What Are Core Needs?
The thing that makes Creative Play Therapy different from other therapeutic approaches is the use of expressive arts to do deep work on core needs. To be able to do that, however, you need to know what core needs are and how to identify them. Now that you have the tools from the last chapter to respond in reflective ways that help the client move deeper, this chapter will help you see and hear which core needs are being expressed.
At times symptom relief is the most important work that needs to be done. When a client is suicidal, feeling extreme distress from symptoms, or in crisis, deep therapeutic work is not possible, or preferable, until the client is stabilized. At these times, the therapist needs to focus on decreasing the distressing symptoms.
Most times, however, therapists spend too much time on symptoms. There are good reasons for this. First, the symptoms are probably the presenting concerns that clients came to you to resolve. Second, symptoms are easier to measure for treatment outcomes. Finally, it seems easier to tackle, say, panic attacks than what may be underlying them. Yet, if you want your client to experience healing, those deeper contributing factors are exactly where the therapeutic work needs to be done.
The problem with only working on symptoms is that, without addressing the root of the problem, it comes back. Using the panic attack example, maybe the client does experience relief from panic attacks for a few months, but gradually they increase in frequency again. Or, perhaps you do a great job educating the client on how to manage them and they reduce substantially in frequency and duration, but the client begins having migraine headaches.
The symptom comes back in a different form. Symptoms can be psychosomatic, mental chatter, or emotional in nature, but whatever form they take, they are the body’s way of communicating a problem, so they are helpful at pointing to the core need that is not being met, but if those symptoms are ignored, then they either increase in severity or change forms.
Identifying Core Needs
Working with client issues is like weeding dandelions. Those white, fluffy balls of seeds serve a purpose for the plant. If you want to remove the weed from the yard, however, those seeds cause more problems. Picking the flowers will not get the weed out of the yard. You must get the root, but dandelion roots are hard to address without careful deep work (see Figure 4.1). Doing nothing just creates more symptoms by letting it go to seed, so if you want to remove the weed, then you must remove the root cause. Creative Play Therapy helps therapists to facilitate the deeper level root work on core needs.
How do you identify a client’s core needs? Theorists in the social sciences have categorized them in different ways. Maslow outlined five levels of needs, Beck identified basic needs stemming from cognitive beliefs and Glasser offered five genetic needs. While other conceptualizations of core needs exist, this book will build on these to present a simple model for identifying core needs in Creative Play Therapy.
Maslow's Hierarchy of Needs
One of the best-known conceptualizations of needs for motivating action stems from Abraham Maslow’s Hierarchy of Needs (Maslow, 1943). See Figure 4.2. He began with basic needs that are universal to all people, the physiological needs and once a person’s needs are satisfied (or generally satisfied) at that level, then that person is motivated to satisfy safety needs, then social needs, esteem needs and finally the need to self-actualize. Maslow's important contribution was not to identify the needs that most people have, but to classify those needs in levels of importance, a hierarchy. When lower-level needs are not met, higher-level needs are less important or not relevant at all.
A category of need that many clients have unmet is the need for safety, especially clients who have experienced trauma. With adults, the physical
safety concerns may seem to be met, yet emotional safety needs remain. For example, a client may have experienced childhood abuse in another state from a person who has died, yet remains highly vigilant in relationships and has difficulty even trusting the therapist. Maslow addressed this when he wrote (Maslow 1943, p. 395):
Any thwarting or possibility of thwarting of these basic human goals, or danger to the defenses which protect them, or to the conditions upon which they rest, is considered to be a psychological threat. With a few exceptions, all psychopathology may be partially traced to such threats.
Beck's Core Beliefs
Aaron T. Beck, the founder of cognitive theory, believed that people develop ideas about themselves, others and the world beginning in childhood. Those core beliefs become absolute truths that are so fundamental and deep that they are not even recognized by the person (Beck, 2011). His daughter, Judith Beck, identified three core cognitive beliefs: lovability, adequacy and helplessness - as examples, the client believes “I am undesirable,” "I am incompetent” or "I am trapped” - (Wenzel, 2012) that often underlie the problem. When the therapist listens for cognitive distortions in those areas, the therapeutic work is greater than addressing situational cognitive distortions. While this categorization is probably too simplistic for all clients at all times, it provides an excellent framework for filtering the information from the client. In session, it is easy to remember three broad categories and learn phrases and patterns that indicate one of the core cognitive beliefs.
Glasser's Five Needs
William Glasser, creator of reality therapy, believed that all people have five genetic needs: survival (self-preservation), love and belonging, power (inner control), freedom (independence and choice) and fun (enjoyment) (Glasser, 1999). The first two are quite similar to Maslow’s needs, but identifying a genetic need for power, freedom and even fun, was quite different. Glasser believed that all long-lasting problems were relationship problems. For clients who have experienced being overpowered by a parent, another person, society or systems, the need for power and control (not the need to control) can be very important, and it is one of the core needs we will include in the core needs pyramid.