Assumptions VI: Assessment

2 March 2022

It’s not surprising that I like the assessment stage of counselling or clinical psychology.  In my former career in architecture, I dealt mostly with existing (rather than proposed) properties, mostly heritage.  Such properties have rich histories that sometimes took the research right across the Atlantic Ocean in search of a full contextual understanding.  And that’s what a good human health assessment does: It reaches across time and disciplines to understand the biological, psychological, social, and spiritual strands that make a person who she is.  By my lights, a deep assessment is the foundation of a great therapeutic journey.

Last week, and in two previous blogs (Exiting the Stages of Change, 8.ix.21 and Love & Addiction, 18.viii.21), attachment was discussed as a formative influence on human development.  Dr. Gabor Maté (2018), related the story of his mother’s call to the local pediatrician in their Budapest neighbourhood, late in WWII.  Maté related that the tension created in his family’s Jewish but German-occupied Hungarian neighbourhood was enough for his mother to become so tense that the young Gabor internalized that anxiety as rejection.  As a highly accomplished and celebrated physician, author, and lecturer he continues to deal with that sense of rejected aloneness, unintentionally communicated by his loving mother.  Such is the fragility of human lives.

As a training therapist, if I did not ask questions about this man’s early life, I would have missed a piece of his history—a piece so critical that it haunts him still. Which is probably as good an introduction as I’ll find to the related concept of thrownness.  Thrownness is a twentieth century idea that came out of existential phenomenology.  Big words, simple idea: we’re thrown, without invitation, introduction, or landing pad into a world we know nothing about.

I understand thrownness best by recalling the history of a less thrown world.  In the West, as recently as 100-200 years ago, I would have been expected to take on my father’s profession in the same way he had probably taken on his father’s.  Similarly, my sister would have been expected to perform the same role as our mother and grandmother.  To arrive and grow to adulthood in such a world seems more restrictive than the limitless freedom of choice we enjoy today.  The existentialists, (and Heidegger and his thrownness are of that school) saw the limitless freedom of contemporary life as anxiety inducing—enormously so.  To be open to so many choices—with so little preparation—can be terrifying…hence thrownness.  As a training therapist, I want to know how you experience thrownness because it opens up your relationship with the world and yourself in a big way. 

We’ve covered attachment and thrownness as check-in points for therapeutic assessment.  Now we’ll add my final three: Maslow’s Hierarchy of Needs, Erikson’s Eight Stages of Human Growth, and the Stages of Change (Prochaska, DiClemente, & Norcross, 1992).

I have written about Maslow before.  That series begins with p: Happiness Requires Responsibility, (19.v.21) and continues for the next eight blogs.  My interest, when first meeting a person seeking help, is to understand where she stands in relation to growth needs and deficiency needs.  Whether her answers are correct or not is not the point: how she sees herself with respect to his hierarchy can be telling.  Similarly with Erikson’s eight stages.

Depending on a client’s age, only the first six of Erikson’s Eight Stages of Human Growth may apply.  Anybody can read the described stage and rate themselves on a scale of 10.  For example, Stage 5: Identity vs. Confusion raises the issues of ontological intensity, how fully a person occupies self.  Stage 5 also raises the issue of boundaries.  If a person is strong in his identity, he is probably at least semi-skilled at social negotiations in his own self interest.  Regardless, the discussion of each these first six stages reveal a great deal about a person. 

Finally, having looked at attachment, thrownness, Maslow, and Erikson, I am interested in how strongly a client desires change at that point in her life.  For this, I rely on what she has told me relating to the four frames just listed and place her in one of the following Stages of Change: precontemplation, contemplation, or action...depending on what we’ve discussed. 

While all of this assumes a full bio-psycho-social-spiritual history, the conclusion of that history is focused on attachment, thrownness, Maslow, Erickson, and the Stages of Change.  If you want to test this, simply define the two terms (attachment, thrownness) in your own words and ask yourself how you dealt with these in your youth, reminiscence bump...depending on where these words find you in your unfolding.  Then find the stages of the three theories (Maslow’s hierarchy, Erikson’s stages, and the Prochaska, DiClemente, & Norcross’s (1992) Stages of Change to gauge how willingly you wish to change your life.  As a favourite quote of mine suggests, nothing changes if nothing changes.

Dan Chalykoff is working toward an M.Ed. in Counselling Psychology and accreditation in Professional Addiction Studies.  He writes these blogs to increase (and share) his own evolving understandings of ideas.  Since 2017, he has facilitated two voluntary weekly group meetings of SMART Recovery.

References

Maté, G. (2018). In the realm of hungry ghosts: Close encounters with addiction. Vintage Canada.

Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change. Applications to addictive behaviors. The American psychologist, 47(9), 1102–1114. https://doi.org/10.1037//0003-066x.47.9.1102