Reality and Choice Theory

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is flooded with people who are choosing anxious, fearful, depressive, obsessive, crazy, hostile, violent, addictive and withdrawn behaviors.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