1. ‘Reality therapy concentrates on the client’s needs and getting them to confront the reality of the world. In Reality Therapy, these needs are classified into power, love and belonging, freedom, fun, and survival. Survival includes the things that we need in order to stay alive, such as food, clothing and shelter. Power is our sense of achievement and feeling worthwhile, as well as the competitive desire to win. Love and belonging represent our social needs, to be accepted by groups, families and loved ones.
Freedom is our need for our own space, a sense of independence and autonomy. Fun is our need to enjoy ourselves and seek pleasure. We seek to fulfill these needs at all times, whether we are conscious of it or not.’ Choice theory, the new theory of how our brain functions that supports reality therapy, directly challenges this belief. I contend that when we are unable to figure out how to satisfy one or more of the five basic needs built into our genetic structure that are the source of all human motivation, we sometimes choose to behave in ways that are currently labeled mental illness. These needs, explained in detail in Choice Theory, are: survival, love and belonging, power, freedom and fun. What is common to these ineffective and unsatisfying choices, no matter what they may be, is unhappiness: there is no happiness in the DSM-IV.
Choice theory explains that, not only do we choose all our unhappy behaviors, but every behavior we choose is made up of four components, one of which is how we feel as we behave. When we choose a behavior that satisfies our needs, immediately or eventually, we feel good. When we choose a behavior that fails to satisfy our needs, sooner or later, we feel bad. But the choice to be unhappy is not mental illness.
Our society is flooded with people who are choosing anxious, fearful, depressive, obsessive, crazy, hostile, violent, addictive and withdrawn behaviors. All of them are seriously unhappy; there is no shortage of unhappy people in the world. But, unfortunately, many mental health practitioners who believe in mental illness don’t see the unhappy people described above as capable of helping themselves or benefitting from therapy. They see them as ‘suffering’ from brain pathology, incapable of helping themselves without drugs. They reject psychotherapy as useless or too time-consuming. In my new book, Reality Therapy in Action, I describe how my use of reality therapy has helped many seriously symptomatic clients choose to function normally without the use of drugs.
I am far from alone in what I do. Hundreds of thousands of symptomatic people are helped each year by psychotherapy without the use of drugs because most of the effective psychotherapy in the world is done by therapists who cannot prescribe them. Unhappy people need compassionate therapists, not prescriptions. In Choice Theory (see Chapter Four), I introduce the concept of total behavior which explains that all behavior is made up of four different but inseparable components: acting, thinking, feeling and physiology. Acting and thinking are directly under our control and it is these components I focus on when I practice reality therapy. I don’t focus on how people feel or on the physiology of their brains because none of us have direct and predictable control over these two components.
If we want to change how we feel-and almost all clients want to feel better-we have to make more effective acting and thinking choices such as finding a friend if we are painfully lonely. If we find one and we are happy, this choice will also change our brain chemistry from the chemistry of loneliness, (usually the chemistry associated with choosing to depress) to the normal chemistry of satisfying our need to love and belong. Brain scan research on clients who have been helped by psychotherapy without drugs supports this claim. Reality therapy is based on choice theory, a systematic explanation of how the human mind works. According to choice theory, human beings choose many of their behaviors in order to satisfy innate human needs: self-preservation or survival, belonging and love, achievement or power or inner-control, freedom or independence, and fun or enjoyment. Among the philosophical underlying principles of reality therapy are the following: People are responsible for their own behavior; human beings — not society, not heredity, not history — determine their own choices; People can change and live more effective lives; People need not remain victims of external forces, neither do they need to wait for the rest of the world to change before being able to satisfy their own needs; People generate behavior and make choices for a purpose: to mold their environment — as a sculptor molds clay — to match their own inner pictures of what they want in order to satisfy the five needs described above..