Interview with William Glasser, the Friendly Psychiatrist

 

 

Throughout your career, you have moved away from what you learned in traditional psychiatry. What led you to new paths?

When I started practicing psychiatry, I noticed that among the people who came to consult me, many of them were lonely; they needed a friend. I don't mean that a psychiatrist is a friend for life, but let's say, a temporary friend, someone who allows them to discover that they can establish contact with people in a satisfying way.

The traditional psychiatrist is supposed to remain distant, not talk to people in a way that would befriend them, as it would "interfere with the transfer"! And he must talk a lot about their father and mother.

I rejected this system: I told myself, "I must be friendly with them, I must talk to them about what is happening in their current life, what is past is over. It may have affected them, of course, but they still have to face present problems, the stress they have. And my job is to help them face it more effectively.

That was my main disagreement with the traditional approach. I also thought that understanding alone was not enough to improve a person's behaviour. I observed that, even if they understood, most people couldn't make valid choices for themselves. They needed to make a plan, they needed support, discussion to move from understanding to practical and realistic choices.

 So, you get closer to your patients and lean more towards action.

I was oriented towards action, and I am even more so now. I work with my patients to solve their problems in getting along with the people they want to get along with, not with the whole world! And to do that, since they are not getting what they want now, their approach is probably not very effective. And the only thing they can control is their own behaviour. Spending your life hoping that your husband or wife will behave differently is not very effective! And since you can't make your husband or wife behave differently, the only thing you can change is yourself. And I've been thinking like that for 40 years! So, if you change how you treat your husband or wife based on what you know they like, there is a good chance, not a total chance, but a good chance that the other person will make an effort to behave in a way that you like. That's a fundamental idea in reality therapy. That's how you improve people's behaviours.

 

Your approach seems to be based on relational skills. Why did you call it Reality Therapy?

I'm not sure, I've never been sure about that. But it has to do with the idea that most people I treat, like the patient this morning, talk about reality. And then people feel like they're not handling reality very well. And since I bring them to face the real world, I called my approach Reality Therapy. The world may not be extraordinary, but it is real. I am very satisfied with that name.

 

Have you achieved results that you didn't get with traditional methods?

Absolutely! And I got these results quickly. In my last years of residency in psychiatry, I had a group of patients who the previous year had another psychiatrist, and the year before that, another psychiatrist. During that year, all my patients were discharged fairly quickly, and I even saw other patients at the end of the year. At the end of the year, they all came for outpatient consultation to my own office when I started my practice. And my experience confirms that you can do good work with one session per week.

 

Do they have actions to take between sessions?

Now I would say that people read my book "Choice Theory." We move to action quite quickly. The greatest human misery is psychological: it's the conflict between what you want to do and what someone is trying to make you do, or what they threaten to do, for example, threatening to leave if you don't do it. There are many forms of collusion, and we can end this collusion, but psychological problems do not diminish. Unless we change the theory, it won't work.

 

You work with young delinquents. What visible results do you get?

I have learned a lot in this field. But I wouldn't say that we have done therapy, since I am the only psychiatrist for 400 girls.

 

You don't do individual consultation?

Once, probably not more than once. But we had six other counsellors who met with the girls. But we created a therapeutic environment. The results are the same, after some individual and community educational work. We have group meetings to exchange ideas and solve problems. We first help the delinquents discover their values, develop their identity, then review their behaviours, and finally use more effective and responsible behaviours to achieve genuine satisfaction.