COUNSELING THEORY AND PSYCHOTHERAPY

ANSWERS CASE 5 Case 5 revolves around the issue of empty shell marriage between Hamish and Carolyn. They want to recapture the love that they both left behind. From my opinion, REBT is the suitable theory to use for such case. Maladaptive thoughts are common among many people. Also, people show maladaptive behaviors. The REBT cognitive theories are used to explain why people show problematic behavior .People develop irrational thoughts that result from the external environment. Irrational thoughts have negative effects on the person like they make the person sad and live unhappy life. REBT explains why Hamish and Carolyn show maladaptive behaviors. It guides therapists when helping a client adapt good behaviors. Rational emotive behavior therapy is a technique that helps people resolves emotions and behavioral problems. It also helps solve disturbances so as to help people live a happy life. REBT assumes that people get upset not only by adversities, but also by the views they construct (Harris, 2007). Many people construct various views through various means. For example, the views result from language and beliefs. Clients learn how to solve problems using the A-B-C model. REBT model claims that people have innate rational and irrational behaviors. The author of the REBT claims that people construct emotional difficulties. They can create them consciously or unconsciously. For example, people will always create a feeling of blame and start blaming them. They will also create a feeling of guilt and depression. In addition, people create some behaviors like avoiding other people and withdraw from other people. The views and feelings created have adverse effects on the person. This happens if the person creates behaviors that affect him negatively (Harris, 2007). REBT framework assumes that humans have both innate rational (meaning self- and social-helping and constructive) and irrational (meaning self- and social-defeating and unhelpful) tendencies and leanings. REBT claims that people to a large degree consciously and unconsciously construct emotional difficulties such as self-blame, self-pity, clinical anger, hurt, guilt, shame, depression and anxiety, and behaviors and behavior tendencies like procrastination,

over-compulsiveness, avoidance, addiction and withdrawal by the means of their irrational and self-defeating thinking, emoting and behaving. REBT is then applied as an educational process in which the therapist often active-directive teaches the client how to identify irrational and selfdefeating beliefs and philosophies which in nature are rigid, extreme, unrealistic, illogical and absolutist, and then to forcefully and actively question and dispute them and replace them with more rational and self-helping ones. By using different cognitive, emotive and behavioral methods and activities, the client, together with help from the therapist and in homework exercises, can gain a more rational, selfhelping and constructive rational way of thinking, emoting and behaving. One of the main objectives in REBT is to show the client that whenever unpleasant and unfortunate activating events occur in people's lives, they have a choice of making themselves feel healthily and self-helpingly sorry, disappointed, frustrated, and annoyed, or making themselves feel unhealthily and self-defeating, horrified, terrified, panicked, depressed, self-hating, and selfpitying. By attaining and ingraining a more rational and self-constructive philosophy of themselves, others and the world, people often are more likely to behave and emote in more lifeserving and adaptive ways. Hamish and Carolyn had such problems because they start having irrational beliefs upon each other. They start blaming each other even for a minor reason. They have all the notion of must, should and ought. They feel that they have lack of connection in their marriage life by lacking doing things together and neglecting their feeling by abandoned each other as a result of rebelling of everyones action. Suppose that , like Hamish and Carolyn, and most human beings on the surface of this planet, believe that your partner is upsetting you. What can they do? They can tackle the problem in three stages: 1. Take responsibility for your upset; 2. Identify your "musts"; 3. Dispute your "musts.

Take responsibility for their upset. Face the fact that no one else can ever upset you. Only you can upset yourself. No one can get into your gut and churn it up. Only you can do that, by the way you think. Identify your "musts." Once you have fully acknowledged that only you can upset your own emotions, identify precisely what youre telling yourself. The culprit can usually be found in one of three basic "musts": a demand on oneself, a demand on other people, or a demand on "The Universe". In marital frictions, these "musts" take the following forms:
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"Must" 1 (a demand on oneself): "I MUST do well by my mate and get her approval, or Im no good." "Must" 2 (a demand on others): "My mate MUST treat me well, or shes no good."

"Must" 3 (a demand on circumstances, or on The Universe): "The relationship MUST go well, or lifes no good."

Try to discover what youre demanding of yourself, your partner, and your relationship. Not until youve identified your key "must" can you most effectively reduce your distress. As is often the case with Hamishs and Carolyns self-defeating thinking included all three "musts." Dispute your "musts." Question and challenge those beliefs which are upsetting you. Once youve exposed your "musts" to the pitiless light of day, ruthlessly attack them. The only reason you could remain disturbed about marital problems is that you are vigorously and persistently telling yourself nonsense about them. Change that warped view to a "must"-free one, and the emotional disturbance will probably diminish, or even vanish. You make that change by asking yourself, in writing or in your head, again and again: "What is the evidence for that "must," "awful," or "cant stand it"? "What is the evidence the relationship MUST provide me with total satisfaction?"

And he concluded, over and over: "No damned evidence. No reason I HAVE TO have an eversupportive wife, since she may choose not to support me at times. She doesnt always HAVE TO comply with my sexual requests, since I dont run the universe. The relationship doesnt HAVE TO provide me with total satisfaction since life and relationships often consist of one hassle after another." The next stage, "D", is to dispute the irrational Belief, simply by questioning it, which leads to "E", for "Effective new thinking," a statement of the more reasonable way of thinking which denies "B." Finally, if this works out OK, we arrive at "F", the new, better "Feeling" which replaces "C." Once this method has been learned, it can be applied in three minutes, whenever the occasion arises. Actually learning the method, of course, takes somewhat longer.

CASE 7 Case 7 focusing on the Terry state of denial regarding his drinking problem and difficulty expressing his feelings. For me, Psychoanalytic Theory developed by Freud is the suitable theory that can be used for this case. This is because in Freuds theory, he places a heavy emphasis on the workings of the unconscious mind. Unhealthy individuals are not aware of their own unconscious processes and as a result may suffer from irrational pleasure-seeking or guilt. Successful therapy involves bringing an understanding of the unconscious mind and its defense mechanisms into the client's conscious, resulting in a healthy individual who is able to fully understand the choices that he/she has in life and to not be ruled by unconscious processes that are not understood. Besides that, denial is a concept originating with the psychodynamic theories of Sigmund Freud too. This is another reason why it is suitable for this case of Terry. According to Freud, three mental dynamics, or motivating forces, influence human behavior: the id, ego, and superego. The id consists of basic survival instincts and what Freud believed to be the two dominant human drives: sex and aggression. If the id were the only influence on behavior, humans would exclusively seek to increase pleasure, decrease pain, and achieve immediate gratification of desires. The ego consists of logical and rational thinking. It enables humans to analyze the realistic risks and benefits of a situation, to tolerate some pain for future profit, and to consider alternatives to the impulse-driven behavior of the id. The superego consists of moralistic standards and forms the basis of the conscience. Although the superego is essential to a sense of right and wrong, it can also include extreme, unrealistic ideas about what one should and should not do. These three forces all have different goals (id, pleasure; ego, reality; superego, morality) and continually strive for dominance, resulting in internal conflict. This conflict produces anxiety. The ego, which functions as a mediator between the two extremes of the id and the superego, attempts to reduce this anxiety by using defense mechanisms. Defense mechanisms are indirect ways of dealing or coping with anxiety, such as explaining problems away or blaming others for problems. Denial is one of many defense mechanisms. It entails ignoring or refusing to believe an unpleasant reality. Defense mechanisms protect one's psychological wellbeing in traumatic

situations, or in any situation that produces anxiety or conflict. However, they do not resolve the anxiety-producing situation and, if overused, can lead to psychological disorders. Although Freud's model of the id, ego, and superego is not emphasized by most psychologists today, defense mechanisms are still regarded as potentially maladaptive behavioral patterns that may lead to psychological disorders. Freud view of human nature is basically deterministic. According to Freud, our behavior is determined by irrational forces, unconscious motivations, and biological and instinctual drives as these evolves through the psychosexual stages in the first 6 years of life. As the unconscious become conscious, blind habit is replaced by choice. This is a usually liberated form of determinism. Instincts are central to the Freudian approach. Although he originally used the term libido to refer to sexual energy, he later broadened it to include the energy of all the life instinct. These instincts serve the purpose of survival of the individual and the human race; they are oriented toward growth, development, and creativity. Libido then should be understood as a source of motivation that encompasses sexual energy but goes beyond it. Freud includes all pleasurable acts in his concept of the life instincts; he sees the goal of much of life as gaining pleasure and avoiding pain. Freud also postulates death instinct, which account for the aggressive drive. At times, people manifest through their behavior an unconscious wish to die or to hurt themselves or others. Managing this aggressive drive is a major challenge to the human race. In Freuds view, both sexual and aggressive drives are powerful determinants of why people act as they do. Terry had such problem because he is now feeling under extreme pressure both at work and at home. He is trapped into his unconscious mind and do not know how to managing his aggressive drive. Because of this, he is in the state of denial about his life and blind of others concerned and hard to express his true feeling. He suppressed his feeling down to his unconscious mind. He tries to gaining pressure and avoiding pain. Denial is treated differently in different types of therapy. So, Terry needs denial treatment to helps him back to normal. In psychoanalytic therapy, denial is regarded as an obstacle to

progress that must eventually be confronted and interpreted. Timing is important, however. Psychoanalytic therapists wait until clients appear emotionally ready or have some degree of insight into their problems before confronting them. In the humanistic and existential therapies, denial is considered the framework by which clients understand their world. Not directly confronting denial, therapists assist clients in exploring their world view and considering alternative ways of being. In cognitive-behavioral therapies, denial is not regarded as an important phenomenon. Rather, denial would suggest that an individual has not learned the appropriate behaviors to cope with a stressful situation. Therapists assist individuals in examining their current thoughts and behaviors and devising strategic ways to make changes. Traditional treatment programs for substance abuse and other addictions view denial as a central theme. Such programs teach that in order to overcome addiction, one must admit to being an alcoholic or addict. Those who are unable to accept such labels are informed they are in denial. Even when the labels are accepted, individuals are still considered to be in denial if they do not acknowledge the severity of their addictions. From this perspective, progress cannot be made until individuals recognize the extent of their denial and work toward acceptance. However, there is much controversy in the field of addictions regarding the role of denial and how it should be addressed. Traditional programs stress direct confrontation. Other professionals do not insist on the acceptance of labels. They believe that denial should be worked through more subtly, empathically focusing on the personal reasons surrounding denial and seeking to strengthen the desire to change. This subtle form of addressing denial is known as motivational enhancement therapy, and can be used with other types of disorders as well. How should a person's denial be confronted? Carefully. Confronting an Terry's denial too harshly or abruptly may only serve to drive him away from necessary treatment. Denial is not always a bad thing. It can be positive protection for a person who has experienced trauma or emotions too painful to acknowledge all at once. Denial is maladaptive when it persists and prevents a person from getting the help he needs. In addressing denial, one's fears need to be taken seriously and support provided. Terry should be allowed to freely talk about his fears in relation to his addiction. Irrational thoughts or beliefs the addict holds need to be identified and replaced with evidence of truth. For example, many addicts believe that the addiction is too

powerful and that nothing will help. This is an irrational thought that can be replaced with truthful evidence of treatment options. Denial may also be covering up shame and guilt an addict feels. Attacking Terrys denial by telling him he should be ashamed of how he's affected others and damaged himself is quite harmful. Confronting denial with attacks and beating the addict down creates further destruction that will need to be repaired before recovery can take place. Empathy and understanding, while at the same time telling the reality of what one sees, will reassure the addict that it is safe to face his denial. As an addict sorts through his fears and anxieties over addressing his addiction, he will need to experience acceptance and support. The person considering the need to confront Terry may need help in dealing with his own feelings of anger and resentment before he can be effective. This is understandable. Confronting denial around addictions is difficult for everyone concerned. Patience is most definitely a desirable quality in this situation.