The Freudian Approach to Psychotherapy - Essay Example

?Existential Theory, Gestalt Therapy, and Person-centered Counseling Methods In preparing for a career in substance abuse counseling, I have researched into the various schools of psychology to find a methodology which would best represent my own personal approach to practice. With regard to this, I have reviewed the basics and fundamentals of Behaviorism and found this more applicable to institutional or industrial psychology than counseling. The Freudian approach to psychotherapy has a long history but its methodology and approach may be more suited to some personality types over others, and does not represent the general needs of the addiction group as directly as I would like. I have compared aspects of Adlerian therapy, which to me seems to be a type of reform or broadening of the Freudian approach to psychotherapy to increase its application by focusing on family issues and personal problems, but decided that the Existential Theory represented by Carl Rogers and others would finally be the best field to specialize in for addiction therapy. I would like my work in addiction to relate to social functioning as a type of healing for the disfunctionality in the person suffering from substance abuse. When that person is able to return to a normal daily life and take part in activities that represent his or her own goals of self-realization, I feel that the counseling process will have been successful. In order to assist the individuals with this recovery process, there should be a combination of methods integrated into the counseling practice, and these should be based in a broad understanding of the schools of psychology and their unique benefits for treatment. I am personally focusing on Existential Therapy, Gestalt Theory, and Person-centered approaches for my counseling practice. Assumptive World In searching my own personal assumptions and subjective bias as a counselor, my primary goal is to help the people to recover from substance abuse and return to normal lives where they self-determine their daily decisions without falling into the destructive patterns symbolized in drug abuse. One of my assumptions is that the substance abuse itself is a symbol of larger psychological issues related to a wide variety of causes in the individual. In getting to know the people seeking treatment personally, the first aspect of counseling is to look through the substance abuse itself as a symptom to the deeper causes. An important aspect of this is being able to recognize aspects of abnormal psychology which may have roots in degenerative mental illnesses from adjustment problems and substance abuse related to traumas, childhood abuse, coping problems, peer pressure, or other factors that may have led to the behavior initially. The assumption in this process is that in identifying the root cause of the mental origin of the substance abuse problems by counseling, there can also be a conscious recognition of that issue by the person, and through this understanding the problem can be healed as that person becomes aware of methods through which the problems can be positively overcome. In seeking to provide an assistance role for these people to return to normal functioning in society on their own terms, the importance of Existential Theory in counseling becomes clearly evident. One assumption this method includes is that drug addiction and particularly the self-destructive aspects of it that lead people to counseling and recovery therapy are related to “deeper” problems of self –development and not genetically conditioned or caused by physical addiction to drugs like heroin or cocaine. Where there are physical addictions, these must be eliminated before the counseling can really progress, but in addiction therapy relapses are common so that the person may be constantly moving between treatment, substance use, abuse, and counseling. Thus the “detoxification” stage should be distinguished from the “treatment” stage, and the recovery itself proceeds from the treatment as the individual returns to normal daily functioning in life. In this context, the counselor assists the individual to first detox, and then over a period of time, to enter into the psychological issues that may be at the root of the behavior. The counselor needs to interview the person to not only understand the particular treatment needs, but also to help that person understand personally what the psychological issues are at the root of the self-destructive behavior. From that basis, the counselor can also help the person understand what they would like to do to be successful in life and what is preventing them from accomplishing it. From this, Existential Theory can be used to assist the person to attain greater levels of self-realization and self-actualization. These assumptions are slightly different than addiction theory based around the “disease” treatment philosophy. Under this view, the substance abuse patients should be taught that they have an inherent disease that condemns them to a chronic life of suffering and that they can only be successful by following a step-by-step path that includes submission, acceptance, appeal to a higher power, community meetings to discuss sobriety, etc. My practice is not based around a system like this though it does encourage people who have an affinity for AA and NA to follow that path. Rather, my counseling practice views the primary importance of finding the best treatment for every person individually. For example, those with more serious mental illness as a root cause of the disease may require specialist treatment and medication. For others, detoxification and return to daily life requires a process of willpower and humility to accept challenges as they arise and not retreat into self-destructive patterns. Yet others may need to change abusive relationships or adapt to peer pressure that is inherent in the environment. Some may benefit from inward looking, psychoanalysis-based inquiries into the symbolism of dreams and the causes of neurosis, but others may find adventure therapy and outdoor activity much better than medication for anxiety or coping problems. The modern society is very complex in its symbolic patterns of communication and meaning, and the variety of individual interpretation is unpredictable. Because of this the counselor needs to evaluate all cases individually and understand numerous methods from different psychological schools, in order to be ready to apply these techniques in treatment. Guiding Theory "Existential therapy responds to the human condition of anxiety as being a part of living by encouraging self-awareness and experiencing of our common struggles of existence (being along, meaninglessness, and death). Person-centered therapy also encourages clients to become more aware so that their potential is enhanced, that is, there is less difference between what a person is and what he or she wants to be. Gestalt therapy encourages the client to integrate thoughts, feelings, and behaviors so that the client is more whole. All three theories emphasize the importance of the therapeutic relationship." (Miller, 2010) My counseling seeks to integrate the three methods of Existential Therapy, Person-centered Therapy, and Gestalt Therapy into a unified practice in the field of addiction and substance abuse recovery. One reason why I believe that Existential Theory applies ideally to addiction therapy is that it centralizes anxiety in the individual as the common experience in life. This is important because many substance abuse sufferers may be feeling a regular sense of anxiety that relates to their day to day life. In centralizing this in the counseling, in looking for it in the recovery, and in accepting it as a basic part of life, the individual may also understand better why it is important to not try to escape from anxiety by retreating into substance abuse. By locating this at the center of the therapy, the fundamental point will be made clear in sessions that first, the person must recognize the anxiety, and then second, recognize the source of this in life problems that may have led to maladjustment. I would like to help the people trying to recover understand that there may always be problems in their daily life but that they need to get beyond self-destructive behavior by accepting these problems and making the issues conscious. Because of this, my counseling sessions will also focus on feelings, on the individual emotions that cause the person to escape or seek other states of consciousness by using drugs and alcohol. In this manner the counseling will also be Person-centric. I am integrating this with aspects of Gestalt psychology which seeks to develop wholeness in the individual through a fully expressed sense of Self. I believe that depression is also a major cause of substance abuse and because of this will focus in sessions on understanding why the person is motivated to use or abuse substances, in order to get to the root issues that drive the individual to escapist or self-destructive patterns of identification. As all of these therapies are focused on the relationship between the counselor and person in recovery, I would like to incorporate aspects of adventure therapy such as walking in outdoor locations or group social activities such as hiking, backpacking, camping, and rock climbing so as to promote group bonding outside of a therapeutic environment. A major issue with addiction therapy is the conflicting drives of the individual. One part of their intentionality may be seeking a social, career, or personal goal, while another aspect of their personality is destroying the possibility for this through self-destructive behavior. In other instances, the individuals are seeking escape from memories of bad experiences, traumas, or abuse that occurred previously in the life and has negatively imprinted the self-image. The process of identification of life goals and motivations will thus be the main goal of a People-centered therapy, yet this should be further related to the goals of normal functioning being established by the person themselves in the session. The purpose of the counselor in therapy will be to support the process of self-inquiry into the root causes of self-destructive and escapist behaviors as they relate to addiction as a process. Existential Therapy seeks to provide personal care to those seeking assistance that the problems associated with isolation, loneliness, death, and “meaninglessness” in life are in fact universal and suffered by nearly all human beings in some form. Group activities such as those involving adventure therapies may be used to balance counseling sessions if they appear to increase the isolation of the person due to the process of introspection or alienation from the setting. Many substance abusers are forced into therapy against their ego wishes, so a basic understanding of how their ego-identity is constructed through conflicting desires, emotions, and ideas in the mind is important in building strategies to “stay clean” and recover from addiction. Family issues may be discussed in order that the person may consciously pose the issues to a trusted source and in doing so bring them to conscious articulation and awareness. In general, my counseling sessions will not be related to prescribing medication to patients, but I do expect to work with clinical psychiatrists in supporting pharmaceutical integration and medication that is used within the addiction facilities. Key Concepts "Existential therapists are concerned with the human condition, being in the present, and experiencing the self, and in that way they share values that were important to Carl Rogers (Sanders, 2004). Gestalt therapy, which has a strong existential basis, emphasizes experiencing current awareness in a more bodily and active way than does person-centered therapy. O'Leary (1997) demonstrates how the person-centered focus on the client-therapist relationship can be integrated with the emphasis that gestalt therapy gives to self-support and interdependence." (Scharf, 2011) The combination of Existential Theory, Gestalt therapy, and a Person-centered approach can all be considered aspects of a basic “Humanistic Psychology,” or one that integrates the best traditions from many schools of psychology and avoids the extremes of both Behaviorism and Psychoanalysis. This relates to the practice of counseling by focusing on the individual’s needs and building on the foundation of each person’s unique identity. This combination of theory requires that the counselor not only be familiar with many approaches to psychology, but also that the individual is treated on his or her own terms. The process of self-realization, according to humanistic tradition, must include the person’s own articulation of desires, goals, hopes, fears, feelings, emotions, and thoughts in order to build conscious understanding of conditioning patterns and subconscious issues that impact everyday life. According to Steven J. Park in his essay “Existential Theory” (2011), “There are six key concepts behind the Existential theory: Proposition 1: The Capacity for Self-Awareness Proposition 2: Freedom and Responsibility Proposition 3: Striving for Identity and Relationship to Others Proposition 4: The Search for Meaning Proposition 5: Anxiety as a Condition of Living Proposition 6: Awareness of Death and Nonbeing” (Park, 2011) One reason I have chosen to base my personal counseling practice on Existential Theory is that I believe these guidelines make for an excellent guide to conduct counseling sessions. The capacity of self-awareness relates to the counselor being able to discuss the problems, emotions, drives, desires, personal issues, or life goals with the individual in a trusted environment and with confidentiality towards gaining a personal understanding of the self by the process of discussion. The emphasis on freedom and responsibility relates to the approach that the individual must take in the counseling session and in order to recover from substance abuse. The individual needs to see with conscious awareness and understanding why he or she is making the life-style choices that lead to self-destruction, and contrast that with a vision of life that is positive. In doing this, the session focuses on self-realization and self-actualization on the person’s own terms, rather than forcing them to fit a standard of behavior or a preset identity of normality. The search for meaning relates to subjectivity in that meaning is experienced and created by the person from their own mind. This includes conscience as it relates to behavior. In awareness of death and non-being there is the opportunity to discuss religion and transpersonal aspects of psychology as an aspect of both meaning creation, identification, and self-actualization. Criticisms One criticism of this philosophy of counseling and therapy is that existential theory may be too introverted and office-related to be totally integrated into the person’s life. I would like to seek ways to extend therapy by incorporating aspects of adventure therapy and outdoor, group events both to overcome the relationship of counseling to the office, and also to overcome isolation in the group members through social bonding. Another aspect I would like to explore more with the addiction patients is art therapy that overcomes the bias to verbal expression in self-discovery. Some people may be able to express feelings and emotions through visual expression in drawing, painting, or sketching. The use of literature and creative writing can also assist in overcoming the bias inherent in a typical counseling session. Rather than establishing a repetitive model of counseling that is formal and technical, I would like to encourage a wide variety of techniques for self-expression in the recovery groups, in order that these may also integrate into a wider form of self-knowledge. In focusing on addiction and substance abuse as symptoms of deeper causes and issues in the personality, and not as a disease as such that can be treated outside of the individual’s own decision-making patterns, the counseling method puts an emphasis on personal responsibility and moral choice, which may be inevitably difficult to implement by the people who seek treatment for addiction. The aspects of willpower are not easily qualified or quantified by counseling, and it is difficult to support individuals through Existential methods who are not willing to inquire into their own feelings, motivations, and ideas in order to build an understanding of their self-identity. Where this may increase isolation, the counselor should also make sure that the therapy includes group aspects, or techniques like art, music, and writing therapies that allow the people in the treatment programs to grow into a wider vocabulary of self-expression. Application The application of this method generally requires the voluntary participation of the person in therapy, and that person’s honesty in addressing the process. To a certain degree, the counselor will need to also accept that some individuals may be forced into the program against their personal will or choice. These people may only formally participate with the counseling sessions, and seek to return to addictive behavior patterns at the earliest opportunity. While some schools of psychology view this as evidence of “the disease” of addiction, the Existential approach sees this as merely a symptom of avoidance and an aspect of ego that is still resisting a greater awareness of the Self. Resistance to treatment may also signal the power of the issues that remain unprocessed in the subconscious, and which lead to self-destructive or abusive behavior. Thus, the counselor will need to be aware of the stages of addiction and prepare for each stage of the process of recovery, as well as treating the people individually according to their unique individual needs and issues. Sources Cited: Benjamin, Ludy T. (1997). A brief history of modern psychology. Wiley-Blackwell, 2007. Retrieved from http://books.google.co.in/books?id=BveMINT51b4C Capuzzi (2008). Counseling And Psychotherapy: Theories And Interventions, 4/E. Pearson Education India, 2008. Retrieved from http://books.google.co.in/books?id=OqOBmsHRLdYC Carlson, Jon & Slavik, Steven (1997). Techniques in Adlerian psychology. Taylor & Francis, 1997. Retrieved from http://books.google.co.in/books?id=eLT02XEhnvwC Corey, Gerald (2009). Theory and Practice of Counseling and Psychotherapy, Brooks/Cole, 2009. Ford, Donald Herbert & Urban, Hugh B. (1998). Contemporary models of psychotherapy: a comparative analysis. John Wiley and Sons, 1998. Retrieved from http://books.google.co.in/books?id=49OUyshEDhYC Griffin, Emory A. (2008). A First Look at Communication Theory. Irwin/McGraw-Hill; 7th edition, July 2008. Retrieved from http://www.afirstlook.com/docs/existential.pdf Miller, Geri (1997). Learning the Language of Addiction Counseling. John Wiley and Sons, 2010. Retrieved from http://books.google.co.in/books?id=2qUUEf9PvPYC Park, Steven J. (2011). Existential Theory. University of North Texas, 2011. Retrieved from http://people.unt.edu/~sjp0013/existential.htm Sharf, Richard S. (2011). Theories of Psychotherapy & Counseling: Concepts and Cases. Cengage Learning, 2011. Retrieved from http://books.google.co.in/books?id=XF1N1GD0aIAC Sommers-Flanagan, John & Rita (2004). Counseling and psychotherapy theories in context and practice: skills, strategies, and techniques. John Wiley and Sons, 2004. Retrieved from http://books.google.co.in/books?id=OqOBmsHRLdYC Read More