Saturday, October 27, 2012

Therapy is a Zen koan

Threads:                        Not knowing
Relevant recent posts:     12/3/10     What is hypnosis?
                                      6/29/11     In support of not knowing

I think any theoretically based psychotherapy is mistaken because each person is different.
   Milton Erickson (1980)

What is psychotherapy? A process where two people get together to try and figure out what the hell one of them wants.

— One of Erickson’s descriptions of psychotherapy (Gilligan, 1987, p. 82)

This post is certainly for therapists and their clients; but it also for anyone who knows the freedom and depth of connection that comes with shedding old patterns of thinking, behaving, and relating to self, other, and world.

I found a lovely description of the sensibility with which I was taught and mentored to practice therapy. It’s from paper by Hillary and Bradford Keeney published in the Journal of Systemic Therapies. I’ll include an excerpt and two other quotes below, but first, I’d like to provide a bit of context to make clearer what the Keeney’s are pointing at.


The problem with categorizing

We categorize things based on similarities and differences. This process has inherent limitations. For example, the act of recognizing that something is a cat emphasizes what similarities it shares with all other cats while deleting (or at least downplaying) all that make a particular cat different and unique from other cats. Some cats like laps; some cats like their belly rubbed; some cats will scratch if you try to pet them. You can’t treat all cats the same; best to learn about each cat.

Let’s switch from cats to therapy clients.

Fear of flying: I know how to work with that!

Assume I start work with a client who tells me they have fear of flying. My big brain could easily serve up the following: “Fear of flying—I recognize that! I’ve worked with lots of folks with that. Great, I know how to do this… just like I have before. Let’s go!” Three minutes into the exchange and I’ve already generated a diagnosis (fear of flying) and sketched out a treatment plan (what I’ve done before).

Who are you actually with?
I was taught to see this as a problem of my own creation: In categorizing my new client as being like other clients with fear associated with flying, I miss how they are different from the others.

What makes this particular person different from other people?
For example, what exactly are they referring to as fear of flying? Getting on the plane? Being in a cramped space? The doors shutting? Having no escape? Lift off? Turbulence? What are the details of their internal experience? How did they learn to have this fear? Given their unique personal history, what resources do they have which will enable them to solve this problem and be more comfortable—in a way that is both possible and natural for them?

Everyone is different. There is no normal. The most profound fortune cookie I ever got said,

Normal only means you don’t know them well enough.

Best not to treat all people the same
It quickly becomes clear: Any codified approach, method, model, treatment plan, or recipe blinds me to seeing the individual in front of me. How will I drop all that and see who I am with as we both try to learn to collaborate with each other on behalf of clarifying and promoting what this client wants?

In it together: In any relationship we mutually affect each other…

…and so to between therapist and client. But let’s start simply: We could model therapeutic interaction as one in which the therapist is responsible for causing a change in the client (and not the other way around). Systems in which A affects B but not vice-versa are formally called first order cybernetic systems. There are more insightful and useful models.

Systems of mutually affecting parts
Gregory Bateson (1904 - 1980), among other of his far reaching explorations, developed ways of thinking about living systems as consisting of mutually affecting parts, formally called second order cybernetic systems.

The family as a system of mutually affecting parts
For instance, if we take the family as our system of living things, each family member influences every other family member and each family member is influenced by every other family member: Mom affects Dad, Dad affects Mom, kid affects parent, parent affects kid, and kids affect each other.

Lots of complexity

Inviting you a bit further into a second order cybernetic way of thinking, consider just the relationship between Mom and Dad: Mom's behavior affects Dad, and then the reaction of Dad to Mom's behavior affects Mom's behavior, which in turn will affect Dad's behavior, and so on. Add more parts to the system (for instance, kids) and it becomes even more complex.
When you are part of a system you can’t just step outside of it
While enmeshed in the family, no family member can stand outside of the family system. You can’t just suddenly take a break from the family. Your break-taking, your thinking, your perspective on the family is—all of it—still enmeshed within field of the family system.

Nobody in the system has a perspective outside of the system
Consequently, no family member can claim a perspective outside of the family from which they can then objectively comment. Each family member’s story is but a single facet of what’s going on in the family; and no member’s story is more complete or more true than any other member’s.

So to, therapist and client form a system of mutually affecting parts
As therapist and client spend time together they form a system of mutually affecting parts. It is as if they both get in a little boat, cast off from shore, and hope they together figure out how to get back to land. Movement towards what the client wants arises out of the in-the-moment mutually influencing interactions between client and therapist. Together they make use of themselves and each other.

A fundamental assumption
You have to be part of a system to affect it; and if you are part of a system, you no longer have a perspective that is outside it.

This is one of the assumptions that underlie my training as a hypnotherapist… and which has become part of the lens through which I see the workings of the world.

Approaching therapy

Here the excerpt from Hillary and Bradford Keeney's paper (2012):

Therapy is a Zen Koan: it has no answer that is right and is no more likely to solve life than theatre, religion, or weather. When we make therapy a game in which theory (or meta-theory) gets to sit in the throne, we all lose. The art of helping bring forth change asks us to go beyond theoretical discourse. It asks for its embodiment in ways that seldom need to be spoken except in those occasions in which it naturally expresses itself without preplanned intent or purpose.

If your therapy of tomorrow is the same as it is today, then your therapy is dying. Its particular form is only true for the moment in which it arose for the client who inspired it. In the changing forms is found the wise process therapist, the practitioner of change who is always changing in order to help others change. Whereas first-order cybernetics asked us to take responsibility for changing the client, second-order cybernetics ups the ethical imperative by asking us to change ourselves in order to foster change in others….

It is time that therapists realize they are in the same domain of interaction as the Zen master and other interlocutors of transformation who mediate in the unknowing of fettered knowing. Let us become emancipated from being fenced in by any architect of an over-schooled approach. All schools of therapy are actually the same: prescriptions to follow someone else’s arbitrary rules rather than being more flexibly responsive to what each session invites…. Here we find an invitation to be more creatively alive in a session and not be attached to any habit of thought that limits other possible ways of serving therapeutic transformation.
In keeping with the sensibility expressed above, here is Milton Erickson's response to one of his students, Steve Gilligan (1987, p. 83), asking, "How do you know what to do?"
I don’t know. I don’t know what I’m going to do. I don’t know what I’m going to say. All I know is that I trust my unconscious to shelve into my conscious what is appropriate. And I don’t know how the clients are going to respond. All I know is that they will respond. I don’t know why. I don’t know when. All I know is that they’ll respond in a way that best suits them as individuals. And I become so intrigued with wondering exactly how their unconscious will choose to respond that I can comfortably wait for their response, knowing that when it occurs I can accept and utilize it. I know that sound ridiculous, but it works.

And finally this from Abu Yazid Al-Bistami (circa 874) , the prince of Sufis in his time:

Nothing is better for a man than to be without anything, having no asceticism, no theory, no practice. When he is without everything, he is with everything.

Gregory Bateson (1904 - 1980) was an English anthropologist, social scientist, linguist, visual anthropologist, semiotician and cyberneticist whose work intersected that of many other fields (see wikipedia). For me, reading him is both rewarding and exhausting: so many new ways of seeing the world, two or three pages and I’m done for a while. Here are three of his books.

Gregory Bateson (1987). “Steps to an Ecology of Mind.” Jason Aronson Inc., Northvale, NJ.

Gregory Bateson (1980). “Mind and Nature: A Necessary Unity.” Bantam Books, Elsevier-Dutton Publishing Co., Inc., Two Park Avenue, New York, NY 10016.

Gregory Bateson (1991). “Sacred Unity: Further Steps to an Ecology of Mind.” Donaldson, R. E., ed., Harper Collins Publishers, 10 East 53rd Street, New York, NY 10022.

Stephen Gilligan (1987). “Therapeutic Trances.” Brunner/Mazel, Inc. 19 Union Square, New York, NY 10003.

Milton Erickson (1980). “A teaching seminar with Milton H. Erickson.” Edited J. K. Zeig. Brunner/Mazel, NY, 1980.

Hillary Keeney & Bradford Keeney (2012). “What is systemic about systemic therapy? Therapy models muddle embodied systemic practice.” Journal of Systemic Therapies, v31:1, p 32-33.

Abu Yazid Al-Bistami from Stephen Mitchell, ed. (1991). “The Enlightened Mind: An anthology of sacred prose.” HarperCollins Publishers, 10 East 53rd Street, New York, NY 10022. p 75.