to the development of inferiority
in Louise due to the fact that the parents were overly involved in the children’s lives and the
father was permissive of Louise. Louise’s father has clearly had an impact on how she felt the
over encouragement to do everything has negatively impacted her. Being dictated by parental
expectations, Louise could not live the style of life she actually wanted.

Recommendations and potential goals for the therapy

The Adlerian approach emphasized the importance of encouragement with client. The
therapist’s role is to help the client explore feelings of inferiority and consider how they
might change this. Louise was self- referred to the counselling service. She needed
encouragement form the counsellor that she is doing okay, with an aim to reduce the feelings
of inferiority, which she felt because she was constantly reminded about her sister’s academic
achievements and her spoke to her in belittling manner. The therapist also needed to promote
the feeling of belonging in Louse, which she lacked as she criticized for being ‘less than
perfect’.

The approach involves making a good life choices and looking at the positives. The first step
is engagement, where the therapist encourages the development of warm, trusting therapeutic
relationship, which can be defined as “the collaborative between the therapist and patient”. A
client- therapist relationship is arguably more important than anything else in a successful
treatment, and this was particularly important in Louise’s case as she hadn’t got a strong
relationship with her family members.

The used of Socratic questioning was employed by the therapist to encourage Louise to self-
reflect and develop new perspectives (Braun et al, 2015). Socratic questioning is disciplined
questioning that can be used to explore complex ideas and to open up issues and problems
(Paul and Elder 2007. There are contradictive findings on the effectiveness of Socratic
questioning. Talking about negative life events can be distressing; therefore, asking Louise
questions like “and why did that make you feel unwanted?” could have either a positive or
negative effect. Experts have suggested that the use of this approach helps patients to be more
active throughout therapy, take new perspectives and experience improvements.

The therapist also explored Louise’s relationships to make an assessment on her life style.
The therapist seeked to address the issues within the family by exploring family
constellations, a therapeutic approach by Bert Hellinger. This approach is useful as its
designed to help reveal in hidden dynamics in a family in order to address any issues
impacting these relationships and heal them. ‘Family Constellations’ means the client’s
physical- emotional positioning and re- positioning of substitute family members in relation
to each other with the help of a therapeutic group. It’s a one session approach that addresses
family of origin issues. The relationship Louise had with her family was having an impact on
her sense of belonging and outlook on life, so the aim was to restore a sense of belonging and
hope in Louise. The therapist was careful about what she asked Louise to do in family
constellation. For example, if she asked Louise to do something like bowing (the
representative in the constellation of) to her father. As the father already spoke to Louise in a
belittling manner, which had a negative effect and led to therapeutic abuse.
The therapist encouraged Louise to think in different ways to have a more positive outlook on
her life. The aim should be to get Louise to understand her motivations and then Louise can
these use these insights to form a healthier interpretation of the relationship she has with her
family members. For example, she could try to view the pressure from her parents or succeed
in a caring manner rather than belittle one. Should was encouraged to see that she has
choices- if she doesn’t achieve the grades she desires, she will still have the potential to
secure a good job. There are also other options if she is struggling academically and not
enjoying University, to live the style of life she wants. For example, she could find an
apprenticeship in the sector which interest her. Seeing that she has other options helped her
with stress and anxiety. The therapist seeked reorientation by working with Louise to change
her style of life based on her learning and encourage to change her behavior and think
positively.

Conclusion

The case report adopted an Adlerian approach to contextualize the pertinent issues within
Louise’s case. Consequently, the suitability of an Individual Psychodynamic(Adlerian)
approach was evaluated, together with justifying the potential methods of therapy, such as
encouragement and family constellation for Louise’s case. To summarize, the upbringing and
parenting styles in Louise’s childhood had affected in her later life which led her the feeling
of inferiority which further led a bad relationship with her sister. She suffered with anxiety
which she developed in school. The therapist aimed to address these issues and gave Louise a
positive outlook on life and see that she has other choices.