Freud, Mahler & Adler Evaluation Paper

Freud, Mahler & Adler Evaluation Paper

Adier’s Need to Belong as the Key for Mental Health

Rachel Shifron

Abstract

According to Adier’s (1932) Individual Psychology the inability to belong or to connect with others results in pathology. In this essay the author presents several case studies that highlight the need to belong as a primary issue in therapy. The case descriptions include therapy with an individual, a couple, a client with addiction issues, a cross-cultural couple, and a mother and daughter-in-law. The case materi- als presented in this article reveal that individuals with psychological disorders can lessen their psychopathology by learning more effective methods to promote belong- ing. Adlerian methods and interventions to promote belonging are discussed.

In Adier’s (1932, 1991) Individual Psychology every child is born with the need to belong and with the ability to connect with others. Acquiring the methods of connecting involves a learning process. This kind of learning is the key for well-being. It is essential that one belongs and is connected to three significant groups in one’s circle of life. I expand Adier’s descrip- tion of the life tasks (Dreikurs, 1950) to refer to these significant groups as being family, friends, and work associates. Feeling a sense of belonging to these groups is the primary universal issue of mental health. Individuals with psychological disorders can lessen their psychopathology by learning more effective methods to belong.

This article reflects my many years of counseling and therapy from an Individual Psychology perspective (Shifron, 2006, 2008). My clinical experi- ences have shown me the universality of the need to belong, and I believe this paper offers an exceptional opportunity for clinicians from different theoretical approaches to learn more about Adier’s optimistic and brilliant perspective. Adier’s Individual Psychology is based on the conceptualization that psychopathology results from the lack of feeling belonging. This is an optimistic view, because the absence of feeling belonging is a curable situ- ation. According to Adier’s theory (Ferguson, 2006), every individual makes choices. In this paper I focus on the belief that every individual is capable and creative and that by making different kinds of choices, each person can learn how to feel belonging.

Throughout my work with clients over many years, each individual or couple presented unique problems. However, there was a common theme among a majority of them. The hidden goal for most of them included the

The Journal of Individual Psychology,/o. 66, No. 1, Spring 2010 O2010 by the University of Texas Press, P.O. Box 7819, Austin, TX 78713-7819

Editorial office located in the College of Education at Georgia State University.

Adier’s Need to Belong: Mental Health 11

desire to belong. This hidden goal was identified in many instances when exploring clients’ early recollections and dreams. I found the need to belong surfaced among couples, parents, children, and siblings. I found a similar need to belong with friends and in the work setting. I discovered many cre- ative and diversified ways that individuals use to meet this need to belong. In therapy an important process was for clients to learn whether the creative methods they chose were effective or not, and whether they could use their creative abilities to choose more effective methods to feel belonging.

To understand Adier’s concept of belonging, I find it helpful to remem- ber the concept of holism. In a holistic system, the whole is a dynamic, moving, developing, growing, creative system. It operates through the inner links within all parts of the system. Each part has a specific role or place that enables the other parts to operate and to move. The movement is the consequence of the interrelations and the contributions of each part. In a holistic system the cooperative interactions of the parts constitute the whole. “The organism is more than the sum of its parts and if these parts are taken to pieces the organism is destroyed . . . these parts are in active relations to each other” (Smuts, 1926, p. 101, as cited in Linden, 1995, p. 254).

In Individual Psychology the individual is a whole system, but the indi- vidual is also a cooperating and interacting part of larger systems, like the family, the community, and the universe. A sense of belonging is essential in order for one to feel that he or she is an actively contributing part of the larger whole. This feeling, that one belongs and that one has a place in the larger systems, is achieved when one is encouraged and appreciated for one’s special talents and creative abilities. An individual who feels be- longing feels valued and significant, and the person will contribute his or her best to society. That contribution represents social interest (Ansbacher, 1991 ), that is, a concern for and commitment to the welfare of the commu- nity. Adler characterized

the socially useful type as prepared for cooperation and contribution in whom we can always find a certain amount of activity which . . . is in agreement with the needs of others. It is useful, normal, rightly embedded in the stream of evolution of mankind. (Mosak, 1991, p. 316)

Adler emphasized belonging as the primary factor for the individual’s and the community’s mental health. Mosak (1991) wrote, “Closeness is a tran- scendent variable. It encourages people to look outside of and beyond themselves to the need of others in the community and of the community itself. It encourages the feeling of intimacy, empathy, and identification” (p. 315).

Recently, I conducted workshops on Adierian psychotherapy in Cam- bridge, England. My hostess, Anthea Millar, described a project by Foresight Science Future with the following information that was published in the

12 Rachel Shifron

London Times. The project was led by Felicia Huppert (2008), professor of psychology at Cambridge University, and it was intended to improve men- tal well-being. The project was included in a “well-being” report, compiled by more than 400 scientists, sent to the British government. The research proposed to encourage behavior that will make people feel better about themselves. The researchers concluded that they found five categories that can make profound differences in people’s well-being. They named the pro- gram “five a day”:

1. Connect with people. 2. Be active—do physical activities with others. 3. Take notice—be aware of sensations around you, be in the state of

mindfulness. 4. Keep learning—as a way of rebooting the mind to experience joy in

the here and now. 5. Give—committing an act of kindness each day is associated with

an increase of well-being.

For those following the work of Adler, it is a welcome finding that his ho- listic psychology that emphasized belonging is actualized in reports about well-being to the British government, many decades after Adler first wrote about the importance of social interest and the feeling of belonging.

In this essay, I focus on belonging as the primary variable in clients’ mental health. I discuss case studies with the focus on the clients improv- ing the ways they cope with life through increasing their social interest and through gaining feelings of being accepted and belonging. The issues I ad- dress are as follows:

Belonging to the family of origin—identifying creative methods used to secure the feeling of belonging.

Belonging in a couple relationship—examining the complexity of cul- tural differences in basic norms and values as these relate to the feeling of belonging.

Belonging to the world of work—considering the need to maintain a balance between work and family.

Readers familiar with Adierian psychotherapy know that early recol- lections provide rich clinical material (Manaster & Mays, 2004; Shifron & Bettner, 2003). I employed this technique extensively to explore the impor- tance of belonging in many of the cases reported. For me, early recollections are a type of metaphor. They reveal lifestyle (Ferguson, 2006) as well as the individual’s current emotional situation. The use of early recollections is an accurate and quick method to discover the person’s feelings of belonging and the creative methods the person uses in order to feel belonging. All names and other personal data were changed completely for confidentiality.

Adier’s Need to Belong: Mental Health 13

Case Studies: Individual Therapy

The Creative Contributor. The need to belong is so strong that some in- dividuals excessively seek to please others. These individuals invest much of their energy in pleasing, helping, and rescuing their family members. They often feel that their “membership card” of being a valued and accepted per- son is valid only through their being available to others at all times until they become exhausted. This may lead to creative solutions for seeking rest. An example is “Pamela,” who is in her 20s. She is a student who works in her free time, and she is the youngest of four siblings.

The presented issue, as she stated, was that she suffered from anxiety and “unrealistic fears.” Her relationships with men were complicated in that she was attracted to unreliable men who were not interested in her, and she was not attracted to those who showed her care and affection. From an Ad- ierian perspective this is an excellent method to avoid intimacy.

A thorough analysis of her lifestyle, which included early recollections and dreams, disclosed that in order to feel that she belonged in her family, she had chosen behaviors that made her feel that she was needed at all times by her parents and siblings. In psychotherapy, she gradually under- stood, through our work with her early recollections and dreams, that in order to gain recognition she often neglected to take care of her own needs in favor of the needs of others. She also became aware of the fact that it was almost impossible for her to ask for help. She perceived her mother as a helpless woman. Pamela was her mother’s caretaker, and she strove to excel in being a caretaker.

Pamela learned to understand that her way of fulfilling her need to be- long included a consistent set of behaviors revolving around caretaking, pleasing others, and giving, which created in her feelings of anxiety, frustra- tion, disappointment, and anger. This set of behaviors was consistently void of self-care strategies. For example, when I asked her if she ever asked for help when she needed it, she said she never did. She reported that her father was too busy and her mother and siblings lacked the skills to be helpful to her. An example of her private logic on this point was reflected in the fol- lowing early recollection she reported:

At age 8 I was in a boat and a young boy fell off the boat. I jumped into the water and saved him. Everyone reacted as if it was the most natural thing to do. I felt that it was expected of me to jump and save the boy because I was an excellent swimmer.

I viewed this early recollection to be a metaphor representing the way she thinks about herself and her primary role in her life.

As we continued in therapy, I avoided dealing with her initially reported concern with her anxiety and chose instead to focus directly on the creative

14 Rachel Shifron

ways in which she was seeking to fulfill her need to belong. We continued to explore ways that her exaggerated need to “give and please others” were directed toward her need to feel belonging. We were also able to come to a consensus that the anxiety attacks, which were her presenting concern, had a purpose. The purpose was that it was a creative way of giving her a rest from being in the service of others. It was only then that we were able to work together to assist her in finding less stressful and anxiety-driven be- haviors to fill the need to belong. At present, Pamela is in the process of establishing new behaviors to practice her “excellence in swimming,” which includes courage, movement, and initiation. Pamela is developing a new relationship with a man who adores her. She is more assertive with her family members as well as at work and with friends, without her former fears that by setting healthy boundaries she will no longer belong. She is free of anxiety attacks. From my clinical perspective I view addiction, anxiety, and depression as an example of goal-oriented behavior. They are creative, pur- poseful, and chosen behaviors (Shifron 1999). Interpersonal relationships and feelings of belonging are essential for the development of significant intimacy, and they are as essential for adjusting to other life situations, in- cluding the world of work.

Despair. Robert, a man in his fifties, holds a very prestigious work po- sition. His performance at work is considered to be excellent, but he lacks skills in interpersonal relations. He became aware of the fact that he might lose his job if he did not change his attitude toward his co-workers.

Robert is the oldest of three siblings. His parents divorced when he was very young. He and his sisters never married. In his early recollections, he described a detached mother who was busy fighting with her husband (Robert’s father), two sisters whom he did not like, and a father who was not around when he was needed. Robert was a very good student but was always angry, sensitive, and sad. This picture of his childhood corresponded very vividly to his emotional state at the time he began therapy. He felt lonely and alone, did not trust friends or partners, and did not keep in touch with his immediate family. At the same time, he was extremely invested in his work. He said, “I don’t belong to anyone. Work isn’t a substitute for fam- ily and couple relationships. There is no sense in living like that, I have to change it.” Robert’s feelings of sadness and despair were extreme because he had no support from anyone, neither his family nor a partner.

Developing trust in the therapeutic process was a challenge. Robert did not trust that anyone had a genuine interest in him. It took a long time be- fore he developed some confidence in the process. Accepting his strengths was an important step for him. He realized how efficient, productive, and intelligent he was in his job. He learned to appreciate the meaningful rela- tionships that he had succeeded in establishing at work. Robert practiced at

Adier’s Need to Belong: Mental Health 15

work how to express his feelings, and doing so helped to prevent him from exploding. Work became an anchor for his need to belong, and thus he increased his belief that he was capable of developing meaningful relation- ships in his private life.

Dreikurs (1991) wrote,

The human community sets three tasks for every individual. They are: work, which means doing useful work; friendship, which embraces social relation- ships with comrades and relatives; and love, which is the most intimate union with someone of the other sex and represents the strongest emotional relation- ship which can exist between two human beings. These three tasks embrace the whole of human life with all its desires and activities. All human suffering originates from the difficulties which complicate the tasks, (p. 7)

Relationships are learned in one’s own family. Those who completed this learning process successfully will feel that they belong, and they are likely to form meaningful relationships outside their family—at work, with friends, and with an intimate partner.

Robert’s despair and suffering originated from the fact that he had no re- lations with his family, which inhibited him from establishing his own family unit and knowing how to relate to others at work. In a therapeutic process, when there is no opportunity to work with the entire family and when the client refuses to make contact with family members, the learning process will take place in another life task. In Robert’s case he was motivated to learn and to practice his interactions with others at the workplace, where he finally felt that he belonged. The workplace became a laboratory for acquir- ing a sense of belonging. He learned how to relate to others and to form meaningful relationships.

One of the primary factors in work adjustment is the feeling of belong- ing. Holland (1985) developed a vocational instrument that was based on the idea that individuals adjust much better to work when they are around people like them, when they feel that they belong with the group. Holland’s prediction was that individuals who belong would be motivated, satisfied, and able to grow and to develop. The need to feel belonging in the work- place is so strong that some people develop workaholic symptoms (Shifron, in press).

Couples Therapy

Conceptual issues to consider with couples. The need to belong is cru- cial in romantic relationships. Romantic relationships are complex and can be very disturbing when the very basic need to belong is ignored.

16 Rachel Shifron

Certainly, love in all its thousand variations is a feeling of belongingness and hence is characterized by its content as a social feeling. Therefore, that man and that woman will be best prepared for love, marriage and parenthood, which surpasses all others in being fellow men . . . the worse preparation for marriage is when an individual is looking for his own interest. If he has been trained in this way, he will be thinking all the while what pleasure or excite- ment he can get out of life. He will always be demanding freedom and relief, never considering how he can ease and enrich the life of his partner. (Adler as cited in Ansbacher & Ansbacher, 1956, p. 435)

Each partner wants to feel safe, secure, and cared for in the relationship. Each individual in a couple contributes creatively in order to maintain the relationship. At times, problems arise when the “creative contribution” does not fit the partner’s lifestyle, wishes, and expectations. The outcome is frus- tration, anger, and distance. In such cases, the therapist’s roles are:

1. to identify with the couple their genuine goal to maintain their re- lationship and their desire to belong to each other (If one of them is not invested in the relationship, couple therapy is not going to work.);
2. to show using early recollections or dreams the “creative method” each one employs in order to feel connected and to belong to the other person;
3. to unfold the “blind spots” in the method, that is, the blind spots that create distance instead of the closeness the couple intends;
4. to work with couples creatively to form behaviors that will en- able both of them to feel the closeness that they desire (Shifron, 2008) (One can do couples therapy even when only one partner is involved.).

Building the wall. This case is an example of creative methods used by a couple to maintain their relationship. Molly and Charles are in their 30s with two children. Molly is the oldest sibling in her family. Charles is an only child. Both of them work full time. Molly works in a very demanding sophisticated organization. Charles does freelance work.

The presenting issue is a growing distance between them. There was no communication about experiences and feelings, and they had no intimacy. They claimed that they are very effective as parents. Both of them expressed their need to feel closer and that the relationship is very meaningful for them. They feared their own anger at each other and repressed it.

In the first stage of therapy, the work with their early recollections dis- closed their strengths, special abilities, uniqueness, and special needs. It was a stage of self-awareness for both of them. They gradually became aware of the specific roles each one of them played in their families of origin and in

Adler^s Need to Belong: Mental Health 17

their couple relationship. The second stage of therapy focused on the ways each of them worked at finding their comfort in the relationship, that is, a sense of belonging. The use of early recollections enabled them to discover the creative methods both of them used to maintain their relationship and sense of belonging. It became clear that “not rocking the boat” was their creative strategy to maintain the relationship. Charles’s method was to with- draw, not to share information about his business, doubts, questions, and difficulties. He was sure that this “method” would save him from her criti- cal reaction, would prevent a potential confrontation, and thus would save the marriage. Molly’s method was to spend more and more time at work in order to limit their time together and to avoid potential conflicts. She was confident that her method would maintain their togetherness. Both of them wanted to prevent conflicts at all cost.

The more Charles withdrew, the more Molly was out of the house, and vice versa. The third stage of therapy focused on their understanding this process. When they were presented with the question regarding whether there was a thought about separation, both of them reacted very anxiously that they definitely wanted to maintain their relationship and they wished to get closer.

In one of his early recollections (age 5), Charles described standing behind the window, watching the children playing outside. He wanted to join them but feared their rejection and thus kept staying inside. Almost all of Molly’s early recollections were outdoors, enjoying the company of her immediate and extended family. Their recollections/metaphors present very accurately the difference in their lifestyles. In her adult life, Molly worked in an organization in which she felt satisfied because she was respected and appreciated for her contributions. She felt that she belonged to the organi- zation. In his freelance occupation, Charles worked by himself. The early recollections also showed the dynamics of their relationship. He perceived her as having a wonderful time and craved to be included, but his fear of rejection immobilized his initiative and actions. (She was the one who had initiated the therapy, and he had joined her gladly.) Molly was enjoying the outside world she created for herself, but eventually discovered that her method actually widened the gap between them. She also, like Charles, craved the warmth and the feelings of togetherness.

The fourth stage of therapy was devoted to finding new and different ways for them to use their creative abilities and strengths and for them to apply these to their mutual goal to be together. At present they are still prac- ticing how to “break the wall” and join each other: for her to join him at home, for him to join her outside. They are also learning to talk about their anger courageously and gradually to understand that communicating feel- ings is one important way to “break the wall.”

18 Rachel Shifron

How can I belong with “the big guys”? The problems associated with feeling belonging are a primary issue among most couples who come for therapy. “Am I really significant in her/his life? Does she/he really love me? Why me? Do I fully belong to this couple relationship? Do I fully belong to her/him?”

Carola came to therapy when she was separated for several weeks from her husband. She wanted to know what she did wrong and whether she planned to continue with the relationship. Her husband told her to try and “fix” herself. She is in her 20s, the youngest in her family. She experienced a very close family. She had excellent relationships with her siblings, who paid a lot of attention to her. Carola describes her parents as very supportive and respectful of her choices. She describes her husband as being distant from his parents and siblings and that he is very punitive.

Her early recollections are beautiful metaphors that demonstrate her need to feel that she belongs in that relationship and what the real obstacle is in her relationship with her husband. During the initial stage of therapy, she shared the following recollection (age 5):

I was in the car with my sister (who is 12 years older). She taught me a few words in a foreign language the others in my family knew, and I felt I was a big girl. I felt included with the big guys in the family. It was a feeling of elation.

Later in the therapy process, she provided this early recollection (age 4):

I sprained my ankle and was in pain. In the evening, I was in my room. Every- one else was in the living room. I got up. It was painful to walk but I overcame the pain and found everybody in the living room. I felt happy I was with ev- erybody else.

In both memories, Carola described how important it was for her to be in- cluded. In the first memory she was responding to her sister’s initiation. In the second memory she initiated her action in order to be included.

In the therapy sessions Carola brought many detailed early recollec- tions and metaphors. She realized that often she expected another to initiate her inclusion with the “big guys,” but it is clear from her later recollection that she could, even though with difficulty, initiate by her own efforts being included with the “big guys.” She became aware of the choices she made and the choices she could make in her current life in order to get what she needed and deserved. At that stage, she was trying to initiate closeness with her husband. She was more active in creating a safe place for herself in their relationship. The awareness of one’s own strengths and abilities to make choices helps the person to initiate and to act. Very often, it might help part- ners to overcome anxiety and frustration in the relationship.

Adler^s Need to Belong: Mental Health 19

Cross-Cultural Couples and the Need to Belong

Conceptual issues. In a global environment where traveling overseas, studying abroad, and working and living in various countries are becom- ing a more common way of life, cross-cultural romantic relationships are increasing. When developing a relationship within one’s own culture, the task is already complex because it requires an ability to merge two differ- ent family cultures. In a cross-cultural relationship, merging is much more difficult, for it requires not only understanding distinct family cultures but also a thorough knowledge and understanding of the other’s total cultural background. Primary parts of the cultural differences are other norms and creative ways to connect and to belong. Another major issue in the cross- cultural coupling process is that many times one of the partners feels a lack of belonging to the new country and to its culture. Usually, one of the indi- viduals must leave family, friends, language, and native culture. Adjustment to the new environment leads to a continued sense that “1 don’t belong here! Nobody notices me in a valued way!” It may create a growing tension between couples, and at times it is likely to end in a divorce.

The following case is an example of a cross-cultural couple’s problems with regard to feeling belonging. It also illustrates that cross-cultural couple relationships entail a challenging task and that when individuals learn to appreciate their own creative power, to actualize it, and to contribute to the new community, their newfound strengths increase feelings of belonging and decrease tensions in the family. The most significant lesson in the case is that cultural differences need not present a real obstacle to developing feel- ings of belonging. Rather, cultural differences require more understanding, mutual respect, and much more work.

“I want to be noticed and valued!” This case describes my three years of therapy with a woman in her late 40s who agreed to leave her native land and move to her husband’s country with their four children. When she came to therapy, her four children were still at home. She came to therapy reporting that she was feeling a distance between herself and her husband, and she reported feelings of loneliness and depression. The analysis of her lifestyle presented a very talented person in specific areas of the arts. She claimed that if she remained in her own country, she probably would be a famous artist. The focus of therapy was on her ability to actualize her- self as an artist in the country in which she has chosen to live and to raise her children.

During the lifestyle assessment I asked her to describe the steps she would have taken to reach or realize her goal in her native land. It was not surprising to me that she was able to describe rather specific steps to reach

20 Rachel Shifron

her goal. In therapy she was encouraged to proceed with her own strategy. She made contacts with people around her, and she volunteered in several activities in her community. As a result of her volunteer activities, she found sponsors who encouraged her to show her work in exhibitions. Gradually, the relationship with her husband improved. He encouraged her activities and enjoyed her contribution. Although the relationship was not the focus of the therapy, the fact that she had learned to appreciate herself and her work and that she felt respected, accepted, and appreciated by others, including her husband, drew her much closer to him and improved her feelings to- ward him.

It was a very slow process. In almost every session she brought early recollections, pictures from her childhood home, and art projects and paint- ings of her recollections. This fascinating process was the onset of the shift of her frustration and anger toward actualizing her real abilities. She started to realize that she might become a real asset to her adopted community and to her country of choice. In the early recollection she brought to our last ses- sions, she revealed her new outlook:

She was three, walking in the woods with her nanny, whom she loved very much. She could smell the flowers; listen to the birds, and she sensed her nanny’s hand holding hers. She described very vividly all the colors she saw in the woods.

This memory was a metaphor for how she felt at her final session. She was surrounded with people who respected and loved her, the relationship with her husband improved, and she felt valued for her contribution to young children and adults. Today, years later, she is a known artist and feels that she belongs.

Therapy with Family Problems

Hidden depressions. Feelings of inferiority inhibit one’s ability to form meaningful relationships as a couple, parent, or family member. The fol- lowing is an example of an individual’s quest to find her place or sense of belonging.

Ada was a woman in her late 40s. She was an attractive, elegant, married mother of four children. Her presenting issue was depression. She stated, “My depression is because my husband is not an understanding man.” She perceived her mother as a depressed woman who never took care of the house or herself. “I was ashamed that my mother looked so neglected. I never brought friends home. I didn’t want them to see my house. My friends rejected me, they didn’t want my company, I felt left out and very sad.” Ada

Adler^s Need to Belong: Mental Health 21

described her husband’s family as very close and warm. His parents’ home was a very comfortable and attractive one, and he had a close relationship with his mother.

In therapy, she gradually became aware that she never wanted to be part of her family of origin, that she detached herself from her parents and siblings. She described that her siblings “were like her parents.” She felt rejected by friends in grade school and high school. She developed the “cre- ative ability” to disassociate from others when she felt unsure of herself and her position. She had no chance to experience fully the feeling of belonging nor the pride and happiness that is part of that feeling. During her married years her solution to her depression was to stay alone in her room and com- pletely detach herself from her husband and children. She thought that she was successfully hiding the depression and protecting her family.

I saw her on and off for several years, and gradually we evolved into a process of family therapy, when I started to see two of her children at the time they experienced severe anxiety attacks. Both children felt that their mother was not really there. Most of the sessions with Ada focused on how she can use her creative abilities to bond and to feel that she belongs to her family.

She was learning how to deal with her depression differently. Instead of choosing to distance herself in order to protect herself and the others in her family, she communicated her feelings and connected with her husband and children. The fact that she could speak with her children about her anxi- eties helped them to realize that they have something in common with her; it drew them closer together. Dreikurs (1991) stated that “The community feeling is expressed subjectively in the consciousness of having something in common with other people, and being one of them . . .” (p. 7). Ada had always thought she was very different and that nobody felt like her. When she realized that she is capable of developing an understanding relationship with her husband and children, she felt that she belonged to her family and was significant in the family she had chosen for herself.

“Does my mother care for me? Does my wife care for me?” Doubts during early childhood about feelings of belonging are unfortunately a com- mon part of modern life. Questions such as: “Does my mother really care for me? Do my parents prefer my young brother and not care about me?” become a major part of many people’s emotional existence. These questions and doubts then become part of every relationship: in school, at work, in the adult’s romantic relationships, and when one becomes a parent. The follow- ing case illustrates these questions and doubts.

Kurt is a very intelligent and insightful man in his late 40s. He is a mar- ried father of four. The reason he came for therapy is that he felt that his wife did not care for him and he was sure there wa

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