JC Disciples
Reality Therapy, by William Glasser, MD
First published in 1965, Reality Therapy describes Dr. William Glasser’s break with conventional Freudian psychoanalytic practice. The conventional practice at that time operated from the perspective that patients suffered because of personal moral standards that were unreasonably high. The therapist, operating as a shadowed substitutionary authority figure, guided the patient to behaviors that were less inhibited and would bring greater happiness to the individual. Reality therapy, as described by Dr. Glasser, takes a very different approach. The problem is not that the patient’s standards for behavior have been too high; the problem is that the patient’s behavior has been insufficient. A therapist using the principles of reality therapy helps patients to face reality and meet their needs in the world as it truly is.
In addition to the generally understood physiological needs, humans have two basic psychological needs: love and personal self-worth. Both needs flow between the self and others. We need to love and we need to be loved. We need a personal sense of our own value; we also need to be valued by others. According to Glasser, if an individual cannot fulfill these two needs in the "real world," the individual will dissociate from reality or engage in irresponsible behavior or both.
Glasser rejects the concept of mental illness and focuses on the patient’s behavior in his approach to therapy. The therapist becomes involved with the patient and helps the patient to examine his current behavior with a goal of improvement in the future. Examination of a patient’s past and probing his subconscious are not useful to reality therapists. The therapist relates directly to the patient rather than plays the role of a transference figure. Irresponsible behavior is confronted, not explained, as the therapist helps the patient to learn ways of acting that will fulfill his psychological needs.
Responsibility is the key concept in reality therapy. Glasser defines responsibility as "the ability to fulfill one’s needs and to do so in a way that does not deprive others of the ability to fulfill their needs." " Any behavior which does not match this standard is regarded as irresponsible. According to Glasser, humans learn responsibility through relationships, primarily as children from parents. However, the process of becoming responsible is a life-long one. As situations change, each individual must adjust and find new ways of acting responsibly to meet his needs. When this is not done, irresponsible behavior results.
Although Glasser may be too dismissive of mental illness, especially in light of recent research showing a physiological basis for some types of mental illness, his approach to therapy is a solid one for many cases, particularly those which bring parishioners to their pastors. His emphasis on the involvement of the counselor or therapist with the individual is very encouraging. With a focus on the present behavior rather than past events and subconscious motivations, counselors do not need a high level of training in order to be effective. They need only be able to recognize and reward responsible behavior and to offer correction to irresponsible behaviors.