Tag Archives: Religion

Choice Theory/Reality Therapy and Spirituality

John and Bob Wubbolding 2017 B

Counseling and psychotherapy theories are wildly variable and surprisingly convergent. What do I mean by this? Well, despite the fact that Sigmund Freud and Francine Shapiro and Steven Hayes and Marsha Linehan have very different ideas about what helps people change for the better, there’s also a boatload of commonality.

Based on my narrow range of experience and knowledge, nowhere is there more commonality than the theoretical outposts of Adlerian theory (i.e., Individual Psychology) and Choice Theory/Reality Therapy. Both of these approaches include a broad theoretical concept related to an individual’s personal and cultural construction of how they view themselves, others, and the world (i.e., Adlerians say “Lifestyle” while Reality Therapists say “Quality World”); both perspectives view individuals as pulled forward by internal values (and not driven by Freudian conflicts); both perspectives view behavior as purposeful, and perhaps not coincidently, they also view psychopathology as purposeful.

All this theory-speak is way for me to introduce this post as a continuation of my spirituality and counseling/psychotherapy theories series. What’s especially interesting about this post (IMHO) is that I’m writing about spirituality and Reality Therapy. I mean, how can a form of therapy that explicitly emphasizes “reality,” accommodate “spirituality?” We’ll see about that . . . maybe.

Chapter 9 of Counseling and Psychotherapy Theories in Context and Practice focuses on choice theory and reality therapy. Many people may not perfectly understand the definitions of choice theory and reality therapy. As a quick refresher, here’s an excerpt from the beginning of Chapter 9, followed by the brief spirituality section.

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Reality therapy is often oversimplified and confused with confrontational therapeutic approaches. In this chapter we describe and explain the nuances and clarify the confusion.

What is Choice Theory and Reality Therapy?

Glasser developed reality therapy in the 1960s. Later, recognizing that he needed a theoretical foundation for his therapeutic approach, he began exploring cybernetics and control system theory (Powers, 1973; Wiener, 1948). Initially, Glasser used control theory to explain reality therapy. Later, he adapted the theoretical model and shifted to using choice theory (Glasser, 1998).

Choice theory is based on the idea that conscious behaviors are chosen in an effort to satisfy one of five internal basic human needs (Wubbolding & Brickel, 2017). The human mind or brain acts as a “negative input control system,” providing feedback to individuals so that they can correct behaviors and continue getting what they need and want (Wubbolding, 2012, p. 13).

Reality therapy is a present-focused, directive therapeutic approach designed to help individuals identify and satisfy their needs and wants more consistently and adaptively. As Wubbolding (2012) has written, “If choice theory is the track, reality therapy is the train that delivers the product” (p. 5).

Choice Theory, Reality Therapy, and Spirituality

In the 1989 Spring issue of the Journal of Reality Therapy, Brent Dennis, a certified reality therapist, wrote an article titled, “Faith: The fifth psychological need.” Glasser (1989) responded later that year. Glasser noted that he found the discussion interesting, but that there is “no possible way to resolve an argument about belief” (p. 29). He concluded with a statement embracing inclusiveness toward whatever anyone might place in their quality world. Consistent with this perspective, contemporary reality therapists have published book chapters on how to help interfaith and multicultural couples succeed in their partnerships and marriages (Minatrea & Duba, 2012; Olver, 2012). It’s interesting however, that Glasser described faith as residing in an individual’s quality world; he did not embrace it as a new psychological human need.

In an article on integrating reality therapy into Malaysian Islamic culture, Jusoh and Ahmad (2009) described many ways in which choice theory is consistent with Islam and can be practiced in Asian cultures. Specifically, they focused on the WDEP and SAMI2C3 systems and emphasized their compatibility with Islamic concepts. They concluded that “choice theory and reality therapy have universal attributes, and these can be interpreted in any religion or culture” (2009, p. 7). This statement seems consistent with Glasser’s (1989) inclusive statement on spirituality as a potential human need.

Overall, aside from the content briefly summarized here, little information exists on the integration of spirituality into reality therapy. However, given the growing international flavor of CT/RT, progress in this area seems inevitable.

 

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CBT and Spirituality

Evening Snow Absarokee

We have a friend who is the pastor of a church in Absarokee, Montana. My impression is that she frequently talks about theories of counseling and psychotherapy . . . even though I’m sure she hasn’t planned to integrate psychological theory into her sermons. The fact that I hear psychological theories as she talks theology is just another way in which the lens of the listener frames what is heard, seen, and experienced.

Today she was preaching about feelings of inferiority. She made the case, as Adler would, that inferiority feelings are natural and normal. Then she shifted to God’s acceptance or grace. Surprisingly (to me) her focus on acceptance reminded me of Albert Ellis’s REBT and his concept of universal self-acceptance. Although my friend was speaking about God’s acceptance of all humans, regardless of our warts and behaviors, I found myself thinking of times when I’ve heard parents express deep acceptance of their children and of when clients have strived to experience greater self-acceptance.

All this brought me to a place where I started thinking about how Ellis and his REBT model might actually have a spiritual dimension. “That was pleasantly unexpected” I thought to myself . . . which prompted me to write this Sunday evening spirituality post.

The following is an excerpt (preview) from the cognitive behavior chapter of the forthcoming 3rd edition of Counseling and Psychotherapy Theories in Context and Practice. Please let me know what you think.

CBT and Spirituality

Like all therapists, cognitive behavior therapists work with religious or spiritual clients. Given that cognitively oriented therapists routinely identify and challenge (either through disputation or collaborative empiricism) client beliefs, there’s a risk that clients’ deeply held religious or spiritual beliefs might also be challenged. Additionally, practiced as a radical modernist scientific paradigm, CBT has been critiqued for overlooking transcendence, grace, and evil (Stewart-Sicking, 2015).

Looking at the situation logically (which cognitive theorists would appreciate), CBT practitioners have three options:

  1. Ignore client religion and spirituality.
  2. Freely challenge religious beliefs, whenever they cause emotional distress.
  3. Integrate religious/spiritual knowledge into practice in a way that supports nuanced discussions of religion and spirituality. Unhelpful or irrational thoughts might be questioned, as needed, but not central religious values (Johnson, 2013).

Historically, cognitive therapists have followed these first two options, mostly ignoring religion, or questioning its rational foundations (Andersson & Asmundson, 2006; Nielsen & Ellis, 1994). However, in the past decade or two, interest in integrating religion/spirituality into counseling and psychotherapy has increased (Stewart-Sicking, 2015).

It can help to think about client religion/spirituality as a multicultural/diversity issue. If so, the general guide is for therapists to (a) seek awareness of their own spiritual and religious attitudes and how they might affect counseling process and specific clients, (b) obtain relevant knowledge about religion/spirituality, (c) learn religion/spirituality specific skills, and (d) advocate for individuals who are oppressed on the basis of religion/spirituality as needed and as appropriate. Each of these cultural competence components can be stimulating for individual practitioners.

For practitioners interested in religion/spirituality integration with cognitive approaches, the following two areas can provide focus for further training and development.

Gain and Apply Scriptural Knowledge with Clients

Gaining knowledge regarding how to use specific religious scriptures to dispute irrational or maladaptive cognitions may seem daunting. However, from an REBT perspective, Nielsen (2001) wrote:

Since clients usually upset themselves through their awfulizing, demanding, frustration intolerance, and human rating, REBTers need only search Scriptures that decatastrophize life, suggest forbearance in the face of uncontrollable people and situations, tolerance of life’s frustrations, and that affirm basic human equality. The prominent religious writings of most major world religions emphasize such rational values. (p. 38)

Using scriptural knowledge would be most appropriate when working with clients who have similar religious beliefs. Nielsen (2001) is advocating general knowledge, but general knowledge could prove problematic. For example, if a Jewish therapist quoted the Koran to a Muslim client, the discussion might quickly shift away from being therapeutic. On the other hand, having general knowledge, if used sensitively, could represent appreciation of religious diversity and enhance the working alliance.

Use Spiritual Principles of Acceptance for Managing Disturbing Cognitions.

Contemporary CBT approaches (covered in Chapter 14) offer an alternative way of viewing and handling so-called irrational or maladaptive cognitions. These approaches include acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), and mindfulness-based cognitive therapy (MBCT). ACT, DBT, and MBCT integrate religious/spiritual philosophy (e.g., Buddhism, contemplative Christian, etc.) and generally view cognitions as disturbing, but not necessarily pathological. Acceptance of all cognitions is advocated; encouraging clients to dispute or restructure their thoughts, memories, and experiences can increase suffering (Hayes, 2016).

 

Behavior Therapy and Spirituality

1974 Football Cropped II

The whole idea of integrating behavior therapy with religion and spirituality might seem odd or off or impossible. But here in Theories Land, we don’t believe in the impossible. In fact, many religious folks do just fine with behavior therapy and many behavior therapists do just fine with religious folks. If you think about it, for behaviorists, the focus is purely on problematic behaviors. In some ways, this naturally leads to an acceptance of all people . . . .

Put another way, for behaviorists, there’s no room or need for discrimination based on race, sexuality, or religion. Behaviorists work with all people to help them with their problem behaviors.

Rather than digressing into the political, let’s refocus on behavior therapy and spirituality. Here’s the short section from the 3rd edition of Counseling and Psychotherapy Theories in Context and Practice. If you feel moved (by the spirit, or anything else), please let me know what you think.

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Strict behaviorists don’t believe in the utility of cognition. The clients’ problems are behaviors. Behavioral treatments involve new learning to facilitate behavior change. If you stick with the perspective that cognition is irrelevant—which is the perspective we’re sticking with in this chapter—then client religious or spiritual beliefs are also not relevant.

Considering religious and spiritual beliefs as irrelevant doesn’t imply disrespect for religious and spiritual beliefs. Behaviorists are respectful of beliefs, but the focus of therapy would be on behaviors—these behaviors could include religious or spiritual behaviors. If you’re following the logic here, then you can see that behavior therapy is 100% compatible with religion and spirituality.

The focus of behavior therapy with religious and spiritual clients would be on behaviors that are related to religion and spirituality. From a behavioral model, the question is, “Are your religious/spiritual behaviors causing you distress or contributing to your well-being?” The good news about this is that behavior therapy is an evidence-based approach for modifying behavior, including the development of positive and healthy habits (and behaviors commonly thought of as representing self-control and self-discipline). The focus on enhancing self-control and self-discipline is a good fit for clients with religious or spiritual orientations (Shapiro, 1978).

Researchers have explored the relationship between behavioral activation and client values. In one study, it was found that when individuals with high intrinsic religious values engaged in a greater frequency of religious behaviors, they reported reduced depressive symptoms (Agishtein et al., 2013). Conversely, for individuals with low intrinsic religious values, increasing religious behaviors were associated with more depressive symptoms. In conclusion, despite disregard for religious/spiritual beliefs, a strict behavioral approach can be used to increase or decrease specific religious and spiritual behaviors. . . and increasing or decreasing specific religious and spiritual behaviors may be therapeutic—depending on the individual client and his/her/their situation.

 

Person-Centered Spirituality

Rogerian Spirituality

Most of the distinct figures who developed major theories of psychotherapy also had distinct views about religion and spirituality. As you may recall, Freud was antagonistic toward religion. One of the interesting parts of exploring how each theoretical orientation deals with spirituality has involved learning a bit more about the religious and spiritual perspectives of people like Freud, Adler, and others.

In chapter 5 of Counseling and Psychotherapy Theories in Context and Practice, the focus is on Carl Rogers. Other than knowing that he was raised in a conservative Christian family, I didn’t know much about Rogers and his personal spirituality. Here’s a sampling of what I discovered.

Person-Centered Spirituality

On his journey to developing person-centered theory and therapy, Carl Rogers renounced traditional Christianity. Given that all religions, including Christianity, can be viewed as directly imposing judgmental conditions of worth, Rogers’s renouncing Christianity as antithetical to his beliefs is not surprising. In particular, Rogers may have been especially reactive to religious dogma because of his childhood experiences in an extremely conservative Christian family. Thorne (1990) proposed that Rogers broke from Christianity, at least in part, over the doctrine of original sin.

Although he died an agnostic, toward the end of his life, Rogers began speaking about transcendental or mystical experiences (Thorne, 1992). These spiritual statements were mostly made in the context of interpersonal mutuality and human connection, derived from person-centered or I-Thou experiences. Within the person-centered world, his statements about spirituality have been viewed as controversial (Fruehwirth, 2013). In an interview with Elizabeth Sheerer, one of Rogers’s early colleagues at the University of Chicago Counseling Center, Sheerer was asked about why Rogers never formally addressed spirituality. Her response included:

That’s Carl. This was an area of difficulty for Carl. We learned early in the game not to talk about religion with Carl … it was uncomfortable for him …. But, of course, his work is so profoundly influenced by his background in Christianity. I don’t think he could have developed without that background. (Barrineau, 1990, pp. 423–424)

There have been contemporary efforts to build a bridge between spirituality and PCT. On example is Fruehwirth’s (2013) work connecting PCT and Christian contemplation. He proposed that if wordless contemplation can be regarded as “the heart of the Christian spiritual tradition” (p. 370), then parallels can be drawn to wordless contemplation and the PCT experience. Similarly, a case can be made connecting the acceptance doctrine of Christian, Buddhist, and other religious viewpoints with the PCT process.

Overall, it seems reasonable that, for some therapists and clients, the deep interpersonal acceptance inherent in the PCT experience might have religious, spiritual, or mystical components. Spiritual-based acceptance is probably the main place where an integration of PCT and religion/spirituality can occur. In contrast, wherever and whenever judgment flows from religious doctrine, religion and PCT are incompatible.

 

Adlerian Spirituality

John and Jon on M

In these uncertain times, I know you’ve been wondering about the future. You’re probably asking, “Who will prevail in the 2018 midterm elections?” “Will the evil New England Patriots win the Super Bowl again?” and “When will the coveted 3rd edition of Counseling and Psychotherapy Theories in Context and Practice finally be available?”

Predicting the future is complicated. My psychic powers tell me that the answers to those first two questions remain uncertain and are dependent upon various intervening events such as Hillary’s emails, the battle between fake and real news, economic inflation (as well as inflation of various footballs), and the health and well-being of several very old quarterbacks. However, based on the fact that Saturn has entered my 4th House and is dropping a psychological anchor, I can say with confidence that the 3rd edition of our theories textbook is coming soon . . . probably in April, 2018.

In the run-up (as the Brits like to say) to the publication of T3 (Theories, 3rd edition), I’ll be intermittently posting a few exciting T3 previews.

One new feature is a short section on how each primary counseling and psychotherapy theory intersects with spirituality. We’re including this feature because of the core role that spirituality plays for many clients (and many counselors and psychotherapists). In addition, spirituality is often a key component of multicultural sensitivity.

Way back in June of last year, I posted the spirituality section for psychoanalytic theory (chapter 3). You can read that here: https://wordpress.com/post/johnsommersflanagan.com/2571

Today’s post includes a look at spirituality from the Adlerian perspective (chapter 3). Keep in mind that these spirituality sections are very short samplings, designed only to help readers understand how spirituality can be viewed from specific theoretical perspectives. If you’re interested in additional (and deeper) information, we recommend you track down the citations from each chapter.

Here’s the spirituality taste or peek or snippet from the Adlerian chapter.

Adlerian Theory and Spirituality

Over the years, Adlerian theory has been open to client spirituality and has attracted practitioners and writers with strong religious convictions (Cashwell & Watts, 2010; Johnson, 2013; Sweeney, 2009). This is probably because of Adler’s emphasis on social equality and justice, but also because, as Carlson and colleagues (2006) wrote:

The cardinal tenet of Adlerian theory is social interest, something Adler equated with the mandate to “Love one’s neighbor as oneself” and the Golden Rule. (pp. 33–34)

Although the Golden Rule is a Christian concept, Adlerian writers and practitioners are consistently open to other religious and spiritual perspectives. In particular, Johansen (2010) provided guidelines for integrating individual psychology (IP) concepts into Christianity, Judaism, Buddhism, Hinduism, and Islam. Overall, as described in the theoretical principles section of this chapter, Adlerians view spirituality as a life task that can contribute encouragement and meaning into clients’ lives (Bluvshtein, Belangee, & Haugen, 2015).

Consistent with what is known about Adler, the specifics of client spirituality and religious belief is of minimal importance. Recall that the Adlerian position is that all behavior is purposeful. Consequently, what’s important is for what purpose religion is used, and not the particulars of a client’s theology. A couple Adlerian questions about spirituality might include: “Does the client use religion (or spirituality) to promote separation and violence? Or is religion (spirituality) used to bring people together as a working and compassionate community?

Given Adler’s valuing of social interest and interdependence, the latter of these alternatives is clearly the Adlerian way.

Psychoanalytic and Spiritual Compatibility: A Friday Evening Spiritual Reading

Rainbow 2017As we roll through the revisions in our Theories text, we’re adding a short section in each chapter on spirituality. This seems important partly because spirituality is so meaningful to so many people and partly because counseling and psychotherapy is often viewed as at odds with or contrary to religious beliefs. Of course, this new integration might also be related to Rita’s ongoing blog titled, Short Visits with an Honest God. Check it out at: https://godcomesby.com/

In this sneak peek of the 3rd edition, we briefly (very briefly) discuss Freud, psychoanalytic approaches, and religion/spirituality. Our purpose isn’t to go into greata detail, but to offer students a taste of spiritual integration in counseling and psychotherapy.

As always, if you have any reactions, please feel free to share them using your preferred communication modality.

Spirituality and the Psychoanalytic Approach

Freud was no fan of religion. He often referred to himself as a “Godless Jew.” Gay (1978) wrote that Freud “advertised his unbelief every time he could find, or make, an opportunity” (p. 3). Freud (1918) viewed religious beliefs as irrational, projective, and regressive. In return, most religious people are no fans of Freud. Casey (1938) captured some of the disdain early psychoanalysts held toward religion, “Even in the higher religions with their impressive theological facades there is always . . . a myth, a rule of piety, a cult, which is rationalized but which neither begins nor ends with reason” (p. 445).

Despite this rather poor start, contemporary psychoanalytic theorists and practitioners have made strides in accepting religion and integrating spirituality into psychotherapy. A common psychoanalytic position is that religious and spiritual experiences are meaningful and therefore deserve the same level of analysis and respect as sexuality, family relationships, work, and other life domains (Rizzuto & Shafranske, 2013). This respectful stance toward religious experiences is relatively new and exciting territory for practitioners who want to integrate religion and spirituality into psychoanalytic approaches.

As one example, Rizzuto and Shafranske (2013) wrote that, “God representations always involve a representation of the self in relationship with the sacred” (p. 135). They view client disclosures about religion as opportunities to attain a deeper and more useful understanding of clients. God representations are not only respected, but also explored as multidimensional components of human experience that can exert both positive and negative influence on individual’s lives. They believe, “Religion and spirituality can serve as a foundation for the healthy appreciation of the self and for the resolution of psychic pain and trauma” (p. 142). Clearly, this perspective plays better with religious clients than beginning with an assumption, like Freud, that all religious views and experiences are immature and irrational.