“Briefest Moments” video of Steve.
In January 2015 I invited a colleague, Chris Gunn, who is also a videographer, to spend a week with me in a house on the beach in Kauai. One afternoon Chris set up a couple of cameras and asked me some questions — some professional, some personal, some both — and edited the result into a 40-minute movie that might be titled, “Hanging out with Steve.” A sample from the video appears below. Chris created the video as a gift, but knowing the time and skill that went into this project, all proceeds will go to him.
Watch a sample on Youtube! https://youtu.be/Y3jIVIPv81k
Therapy Case Example article by Ron Soderquist
The current issue of the Psychotherapy Networker has an elegant example of using careful framing, and both conversational and overt hypnosis to change a simple unwanted habit. (with comments by Steve)
How to motivate a family member to participate in therapy
In the same issue of the networker I have a letter to the editor about using “mental Aikido” to gently motivate a family member to join in change work by expanding the scope. The editor shortened my letter somewhat to fit the magazine. The slightly longer version of my letter is below:
In Kirsten Lind Seal’s case study, “Managing Hecklers in the Therapy Room,” the father insists that the problem is his daughter’s disrespect, and wants Seal to treat the daughter without involving him in therapy. Seal quite rightly wants him to be involved, and says, “Can we try it my way first?” The father responds, “All right, you win,” clearly indicating that he sees this as a struggle between them, and that he has given in—not the greatest for eliciting rapport and cooperation.
Whenever a client attempts to take charge of what happens in therapy in ways that are not likely to be productive, there is a more subtle intervention to elicit voluntary compliance.
“Look, you’re a lawyer, and I’m not. It would be pretty silly if I told you how to prepare for and handle a case, don’t you agree?” That sentence is something that the father has to agree with—and the more arrogant and dictatorial he is, the more he will have to agree. The implication is that it would be equally silly for the father to dictate how to do therapy. But since this is unstated, the father can change his response without a struggle or having to “give in.”
Whenever a family member refuses to participate in therapy, there is another intervention that will usually elicit compliance without a struggle. “You’re saying that the problem is entirely your daughter, so there is no need for you to participate. I’m OK with working with your daughter alone on this. However, that means that you will have no opportunity to contribute your views and ideas, and I assume that also means that you will have no objection to whatever changes we make without your participation.”
The changes in the father’s facial expression in response to this expansion of scope are a delight to watch, and if the daughter is present, her change in expression will be even more precious.
If you rehearse these two interventions so that you can deliver them smoothly and congruently, you will find many opportunities to use them to avoid struggling with this kind of client.
Posted by: Steve Andreas in: Articles
In my previous blog post I went into some detail about the difference between content and process. In this post I explore this important distinction further by examining a method called, “Imagery with Rescripting,” described in an article, “Treatment of childhood memories: theory and practice,” (pdf) by Arntz and Weertman. The article is unusually clear in describing exactly what the authors actually do with a client, including examples of verbatim dialogue, making it possible to clearly distinguish process interventions from those involving content.
This article presupposes that a problem in the present is a result of a memory of a traumatic event, and that the best way to change the present problem is to change the memory. In my commentary below, I will also accept those presuppositions, but it is useful to keep in mind that some other change method, such as core transformation, timeline adjustment, strategies, submodalities, etc., might be more appropriate and effective. All quotes below are taken directly from the article.
Outline of the Method
The article describes a package of several different interventions to change a troublesome memory, derived from what is called “Schema-based therapy.” A schema is defined as “an organized knowledge structure, which develops during childhood and manifests in certain behaviors, feelings and thoughts,” also described as a “belief.” The authors present a three-phase process for changing a schema experience, summarized below:
The authors present graphs showing improvements on several outcome measures using this method with a client, indicating scores at 5 different times, pretest, at 12 and 24 sessions “focusing on the past,” and at 12 and 24 sessions “focusing on the present,” for a total of 48 sessions. This is definitely not brief therapy, indicating a laborious process, and one that offers only limited improvement. No figures are presented for rates of dropping out of treatment.
Phase 1. Describing the troubling memory out loud to the therapist is a process intervention, because the verbal description will always be a huge simplification of the experience itself. Describing the experience verbally will also slow down the tempo of the memory. The therapist may ask about categories of experience to elicit what the client sees, hears, feels, thinks, does, etc., but the client supplies the content.
This kind of re-experiencing is a kind of “exposure” therapy; depending on how long it goes on, perhaps even “prolonged exposure.” Exposure is widely accepted as a valid treatment, but it risks re-traumatizing the client. At best it is usually very uncomfortable for the client, slow, only partially effective, and typically has a high dropout rate.
Phase 2. “Becoming an adult bystander” is another process intervention, because being an adult implies a more extensive background of knowledge and experience gained in the years between childhood and adulthood, and it also provides a different point of view, but the client provides the content for both.
The bystander point of view involves “self-distancing” and this often elicits different feelings, for instance compassion instead of terror. This is somewhat similar to the phobia cure, but with a very significant difference; instead of seeing a movie of the entire memory from a distant outside point of view as if viewing it in a movie theater, the bystander is in the memory as they review it. This limits the separation between the viewer and the events viewed, like being in a play, in comparison to viewing the play from the back of a theater. When viewing a movie, the implication is that the events occurred in a different time frame, which creates additional separation, but if the bystander is in the play, there is no separation in time.
The adult client is invited to first describe what s/he sees, hears, feels, thinks, does, etc., which again is a process intervention, since the process of describing is different from the sensory-based experience. Then the adult client is asked, “What are you inclined to do?” and then instructed to do it. These actions can range from lecturing an abusive parent in the scene, or telling the child that “it is safe now, and the abuse was not your fault,” to physical interventions such as “pull him off the little girl, curse him, and throw him out of the room,” or even getting a gun to threaten or shoot an abuser. All these actions are content interventions, which can be revised, repeatedly if necessary, until the child is fully satisfied.
Phase 3. The client becomes a child again, and the process of changing the content of what happens continues by having the child as adult ask the child, “Is there anything you need,” and changing events in order to provide it. For instance, if the child says, “I’m afraid that papa will punish me,” the adult says, “I won’t allow that to happen.” If the child says, “I want to be comforted, held in your lap,” then the adult does that.
Any action, comforting, etc., that the adult does is a content intervention, because it changes what happens in the memory, not just the process used to represent it. There are several aspects of these content interventions that need to be examined and clarified in order to understand their consequences.
Problems with making content changes
Altering reality. Any content change in what happens in the memory will create an alternate reality for the client, which can lead to confusion about what actually happened in the past. In careful NLP work we don’t attempt to change the external events; instead, we change the way those events are perceived, evaluated, and responded to internally, as I described in considerable detail in an earlier blog post:
If a change in internal response suggests an action to be taken, that is only useful if it is both under the client’s control, and consistent with external events. For instance, if the client is reviewing a memory of being in a car wreck in which they were injured, the client could decide to relax just before the impact, so that their body is softer and less likely to be damaged. That is under their control, and it is something that doesn’t change the external facts of the accident—the speed of the car, the force of the impact, etc.
If you attempt to change the external events in a memory, such as “pull him off the little girl, curse him, and throw him out of the room,” that can lead to confusion between imagination and memory. It can result in denial of the events that actually happened, and/or living in a fantasy world in which we expect unpleasant events to be magically “fixed” for us. Many clients already have confusions of this kind, sometimes called “delusions.” We certainly don’t want to add to them.
Under client’s control? Even as an adult, the client may not have the strength or ability to, “pull him off the little girl, curse him, and throw him out of the room.” To imagine that this is possible provides another kind of discrepancy between the reality of what is possible for the client and imagination. If the client accepts this kind of intervention, it will be at the cost of their sense of what is real or possible for them and what isn’t. If the client holds onto reality and says, “I wouldn’t be able to do that,” the intervention will have no effect.
Indeed, the article states that in some cases, “the patient is too anxious or feels too powerless in the adult role to undertake any corrective action,” and that sometimes “the patient dismisses the intervention and starts an argument with the therapist (using rationalizations like that the intervention would have been impossible, that the method is useless because the past cannot be redone, etc.)” These “rationalizations” sound quite rational and reasonable to me; these objections can easily be avoided if no there are no attempts to change the external events of the memory.
Empowerment. “The major aim (of imagery with rescripting) is to increase the sense of empowerment. . . . When the patient does not feel powerful enough to intervene (e.g. stop the abuse) in phase 2, or is too afraid of the perpetrator(s) the patient can imagine others, and/or tools as helpers.” These “others” can include friends, family members, neighbors, the police, “or fantasy figures like Batman,” and “tools” can include guns or other weapons.
If these content interventions are not fully successful, “the therapist might actively instruct the patient in what needs to be done, proposes actions, etc. . . . When the patient is completely unable to play an active role in phase 2, or is unable to view the situation as an adult, the therapist plays the role of the correcting adult. In that case, the patient imagines the interventions by the therapist from the perspective of the child.”
Even when this kind of intervention makes the client feel better during a session, it doesn’t empower them, because the power is in the “other,” not themselves. It might be very nice to be rescued by Batman or a gun or the therapist, but that implies that the client is powerless to act on their own, so it actually decreases the sense of empowerment, rather than increasing it.
When the client as child is comforted, assured, held, etc., by the client as adult, that is also disempowering, because the power is in the “other,” not the self. However, if the child as adult does any of this with the child, it is empowering, because the adult has the power. This may seem like a trivial distinction, but empowerment will only occur when the client identifies with having the power, rather than being only the recipient of power provided by an “other,” whether real or imaginary.
These are inevitable results of using content interventions to change what happens in a memory. There is a simple test of any such content change to decide whether it is useful or not. Ask, “If a similar situation were to happen in the future, would the proposed change help the client deal with it?” Clearly expecting to be rescued by Batman would not be helpful, but relaxing just before a car crash could be. The therapist is unlikely to be available to help, but the client’s knowledge that they survived a similar event in the past could be useful in reducing the fear of imminent death.
This illustrates that a useful intervention will be one that changes the client’s perception, understanding, attitude, ability, etc., as described in my earlier blog post. In contrast, any intervention that attempts to change the objective external event will not protect from a recurrence, and will only confuse and delude the client.
Role-playing. The article goes on to describe how phases 2 & 3 can also involve role-playing, which involves further content changes. “The patient playing him/herself as a child, the therapist playing the other person (often a parent),” and that other people (colleagues, friends) can also play roles as needed. Role-playing only further complicates the problems I have described above.
If the therapist plays the role of an abusive parent, that aversive role may become part of how the client perceives the therapist’s identity—and this can happen even with careful de-roleing after a role-play (the article doesn’t even mention de-roleing). Reversing roles is also a possible intervention. “The patient takes the role of the other person, the therapist takes the role of the child.” If the client identifies with the other, that can be very useful in gaining understanding the other’s point of view, intention, confusion, limitation, etc., because the client provides the content.
But if the therapist plays the role of the child, that will add content, because even an accomplished actor will play a role somewhat differently than how the client remembers someone in their past. A therapist’s role-play will always be only a rough approximation to the client’s experience, introducing additional changes in content, both verbally and nonverbally, increasing possibilities for confusion. All these possible content confusions resulting from role-plays can be completely avoided if the client plays all the roles him/herself. When the client imagines being someone else, the resulting understandings emerge from the client’s experience, uncontaminated by content introduced by others.
It would be far better to begin phase 1 by using the phobia cure on the entire event—or on the worst example of a series of events. The phobia cure teaches a dependable and clear form of dissociation, in contrast to the exposure method presented in phase 1 of this method. The phobia cure neutralizes the intense feelings from the unpleasant memory, making any additional changes much easier, faster, and more comfortable. Often the reduction of the strong feeling also results in more details of the event becoming available to the client, and this additional information can result in some useful spontaneous reframing. After using the phobia process, there are much more elegant ways to reprocess a troublesome event.
Robert Dilts’ Reimprinting
In this method, the client finds an appropriate resource experience that happened at a different time and place, elicits it, and combines it with the problem event. This alters the client’s internal response to the event, without changing what actually happened.
Richard Bandler’s Decision Destroyer
In this process the client is asked, “What experience could you have had earlier than that event, which would have prepared you for it in some way? That if you had had it earlier, it would have prepared you for that problem experience?” Then the client is instructed to create this experience in a way that is vivid and powerful in preparing them for the traumatic event. Both the choice of the experience, and the details of it, is content that emerges entirely from the client, so no content is introduced from a therapist, role-player, or other outside source. It results in an internal experience that the client carries with them, and it is one that is carefully designed so that it doesn’t change external events. The entire process is essentially a way to reorganize the client’s internal experience, in contrast to meddling with what happened in the traumatic memory.
The inspiration for the Decision Destroyer was Milton Erickson’s case titled “The February Man” in which Erickson age-regressed a woman and appeared at various times in her lonely childhood in order to give her experiences of being cared for and acknowledged. Erickson was extremely careful to appear in her life at times that would not conflict with actual events in her life.
The client advises and comforts the younger self.
The client imagines being with the younger self in the troubling memory, and advises and comforts the younger self in whatever way is appropriate, using nonverbal feedback to verify when the younger you has, in fact, been comforted and reassured. This process was published in Frogs into Princes (1979) by Richard Bandler and John Grinder, s a follow-up to the phobia cure, but this step was later replaced by the “rewind” process.
“And now I want you to do something very powerful and important for yourself. Younger Tammy did something very powerful for you; she went through those feelings again for you, and she let you watch and listen with comfort and strength to stimuli which in the past have triggered overwhelming responses. This time you were able to see and hear those without panicking. I want you to walk over to young Tammy in your mind’s eye. I want you to reach out and use all of the adult female resources you have, to comfort her and reassure her that she will never have to go through that again. Thank her for living through the old feelings for the last time for you. Explain to her that you can guarantee that she lived through it, because you are from her future. And when you see on her face and in her posture and in her breathing that she is reassured that you will be there to take care of her from now on, I want you to really reach out, take her by the shoulders and pull her close and actually feel her enter your body. Pull her inside. She is a part of you, and she’s a very energetic part. That energy is freed now from that phobic response. I would like your unconscious mind to select some particular pleasurable activity that some of that energy can now be used for, for yourself here in the present and in the future. Because energy is energy and you deserve it. Just sit there and relax and enjoy those feelings. Let them spread through your whole body. Take your time.” (p. 115)
This process is completely content-free, so it avoids all the problems I discussed earlier. It’s immensely faster—typically effective in one session, instead of 48! It’s a really lovely integration process that can be used for any troubling memory. I have used it to reprocess past memories of many different difficult times of uncertainty, turmoil, despair, losses, etc. The statement that, “I can guarantee that you lived through it, because I am from your future” is hard to argue with, and you can expand on this by mentioning positive events that happened later that the younger you couldn’t know about—achievements, relationships, children, etc. This provides a broader positive perspective in time for the unpleasant memory. I urge you to try this process yourself, and let me know how you experienced it.
The distinction between content and process is one that many people talk about, but very few pause to think about in any detail. When we communicate with a client, we can use a process intervention or a content intervention, or a single intervention could include both. Each kind of intervention can be useful (or not useful) but they are different, and it is useful to know which kind of intervention you are doing so that you can anticipate the kind of response you are likely to get.
The most important difference is that a process intervention invites the client to think of the same content using a different process, without the therapist introducing any additional content. This is completely respectful of the client’s world, so you don’t need to know anything about that world in order to offer them new choices. It is very simple and elegant, and it is very difficult to impose your opinions, values, etc. A process intervention is also typically very rapid.
In contrast, a content intervention introduces specific content as a way to change the client’s response to what they experience. That can also be very useful, and it may be exactly what they need. But since it introduces content from your world into theirs, it risks imposing your opinions and values on the client, and sometimes those may not fit well into their world.
Let’s start with some ridiculously simple examples of the content/process distinction, and then move on to others that are more interesting and relevant to therapy. If you have a cup of coffee, the coffee is the content, and the cup is the process, which in this case is a “container,” it keeps the content in a particular place and shape. A different container, such as a jar with a tight lid would supply a different kind of process to the same content. The cup of coffee can be tipped over and spilled (a different process), while the jar with a lid would continue to contain the coffee if it were tipped over. If you change the liquid from coffee to tea, or soda, or dandelions, that would change the content, but the process would be the same.
Sensory Modalities When we are aware of an event in real time, we can be aware of it in any one or more of the five different sensory modalities (visual, auditory, kinesthetic, taste and smell). Each of these modalities is a distinct process, and since each is sensitive to different aspects of a given event, each will carry significantly different content information about the same event.
One of the simplest interventions is to ask a client to attend to one or more sensory modalities that they are not attending to, in order to expand the scope of their experience of an event, or a memory of an event. “When you look at that image, what are the sounds that accompany it?” or “What is the sound of that event?” is a pure process intervention. The client supplies any change in the content (the particular sounds that they hear).
In contrast, “That probably sounds awful, like a screen door slamming,” or “Can you hear that conversation in your head as if it were a pleasant babbling brook?” introduces content on two different logical levels simultaneously—on the sensory level, a particular sound (screen door slamming, or babbling brook) and also at a higher level, an evaluation and categorization of the sound—that it is “awful” or “pleasant.”
If our representation of an event omits any of the sensory modalities, we will have less information than if we had input from all five modalities. Our evaluation of an event is in response to the information received; when this information is only partial, we may have a very different response than if we had full information (and vice versa).
For instance, a visual image of a food might look very attractive, but if we add in the actual taste of it, and/or how it would feel in our stomach if we ate it, the same food might become much less attractive to us. A Playboy magazine centerfold may look fantastic; but if you add in a whiny voice with many demands, or the smell resulting from not taking a bath for a week, it’s probably not nearly as appealing. Sometimes the reverse will be true; the visual image might be unattractive, but if the taste and feel are added in, it might become quite alluring. The same is true of any event that is recalled in memory, or any representation of a forecast of a future event.
Submodalities Within each sensory modality there are smaller process aspects or subdivisions within each modality—each of which is represented in the brain as a separate neurological processing mode. For instance, in the visual modality, an image can be large or small, close or distant, bright or dim, black and white or color, panoramic or framed, etc. In the auditory modality, a sound can be loud or soft, near or far, high or low, fast or slow tempo, melodic or staccato, etc. In the tactile kinesthetic system, a sensory feeling can be felt in any part of the body, both from touch sensors in the skin and internal sensing of position, tension, etc. The feeling can vary in intensity, extent, pressure, rough or smooth, hot, warm, cold, etc. Just as each of the five sensory modalities is a different process, each submodality is also a somewhat different way of processing the same content, and each will include or omit some information.
Perspective In the visual modality, the position from which an image is seen is a very important process variable. Seeing an event from out of your own eyes will always be different from seeing the same event as if we were looking out of someone else’s eyes, or out of the eyes of a disinterested observer, or from any other particular location in space. The ability to choose to take a different perspective is the basis for a wide variety of human skills and abilities, including being “objective,” empathizing with someone else, knowing clearly what I want in a given situation, etc.
Although a process change in perspective provides different content, that content emerges completely out of the client’s experience; the only thing the client is asked to change is the process. Being able to shift perspective is a major skill that enables flexibility and choice in responding to a situation with wisdom and balance. When the different perceptual positions are “aligned,” the usefulness of these different positions is enhanced immeasurably, because the different sensory elements are sorted and arranged for greatest clarity.
Phobia In a simple phobia, the content is what the person is afraid of: spiders, mice, water, heights—even stuffed olives, which is my all-time favorite. Mainstream psychology has classified phobias by content—arachnophobia, musophobia, aquaphobia, acrophobia—but they haven’t yet gotten around to giving a Greek or Latin name to an intense fear of stuffed olives. Most psychotherapies attempt to resolve a phobia by focusing on the content, its history, its symbolic meaning, its development over time, or its place in the dynamics of a family system, etc.
However, what is important in a phobia is not the content, or the past events that caused it, or the current context, etc. What is important is the process in the present. Someone with a phobia responds to an external stimulus by recalling an unpleasant traumatic memory. This process is not a problem in itself; we all sometimes respond to external stimuli in this way. What is important is that someone with a phobia remembers it by being back inside it, as if it were happening again in the present. As a result, they have all the same horrible feelings that they had in the original experience, often with the same intensity.
The phobia cure changes the process that the client uses to recall the memory, so that they are outside the experience, as if watching it on a movie screen. Now it is as if they are watching someone else go through the experience, so they have the feelings of an observer instead of those of a participant. That is a very different feeling in response to the exact same content. Instead of the fear, shock, etc. that they felt in the original traumatic event, now they can have feelings of compassion, or sadness, being glad that it is happening to that other person, or whatever other feelings they would have if they watched someone else go through that horrible experience in real life.
The same process can be used for any disturbing traumatic memory, from mild unpleasantness up to and including PTSD flashbacks. Some people use this process spontaneously; despite undergoing truly horrible experiences, they never experience PTSD symptoms. A few years ago I heard a radio interview with a woman who was arrested in Bahrain for treating injured political protestors during the “Arab Spring.” She was repeatedly severely beaten and raped for many weeks by many men—certainly a “history” that most therapists would consider adequate to cause PTSD. But in describing her memory of those experiences, she said calmly, “When I think of those events, it’s like they happened to someone else.”
Since the process is what is important, a therapist using the phobia cure doesn’t need to know anything at all about the content of the phobia to resolve it. The therapist doesn’t have to explore the content, probe the symbolic meaning, history, development over time, or its impact on the family system, etc. And the client doesn’t have to reveal any of the sensitive or shameful details of what happened, so it is much simpler and less unpleasant for them. The therapist only needs to know that the client has a very rapid unpleasant response to a memory or cue. Since the same procedure can be used for any content, this greatly simplifies the therapist’s task.
Sometimes the cue that triggers a phobic response is something that is not actually dangerous, but only what the client happened to be aware of at the moment of peak arousal in the original traumatic event. I don’t think that anyone has ever been attacked or harmed by a stuffed olive, but if the client was looking at a stuffed olive at a moment of the intense fear, it may become the trigger for it. A client who had a phobia of not seeing her feet happened to be looking down at her feet in shallow muddy water at the moment of peak terror after falling off a boat. These and other examples clearly indicate that the content is really irrelevant to the phobia; it just happens to have been the stimulus that got associated with the emotion, and became a trigger for it.
This focus on process rather than content is a revolutionary paradigm shift that was offered to the field of psychotherapy over 35 years ago, in the book Frogs into Princes. Most therapists spend a great deal of time “working through” clients’ unpleasant past experiences, and usually that involves some form of re-experiencing, “prolonged exposure” or “emotional expression.” Given that someone with a phobia has probably re-experienced it intensely hundreds or thousands of times already, it seems unlikely that simply doing the same thing a few more times in therapy would be useful.
The shift of attention from content to process was a shift that many therapists found very difficult to accept. My wife Connirae once demonstrated the phobia resolution process to a group of therapists with a woman who had a phobia of heights. Before doing the process, the woman was trembling and sweating when she put one foot on the second rung of the ladder, and couldn’t go higher. After doing the process, she climbed to the top of the ladder, cheerful and relaxed. A psychiatrist who had observed the entire process spoke up and said, “Excuse me, you’re a nice lady, but you just can’t do that.” One might think that therapists would be happy to learn a quick and effective way of working in this way. Unfortunately, it is has been largely ignored by mainstream psychotherapy, and most therapists are unaware of it.
Resolving Grief The process in grief is the exact opposite of a phobia in two ways. Someone with a phobic response is stepping back inside a negative experience; someone who is grieving is stepping outside of a very positive one, feeling only emptiness and longing for the lost good feelings. Accordingly, the process for resolving grief is the exact opposite of the process used for a phobia, namely stepping back into the treasured experience to recover the good feelings that they had with that person, a pure process intervention. Many therapists think about “grief work” as “learning to say goodbye” but this is exactly backwards—they really need to say “hello” again and reengage with the good feelings they are presently separated from.
Many grieving clients remember the fight, accident, or death that ended a relationship, rather than an event that represents the good experiences that they enjoyed. However, the ending of the relationship is not what they miss and yearn for. When this is the case, it is crucially important to change this content to a representation of what was positive about the relationship, because this is what the person misses and longs for. This is a content change that must be done before doing the process intervention, because stepping back into a fight, accident, or death scene is neither pleasant nor useful. In a recent conference workshop I asked for someone who experienced grief, in order to demonstrate the grief resolution process. The first two people who volunteered were troubled by remembering the end of the relationship. As soon as I asked them to change the content to a special moment, they no longer experienced grief. In the grief process there are both content and process interventions, and both are useful.
Decisions Making a decision has both a content and a process. The content might be whether or not to marry, or buy a car, or eat another cookie, or any of the many thousand of decisions that we make every day. The process that we use is the series of mental events that we use to think of options, evaluate options for their desirability, and finally choose between them. Typically, each of us has one basic decision process, no matter what the content of the decision is, though there will always be small variations to adapt to the content. For instance, a decision about music will usually require an auditory evaluation step, while a decision about food will usually require a taste evaluation step, a decision about a shirt might require both a visual evaluation of how it looks, and a kinesthetic evaluation of how it feels on your body.
Some people have a decision process that works very well, while others have a process that doesn’t work well at all, or only works well in certain contexts. Since this is a more complex process than a phobia, there are more opportunities for processing errors. For example, a person may not have a way to think of additional options, or they may represent options only in one major modality (visual, auditory, or kinesthetic) rather than all three, omitting vitally important information. They may think of an option as a still picture rather than as a movie, again omitting important information that is only available in a movie that extends into the future. They may use only one (or a few) criteria in evaluating options, or they may oscillate between different criteria. They may try to decide among many options at once, rather than taking only two options at a time, and discarding the less desirable one. If the decision process is faulty, the resulting decisions will be unsatisfying, irrespective of the content, even if many desirable options are available. (For more detail on decisions, see chapter 16 of Heart of the Mind.)
Communication When we communicate, we usually attend to the message that we want to send—the words that are primary in conveying the content. The process that we use to communicate the content is everything else—the volume, tone, tempo, hesitations, melody of the voice, and the visual information offered by the posture, facial expressions, tilt of the head, proximity, body tension, hand gestures and movements, the clothes we are wearing, the larger context—and all the ways in which these separate aspects are linked together into repeating patterns.
That “everything else” is a huge amount of information that far exceeds our limitation of 7 +/- 2 “chunks” of conscious attention that George Miller identified over a half century ago. If most of our attention is focused on the content—and often also on the other person’s response to it, we have only a tiny bit left to notice a few aspects of that “everything else” that is going on. Accordingly, most of this process information is not conscious most of the time (though it can become conscious with a shift of attention). This “everything else” of the process may convey far more important information—particularly about the relationship between you and the other person—than the content being expressed.
The tricky part The distinction between process and content is not fixed, but is dependent on what is attended to, and the context. A process can become the content of another process. For instance, if you pay attention to voice tone, or any other process, then what had been process becomes the content, and the process becomes something we might call “observing,” or “noticing,” or “evaluating.”
A world event is a content that is processed by our sensory modalities and submodalities to yield what we call our experience of the event. Then that experience becomes the content that is processed by language to become a verbal communication. That communication can then become the content that is processed by linguistics (words, grammar, syntax, etc.)
In this article, both “process” and “content” have become the content of a process that might be called “describing” or “understanding.”
Exploring the shifting dance between process and content requires some mental gymnastics that few of us can do easily; if you think you understand this clearly, then you probably don’t.
Hopefully this short article can begin to sensitize you to some of the differences between content and process, the beginning of an interesting and very useful exploration that can often make sense of what otherwise be very puzzling and confusing. For further reading about this, read my book, Six Blind Elephants.
After getting an MA in psychology from Brandeis University in the early 1960s—a sort of consolation prize when I dropped out of a PhD program—and then teaching psychology for several years in a community college, I discovered Fritz Perls and Gestalt Therapy. The excitement of seeing change happen right before my eyes was a heady contrast to the other therapies that took months—or sometime years—to get anwhere. I became a “true believer,” and devoted all my spare time to learning how to do it, over a period of ten years, 1967-1977, when my name was John O. Stevens. (I took my wife’s last name when we married in 1981.) In 1969 I edited and published Perls’ Gestalt Therapy Verbatim and his autobiography In and Out the Garbage Pail, and the next year I wrote and published Awareness: exploring, experimenting, experiencing, a book that applied Gestalt principles in exercises that I was using in my college teaching.
During this time I was invited by an Air Force psychiatrist to come up to his base and make a presentation to his staff. Walking to my car after the talk, Bill told me about his dissatisfactions with life in the military. He talked about the salary and all the benefits that kept him there, and all the rules and restrictions that rankled him. At one point he said, “I pay a terrible price for all that security.” I said, “Well, I guess we all have our price,” meaning that we all make difficult choices and compromises in a less-than-perfect world, and that benefits never come to us without some kind of price.
Later I learned that my simple normalizing comment gave Bill permission to carefully examine the price he was paying, and he decided that he didn’t want to pay it any more. Since he had just signed up for a 3-year hitch, he couldn’t just quit. So he faked a psychotic depression, palmed and flushed the drugs they gave him, and was discharged soon after, free to find a new life with a different price. I wasn’t trying to “do therapy” with Bill, but my short comment, which couldn’t have taken longer than six seconds, had a literal life-changing effect, and ought to qualify for “briefest therapy.”
At that time, “brief therapy” typically meant 10-20 sessions, and psychoanalysis took years, often with little to show for it. Although I was used to fairly rapid changes in Gestalt sessions, this was one of my first clues that—at least sometimes—personal change could be even faster and gentler. Perhaps if I knew more about the internal structure of someone’s experience, I could be more systematic about helping them change quickly. I don’t know anyone who thinks that a complex motor skill like playing a violin, basketball, or brain surgery can be learned quickly, but changes in attitude, orientation, and belief can often occur in seconds.
Looking backward, Gestalt Therapy had some significant flaws, one of which was the “one size fits all” assumption that a single process will work for all kinds of different problems, an idea that is still quite pervasive in the field of therapy. In medicine, there are more than 13,000 distinctly different diseases, syndromes, and types of injury, most of which have a very specific intervention protocol. Contrast that with the current state of psychotherapy, in which there are over a thousand different named therapies (and how many unamed?) and nearly all of them assume that their one process will work with any and all difficulties.
Gestalt assumed that stepping into every experience and fully experiencing it kinesthetically and emotionally was the key to resolution and change. This was particularly useful with grief, in which the feeling of loss results from seeing an image of the dead person at a great distance, or being separated from them in some other way. Stepping into a memory of love and connection with that person results in a full-body sense of presence, replacing the feeling of loss, and eliminating the grief.
Stepping into a part of the person that is alienated, represented as “other” was also very useful for becoming more fully aware of the “shadow self,” sometimes called the “dark side” of the person, as a first step toward integration.
However, fully experiencing all the feelings of a terrifying memory is of no use to someone who has a phobia or a PTSD flashback, because that is what they are already doing. If someone is making poor decisions, it will seldom be useful to step into the bad decision, but it can be very useful to view a series of decisions objectively to discover how the process itself is flawed, in order to improve it.
To summarize, stepping into a memory is sometimes useful, while at other times, stepping out of it to become more objective is much more useful. Both are skills that everyone has, but most people don’t realize that they have them, or that they have a choice about which will be useful in a given context. Often alternating between the two will be most useful, reaping the advantages of each in turn.
Gestalt was a part of the zeitgeist of the 1960’s that advocated paying attention in the here and now, which has been part of a number of very old spiritual traditions, and has been reincarnated recently in a secular form as “mindfulness.” In the context of Gestalt Therapy, paying attention in the present moment was a very useful advance over endlessly talking about the past, which was the most common approach at the time—and which still occupies a large part of most typical therapeutic sessions today. In a Gestalt session, talking about a problem was only a point of departure for acting it out behaviorally, doing something rather than reciting a well-rehearsed lifeless verbal “tape-loop” description.
Whether role-playing and becoming some part of a dream, or talking to a parent or some other person in an “empty chair” dialogue, the nonverbal behavior in the present moment revealed key aspects of the interaction. Although this method was borrowed from Moreno’s psychodrama, a crucial difference was that the client’s enactment emerged entirely from their own inner world of experience, not inevitably distorted by someone else’s attempt to portray it.
As the client shifted between being themselves and the “other,” shifts in their nonverbal behavior revealed vital aspects of their inner conflict. A man might verbally be expressing positive thoughts, but his hand might be clenched in a tight fist. The fist (which he often wasn’t aware of) often indicated anger, or open hands palm up suggested pleading. When Fritz would say, “Give your fist words,” or “What are your hands saying?” these nonverbal expressions added to the richness of the dialogue, and could participate fully in its clarification and eventual resolution.
I can still hear Fritz saying, “Nyah, nyah, nyah” pointing out to a woman with a whining voice that she was implicitly asking someone else to do the work of lifting her out of her “poor me” victim role, provoking her to take charge of her life. And I can also hear him gently saying to someone else, “I hear your voice drenched with tears,” revealing a need to acknowledge and resolve a loss that colored her world a dull and lifeless gray.
Someone, or something, in the real world might be very difficult to deal with, but in the context of a two-chair dialogue it became inescapably clear that the real conflict was between two (or more) parts within the client. When someone is yelling at a parent in the empty chair, but the parent is nowhere near—or may be dead and gone long-ago —it is obvious that they are actually yelling at their internal image of the parent, something that Virginia Satir was also very clear about.
As the client successively acted out each side of the conflict kinesthetically, they identified with each, implicitly agreeing that each was a part of their own behavior, even if it was labeled “father” or “mother” or someone else. Each time they switched between parts, the transition from one to the other overlapped, and this tended to blend and integrate the two sides of the conflict. When integration was successful, that made it possible for the client to own and use all their personal behaviors and skills to deal with the external conflict in the real world.
Like any other process, the usefulness of awareness in the present moment in the limited context of therapy can easily be overgeneralized to become a universal panacea. If someone noticed that we need to breathe in air, and then declared that we should always breathe in, their error would be apparent to most—especially if they tried to actually do that.
However, the same fallacy is true of the doctrine of being aware of the here and now in contrast to the “there and then” of the past or future. While it can be very useful to be able to redirect attention from past disasters and future anxieties to the present moment, particularly for people who tend to overplan, the reverse can also useful. Many people already spend most of their life in the present moment, untroubled by past mistakes or future consequences. Those who overeat, abuse drugs, or engage in risky behavior of all kinds could benefit greatly from expanding their scope of time in order to pay more attention to the past and future.
Images of the past and future can be very sustaining, and even life-saving, especially when the present is horrible. Viktor Frankl survived the Nazi death camps by vividly remembering being with his wife, and planning the talks and writing he expected to do after the war was over. Happy memories and exciting future goals are part of the experience of being human. Without the past and future, our lives would be as restricted as a chimpanzee’s.
If you think that being in the here and now all the time would be wonderful, spend a few minutes watching a YouTube video of Clive Wearing, who has a memory lasting only 7-30 seconds, and you will soon be released from that particular delusion. Jill Bolte Taylor provides another very interesting report of being in the here and now in her TED talk, “My stroke of insight.” She loved being in the present moment—what she called “la la land”—but it made her incapable of making a simple phone call to save her from the stroke that intermittently shut down her ability to understand and use language.
One particularly admirable aspect of Gestalt Therapy was Perls’ willingness to record his work on film—when it was far more expensive and difficult than it is today. Now anyone with a smart phone can record events with the tap of a finger—and without the bright lighting that filming used to require. Virginia Satir, Albert Ellis, Carl Rogers, and a few others also made film and video recordings, so that others could see and hear exactly what they did in therapy sessions. That kind of openness is still very rare in the field; most therapists prefer “private practice.” I have often tried to locate videos of prominent therapists, so that I could see exactly what they did in sessions. But usually all I can find are lectures about their work, and their theories, not the work itself. Some prominent therapists have made “therapy” films based on actual cases, but using trained actors—producing only a distorted caricature of what actually happens in therapy.
The main reason often given for not videotaping real client sessions is client confidentiality. However, I think that “client confidentiality” is more often protection for the therapist, rather than the client—a way for therapists to avoid revealing what they do—and how long it takes for them to make any progress at all. I have found that most clients are quite willing to be videotaped if you tell them that no public use will be made of the video without their written permission. Even when they have this absolute veto power, very few have exercised it.
Another valuable aspect of Gestalt was that it usually occurred in groups, so all group members could observe the struggles of the person in the “hot seat” who was actively working with the therapist. The benefits of observing others ranged from simply becoming familiar with the process, and the typical benefits of the process, to complete “piggybacking”—stepping into the shoes of the protagonist, and getting personal resolution for themselves.
When a client had fully identified with a rejected and alienated part, s/he was often asked to go around to the other people in the group and act out that part in relation to each person. For instance, if a “dark side” part was arrogant or insulting, the client would be told to be arrogant and insulting to each person in the room in turn. Usually their insults would vary in interesting ways as they responded to the personality or behavior of each person, targeting their individual weakness or sensitivity. The insult to one person might be to their appearance, another’s intelligence would be demeaned, while a third’s social status would be scorned. This combined expressing and owning the problematic behavior with making authentic contact with others in the group. This provided a behavioral richness and texture far beyond the word “arrogance,” making it very clear exactly how pervasively someone’s “dark side” was expressed in their interactions with others.
Although these processes were quite useful, they required publicly acting out aspects of their personality that were often embarrassing to clients. Some were understandably reluctant to do this, a significant obstacle that prevented some from benefitting fully, or at all.
Although Gestalt was quite good at revealing the dynamics of internal conflicts, and eliciting alienated behaviors, it was not nearly as effective in resolving them. The client kept switching back and forh between the two parts of the dialogue until integration occurred. Sometimes this took a long time, and it often involved a lot of broken furniture as they acted out their anger and fantasies of revenge on the empty chair.
This was primarily because Gestalt didn’t include the presupposition of positive intent behind every behavior. Assuming positive intent makes it much easier for us to accept an alienated part, and be willing to identify with it and learn from it. Gestalt took a small step in this direction by assuming that every alienated part had a valuable power. No matter how troublesome or destructive a behavior was, it was a resource that could be integrated and used in more positive ways if it was acknowledged as part of the self. The only real choice was between the present state in which the alienated part would express its power in whatever way it wanted, or identifying with it, taking it into the self, and gaining some degree of choice about how the power was expressed.
However, acknowledging the power in a troublesome aspect of behavior is not nearly as convincing and liberating as realizing that an alienated part is already performing a positive function that can be acknowledged and celebrated, building a positive alliance with the part. For instance, a parent’s withering criticism might have the positive intent of motivating a child to succeed, as well as the positive intent of expressing the parent’s feeling of helpless frustration.
Since the child also wants to succeed, the parent and child are now in agreement about the intent, so they can now explore together how to alter the problematic behavior to make it even more effective in achieving the positive intent. Once this alliance is established, it is relatively easy to work together with the part, instead of battling with it.
There are actually three fundamentally different kinds of positve intent, and they can be illustrated in a familiar scenario in which a parent or other important person criticizes a child, and the child understands this behavior as meaning something about the child. Often a criticism is a clumsy overgeneralization like, “You’re stupid,” or it’s loaded with unuseful presuppositions like, “Why won’t you ever grow up?”
Of course these three kinds of positive intent are not mutually exclusive; a single critical comment could include two, or all three, kinds of positive intent simultaneously.When this is the case, it is useful to sort out the different aspects of intent, and deal with each appropriately—ignore it, modify it, or rebalance it.
Most current “parts work” or “internal family systems” work is similar to Gestalt. Either they don’t use positive intent, or they use it imprecisely, limiting its usefulness. Many other approaches either oppose a part, or try to eliminate the part altogether, which is even worse.
With the understanding that all aspects of a person (feelings, behaviors, thoughts) have positive intent, conflicts can be resolved much faster. Rather than have a client act out the two sides of a conflict overtly by switching chairs, I now often ask clients to close their eyes and have an internal dialogue with someone, or some part of themselves, with only occasional guidance from me. Since the client only needs to reveal the general character of what occurs in the dialogue, they don’t have to report, or act out, aspects of themselves that could prove embarassing, making it much easier to achieve mutual understanding between conflicting parts, and eventual integration.
Although I have learned many, many specific distinctions, interventions and ideas about therapy since those long-ago days, there are certain core principles from Gestalt that continue to underlie and guide everything I do with a client:
Every aspect of our experience is a part of ourselves. Any attempt to eliminate or destroy any part of our experience only perpetuates and escalates conflict.
Since every experience we have is a part of us, attempting to eliminate any aspect of it is doomed to failure—and if it were to be successful, that would make us less whole, less capable, and less human.
Every aspect of our experience needs to be acknowledged, understood, and utilized in the contexts in which it is most useful, integrating it smoothly into the fabric of our lives.
After ten years of being deeply involved in Gestalt, I discovered neuro-linguistic programming (NLP). Again there was the heady excitement of learning a radically new way of helping people change, with all its challenges, frustrattions, and discoveries. NLP offered very specific ways to elicit and verify a client’s internal experience, as well as a multitude of ways to alter that experience in order to resolve problems. The field continues to evolve, often far beyond its stumbling iconoclastic beginnings in the early 1970s, when Richard Bandler and John Grinder first developed it. What’s next?
An interviewer asked a famous songwriter, “Of all the songs that you have written, what is your favorite?”
The songwriter replied, “The next one.”
I think this interview is remarkable in many ways. It is a rich and refreshing demonstration of what it is like to be free of ego and full of immense appreciation for all the people who have been and still are, a part of her life. I recommend that you find a quiet evening when you are to tired to accomplish anything, and would like some inspiration, to enjoy listening to someone who was fully committed to her singing, without getting caught up in self-importance — a much-needed antidote to Hollywood, Kim Kardashian, and all the enlightenment gurus who talk about egolessness, but don’t demonstrate it. If you think you don’t have time to watch the video, below are a few short transcripts that I hope might entice you to change your mind. Use the time to sample that segment of the video.
Linda begins by discussing her recent diagnosis of Parkinson’s disease, which makes it impossible for her to sing anymore. Rather than complaining about this, the Tucson farm girl is deeply grateful for what she had for so long:
0:52 “I had a long turn at the trough.”
4:15 “I had a good ride.”
6:40 “I had a long time at the trough.”
Her work was important; fame only useful in getting paid better:
26:15 When asked about being on the cover of Rolling Stone, she replies, “It didn’t matter; I mean the music is what counted. As long as I had a good band, a rehearsal, enough rehearsal, that’s all I cared about. If we were successful, that was good because that meant I could hire better musicians. The more money we made, the more we could pay the players.”
26:50 When asked about being on the cover of Time Magazine, she replies, “Who cares? . . . I don’t read it; do you? . . . I mean what does it matter? The work is what counts. The work is what counts. I would know whether I was doing very well or not — that’s what would count. Most of the time I wasn’t doing very well as far as I was concerned — I’d work a little harder. I was always trying to get it a little better — “I’ve got to sing this a little better.”
30:46 When the interviewer says, “Your Spanish album is the highest-selling foreign language album of all time, Linda responds, “I think so. I don’t know. You’d know better than I. I’d have to look it up.” Q: “Did that surprise you?” Linda: “I just didn’t think about it; you know that wasn’t what I was thinking about when I recorded it. I just wanted to record it because the songs are so beautiful.”
34:20 When the interviewer says, “You were at the zenith of your career, and (her good friend) Jerry Brown was governor of California,” Linda says, “Who cares?”
The impact of her experiences on her singing:
46:30 “Everything that ever happened to you is like a clear colored gel; you get an experience, you put it down — like putting it over that light there — it changes the whole slant of things; the color of your light changes the color of your sound. So every event that ever happens to you, every book you ever read, every song you ever listened to — it all becomes part of what you put back out.”
47:00 “So everything you ever read, everything you ever saw, every dance you ever saw, every dance you ever did, that all becomes a part of it, becomes a part of your voice. It changes the sound and makes it richer and better.
When she is asked to compare herself to other singers:
58:38 “I don’t put myself in that exalted category. I’m a pretty good singer; I do pretty well. I don’t think I’m a great singer; I think I’m a competent singer, a highly competent singer.” Then she extends her right arm over her head and mentions several other singers, and then lowers her hand to eye level and says, “Linda’s somewhere about here. Fine.”
Linda’s voice may be silenced by Parkinson’s, but her simple presence continues to sing of the human spirit at it’s uncomplicated best. I’m sure she would agree with the famous songwriter who was asked, “Of all the songs that you have written, what is your favorite?”
The songwriter replied, “The next one.”