Tag Archives: Counseling

Cool Counseling, Counseling and Psychotherapy Theory and Practice, Parenting, Personal Reflections, Therapy with Adolescents, Tough Kids Cool Counseling

Goodnight, South Carolina

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Some days . . . the news is discouraging. Some days . . . evidence piles up suggesting that nearly everyone on the planet is far too greedy and selfish. On those days, I can’t help but wonder how our local, national, and worldwide communities survive. It feels like we’re a hopeless species heading for a cataclysmic end.

Sunset on StillwaterBut then I have a day like yesterday. A day where I had the honor and privilege to spend time hanging out with people who are professional, smart, compassionate, and dedicated to helping children learn, thrive, and get closer to reaching their potentials. I’m sure you know what I mean. If you turn off the media and peek under the surface, you’ll find tons of people “out there” who wake up every day and work tremendously hard to make the world just a little bit better, for everyone.

For me, yesterday’s group was the South Carolina Association of School Psychologists. They were amazing. They were kind. About 110 of them listened to me drone on about doing counseling with students who, due, in part, to the quirky nature of universe, just happen to be living lives in challenging life and school situations. The school psychologists barely blinked. They rarely checked their social media. They asked great questions and made illuminating comments. They were committed to learning, to counseling, to helping the next generation become a better generation.

All day yesterday and into the night I had an interesting question periodically popping up in the back of my mind. Maybe it was because while on my flight to South Carolina, I sat next to a Dean of Students from a small public and rural high school in Wisconsin. Maybe it was because of the SCASP’s members unwavering focus and commitment to education. The question kept nipping at my psyche. It emerged at my lunch with the Chair of the Psychology Department at Winthrop University.  It came up again after my dinner with four exceptionally cool women.

The question: “How did we end up with so many people in government who are anti-education?”

Yesterday, I couldn’t focus in on the answer. I told someone that–even though I’m a psychologist–I don’t understand why people do the things they do. But that was silly. This morning the answer came flowing into my brain like fresh spring Mountain run-off. Of course, of course, of course . . . the answer is the same as it always has been.

The question is about motivation. Lots of people before me figured this out. I even had it figured out before, but, silly me, I forgot. Why do people oppose education when, as John Adams (our second President) said, “Laws for the liberal education of youth, especially for the lower classes of people, are so extremely wise and useful that to a humane and generous mind, no expense for this purpose would be thought extravagant.”

The answer is all about money and power and control and greed and revenge and ignorance. Without these motivations, nearly everyone has a “humane and generous mind” and believes deeply in funding public education.

Thanks to all the members of the South Carolina Association of School Psychologists, for giving me hope that more people can be like you, moving past greed and ignorance and toward a more educated and better world.

Good night, South Carolina. It’s been a good day.

 

Cool Counseling, Counseling and Psychotherapy Theory and Practice, Tough Kids Cool Counseling

Revisiting the 3-Step Emotional Change Trick — Including a Video Example

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One of my current students asked where she might find a video example of the 3-Step Emotional Change Trick. Since I made up the Emotional Change Trick in 1997, the answer was easy: No such video exists.

Then I remembered that this past summer, while putting together video content with Wiley for our Clinical Interviewing text, I did a video demo of the 3-Step ETC with a 12-year-old girl. Due to space considerations, the footage didn’t make it into the text, but Wiley sent me a copy of the 6:44 minute clip.

Keep in mind that the girl in this video is exceptional. She’s the daughter of some friends and she agreed to be filmed for educational purposes. My sense is that she could have taught me the 3-Step ECT, but I tried to make it look like I was teaching her anyway.

Here’s the youtube link: https://www.youtube.com/watch?v=ITWhMYANC5c

And below you can read a version of the Emotional Change Technique adapted from Tough Kids, Cool Counseling:

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The Three-Step, Push-Button Emotional Change Technique

            An early and prominent Adlerian therapist, Harold Mosak, originally developed and tested the push-button technique as a method for demonstrating to clients that thinking different thoughts can effectively change mood states (Mosak, 1985). The purpose of Mosak’s technique was to help clients experience an increased sense of control over their emotions, thereby facilitating a sense of encouragement or empowerment (Mosak, 2000, personal communication).

            Mosak’s push-button technique can be easily adapted to work with young clients. When we implement this technique with younger clients, we are playful and call it an emotional change trick. When using this technique with teenagers, we describe it as a strategy for gaining more personal control over less desirable emotions. In essence, the three-step, push-button, emotional change technique is an emotional education technique; the primary goal is to teach clients that, rather than being at the mercy of their feelings, they may learn some strategies and techniques that provide them with increased personal control over their feelings.

The following example illustrates Adlerian emotional education principles and Mosak’s push-button technique expanded to three distinct steps.

Case example.  Sam, a 13-year-old European American boy, was referred because of his tendency to become suddenly stubborn, rigid, and disagreeable when interacting with authority figures. Sam arrived for his appointment accompanied by his mother. It quickly became obvious that Sam and his mother were in conflict. Sam was sullen, antagonistic, and difficult to talk with for several minutes at the outset of the session. Consequently, the Three-Step, Push-Button Emotional Change Technique (TSPB) was initiated:

Preparation/Explanation.

JSF:     I see you’re in a bad mood today. I have this . . . well, it’s kind of a magic trick and I             thought maybe you’d be interested. Want to hear about it?

S:         (Shrugs).

JSF:     It’s a trick that helps people get themselves out of a bad mood if they want to. First, I need to tell you what I know about bad moods. Bad moods are weird because even             though they don’t really feel good, lots of times people don’t want to get out of their bad mood and into a better mood. Do you know what I mean? It’s like you kind of want to stay in a bad mood; you don’t want anybody forcing you to change out of a bad mood.

S:         (Nods in agreement.)

JSF:     And you know what, I’ve noticed when I’m in a bad mood, I really hate it when someone comes up to me and says: “Cheer up!” or “Smile!”

S:         Yeah, I hate that too.

JSF:     And so you can be sure I’m not going to say that to you. In fact, sometimes the best thing to do is just really be in that bad mood—be those bad feelings. Sometimes it feels great to get right into the middle of those feelings and be them.

S:       Uh, I’m not sure what you’re talking about.

JSF:     Well, to get in control of your own feelings, it’s important to admit they’re there, to get to   know them better. So, the first step of this emotional change trick is to express your bad feelings. See, by getting them out and expressing them, you’re in control. If you don’t  express your feelings, especially icky ones, you could get stuck in a bad mood even    longer than you want.

As you can see, preparation for the TSPB technique involves emotional validation of how it feels to be in a bad mood, information about bad moods and how people can resist changing their moods or even get stuck in them, hopeful information about how people can learn to change their moods, and more emotional validation about how it feels when people prematurely try to cheer someone up.

Step 1: Feel the feeling. Before moving clients away from their negative feelings, it’s appropriate—out of respect for the presence and meaning of emotions—to help them feel their feelings. This can be challenging because most young people have only very simplistic ideas about how to express negative feelings. Consequently, Step 1 of the TSPB technique involves helping youth identify various emotional expression techniques and then helping them to try these out. We recommend brainstorming with young clients about specific methods for expressing feelings. The client and counselor should work together (perhaps with a chalk/grease board or large drawing pad), generating a list of expressive strategies that might include:

  • scribbling on a note pad with a black marker
  • drawing an angry, ugly picture
  • punching or kicking a large pillow
  • jumping up and down really hard
  • writing a nasty note to someone (but not delivering it)
  • grimacing and making various angry faces into a mirror
  • using words, perhaps even yelling if appropriate, to express specific feelings.

The expressive procedures listed above are easier for young clients to learn and understand when counselors actively model affective expression or assist clients in their affective expression. It’s especially important to model emotional expression when clients are inhibited or unsure about how to express themselves. Again, we recommend engaging in affective expression jointly with clients. We’ve had particular success making facial grimaces into a mirror. (Young clients often become entertained when engaging in this task with their counselor.) The optimal time for shifting to Step 2 in the TSPB technique is when clients have just begun to show a slight change in affect. (Often this occurs as a result of the counselor joining the client in expressing anger or sadness or general nastiness.)

Note: If a young client is unresponsive to Step 1 of the TSPB technique, don’t move to Step 2. Instead, an alternative mood-changing strategy should be considered (e.g., perhaps food and mood or the personal note). Be careful to simply reflect what you see. “Seems like you aren’t feeling like expressing those yucky feelings right now. Hey, that’s okay. I can show you this trick some other day. Want some gum?”

Step 2: Think a new thought (or engage in a new behavior). This step focuses on Mosak’s push-button approach (Mosak, 1985). It’s designed to demonstrate to the client that emotions are linked to thoughts. Step 2 is illustrated in the following dialogue (an extension of the previous case example with John and Sam):

JSF:     Did you know you can change your mood just by thinking different thoughts? When you think certain things it’s like pushing a button in your brain and the     things you think start making you feel certain ways. Let’s try it. Tell me the funniest thing that happened to you this week.

S:         Yesterday in math, my friend Todd farted (client smiles and laughs).

JSF:     (Smiles and laughs back) Really! I bet people really laughed. In fact, I can see it makes you laugh just thinking about it. Way back when I was in school I had a friend who did that all the time.

The content of what young people consider funny may not seem particularly funny to adults. Nonetheless, it’s crucial to be interested and entertained—welcoming the challenge to empathically see the situation from the 13-year-old perspective. It’s also important to stay with and build on the mood shift, asking for additional humorous thoughts, favorite jokes, or recent events. With clients who respond well, counselors can pursue further experimentation with various affective states (e.g., “Tell me about a sad [or scary, or surprising] experience”).

In some cases, young clients may be unable to generate a funny story or a funny memory. This may be an indicator of depression, as depressed clients often report greater difficulty recalling positive or happy events (Weerasekera, Linder, Greenberg, & Watson, 2001). Consequently, it may be necessary for the counselor to generate a funny statement.

S:         I can’t think of anything funny.

JSF:     Really? Well, keep trying . . . I’ll try too (therapist and client sit together in silence for about 20 seconds, trying to come up with a positive thought or memory).

JSF:     Got anything yet?

S:         Nope.

JSF:     Okay, I think I’ve got one. Actually, this is a joke.  What do you call it when 100 rabbits standing in a row all take one step backwards?

S:         Huh?

JSF:     (repeats the question)

S:         I don’t know.  I hate rabbits.

JSF:     Yeah.  Well, you call it a receding hare line.  Get it?

S:         Like rabbits are called hares?

JSF:     Yup.  It’s mostly funny to old guys like me.  (JSF holds up his own “hare line”)

S:         That’s totally stupid, man (smiling despite himself). I’m gonna get a buzz cut pretty             soon.

When you tell a joke or a funny story, it can help clients reciprocate with their own stories.  You can also use teasing riddles, puns, and word games if you’re comfortable with them.

We have two additional comments for counselors who might choose to use a teasing riddle which the client may get wrong. First, you should use teasing riddles only when a strong therapeutic relationship is established; otherwise, your client may interpret teasing negatively. Second, because preteen and teen clients often love to tease, you must be prepared to be teased back (i.e., young clients may generate a teasing riddle in response to a your teasing riddle).

Finally, counselors need to be sensitive to young clients who are unable to generate a positive thought or story, even after having heard an example or two. If a young client is unable to generate a funny thought, it’s important for you to remain positive and encouraging. For example:

JSF:     You know what. There are some days when I can’t think of any funny stories either. I’m sure you’ll be able to tell me something funny next time. Today I was able to think of some funny stuff . . . next time we can both give it a try again if you want.

Occasionally, young clients won’t be able to generate alternative thoughts or they won’t understand how the pushbutton technique works. In such cases, the counselor can focus more explicitly on changing mood through changing behaviors. This involves getting out a sheet of paper and mutually generating a list of actions that the client can take—when he or she feels like it—to improve mood.

Sometimes depressed young clients will need to borrow from your positive thoughts, affect, and ideas because they aren’t able to generate their own positive thoughts and feelings. If so, the TSPB technique should be discontinued for that particular session. The process of TSPB requires completion of each step before continuing on to the next step.

Step 3: Spread the good mood. Step 3 of this procedure involves teaching about the contagion quality of mood states. Teaching clients about contagious moods accomplishes two goals. First, it provides them with further general education about their emotional life. Second, if they complete the assignment associated with this activity, they may be able to have a positive effect on another person’s mood:

JSF:     I want to tell you another interesting thing about moods. They’re contagious. Do you  know what contagious means? It means that you can catch them from being around other  people who are in bad moods or good moods. Like when you got here. I noticed your  mom was in a pretty bad mood too. It made me wonder, did you catch the bad mood from    her or did she catch it from you? Anyway, now you seem to be in a much better mood. And so I was wondering, do you think you can make your mom “catch” your good mood?

S:         Oh yeah. I know my mom pretty well. All I have to do is tell her I love her and she’ll get all mushy and stuff.

JSF:     So, do you love her?

S:         Yeah, I guess so. She really bugs me sometimes though, you know what I mean?

JSF:     I think so. Sometimes it’s especially easy for people who love each other to bug each other. And parents can be especially good at bugging their kids. Not on purpose, but they bug you anyway.

S:         You can say that again. She’s a total bugging expert.

JSF:     But you did say you love her, right?

S:         Yeah.

JSF:     So if you told her “I love you, Mom,” it would be the truth, right?

S:         Yeah.

JSF:     And you think that would put her in a better mood too, right?

S:         No duh, man. She’d love it.

JSF:     So, now that you’re in a better mood, maybe you should just tell her you love her and spread the good mood. You could even tell her something like: “Dude, Mom, you really   bug me sometimes, but I love you.”

S:         Okay. I could do that.

It’s obvious that Sam knows at least one way to have a positive influence on his mother’s mood, but he’s reluctant to use the “I love you” approach. In this situation it would be useful for Sam to explore alternative methods for having a positive effect on his mother’s mood.

Although some observers of this therapy interaction may think the counselor is just teaching Sam emotional manipulation techniques, we believe that viewpoint makes a strong negative assumption about Sam and his family. Our position is that successful families (and successful marriages) include liberal doses of positive interaction (Gottman et al., 1995). Consequently, unless we believe Sam is an exceptionally manipulative boy (i.e., he has a conduct disorder diagnosis), we feel fine about reminding him of ways to share positive (and truthful) feelings with his mother.

To spread a good mood requires a certain amount of empathic perspective taking. Often, youth are more able to generate empathic responses and to initiate positive interactions with their parents (or siblings, teachers, etc.) after they’ve achieved an improved mood state and a concomitant increased sense of self-control. This is consistent with social–psychological literature suggesting that positive moods increase the likelihood of prosocial or altruistic behavior (Isen, 1987). Because of developmental issues associated with being young, it’s sometimes helpful to introduce the idea of changing other people’s moods as a challenge (Church, 1994).  “I wonder if you have the idea down well enough to actually try and change your mom’s mood.”

Once in a while, when using this technique, we’ve had the pleasure of witnessing some very surprised parents. One 12-year-old girl asked to go out in the waiting room to tell her grandmother that she was going to rake the lawn when they got home (something Grandma very much wanted and needed). Grandma looked positively stunned for minute, but then a huge smile spread across her face. The girl skipped around the office saying, “See.  I can do it.  I can change her mood.”

One 14-year-old boy thought a few minutes, then brought his mom into the office and said “Now Mom, I want you to think of how you would feel if I agree to clear the table and wash the dishes without you reminding me for a week.” Mom looked a bit surprised, but admitted she felt good at the thought, whereupon I (John) gave the boy a thumbs up signal and said, “Well done.”

Step 4.

At this point, readers should beware that although we’re describing a Three-Step technique, we’ve now moved to Step 4. We do this intentionally with young clients to make the point that whenever we’re working with or talking about emotions, surprising things can happen.

In keeping with the learn-do-teach model, we ask our young clients to teach the TSPB procedure to another person after they learn it in therapy. One girl successfully taught her younger brother the method when he was in a negative mood during a family hike. By teaching the technique to her brother, she achieved an especially empowering experience; she began to view herself as having increased control over her and her family’s emotional states.

Counseling and Psychotherapy Theory and Practice

A Brief Description of Motivational Interviewing

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In response to some questions on CESNET, I’m posting a brief description of Motivational Interviewing. Of course, Miller and Rollnick’s Motivational Interviewing text is a much more thorough source and is highly recommended if you want more complete information.

This description is an excerpt from the second edition of our Counseling and Psychotherapy Theories textbook. If you’re interested, you can check it out here: http://bcs.wiley.com/he-bcs/Books?action=index&itemId=0470617934&bcsId=7103

For the third edition (in preparation now), we’ll be substantially expanding this section and so if you have insights, publications, or other information that you think we should be aware of, please email me at john.sf@mso.umt.edu.

Here’s the excerpt:

Motivational Interviewing: A Contemporary PCT Approach

Person-Centered Therapy (PCT) principles have been integrated into most other approaches to counseling and psychotherapy. However, there are three specific approaches that are explicitly new generation person-centered therapies. These include:

  1. Motivational interviewing
  2. Emotion-focused therapy
  3. Nondirective play therapy

Next, we discuss motivational interviewing. Due to its strong integrational characteristics, emotion-focused therapy is covered in Chapter 14. Additional resources are available on nondirective play therapy (Landreth, 2002).

Moving Away From Confrontation and Education

In his research with problem drinkers, William R. Miller was studying the efficacy of behavioral self-control techniques. To his surprise, he found that structured behavioral treatments were no more effective than an encouragement-based control group. When he explored the data for an explanation, he found that regardless of treatment protocol, therapist empathy ratings were the strongest predictors of positive outcomes at 6 months (r = .82), 12 months (r = .71), and 2 years (r = .51; W. R. Miller, 1978; W. R. Miller & Taylor, 1980). Consequently, he concluded that positive treatment outcomes with problem drinkers were less related to behavioral treatment and more related to reflective listening and empathy. He also found that active confrontation and education generally led to client resistance. These discoveries led him to develop motivational interviewing (MI).

MI builds on person-centered principles by adding more focused therapeutic targets and specific client goals. Rollnick and Miller (1995) define MI as “a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence” (p. 326).

Focusing on Client Ambivalence

Client ambivalence is the primary target of MI. When it comes to substance abuse and other health related behaviors, Miller and Rollnick (2002) view ambivalence as natural. Most all problem drinkers recognize or wish they could quit, but continue drinking for various reasons. Miller and Rollnick described what happens when therapists try to push healthy behaviors on clients:

[The therapist] then proceeds to advise, teach, persuade, counsel or argue for this particular resolution to [the client’s] ambivalence. One does not need a doctorate in psychology to anticipate what [the client’s] response is likely to be in this situation. By virtue of ambivalence, [the client] is apt to argue the opposite, or at least point out problems and shortcomings of the proposed solution. It is natural for [the client] to do so, because [he or she] feels at least two ways about this or almost any prescribed solution. It is the very nature of ambivalence. (pp. 20–21)

In many situations, humans are naturally inclined to resist authority. Therefore, when resistance rises up in clients, MI advocates person-centered attitudes and interventions. This leads to Miller and Rollnick’s (2002) foundational person-centered principle of treatment:

It is the client who should be voicing the arguments for change (p. 22).

Although Miller and Rollnick describe Rogers as collaborative, caring, and supportive—they emphasize that he was not nondirective (W. R. Miller & Rollnick, 1998). Instead, they note that Rogers gently guided clients to places where they were most confused, in pain, or agitated and then helped them stay in that place and work through it. The four central principles of MI flow from their conceptualization of Rogers’s approach (W. R. Miller & Rollnick, 2002). According to these principles, it’s the therapist’s job to:

  • Use reflective listening skills to express empathy for the client’s message and genuine caring for the client.
  • Notice and develop the theme of discrepancy between the client’s deep values and current behavior.
  • Meet client resistance with reflection rather than confrontation (Miller and Rollnick refer to this as “rolling with resistance”).
  • Enhance client self-efficacy by focusing on optimism, confidence that change is possible, and small interventions that are likely to be successful.

MI is both a set of techniques and a person-centered philosophy or style. The philosophical MI perspective emphasizes that motivation for change is not something therapists can effectively impose on clients. Change must be drawn out from clients, gently and with careful timing. Motivational interviewers do not use direct persuasion.

A Sampling of MI Techniques

Miller and Rollnick (2002) provide many excellent examples of how reflection responses reduce resistance. The following interactions capture how reflection of client efforts lessens the need for resistance:

Client: I’m trying! If my probation officer would just get off my back, I could focus on getting my life in order.

Interviewer: You’re working hard on the changes you need to make.

or

Interviewer: It’s frustrating to have a probation officer looking over your shoulder.

Client: Who are you to be giving me advice? What do you know about drugs? You’ve probably never even smoked a joint!

Interviewer: It’s hard to imagine how I could possibly understand.

Client: I couldn’t keep the weight off even if I lost it.

Interviewer: You can’t see any way that would work for you.

or

Interviewer: You’re rather discouraged about trying again. (pp. 100–101)

In the following excerpt from Clinical Interviewing (2009), we describe the MI technique of amplified reflection:

Recently, in hundreds of brief interviews conducted by graduate students in psychology and counseling with client—volunteers from introductory psychology courses, consistent with Miller and Rollnick’s (2002) motivational interviewing work, we found that clients have a strong need for their interviewers to accurately hear what they’re saying. When their interviewer made an inaccurate reflection, clients felt compelled to clarify their feelings and beliefs—often in ways that rebalanced their ambivalence.

For example, when an interviewer “went too far” with a reflection, the following exchange was typical:

Client: I am so pissed at my roommate. She won’t pick up her clothes or do the dishes or anything.

Interviewer: You’d sort of like to fire her as a roommate.

Client: No. Not exactly. There are lots of things I like about her, but her messiness really annoys me.

This phenomenon suggests that it might be possible for interviewers to intentionally overstate a client’s position in an effort to get clients to come back around to clarify or articulate the more positive side of an issue. In fact, this is a particular motivational interviewing technique referred to as amplified reflection.

When used intentionally, amplified reflection can seem manipulative, which is why amplified reflection is used along with genuine empathy. Instead of being a manipulative response it can also be viewed as an effort on the interviewer’s part to more deeply empathize with the client’s frustration, anger, discouragement, and so on. Examples of this technique include:

Client: My child has a serious disability and so I have to be home for him.

Interviewer: You really need to be home 24/7 and really need to turn off any needs you have to get out and take a break.

Client: Actually, that’s not totally true. Sometimes, I think I need to take some breaks so I can do a better job when I am home.

Client: When my grandmother died last semester I had to miss classes and it was a total hassle.

Interviewer: You don’t have much of an emotional response to your grandmother’s death—other than it really inconveniencing you.

Client: Well, it’s not like I don’t miss her, too.

Again, we should emphasize that amplified reflection is an empathic effort to get completely in touch with or resonate with one side of the client’s ambivalence (from J. Sommers-Flanagan & Sommers-Flanagan, 2009, pp. 316–317).

End of excerpt

Counseling and Psychotherapy Theory and Practice

On Becoming a Counselor: What’s a Rogerian, Anyway? by Lauren Leslie

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carl-rogers

IMHO, more people should read Carl Rogers. But I understand, sometimes there just isn’t enough time in the day to fit in your Yoga class, mindfulness meditation practice, cardio workout, meal prep, work and family-life, and other responsibilities. So here’s an option: Below you’ll find a review of a classic Carl Rogers work: On Becoming a Person. It was written by Lauren Leslie to fulfill an assignment I give in our Counseling Theories class. It’s a fun read and gives you an abbreviated glimpse of the amazing Carl Rogers from the perspective of a first-year graduate student in clinical mental health counseling.

On Becoming a Counselor: What’s a Rogerian, Anyway?

Lauren Leslie
University of Montana

            Carl Rogers’ On Becoming a Person is a collection of essays and edited speeches written between 1951 and 1961, while client-centered humanistic therapy was being simultaneously embraced and challenged by the establishment. Rogers states he intends to write to professional psychologists, members of the counseling profession, and informed laymen, different populations who nonetheless have at least one thing in common:

. . .while the group to which this book speaks meaningfully will…have many wide-ranging interests, a common thread may well be their concern about the person and his  becoming, in a modern world which appears intent upon ignoring or diminishing him. (Rogers, 2012, “To the Reader” para. 8)

Throughout the text, Rogers offers a picture of himself as a person and a therapist. He provides insights into the growth of his theoretical framework as well as therapy transcripts to flesh out central elements of client-centered practice. Ultimately, the text crystallizes the effectiveness of empathy, congruence, and unconditional positive regard within a therapeutic relationship, and it is difficult to argue against Rogers’ persuasive and clear writing. Critics insist Rogers’ model is incomplete or insufficient, but the core tenets remain central to the practice of contemporary psychotherapy.

On Becoming a Person collects texts of varying genres into a sort of holistic catalog of Rogerian thought. Due to this variety of genre, Rogers’ tone and subject matter shifts; he addresses his own personality and life, includes transcripts of counseling sessions, and tries to systematize examples of his practice into stages of client development to analyze effectiveness of treatment. Rogers philosophizes on the human condition and therapeutic practice, Kierkegaard and Buber, and scientific research and personal change. It is a sweeping book which attempts meaningful understanding and data-driven conclusions. At one point, Rogers claims “There is no general agreement as to what constitutes ‘success’ [in psychotherapy]…. The concept of ‘cure’ is entirely inappropriate, since … we are dealing with learned behavior, not with a disease” (Rogers, 2012, p. 227). He consistently moves in opposition to the kind of concrete, experimental thinking favored in certain parts of the psychological community and comes off far more as a philosopher studying existential questions than as a data-driven scientist.

In considering himself, Rogers (2012) states, a client “discovers how much of his life is guided by what he thinks he should be, not by what he is. Often he discovers that he exists only in response to the demands of others…” (p. 109). In the same passage, he muses on the insight of Kierkegaard on this point: “He points out that…the deepest form of despair is to choose ‘to be another than himself.’ On the other hand, ‘…to be that self which one truly is, is indeed the opposite of despair,’” (p. 109). If this isn’t existential philosophy, the reader must ask, what is? In his own practice, Rogers (2012) characterizes a fundamental shift from “How can I treat, or cure, or change this person?” (p. 32) to his later, fuller question “How can I provide a relationship which this person may use for his own personal growth?” (p. 32). From his training in psychology, Rogers claims to have followed his own instincts into client-centered therapy. His writing overtly embraces that exploration.

Despite his philosophical bent, in large sections of his writing, Rogers draws on established scientific structures or language. He writes a whole chapter which tries to formulate a “general law of interpersonal relationships,” then launches into a lengthy and example-laden consideration of the firmness of knowledge and conclusions within the behavioral sciences at the time. His cognitive resting place seems to be that the behavioral sciences are in their infancy, and while practitioners may rely on a lot of interesting information now being discovered, exploration, philosophy, and instinct still hold places of honor within the field. More than fifty years after the book’s first publication, the situation seems to have changed very little, though there is more data in certain areas. Though Rogers seems to have viewed psychotherapy as a scientific practice, his person-centered view showed him countless variables with which to contend. Perhaps in an environment without controls, philosophy and instinct present better-formed or more immediate solutions than experimentation can.

Rogers seems to boil complex situations down to essentials wherever he can: relationship is his central theme, and empathy, congruence, and unconditional positive regard are the three relationship components. This pursuit of simplicity may be attentiveness to the broad audience of On Becoming a Person or may be indicative of Rogers’ own worldview. Whatever its source, it leaves Rogers open to criticism from those who see things as unsimplifiable. In a similar way, the individual variation and client focus implicit in Rogers’ therapy leave him open to criticism from those who see him acting only as a clarifying mirror for clients, not as a truly congruent party to change-spurring relationships. In one example of a common critique, Ralph H. Quinn (1993) contends that “[a] fully person-centered therapist…would feel compelled to stay with the client’s lead…[and] trust that the client knows best” (p. 20) rather than confronting the client in a moment of genuine human response.

Genuineness in psychotherapy…does not mean simply the willingness to confront a client…. More than anything it means that the therapist must strive to be fully present with the client, to bring all of himself or herself to the therapeutic relationship. As therapists, we must be willing to risk as much as we ask our clients to risk, to be as transparent and courageous as they must be, if the therapy is to produce real life change. (Quinn, 1993, p. 20-21)

This section includes the assertion that bold congruence and full presence are not already parts of person-centered therapy, and Rogers was remiss in not addressing them. Quinn (1993) later implies a fully person-centered approach can easily be seen as practicing “Pollyannish optimism and therapeutic passivity” (p. 21). Such criticism is valid enough, and points out elements of Rogers’ work that may be over-simplified. However, the complexity with which Rogers addresses each essay, idea, and client interaction suggests he did not see humanity or psychotherapy as simple, and did not approach them passively. Rogers may not have dwelled enough in his writing on the practice of congruence; perhaps it was an element that seemed also to contain infinite variables and defy simple definition. I tend to think this criticism stems from a misinterpretation of Rogers’ intentions and practices. In the final analysis, even critic Quinn (1993) only suggests practicing more (riskier?) congruence on the part of the therapist, not abandoning Rogers’ principles.

In terms of my own use of this book, its variety in tone and subject matter makes it a uniquely useful text. Each section and each essay can be read independently, and dipping into Rogers’ world is a clarifying and centering experience that could bring me back to the core of therapeutic practice in times of questioning and uncertainty. Reading this book now gave me a window into the complexities inherent in a model that can be seen as very simple (by Rogers’ design, admittedly). Considering this approach in my own attempts to define or grasp client “distress” has been helpful in placing myself in the wide world of this human-helping profession, and has helped me frame my own conception of what I am doing here and what a client might want or need from me in this role. This reading has been one new way of incorporating personal change into myself: deliberately approaching the self I am discovering myself to be.

 

References

Quinn, R.H. (1993). Confronting Carl Rogers: A developmental-interactional approach to

person-centered therapy. Journal of Humanistic Psychology, 33(1), 6-23. doi:

10.1177/0022167893331002

Rogers, C. (2012). On Becoming a Person. [Kindle Voyage version]. Retrieved from

Amazon.com

Clinical Interviewing, Uncategorized

The 6th Edition of Clinical Interviewing is Now Available

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Way back in 1990, a university book salesman came by my faculty office at the University of Portland. He was trying to sell me some textbooks. When I balked at what he was offering, he asked, “Do you have any textbook ideas of your own?” I said something like, “Sure” or “As a matter of fact, I do.” He handed me his card and a paper copy of Allyn & Bacon’s proposal guidelines.

Not having ever written a book, I never thought they’d accept my proposal.

They did. But after three years, A & B dropped our text.

Lucky for us.

Two  years later, Rita and I decided to try to resurrect our Clinical Interviewing text. We polished up a proposal, sent it out to three excellent publishers, and immediately got contract offers from W. W. Norton, Guilford, and John Wiley & Sons.

We went with Wiley.

Here we are 18 years later in the 6th edition. It’s been fun and a ton of work. Over the past five years we’ve started recording video clips and interviewing demonstrations to go along with the text. For the 6th edition, we got some pretty fantastic reviews from some pretty fancy (and fantastic) people. Here they are:

“I’m a huge admirer of the authors’ excellent work.  This book reflects their considerable clinical experience and provides great content, engaging writing, and enduring wisdom.”
—John C. Norcross, Ph.D., ABPP, Distinguished Professor of Psychology, University of Scranton

“The most recent edition of Clinical Interviewing is simply outstanding.  It not only provides a complete skeletal outline of the interview process in sequential fashion, but fleshes out numerous suggestions, examples, and guidelines in conducting successful and therapeutic interviews.  Well-grounded in the theory, research and practice of clinical relationships, John and Rita Sommers-Flanagan bring to life for readers the real clinical challenges confronting beginning mental health trainees and professionals.  Not only do the authors provide a clear and conceptual description of the interview process from beginning to end, but they identify important areas of required mastery (suicide assessment, mental status exams, diagnosis and treatment electronic interviewing, and work with special populations).  Especially impressive is the authors’ ability to integrate cultural competence and cultural humility in the interview process.  Few texts on interview skills cover so thoroughly the need to attend to cultural dimensions of work with diverse clients.  This is an awesome book written in an engaging and interesting manner.  I plan to use this text in my own course on advanced professional issues.  Kudos to the authors for producing such a valuable text.”
—Derald Wing Sue, Ph.D., Professor of Psychology and Education, Teachers College, Columbia University

“This 6th edition of Clinical Interviewing is everything we’ve come to expect from the Sommers-Flanagan team, and more!  Readers will find all the essential information needed to conduct a clinical interview, presented in a clear, straightforward, and engaging style.  The infusion of multicultural sensitivity and humility prepares the budding clinician not only for contemporary practice, but well into the future.  Notable strengths of the book are its careful attention to ethical practice and counselor self-care. The case studies obviously are grounded in the authors’ extensive experience and bring to life the complexities of clinical interviewing.  This is a ‘must-have’ resource that belongs on the bookshelf of every mental health counselor trainee and practitioner.”
—Barbara Herlihy, PhD. NCC, LPC-S, University Research Professor, Counselor Education Program, University of New Orleans

You can check out the text on Amazon https://www.amazon.com/Clinical-Interviewing-John-Sommers-Flanagan/dp/1119215587/ref=dp_ob_title_bk  or Wiley http://www.wiley.com/WileyCDA/WileyTitle/productCd-1119215587.html  or other major (and minor) booksellers.

 

 

Parenting

The Practically Perfect Parenting Podcast — Episode 2

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Hello Parents, Fans of Parents, and Fans of Healthy Child Development:

I need a tiny bit of your time and help.

As you know, the Practically Perfect Parenting Podcast was launched on October 31. Yesterday, Episode 2 became live. The title: Practically Perfect Positive Discipline. Today, I’m flexing my marketing muscles (which, as it turns out, are disappointingly more like Gilligan’s than the Incredible Hulk)

Podcasts are a competitive media genre. One way we can try to improve our status from way out here in little Missoula, Montana is for people to listen, like, and rate.

Here’s how you can help:

If you use iTunes, here’s the link. https://itunes.apple.com/us/podcast/practically-perfect-parenting/id1170841304?mt=2#episodeGuid=2d80f23353e2c7f9d21af865f190d2c4

Please check it out and if you like it, like it, and then give it the rating you think it deserves. We’re trying to get enough ratings to climb up the iTunes rating list.

If you don’t use iTunes, you can get to our podcasts via this link: http://practicallyperfectparenting.libsyn.com/2016

And, either way, we’d love it if you’d like our Facebook page. To do that, go here: https://www.facebook.com/Practically-Perfect-Parenting-Podcast-210732536013377/?notif_t=page_fan&notif_id=1479160427608384

In addition to your social media ratings, we’re ALWAYS interested in your supportive or constructive feedback. We also take questions and suggestions for new show topics. You can provide any or all of that here on my blog or directly to me via email at john.sf@mso.umt.edu

Thanks!

Dr. John and Dr. Sara, The Practically Perfect Podcasters

pppp2

Suicide Assessment and Intervention

A New Journal Article on Suicide Assessment Interviewing

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Article · Oct 2016 · Professional Psychology Research and Practice
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Counseling and Psychotherapy Theory and Practice

Check Out These Blogs about Counseling Theories

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John and Jon on M

Over the past five years I’ve written over 50 blog posts linked to teaching and learning the theory and practice of counseling and psychotherapy. While procrastinating on another project, I decided to organize these blog posts by topic. If you follow the links below, they’ll take you to blog posts relevant to specific theories. Included in some of these are a few links to short (and free) theories-based video examples. If you teach a theories course, you could select some of these links to assign students outside readings or you could peruse them yourself to stimulate a few lecture ideas.

Please note that if you use our Counseling and Psychotherapy Theories in Context and Practice textbook, there’s a bit of redundancy with the textbook’s content. However, if you don’t use the text, the material will be new to you and your students.

Chapter 1 – Opening and Overview

A Plan for Maximizing Positive Counseling and Psychotherapy Outcomes: https://johnsommersflanagan.com/2014/09/07/a-plan-for-maximizing-positive-counseling-and-psychotherapy-outcomes/

Teaching Counseling and Psychotherapy Theories: Reflections on Week 1: https://johnsommersflanagan.com/2012/08/29/teaching-counseling-and-psychotherapy-theories-reflections-on-week-1/

Reformulating Clinical Depression: The Social-Psycho-Bio Model: https://johnsommersflanagan.com/2013/09/03/reformulating-clinical-depression-the-social-psycho-bio-model/

What’s the Difference between Counseling and Psychotherapy? https://johnsommersflanagan.com/2016/07/14/theories-highlights-i-whats-the-difference-between-counseling-and-psychotherapy/

Neuroscience New Year’s Resolutions: https://johnsommersflanagan.com/2016/01/15/neuroscience-new-years-resolutions-for-2016/

Evidence-Based Relationships in Counseling and Psychotherapy: https://johnsommersflanagan.com/2015/09/29/evidence-based-relationships-three-new-case-examples/

Chapter 2 – Psychoanalytic Approaches

Attachment-Informed Psychotherapy: https://johnsommersflanagan.com/2015/08/12/attachment-informed-psychotherapy/

The Story of Freud’s Seduction Hypothesis: https://johnsommersflanagan.com/2016/07/15/theories-highlights-ii-the-story-of-freuds-seduction-hypothesis/

The Working Alliance in Counseling and Psychotherapy: https://johnsommersflanagan.com/2016/04/06/five-recommendations-for-developing-a-positive-working-alliance/

Chapter 3 – Adlerian Approaches: Individual Psychology

The Three-Step Emotional Change Trick: https://johnsommersflanagan.com/2012/09/23/the-three-step-emotional-change-trick/

A Parenting Homework Assignment on Natural and Logical Consequences: https://johnsommersflanagan.com/2011/11/30/a-parenting-homework-assignment-on-natural-and-logical-consequences/

More Than Praise — Other Ways Parents Can Be Positive With Their Children: https://johnsommersflanagan.com/2012/08/16/more-than-praise-other-ways-parents-can-be-positive-with-their-children/

Chapter 4 – Existential Approaches

Reflections on Listening to Irvin Yalom at the ACA Conference: https://johnsommersflanagan.com/2012/03/25/reflections-on-listening-to-irvin-yalom-at-the-aca-conference/

A Short Existential Case Example from Counseling and Psychotherapy Theories . . .: https://johnsommersflanagan.com/2015/08/25/a-short-existential-case-example-from-counseling-and-psychotherapy-theories/

Fun with Existential Theory: https://johnsommersflanagan.com/2016/08/01/fun-with-existential-theory/

Chapter 5 – Person-Centered Approaches

Reflections on Magic: https://johnsommersflanagan.com/2011/11/28/reflections-on-magic/

Listening as Meditation on Psychotherapy.net: https://johnsommersflanagan.com/2014/02/25/listening-as-meditation-on-psychotherapy-net/

An Interview with Natalie Rogers (Daughter of Carl Rogers) about Person-Centered Therapy: https://johnsommersflanagan.com/2015/08/04/an-interview-with-natalie-rogers-daughter-of-carl-rogers-about-person-centered-therapy/

Why Therapists Should Never Say, “I know how you feel”: https://johnsommersflanagan.com/2013/05/30/why-therapists-should-never-say-i-know-how-you-feel/

Carl Rogers and Brain-Science do an Empathy Smackdown in Chapter 3: https://johnsommersflanagan.com/2015/07/09/carl-rogers-and-brain-science-do-an-empathy-smackdown-in-chapter-3/

An Invitation for Collaboration: https://johnsommersflanagan.com/2016/03/27/using-an-invitation-for-collaboration-in-counseling-and-psychotherapy/

Chapter 6 – Gestalt Approaches

Go Go Gestalt: The Theories Video Shoot, Part I: https://johnsommersflanagan.com/2012/04/24/go-go-gestalt-the-theories-video-shoot-part-i-2/

Chapter 7 – Behavioral Approaches

A Black Friday Tribute to Mary Cover Jones and her Evidence-Based Cookies: https://johnsommersflanagan.com/2011/11/25/a-black-friday-tribute-to-mary-cover-jones-and-her-evidence-based-cookies/

Behavioral Activation Therapy: Let’s Just Skip the Cognitions: https://johnsommersflanagan.com/2014/06/30/behavioral-activation-therapy-lets-just-skip-the-cognitions/

Imaginal or In Vivo Exposure and Desensitization: https://johnsommersflanagan.com/2012/05/19/imaginal-or-in-vivo-exposure-and-desensitization-2/

A New Look at Time-Out for Kids and Parents: https://johnsommersflanagan.com/2012/08/04/a-new-look-at-time-out-for-kids-and-parents/

Information on Using Time-Out — Part II: https://johnsommersflanagan.com/2012/08/05/information-on-using-time-out-part-ii/

Talking with Parents about Positive Reinforcement: https://johnsommersflanagan.com/2014/09/06/talking-with-parents-about-positive-reinforcement/

Backward Behavior Modification: https://johnsommersflanagan.com/2012/12/02/backward-behavior-modification/

Behaviorism for Everyone: https://johnsommersflanagan.com/2015/10/06/dont-let-your-philosophical-beliefs-make-you-less-professionally-competent/

Chapter 8 – Cognitive-Behavioral Approaches

Positive Thinking is Not (Necessarily) Rational Thinking: https://johnsommersflanagan.com/2011/12/06/positive-thinking-is-not-necessarily-rational-thinking/

How to Use the Six Column CBT Technique: https://johnsommersflanagan.com/2014/02/18/how-to-use-the-six-column-cbt-technique/

A Quick Look at the Collaborative Cognitive Therapy Process: https://johnsommersflanagan.com/2012/09/30/a-quick-look-at-the-collaborative-cognitive-therapy-process/

Tomorrow’s Election and Confirmation Bias: https://johnsommersflanagan.com/2012/11/05/tomorrows-election-and-confirmation-bias/

Confirmation Bias on My Way to Spearfish, South Dakota: https://johnsommersflanagan.com/2014/04/30/confirmation-bias-on-my-way-to-spearfish-south-dakota/

Chapter 9 – Choice Theory and Reality Therapy

The Seven Magic Words for Parents: https://johnsommersflanagan.com/2012/12/23/the-seven-magic-words-for-parents/

Give Information and then Back-Off: A Choice Theory Parenting Assignment: https://johnsommersflanagan.com/2012/07/09/give-information-and-then-back-off-a-choice-theory-parenting-assignment/

How Parents Can Use Problem-Solving Power: https://johnsommersflanagan.com/2012/10/23/how-parents-can-use-problem-solving-power/

Chapter 10 – Feminist Approaches

Opening Thoughts on Feminism: https://johnsommersflanagan.com/2012/04/03/opening-thoughts-on-feminism-3/

The Girl Code by Ashley Marallo: https://johnsommersflanagan.com/2012/12/03/the-girl-code-by-ashley-marallo/

A Guest Essay on the Girl Code and Feminism: https://johnsommersflanagan.com/2014/12/07/a-guest-essay-on-the-girl-code-and-feminism/

Feminist Culture in Music: https://johnsommersflanagan.com/2013/11/18/feminist-culture-in-music/

Chapter 11 – Constructive (Solution-Based and Narrative) Approaches

Is Solution-Focused Therapy as Powerfully Effective as Solution-Focused Therapists Would Have Us Believe?: https://johnsommersflanagan.com/2012/07/01/is-solution-focused-therapy-as-powerfully-effective-as-solution-focused-therapists-would-have-us-believe-2/

Secrets of the Miracle Question: https://johnsommersflanagan.com/2015/03/04/secrets-of-the-miracle-question/

The Love Reframe: https://johnsommersflanagan.com/2013/04/07/the-love-reframe/

Constructivism vs. Social Constructionism: What’s the Difference? https://johnsommersflanagan.com/2015/12/05/constructivism-vs-social-constructionism-whats-the-difference/

Chapter 12 – Family Systems Approaches

None posted on this topic. Obviously, I need help here.

Chapter 13 – Multicultural Approaches

Four Good Ideas about Multicultural Counseling and Psychotherapy—In Honor of Martin Luther King, Jr.: https://johnsommersflanagan.com/2012/01/16/four-good-ideas-about-multicultural-counseling-and-psychotherapy-in-honor-of-martin-luther-king-jr/

Good Ideas about Multicultural Counseling and Psychotherapy – Part II: https://johnsommersflanagan.com/2012/01/22/good-ideas-about-multicultural-counseling-and-psychotherapy-part-ii/

Cultural Adaptations in the DSM-5: Insert Foot in Mouth Here: https://johnsommersflanagan.com/2014/07/08/cultural-adaptations-in-the-dsm-5-insert-foot-in-mouth-here/

Psychic Communications . . . and Cultural Differences in Mental Status: https://johnsommersflanagan.com/2013/01/02/psychic-communications-and-cultural-differences-in-mental-status/

A White Male Psychologist Reflects on White Privilege: https://johnsommersflanagan.com/2012/09/14/a-white-male-psychologist-reflects-on-white-privilege/

Tips for Counseling Culturally Diverse Youth: https://johnsommersflanagan.com/2015/11/19/counseling-culturally-diverse-youth-research-based-and-common-sense-tips/

Chapter 14 – Integrative Approaches

Making Memories in L.A.: An Interview with Matt Englar-Carlson: https://johnsommersflanagan.com/2016/05/20/making-memories-in-l-a/

My Response to a Petition from a Theories Class at Xavier University: https://johnsommersflanagan.com/2016/04/29/why-xavier-university-students-in-cincinnati-sent-me-a-petition/

With Wubbolding

Counseling and Psychotherapy Theory and Practice

Fun with Existential Theory

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I think existentialists have gotten a bad rap over the years. They don’t deserve their depressive reputation. If you’re not sure about this claim, invite a bunch of existentialists over for a party. They know how to have a good time. Just think of Jean Paul Sartre and Simone de Beauvoir. I’m sure they did some table-dancing (among other things) in their time.

Why are they so much fun? Well, in addition to their tendency to go on and on about death and meaninglessness, existentialists were some of the original embracers of carpe diem. They believe in seizing the day (or moment)–regardless of whether they’re playing Pokemon Go or working with you in counseling or psychotherapy.

Below I’ve included a short excerpt from the upcoming 3rd edition of Counseling and Psychotherapy Theories in Context and Practice. One of the reasons I’m posting this is because one of the reviewers of the 2nd edition noted that we were trying too hard to to be “cute” . . . so I thought I’d see if any of you blog-readers think that’s the case. This particular excerpt is as cute as we get in this chapter. What do you think?? Overboard? Just right? Or should we try to be more like Stephen Colbert. You be the judge in this moment in time.

Theoretical Principles

As noted previously, there’s no single theorist or theory of existential psychotherapy. Consequently, although we focus on key existential philosophical and phenomenological principles, other existential writers and theorists may emphasize principles slightly different from the following.

The I-Am Experience

The I-am experience is the experience of being, of existing (R. May et al., 1958). The experience of being is often referred to as ontological experience (ontos means “to be” and logical means “the science of”). Literally, then, a major focus of existential therapy consists of exploring immediate human experience. You might think of it as suddenly waking up and being completely tuned into what it’s like to exist and be here and now in this particular moment in time.

Existentialists like to use hyphens to capture the interconnectedness of phenomenological experience. For example, in contrast to May’s I-am experience, Boss (1963) and Binswanger (1933) used Dasein (which is translated to being-in-the-world) to describe the sense-of-existence. Also, the phrase, “Dasein choosing,” which is translated to the-person-who-is-responsible-for-his-existence choosing is used. We should note that this practice is in no way related to our own hyphenated last names, although it has inspired John to consider adding a hyphenated middle name so he can refer to himself in the third person as, “John-who-is-responsible-for-his-existence-Sommers-Flanagan,” which he thinks sort of rolls right off the tongue.

It follows, as-if-anything-really-follows-from-the-preceding, that existential therapy is almost always in the service of self-awareness or self-discovery. However, unlike psychoanalysts, existentialists seek to expand client self-awareness rather than interpreting client unconscious processes. This is because existentialists believe the entirety of an individual’s human experience is accessible to consciousness. It’s not so much a matter of uncovering an elusive unconscious as it is a matter of elucidating the conscious and deepening the relational.

Four Existential Ways of Being

There are four primary existential ways of being-in-the-world. They include:

  1. Umwelt: Being-with-nature or the physical world.
  2. Mitwelt: Being-with-others or the social world.
  3. Eigenwelt: Being-with-oneself or the world of the self.
  4. Uberwelt: Being-with-the-spiritual or over world.

The first three of these existential ways of being were described by Boss (1963), Binswanger (1963), and May et al. (1958). The fourth way of being was added by van Deurzen (1988).

These four dimensions of existence are ubiquitous and simultaneous. Some people focus more on one dimension than others or shift from one to another depending on particular intentions or situations. For example, while on a mountain hike up the Stillwater gorge in Montana, it’s difficult not to become profoundly into being-with-nature as water powerfully cascades around you, making all conversation (being-with-others) impossible. However, depending on other factors, this experience can take people inward toward eigenwelt, toward an uberwelt spiritual experience, or stimulate a deep mitwelt (albeit a nonverbal one). In most cases the direction that your being moves in a given situation is likely a combination of several factors, including, but not limited to: anxiety, previous experiences, intention, as well as your spiritual predisposition.

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Counseling and Psychotherapy Theory and Practice

Theories Highlights II: The Story of Freud’s Seduction Hypothesis

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Let’s put it this way: When it comes to the history of counseling and psychotherapy, there’s plenty of conflict and drama. In the following excerpt from Chapter 2 of Counseling and Psychotherapy Theories in Context and Practice, you’ll get to read about Freud and his formulation and then recanting of the seduction hypothesis. Is it all true and factual? Probably not. Is it fascinating? As Freud would have likely said, “Hell yes!”

Historical Context

As suggested toward the end of Chapter 1, psychological theories are partly a product of the prevailing Zeitgeist and Ortgeist. Bankart (1997) stated:

To fathom Freud’s near-obsession with the sexual foundations of emotional distress is also to come to a fuller awareness of the sexual repression and hypocrisy in the lives of the Austrian middle class at the turn of the…[nineteenth] century and the effect of this repression on the mental health of adolescents and young adults during the time when Freud derived his theories. (p. 8)

A good illustration of psychoanalytic historical context and of Freud’s dominant persuasive powers is the dramatic story of Freud’s development and subsequent recanting of the seduction hypothesis. This story captures his psychoanalytic thinking along with the social dynamics of his time. Interestingly, there’s conflict over the truth of this story—which further illustrates the divisive nature of Freud and his legacy. As you read through the drama of the seduction hypothesis, keep in mind that certain points have been contested…but the unfolding of a spectacular drama around sexuality, sexual fantasy, and sexual abuse in a sexually repressed society is likely accurate.

The Seduction Hypothesis

In 1885, Freud went to France to study under the famous neurologist Jean Charcot. According to Jeffrey Masson, former projects director of the Freud Archives, it’s likely that Freud visited the Paris Morgue, observing autopsies of young children who had been brutally physically and sexually abused (Masson, 1984). Masson speculated that Freud’s exposure to the grisly reality of child abuse combined with stories of abuse he heard from his patients, led him to believe that hysteria was caused by child sexual abuse.

Later, Freud presented a paper titled “The Aetiology of Hysteria” at the Society for Psychiatry and Neurology in Vienna (Freud, 1896). In this paper, he outlined a controversial hypothesis:

I therefore put forward the thesis that at the bottom of every case of hysteria there are one or more occurrences of premature sexual experience, occurrences which belong to the earliest years of childhood, but which can be reproduced through the work of psychoanalysis in spite of the intervening decades. (Freud, 1896, cited in Masson, 1984, p. 263)

Note that Freud stated, “. . . at the bottom of every case of hysteria.” He was emphasizing a clear causal connection between childhood sexual abuse and hysteria. This presentation was based on 18 cases (12 women and 6 men), all of which included childhood sexual abuse. At least three key points are important in this presentation:

  1. Freud’s idea about the connection between childhood sexual abuse and subsequent psychopathology may represent an early formulation of the contemporary diagnosis of Posttraumatic Stress Disorder and/or Dissociative Identity Disorder.
  2. Critics contend that in Freud’s paper, “the ‘facts’ of specific case histories are never provided” (Wilcocks, 1994).
  3. Freud may have been constructing sexual memories both through a direct pressure technique and by distorting what he heard to fit with his pre-existing ideas (Esterson, 2001).

Despite a lack of supporting detail in his presentation and the possibility that he was building evidence to support his theory, Freud goes on to suggest that hysterical symptoms don’t arise immediately, but instead develop later:

Our view then is that infantile sexual experiences…create the hysterical symptoms, but…they do not do so immediately, but . . . only exercise a pathogenic action later, when they have been aroused after puberty in the form of unconscious memories. (Freud, 1896, cited in Masson, 1984, p. 272)

It appears that Freud continued to believe his clients’ sexual abuse stories (or perhaps he believed his own constructed version of his client’s sexual abuse stories) until the late 1800s or early 1900s.

Recanting the Seduction Hypothesis

Imagine yourself alone with a great and horrible insight. In Masson’s version of the seduction hypothesis story, this was Freud’s situation. Masson (1984) describes the reception Freud received after presenting his hypothesis (and this part of the seduction hypothesis story is not disputed):

The paper…met with total silence. Afterwards, he was urged never to publish it, lest his reputation be damaged beyond repair. The silence around him deepened, as did the loneliness. But he defied his colleagues and published “The Aietology of Hysteria.” (pp. xviii–xix)

Five days after presenting his paper, Freud wrote about the experience to his friend and otolaryngologist (ear, nose and throat physician) Wilhelm Fliess. Freud’s anger is obvious:

[My] lecture on the aetiology of hysteria at the Psychiatric Society met with an icy reception from the asses, and from Kraft-Ebing [the distinguished professor and head of the Department of Psychiatry at the University of Vienna] the strange comment: “It sounds like a scientific fairy tale.” And this after one has demonstrated to them a solution to a more than thousand-year-old problem, a “source of the Nile!” They can all go to hell. (Schur, 1972, p. 104)

Although it’s clear that Freud’s lecture received “an icy reception” it’s less clear why the audience was unimpressed. According to Masson, the reception is icy because Freud is bringing up sex and sexual abuse and that psychiatry (and most professionals and citizens at the time) were uncomfortable with facts linked to high sexual abuse rates. Alternatively, others have suggested that Freud’s style, perhaps a combination of arrogance along with an absence of scientific rigor or detail, moved the audience to rebuke him. For example, Wilcocks (1994) wrote:

The inferential support offered—without detail, of course—is that in eighteen cases out of eighteen, Freud has “discovered” the same etiological factors. But since neither we nor his audience are/were privy to the circumstances of any of his cases, this claim—whatever it’s other inferential mistakes—is simply useless. (p. 129)

It may never be clear whether Freud’s motives in presenting the seduction hypothesis were noble or manipulative. However, regardless of motive, the ensuing years following his “Aetiology of Hysteria” lecture were difficult. Reportedly, his private practice was in decline and his professional life in shambles. It was at this time that Freud began what has been described as “his lonely and painful self-analysis” (Prochaska & Norcross, 2003, p. 29). His 2-year self-analysis included uncovering memories of yearning for his mother and equally powerful feelings of resentment toward his father (Bankart, 1997).

Eventually, Freud discarded his seduction hypothesis in favor of the Oedipus complex (where the child holds unconscious wishes to have sexual relations with the parent of the opposite sex). Some suggest this was because he began noticing seductive patterns in so many parent-child interactions that it was unrealistic to assume that child sexual abuse occurred at such a ubiquitous rate. Others believe Freud was ahead of his time in discovering child sexual abuse, but buckled under the social and psychological pressure, abandoning the truths his patients shared with him. Still others contend that while Freud was constructing his theoretical principles, he was projecting and mixing his own fantasies into his clients’ stories. The following statement illustrates the highly personalized nature of some of Freud’s theorizing:

I found in myself a constant love for my mother, and jealousy of my father. I now consider this to be a universal event in childhood. (R. A. Paul, 1991)

Eventually, in 1925, long after he recanted the seduction hypothesis, he reflected on his struggle:

I believed these stories, and consequently supposed that I had discovered the roots of the subsequent neurosis in these experiences of sexual seduction in childhood.… If the reader feels inclined to shake his head at my credulity, I cannot altogether blame him.… I was at last obliged to recognize that these scenes of seduction had never taken place, and that they were only fantasies which my patients had made up. (Freud, 1925, cited in Masson, 1984, p. 11)

In the creation and recanting of the seduction hypothesis, it’s difficult to sort out fact from fantasy. Perhaps this is as it should be, as it illustrates at least one formidable lesson about psychology. That is, when diving headlong into the deep psychological processes of humans, it’s possible to elicit confused and confusing storylines and to knowingly or unknowingly (unconsciously) mix (or project) our own personal issues into the plot. In the end, it may be that we create Kraft-Ebing’s “Scientific fairy tale” or, alternatively, something with lasting and meaningful significance. More likely, we create a combination of the two. (See Table 2.1 for three possible conclusions about Freud and the seduction hypothesis.)

Table 2.1: Freud’s Seduction Hypothesis: Three Conclusions

The official Freudian storyline goes something like this: Sigmund Freud was an astute observer who had to discard his earlier views about child seduction and sexual abuse to discover the more basic truth of the power of internal fantasy and of spontaneous childhood sexuality.

Although he initially believed his clients’ sexual abuse reports, he later discovered that it was not actual abuse, but imagined sexualized relationships (fantasies) between children and caretakers—aka: the Oedipus complex—that caused psychopathology.

 Masson’s (1984) version, subsequently labeled “a new fable based on old myths” (Esterson, 1998), suggests that Freud was ahead of his time in recognizing child sexual abuse. These abuses were real and it was correct of Freud to identify them and to develop his seduction hypothesis. However—and unfortunately—Freud abandoned his sexually abused clients by recanting the seduction theory. He abandoned them because of pressure from medical and scientific colleagues and because society was not ready to face the reality of rampant child sexual abuse. Freudian critics suggest that Freud was an exceptionally bright, persuasive, and powerful speaker and writer, but he was practicing bad science. He was more interested in building his theory than psychological reality. Consequently, he twisted his clients’ stories, mixing them with his own issues and fantasies, and created an elaborate theory initially around sexual abuse and later around sexual fantasy. His theories, although fascinating and capturing much about the projective potential in human thinking, are more about Freud than they are about his clients.