SELLING WATER BY THE RIVER,

by Roger Fritz,

last edited: 5-19-06

---

PROLOG

"You can tell more from a person's mask than from his face" (adage quoted in Weinberg, 1984, p. 155).

DISCLAIMER

"A scientist wished to catalogue the fish in the sea. He took a net of two-inch mesh and cast it into the sea repeatedly. After carefully cataloguing his findings, he concluded that there were no fish in the sea smaller than two inches." (Howard, 1982, p. 319)

It turns out that counseling isn't a science, or even an art. It's human connection. Of course, the art and science support the connection, making it safe and therapeutic. The science is the map, and the art is whatever driving skills you've picked up along the way, but human connection is the engine that powers the car.

PREFACE

"You ask yourself what helping is, or who helps, or what helps, and how much, and when you are, and when aren't you... and the whole conversation can get a little dizzy. What you're talking about is something you really understand instinctively, but the words can start to have a life of their own. Not that it isn't a wonderful topic. But there's always the potential for it all turning into the tea party in Alice In Wonderland.

"I get evidence of this in a phone call one day. I am talking to a woman who is working for the Gallup poll. She's actually doing a poll on how much time people spend helping. She's trying to explain the criteria. I finally start to crack up, seeing something of the absurdity of it all.

"'You all are crazy. "How much time are people helping?" What kind of question is that? Tell Gallup he's nuts!' "She started to laugh as well. 'I know. That's what I said too. What can I tell you? It's a job.' She was sort of whispering, which made me laugh more. We got into this conspiratorial, infectious laughter at it all.

"When we stopped laughing, I asked, 'Was that helping?'

"She said, 'I guess so, sort of. Why was it?'

"I said, 'That's YOUR job. You tell ME why.' And then I threw in, 'We were trying to make the best of a nutty situation. In fact, that's what I'm trying to do all the time. That's it-- I want you to put me down in the Gallup poll as someone who helps all the time.'

"More laughter. She said, 'We don't have a category for "All the Time."'

"'Oh ye of little faith.'

"'But we do have a line here that says, "All of the Above."'

"(At this point I didn't know if she was kidding, but I went for it.) 'Perfect. Put me down under "All of the Above." I am very All-of-the-Above. Everybody's trying to make the best of a nutty situation. Gallup can release a poll saying "Everybody in America is Helping."'

"'God,' she said, 'I wish I had the nerve. Maybe I'll do it with alternate answers. "One Out of Every Two People in America is Helping." The other half is being helped.'

"By this point we were just in love with the idea of throwing the topic back into blessed confusion, which is where it really is anyhow. Finally, we said goodbye.

"'It's been great,' I said.

"'Very helpful,' she agreed.

"Months later, there's a story in the newspaper: Gallup Poll Reveals Half of All Americans Help Out as Volunteers. Right there in the paper. She did it! She pulled it off!

"I rush into the kitchen reading the headline to my wife. 'That's me!' I exclaim.

"'Which half?' says my very formidable and wonderful wife.

"'All of the Above,' I answer triumphantly.

"'Just wash the dishes,' she replies" (Ram Dass, 1985, pp. 241-243).

INTRODUCTION

Strean (1988, 1993) points out that one's theory and practice of counseling grow out of one's life experience, and that the counselor's assumptions and operating principles are intuitively sensed by the client. So it becomes important to clarify my own history, assumptions and grand principles.

PERSONAL HISTORY

I'm 54 years old. I was born in Wyoming, in cowboy culture. "Children should be seen and not heard." "Little boys don't cry." "Stop crying or I'll give you something to cry about." "You can smile and smile and still be a villain." "A man is as good as his word." "Take care of your horse before you take care of yourself." "Help your neighbors, without being asked."

The cowboy myth is the clever stranger who can fix anything, has a dry sense of humor, says little, notices much, never complains, survives everything and never brags about himself. My family's version of the general myth is scratching out a living against all odds, while the men and the women cooperate to survive but don't really like each other.

After the age of three I began to suffer from anxiety, triggered by a specific incident. Our family was moving from Powell, Wyoming, to Cheyenne, in the opposite corner of the state. Dad had gone on ahead with a truck. Mom was following in a car with my sisters and me. Late on a moonlit night, on the snow-covered prairie, we had a flat tire. This was the third flat, so we had no spare. Mom said she was going to walk back to a filling station a half-mile back and get some help. "Take care of your sisters," she said to me, and walked away into the darkness. I was left with a 2-year-old and a 1-year-old, and I felt overwhelmed by the responsibility of protecting them from unknown dangers. (It was many years before I realized what she wanted me to protect them from was the cold.) Ever since this experience, I have believed that life is full of unseen dangers.

At four years old I spent a lot of time wondering what time is, and why I'm me. Why am I not my sister, or five people instead of one? I discovered death when a pet turtle died, and had nightmares about death till I was 12. As a pre-teenager, I was a sleep-walker.

The rest of the people in my family are born-again Christians, and I grew up believing in God. We moved to Afghanistan when I was five, and I spent a total of five years there (though not in a row), which made me appreciative of Eastern ways. The trips back and forth made me a world-citizen before my peers.

I've been an artist, a soldier in Vietnam, a hippie, a yogi, a chiropractor and a godfather. My ten years as a chiropractor led me to believe that there are only psychosomatic diseases.

I've been married and divorced. I had a son who died when he was six weeks old, and it took me ten years to recover. Part of the recovery was taking up hang-gliding. I had to challenge death.

I discovered counseling in the seventies, and I've been a therapy-junky off and on ever since. As a client, I've worked with between forty and fifty different therapists in the last 30 years. For me, religion answers the big questions (Who am I? Why am I here? Where am I going? Who are you?), and counseling answers the little ones (How do I get in touch with my feelings? How do I express them? How do I communicate and relate to others?).

PERSONAL ASSUMPTIONS

I'm a religious person. I believe in God, the soul, life after death, and reincarnation. Life is a growth experience, the ultimate therapy. Which would make God the ultimate therapist. And would make character development the point of being alive, in the long run. Character includes ethics and agape: living well and loving others. One of the finest expressions of fundamental ethics I've heard was said once by Dr. Livneh in Research class: "It's not enough to do no harm. One must do good. Doing good is a matter of values, which change and which don't supply black-and-white answers."

This much is black and white to me. All people are the children of God, and therefore of equal intrinsic worth. This leads to the necessity of non-judgementalness (or more exactly, to judging people only from within their own frames of reference). This in turn leads to the idea that the therapist is an assistant and an ally to the client rather than a leader or an authority figure. However, this doesn't mean the client is in control. As a Zen master assists the student and at the same time sets the rules for the relationship, so too does the therapist.

Since we are all the children of God, a life without service to our siblings is empty. "Expressing our innate generosity, we experienced our 'kin'-ship, our 'kind'-ness.... In service, we taste unity" (Ram Dass, pp. 5-6). "What could that mean practically, as more than a lofty abstraction? It could mean that when we're holding a frightened, battered child... or hearing the grief of a total stranger... or bandaging the wound of an enemy soldier... or sitting with a dying friend... they can feel in who we are the reassurance that they are not simply isolated entities, separate selves, lonely beings, cut off from everything and everyone else. They can feel us in there with them. They can feel the comfort that we are all of us in this together. They have the chance to know, in moments of great pain, that nevertheless we are Not Separate" (Ram Dass, 1985, p. 50).

One must be cautious about helping, thobguh, because people come to a counselor to heal, and they will do this with whatever tools they're given. Even if they're clumsy tools, or the wrong tools. Even if they're given advice and scolding. Just because a counselor's tools seem to work doesn't mean that they actually do, or that other tools wouldn't work far better. Even disrespect will seem to work for awhile, until it provokes reluctance and back-sliding and termination out of protest.

GRAND PRINCIPLES

I believe, as do many in India, that the mind is not conscious. The soul is conscious, and it's only manifestation in this level of reality is the attention, which steers the thought processes, as well as forming new thoughts and modifying old ones. The mind is a computer, and the soul is the computer operator, and the attnetion is the interface. To control the attention is to control the mind. And consequently, attention is the most powerful force a counselor can evoke as an ally, and perhaps (in a sense) the only one.

Feelings are reactions to thoughts and beliefs. Or another way to put it is that every thought has an emotional color to it. Self-defeating behaviors and physical symptoms are reactions to emotions. This idea doesn't negate the idea that symptoms can be manuevers in power struggles and relationships. Rather, it explains how symptoms come about, whether their purpose is social, or for internal emotional reasons, or (as is usual) a mix of reasons.

Louise Hay (1984) covers the emotion-symptom connection extremely well. Appendix 19 is a much-abbreviated list of those connections.

PART (1): MENTAL STRUCTURE

CONSCIOUS AND UNCONSCIOUS

Research has confirmed the Freudian theory that the human mind consists of two distinct-but-not-separate parts: let's call them the conscious and the unconscious. The unconscious does acts as the repository of all the things we've learned in our lives that have become automatic, series of actions that have been metabolized till we're not aware of them any more. Without an unconscious, we'd be overwhelmed with detail.

Automatic behaviors like breathing, scratching, yawning, sneezing, facial expressions, gesturing while talking, posture, throwing things, walking, driving, speaking (the action itself as distinct from word selection), laughing, going into shock, and hysterical strength are all behaviors of the unconscious. The unconscious is also the repository of higher level actions: values, attitudes, preferences, likes and dislikes. And at the highest level, it's the repository of basic beliefs about how life works, one's core operating principles.

Current theory is that the conscious is associated with the left brain and the unconscious with the right. We don't just have a bicameral brain, we have a bicameral mind, a bicameral existence.

It's known that during the waking state, the left brain has a sense of self, and the right brain doesn't. The left brain thinks in words, is the seat of anger, and uses linear logic. The right brain thinks in images, is the seat of sadness, and uses associative logic. And it's known that attention is a function mediated in the brain stem. This suggests that nuclei in the brain stem turn on sense-of-self in the left brain when we are awake, and in the right brain when we're dreaming.

"The difference between conscious reasoning and unconscious response is that responses serve to have purposes and not meaning.... Purpose is simply a function. If something has a function, it accomplishes something. What it accomplishes is not necessarily worthwhile. However, it is habitual. It accomplishes something that at some time in the history of the organism had a worthwhile meaning to it. Most of you who are clinicians have noticed that people engage in behaviors which would be useful and appropriate for someone who is five years old, but not for an adult. However, once the program for the behavior was set up, they continue to use it" (Bandler & Grinder, 1981, p. 140).

"A belief is a thought or a perception that you consider a fact or a reality. Beliefs are very powerful. They determine the way you think, feel and behave. In fact, they determine the fabric of your life.... The beliefs that specifically dictate the quality of life, however, are our subconscious beliefs, which are generally so deep-seated that we're not even aware of them.

"They affect our perception of reality just as tinted glasses allow only certain colors to reach our eyes. For example, a man's CONSCIOUS belief might be that men and women are equal in their ability to drive vehicles; however, SUBCONSCIOUSLY he may believe that men are superior drivers. His conscious mind may not even know what his subconscious mind believes. Yet he selectively sees only the reckless drivers who are women, which validates his subconscious belief.

"Our subconscious programming directs the way we see the world around us and also determines the way others see us. This programming comes from the way others related to us when we were children, from decisions that we made in past lives, and from the collective unconscious of the society in which we live. If you are not sure what your subconscious beliefs are, just look at your life. Your life is an accurate projection of your subconscious beliefs about yourself and life.... A young girl being told repeatedly that she is clumsy provides an example of how subconscious beliefs begin to develop. The child's critical faculties are not develped enough to reject this negative programming, so her subconscious accepts the idea that she is clumsy. This belief of clumsiness begins to become a part of the girl's reality, and she begins to see herself as a clumsy person. Whatever is expected tends to be realized, so the child grows up being clumsy. Her programming is so deeply embedded in her mind that it becomes part of her 'ground of being.' When a subconscious belief becomes part of your ground of being, it doesn't seem like a decision or belief, it seems true" (Linn, 1996, pp. 10-11).

Our bicameral self has an odd ability. Either part of it can be awake or asleep. Therefore it can exist in a number of states:

1) AWAKE: When we're awake the conscious mind is awake, in focus, and the unconscious is asleep, "out of awareness." The unconscious, though asleep, is supplying the automatic functions we need in order to get through daily life. The conscious is acting, and the unconscious is responding automatically in support.

2) DEEP SLEEP: When we're in deep sleep both "selves" are asleep.

3) REM SLEEP: " When we're in dreaming-sleep, the unconscious is awake and the conscious mind is asleep. Dreams are the thoughts of the unconscious mind, thoughts using images and associative logic rather than words and symbolic logic. What is learned during the day is processed by the unconscious at night. During dreams, the unconscious is thinking about what's been passed on from the conscious, integrating the new material into everything else it already knows. That's why we often have to "sleep on it" before we know how we feel about something. There's a physical analogy to this: most of digestion and healing also happens during sleep.

We all come from the "dream-time," as the Australian aboriginal tradition would phrase it. Dreaming is the original form of thought, the "primary process." Babies in the womb are in REM sleep. Dreaming peaks at seven and a half months, when the baby dreams 24 hours a day. Which brings up an interesting question: before babies are born, what might their dreams be like?

4) SLEEP PARALYSIS: 6% of the population in America experience sleep paralysis. They wake up, unable to move. Their chests are paralyzed, and they can breathe only with their stomachs, so it feels like someone is constricting their chests. They can see the room around them, and at the same time they can see and hear dream images. They're awake and asleep at the same time, and physically paralyzed. Naturally, most people panic.

5) LUCID DREAMING: "Another circumstance where both the conscious and unconscious are awake is lucid dreaming. When this occurs, one becomes aware that one is dreaming and is able to influence the dream. The unconscious is awake, having a dream, and the conscious wakes up and joins it.

I have lucid dreams, myself, and there's something odd about mine. My conscious mind is not as clear and straight-forward as when it's awake by itself. For example, I don't think decisions out. To realize that there's a decision to be made ("should I fly this time?") is to make it, without a gap for pondering and consideration. My conscious mind is awake but groggy and sort of oddly sleepy.

6) TRANCE STATE: Here's another circumstance where both the conscious and unconscious are awake. When one goes into a trance state, the unconscious wakes up and joins the conscious in the spotlight, so to speak. In common experience this is a state of reverie or absorbtion. When brought under willfull control, it's the state in which sorcerers and mystics function. Sometimes, when out of control, it's schizophrenia.

When facilitated by another, this state is called hypnosis. We know the unconscious wakes up because REM is observed [Yapko, 1995, p. 61]), and the conscious mind becomes sleepy without going completely to sleep. The unusual thing about this state is that the unconscious has control of the body, rather than the usual sleep-paralysis that sets in on going to sleep. So this is a state similar to sleep-walking. In this state things can be done that wouldn't normally be possible, like turning off pain and raising blisters on the skin at will.

The conscious doesn't seem to go all the way to sleep: "... even when the hallucinations are extremely vivid, the individual will still behave both as though the hallucination were there and as if it were not. For example, hypnotized subjects will not try to sit on a hallucinated chair, whereas subjects who are simulating hypnosis will" (Spanos, 1986).

PART (2): HUMAN NATURE

HUMAN NATURE: FUNDAMENTAL PRINCIPLES

In order to put human nature into perspective, it's useful to know something of where we humans come from, and for that I include Appendix 27: Prehistory.

On 8-31-01 there was a story in the Oregonian about a 26-year-old woman in Seattle. She was distraught over a relationship, and decided to kill herself. She went down to the Ship Canal Bridge on Interstate 5 and threatened to jump off. Traffic through much of Seattle came to a stop, and motorists were so angry that they were shouting insults at her, cursing her, mocking her and urging her to jump.

Police eventually closed the bridge entirely, causing massive congestion. After hesitating for 3 hours, the woman finally jumped. She fell 160 feet into the water of the canal and survived. She was taken to the hospital with a fractured spine and internal injuries, and she recovered. Some people who heard about her on the news deluged her in the hospital with cards and offers of help. Other motorists were angry for days, calling talk shows and e-mailing the newspapers, blaming her for picking such a well-travelled place to kill herself.

It's my belief that people are innately good. But some people have lost touch with their innate goodness, usually because they have been abused, and they've come to feel that someone has to pay. So there are two types of people, in practice. One is the sadist, who enjoys causing pain. And the other is the ordinary person, who goes through daily life doing the best they can with what they've got.

This enjoyment in causing pain to others seems to be one of the most fundamental properties of human nature. It seems to run deeper than personality type. There are sadists of every personality type. And there are altruists of every personality type, as well.

Because it's neither politically correct nor good strategy for people to reveal that they're sadistic, they try to look like everyone else. Wolves go through their daily lives in sheep's clothing. They seem amiable. But if you pay attention to your feelings, you'll notice a little clench of fear in your gut the first time you meet such a person.

Sadists reveal themselves by their tendencies to cultivate a cool image but periodically lose it and go into scolding and shouting. They tend to accuse and criticize, to cast blame, to judge before getting the facts, to be authoritarian, to abandon all pretense to equality when they're under stress, to use cajolery, trickery and coercion to get people to do what they want them to. We all know these people. They're everywhere. It's because they're common that everyone must learn self-defensive warrior skills. The only viable way to deal with abuse is to stand up to it, but one can do that in a gentle and nonviolent way.

People who aren't sadistic aren't necessarily altruistic. Most people act out of self-interest most of the time. I once saw a bumper sticker that said, "It really IS all about me." That's the function of the human ego, to keep track of what's good for the self. If an action is in someone's self-interest, he will do it. If it's not in her best interest, she won't. There's a saying in India that no one can give you even so much as a glass of water without wanting something in return.

There are three complications to this principle.

1) The most common complication is that people act against their own interest because they make mistakes or because they're bound by a rigid pattern of behavior. Sometimes they don't actually understand what's in their own best interest. Sometimes this failure to act in one's self-interest is the result of trauma. An abused animal will stop reaching out for nourishment or touch. So will an abused person.

2) A less common complication is enlightened self-interest. Some people understand that it's in their long-range best interest to be altruistic, and are free enough from traumatic reaction to be able to do it. They act on the principle of win-win. They don't do something that benefits them if it also harms others. This might be considered basic ethics.

3) The least common complication is the exception to the rule. Some people act out of love, without thought of how they will be benefitted or harmed. This is relatively rare in any society, except for parental love, deep friendship, intimate partners and between men during war.

HUMAN NATURE: GENERAL PRINCIPLES

I have to laugh at the Rogerian theory that people are trustworthy and self-actualizing, although technically I would have to agree. But I would have to add the word "convoluted" to the description to make it one I could actually go along with. I know a lot of lovely people. But I also know a lot of people who aren't.

People are innately good, and that's why babies' faces are so open and beautiful. "Everyone's doing the best they can with what they've got." But the best some people can do is terrible. I know people who are frothing with anger, who spend their lives seething and looking for fights. I know people who were so abused when young that they seem to have no sense of self. They pretend to be whoever they're with. I know a man who is schizotypal, who has no feelings or ethics in the ordinary sense, and who can't tell the difference between reality and his own thoughts. These people aren't within shouting distance of being trustworthy and self-actualizing. Many people are not only not getting better, they're busy getting worse: spiraling downward.

And these are individual examples. Amnesty International's 1999 report says that torture or ill treatment is reported in 66% of the countries in the world. Torture-related deaths are reported in 27%, and documented disappearances are reported in more than 20%. (Oregonian, 6-17-99, p. A12)

As I write this paragraph in October of 1998, there are 275,000 people who are homeless in Kosovo from Serbian brutality, and winter is coming. The Taliban have taken Afghanistan back to the dark ages, with public beatings and beheadings. The war in the Congo is being fought by boys who go into battle chewing "magic" grass that makes them "immune" to bullets. Private prisons are the fastest growing industry in America. As a prison guard in a report on TV said, "I have to be two people. If I went home and treated my fiancee the way I treat even the best-behaved inmate, she'd be very angry."

The Oregonian reported on 1-22-00 that there are about 300,000 child soldiers in the world, fighting in wars from Africa to Chechnya to South America. It reported on 7-6-00 (p. A9) that President Clinton has signed two international agreements, one to prevent anyone under 18 from being sent to war and one to protect children from the sex trade and human trafficking. "Tens of millions of children are trafficked around the world as bonded labor or sex slaves, according to UN estimates." But gettting the agreements ratified will be hard. It took more than 6 years to get the Pentagon to approve a measure on child soldiers because it included a ban on recruiting people under 18. The Senate and Pentagon have refused to approve treaties on a range of issues from the environment to international law to gun control.

A CIA report released in April of 2000 says that between 700,000 and 2 million women and children in the world are enslaved. About 50,000 of those are brought into the US every year, where they are forced to work as laborers or prostitutes. Women answer ads for au-pair, secretarial or waitress jobs in the US, and find themselves in deep trouble. Girls as young as 9 are outright sold by their parents to traffickers. Some traffickers charge parents money to bring their children to the US, where they will "get a better education," and then sell the kids when they get them here. (Oregonian, 4-2-00)

The UN estimated in May of 2001 that profits from trafficking in women reach from $7 billion to $12 billion a year. (Oregonian, 5-17-01, p. A14)

Amnesty International launched a year-long campaign in October 1998 to call attention to the U.S. The problems are "widespread and persistent police brutality, endemic physical and sexual violence against prisoners, racist application of the death penalty, and use of high-tech repression tools such as electroshock devices and incapacitating chemical sprays." Amnesty International says that a particularly disturbing trend is the growth of high-tech security units, where prisoners are placed in long-term or even permanent isolation.

(Something they don't mention is that these same means were used by the Quakers and the KGB in order to drive people mad. The first penitentiary in the US was built by the Quakers. They hoped that in isolation the prisoners would repent and turn to God. It was shut down because the prisoners went insane. The KGB is known for using isolation in the infamous Red Room to drive people over the brink.)

Amnesty International also points out that the US has the largest number of people on death row of any country on earth, over 3,300 at this point (October, 1998), that 24 states kill people under 18, and that we execute people who are mentally impaired. (Oregonian, 10-5-98)

America seems to me to be a land of compulsives. So many people are obsessed by work, appearances, greed, territoriality, wealth and status. So many waste their lives in materialism and consumerism. American society at large doesn't support people actualizing themselves, which is odd, because it makes a great show of supporting personal freedom. Social homeostasis maintains classism and compulsivity.

As the Reverend Rodney Page, former executive director of Ecuminical Ministries of Oregon, says, "Although a handful of countries has prospered in the global enocomy, many others are being left behind. The great divide between rich and poor is only growing deeper. Powerful nations dominate, while the rest of the world is mired in poverty, misery and hunger." (The Oregonian, 3-18-00, p. B5)

On the other hand, America gives more in charity than any other country in the world. Americans are in many ways wonderful people: inventive, sensible, active and generous.

In short, human nature is mixed, both good and evil, but the good is often deeply buried, and it can take a lot of digging to bring it to light. I think of people as having an allegiance either primarily to the negative or to the positive. Saadists are committed to the negative. Some peoples' first goal would have to be to get to the zero line, and for that they'd have to switch allegiance first.

Another critical point about human nature is that most people are territorial. For a trivial example, people leaving a parking place take longer if there's someone waiting. On the average, women take seven seconds longer, and men take eleven seconds longer.

Many people are also invested in power-struggles. Typical strategies are threats, violence, withdrawal, sabotage, manipulation, passive resistance and "physical inability" to do what the other person wants them to (using illness). Some, in any relationship, are maneuvering to be "top-dog."

People's contrariness has implications for counseling.

One implication is that the counselor must be in control of the relationship, be the one who sets the rules. If the client gains control in therapy, there's little chance of therapeutic change. (Haley, 1963, p. 25) This doesn't mean the counselor can't "appear" to lose control, for strategic reasons.

Another implication is that if you want someone who loves power to change a behavior, you might start by encouraging that very behavior. Let them start getting better by rebelling against the counselor. This is an example of using a psychological bind to trick someone into healthier behavior.

HUMAN NATURE: INADVERTANCE

I don't agree with classical Freudian theory that there are no accidents, that everything a person does is unconsciously intended. George Weinberg (1990), in a chapter called The Accident, makes a powerful case for the existence of inadvertence. "A major mistake of reasoning has been to conclude that simply because a person caused an outcome, he secretly wanted that outcome-- as if people had perfect control over their actions and the effects of those actions. A man may be in a traffic accident or lose all his money gambling without having secretly longed for that result. If it befalls the gambler that his father dies of a heart attack over his losing so much money, it need not follow that the gambler wanted that either" (Weinberg, 1984, p. 141). People make mistakes.

HUMAN NATURE: HOW TO GET WHAT YOU WANT

There's an idea that's incredibly popular in pop psychology circles, self-help books and the media. I've been running across versions of it for decades. It's the flip side of inadvertance.

It goes something like this. The way to get what you want is to control your thoughts and attitudes. If you're not getting what you want, it's because you're thinking the wrong thoughts, your attitude is wrong. If bad things happen to you, it's because you're causing them to happen.

Perhaps this idea grew out of the Freudian idea that there are no accidents, that everything one does is unconsciously intended. As Qui-Gon Jinn says in Episode 1 of Star Wars, "Nothing happens by accident." Perhaps it grew out of the ancient ideas of sympathetic magic, that one can control nature and life with magical rituals or focused attention.

Perhaps it comes out of the very human urge to avoid pain, to find an easy road to instant success, and to find someone to blame when things go wrong. Many people would rather blame themselves than live in a world where they have no control. "The condition of helplessness is one that we tend to push away, deny, or stigmatize, as a society and as individuals. Our cultural myths neither encourage us to accept a common helplessness nor teach us how to act upon it. When it's suddenly thrust upon us, we're unprepared" (Ram Dass, 1985, p. 134).

Perhaps this idea arises from the sort of circumstance that a friend of mine named Robert told me about. He was in the army in Vietnam during the Vietnam war. One day he was with an eleven-man squad when it was attacked by an entire battalion of NVA. The people around Robert were killed, and he pretended to be dead too. He was lying on the ground, knowing that after a battle the NVA commonly stabbed the corpses with bayonets to make sure they were dead. Robert saw an NVA soldier notice him and start to walk toward him, and so he did what he called "becoming invisible." He became still, not just physically, but mentally and emotionally as well. The soldier was distracted by something and never got around to stabbing Robert. At that moment Robert realized that he could do anything, that even if bullets hit him he would survive, that he was in control of his survival. To this day he believes that life can be controlled through sheer effort of will.

Sorry. I don't get it. I would say that there's no way to know why the NVA soldier turned and walked away, that Robert was lucky, that there are lots of other explanations for why he's still alive today than to say his effort of will saved him.

This magical idea that one can control life through correct thinking is just close enough to the truth to be very seductive.

The true version of this idea goes under the name "internal locus of control." This idea is that peoples' attitudes influence the results they get. For example, if a man is angry at women in general for not giving him the affection he wants, then the women he meets are going to pick up this hostility and be repelled. To some extent, his anger becomes a self-fulfilling prophecy.

Certainly our beliefs structure what we experience. One example of this is the placebo effect. A study was done at University College London by psychiatrist Charlotte Fineman with people recovering from dental surgery. Some people received an ultrasound treatment. Others received what appeared to be the same treatment, but the machine was turned off. Those receiving the placebo treatment had less swelling and pain than those receiving the actual treatment. (Landis, 1999) To say the mind has a powerful effect on the body is an understatement.

But pop psychology takes this idea one step too far. It says the mind has a powerful effect on life outside the body and mind. It makes life something small, something that can be controlled by the individual, something that can be manipulated by a magic trick. Do you want money? Change your thoughts, and it will come to you without effort. Do you want success? If your attitudes were correct, it would come to you without your doing anything. Do you want love? Think that you deserve it, and it will come to you without your having to change or reach out. Do you want to live forever? Stop thinking about death, and you will.

The other side of this misapplied truth is victimhood. If something bad happens to you, it's your own fault. Many people would rather castigate themselves than feel helpless or powerless.

Many don't know that self-castigation is untrue. Life is bigger than the individual. Things happen that can't be prevented or avoided. The fact that one is not in control is something that one comes to accept in the course of maturing. A large part of the struggle to grow up is acceptance of the fact that bad things happen, and there's no one to blame. "And we must allow the universe to be exactly the way it is" (Ram Dass, 1985, p. 146). One does what one can, of course, but this doesn't lead to instant and effortless success, to control over existence. Life is in control. We are tiny beings in the great tapestry, and much of what happens to us is forever beyond our control. To be joyful in spite of this is the goal, the mark that someone is emerging from emotional infancy.

"Luck is a variable, but courage and directed effort are controllable" (Weinberg, 1984, p. 128).

HUMAN NATURE: PERSONALITY TYPES

I've been interested for a long time in personality types, and I like this system because it seems to reflect what I see around me. I've come across four different ways of labeling four basic types. My favorite is in parentheses.

CLASSICAL 70's 80's 90's
Type 1] choleric controller dominating (lion)
Type 2] sanguine performer extroverted (golden retriever)
Type 3] phlegmatic pleaser conforming (beaver)
Type 4] melancholic supporter patient (otter)

Michael Ebner (1977) theorized that children decide before the age of three how to get their needs met. A more accurate way to say this would be that children develop in their early years like an image emerging on a piece of exposed photographic paper when it's put into a bath of developer. The personality type that emerges comes from past lives, but from the outside this process looks like someone making decisions.

Those who discover that having control over others is the answer become lions. Those who find that pleasing others is the solution become the other three types. Those in whom anger predominates may become golden retrievers, those in whom sadness is the favored emotion become beavers, and those whose habitual feeling is fear become otters.

A lion is direct. When she wants something, she goes after it. When she wants to do something, she does it. She's not devious. She's direct, strong, a leader, and makes friends easily. She doesn't mind being told no. She likes things to be just so, and can be a workaholic. She's social and adventurous, likes to explore and see what's to be seen. She's funny almost by accident. She can get discouraged. She can be critical and criticizing, wanting others to be the perfectionist she is. The light side of the lion is that she's determined. She accomplishes wonders. The dark side of the lion is that she can be a manipulative controller. The lion's challenge is to learn to be a good listener and to play for win-win. The challenge for others in dealing with a lion is to set boundaries. The way to get along with a lion is to be direct. Dorothy in the Wizard of Oz is a lion. She needs to achive her goal, her dream. She's the one who's on her way somewhere.

A golden retriever is the life of the party. He's gregarious and social, fun to be around, witty and amusing and usually the center of attention. Although he may be a different person to be around when he's home and "off." The light side of the golden retriever is the joy he brings to others, the cheerful and entertaining approach to life. The dark side of the golden retriever is someone who demands attention, who won't share the spotlight with others. The challenge in being a golden retriever is to accept love without having to perform. The challenge for others in dealing with a golden retriever is to get them to be serious for a minute. The way to relate to a golden retriever is to play with them. The scarecrow in the Wizard of Oz is a golden retriever. He has a hard time taking things seriously, letting go of his role of entertaining the others.

A beaver will make a workaholic tired. She's always working, mostly in the service of others. She's always supportive. She's level-headed and sensible, and gets along well with everyone, though she's hard to get to know. She's strong, but self-effacing. She has a quiet sense of humor. She's the one in the kitchen washing the dishes after the party's over. She has a hard time taking care of herself, avoiding exhaustion. She can be troubled by depression. The light side of the beaver is the person who takes joy in serving others, the true helper. The dark side of the beaver is someone who collapses from exhaustion, and their challenge is to learn self-care. The challenge in dealing with them is to get them to open up and share. The way to get along with them is to work with them. The tin man in the Wizard of Oz is a beaver. He needs the heart to take care of himself.

An otter is flexible and inventive and easy-going and patient, social but not a leader. He's lazy until there's work to do and then works hard. He likes helping others. He's loyal and sensitive and generous. He tends to be self-effacing, and can be hypersensitive: lonely and melancholic. He might have a hard time asking for what he wants. He might believe that life is something to endure. The light side of the otter is the playful, inventive presence inviting you to laugh, the jester, the fool. The dark side of the otter is someone who is lonely and isolated and depressed. The challenge for otters is to learn to be outgoing and friendly, to connect. The challenge for others in dealing with an otter is to get them to stop being equivocal. The way to relate to an otter is to hang out, and to talk about their many interests. The cowardly lion in the Wizard of Oz is an otter. He needs the courage to express himself.

HUMAN NATURE: NEEDS

The other day on public radio I heard a talk show with a guy who'd done some research on needs. He found 16 needs: water, food, exercise, power, curiosity, independence, tranquillity, order, idealism, savings (including collections), social context, acceptance, family, status, revenge, and romance.

Another way to regard personality types is how high or low a person scores for each of these needs. Otters, for example, don't usually have nearly as much need for order as do lions or beavers.

HUMAN NATURE: STATUS

It can be useful to pay attention to a client's status. There are two kinds of status: social status, and class. Social status refers to an individual's rank within their own group, whether they are popular, ignored, rejected or controversial. (Sigelman, 1999, p. 380) Class refers to the rank of one's group in society at large.

The way social status works in practice was shown in a study at a girls' school. Even though the girls wore uniforms, when they were let out for recess, they clumped into groups, who hung out and talked to each other. A number of people weren't welcome in any group. They spent most of their time alone. But even these people talked to each other some. They formed a quasi-group of outsiders. The rejected tend to be those who are poorer than the rest of the group, and more lacking in social skills.

Class refers to the status of a group within the culture as a whole. America's the most classist country in the world, even including India with its caste system. It's harder to change class in America than anywhere else on the planet, and the classes are more rigidly defined by money.

The ladder of class in America for men might ascend something like this: homeless, migrant worker, servant (gardener, waiter, janitor, bartender, etc.), unskilled labor, blue-collar worker, poor white-collar worker, well-to-do white-collar worker, rich white-collar worker, policeman, CEO, politician, President.

The situation is more complicated for women. They also have a ladder of class similar to men's. A woman doctor has more status than a waitress, for example. But another factor comes into play: the largest part of womens' status comes from physical beauty. An attractive woman is more likely to marry a man who is in a higher financial class than her, and thereby move upward, economically speaking.

Status is particularly important in dealing with male-female relationships. Research with birds has found that the female mates with a male who's at her level in the pecking order. Then she goes out and has sex with any male she can who's higher in the pecking order than her mate, while the male goes out and has sex with any female who's lower than him. Up to half the eggs in a nest are fathered by extracurricular matings.

This has a number of implications. It means all the males higher than a female are available to her for sex, and all the females lower than a male are available to him. It also means the males at the bottom and the females at the top have fewer sexual opportunities.

Research has found that humans work the same way. Women seek a mate with as much status as possible, and then they have affairs with men who have more status than he does. An interesting finding, for example, is that when women have extramarital affairs, they have sex with their husbands when they're not fertile and sex with their lovers when they are. (See appendix on Sex for more information.)

This research must be taken with a grain of salt. People are not as bound by their biology as birds. There's also such a thing as love, and people will do the most marvelous things for love.

HUMAN NATURE: ASSIMILATION CYCLE

Elizabeth Kubler-Ross discovered what's often called the grief cycle. A more general name might be the assimilation cycle, as even good changes are a stress, and are metabolized with a series of feelings, not necessarily in the following order or one at a time. These feelings include disbelief and numbness, anger and protesting, bargaining, sadness and yearning, resignation, and (as the culmination of the process) acceptance and joy.

The therapeutic process might be regarded as an assimilation cyle, and life itself might be regarded as an one too, on a larger scale. Negative people might be thought of as stuck in the stage of disbelief and anger. One might think of the assimilation cycle as going once around a spiral. Reality Therapy (Wubbolding, 1999, pp. 290-291) talks about the stages one goes through in spiraling up or spiraling down.

Regressive:
Stage 1: I give up.
Stage 2: negative symptoms (such as acting out,
pessimism, depression, chronic anger, phobias,
and physical ailments).
Stage 3: negative addictions (such as drugs, alcohol,
gambling and over-work).

Positive:
Stage 1: I'll do it.
Stage 2: Positive symptoms (such as self-assertion,
self-care, altruism, acceptance of the
unchangeable, responsibility, sociability, and hope).
Stage 3: Positive addictions (such as running and
meditating).

HUMAN NATURE: REGRESSION

When people are under stress, they use increasingly primitive methods of coping, and they appear to regress to a younger age. Just when people most need advanced coping skills, they lose touch with them. Part of what a counselor can do is assist in resource retrieval.

"Some of us become obsessed by our suffering. Others try to ignore it. Some curl up in the fetal position and withdraw into themselves; others wander about confused, grabbing at straws in the wind. Some keep businesslike; others childishly irresponsible. Some keep a stiff upper lip. Others cry and turn to jelly.

"Habitual reactions also include the way we respond to help from others. When in pain, we may reach for help swiftly or spurn any aid. We may be embarrassed at discovering our need or assume it is our right to demand help aggressively. We may feel we have been wronged or are being punished by suffering and become angry or play martyr, or we may be softened by pain and receive support graciously" (Ram Dass, 1985, pp. 85-86).

HUMAN NATURE: ORIGIN OF KNOTS

"It's not what happened to you in your past, but what you took it to mean that's important," as a friend of mine once said. Fundamental beliefs about worth, competence, safety, lovability, meaning and life-plan are formed when we're children and are the least qualified to make them. (Again, a more accurate way to say this is that beliefs are formed in past lives and emerge during childhood, but the principle is the same.) I like the Adlerian name for this: "private logic."

Mistakes are made, and then they tend to become self-fulfilling prophecies. Another way to say this is that some beliefs facilitate adaptation, and some are constraining. G. Stanley Hall discovered in 1891 that the "logic" of children is often not very logical. (Sigelman, 1999, p. 9) The unconscious mind can also be illogical. Beliefs cause behavior, but the causality is circular and homeostatic.

Dysfunctional beliefs and their associated behaviors might be called knots. Perhaps the most famous example of a knot is Groucho Marx's remark that he wouldn't join any club that would have him as a member. R. D. Laing once wrote an entire book about knots, called Knots.

Abuse has an incredible impact on children, reducing self-worth to pathologically low levels. Loneliness and disrespect and lack of control over one's own life and body are also potent disruptors. Mixed messages from parents, double binds, can cause severe distortions in private logic.

Another source of knots is avoiding thoughts and fears. These can strengthen into dread and lead to obsessions.

Perhaps the deepest source of knots is individuality. We are all ultimately alone in a beautiful and dangerous world. We all have a sense of separation and vulnerability that can lead to living with a deep fear of life itself.

HUMAN NATURE: PREVENTING THE UNTANGLING OF KNOTS (DEFENSES)

The commonest defenses are denial of reality, distortion of reality and ignoring reality. Defenses carried to be extremes become maladaptive behavior and physical symptoms.

"Denial often comes into play almost automatically. We blot out the suffering right before our eyes. We walk down the street past beggars and people obviously in pain without even noticing them. An ambulance goes by; it's just a loud noise, it'll pass. We hear cries in the night; it's only a family feud, we turn over and go back to sleep. Potential nuclear annihilation is only twenty minutes away; we can't handle the thought of it. It's as if we have an invisible screen that deflects evidence of pain as soon as it gets close enough. How easily we delete it from awareness, without even being aware that we've done so....

"When this early-warning system fails, the mind must call on other devices in its repertory of response to suffering and the fear of it. One tactic is so simple we usually fail to notice it. We put some concept or idea between ourselves and the suffering. In comes Mary Jones, hurting real bad. As she sits across the desk she suddenly becomes Mary Jones, 'schizophrenic.' With a flick of the mind, we've turned a person into a problem. "Or we try to stuff suffering into a facile spiritual or philosophical perspective: 'It's just the way of things.' 'Suffering is part of the Grand Plan.' 'It's their karma.' 'Suffering is grace.' A party line, glib and heartless. "Sometimes we even use the fact of human suffering to justify abstract ideologies. We use it to prove points.... 'If she wasn't a drunkard, she wouldn't have ended up that way.' 'Well, they always cut school, no wonder they can't find a job.' 'If those people in India didn't spend so much time meditating, they'd have their economic scene together and there wouldn't be so much starvation.'

"Pity is another way we keep suffering at arm's length. We may let in a little of someone's pain, but never enough to threaten our own self-control. We may feel a little moved to respond to the suffering-- we'd feel guilty or uncomfortable if we didn't-- but we'd like to get it all over with as soon as possible and get on with our own affairs. Compassion and pity are very different. Whereas compassion reflects the yearning of the heart to merge and take on some of the suffering, pity is a controlled set of thoughts designed to assure separateness.

Compassion is the spontaneous response of love; pity, the involuntary reflex of fear.... "Perhaps the strategy for dealing with suffering most familiar in our helping institutions is that of 'professional warmth.' Like pity, it's a stance to keep our distance. Since many professionals even believe that it's appropriate 'not to get involved,' they demonstrate a cool efficiency and impersonal friendliness, at best a facade, at worst plain hypocrisy. They become like their machines: cool green, giving off a competent hum....

"Frequently, our reactiveness to suffering takes the form of having instantly to do something, do anything. It's the 'we gotta' syndrome. 'We gotta' fix this up right away. 'We gotta' call this person for advice. It's tricky, because this impulse may arise from genuine empathy, but the form of action is compulsive. Often what's happening is that 'we gotta' get rid of someone else's pain because it's hurting us too much....

"Denial, abstraction, pity, professional warmth, compulsive hyperactivity: these are a few of the ways in which the mind reacts to suffering and attempts to restrict or direct the natural compassion of the heart.... As hard as this is for us, what must it be like for those who need our help" (Ram Dass, 1985, pp. 59-64)?

HUMAN NATURE: PRIMARY KNOTS

Death and meaning are the most likely areas to be knotted and defended. Existential Theory says that the fear of death is the strongest fear that most people have. It's difficult to work with because the only option is acceptance of the inevitable. (Haley, 1973, p. 297)

On the other hand, once it's faced, awareness of death is a positive, balancing and motivating force. It lends one of the most-difficult-to-acquire qualities: perspective.

Meaning (like death) is a fundamental question at any age, and is valuable to work with because it goes straight to core material, to one's deepest fears and feelings. This issue, too, is enormously liberating once it's embraced.

HUMAN NATURE: FRAMES OF REFERENCE

The accumulation of a person's private logic forms a map, a representation of external reality. We all operate out of our mental charts, our frames of reference. In addition to "knots" in it (incorrect ideas), the mental map can suffer from deletions, distortions, and over-generalizations. (Grinder & Bandler, 1976, p.3)

As map-makers, counselors have their work cut out for them.

PART (3): HUMAN RELATIONS

HUMAN RELATIONS: BOUNDARIES

"Boundary issues [in families] have to do with who lives where, when, who is allowed to give input on what issues, who is present in certain locations (such as the parents' bedroom), and how time is spent" (Hudson & O'Hanlon, 1991, p. 133). Boundary issues between two individuals have to do with taboos enforced by fear. Typically fears of vulnerability, being alone, and being strong.

Some common boundary problems are:

fear of intimacy, or fear of asking for what one wants (rigidity),

codependence, or fear of saying no to what one doesn't want (permeability),

fear of autonomy, or of knowing what one wants (introjection),

rejecting elements of the self, self-hatred (retroflection),

seeing one's own rejected qualities in others (projection),

avoiding contact by diverting it (deflection).

HUMAN RELATIONS: MELODRAMAS

There are two kinds of relationships: cooperative and non-cooperative. Non-cooperative relationships are scripted by melodramas.

Melodramas have three main roles: victim, persecutor and rescuer. Generally the victim resents rescue (because it reveals helplessness) and turns into a persecutor against the rescuer, who feels surprised and betrayed by the change. The persecutor and the original victim often form an ad-hoc alliance to go after the rescuer. Demonstrating once again that (in the world of melodramas) no good deed goes unpunished.

Melodramas can be played as two-handed games by having one of the three roles implicit or by having players switch roles.

Systems theory would call a melodrama an example of the behavior of a system, a pattern. Melodramas may be thought of as maladaptive patterns, old habits of response to life, as defenses against fears.

One of the implications of melodramas is that therapists must watch out them, for becoming part of the client's system, and especially for that moment of feeling betrayed, the role-switch: from victim-client to persecutor-client.

Melodramas are even more likely with mandated clients. They don't want to be here, and they will attack at every opportunity, generally in subtle ways. It's up to the counselor not to give them opportunities. The surest way to give them opportunities for attack is to try to rescue them. As usual, the victims turn into persecutors. Rescuing will get counselors sued, because it makes the client angry. Assist only, rather than become a rescuer, even when people are in crisis.

There's a difference between rescuing and crisis intervention. (See the section later on crisis counseling.)

HUMAN RELATIONS: GAMES AND SYSTEMS

Since people maneuver for advantage and power in non-cooperative relationships, it helps to be familiar with the dynamics of what's going on, and what the moves in the games are. Eric Berne, in his book Games People Play (1964), gave names to many common melodramas.

One example is "Poor Me:" manipulating others with self-pity. Another is "Kick Me:" unconsciously provoking abuse. Another is "Now I've Got You, You Son Of A Bitch:" disengenuously soliciting an excuse to attack. Another is "Harried:" staying busy to avoid life. Another is "Yes, But...:" using reasonableness to justify failure or non-compliance. Berne's book has many more.

There's one problem with game theory. It's the harshest interpretation of behavior, and it might be wise to leave room for more forgiving possibilities. People might be in denial about money, for example, or they might be courageous. There's a fine line. It's hard to see someone's reality from within, and simultaneously impose game theory from without.

For another example, suppose a man and a woman fall in love. They reach a level of commitment and intimacy that scares the woman, and she withdraws emotionally. Game theory would say that she enjoys the pain that the rejection causes the man, that she wants to substitute arguing for closeness and is possibly hoping to provoke confrontation. Love theory (to coin a phrase) would say that she's been hurt in the past and is suffering from fear, that she needs communication, reassurance, love and time to heal. Fortunately, there's a sure way to find out which theory is true in this particular case: giving her those things, and see what happens.

Another way to look at this is with systems theory, a more modern development. Systems theory is very close to game theory, except that it makes everything cyclic. Where game theory would say that person A manipulated person B, systems theory would say A and B are part of a system, part of which is: A manipulating B, and part of which is: B eliciting manipulation from A. Any repetitive bahavior between two people is a behavior getting a response that causes more of that behavior. It might be thought of as a standing wave, a self-perpetuating pattern.

The wonderful part of this is that it removes blame from everyone. It's not A's fault for being manipulative any more than it's B's fault for being submissive. And the useful part of this is marvelous: to stop a system, it's sufficient to interrupt it anywhere. Of course the pattern is homeostatic and will attempt to reestablish itself, and so must be interrupted again till it fades out.

A man tells his wife he feels sad. She knows he starts doing this whenever he's going to want sex later in the day. She's angry about his indirectness, and you question him, and it turns out he's indirect because he's afraid of her anger. (Weeks & Treat, 1992, p. 52) It's no one's fault. It's an unfortunate and accidental interlocking of two tendencies. And for either of them to change would stop the pattern. He could stop being afraid of her anger, or she could stop being angry at his indirectness.

A man apologizes to a woman for letting her down. She finally softens, and things are good for awhile, and then he disappoints her again, and the cycle repeats. Both feel abused and rejected, feelings familiar to them from their childhoods. (Weeks &Treat, 1992, p.53) Game theory would try to get the man to stop letting the woman down. Systems theory might try to get the man to stop apologizing, or get her to stop buying his apologies, as an opening ploy.

There's a difference in flavor between game theory and systems theory. Game theory tends to be imposed from outside as a diagnosis, and it tends to point towards a single intervention, a problem-solving approach. Whereas systems theory is the art of discovering with the client what the toxic patterns are in their lives, and then disrupting them in various charming ways until there's room for spontaneous change to bring about a new way of living.

HUMAN RELATIONS: SCRIPTS

Claude Steiner's book Scripts People Live (1974) talks about games at the scale of a lifetime, the ways people structure their whole lives. People are said to know intuitively, within seconds of meeting each other, what each other's scripts and favorite games are. It's part of the process of exchanging pheromones.

Some common Victim Scripts:

(1) Plastic Woman, obsessed by appearances, afraid to love herself.

(2) Poor Little Me, helpless victim, afraid to take care of herself.

(3) Creeping Beauty, lonely and doesn't like herself, afraid to do meaningful things.

(4) Fat Person, overly self-protective, afraid to be angry or say no.

(5) Playboy, endlessly searching for appearances, afraid to be real, afraid of connection.

(6) Man In Front Of The Woman, promotes the sham, afraid to be equal.

Some common Rescuer Scripts:

(1) Woman Behind The Man, supports husband, afraid to use her own talents.

(2) Mother Hubbard, takes care of everyone but herself, afraid of life.

(3) Nurse, professional rescuer, afraid to ask for what she wants.

(4) Big Daddy, burdened by responsibility, afraid to enjoy.

Some common Persecutor Scripts:

(1) Guerrilla Witch, trouble-maker, afraid to like others.

(2) Tough Lady or Woman-Hater, lonely, afraid to trust or love.

(3) Queen Bee, successful in a man's world, afraid to cooperate.

(4) Jock, competitive, afraid to be smart.

(5) Intellectual, reason prevails, afraid to feel.

Scripts, like games, must be taken with a grain of salt. If they are used to label people, in a way that is extrinsic, unflexible, and estranging, their application will cause hurt feelings rather than provoking insight. And systems theory adds new dimension to script theory. They are life-long patterns, and they exist in relationship with other people and with life at large. To consider them in isolation will miss the point. People's lives exist within a zetgeist, a ghost of the time, and are creative responses to their unique circumstances.

My script, by the way, is The Ugly Duckling. One can blossom, even late in life.

HUMAN RELATIONS: FUNCTIONS OF SYMPTOMS

Symptoms are not essentially bad things. They serve unconscious purposes. They are efforts to achieve goals. They are behaviors that were once useful, and may be still. Like melodramas, they can be thought of as patterns or standing waves. The symptom causes a reaction that makes it useful to have the symptom.

"I always think of symptoms as being peoples' friends, not their problems, because I think of symptoms as communication channels. However, as with most communications between people, the purpose and the outcome is often forgotten. Symptoms, like people, don't always realize the difference between what they INTEND to communicate and what they DO communicate" (Bandler & Grinder, 1981, p. 143).

A woman was hypnotized so that the numbness in her feet became intermittant rather than continuous, and only happened when her symptom needed to communicate with her. "Now, her symptom became a teacher for her. When she left my office and went home, she was delighted. She cleaned the house and did things she hadn't done for a long time. When her husband came home, she told him the good news, and said, 'Why don't you take me out to dinner to celebrate?' He said, 'I'm too tired. Why don't you just cook me something?' She responded, 'Well, OK,' and the numbness began to creep up her legs. She said, 'No, I think we'd better go out' and the numbness went down.

"Her numbness became her best friend for quite some time. It became a teacher. When a symptom becomes a teacher for you, it becomes an ally, because there is nothing in the world that can't be made useful in some way" (Bandler & Grinder, 1981, p. 145).

Symptoms can have social functions. Relationships are either cooperative, or they're power struggles. Haley (1963, p. 125) points out that the most visceral level of power struggle is over who defines the relationship, who sets the rules. "...the crucial aspect of a symptom is the advantage it gives the client in gaining control of what is to happen in a relationship with someone else. A symptom may represent considerable distress to a client subjectively, but such distress is preferred by some people to living in an unpredictable world of social relationships over which they have little control" (Haley, 1963, p. 15).

A woman sought therapy because she was forced to ritually wash her hands many times a day. Her ritual washing would classically be seen as a defense against various types of ideas. However, in this case, her husband was brought into the therapy and an examination of their relationship revealed an intense and bitter struggle between the client and her husband over the compulsion. The husband insisted on being tyrannical in every detail of their lives. Although the wife objected to the husband's tyrannical ways, she was unable to oppose him on any issue-- except her handwashing. As a result of the handwashing, she could refuse to do almost anything he suggested. He was dethroned by the simple washing of a pair of hands. (Haley, 1963, pp. 13-14)

It can sometimes be more effective to treat marriages and families than to treat individuals. Often the client will describe how the presented symptom serves a role or a purpose in their family or with significant others. (Talmon, 1990, p. 40) On the other hand, having access to even one person means the counselor has ways to interrupt the partner patterns and family patterns the client's involved in. Any change in the client will introduce change into the couple or family.

Counselors would be wise to expect that at some point the client might struggle with them over who makes the rules. The counselor and client become a system that will show it's own behaviors. And though the two people are equal in intrinsic value, it's up to the counselor to make sure that two-person organism remains healthy.

HUMAN RELATIONS: THE TIGHTEST KNOT: SCHIZOPHRENIA

Current thought is that schizophrenia is primarily a disease of the brain. One quarter of the cause is thought to be spontaneous mutations in sperm. A man in his fifties has twice the risk of having a schizophrenic child that a man in his late 20's does, since the sperm cell precursors divide 23 times a year. (As compared to a woman, whose egg precursor cells divide a lifetime total of 24 times, and 23 of these occur before she is born.) (Glausiusz, 2001) Another third of the cause is thought to be a dormant retrovirus that was incorporated into our genome millions of years ago. It's found to be active in 29% of those who've recently developed symptoms and in 7% of chronic cases. The retrovirus seems to be triggered by another virus, one in the herpes family. One of the genes on the retrovirus is used to make a hormone that makes the cells of a developing placenta knit together. This suggests that one origin of schizophrenia may lie in a herpes infection during fetal development. (Glausiusz, 2001)

The information generated by our eyes passes to the rear of the brain, where it's processed by more than 30 different areas, each area specializing in an aspect of vision. Then the processed data streams forward into the temporal lobes, where an area of the brain recognizes the objects being seen. The data then goes to an area (still in the temporal lobe) that adds emotional significance to the objects, and then it goes to the forebrain for decisions and action. (Ramachandra, 2001)

Schizophrenia in general seems to be a disturbance of the area that recognizes objects, primarily. Subtypes of schizophrenia depend on what parts of the brain are disturbed in addition. Paranoid schizophrenia also involves the part of the brain that makes sense out of hearing, as it's marked by auditory hallucinations. The disorganized type of schizophrenia (marked by silliness and laughter) seems to be right sided (as the right temporal lobe processes happiness). Left sided schizophrenia seems to be schizoaffective disorder, depressed type, as the left temporal lobe processes sadness. The catatonic type seems to have spread to the parietal lobe (which builds a picture of the 3-D environment around us, and controls voluntary movement).

People with temporal lobe epilepsy report the same feelings of unreality that schizophrenics do. Some insist everything they see has been replaced by an imitation of itself. Some (though not all) have intense religious experiences, insist that they're God, and become very sensitive to the sufferings of others (though not to their own). Everything to them has cosmic significance. Some people with temporal lobe epilepsy emphatically refuse a cure. (Ramachandra, 2001)

Renee, in Autobiography of a Schizophrenic Girl, describes her episodes, which began when she was 5. A disturbing feeling of unreality comes over her, and familiar objects seem unfamiliar. Panic fills her. The vastness of space seems without limit, light is brilliant, and physical objects seem smooth and glossy. Familiar people can't be recognized. When people approach, they seem to swell in size. They seem to act without cause or objective, like puppets or robots. Some extraordinary catastrophe seems about to happen.

These states alternated for Renee with states of exaltation, when listening to the wind was her greatest joy. Since schizophrenia is akin to a mystical experience or a spiritual crisis, this period of non-ordinary reality can have positive aspects. A "recovered schizophrenic" man once said:

"Psychiatrists can't get beyond the medical model that says if some part of the human being is not performing as usual, as expected, it must be sick! God forbid that they should think something wondrous is happening, and that's why the person is behaving in this exotic way! Look, most doctors even think of childbirth as a pathological condition that results in a medical emergency!

"What I'm saying, Bob, is that what you call psychosis really means 'too many windows open.' Our fear of our own greater being is so overwhelming that we prefer 'lobotomy'-- that includes Prozac and all the rest-- to the risk of being all we could be. Stanislav Grof--you know, the last of the LSD researchers-- says that the only real distinguishing feature between episodes of enlightenment and episodes of psychosis is that the psychotic places the power and the fault outside himself, while the former accepts ultimate responsibility for his condition and for the resolution of it. I'd go even further. I'd say that all the stuff we call nervous breakdowns, depressions, mid-life crises, psychotic states, and probably most of what we think of as physical illness, all of that stuff is what happens when the organism, in its struggle to block the Shakti, is either destroyed by itself or surrenders and is healed. The thing we've all got to remember is that in other societies when a person goes through one of these upheavals, he is considered to be in touch with extraordinary forces and realms of the mind. Not here, not now. Here, if you start shaking and quaking, they want to give you a pill to shut everything down, to close all the windows" (Akeret, 1995, pp. 140-141)!

The schizophrenic person seems to be awake and asleep at the same time, "dreaming" the voices and hallucinations, even while they're wide awake. This would suggest that part of the treatment of schizophrenia might involve getting the unconscious to go back to sleep.

PART (4): PROCESS

PROCESS: HUMILITY AND WILLINGNESS

Strupp (1980a, 1980b, 1980c) found that patient variables are more powerful in determining outcome than therapists' attitudes and technical skills. Humility, therefore, might be an appropriate part of every counselor's bag of tools.

The primary necessary quality for a counselor is humility. A definition of humility that I like comes from India: not bending your head to anyone else, nor allowing them to bend their head to you. If you have a fundamental belief that all people are of equal value, then you're qualified to be a counselor.

If you're religious, you believe that all souls are sparks from the fire of God, and that all souls are of equal value. If you're not, science can be used to justify the idea that all are of equal value.

The opposite of humility is sadism. To enjoy having power over others is one step away from enjoying the pain of others. Unfortunately, many people without humility become counselors. They're atttracted by having power over other people, and by pain. Carried to its extreme, we have the sadistic counselor. They don't need to work to become detached. They already are. Sadistic counselors are wolves in sheep's clothing, and the public is their prey.

Less extreme, we have counselors who try to impose their agendas on their clients. My brother in law, for example, had to go through five counselors before he found one who would assist him in getting done what he wanted to get done, rather than dictate to him the changes they thought he ought to make.

The value of being humble for a counselor is that it's your clients who teach you. Clients are the perfect teachers. They come in and sit down and teach you, about what they know, about God, about life. We should be paying them.

The primary patient variable, and the central and greatest mystery of counseling, is willingness. "The philosopher Guerdjieff pointed out that if we wish to escape from prison, the first thing we must acknowledge is that we are in prison. Without that acknowledgment, no escape is possible" (Ram Dass, 1985, p. 139).

Some people are willing and even eager to change. They seek growth as though it were food and they were hungry. Other people are unwilling even to begin, though it's obvious to those around them that they're their own worst enemy. They don't want to look at their own minds, their own feelings and pain. They're like the monkeys in a famous experiment who were shocked when they reached for food: they've been so traumatized that they won't reach out for nourishment, for what they need.

No one can be forced into willingness, or tricked or persuaded or advised. It arises or it doesn't. It's there or it isn't. The closest one might get to evoking it is appealing to enlightened self-interest, perhaps by encouraging the client to imagine what a good future would be like. People, when they do change, go from unwilling to willing in a moment, without forethought. The Buddhists refer to a change like this as a "turning about in the deepest seat of consciousness." "Though we seem to be sleeping, there is an inner wakefulness that directs the dream and that will eventually startle us back to the truth of who we are" (Maulana Rumi).

Willingness seems to have some relationship with bottoming out. Sometimes people have to hit bottom and bounce off before willingness arises. When there are no other choices left, sometimes willingness appears. But even this isn't predictable or controllable. Willingness, at this point in time, remains a mystery.

"In 1927, a 32 year old man stood on the edge of the lake in Chicago's Lincoln Park, planning to drop into the dark water and drown. His daughter had died, his company had gone bankrupt, his reputation had been ruined, and he was becoming an alcoholic. Looking into the lake, he asked himself what one small man in his position could possibly do. Then an answer came to him: since he had lost everything, he was now free to take risks, to initiate action on his own, and by doing so to help other people. He returned home and committed himself to the work that he believed the universe wanted him to do. He watched the laws of the natural world, and altered his own living patterns accordingly, eventually changing his life completely. Those laws were to inspire and support him in his greatest achievements. But without his taking a chance, his contributions to humanity would never have been made, and no one would have come to respect the name of Buckminster Fuller" (Hoff, 1982, p. 121).

PROCESS: RAPPORT

"I happened to have been on a mountaintop in a state of great bliss when a stranger suddenly appeared next to me, sat down, and immediately started to describe this problem he was going through. By the time I'd pulled myself out of the Higher Realms, he'd already detailed the whole drama, the cast of characters, and the decisions he was facing. I hadn't gotten a bit of it. Nothing. Nobody. Moreover, it was much too late to ask him to run it all down once more. He would have felt very uncomfortable, justifiably.

"So there I was, intimate confidant to a deep problem, without the slightest idea of who was who, and who had done what to whom. My first reaction was to laugh hysterically. It was one of those great Human Condition moments. But this guy was obviously in distress and looking for a kindly pair of ears, so I picked up as best I could. "To my continued amazement, none of the detail became any clearer as we walked down the mountain. I kept hoping I'd find out who 'she' really was, and what 'he' had actually done. No such luck. And I wasn't about to ask a question that would reveal my total ignorance, make him feel terrible, or lead me to hysterical laughter. "So we just quietly walked on down. And from time to time I would punctuate the conversation with what seemed like appropriate remarks: 'That must have been hard.' 'What did you feel then?' 'Oh, yes, I've been through that one before.' 'Boy, things sure do get confused in life.' Great insights like that. And he would nod appreciatively, continue, and I'd contain my sense of this wonderful human absurdity.

Meanwhile, I was growing increasingly fond of this guy.

And feeling great empathy for his problem-- whatever it was.

"When we reached the bottom of the hill, he stopped for a moment and then suddenly embraced me. 'I just want you to know how incredibly helpful you've been,' he said. 'You're one of the most understanding, compassionate people I've ever met. Do you think we could have another conversation like this again?' I was dumbfounded. It was one of the great moments of my life. 'Sure,' I said, 'I'd love to.' And he walked off to join some other people-- a number of whom kept coming to me during the day saying, 'What did you tell Eddie. He's just so grateful to you. He says you're wonderful'" (Ram Dass, 1985, pp. 128-129).

PROCESS: ACCEPTANCE

A disputatious married couple went to see their esteemed rabbi for advice. The wife, who was the first to consult the rabbi, told a long tale of woe about her insensitive, selfish and uncouth husband who was entirely to blame for their marital problems. The rabbi sagely and patiently listened to the woman's long harangue and then said, "You know, I think you're right." Feeling vindicated, the wife left.

The husband, who next consulted with the rabbi, excoriated his wife by referring to her as an inconsiderate, unkempt and half-witted shrew who was entirely at fault for their marital difficulties. The rabbi once again listened with forbearance and then replied, "You know, you're right." The husband then left the rabbi's study feeling quite satisfied. The rabbi's assistant came to him and said, "Rabbi, how could they both be right?" The rabbi looked at him and said, "You know, you're right."

"One of the greatest paradoxes in therapy is that people don't change unless they feel accepted as they are" (Gottman, 1994, p. 184).

Therapy is a relationship designed to invite change, and a prerequisite for change is accepting clients as they are, in order for them to feel safe. Unconditional, non-judgmental acceptance is a must, a "necessary but not sufficient condition." There's a saying in India that "if you really love someone, their faults appear to be virtues." Until someone's faults appear to be virtues, the counselor's not in rapport, and not ready to intervene. (And once someone's faults appear to be virtues, intervention in the ordinary sense is no longer necessary. Isn't systems theory fun?)

If you really see things from the client's point of view, you see why they're behaving the way they are. In fact, the only way the therapist CAN understand clients is by looking from within their viewpoints. There's no absolute frame to judge anyone by. All human behavior makes sense only if seen from within the individual human's frame of reference. Genuineness is fundamental to acceptance. You can dislike someone and still genuinely accept them. "The human mind needs truth just as human lungs need air" (Farrelly, 1974, p. 63). Acceptance can't be faked. Inequality can be sensed unconsciously. People are aware of even very subtle criticism.

Milton Erickson said, "People come for help, but they also come to be substantiated in their attitudes, and they come to have face saved. I pay attention to this, and I'm likely to speak in a fashion that makes them think I am on their side" (Haley, 1973, p. 206). Whatever the client offers is accepted, in order to create rapport, to form the therapeutic alliance. (Haley, 1973, p. 125) Once the counselor understands the client from within the client's frame of reference, the places where change is needed become obvious to both the counselor and the client, and the client effects the changes.

"I had a friend, a chemotherapy nurse in a children's cancer ward, whose job it is to pry for any available vein in an often emaciated arm to give infusions of chemicals that sometimes last as long as twelve hours and which are often quite discomforting to the child. He is probably the greatest pain giver the children meet in their stay in the hospital.

"Because he has worked so much with his own pain, his heart is very open. He works with his responsibilities in the hospital as a 'laying on of hands with love and acceptance.' There is little in him that causes him to withdraw, that reinforces the painfulness of the experience for the children. He is a warm, open space which encourages them to trust whatever they feel.

"And it is he whom the children most often ask for at the time they are dying. Although he is the main pain-giver, he is also the main love-giver" (Ram Dass, 1985, pp. 86-87).

PROCESS: PAYING ATTENTION AND EMPATHY

Paying attention is the fundamental technique for counseling: active listening with empathy, genuineness, humor, feedback and challenge. Paying attention to another person is, of itself, healing. It's natural that this should be true, since attention is the outward expression of the soul.

Dr. Russ Miars tells a story about asking a client, after a course of counseling, what he did that was helpful, and the client said, "You listened." There's great power in "just listening."

Part of paying attention is to body-language, including the recognition reflex. Body language can be addressed directly. "What's your tapping foot saying?" Or indirectly. "Is there a part of you that feels impatient?" (See Appendix 4 on body language.)

Another part is using empathy. The formula for empathy is, "You feel ______ because/when ___________." This formula has amazing power, and sounds remarkably unlike a formula when you're using it. The marvelous thing about it is that it's OK to be wrong. If you make a mistake, the client will correct you and go on, feeling happy that you're trying to understand.

Listening and responding with empathy are enough at first, and then as the client's story emerges, the counselor begins asking questions to clarify. In the beginning of a therapeutic relationship, the counselor needs to "buy" the right to ask a question (so to speak) with some statements of empathy. Later in the relationship empathy becomes assumed and implicit, and the counselor can ask strings of questions.

Whenever you ask a question, it's a good idea to make a statement of empathy after the response. That way the person you're talking to feels heard.

Questions can be used to clarify, and they can be used to challenge. And they can be used to look for pockets of emotion. As a guiding principle for counselors, it's hard to find a better one than this. Where there are unresolved areas in the client's psyche, there will be feelings. It's talking about those loaded topics that will give the client a feeling of release.

PROCESS: COUNSELOR'S AGENDA

It's vital that counselors keep their own agendas out of therapy. It's hard to overstate the importance of this, but I'll try. Akeret (1995), in the chapter titled "Charles: The Soul of Love," shows what happens when therapists allow an agenda to intrude. Charles fell in love with a polar bear, and intended to go into the cage to make love with the bear. Akeret was afraid for his client's life, and managed to scare him out of his determination. But in the process he managed also to scare Charles out of having any animation, enthusiasm or purpose in life. There had to be a better way, a way that worked within Charles' frame of reference. Akeret wasn't acting as Charles' ally. He rescued Charles, protected him without leaving him free.

When Erickson was a young man, a horse wandered into his family's yard. Although the horse had no identifying marks, Erickson volunteered to return the horse to its owners. He got on the horse, guided it onto the road, and gave it its head. He intervened only when the horse stopped to graze or wandered off the road. When the horse arrived at the yard of a neighbor several miles down the road, the neighbor asked, "How did you know the horse came from here and was our horse?"

Erickson said, "I didn't know-- but the horse knew. All I did was keep him on the road." (Rosen, 1982, pp. 46-47)

PROCESS: DEALING WITH "RESISTANCE" AND DEFENSIVENESS

"Resistance" can be thought of as a message from the client that the counselor has an agenda, is being bossy, is subtly criticizing the client or is arguing a particular point of view. In Ericksonian therapy, clients aren't thought of as being resistant. Erickson wrote, "If they bring in resistance, be grateful for that resistance. Heap it up in whatever fashion they want you to-- really pile it up.... Whatever the patient brings to you in the office, you really ought to use" (Erickson and Rossi, 1981, p. 16).

There's a fine line between resistance and defensiveness. An effective way to deal with "defensiveness" is with aikido, the way Erickson does. In aikido, one deals with attack by accepting and accentuating it. In counseling, one applauds and "takes over" the defense.

PROCESS: DETACHMENT AND COUNSELOR BIAS

My small experience with being a counselor is that during sessions I switch to another gear than the one I normally operate in. I set aside personal feelings and considerations temporarily in order to be detached and to focus on the client. An important part of this is giving empathy without sympathy.

"The ability to avoid being entrapped by one another's mind is one of the great gifts that we can offer each other. With this compassionate and spacious awareness, and the listening it makes possible, we can offer those we are with a standing invitation to come out from wherever they are caught, if they are ready and wish to do so. It is as if we are in the room of experience with them, but also standing in the doorway, offering our hand, ready to walk out together" (Ram Dass, 1985, pp. 114-115).

An important part of detachment is setting aside (as much as possible) therapist bias. "We are only as good as our genuine involvement with the patient's welfare and our freedom from bias" (Weinberg, 1984, p. 181).

"Every conceivable human bias may appear as a form of countertransference, threatening to distort the therapist's perception of his patient" (Weinberg, 1984, p. 164). No counselor is completely objective. A bias towards seeing the client as helpless and needy is especially likely to go unnoticed. (Weinberg, 1984, p. 163) Also common are rivalry with the client and jealousy of the client. "We've worked hard, grown up poor, and we still have to get up early in the mornings to make enough for our mortgages. And here comes this smug, narcissistic little rich man's son, seducing women at will, breaking promises, taking no one seriously, and buying our time so that he can discuss the merits of summer resorts we'll never be able to afford." (Weinberg, 1984, p. 164)

Other countertransferance reactions are fear of intimacy, or falling in love with the client, or reluctance to see people as exploiters, or being naive, or too polite, or wanting the client to be a friend, or the urge to offer advice, or reluctance to confront a client, or dread of disappointing the client. (Weinberg, 1984, pp. 163-169) The cure for countertransference is to do what we ask the client to do: work on ourselves.

PROCESS: SAFETY AND BEGINNING

The first priority in a counseling session is to make the counseling situation safe for the client, by using empathy and by asking them what they need in order to feel safe. Sometimes asking is all that's needed for their problems and feelings to come pouring out.

If it isn't, Reality Therapy provides a framework to get a problem-solving-process started.

(1) What do you want and need? How do you perceive your situation?

(2) What's your behavior? What are you doing? What's your direction?

(3) What's your evaluation of all this?

(4) What's your plan? What are you going to do?

(Wubbolding, 1999, pp. 302-307)

Egan (1998) provides a more detailed version of the problem-solving model, and a study of Milton Erickson's work provides more information, since Egan's model (and brief therapy itself) derive from the study of Erickson's work.

PROCESS: FOCUS

After forming an alliance, The counselor's next function is to facilitate finding a focus. It is rarely a deep-seated secret, so counselors shouldn't overlook the obvious. Clients sometimes provide the focus in their own words, so the counselor can listen for it. Sometimes, however, clients are in so much pain, confusion and conflict that they are unable to sort it out, and need assistance. There's an art to facilitating focus. Questions that bring the client back around can help. Visual aids, diagrams, can help.

I like Brief Solution-Focused Therapy's strength perspective and solution-focused perspective. This involves getting to know the client, deconstructing the client's stories, finding a focus, and reframing the problem in order to spark action. The function of reframing the client's difficulty is to be a pivot for change. A good focus can provide leverage for a whole chain of changes. (Talmon, 1990, pp. 38, 41)

PROCESS: DIRECTIVE VS. NON-DIRECTIVE

Schools of therapy and various therapeutic tools can be arranged on a spectrum, running from non-directive to directive. Rogerian Therapy would be near the non-directive end, whereas Reality Therapy would be near the directive end. Each client needs a different place on the scale, and finding that balance is one of the arts of therapy.

Those clients with an inner locus of control are more likely to benefit from non-directive therapy, and those with an external locus of control are more likely to benefit from directive. (Dykeman & Appleton, 1998, p. 108) Some clients need a counselor to facilitate focus.

It's easy to go too far with directive counseling. Counselors can get caught up in trying to get their clients out of pain. Too great a concern with saving someone from their immediate pain can turn into rescuing. The job of a counselor isn't to get people out of pain, it's to teach them how to get out of pain. Clients are to be empowered, and sometimes that can mean leaving people in pain for awhile. For one thing, pain can provide motivation. For another, freedom is more important in the long run than pain. People will leave wealth and comfort to get free. The fundamental job of a counselor is to make the client more free.

PROCESS: THERAPIST AND CLIENT ATTITUDES

Talmon (1990) has some good general advice:

"On the whole, I realized that I had taken my interventions and my words much too seriously. Clients reported following suggestions that I could not remember having made. They created their own interpretations, which were sometimes quite different from what I recollected, and sometimes more creative and suitable versions of my suggestions" (p. 60).

"Most of the successful SSTs [Single Session Therapy sessions] we have studied do not resemble the demonstrations of master therapists in conferences or books.... In most of the SST cases where clients reported particularly successful outcomes, the therapist appeared to have conducted a rather simple, almost dull session. In fact, in many successful SSTs, it is the client who appears in control and sets the pace for change" (pp. 110-111).

"Recent research indicates that many times the troublemakers, those who challenge the doctors, question every decision, and burst out of the hospital in anger, are more likely to survive difficult illnesses such as cancer than are the compliant and passive clients who follow doctors' instructions faithfully" (p. 125).

What does a therapist do when pathology prevails and the prognosis is poor? Remember that a considerable number of clients are capable of recovering "against all odds," in ways that are very difficult to explain using logical thinking within traditional theories. Therapists should allow as much room as possible for spontaneous recovery and for self-correcting and random solutions to take their course. (pp. 63-65,69)

An example of this appears in Critical Incidents in Psychotherapy (1959, pp. 1-4):

Tom's mother was fourteen when he was born. By the age of 25 he'd spent thirteen years in correctional institutions. Tom was referred to a prison psychiatrist as hopelessly incorrigible. He was put in a therapy group, but was kicked out for verbally attacking everyone else in the group. At that point, Tom looked the therapist in the eye and said, "If you give me up, then there is no hope." So the therapist continued by doing individual sessions with Tom. After ten weeks they gave that up as a failure.

Then one day Tom was walking across the big yard when something came over him like a cloud. "I couldn't move. Suddenly I felt peaceful and happy. I felt clean, pure, good and wonderful. I never experienced such a feeling of happiness." Tom went back into therapy. When he got out of prison, he got a job and got married. Six years after release, he was the father of a child, owned a car, and was buying a house.

PART (5): TYPES OF TREATMENT

When a diamond-cutter has a raw diamond, her first challenge is to cleave it into useful chunks. She taps it here and there, she turns it in her hand, she feels it, until she finds the right spot. And then she places her cleaver and strikes a blow with her hammer. If she's chosen wrongly, the diamond crumbles into worthless junk. If she's chosen rightly, the diamond falls apart into useful and valuable raw gemstones.

George Weinberg (1978, 1993 pp. 87-89) has found one such place to tap the concept of therapy and split it into meaningful portions.

He points out that attitudes and beliefs fade out unless they're continually maintained by behaviors. This observation is profound, and simple as a safety pin.

The other side of the coin has been known for a long time: that behaviors come from attitudes and beliefs. So here again we have the standing wave of systems theory. Beliefs cause behaviors which stengthen the beliefs, which cause more behavior to strengthen those beliefs....

This principle of reciprocal cause has a number of implications that are relevant for counseling: (1) Whenever an action is performed, the motivation behind it is strengthened. Act on fear, and the fear increases. Act on trust, and the trust increases.

(2) If an action is refrained from, the motivation behind it decreases. Refrain from acting on anger, and the anger subsides to some degree. Refrain from acting on love, and love dwindles.

(Just from these two principles one can see that taking action can be used deliberately to create desired attitudes.)

(3) On the other hand, there's a fine line between refraining and repressing. The difference might be thought of as whether one is restraining oneself willingly or unwillingly. If a motivation is repressed (refrained from against one's will), the impulse becomes stronger, because punishment suppresses a behavior without weakening the motive. Here's a story about punishment:

A man named Don lived south of Denver. He was a farmer type, the salt of the earth, and generally soft-spoken. Don's daughter married a man named Jerry who beat her. The first time Don saw a mark on his daughter, he didn't ask Jerry whether he'd made it or not, he went and got some of his buddies, and they kidnapped Jerry and took him up into the mountains and chained him to a tree with padlocks and tire-chains.

The next day they came back and unchained him and took him to a restaurant, where they bought him dinner and a couple beers. All Don ever said to Jerry was, "Isn't having dinner and a few beers better than being chained to a tree?"

The second time they did it, Jerry got mad and went to the police and tried to lodge a complaint against Don. The police called Don in, and after they'd heard the whole story, they pointed out to Jerry that there was no proof he'd been kidnapped, and anyway they didn't see a problem here.

The third time they did it, Jerry got the point, and he never beat his wife again.

Punishment did succeed in changing Jerry's behavior, but this doesn't mean that the causes of his violent urges had diminished. In fact, it means they increased. One implication of this prinicple is that prisons create criminals. They increase the motivation to commit crime.

(4) Another implication of repression (if it's repressed fear) is that it leads to obsession and compulsion. Compulsives act out motives indirectly, symbolically, placating a fear they can't face. As soon as one is performing actions to decrease anxiety, one is headed down the road to obsession and addiction.

This avoidance of fear acts like punishment: the behavior has been changed or the fear avoided, but the motive has been strengthened. Every time compulsives buy off the fear, the compulsion grows. Compulsives are fleeing in a tightening circle from a dread they can't confront. (Weinberg, 1993)

(5) Phobics are also dealing with repressed fear. In their case, the way they behave when they encounter the feared situation (fleeing), strengthens the fear. And then going a step further and avoiding situations that are likely to cause the fear, is also acting on the motive, and so also increases the fear. But there is hope in this impasse: if the feared action can be faced (gradually and with support), and especially if it can be performed without thinking the underlying thought and feeling the associated feeling, then the phobia decreases.

(6) The broadest implication of the principle that beliefs and behaviors cause each other is that it provides two grand approaches to facilitating change. Both approaches might be thought of as interrupting the pattern. Attitudes and beliefs can be changed by first figuring out what behaviors maintain them, and then deliberately altering those behaviors. Working with behaviors to bring about change might be called "Behavior Therapy."

Conversely, behaviors can be changed by finding out what attitudes and beliefs are maintaining those behaviors, and deliberately altering those thoughts. Working with beliefs to produce change might be called "Belief Therapy."

Of course, doing either of these things stirs up a backlash, as the system tries to maintain homeostasis, which must be dealt with as part of the growth process. It's not easy outgrowing a comfort-zone or an old habit. It takes willingness, courage and persistence.

Among the schools included in the broad appoach of Belief Therapy might be insight therapy, problem-solving (brief) therapy and instruction. Insight therapy is the art of facilitating insights. Problem-solving counseling hooks up a new response to an old trigger, or a new solution to an old problem. This approach arose from the work of Milton Erickson. Instruction is the art of therapeutic teaching.

Included in the broad avenue of Behavior Therapy might be homework therapy and coyote-trickster therapy. Homework therapy, the art of giving directives, also arose from the work of Milton Erickson.

Coyote-trickster therapy goes beyond ordinary counseling into using mockery, trickery and outright deceit to bring about change. Or to put it another way: using tools like mirroring, reframing and binding. It arises from an ancient, world-wide tradition of teachers who use crazy wisdom to pass on to future generations some of what they've learned about living lightly. Frank Farrelly's Provocative Therapy and Don Juan's sorcery are two examples of coyote counseling.

Here's an example of a coyote intervention: a young woman came to Erickson because she was alarmed about her possessive parents. What was most upsetting to her was that they'd built rooms onto their house so that when she married she could live there. Erickson saw the parents together, and they had a series of pleasant talks. He congratulated them on being willing to put up with toddlers, with the way toddlers get into everything, and the way that everything breakable has to be put away. He praised them for their solicitude, for being available as baby-sitters. He asked if they'd soundproofed the walls so the babies crying in the night wouldn't bother them?

No, as a matter of fact, they hadn't thought of that.

The parents decided they really didn't want their daughter living with them. They decided to rent the rooms to a quiet person and bank the money for their grandchildren's' future education.

Erickson commented, "Is it essential to feel guilt? I don't believe in salvation only through pain and suffering." (Haley, 1973, pp. 280-282) He interrupted the pattern in a way that saved face for everyone.

PROCESS: TREATMENT SELECTION

Insight, problem-solving and homework therapies are natural allies. One approach is to use insight and problem-solving therapy during the session, and assign directives as homework.

Insight therapy alone is useful for: grieving, anxiety, depression, low self-esteem, mild compulsions, stress, relationship problems, growth and character change. It's unlikely to help involuntary clients, or violent, severely compulsive people or those with psychosis.

Problem-solving therapy can be applied to almost anything, since almost anything can be regarded as a problem. One of the few things that's difficult to regard as a problem is growth. Homework therapy is more likely to benefit clients with a natural robustness and urge to act, and those with behavior problems and physical symptoms.

Erickson used a mixture of these therapies and hypnosis for athletic performance problems, habits, compulsions, physical problems and pain, sexual problems, sleeping difficulties, anxiety, depression, phobias, speech problems, academic problems, memory problems, marital and family problems, violent behavior, delusions, hallucinations, and schizophrenia. Although even he had trouble getting more than slow progress with schizophrenic clients. (O'Hanlon, 1990)

Coyote therapy is the treatment of choice for negative people, people who are unwilling to change, as well as chronic schizophrenics and involuntary clients. Reality therapy also works well with institutionalized clients. (Wubbolding, 1999, p. 307)

Long-term therapy is appropriate for abusers and for chronic schizophrenics. Brief therapy is appropriate for everything up to and including the first episode of psychosis. (Haley, 1993, p. 113)

PART (6): DIAGNOSIS

DIAGNOSIS: CLINICAL

There are two kinds of diagnosis: "clinical" and "working."

Clinical diagnosis, as delineated in the DSM4, is a double-edged sword. The positive edge is its usefulness. It supplies a framework for thinking about mental illness and a language for talking to other clinicians. It supplies clues for further investigation. If a client has some of the symptoms of depression, for example, it's proper to check whether the client has more of them.

It's essential to be able to evaluate depression, anxiety, psychosis, somatoform disorders, eating, sleep and personality disorders, and ADD, and to be able to do a suicide assessment. (And it's a good idea to have an explicit form in the records. See the Appendix for evaluation forms.)

The negative edge of clinical diagnosis is that it can seduce the counselor into thinking that categorizing clients and understanding them are the same thing. "A situation defined is a situation confined" (Ram Dass, 1985, p. 122). "To apply such discriminative models to people can be functional; to limit people to these, does violence to their beings. Indeed, to view the world only in terms of concepts strips it of its mysterious beauty, its power to refresh" (Ram Dass, 1985, p. 130).

"I was indulging in what Erik Erikson (1964) has aptly termed 'diagnostic name-calling.' I had known for some time that when I or any other mental health professional stereotypes patients by assigning diagnostic labels to them, we are often using these labels to discharge latent resentment toward them. For example, I have yet to hear a therapist talk positively about a patient who is labelled 'sociopathic,' 'ambulatory schizophrenic,' 'borderline,' or 'impulse disorder.' As Fine (1982) suggests, when these diagnostic labels are used, they are almost always a sign that negative countertransference is at work in the clinician" (Strean, 1993, p. 105).

Unfortunately for the scientist in all of us, there's often not a direct connection between clinical diagnosis and effective treatment.

One of my favorite stories about the difference between categorizing a client and working from within their view of the world is one I heard about Milton Erickson. When he'd visit an asylum in his travels, the staff would try their most difficult cases on him. In one institution they wanted him to address his talents to a man who'd been there for years with the "delusion" that he was a CIA agent.

Erickson slipped into the client's room in a furtive manner and said to him, "OK, listen up, I don't have long. I'm an agent of the CIA, and I'm here to give you your next mission. Your assignment is to do whatever it takes to get out of here, and you're to go out in the world and assume a normal lifestyle. Then you're to wait till someone contacts you with your next mission. You're going to be under deep cover, so it may be a long time. Being under deep cover is a difficult mission. Can you do it?"