Changework – the origin

…or “How to get your clients to pay YOU for the privilege of entertaining you”

As an undergraduate student in Psychology, I noticed that the “classical” or traditional forms of psychotherapy and intervention I studied had a very intense layer of abstraction contained within them. It wasn’t like in Math, where an equation is simple, predictable, and readily solved, once you understand the process (note to Math-phobics: Please emphasize that last phrase, as it’s key to not only equations, but to everything: “…once you understand the process”). Therapy appeared to have all these mystical components to it, analysis of relationships long since past, such as that between a patient (or client, depending upon the nomenclature in vogue at that time) and a dead parent. Freudian psychoanalysis, for instance, placed great stock in what that parent did, how they spoke to the client (as a child), and the ensuing issues along with the challenges and presenting symptoms that resulted from those issues. I was fascinated by the complexity, the abstraction. It just seemed like a great fantasy novel, this id, ego, superego, and the influence that a dead relative could still exert on the client. This bordered on gothic horror fiction or at least a good mystery story.

Years later, I am struck by how much of that analysis may have been created for the entertainment of the “doctor”. Not to trivialize or insult a form of therapy that, while complicated and abstract, may have in fact helped someone at some time. Rather, our history is filled with examples of superstitions being slowly peeled away from an explanation until we are left with a verifiable, repeatable process. For instance, consider that when someone is ill, we used to believe that they were possessed by evil spirits. To have contact with that person put us at risk of becoming similarly possessed (or catching their cold, as we later learned was really happening). Here’s the kicker – the evil spirits idea is functional. it satisfactorily explains the observable phenomena. That is, if a primitive tribesman had a cold and others sat with him, they often would indeed catch his cold. So far, with that information, we can’t disprove the evil spirits idea. But later we learned that it wasn’t evil spirits, but rather a virus, afflicting him. The irony is that while our new explanation is more scientific and contemporary, it explains the symptoms no better.

However at one point we noticed that the methods we used to heal that man weren’t working. Praying to a deity didn’t seem to help, nor did any sort of incantation to banish the alleged evil spirit. Suddenly we found a lack of functionality – our avoiding contact with the “possessed” man did seem to prevent the spread, however our treatment didn’t work. How could this be? It was after science advanced and we peeled back the superstitions, no matter how well they explained the phenomena, until we arrived at something we could demonstrate and repeat. That left us with verifiable facts, something upon which we could build customs and practices that supported good health (or keep us free from possession, if we cling to that).

Why does this matter? There is an old phrase in Neurolinguistic Programming, “the difference that makes the difference”. When we get to the essence, the real explanation, the formula, we can streamline our efforts, skipping the steps that don’t contribute to our success, and enhance those that do. We become more effective when we get rid of our superstitions and focus on what we can verify really does makes a difference.

Some people really like their superstitions, so in most cases I would say, “good for them, no harm done”. As long as the superstition doesn’t impede or cancel out the steps that do matter, it’s just extra work. If a person doesn’t mind doing it, that’s their choice.

And that’s how I felt about many traditional forms of therapy. They seemed to have a lot of colorful extra things, superstitions, tacked on. While these made for an interesting narrative, keeping therapists (and sometimes their clients) entertained, I was not convinced that it was in the client’s best interest to overcomplicate things. Consider non-directive therapies like psyhcoanalysis, in which it is not at all unusual to be “in therapy” for many years when facing a “childhood trauma”. If the client is really suffering, shouldn’t an ethical therapist draw upon every skill he or she has mastered in order to offer relief as quickly as possible? My thought was yes. I’ve heard the argument of course – “No, no, no, you just don’t understand! It takes years to get in touch with the patient’s inner feelings! It takes a great deal of time to even remember the trauma!” Then, as I learned, the patient becomes aware of the unresolved conflict, presumably resolves it (with little more than questions from the therapist for help), and lets go of irrational thoughts and beliefs about the trauma.

To me this seemed needlessly complex. I recall that the toughest math problems I faced as a kid were the word problems. The key there is to read the paragraph, determine which pieces of information were relevant to the equation you had to create, then do so. With all the abstraction of language removed from the numbers, the equation became really simple. However as I learned more about how the world works, I realized that most problems in life actually are word problems. There are abstractions and complexities enveloping the numbers, or the simple elements of the issue. Our task is to peel away the abstraction, find that essence, and discern the now-simple question. Often at that point the answer presented itself. So looking at the preceding paragraph as a word problem, I began to see how the abstraction could be peeled away, revealing the essence of the challenge.

It seemed to me that when dealing with trauma, it was less relevant to remember every detail of the injustice than it was to feel differently about it, to learn from it, though to be able to function as an adult with the awareness that yes, something bad happened to me, just as bad things happen to many people. As Neitzche implied, we now can view ourselves as stronger and potentially wiser.

This is not to diminish the use of abstraction if in fact that client derives comfort from it, or finds value in it. I worked with a client once who had been working with a transcendental psychotherapist (sounds impressive, doesn’t it?) for many years to deal with a minor personality issue. She was convinced that the Greek god Loki was behind this, and that as he was such a mischief-maker, the only thing she could do was begin to identify his presence (by virtue of his mischief, of course!) take a deep breath, and think through more carefully what she should do next. No, she didn’t go to the therapist because of that belief – he actually taught her this technique as a form of therapy! But wait, it is as though I am taking away her functional results just because I don’t believe in Loki. This is like the evil spirits/virus issue. The Loki superstition could be functional – it could assist her in thinking about her next action before taking it, which in most cases is a very good idea. Yet we might do that because of awareness of Loki’s presence or we might do it because it’s the smart thing to do. The former can’t be proven or easily demonstrated, the latter can. More importantly, because we have a simple enough solution, “Think before you act”, it seems unnecessary to add in invisible spirits or deities to underscore the point. Does Loki really need to be involved at all?

My answer is no, though with one big caveat – if that layer of abstraction means something to the client, if they derive comfort from it, if it serves as a teaching tool or an anchor to a more resourceful state, is there really any harm in it? In many cases, no, so I would suggest leaving the abstractions if someone really values them.

Accordingly, I decided early on that I wanted to help people make changes in their lives. So while I wasn’t intolerant of those abstractions, I definitely wanted to be able to tell the difference between the “difference that makes the difference” versus the rest. That would give me that ability to use what worked, and to add in anything else that the client valued if it would help.

Therefore, when I decided that Psychology was going to be my primary vehicle for creating change, I began sorting through the various accepted forms of therapy so I could make that differentiation in each of them. I had a professor in an Undergrad Psych class who taught me more than most of the professors that followed him. He didn’t seem to comprehend a realistic workload for a student in that class, so he inadvertently treated it like a Graduate study. In hindsight it was a great experience, but at the time, most of his students hated him and his irrational expectations.

It was through him however that I learned about Milton Erickson and Neurolinguistic Programming. The idea that change could happen quickly seemed strange, as I’d spent so much time studying Cognitive models, complex and abstract superstitions about the mind and human behavior. While these are very entertaining, in a sci-fi, fantasy-story sort of way, they seemed to have dubious success rates. Granted, I am treading on a point I made in a post here about temporal components making it easy to label something a “failure”. However if you are a paying client wanting to make a change, it just seemed unethical to delve into areas that may or may not have anything to do with your challenge. Adherents to the specific philosophies or superstitions might challenge that, insisting that the invisible and untestable parts of the mind somehow need to find balance and to reconcile differences. Maybe. Just as they can’t prove that, I can’t disprove it. That’s what makes it superstition instead of science.

Some superstition, as mentioned above, can be useful and entertaining. However it seemed to me as a student and young psychologist that we could do better for our clients. They aren’t there to entertain us or make us wealthy, they come to us with challenges that are creating real problems for them – and they want help. So the notion of Brief Therapy, of Ericksonian Hypnosis, of Neuro-linguistic Programming, and of Behaviorism, held great interest for me.

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