This post is a follow-on to the previous post on scaling, responding to the many comments that were made to that post. (The following will only make sense if you have read the previous post and comments.) Thanks to all of you who posted comments, and also those who emailed me privately. They have given me quite a lot to think about. I wish there was more of this kind of fertile discussion in the field, aligned with the Japanese proverb, “None of us is as smart as all of us.” Before I explore some additional interesting details about scaling, I want to reiterate the main points, so they don’t get lost in the minutiae.

The Upside

Primarily, scaling is useful because it changes what is often an overwhelming digital, either/or experience into an analog range or continuum, making it easier to make smaller incremental changes from one point to another on the scale. It also tends to represent the feeling as an external visual comparison in which the image of the problem state is not only distant, but usually smaller. All these factors reduce the intensity of the feeling, making the problem feel less overwhelming.

Of course there is also the overt reason for scaling, using it as ongoing feedback on the effectiveness of interventions. The client’s nonverbal behavior is the best feedback about the impact of an intervention, but since these cues are not always robust enough to be noticeable or convincing, it can also be useful to pause periodically to ask a scaling question.

This makes scaling a useful intervention any time an analog change is appropriate, such as reduction of pain, tension, stress, etc. Scaling is also useful in adjusting the relative importance of different experiences. For instance, a workaholic who neglects important family or social activities, might want to make work less important, or family more important. Many problems require adjusting the relative importance of images of present pleasure in relation to future enjoyment. In these examples we don’t want to eliminate anything, only restore balance between different urges, needs, or values.

 

The Downside

The drawback of scaling is that it tends to ignore the possibility of making a digital shift to a response for which the original scale is inappropriate and irrelevant. When someone experiences a congruent, full-body forgiveness, resentment doesn’t just diminish to zero; it simply isn’t an issue any more. Whenever you have an intervention that makes a digital change in response, scaling is inappropriate, and may interfere with the process. For instance, the phobia cure elicits a digital change in feelings—from the terror of being in a life-threatening experience to being a distant observer, who may feel nothing, or empathy, or sympathy, but not terror. If you were to ask a client to scale their terror, that would direct their attention toward pulling them back into the troubling memory.

Since scaling directs attention to whatever variable is scaled (most often a feeling) this tends to withdraw attention from other aspects of the experience that is scaled. Some of these may be major factors in eliciting the feeling, providing important feedback about how to intervene next.

 

The Best of Both Worlds

Whenever we seem to be faced with an either/or choice of alternatives, it is useful to contemplate how this apparent opposition can be transformed into a both/and. In retrospect, I wish that I had put more emphasis on the theme of the last paragraph of the previous post, namely to request feedback about many different aspects of the client’s experience rather than only a single variable that is scaled. For instance, “I want you to let me know of any changes in the intensity of your feeling. And I also want to know if the quality of your feeling changes—for instance from fear to curiosity, or from hesitation to eagerness, etc. I want you to tell me if the way you see an internal image changes, for instance, the size, distance, location, color, focus, etc. If an internal voice changes in loudness, location, or tonality, I want to know that. I also want to know if what you see in your image, or the words of your internal voice change.” An instruction like this invites specific feedback information that is far more varied and useful than just scaling a single aspect of experience.

 

Additional Details

I want to respond to a number of points that have been raised in the comments to date.

Several people proposed using a scale of 1-10 rather than 0-10. A 1-10 scale implies that the lowest point on the scale is 10% of the highest point on the scale, making it difficult to scale a zero response. When I asked one woman why she used 1-10, she replied that the physicians who refer to her insisted on her using that scale in reporting progress, and that their reason was that, “There was no possibility of a complete absence of an issue” (precluding any possibility of a digital shift).

I responded that I thought it would be fairly easy to think of counterexamples to that particular limiting belief, such as asking the physician, “Do you ever seriously think about wearing women’s clothes to your office, or taking up wing suit flying?”—or some other similar unlikely possibility. And then ask him if he would scale that “issue” as a 1 or a 0, with 10 indicating, “Yes, I’m planning to do that tomorrow!” However, in her position I thought it would probably be best to just use 0-10 in her work with clients, and translate a 0 into a 1 when reporting to a physician.

Since we usually assume that a higher number indicates more of something, Bob’s suggestion to assign a 1 to the “most resentful” seemed counterintuitive to me. When I try doing that, I get a little confused, so I asked myself, “OK, When might it be useful to introduce a little confusion or uncertainty?” Many clients suffer from an excess of certainty, so it would be interesting to try that with a few of them, and find out if it is useful in loosening up the present state. Bob and I are corresponding about this, but haven’t yet reached a resolution to share.

Bob’s third comment was, “ ‘Physical’ scaling works too. I have clients work with ‘projects’ on a time-line facing into the future: ‘Hey, that looks a bit big, just to make it easier here, how about we shrink it down so that you can clearly see all of it?’ accompanied with a downward movement of both hands to allow the client to look down at the project in front of them.” That kind of intervention can be very useful, but it is somewhat different from asking an overt scaling question, so I won’t comment further on now.

I like both Bob and Nick’s suggestion of going off the scale that has been established. “What would an 11 (or a -1) be like?” This ought to be especially useful for a client whose experience is mired in the mid-range of what is possible for them, and who could usefully expand that range—something that is probably true for all of us.

Finally, Rob Voyle’s excellent post clarifies a very important additional situation. A client’s problem, described with a very general word like “distress,” “resentment,” or “bad feeling” may appear to be analog, but may actually be a combination of two (or more) distinct digital components. When one of these components is resolved, the overall intensity of distress is reduced, so it may appear to be an analog change, but full resolution requires a digital change in the one(s) remaining. This will often be true in PTSD, because the client’s bad feeling may be a mix of guilt, shame, grief, resentment, etc. in addition to the core phobic experience. Resolution of one of these digital components may actually be successful, but appear to have failed because of the remaining components.

The original question about when scaling is appropriate led first to the distinction between analog and digital change, and then to quite a number of additional understandings, which has certainly refined how I think of change. Again thanks to all who participated in this exploration.