Re: Problem of Obesity

Overeating may have other "symbolic" value besides "replacing an emotional emptiness." The "comfort" factor may be primary in many cases, but I can recall a case where eating an abundance of sweets represented a compensation for the bitterness of life that was deeply felt. In another case, a child who was eating massive amounts of food, believed that it would help him grow up faster and catch up in size with his older brother. I would always look for the individual, unique root of an unusual eating habit.

Developing a "concrete sense of self" and an "acceptance of self" is indeed a prerequisite to increasing the feeling of community. In order to achieve this, the push of the inferiority feeling and the pull of the fictional final goal must be progressively diminished. A genuine sense of self is discovered after the artificial role, dictated by the style of life and fictional goal (designed to relieve a dreaded fear of inferiority) is dissolved.

An examination of the stages of Classical Adlerian psychotherapy can clarify the sequence of strategies that lead up to the development of a feeling of community.

(This is a broad simplification of Individual Adult Psychotherapy.)

PHASES	STAGE NO.	STAGE	TASKS TO BE ACCOMPLISHED
Support	1	Empathy & Relationship	Providing warmth, empathy, and acceptance. Generating hope, reassurance, and encouragement. Establishing a cooperative working relationship.
	2	Information	Unstructured gathering of relevant information: Eliciting details of presenting problem & life tasks. Exploring early childhood influences and memories.
Encouragement	3	Clarification	Clarifying vague thinking with Socratic questioning. Evaluating consequences of ideas and actions. Correcting mistaken ideas about self and others.
	4	Encouragement	Helping generate alternatives. Stimulating movement in a new direction, away from life style. Clarifying new feelings about effort and results.
Insight	5	Interpretation - Recognition	Interpreting inferiority feelings & goal of superiority. Identifying what has been avoided. Integrating birth order, recollections, dreams, & daydreams.
	6	Knowing	Client fully aware of life style without help. Individual knows and accepts what needs to be changed. In spite of insight, client may feel emotionally blocked.
Change	7	Emotional Breakthrough - Missing Experience	When needed, promoting an emotional breakthrough. Offering corrective or missing developmental experiences. Creative use of role-playing, guided imagery, and narration.
	8	Doing Differently	Converting insight into new attitude--breaking old patterns. Fostering experiments, concrete steps based on abstract ideas. Making the unproductive feel unpleasant.
	9	Reinforcement	Encouraging all new movements toward significant change. Affirming positive results and feelings. Evaluating progress and new courage.
Challenge	10	Social Interest	Using client's better feeling of self to promote more cooperation. Extending feeling of equality, cooperation and empathy to others. Giving one's all, 100% in relationships and work--taking risks.
	11	Goal Redirection	Challenging client to let go of self and old fictional goal. Dissolving the old style of life--finding a new direction. Opening a new psychological horizon--living by new values.
	12	Support & Launching	Inspiring client to love the struggle and prefer the unfamiliar. Strengthening the feeling of connectedness & desire to share. Promoting a path of continual growth for self and others.
Meta-Therapy	-	Post-Therapeutic Dialogue	A philosophical and/or spiritual discussion of values, the meaning of ones' life, and the committment to a mission.

Classical Adlerian psychotherapy is characterized by a diplomatic, warm, empathic, and Socratic style of treatment. This climate embodies the qualities of respect and equality necessary for building a trusting, cooperative relationship. A full psychotherapy can be envisioned as a progression though twelve stages, however, these stages should be considered as teaching guidelines and should not be interpreted as a systematic procedure. Psychotherapy is an art that must be practiced creatively. The best therapeutic strategy is frequently a unique invention for the individual client.

GENERAL NOTES

1. Throughout all of the stages, a variety of treatment strategies are utilized to stimulate cognitive, affective, and behavioral change.
• The Socratic method guides clients to: clarify meanings, reasons, and feelings; gain insight into intentions and consequences; consider alternative opportunities; reach rational decisions; and generate effective plans for action.
• Guided and eidetic imagery techniques facilitate affective awareness, change, and growth. By providing a "missing developmental experience," we can offer a deep level of acceptance, support, and encouragement that frequently dissolves the residues of early, painful, inferiority feelings, and discouragement.
• Role-playing and "future scenarios" provide safe and encouraging behavioral preparation and practice. Progressive positive and/or negative circumstances can be devised to build confidence in dealing with difficult or unfamiliar experiences.
2. Classical Adlerian psychotherapy has the potential for bringing each individual to an optimal level of personal, interpersonal, and occupational functioning.
   • For many clients, however, brief therapy is the limit of their current interest or budget, and therapy therefore stops somewhere between the fourth and sixth stages. Normally this involves modest behavioral and cognitive change. Treatment may be resumed at a later date to continue the desired therapeutic progress.
   • A complete psychotherapy targets deeper attitude and personality change. The limits of the style of life are at least reduced, and sometimes eliminated, opening the door for fully functioning, creative living.
   • Some clients, after completing the twelve stages, may wish to discuss philosophical and/or spiritual issues. This stage of meta-therapy represents a transcendance from the deficiency motivation inherent in a style of life to the "meta-motivation" of higher values. (For additional information, read The Farther Reaches of Human Nature, by Abraham Malsow.)

   For more detailed information about the process of psychotherapy, read Classical Adlerian Theory and Practice at http://www.themall.net/~adler/theoprac.htm .
   

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