The Contribution of Alfred Adler to Mental Health
By J. H. WALLIS
Joint Organizer, Windsor Mental Health Association The conception of Mental Health is not easy to define although in practice there is a large common measure of agreement among investigators and practitioners in its ever-widening field of endeavour. Some regard it as a state of satisfactory balance between conscious judgment and unconscious drives, motives and desires; others as a readiness to fit into the environment and accept the responsibilities involved. But few to-day would disagree with the suggestion that Mental Health involves fitness for life.
This idea is the basis of Adler’s teaching, implying as it does the common use of fitness in its athletic, physical sense and also in the sense that a person fits into his situation, that his responses and activities are relevant and fitting to the demands made upon him.
This view does much to explain the difference between formal psychology and Mental Health. It is not unlike the difference between academic philosophy and moral philosophy.
Much progress has been made in the attempt to t make psychology a science. To do so of course implies relative measurement and units but there still remains a large group of factors that are highly speculative and hypothetical. One cannot as yet measure emotion, compare the intensities of the same emotion or even satisfactorily classify emotions, still less aims, ideals and convictions.
The nearest one can get is the comparative measurement of the rate of perception and this does not get one very far. And so two diverging lines of investigation have appeared: scientific psychology and Mental Health. Scientific psychology is concerned with ability (for example, intelligence), Mental Health with the purpose to which ability is put. The former is a psychology of possession, the latter a ‘psychology of use and meaning. Adler can be said to be the founder of the latter.
The importance of this distinction becomes apparent from the fact that ability is. largely, perhaps wholly, innate and constant throughout a person’s life, whereas the use he makes of his ability is subject to maturation, and is very largely an emotional matter. Forty years ago Adler, who like Freud had been investigating hysteria, published a paper on psychological compensation for organic defect. This led him to one of the foundations of his teaching, the unity of mind and body. This relationship had long been the concern of philosophers who had merely confined themselves to discussion as to Which was the superior authority. Christianity had lent powerful support to the view that the spirit could be willing though the flesh was weak. Recently Adler’s view has been expressed by what j is a little pompously called psychosomatic medicine- | Adler expressed himself more clearly by insisting that Health means Wholeness?even etymological^Adler however went farther than this and always insisted on the unity of the personality. This was the first split with Freud’s teaching which postulates the division of the personality into conscious and unconscious elements which can be and usually are in conflict.
Those?and there are many?who cannot accept j the idea of the unity of the personality even though they act upon it, are usually confused by the second fundamental difference in the teaching of the tw? masters, Freud’s being causal and Adler’s teleolog1” cal. We can only understand a person’s behaviour Adler taught, when we appreciate his aim: we shall j then see that his actions make sense. Adler asks-” What is this person seeking to achieve? Freud-” | What elements of his personality are in conflict ? Anyone who to-day is actively engaged on Menta’ Health work must sooner or later find himself ?n the borderland of ethics. If an individual is conflict with the demands of his situation, we mus ask which is at fault and which should be changed; Most Mental Health Workers act on the logi^ assumption that since problems of behaviour be resolved into questions of relationship, adjust ? ment should come from both sides. Hence ^ ( need of Psychiatric Social Workers to supplemefl the work of Psychiatrist and Psychologist in a Child Guidance Clinic. But nevertheless the* must be some ethical standard implied. Is ^ individual entitled to have his own way as far a conditions permit?and if not, why not ? One answer is provided by the ” Gemeinschafts’ j gefuhl ” of Adler’s teaching?usually translate | as Social Feeling- or Social Interest. It amoufl1 to good-will?a willingness to co-operate wn others and contribute to the well-being of & world both in the present and towards the futuf’ Adler continually stressed that all the relationship of life, at home, at work, in love and mariiag ” demand Social Feeling for their successful develop ; ment. His treatment was always directed towar^ | an increase in the Social Feeling of his patients afl pupils. It will be seen how far this approa^ differs from the disinterested detachment of scientip psychology. 3
The Adlerian method of treatment is similarly direct and personal approach. There are ^ stages, diagnosis and encouragement. By seel[L j the world through the eyes of the patient,. ‘ understanding his aims and ideals and the meam11^ , that he attaches to life (his ” scheme of apP^ ception “) the psychiatrist should not be long j laying bare the characteristic ” life-style ” of. the Patient. He must then show the patient how he is employing devious methods for purposes that do not fit the responsibilities of civilized life or his own Personal situation.
The second stage consists of building up on whatever degree of Social Feeling the patient may Possess and renewing his courage. The first sets him free, the second shows him opportunities for using his freedom.
At a stage in the world’s troubled history where man’s technical and intellectual achievements have So far outstripped his emotional maturation, where means have developed with almost bewildering acceleration and ends remained largely undeveloped since the days of Plato, Adler’s insistence on a teleogical understanding of human nature and the assessment of behaviour in terms of Social Interest shows itself as a contribution whose importance can hardly be exaggerated. Optimism is not highly valued to-day but, surely there is good ground for hope in the separation of formal psychology from Mental Health. Adler’s last book had the subtitle ” A Challenge to Mankind ” and it is encouraging to observe how far, though often unacknowledged, his challenge is being accepted.
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