Although he is not as famous as his contemporaries Sigmund Freud and Carl Jung, Alfred Adler (1870-1937) was the source of many of the ideas of Cognitive Behavioural Therapy (CBT). 

Adler's contributions to therapy have been underestimated; he was the first person to coin the term “inferiority complex”. His work on the social context of mental health has been important in a number of different fields.

In the past two years, his work has been brought to public awareness through the self-help manual "The Courage to be disliked" by Ichiro Kishimi and Fumitake Koga. This book has sold over 3 million copies since its publication. In the light of this, it might be useful to highlight Adler’s contributions to both therapy in general and CBT specifically.

Real change requires the courage to change habitual behaviours

It could be claimed that Adler was the father of CBT in that he was able to identify the connection between thoughts and feelings and how similar events can be interpreted differently due to the meaning which is imposed on them. A central idea in Adler’s theory of individual psychology is, as the title of the book suggests, courage.

Courage matters because, as CBT tells us, real change requires stepping outside of our comfort zones. When Adler talks about the role of the therapist, he says that they need to be “encouraging” in the sense of helping the client to be more “courageous”. Real change requires the courage to change habitual behaviours. Adler wrote about how we can often come up with excuses for not changing, noticing that these excuses were often concerned with factors which are outside of a person’s control.

Separation of tasks

CBT recognises that people want to change how others behave. We develop SMART goals as a way of getting back in “control”. The A in the acronym stands for “achievable”. However, in setting ourselves goals we need to be clear about what Adler would call “the separation of tasks”.

The separation of tasks means knowing what our tasks are and how they differ from the tasks of others. Many depressed people fall into the habit of trying to please others in order to get some positive feedback from them. In this scenario, Adler might say that one of the tasks of the individual is whether they choose “to like” someone or not.  People who try “to please others” all of the time are taking on “tasks” that should be done by the other person. We can try to influence others but we cannot “make” someone else like us.

A teleological approach

Adler also identified that all behaviour had a goal in mind. He devised a term to describe this called “teleology”. We are always motivated to achieve a goal, even when we are depressed. People who avoid going out are motivated by the goal of “not wanting to experience anxiety”. This notion is central to the Behavioural Activation which I have written about in a previous blog.

Unlike all of his contemporaries, it must be mentioned that Adler spoke about issues of inequality between men and women and the social context of mental health. People said that Adler was “before his time”. I hope with the popularity of this book that his “time” has now come.

 

Buy "A Practical Guide to Working with Depression: A cognitive behavioural approach for mental health workers" by Michael O'Sullivan (Derbyshire Healthcare Foundation Trust)

Caption: Alfred Adler, Public Domain Library of Famous Psychologists, Sonoma University