Theories of Counseling

Counseling schools/theories

Psychoanalytic/psychodynamic Adlerian Existential Person-centered Gestalt Behavior Cognitive Behavioral Reality Feminist and post-modern approaches Family systems therapy

Classical psychoanalytic tradition

View of human nature

Fatalistic We are under the control of biological and instinctual drives

Life instinct our motivation to gain pleasure and avoid pain. Includes libido sexual energy Death instinct aggressive energy, unconscious wish to hurt self and others

Structure of personality

Energy is distributed between the id, ego and superego

Id primary source of psychic energy Ego seat of intelligence and rationality Superego Your parents in your head

Id, ego, and superego

Conscious and unconscious

The unconscious cannot be seen or studied but can be inferred from behavior through
Dreams the golden road to the unconscious Slips of the tongue Projective tests ambiguous pictures, music Free association Symbolic contents of psychotic symptoms

The aim of psychoanalytic therapy is to make the unconscious motives conscious, for only then can an individual exercise choice (p. 58)

What does this mean?

Incomplete resolution leads to repetition compulsion

We are unconsciously motivated to repeat our problems until they are resolved We transfer our original problems with our parents or significant others to our relationships with other people, so that we can resolve them We will repeat this cycle until we are satisfied with the outcome

Incomplete resolution leads to repetition compulsion

One way to break the cycle is to

Become conscious of the cycle Understand what you want from the original hurt Go through the process of grieving and letting go

Repetition compulsion in clinical situations Hanna Levenson and her client

Anxiety

Tension that arises out of conflict between id, ego and superego Neurotic anxiety I might lose control and do something stupid that will be punished. Moral anxiety I feel so guilty for what I have done.

Personality development

Infancy trust vs. mistrust Early childhood autonomy vs. shame and doubt Preschool age initiative vs. guilt School age industry vs. inferiority Adolescence identity vs. role-confusion Young adulthood intimacy vs. isolation Middle age generativity vs. stagnation Later life integrity vs. despair

Question: How do these stages relate to counseling? What is the relationship between an individuals current problems and significant events in earlier stages of life?

Therapeutic goals

Goal one: make the unconscious conscious Goal two: make the ego stronger so that our behavior is based on reality instead of

Instinctual cravings or Irrational guilt

Therapists function and role

Therapists try to foster a transference relationship so that clients will make projections unto them
Clients tend to project their unfinished businesses onto their therapists. Eg. Stern father perceive therapist as stern Transference relationship must be worked through

Pays attention to resistances places where client is stuck Interpretation helps client make connections

Therapists function and role

Countertransference therapists own feelings towards clients

Therapists own conflicts are triggered Can help therapist to understand the world of the client how other people must have viewed client

Existential therapy

Proposition 1: Capacity for selfawareness

The greater our awareness, the greater our possibilities for freedom Existential anxiety is the consciousness of our own freedom

Proposition 1: Capacity for selfawareness

So, do you want

The security of dependence or The freedom that comes with a lot of anxiety and responsibility? How someone else defines you or Your own evaluation of who you are

So, is your identity built on

Are you so preoccupied with suffering, death and dying that you are not living fully in the present? Even though you cant change certain events, you can change the way you look at these events

Proposition 2: Freedom and responsibility

We are free to shape our destinies Existential guilt Guilt that comes from choosing not to choose Living inauthentically allowing others to define us, or to make choices for us Therefore, two central goals of therapy

recognize how we have allowed others to decide for us encouragement to take control of our lives, to risk it!

Proposition 3: Striving for identity and relationship to others

Creating a personal identity not an automatic process but takes courage The courage to be. Clients greatest fear Ill discover Im a nobody apart from others definition of who I am. Im afraid to realize that I am, in reality, an empty shell. If I shed my masks, people will find out that I am really nothing. Creating connectedness with others I/Thou relationships which are real not treating others as objects to achieving our goals

Proposition 3: Striving for identity and relationship to others

We have to be able to stand alone before we can truly stand beside another. (p. 140) Neurotically dependent attachment vs. life affirming relationship
Dependent dominated by fear, jealousy, possessiveness youre clingy because youre too empty to stand on your own Affirming out of the fullness of your life you contribute to the fullness of others lives GIVE FREEDOM!!.

Loneliness and isolation are normal frantically doing vs. experience being.

Creating space to dance together

When we feel lonely we keep looking for a person or persons who can take our loneliness away. Our lonely hearts cry out, "Please hold me, touch me, speak to me, pay attention to me." But soon we discover that the person we expect to take our loneliness away cannot give us what we ask for. Often that person feels oppressed by our demands and runs away, leaving us in despair. As long as we approach another person from our loneliness, no mature human relationship can develop. Clinging to one another in loneliness is suffocating and eventually becomes destructive. For love to be possible we need the courage to create space between us and to trust that this space allows us to dance together.

Proposition 4: The search for meaning

Do you like the direction of your life? Are you satisfied with who you are now and who you may become? Discard old ways of living and thinking and adopt new ways of being that is consistent with who they are Human suffering can be turned into human achievement You are committed to engage with life to create, love, work and build

Mans Search for Meaning

"We who lived in concentration camps can remember the men who walked through the huts comforting others, giving away their last piece of bread. They may have been few in number, but they offer sufficient proof that everything can be taken from a man but one thing: the last of the human freedomsto choose one's attitude in any given set of circumstances, to choose one's own way."

Proposition 5: Anxiety as a condition to living

Anxiety can be a stimulus for growth You can choose to lessen anxiety by narrowing the possibilities in your lives and reduce your choices or You can leap into the unknown and live courageously

Lives of quiet desperation

Proposition 6: Awareness of death and nonbeing

Therapeutic goals

Moving clients toward authenticity and realize where they have been deceiving themselves Listen to what they already know about themselves Generate alternative ways of existing which were not conceived of before

Therapists function and role

Understand subjective world of clients Dont really care about the past the focus is on current life situations Point out places where client is avoiding responsibility Be present in an I/Thou relationship

Phases of therapy

Phase 1: Identify and clarify clients view of the world what is their existence like? What is their role in creating their own problems? Phase 2: Who are the sources of authority in their present value system? Phase 3: Put into action what they are learning in concrete steps

Stop being a pleaser

You have to let your father and father figures go. You must stop seeing yourself through their eyes and trying to make them proud of you. For as long as you can remember, you have been a pleaser, depending on others to give you an identity. You need not look at that only in a negative way. You wanted t0 give your heart to others, and you did so quickly and easily. But now you are being asked to let go of all these self-made props. You must stop being a pleaser and reclaim your identity as a free self. - Nouwen

Person-centered therapy

Carl Rogers

View of human nature

Human beings are basically good and naturally capable of growth. Therapists convey realness, caring and non-judgment to facilitate growth Primary responsibility for healing is on the client

Acorn

Therapeutic goals

Provide a climate conducive to helping the individual become a fully functioning person People who are more self-actualized have

An openness to experience A trust in themselves An internal source of evaluation A willingness to continue growing

Therapists function and role

Dont try to control or manage the client Dont ask probing questions Dont make interpretations Dont evaluate client s ideas Dont decide for the client

Clients experience in therapy

Becoming more realistic Appreciate themselves more Behave in ways that are more authentic Have a sense of increased freedom and power upon their lives

Relationship between therapist and client

Equality Congruence therapists are genuine Unconditional positive regard and acceptance

Ill accept you when. Vs. Ill accept you as you are. Therapist can feel with the client without being lost in clients feelings

Accurate empathic understanding

Therapist follows clients lead in the dance

Behavior therapy

B. F. Skinner

Basic characteristics and assumptions

Follows the scientific method Focusses on current problems and how to change them Clients actively do and learn something Client transfers what he or she learns to everyday life Client evaluates target behavior (self-monitoring) and evaluates change Client is empowered through empowerment strategies Interventions are individually tailored

Therapeutic goals

Increase personal choice Create new conditions for learning

Therapists role

Conducts a thorough assessment to determine what causes and maintains problem behavior Formulate treatment goals Design and implement treatment plan Evaluate progress and conduct follow-up Modelling for client

Relationship between client and therapist

Acceptance is necessary but insufficient for change Progress happens because of specific behavioral techniques rather than because of the therapeutic relationship

Some methods

Relaxation training Systematic desensitization Exposure therapies

In vivo desensitization Flooding

EMDR Assertiveness training Self-management programs

Cognitive behavioral therapy

Elliss Rational Emotive Behavioral Therapy

Albert Ellis

Assumptions

People contribute to their psychological problems by the way they interpret events and situations Integrative approach cognition, emotion and behavior interact and have cause-effect relationship Aims to provide clients with tools for disputing irrational thoughts Irrational beliefs are replaced with effective and rational beliefs

View of human nature

As children we are taught or we develop irrational beliefs They are maintained and repeated, being kept alive Our desires and preferences are escalated into needs

Shoulds, Musts, Oughts

I must have the love and approval of the significant others in my life I must do everything perfectly Because I strongly desire people to treat me considerably and fairly, they absolutely must do so!

A-B-C Theory of Personality

A (activating event) B (belief) C (behavioral and emotional consequence) D (detect, debate, and discriminate irrational beliefs) E (effective philosophy replace unhealthy thoughts with healthy thoughts) F (new feelings)

Goals

USA Unconditional self-acceptance UOA Unconditional other acceptance

Clients experience

Who Client and therapist participate actively When? Here and now Where? Both during and outside sessions

Some interesting techniques

Role-playing Shame-attacking exercises unashamed even when others clearly disapproves of them do a homework assignment which is shame provoking Use of force and vigor debate hotly with the therapist

Cognitive Behavioral Therapy

Becks Cognitive Therapy

Basic principles

Everyone has a bias in interpretation and thinking called cognitive distortions Modify dysfunctional thinking therapist holds a Socratic dialogue with client Therapist makes a connection between clients thoughts and feelings

Cognitive distortions

Arbitrary inferences making conclusions without supporting evidence. Eg. Catastrophizing Selective abstraction isolating detail, ignoring other information Overgeneralization one thing applies to everything Magnification or minimization too much or too little significance assigned Personalization taking things personally Labeling and mislabeling allowing our mistakes to define our true identity Polarized thinking all-or-nothing

Personalization

"You keep listening to those who seem to reject you. But they never speak about you. They speak about their own limitations. They confess their poverty in the face of your needs and desires. They simply ask for your compassion. They do not say that you are bad, ugly, or despicable. They say only that you are asking for something they cannot give and that they need to get some distance from you to survive emotionally. The sadness is that you perceive their necessary withdrawal as a rejection of you instead of as a call to return home and discover there your true belovedness. - Nouwen

Applying cognitive techniques

What are possible alternative interpretations? Socratic questioning

What would be lost by trying? So you made a mistake. Has it occurred to you that everyone makes mistakes?

Biting the bullet can you live that that and move on?

She doesnt like you? Why must that rejection be an attack on your whole identity? Is she perfect too? If I were to make the same mistake myself, would you despise me the way you despise yourself?