Adlerian Ethics
Adlerian Ethics - Applications in Counselling and Psychotherapy
Book ReviewThe Journal of Individual Psychology, Vol. 70, No. 4, Winter 2014
Reviewed by Erik Mansager
A rare book-length treatment of ethics within Adlerian psychology. Marková and Čechová examine the ethical foundations of Individual Psychology across three dimensions: Adler's conception of the human being, the ethical structure of his theory, and its practical application in counselling and psychotherapy. Drawing on European Adlerian scholarship largely unavailable in English, the volume makes a compelling case that ethics is not peripheral to Adler's work — it is central to it. Shearman, Adriana and Shearman, David (Trans.). London: Adlerian Society UK and Institute for Individual Psychology ASIIP.
The ASIIP treasure trove of Adlerian jewels is expanding. As of 2016 it includes a handsome new volume on ethics in psychology. Dagmar Marková and Daniela Čechová do a great service to healing professionals by opening the issue of ethics in our Adlerian community. You can count on one hand the Adlerian publication titles that directly address morals and ethics when you review Rosen's (2012) exhaustive bibliography on the matter. Within the 176 articles in her religion and spirituality bibliography, these topics certainly might be addressed peripherally — notably the numerous works on Gemeinschaftsgefühl. Still, it would seem the topic of ethics has not been addressed by a book-length effort until now. For two university scholars — of whom one is also a psychotherapist — it is a very important contribution to have taken on the subject of ethics with the aim of influencing a broader discussion among colleagues.
In the following review, before providing a sympathetic critique, I offer an overview of the book and identify a few of the contributions on offer. I conclude with encouragement for a thorough reading of a fine book.
Overview
The 134 pages of the book that directly engage the topic — with another 22 pages of references and other pertinent information — offer a three-dimensional presentation of what is at stake in psychological treatment from the viewpoint of ethics. The authors present their subject in a simple, elegant arrangement of three chapters: an overview of Adlerian conceptions of the human being; a focussed look at Adlerian psychology itself as an ethical construct; and a rich offering of ethics-related applications in individual and family-focussed cases of Adlerian counselling. While in some cases ideas seem one-dimensionally stated, at the very next turn the nuance is presented and a holistic intertwining of concepts is used to deepen the reader's understanding or to challenge the reader to consider the matter more profoundly. This is one of the fine contributions of the book — it invites the clinician to think ethically and challenges Adlerians to cohere into the ethics of our theory.
Chapter One
The first chapter provides a refreshingly original presentation of Adler's theory of the human person centred on six intertwined constructs: evolution, teleology, phenomenology, holism, idiographic tendencies and social repercussions. Throughout this foundational chapter, the authors include helpful footnotes in each construct's explanation that point to more extended discussions later in the book. This demonstrates the interdependence of Adler's conceptualising of the individual.
The chapter starts, as Adler often did, with the long view of evolution. The authors insist that evolution impacts on each individual within the species and that the ideal adaptation for species' survival is only achieved if each one within the species is "constantly adapting to the outside world and overcoming difficulties" (p. 11). They build on this survival disposition by introducing the teleological focus of Individual Psychology. Teleology aims along the path of evolution towards its anticipated outcome: "a specific goal of overcoming via his [her] creative power" (p. 15). Teleology is not devoid of social feeling — a concept underlined later in the chapter. In fact, the authors somewhat controversially affirm: goal-orientation can only be fulfilled "when one cares about others and takes their interests into account" (ibid.), thereby weaving the major focus of ethics into Adler's conceptualising of the individual.
From this underpinning, the authors turn to the phenomenological aspect of Adler's theory. They intertwine the concepts of fictional goals, private logic and apperceptive schema into a clear presentation of how we form our worldview — or the felt experience of our reality, something of which we have little direct perception. These complex ideas are handled in a friendly and understandable way without confusing the reader, with fitting references from a range of Adlerians.
Marková and Čechová then address holism from the perspective of both the person's internal, psychic make-up as well as the interface of that individual with the larger world via her or his Life Style. They help us see holism as integration: unifying the individual per se, but also incorporating one as part of the larger society. This, at least, is the case when considering mentally healthy individuals. The authors proceed to develop the Life Style construct in great detail (pp. 24–30). Then, in an example of applied theory, they demonstrate this concept by introducing the idiographic nature of the Life Style. Acknowledging that general laws likely apply to the species, the authors emphasise that our interactions with life occur not so much according to general human tendencies (nomothetic inclinations), but are individually crafted (idiographic inclinations) in the midst of our interactions.
The authors cap these intertwined concepts by considering the social implications of life's challenges whenever an individual engages the idiographic-other in society. The authors illustrate what was a fixed canon for Adler: trials that occur around logical thinking, shared language and interpersonal relationships — from infant attachment to couple pairing — are solved always and only in a social context.
Given this rich, multi-faceted conceptualisation of the human being, Marková and Čechová are ready to present the overarching ethical element of Individual Psychology. By focusing on the antithetical construct "good"/"bad," they navigate into the broad middle ground showing the complexity of ethical determinants. They strike Adler's balance of neutrality in considering the moral implications of human interactions. Interestingly, this section reflects on broadly defined individual morals by using a nomothetic — rather than idiographic — approach to show how ethics subsists within the Life Style (p. 42).
The authors conclude by considering the frequent outcome of moral transgression: conscience and guilt feelings. They provide a clear and intriguing presentation of what Adler, following Nietzsche (1887/1989), considered the immoral use of guilt feelings.
Chapter Two
This chapter addresses the structure of ethics within Individual Psychology by bringing together the opinions of several European Adlerians. In some fashion, each contends that "Adler incorporated powerful moral components into his psychology" (p. 48). The authors then refer to a number of Adler's writings underlining that the value of human beings' actions is found in their ability to enhance the welfare of all. They entice and challenge the reader with a discussion of what might be considered the relativity of absolute values. Thereafter, with appetite whetted, the authors take up the three main pillars of Adlerian ethics: freedom and responsibility, equality, and Gemeinschaftsgefühl.
The paired values of freedom and responsibility are folded into an ongoing discussion already introduced in Chapter One: the importance of an individual's creative power. A major implication in the authors' presentation addresses the degree to which the individual is aware of the decisions and choices that went into creating one's Life Style. They spell out how choice impacts on personality development as well as growth and development facilitated by therapy. The discussion is a challenging one that raises many questions — some of which might be roundly contested and likewise defended — in an open Adlerian dialogue. The authors remind us that individuals "amass recollections, experiences, perspectives and emotions on the basis of their goals" (p. 55). But how can these be combined so that the individual is responsible for the amassing — if such amassing includes non-conscious environmental correlates and influences? The discussion goes a long way to emphasise the complexity of the ethics issue. As a result, the reader's interest in practical applications — coming in the next chapter — is awakened.
The authors conclude their discussion of the first pillar by reminding the readers of Adler's "optimism … in the development of human potential" (p. 57). They do not make a direct application of this potential but, nonetheless, make reference to other theorists who concur with Adler. Concepts such as "resilience," "protective factors" and other positive psychological theoretical aspects are called on to support the relevance of Adler's optimism.
The second pillar of Adlerian ethics presented by Marková and Čechová is equality. They open with a discussion of the importance of mutual respect as the basis of interaction and offer the level of one's Gemeinschaftsgefühl as the "objective measure" of this important factor. Here the authors step forward into a lively discussion about the feeling of inferiority as the motivation for its own compensation. In a somewhat unconnected segment (pp. 62–63) they emphasise Dreikurs' modification of inferiority feelings (see "Appreciative Critique" below).
Afterwards, however, the authors conclude the discussion of the second pillar with their own contribution to the discussion. Three aspects of Adler's Psychology are "directly associated with contemporary education and psychology" (p. 63): conceiving of mental health along a continuum (rather than health vs. illness); identifying the societal benefits of developing democratic character from childhood, specifically in the school system (rather than segregated learning environments); and heralding the advancement of equal relations between therapist and client (rather than a teacher and learner arrangement).
The third pillar of Adlerian ethics is Gemeinschaftsgefühl. The authors address this construct (pp. 65–70) in one of the most thorough discussions I have read outside of key introductory texts. They cover salient contributions from a range of European thinkers that are available here for the first time to English speakers. An especially powerful exposition underscores Adler's consistent assertion on the innate capacity of Gemeinschaftsgefühl — rather than it somehow being misunderstood as a hereditary condition.
The discussion is continued in the following section, "Ethics of Social Interest," which is figuratively — and at p. 70, almost literally — at the centre of the book. This is a stimulating application of the preceding definitions. The authors return to an often-repeated phrase: "The basic universal human psychological needs are to belong and to feel included in society" (p. 71). They make their case in the light of the just-concluded argument that this is a potential-state and not a fixed condition. Identifying this as an ideal of the human ethical project, the authors are laying the groundwork for this chapter's quite complex conclusion on "the meaning of life" (pp. 74–78).
Chapter Three
In the final chapter, the authors provide a rich palette of cases within which they apply their ethical approach, thoroughly discussed in the preceding chapter. They do this by circumscribing the issue in a broad contextualised manner (consideration of ethical codes), then by focusing on the importance of the therapeutic relationship more specifically, and finally by offering detailed examples.
Marková and Čechová start by reviewing ethical codes from an impressive number of American and European professional organisations. These cover a range of helping disciplines — including counselling, psychology, marriage and family interventions and psychotherapy — from both American and European associations. Their aim is to show how well blended Adler's premises of freedom and responsibility, equality and Social Interest are within the deontological (ethical) codes of these professional associations. The authors maintain that Adlerian theory offers both what can be useful within Adlerian practice (applied ethics) as well as what ought to be present (normative ethics) in all practices.
Thereafter, they highlight the importance of the therapeutic relationship itself by drawing attention to what several decades of research have affirmed: "A therapeutic alliance … is the major contributing factor to a successful outcome of treatment, irrespective of the theoretical orientation and the techniques utilised" (pp. 86–87). The Adlerian focus of the authors is on encouragement within relational interactions. They make the helpful observation that encouragement itself is ethically neutral and provide guidelines (p. 88) for assuring ethical interchanges.
After these helpful preparatory steps, Čechová offers specific case examples of her own therapeutic interventions. These cover a range of therapeutic interactions including adult counselling and psychotherapy, adolescent psychotherapy, child and family counselling, couples counselling and working with groups. As these are the heart of the book, deserving close, individualised attention, I shall share only the general process the authors use, leaving the fun of a fuller exploration to the reader.
Each of these practical examples begins with a helpful overview of the modality concerned and a helpful number of primarily Adlerian sources. Next, an overview of a specific case is provided along with specific presenting information. This most typically focuses on the clients' Early Recollections. While there are explanatory comments along the way as to how this information is used, Čechová concludes each example with an intriguing summary of the case wherein you learn how she was thinking about the material and the client. She shares salient techniques and how the case generally proceeded to resolution.
The clinician author is especially adept at weaving in the Adlerian ethical themes — freedom and responsibility, equality and Social Interest — without overemphasising them and interfering with the clinical focus. An especially useful aspect of this section is the creative use of interventions Čechová employs. Some are familiar from the literature, others are designed by the therapist or the clients in the interaction. Creativity abounds here and brings liveliness to the final chapter that was enjoyably surprising given the weight of the overall subject.
Appreciative Critique
The authors did an excellent job of identifying the primary works of Adler, referencing 37 in total. Thirty-four of these are drawn from the original German.
Prior to the very useful applications offered in Chapter Three, the theoretical discussions are richer than typically found in Adlerian primers because they introduce European Adlerian thinking and formulations, which make for stimulating and sometimes provocative presentations. As a result, I found myself both intrigued and feeling somewhat argumentative throughout the reading. That is, in spite of the acknowledgement of Adler's original works — drawing from them and from several European Adlerians early in the book — the clinical presentations solely come from the perspective of Adlerians who follow Rudolf Dreikurs' approach to Adler's theory and therapy.
This leaves an inaccurate impression: despite the authors' use of a broad range of Adlerians to depict Adler's theory, when therapy is actually done, Dreikurs' approach is the way one does it. This might have been avoided if the clinician-author had acknowledged her Dreikursian training, preference and approach. In a book with a subtitle promising — and delivering — "applications in counselling and psychotherapy," it would have been desirable for these applications to be as richly diverse as the theoretical presentation made by the authors.
This is not the place to delineate the variations among Adlerian therapies, but the reader may find the uneven mixture of these differences thought-provoking, if not confusing.
The conflating of Adler and Dreikurs' understandings occurs most notably in the authors' presentation of human motivation. Adler understood inferiority feelings as a necessary and initially positive motivating factor, while Dreikurs believed they "came about by inadequate training … the result of 'faulty child raising'" (Dreikurs-Ferguson, 2016, pp. 17–18). Dreikurs' perception (pp. 60–62) seems to be fused with Adler's increasing clarity and emphasis on the importance of Gemeinschaftsgefühl (p. 67). That is, both of these viewpoints are presented as having "developed" over the course of Adler's professional life. To bolster this view, the authors include a reference to Oberst & Stewart's (2003, p. 61) also-undocumented developmental schema. While this is historically demonstrable in the case of Gemeinschaftsgefühl, it is not so with the issue of human motivation. According to Eife (personal communication, 18 September 2016):
"As Adler wrote in 1926 and 1933, being human means to have inferiority feeling. That means Adler did not abandon his early understanding of inferiority feeling. In my understanding there are no stages to Adler's concept of inferiority feeling. Adler expanded his organising principle, which he found in the neurotic, to the human being in general. After World War I, he developed his concept of community feeling and succeeded to integrate both inferiority feeling and community feeling into his concept of the dual dynamic" [cf., Adler, 1918/2003].
I hope this detail is not too puzzling, because the tension created by the authors could have a great effect on the reader's interaction with the text.
Conclusion
There is much to be cherished with such a fine contribution as this book: Jim Holloway provided a congruent and appealing cover design; Adriana and David Shearman did the difficult job of translating a complex text into a stimulating read for clinicians; and Paola Prina — yet again — showed an eye for a unique and useful manuscript. Having read the document as an early draft initially and then after extensive further editing resulting in its final version, she has my deep respect for the labour of love she imparts to each of the ASIIP jewels.
But primarily, a heartfelt "thank you" is due to Dagmar Marková and Daniela Čechová for wading into the international Adlerian dialogue in such a focused manner. Our Slovakian colleagues bring to the discussion table both a thorough-going familiarity with European ethical codes and a sophistication about the values of Individual Psychology. They make their case clearly and convincingly: that ethics is at the centre of both Adler's theory and therapy and that these are a genuine gift to our profession. Reading how a value-oriented approach benefits clients and the counselling field in general is an important contribution in today's psychological development.
References
Adler, A. (1964). Social Interest. New York: Capricorn Books. (Original work published 1933).
Adler, A. (2003). Dostoyevsky. In: H.T. Stein (Ed.), G.L. Liebenau (Transl.), The Collected Clinical Works of Alfred Adler (Vol. 4, pp. 115–122). Bellingham, WA: The Classical Adlerian Translation Project. (Original work published 1918).
Adler, A. (2005). Origin of the Striving for Superiority and of Social Interest. In: H.T. Stein (Ed.), G.L. Liebenau (Transl.), The Collected Clinical Works of Alfred Adler (Vol. 7, pp. 95–100). Bellingham, WA: The Classical Adlerian Translation Project. (Original work published 1933).
Adler, A. (2006). The General System of Individual Psychology. In: H.T. Stein (Ed.), The Collected Clinical Works of Alfred Adler (Vol. 12). Bellingham, WA: The Classical Adlerian Translation Project.
Adler, A. (2002–2006). The Collected Clinical Works of Alfred Adler (12 Volumes). H.T. Stein (Ed.). Bellingham, WA: Classical Adlerian Translation Project.
Ansbacher, H.L. & Ansbacher, R.R. (1956). The Individual Psychology of Alfred Adler. New York: Basic Books.
Ansbacher, H.L. & Ansbacher, R.R. (1964). Superiority and Social Interest. New York: Norton.
Ansbacher, H.L. & Ansbacher, R.R. (1979). Cooperation Between the Sexes. New York: Doubleday Anchor.
Dreikurs Ferguson, E. (2016). An Interview with Eva Dreikurs Ferguson: Reflections on a Lifetime of Individual Psychology by R.M. Kern & W.L. Curlette. The Journal of Individual Psychology, 72(1), 12–28.
Eife, G. (2016). Analytische Individualpsychologie in der therapeutischen Praxis [Analytic Individual Psychology in Therapeutic Practice]. Stuttgart, Germany: Kohlhammer.
Nietzsche, F. (1989). Beyond Good and Evil (W. Kaufman, Trans.). New York: Vintage. (Original work published 1887).
Oberst, U.E. & Stewart, A.E. (2003). Adlerian Psychotherapy: An Advanced Approach to Individual Psychology. London: Routledge.
Rosen, M. & Mansager, E. (2012). Striving to Understand Religion and Spirituality: An Individual Psychology Perspective. In: P. Prina, C. Shelley, A. Millar & K. John (Eds.), UK Adlerian Year Book 2012 (pp. 235–258). London: UK Adlerian Society and Institute for Individual Psychology (ASIIP).
Stein, H.T. (2013). Classical Adlerian Depth Psychotherapy, Volume 1. Theory & Practice. Bellingham, WA: The Classical Adlerian Translation Project.