- That is so random….
My present belief system is that clients seek help from a therapist due to their feeling stuck in some way. Their ability to work through what they perceive as a problem is hindered by their attempting to deal with the problem with a pattern of action/reaction which furthers to cement the pattern and, unfortunately, makes it worse. If clients are continuing to perform the same patterns of action, thought, and emotion toward the problem, then the problem will be maintained and clients will feel it insurmountable to overcome. This will lead to them perceiving their problem as a personal reality and their automatic responses to this “reality” further solidifies the pattern.
In order to facilitate a change in these patterns, I believe therapists must be comfortable talking about and doing things that are unexpected and random. Our therapeutic interactions are there to provide clients with new information which can be used to alter the patterns which have previously caused distress. When new and random information enters their present perceived reality, then their reality has to adjust. Sometimes merely giving straightforward logical information in dialogue may not be very effective due to the brain being stuck in a deeply entrenched pattern. Introducing the random into a session can cause the brain to experience different and new realities which can create a shift in how clients respond to their problems. As Gregory Bateson stated in his classic text, Mind and Nature, “Without the random, there can be no new thing.”
Random information can come from anywhere. Sources such as popular culture, spirituality, childhood hobbies, fine arts, etc. can all introduce new information about different ways to respond to old problems. Further examination of the problem and trying to solve the problem only continues the process of the problem. Introducing the random or unexpected into the problem alters the problem.
I once had a client who was dealing with social anxiety issues and panic attacks due to a variety of factors. He was very worried about running into people he used to know and their observing how little he had advanced in his life. He stated he knew he was depressed and was not in a good place to talk to former friends as he “did not want to burden them” with his problems. When he did go out he would sometimes have a panic attack which would cause him to immediately return home. He felt stuck and more depressed due to his inability to go out often.
PATTERN: Go out –> worry about seeing someone he knows –> think about the present condition he is in and the shame he has about it –> have a panic attack –> immediately go home
I heard him state that he didn’t want to “burden others” with his problems. I immediately latched onto how a desire to not burden someone was actually an act of compassion. I told him that his concern for how other people feel was quite remarkable. I complimented him on how compassionate he was to willingly allow himself to suffer so that others would not suffer. I told him it was possible that his unconscious mind could even be creating these panic episodes to help shield others from feeling his pain. He responded favorably to my conjectures. Our conversation on compassion continued as we discussed many other examples of times he was kind to others. Since he was a religious person, we also discussed the spiritual role of compassion and the many saints who had shown great compassion while going through hardships. The topic of compassion was a “random” entry into the interaction as neither of us expected it to appear. It did not fit the prearranged pattern of the problem.
I then told him that it was not fair for him to waste his compassion being alone at home. We had to come up with some way for him to help others with his strong sense of compassion. I told him he had much to teach all of us about how to become more compassionate in our lives. I reminded him about the hardships that the various saints had to face trying to spread their messages of hope to others. I let him know that he could not fully show compassion by staying at home. He needed to find somewhere to interact with others on a small scale to help them learn to have compassion toward themselves. He agreed that this was important work to do. In time, he found that when he did go out he was not as nervous as before and he found that he could interact with people with fewer panic episodes. The random inclusion of “compassion” into the pattern caused his reality to adjust. His previously self-defeating fear was now a source of compassion to be shared with others.
Random information does not come from a scripted, rehearsed treatment protocol. It can only come from an alive interaction with room for spontaneity. It also does not come from excessive problem investigation. When we allow the random to show up in our therapy room, we can let it flow as we ride the wave of interaction.
- Healing Trauma with Hypnosis in Nashville – January 27-29, 2017
Join me and Courtney Armstrong for a dynamic 3-day workshop that will teach you how to effectively heal trauma using a respectful, strengths-based hypnosis approach. This high-powered workshop worth 25 CE’s that is filled with experiential activities and practice sessions that help you discover: 1) why hypnosis is one of the most gentle and effective evidence-based tools you can use for reconsolidating traumatic memories, 2) how to use hypnosis to quickly rewire the brain and activate inner healing states, and 3) how to easily adapt interventions to fit your client’s spiritual, cultural, and personal needs.
This training will qualify you for LEVEL 1 Certification in Courtney’s cutting edge “Trauma-Informed Hypnotherapy“.
You’ll learn that hypnosis is not scary or complicated, but merely a way of communicating with the emotional brain where our emotional memories, attachment schemas, and automatic patterns are stored. You’ll see that when you speak to the emotional brain in a language it understands, it updates rather quickly and painlessly. Clients typically enjoy the hypnosis approach we’ll be teaching you, and often finish sessions feeling relieved and uplifted, rather than tired, retraumatized, or drained.
Don’t miss the fun, fascinating, and educating event!
For more information go HERE!
- Hypnotic Storytelling 101
- Creating Ethical and Effective Directives
I received a question the other day about the use of directives in psychotherapy due to my having written other posts about applying absurdity and paradox as effective therapeutic directives. The question I received is “How do you do directives in an ethical manner”? This question caused me to pause as I usually do not think about how I do directives as being unethical at all. Upon further reflection I think the question came about because of the power distribution within the session in which directives arise. In order to give directives, the therapist has to become the “director” of the session and cannot be merely a passive onlooker. This can create concern for those who are uncomfortable with having a larger amount of power and control in their therapy sessions. I completely understand this concern.
To address this concern, first, I must state that if you are a therapist it is crucial that you adhere to the ethical guidelines set forth by the organizations who are involved in your licensing (APA, ACA, NASW, etc.). Thoroughly knowing what is appropriate and what is not in the ethical codes is an important part of being a professional therapist. If there is uncertainty on one’s part about a course of action, I recommend consulting with a colleague or supervisor to bounce ideas off of so that one can have a better perspective on a directive. The allure of power can be seductive so it is imperative that we in the healing profession proceed with caution. At the same time, we need to not be so uptight and worried about what we are doing that we lose our spontaneity and creativity.
Secondly, I think the best way to use directives is to simply ask yourself, “Would I be willing to do what I am asking my clients to do?” If the answer is “yes”, then implement the directives. If the answer is “no”, then do not implement the directive. If we are unwilling to do what we are asking of our clients, then not only are we not congruent with the therapeutic offering, but we are also putting unnecessary burdens and expectations on the people we are trying to help. By approaching directives with this mindset, it creates an opportunity for us to expand our own comfort zones. If we ask our client to do an odd action to change his or her patterns of interaction, then why not implement that same pattern in our own lives? It may help us become less regimented and more creative in how we approach our own problems. I have a rule that I never ask any of my clients to do anything that I would not be willing to do. This helps keep me mindful of the issue of power in the therapeutic relationship and also reminds me that there are areas that I need to work on and expand in myself.
A recent example of this occurred when I had a client who was very anxious about having things in order. She specifically was bothered by the idea of germs in her home. I was able to get her to agree to not wash one of the pans she used in cooking for two days (it was no small feat to get that agreement!). This allowed her mind to observe that not having everything perfectly clean would not automatically lead to excessive germs and sickness. As I gave this directive, I noted that I can be a bit of a neat freak in my own home. I make my bed and wash my dishes daily and do not like things out of order. As a result of giving her the directive to not wash a pan for two days, I decided to implement a similar directive for myself. I did not wash a pan for two days nor make my bed. This may seem like it is not a big deal to some of my readers, but for me it was an annoyance to alter my usual routine. It did pay off as I reminded myself that routines are sometimes made to be broken and it also gave me a level of congruence with my client.
If you direct your client to stand up more for himself in situations where he would previously back down, then make sure you are willing to stand up for yourself in a situation where you usually back down. If you want your client to expand her comfort zone by try something new, then make sure you are willing to try something new outside your comfort zone. By being willing to do what we ask of people we can defend against potential ethical issues.
- That’s Absurd!: Using Absurdity to Create Change
Performing odd, unexpected and absurd actions in psychotherapy is not something one usually learns in graduate school. In fact, in my many years in training, giving absurd directives was never covered. There were examples of various leaders in the field doing strange things to create change but this was never followed up with explanations or encouragement on how to perform such actions. In really examining the use of absurdity and paradox in therapy we find that it is the unexpected that creates a sense of confusion in clients which opens the space for new possibilities to emerge.
Even though great therapists such as Whitaker, Haley, Erickson, Palazzoli, etc. have used absurdity and paradox in their work, as of late there does not appear to be much information in the literature about how or why to perform such maneuvers. I personally believe that being open to absurdity not only makes you a better therapist, but also allows you to have a happier life. The nature of life itself is absurd, so why not embrace this fact? Absurdity can be utilized for shaking up interactions in a way that forces clients to find a different way of relating to the situation which originally brought them to therapy.
In order to create absurdity in the therapy room, clinicians must be one hundred percent willing to abandon any rigid ways of interacting with clients. They should be prepared to act in a spontaneous and creative manner. To be absurd we need to not make any sense. This statement will clash with the prevailing paradigm of logical, left brained therapy which appears to engulf much of the evidence based research. We are often taught that we need to teach our clients to think and act rationally in order for them to change. Certainly these are good objectives, but I will raise the point that it is in learning to deal with the absurdity of life where we really learn to be happy. When we become confused by things we naturally search for understanding. While we are trying to make sense of certain absurd actions, we automatically are being stretched out of our habitual ways of relating to our world. With this stretching process we become open to new resources in how to respond to the absurdity of the moment and of life in general.
Some examples of using absurdity to create change:
1. I once saw a couple who were having issues due to the wife’s unwillingness to let her husband have any power in the relationship. She was very controlling but at the same time wanted her husband to “step up” and take some control in the household. The husband wanted to do this but every time he attempted to “step up” she would create a fight because it triggered her control issues and he would back down. He was stuck in a “double bind” situation (which was absurd to begin with). Even though both the husband and the wife logically knew what the situation was, nothing was changing. When they came to their first session, I got their approval for them to do anything I asked them to do as long as it did not violate any safety, security or ethical boundaries. I then told them to go home and on the next day that they were home alone with nowhere to go (which was the upcoming Saturday), they were to wear each others’ clothing for the whole day. The husband was to wear one of his wife’s dresses and she was to wear one of his suits. They were instructed to do whatever they wanted to do that day but they were not allowed to talk about how they felt about the change of clothing. They reluctantly agreed. On the next session, three weeks later, it was revealed that the wife had begun to allow the husband to take on more responsibility in the home.
2. A man in his late 50s came to therapy stating that he was emotionally wounded from the constant “destructive” criticism he received growing up. He stated that he was in a wonderful marriage and his wife rarely ever criticized him. He said the problem was anytime she would offer anything that was “constructive” criticism; he would emotionally withdraw because it would activate his old fears and emotional pain from his past history of “destructive” criticism. He was open to trying anything to get past this problem. His wife was called during the session and put on speaker phone. I directed her to constantly criticize her husband for the next three days about everything. I told her to let him know that he was breathing incorrectly eating incorrectly, sleeping incorrectly or anything else he naturally did. Clearly confused, both parties agreed to do it. When the husband returned in a week he told me not only had he not been upset at any criticism, but both his wife and daughter began to open up more to him to let him know how they felt about certain private things. The dialogue in the home was more emotional in a positive way and he felt closer to his family. He was clearly confused how getting criticism from loved ones for three days created the ability for a family to become closer and more loving toward each other.
In order to be effective at performing absurd actions in therapy we need to be sure that we have our clients’ best interests at heart and that we are asking them to do things which we would be willing to do ourselves. We are creating an alive” Zen Koan” in our therapy room when we allow absurdity in. By being open to absurdity and paradox we also free ourselves to become more creative in our interventions. There is not fixed pattern when we utilize absurdity. To do this we are jumping off into the unknown. This may be frightening to some practitioners who cling to standardized regimentation. To me, that is absurd!
For a case study of the absurd I offer the following clip from the Marx Brothers. Get out your notebooks and watch how literally everything within this clip is absurd, yet it creates a wider perspective of what could happen.