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Counseling is defined as the act of giving professional psychological guidance or advice to someone with a personal psychological problem (Myers, 2008). This case covers a hypothetical psychology issue that requires counseling. Tom has been feeling lonely since childhood. He clearly has some unresolved issues with his parents and his sister Mary. The fatigue he has been experiencing lately indicates that he is stressed and well on his way to depression. His dream can be interpreted to mean he feels as if he carries a burden which he is stuck with. He appears to be a nice, hardworking guy at work and is open to children. However, his fear and discomfort around the opposite sex at his age and his failure to sustain a long term relationship with a woman are indicators of a psychological issue that needs to be addressed.
Thistype of therapy emphasizes that concepts relating to superiority and inferiority such as lifestyles and birth orders are important components of individual personality. In this case Tom is the middle child. He appears to have been ignored for the most part as a kid and quietly holds a grudge against his mother. Under this kind of therapy, mistaken beliefs result in feelings of inferiority or superiority and the focus is to reduce these beliefs. The therapist in this case would need to understand Tom’s past experiences, his family constellation and his dreams. The goal of Adlerian therapy is to solve the problem by increasing the patient’s social interest and modifying any self destructive behavior they may have developed.
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In this case Tom is anti-social and a loner hence lonely. The goal of the counselor taking him through this kind of therapy would be to make him more sociable and genuinely interested in socialization. To reach this goal the therapist would have to understand exactly why Tom was not socially interested or the reasons he was afraid of the opposite sex and could not maintain a long term relationship with any woman. This could be achieved by observation and assessing of the patient in order to gauge their early childhood experiences, their lifestyle and especially their family dynamic.
The Adlerian therapist would then interpret Tom’s dreams to gauge his present condition, his fears and struggles. The therapist can obtain this information either through direct inquiry or through a questionnaire. In this case both would apply. Tom may be antisocial and lonely but he does not appear shy. Therefore, direct inquiry would be a way of getting him to open up about his childhood experiences.
In Tom’s case a couple of techniques would come in handy. The first is immediacy, which entails getting Tom to communicate his present condition, events happening around him, his present feelings and generally getting him to understand his own condition presently. It would also be important for the therapist to be encouraging towards Tom especially in order to create rapport between the two of them which would help in case Tom felt defensive due to his inferiority complex.
Once the problem had been analyzed the therapist could use other techniques to solve it. One technique involves acting as if, which usually requires the client to presume a future action as having successful results. In this case the therapist would request Tom to presume the successful result of a yet to be attempted action.
A second technique would be one known as spitting in the patient’s soup. This would have the aim of making the client perceive certain behaviors as less attractive. The perception of a certain behavior as repulsive is likely to make the client ensure it does not recur. The counselor deliberately constructs questions that assist the client in identifying the existence of an underlying psychological problem (Carlson, 2005). The Adlerian counselor usually ensures they give the client homework in an attempt to assist the client to think about and solve their problems outside of the counseling sessions.
Adlerian therapy in order to be successful would require that Tom and the counselor have similar goals. The counselor would need to accomplish this at the beginning of counseling. There would need to be mutual respect and trust between Tom and the counselor. That way, Tom would be likely to apply the counselor’s therapeutic techniques more readily and be more open and honest with them. Adlerian therapy focuses on the achievement of goals rather than on the problem and because of this it is often successful.
The counselor could work towards group cohesion to assist Tom function better in social settings. Self esteem is better fostered in a group setting as compared to an individual setting. Placing him in a group with similar goals would give him the sense of belonging that is lacking in his present condition. This kind of therapy takes time and focuses on long term solutions as opposed to short term ones. The counselor would require Tom to understand the root of his problem which requires that there be a thorough analysis of past experiences and their effect on him. Then they would work on the mistaken beliefs and attitudes resulting from these experiences and work towards correcting them.
According to Irvin Yalom there are four givens in life. They are death, freedom, responsibility and existential isolation. The existential therapy approach views a person’s psychological problem as resulting from their interaction with these four givens. This kind of therapy would approach Tom’s case from this point of view. The counselor would encourage him to disengage from the societal norm and truths that society claims are objective and create his own subjective truth. This kind of therapy would be aimed at enabling Tom make sense of his existence.
This kind of therapy recognizes the need for human beings to connect to other people even though they are essentially alone. This is inherent in the loneliness that Tom experiences even when he has close friends. He claims to have an empty spot in his heart and is not happy with his social life. He seems to have a problem with reception and giving of validation. The counselor taking him through existential therapy would have him understand that while validation is essential it cannot come from other people but has got to come from within. This revelation is likely to cause anxiety, and since this approach views psychological problems as arising from an individual’s inability to confront the four givens, isolation inclusive, the counselor would embark on assisting Tom deal with the realities he would encounter upon confronting life’s givens, in his case isolation especially.
The focus for this counselor would be aiding Tom in coming to terms with and dealing with the anxiety that will result from accepting that he is alone in the world. The counselor would assist him on the road to acceptance rather than try to change this situation. The aim would be to help him embrace the givens of freedom and responsibility and instead of getting rid of feelings of meaninglessness; he could choose new meaning for his life. He could then to choose to love, to create and to build in pursuit of his life adventure.
Coming to terms with the four givens would assist Tom in enjoying life unencumbered and without feeling burdened because it would free his mind. An unclouded mind would enable him steer his life in the direction of his choice and would make him less uptight and therefore more sociable. The principle behind existential therapy is that one chooses how to live by accepting unchangeable facts, the givens, and making the necessary changes and choices in regards to attitudes, beliefs and way of living.
This counselor administering this kind of therapy would not be interested in Tom’s past but would focus on present and future choices. Therefore his past experiences with his family would have to be forgotten as a thing of the past and emphasis placed on his present relationships and choices. He could choose to live out the life he wanted to. He would be made to understand that he was not special and that his existence was simply coincidental. There therefore could not be a blue print as to how he should live out his life, and his life was not controlled by fate or destiny. The goal of the counselor would be to change Tom’s view of an ideal life as one that is socially desirable to viewing life as free moments where he could choose what to make out of it.
In summary the counselor helps tom release himself from restrictive social norms that define the ideal life. Sooner or later everyone faces moments of loneliness and rather than try to change them, they need to accept them and choose to be happy if happiness is their goal. The goal is to enable him to accept and appreciate himself as he is so that his actions will be geared towards self satisfaction as opposed to fitting himself into the person he thinks society expects of him.
The counselor’s focus under this kind of therapy would be to make Tom focus on himself and how his feelings, behavior and attitude were being affected negatively and focus on finding their positive potential and exercising it. This kind of therapy enables the client to create a sense of individualism and self so that they analyze their problems and come up with solutions for them in the course of therapy sessions. This kind of therapy like existential therapy believes that people are capable of solving their own problems through making constructive and positive choices. The therapist is required to show unconditional positive regard for the client.
The counselor in this case would center the therapy on Tom in a person centered rather than problem centered approach. The counselor in this case would not be required to give advice, teach him or suggest solutions. He however, would lead Tom in a personal evaluation over the therapy sessions and help him understand his problems. He would then assist Tom come to the realization that he could choose to solve them. Tom would therefore have to deal with the grudge he held against his parents and his sister and the negative effect it had on his life. Rather than focus on the cause of the problem, he could choose not to allow his experience to negatively affect his behavior and attitude and choose to exercise positive attitude and behavior based on will not on his situation.
The counselor would bring Tom to the realization that he is the steward and architect of his life. He could choose to alter his attitude and behavior to what he wanted them to be and he could also choose to be positive about his life and his relationships. His happiness at the end of the therapy had to be a result of the choices he made rather than a result of the way people treated him or viewed him. The counselor would help him understand that his life, his attitude, his feelings and success in every part of life was solely up to him and was not up to, though influenced by the people around him.
The goal here would be to improve Tom’s self esteem and his ability to trust himself. That way he would not be afraid that his socialization skills were wanting or that he would be judged negatively. If the counselor could assist Tom in trusting himself and improving his self esteem, then he would help him be more comfortable in expressing his opinions and be more open to new experiences. It would also enable him to be more positive when relating to others and would greatly improve his social life.
One important strategy the counselor uses in this kind of therapy is unconditional positive regard. Only then can there be mutual trust such that Tom will not feel the need to put up a defensive false front out of the fear of being misjudged. The counselor would need to relate to Tom’s painful experiences and be sensitive to his feelings in order to positively communicate. This therapy would aim at assisting Tom to develop positively by striving to become the best he can be.
Under this kind of therapy the goal of the counselor would be to identify distorted beliefs, attitudes and thought patterns which are the cause of the psychological problem. In this case the counselor would focus on the negative attitude and beliefs that resulted from Tom’s childhood experiences and the negative impact they had on his social behavior. The counselor would provide therapy based on the point of view that, mistaken and distorted beliefs about one self directly result in negative emotions and feelings.
The goal of the counselor would be to help Tom reassess the negative and mistaken thoughts and attitudes he adopted as a result of his painful childhood experience and replace them with positive thoughts and attitudes about himself. Then he could improve his social life by changing the way he presents himself. Positive beliefs and attitudes about him would mean he would be more confident and hence more social. In Tom’s case his cognitive distortion may have been a result of mental filter, that is, he has likely singled out his negative experiences and overlooked the positive experiences. This results in treating positive experiences as if they do not count. It also could have resulted in viewing a situation emotionally instead of analyzing the facts objectively.
This approach would have the counselor focus on Tom’s undesirable behavior and help replace it with desirable behavior. This could be achieved through operant and classical conditioning. The counselor could help Tom understand how behavioral change could change how he felt. Behavioral change can be encouraged by encouraging Tom to get more involved in positive activities with the aim of increasing his positive experiences. Continual participation in positive activities is bound to increase positive experiences and therefore be an incentive for positive behavior (Martin, 1975).
Another strategy the counselor could use would be role playing. This would entail focusing on undesirable social behavior that Tom practiced and practicing its opposite with the help of the doctor. For instance, the counselor could focus on the behavior that Tom practiced and found to be undesirable and practice desirable behavior he was willing to practice.
This therapy would focus on Increasing Tom’s level of self awareness in a wholesome manner. This stems from the fact that humans are bound to suppress some aspects of their individuality in an effort to fit the acceptable societal personality. These suppressed feelings cannot be done away with and have to be dealt with in order for humans to be whole and to change positively.
The strategy of the counselor would be to help Tom constantly be aware of his feelings or lack thereof and analyze the basis of these feelings or lack of feelings. It could be perceptions concerning himself that are based on the feelings resulting from past experience rather than being based on reality.
The counselor could use the empty chair technique to help Tom confront his suppressed feelings. This would involve having him sit across an empty chair and imagine his sister, mother or father seated across from him. Then he would be required to converse with his imaginary family member as if they were there to listen to him and tell them exactly how their actions made him feel then as well as now. This would obviously evoke a lot of emotion which would help Tom expose any suppressed feelings of anger, hatred, inferiority, etc. The point here would be to take note of whatever feelings that will surface. Tom would realize that he harbored these negative feelings and that they were really a part of him then even if they had been triggered by an actual external experience. However, during such a session, Tom would realize that he had created the upsetting image and could therefore in the same way deal with it and dismantle it. This prevents him perceiving other people as being responsible for the solution to his problem and helping him realize he held the solution to the problem just as he allowed the problem to bother and negatively affect him.
This would address the inner conflict between the person he wanted to be and the person he was by removing all his focus from who he wanted to be to include who he really is. Only then can he better focus on the person he wants to be based on an understanding of who he really is as opposed to approaching change from a point of ignorance.
Loneliness is a feeling that each one of us encounters at one point or another and in some cases it could be overwhelming. A psychological problem occurs when an individual is unable to come to terms with this feeling and they deign to succumb to the overwhelming weight of this feeling. The longer it takes to deal with a psychological issue, the harder it becomes to solve (Patrick, 2009). In Tom’s case it would have been easier to deal with his hurt and negative experience when he was still very young. It would have been easier then to change his attitude and beliefs and to improve his behavior.
At the age of thirty, it was not too late, but it was more difficult to change beliefs and attitudes he harbored for more than two decades. I think the best approach would be to assist Tom in dealing with his past, accepting what he could not change and changing what he could. The principle behind existential and person centered therapy approaches, which centers on human free will and the ability to choose to steer one’s life in whatever direction they desire is key to a situation like Tom’s. Tom cannot change the past, and while it may have impacted him negatively, he can choose to replace the negative effects with positive ones and become the person he wants to be.
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