Adlerian Thought and Process in Systems of

Family Therapy

James Robert Bitter and Jon Carlson

Abstract
Family therapy does not consist of just a single way of working with people but is
composed of many different approaches. This article divides family therapy into four
historical groupings and explores the degree to which Adler’s ideas have influenced,
whether directly or indirectly, the various models of family therapy. Family systems
therapy, often without recognition, has incorporated much of what Adler and his
associates brought to the understanding of human nature and the contexts in which
humans live and work.
Keywords: Individual Psychology, family therapy, family systems therapy, genograms,
Alfred Adler

In order to make the best choices we human beings need to appreciate that we
are all connected to each other and to the earth, to the past and to the future of
each other and of our planet. So making the best choices means aiming toward
positive connectedness with family, friends, community, coworkers, and nature
that surround us. The aim of therapy is to support clients’ maximal self-effective-
ness in their lives. (McGoldrick, 2016, p. 2)

In 1985, Monica McGoldrick, with Randy Gerson, formalized the most

important assessment tool in couples and family therapy, the genogram,
pulling together the diverse mapping procedures of Bowen, Minuchin,
Haley, and Satir (see McGoldrick, Gerson, & Petry, 2008, for the most recent
version). The evolution of this tool has steadily increased our understand-
ing of the significance of family and community, connection, and social
embeddedness in the lives of individuals, a concept that Alfred Adler raised
to a standard for mental health and human development. Every part of
McGoldrick’s (2016) most recent description of the purpose of therapy, in
the epigraph to this article, is imbued with Adler’s ideal of a community feel-
ing and its action line, social interest (Ansbacher, 1992).
In 1935, two years before his death, Adler (1935/1988) decided to
comment on the article “On the Essence and Origin of Character,” written
some six years earlier by Professor Father Agostino Gemelli (1926/1935) in
Acts of the Italian Society for the Progress of Science. It is in Adler’s article
that he affirms the systemic perspective that Gemelli shares with Individual
Psychology as well as an emphasis on community feeling and social interest
The Journal of Individual Psychology, Vol. 73, No. 4, Winter 2017
©2017 by the University of Texas Press

Published for the North American Society of Adlerian Psychology.

308 James Robert Bitter and Jon Carlson

as measures of an effective life. A genogram maps for individuals, couples,

and families the immediate interactions and connections to others within the
system, the place people have in the flow and development of life over mul-
tiple generations, the relationship the family has to the environment, as well
as their sense of belonging and being at home in the world. In this sense, the
genogram is a diagram of the individual’s—even the family’s—community
feeling. This is what connects all of humankind to Adler’s (1935/1988) al-
most spiritual challenge: “Character [who we become as individuals], more-
over, corresponds to the degree of its social interest, whose ideal measuring
stick is nothing else but the goal of an ideal attitude (Verhalten) toward the
welfare of all humanity and toward eternity” (p. 425).
It took the family therapy field in general more than half a century to
rediscover the integration of individual and system that Adler (1927/1965)
proposed in Understanding Human Nature with its emphasis on family con-
stellation, phenomenological birth-order positions, social embeddedness,
and human connections. Even the movement from a more mechanistic-­
deterministic application of general systems theory to an emphasis on more
fully human, organic, living, and growing systems paralleled the earlier shift
from Freud’s model to Adler’s. It was, for the most part, the women of family
therapy, with whom McGoldrick was a prime mover, who first pushed the
field to incorporate lenses related to family life cycles, gender, culture, and
race, and to fully engage the growth of individuals as well as systems, to em-
brace what Satir (Satir & Baldwin, 1983; Satir, Banmen, Gerber, & Gomori,
1991) had called “the seed model.”
The history of family therapy can be divided into four groupings or phases:
the pioneers, including Adler, Bowen, Satir, and Whitaker; the structural-
strategic era; the postmodern social constructivists; and the era of evidence-
based practice and neuroscience in therapy (Bitter, 2014; Bitter & Carlson,
2016). In each of these phases, Adler’s ideas and influence, whether direct
or indirect, are present in the various models of family therapy. This is not to
say that all models are Adlerian in nature. Indeed, some are incompatible
with Adlerian approaches to therapeutic practice (e.g., Whitaker’s symbolic-
experiential family therapy), and some have only a tangential relationship to
Adlerian practices (e.g., the MRI model; Haley’s strategic family therapy).
Carlson, Watts, and Maniacci (2006) have fully delineated the influ-
ence and incorporation of Adlerian thought and practice in the broad range
of psychotherapeutic orientations. Their assessment included the notation
that more than 90% of the therapeutic items found in Adlerian family ther-
apy were supported by the other approaches that make up family systems
therapy. Carlson, Sperry, and Lewis (2005) also fully developed an Adlerian
model for conducting family therapy that integrates perspectives from mul-
tiple family systems models.
 Adlerian Concepts in Family Therapy 309

In 1987, Sherman and Dinkmeyer and their associates delineated many

of the ways in which Adlerian principles and process had been integrated
into family systems therapy. At that time, the work of Murray Bowen and
Carl Whitaker was not considered, postmodern approaches from solution-
focused therapy to narrative therapy had not been developed, and cognitive
approaches were limited to the work of Albert Ellis. This article returns to
Sherman and Dinkmeyer’s early effort at proposing an Adlerian integration,
updating the influence of Adler on their models as well as the ones that have
developed over almost three decades.
Even though object relations theorists would eventually create a model
of family therapy, Freud, himself, stuck to a deterministic, intrapsychic
model focused on individuals. There is some evidence that he once coached
a father on how to interact with his son, the case of Little Hans (Freud,
1909/1957), but there is no record of Freud ever having worked directly with
an actual family. In contrast, Adler and his associates established more than
20 child guidance centers in Vienna, before the Nazis took over, and coun-
seled whole families in front of the larger communities in which they lived.
Adler’s model was later systematized by Rudolf Dreikurs and brought to the
United States as open-forum family education centers (Christensen, 2004).
The other early pioneers of family therapy included Murray Bowen, Virginia
Satir, and Carl Whitaker. Of the three, only Whitaker seems to have devel-
oped an experiential model with little or no relation to Adlerian psychology.

The Pioneers of Family Therapy

Bowen’s Multigenerational Family Therapy

Murray Bowen’s model was perhaps the most comprehensive family sys-
tems theory of its day, and its lasting influence is still being felt in the field.
Three of his most important concepts were his multigenerational perspec-
tive, along with the notions that family problems and processes were trans-
mitted across generations, differentiation of self as both an individual and
relational construct, and triangulation.
Like Adler’s, Bowen’s model included an assessment of the impact of
birth order. Bowen’s model, however, focused more on the concrete ordi-
nal position advanced by Walter Toman (1961/1993), and Bowen was more
likely to assume that these birth positions had a direct influence on the in-
dividual’s capacity to differentiate. By comparison, Adler’s approach to birth
order had always been more phenomenological. Each position was a van-
tage point from which people viewed life. Each vantage point had its advan-
tages and limitations, but it was what the person made out of the position
that counted, not the position itself.
310 James Robert Bitter and Jon Carlson

Bowen was impressed with the development and function of the frontal
lobes of the brain. This area of the brain was the last part to develop in hu-
mans, and it is the part that differentiates humans from other animals. The
frontal lobes make it possible for humans to anticipate and plan, to think
rationally and logically, and to overcome the more reactive, emotional parts
of the brain—especially those parts of the brain which when stimulated lead
the individual into flight, fight, or freeze responses. Just as stress, challenges,
and other life demands test, in the Adlerian model, the individual’s pre-
paredness for life, these same external stimuli—in Bowen’s theory—test the
individual’s differentiation of self.
Differentiation in Bowen’s model is required at both the individual and
relational levels of life. In the individual, differentiation is the process of
using one’s reason to stay calm during stressful events, to overcome and
control emotional reactivity, and to think through a plan for an effective
handling of any situation. At the relational level, differentiation is the ability
to put oneself in potent situations—often within the family—in which other
people have traditionally been able to “push your buttons,” and by going
into an observer role, to stay calm and assess the process (Titelman, 2014). In
this sense, relational differentiation is the test for individual differentiation.
Since both Adler’s concept of social interest and Bowen’s differentiation
of self have been hallmarks of mental health, it is important to understand
how they are related. For Dreikursians, the easiest link is between Bowen’s
differentiation and the Mosak and Dreikurs (1967) fourth task of life: getting
along with oneself. All three writers posit a duality in human nature that sets
one part of the individual against the other. For Bowen, it is literally reason
that must overcome emotional reactivity; for Mosak and Dreikurs, the task is
to stop fighting with oneself, to end the war between “I” and “me.” These du-
alities, however, do not exist in a vacuum. All humans, recognized by both
Adler and Bowen, are socially embedded, and there is no escaping the “iron
logic of human communal life” (Adler, 1927/1965, p. 34). Neither do prob-
lems exist in a vacuum; all problems are problems of coping with challenges
presented in life. People with inferiority feelings or who lack courage in the
face of challenges react emotionally, most often with fear and anxiety or
their compensations, anger or depression. To think rationally or to stop fight-
ing with oneself is to connect one’s psychic experience to a sense of being
at home in the world (Adler’s community feeling), to engage the feeling of
belonging and common sense that allow people to observe and calmly plan
the next step. In this sense, emotional reactivity is almost always permeated
with what Adler called private intelligence, or that private logic that seeks
only personal survival and is at odds with the well-being of the whole. In this
sense, “reason is inseparably connected with social interest” (Adler, as cited
in Ansbacher & Ansbacher, 1956, p. 149). To paraphrase the Canadian stress
 Adlerian Concepts in Family Therapy 311

researcher Hans Selye (1974), the secret to keeping stress from becoming
distress is to live each day in such a way that you earn your neighbor’s love.
In 1979, Heinz Ansbacher described people with social interest as “more
relaxed, having a sense of humor about the whole situation and about them-
selves. . . . They will be interested in the interests of others. They will be more
mature and more reliable. They will be the better cooperators” (in Bitter &
West, 2011, p. 34). In a somewhat similar description of people who are
more differentiated than most, Bowen (1978) suggested such people were
• Clearer about the differences between emotion and intellect;
• Better able to state their own convictions and beliefs calmly, without
attacking the beliefs of others, and without defending their own; . . .
• Able to have marriages that are functioning partnerships; spouses
can express a range of emotional intimacy without the loss of self to
the other;
• Able to allow their children to grow up and develop autonomous
selves without trying to create their children as copies of themselves;
• Able to be more responsible individuals; they don’t blame others for
their failures, or credit others for their successes;
• Better able to function with others, or alone, based on what the situ-
ation requires. (pp. 369–370)

The Human Validation Process Model

Echoing Bowen’s process for differentiation, Satir (1983) suggested:
“Thought and feeling are inextricably bound together; the individual need
not be a prisoner of his feelings but can use the cognitive component of his
feeling to free himself” (p. 125). Satir uses the concept of maturation to de-
scribe the socially embedded, functional individual:
A mature person is one who, having attained his majority, is able to make
choices and decisions based on accurate perceptions about himself, others,
and the context in which he finds himself; who acknowledges these choices
and decisions as being his; and who accepts responsibility for their outcomes.
(p. 118)

For a long time, Satir was one of very few women in the field of family
therapy, and she was the only woman to pioneer her own approach to work-
ing with families. Her emphasis on empathy, congruence, and emotional
honesty created a foundation for a kind of therapeutic presence that was
achieved by very few. Adler found the therapeutic sense of empathy hard
to define but borrowed a few lines from an undisclosed poet: “To see with
the eyes of another, to hear with the ears of another, to feel with the heart
of another” (Ansbacher & Ansbacher, 1956, p. 135). Like Adler, Satir paid
close attention to the language used in the expression and disclosure of self.
312 James Robert Bitter and Jon Carlson

Her orientation to working with individuals and families parallels Adler’s

conceptualization of intuitive understanding:
Psychotherapy is an exercise in cooperation and a test of cooperation. We can
succeed only if we are genuinely interested in the other. We must work out
his attitude and his difficulties together. Even if we had felt we had understood
him, we should have no witness we were right unless he also understood. A
tactless truth can never be the whole truth; it shows that our understanding was
not sufficient. (Satir, 1983, p. 340)

Perhaps the closest connection between Satir’s human validation pro-

cess model (Satir & Baldwin, 1983) and Adlerian psychology is the relation-
ship of her functional and dysfunctional communication stances and the
personality priorities developed by the Israeli Adlerian psychologist Nira Kfir
(1972, 1989; Kfir & Corsini, 1981/2001). Satir (1988) lists four dysfunctional
communication stances through which people tend to communicate when
they are in distress: blaming, super reasonable, placating, and distraction
through irrelevance. Kfir’s four personality priorities—significance, control,
pleasing, and comfort—are immediate coping strategies in the face of crisis,
trauma, or distress.
The enactment of a moral superiority priority aims to preserve one’s sig-
nificance; people using this coping process often engage in blaming when
in distress. Similarly, Kfir’s priority of control is greatly facilitated by what
Satir calls super reasonable communication, and the priority of pleasing is
enacted through placating. The fourth priority of comfort is really about the
avoidance of stress or pain; here, distraction and irrelevance keeps others off
balance and helps the individual avoid facing problems directly.
I, Jim Bitter (1987), have already charted the relationship of Satir’s com-
munication stances to Kfir’s personality priorities, which is shown in Table 1.
Reading across the table from left to right, it is possible to see the effects that
dysfunctional communication and personality priorities have on emotional
reactions, body tension, and the development of physical symptoms. Each
stance or priority sacrifices some part of the self, others, or the context of
interactions in an effort to avoid anticipated harm; each stance or priority
requires a price to be paid in the service of survival.
The antidote to dysfunction is found in the pairing of Satir’s congruence
(as a fifth communication stance) to Adler’s social interest construct. Again,
this functional stance/priority can be mapped across similar dimensions, as
shown in Table 2.

The Structural-Strategic Models

In 1948, the anthropologist Gregory Bateson invited Jay Haley, a com-
munications major from Stanford University, to join a group that would seek
to apply communication theory and general systems theory to forge a new
 Adlerian Concepts in Family Therapy 313

understanding of families. The group started with severely disordered fami-

lies that included a member identified as schizophrenic. Starting with obser-
vation and an early approach to action research, the group pieced together
a seminal paper that introduced, among other things, double-bind theory
(Bateson, Jackson, Haley, & Weakland, 1956). Bateson himself never fol-
lowed up with an investigation of whether double-binds cause schizophre-
nia, but the rest of his group would go on to establish the Mental Research
Institute (MRI), and over time would develop the beginning models of strate-
gic family therapy.
MRI had a number of amazing therapists in the group, including for
a time Virginia Satir and Lynn Hoffman. It was Hoffman who helped Satir
in 1964 to bring her first book, Conjoint Family Therapy, to completion.
Hoffman was also instrumental in articulating Jay Haley’s approach. As im-
portant as these two women were to family therapy, MRI was really a boy’s
club in which the men regularly dismissed the women or limited them to
lesser roles.
Haley and Weakland were the first to bring the work of Milton Erickson
to MRI. It is out of Erickson’s work with hypnosis that direct and indirect
communication, paradoxes, and therapist stances and influence are inte-
grated into strategic therapy (Haley, 1973). Each of these interventions be-
came central to MRI’s brief therapy approach, which is still in use today.
In the mid-1960s, Haley left MRI for Philadelphia, joining Salvador
Minuchin and Braulio Montalvo in the development of structural family ther-
apy. While Haley’s influence can be seen throughout the early development
of the structural model, Haley never stepped out of his strategic Ericksonian
approach. In 1976, Haley and his second wife, Cloé Madanes, moved to
Washington, DC, and opened their Strategic Family Therapy Institute. Out of
this collaboration, the variety of strategic interventions and the diversity of
families seen at the institute grew exponentially.
There were other strategic models, including a very prominent team ap-
proach in Milan, led by Maria Selvini Palazzoli (with Boscolo, Cecchin, &
Prata, 1977, 1978) that focused on family rituals and paradox and counter-
paradox. But all other strategic models really evolve from the initial work at
MRI and the Haley and Madanes institute.
Structural family therapy started as the purest of systems models, fo-
cused on macroenvironmental systems, the family, subsystems, boundaries,
alignments, power, and roles; it evolved into the more personal work of
challenging certainties about both who the family members are and what
the structure of the family must be (Minuchin, Reiter, & Borda, 2014). The
structural model still maintains a focus on how the family is organized
and the effects of family transactions and sequences of interaction. In this
sense, the movement of family members through life toward goals is not
considered—nor is it very important. Changing the structure and process of
 Table 1
Dysfunctional Communication and Goals in Response to Stress

Self Others Kfir’s

Satir’s Stress & Social Thing Most Personality
Positions Words Feelings Context Avoided The Price Paid Priorities

Loss of identity/­
Placating Agreement Anxiety Rejection too many people Pleasing
to please

Overworked/ Superiority/
Blaming Disagreement Anger/irritation Meaninglessness
314 James Robert Bitter and Jon Carlson

overburdened significance

Super- Irritation/fear to Humiliation/

Rational Social distance Control
reasonable come out embarrassment

Irrelevant Distracting Confusion Pain & stress Low productivity Comfort

 Table 2
Functional Communication and Goals in Response to Stress

Self Others Adler’s

Satir’s Stress & Social How the Person Number 1
Positions Words Feelings Context Faces Stress Resources Priority

Words match Personal senses,

feelings & talents, &
Calm Balanced/ Courage/ Social
Congruence experience/ connections with
centered confidence interest
use of “I” others; choices &
statements options
             
Adlerian Concepts in Family Therapy 315
316 James Robert Bitter and Jon Carlson

the family so it becomes more functional is what constitutes therapy. Even

Minuchin’s investigations of individual family members and his challenges
to their identities aims at enlarging options more than learning about life-
style. Indeed, the influence of Michael White (2011) and the development
of alternative realities is clearly present in Minuchin’s challenges.
From the mid-1970s to the early 1990s, structural-strategic models of
family therapy dominated North American practices. There were several at-
tempts to link Adlerian family therapy with these models (see Hirschorn,
1987; Kelly, 1987; McKelvie, 1987). In the end, however, there are more
differences between Adler and these models, both in theory and in practice,
than there are similarities. At its foundation, strategic family therapy is a
behavioral model that wants to define the problem and then intervene in
the family system to solve the problem. Structural family therapy is what
Adlerian therapy would be if Adlerians were not interested in the life move-
ment of adults, the mistaken goals of children and adults, or the develop-
ment of a democratic approach to parenting. While both the strategic and
structural models believe that the goal of any interaction is to maintain the
family system, the status quo, or homeostasis, Adlerians are interested in
how each person’s orientation to life and each other seeks to maintain secu-
rity and move the family and its members forward.
Still, there are aspects of the structural-strategic models that have roots
all the way back to Adler’s earliest formulations (Ansbacher & Ansbacher,
1956). Here, we focus on Adler’s psychology of use, especially as it relates
to symptoms, paradox or anti-suggestion, and functional family structures.
Like Adlerian psychology, the structural-strategic models look at what
people do within the system. Everything that family members do with each
other has a purpose, and each experience and interaction is dedicated to
that purpose. In strategic therapy, the purpose is almost always to maintain
the system (e.g., keeping the family together through developmental cycles)
and the rules that govern that system; problems result from rigidity and in-
effective actions in the system. In structural therapy, the purposes can be a
bit more varied; they include the goal of getting or maintaining power and
forming coalitions and alignments that benefit some over others as well as
keeping the system intact. Purposiveness in these models never leaves the
realm of immediate interaction.
The Adlerian approach to purposiveness includes systemic goals for
inter­actions, especially between parents and children (Bitter, 2009), but pur-
pose is also conceptualized as immediate and long-term (life) goals held by
individuals seeking to achieve a sense of happiness, fulfillment, and even
perfection. When a life goal is formulated, all thoughts, beliefs, feelings,
convictions, behaviors, and interactions are oriented toward that goal, and
in this way, the personality is unified in movement toward that goal. Even
symptoms become purposeful. Most often, they are used in the avoidance of
 Adlerian Concepts in Family Therapy 317

or coping with one of the life tasks (the social task, occupation, or intimacy)
that seems to the individual or system overly challenging.
By contrast, the structural-strategic models see symptoms as aimed only
at maintaining the family system and its established processes. So an only
child goes away to college. Her parents start to fight and disengage from
each other. The child develops any of a number of possible symptoms (e.g.,
depression, anxiety, physical ailments, substance abuse, delinquency) and
gets herself sent home from college, at which point her presence brings her
mother and father back together in an effort to help her. The system is main-
tained. Its use is effective.
By the late 1920s, Adler was already using paradoxical interventions.
Sometimes, these interventions were referred to as anti-suggestions or nega-
tionary tactics (Wexberg, 1929/1970). One of Adler’s early disciples, Viktor
Frankl (1955), would make paradoxical interventions a centerpiece of his
logotherapy. In Frankl’s model, the goal of a paradox is to handle anticipa-
tory anxiety. In Adlerian psychology, the goal is to diminish or end the symp-
tom by prescribing it or predicting its eruption. Adler used several versions
of paradoxical directives—all of which were incorporated without reference
into the structural-strategic models.
Adler would ask some patients to practice a symptom, thereby taking
it out of the realm of uncontrollable experience and putting its use into the
hands of the client. There is an “as if” quality to these paradoxes, allowing
the client to experience the symptom as a choice. Predicting an eruption of a
symptom, again, flies in the face of its inevitability, normalizing it, and keep-
ing its possibility as one possibility among others. So a couple comes for
counseling because they are “always fighting.” During the session, they hear
each other better and start to communicate lovingly. The therapist reminds
them on the way out that they are likely to have a fight on the way home,
because they have simply become too close during the session.
The “go-slow” paradox, of which the MRI brief therapists are so fond,
was a favorite of the Adlerian therapist, Erwin Wexberg (1929/1970). When
a man after a long depression noted that he was ready to go back to work,
Wexberg responded skeptically, suggesting that going back to work was only
a goal and that the client “must not be too hasty” (pp. 90–91). This paradox
works when it engages the person’s sense of pride and the oppositional deci-
sion to show the therapist he can make it.
In Adlerian therapy, any symptom can be explored for its use and pur-
pose, simply by asking, “How bad does it get? Can you show me how it
looks when it is worse than it is now?” (Griffith & Powers, 2007, p. 78). The
performance of the symptom takes the power out of resistance. Prescribing
the symptom in a manner that activates social interest can also challenge
the self-orientation of a symptom. So a client who can’t sleep might be told,
“Tonight, while you are awake, make a list of really nice things you would
318 James Robert Bitter and Jon Carlson

like to do for your family and friends.” In more than one case, Adler recalled
that given this alternative, the patient fell asleep immediately and stayed at
rest all night (Ansbacher & Ansbacher, 1956). For a full description of the
relationship of Adlerian principles to the methods of strategic family therapy,
see Mozdzierz, Peluso, and Lisiecki (2009, 2014).
Long before Minuchin described enmeshed and disengaged ­family struc-
tures, Adler (1927/1965) spoke of children who were pampered, spoiled,
or overprotected (versions of enmeshment) and those who were hated
or neglected (resulting in disengagement). In the early part of his career,
Minuchin often worked with mothers who were overly involved with their
children (enmeshed) and fathers who were gone or distant (disengaged). Like
Adlerians, he would work to unbalance this arrangement, often supporting
the disengaged parent to become more involved, to take charge more often,
and encouraging the enmeshed parent to let children work things out for
themselves. When the specifics of such a rebalancing are accomplished in
an Adlerian model, the result is what Dreikurs and Soltz (1964) called demo-
cratic parenting. The model anticipates that both parents will be involved in
child rearing; that when any two people are engaged in an interaction, other
people should stay out of it (thus avoiding triangulation); and that discipline
should be founded on natural and logical consequences rather than punish-
ment or pampering.
Even though the structural-strategic models are not as specific as
Adlerians are about effective parenting (Minuchin once professed to have
no perspective on what constituted “good” parenting practices), all three
approaches support the importance of parents as leaders of the system, as
raisers of children, and as the people most able to implement a structure and
process that will solve their family issues and problems.

Postmodern, Social Constructivist Approaches

Partly in reaction to the dominance of the structural-strategic models
with their emphasis on therapist interventions to fix family problems and
partly in reaction to an increasing emphasis on essences, psychopathology,
and applications in mental health of the medical model, postmodern, social
constructivist approaches emerged to literally rebalance the field. Feminists
had begun in 1978 to challenge both the male dominance of family therapy
and, more important, the privileges that family therapy maintained for men
(Hare-Mustin, 1978). By the late 1990s, feminist family therapy with its em-
phasis on collaboration, the personal as political, and the challenging of
gender stereotypes within families as well as society had developed into a
full-scale model (Silverstein & Goodrich, 2003). At about this same time,
Harlene Anderson and Harold Goolishian (1992) developed a linguistic-
centered approach that focused on clients as experts in their own lives. In
their model, the therapists took a curious, respectful, not-knowing position
 Adlerian Concepts in Family Therapy 319

in therapy that led clients to expand their stories through the telling and
retelling of what mattered to them. This therapeutic position would also be
adopted by Michael White (1992, 1998, 2007, 2011) but called a decen-
tered position. Each of these models recognized and reacted to the enor-
mous amount of power that family therapy had previously invested in the
therapist-as-expert. They sought to replace therapeutic strategies with a real
interest in client or family narratives or the stories by which people and sys-
tems constructed their lives.
Even solution-focused therapies, the leaders of which had been trained
in the MRI model, turned the strategic therapy model on its head (Nichols,
2013). Steve de Shazer (1985, 1988, 1991) and Insoo Kim Berg (de Shazer
& Berg, 1993) had little interest in even defining the problems for which
families sought help. Rather, their work at the Brief Family Therapy Center
in Milwaukee, Wisconsin, focused on the co-creation of solutions, of de-
sired outcomes, the strengths of families and family members, and the ability
to improve, to move incrementally (assessed through scaling) toward those
preferred ways of being. Like Anderson and Goolishian, White and Epston’s
(White, 1992) preferred mode of therapy began with curiosity, with the use
of inquiry and questions, and with a centralizing of the capacities already
available in their clients. Watts and Pietrzak (2000) found substantial corre-
lation between these processes and the Adlerian conceptualization and use
of encouragement.
Central to all of these postmodern models is the belief that reality is co-
constructed in the form of narratives: We do not merely live life; we live the
stories of our lives. And the stories that we create as individuals and families
often absorb the dominant power positions and stories of society and the
cultures within which we live:
Stories about life and identity are not radically constructed. They are not a
stand-alone phenomenon, set apart from cultural discourses. Rather, stories of
life and identity are shaped by the discourses of culture, and they are the bear-
ers of these discourses. (White, 2011, p. 8)

Thus, to paraphrase Dreikurs (1971), the problems that exist between cou-
ples and in families are just subsets of the problems that exist in society as
a whole. And many, if not most, of those problems relate to the misuse of
power and privilege. People come to therapy, because they are caught in the
middle of one or more problem-saturated stories.
Using the language of White (2011), the stories of our lives are con-
structed through a sequencing of events that unfold through (across) time
according to a theme or set of themes or plots. These events and the inter-
pretations of meaning associated with them are selected (individually) or co-
constructed (relationally) in ways that focus on some lived experiences more
than others. Identity is the result of linking the sequence of events to what it
320 James Robert Bitter and Jon Carlson

tells the individual and others about who the people are. Compare this nar-
rative description to the language many Adlerians use to describe one’s style
of living:
Human beings from birth to death are in constant movement through ad-
vancing time and ever-changing circumstances, facing new and recurrent
challenges, while seeking opportunities for enhancement and validations.
How each person moves defines the individual style of living, the lifestyle.
(Rasmussen, personal communication, June 10, 2016)

It is no accident that all forms of lifestyle assessments (Eckstein & Kern,

2002; Powers & Griffith, 2011, 2012; Shulman & Mosak, 1988) result in
summaries that read like stories with plots and themes. Adler (1930/1982)
provided multiple cases of lifestyle narratives as well as the interventions
he would use to reorient the person to the useful side of life. While the
methods of getting there may differ, both Adlerians and narrative thera-
pists seek to reauthor the problem stories that people live through the de-
velopment of counter­plots and preferred outcomes (Disque & Bitter, 1998;
Rasmussen, 2015).

Evidence-Based Family Therapy

The emphasis on evidence-based practice coincides with the develop-
ment of managed, for-profit care in the United States. Although the term was
not introduced until 1992 (as “evidence-based medicine”), it is one more
description of a movement toward the implementation of cost-effective in-
terventions to meet the health-care needs of individuals and families, tailor­
ing research-based remediation to the specific diagnoses and problems of
clients. For most of the past 50 years, Cognitive Behavior Therapy (CBT)
has led the way with research-based interventions. Starting with the work
of Albert Ellis (1962/1994) and Aaron Beck (1979), the linking of cognitive
processes to emotion and then behavior has been the most adopted modal-
ity in managed care.
For all its years of favored status, CBT came rather late to the field of
couples and family therapy (Dattilio, 2010; Ellis, 2000). At the heart of the
model is an understanding that couples and families interact in negative ways
on the basis of the cognitive orientations of the people involved. Troubled
relationships both result from and reflect the irrational thoughts, cognitive
distortions, and the cognitive schema that underlie emotional reactivity and
dysfunctional interactions.
Of all those associated with CBT, Albert Ellis (1974) has drawn the clear-
est line between his work and that of Alfred Adler. Ellis indicates that ir-
rational beliefs lead to distress (emotion) and dysfunction (behavior). His
irrational beliefs all contain elements of what Adler had called a private
intelligence or private logic (Ansbacher & Ansbacher, 1956). For Adler, a
 Adlerian Concepts in Family Therapy 321

private intelligence is that which stands in the “common sense”—or that

which would make sense to the whole of humanity. A private logic serves
to either elevate the individual to a superior position or to ensure personal
survival without regard for others. For Adlerians, a private logic is always
part of a dysfunctional movement through life or lifestyle. What corrects a
private intelligence is the development of a community feeling and social
interest. While Ellis was not fond of the term “social interest,” he recognized
that an enlightened self-interest necessitated taking the well-being of others
into consideration.
Beck’s (1979) notion of schema more closely fits the guiding principles
that individuals adopt in their styles of living. What is missing from Beck’s
assessment of cognitive schema and distortions are the purposes and goals
that these thought-feelings have for the person—and ultimately the couple
or family. Rasmussen (2005) is the person who pulls all of this together for
both Adlerians and those using CBT.
Increasingly, those working in evidence-based couples and family ther-
apy are finding value in attachment and emotional attunement. The work
of John and Julie Gottman (2013) rediscovered the communications theory
of Haim Ginott (1965/2003) for parents raising children. The emotionally
focused couples therapy of Susan Johnson (2004) and the neuroscience-
informed psychotherapy of Alan Schore (2012) are rediscovering the value
of John Bowlby’s (1969/1982) attachment theory. While it is clear that Adler
valued both attunement and attachment, these were not central aspects to
his model or that of Dreikurs. Indeed, Dreikurs and Soltz (1964) focused on
engagement and communication as processes within effective parenting but
not as the sole means by which parents finally produced happy and healthy
children. Currently, there are serious research efforts in progress that will
place Adlerian therapy on the list of evidence-based practices.

Summary

In the past 90 years, Adlerian thoughts, principles, and processes have

made their way in and out of mainstream therapeutic practice. Family sys-
tems therapy, often without recognition, has incorporated much of what
Adler and his associates brought to the understanding of human nature and
the contexts in which humans live and work. What we take from all of it is
a set of general principles for both daily living and for the continuation and
imaging of a journey toward the perfection of humankind. In general:
• Individuals, as well as couples and families, are in constant move-
ment through advancing time and ever changing circumstances, fac-
ing new and recurrent challenges, while seeking opportunities for
322 James Robert Bitter and Jon Carlson

enhancement and validation (Rasmussen’s reframing of Adler and

Dreikurs; McGoldrick; Satir; White)
• It is better for individuals, couples, and families to discover or redis-
cover their connections than to be in disarray or disengaged (Adler;
Dreikurs; Satir; Minuchin)
• Life works better for individuals, couples, and families when peo-
ple feel that they belong to the ongoing community of humankind
and when they choose to be at least as concerned about the well­
being of others as they are about their own welfare (Adler; Dreikurs;
McGoldrick; Bowen; Satir; Ellis; White)
• It is better to be organized than disorganized even though noth-
ing changes without disorganization (Dreikurs; Mozdzierz; Haley;
Minuchin)
• When we remove constrictions from individual movement and fam-
ily functioning, people experience life more fully (Adler; Dreikurs &
Soltz; Satir)
• Communication works best when it is open, clear, congruent, and re-
sponsive rather than closed, defensive, or dismissive (Adler; Dreikurs
& Soltz; Bowen; Satir; Gottman & Gottman)
• It is better to say what one thinks and feels than to be blocked in
silence—although tact and timing are almost always appreciated
in any communication (Adler; Dreikurs & Soltz; Satir; Gottman &
Gottman; Johnson)
• It is better to set limits, define one’s bottom line, and clarify what
one can do and give than to be controlled by others (Adler; Dreikurs;
Bowen; Haley; Minuchin; CBT)
• Rational thought is almost always better than irrational thought, and
more often than not, common sense works better than private logic
(Adler; Dreikurs; Rasmussen; Ellis; Beck; Satir)
• Knowing is usually better than not knowing, and facing one’s prob-
lems is usually better than avoidance (Adler; Dreikurs; Ellis; Beck;
Satir)
• It is better to feel something—even sadness or hurt—than to feel
nothing at all (Adler; Satir; CBT)
• Acting and taking a chance beats the feeling of being constricted or
the experience of being immobilized (Adler; Dreikurs; Bowen; Satir;
Haley; Minuchin; CBT)
• Having goals, options, and hope is the antidote to discouragement
(Adler; Dreikurs; Bowen; Satir; CBT; White)
• Being able to use more of yourself in the service of moving toward
your goals is the foundation for options, hope, and encouragement
(Adler; Dreikurs & Soltz; Sherman & Dinkmeyer; Satir; Minuchin,
CBT; White)
 Adlerian Concepts in Family Therapy 323

• It is better to understand and be appreciative of one’s gender, affec-

tional or sexual orientation, culture, and ethnicity than to reject it,
hide it, or be cut off from it (Adler; Dreikurs; Bitter, Balla, Carlson,
McGoldrick, Bowen; Satir; Haley; Minuchin; CBT; White)
• Everything can always be different: Write yourself or your family a
new story with a counterplot to the one that is keeping you stuck
(Adler, Dreikurs; Minuchin; White)
• And always, it is better to risk optimism, faith, and courage than to
live in fear (ultimately everyone).

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James Robert Bitter is a professor in the Department of Counseling and

Human Services at East Tennessee State University and current president
of NASAP. He has studied Adlerian psychology with Ray Lowe, Oscar
Christensen, and Manford Sonstegard. He studied at the Alfred Adler Institute
of Chicago and was taught therapy by Robert Powers and Jane Griffith in their
practice in Chicago. He has contributed much to the literature on Adlerian
psychology through his writing and publishing.

Jon Carlson, PsyD, EdD, ABPP, was Distinguished Professor of Adlerian

Psychology, Adler University, Chicago, and a psychologist with the Wellness
Clinic in Lake Geneva, Wisconsin. He authored 62 books and 180 journal
articles and book chapters, and produced more than 300 professional video
programs.
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