Tag Archives: psychotherapy theories

Readers Needed for our Counseling and Psychotherapy Textbook

Hello All.

We’ve just started working on the 3rd edition revision of our textbook, “Theories of Counseling and Psychotherapy in Context and Practice.”

For each edition of this and our Clinical Interviewing textbooks, we ask interested students, professionals, and academics to provide feedback. This is usually a positive process for us and for reader-volunteers because we usually end up learning from each other.

This time around, to make things manageable on my end, I’ll be accepting the first two volunteers for each chapter. If you’re interested, take a look at the list of chapters below.

What do you get out of the deal? Well, you get that nice warm feeling . . . AND a complimentary copy of the text (when it comes out) and your name and affiliation listed in the acknowledgements section of the text, and a BIG THANKS from Rita and me for your insights and assistance.

Thanks for your potential interest and have a great weekend.

Below there’s an outline listing the existing textbook chapters. If you’re interested in reading and commenting on one of these or need more information, send me an email: john.sf@mso.umt.edu

Thanks again for your interest and support!

John

Chapter 1: Psychotherapy and Counseling Essentials: An Introduction

Chapter 2: Psychoanalytic Approaches** [Each of the subsequent theories chapters follows the same outline as this one]**  

Biographical Information: Sigmund Freud

Historical Context

Psychoanalytic Theoretical Principles

Evolution and Development in Psychoanalytic Theory and Practice

The Practice of Psychoanalytic Therapy

Case Analysis and Treatment Planning

Evidence-Based Status

Concluding Comments

Chapter Summary

Psychoanalytic Key Terms

Recommended Readings and Resources

Chapter 3: Individual Psychology and Adlerian Therapy

Chapter 4: Existential Theory and Therapy           

Chapter 5: Person-Centered Theory and Therapy             

Chapter 6: Gestalt Theory and Therapy 

Chapter 7: Behavioral Theory and Therapy          

Chapter 8: Cognitive-Behavioral Theory and Therapy     

Chapter 9: Choice Theory and Reality Therapy   

Chapter 10: Feminist Theory and Therapy            

Chapter 11: Constructive Theory and Therapy    

Chapter 12: Family Systems Theory and Therapy              

Chapter 13: Developing Your Multicultural Orientation and Skills              

Chapter 14: Integrative and Evidence-Based New Generation Therapies 

One Theory or Many?

Psychotherapy Integration: Historical and Theoretical Trends

The Practice of Eclectic and New Generation Integrative Therapies

Concluding Comments

Chapter Summary

Integrative Key Terms

Recommended Readings and Resources

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

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.

Doing an Internet Interview on IHeart Radio

Today I did an internet interview with Dr. Carlos Vazquez on his “Circle of Insight” show on IHeart Radio. A few minutes after we finished, I got an email from Dr. Carlos indicating it was posted and ready to hear. Wow. Technology is amazing and it’s especially amazing when it works.

Here’s the link to the interview. Check it out if you like. Or ignore it if you prefer.

https://www.spreaker.com/episode/7224462

The show is titled: A discussion about Psychological Theories and how to talk to parents so they Listen with Dr. Sommers-Flanagan

This is what I look like when I do radio interviews.

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Tips for Teaching Theories of Counseling and Psychotherapy

[These tips are adapted from the online instructor’s manual for

Counseling and Psychotherapy Theories in Context and Practice by

John and Rita Sommers-Flanagan, John Wiley & Sons, 2012]

            At the University of Montana,  we teach theories in both large lecture sections and in smaller graduate seminars. Regardless of class size and venue, we find the following teaching strategies useful.

  1. Open the class with an engaging story about whichever theory, theorist, or approach you’ll be covering.
  2. Alternatively, open class with a quick reflection on what students recall from the previous class period.
  3. Then transition to a brief description or outline of what you intend to cover (generally we follow the outline of the chapter, but regularly make planned or spontaneous detours).
  4. Focus on historical context and biographical information linked to the theory/theorist. We use some of the powerful quotations available in the text and elsewhere for this and have the quotations on the powerpoint slides.
  5. Transition to theoretical principles.
  6. Approximately every 15-20 minutes we weave in one of the following teaching strategies
    1. A personal or professional anecdote about the theory or theorist (e.g., When I met William Glasser in the ACA Exhibition Hall)
    2. A short “turn to your table or neighbor” discussion question; we generally allow 3-5 minutes for these activities
    3. A short answer question posed to the entire class
    4. A video clip (this may include a youtube video or a more professional video clip demonstrating a therapy technique)
    5. A short interactive activity where students turn to each other and “try out” specific counseling or psychotherapy techniques (e.g., we have students do a 90 second “free association” with each other – see Section Two of the Instructor’s Manual for more interactive, in-class activities)
    6. A brief in-class demonstration of a technique with a class volunteer, followed by classroom debriefing and discussion
    7. A story about a specific therapy case that illustrates how the theoretical perspective is applied
    8. After reviewing the key theoretical principles, it’s time to focus on specific therapy process and specific therapy techniques associated with the theory. This is one place where we’re likely to do an in-class demonstration or a therapy video clip. However, our policy is to keep things moving by never going over 10 minutes of a demonstration or video without stopping the action and discussing student observations.
    9. After reviewing specific therapy process and techniques (including demonstrations), we move to briefly exploring the evidence-base or empirical support for the approach. We recognize that this is not a class that emphasizes research, but featuring a particular research study or reviewing meta-analytic data can help keep students oriented to the value and limits of research.
    10. Although we try to integrate ethics and diversity issues into as many parts of our lecture and class presentation as possible, at the very least we take time to focus on these issues toward the end of class. For example, we pose questions to the class like: (a) How do you think you could apply this approach with an Native American client, or (b) What are some of the common ethical issues that might arise when doing Gestalt therapy?
    11. At the end of each class we make a practice of asking students to do an informal homework assignment. For example, after the class on psychoanalytic theory and therapy we ask students to pay attention to the internal thoughts (or voice) in their head and think about whether this inner voice is speaking nicely to them (e.g., supportive ego type inner speech) or harshly (e.g., more like a negative internalized object or harsh superego/conscience). The purpose of these informal assignments is to help students not just gain intellectual knowledge, but to have them experience how the theoretical concepts might play out in their lives.

Perhaps the most important principle to teaching theories is to never let too much time pass without student-student or student-instructor interaction. The purpose of these interactions is to not simply keep the class moving and students engaged (although that’s important as well), but to consistently make counseling and psychotherapy theory and technique something that students are able to talk about and connect with their daily experiences.