Five-Dimensional Assessment of Functioning
Ralph H. Quinn
The V-DAF, or Five-Dimensional Assessment of Functioning, is an assessment instrument to rate clients on their relative functionality on (1) perception of reality, (2) acceptance of self, (3) genuineness, (4) intentionality, and (5) capacity for intimacy.
I. Perception of Reality
Self-Actualization Theory holds that one strong characteristic of full functionality is a clear and accurate perception of reality. A fully functional individual has the ability to both see the world as it really is and to problem solve well in that world. Most of us see the world not so clearly. We see it through schema of habit and unconscious expectation. Jerome Bruner of Harvard conducted an experiment with a college class in which he showed them slides of standard playing cards and told them their task was to identify the card. Without telling them, Bruner mixed in a black seven of diamonds and a red nine of clubs. None of these Harvard students caught the discrepancy. They saw what they expected to see. Our normal perception of reality is regularly clouded by the Freudian defense mechanisms. We repress and deny that which is too painful to accept. We rationalize, project and intellectualize aspects of reality that we are unwilling to look at. Defense mechanisms always distort reality to some extent.
Depression, anxiety, and paranoia can be even more serious distortions of reality. Clinical depression is akin to wearing extremely dark glasses. The depressive cognitive triad is: 1. my present reality is seen as extremely dark and negative. 2. my own self is viewed as worthless and helpless 3. the future is seen as hopeless and dark and negative. Severe anxiety can also critically affect our perception of reality. Things (especially the future) are viewed through a lens of foreboding and fear. Expectations (again especially regarding the future) tend to be terrifying and catastrophe. Anxiety paints reality bright red: The color of danger, extreme risk, and doom. Paranoia is seeing through a lens of grave suspicion. Conspiracies are real. Others are seen as dangerous conspirators out to get us. There are secrets, plots, and enemies everywhere and you must stay constantly vigilant ready flee or fight.
At the extreme dysfunctional end of perception of reality are the thought disorders of psychosis, schizophrenia, and mania. Hallucinations and delusions distort, convert and capture our perceiving functions so that fundamental self-care like hygiene, sleep and eating are neglected.
Rational Emotive Therapy, Albert Ellis
Cognitive Therapy, J.S. Beck
II. Acceptance of Self
Concepts like self-worth, self-love, self-valuing all presume and are based upon a high acceptance of self. Acceptance of self does not imply overestimation, superiority, perfection or an ideal self. It implies an acceptance and prizing of the true self, as the cliché goes, warts and all. High acceptance of self, then, is tied to a clear and accurate perception of self and an unconditional prizing or valuing of that accurately perceived
A normal or moderate range of self-acceptance introduces the agency of the inner critic, the Freudian superego. At the normal range most of us like and approve some of our qualities but are critical of others. Body image, intelligence, shyness, beauty, achievement and grades are all examples of cultural measuring sticks used to ascribe relative values. The disease of not enough-ness spread by capitalism and its mouthpiece advertising create the symptoms of inferiority, shame, and small self, that is, not enough-ness. The inner critic or superego is the introjected agency of our cultural dis-ease.
The dysfunctional end of the spectrum of Acceptance of Self involves concepts like self-rejection, self-condemnation, inferiority complex, worthlessness, and self-hatred. Beneath the surface of persona or social mask we uncover an inner critic enraged with the perceived failings of the self and holding judgments of abject condemnation and complete rejection. At this extreme end of the spectrum suicidal ideation is common.
An Outline of Psychoanalysis, S. Freud
Shame and Guilt, G. Piers & M.B. Singer
The existential philosopher Martin Heidegger wrote about an authentic existence which contrasted with an inauthentic one. Genuineness, naturalness, spontaneity, being real all resonate with this notion of authenticity. Carl Rogers, at times, used the term congruence by which he meant a capacity to show on the outside in words, body language, tone of voice, and facial expression what it is I am feeling on the inside. The genuine person knows themself in the deepest way and is confident in allowing you to know them in the same way. A further characteristic of the genuine or authentic personality is a strong inner locus of control. This individual is much less subject to the influences of culture.
At the mid or normal range of the spectrum an individual is somewhat real and natural but also prone to inauthenticity, phoniness, hiding or not disclosing difficult feelings or thoughts, and being controlled by the fashions, whims, rewards and punishments of one’s culture. In our normal lives it is difficult not to fall prey to wanting to be liked by everyone and thus acting in ways to please others even if it is inauthentic to our deeper feelings. At the normal range of functioning it is more common to find the employment of social masks or defensive facades. At times an individual can become trapped behind their mask and thus come to identify with it.
At the dysfunctional end of the spectrum rigidity, extreme defensiveness, over- identification with persona, and other forms of inauthenticity dominate the personality. There is more of an extreme allegiance to an external locus of control. The rules and influences, whims and fashions of society are the internalized code of the individual. This thoroughly inauthentic existence leaves the person to sleepwalk in a trance-state through their life. Existential crises (e. g. severe illness, death of a love one, loss of an important position, near death experience) provide the only chance for such individuals to crack open and wake up to their real, authentic situation.
On Becoming a Person, Carl Rogers
On Personal Power, Carl Rogers
Confronting Carl Rogers, R. H. Quinn, Journal of Humanistic Psychology
There is a purposeful, intentional element to being human. At our best, intents arise from unconscious human needs. We become aware of them, first, as wishes or dreams. They become more concrete as specific wants, are sent forward through an act of will, emerge as an action, and take final form in actualization or interaction. A highly intentional individual moves easily from wishing to wanting, to willing to action and interaction in a way that demonstrates confidence, clarity, effectiveness and accomplishment. The bugaboos of self-doubt, procrastination, confusion, and failure are little seen.
At the normal, mid-ranged levels, depending perhaps on contexts, we find some areas of functional intentionality, others not so successful. So, for example, one individual in the context of school performance may have little difficulty in actualizing intents, but in the social context of dating find themselves highly inhibited.
Dysfunction occurs because of blockage at one or more junctures in the overall intentionality system. Some people have lost the ability to dream, to fantasize or wish upon a future. They were told as children to “quit dreaming, be practical.” Their lives are flat and meaningless.
At the want level, often the problem is finding out what, in fact, we really do want. External cultural forces like advertising intrude to continuously tell us what we need and desire. At the will level, and here we do not mean conscious, effortful will power, but a more unconscious process, the problem is often assertiveness. This is the critical juncture between internal subjective desiring and external visible action. Fear of conflict or avoidance of ridicule can damage our ability to will.
At the action and interaction levels the damage comes from excessive vulnerability. The external world is seen as more hostile and dangerous than it is. The impulse is to retreat back to the safer regions of fantasy and desire.
At the more extreme dysfunctional end of the spectrum where blockage has become full impediment, we find the individual entirely unable to initiate and carry through courses of action. They have become so mired in their own psychological mud that they cannot even dream of a happier time. This is the definition of clinical depression.
Love and Will, Rollo May
Dispiritedness, J.F.T. Bugental, Journal of Humanistic Psychology
V. Capacity for Intimacy
Writers like Judith Jordan, Carol Gilligan and Jean Baker Miller have noted a powerful relational component to mental health which they find on a spectrum from connection to disconnection. Being able to connect to others in a sustained, supportive, and self- disclosing way is a hallmark of full functionality. Connection or genuine intimacy is founded on the capacity for mutual respect, mutual empathy and mutual disclosure.
Normal functioning implies some capacity for intimacy/connection but also degrees of disconnection. Desires to always please others, or needs for safety and self-protection, hiding feelings deemed unacceptable or threatening can lead to pseudo-intimacy and the dis-ease of disconnection.
Genuine mutual respect and empathy are strongly tied to high levels of self-acceptance which allows for full self-disclosure. Only presenting parts of one-self (“the acceptable self”) denies the capacity for full intimacy. At lower levels of normal functioning, this can lead to feelings of chronic loneliness and misguided attempts to connect. For example, consider the individual who chatters incessantly in an attempt to find connection, but succeeds only in driving people away, thus reinforcing the loneliness and disconnection.
At the more dysfunctional end of this spectrum lies the outpost of isolation. People who lead isolated existences (whether in actuality or in a crowded room) are prone to the symptomologies of depression and paranoia. Without connection we are a risk of becoming lost in the shadow lands of our own psyches. Distrust, suspicion, self- abnegation, and other dark and dangerous avenues beckon.
Women’s Growth in Connection, J.V. Jorden, J.B. Miller
Co-Actualization, Renate Motschnig Pitrik, Journal of Humanistic Psychology