Reality therapy


Reality therapy is an approach to psychotherapy and counseling developed by William Glasser in the 1960s. It differs from conventional psychiatry, psychoanalysis and medical model schools of psychotherapy in that it focuses on what Glasser calls "psychiatry's three Rs" – realism, responsibility, and right-and-wrong – rather than mental disorders. Reality therapy maintains that most people suffer from socially universal human conditions rather than individual mental illnesses, and that failure to attain basic needs leads to a person's behavior moving away from the norm. Since fulfilling essential needs is part of a person's present life, reality therapy does not concern itself with a person's past. Neither does this type of therapy deal with unconscious mental processes.
The reality therapy approach to counseling and problem-solving focuses on here-and-now actions and the ability to create and choose a better future. Typically, counseled people seek to discover what they really want and how they are currently choosing to behave in order to achieve these goals. According to Glasser, the social component of psychological disorders has been overlooked in the rush to label the population as sick or mentally ill. If a social problem causes distress to a person, it is not always because of a labelled sickness, it may sometimes just be the inability to satisfy one's psychological needs. Reality therapy attempts to separate the person from their behavior.

History

Reality therapy was developed at the Veterans Administration hospital in Los Angeles in the early 1960s by William Glasser and his mentor and teacher, psychiatrist G. L. Harrington. In 1965, Glasser published the book Reality Therapy in the United States. The term refers to a process that is people-friendly and people-centered and has nothing to do with giving people a dose of reality, but rather helps people to recognize how fantasy can distract them from their choices they control in life. Glasser posits that the past is not something to be dwelled upon but rather to be resolved and moved past in order to live a more fulfilling and rewarding life.
By the 1970s, the concepts were extended into what Glasser then called "control theory", a term used in the title of several of his books. By the mid-1990s, the still evolving concepts were described as "choice theory", a term conceived and proposed by the Irish reality therapy practitioner Christine O'Brien Shanahan at the 1995 IRTI Conference in Waterford, Ireland and subsequently adopted by Glasser. The practice of reality therapy remains a cornerstone of the larger body of his work. Choice theory asserts that each of us is a self-determining being who can choose future behaviors and hold ourselves consciously responsible for how we are acting, thinking, feeling, and also for our physiological states. Choice theory attempts to explain, or give an account of, how each of us attempts to control our world and those within that world.
In 2007, reality therapy was recognised as a legitimate psychotherapeutic approach in Europe, recognised by the European Association for Psychotherapy, thanks to the publication Scientific ''Argument for Reality Therapy'' by Leon Lojk, a Slovenian psychologist and psychotherapist.

Approach

According to Glasser, human beings have four basic psychological needs after survival: the most important need being to love and be loved by another person or group for a feeling of belonging; the need for power, through learning, achieving, feeling worthwhile, winning and through being competent; the need for freedom, including independence and autonomy while simultaneously exercising personal responsibility; the need for fun, pleasure seeking enjoyment and relaxation is also a very important need for good psychological health.
One of the core principles of reality therapy is that, whether people are aware of it or not, they are always trying to meet these essential human needs. These needs must all be balanced and met for a person to function most effectively. However, people don't necessarily act effectively at achieving these goals. Socializing with others is one effective way of meeting the need to belong. But how a person chooses to interact with and gain attention and love from others is most often at the root of their psychological dismay. Reality therapy stresses one major point—people are in control of what they are currently doing in their lives whether or not it is working in their favor toward meeting their basic psychological needs for power, belonging, fun and freedom. And it is through an individual's choices that he or she makes change happen for the better or worse.
For most people in the United States, the survival need is normally being met. It is then in how people meet the remaining four psychological needs that they typically run into trouble. Reality therapy holds that the key to behavior is to remain aware of what an individual presently wants and make choices that will ensure that goal. Reality therapy maintains that what really drives human beings is their need to belong and to be loved. What also drives humans is their yearnings to be free, and with that freedom comes great responsibility. Reality therapy is very much a therapy of decision and change, based upon the conviction that, even though human persons often have let themselves become products of their past's powerful influences, they need not be held forever hostage by those earlier influences.

Role played by the therapist

Reality therapy seeks to treat patients who face difficulty in working out a relationship with others. So, the formation of a connection of the patient with the therapist is regarded as an important milestone at the start of the therapy. According to the therapists, bonding of the patients with their therapists is the most crucial dynamic that would facilitate the healing process. As soon as this bonding is stable, it can help to form a fulfilling connection outside the therapeutic environment.
Patients receiving this kind of therapeutic treatment will learn various ways to strengthen relationships in the most suitable manner possible and that too in the absence of their therapists' safe relationship. Moreover, they will be able to use their newfound skills in their personal lives.
Reality therapists say that when patients are able to use the skills, behaviors, actions, and methods learned through the therapy in their personal lives, then they will be able to successfully work out external relationships as well. This will provide them with the satisfaction of leading a more fulfilling life.

Core ideas

Action

Glasser believes that there are five basic needs of all human beings: survival, love and belonging, power, freedom or independence, and fun/pleasure. Reality therapy maintains that the main reason a person is in pain and acting out is because he/she lacks that one important 'other being' to connect with, or lacks another basic need for survival. Glasser believes the need for love and belonging is the most primary need because we all need other people in our lives in order to satisfy the rest of our needs. Therefore, in a cooperative therapeutic relationship, the therapist must create an environment where it is possible for the client to feel connected to another 'responsible' person whom they actually like and might choose as a friend in their real life.
Reality therapy maintains that the core problem of psychological distress is that one or more of the client's essential needs are not being met thereby causing the client to act irresponsibly or make poor choices. The therapist then addresses this issue and asserts that the client assume responsibility for their behavior. Reality therapy asserts that we learn responsibility through involvement with other responsible people. We can learn and re-learn responsibility at any time in life". The therapist focuses on realistic attainable goals in order to remedy the real life issues that are causing discomfort.
William Glasser's choice theory is composed of four aspects: thinking, acting, feeling, and physiology. We can directly choose our thoughts and our actions; we have great difficulty in directly choosing our feelings and our physiology.
A critical first step is the client learning how to use their emotions and feelings to self-evaluate. The client must realize that something must change; realize and accept that change is, in fact, possible and can lead to a plan for making better choices. The therapist helps the client create a workable plan to reach a goal; this is at the heart of successful reality therapy. It must be the client's plan, not the counselor's. The essence of a workable plan is that the client can implement it. It is based on factors under the client's control. Reality therapy strives to empower people by emphasizing the power of doing what is under their control. Doing is at the heart of reality therapy.

Behavior

Behavior is an immediate and live source of information about whether we are happy with what is going on in our lives. It is very hard to choose to change our emotions directly, thus it is much easier to change our thinking, which will lead to more positive emotions. The client must make a conscious decision to alter his/her thought process. For example, to consciously decide that we will no longer think of ourselves as victims, or to decide that in our thoughts we will concentrate on what we can do rather than what we think everybody else ought to do. Reality therapists approach changing "what we do" as a key to changing how we feel and how we will work to obtain what we want. These ideas are similar to those in other therapy movements such as Re-evaluation Counseling and person-centered psychotherapy, although the former emphasizes emotional release as a method of clearing emotional hurt.

Control

Control is a key issue in reality therapy. Human beings need control to meet their needs: one person seeks control through position and money, and another wants to control their physical space. Control gets a client into trouble in two primary ways: when he or she tries to control other people, and when he or she uses drugs and alcohol to give him or her a false sense of control. At the very heart of choice theory is the core belief that the only person the client can really control is him or herself. If the client thinks he or she can control others, then he or she is moving in the direction of frustration. If the client thinks others can control him or her and follows up by blaming them for all that goes on in their life, then he or she tends to do nothing and heads for frustration. There may be events that happen to the client which is out of their control, but ultimately, it is up to the client to choose how to respond to these events. Trying to control other people is a vain naive hope, from the point of view of reality therapy. It is a never-ending battle which alienates the client from others and causes endless pain and frustration. This is why it is vital for the client to stick to what is in their own control and to respect the rights of other people to meet their needs. The client can, of course, get an instant sense of control from alcohol and some other drugs. This method of control, however, is false, and skews the true level of control the client has over him or herself. This creates an inconsistent level of control which creates even more dissonance and frustration.