Change is occurring all the time. Change is occurring all the time.
In the preceding chapters, we have detailed how to use the conversational frames, criteria for a well-defined goal, pathways of constructing solutions, use of feedback and tasks, the interactional matrix, and cooperating modes. We will now present case examples to help you pull all of the preceding chapters together.
The five cases will demonstrate constructing solutions with different circumstances, namely:
A woman came to me, Jane, because she habitually used cocaine. She reported that she would do $400 worth of cocaine almost every night. She wanted to stop. Through solution-focused questioning, it became clear that there were several periods during the week when she did not do cocaine.
Therapist: So, tell me about the times where you do not do coke? (Exceptions frame)
Client: Oh, there are lots of times that I don’t do it. I never ever do coke when I am going to work or when I am at work.
Therapist: Really, how is it that you decide not to coke then? (Specification of the process, implying an active decision)
Client: Jane, I would never do that; I am a responsible person. My mother did not bring me up to be a coke head.
Therapist: Yes, but how do you decide not to do it?
Client: I just tell myself that my mother did not bring me up to be a coke head and I don’t do it. (Contextual difference)
Therapist: Are there other times where you do not do coke? (Exceptions frame)
Client: (Thinking for a while) Yes, I never do coke when I am going to see my lover. She would kill me if she saw me high and she always knows. (Another context)
Clearly these were exceptions where she consciously decided not to do coke. They were exceptions that she perceived to be in her control and could continue to do.
Therapist: When was the last time you did coke? (Attempting to set up the amount of time since she did coke as a further exception)
Client: Well, actually four days ago. I decided that this had to stop and everyone told me that I had to go into a drug rehab center. I do not want to do that. I have seen too many people go in, clean up, only to come out and get high again.
Therapist: Four days ago! Four days without coke! That’s great! How have you done that? (Specification of the process of this most recent exception)
Client: Well, I decided it was time, so I decided several weeks ago to stop buying large amounts of cocaine at one time and I also changed my home phone number so that only one dealer could get in touch with me. As a matter of fact, the last time I did coke, I did only $150 worth.
Therapist: Only $150 worth! How did you resist doing the usual $400? (Presupposing that this is exceptional that she did not do the usual amount)
Client: Well, as part of all this, I decided that I would buy only small amounts of coke at a time, instead of all at once. This way, even if I want more, I have to go get it. You know, I have to call the dealer, get in my car, drive wherever, bring it back. It’s harder that way.
The client not only had exceptions to doing coke but had already changed some important parts of the way she normally did coke. Both the exceptions and the changes in her habits were very important first signs of her “on track” solution behavior. She did not perceive them, however, as exceptional or something that was substantially different yet.
Given her statements, I asked:
Therapist: So, at what point will you be convinced that the problem is solved? (Eliciting signs for concluding therapy)
Client: If I don’t do coke for 10 days straight, I will be over the hump.
My first session feedback was designed to support the client in the changes she was already making and to help her to continue these changes while beginning to perceive them as more within her control:
(Compliments)
I am very impressed with your sense of integrity about when to say “no” to the coke. You never do it with your lover, at work, or when you think of what your mother wants for you. I am also impressed that you want to stop doing coke despite the fact that you still like it. However, you know that is a much harder job. If you did not like it, the job would be easier.
I am impressed with the steps you have already taken to get on track, not taking from savings, cutting the coke dealers except for one, changing the phone number, and buying only small amounts at a time.
(Message)
But especially, I am impressed that there are lots of times where you do not do it and where you say, “I have had enough.”
(Task)
Between now and the next time we meet, I want you to watch for what is different when you do not do coke.
The second session was two and a half weeks later because the client had gone on vacation.
Therapist: So, what is different or better since I saw you? (Presupposing change)
Client: (With great excitement) I have not done any coke. Can you believe that!!!
Therapist: That’s really great!!! How did you do that? (Enhancing agency)
Client: I just don’t want to feel bad anymore.
Therapist: Of course you don’t. But how did you do that? (Specification)
Client: Well, some of the time I was on vacation with my lover, so that helped a lot, but I could have gotten some coke. Mostly, I just put it out of my mind.
Therapist: Really, what were you thinking instead? (Asking for the positive)
Client: Well, I was thinking of myself more and I was sleeping better. Just generally calmer. (Difference of meaning, “thinking of myself more”)
I thought this change was really significant and definitely on the right track, especially when she stated that she was 50 percent confident that she would continue in this manner. During this session, we explored what other things she would be doing instead of coke. She talked a lot about her dreams of changing professions and opening a store.
However, today had been a difficult day for her to say “No” to the coke. She really wanted to do coke and was therefore glad that she was coming to see me today. She could not explain how she had not done some coke today.
Fifty percent confidence is a good start, but neither the client nor I were sure that this change would continue without problems. I wanted to reflect that concern to the client and so I gave the following feedback …
(Compliments)
I am really excited and impressed that you have not done coke in over three weeks now. It is really great and you should be very proud of yourself. I am also very impressed that you have decided to be thinking of yourself more. How that will play out I do not know yet, but I am sure it will be helpful to you.
(Message)
I am absolutely convinced that you have a good running start with saying “No” to coke, but I do not think that you are over the hump—yet. Today was an example of the hump where you really wanted to do some coke and you did not.
(Task)
Therefore, I want you between now and the next time to watch closely for how you overcome the temptation to do coke—in other words, the ways you say “No” to coke.
Again, as in the first session, this feedback was specifically designed to help her perceive the saying “No” to coke as within her control.
The next session was scheduled for a week and a half hence because she thought she was shaky about these changes. Given that the time between session one and session two was two and a half weeks, I was concerned that an appointment sooner than a week and a half would be taken by the client as a sign of “no confidence” on my part in the changes she was making despite the shakiness.
By the third session the client could be clearer on how she said “No” to coke. She stated that what happens is that she pictures herself going to buy coke, cooking the coke, getting high, and then realizing that she just cannot start again because it is never enough. She also talked about how she had started being around non-drug people, had given all her money to her lover to hold, and had worked out a way to get an allowance. “Otherwise, the money just burns in my pockets,” she said.
These were all very positive signs of her continued efforts at saying “No” to the coke. However, she described one time where she had decided to do coke. In very clear detail, she described her decision, calling the dealer, making the arrangements, getting into her car, driving to the bank to get money, and going to meet the dealer.
Client: I had the stuff and I was ready. But then, I pictured myself doing it … (described in detail) and I realized that it would never be enough. Plus, it just did not fit with the other things I am doing for myself. I gave the coke away.
Even though she had not done the coke, she clearly was having a hard time continuing her efforts of saying “No.” Clearly, there were times that were easier for her and times that were harder. I used scaling to help her measure her progress and confidence in continuing in her solution.
Therapist: On a scale of one to 10, one being easy for you to say “No” to coke and 10 being difficult, where would you say you are averaging this week?
Client: About a three to five, I guess.
Therapist: Okay. What number are you when you start having trouble with saying “No?”
Client: I would say a six and up.
Therapist: And what are you doing, saying differently when you are below a six?
The client described that when she is in the “lower numbers” she is doing various things that I classified as ritual behaviors, things that helped her to reinforce her doing something other than thinking about or doing coke. In the feedback, I wanted to build on those behaviors. Therefore, I offered her this feedback:
(Compliments)
I think you are doing really great!!!
Again, you are not over the hump (“Oh no, she said in agreement”), but I guess this episode let you know what the hump consists of now. Before, you did not know, so you did not know what to expect or how to get over it like you are doing.
I am really impressed and think that the things you are doing are clearly signs for being on the right track.
(Message)
I think that it is normal for there to be a psychological withdrawal. So a lot of what you are feeling is part of the territory. It is the nature of the beast to have it come up when you least expect it.
(Task)
I really like these ideas that you have when you are “below a number six” like (I listed what she had told me) … and I want you to do these things purposefully each day, kind of like a preventive medicine.
The next session was scheduled for one week later because the client thought that she was even more shaky than before about continuing these changes.
When the client returned one week later, she reported that she had decided to do coke and she did the coke. The day after she left the session, she decided she would do $50.00 worth of coke.
Therapist: Really, how did you decide that?
Client: I really, really wanted some coke and decided I was just not going to avoid it. So I called the dealer, went down, and got it. I came home, cooked it up, and did it.
In solution-focused therapy, we think of change occurring with two steps forward and one step back. Therefore, what might seem like a failure, a negative, or a sign that therapy is not on track is really only part of the process of change occurring. Therefore, I asked further about the “step back,” but with an exceptions frame.
Therapist: How is it that you stopped at $50.00 worth? (Exceptions frame)
Client: Well, once I got high, I freaked out. I got paranoid. I was looking in the bathroom mirror and my eyes were jumping out of my head, sweat was pouring down my face, and I freaked. And I thought, “Something is wrong here;” what would my mother say if I died of coke.
At that point, she made the commitment to the decision to say “No” to coke. The rest of the session focused on the other six days since she had the last session when she was continuing all of the changes she had made previously. She was beginning to think of the other changes as “all the positives to not doing coke.” The feedback to her was:
(Compliments)
I am sorry to hear how painful this episode was for you, yet I am very impressed that you stopped at 50 dollars worth. Other people would have just continued.
(Message)
One half of me thinks this episode of doing coke was necessary, maybe even required or good that it happened, for you to learn that you can choose to do it. Therefore, it was a rational choice and not out of being a “drug addict.” It is good that you know when is enough, and see the positives of not doing coke.
It is also amazing how you could truly look at yourself in the mirror.
The other half of me thinks that it is like Russian roulette, that you never know which of those times you would not stop.
Continue to do and practice the positives and notice what happens.
Next session was scheduled for three weeks off because I was going on vacation. The client was given the name of another therapist to call, if she needed to be seen. She never called that therapist; she did not have to.
When the client came into the session, she reported that she had not done coke and even gave a little laugh at my question of whether she had done coke. Her coke days were over, but she reported that she was feeling depressed and had cried a lot since we last talked. She was deciding and making some important decisions in her life about her relationship and her profession. All of these she thought were good, but very hard. My feedback to her was:
I do not think you fully realize the extent of the effort, energy, and force that you have put forth the last six months. I agree with you that, as you say, you are emotionally tired. Change is hard, it is a metamorphosis.
The client was confident that the changes would continue and therefore set the next appointment for four weeks. At six weeks, she was continuing her thinking of herself and a follow-up session was scheduled for three months away. At the follow-up, she was continuing to be coke-free and she and I decided that she could call if she needed another session. She came in again six months later about another matter in the process of her other personal and professional changes. She told me at that time that she had tried to do coke one time and, ironically, had failed. She went to buy the coke and started cooking it, slipped, and spilled it all over the floor. She went to get more coke and as she was cooking it, she spilled that amount too and it fell down the sink. At that point, she realized that it was just not worth it and has not looked for coke since.
A young man came to see us for fear of being fired from his job. He described an intense fear he had that people at his job thought he was stealing from work. He said he knew this because of the things being said to him and the way people looked at him. He had no idea why they thought he stole because he was a 100 percent honest person and would never do that. He felt hurt that they thought he stole and, therefore, he withdrew from interacting with them and kept to himself at work. His goal in coming to see us was initially stated as, “I am helpless in my job and I do not want to get fired from work.” (Not yet well-defined)
Therapist: So, how will you be acting differently when you are not acting scared of losing your job? (Hypothetical solution frame)
Client: I will be more powerful at my job and continuing in my efforts in my outside life.
Therapist: When you are more powerful at your job, what will you be doing differently? (Accepting the feeling statement of “powerful” and asking the hypothetical solution question again)
Client: I won’t care what people think of me. (Negatively stated)
Therapist: And what will you be thinking or doing instead when you don’t care what people think of you.
Client: I will be taking care of myself. (Positively stated and more behavioral)
The conversation continued to clarify his goal of taking care of himself and acting in a more powerful manner with others at work. There were a few exceptions when he had acted in a powerful manner at work in the past, but not in the recent present. The exceptions were prior to his thinking that co-workers thought he was stealing. During the times when he had acted in a powerful manner, he thought that it was because he just felt powerful rather than something he consciously did. These exception times were perceived as feeling states that were something that just happened to him and not something he created. We wanted to help him construct a solution that he would perceive as within his control. Therefore, we gave him the following feedback:
We are very impressed that with all this pain over being confused that you have not let it interfere with your performance at work or in class. We are also struck with your desire to be clear about what you want for yourself.
(Message)
We do not know if you are going to be fired at work or not. But we do know that you need to protect yourself. The way to do that is to take care of yourself at home so that you feel powerful with yourself and know what is true about you. We also know that if you act “as if” they are going to accuse you, you will start a cycle where you act guilty when you are not, but which will give them proof for their point of view that you are guilty! We know you do not want that!!
(Task)
Therefore, this might sound crazy but, between now and the next time, we want you to pretend to be powerful and act in a powerful manner with others even if you do not feel like it. When you do that, take note of what happens.
He came back two weeks later and reported with much surprise:
Client: Well, I did what you said and pretended in a powerful way and you know what? It worked! When I acted powerful, I could change their impression and then it became a reality! I knew what was the truth and told them. I even told them outright that I did not steal the desk cleaners.
This case is a clear example of what happens when clients pretend their own reality and therefore create the interchange they want to happen.
A couple came to see us about some marital difficulties. They reported a brief affair the wife had had about a year previously as having made their relationship steadily worse. She stated that she felt guilty about the affair and ever since that time had been trying to make up for it and regain her husband’s trust. The husband said he felt that he could not trust her and that he was staying married to her because of the kids. She said, however, that she would like him to trust her again and he, too, after some time in the session, said that he would like that trust again. We asked the hypothetical solution question and they responded:
Husband: I would like not to be mad. (Negatively stated)
Therapist: What would you like instead? (Redirecting the negative statement to a positive one)
Husband: I would be getting over the affair and maybe feel for her again. I don’t know. I don’t hate her, but I would just like to know I am as important as the other guy was.
Therapist: How would you know that you were that important? (Asking for signs of trust)
Husband: She had her chance and blew it. I asked her to tell this guy off and not to call anymore. She did not do it. I was so mad. And she still won’t tell the guy not to call.
Wife: But I did tell him.
(A brief argument ensues and therapist redirects the conversation.)
Therapist: So when the problem is solved for you, Karen, what will you be doing differently? (Hypothetical solution frame, self position)
Wife: I think when he is trusting again that we would do some things together again, we would go out without the kids, and I would not feel so guilty.
Therapist: So there are times now when he seems somewhat trusting or the two of you do things together? (Exceptions frame)
Wife: Yes, there are some times when he will joke a little.
The remainder of the session was spent in discussion of the “joking times” and how they each brought it about. The husband could not explain how he sometimes forgot about the past and just joked around. The wife could not explain how she joked rather than letting her guilt stop her. They both agreed, however, that they liked the joking times and thought that those types of times were more of what they wanted.
The goal for her was his trusting her again. The hypothetical solution involved his getting over the past and feeling for his wife again. For her, she would be acting relaxed rather than guilty and the two of them would be doing things together again.
The exception was the “joking times” when both of them were thinking about something other than the past or how they felt about the past. We offered them this feedback:
(Compliments)
We are very impressed with both of your efforts to do things differently, your coming here and talking about things that are not easy to talk about. You both mentioned doing something that you think the other wants. It is obvious how much you care and how important it is to you that the other care.
(Message)
It would be normal to be scared at this point, scared that it might work and scared that it might not, scared of the changes you might make.
We are impressed with the “joking times,” how each of you put your feelings and thoughts about the past aside or did something different so that you can enjoy yourselves for awhile. We are struck that you have the courage to relax like that.
(Task)
If you decide to come back, we would like to suggest that between now and the next time each of you notice what you do and what the other does differently during the joking times.
According to the solution construction map, we have exceptions, the “joking times.” However, both husband and wife are looking for the other to change first and neither can explain what he or she does individually during the “joking times” that makes that a better time. To them, the exceptions seemed spontaneous and out of the individual control of each. We wanted them to find out more about those times and, more specifically, about what they individually did that contributed to those times being better. By identifying what they did, they could then have more control and the choice of making the good times happen more often.
We scheduled the next session one week later. A week allowed them time enough to do the task and would maintain continuity in the therapy process.
When we asked what was different or better, they both said that things were better. She said that he did not seem so grim and unhappy and as a result she was more relieved. Since she was more relieved, she was looser with him and had more fun. She said that during this “relaxed” time he was more relaxed and that on her own she had decided to relax more even when he was not in a good mood. We asked how this was different and she said normally she would try to cheer him up or try to be as good as she could so that he would have no reason to mistrust her.
Her husband stated that he did not like how in the past she had tried to be perfect all the time. When she did that, she was defensive and she was always there underfoot. During those times, she stayed physically with her husband all the time so that there would be no way he could think she was doing something wrong. He liked much more the fact that, rather than being physically with him all the time, she had decided to do some of her own things.
He did not like her trying to be perfect for him. We asked how he will be different when she is not being perfect. He did not know. He just did not want to be hurt again. We asked if they were looking for guarantees. Both were looking for guarantees. He did not want to be hurt again and she wanted a guarantee that if she gave up trying to be perfect he would not leave.
Even though they described the above concerns about guarantees, most of the session was focused on the relaxed times when guarantees were not even a question.
They also stated an exception context. With regard to their parenting his daughter from a previous marriage, they did not let the event of the affair interfere. He was allowing his wife to assert herself as a parent rather than his trying to protect and stick up for his daughter. She was realizing that they had to work together. Parenting a teenager was getting too difficult to leave to just one of them.
In this session, we had more examples of the joking time and what each did differently. Both explained that they decided to joke around and not wait for the other to be in a good mood. Our feedback was:
(Compliments)
We agree with the two of you that you are on track by concentrating on what is important in the present and the future. You have been focusing on being a good parenting team with your oldest becoming a teen. You, Tom, have been deciding to let go of the notion of being a single parent. You, Karen, have decided to pick up on being a parent. You both have been realizing that there are no guarantees about the future or what the other might do.
Before, you, Tom, said, “If I am certain she won’t do it again, then I can go forward.”
And you, Karen, said, “If I am certain, that I have convinced him that I won’t do it again, then I can relax and be myself again.”
Now, you both are beginning to realize that those ways of thinking do not work and to look beyond the notion of a guarantee to create good times now that will be more the basis of your trust.
You, Karen, are saying, “I am just going to relax regardless of whether he is in a good mood or not.”
You, Tom, are deciding to be yourself and not care so much about her feelings.
(Message)
We have one further thought. We know that you, Karen, have been working very hard to be perfect for Tom. But we are afraid that your being perfect and being always around may be too much of a good thing. It is a little like having a perfect chocolate cake every day. After awhile, you do not think much of it anymore. So we think you may want to think about how you can show Tom the not-so-perfect side once in awhile so that he can trust that side too. Tom, we suggest that since neither of you can change the past, you might consider how you will know when to trust and how you will let her know.
In conclusion, we think you should continue to do what you are doing and keep notes of what you are doing so we can talk about it next time.
The next session was scheduled two weeks later to give them time to do the task and notice differences.
Therapist: So what has been different or better? (Presupposing change)
Both: It has been better.
Karen: It has been better and harder.
Therapist: How do you mean?
Karen: Well, it has been difficult to go do my thing when he is in a bad mood or mad. I wonder what he is mad about and if he is mad at me. But I went and cleaned out my office, something I have put off for some time, and reacquainted myself with my weaving. It was hard because I was really tempted to hang around him and see what was wrong. (Exception)
Therapist: So, what happened? (Specification)
Karen: I do not know. I guess it was just a mood for him because later he was joking around. He has been back into his things too. I noticed he was back to his projects in the garage.
Therapist: (to Tom) This is true. Things were different for you? (Exceptions frame)
Tom: Yes, somewhat. Before I was so caught up in that stuff about the past. Now I am using more energy to get back into other things. (Exception and new meaning, “using more energy to get back into other things)
Therapist: How are you doing that? (Specification)
Tom: I cannot stay mad forever. I have to move on. (Difference of meaning)
Therapist: (Cheerleading) This must be a really big step for each of you. (With raised voice tone and curiosity) How are each of you doing this? (Further specification with agency presuppositions)
The remainder of the session brought out more details of how things were going with these emerging decisions to relax and get into her own things again on her part and to “move on” on his part. Each was identifying things that they were doing individually and within their control.
When asked how confident they were of continuing with these decisions, they both said about 90 percent. We asked what may have been some of the good things that came out of this event in the past. She said that it reminded her that she is not so strong. She used to think that she could do anything and that she was always honest. Now she knows she is not so invincible. Tom liked that they were even more together in sharing the responsibility of parenting.
We scheduled another appointment in two weeks as follow up on the changing they were doing. They called and canceled this appointment. They reported that things were going fine and they thought they were on track.
A mother had called and wanted to talk about getting her daughter into therapy.
Therapist: What would you like out of coming here? (Goal frame)
Client: Well, I would like to get some advice from you about getting my daughter into therapy. (Complaint statement)
Therapist: You think your daughter needs therapy?
Client: Yes, she is living at home, she is not working, she is not talking either to me or my husband, and she blames me for being unhappy. (Complaint statement)
Therapist: Uh-huh. Would she say these are problems or that she wants to be in therapy? (Clarifying who is the client—that is, who wants what from therapy; the question uses the “for the other” reporting position.)
Client: No, and that is the problem. She thinks I am her problem and she will not even consider therapy. She thinks that it is my fault that she feels bad about herself because I did not give her enough attention when she was a child. She is 22 now.
Therapist: I see. So if your daughter were doing more of what you want her to, what would you be doing differently? (Hypothetical solution)
Client: Well, if she were showing some initiative and were a little happier, I would not feel so guilty. I could relax and get back into my own things. Sometimes, I think what she says may be true. I did favor my son over her. (Appears to think changes in her daughter have to happen first before she will be relaxing and feeling some relief)
Therapist: What would you be doing as you are relaxing and getting back into your own things? (Specification of the hypothetical solution)
She responded further to the hypothetical solution questioning by saying that she would be letting go of her daughter rather than worrying so much now. Now she was afraid to say anything—either to confront her or to remind her—for fear that what she might say would jeopardize their already deteriorating relationship. When she would be letting go, she would know that she had accomplished her job as a parent and she would be seeing friends again and thinking about what she would do for herself now that she was done with raising children. She thought that if she let go now her daughter might fail and be angry with her, while she herself would feel guilty.
In response to queries about times when she was letting go some now, she said that she was going off on a religious retreat by herself this coming weekend and was planning a Fourth-of-July picnic for her friends. She responded that this was different for her because she had been so worried about her daughter. When asked how she was doing this, she said that she was responding to advice from her minister that she had to let go.
We asked if, since she was not able to change her daughter or make her daughter’s life happy, or even force her to make use of therapy, she would think she was on track for herself if she were continuing to “let go” and think of her future without childrearing. She said, “Yes,” although she felt sad that there was not more that she could do for her daughter. We offered her this feedback:
(Compliments)
We cannot tell you how impressed we are with how much you care about all your children. You obviously have gone above and beyond the call of duty over the years in taking care of them and providing for them.
With your daughter, too, it is obvious how much you care about her. You may now at times think mistakenly that your only motivation is guilt, but we think your motivation is a deep love for her.
We also think that it is because you love her so much that you are finding it difficult to go through the transition that all families have to go through where kids go off to make their own successes and mistakes and parents let go and focus on the next phase of their life.
(Message)
We are very impressed with how you are already showing signs of letting go and thinking of yourself, namely, your going on this retreat and planning the picnic with your friends and not the kids.
(Task)
We think this is great for you and your daughter and we would like to ask that you keep your eyes open for other, maybe more subtle ways, that you are letting go and thinking of yourself.
Therapist: What has been different or better? (Presupposing change)
Client: Well, I have been getting back to reading and I have gone ahead with my plans for the picnic.
Therapist: Really, (with curiosity) how have you been doing that? (Specification of the exception)
Client: Well, my spiritual adviser gave me the same advice as you. So, I decided to get back to my reading and take the chance that if I have the party my daughter will not make a scene.
Therapist: So you are taking some risks. (Cheerleading) How are you doing this? I imagine you must have doubts and maybe feel guilty. (Specification in a process form and within the frame of difficulty)
Client: That is true and I am still very worried about my daughter, but I guess I am becoming more convinced that I am not helping by worrying so much.
Therapist: How do you think your daughter has noticed your changing? (Exceptions frame and from the “for other” reporting position)
Client: She has not said anything, but she did ask me about my spiritual retreat that I went to.
Therapist: Was that different?
Client: It is different for my daughter lately because she was not talking to me at all.
Therapist: What do you think she would say about your thinking of your future if she were here? (Exceptions frame from the “for other” reporting position)
Client: I am not sure. She might say it is good for me to do.
The client went on to say how difficult it was to plan this party for fear that her daughter would make a scene because the client’s son was invited and sister and brother were not talking to each other. The daughter was terribly jealous of her brother.
Despite the client’s concerns, the client was describing backing off and not trying to change the daughter like before. We thought she was on track in focusing on herself and her own changing. We offered her these compliments and feedback:
(Compliments)
We are so impressed with your deciding to focus on yourself and your own personal goals. We do not know if that is coming from an increasing self-respect or from an emerging knowledge that what is good for you is good for your children. We agree with you that contrary to sacrificing all the time it is better for you and for your daughter in the long run for you to be taking care of yourself. As you say, when you do not take care of yourself, you are irritable with her and with everyone.
We are just so impressed with your planning the party. We agree with you that your daughter will have to learn to adjust to her brother being around.
(Message)
It seems to us that your daughter loves you a great deal and that she is noticing these changes in you. We suspect that she may let go in her own way as she becomes more convinced of your letting go. Along the way, she may test your commitment, though.
Keep doing what you are doing and take note so you can tell us next time.
Given that she was now working on a goal that was within her control—focusing on herself and her own future rather than trying to change her daughter—and given that she was now entertaining the idea that it was also good for her daughter in the long run that the client focus on herself and let go of the daughter, we began to space the sessions and allow her to practice her new thinking. The next session was in 10 days, followed by sessions at two weeks, three weeks, and a month.
A young married man called for therapy about problems in his four-year-old marriage, stating that he wanted to come in alone. His wife had insisted that he had the problem and that it was not up to her to make changes. He at least partially agreed with her that the problems were mostly his, and also he wanted to talk with someone alone, without her.
Therapist: What is your goal in coming here? (Goal frame)
Client: I wanted to talk with you alone, because I want you to understand what the situation is like for me. My wife is totally fed up with my angry outbursts and she will not have anything to do with counseling. We have been in marital therapy before and she felt very hurt and discouraged. I have to agree with her that my anger is a problem, but she is so provocative. I do get violent, but it is not just that. She cuts me off at the knees. She just will not have any sympathy for me either about us or about my working. She is just so critical about everything and she argues over everything. (Complaint statements)
Therapist: So you want me to understand what it is like for you and that she won’t come in. And it sounds like you agree with her that your getting angry gets out of hand, but you also think she is part of it. Is that right? (Clarification)
Client: Yeah. She sees everything I do as an opportunity to remind me of everything I have done wrong.
Therapist: So, what about this would you like to change? (Asking for a goal statement)
Client: Well, as much as I think she is wrong, I think I will never have a leg to stand on in arguing with her as long as my anger snaps. I will always be on the defensive or feel guilty about that unless I make a change. She is scared of me and I think my daughter is too. I need to be in control and acting proper in order for me to show her she is in the wrong.
Therapist: So you are hoping that by controlling your anger you can show her that she is in the wrong? (Clarification)
Client: Well, I need to know who is right so I can decide whether I have given it my best shot and it is okay to leave her.
Therapist: So, you want to be handling your anger differently so that when you do make a decision whether to stay or leave, it will be for the right reasons.
Client: Yes, I just have to be in control of myself so that I know it is not my fault if things do not work out. We have been married only four years, but I would not want a divorce to be my fault.
The statement “handling his anger differently” was accepted as a goal and we explored the hypothetical solution. He imagined that if he was able to handle the situation the way he wanted, he would be able to talk to her calmly, even if he was mad. He thought if he had more self-esteem, he would be able to act more calmly with her.
We complimented him on his sense of responsibility and honesty—that even though he thought he had many legitimate gripes about his wife, he was seeking to change his actions. We also complimented him on his sensitivity to his wife and child, that he was well aware of how he scared them with his angry outbursts. We were impressed that he wanted to do something about that.
The limited time of the session did not allow for any discussion of exceptions, so we based our suggested task on the hypothetical solution he had developed. We mentioned that we wanted to know more about the times when he believed he acted somewhat calmly with his family, or times when he could let go of control but did not.
In the second session he reported that he had decided to follow a little motto, that every day was a new day and he would try to make it a good day. This would be different than carrying over his resentments and feelings from the previous day. Several times he decided to join his family and do some things with them rather than retreating to the solitude of his study. He participated and tried to listen to his wife’s side in a decision over the purchase of a new computer. He said both of these things were quite different on his part. He said that he found it very difficult to listen to her arguments about the computer and to compromise with her. However, he was pleased that he did not yell or lose control.
When asked how he decided to do these things, he said that he was determined to do his part to save the marriage. This was different in that he now seemed to be wanting the marriage to work out. Again, we shared with him how impressed we were with his determination to do his part to make things work and how that meant his doing some very difficult things such as making compromises and trying to resist viewing compromise as giving in.
The third session was several weeks later because of his schedule and ours. He initially reported that things were very bad but that one time when he was about to get into an argument, he said to her, “I don’t want to fight. I just want to be friends.” This stopped the argument and later she was friendly with him again. We asked if this was different and he said this was very different for him to say. Her talking with him again so soon after the argument was also different. We asked if this were true that he wanted to be friends. He said he was not sure it was possible but, yes, he would like to be treating her nicely and be friends again. He thought that friends cooperated rather than trying to win or make the other lose. This is what he wanted.
We again complimented him on his perseverance and on how he discovered that trying to be friends was somewhat helpful. When he thought of his wife as a friend, he was less likely to think she was trying to put him down and more likely to give her the benefit of the doubt. We asked him to notice what else was different when he thought of her as a friend.
In the next two sessions, which were several weeks apart, he reported several things he had done differently when he thought of her as a friend and not just a wife. He decided he had been selfish by withdrawing into his solitude and that he needed to participate more in family matters. One time he listened to her complaints about him and did not respond defensively. He merely stated that he was sorry that things were difficult.
We asked how he did that. He said he realized that there was nothing he could do about her complaints, so he just said he was sorry. He said she was just quiet after that.
By this time he was feeling quite good about his changes, that he was not flying off the handle. He was being calm and acting like a friend rather than being defensive or assuming the worst. He was pleased that she was changing, that she was being friendlier. He still wished she would give him more acknowledgment, but he was pleased that she was now willing to come to the next session.
When she came in she maintained that there was nothing she wanted to change. She was still waiting to see if these changes on his part were going to last or if she was going to be hurt and disappointed again. At the same time they both reported things the other was doing differently, as well as things they were doing differently. The remaining sessions continued to focus on what they were doing that was working and on how they would know and convince each other that these changes were for real.
Although this case began with a marital complaint, we did not insist that the wife come in. Instead we helped the husband focus on a goal that was within his control, “handling his anger differently,” and assumed that with changes on his part, changes in the relationship would develop. As he made his changes, they both decided that she would join the sessions. She had no stated goal but participated in reporting changes and in identifying what good things she noticed.
Although in this case the spouse joined the therapy later, spouses do not always participate nor is their attendance necessary. The marital relationship can change as one person makes changes in their interactions. Marital therapy can work with only one person as long as the client defines the change as within her or his control and not exclusively a change in the other.
QUESTION:
Do you ever have cases like the above where the other spouse does not change and they divorce?
Yes. Just because one makes changes in the interaction with the spouse does not mean that the couple always stay together. Sometimes, as could have happened in the above case, one spouse makes several changes and then decides that she or he has given the marriage the best shot, but the marriage is still not working or the change is not worth it. Sometimes, the changes are too late for the other spouse.
However, some cases with a marital complaint can be more hopeful when we assume that a change by one of the spouses can make a difference and that both spouses do not have to be part of the therapy in order for the relationship to improve.
QUESTION:
What if members of a family or spouses have different goals?
We assume that very often family members or spouses will define their goals differently. Having different goals is fine, and we help them develop their own solutions while meeting together. Oftentimes the goals overlap. Sometimes a teenager may be trying to get more freedom while her or his parents may want to see more responsible behavior. These goals are very complementary even if the clients initially see them as contradictory. Usually, a teen gains more freedom by doing actions that her or his parents see as more responsible. A parent needs to reward the teenager with increased freedom in order to foster the responsible behavior.
When the stated goals are mutually exclusive, for example, when one spouse wants divorce and the other wants to pursue the relationship, we see the clients separately. We work with each spouse toward his or her stated goal. Eventually one or both goals change.