Counselling Final

Choice Theory and Reality Therapy :

Choice Theory® is based on the simple premise that every individual only has the power to control
themselves and has limited power to control others. Applying Choice Theory allows one to take
responsibility for one’s own life and at the same time, withdraw from attempting to direct other people’s
decisions and lives.
1) The essence of choice theory and reality therapy is that we are all responsible for what we do and that
we can control our present lives According to choice theory (formerly known as control theory), we
choose all of our actions and thoughts, based on the information we receive in our lives. Other people
cannot make us feel or act a certain way

 Glasser indicates that most of the misery that people experience is a result of unsatisfying
personal relationships. He says if a person is experiencing misery, he or she is more likely to be
involved in attempting to control someone or in being controlled by someone.
Example: Smoking quit
Choice Theory is an explanation of how the brain works as a control system and is the theoretical
foundation for Reality Therapy According to CT, no matter what the situation is we must behave. We
cannot control the situation but we almost always can control how we choose to behave. Specifically, we
cannot control genetics, accidents, or other people.
Choice Theory also presents the notion that all behavior comes from within us-driven by our genes to
satisfy basic needs. This concept is opposite to the views associated with stimulus-response psychology.
For example, when the phone rings do we always answer it? Do we always stop at red lights? From
Glasser's (1984) perspective, most of us answer the telephone most of the time because we have a desire
within us to speak with anyone willing to talk with us. However, our desire for privacy is sometimes
greater than our desire to talk, in which case we may choose not to answer the phone. The key element
here is choice--we choose what we will or will not do. The ringing does not cause us to pick up the
telephone nor does the red traffic light cause us to stop.
Nothing humans do is caused by outside forces. As living beings, we always have a choice; we can
choose to respond to life situations in a variety of ways. Basically, we can choose positive, self-
enhancing behaviors, or we can choose negative, self-destroying behaviors.
Only a machine, such as a telephone answering device, will respond to outside stimuli every time, all the
time, and in the same way. It has no choice
History: developed by Dr. William Glasser, evolved from control theory and is the basis for Reality
Therapy. Control theory, on the other hand, was developed by William Powers The rationale for the name
change was that the guiding principle of the theory has always been that people have choices in life and
these choices guide said life. needed to take more responsibility for their behavior and that reality therapy
could help them do this.
Basic Needs:
Choice theory is an internal psychology that postulates that all behavior is a result of choices, and our life
choices are driven by our genetically encoded basic needs. Dr. Glasser presented only two basic needs:
love and acceptance . By 1981, the basic needs had increased to five and are: survival, love and
belonging, power, freedom, and fun.
Choice Theory and Reality Therapy : The choice theory also explains that all behavior is purposeful,
and is an attempt to close the gaps between our needs, wants, and what we are actually getting out of life.
The focus of reality therapy is to address the issue of these unsatisfying relationships which can result in
unfavorable behavior.
A person can be taught how to effectively make choices to better deal with these situations (Bradley,
2014). Reality Therapy teaches clients to focus on the present and the future while learning to let go of
the past.
Emphasis is placed on the client focusing on their own behavior rather than playing the blame game. “The
only person you can control is yourself.” Reality therapy also involves being in the present and not
focusing on the past. We cannot allow the past to dictate our present and future actions. Focus should be
on current behavioral issues since that is what needs to be “fixed”. The successful use of Reality
Therapy is dependent on the counselor knowing Choice Theory
Goals:

 To help clients get connected or reconnected with the people they have chosen to put in their
quality world
 To help clients learn better ways of fulfilling all of their needs, including achievement, power or
inner control, freedom or independence and fun.
 To assist clients in making more effective and responsible choices related to their wants and
needs.
 To make their clients psychologically strong and rational. They must learn to be responsible for
their own behavior that affects themselves and others.

Therapist and client Role: The therapist is the teacher and the client is the student. Reality therapists
teach clients how to engage in self-evaluation Reality therapists assist clients in evaluating their own
behavioral direction, specific actions, wants, perceptions, level of commitment, possibilities for new
directions and action plans.
WDEP:
WDEP: Wants, Direction and Doing, Self-evaluation, Planning
The WDEP system can be used to help clients explore their wants, possible things they can do,
opportunities for self-evaluation, and design plans for improvement.
Directions and doing: It is essential to discuss with clients the overall direction of their lives to help
clients make more need-satisfying choices. Reality therapy focuses on gaining awareness of and changing
current total behavior. To accomplish this, reality therapists focus on questions like these: "What are you
doing now?” "What stopped you from doing what you said you wanted to do?”
Evaluation: The core of reality therapy is to ask clients to make the following self-evaluation:
"Does your present behavior have a reasonable chance of getting you what you want now, and will it take
you in the direction you want to go?” Evaluation involves the client examining behavioral direction,
specific actions, wants, perceptions, new directions, and plans. It is the counselor’s task to assist clients in
evaluating the quality of their actions and to help them make responsible choices and devise effective
plans.
Planning: The process of creating and carrying out plans enables people to begin to gain effective control
over their lives. The plan gives the client a starting point, a toehold on life, but plans can be modified as
needed. Wobbling uses the acronym SAMIC to capture the essence of a good plan:
Simple, Attainable, Measurable, Immediate, Controlled
Techniques and Procedures: Reality therapy techniques and procedures aim to help individuals develop
new behaviors and attitudes that will enable them to better meet their needs and achieve their goals. Here
are some examples of reality therapy techniques and procedures.
1) The Basic Needs: Reality therapy emphasizes that all individuals have following as under:-Love
and belonging, power and achievement, freedom and autonomy, fun and enjoyment, and survival.
The therapist helps the client to identify which of these needs are most important to them and
develop strategies to meet those needs in a positive and healthy way
2) Focus on the Present Reality therapy emphasizes the importance of focusing on the present
rather than the past or future. The therapist helps the client to identify and address the immediate
issues that are causing distress in their lives
3) Action Plans: Reality therapy encourages clients to take responsibility for their lives and develop
action plans to achieve their goals. The therapist works with the client to develop specific and
achievable steps that they can take to make positive changes.
4) Positive Reinforcement: Reality therapy emphasizes the importance of positive reinforcement in
creating lasting change. The therapist helps the client to identify and reinforce positive behaviors
and attitudes, which can increase motivation and lead to further positive change. The therapist
uses positive reinforcement to encourage the client to make positive changes, such as
acknowledging progress and celebrating achievements. Challenging negative thinking The
therapist challenges negative thoughts and beliefs that may be holding the client back, and
 encourages them to develop more positive, realistic ways of thinking. Encouraging the client to
take action The therapist encourages the client to take action towards their goals, and supports
them in making positive changes in their lives.
5) Developing A trusting Relationship The therapist builds a strong therapeutic alliance with the
client, establishing trust and a safe space for them to share their thoughts and feelings.
6) Identifying the Clients needs: The therapist works with the client to identify their basic needs
and what they want in life, such as love and belonging, power and achievement, and freedom and
independence.
7) Evaluating the client’s current behavior: The therapist helps the client evaluate their current
behavior and how it is affecting their ability to meet their needs and achieve their goals.
8) Establishing goals and a plan of action: The therapist works with the client to set specific,
achievable goals and develop a plan of action to reach those goals.
9) Encouraging self-evaluation: The therapist encourages the client to evaluate their own behavior
and progress, and to take responsibility for their actions.
Overall, reality therapy techniques and procedures aim to empower individuals to take control of their
own lives and make positive changes. The therapist acts as a supportive and collaborative partner,
helping the client to develop the skills and strategies they need to achieve their goals and improve their
wellbeing.
Implications:

 Focus on the present: Reality therapy emphasizes the present and future, rather than dwelling on
the past. The therapist works with the client to identify what they can do now to improve their
situation.
 Personal responsibility: The therapist helps the client recognize that they have control over their
thoughts, feelings, and behavior. The client is encouraged to take responsibility for their actions
and make choices that are in their best interest.
 Needs assessment: The therapist works with the client to identify their unmet needs, such as the
need for love and belonging, power and control, freedom, and fun. The client is encouraged to
develop more effective strategies for meeting these needs.
 Goal-setting: The therapist helps the client set achievable goals and develop an action plan to
reach those goals. The emphasis is on taking concrete steps to change behavior, rather than
simply talking about problems or feelings.
 Feedback: The therapist provides feedback to the client in a supportive and non-judgmental way.
The client is encouraged to be open to feedback and use it to make positive changes.
 Role-playing: The therapist may use role-playing exercises to help the client practice new
behaviors and build self-confidence.
 Homework assignments: The therapist may assign homework to help the client practice new
skills and reinforce positive changes outside of therapy sessions.
Importance: Behavior. It’s categorized into organized behaviors and reorganized behaviors, to satisfy
your needs. Control, a person is only controlled by themselves. Responsibility, control is closely linked to
responsibility. Action, your actions are part of your overall behavior. Present movement, claims that
current behavior is determined by the present unmet needs.
Limits: Opposition of mental illness. Dr. Glasser claimed that mental illness doesn’t exist, which has
received pushback from the psychiatric community. Potential to impose views. A reality therapist helps
people develop new actions. Some say this allows the therapist to impose their values and judgments.
Anti-medication stance. Dr. stated that medication is never required to treat mental health conditions.
Critics say he could have mentioned the benefits of conventional therapy over drugs, instead of
dismissing them entirely. Disregard of the unconscious. Some people say that reality therapy fails to
recognize the power of our unconscious. Limitation to the present. Reality therapy doesn’t aim to
understand past conflicts, unlike traditional forms of therapy.
Benefits:
The strengths and benefits of reality therapy lie in its focus on solution-building, particularly on changing
thoughts and actions. It provides individuals with a self-help tool to gain more effective control over their
lives and their relationships. In return this gained control helps to boost their confidence and self-esteem
as well as enabling them to better cope with adversity and grow personally.
This approach can be used to treat addictions, eating disorders, substance abuse, phobias, anxiety, and
other behavioral and emotional issues. It can also prove useful in treating highly sensitive problems such
as racial issues, sexual identity issues, and cultural clashes. These can all cause division and tension, but a
reality therapy program can help bridge the gap between intolerance and ignorance by helping individuals
not only promote equality but also recognize how their behavior is negative.
In particular, reality therapy has been proven to be an effective treatment method for mental health
disorders. Research has shown that group reality therapy is effective in improving social anxiety,
interpretation bias, and interpersonal relationship in adolescents. 1 Because we offer dual diagnosis
treatment in Boca, our reality therapy program is designed to help people with both mental health and
substance abuse problems if necessary. Another study found that group reality therapy for people addicted
to drugs was effective in improving both their mental health and self-esteem compared to a control group
Lazarus Multimodal Approach
Multimodal therapy (MMT) is a type of holistic approach to psychotherapy, usually involving several
therapeutic techniques or approaches at once. 1
In other words, the focus tends to be on treating the whole person rather than focusing too narrowly on
specific symptoms. It is also called "eclectic therapy" or "integrative psychotherapy.
It appears that most theoreticians and clinicians are now in favor of using a broad-spectrum approach to
treating patients. For example, there is a current trend toward the use of holistic treatments that not only
consider intraindividual, interpersonal and systemic factors, but also argue for the inclusion of a separate
transpersonal (i.e., spiritual) dimension. Multimodal therapy (MMT) strives to combine a broad and
interactive set of systematic strategies, and offers particular assessment tactics that enhance diagnosis,
promote a focused range of effective interventions, and improve treatment outcomes.
Multimodal Therapy is a technically eclectic approach to psychotherapy. While drawing heavily on
communications theory, cognitive theory, and social learning theory, multimodal therapists are willing to
apply effective methods and techniques from any discipline.
Assumptions:
1. Psychological disorders represent some combination of biological determinants and learning
factors MMT is based on the assumption that most psychological problems are multifaceted,
 multidetermined and multilayered, and that comprehensive therapy calls for a careful assessment
of seven dimensions or “modalities” in which individuals operate – Behavior, Affect, Sensation,
Imagery, Cognition, Interpersonal relationships and Biological processes.
2. Abnormal behavior that is a product of learning factors is acquired and maintained according to
the same principles as normal behavior.
3. Dysfunctions attributable to faulty or inadequate learning, and even many disturbances with
strong biological inputs, may be alleviated by the application of techniques derived from learning
principles.
4. . Presenting problems are viewed as real problems, and are investigated on their own merits,
rather than being regarded as symptoms of some underlying problem or process
5. The focus is on the present rather than on remote antecedents or unconscious processes.
Immediate antecedents and current factors maintaining behavior are emphasized.
6. Assessment involves investigation of all areas of behavioral, cognitive, and interpersonal
functioning to discover dysfunctions or deficits that are not immediately presented.
7. Simple behavioral descriptions are preferred to diagnostic labels
8. Though recognizing that therapy, to some extent, involves transmission of values, behavior
therapists minimize value statements. Rather than behavior being labeled as good or bad, its
consequences are specified.
9. The therapist is active and interactive, often assuming the role of teacher and serving as a mode
10. The locus of resistance is primarily in the therapy and the therapist rather than in the patient
11. Emphasis is on selfmanagement. Patients are taught specific selfmanagement techniques so that
the likelihood of autonomous functioning in problem areas is maximized and dependency on the
therapist is reduced. Assigned homework is an essential part of the behavioral approach.
12. Involvement of the identified patient's social network is desirable and often necessary. It permits
the therapist to structure an optimal reinforcement environment and to resolve interpersonal
conflicts through such approaches as communication training and contracting. (For details of
specific behavioral techniques
The multimodal orientation begins with the assumption that therapy must assess seven discrete but
interactive modalities (abbreviated by the acronym BASIC ID, which stands for Behavior, Affect,
Sensation, Imagery, Cognition, Interpersonal factors, and Drug/Biological considerations).
BASIC ID:

 Behavior, which can be manifested through the use of inappropriate acts, habits, gestures, or the
lack of appropriate behaviors.
 Affect, which can be seen as the level of negative feelings or emotions one experiences.
 Sensation, or the negative bodily sensations or physiological symptoms such as pain, tension,
sweat, nausea, quick heartbeat,
 Imagery, which is the existence of negative cognitive images or mental pictures
 Cognition or the degree of negative thoughts, attitudes, or beliefs.
 Interpersonal relationships, and refers to one's ability to form successful relationships with others.
It is based on social skills and support systems
 Drugs and biological functions, and examines the individual's physical health, drug use, and other
lifestyle choices.
TECHNIQUES
  Cognitive-Behavioral technique: Learning relaxation and stress-management skills, and
developing coping strategies
 Behavioral Techniques Engagement in pleasurable activities, or exposure therapy
 Humanistic Techniques Mindfulness practices, selfreflection, and building selfesteem.
 . Psychodynamic Techniques Exploring early childhood experiences, relationships with parents
and caregivers, and unresolved conflicts
 Interpersonal Techniques Improving assertiveness, conflict resolution, and social skills
 Pharmacotherapy: Medication may be used to treat psychological problems, particularly when
they are caused by biological factors
ADVANTAGES
. Addressing the multiple factors that contribute to a person's psychological and behavioral problem
. Developing a comprehensive treatment plan
3. Enhancing self-awareness and self-efficacy
4. Improving interpersonal relationships
Facilitating long-term change
DISADVANTAGES
Time Consuming, complex, potentially overwhelming, not suitable for everyone
APPLICATION
Multimodal Therapy has been applied to individuals, couples, families, and groups
Target problems include depression, anxiety, psychosomatic difficulties, obesity, sexual inadequacy, and
mental retardation. Other practitioners who use the multimodal approach are encouraged by the results.
n essence, Multimodal Therapy provides a useful framework for detailed assessment, one that is open to
validation, and one that permits a problem-centered treatment plan to emerge within the context of
patients’ needs rather than within the constraints of therapists’ theoretical predilections
When to do?:
Create a list of problems and the suitable treatments that may suit the client. Since the treatment is based
upon individual cases, each remedial strategy is considered as an effective method for the patients
The therapist shall diagnose both the actual profile as well as the structural profile of the patient. Such a
diagnosis will define the target which both the therapist and the patient would want to achieve once the
treatment is complete
Besides psychotherapy, the therapist will try to include dietary measures and stress management
programs to treat patient's associated psychiatric symptoms
MMT is a flexible mode of psychotherapy because each treatment plan is devised keeping all the
possibilities in mind
FUSION OF CBT AND BT
Arnold Lazarus added the idea that, since personality is multidimensional, treatment must also consider
multiple dimensions of personality to be effective. His idea of MMT involves examining symptoms on
each dimension of personality in order to find the right combination of therapeutic techniques to address
them all.
DidAdvantages of Multimodel:

 There is a risk that therapists will not use techniques from all modalities or that they will miss an
approach that could contribute substantially to the patient's treatment.
 Therapists must have a broad range of knowledge and experience with many different
psychological approaches to be able to utilize them effectively together.
 Research is still limited on the benefits of MMT, so it may be difficult for therapists to know
what techniques will work best together or for which patients.
 Patients who are not open to using multiple approaches at once may not benefit as much from
MMT.

Object Relations Theory

It is a variation of psychoanalytic theory that diverges from Sigmund Freud’s belief that humans
are motivated by sexual and aggressive drives, suggesting instead that humans are primarily
motivated by the need for contact with others—the need to form relationships.
Object relations theorists didn’t assume that the object is merely there to satisfy a drive but that
there is a relation that involves emotions, action and reaction, a longing for safety, connection,
love, aggression, autonomy, separation. In this way, the object relations theory turned Freud’s
one-person psychology into a two-person psychology. And it’s this early relationship that has
lasting effects for the development of one’s personality.
When object relations theorists talk about the object, they usually refer to the mother or early
caregiver. The way that those early objects still have an impact on us later in life is because we
internalize them. You could say they live on inside of us. We use those internal objects as
blueprints. They hold the ideas we have about who we are and how to treat ourselves (the
socalled self-representations). And ideas we have about others and what to expect from them (the
so-called object-representations). The fascinating thing is that you don’t really internalize your
mother or father or any other object as they were. What you internalize is your own subjective
experience of it that is a mixture of reality and fantasy. That is one of the reasons that if you
listen to siblings, it can seem like they had different parents.
Difference Between Freud and Klein concept: Freud and Melanie Klein both believed that
relationships with others play a role in behavior and personality development. However, Klein's
object relations theory differs from Freud's in several ways. • Freud emphasized biologically
based drives, such as the sexual drive, as the prime motivation for behavior and personality
development. In contrast, Klein's theory places more importance on interpersonal relationships
and the mother-infant relationship in particular. • In her theory, objects can be external or
internal and internal objects are linked to the theory of unconscious phantasy and the
development from the paranoid-schizoid position to the depressive position. • Klein's theory of
the unconscious is based on the phantasy life of the infant from birth, and she stressed the first
four to six months after birth as a crucial period . Overall, while both Freud and Klein recognized
the importance of relationships, Klein's emphasis on the mother-infant relationship and the role
of phantasy in shaping personality development distinguishes her object relations theory from
Freud's.
Objects: The term "objects" refers not to inanimate entities but to significant others with whom
an individual relates, usually one's mother, father, or primary caregiver. It may also be used to
refer to a part of a person, such as a mother's breast, or to the mental representations of
significant others
Object relations theorists stress the importance of early family interactions, primarily the mother-
infant relationship, in personality development. Infants form mental representations of
themselves in relation to others and that these internal images significantly influence
interpersonal relationships later in life. Since relationships are at the center of object relations
theory, the person-therapist alliance is important to the success of therap
“object relations: The term “object relations” refers to the dynamic internalized relationships
between the self and significant others (objects).
An object relation involves mental representations of:
• The object as perceived by the self •
The self in relation to the object •
The relationship between self and object
Example An infant might think: • "My mother is good because she feeds me when I am hungry"
(representation of the object). • "The fact that she takes care of me must mean that I am good"
(representation of the self in relation to the object). • "I love my mother" (representation of the
relationship)
Internal Objects:
Internal objects are formed during infancy through repeated experiences with one's caregiver.
Images do not necessarily reflect reality but are subjectively constructed by an infant’s limited
cognitive abilities. In healthy development, these mental representations evolve over time; in
unhealthy development, they remain at an immature level. Internal images have enduring
qualities and serve as templates for future relationships.
 Notion of splitting, which can be described as the mental separation of objects into
"good" and "bad" parts and the subsequent repression of the "bad," or anxiety provoking,
aspects. •
 Infants first experience splitting in their relationship with the primary caregiver: The
caregiver is “good” when all the infant’s needs are satisfied and “bad” when they are not.
Initially, these two aspects of the object (the caregiver) are separated in the mind of the
 infant, and a similar process occurs as the infant comes to perceive good and bad parts of
the self. • If the mother is able to satisfactorily meet the needs of the infant or in the
language of object relations if the mother is "good enough," then the child begins to
merge both aspects of the mother, and by extension the self, into an integrated whole. • If
the caregiver does not satisfactorily meet the infant’s needs, the infant may repress the
"bad" aspects of the mother and of the self, which can cause difficulty in future
relationships
Theory of Object Relation And stages of Development
Margaret Mahler 1975 formulated a theory that describe separation–individuation process of the
infant from the maternal figure (primary caregiver). Her study on separation-individuation has
considered her most valued contribution stressing the importance of consistent attentiveness
especially from the mother during a child's first three years of life as vital to the ultimate goal of
raising children who grow to be successful, adaptable adults.
Based on the separation–individuation process of the infant from the maternal figure (primary
caregiver) there are 3 phases of development:
Phase I: The Autistic Phase (Birth to 1 month) In the autistic phase, also known as normal
autism. The infant exists in a half-waking and half-sleeping state and does not perceive the
existence of other people or an external environment. The fulfillment of basic needs for survival
and comfort is the focus and is merely accepted as it occurs.
Phase II: The Symbiotic Phase (2 to 5 months) At this phase, the child is now aware of his/her
mother but there is not a sense of individuality. The infant and the mother are one, and there is a
barrier between them and the rest of the world.
Phase III: Separation–Individuation (5 months to 36 months) The arrival of this phase marks
the end of the Normal symbiotic phase. Separation refers to the development of limits, the
differentiation between the infant and the mother, whereas individuation refers to the
development of the infant's ego, sense of identity, and cognitive abilities. Mahler explains how a
child with the age of a few months breaks out of an "autistic shell" into the world with human
connections. This process, labeled separation–individuation, is divided into subphases, each with
its own onset, outcomes, and risks. The following subphases proceed in this order but overlap
considerably
1. Differentiation (5 to 10 months) • Also known as hatching, as the baby matures, he develops
an increased interest in both the mother and the outside world. • The infant becomes increasingly
interested in discovering his mother (e.g., how she looks or smells) rather than trying to become
symbiotically unified with her. • Not yet able to understand that she exists outside of his view,
parents often first notice their baby's first outward signs of separation anxiety during this time as
the baby continually "checks back," looking at other things but then looking for the mother as a
reassurance that she is still present.
2. Practicing (10 to 16 months) • Practicing occurs as the child becomes a toddler, gaining
motor skills that enable the child to explore the world independently from his or her caregivers. •
As children's mobility increases, they are able to explore their environment with an autonomy
that was previously impossible. Still not ready for extended separation from their mothers,
crawlers and beginning walkers will sometimes choose to separate briefly from their mums but
will typically return quickly for assurance and comfort.
3. 3. Rapprochement (16 to 24 months) • Rapprochement marks a “backing off” from
separation, as the child becomes anxious about separating from his or her mother and tries to
regain closeness. This can lead to separation anxiety and abandonment fears
4. Object Constancy/ Consolidation (24 to 36 months) • With the achievement of consolidation,
a definite individuality, and a sense of separateness of self are established. • Objects are
presented as a whole, unification of the good and bad in mother with the image of her as a
separate entity in the external world and the beginnings of the child’s own individuality and
separate personhood as seen in the development of a self-concept based on a stable sense of
“me”. • Children begin to be more comfortable separating from their mothers, knowing that they
will return (object constancy). This ability makes it possible to accept that they are unique from
their mothers without anxiety, allowing the child to engage substitutes for the mother when she is
absent.
How it is different from Freud? 1. Sigmund Freud's focuses on the development of psychic
structures, as outlined in structural theory, the id, ego, and superego. Mahler's focuses on
developing ego centered on its development within the context of object relationships. 2. Object
relations theory emphases less on the gratification of instincts or biological needs as the basis for
mental life and emphasis more on how interpersonal relationships become internalized within the
ego or self. 3. Object relations theorists generally see human contact and relatedness, not sexual
pleasure as the prime motive of human behaviour
Techniques:
Many of the techniques used in object relations therapy are similar to those employed in
psychoanalytic and other psychodynamic therapies. The primary distinction lies in the therapist's
way of thinking about what is happening in the therapeutic exchange. For example, in classical
psychoanalysis, transference tends to be carefully analyzed, as it is thought to provide valuable
information about the person in therapy. The object relations therapist, however, does not
typically view transference reactions as evidence of the person in therapy’s unconscious
conflicts. Rather, they are often seen as indications of the infantile object relations and defenses
that may be considered to be the “root” of the individual's problems. Object relations therapists
explore clients’ early childhood relationships (believing that this shape how they relate to others
and situations in their adult lives).
Common aspects of therapy include: • Assessment, which is seen as vital for sound
interpretations. • Therapeutic alliance, the importance of which is emphasized more by object
relation therapists than by traditional psychoanalysts. • Countertransference, which describes ‘the
transference feelings and responses of the counselor towards the client’. • Projective
identification, which is ‘the Kleinian concept that one may unconsciously project into others’
aspects of one’s own psyche’. • Resistance, which is seen as ‘reflecting a rigid transference,
growing out of the client’s strong need for a particular type of object relationship’ (Seligman,
2006) • Interpretation (by the therapist), including of transference, countertransference, and
projective identification. In the initial stage of object relations therapy, the therapist generally
attempts to understand, through empathic listening and acceptance, the inner world, family
background, fears, hopes, and needs of the person in therapy. Once a level of mutual trust has
been developed, the therapist may guide the person in therapy into areas that may be more
sensitive or guarded, with the purpose of promoting greater self-awareness and understanding.
During therapy, the behaviors of the person in therapy may help the therapist understand how the
person is experienced and understood by others in that person’s environment. Because the
therapist is likely to react in such a way as to encourage insight and help a person achieve greater
awareness, an individual may strengthen, through the therapeutic process, the ability to form
healthy object relations, which can be transferred to relationships outside of the counseling
environment.
Goals: • Object relations therapy focuses on helping individuals identify and address deficits in
their interpersonal functioning and explore ways that relationships can be improved. • A therapist
can help people in therapy understand how childhood object relations impact current emotions,
motivations, and relationships and contribute to any problems being faced. • Aspects of the self
that were split and repressed can be brought into awareness during therapy, and individuals can
address these aspects of themselves in order to experience a more authentic existence. • Therapy
can often help a person to experience less internal conflict and become able to relate to others
more fully. • Used so that the client holds a neutral position in how they view others. • The goal
is to see people and the world around them in a neutral manner instead of attaching their world to
this behavioral object. • Focus of treatment is to show the client that they can improve
relationships and interactions with others by removing the "object" that they naturally attach to
events and people. • This object shapes how they act in relationships. When it is held in a
negative manner it could be detrimental to their happiness and health. By eliminating the
standards and allowing the client to see people and relationships in an unbiased way it will rid of
their conditioned perception.
Who Practices Objects Relations? • Object Relations Therapy is practiced by mental health
professionals such as clinical psychologists, psychotherapists, and psychiatrists who have
received specialized training in this approach. However, Object Relations Theory can also be
applied by other mental health professionals, such as social workers or counsellors, who have a
background in psychotherapy and are familiar with the basic principles of this approach. • Object
Relations Therapy can be used to treat a wide range of mental health issues, including anxiety,
depression, personality disorders, and relationship issues. It is often used in long-term therapy
and can be particularly helpful for individuals who have experienced early childhood trauma or
have difficulties forming and maintaining close relationships.
Applications: Object Relations Therapy has various applications in clinical practice that are as
follows: 1. Treatment of Attachment Issues: Object Relations Therapy is often used to address
attachment difficulties in both children and adults. It focuses on exploring early attachment
experiences and working towards developing healthier attachment patterns. 2. Addressing
Relationship Problems: Object Relations Therapy can be effective in working with individuals
who struggle with problematic relationship patterns. It helps clients gain insight into their
internal representations of significant others and how these representations impact their current
relationships. 3. Healing Childhood Trauma: Object Relations Therapy can assist individuals in
processing and healing from childhood trauma. It helps clients explore the impact of early
traumatic experiences on their current functioning and relationships. 4. Treating Personality
Disorders: Object Relations Therapy has shown effectiveness in treating personality disorders,
particularly those related to difficulties in forming and maintaining relationships. It helps
individuals develop a more integrated sense of self and healthier ways of relating to others. 5.
Exploring Self-Identity and Self-Esteem: Object Relations Therapy can be valuable in helping
individuals develop a stronger sense of self-identity and improve self-esteem. It assists clients in
exploring their internalized representations of themselves and others, thereby facilitating self-
discovery and personal growth.
Limitations: Object Relations Therapy, like any other therapeutic approach, have some
limitations. Here are some of the potential limitations of Object Relations Therapy: 1.
Complexity and length of treatment: A form of psychodynamic therapy, object relations therapy
typically requires a longer time commitment than some other forms of therapy. It may often last
years, instead of months. The approach is largely non-directive, so it can take time and may be
distressing for those looking for instant results. 2. Focus on early childhood experiences: Object
Relations Therapy places a strong emphasis on early childhood experiences and their impact on
later development. While these experiences are certainly important, they may not be the only or
most significant factors contributing to an individual's current psychological difficulties. 3.
Potential for therapist bias: The concept of countertransference, where the therapist's own object
relations can influence their perception of the individual, can potentially lead to biased treatment.
4. Non-Directive Approach: Some individuals prefer a more solution-focused approach and may
find it difficult to work with the somewhat non-directive style of object relations therapy. Quick
results may also be desired in some cases, such as when a person experiences addiction or
another condition that may lead one to harm oneself or others. The non-directive approach of
object relations therapy is not considered sufficient to deal with such an issue. Once critical
symptoms are dealt with, however, an individual may choose to engage in object relations
therapy to determine how past relationships with significant others might contribute to present
concerns.