Running head: PERSONAL THEORIES PAPER INTEGRATING ADLERIAN, GESTALT & CBT!

An Integrative Model of Psychotherapy Consisting of Adlerian, Gestalt and Cognitive-Behavioral Theories of Therapy Faraz Hussain Illinois Institute of Technology

Personal Theories Paper!

Abstract This paper proposes an integrative theory of psychotherapy composed of Adlerian, Gestalt and Cognitive-Behavioral theories of therapy. The Adlerian approach contextualizes an individuals motivations in relationship to their social and interpersonal relationships. Gestalt therapy focuses on not any one single aspect but every facet of the clients life, feelings and behavior taken as a whole. Cognitive-Behavioral therapy attempts to correct erroneous thinking and belief patterns in order to effect positive change in the individuals behavior. All three have strong emphases on cognitive awareness and a collaborative relationship between client and counselor, and provide complementary frameworks especially conducive to providing rehabilitation therapy to persons with disabilities.

Personal Theories Paper!

Resulting from a schism with Freud due to Adler's rejection of the preeminence of the sexual impulse, Adlerian therapy has outgrown it's formerly restrictive organic slant and developed into a comprehensive psychosocial theory of behavior. Adler's belief in the import of the attitude adopted by a person toward their disability, dened by their distinctive mental processestheir 'lifestyle'continues to have an impact on rehabilitation counselors today; Adlerian therapy itself, or at least several components thereof, is indeed in the process of making a comeback. Adler had a rm belief in the irreducibility of the individual, and fostered the investigation of the person as a whole, in relation to and apart from their disability. He was a believer in the creative power of the individual rather than the inuence of heredity and environment as deterministic forces. Personal problems, according to Adler, can only be fully understood as interpersonal or social problems (Ansbacher and Ansbacher, 1956). Everyone attempts to achieve a position of signicance in the eyes of others, and the process of obtaining this 'place of somebodyness' differs from person to person based on their social context and interpersonal worldview. One's goals and behaviors are inuenced by one's need to improve their social standing. In Adler's estimation, human behavior and emotion is both purposeful and a direct consequence of their thoughts and ideas. Even when aware of their purpose for behaving in a certain fashion, people are often not consciously aware of the goals directing these behaviors. The inner machinations affecting an individual's perceptions play a larger role in determining their behavior than reality itself, and cause the individual to organize their perceptions in a manner consistent with their goals. Hence, Adlerian therapy emphasizes a cognitive understanding of the individual.

Personal Theories Paper!

Adler was convinced that these goals were directed towards one's attaining their conception of one's 'ideal self'a construct he believed to originate and develop throughout one's childhood. In the pursuit of this ctional, ideal state of selfhood, an individual is continually traveling from an perceived minus state of 'non-enoughness' to a perceived plus state of 'enoughness'never, of course, entirely arriving at it. The primacy of inferences rendered from childhood experiences makes them the most consequential factors inuencing these goals, long after the individual has moved beyond the circumstances that engendered those early conclusions. Mosak (2000) describes how Adlerian theory promulgates the idea of the continuum arising from experience to goals to behavior to achieving signicance. Fritz Perls was a neuropsychiatrist whose knowledge of Gestalt psychology and contemporaneous involvement in the bohemian 1920s Berlin theater scene informed his practice as well as the construction of the therapeutic framework that he and his wife Laura developed together, which came to be known as Gestalt therapy. His experiences with acting supplied him with an abiding eye for nonverbal communication, while his work with the neurologist Kurt Goldstein instilled an appreciation for a holistic interpretation of the individual. Instead of a psychoanalyst's preoccupation with 'why' a person nds himself in a particular situation, a Gestalt therapist investigates instead 'how' the person arrived at it. Whereas Laura Perl believed in an incrementally more permissive progression of the counselor-client relationship, her husband Fritz advanced the idea of a more independent relationship, which is encapsulated in the form of a Gestalt 'prayer' that he wrote towards the end of his life:

Personal Theories Paper!

"I do my thing and you do your thing. I am not in this world to live up to your expectations, And you are not in this world to live up to mine. You are you, and I am I, and if by chance we nd each other, it's beautiful. If not, it can't be helped." According to Livneh and Sherwood (1991), Gestalt theory proposes that human beings are not just an amalgam of their discrete parts but the product of the dynamic interrelationships between their mind, soul, sensations, thoughts, emotions and perceptions. The word 'gestalt' itself is a German loanword that refers to an 'organized whole that is perceived as more than the sum of its parts'. The applicability of this concept to human experience is immediate: difculty in marriage will inuence job performance, and failure in school will affect interpersonal relationships (Patterson & Welfel, 2000); it is also just as applicable to intrapersonal interactions. An individual is always seeking for balance in their life, which is threatened by external events and internal conict. Using the gure-ground analogy (imagine an image with a vase as the foreground or two identical faces looking at each other as the background), a person's perceived immediate needs are represented by the gure while their environment in relationship to those needs by the background; once the gure has been fullled, it retreats to the background and is replaced by another. Impediments in the way of individuals making the necessary contact with their environments and getting the support to fulll these needs include unsuccessful integration of ideas, ethics and norms into their personalities, leading to feelings of

Personal Theories Paper!

phoniness, otherness and superciality; projecting responsibility for their life occurrences onto others; retroecting behavior towards themselves that they in actuality want to direct towards others; deecting behavior so that their efforts are misplaced away from where they are needed; or by the inability to create a boundary between the self, the environment and others. Resolving unnished business can come to dominate a person's attention, to the detriment of their other life needs. Fragmentation, on the other hand, causes a person to place undue emphasis on one or more dimensions of their self, at the expense of other dimensions. Cognitive-Behavioral therapy (CBT) incorporates basic counseling techniques as well as those arising from cognitive theories and aspects of Behavior therapy and RationalEmotive Behavior therapy to investigate, in concert with the client, thought patterns and belief systems leading to maladaptive behaviors, erroneous beliefs and unhealthy relationships. According to Svett and Kaplan (2004), information-processing functions integrate leading to the development of cognition, which in turn prompts one to draw conclusions about one's circumstances, thus moderating affect and behavior. Errors introduced into information processing or cognitive mediation result in psychological disorders; CBT seeks to inuence these events from the level of nascent thought processes on up. It is evidence-based and deemphasizes painstaking analyses of personality in favor of examining the interaction of an individual's environment with their disposition. Rather than just being an eclectic approach, CBT allows a therapist to deliberately draw upon an arsenal of behavioral, interpersonal and constructivist techniques as dictated by the client's needs.

Personal Theories Paper!

This framework allows an individual to be viewed as a practical being, otherwise motivated by a scientic approach to life, who has been hindered by informationprocessing problems. By identifying pervasive errors in their belief system and connecting the dots to reveal the overarching pattern, the client can be restored to more adaptive schemes of thought and behavior. An integrative approach to psychotherapy incorporating these and other theories could allow beginning the client-counselor relationship with an Adlerian exploration of the clients frame of reference as a whole as well as in relation to their disability. This would be followed by an investigation of their lifestylewith a focus on ve areas of living: work, love, friendship, spirituality and self-convivialityand succeeded by an exploration of their childhood, earliest recollections, and family dynamics to tease out relationships between their early past and present life. Based on these, the therapist would attempt to extrapolate what long-terms goal the client would have chosen consistent with the conclusions they would be expected to have drawn from their own lifestyle. If the themes that become apparent tend to be of a self-serving variety, they still provide evidence of the individualss striving to move from a position of ill-dened inferiority towards a state of signicance. These themes are not necessarily detrimental and can be usefully channeled to the benet of ones social as well as personal life, and allow the individual to exercise creativity in choosing how to implement their lifestyle. Once an awareness of the clients lifestyle has been cultivated, it illuminates those features that can be changed for the better or extinguished as the client and counselor collaborate towards reorienting the clients lifestyle.

Personal Theories Paper!

This emphasis on the clients personal growth is well-complemented by a Gestalt awareness of their existential orientation (Whitmore, 1991). While being counseled, it is made incumbent upon the client to assume responsibility for their behavior and life choices. Encouraging the use of personal pronouns such as I, me and my rather than impersonal ones such as it or you motivates them to take ownership of their actions and beliefs. A focus on the clients body language and contact functions is emphasized (Polster & Polster, 1973), and discrepancies between their verbalizations and nonverbal behaviors are magnied. There is an emphasis on the present, and the client is mentally, physically and emotionally engaged with in order for them to be holistically reoriented. According to Angermann (1998), the goal is to allow the client to selfactualize their true self rather than vainly pursue trying to become someone they are not. In the process, the client and counselor enter into a dialogue that allows the growth of both their personalities through collaborative, interpersonal interaction. This emphasis on a collaborative relationship is also a hallmark of CBT, in which the goal shifts to identifying and ameliorating the cognitive dissonance responsible for the clients dysfunctional behavior. Negative cognitive patterns are mitigated using strategies like distancing, decentering, reattribution and decatastrophizing (Craighead et al., 1994). The techniques involved include thought stopping, meditation, relaxation, systematic desensitization, invoking mental and emotive imagery, cognitive modeling and restructuring, reframing, and stress inoculation. Different modalities of CBT variously advocate differing approaches; in the context of rehabilitation, Meichenbaums (1995) method of combining cognitive techniques with behavioral interventions and Nezus (1987) focus on problem-solving rather than purely cognitive patterning would

Personal Theories Paper!

appear to be the most effective, especially when combined with an Adlerian emphasis on lifestyle and a Gestalt approach to holism. These three theories are largely compatible with one another, especially in the context of rehabilitation counseling. Adlerian therapy stresses subjectivity, cognitive awareness, early familial relationships, lifestyle choices, logical reasoning and an equal, collaborative partnership between counselor and client. Gestalt therapy highlights focusing on verbal statements, cognitive processing, and especially the clients comprehension of their life and the therapeutic process. It is malleable and allows for individualization to cater to the unique needs of each client, and requires that close attention be paid to the clients nonverbal cues, offering existential rewards to both client and counselor. CBT has proved efcacious in dealing not only the primary underlying disability that causes a client to seek therapy, but also in managing the attendant changes in mood and personality. It eases the clients adjusting to their disability by encouraging collaborative problem-solving between client and counselor, focusing on recognizing and modifying self-defeating cognitive patterns. It does not necessarily lend itself to treating all kinds of populationsthose with cognitive impairments would prove particularly problematicbut in those where it works, it has the potential to be very efcacious.

Personal Theories Paper!

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