The role of meaningful relationships in fostering emotional health is receiv- LO4 ing increased attention in contemporary reality therapy, which quickly focuses on the unsatisfying relationship or the lack of a relationship. Clients may complain of not being able to keep a job, not doing well in school, or not having a meaningful relationship. When clients complain about how other people are causing them pain, reality therapists ask clients to consider how effective their choices are, especially as these choices affect their relationships with significant people in their lives. Choice theory teaches that talking about what clients cannot control is of minimal value; the emphasis is on what clients can control in their relationships. The basic axiom of choice theory, which is crucial for clients to understand, is that “the only person you can control is yourself.”
Reality therapists spend little time listening to complaining, blaming, and criticizing, for these are the most ineffective behaviors in our behavioral repertoire. What do reality therapists focus on? Here are some underlying characteristics of reality therapy.
Emphasize Choice and Responsibility Reality therapists see clients as being responsible for their own choices as they have more control of their behavior than they often believe. This does not mean people should be blamed or punished, unless they break the law, but it does mean the therapist never loses sight of the fact that clients are responsible for what they do. Choice theory changes the focus of responsibility to choice and choosing.
Reality therapists deal with people “as if” they have choices. Therapists focus on those areas where clients have choice, for doing so gets them closer to the people they need. For example, being involved in meaningful activities, such as work, is a good way to gain the respect of other people, and work can help clients fulfill their need for power. It is very difficult for adults to feel good about themselves if they don’t engage in some form of meaningful activity. As clients begin to feel good about themselves, it is less necessary for them to continue to choose ineffective and self-destructive behaviors.
Reject Transference Reality therapists strive to be themselves in their professional work. By being themselves, therapists can use the relationship to teach clients how to relate to others in their lives. Glasser contends that transference is a way that both therapist and client avoid being who they are and owning what they are doing right now. It is unrealistic for therapists to go along with the idea that they are anyone but themselves. Assume the client claims, “I see you as my father or mother and this is why I’m behaving the way I am.” In such a situation a reality therapist is likely to say clearly and firmly, “I am not your mother, father, or anyone but myself.” Wubbolding (personal communication, April 4, 2015) states that he discusses this issue with clients in a detailed manner.
Keep the Therapy in the Present Some clients come to counseling convinced that they must revisit the past if they are to be helped. Many therapeutic models teach that to function well in the present people must understand and revisit their past. Glasser (2001) disagrees with this assumption and contends that whatever mistakes were made in the past are not pertinent now. An axiom of choice theory is that the past may have contributed to a current problem but that the past is never the problem. To function effectively, people need to live and plan in the present and take steps to create a better future. We can only satisfy our needs in the present.
The reality therapist does not totally reject the past. If the client wants to talk about past successes or good relationships in the past, the therapist will listen because these may be repeated in the present. Reality therapists will devote only enough time to past failures to assure clients that they are not rejecting them. As soon as possible, therapists tell clients, “What has happened is over; it can’t be changed. The more time we spend looking back, the more we avoid looking forward.” Wubbolding states, “history is not destiny” (personal communication, April 4, 2015). Although the past has propelled us to the present, it does not have to determine our future. We are free to make choices, even though our external world limits our choices (Wubbolding, 2011b).
Avoid Focusing on Symptoms In traditional therapy a great deal of time is spent focusing on symptoms by asking clients how they feel and why they are obsessing. Focusing on the past “protects” clients from facing the reality of unsatisfying present relationships, and focusing on symptoms does the same thing. Whether people are depressing or paining, they tend to think that what they are experiencing is happening to them. They are reluctant to accept the reality that their suffering is due to the total behavior they are choosing. Their symptoms can be viewed as the body’s way of warning them that the behavior they are choosing is not satisfying their basic needs. The reality therapist spends as little time as he or she can on the symptoms because they will last only as long as they are needed to deal with an unsatisfying relationship or the frustration of basic needs.
According to Glasser, if clients believe that the therapist wants to hear about their symptoms or spend time talking about the past, they are more than willing to comply. Engaging in long journeys into the past or exploring symptoms results in lengthy therapy. Glasser (2005) maintains that almost all symptoms are caused by a present unhappy relationship. By focusing on present problems, especially interpersonal concerns, therapy can generally be shortened considerably.
Challenge Traditional Views of Mental Illness Choice theory rejects the traditional notion that people with problematic physical and psychological symptoms are mentally ill. Wubbolding (personal communication, April 4, 2015) takes a firm stand on using the DSM-5 in creative ways and adhering to standard practice, which includes diagnosing mental disorders. Glasser (2003), however, has warned people to be cautious of psychiatry, which can be hazardous to both one’s physical and mental health. He criticizes the traditional psychiatric establishment for relying heavily on the DSM-5 (American Psychiatric Association, 2013) for both diagnosis and treatment. Glasser (2003) challenges the traditionally accepted views of mental illness and treatment by the use of medication, especially the widespread use of psychiatric drugs that often results in negative side effects both physically and psychologically. Wubbolding (personal communication, April 4, 2015) emphasizes that reality therapy is a mental health system rather than a remediating system. He incorporates the Ericksonian principle that “people don’t have problems, they have solutions that have not worked.” By reframing diagnostic categories and negative behaviors, the counselor helps clients perceive their behaviors in a very different light, which facilitates the search for more effective solutions and choices.