Alfred Adler Institutes of San Francisco and Northwestern Washington

Demonstration of Initial Interview in
Classical Adlerian Depth Psychotherapy

This is an unedited transcription of a demonstration of various stages of individual adult psychotherapy. It was presented at the Cape Cod Seminars in June of 1997. Henry T. Stein, Ph.D. worked with Martha E. Edwards, Ph.D. who played her client. This material is protected by copyright and may not be reproduced, in whole or part, without the expressed consent of Dr. Stein.

H= Henry


(Henry’s explanation) We’re assuming now that I met Liz in the waiting room and (inaudible) and I’m just sitting down at this point. Whoever -- that, diagnostically, that would have been very important because the initial greeting of a client in the waiting room, according to Adler, the person cannot avoid revealing their life style in the initial greeting. So if you’re sensitive to how you interpret that, that’s the first clue you have -- actually, the second. The first clue is the telephone call, where life style issues begin to emerge. The greeting is the next one. The third thing is as we walk down to the office, I would be observing how she’s (inaudible) walking (down), which is another issue, going into a new place never having been before, how she approaches it, and then the taking of the seat, all of this I log in casually but I remember it because these are golden moments of the first contact. (Adler said this is very important.) And the person, after that, they don’t realize what they’ve revealed, but then we sit down, ok? And we start.

H - Can I have your full name please?

M - Liz Osterman.

H - Would you spell that for me?

M - O-S-T-E-R-M-A-N.

H - Ok. And I have your telephone number and I have your address, which you gave me. Thank you. Ok. What is your age, Liz?

M - 42.

H - 42. What is your marital status?

M - Married.

H - Your occupation?

M - Uh, right now I’m, um, a special events coordinator for the center.

H - Ok. And is your husband working?

M - Yeah, he’s a lighting designer. He freelances.

H - Do you have any children?

M - No.

H - How long have you been married?

M - Um, we’ve been married for 6 years and we lived together 2 years before that.

H - What is your state of health?

M - Oh, I mean, other than the fact I’m a little overweight, um, it’s fine.

H - A little meaning how much?

M - Um, 5-10 lbs.

H - Are you taking any medication?

M - Yeah, I’m on Prozac.

H - How much Prozac?

M - Um, I don’t know, a pill a day.

H - Do you know the dosage? Who’s prescribed this for you?

M - My GP.

H - How long have you been taking Prozac?

M - Um -- how long has it been -- uh, I think it’s been about 6 months?

H - Ok. Do you smoke?

M - Yeah.

H - What (inaudible) how much?

M - Oh, I’m trying to quit, but a pack a day maybe. Half a pack to a pack.

H - Ok.

M - Half a pack.

H - Do you use alcohol?

M - Oh, you know, beer, wine.

H - Um, how often and how much?

M - You know, when we go out, I have a glass or two, a couple of glasses.

H - Do you use any drugs?

M - Nah.

H - Ok. Thank you. Now, how can I help you?

M - Oh, um, I don’t know where to begin. Um, I just don’t feel very happy. I don’t know how to be happy.

H - How unhappy are you?

M - I mean, it varies. Um, I mean I -- part of it, I think I’m -- you know, I can be really, really, really happy, but it never lasts and then I get depressed. I think I’ve been cyclically depressed all my life.

H - Where did you get that term cyclically?

M - Um, another therapist I had told me.

H - When did you see another therapist?

M - Um, I was in therapy for a couple of years, um, individual and group, and I quit about 4 months ago.

H - Why did you quit?

M - I don’t think anyone understood me. I don’t think my group was very helpful.

H - Did you get anything from the experience, anything positive?

M - Oh, I would say, you know, mostly to understand that my problems are very complex.

H - When did you first start feeling these symptoms as depression?

M - You know, I think I’ve been depressed all my life, and -- even as a kid.

H - Even as a child.

M - Yeah. I would say maybe real depression when my parents split up. I was 14.

H - When you said real depression, what do you mean?

M - Uh, sad, crying.

H - But you also think that you were depressed before that.

M - Well, I was never happy.

H - Do you have any idea of what was going on earlier that led to your unhappiness?

M - Well, my parents never got along, there was always fighting. Um, I think my mother has incredibly low self-esteem, my father, you know, he’s a lying sonofabitch, um...

H - Tell me a little more about your mother. From your childhood, what do you remember her being like?

M - Um, she was a nurse, she always -- she supposedly was a fantastic nurse, she took great care of her patients, I think much better care of her patients than of me. I think she cared more about her patients than she cared about me.

H - Did that bother you?

M - Yeah.

H - How much?

M - Well, I just felt very -- you know, like I didn’t matter. I mean -- and sometimes she’d be very nice to me. Sometimes she would be wonderful to me. And sometimes I didn’t -- I didn’t exist, you know. I think she might have been depressed. I used to have to kind of, you know, entertain her, kind of get her up, because she’d come home and she’d just, you know, go to sleep.

H - So it went from a high to a kind of low with your mother, yes? What was the high point with your mother? What was -- what did you like so much about what she did?

M - She was funny. She’d make up stories for me. She would sing to me. She would -- yeah, those are the -- yeah.

H - And then what was at the bottom, what -- when did it get really bad? What was the worst that you remember (voice fades out)?

M - Um, she would just -- you know, like I wouldn’t be there. And I would kind of try to get her attention and she would just act as if I didn’t exist.

H - And that’s when you felt really bad? What about your father? Tell me about him.

M - Um, like what I what I know about him now, or...

H - No from -- the impression of your -- from your childhood, as you remembered him?

M - Well, he, you know -- sometimes -- sometimes I thought he loved me and sometimes I thought he didn’t. You know, he could be fun, but he could be mean.

H - What do you mean, “mean”?

M - If he was made at something I did, he would hit me, um...

H - Hit you how?

M - Spank me.

H - Spank you?

M - Hard.

H - Very hard?

M - Hard.

H - Did it leave any bruises, do you know?

M - Maybe -- probably, yeah. It hurt, it hurt.

H - Do you remember how you felt when he did this?

M - I was so mad at him.

H - What were you like as a child?

M - I suppose I was a little bit of a handful.

H - How so?

M - I remember, um, when I was about 2 or 3, I flushed my -- or tried to flush my father’s slippers down the toilet. And I got in trouble. And they told me not to do it again. But I did it again.

H - You did it again?

M - I did, and um -- um, I got in trouble again and I got spanked that time, um, and I did it again. And nothing they could do would stop me.

H - You were very determined, (weren’t you)?

M - I was.

H - Are you still a very determined person?

M - Sometimes.

H - Sometimes. Do you have any brothers and sisters?

M - Mm mm. Well, I have -- I have a half-brother. I’ve never met him.

H - Did you hear anything about him? Do you know anything about him?

M - No. I don’t want to know.

H - You don’t. Was that from your mother’s side or your father?

M - No, my father. He’s, um, remarried, divorced.

H - Did anybody else take care of you as a child?

M - Um, no one really took care of me as a child.

H - Was anybody assigned to you for your care?

M - No.

H - No. Did you have any contact with your grandparents?

M - Yeah, I mean -- yeah, we had a lot of contact.

H - A lot of contact.

M - Yeah.

H - Who stands out?

M - I would say -- everybody. My, um, my father’s mother taught me to sew and that was wonderful, although she could be pretty difficult at times, she was -- and my mother’s mother was really a bitch on wheels. But my grandfather was wonderful.

H - Your grandfather.

M - Yeah, my -- my mother’s father.

H - Your mother’s father. In what way was he wonderful?

M - Oh, he was musical, he would -- he taught me about music, he treated me like I was special, he gave me lots of attention that I didn’t get at home. And we -- I used to go spend summers with them a lot, um, and -- in fact, I think my mother -- he gave to more to me than he gave to my mother, and my mother was kind of jealous of that, but, um, maybe that’s what grandfathers are for.

H - So he stands out as a very wonderful person (inaudible). Was anybody else?

M - (No.)

H - How far back can you remember into childhood? Can you go way, way back. Does something specific that you kind of get a mental picture of and describe to me?

M - Ok. Um, I guess the thing I remember first is when I was, um, I -- when I was -- I must have been 2, I think -- yeah, 2 -- and my mother used to sing me a lullaby when I was at that age. And she brought in a little, like, music box, um, stuffed animal music box and it played the lullaby. And she said that she couldn’t sing the lullaby anymore and that this would, you know, be my lullaby. And at first it was, you know, it was neat. But then I realized she’s not going to be here anymore.

H - What do you mean, “not be here anymore”?

M - Well, I mean, my -- you know, she’s not going sing me my lullaby.

H - Sing again. How did you feel?

M - Horrible.

H - Horrible?

M - Alone, you know (inaudible) I haven’t thought of this in years.

H - It’s bothering you right now.

M - Yeah.

H - Sounds like a pretty miserable feeling. This is not part of the memory, was there a reason why your mother stopped singing a lullaby that you found out later on, and why she gave you this little music box?

M - I never found out.

H - You never found out.

M - I mean, I never really thought about it actually.

H - Oh, you haven’t thought about it, that there might be a reason that we don’t know of right now.

M - That’s true, yeah, I suppose. I never thought about that.

H - Well, maybe, we can think about this together later on. Is there any other memory that you can recall that seems very early?

M - Well, you know, in addition to that one with the flushing the slippers down the toilet, um, I remember my father -- he had this cigarette lighter he used to keep on his bedside table. And it was -- you know, he came and he said, “Where’s my cigarette lighter?” And I said, you know, I don’t know. And he -- he accused me of taking it. And I kept saying, “I didn’t do it, I didn’t do it.” I mean, you know, how many people were there? I didn’t do it. And he didn’t believe me and so he spanked me, um, and then later he found it on his bedside table.

H - How did you feel about all of that?

M - It was really unfair.

H - Did that happen more than once, the accusing you of things?

M - Well, yeah, I mean, they accused me -- well, I did it that time, but you know, I did -- I did flush the slippers down the toilet so they accused me of that.

H - Yeah, but did he accuse you of things that do really didn’t do at other times?

M - I mean, no, because I was an only child, so it’s hard -- I mean, if someone did it, it probably was me. So most of the time I would say it was -- he didn’t do it very well, but most of the time if he accused me, I did it.

H - Are there any other memories you have that are early?

M - Um, I remember being at school. Is that early enough?

H - Oh, yeah, that’s -- that’s ok. About what age, do you think?

M - It was after I was fat, so -- I don’t know, second grade maybe -- 7.

H - What happened?

M - Um, we were on the playground and we were choosing sides for the game and I didn’t get chosen so I just went off. And I remember looking at the birds, they were flying around and just feeling like I didn’t want to be there anymore. So I gave myself an asthma attack and I got sent home.

H - You gave yourself an asthma attack. How did you do that?

M - If you breathe right, you know, or wrong, whatever, I could get it to come on. So I used to make myself do that sometimes. And then I got to go home.

H - Can you still do that?

M - No, I don’t think so. I -- I don’t think I have -- I don’t have asthma in the way I used to.

H - Did you have any other childhood illness?

M - Other than being fat?

H - Well, how fat were you?

M - Fat. I was really fat. I mean, you know, like getting clothes in the -- what do they call it -- the fat girls...

H - Oversized. Ok. Was that a reason for that? Was anything ever explained to you?

M - Why I got fat?

H - yeah.

M - I ate to much. I mean, I ...

H - Well, that’s one reason, yeah, but there may be other reasons.

M - What?

H - Well, nobody explained anything to you. You never went to a doctor?

M - No, I mean, my mother was a nurse, she -- she knew what she was doing. I just think I was so unhappy -- I also got asthma -- asthma and fat at 5. And you know, um...

H - Sounds like you were pretty unhappy.

M - Yup.

H - Did anybody know that and respond to it at all?

M - No.

H - Did you ever tell either of your parents how you were feeling?

M - I don’t think so. I don’t think it would have done any good, so...

H - You don’t think so.

M - ...I don’t think so.

H - But you didn’t do it, though. You don’t remember?

M - No.

H - Let’s come back to the current situation. You’re married and you’re working. Tell me about your work. How do you feel about it?

M - Uh, it’s really demanding. Um, you know, I run special events, lots of money, we’re trying to get money into the place, so you know, we have these big events, there are lots of rich people there, I have to have everything on -- you know, absolutely perfect, um, but I have to make it look like it’s effortless, and, um, so I don’t think -- because it looks effortless, people don’t realize how much work it is. I work 14 hour days, some nights, sometimes.

H - How many days a week?

M - During events season? Sometimes 6 or 7.

H - 6 or 7 days.

M - And people don’t see it, because I make it look -- I know I make it look easy.

H - You make it look easy. Is it easy for you?

M - No! No!

H - It’s very difficult for you.

M - It’s very demanding. I’m good at it.

H - Why do you make it look easy if it’s so difficult?

M - Because you’re supposed to. You’re not supposed to...

H - Oh, you’re supposed to.

M - I mean, if people are at an event, they don’t want to see you looking like you’re, you know, working hard. They want to see you looking like, you know, everything is under control. Nothing ruffles you.

H - And you can do that.

M - Oh, yeah, I’m good at it. I used to be an actress.

H - When were you an actress?

M - When I was in high school I was in the Virginia Community Theater and I lost weight and, um, I did a lot of children’s theater.

H - You lost weight. That takes discipline, doesn’t it? How did you do that?

M - I stopped eating.

H - You stopped -- well, you must have eaten something. Did you have a medically-approved diet? You just did it on your own? Did your mother advised you or...

M - No, I just stopped eating, you know? I mean, it probably wasn’t all that healthy. I drank a lot of bouillon, I remember, and ate a lot of apples. I think that was -- that was it for a while.

H - So it may have been not the best diet.

M - No, it wasn’t the best diet.

H - But it had the result you lost weight.

M - But I got -- I lost weight.

H - Ok. And then you were an actress in the theater and you performed in plays?

M - Uh huh.

H - Did you like doing that?

M - I loved it. I loved it.

H - You loved it. Why didn’t you continue?

M - My junior year my mother decides -- the Ouji Board told her that we should move, so she ripped me out of school, she took me away from my theater, we moved all the way from Virginia to Seattle with no job, no house, no nothing.

H - On the basis of a Ouji Board.

M - The Ouji Board. She took it from me. She couldn’t stand that I had something. She had to take it away.

H - And you felt what?

M - Devastated.

H - Devastated. What did you do about it?

M - Cried a lot. I mean, eventually when I put myself through college, because neither one of my parents, uh, did anything about it, but I got into dance, um, and choreography. So I didn’t go back into acting but I got back into performing and making dances.

H - Do you ever wish that you would do that again, or have you left that behind you, the (dancing and acting)?

M - I wish I could be an actress. I mean, it’s too late for me to be a dancer, but I would love to be an actress.

H - You would love to be an actress. Do you do anything about that?

M - Other than wish?

H - Yeah.

M - I mean, living in New York, I mean, what -- like, what is there to do? There’s only about a million other actresses.

H - Who are also in the same boat.

M - No, they’ve been doing it for 20 years. I haven’t.

H - All of them?

M - Most of them.

H - Some of them.

M - Maybe some for 30 years.

H - Maybe some of them for 1 week. Tell me about your marriage, your relationship with your husband.

M - John is exasperating sometimes, but he can also be very sweet. Um, I would say it’s, you know, very -- like my best friend, um -- he’s kind of a strong personality.

H - In what way strong?

M - Well, you know, has his own views. Likes to get his own way.

H - You said he was exasperating. What -- about what?

M - Exacerbating.

H - Oh, exacerbating. Sorry.

M - Exasperating. Exasperating. That’s what he is.

H - Exasperating. Ok. What attracted you to him when you first met?

M - His sense of spontaneity. I’d just come to New York. You know, he was one of the first people I met. We wanted to have sex, so we did.

H - How is your sex life today?

M - Depends on who you ask.

H - I’m asking you.

M - I would say it sucks. He wants it, I don’t. He’s not a very, um, sensitive lover.

H - How long has he been this way?

M - You know, if I were honest, I would say maybe for the whole time we’ve been together. I just didn’t notice it as much until, you know, the last few years.

H - Does it bother you?

M - I would like to have a sexual relationship, but with him I don’t know that it’s possible, so...

H - Why not?

M - Because I think he’s so insecure. He is -- sex is a real issue with him. He thinks he has a small penis so he feels insecure about it.

H - Does that bother you?

M - What?

H - The size of his penis?

M - No, no. Well, I guess sometimes I want -- I’m not sure.

H - You’re not sure. You say you’d like to have a better sex life, but you’re not sure it’s possible with him. Have you investi -- explored this at all with anybody, with a therapist?

M - Oh, here and there but not -- nothing, you know, real -- a lot.

H - Is there much affection between you?

M - When he wants it.

H - When he wants what?

M - Affection. You know, mostly when we’re out he will put his arm around me and hold my hand. It’s almost like, you know, his little show. Like I’m his little -- I’m his wife and I’m -- I’m so wonderful. But when we’re home, you know, there he is, he’s on the computer, he’s watching television. You know, I don’t really seem to matter much to him.

H - Does that bother you that he is involved with his television and computer?

M - Well, yes and no. Um, there are times when I want to be doing something and that’s ok. But what really pisses me off is when, you know, on the outside he wants one thing, he wants to make it look like (inaudible) but when -- when it’s just me, I don’t matter enough to make it -- you know, for him to -- to be affectionate to me.

H - Are you able to talk with him about this? Have you tried?

M - I -- no. I mean, we’ve had fights about it.

H - You have fights about it. How’s -- what kind of fighting takes place? Just words?

M - Um, what...

H - When you say -- when you say you have fights, are they ever physical?

M - Um, mmm, you know, I think he has grabbed me, uh, you know, a few times, but nothing...

H - Has he bruised you at all?

M - Maybe.

H - Does he still do that?

M - I mean, (inaudible) happened.

H - He’s grabbed -- has he hurt you?

M - Well, it hurts if someone grabs you. But, I mean, it’s not that big a deal or anything.

H - Do you have friends?

M - Um, not really. I mean, you know, I have a few from college and I see them and, you know, whatever, but I don’t -- I don’t really have that many friends in New York.

H - What do you do in your free time?

M - Um, what do I do? I sew, um -- sew.

H - You like to sew.

M - Yeah, I make all my -- all my own clothes. I go to theater, I go to movies, I read.

H - Do you sleep well?

M - Um, why do you ask?

H - Well, I want to know if you have -- you know, always get to sleep, do you sleep restfully, do you wake up refreshed?

M - Um, it depends. If it’s -- if I’m really, you know, under heavy stress, I wake up several times during the night, I keep a pad by my bed, I write down ideas I have, things I need to do, um, so sometimes I don’t get a whole lot of restful sleep.

H - Do you remember your dreams?

M - Um, no, not usually. Sometimes but not usually.

H - Not usually. Do you recall any dreams from childhood? Like, especially dreams that reoccurred in childhood?

M - I can’t really -- I remember one -- I don’t know how far -- if it’s from childhood or it’s just -- but my mother -- my mother is naked, I think she jumps out my apartment building window. It’s vague. I can’t remember too much (voice fades out).

H - Can you recall any of the feeling that was at the end of that dream or within the dream?

M - No, um, no right off hand.

H - Now, you told me one memory connected with school. But that wasn’t the earliest. Can you remember the first day of school?

M - No, uh uh. I went to -- how many -- I went to 3 different schools that first year, so it’s kind of a big...

H - Nothing stands out. Does any memory from adolescence stand out?

M - Um, the things that stand out the most are, you know, being in, um, the theater, um, and kind of feeling like I was with people who are -- who at least liked me.

H - Well, we’re almost near the end of our session right now. Um, there is something that would save us a little bit of interview time if you are willing to do it. I have a questionnaire which you could take with you and look it over, and if you fill it out and bring it back, it’s simply to save us some interview time. Can I show it to you? This is the questionnaire. Take it with you and fill out as much of it as you’d like.

M - Should I bring it back next time?

H - Bring it back as soon as you can.

M - Ok. Sure.

H - I’ll see you next week at the same time, will that be all right.

M - Sure, yeah. Yeah, that would be great.

H - Ok.

M - Ok, thanks, bye.

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