How has psychotherapy actually changed over the decades?
Everyone knows Sigmund Freud and many know C. G. Jung, too, and you associate the term "analysis" with them.
The picture of a patient who lies on the couch and associates his thoughts with a silent gentleman who sits behind him and, if possible, "disturbs" little. This kind of free association, the interpretation of dreams, the "interpretation" itself of what a patient says to his therapist, we attribute all this to Freud & Co. We also know the "hysteria" from that time, especially the image of women has suffered from it.
Sure you also have heard of electro-shock therapy and were quite set back by it. Other than really rare and under much more controlled circumstances compared to the "lunatic homes" of the past this form of therapy is a not a very common one nowadays.
Later, films were produced that took over the language of psychology - "Der Großstadtneurotiker" ("Annie Hall" with Woody Allan and Diane Keaton) for instance - and much of what we talk about so naturally today dates back to the time when we began to deal professionally with the human psyche.
"He compulsively sorts the towels in a straight line," for instance. Or, "She's got an compulsive washing habit." Also popular: "The adolecent has a social phobia" (although this expression came much later).
Solving problems from the couch?
But what has happened since the beginning of the 20th century? So much that you could never put it in an article.
In the 1950s, psychotherapy was still a matter between two people: therapist and client. The rules of abstinence were very strict and for a long time no therapist dared to ask relatives of the client for a conversation.
But the image of a therapist in quiet privacy, with his client removed from the rest of (social) reality, began to make some practitioners sceptical. Thus, the view that a person could have a problem all by himself, and that this problem could only be solved by analysing himself/herself, was too limited.
It was courageous therapists from around the world at that time who began to change the setting and involve relatives in the process, even though they were in danger of losing their reputation.
Put yourself and others in a system
Gradually, however, one began to perceive "problems" as components of social system structures and not as "characteristics" of individual persons. Mental disorders could no longer be seen as individual processes. Even the term "illness" was and is no longer appropriate for phenomena that are obviously closely related to social problems. One can speak of a paradigm shift, because this was and still is a quite radical view.
Why? Because films and media like to show this two-person-setting and still prefer to use it - scripts are still written in the same questioning technique. Unfortunately, clichés are very difficult to eradicate.
The basics of systemic therapy developed from the viewpoint that no human being exists outside of a social environment and that in these systems the participants interact with each other and are equally responsible for problems and solutions.
Systemic therapy has no real "founders",
it is a development from a certain mindset. However, this way of thinking is basically not new, because the view of the living being "man" has also taken place in prehistoric times, only with other methods, symbols and terms. The commonality lies in the holistic viewpoint: that man as an "animal" is integrated into the organism of the planet Earth and therefore inevitably with all other living systems.
Human perception and consciousness enable him to have empathy with other people and living beings and to feel affected by the events around him. A human being cannot simply decide that the events in the world do not concern him, even if some people like to believe this or force it. The language in which these facts are presented is now another matter and the different disciplines are often more disunited than united.
One of the brave ones was Alfred Adler, who created the term "Individual psychology".
Unfortunately, individual psychology could today be misunderstood: as psychology for the single. More than in the past we live a high individualized life and so I would like you to take the term correct and in the sense it was meant by Adler.
Adler's notion of man was basically positive;
he saw man as an indivisible unity, as a conscious being that reacts holistically and purposefully. Individual psychology emphasizes the uniqueness of the person.
As with all models of explanation for human reality, Alfred Adler can be mistaken. In our self-centered world this is by no means a rare phenomenon. I especially think of concepts of "independence" which have the aftertaste that our existence is about having to be lone fighters in order to "survive" or to find a "suitable" identity.
According to Adler, however, man has been a social being since birth. The aim of each individual is therefore the pursuit of self-realization in positive form. Disorders of the individual are due to a pathological lifestyle. He generally sees the "discouragement" of an individual (from childhood on) as the greatest disturbing factor in human development. The conclusion is not far away that there is an early discouragement in the family system - and above all others.
Man is a social being by nature.
The "sense of community" or the "social interest" is innate, even if the specific forms of developing relationships with others and social institutions are determined by the type of society into which the individual is born, i. e. is also culturally conditioned.
In one respect, Adler takes an equally biological point of view as Freud does, in that both assume that man has an inherited disposition that determines the direction of character development. While Freud places the emphasis on sexuality (or is known for), Adler puts social interest and the social determination of behavior in the foreground of personality development. Both of them have been partially right as well as wrong in their models, contributed a lot of valuable things to the exploration of the human psyche.
Adler lived at the same time as Freud and had cultivated contact with him, but there was a disagreement between them and he left the circle of up-and-coming analysts.
Crypto-Adlerians
The Second World War drove many academics to emigrate and in view of these pressures, which by a citation prohibition of Freud versus Adler did not want to mention his individual psychology by name, most of the individual psychologists who had emigrated to the USA went "underground". Externally, they pretended to be "Freudians", used psychoanalytical phraseology and avoided even mentioning Adler or "individual psychology".
However, they continue to apply the individual psychological methods they have learned. Among these so-called "crypto-Adlerians" is the well-known individual psychological theorist Erwin Wexberg, who ceased to confess individual psychology after his emigration to the USA. Only the individual psychological groups in New York (around Alexandra Adler) and in Chicago (around Rudolf Dreikurs) were able to assert themselves during these years.
In my training A. Adler belonged to the treated influential persons of systemic therapy. Referring to the goal orientation of people, which results from a desire, he wanted to find out what the goal of an action is.
Example:
A family comes to counseling with the child. The parents report that the child behaves disturbingly. That would be the question: "What is the purpose of this disturbance?" "What is the aim of the child's behaviour?" Adler examined the Kausa finals - even though we are referring to the past and future in our behaviour, Adler wanted to move away from focusing on the past and focus on the immediate goals (according to Rudolf Dreikurs).
Now you could just ignore this and think: So what? What's so special about it? But when you consider that "near targets" in connection with the analysis of human problems often disappear in favor of overcoming the past, this method gains momentum.
I remember a client who was worried about her eight-year-old daughter
because she had begun to wet her bed at night. Parents or mothers are immediately worried and often look for the causes of inappropriate behaviour of their child in the past. It is better to first concentrate on what the child needs now (!). Because children always react very directly to changes and difficulties in the family system, bed-wetting can be an expression of a momentary need, which is only expressed by the child because it wants to see something accepted.
If it notices that there are not many words of concern or annoyance, it will normalize its behaviour by itself, because for the child it is bothersome and uncomfortable to be active in the middle of the night, too. It is old enough to realize that. Parents reported that engaging in the child's "problem" in this way, relieves the situation much quicker and is for both, parents & their kids, a very positiv experience. The child gets the needs fulfilled, the parents match their roles in a mature and responsible manner.
It's never too late for a good childhood
I am not sure whether it is from A. Adler or another therapist, but I like the phrase "It's never too late for a good childhood". "Reframing" is here a keyword. Although one can HAVE a bad childhood, childhood itself cannot be judged as all over bad (except of very extreme situations).
To remember exceptions and to recapitulate encouraging childhood experiences or even to mentally create a way out of a previously difficult childhood situation (also with the help of "Gestalt"-elements) should help people to break through their too one-sided and linear view of themselves and their childhood and to create themselves anew, in order to express it a little bit pathetically.
Gestalt therapy theory essentially rests atop four "load-bearing walls": phenomenological method, dialogical relationship, field-theoretical strategies, and experimental freedom (source: https://en.wikipedia.org/wiki/Gestalt_therapy)
Gestalt-practice is related to systemic therapy and nowadays "has also been applied in Organizational Development and coaching work." Which covers the field, I am working in. As System theory and Gestalt-work are main sources I got my knowledge and education from, I still love to do further research and mental activities on. It is a rich and diverse realm of discovery and I don't know, if I will ever come to an end with digging into it.
I hope you enjoyed this trip to the field of psychotherapy and my focus on Alfred Adler. Maybe I'll start a series that will illuminate some of the characters from this special area.
text sources:
Erwin Wexberg: https://books.google.de/books/about/Erwin_Wexberg.html?id=s7GDbve4jHUC&redir_esc=y
Rudolf Dreikurs: http://www.newworldencyclopedia.org/entry/Rudolf_Dreikurs
PDF-document (only in German): http://www.adler-institut-mainz.de/uploads/media/Individualpsychologie.pdf
https://en.wikipedia.org/wiki/Gestalt_therapy
picture sources:
Freud's couch: Robert Huffstutter - Source: Flickr
Sigmund Freud: Max Halberstadt Public domain via Wikimedia Commons
Woody Allan & Diane Keaton: with the Broadway cast of Play It Again, Sam (1969).
Alfred Adler: Ann Ronan Picture Library (https://en.wikipedia.org/wiki/Alfred_Adler)
Kennedy Family: Cecil W. Stoughon
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