Prescribing a symptom - or how doing exactly what has become a problem, can help the problem. Huh?

in #steemstem6 years ago (edited)

You shouldn't bother reading two really sexy methods of getting involved with each other. ... Nah, just skip this article and move on to the next without learning about really cool techniques in solving problems. Or: Go on if you must. But don't tell anyone. No? You decided to stay?

Then I want to introduce to you my favorites of systemic integrative consulting:

- Paradoxical intervention

- Impact method


Let's get started right away with a scenario. An angry and frustrated one:

"Well, that's enough! I'm splitting up - and I'm splitting up for good!" Have you ever thought that before? Or do you know couples who argue or quarrel all the time? What would you like to advise or prescribe yourself? What would you like to say to the couple?

A significant part of the systemic and integrative consulting is to irritate or surprise clients with tasks and questions that they do not expect.

"Against common sense," it should work (btw: thank you, @Justtryme90 for this term and idea). Why? Because only when you need to leave your comfort zone are you ready for a new lesson. If someone answers you to an old problem with the usual phrases. How do you react to that? You describe your worries and fears and someone says to you: "Heads up, it'll be all right again" or "don't fight so much." Or, "Yeah, you just have to set a limit!" Most of the time you have inner answers like: I've heard it a thousand times. Yeah, I know all that. Yawn." Of course you are too polite to say that out loud.

But what if someone were to write you a recipe - that is to say, give you a proper note - which says on it:

"Please argue with your loved one every evening at exactly eight o' clock".

Would you feel like you're being teased or provoked? Sure. But what else? Let's say you've visited a counsellor - a couple counsellor - and he or she would listen to your problem and end up giving you the task that you have to fight hard twice a day - until the next appointment.

This goes against what you know, right? You're confused by such a ridiculous task and you think, "What nonsense! We can't do that! The consultant goes even further and recommends hanging the note on the cupboard in a way that is clearly visible, and also once again where the couple usually spends a lot of time.

This is also called an "anchor". On the one hand, people begin to laugh at such an unusual and absurd idea. That's good. On the other hand, the note is a visual reminder that if it threatens to get out of hand again, a look at the note reminds the involved parties that they actually want to resolve their differences in a different way. What is especially important is what goes on inside the man or woman when looking at the note: it can help to keep the humour. To remember, to breathe deeply and not to react to each other in the usual way. You buy yourself time, get spaces in between, which serve to interrupt a pattern.

Pretty much everything is right, which prevents a bad habit. It can be a stone that you now wear in your trouser pocket to remember that you are ready to face a challenge, it can be another symbol.

The whole thing is called "paradoxical intervention".

The systemic advisor is looking to shake his clients up in terms of their convenience. It is sometimes appropriate to provoke anger in order to overcome a possibly disinterested or tired moment. It is necessary for the consultant to explain his intention either beforehand or afterwards, depending on what he has in mind.

Paradoxical intervention is a method of prescribing a "symptom", i. e. doing exactly what has become a problem for a person.

One prescribes "more of the same".

It is a method which seems to be in contradiction with the goal to be achieved, but which is actually designed to achieve that goal.

The client is challenged by the paradoxical intention to evoke in a (paradoxical) way exactly what he is afraid of. This is based on the idea of breaking through a self-confirming vicious circle of fear. The paradoxical intention is a method of speech therapy by Viktor Frankl, an Austrian neurologist and psychiatrist.

The following techniques are considered paradoxical interventions:

  • symptom prescription
  • paradoxical intention
  • reinterpretation (reframing)

Quote from Wikipedia:

"If the client does not manage to follow the symptom prescription and deliberately execute the symptom, then he experiences a weakening of the symptoms. If he succeeds in deliberately causing the symptom, this leads to an increased self-efficacy expectation. This method can be particularly effective if the fight against the symptom has contributed to its maintenance."

For our couple, this means that if they don't manage to argue at eight o' clock every night, then they have a success for themselves. If they consciously lead the argument, they expect a different behavior from themselves than they would otherwise expect.

Beautiful, isn't it?
I have often thought that counselling (and the work of a therapist) is not just science but rather an art - let's say it's both.
A science has developed the other way round, where people have previously recognised other people as role models who practised their profession as artists. Alan Watts (of whom I am a great admirer) once said that therapy is more of an art than a science.

Systemic therapy often reminds me of the old Zen masters in its approach.

If one asked them a secular question, they answered it philosophically. If one asked them a philosophical question, they answered it with an everyday banality.

Like when a master and his disciple cooked together: "Please give me the knife." The master gives the questioner the knife with the blade pointing forward. He is asked by him: "Why are you giving me the knife like this? Answer: "You should think about that."

The student asks his master: "How can I attain the highest enlightenment?" Answer: "By washing your rice bowl clean every day."

What causes an impact?

The second, very elaborate method in systemic counselling (and therapy) is called "impact method" - it is an art of memory and is also called mnemonic technique.

I read a very interesting book about it. The author is Danie Beaulieu, who presents in her work "Impact Techniques for Psychotherapy" easily digestible basic mnemonic principles, with which it is not only in psychotherapy possible to leave quicker and easier traces in the memory. I translate from a German book review:

In the first chapter the author presents the impact techniques with different objects. The use of the visual dimension concretizes the therapy and makes it easier to focus the client's concentration on a specific topic. There are at least two variants. Either the therapist selects something visual from the client's everyday life, which he or she sees regularly between therapy sessions and which increases the effectiveness of the intervention. Or he uses other objects that are easily accessible and inexpensive for him.

The therapist can give the client one or the other object as a gift and in this way promote further discussion of the topic after the session. For example, a piece of paper can be used to illustrate the relationship between two people. Smooth and clean, it symbolizes a pleasant and satisfying relationship. If it is wrinkled, torn or full of stains, it represents an unfavourable relationship; ... the more therapists try to empathize with the psychological reality of the client, using concrete, tangible, visual elements, the more attentive they become to what clients themselves bring in. Learn more about the way they learn and change.

In my training, I gave a presentation on this topic in front of my classmates.

The use of objects is by no means one of the most effective ways to give someone insight.

Much faster than in lengthy conversations. I often use facilitation cards or simply paper in my professional client's everyday life. Either it becomes a ground anchor or I sketch something.

Once I took an old pizza box with me to the office and wrote the word "Problem" on the inside in big letters.

This should hold the client very close to her eyes. I asked her: "If you have the cardboard in front of your face, what do you see?" She was irritated by this unexpected action, I asked her if she wanted to participate. After agreeing on that she said, "Well, I see nothing at all!" I said, "And what if you keep that piece about 15 centimeters away?" .... and so on.
Sure, what's the point of that, isn't it?

I also like the plastic mug experiment.

I used this in a couple-consultation, where it was about the fact that the affection expressions of one did not get stuck with the other or needed a constant renewal (in high measure). In this case I did actually not use real objects but asked the clients to follow this imagination (as I came up with it spontaneously and didn't have a cup):
"Imagine a plastic cup I drilled some holes in. When I take a water carafe and start pouring it into the cup. Now imagine, this cup represents you and I begin to pour in the following: attention ... (pour), affection ... , love ... , affirmation ... . What is going to happen?"

Coins can also be taken

In the case of an addiction problem, for example, you can press a coin into the client's hand and say: "On the one side, there's your dependency, on the other, is the consequence of it. Now just give me back only the addiction!" And you hold your hand open for the coin. What will happen?

Make decisions

If someone has difficulty in choosing between two options. The client is asked to throw the coin and then the head and tail stand for the respective statement. If number falls and the client is still not happy, however, this dissatisfaction is felt much more clearly than if one had only talked about it. Contrary to the result that has been achieved, a decision is far more powerful than making the decision in your head. If you make the decision and there is no contradiction: Good!

For today, that is all. Thanks for reading!

If you like to know more about methods & objects like timelines, family board and other stuff: just ask me & I will write or answer in the comment section about it.

Now you know a little more about the practice of a systemic integrative consultant. ... Or, wait ... ! I hope, you will forget everything you just read! In fact, go and shred some paper while NOT thinking about what you've just learned ;-)


Text sources:
Paradoxical Intervention: https://en.wikipedia.org/wiki/Reverse_psychology
Viktor Frankl: https://en.wikipedia.org/wiki/Viktor_Frankl
Zen Tradition: https://en.wikipedia.org/wiki/Zen
Danie Beaulieu: http://www.academieimpact.com/en/danie-beaulieu.php

Book "Impact Techniques for Psychotherapy": http://www.systemagazin.de/buecher/neuvorstellungen/2007/03/beaulieu_impact-techniken.php (quote from above translated into English)
Art of memory/ mnemonic: https://en.wikipedia.org/wiki/Art_of_memory
Impact Therapy - founded by Ed Jacobs, Ph.D.: http://impacttherapy.com/
Other article on "mnemonics": https://www.scientificamerican.com/article/bring-science-home-mnemonics/
For fun: http://listverse.com/2007/12/17/top-10-scientific-mnemonics/


Picture sources:
"not to press"-button: https://en.wikipedia.org/wiki/Reverse_psychology
Bored: https://pixabay.com/de/gelangweilt-langweilig-cartoon-2022500/
Buttered cat - made by Greg Williams
Chinese Letter: https://en.wikipedia.org/wiki/Zen
Explosion: https://pixabay.com/de/explosion-sternchen-auswirkungen-2283147/
Coin flipping: By Ipipipourax (Own work), via Wikimedia Commons



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And here I am ;)

amazing! One man, one word. You gave me the full treat.
Generous, you are (would Joda say)!! :-)))

Paradoxical intervention is the single greatest tool for self development I know. Personally I use a more extreme version of it. Since I was a teenager I used to burn myself down like a phoenix to find flaws in me.


Generally my first reaction to anything is trying to ideologically break it. If it breaks, I've got something better. If it doesn't break, I've found something better.

You could say I use Paradoxical intervention on myself frequently as a hobby. I've actually got a friend who got into some really raw and heated arguments with me (I mean it was pretty hard to go worse than that) and it was all because of boredom. Even at the very first time I figured it out in few minutes and still continued only to end up blaming my friend for ending the fight ~30mins later because I too was having a genuinely good time.

It's a really amazing and impressive method. I'm glad to see that there is even a word to describe it.

On the other hand the Impact method has zero subjective value to me. There aren't many things I bother to care about. For the situations you described, my reaction would be either blank of just mild disdain.

Resteemed mainly because of the discription of Paradoxical intervention. I'm a living proof for the effectiveness of it. Thanks for posting :-)

My great thanx to you, @vimukthi - I appreciate a lot your openness. It takes time to say something personal and to decide what it could be.

I imagine you can be tough on people who deal with you :) some do like that, others don't, I assume. During my life I started to honor the challenge even though it didn't came instantly that I thought that way. Often later on. Still the case in most times. But learning :)

Generally my first reaction to anything is trying to ideologically break it. If it breaks, I've got something better. If it doesn't break, I've found something better.

Very profound, yes really.... I read it twice to understand. Or so I think. That's why I give you my interpretation:

You mean dissolving an ideology (because ideologies are difficult or problematic between people): then the viewpoint in the other was not really "true" - and it wasn't dramatic to do that. And if your interlocutor's point of view was authentic, have you received a useful lesson for yourself? Did I get that right?

Are you and your friend back to normal? Did he got it that you were internally enjoying the argument? I ask because people can get really offended by that. Not easy to navigate through emotions.

So far I haven't tried paradoxical intervention on myself. Interesting thought, though ...

I imagine you can be tough on people who deal with you

It's like the movie Watchmen(The greatest superhero movie ever IMO). The reaction is very polarizing. The same goes for my looks. People either love it or hate it; not much middle ground.

You mean dissolving an ideology (because ideologies are difficult or problematic between people): then the viewpoint in the other was not really "true" - and it wasn't dramatic to do that. And if your interlocutor's point of view was authentic, have you received a useful lesson for yourself?

You did get it right. But my teenage self was thinking more on the lines of diamonds and cybersecurity penetration tests (white hat hacking). Rub some graphite on paper and graphite breaks. Rub a sharp diamond on any other natural substance and the substance breaks.

To check the security of a computer network the the ones who want to protect it hacks first with all their might and try to figure out all the flaws within the system.

Are you and your friend back to normal?

We were normal the moment we closed the fight. It's like a switch really. You can turn it on and off. I don't start arguments for fun. It was she who was bored and started the fighting every time it happened. I don't know whether she knew it at the time. She certainly knows that nothing can really make me feel down or depressed (I've never scored anything above zero neuroticism for and anything below 100 for assertiveness on the few online tests I've done.)

So far I haven't tried paradoxical intervention on myself.

I self-discovered the process you describe by trying it on myself. I had few bad days and I wanted to really solve my problems once and for all. That's how I came up with Psycho-Engineering. I spend too much time alone and that time is well spend deconstructing myself. It's a lot like trying to make sense of computer code. When you understand enough, you can change it. It's like genetic engineering but for your mind. Hence the name Psycho-Engineering.

You seem well experienced. So you can use paradoxical intervention on yourself without making a mess. It'll really help you to develop psychologically and spiritually.

P.S. I thought about your feedback on "impact method" and had to smile:

On the other hand the Impact method has zero subjective value to me. There aren't many things I bother to care about. For the situations you described, my reaction would be either blank of just mild disdain.

You probably would be a tough client :) - I want to add that it's not only about memory but about "irritation", too. If the described symbols or helpers were leaving you blank (which is not so bad, actually, because blankness can be seen as slightly irritation), than this could be helping in a consulting process. If it leaves you with mild disdain, then the consultant has to get creative and find something which you do not know, not expect, which is getting you surprised.

How do you learn or keep memory of something you defined as a habit you want to get rid off? As I find it much easier to use an anchor.

The universe is actions and consequences and nothing else. I get rid of things because I remember them well. Why don't you think about putting your hand over a fire? It's because you remember what fire does to you.

When I understand things enough to see the consequences and when I don't like those consequences I remember to not take actions that lead to such consequences. It's a process like a smart contract on the Ethereum network.

This is an interesting take on this how to go about a problem. It looks as if you are a psychologist. That should be an interesting job as no day is ever the same!

Thank you. No, I am not a psychologist but a consultant. Though my education had a huge therapeutic part and many hours of practicing. I am still thankful for the teachers I had. They were just excellent. During the years I got proof of the methods and lost the kind of tensed attitude of the beginning phase.

My working days do have routine, though - but you are right, I see many different people and hear very interesting biographies and narratives.

Hearing the different history of people could help lessen the monotony associated with jobs with crazy routine.

She once said, she met 2.000 people in the last 6 years due to her job. Isn't that awesome?

That is an amazing number of people. Wow.

:) it sounds much, thx @antikesdenken for mentioning it. But in five years (not six ;-)) the number is relatively small - on purpose. Because seeing too much people doesn't do good; at least for me. I need time to do other things in between and to stable myself in order to stay balanced. Once in a while I get caught by very sad and heart breaking narratives.

But also then I am impressed an touched by stories which are actually unbelievable. I am very honored by the trust people give me.

... you got me talking:)

But isn't more people more business? People do open up to counselors. It is amazing the things you would experience.

for sure. But I like to have less clients but more quality and money for a single session instead.

I am not so much after the experience as after having the assurance that I was of service and could make a difference in a persons life. The experience though is a really appreciated add on - it feeds my fantasy & inspiration.

I like to joke about my profession or service that I am there for a client to make myself unnecessary.

I understand this perspective; quality service over money. It is a job that brings a sort of fulfilment of being able to help out someone in need.

"balance" is what I would call it, when money & quality meet a healthy middle ground. My work gives me a lot of insights of my strong & weak points and where I have to work on myself.

Did you find a path in what is important to you for yourself, if I may ask?

Good read. You briefly touched upon the topic of breaking bad habits, and I would love to hear more about this. I've managed to stop smoking by practicing amateur level NLP and consuming large doses of psilocybin mushrooms, but when I tried to end my tongue-chewing through these methods it was not effective.

To describe the problem: I chew my tongue from time to time. Not violently, but enough to make me feel unappealing and being shy of smiling with an open mouth. Sometimes I do it because it's interesting to see how big of a chunk I can bite off in one go, other times I do it compulsively without thinking about it. Sometimes I manage to quit doing it for a couple of weeks, but then I let it sneak up on me, and suddenly I catch myself doing it again. Pardon the details. I hope it doesn't gross you out too much. Anyways, would you happen to know a suitable method to practice in order to end this bad habit?

Thank you.

Interesting question. I would like to ask you, In what relation are the associated pleasures and pains? If there are any.

What is different during the couples of weeks where you totally drop the chewing? What did you do or don't do during that time or what is in your opinion the cause you let your tongue alone? Different conversations or meetings, alone time, time with others? Etc.

If you "let it sneak up" on you it's different from "it sneaks up on" you, so I can see some control in that. How about not letting "it"?

If you consider it to be a bad habit, and otherwise deal with it in an even-tempered way (therefore it has no deeper meaning for you), then in my opinion you would have to replace this habit with another one. An anchor would be good. How often - in 10 cases - do you notice that you do it? If the rate is high, you should make a replacement action immediately in such cases. Is there something simple you can think of? Maybe whistle a song or try to memorize something that you always wanted to learn.

It must be something you really can gain a motive on. Otherwise it will be to weak and not brake the habit.

I think you have your two good experiences in giving up things. Some people actually DO NOT want to give up a habit even though, they say they do. My last tipp would be to ask yourself, if you really want to let go of that.

Hope, that was of some help:)

There aren't any association between the pain and pleasure. Generally it doesn't hurt because it's just thin layers of new tissue. The times it does hurt, it's not intentional. I just get caught up in "fixing" the tongue until it got something that feels like a smooth surface. If one chuck disappears, I feel the need to trim away the rest as well.

Generally I find it easier to refrain from doing it when I'm in a positive/motivated state of mind. In periods of stress and uncertainty, the chewing intensifies. It generally happens when I am alone, or at least not interacting with anyone, so I can control it to some degree.

Yeah, I consciously chose the phrasing "let it sneak up" because I believe it's important to own your my own actions. Truth to be told, I don't really feel like I'm in the driver's seat on this one. I've tried not letting it, but it is as if I start to bagatellize and justify doing it sooner or later. The trigger here is what I've been trying to pinpoint, without any success other than being of the impression that it's linked to stress and motivation.

8/10 times I notice that I'm doing it. I will try this replacement action technique with praying for those dear to me. Cheers!

I will let you know how it all pans out. And if you've got any interventions in accordance to the answers I just presented, please do tell :-)

sorry, I cannot answer you properly. Have an eye infection and must stay away from screen. Just did not want to let your comment unanswered. Maybe I'll come back to you, but don't know when:)

Ouch. I'm sorry to hear. I'm practicing the technique you thought me. I'm getting better. Followed you, btw. Looking forward to more interesting reads. Feel free to check out my profile as well :-)

Get well soon!

Thanks to you:) I hope you will well do in practicing:) It's kind of heavy to overcome habits. I have mine as well:)

I will check your profile for sure & see what you got. Right now I am still dealing with a quarter of my energy and look forward to Christmas and my family. We'll stay in touch.

"A significant part of the systemic and integrative consulting is to irritate or surprise clients with tasks and questions that they do not expect."
Yes please. I love being challenged like that.
Problem is, I was doing that since I was young and nowadays rarely something surprises me.... :<
Still trying though :)

Great article. I read several times and still 10/10 would read again.

HeHe, so you are speaking from life - kind of "been there, done that"? - tiredness? I know that, too. And sometimes when I thought and felt it, my environment showed me something different. Stay open for things and do not follow your inner habit so much. You'll find out that daily routine and things you already know, can be new in experiencing them if you want to break your condition.

Yeah, never stopp trying :-))

As I perceive you, I can sense this openness & readiness for the surprise and the unexpected. It shows in your articles. I like it a lot how you express yourself.

Do you want some little tipps in breaking habits within daily routines? I have some, if you like.

I would love some tips :)

nothing really fancy. Just prepare your coffee differently in the morning. Like: get yourself a coffee grinder and grind the beans by hand.

Use another way to and from work/groceries.

Talk differently to the man/woman behind the counter.

Ask stupid questions.

Most important: Do not expect the answer from another human being which you already have in mind. When you realize doing that, than let lose. This is one of MY most impressive experiences. I instantaneously noticed that the human sitting in front of me relaxed quite a bit.

:) have FUN in experimenting. Even if you only get one of the things done or remember to think of, it gives some joy.

Curious, what you think.

So, pretty much "do small things differently" ? :)

I always try to ask questions in a way that will leave open field for discussion.
I also don't see a point in agreeing all the time with each other, that's not how progress is made :)

Oh well.

thank you, that is a really good point. Not agreeing has a high potential of progress. I think that, too.
I agree :) LOL

Nooooo, we agreed with each other again!! Damn you fate!

Lol =3

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