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SWBTR


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 catalog the fish in the sea. He took a net of two-inch mesh and cast it into the sea repeatedly. After carefully cataloging 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?"

The client said he could. Erickson slipped out of the room. And the client got out of the hospital and assumed a normal-appearing lifestyle.

DIAGNOSIS: WORKING

Working diagnosis is a horse of another color. It begins with a counselor's first contact with the client and goes on sometimes for years after the last session. The counselor develops an understanding of the client's world, and it's out of that understanding (as well as the client's understanding) that changes grow. The clinical diagnosis is objective, and sometimes alienating if it's done impersonally, whereas the working diagnosis is a journey of empathic discovery. "It is because we go on making discoveries throughout the course of therapy that diagnosis must be progressive" (Weinberg, 1984, p. 82).

Part of working diagnosis is to ask clarifying questions, while looking for trends in the client's life.

People might believe that there's no point in trying new things because they're bound to fail. They might not believe it's safe to ask for what they want, or to say no to requests from others. A man might tell stories of bad breaks and disasters, and his counselor might wonder why he never anticipates these outcomes. A man is dismayed that people constantly take advantage of him, but doesn't see that he drifts toward people whom he has reason to be suspicious of. A man whose life is in a shambles doesn't see that the only constant is that he's constantly talking about a golden opportunity just over the horizon. A person who's always anxious never has two worries, and never has none.

Lives are always changing, but fixated beliefs remain remarkably constant. "It is remarkable how slow even very bright people can be at seeing trends in their lives" (Weinberg, 1984, p. 85). A counselor searches to describe what doesn't change amid the tumult.

Counselors also observe these trends first hand. What clients have done in the past with others, they also do in the present with their counselors (a phenomenon called parallel process). Variations in personal style say a great deal about peoples' traits. One of the first ways a client's style impacts a counselor is through the way the counselor feels in the client's presence. (Weinberg, 1984, pp. 87-91) "Through the instrument of our feelings, even in the first session, we sense how the patient feels, how he may get in trouble with others, and how he might make other people feel" (Weinberg, 1984, p. 284). This first impression is partially mediated through pheromones.

Another way to find trends is to watch for "movies," both in the client's story and in current behavior. When a "button is pushed," a person will go into a state of heightened emotion, with a particular set of compulsive attitudes and thoughts. Other ways to say this are that people get upset, freak out, contract or go into reactivity when they feel threatened with humiliation, loss, invasive criticism, abuse or attack.

The sympathetic system activates, adrenalin pours into the bloodstream, and people go into emergency mode. Men go into "fight or flight" mode, and women go into "tend and befriend" mode. In an emergency men get ready to struggle or flee, whereas women check to see the children are OK, and then look to give and receive emotional support.

The first stage of this human urge to contract is black-and-white thinking, defensiveness and the inability to remember when things were good.

The second stage is light armoring: suspiciousness and hostility.

The third stage is heavy armoring: unrevealing withdrawal, wooden silence, delayed responses to questions, and feeling abandoned and unconnected. (Vinson, 1999)

It's as though a little movie rolls, and while it's rolling the person's reality is altered. At the heart of these mini-dramas lie pathologic beliefs, errors in private logic. So when counselors sees a client go into a "movie," they welcome the opportunity to flush another weasel out of the brush.

Counselors develop a set of questions to ask themselves about clients, reflecting a concept of health. What are their values? What are their ethics? What are their ruling passions? Are they in touch with their feelings? Do they express their feelings? Are they givers or takers? Do they treat personal relationships as business? Do they control others? Do they betray others? How well do they function at work? Do they keep friends for a long time? What do they value about them? Are they engaged in long-standing love relationships? Do they have the ability to accept and to give love? Are they capable of commitment? Are they living in denial about aging? About death? Do they have a spiritual belief? If I were going to take a three-day trip with this person, how would I feel? What would it be like to be married to this person? Is this person overly concerned with the comfort of others? Is this person overly forgiving? Do they agonize over mistakes? Can they enjoy pleasure? Do they have humor, kindness, rage, love? What makes them angry? Do they blame themselves? Do they blame others? How do they cope with frustration? Are they perfectionists? Are they selfish? What are their personal gifts and strengths? Can they accept appreciation? Who are their heroes? (Weinberg, 1984, pp. 94-96, 266-268)

Peoples' greatest strengths are often integrally tied to their worst failings. The loyal person is likely to stay too long in relationships. The generous person is likely to give too much. By exploring clients' strengths, the counselor can be laying the groundwork for seeing where clients do themselves some disservice. A good way to approach a harmful trait is to begin by pointing out the same trait where it's a virtue. (Weinberg, 1984, pp. 97-98) One might begin with a client who has a hard time saying no by pointing out that he's a generous person.

Often clients present with situational goals. A man wants a particular woman to marry him. Another wants material success or celebrity. The counselor's goal is to help the client convert situational goals into personal ones. A man who wants fame might really want to feel potent and be loved. The counselor can't change the way the world responds to the client. The most the counselor can do is help the client change, and then others will respond to the changes. (Weinberg, 1984, pp. 114-115) A different standing wave will be generated.

DIAGNOSIS: UNCONSCIOUS MOTIVATIONS

Part of working diagnosis is uncovering unconscious motivations. Fortunately, clients have the ability to bring their unconscious motives to the surface. For example, a man uses graphic arm gestures when he talks. Ask him to keep his arms at his sides, and to report whatever feelings and ideas come to mind. "I feel small, as if you won't notice me. If I move my arms, you'll listen to me."

Whenever a routine behavior is engaged in, it has the effect of silencing the motive behind it. On the other hand, when a person stops (or even mildly restrains) a habitual behavior, fragmentary feelings and glimpses of motives come to the surface. (The most extreme example of this is compulsion, but it works at the level of common habits as well.) When a behavior is restrained, the reasons for it come forward out of the silence. (Weinberg, 1984, p. 104-107) One way to begin working might be to have the client close their eyes and imagine restraining the pattern. (Rosen, 1982, p. 136)

Alternatively, the stopping of a behavior can be the stopping of an inhibition. A woman who is sexually repressed and forces herself to enjoy sex sees images of her dead mother pointing a finger at her and saying sadly, "I knew it, I knew it." (Weinberg, 1984, p. 108)

PART (7): TREATMENT

TREATMENT: ARISING FROM WORKING DIAGNOSIS

Diagnosis segues into treatment. A counselor offers treatment in two ways: supplying support, and supplying alternatives.

Supplying support allows changes in the client's frame of reference to come about of themselves, through the magic of saying things out loud to an empathetic person, through active listening. Specifically, the counselor supports clients with empathy and non-judgmental acceptance, by seeing things from the clients' points of view.

And the counselor also suggests to clients that they hold back from habitual behaviors. At first this is to bring forward unconscious motives, for diagnostic reasons. But then, as the client continues to hold out against the urge to do a patterned behavior, the holding back changes from diagnosis into treatment. As the hunger for the old habit rises, the underlying perceptual drive becomes loudly conscious, and then with perseverance the motive fades out, making room for the attainment of new qualities, for new and healthier habits. (Weinberg, 1984, p. 110-113) The counselor offers encouragement to persevere with change.

In addition to support, the counselor can offer alternatives. There are many ways this might be done. Some of these ways are: instruction, insight, feedback, problem-solving, reframing, mirroring, psychological binding, and homework.

Instruction can be providing information or teaching new skills. Sometimes the difficulty is ignorance, and the best cure is information. "The counselor can sometimes get better results by pointing out a commonsense course of action to the client than by doing therapy" (Amada, p. 34). Some sessions are like a class, more oriented to learning new skills than to "therapy." Clients sometimes need information about the grief cycle, victim theory, or boundaries, for example. Or they might need to learn new skills. Skills range from simpler to more global skills: from assertiveness, communication, negotiation, and relationship to resilience skills.

Insight is rarely something that can be handed to the client. But insights can be found, uncovered, and discovered in the process of growth and change. Part of provoking insight is the art of asking questions, and summarizing what's heard. The central part of what's listened for is pockets of emotion, since those reveal where insight is needed.

Feedback can be offered as questions that lead clients to see the patterns for themselves, or (more directly) as observations. What's pointed out to the client are the trends the counselor observes in attitude and behavior. Pointing out patterns of maladaptive behavior must be done simply and dispassionately, to say the least. It won't help to hurt the client's feelings. Face must be saved if the feeling of safety is to be preserved. It's better to say, "It sounds like...." or "I wonder if...." than to state things as facts.

Problem-solving is at the heart of counseling, since generally the client is coming to the counselor for aid in solving a problem. It provides both the structure at the grand scale of the entire course of therapy, and at the small scale of a single session. It takes care of the presenting difficulty, and teaches problem-solving skills along the way.

Problem-solving is one way to interrupt the pattern. A slightly different way is that of changing the response. A man reacts to being in groups by becoming talkative. If he can change his response to that triggering event, the problem disappears. And the act of changing his response strengthens attitudes and beliefs that fit the new situation. Feedback can also be offered as mirroring. Summarizing can be thought of as a form of verbal mirroring. And mirroring can be done with body language, humor and values.

The fundamental beginning of helping clients is to see things from within their frames of reference, and the fundamental way of helping them is to change those frames. Reframing and binds are shortcut techniques for changing frames of reference. When they work, they can tremendously shorten the process of change. They can be quicker at it than the one-belief-at-a-time change of insight therapy. This is not to say that there's a conflict. Both approaches are necessary, and they work together synergistically.

Homework can be used to give clients an experience out in the world of restraining themselves from habits, so that motives surface. And it can be used to provide better experiences than the ones they're currently having, to block habitual behaviors, and to set up therapeutic psychological binds. A fruitful way to assign homework is to ask the clients what they think their homework should be, to let it grow organically out of the session.

The counselor is also a model. And the situation itself is a model. The client, couple or family are encouraged to do something new for them: talk openly about their feelings and relationships with other people, without receiving sarcasm or hostility or judgement. The counselor acts as referee to keep criticism and blaming out of the session.

TREATMENT: SUPPORT

Clients can be supported with empathy and active listening to explore and discover new alternatives for themselves. And they can be supported with companionable encouragement to restrain from a habitual behavior in order to surface the underlying motives, but there's a more fundamental form of support than these two forms.

"I've been chronically ill for twelve years. Stroke. Paralysis. That's what I'm dealing with now. I've gone to rehab program after rehab program. I may be one of the most rehabilitated people on the face of the earth. I should be President.

"I've worked with a lot of people, and I've seen many types and attitudes. People try very hard to help me do my best on my own. They understand the importance of that self-sufficiency, and so do I. They're positive and optimistic. I admire them for their perseverance. My body is broken, but they still work very hard with it. They're very dedicated. I have nothing but respect for them.

"But I must say this: I have never, ever met someone who sees me as whole....

"Can you understand this? Can you? No one sees me and helps me see myself as being complete, as is. No one really sees how that's true, at the deepest level. Everything else is Band-Aids, you know.

"Now I understand that this is what I've got to see for myself, my own wholeness. But when you're talking about what really hurts, and about what I'm really not getting from those who're trying to help me... that's it: that feeling of not being seen as whole" (Ram Dass, 1985, pp. 27-28).

TREATMENT: ALTERNATIVES: INSTRUCTION

Instruction is one way of offering alternatives. Clients might benefit from information about consciousness, feelings, innate worth, human nature, status, power struggles, victimization, knots, compulsions, personality types, the grief cycle, melodramas, boundaries, games, scripts, systems theory, self-care, self-talk, freedom, fun and other topics of the human condition.

Or they might need to learn new skills. These might be self-introspection, communication, friendliness, and relationship skills, or opening to pain, letting go, progressive relaxation, etc. I include information about these skills as appendices.

Teaching must be done with delicacy. Patterson and Forgatch (1985) found that therapist teaching behavior causes client resistance. Perhaps the best procedure is to wait until the client asks for information. Nothing makes food taste good like being hungry. Creating some drama around the giving of the information might make it more palatable, too. A spoonful of sugar....

TREATMENT: ALTERNATIVES: INSIGHT

Offering alternatives by facilitating insights is both a science and an art. Clients can be supported to discover alternatives for themselves, or they can be led to insights with many techniques. Among those perhaps the fundamental one is asking questions. "A good question gets the patient to do the work, which is always preferable to our doing it" (Weinberg, 1984, p. 182).

"I find myself in this crazy position that I've often been in before, where the more I want sex the more my girlfriend withholds, and the more she withholds, the more I want it. And we're spiralling down."

"How can you stop the downward spiral?"

"By getting her to WANT to make love with me."

"Oh? How can you do that? What makes a woman feel attracted to a man?"

"Power, manliness, being centered, being strong, having my mojo back."

"How can you get your mojo back?"

"By dealing with the stress with my boss at work."

"What? You're saying the problem isn't with your girlfriend, but it's with your boss at work?"

"Yes. I use sex for stress relief."

"You do? How many women in the history of the planet have made love with a man because he was stressed out and feeling weak?"

"Roughly zero."

"Oops. That's what I thought. How can you deal with the stress with your boss?"

"By standing up to him when he abuses me."

"How does he abuse you?"

"He humiliates me in front of other people."

"How can you stop him from doing that?"

"By dressing in a suit instead of crummy clothes, and by refusing to cooperate with the abuse."

"Will that work?"

"Yes. I'm scared to do it because I'm scared he'll fire me."

"So you're accepting abuse for monetary reasons?"

"Right. I see what you mean. There must be some way to stand up to him without causing a flare-up and getting myself fired."

"What is it?"

"Well, I know what is is, really. I just haven't done it yet."

"When will you do it?"

"Well, now. I mean I AM doing it, really, as much as I can. I've taken enough abuse, but I have to work my way out of it gradually...."

"Ah...."

TREATMENT: ALTERNATIVES: FEEDBACK (INTERPRETATION)

Feedback may be offered directly. But people feel hurt if you tell them the cold, hard truth about themselves. It makes people angry because it's painful. A big part of a lot of peoples' problem is that they're running so hard from pain. So counseling has to be the art of telling somebody something painful in a painless way.

Isn't paradox wonderful?

One might try sincerity. "Dear friend, it seems to me that...."

One might try neutrality. "When I hear you running yourself down, I feel sad and angry, because I know you're better than that. What I'd like is for you to speak positively about yourself. Are you willing to do that?"

One might try a bit of mild coyote trickery. Suppose a man lowers his voice when saying that something good is in store for him. The counselor, rather than describe the behavior, might say, "Shhh, your father might hear." (This technique has been called "interpretation by joining.") If the counselor's on target, the client may laugh, even as he gains some insight. (Weinberg, 1984, p. 205)

The classical form of interpretation attributes a choice to something that isn't controllable. "You're late to your job because your boss reminds you of your father, and you're afraid of your father." Emotions cause behaviors. This is technically true, but it may also feel invasive, humiliate the client, and make the client feel helpless. His being late may now seem even further out of his control. Any interpretation which attributes an action to its unconscious roots may leave the client feeling at a dead end. (Weinberg, 1984, p. 206)

Another kind of interpretation goes in the opposite direction. It attributes an emotional state to the person's behavior. Behaviors cause emotions. "It's no surprise that your boss seems more like your father than when you started this job. You hide from him in the lunchroom, and curry favor with him, and now you're arriving late." The suggestion is that the client is assigning his boss a part in his life like his father once played, and thereby is making himself feel inadequate.

This form of feedback is just as "true" as classical interpretation. Systems theory would say that both ways of considering the interaction are true. The second has the advantage of leaving clients feeling that they have the power to do something about their behaviors and feelings. (Weinberg, 1984, p. 206) The most important things about interpretation are to do it at a time when the client feels receptive, and to do it in a way that isn't an authoritarian imposition but rather a friendly possibility. One might ask it as a question, so the client can agree or disagree or expand upon the idea.

TREATMENT: ALTERNATIVES: FEEDBACK (CHALLENGE)

Challenging is appropriate, since clients experience support without challenge as unsupportive. And challenge can make therapy briefer. Needless to say, challenge never becomes personal, since counseling isn't a personal relationship.

A saying from India puts it well, "Tell only so much of the truth as goes to harm no one."

And as Passons (1975) says: "...if the counselor is skilled in the use of confrontation, the client may not realize that he or she has been confronted." The importance of the client's not feeling confronted is suggested by Wampold and Kim's (1989) finding that confrontation doesn't lead to the client's opening up. Perhaps the gentlest form of challenge is a friendly persistence to find the truth together.

Frankl developed a procedure (as a technique of logotherapy) called "Paradoxical Intention." The client is asked to have his symptom right now. In a case of a client afraid of passing out, a therapist said, "To evoke humor in the client I always exaggerate by saying, for example, 'Come on, let's have it; let's pass out all over the place. Show me what a wonderful "passer-outer" you are.' And, when the client tries to pass out and cannot, he starts to laugh." (Haley, 1963, pp. 65-66)

A woman came to Erickson because she compulsively scratched her nipples. Erickson told her he could cure her in thirty seconds if she would say yes and mean yes. She said she would. He then told her the next time she felt like scratching her nipple, come into his office and do it in front of him. (O'Hanlon & Hexum, 1990, p. 39) Here's a story about the creative use of challenge:

An eight-year-old boy began rebelling in school and destroying things in the neighborhood after his mother, a single parent, began dating. His mother brought him to Erickson, and Erickson gave her a plan. She was to gather some food, something to drink, a good book and the telephone in the living room of her house. The next day, when he threw his breakfast on the floor, she took her son to the living room and sat on him. He cried, struggled and threatened. She told him that since she didn't know how to help him control his behavior, she would just sit there till she did. Or he could come up with a plan, if he liked.

The boy went through fits of struggling and cursing, and then would collapse into sobbing. She sat on him most of the day. She rejected his promises to be good as insincere, but he finally convinced her he had a plan about how to control his behavior. She let him up, and he cried himself to sleep in his room.

The next day he quietly ate his breakfast, and then went to each of the neighbors to apologize and promise to make amends. He apologized to his teachers at school, and things settled down after that and went along fine. (O'Hanlon, 1990, pp. 272-273)

TREATMENT: ALTERNATIVES: PROBLEM-SOLVING

The problem-solving model can be applied to counseling as a whole, providing a structure for the entire course of therapy. And it can also be applied to specific problems. Bandler & Grinder (1981, pp. 147-160) suggest one version of this technique:

(1) Identify a pattern of behavior or a response to a triggering stress that needs to be changed.

(2) Find out what the motive is for the behavior or response.

(3) Create new alternatives to satisfy that motive.

(4) Evaluate the new alternatives.

(5) Select one alternative to try for three weeks.

(6) Try out the new alternative in fantasy to see if it works or has side effects.

(7) If the alternative hasn't worked after three weeks, repeat steps three through seven.

A larger-scale version of this process is put forth by Gerard Egan (1998), designed to solve life problems and seize life opportunities:

"Helping is about client-enhancing change-- changing self-defeating beliefs, values and norms and changing the self-defeating patterns of behavior they spawn. Therefore counseling sessions deal with exploring the need for change, the kind of change needed, creating programs of constructive change, engaging in change 'pilot projects,' and finding ways of dealing with obstacles to change. This is work pure and simple. It can be arduous, even agonizing, but it can also be deeply satisfying, even exhilarating" (Egan, 1998, p. ?).

The process might be considered to have these stages, though not necessarily in this order or visited only once:

(1) Listen to the client's story of their difficult situation, responding to them with empathy.

(2) Ask questions to clarify the client's experiences, behaviors, feelings and dilemmas.

(3) Help them prioritize. Ask, "Of the difficulties you have, which are the most important?"

(4) Help them visualize a solution. Ask, "How would things be if they were going well?"

(5) Help them focus. Ask, "What changes are needed to get from here to there?"

(6) Help them commit. Ask, "What are you willing to do or to pay to get there?"

(7) Help them create possibilities. Do some brainstorming.

(8) Help them evaluate the possible courses of action, and polish the viable ones.

(9) Help them choose one and act on it.

TREATMENT: ALTERNATIVES: MIRRORING

Part of offering an alternative is to demonstrate the need for one. One way to do that is with mirroring, which shows the client what their behavior looks like when seen from the outside.

One form of mirroring is summarizing. If I have a client who repeats his story over and over, I might say, "So let me see if I've got this right. You met your girlfriend in the Bahamas, and before she met you she had an affair, and you got together with her anyway, and you guys have been living together for two years, and you have a baby, and now you're mad about what happened three years ago, and you're ending the relationship. Have I got it right? Am I followinig you?"

Here's an extreme story of mirroring. No one at Worcester Hospital could handle Ruth, a twelve-year-old who acted sweet and winsome until a nurse was within reach, and then Ruth would break the nurse's arm or stomp on her feet. She also liked to tear the plaster off the walls. Erickson made a plan. One day when she was on a binge, he joined her. He helped her destroy a bed, break windows, tear a steam register away from the wall and break it off its pipe. He attacked a nurse (with whom he had arranged things ahead of time), and tore off her uniform and her slip. This was finally too much for Ruth, who said, "Dr. Erickson, you shouldn't do a thing like that," and wrapped the torn bedsheets around the nurse. After that Ruth was a good girl. Erickson said, "I really showed her what her behavior was like." (Rosen, 1982, pp. 229-231)

TREATMENT: ALTERNATIVES: REFRAMING

Another way to offer alternatives is with reframing.

Relabeling, redefining and reframing are the so-called "paradoxical" tools. Putting the client's problem in a new light that lets it be dealt with will sometimes get the client unstuck.

A blind woman who was talking to a group said, "You people just don't understand what it is like to be blind!" The group's leader said, "Gee, we must be missing a lot." (Bandler & Grinder, 1982, p. 24)

The art of reframing lies in persuading the client to accept the redefinition. But caution must be used. Many clients find "paradoxical prescriptions as signs of therapist sarcasm or incompetence, that engender massive resistance, sometimes destroying all together the client's faith and cooperative attitude in therapy" (Green and Herget, 1991, p.323).

But used judiciously, reframing can be a tremendous shortcut. For esample, a family came to Erickson for therapy. In order to help the mother cope with her sons moving out, Erickson redirected her attention from being a good wife and mother in the past to being a good grandmother in the future. (O'Hanlon & Hexum, 1990, p. 227)

TREATMENT: ALTERNATIVES: BINDS

Another way to offer an alternative is to force the issue by putting the client in a psychological bind. Here's an old story about a psychological bind:

"A big, tough samurai once went to see a little monk. 'Monk,' he said, in a voice accustomed to instant obedience, 'teach me about heaven and hell!'

"The monk looked up at this mighty warrior and replied with utter disdain, 'Teach you about heaven and hell? I couldn't teach you about anything. You're dirty. You smell. Your blade is rusty. You 're a disgrace, an embarrassment to the samurai class. Get out of my sight. I can't stand you.'

"The samurai was furious. He shook, got all red in the face, was speechless with rage. He pulled out his sword and raised it above him, preparing to slay the monk.

"'That's hell,' said the monk softly.

"The samurai was overwhelmed. The compassion and surrender of this little man who had offered his life to give this teaching to show him hell! He slowly put down his sword, filled with gratitude, suddenly peaceful.

"'And that's heaven,' said the monk softly" (Ram Dass, 1985, pp. 99-100).

Here's a modern story about a psychological bind:

A man came to Erickson because he couldn't get erections. He wanted to marry a woman, and they'd tried to have sex, but he was impotent. Erickson asked to talk to the woman, and he told her, "Go to bed with him every night, but be a thoroughly cold woman. Don't permit him to touch your breasts, touch your body in any way at all. Just forbid it. And it's very important you obey these instructions." He told the man what he'd told the woman, and told them to come back in three months. In less time than that the problem had disappeared. (Rosen, 1982, p. 157)

TREATMENT: ALTERNATIVES: HOMEWORK

Homework has several uses. One is to uncover unconscious motives by asking the client to refrain somewhat from a routine behavior, since holding back on a habit will surface the thoughts and feelings that drive that habit. Another use is to alter the symptom in other ways.

Homework can also be used to provide an alternative by giving the client an experience of a behavior that's more satisfying than the old behavior, and it can be used to block the old behavior, or to set up a bind. It can also be used to teach a client self-care and beneficial skills, to put what's being learned in the sessions into action.

A nice approach to homework is to ask clients what homework they would give themselves.

PART (8): THEORY

INSTRUCTION THEORY

The theory of instruction is contained in the old saying that if you give a man a fish you feed him for a day, and if you teach a man to fish you feed him for a lifetime. Counselors may be thought of as map-makers, and much of the work of changing someone's frame of reference can be done by giving them information. Nothing changes a point of view like new information. It's hardly ever a mistake to make someone's world bigger.

INSIGHT THEORY:

Here's a statement of the core of insight counseling, that comes from a yoga tradition in India: "Once you become aware of a failure, you should be able to trace it to a certain situation, and this situation will help you to identify the cause of the weakness in you that has to be strengthened. By and by, the very cause of the failure will drop off by itself" (Singh, 1976, pp. 382-383).

When the client or the counselor becomes aware of a problematic feeling, they can trace it to current and past situations, and that will help identify the piece of private logic that's inaccurate. That piece isn't changed deliberately. It's focused on, and it changes of itself. What it changes to is spontaneous, and wholistically appropriate. Clients create their own alternatives.

One way to find the thread stringing the beads together is to listen and watch for trends in the client's stories and behavior. Another way is with a series of questions to track back from an incident: "What's the last time you felt like this? And the time before that? And before that?" Resurrecting a series of emotionally similar incidents will sometimes reveal the underlying beliefs.

A critical point is that once the cause is found, nothing is done. One "hangs out" with it. The client brings their attention to bear on it, without exerting effort. Change happens of itself. This is one reason the therapist needs to be agenda-free.

A good example of this kind of work is in Strean (1988), though there he's using it on himself. This process works both as therapist-mediated and as self-introspective.

PROBLEM-SOLVING THEORY

A man who has a fear of groups will dive in and talk too fast as a response to being in a group, which then elicits a negative reaction from the group. He regards the group as the problem. They regard his response as the problem. An outsider would regard both of them as being part of the problem. If he could connect a different response to the triggering event of being in a group, both their problems would be solved.

(1) Identify a pattern of behavior to be changed. Get him to tell his story. His pattern is that when he's in groups feelings come up, and he becomes a compulsive talker and offends the members.

(2) Separate the behavior from the motive for it. Ask clarifying questions. His motive might turn out to be that he's protecting himself from embarrassment and rejection.

(3) If he has more than one problem, get him to prioritize. Make sure the issue is one whose resolution will make an actual difference.

(4) Help him visualize success. "What would it look like if you were comfortable in a group? Describe that."

(5) Help him see what's in his way. "What do you need to change in order to walk into a group and have fun?"

(6) Help him see what his level of commitment is. "What are you willing to do to bring this about? How important is it?"

(7) Help him create new alternatives to satisfy the motive of self-protection. Do some brainstorming. Ask him to comes up with ten new ways to fulfill that same goal.

(8) Help him evaluate the new alternatives. Ask him to review them and find three that will actually work. If he can't find three, ask him to imagine another ten possibilites, and keep winnowing those down until he has three viable ones.

(9) Ask him to choose one alternative out of the three and try it as an experiment for three weeks. If the alternative doesn't work, that will be a reason to generate ten more possibles on his own, find three, select one, and try another experiment.

(10) Try out the new alternative in fantasy to see if it works or has side effects. Ask him to close his eyes and imagine the future and living the new alternative in various situations. See if it's effective. See if if has unintended side effects that he hadn't noticed before.

(11) Support him in going out and trying the new alternative in real life.

COYOTE THEORY: MIRRORING THEORY:

Would that we could see ourselves as others see us. Mirroring shows someone what their behavior looks like when seen from the outside. It can be done dramatically or subtly. The trick is to have the client feel increased awareness rather than feeling mocked.

A client came in with an involuntary squint. The therapist squinted back at him each time he squinted, and in one session the squint was gone. (Haley, 1963, p. 56)

A husband and wife quarreled constantly about going to the movies. The husband would sabotage by scheduling an appointment at an interfering time with Erickson. Erickson suggested the wife pick a night to go to the movies, and she did. The husband called and asked for an appointment with Erickson that same night, and even though he knew it conflicted with their movie-date, Erickson made the appointment. When they came for the appointment the wife was angry with her husband, and he was angry with Erickson.

"Why couldn't you have given us an appointment on a different night?"

Erickson replied, "I didn't think of it."

"But you could have thought about it," the man said, "and I could think about it too." (O'Hanlon & Hexum, 1990, p. 247)

One of the more entertaining examples of "mirroring" appeared in Lindner's article "The Jet Propelled Couch." A borderline client presented delusionary material to Lindner about his contact with other planets. He presented this in such a way that Lindner was excluded and the client was in charge of the subject. Lindner encouraged the client to bring in the material and then proceeded to correct him on it and suggest additions. The more Lindner took the initiative with the planetary discussions, thus gaining control of the behavior the client offered, the more reluctant the client was to make an issue of the matter, and eventually he abandoned the whole topic. (Lindner, 19??)

Erickson had a state hospital patient who spoke only word-salad. He'd been in the hospital nine years, and seemed to be attempting to communicate with others. Erickson taught himself to speak word salad, and had conversations with the patient, in which both spoke word salad. The patient was skeptical at first, but got interested and carried on long talks with Erickson. Everyday phrases began to creep into his speech, and over time the percentage increased. Erickson gradually got a history, and was able to provide therapy and facilitate the patient's release from the hospital. (O'Hanlon & Hexum, 1990, p. 202)

COYOTE THEORY: REFRAMING THEORY

A woman came to Erickson who had been molested by her father from the age of six till she was seventeen. She was frozen with fear, and felt "dirty, inferior, inadequate and ashamed." She worked her way through high school, college and graduate school, hoping that would give her a feeling of self-respect. It didn't, and she gave up and became a prostitute. Sex remained a painful, horrible experience. "Now I come to you. I feel like filth. An erect penis just terrifies me and I just get helpless, and weak, and passive."

Erickson said, "That's an unhappy story, and the really unhappy part is-- you're stupid! You tell me that you are afraid of a bold, erect, hard penis-- and that's stupid! You know you have a vagina; I know it. A vagina can take the biggest, boldest, most assertive penis and turn it into a dangling, helpless object. And you can take a vicious pleasure in reducing it to a helpless dangling object."

The change on her face was wonderful to see. She came back in a month and reported that she'd taken vicious pleasure in reducing men to helplessness, that sex was pleasurable, that now she was going to get her Ph.D. and wait until she saw a man she wanted to live with. (Rosen, 1982, p. 36)

"Reframing takes one symptom and turns it into another" (Bandler & Grinder, 1981, p. 142). Erickson didn't attempt to remove the woman's fear of penises. He turned it into "vicious pleasure." That's not a completely healthy attitude, but it's functional and allows a step forward.

More generally, reframing endorses the idea that people can "break out of limiting preconceptions to a broader understanding of human possibilities" (Erickson & Rossi, 1981, p. 26). "Any successful suggestion [that] puts our patient's reality into a different conceptual and emotional frame is reframing" (Lankton & Lankton, 1983, p. 336).

"Throughout this inquiry we have steadily been examining the value of stepping outside and reperceiving some of the problems we face. perception itself, we've found, has the power to transform situations. Things change as they are seen differently, not necessarily because we are busy altering circumstances. From these shifts in perspective, in turn, we ourselves change" (Ram Dass, 1985, p. 187).

Reframing has several goals:

(1) Reduce defensiveness by relabeling motives, attitudes, desires, needs and intentions as positive (and normal) rather than negative.

(2) Discriminate between the maladaptive behavior and the motive for it, to make room for new alternatives.

(3) Restructure an experience so that a new set of learning and experiences can be created. For example, experiencing a symptom can become a cue for the emergence of new resources.

(Lankton & Lankton, 1983, pp. 336-337)

One kind of reframing is content reframing, in which you need to know the content in order to make the reframe. There are two subtypes of content reframing, one where you change the meaning and one where you change the context.

Meaning reframing is used when the stimulus for a problem doesn't need to change, because there's nothing inherently bad about it. And it's used for statements of the kind, "I feel X when Y happens." "I feel sad when I fail," that sort of sentence.

Here's an example of changing the meaning. One day in a workshop, Leslie Cameron-Bandler was working with a woman who was a compulsive cleaner. She even dusted the light bulbs. She spent a lot of time trying to get her family not to walk on the carpet, because it left footprints in it, not muddy or dirty, just dents. She vacuumed the carpet 3-7 times a day. Leslie said to the woman, "I want you to close your eyes and see your carpet, and see that there is not a single footprint on it anywhere. It's clean and fluffy, not a mark anywhere." This woman closed her eyes, and she was in seventh heaven, just smiling away. Then Leslie said, "And realize fully that that means you are totally alone, and that the people you care for and love are nowhere around." The woman's expression changed radically, and she felt terrible. Then Leslie said, "Now put a few footprints there and look at those footprints, and know that the people you care most about in the world are nearby." Then, of course, she felt good again. (Bandler & Grinder, 1982, pp. 5-6)

Context reframing is used when the client is making comparative generalizations. "I'm too tyrranical." Too tryannical for what, for whom? "He's too arrogant."

Rather than imposing a context, one can assist the client in finding a new context. When the client wants to stop a behavior, ask them for the situation in which that behavior is appropriate. Every experience in the world, and every behavior is appropriate, given some context, in some frame. "See yourself performing that behavior, and listen to it. Now where did that happen? Now go inside and ask the part of you that has you do that behavior if it would be willing to be the most important part of you in that situation, and to generate that behavior exquisitely and congruently only in that context" (Bandler & Grinder, 1982, p. 10-11).

Here's an example of changing the context. Virginia Satir was working with a family. The father was a banker and professionally stuffy. The mother was a placater. The daughter always sided with the mother, but she acted like the father. The father's complaint was that the daughter was so stubborn. Virginia said to the father, "You're a man who's gotten ahead in your life, is that true?"

"Yes."

"Was all that you have, just given to you? Did your father own the bank and just say, 'Here, you're president of the bank'?"

"No, no. I worked my way up."

"So you have some tenacity, don't you?"

"Yes."

"Well, there is a part of you that has allowed you to be able to get where you are, and to be a good banker. And sometimes you have to refuse people things that you would like to be able to give them, because you know if you did, something bad would happen later on."

"Yes."

"Well, there's a part of you that's been stubborn enough to really protect yourself in very important ways."

"Well, yes. But you know, you can't let this kind of thing get out of control."

"Now I want you to turn and look at your daughter, and to realize beyond a doubt that you've taught her how to be stubborn and how to stand up for herself, and that that is something priceless. This gift that you've given her is something that can't be bought, and it's something that may save her life. Imagine how valuable that will be when your daughter goes out on a date with a man who has bad intentions."

(Bandler & Grinder, 1982, p. 8)

COYOTE THEORY: BINDING THEORY:

Binds use ordinary human qualities like competitiveness and territoriality to evoke an awakening. Binding puts people in situations where they have no response that works, so their old way of seeing and dealing with the world breaks down, and they are left with no choice but to break through into a new way. The cage collapses inward, and the bird is left with no option but to fly out to freedom.

"By therapeutic double binds we mean situations, imposed upon the client by the therapist, in which any response by the client will be an experience, or reference structure, which lies outside the client's model of the world. Thus, therapeutic double binds implicitly challenge the client's model by forcing him into an experience which contradicts the impoverishing limitations of his model. This experience then comes to serve as a reference structure which expands the client's model of the world" (Bandler & Grinder, 1975, p. 169).

Early in his career, Erickson had a patient named Herbert in a State Hospital. Herbert had to be tube-fed, and didn't believe he had a stomach. Erickson told Herbert he'd prove to him he had a stomach. He forced air into Herbert's stomach with the tube-feeding, and Herbert burped. Herbert said, "You think you're smart, don't you?" And Erickson agreed with him.

Herbert slept standing up. Erickson told him he'd prove Herbert could sleep lying down. He put him in a continuous bath, which is a long bath-tub with a canvas hammock in it, and kept him there all night. Herbert went to sleep. Herbert said, "You're a smart aleck."

Herbert didn't believe he could swallow, and Erickson told him he'd prove that he could. He put extra salt in his tube feeding one night, and the next day Herbert was pounding on the door of the ward and begging for a glass of water. Herbert said, "You think you're smart," and Erickson agreed with him.

Next Erickson told Herbert he'd prove that Herbert could swallow solid food. He put a plate full of food in front of Herbert, and on either side he put patients who ate off of other peoples' plates. In order to protect his food, Herbert had to eat it. But Herbert still claimed he had no appetite. So Erickson sent him out to a farm to work all day without a lunch. When he came back, Erickson sat him across the table from a 350 pound woman who'd been fasting all day and was about to make up for it. Herbert watched her eat, and got so hungry he asked, "Can I have some?" "Sure," said Erickson. On the ward that evening, Herbert said, "You really are smart." (Rosen, 1982, pp. 202-210)

COYOTE THEORY: PROVOCATIVE THERAPY

One example of coyote therapy is Provocative Therapy, pioneered by Frank Farrelly. The central hypothesis is that people will change if they're provoked into self-annoyance. This is done by challenging them in a non-overwhelming way. The provocation must be done humorously, perceptively, and from within the client's own frame of reference. The counselor takes a "devil's advocate" position, and the clients recoil from seeing their own absurdities writ large. They are tricked so that they recoil into better health. This might be considered an advanced form of mirroring.

If urged provocatively to continue their self-defeating and deviant behaviors, clients will tend to stop them, and they'll begin to engage in self-enhancing and other-enhancing behaviors. Farrelly doesn't believe people are fragile, and he does believe in therapeutic and joyful sadism. (Farrelly, 1974, pp. 37-48, 52)

Provocative Therapy was developed for people who were doing therapy against their will, for reluctant and resistent clients, and for people with schizophrenia, but it works with anyone.

COYOTE THEORY: DON JUAN

Another example of coyote therapy can be found in Carlos Castaneda's books, where he talks about the therapy system of the sorcerers of Mexico. He was apprenticed to a sorcerer named Don Juan, who talked about therapy issues in refreshingly different terms.

Don Juan said that most people suffer primarily from self-pity. Another term for it might be self-importance. Or one could say that self-pity and self-importance are two sides of the same coin. In order to change, people need to "stop the world," to change their fundamental idea of what's going on.

In order to overcome self-pity and "stop the world," they need to develop the qualities of ruthlessness, patience, sweetness and cunning. (It's no coincidence that these four qualities are also the ones effective counselors develop.) For a story about Carlos Casteneda being tested on the four qualities, see Appendix 1.

HOMEWORK THEORY:

One use of homework therapy is to uncover unconscious motives by asking the client to refrain somewhat from a problem behavior. Holding back on a habitual behavior will bring the motivating thoughts and feelings to the surface. This can be done in the counseling session using fantasy, or it can be assigned as homework.

Homework can also be used to provide the client with an experience that is more satisfying than the old way of behaving, and at the same time (if necessary) to block the problem behavior or symptom. It would seem an obvious directive to give the new, desired behavior as homework. In practice, this is seldom possible, as it's usually too big a step. If the client could just do the behavior, they already would be.

Using directives to give the client a more satisfying experience is an art, and like all artforms once the theory is internalized, it comes from the heart and from life-experience and intuition. The better counselors know their clients, the more issues a single piece of homework can address at once.

Using directives to block the problem behavior is also an art. One way is to "take over:" give a directive to do what the client is already doing. Once the symptom is defined as cooperation, the therapist can begin to direct lessening or changing. "Taking over" the behavior gives the therapist control, lays the groundwork for a later shift, and utilizes whatever rebelliousness the client might have. (Haley, 1963, p. 147)

Another way to block the symptom is to confront it. When a symptom is seen as a way a client gains an interpersonal advantage, one can arrange situations where the symptom places the client at a disadvantage. (Haley, 1963, p. 56)

For client's with strong motivation or who are trying to break a habit, one can persuade the client to undergo a consequence when the symptom occurs. (Haley, 1963, p. 55) If the client sees this as punishment, the process will backfire, but if they see it as a procedure, then it can sometimes bring about results quickly.

Hakomi Therapy has a physical analog of taking over. For example, if the client feels sadness at some point in slowly reaching out with one hand, the therapist holds the arm in that position. The muscles can relax, and that facilitates emotional release. The emotions are used to lead to core material, pivotal thoughts. (Kurtz, 1981)

Hakomi is useful for looking at the feelings lying behind behaviors. It's also useful for people who have a hard time expressing their problems verbally, whom I suspect are more frequently encountered.

PART (9) TECHNIQUES

INSTRUCTION TECHNIQUES

It's all in the timing. The same piece of information presented at different times can be boring or life-changing. It doesn't hurt to be dramatic, to create a hunger in the client to know what you have to tell them. On the other hand, sometimes you may want to be indirect in how you slip new information to a client. There are ways and ways to say something. To say it in a way that's kind and intriguing is unlikely to provoke resistance.

In the Disney movie Mulan, a father says to his daughter, who is feeling disappointed with herself, "My my, look at what beautiful blossoms we are having this year. Look, that one is late. But when it blooms, I'm sure it will be a real beauty."

INSIGHT TECHNIQUES: BASIC

The basic insight techniques are active listening, empathy and asking questions. Questions are used to clarify the issues and to challenge the client's beliefs, and to look for pockets of emotion.

The counselor wants to find out what's troubling the client, and what thoughts in private logic are supporting problem behaviors. Sometimes they will become evident as a trend in what the client is saying and doing. One can ask the client what their problem patterns are. Often they know. Another way to find these pivotal beliefs is to ask, "When was the last time you felt like this? And the time before that?...."

One can also ask solution focussed questions:

scaling questions: ("On a scale from one to ten, how well are you doing, how bad is the problem?")

exception-oriented questions: ("When is the problem not occurring?"),

difference questions: ("How did you get the problem to go away?", "What's different about the times when the problem isn't as intense?").

presuppositional questions: ("What will your life look like once the problem is solved, and what would you be doing differently?"),

miracle questions: ("Suppose there was a miracle and this problem was solved. How would you know? What would be different?"),

(Sieber & Lewis, 1999)

INSIGHT TECHNIQUES: ADVANCED

There are many other ways of reaching pivotal thoughts: physical exercises such as those from Hakomi and Bioenergetics, breathing techniques from Rebirthing, re-enactment, metaphor, dream-work, "locating feelings", confrontation, watching for "movies," to name some of them.

When clients reach the pivotal thought, the counselor supports them to "hang out" with it. Often they will want to shy away from it and will need encouragement to stay with it. Sometimes "hanging out" will release emotions. Sometimes the client has an "aha." Sometimes there's only a tiny shift. Sometimes the change comes later. Pivotal thoughts don't change from an effort of will. They change from being exposed to the "light of day." It's as though they were blocked from growth, and putting attention on them frees them to develop further. Once the root thought is allowed to change, the associated behaviors may change on their own. If they don't, homework can encourage realignment.

Sometimes in the course of working, clients will have emotional releases. Generally these are sadness, fear or anger. Sadness needs quiet support. Fear needs the same, with sometimes a pillow to hold.

Getting in touch with anger might need a bataka or a tennis racket and a couch to beat on. I like the Bioenergetic technique of beating the couch three times and then stopping to take a deep breath and to assess what's come up. Don't underestimate the power of a bataka. I've seen a man destroy a metal chair with one.

When clients emerge from a session of "riding the rapids," as Ron Kurtz (1981) calls it, they're in a good position to do some looking at the thoughts and feelings it's brought up.

INSIGHT TECHNIQUES: GESTALT

Many insight techniques from Gestalt are useful:

Work with what comes up spontaneously.

Make things concrete rather than abstract.

Get the client to talk in the present tense when describing a dream or a past experience.

Question the use of the words "should" and "ought."

Get clients to change sentences like, "He makes me angry," to, "I feel angry at him," to encourage autonomy. "Why?" isn't usually as good a question as, "How?"

"Would you rather be right or happy?" is a good question for people who are caught in power struggles or righteousness or blaming.

Asking where in one's body a client feels an emotion is a good way to help them get in touch with feelings. Gestalt therapy also provides the two-chair technique, which is useful in many ways. One example is dealing with hostility directed to the counselor, or from one family member to another. I tend to use it whenever a client drifts into talking "to" an issue or absent person rather than "about" them. A rather exotic example is using one to visualize a headache externalizing to, as though it were a cloud forming above the chair's seat. (Bandler & Grinder, 1976, p. 20)

Dream-work using Gestalt techniques is clarifying. The point is not that dreams are a window into a mysterious world, but that dreams show more holistically than linear thought does, what one is thinking and feeling. It works well to pretend to be each thing in the dream and describe oneself (using present tense) as that thing.

INSIGHT HOMEWORK: CONTINUOUS BREATH, AFFIRMATIONS

It can be useful to give insight homework, such as continuous breath, affirmations or (an idea from Morita therapy) bed rest.

Continuous breath originated with yoga in India (where it's called "pranayama"), and was imported to America by (among others) the Rebirthing movement. It brings up feelings, and relaxes and energizes both the mind and emotions. I've done over 700 continuous breath sessions in the last 25 years, and I find it easy to teach and very useful. Two of the best times to use it are when one is stressed and when one's feelings aren't clear. (See Appendix 10: Continuous Breath.)

The use of affirmations has gone out of style. I still think they have some usefulness, though not in the way they were originally used (as a way of programming the unconscious), but as a probe to see what responses come up (a way to query the unconscious). One homework method is to ask the client to write the affirmation (or a variation) on the left side of a piece of paper, and the response on the right side. Then write a new variation on the left side, etc. This clarifies one's private logic and the defenses against changing an attitude or a thought.

INSIGHT HOMEWORK: WRITTEN QUESTIONS

One can ask the client as well as others (like the referring source, personal physician, parent, teacher, or employer) to write out the answers to three questions:

1. What are the central issues (or problems)?

2. What are the factors or circumstances that seem related to the issue?

3. What measures have been used so far in an attempt to solve the key issues?

(Talmon, 1990, p. 20)

PROBLEM-SOLVING TECHNIQUES:

This framework can be used at every scale from a ten-minute exercise to a years-long course of therapy:

(1) Identify a pattern of behavior to be changed. Listen to their story. "What do you want to change?"

(2) Separate the behavior from the motive for it. Ask clarifying questions. "What you are trying to accomplish with this behavior?" "Is that intention acceptable to you?"

(3) "If you have more than one problem, what's the most important?"

(4) "If things were good, what would that look like?"

(5) "What would have to change in order for things to be like that?"

(6) "What are you willing to pay (or to do) to make some change happen?"

(7) Create new alternatives to satisfy that motive. "Let's do some brain-storming. Will you imagine ten new alternatives, however wild and unrealistic?"

(8) Evaluate the new alternatives. "Please choose at least three out of the ten that will actually work."

(9) Select one alternative to try for three weeks. "Now choose the best of the three and try it out for three weeks. If the strategy fails, please generate new strategies, evaluate them and try a new one."

(10) Try out the new alternative in fantasy to see if it works or has side effects. "Let me ask you to close your eyes and imagine yourself doing the new pattern." "Does it work?" "What happens?"

COYOTE TECHNIQUES: MIRRORING TECHNIQUES:

Mirroring uses mimicry. Do what the client is already doing, perhaps even amplifying it, and confront them with it. Sometimes it's best to use comic exaggeration, so clients can laugh at the counselor and thus be surprised to find themselves laughing at themselves.

"There's an old gestalt technique to use when the client says, 'There's no way in the world that I can think of anything that would be helpful.' You look at her and say, 'You're right. You could never do it. You are an absolute failure; you could never think of anything that would be helpful, not even the smallest thing.' Typically she will then respond, 'Well, there is this one little thing.' That's part of the natural polarity response of many people" (Bandler & Grinder, 1981, p. 161).

COYOTE TECHNIQUES: REFRAMING TECHNIQUES:

Reframing is not so much a technique as a goal. The process begins with going into the client's point of view and agreeing with what is seen. But the counselor retains enough detachment to see angles the client doesn't see. From intuition and creativity comes a way to get across to the clients a way of seeing their problems that flips them into a whole new light. In order to begin, one might ask oneself, where are the clients attributing power? What can I say that will get them to attribute power to themselves rather than to something outside themselves?

One way to reframe is to get clients to imagine a good future. (O'Hanlon and Hexum, 1990, p. 233) Or one can have them imagine a successful future and then have them tell you how they solved their problems. (O'Hanlon and Hexum, 1990, p. 239)

One can even do reframing using paradoxical instructions. A couple came to Erickson, distraught over having to get an abortion. Erickson gathered they were being bullied by their parents. Erickson instructed them not to think of a name for the baby. They came back several days later and told Erickson they'd decided not to have an abortion, and they'd talked the parents into supporting them in getting married. (O'Hanlon and Hexum, 1990, p. 232)

"I saw Frank Farrelly do an interesting 'negative' reframe once. Frank was working with a man.... The man was telling Frank about how he couldn't seem to get a zing out of his wife, basically. And Frank, in his inevitable form, was badgering the guy so fast he couldn't keep track of what he was saying.

"Frank: 'Well, did you ever kind of give other women the eye, you know?'

"Man: 'Well, yeah, sometimes.'

"Frank: 'But you get with your wife and nothing happens?'

"Man: 'Well, yeah, I just kind of stiffen up.'

"Frank: 'Well, WHERE do you stiffen up? THIS IS VERY IMPORTANT!'

"MAN: 'Well, you know, all over.'

"Frank: 'And when you're with other women, do you stiffen up all over?'

"Man: 'Well, no, no. You know, I've had lots of interactions with other women and ah--'

"Frank: 'INTERACTIONS? Is that like fucking?' Frank is very subtle.

"Man: 'Well, ah.... yes.'

"Frank: 'Does your wife know about this?'

"Man: 'No.'

"Frank: 'Well, does your wife have "interactions," too?'

"Man: 'Well, ah, no.'

"Frank: 'How do you know?'

"Man: 'Well, you know, I just feel that--'

"Frank: 'Ah! The intensity of your feelings is not the test of reality.'" (Bandler & Grinder, 1982, pp. 30-31)

COYOTE TECHNIQUES: BINDING TECHNIQUES:

A client had a severe fear of saying no to anyone, because as a child she had once said no to her father's request to stay at home with him, and when she returned he had died. The counselor told the client to go around the room and say no about something to each of the group members. The client refused the task, saying, "NO! It's impossible for me to say NO to people. You can't expect me to do it just because you ask me to." She continued in this way for several minutes, until the counselor pointed out that she had in fact been saying no to him all along. He pointed out that he hadn't been hurt and certainly hadn't died. This experience was so powerful for the client that she was immediately able to go around the room and say no to the group members. (Bandler & Grinder, 1975, pp. 170-171)

Binding consists of two steps:

(1) Finding a generalization in the client's belief system.

(2) Structuring a bind such that the choices available all contradict the original generalization.

Setting up psychological binds is an artform. One may assign them as homework. A woman who had the belief, "I can't try anything new because I might fail," was given the homework to try something new every day for a week and fail every time. She only has two choices. She can try something new each day and fail at it, or she can fail to fulfil the homework. Either way she has to confront failure. (Bandler & Grinder, 1975, pp. 171-172)

Part of the artform is that no matter what the clients do, they benefit by an increase in their amount of choices available. The counselor might ask significant others in the client's life to cooperate. The binds might seem like practical jokes. The client should be surprised, but never demeaned or humiliated. (Rosen, 1982, p. 211)

COYOTE TECHNIQUES: PROVOCATIVE THERAPY

Provocative therapists act as devil's advocates, urging the client to continue the pathologic behavior. They echo the client's worst thoughts and fears, verbalizing all the taboo things people can't say in our culture. Everything is carried to the point of absurdity. Attitudes are lampooned and burlesqued. Everything is larger than life, extravagantly exaggerated. The therapist quickly approaches any areas the client sends messages to avoid, for example: provoking anger in the openly hostile client. Immediate feedback is considered a virtue.

When a therapist is acting in this way, the fundamental alliance with the client hasn't broken down, and acceptance is mostly communicated nonverbally. Humor is one of the main vehicles of positive regard. (Farrelly, 1974, p. 57-66)

A young man in Farrelly's private practice called for an unscheduled interview. He felt he was on the brink of suicide, and the only thing holding him back was that his death would precipitate a psychotic break in his mother. "Don't you worry," Farrelly said, "I'll explain the whole thing to your parents after your funeral. I can see us now, your mother and father sitting there, and your mother saying, 'Why, why, why, did he do it, Mr. Farrelly?'

Farrelly to mother: "I can understand how all this is a shock to you, Mrs. Jones, but we can explain this professionally to you. What is involved here is what we call psychodynamics, and--

Farrelly as father, interrupting: "What the hell are them?

Farrelly: "Now, Mr. Jones, I can explain that. It means the way your screwball son-- er, poor George-- felt and thought. You see, he had what we call an unresolved Oedipal complex.

Farrelly as father: "What the hell is--

Farrelly: "Just-- just a minute, Mr. Jones, I'm going to explain it. You see, he wanted to ball-- er, excuse me, fu-- uh, have relations with his mother here--

Farrelly as father: "God dammit!

Farrelly: "I know, I know, Mr. Jones, but you have to understand this is the way these diseased minds work. You see, this impulse or desire on his part was unacceptable to him--

Farrelly as mother: "Oh, thank God, I never--

Farrelly: "So he repressed this and projected it onto you, Mrs. Jones, and was convinced that you wanted to scr-- uh, have sexual relations with him.

Farrelly as father: "What the shit, I'll--

Farrelly: "Hold it please, Mr. Jones--

Farrelly as mother: "I never, never felt that way towards him, it's unnatural--

Farrelly: "I know, Mrs. Jones. But then, he felt horrified at your unnatural feelings toward him and wanted to kill you--

Farrelly as father: "God dammit, I'll kill the little prick--

Farrelly: "You're too late, Mr. Jones. Now let me finish my professional explanation. But that thought too was unacceptable to him, so he repressed it also and killed himself. Because we know, Mrs. Jones, we know that every suicide is a homicide. Your son was a murderer at heart.

Farrelly as mother: "Oh, Mr. Farrelly, I don't know what--

Farrelly as father: "Well, god dammit, I'm glad he's dead if he was that type of prevert--"

The patient has been observing this with an increasing frown, and he interrupts angrily, "Wellll, you sonuvabitch! That's another reason I ain't gonna commit suicide-- have you tell my parents all them lies after I'm gone!"

Farrelly: "What will you care? You'll be dead and long gone and it won't bother you one bit then" (Farrelly, 1974, pp. 165-166).

COYOTE TECHNIQUES: DON JUAN

Don Juan used conversations, teaching stories and assigned tasks to bring about change. Some of the tasks are nonsensical, such as drawing circles in the dirt, making arrangements of firewood or stones, always tying the left shoelace first, or sweeping debris from one place to another. Their purpose is to teach acting without believing, without expecting rewards, just for the hell of it. (Castaneda, 1974)

The process of stopping the world has steps. An early assigned task is freeing oneself from the encumbering expectations of others, of being taken for granted, by erasing attachment to personal history. This brings freshness, and freedom from boredom.

Another early step is learning to use death as an adviser. An immense amount of pettiness and impatience can be dropped by becoming aware of death. Don Juan once advised Castaneda that a boy who was acting out could be changed by being shown a dead body of a boy his own age and being forced to touch it, thereby changing his idea of reality. (Castaneda, 1972, p. 4)

It's important to assume responsibility for one's decisions, proceeding without doubt or remorse or complaining.

One learns to be inaccessible: to live without desperation or hunger or worry, using the world sparingly, without exhausting oneself or others.

Further, it's necessary to disrupt the heavy routines of life, in order to become free, fluid and unpredictable. (Canstaneda, 1972)

The field within which one learns all this is ordinary life. One can use encounters with the petty tyrants one meets in daily life to hone one's abilities (patience, cunning, sweetness and ruthlessness). The general procedure is to submit with humility to whatever the tyrant does, while observing his weaknesses. Then, at a moment selected intuitively, one suddenly stands up in public defiance. The tyrant, because of his weaknesses, will destroy himself. (Castaneda, 1984, 1987)

For example: a woman who worked in an office was being sexually harassed by a man named Henry. She formed an alliance with another man in the office, named Bill. Whenever Henry was in Bill's office, she would come in and flirt outrageously with Bill. Henry's face would turn purple. He got so upset, he turned Bill and the woman in on some charge or other. At the hearing, Bill and the woman were all innocence. "We have no idea what he's talking about," they said. Henry looked the fool and was demoted out of the office.

HOMEWORK TECHNIQUES: BASIC

The central homework technique is to find a problem behavior, and give the client homework to deliberately change that behavior. The object of changing the behavior is that the pivotal thoughts in private logic that engender this behavior will surface into awareness, where they will either change spontaneously or can be addressed during the session, thereby making the behavior change viable.

The trick lies in getting the client to change the behavior. One can ease them into it, tell them to, ask them to, beg, wheedle, plead, or use indirect suggestion, whatever works. (To go beyond this into using trickery or mockery is getting into coyote therapy.) Erickson was a master at getting people to carry out his directives. He would sometimes get people to dislike him and rebel against him, if nothing else worked.

Frequently, when the counselor makes a client aware of a problematic behavior, the client resorts to another one that's more primitive, that is, one that the client learned earlier in life. The counselor always deals with what the client is offering at the time, peeling away layers of behaviors like the layers of an onion. (Weinberg, 1984, p. 160) One can bring in the relatives of a client to enlist their cooperation in producing a change. Since most symptoms and behaviors are embedded in relationships, a change can often be worked more rapidly by working with the client's friends and relatives present. (Haley, 1963, p. 50)

Phobias reveal a further wrinkle of this process. The trick with phobias is to get the client to go through the phobic experience without thinking the associated thought and feeling the associated feeling. For example, Erickson had a client who was phobic of elevators. He had him ride in one while being distracted by a young woman who kept asking to kiss him. After one ride, the strength of the man's phobia was much reduced. (O'Hanlon, 1990, p. 180)

HOMEWORK TECHNIQUES: DIRECT SUGGESTION

One way to get behavior to change is by direct suggestion. There are three classes of assigned tasks.

The first is to ask the client to lessen a habitual behavior, as homework. But this is only one option.

The second class of directives has no direct relationship to the symptom. The point of these directives is to give the client a positive experience, an alternative to the problem experience, a new behavior that will spontaneously supplant the old one. Some of these are symbolic. (Erickson once asked a man with a drinking problem to go to a botanical garden and look at cactuses, and think about how they could go for years without water.) Some of these are on the order of "go for a walk." Erickson, among others, assigned thinking or reading about certain subjects, reading the Song of Solomon (to accept the longing to have children), reciting the alphabet backwards (for raspy voice), writing positive affirmations or one's life-story or a list of all the stupid things one's ever done, talking to oneself in a mirror (for Parkinsonism), sleeping on stones instead of getting spanked (for bed-wetting), cursing (to release frustration), looking at a tank of fish 30 minutes each night (for difficulty talking from cerebral accident), traveling (for overeating and inertia), moving to the hills (for ulcers), dancing nude in the dark (for inhibition), buying a house (for panic), giving away African Violets (for depression), getting drunk (to dethrone mother from life), investigation of echoes (for fear of falling), using contraception (to restore a happy sex life), planting a tree and getting pregnant (to ease grieving for loss of child), waxing floors (for insomnia), taking a dirty job (for stuttering and subservience), planting flower gardens (for depression), laying out towels to faint on (for stage-fright), reading books backwards (for stuttering and subservience), going fishing (for uncommunicating couple), having sex for fun (for overseriousness about sex), having fun (for overseriousness about everything), and having children (to end fainting spells).

The third class of directives has to do with altering the presented symptom or behavior in some way, other than lessening it to uncover unconscious motives.

(1) The frequency or rate can be changed. Have a person who binges on candy eat it slowly when not on a binge.

(2) The timing can be changed. Have clients schedule their depression for a certain time of day.

(3) The duration can be changed. Have the compulsive handwasher wash their left hand five minutes and their right hand 30 seconds.

(4) The location can be changed. Move a couple who argues into the bathroom, and have him take off his clothes and lie in the tub, all the while still arguing.

(5) Add an element. Clients are told to put on their favorite shoes before a binge.

(6) Change the sequence. Tape-record a harangue and play it back when the next harangue is about to start.

(7) Break the pattern into smaller elements. Tell a couple who argues to write it on paper and exchange papers every five minutes.

(8) Assign consequences. For every minute a person arrives late, he or she has to spend a minute cleaning the bathroom. (O'Hanlon and Weiner-Davis, 1989) Or one can make undesired habits difficult to do. A woman who smoked was asked by Erickson to keep her cigarettes in the attic and her matches in the basement.

Directives of the third type cover a range.

One can tell the clients to do what they're already doing, right in the office. A client's anxiety, for example, can decrease if it is encouraged. In fact, the more one asks a client to become anxious, including asking them to think of anxious situations, the less anxious they become.

One can tell clients to do what they're already doing, as homework. A couple who is fighting might be told to continue fighting. This is only used for rebellious clients, because the danger is that the couple might not come back, and you would have told them to go out and spend the rest of their lives fighting. I think it might be better to build in a "least amount of change" right from the start, so that even if they don't come back the problem might get fixed.

One can tell clients to do what they are already doing, but with an additional instruction to observe the results. A family who fights over dinner might be directed to continue fighting over dinner and watch carefully how people are behaving and feeling.

A stronger directive is for clients to do their behavior a little more, to exaggerate it a bit. A woman came to Erickson for help in losing weight. He instructed her to go out and gain from 15 to 25 pounds. While she was gaining this weight she could organize her thinking to be preparing to lose weight. She gained some weight and didn't want to gain more. Erickson finally permitted her to stop gaining weight at 20 pounds. She then went on a diet and lost the weight she wanted to. (Haley, 1963, p. 53)

A stronger directive is for a larger change to what they are doing, ideally in some way that initiates an avalanche of change. For example: a client came to Erickson reporting that he was lonely and had no contact with other people. All he did was sit alone in his room and waste his time. Erickson suggested he should go to the public library where the environment would force him to be silent and not have contact with others. At the library he should waste his time. The client went to the library and, since he was an intellectually curious fellow, he began to idle away his time reading magazines. He became interested in articles on caving, and one day someone at the library asked him if he was interested in exploring caves, too. The client became a member of a speleological club, which led him into a social life. (Haley, 1963, p. 46)

A yet stronger directive is that one can tell the client to stop most of the behavior. A woman who wanted to lose weight was told to fast for three weeks and then binge on Sunday. (O'Hanlon, 1990, p. 28)

And the strongest directives are that one can assign consequences. These are for people with strong will-power and motivation. The best consequence is one that's of benefit to the client. If a man who feels he should exercise more is required to get up in the middle of the night and do a number of deep knee bends whenever he experiences his symptom, then he is benefiting, whether he acts out his symptom or not. (Haley, 1963, p. 56)

HOMEWORK TECHNIQUES: GETTING DIRECTIVES FOLLOWED

Erickson was a master at getting his suggestions followed. One factor was his sureness. Or he would provoke the client into following his suggestions to prove him wrong. He also encouraged clients to follow his directions by emphasizing the positive aspects of the client's life so that they were pleased to cooperate with him. Besides supplying this context, he made suggestions which the client could easily follow and, in fact, emphasized how the client was already doing these anyway. (Haley, 1963, p. 46)

One can persuade a client to accept a suggestion by making it seem quite minor in nature. A cumulative change can be induced by basing it on small changes that the client can accept. Ask a client with insomnia to report next time that they believe they slept one second longer one night.

The advantages of adopting the attitude that a small change is sufficient are threefold:

(1) It takes the pressure off both therapist and client, so neither falls over their feet in the process of trying too hard.

(2) The client is more likely to be willing to make a small change than a big one.

(3) Any kind of movement may suffice to ignite hope in the client.

(Talmon, 1990, pp. 119-120)

If the client reports that the homework wasn't done, the counselor can condemn the noncompliance, and be puzzled and surprised at their improvement anyway. The therapist never takes credit for positive change.

If the client reports doing the homework partially, the therapist takes the blame. Counselors might say that it was their mistake because they misjudged the client's readiness. Or they can say the homework wasn't specific enough for the client to understand. This adds motivation for the client to do it next time. (Dykeman & Noble, 1997, p. 388)

HOMEWORK TECHNIQUES: INDIRECT SUGGESTION

Erickson liked to direct clients in such a way that they could not recognize that they were being directed and so could not defy the directive. At times he would do this by dropping a casual comment, at other times he would arouse the client emotionally on one topic and then mention another, apparently unrelated topic at that moment. The client would unconsciously connect the arousal to the new topic.

Another way to get over a suggestion indirectly is to use metaphors and anecdotes. One can be tricky. Anecdotes can include an idea which the client will recognize and defend against, but while defending himself against that idea he will be accepting others which encourage change.

Erickson used interspersal with clients he couldn't hypnotize. He'd talk about a neutral subject, like growing tomatoes, for example, and work in phrases suggesting relaxation and health.

Part (10): HYPNOSIS

HYPNOSIS: GENERAL

For a long time after Mesmer, hypnosis consisted of progressive relaxation and direct suggestion. Erickson pioneered the use of naturalistic induction and indirect suggestion. The giants in the field of Ericksonian therapy say that speaking directly with the unconscious can often speed up the process of therapeutic change. "It is a lot easier to make personal changes in an altered state than it is in the waking state" (Bandler & Grinder, 1981, p. 30). "The major positive attribute of an altered state of consciousness is that you don't have to fight with a person's belief system. The unconscious mind is willing to try anything, as far as I can tell, if it is organized and instructed in an appropriate way" (Bandler and Grinder, 1981, p. 99).

HYPNOSIS : NATURALISTIC INDUCTION

Anything that will ease a client into a state of trance is naturalistic induction. "The basic principle of doing a hypnotic induction is to watch for the physiological signs of developing altered states, and to do anything you can to amplify those signs" (Bandler & Grinder, 1981, pp. 34-35). "You will be able to induce altered states naturally, and you will be able to utilize them to achieve changes without the person consciously realizing that anything like 'hypnosis' has ever occurred" (Bandler & Grinder, 1981, p. 61). "Most of the time people went in and started talking to [Erickson] about intellectual things... and suddenly the time had passed" (Bandler & Grinder, 1981, p. 23).

Bettie Mitchell, the founder of Good Samaritan Ministries, uses hypnosis in a simple and natural way. When a client gets into deep stuff, she will shift her gaze away from eye contact, and will let her voice become soft and even. Her client will drift into trance.

Watch for fixity of gaze, pupil dilation, and slow blink rate. Look for relaxed or blank facial expression, general muscle relaxation, small involuntary muscle movements, flushing or other color changes in the skin, changes in breathing pattern, first facial asymmetry and then more-than-usual facial symmetry. Unconscious movement is slow and jerky. (Bandler & Grinder, 1981, p. 33)

Bandler & Grinder (1981) present a system for naturalistic induction (pp. 8-98):

(1) Match any part of the person's behavior. You might match the rythm of their breathing in some way, perhaps by breathing at the same rate they do, or speaking in rythm with their breath rate, or moving a hand or foot.

(2) Use lots of connecting words between your sentences, "and," "as," "while," "even as," "because", "if." "And while you're sitting there you might be wondering, what's going to happen next." Make the transitions smooth.

(3) Describe a situation in which you can become deeply involved, with a limited focus of attention, like jogging, reading, writing, watching TV or a movie. Describe only experiences that have to be there, like: "You can feel the beating of your heart. You notice the temperature of your skin."

(4) One might describe common trance states, such as a long car trip, sitting in a lecture, walking through the woods, riding in an elevator, or watching a movie. (Bandler & Grinder, 1981, p. 50)

(5) Or describe the current situation. "You notice the temperature of your left ear. And you feel the warmth where your hand touches your chin. And you can be aware of the sound of people shuffling papers in the room." Trance can be thought of as helping the client to ampify their responses to the environment.

(6) Use three pacing statements ("You can feel where your body touches the chair. You can feel how your arms are crossing, and how your foot touches the floor. You can hear sounds in the room from other people moving.") for every leading statement ("And you're becoming more relaxed. And you continue to get more comfortable. And you don't know what I'm going to say next.)."

(7) The unconscious doesn't hear negatives, so "Don't relax your breathing" is heard the same as, "Relax your breathing."

(8) If a client does something you didn't suggest, verbally incorporate it immediately. (Bandler & Grinder, 1981, p. 56)

(9) Make your beginning statements externally oriented ("And you are listening to the sound of my voice."), and then gradually increase the percentage of non-verifiable, internally oriented statements ("And you can begin to have a sense of contentment."). (Bandler & Grinder, 1981, p. 35)

(10) One can do pacing and leading nonverbally. Select behaviors outside the client's awareness (such as eye blinks, eye focus, muscle tonus), and feed them back by body mirroring. Either the client will become aware of the behaviors, or his unconscious responses will be amplified, deepening the trance state. (Bandler & Grinder, 1981, p. 43)

(11) One can use interspersal for trance induction. Use any discriminable behavior to mark certain words and phrases as you talk, words like "relax," "be comfortable," "feel comforted." One might lift a thumb, or change voice tone, or turn your head slightly. (Bandler & Grinder, 1981, p. 64) Erickson also used interspersal with people who "couldn't be hypnotised."

(12) Interrupt any automatic behavior (such as interrupting a handshake by raising the person's hand in front of their face), and during the moment of startlement, give instructions. "Allow your arm to come down slowly, and only as quickly as you can sink into a trance." (Bandler & Grinder, 1981, pp. 70-74)

(13) Erickson could induce a trance with a handshake. He used "kinesthetic ambiguity." He let go of a hand with varying touches so that one didn't know when he actually broke contact. The last thing he did before he let go was give a slight push upward at the wrist, inducing catalepsy.

(14) One can use overload. The classic technique is to have a person count backward by threes from a thousand, out loud, while you put your hands on their shoulders and turn them in a circle. When their attention is overloaded, give them a suggestion to go into a trance. "If at any point you discover that it is more comfortable to drop into a nice deep trance, do so in the realization that you are safe and in good hands." (Bandler & Grinder, 1981, p. 81)

A variation is to take the client's hand and start touching the thumbs and fingers, labelling each one as you do. Start making mistakes, and make them more often, and then start interspersing suggestions like, "As I touch your ring finger you feel more relaxed." (Bandler & Grinder, 1981, p. 82)

(15) Another induction method is personal power. If you can tell someone with perfect congruence to go into a trance, they will. If they go into a trance, fine. If they don't, wait until they do. (Bandler & Grinder, 1981, p. 84)

(16) Another induction method is stacking realities. Imbed a story inside a story inside a story. "A woman comes to see me, and she says, 'I have this presenting problem X.' I invite her to notice the wind moving the tops of the redwood trees as she looks out of the office window, and begin to relate to her a story about a young woman who had once come to me and had sat in that chair and had watched ... closely ... the tops of the same redwoods waving ... not pushed, of course, by the same wind ... back and forth ... and that young woman had fallen into a deep reverie; and even as she was listening to the tone of my voice, she remembered a dream in which she had gone to the country to visit someone ... someone special who had made her feel particularly comfortable.... (Bandler & Grinder, 1981, pp. 85-86)

(17) Or one can use confusion technique, jarring someone with a lack of meaningful transitions. "Have you ever read a book? What does it mean to have a book read (red)? It doesn't mean anything at all. Somebody told me one time that there was a 'blue Monday.' I said to myself, 'A blue Monday. That doesn't mean a thing. These things go together somehow, but they don't have any meaning.' They don't mean anything to me. They don't NEED to mean anything to you" (Bandler & Ginder, 1981, p. 23).

(18) "People come into my office and say, 'People have been trying to hypnotise me for years, and it has never worked.' They sit down and say, 'Go ahead and try to hypnotise me.' And I say,' I can't hypnotise you. They say, 'Well, go ahead and try.' I say, 'I can't do it. There's nothing I can do; if I decided to force you to keep your eyes open, that would make you keep your eyes open. I'll try. Keep your eyes wide open. Stay totally alert. Everything you do will make you stay right here and right now.' Then they resist me right into trance" (Bandler & Grinder, 1981, p. 13).

HYPNOSIS: MODIFICATION OF COUNSELING FOR TRANCE USE

Any counseling techniques can be used during hypnosis. Here, for example, are two ways that problem-solving might be modified for trance use.

(1) CONSCIOUS AND UNCONSCIOUS MINDS, WORKING TOGETHER:

(1) Identify a pattern of behavior to be changed. "Will the part of you that runs pattern X communicate with consciousness?" Establish an unconsious yes-no signal, or observe the client for unconscious changes.

(2) Separate the behavior from the motive for it. "Would you be willing to let me know in consiousness what you are trying to do for me with pattern X?" "Is that intention acceptable to consciousness?"

(3) Create new alternatives to satisfy that motive. "Will the part that runs pattern X please communicate with the creative part while it generates new alternatives. When you've generated ten new alternatives, please give the yes signal."

(4) Evaluate the new alternatives. "Please choose at least three out of the ten that will actually work. Give the yes signal when done."

(5) Select one alternative to try for three weeks. "Please try out the new behavior (or response) for three weeks. If the strategy fails, please generate new strategies, elvaluate them and try a new one."

(6) Try out the new alternative in fantasy to see if it works or has side effects. "Is there a part that objects to the new alternative?" If yes, recycle to step 3. (Bandler & Grinder, 1979, p. 160)

(2) UNCONSCIOUS MIND:

(1) Induce a trance, waking up the unconscious.

(2) Establish yes and no signals from the unconcious, or watch the whole body for responses.

(3) Identify a pattern of behavior to be changed. "Do you have a behavior pattern you want to change. Will the part of you that runs pattern X communicate with me?" Establish a yes-no signal, or watch for unconscious reactions in the body.

(4) Separate the behavior from the motive for it. "Is that intention acceptable to consciousness?"

(5) Create new alternatives to satisfy that motive. "Will the part that runs pattern X please communicate with the creative part while it generates new alternatives. When you've generated ten new alternatives, please give the yes signal."

(6) Evaluate the new alternatives. "Please choose at least three out of the ten that will actually work. Give the yes signal when done."

(7) Select one alternative to try for three weeks. "Try out the new behavior (or response) for three weeks. If the strategy fails, generate new strategies, elvaluate them and try a new one."

(8) Try out the new alternative in fantasy to see if it works or has side effects. "Is there a part that objects to the new alternative?" If yes, recycle to step 3. (Bandler & Grinder, 1981, pp. 147-160)

PART (11): COUPLE AND FAMILY THERAPY

COUPLES THERAPY

"In every marriage more than a week old, there are grounds for divorce" (Anderson, 1972, p. 39). When you're counseling a couple, you have three clients: each of the individuals, and the relationship between them. In addition to personal work for the individuals, what might be needed are communication, negotiation, and relationship tools for the relationship.

Begin by introducing yourself and welcoming the clients, congratulating them on taking this step, and ask them if they've done counseling before. Explain in a few sentences that you regard yourself as their assistant, guide and coach, and are here to help them with what they want to do. Explain that your job is to be fair, and ask them to tell you when they feel they're being treated unfairly.

Balance is critical. Stay even-handed, or the counseling will fail. The clients should feel that they get roughly equal amounts of time, attention, and opportunity to express themselves. Ask them to tell you when they don't. Always ask the second partner the same question right after asking the first partner. Even better is to ask "both" or "the two of you." Moral balance (accepting them equally, judging neither) is maintained with systemic thinking. No one in a system is right or wrong.

Ask them how they decided to come in, what precipitated it. What brings you here? Get a clear picture of the presenting problem, using empathy and summarizing. Use the summaries to point out things the couple have in common. Ask them to rate their relationship on a 1-10 scale, and then ask them what's good about the relationship that they rated it above 1. Ask what solutions have been attempted, what changes are sought ("What would you like to accomplish?" "If things could be different, how would you like them to be?"), what recent changes there have been, and ask about the history of this problem in the family of origin. (Weeks & Treat, 1992, p. 14) Ask how long the couple's been together, where their parents live, how many children they have, how they met, where they work.

Don't send them home with nothing to do. End by asking them if they could do one thing different this week, what would they like to do? Rather than call it homework, call it an experiment.

Along the way, use the basic counseling tools of empathy, summarizing, humor, praising strengths, and questioning to clarify (by asking for specifics), to challenge and to look for pockets of feeling. Reframe the negative to positive. Normalize to ease fears.

Phase one in couple counseling might be thought of as facilitating communication, and modeling and teaching communication skills. This starts out with translating, and later includes teaching clients to find the positive in negative feelings, to acknowlege each other and to clarify common goals, and to communicate desires without criticism, blame or contempt.

Friedlander et al, 2000, investigated counselors' responses to blame. They recommend responding whenever it's heard. One way is to create uncertainty about it. The single most commonly used response is focusing on the positive. There are three categories of interventions for blame: diverting, challenging and reframing.

Diverting consists of:

1) focusing on the positive.

2) asking a question to focus on feelings.

3) interrupting.

4) highlighting neutral information.

5) emphasizing a successful resolution of the problem.

Challenging consists of:

1) identifying blame as a topic for discussion.

2) putting the problem in context.

3) challenging black-and-white thinking.

4) questioning the blamer about the other's point of view.

5) speaking for the client in response to the blamer.

Reframing consists of:

1) focusing on competence.

2) focusing on the positive.

3) using metaphors.

4) redefining or reinterpreting.

5) expanding the theme to bring in new perspective.

Phase two might be thought of as moving on to negotiation skills. (A technique for people who fail at negotiation is the Mediation Technique in Appendix 3.) The couple might need to begin by negotiating an agreement to fight fair, if they aren't doing that already. Fighting fair involves agreements about such things as voice tone, raised voices, threats, criticism and contempt. If they're already fighting fair, the couple can move on to negotiating about boundaries. Which is what negotiation is for.

Boundary issues have to do with who lives where, when, who is allowed to give input on what issues, who is present in certain locations, and how time is spent. (Hudson & O'Hanlon, 1991, p. 131) They also have to do with fears and taboos. And the word "bounday" is also used for relationship states, like enmeshed or distant.

Phase three might be thought of as changing the patterns the couple's fallen into, usually with homework. It's a good idea to emphasize that the homework is an experiment. The art of changing patterns is powered by systemic thinking. An important general principle is that the more longstanding the difficulties, the smaller the steps that will need to be taken in getting back on track. (Hudson & O'Hanlon, 1991, p. 79)

Here are some examples of homework for couples. Have each person keep a secret list of things their partner does that they like. Have a person write a continuous letter to resolve old feelings. Have people rebuild healthy rituals. Have the two people reverse roles for awhile. Pat Hudson was seeing a couple where the wife complained that the husband payed more attention to the dog than to her. So Pat had her be the dog. "Don't sit in the other room waiting for him to seek you out. Take action!" (Hudson & O'Hanlon, 1991, p. 109)

Phase four might be thought of as building love. To build love, recognize your partner has a different and valid map of love. What does love look like and sound like to each partner? Get each partner to do more of what feels like love to the other. (Hudson & O'Hanlon, 1991, pp. 157-158) It sounds simple, but there can be a lot of negotiation and feelings involved.

When one partner won't cooperate or is destructive, one needs a hierarchy of interventions. First, make it clear that there's a problem, and it's serious. Ask the person to stop. Second, change the pattern. Get an agreement that a drunk will let his wife drive him home in exchange for her stopping haranguing him about it. Third, make the boundaries and limits crystal clear. The confronter might begin by saying how much the partner is loved, how much the relationship means, and asking for cooperation to keep it alive. And then they need to make it clear that there are escalating consequences. And that the final consequence is the end of the relationship. Fourth, when couples are rebuilding a relationship after one has done something inappropriate, apologizing isn't enough. Action must be taken to make amends. "What can I do to make it up to you?" (Hudson & O'Hanlon, 1991, pp. 111-124)

"As part of our research, we carefully checked the amount of time couples spent fighting versus interacting positively-- touching, smiling, paying compliments, laughing, etc. Across the board we found there was a very specific ratio that exists between the amount of positivity and negativity in a stable marriage, whether it is marked by validation, volatility, or conflict avoidance.

"That magic ratio is five to one. In other words, as long as there is five times as much positive feeling and interaction between a husband and wife as there is negative, we found the marriage was likely to be stable. It was based on this ratio that we were able to predict whether couples were likely to divorce: in very unhappy couples, there tended to be more negative than positive interactions" (Gottman, 1994, p. 57).

The secret to making a relationship work is not so mysterious: it lies in treating each other well. The underlying attitude to make that work is for both people to accept the other as he or she is. That's not easy to do, but it's vital. If one person is unaccepting, they're likely to cross the fine line between complaining (which is positive) and criticism (which is destructive). "You never pay any attention to me," is a criticism, because it casts blame (something's wrong and it's your fault). "You idiot, you don't love me anymore," is a contemptuous thing to say, because it includes name-calling. "I feel sad because I feel like we haven't been connecting lately," is a complaint. "I miss you. I'd really like it if we could spend some time together soon," is a request.

CRISIS COUNSELING

When a family comes to a counselor, it's often because they're in a crisis. That's not so often true of individuals. They might come because they want their life to be better, or to solve a problem. Couples often come because their relationship is in trouble. But families often wait until they're in crisis. The goal of crisis intervention is the resolution of the presenting problem, and returning the client to the pre-crisis level of functioning. Crisis intervention might be thought of as a timely and beneficent intrusion into peoples' lives.

If they're in a physical crisis, then of course they're referred to the appropriate people to handle that. The counselor will normally see them once they're out of physical crisis (or perhaps between physical crises) and are dealing with emotional crisis. They may be feeling numb, disoriented, helpless, lonely, indecisive and panicked. They may be seeking help, consolation and advice. (Roberts, 1990, p. 4) The first thing they need is psychological first-aid. An important part of the first-aid kit is hope. (Hafen & Peterson, 1982, p. 3)

FIND OUT IF THIS IS A CRISIS: A crisis might be thought of as a sudden loss of the ability to cope with life. If a family comes to you with lives that are chaotic, and it turns out that they're always that way, then they're not in crisis. So one of the first things to do is find out if this is a crisis. Disastrous as it may seem to an outsdier, this may be their "normal." But even if it is, assess the danger.

START A SESSION: One might start a session with a family who is in crisis by asking everyone in the room to stop and take a few deep breaths and relax their bodies. Have them shake their shoulders, and massage their own necks for 30 seconds.

EXPLORE FEELINGS: Help them explore feelings and emotions. Give everyone in the room a minute to say how they're feeling right now. Validate their experiences.

DANGER MANAGEMENT PLAN: Make a plan so that everyone will be safe.

PRESENTING PROBLEM: Energies are directed toward the resolution of the presenting problem. The problem is assessed, rather than the client. "What situation or event led you to seek help?" One might begin by helping the individuals gain an intellectual understanding of the crisis. "What does this event mean to you, your expectations, beliefs, and goals?" Use systemic problem-solving to explore alternatives and possible solutions. "If you were out of crisis, what would your lives look like?"

Explore past and possible future coping mechanisms. "How do you handle situations like intense anger, loss of a loved one, disappointment, failure?" "How will you handle a crisis like this one in the future?" (Aguilera, 1998, pp. 18-23)

SUPPORT SYSTEM: Find out what kind of support system the clients have. Encourage them to seek support from the people around them. Encourage them to take good care of themselves, starting with the basics of sleeping well and eating well.

Help the client STOP COMPLAINING or dwelling on the past, and help them face their troubles. Have them do things to help EXPRESS FEELINGS (like dancing and journaling). Have them engage in SECRET SERVICE to others. Helping others, especially those you dislike, does wonders for depression and anxiety. (Hafen & Peterson, 1982, pp. 16-17)

FAMILY THERAPY

Everything just said about marriage counseling also applies to families. In addition, family counseling has its own challenges.

In family counseling, one has many clients: each of the family members as well as the web of relationships.

"You can't fix what's wrong till you understand it," so family therapy begins like individual counseling, with empathy, questions and summarizing. Balance is vital. One oddly useful question is to ask a family member how they see the relationship between two other family members.

A counselor might diagnose the family by asking questions like the following:

(1) How are their communication skills?

(2) How are their negotiation skills?

(3) Are criticism (blaming) and contempt (name-calling) practiced?

(4) Are feelings being expressed? Is the family narrow and rigid? Are there low self-esteem problems?

(5) What kind of stress is the family under?

(6) What developmental stage is the family in, and are they stuck at a transition?

(7) What's the family's structure in terms of what the family rules are, and who makes them? (Families fight hardest over who makes the rules.)

(8) What are the subsystems, coalitions, and alliances? Who has the power, and how is it transferred or delegated?

(9) What are the relationships like? Relationships range along a spectrum from fused to clear to distant to conflictual. (Gladding, 1998, p. 214)

(10) Looking at structure, alliances and boundaries is the application of game theory. How does love theory apply to this family?

(11) How does systems theory apply? Separate the problem from the people. The person isn't the problem; the problem is the problem. What influence has the problem had on the person? What influence has the person had on the problem?

As with individual counseling, diagnosis segues into intervention. Questions can be used to clarify, as well as to challenge and look for pockets of feeling. Since perceptions differ, one can ask everyone the same question. Enactment and sculpting can clarify family structure and bring up feelings.

One can do something the family doesn't usually do: give feedback, pointing out dynamics and patterns of behavior. Use positive connotation. Praise strengths. Focus on exceptions. Take the position that change is inevitable.

One can identify what's a problem and what isn't, and make it clear that only a small amount of change is necessary. One can use reframing to put the problem in behavioral and interactional terms, so that it's something solveable.

If there's an underdog, the counselor can form an alliance with them against the rest of the family, as one way of interrupting the pattern. But it's usually better for the counselor to stay out of alliances, and find other ways to alter the pattern. There are many. Directives are important in family therapy.

One might ask parents who are distant from each other to tell the kids they have a secret, and they are never to reveal what the secret is. (Gladding, p. 244) One might ask family members to observe their own family-members. One might ask each family member to do one thing different. One might have people write, read, and burn their thoughts. Or have them draw pictures of how they feel.

One might write letters to the clients after the sessions summarizing the good news, though most counselors are wary of this for legal reasons. Some counselors do it routinely. One might have celebrations and certificates for goals reached.

One can go beyond changing the pattern. "Use the existing system to create a new system" (Bandler & Grinder, 1982, p. 171). In order to do that, ask who is the one person who can change all the others? Often it's not the aggressive and boisterous person. What you want is the person with tenacity.

Bandler and Grinder (1982, pp. 167-171) tell about a family who came to them for help. When the mother spoke, the husband climbed into the cushions of his chair and hid. The oldest son fought back with the woman, "Rrrrrhh!" When the mother went after the oldest son, the youngest son reacted as though she were going after him. The youngest child was a daughter. The counselor took her aside and said, "Look, I need your help. I want you to play this game with me, and it's going to be our secret. If you play this game with me, something magical is going to happen when you come back here next week!" Previously the little girl had always hidden when the mother started criticizing her brothers. She was told, "You don't need to do that. I want you to test your powers, because I'm giving you powers that you didn't know you had, that you have now. If she's yelling at Billy, I want you to go up to her and simply tug on your mother's hand and ask her the following question: 'Mommie, do you love Billy?' and keep doing it until you are convinced she is telling you the truth."

This little girl was great at it. She would say, "Mommie, do you love Billy?" And the mother would say (angrily), "YES!" When she asked again, "Mommie, do you love Billy?" the mother would say softly, "Yes, yes, I do." "Do you really, Mommie?" The little girl went on and on like that.

When the mother answered the little girl's quesion, she typically went into an explanation of what she was doing. She started to communicate the intentions behind her behavior. Everybody wanted to hang out with the little girl from then on. It wasn't safe to be anywhere else.

PART (12): GOALS

INSTRUCTION GOALS

The goal of instruction is that the client's frame of reference should be impacted in such a way that new behaviors and options become available, and new opportunities arise.

INSIGHT GOALS

A short-term goal is to address the presenting complaint, and through that to bring about whatever changes are necessary. A medium-range goal is to teach the client to do self-introspection, so that a counselor is "always within walking distance."

Another medium-range (and then on-going) goal is to get the client in touch with their feelings, if they aren't already. Another medium-range goal is to teach interpersonal and relationship skills.

A longer-term goal is to untangle the knots in clients' private logic, to change the frames of reference. Even longer-term goals are to help the client develop flexibility, balance, humor, spontaneity, perspective, harmony, acceptance of life as it is, optimism and (most importantly) hope.

PROBLEM-SOLVING GOALS

The goals of changing the response are to alter the client's internal ecosystem by inventing a new way to respond to an old trigger, or to invent a new solution to a problem situation. The new response or solution will have ramifications thoughout the client's frame of reference, bringing about healthier responses to other triggers, more flexible solutions to other problems, and a more dynamic balance overall.

COYOTE GOALS

The general coyote goal is to trick the client with mirroring, reframing, or binding into healthier behavior, and to change the client's frame of reference into one that's more resilient and creative and joyful.

The goals of Provocative Therapy are that the clients should affirm their self-worth, learn to use assertiveness appropriately, defend themselves realistically, engage in reality-testing and engage in risk-taking behavior, particularly in the areas of communicating vulnerability and affection. (Farrelly, 1974, p. 56)

Don Juan's goals are to solve the presented problem (using it to teach and empower the client), and to foster detachment, patience, cunning and sweetness. The ultimate goal is to overcome self-pity and become free: able to laugh, be patient, improvise, be creative, be joyful, and be capable of controlled folly.

HOMEWORK GOALS

The general goal is to lessen or transform the maladaptive behaviors or symptoms. This might involve changing the social situation so that the symptom is no longer useful or necessary. More specifically, the goals are to get the clients to change their behaviors and thereby their private beliefs, their ways of relating to others, their self-images, their feelings of self-worth, and their goals and dreams.

COUNSELING GOAL

The general goal of therapy is that there be a behavior change and at the same time a change in feelings and private logic. Since attitudes and behavior support each other, they both need to be changed in order to create a new stable system. The point of behavior/attitude changes is to become a happier and more functional person, to live a better and more satisfying life.

"Once upon a time there was an old Zen master named Nonoko who lived alone in a hut in the woods. One night while Nonoko was sitting in meditation, a powerful stranger came to the door and, brandishing a sword, asked Nonoko for all his money. Nonoko continued to count his breaths while saying to the stranger, 'All my money is on the shelf behind the books. Take all you need, but leave me ten yen. I need to pay my taxes this week.'

"The stranger went to the shelf and removed all the money except ten yen. He also took a lovely urn from the shelf. 'Be careful how you carry that urn,' said Nonoko, 'It can easily crack.'

"The stranger looked once more around the small barren hut and began to leave.

"'You have forgotten to say thank you,' said Nonoko.

"The stranger said thank you and left.

"The next day the whole village was in an uproar. Half a dozen people claimed they'd been robbed. When a friend noticed that Nonoko's urn was missing, he asked Nonoko if he too had been a victim of the thief.

"'Oh no,' said Nonoko. 'I loaned the urn to a stranger, along with some money. He said thank you and left. He was pleasant enough, but a bit careless with his sword'" (Rhinehart, 19??, p. 140).

SUMMATION 1

Counselors listen for trends in what the client says, and watch for patterns in what the client does. These trends can be pointed out to the client (interpretation and challenge), or the client can be led to discover them (insight). Clients can imagine restraining themselves from these habits, in order to surface the motives behind them, or restraint can be experienced during the session or supplied as homework. Alternatives to these habitual patterns can be provided: by being pointed out, by discovery, by being worked out, and as homework. Homework ideally fulfills at least three functions: (1) mildly suppressing the habitual behavior, (2) giving the client an experience of a better alternative, and (3) blocking the old behavior (if necessary). The use of mirroring, reframing, and psychological binds can sometimes provide quick ways to replace dysfunctional habits, but they must be used artfully or the client will feel betrayed rather than helped.

REALITY CHECK:

Talmon (1990) points out that 30-80% of clients come for one session. So one must of necessity master single-session therapy. The principles are similar to those of Brief Solution-Focused Therapy, with some additions. The best book I've found for this is Moshe Talmon's book, Single Session Therapy (1990). I provide a summation as Appendix 2.

Clients are paying to come to counseling. They should have a good time. They should leave feeling that they got a lot out of this hour, whether things to think about, or a chance to express feelings, or new ways of looking at things, or new skills, or an experience of clarity. It should be such a high point that they look forward to coming back next week. Otherwise, in the long run, they won't.

A word of warning. Counseling is a dangerous profession, as is any that deals with the public. One can lose clients for seemingly trivial reasons. I know a woman who lost a client because she yawned. The client got up and stormed out and wouldn't come back. So it's important to maintain malpractice insurance, act ethically and keep good records.

Counselors are dealing with peoples' feelings, and if someone gets angry, they might sue. A story I've heard making the rounds is of a woman who went to a lawyer and said, "I need some money to pay for graduate school. I've been to five counselors in the last year. Which should I sue?"

The lawyer asked, "Did any of them touch you?"

"No."

"Did you touch any of them?"

"Yes. I shook hands with one."

"That's the one we sue."

Whether it's true or not, this story reflects the level of danger counselors feel they live in.

"And the clients aren't the only danger. Temerlin (1968, 1970) came up with some "hair-raising" findings that should terrify anyone who had to face a psychiatrist or clinical psychologist for diagnosis. You might be the epitome of mental health, but if a prestigious psychotherapist should cast aspersions on your normality, then other psychiatrists and psychologists will damn you as mentally ill just to follow suit.

"Since it is impossible to find a person in perfect mental health, Temerlin's experiment utilized an actor who feigned all the symptoms, signs, attitudes, actions, feelings, and accomplishments of a person enjoying absolute mental health-- at least as healthy as one could be. He, Temerlin, had a prestigious confederate drop the remark: "A very interesting man because he looks neurotic, but actually is quite psychotic." The comment was all that the professionals needed. All twenty five of the psychiatrists present denied that he was mentally healthy. Fifteen of them labeled the man psychotic, the rest neurotic. Only three of the clinical psychologists saw the subject as healthy, seven of them condemned him as psychotic, and another fifteen as neurotic. Actually, laypeople did better. Yet, alas, even they did poorly. It shows the immense social influence authorities carry. We lose all confidence in our own good judgment in the face of theirs.

"If you think that the foregoing was not indictment enough concerning out psychiatrists and clinical psychologists, then get sick over Rosenhan's (1973) experiment. Rosenhan would caution us not to get caught in a mental hospital! If you do, then whether or not you are in perfect mental health, they will condemn you as ill. He had five men and three women disguise the fact that they were normal so as to be admitted as mental patients. Once being admitted, they behaved as their usual normal selves. Rather than the authorities seeing these pseudopatients as the healthy people they were, they perceived them in terms of their diagnosis on entering the hospital. Only the psychotics-- the inmates-- could tell they were faking. Still worse, if you are well outside a mental hospital, then once you become a patient, then conditions are such that you will go berserk or be seen as one who is ill. You may go for a walk out of sheer boredom, for example, but the staff will read that behavior as nervousness. Or you may be found writing, and that will be interpreted as compulsive behavior correlated with schizophrenia. Your regimen of depersonalization alone is sufficient to create mental problems. Rosenhan's experimental findings would advise that a mental hospital is no place for a sick person-- or for a well one either. It is comparable to going to a disreputable hospital and picking up all the diseases circulating there-- or becoming worse due to the incompetent staff. Rosenhan concluded that 'we cannot distinguish insanity from sanity' and that 'we cannot distinguish the sane from the insane in psychiatric hospitals' (1973, p. 257)" (Sahakian, 1986, page 1).

And the clients and counselors aren't the only dangers. Supervisors can be a danger to clients and counselors both. For example, Hiram worked in a clinic with a supervisor named Jake who'd been traumatized on the subject of suicide. Jake had once had a client who went into an emergency room and shot himself right there in the waiting room. While the body was still lying on the floor, Jake was called to the scene. An experience like that would leave anyone feeling shaken, and Jake was a "little bit jumpy" about suicide. When Hiram's client talked in session about her brother's and mother's suicides, Jake called the police and had them take the client to triage, which so tramatized the client that she blew out of treatment.

But the dangers are not the point. All life is dangerous. All one can do is be ethical and honorable, and do continuing research in order to know (as best one can) what one's doing. One has to walk with a certain balance through human affairs, but it can be done. Men like Milton Erickson danced through human affairs. A young man once came to him for counseling, and Erickson wound up going out to dinner with the obstreporous father and doing counseling with him quite against the man's will. The relationship between the father and son got better, and if you'd asked the father, he would have said, "Me? No, I never did counseling with Milton Erickson. Why do you ask?"

SUMMATION 2

It's now the spring of 2001, and I've finished the classes for the master's degree. Reviewing what I've learned for a comprehensive test has gotten me to asking myself what it all means.

It seems to boil down to three things. One of these is: motivation. Another is: self-soothing. And the third is: trance states.

This may take a little explaining.

(1) If you want to understand me, you need to know what motivates me. If I want to understand you, I need to ask, what do you want? (Then there are the accompanying implied questions, like: what can you do to get it?, how hard are you willing to try?, what's in your way?, what are some possible strategies?, etc.) You can't get what you want till you know what it is. So asking what you want leads inevitably to problem-solving, and plans to get what you want, and efforts.

(2) Another central consideration is: what do you do for self-soothing? Unless your life is stress-free, you're going to need some soothing. Some do hot tubs, get massages, go jogging, clean the apartment, climb mountains, things most people would regard as positive. Order, perfectionism, and even vengeance can be regarded as sefl-soothing. Some work constantly, take drugs, acquire things compulsively, over-eat, criticize others, clean or do other actions most people would regard as negative. Has it gotten out of hand? This gets tricky because there's a slippery slope here: even positive self-soothing can slip over the line and become addiction. At the point where self-soothing becomes avoidance, it becomes compulsive, and a self-limiting habit that will have to be changed one day.

(3) It's amazing how many common human experiences turn out to be trances. Sleep, to take the most obvious one. We all spend a third of every day in a trance so deep we're oblivious to the world. Death is another. A dying person goes through the same experience as a person going into a really deep trance, only they don't come back out. The contraction of embarrassment is going into a light trance. "Getting a button pushed," "having a movie roll," contracting into defensiveness when there's a threat of humiliation can be fairly heavy trances. Extreme anger is a heavy trance. Fever puts people into trance. Daydreaming, reverie, driving home and not remembering the trip, focusing on something to the point where you're oblivious of your surroundings, all these are ordinary daily trances. Depression is also a trance state, as are obsession and perfectionism and workaholism. Persisting fears are trances. Some things that aren't common experiences are also trances. Going into shock is going into a trance.

Hysterical strength is a trance phenomenon. The dissociative disorders are trances. (Dissociation is the medical term for going into trance.) People can forget their identity in trance, or develop multiple personalities. When a person with multiple personalities shifts from one personality to another, it looks like a tiny siezure, which is what one would expect of a trance phenomenon. Schizophrenia is a deep trance. The hallucinations are cause by the fact that the person has gone so far into trance that they are dreaming at the same time they're awake. Their dream self woke up, but in a chaotic way. People who can wake up their dream self at the same time their waking self is already awake, in a smooth and controlled way, are called sorcerers or holy people. They can do anything in the waking state they could do in the dream state. This is a source of "psychic powers." The reason schizophrenics don't have pyschic powers is because they're out of control of themselves. There are two kinds of recovery for a schizophrenic. One might be to revert back to an ordinary person, and the other might be to gain control and thus become a sorcerer, in the Carlos Castenada sense of the word.

But trances aren't exotic by nature. They're built into our daily lives. I was at a party one night recently. A pretty young woman was there. Some photos were being passed around, and some of them were of her at a nude beach. Several young men there teased her about "seeing her boobies," and her reaction was to duck her head in embarrassment and walk away. But I could see that she had also gone into a light trance. Suddenly it all made sense. For her to think in her mind, "Oh, these guys think I'm attractive," has little power. It's just a thought. But for her to contract into a light trance gives the experience the added power of hypnotic suggestion. She FEELS that she is desired, and she FEELs the invasive quality of it, and the unconscious connects these feelings. Our attitudes are built up of conscious thoughts,and also from these unconscious, trance-state impacts. Women aren't "taught" that they're beautiful. They're imprinted with it. We're all imprinted by those around us. One way we do it is with jokes. Laughter is a moment of delightful trance, and for a moment we're open to change if the impact is positive, and hurt feelings if it's not.

Children can be imprinted with stupidity or success. A study found they thrive when their teachers are told they're brilliant, even if they're of average intelligence. They can be imprinted with self-confidence, or as easily with low self-esteem.

A hypnotherapist I know commented that a lot of the people who come to him are already in a trance when they come in. His job isn't to get them into trance, or even to get them out of it, but to join them where they are, and then alter their trance into a more beneficent form. Indirect suggestion is a wonderful tool for that reframing process.

People would get into a conversation with Milton Erickson, drift into trance without realizing it, make some changes for the better in basic and powerful ways without noticing it, and then drift back to the conversation feeling refreshed. And the whole thing would feel so natural and relaxed that they wouldn't even notice that something very odd had just happened, though if you asked them, they remembered it all.

The more counselors can deal with the unconscious, the quicker they can help people change. Counselors may be thought of as artisans of the unconscious.

SELLING WATER BY THE RIVER:

So what is it that we, as counselors, do?

Our clients are suffering from thirst, so we sell them some of the waters of compassion, and listening, and clarification, and support for change. But even as we do this, we keep pointing out the paths that lead down to the great river that flows endlessly by, of creativity, satisfaction with life, love of self, love of others, and joy. Even as we slake their immediate thirst, we try to end their dependence on us and bring about their immersion in the source: life itself.

It's been amazing to me to get into the field of counseling and find out that many counselors don't know the first thing about counseling. The first thing is: respect for the client. We're all of equal value.

And many counselors also don't know the second thing about counseling, which is: find out what's wrong, and fix it. Wandering around looking randomly under stones isn't therapeutic. If a mechanic knows how to use every diagnostic tool in the shop, and doesn't know how to fix your car, he's not a mechanic. If counselors don't know how to find out what's wrong and fix it, they're not counselors.

In diagnosis class is school you learn to recognise mental illness. But you're never taught what to do for the "worried well," those who aren't mentally ill but who have problems that have mounted up to crisis proportions.

First you have to find out what's wrong? The actual process is straightforward. You listen and ask questions, and after awhile a gestalt emerges. You realize, oh, I see what's wrong here. In a word, you find the focus.

But this turns out to be a lot trickier than it sounds. The trick turns out to lie in: how do you define what's wrong? The devil, as they say, is in the details. The point is not that you define what's wrong in a way that's right. There are many ways to define a problem that are correct. The point is that you define a problem in a way that's not just correct but useful. The utility of a definition of what's wrong is that different definitions suggest different interventions. Or perhaps I should say, different broad categories of interventions.

For instance, I had a supervisee who defined what was wrong with a couple as being a lack of softness toward each other. That leads to interventions such as exercises to build trust and closeness. It's true that they lack softness with each other, but a more useful idea might be that what's wrong is that they're piling blame on each other. Defining what's wrong as being the presence of blame leads to interventions like confrontation about blaming, and exercises like taking a fast for a week from blaming each other. [Confrontation about blaming might begin with something like, "They have saying in India that if you love someone, they have no faults."] The point is that dealing with blame is likely to be a lot more effective in changing the relationship than dealing with lack of softness. Both are true, but one's a handle you can grab and actually change the relationship.

In the story of Milton Erickson sneaking into the guy's room and telling him he was an agent from the CIA, the difference between Milton and everyone else was in how he defined the problem. Everyone else thought what was wrong was that the guy had delusions he was in the CIA. Milton thought the problem was that the guy was in an institution instead of leading a normal life. Milton's definition was considerably more useful for bringing about change, and it certainly produced a novel intervention.

I had a supervisee who had a couple who were fighting during a session. I asked her later how she defined what was wrong. Her definition was that he was being angry and abusive, and she needed to be protected from him. The result was that the supervisee cut off his angry tirades, and he started feeling like he wasn't being heard, and she wound up losing her detached postition as counselor and being sucked into the whirlwind of their melodrama. How might she have defined their problem in a more productive way? Maybe: they're both in pain, and they're lashing out at each other when they could be supporting each other through this bad time.

So what might be wrong? What kinds of problems does one encounter? In 5 months of working in a crisis clinic, mental illness as defined in the DSM-4 was rare. Some of the problems I ran into were: feeling overwhelmed, feeling like a victim, fearing rejection, being anxious or depressed or having panic attacks, feeling astranged from God, being in change shock, grieving, being sleep deprived, having ADD. Parents were using punishment rather than consequences on their children. One couple had different ideas what an angreement they've made actually was, another lacked communication skills, another had arguments that spiraled out of control, another was in fullblown conflict during divorce proceedings, and several had power struggles and abuse going on.

In school you are taught a lot of tools, including diagnostic tools. But you're not exactly taught what to do with those tools, the wisdom to understand what's wrong. It has to do with basic beliefs. Do you believe it's better to be free and expressive? It has to do with values. Are all people innately equal in value, from business man to homeless guy? It has to do with who you are and your whole life experience. Do you like people? Have you been around the block a few times? For you, has the most interesting question in life always been: what makes people tick?

What can be wrong is almost as individual as fingerprints, and it isn't always something you can learn about in a book. Milton Erickson said he reinvented counseling for each new client. One thing he might have meant by that is that he approached each person as unique, and there were no limits on the creativity he might use to find a solution.

How do you fix what's wrong? The first thing you have to deal with is overwhelm, and after that you usually do something I call thrashing. You metaphorically roll up your sleeves and put your clipboard aside, and get in there and thrash it out.

Sometimes you're thrashing out an agreement two people can live with, sometimes you're thrashing out a new understanding. Perhaps a parent needs to understand the difference between punishment and consequences, perhaps a person needs to face some hard facts. (Of course, if they do, as their ally you are over there facing the hard facts with them.) Perhaps abuse is in the picture, and you're thrashing out a way to stand up to abuse, or to stay safe while getting away from it. Thashing is wonderful for the counselor, because you don't know when you start what solution is going to emerge organically from the effort. But one always does.

Just because you know how to think systemically doesn't mean that you know how to do systemic intervention. This applies more obviously to couples, but winds up applying to individuals, too. The first thing I need to do in a session is do a systemic analysis. Talmon calls that finding the focus. From the clients' side, finding the focus looks like identifying the most important problems. From the counselors' side, it looks like finishing your systemic analysis. "What's wrong is that she wants proof of love, and he tries to do it. Since it can't be done, he fails, leaving her feeling abandoned." That sort of thing.

To intervene systemically means that one can get one of the couple to change their beliefs (like, love can be proved) or their behaviors (like placating), and that'll interrupt the system. Or, if that fails, you can play tricks to try to inturrupt the cycle. Have the man whose wife gets upset if he notices other women on the street keep a count of the beautiful women he sees. Have his wife carry M&M's and give him one for each beautiful woman he sees. That kind of thing.

"The train clanked and rattled through the suburbs of Tokyo on a drowsy spring afternoon. Our car was comparatively empty-- a few housewives with their kids in tow, some old folks going shopping. I gazed absently at the drab houses and dusty hedgerows.

"At one station the doors opened, and suddenly the afternoon quiet was shattered by a man bellowing violent, incomprehensible curses. The man staggered into our car. He wore laborer's clothing, and he was big, drunk, and dirty. Screaming, he swung at a woman holding a baby. The blow sent her spinning into the laps of an elderly couple. It was a miracle that the baby was unharmed.

"Terrified, the couple jumped up and scrambled toward the other end of the car. The laborer aimed a kick at the retreating back of the old woman but missed as she scuttled to safety. This so enraged the drunk that he grabbed the metal pole in the center of the car and tried to wrench it out of its stanchion. I could see that one of his hands was cut and bleeding. The train lurched ahead, the passengers frozen with fear. I stood up.

"I was young then, some twenty years ago, and in pretty good shape. I'd been putting in a solid eight hours of Aikido training nearly every day for the past three years. I liked to throw and grapple. I thought I was tough. The trouble was, my martial skill was untested in actual combat. As students of Aikido, we were not allowed to fight.

"'"Aikido,' my teacher had said again and again, 'is the art of reconciliation. Whoever has the mind to fight has broken his connection with the universe. If you try to dominate people, you are already defeated. We study how to resolve conflict, not how to start it.'

"I listened to his words. I tried hard. I even went so far as to cross the street to avoid the chimpira, the pinball punks who lounged around the train station. My forbearance exhalted me. I felt both tough and holy. In my heart, however, I wanted an absolutely legitimate opportunity whereby I might save the innocent by destroying the guilty. "'This is it,' I said to myself as I got to my feet. 'People are in danger. If I don't do something fast, somebody will probably get hurt.

"Seeing me stand up, the drunk recognized a chance to focus his rage. 'Aha!' he roared, 'A foreigner! You need a lesson in Japanese manners!'

"I held on tightly to the commuter strap overhead and gave him a slow look of disgust and dismissal. I planned to take this turkey apart, but he had to make the first move. I wanted him mad, so I pursed my lips and blew him an insolent kiss.

"'Alright!' he hollered. 'You're gonna get a lesson.' He gathered himself for a rush at me.

"A fraction of a second before he could move, someone shouted, 'Hey!' It was earsplitting. I remember the strangely joyous, lilting quality of it-- as though you and a friend had been searching diligently for something, and he had suddenly stumbled upon it. 'Hey!'

"I wheeled to my left. The drunk spun to his right. We both stared down at a little, old Japanese man. He must have been well into his seventies, this tiny gentleman, sitting there immaculate in his kimono. He took no notice of me, but beamed delightedly at the laborer, as though he had a most important, most welcome secret to share. "'C'mere,' the old man said in an easy vernacular, beckoning to the drunk. 'C'mere and talk with me.' He waved his hand lightly.

"The big man followed, as if on a string. He planted his feet belligerently in front of the old gentleman and roared above the clacking wheels, 'Why the hell should I talk to you?' The drunk now had his back to me. If his elbow moved so much as a millimeter, I'd drop him in his socks.

"The old man continued to beam at the laborer. 'What'cha been drinkin'?' he asked, his eyes sparkling with interest. 'I been drinkin' sake,' the laborer bellowed back, 'and it's none of your business!' Flecks of spittle spattered the old man.

"'Oh, that's wonderful,' the old man said, 'absolutely wonderful! You see, I love sake too. Every night, me and my wife (she's seventy-six, you know), we warm up a little bottle of sake and take it out into the garden, and we sit on an old wooden bench. We watch the sun go down, and we look to see how our persimmon tree is doing. My great-grandfather planted that tree, and we worry about whether it will recover from those ice storms we had last winter. Our tree has done better than I expected, though, especially when you consider the poor quality of the soil. It is gratifying to watch when we take our sake and go out to enjoy the evening-- even when it rains!' He looked up at the laborer, eyes twinkling.

"As he struggled to follow the old man's conversation, the drunk's face began to soften. His fists slowly unclenched. 'Yeah,' he said, 'I love persimmons, too....' His voice trailed off.

"'Yes,' said the old man, smiling, 'and I'm sure you have a wonderful wife.'

"'No,' replied the laborer. 'My wife died.' Very gently, swaying with the motion of the train, the big man began to sob. 'I don't got no wife, I don't got no home, I don't got no job. I'm so ashamed of myself.' Tears rolled down his cheeks; a spasm of despair rippled through his body.

"Now it was my turn. Standing there in my well-scrubbed, youthful innocence, my make-this-world-safe-for-democracy righteousness, I suddenly felt dirtier than he was.

"Then the train arrived at my stop. As the doors opened, I heard the old man cluck sympathetically. 'My, my,' he said, 'that is a difficult predicament, indeed. Sit down here and tell me about it.'

"I turned my head for one last look. The laborer was sprawled on the seat, his head in the old man's lap. The old man was softly stroking the filthy, matted hair.

"As the train pulled away, I sat down on a bench. What I had wanted to do with muscle had been accomplished with kind words. I had just seen Aikido tried in combat, and the essence of it was love. I would have to practice the art with an entirely different spirit. It would be a long time before I could speak about the resolution of conflict" (Ram Dass, 1985, pp. 167-171).


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