Therapeutic Techniques
The creative freedom inherent in Adlerian practice demands a variety of strategies that suit the uniqueness of each client and capture the spontaneous therapeutic opportunities the client hands to us in each session. Although the twelve stages represent a conceptual center line of treatment, essentially, a unique therapy is created for each client. The specific techniques used at any one time depend on the direction that seems currently accessible. Four main strategies characterize current Classical Adlerian therapeutic technique: assessment, Socratic questioning, guided and eidetic imagery, and role-playing [These strategies are rooted in the original Adlerian treatment style and are enriched by the contributions of Sophia de Vries, Alexander Müller, and Henry Stein].
Assessment. A thorough life style analysis serves as the guide to the therapeutic process; generally this occurs during the first three stages of treatment. A central technique that Adler pioneered to assess life style is the projective use of early memories (Adler 1933). These memories, whether they are "true" or fictional, embody a person's core beliefs and feelings about self and the world. They contain reflections of the person's inferiority feelings, goal, scheme of apperception, level and radius of activity, courage, feeling of community, and style of life.
In addition to these early memories, the therapist uses the following to do the assessment: (1) description of symptoms, the circumstances under which they began, and the client's description of what he would do if not plagued with these symptoms; (2) current and past functioning in the domains of love relationships, family, friendships, and school and work; (3) family of origin constellation and dynamics, and extended family patterns, (4) health problems, medication, alcohol, and drug use, and (5) previous therapy and attitude toward the therapist. While much of this information can be collected in the early therapy sessions, it can also be obtained by asking the client to fill out an Adlerian Client Questionnaire (Stein 1993). This permits the client to answer in detail many important questions and increases the client's level of activity in the therapy process. In addition, it saves some therapeutic time and enables the therapist to obtain a binocular view from both the client's written and verbal descriptions.
Socratic Questioning. The Socratic method of leading an individual to insight through a series of questions lies at the heart of Adlerian practice (Stein 1990; Stein 1991). It embodies the relationship of equals searching for knowledge and insight in a gentle, diplomatic, and respectful style, consistent with Adler's philosophy. In the early stages of psychotherapy, the therapist uses questions to gather relevant information, clarify meaning, and verify feelings. Then, in the middle stages of therapy, more penetrating, leading questions uncover the deeper structures of private logic, hidden feelings, and unconscious goals. The therapist also explores the personal and social implications of the client's thinking, feeling, and acting, in both their short and long term consequences. Throughout, new options are generated dialectically, examined, and evaluated to help the client take steps in a different direction of her own choosing. The results of these new steps are constantly reviewed. In the latter stages of therapy, the Socratic method is used to evaluate the impact of the client's new direction and to contemplate a new philosophy of life. The Socratic style places the responsibility for conclusions and decisions in the lap of the client. The role of the therapist is that of a "co-thinker," not the role of a superior expert. Just as Socrates was the "midwife" attending the birth of new ideas, the Adlerian therapist can serve as "midwife" to the birth of a new way of living for a client.
Guided and Eidetic Imagery. For many clients, cognitive insight and new behavior lead to different feelings. Some clients need additional specific interventions to access, stimulate, or change feelings. Guided and eidetic imagery, used in an Adlerian way, can lead to emotional breakthroughs especially when the client reaches an impasse. Eidetic imagery can be used diagnostically to access vivid symbolic mental pictures of significant people and situations that are often charged with emotion. Guided imagery can be used therapeutically to change the negative imprints of childhood family members that weigh heavily on a client and often ignite chronic feelings of guilt, fear, and resentment. These techniques are typically used in the middle stages of therapy. Alexander Müller recommended the use of imagery when a client knew that a change in behavior was sensible, but still didn't take action (Müller 1937). Some clients need a vivid image of themselves as happier in the future than they presently are, before they journey in a new direction that they know is healthier.
Role-Playingrepertoire, and to explore and practice new behavior in the safety of the therapist's office. To provide missing experiences -- e.g., support and encouragement of a parent -- a group setting is recommended. Group members, rather than the therapist, can play the roles of substitute parents or siblings. In this way, a client can engage in healing experiences and those who participate with him can increase their own feeling of community by contributing to the growth of their peers. When learning and practicing new behaviors, the therapist can offer coaching, encouragement, and realistic feedback about probable social. In the middle stages of therapy, role-playing offers clients opportunities to add missing experiences to their consequences. This is somewhat equivalent to the function of children's play as they experiment with roles and situations in preparation for growing up. Clients need to be treated with gentleness and diplomacy, yet offered challenges that strengthen their confidence and courage.
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