The Basic Concepts of Reality Therapy

What is wrong with those who need psychiatric treatment?

What is it that psychiatrists attempt to treat? What is wrong with the man in a mental hospital who claims he is Jesus, with the boy in and out of reform schools who has stolen thirty-eight cars, the woman who has continual crippling migraine headaches, the child who refuses to learn in school and disrupts the class with temper outbursts, the man who must lose a promotion because he is afraid to fly, and the bus driver who suddenly goes berserk and drives his bus load of people fifty miles from its destination in a careening danger-filled ride?

Do these widely different behaviors indicate different psychiatric
problems requiring a variety of explanations, or are they manifestations of one underlying difficulty? We believe that, regardless of how he expresses his problem, everyone who needs psychiatric treatment suffers from one basic inadequacy: he is unable to fulfill his essential needs. The severity of the symptom reflects the degree to which the individual is unable to fulfill his needs. No one can explain exactly why one person expresses his problem with a stomach ulcer while another fears to enter an elevator; but whatever the symptom, it disappears when the person's needs are successfully fulfilled.

Further, we must understand that not only is the psychiatric problem a manifestation of a person's inability to fulfill his needs, but no matter how irrational or inadequate his behavior may seem to us, it has meaning and validity to him. The best he can do in an uncomfortable, often miserable condition, his behavior is his attempt to solve his particular variety of the basic problem of all psychiatric patients, the inability to fulfill his needs.

In their unsuccessful effort to fulfill their needs, no matter what behavior they choose, all patients have a common characteristic: they all deny the reality of the world around them. Some break the law, denying the rules of society; some claim their neighbors are plotting against them, denying the improbability of such behavior. Some are afraid of crowded places, close quarters, airplanes, or elevators, yet they freely admit the irrationality of their fears. Millions drink to blot out the inadequacy they feel but that need not exist if they could learn to be different; and far too many people choose suicide rather than face the reality that they could solve their problems by more responsible behavior. Whether it is a partial denial or the total blotting out of all reality of the chronic backward patient in the state hospital, the denial of some or all of reality is common to all patients. Therapy will be successful when they are able to give up denying the world and recognize that reality not only exists but that they must fulfill their needs within its framework.

A therapy that leads all patients toward reality, toward grappling successfully with the tangible and intangible aspects of the real world, might accurately be called a therapy toward reality, or simply Reality Therapy.

As mentioned above, it is not enough to help a patient face reality; he must also learn to fulfill his needs. Previously when he attempted to fulfill his needs in the real world, he was unsuccessful. He began to deny the real world and to try to fulfill his needs as if some aspects of the world did not exist or in defiance of their existence. A psychotic patient who lives in a world of his own and a delinquent boy who repeatedly breaks the law are common examples of these two conditions. Even a man with a stomach ulcer who seems to be facing reality in every way is upon investigation often found to be attempting more than he can cope with, and his ulcer is his body's reaction to the excess stress. Therefore, to do Reality Therapy the therapist must not only be able to help the patient accept the real world, but he must then further help him fulfill his needs in the real world so that he will have no inclination in the future to deny its existence.

Chaucer and his times

In this chapter we are to get a glimpse of fourteenth century England through Chaucer's eyes. What Chaucer saw—or at least what he chose to record—is by no means all the story. Between the Conquest and Chaucer's time, Saxon and Norman had been gradually blending into one fairly homogeneous people. The kings of England had gradually become, not Norman, or French, but English kings. The people had come to look upon themselves, not as belonging primarily to this or that feudal lord, but as subjects, all together, of their English king. They had made the discovery that as a people they had rights of their own and by acting together could enforce them. In the thirteenth century they had wrested from King John the bill of rights called Magna Carta. In the early fourteenth century the elected representatives of the people, who constituted the "parliament," and who acted with the king in making laws, were strong enough to depose King Edward II. In the last year of Chaucer's life, parliament deposed King Richard II. The political strife of which such incidents are typical does not get into Chaucer's picture. Nor does the growing unrest of the lower classes concern him. Grinding poverty, oppressive taxation, the destitution wrought by war and by the great plague called the Black Death which swept over England in 1349, the great peasant rebellion headed by Wat Tyler in 1381, do not tempt Chaucer's pen. It is to Langland's Vision of Piers Plowman (1362) with its grimly realistic picture of the selfish luxury of the rich and the wretchedness of the poor, that you must turn for this darker side of the picture. Nor does the intense religious unrest of the time interest Chaucer. The central figure of that unrest was John Wyclif (1324?-1384), whose sermons and tracts roused the people to revolt against the luxury and oppressive authority of the church, and whose translation of the Bible (1380), made in order that the people might read and think for themselves, stands as the first great monument of English prose. The revolt of Wyclif and his followers caused great excitement in England and laid the foundation for the Reformation; but as far as Chaucer is concerned it is as if it had not been.

What did interest Chaucer was human nature and the pageant of life. His own career gave him opportunity to sample and to see. He was born about 1340 when Edward III was on the throne. He became a page in the household of Lionel, Duke of Clarence, second son of the king, and learned, like the Prioress of the Canterbury Tales,to countreifete cheere of court, and been estatlich of manere.

He followed King Edward to France, was captured in the campaign of 1359, and was duly ransomed. He returned to take a place at court and married Philippa, a lady-in-waiting to the queen. He was sent on a mission to Italy in 1372. A year after the accession of King Richard II in 1377, he went to Italy again. During the later years of his life he held the office of comptroller of the customs in the port of London. He saw Richard deposed in 1399. He died during the first year of the reign of Richard's successor, Henry IV. During this long and busy public life Chaucer found time to translate or paraphrase a French poem, the Romance of the Rose; to retell in English verse, with extraordinary vigor and vividness, the tale of Troilus and Criseyde, the material for which he borrowed from Boccaccio; to compose various other narrative and lyric poems; and at length, with his powers fully ripe, to write the Canterbury Tales which have made his name immortal. These purport to be tales told by a group of pilgrims on their way to the shrine of St. Thomas a Becket at Canterbury. The host of the Tabard Inn (at which they assemble for the start) decides to accompany them and persuades them to beguile the journey with stories—each traveler to tell two on the way to Canterbury and two on the way back. The twenty-nine or thirty, or possibly thirty-two pilgrims, would, under this first plan, provide for approximately one hundred and twenty tales; but this number was subsequently diminished to approximately sixty, and of these proposed tales only twenty were completed—just about enough, with the four left incomplete, to tide the pilgrims over the journey to the shrine. What they did there and how they entertained each other on the way back, Chaucer leaves untold. But the long "Prologue" describing the pilgrims, the twenty-four tales, and the little prologues in which Mine Host designates the story-teller and gets him going, are enough in themselves to make up a sizable library.

That indeed was a part of Chaucer's intention in writing the Canterbury Tales. Printing had not been invented—manuscripts were rare and precious. The medieval scholar who was fortunate enough to have access to a variety of them, tapped this rich mine, brought together stories from every quarter, and, weaving them into some plausible connection, made a compact library of them. It was what the great Italian scholar, Boccaccio, whom Chaucer admired and imitated, had done in the Decameron, gathering some of his material from actual life, much of it from old French fabliaux, and weaving it together in the form of stories, told in turn by a group of people who have retreated to a country house near Florence to escape the plague and wish to while away the tedium of the days. So Chaucer gathers stories from many old manuscripts, adds others of his own invention, and weaves them together on the thread of this pilgrimage to Canterbury, assigning each story to the pilgrim from whose lips it would most appropriately come.

But if the stories are to be appropriate, the pilgrims themselves must of course be real people, not mere pegs to hang a story on. It is in this characterization of the pilgrims, and in giving each story just the color and tone and turn that that very pilgrim and no other would give to it, that Chaucer shows his skill and takes his chief delight. And that, and the vivid picture of the life of the times which is thus created, is ourchief delight in the Canterbury Tales. So vivid is the picture, so real are the people, that I think that we cannot do better than see them through Chaucer's eyes. Chaucer imagines himself as one of the pilgrims on that Canterbury journey. We, I think, may claim the same privilege, and as we proceed to join them may pick up a few general impressions on the way.

The first thing, certainly, that will strike us is that manifestations of the church, of the usages and practices of religion, are everywhere. Everywhere we shall see men and women clad in garments that mark them as belonging to some organized form of religious life. Monks, lady prioresses, nuns, priests, friars, pardoners, palmers, we shall hear them called. Even the military men, the knights clad in armour, are as likely as not to belong to some religious order, or to have just come back from a religious pilgrimage to Palestine. And when we find ourselves with a merry crowd of Chaucer's people traveling along an English highway, we shall discover that all of them—knights and merchants and millers and doctors and lawyers as well as monks and nuns and priests—are going on a religious pilgrimage. What does it mean, this religious life that is everywhere around us?

Phonology

There is, incidentally, nothing particularly surprising about the fact that conventional orthography is, as these examples suggest, a near optimal system for the lexical representation of English words. The fundamental principle of orthography is that phonetic variation is not indicated where it is predictable by general rule.

Phonological structure

Phonetic behavior and the resulting acoustic signals are continuous dynamic phenomena. The various phonetic gestures involved in speech production overlap and have no abrupt onsets and offsets. Yet it is generally assumed that phonological structures (phonological forms, phonological representations) underlying speech consist of linear sequences of discrete, static segments. This implies that phonological structures would be structurally similar to strings of alphabetic letters. Such letters are in fact used as phonological notation.

The use of alphabetic writing as the metalanguage of phonology is something which may be assumed to have a significant impact on our theories of phonological structure. Before going on to a discussion of this matter, we should notice, however, that not only the abstract, underlying phonological structure of words is notated by means of discrete graphic symbols. We also use more "concrete" representations of the pronunciations of words and utterances, so-called (narrow) phonetic representations, which are likewise couched in a (modified) letter notation. This means, in all probability, that our view regarding phonetic structure is also influenced by the outer form of this written metalanguage. In any case, it would be utterly naive to believe that phonetic transcriptions, no matter how "narrow" they are, are some kind of mechanically computable, "objective" representations (or reflections) of the phonetic signals. On the contrary, they are the result of a conventional transformation of speech into writing and we need have access to implicit (conventional) rules in order to be able to convert them "back" into speech. It seems probable "that our lack of knowledge of what we are doing when we make phonetic transcriptions is actually hampering our own work as descriptive linguists".

The phonemic principle and the idea of the double articulation of spoken language are probably historically dependent on the existence of alphabetic writing. Thus, if the continuous and varying stream of behavior has to be notated in writing, there arises a need for an economic set of discrete signs, e.g. letters or other symbols (such as pictures). Therefore, a practical notational system presupposes an analysis in terms of segments of some sort. The next step in the argumentation implies that these segmental units are not only workable units of analysis, they are in fact inherent properties of the subject matter; hence phonologists discovered that there were in fact segments underlying overt behavior.

It would be stupid to deny that the idea of underlying segments has some kind of basis in speech production and perception. First of all, the drive towards categorization applies to the perception of speech as well. For this and other reasons patterns and routines are developed also in speech production, the same motor elements tend to be used in the articulation of all words in the language. There insubstantial evidence for units like syllables, syllabic constituents (onsets, nuclei, offsets), vowels and consonants as units of production; common slips of the tongue (such as) 'spictly streaking' for 'strictly speaking', 'strunction and fucture' for 'structure and function', 'lawn drawn' for 'line drawn' are but one type of evidence. Nevertheless, it is no doubt true that writing and the ability to read and write enhance our experience of speech as being composed of segments. What is at stake here is not the general idea that vowels and consonants are components of speech, but rather the much stronger hypothesis inherent in most phonological theories, i.e. that the phonological structure of a word is just a linear sequence of non-overlapping segments. Fowler formulates the basic point of this "strong segment theory" like this:

"Segments in a planned sequence are discrete in the sense that (abstractly stated), their boundaries are straight lines perpendicular to the time axis, so that the terminus of one segment is the beginning of the next segment".

According to mainstream phonological theory, each segment is a bundle of simultaneous features. Such a segment sequence is a basically spatial (rather than temporal) organization of thing-like phonological units arranged in a before-after sequence analogous to the left-right sequences of conventional orthography and conventional phonetic notation. In an extreme version, this theory excludes the possibility that supra-segmental features and syllable structure are phonologically significant.

If the phonologist's view of phonetic structure is influenced by the perspective formed by alphabetic writing, this is true of the layman's thinking about speech to an even greater extent. Aside from the fact that sounds (phonemes) and letters are hopelessly mixed up in the linguistic thinking of most laymen, it is clear that writing distorts our phonetic intuition and make us deaf to certain phonetic realities, notably those which have no counterpart in common orthography.

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