Creating Distinctions in Psychotherapy

Many times we are guilty of buying into the maps of reality that our clients bring to us. We often are not clear on how clients are creating their maps. I think we all need to stop and ask our clients (and ourselves) what distinctions were made to create their problems. Making a distinction is the first thing we do when we create some action, emotion, or thought. Making a distinction is how we create a problem (or solution).

 

distinction

 

Any “thing” that exists has to also “not” exist. We distinguish the “thing” from something else.

For example, someone who is “not happy” has to have experienced “happy” previously in order to experience “not” happy. When someone tells you they have never been happy, it is that they cannot focus on those times they were happy, not because they have never experienced happiness. They cannot “not” be something they have never been.

Nothing exists by itself. We end up making the distinctions between “thing” and no thing”. When working with our clients it is a good idea for us to figure out, as Gregory Bateson suggested, what is the difference that makes the difference (distinction).

If a client states he or she is suffering from depression, we as the therapist need to find out what is the distinction this person created to label what they are experiencing as depression (and as a “problem).

 

Example 1:

Client: I am really depressed right now.

Therapist: How do you know you are depressed?

(The therapist is asking for information on how the client has made a distinction of “depressed” and not depressed”)

Client: I sleep too much and don’t go out with my friends these days.

Therapist: So, if you were sleeping less and interacting with your friends more, then you might not feel depressed?

 

Distinction:  depressed / not depressed

Depressed: sleeping more and interacting less

Not Depressed: sleeping less and interacting more

 

 

Example 2:

Client: I am a horrible mother.

Therapist: How do you know you are a horrible mother?

Client: I yell and scream when the kids won’t behave.

Therapist: So if you could speak softer when your kids behaved, then you would be a good mother?

 

Distinction:  good mother / not good mother

Good mother: speak softer

Bad mother: yell

 

At this point, these distinctions are then framed into a context we like to call a “problem.” The context then determines how the person experiences their emotions, actions, and thoughts. By asking questions that push the distinction out of the problem context, the client can gain access to more flexible ways of responding to their situation.

 

GregoryBateson

“Without context, words and actions have no meaning at all. This is true not only of human communication in words, but also of all communication whatsoever, of all mental process, of all mind, including that which tells the sea anemone how to grow and the amoeba what he should do next.”

-Gregory Bateson (1904 – 1980) Anthropologist, Social Scientist, Linguist and Cyberneticist

 

Using Example 2 of the client who believes she is a bad mother:

Client: I yell and scream when the kids won’t behave.

Therapist: Those kids must mean so much to you for you to get that passionate about them doing the right thing.

 

(This comment begins to move the client out of the problem context set up by her distinction between what is a good mother and what is a bad mother. It forces one to question how a “bad” mother could also be “good.”)   

 

Client: Yes, but I need to learn to not be so loud and angry.

Therapist: Sure, but it does let them know that you care enough about them that you will not be negligent and let them get in trouble. In fact, you are willing to really speak up to love and guide your kids.

 

At this point, the context of the behavior has been changed and the distinction between good mother and bad mother has become a little blurry. If a mother who loves and cares for her children can also be loud and yell, then it is difficult to maintain the original distinction.

Take a problem a client gives you and do the following:

  1. Draw a distinction to identify one “thing” from the other:

thing / no thing

2) Try to understand one “thing” in relationship to the other:

thing / no thing

3) Now, try to understand the other things in relationship to the one “thing”:

thing (thing / no thing)

 

Now, use this formula and stretch your psychotherapy brain:

pathology / not pathology

spiritual / not spiritual

healer / not healer

etiology / not etiology

outcome / not outcome

theory / not theory

psychotherapy / not psychotherapy