Adlerian Psychotherapy

Notes on Theory and Practice

Notes developed from workshop “Introduction to Adlerian Psychotherapy” facilitated by Zivit
Abramson Ph.D at ICASSI 2017 and a talk by Anabella Shaked at ASIIP Spring Conference 2018

Five Basic Concepts

Social Embeddedness – everything is social – what goes on is always between self and others.
We are socially embedded beings motivated to find our place in our families, at school, work and in
society. People are just trying to belong.
"In addition to regarding an individual's life as a unity, we must take it together with its context of
social relations... the need to be accepted and to co-operate in communal life, work and love"
(Adler, 1931/1992).

Self determination and creativity – two kinds of free choice – we are creative and self-
determining decision makers and responsible for our own thoughts, feelings, and behaviours. We
have freedom to act, determine our fate, determine our personality and affect our style of life.
Creative power of the self means we consciously shape our personalities and destinies.
Even if we are powerless to change a situation, we can change our response to it.

Perception is subjective – no experience has the same meaning for everyone – reality is as we
perceive and interpret it – our experiences are not objective truth.
The way we interpret any given situation is influenced by our goal in that situation.
Whenever conflict arises between people/groups there will be assumptions about what the other
perceives/means/wants/needs.
Clarify what the client means by the things they say – ask questions to elicit meaning.

Holism – each individual is viewed as more than the sum of their physical, mental and emotional
parts. Mind and body are interdependent, as are individuals, humanity, the world, the universe.
Like taking a drop of blood, any knowledge we have about someone houses the striving of the
whole person in the direction of their goal of perceived superiority (where they feel they are
significant and belong). These details/parts of the puzzle cannot be understood in isolation but
inform our understanding of the whole person. Look for patterns into which the details will fit.

Goal directedness – a person doesn't move because of historical reasons, they strive towards a goal
of belonging/significance/self-worth. As self-determining beings we develop our own goals and
ways of getting to them.
When someone brings a symptom look for the goal behind it.
Social Interest (aka Gemeinschaftsgefuhl or Community Feeling)
Social Interest can be thought of as an innate need we have to connect and cooperate with others,
and directed towards the common good. When our social interest is developed – when we are
encouraged to connect and cooperate with others as an equal – we operate with an awareness of the
welfare of others, recognising and accepting the interconnectedness of all people, and experience
this on affective, cognitive, and behavioural levels.

Low High
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What's in it for me? What are the needs of the situation?
What do others think of me?

Inferiority Feelings
We are all born with inferiority feelings and strive to overcome these feelings, to feel superior.
Whether or not this striving is towards something more socially useful (other directed) or socially
useless (self over others) depends on an individual's level of social interest.

Biological – an awareness of our biological inferiority, that we are not able to do something (yet),
that we are not perfect and that is ok; and a striving to learn and overcome our
limitations/difficulties

Cosmic – an awareness that we are a (small) part of humankind and the cosmos, and striving to
overcome through an appreciation of the the wonder and humility that this brings, being active
participant observers of the universe

Social inferiority feelings – developing a vertical view of society and a perception of being less
than others

Perfectionism – feeling inferior because of a perception of being less than superior/perfect –

leading to a compensatory goal of superiority, that in order to belong, to be of value, I must be
above others.
We are afraid to be exposed as imperfect in what it is we feel we need to be perfect in.
The Neurotic Arrangement
In Adler's concept, a neurotic person retreats from performing life tasks to avoid loss of self-esteem
due to what the individual interprets as failure. This threat is based on a dialectic combination of
inferiority feelings and striving for superiority. Retreating from performing life tasks can happen
only with a poorly developed social interest, which, in turn, is usually connected with having been a
pampered child. To maintain the illusion of the potential for high achievement, avoid inferiority
feelings, and protect themselves from the guilt of not acting according to social interest, neurotics
create excuses and/or symptoms.

Adlerian Psychology is a psychology of use rather than a psychology of possession – instead of

focusing on what someone has (eg. symptoms), focus on how they are using what they have to try
to achieve a position of perceived superiority in the world – to safeguard their self-esteem.

If we feel inadequate or inferior to others, then we doubt our place in the group. Instead of moving
towards participation and co-operation, we defend ourselves against those demands.
We go backwards or stop when meeting a task of life that we don't have the courage to deal with.

The fear of losing the sense of self-worth leads to a loss of courage

Neuroses are based on fear of failure where failure = loss of worth/love (UNDO THE EQUATION)

Neurosis = Avoidance + Symptom (to protect self-esteem)

Components of the neurotic arrangement:

 Accentuated feeling of inferiority
 Over-compensatory goal of superiority and feeling inferior in relation to that goal
 Low social interest
 Lack of willingness to invest effort
 Avoidance – creating distance from a life task
 Symptom – creating an excuse or alibi to justify the lack of participation and contribution –
people create neurotic symptoms
This is always present but only becomes a problem when an individual is faced with a task they
think they can't win at.

Good enough is terrible for people who want to be superior

The neurotic knows the requirements of Social Interest and creates justifications to not demonstrate
it.
The person needs the symptom to stop them having to do what it is they feel they should do.

The neurosis is a perfect arrangement but with one bug – you have to feel distressed all the time to
be able to recuse others into your service

Mental health problems can be seen as self absorbed efforts to overcome feelings of inferiority.
In Adlerian psychology good mental health is seen as being characterized by reason, social interest,
and self-transcendence; mental disorder/poor mental health by feelings of inferiority and self-
centred concern for one’s safety and superiority or power over others.
Goals of the Client
Goals the client is aware of – symptom reduction, validation, wanting the other to change etc.
Goals in terms of the Adlerian understanding of neurosis
1. Help me reach my goal
2. Help me not pay the price
3. Validate me, validate my suffering – give me sympathy, acceptance – the martyr
4. Forced to come – want to not be here, want to appease

The economy of the mind – people keep doing what they do as long as the benefit outweighs the
cost

Goals of the Therapist

Encourage an unconditional sense of belonging – that the client feels good enough as they are – for
the therapist to communicate the feeling of “I respect you for the way you are now” - and to help
the client develop the courage to move away from some of their basic assumptions about life

Help develop and elevate the level of Social Interest – so that it's not all about themselves –
cooperation rather than competition – competition can be seen as striving towards success without
social responsibility – with cooperation it is about working together to meet the needs of the
situation.

Raise the courage for them to acknowledge they are imperfect as is everybody else – make the
conditions under which the client feels self-worth more flexible – work towards self-acceptance –
where they are able to give up exaggerated expectations – acknowledgement of who you are and
feeling ok about this no matter what
Lower expectations – acceptance of being human and that it's ok to be who you are

Help them see the functionality of their relating to their problem and that there is a
choice/possibility for them to approach things differently

How would life be different if you no longer had your current problem?

Four elements of Adlerian Psychotherapy

Establish the relationship – the establishment and maintenance of an empathic, respectful and
collaborative partnership. Align your goals with those of the client

Assess/Investigate – what and how – come to a shared understanding of what is going on for the
client and how they are approaching the challenges that life presents to them. This phase of therapy
involves the gathering of information in order to obtain a context within which the difficulties can
be clarified and understood.

Interpret and gain insight - a mutual effort to understand the meanings, values and goals contained
in the individual's Lifestyle (personality) that make the dysfunctional pattern or symptom necessary.

Reorient/practice change - facilitate movement toward more flexible, effective, courageous and
socially interested ways for the client to see themself, their world and their place of significance,
security and success.