Brief Lecture Notes for Unit 13
Revised 05/08/02
This unit will be an attempt to cover everything we
haven't talked about so far this semester... which is, of course, an
impossibility! Think of it as an "odds and ends" or
"kitchen sink" unit that will involve a whirlwind tour of various
issues related to abnormal psychology and clinical practice, as we move
inexorably toward the final exam and the end of the semester.
Topic 1: The other side of the mental health
continuum
The "continuity hypothesis" that has been the
major recurrent theme of this course, as you (I hope!) recall, states that there
is no clear-cut dividing line between normality and abnormality. Mental
health is a continuum (not a dichotomy); it is a normally
distributed variable (bell-shaped curve), with most of us falling in the middle
(most of us are moderately neurotic). We've spent much time examining one
extreme end of the distribution (more pathology than usual). But what
about the other end of the spectrum? What about those rare individuals who
are healthier than the rest of us -- what are they like? What is the
psychological ideal? What does optimal mental health look like? Is
there a consensus among psychologists about what that is and what it means --
and is that consensus a culture-fair or culture-free one?
One thing is clear: optimal health means much more
than the absence of pathology. It means the acquisition and utilization
of attributes (such as resilience) that are in short supply.
Take a minute to make a list of what you think a
"very psychologically healthy" person would be like. (Begin by
thinking of what you are like when you are at your very best, then add
characteristics that you know you don't have, but wish you did.) Then
compare your list to the lists below, drawn from the thinking of various
proponents of what today would be called the "positive psychology
movement" (went by different names in the past):
Gordon Allport: The "mature person"
- Sets and strives to achieve goals
- Assumes personal and social responsibility
- Accepts the human condition for what it is
- Has courage to be who s/he really is
- Actively involved with life
- Compassionate, tolerant, has capacity for intimacy
- Self-accepting, emotionally secure
- Self-controlled
- Realistically perceives self, other, world
- Has insight into her/his own motives
- Has a healthy sense of humor
- Has a unifying philosophy of life
- Has a balanced life
- Is reasonably (but not delusionally) optimistic
- Is concerned for others -- exterocentric focus
Carl Rogers: The "fully functioning
person"
- Authentic
- Accepts self and others
- Has a growth orientation, not a deficit orientation
- Congruent, integrated
- Participative orientation
- Tolerant of ambiguity
- Open to experience
- Existential orientation -- lives in the now, takes
responsibility for choices
- Self-aware
Abraham Maslow: The "self-actualizing
person"
- Realistic
- Able to face unknowns comfortably
- Accepts self, others, life
- Spontaneous, simple, childlike
- Has strong sense of mission or purpose
- Positive (but not dependent) orientation to others
- Autonomous, individuated
- Continued fresh appreciation for experience
- Empathic, concerned for others
- Capable of intimacy
- Egalitarian philosophy
- Immediacy
- Discriminates between means and ends
- Healthy humor
- Creative
- Transcends merely cultural limits
- Values diversity
- Integrated personality
- Emotionally strong
- Altruistic
- Engages life
- Seeks ongoing personal growth
- Guileless
- Free from crippling psychological defenses
Erich Fromm: The "productively oriented
person"
- Connected to others
- Able to transcend or overcome difficulties
- Strong sense of identity or "rootedness"
- Sense of perspective
Mihaly Csikszentmihalyi: The "autotelic
person"
- Skills match life challenges
- Self-directed
- Engages in valued activities for their own sake
- Intrinsically motivated
- Fully immersed in the present moment
- High self-esteem
- Active, not passive
- Not dependent on material possessions
- Not dependent on what others think
- Autonomous, independent (or interdependent)
- Unique, doesn't try to be a clone of others
- Interested in life
- Goal oriented
- Strong sense of mission, purpose, meaning
Lawrence Kohlberg: The "postconventional
person"
- Able to transcend culture and background
- Focused on universal ethical principles
- Values the common good
- Flexible, adaptable
- Cognitively complex
- Long-range perspective
- Willing to endure deprivation for the sake of a
higher or transcendent value
- Altruistic
- Not xenophobic
A thought question: Can you translate these
characteristics into Big Five terms? And if so,
does that contradict the notion that all Big Five profiles are equally good or
equally valuable?
What might promote the acquisition of characteristics
similar to those above, if you agree that this is a "good" list?
Is the question even a meaningful one? Is there
one and only one "healthy" way to be, or are there as many healthy
ways to be as there are people?
Topic 2: Personality and counseling (redux)
Earlier in the semester I made some brief allusions to
the relationships between the Big Five and the process of counseling, but am
going to make these more explicit now:
Extraversion
- Being E+ means that you act first, think later (if at
all... sometimes not; the outer world is the real world, so thinking
is optional). So E+ types need to experience life first. Then
they have something to discuss and ponder! This should not be
interpreted as pathological impulsivity (though sometimes it can be).
They also like a highly interactive counseling process and may be disturbed
by silence. Don't assume that an E+ type means everything s/he
says; s/he may simply be thinking out loud (which is the main way E+
types think).
- Being E- means that you think first, act later (if at
all... sometimes not; the inner world is the real world, so doing is
optional). So E- types need to understand life first. Then they
have a basis for attempted action! This should not be interpreted as
avoidance behavior, passivity, or pathological deliberateness (though
sometimes it can be). They also like lots of "soak time" in
counseling and may like more private forms of learning such as bibliotherapy.
Listen carefully with an E- type, because they may say something only once,
and often tangentially (dropping hints).
Openness
- O+ types live in a world of possibilities, so they
are prone to see the world through rose-colored glasses. (When their
illusions are shattered, as happens every so often, the resulting
"rebound" or mental correction effect is not always so
pretty.) They assume that anything is possible if one is clever or
insightful enough, but sometimes forget to take practical, factual
limitations seriously... ignoring the facts, or thinking they know the facts
when they don't. They usually underestimate the effort involved in
change, and dislike too much direction (want to find their own way).
They may need reminders that thought alone does not produce change.
They respond well to metaphorical and symbolic approaches. Their
tendency to obsess under stress may cause them to get stuck or cingulate at
such times. They need a dream (remember Jim Croce? well,
probably not -- your loss) and can endure present hardship if their vision
of the ideal future remains intact.
- O- types live in a world of realities and
practicalities, so are likely to take the present situation as a given and
hence be rather pessimistic. They may find the notion of change
threatening and may be too focused on reasons why change "can't
work". They usually overestimate the effort involved in change,
may need excessive direction, and may miss trends and themes in their
behavior and personality (can't see the forest for the trees). They
respond best to narrowly focused, practical, linear, and literal
approaches. Their tendency to catastrophize under stress may cause
them to push the panic button at such times. They need to get grounded
in simple, rewarding activities (often of a tangible or tactile nature) in
the present moment.
Agreeableness
- A+ types need a personal bond with a counselor they
can like and trust and whom they believe likes and trusts them. Value
compatibility (affirmation of their view of the world) is important.
They may be oversensitive or easily hurt and may need help with bolstering
weak self-esteem. They may become overdependent on the
counselor. Cynicism in an A+ type is a danger signal indicating that
the person needs to find something (person, animal, idea, cause, goal) in
which to believe again. Existential forms of counseling like Rogerian
therapy often work well for them; A+ types want to be loved and
understood.
- A- types may seem rather alexithymic -- wanting to
analyze rather than feel, using "thinking" rather than emotive
language. They may be or seem unaware of their own feelings, needs,
and values. They need to understand their situation logically and to
understand the chains of cause and effect that underlie them. Cerebral
forms of counseling like Rational-Emotive Therapy often work well for
them; A- types want to understand and to be in control.
Conscientiousness
- C+ types need predictability, structure, and a
systematic, organized, goal-oriented approach with clear objectives.
Issues of control may be significant for them. They may need to
"plan to relax" or find other strategies to come to terms with
unpredictability and uncontrollability in their lives, and to learn how to
play, not just work.
- C- types need flexibility, adaptability, and a
free-floating, open-ended, process-oriented approach that lets things
unfold. They may struggle with autonomy issues. They may need
help with procrastination, drifting, or other issues related to difficulty
with planning and holding themselves accountable.
Negative Emotionality
- N+ types struggle with anxiety, and need help in
moderating it. They may be unnecessarily intrapunitive. They may
have a need to present a "weak" persona to the counselor.
- N- types are likely to bind anxiety, and need help in
recognizing it. They may be unnecessarily extrapunitive. They
may have a need to present a "strong" persona to the counselor.
If you are interested in the Big Five, be sure to click
here for even more applications (scroll past the first few pages, which
review the model for those who are more naive than you are).
Topic 3: Counseling and values
Like all other human activities, counseling doesn't take
place in a vacuum. Counselors, being human beings (yes, even college
professors are, contrary to popular opinion, human beings), have their own
perspectives, life experiences, priorities, assumptions, biases, predilections,
and values. The challenge is to (a) become aware of what these are, (b) be
honest (congruent!) with clients about what these are, (c) make sure that you
are controlling them, rather than letting them (unconsciously, as in a
transference reaction) control you.
How might we classify or categorize human values, to try
to make point (a) more manageable? The Schwartz value wheel is one
approach.
In an extensive cross-cultural study of values, Schwartz
(1992) surveyed thousands of primary and secondary school teachers in 20
countries. (He chose teachers in part because their job is to be conveyors
of cultural values to students.) He used a correlational method to
identify clusters of similar values. Based on a comprehensive statistical
analysis of the correlational results, he found that value similarities and
differences can largely be explained on the basis of two orthogonal dimensions,
yielding a value circumplex. The two dimensions are:
- Self-enhancement (seeking what's good for me) versus
self-transcendence (seeking what's good for everyone, or putting others
first)
- Change (seeking to find the new) versus conservation
(seeking to preserve the old)
If these dimensions sound familiar, Big
Five fans, they should! Although Schwartz' work shows no direct
evidence of being influenced by the Big Five model, what his research suggests
is that values are driven by two of the Big Five dimensions. The first
dimension above largely corresponds to Agreeableness (self-enhancement is like
A-, self-transcendence is like A+), while the second obviously corresponds to
Openness (change is like O+, conservation like O-). This is convenient in
one way, a trifle frustrating in another:
- The convenient side: this suggests four
quadrants (O+ A+, O+ A-, O- A+, O- A-), which correspond nicely to what
other, pre-Big Five theorists think of as four basic mental orientations
(e.g., in Myers-Briggs language, these are the NF or oceanic-relational, NT
or conceptual-theoretical, SF or experial-collegial, and ST or
structural-pragmatic orientations).
- The frustrating side: as you hopefully remember
from our discussion of the interpersonal circumplex (unit 10), the ways in
which people primarily interact with one another are a function of a
different pair of Big Five dimensions (E and A, not O and A). This
doesn't necessarily mean that there is anything "wrong" with
either model (the interpersonal circumplex or the Schwartz value circumplex),
but since values and behavior (particularly social-relational behavior) are
hopefully linked... we care about values primarily because they impact on
human relations... it's a bit frustrating to find that the same two
dimensions don't appear to govern both.
Here are sample values that fit in each quadrant of
Schwartz's model. The model doesn't imply that people of a given
personality type are only driven by values in "their quadrant",
but it does suggest that these should, all things being equal, be primary
values for a person of that type:
- O+ primary: excitement, novelty, challenge,
freedom, independence, curiosity, creativity
- A+ primary: equality, justice, tolerance,
helpfulness, benevolence, responsibility, intimacy
- O- primary: politeness, obedience, respect,
conformity, safety, security, belongingness
- A- primary: power, status, authority,
competence, ambition, achievement, success, hedonism
Sidebar: from a Jungian standpoint, the pole of
each dimension that is not part of one's conscious self becomes part of
the "shadow"; that is, these motives still exist within the
personality (since they are all more or less universal), but are not consciously
recognized as such. Hence they tend to be parts of the self that one
rejects or disparages, but that can govern one's behavior especially during
times of stress. (That which is unacknowledged is uncontrollable.
The truth, in contrast, sets you free.)
Interestingly, cultural differences in the prevalence of
different values makes good theoretical sense as well. More
individualistic cultures tend to emphasize O+ A- values more, while more
collectivist or communitarian cultures tend to emphasize O- A+ values
more. Within our own culture, we can perhaps (?) associate O+ with
liberalism and O- with conservativism in a political sense, and with less
certainty, might expect correlational relationships between A- and secularism,
A+ and religious faith.
What does this mean for a counselor? In general,
it means that:
- Clients who share the counselor's outlook (values and
personality) are easier to understand. It's easier to develop
rapport. It's easier to work within the client's internal frame of
reference, because it is consistent with your own. But as a dyad, you
may share the same blind spots, or may reinforce pathological behavior in
the client because it seems normal to you. Helping the client deal
with pathologies in her/his life may force you to come to terms with similar
unresolved issues in your own.
- Clients who have an opposing (opposite quadrant)
outlook to that of the counselor are difficult to understand. There
may be a strongly oppositional quality to the counseling relationship, or
the two of you may speak different languages and clash over goals.
Since most counselors believe that clients should be in charge of their own
counseling goals, you may be put in an awkward situation of having to help a
person achieve goals with which you personally disagree or that are foreign
to you. It may be hard to view the client objectively, in
non-stereotypic terms. What is normal for her/him may seem
pathological to you because it is foreign to your way of being. The
likelihood of transference reactions, whether attractive or repulsive, is
heightened considerably. Each of you may become a "shadow
carrier" for the other.
The moral?
- Counselors need to be (or become) clear about the
kinds of clients with whom they can, and cannot, productively work.
Certain kinds of people, and certain kinds of issues, may be impossible for
a given counselor to work with at a given point in her/his personal and
professional development. Far better to be upfront about that fact,
and make a referral to another, more compatible counselor, than to attempt
the impossible. Since no counselor is omnicompetent, a pretense that
you are immediately destroys the authenticity that is the hallmark of
effective counseling.
- Counselors need to be (or become) authentic and
congruent about their own values -- communicating them clearly, without
imposing them on clients. Hidden messages destroy the effectiveness of
counseling. If you say one thing in order to convey another,
subtextual or subliminal message, you are by definition being
counterproductive as a people-helper. In congruent
communication, things mean what they seem to mean; counseling, of all
human interactions, needs to be a model of congruence in order to do good,
not harm.
- Counselors need to work through their own issues --
not completely, for this can never be done completely and perfectly in this
life, but sufficiently: to the point that transference reactions do
not govern the counseling interaction. (The test of transference is
this: when you are using the client as a means to work through your
own issues or meet your own needs, rather than authentically helping her/him
to work through issues and meet needs, you are in a transference
reaction.) Transference is universal, but needs to be addressed
honestly (hard to do, because transference and denial are inextricably
linked), usually with the help of another counselor or counseling
supervisor. Counselors are allowed to have needs, being human,
but of course should meet them in honest ways that do not involve abuses or
distortions of the counseling process as such. Sometimes an honest,
congruent admission of the problem ("I am feeling too attracted to you
to work with you as a client", "my feelings of irritation are
impeding our ability to work together", or whatever) is best, but like
playing with nitroglycerine as a hobby, this needs to be treated with
extreme care, including external accountability as provided by a counseling
supervisor.
I didn't add any other topics, as you can tell.
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