Recently I watched a workshop presentation of our forgiveness pattern. Overall it was an excellent presentation, and one thing caught my notice: the presenter used scaling on the problem state, resentment. “On a scale of 0-10, with 10 being the most intense resentment you have ever felt, how resentful are you now?” Initially I thought, “Oh that’s interesting, I never thought of doing that.” But over the next few weeks I had a nagging feeling that maybe it wasn’t actually such a good idea. This led me to think in much more depth about how scaling works, and when it’s useful and when it isn’t.
Some therapeutic approaches make regular use of “scaling” as a way to monitor changes in the intensity of a client’s feeling response, in order to track the usefulness of interventions. This is particularly true in Solution Focused Therapy, and in EMDR where the scale is known as a SUDS scale, an acronym for “subjective units of distress.” Scaling is most often used for unpleasant responses, but it can also be used for feedback about progress toward a positive outcome. “On a scale of 0-10, where 10 is the happiest you have ever been, how would you rate the way you feel right now?”
What’s not widely recognized is that scaling isn’t just a way to get feedback about interventions. It is actually a substantial intervention in itself, because scaling elicits a number of specific predictable changes in the client’s experience.
Many clients start out focusing exclusively on their present feelings without reference to other times and places, creating a kind of “tunnel vision,” in which their problem state occupies all their attention. This narrow focus often leads them to think of their problems in absolute digital terms, as something they are in—a “depression,” a “trap,” a “stuck state,” etc. that they would like to be out of.
When an experience is thought of as being a digital either/or, that implies that it would be very difficult to make the huge change to the opposite polarity, for instance from depression to happiness. When the problem experience is located on an analog scale, it is easier to think about making smaller changes along that scale, say from a 10 to a 9.
A conversational way to reply to a client who is thinking about their situation in a digital way is to say sincerely, “OK, how depressed (or trapped or stuck, etc.) are you right now?” The word “how” changes the absolute either/or into a comparison with other similar experiences, creating an analog continuum that presupposes different degrees of depression (or being trapped or stuck). The same thing happens when a client is asked to locate their present feeling somewhere on a scale of 0-10. Even if they rate it as a 10 at the end of the scale, that places it in relation to other experiences on the analog scale, creating a more balanced perspective.
A scale also requires the client to make simultaneous comparisons between different experiences. “Well this one was bad, but this other one was worse, and this other one wasn’t quite as bad.” While it is possible to make a simultaneous comparison in the auditory or kinesthetic modalities, it is much easier to do this with visual images. So even when the scale is not explicitly described visually as a horizontal scale or a vertical ladder, there is a strong likelihood that a client will spontaneously represent their kinesthetic feeling state as a visual image. When a kinesthetic feeling is represented as a visual image, that reduces the felt emotional response, making it less overwhelming, and easier to change.
When you visualize two (or more) experiences on a scale simultaneously, you become an observer of both, making it even harder to be immersed in either one. This creates some distance between the client and the problem state, sometimes called “self-distancing,” “externalization,” or “becoming more objective.” (NLP has traditionally called this “dissociation” but that term has many troublesome connotations in psychiatry, so I have turned to other more descriptive words.)
Seeing two images at the same time also usually reduces the size of the mental image of the present state, because generally the two images have to fit into the same space as a single image. This smaller size further reduces the emotional response, and this makes the problem appear easier to resolve.
Scaling can also be used as a basis for adjusting the location of a problem on the scale. “If you were to be at a 5, rather than a 6, how would your experience be different?” “What would it take for you to change from a 10 to a 9?” Scaling is particularly useful in something like pain control, or physical tension, in which the goal is simply to reduce a troublesome sensation.
So to summarize, what seems like a simple question for gathering information is actually a substantial intervention that changes a client’s experience in a number of ways, and sets the stage for further interventions.
This morning was chilly, with a beautiful fresh snowfall. My wife said, “It’s 7:45,” using a time scale. But she could as easily have said, “It’s 66” if she was commenting on the temperature, or “4” to indicate the depth of the snow in inches. Each of these responses can be useful, depending on the context. The time might be most important if we have a morning appointment, the temperature if I need to build a fire, the depth of snow if we’re concerned about driving somewhere. Whenever we quantify one aspect of an experience, that reduces it to a number on a single continuum, a huge oversimplification that ignores all the other aspects. Numbers are great for allocating people to airplane seats, but that inevitably ignores all their individual differences, and this can create problems.
In therapy, focusing on a “scale of 0 to 10” for a given feeling directs attention to its intensity, and away from qualitative aspects that may be more important. For instance the forgiveness pattern does result in resentment being reduced. However that’s not all it does. Much more significant is that it replaces resentment with a completely different feeling response, forgiveness. Using scaling for resentment continues to focus the client’s attention on the resentment, diverting attention from the possibility of having a qualitatively different response. While this may not prevent a client from benefitting from the forgiveness process, it certainly doesn’t support the change. Ideally every aspect of our interventions support each other in reaching an outcome.
Conclusion
If your goal is to simply elicit an analog change in the intensity of a response, as with pain, stress or tension, then it’s useful and appropriate to use scaling, which presupposes that a change in intensity is what matters.
But if your goal is to elicit a digital change in response—such as from anger to forgiveness, anxiety to confidence, grief/loss to a sense of presence, etc.—then scaling is not appropriate, and could even interfere with the process you are using.
If you’re not sure whether a quantitative or qualitative change is appropriate for a particular problem or outcome, you can combine these two approaches, which is what Connirae and I did many years ago when we were developing the Eye Movement Integration process. We asked clients to report any difference in the intensity of a feeling, and also asked them to report any qualitative changes in the content of the image, the submodality process elements (color, brightness, distance, etc.) or any changes in the kind of feeling.
13 Responses
Nick Kemp
05|Mar|2016 1I use scaling a lot when working with clients who have anxiety issues, along with a lot of fractionation. My strategy is to show the client how they can create and maintain their own personal control over their own states. All sessions are recorded so everything “is on the record” for the client to listen back to from a 3rd position. This has proved to be exceptionally effective and a recent international athlete was able to achieve her lifetime best track time after a client session using this approach!
Bob Janes
05|Mar|2016 2A few random thoughts on scaling after reading this.
+ I don’t like setting the ‘most resentful’ at the ten end. “Let’s put this on a scale, if we put your most resentful down here at zero, what goes up here at 10?”
+ Going off the scale can be useful: “OK so if 10 is the happiest you’ve ever been, I’m curious, what would 11 or 12 be like? What would you have to do for that to happen?”
+ ‘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.
Bruce Teall
06|Mar|2016 3Steve — This is a wonderful example of you taking something that is often taken for granted and then analyzing the heck out of it! I totally agree that scaling questions can be very useful, and also that it is important to be mindful of the way in which they are used and to what purpose.
As you mentioned, Solution-Focused Therapies use scaling questions, and I think often as an intervention. They can be very useful in breaking up all-or-nothing thinking. As an example, this can be done by asking “On a scale of 1-10 where 10 is having completely achieved your goal, how much progress have you made so far?” In this way you accomplish a few of things. First, by asking a scaled question instead a yes/no question you are offering a range of evaluations instead of “yes I’ve achieved my goal” or “no I haven’t achieved my goal.” Second, the way the scale is set up you are leading the client to be aware of their progress, no matter how small, instead of how much they haven’t achieved. Third, once they answer you are set up to help them explore realistic next steps in the process by asking, “So you are currently 4/10, what would let you know you were at 5/10?”
Thanks for a thought-provoking article.
Nick Kemp
06|Mar|2016 4PS I would regularly ask clients “So what makes this a 5 as opposed to a 6?” The paying attention to the analogue differences in my experiences allows the client a better opportunity to identify and have better insight into these distinctions. Also it’s at the heart of The Provocative Change Works model whose purpose is to empower the client into affirming what is useful!
Nick Kemp
07|Mar|2016 5I do very simple relaxations with clients relaxing from 5 – 0. It then occurred to me also I could suggest a minus scale. This works surprisingly well as clients don’t expect it. I also like to add in the suggestion of “counting on and counting in whatever number is appropriate in future times”
Regards
Nick
Mike
07|Mar|2016 6Steve, it is such a pleasure to read your analysis of anything. I fondly remember joining you for breakfast before your 3-day seminar about Scope and Category in Austin. Now when I read your words, there is a deeply compassionate voice to go with them. Your posts always leave me at an 11 (on a scale of one to ten).
Mike Brown
Kris Hallbom
08|Mar|2016 7Great article Steve. Tim and I couldn’t agree with you more. I use scaling for pain and stress when working with clients. However, I have never used it for anger, forgiveness, grief and so on. It never even occurred to me to use scaling for those type of issues, it doesn’t make sense for all the reasons you listed. Thank you for writing such a thought provoking and well written article.
Steve Andreas
11|Mar|2016 8(Note from Steve: Rob Voyle is the trainer whom I observed teaching the forgiveness pattern at the December Erickson Brief Therapy Congress; we spoke on Skype a couple of weeks later.)
Hi Steve,
Following our conversations, and reviewing several recent days of forgiveness training and retreat days, I realized that I had inadvertently applied an analog “resentment distress scale” to several discrete digital experiences. For example imagine a client “Sam” who has been badly hurt by “Bill.” At a training program when I ask for a volunteer who wants to resolve resentment, Sam volunteers. Sam will report a general sense of distress with a dominant emotion of anger when he remembers what Bill had done to him. Sam may also call this general distress resentment, which he reports is at 8 on a 0-10 scale
The resentment/anger can be resolved using the forgiveness process and the change is typically quite dramatic and clearly a digital response. However, when Sam thinks of Bill there is still some distress, possibly at a 3 on the 0-10 scale. Upon further inquiry this residual distress is not resentment but grief. Sam may be saying something to himself like, “My life is over because of what Bill did to me.”
In this scenario resentment is an angry looking back on a past event that was resolved using the forgiveness process. However, the inability to look forward with confidence is technically grief about a lost future, which can be resolved using elements of the grief protocol Steve and Connirae developed. The resolution of this grief is also digital.
In many cases the client (and sometimes myself as the therapist) may be unaware of these distinctions, and just lumps all their distress into the category of resentment. As a result it appeared that we had systematically reduced this distress in an analog fashion, when we had actually reduced it in two stepwise digital processes.
The digital shift is clearly demonstrated by a participant in a forgiveness retreat when they reported, “Forty years I’ve been carrying this resentment, had therapy with two psychiatrists about it, and now in just a few minutes it’s gone. It’s like a miracle.”
On another note I have had several people unable to sustainably resolve resentment until they had future-paced the potential learning from the experience that evoked resentment. While the client had resolved any objections to forgiving and had gone through the forgiveness process, the resentment still persisted, although at a somewhat lessened level of intensity. When they future-paced “what they would do differently if they encountered a similar experience in the future” they reported a profound digital response, “Wow, it’s (their resentment) gone.”
Rob Voyle
Note: this discussion is continued on the next blog post.
Hugh Comerford
17|Mar|2016 9Steve,
Thanks for this and thanks for posting on the forum.
One thing really stuck out for me in your article, which is actually an insight from consulting as an Innovation Facilitator with a strong NLP bent, was the word choice and how certain words can shift people very elegantly into different perceptual positions.
“How” questions (really, “how-to”) tend to gentle people toward 3rd position thinking whereas “why” questions can push them toward 1st position responses. “What” can be 1st or 3rd depending on the follow-up.
For example, “If we were to come up with ways how to reduce your anxiety from a 7 to a 5, what strategies would we come up with?” would tend to elicit a 3rd position response which would likely come from a place with little or no anxiety.
“Why do you think you’re anxious?” Would tend to push them toward 1st position and have them mine all the reasons for the anxiety and thus re-entrench it as a state.
“What do you think you would need to do in order to reduce your anxiety?” (notice the word ‘would’ which acts as a distancer) This would tend to push them toward 3rd. The distancer word, would, tends to help that along…creating distance between reality and possibility.
Scaling is a lovely ‘trap’ because it granulates an opinion into a finite scale…most times.
Hugh
Anneke Meijer
17|Mar|2016 10Thank you all for sharing on scaling.
Since I learned and felt ‘there has to be some movement to be able to keep noticing a feeling…” I have been asking for ranges of feelings, which is helpful for people who had difficulty in deciding how much on a scale. It also opens up to ‘having a steady pain, that can go to the background more easily because it is so steady that the body becomes habituated…’ When I use scaling I also ask for submodality distinctions by wondering respectfully ‘how do you know it is 5-7 compared to 4-6? ‘
When I was operated and asked to scale my pain I found it very hard to do that myself… I knew it was not 8-10 (because…) I knew it was not 1 – 3 because I would ignore it, being a tough girl.. They told me 1-3 was OK … standing there, with their paper to be filled in… gosh it felt like helping them to fill in the forms i.s.o. helping me expressing my feelings through using the scaling…
I told them ..I am continually busy readjusting to feel less… and they came out of their ” filling in numbers on their form” and reacted towards me…
I enjoyed reading the outscaling when talking about positive feelings and minus scaling (‘since you are more experienced in relaxing now…I sometimes said) since it shows using the scaling as a helpful flexible tool.
In the past, before i knew NLP, I worked with people with not traceable pain complaints…just noting down the times they sat, walked, lied down for some days made a remarkable difference in their experience..
Sunny regards form Holland – Anneke Meijer
Joy Livingwell
19|Mar|2016 11Excellent distinctions — thanks to Steve for posting and the commenters for a most interesting discussion full of useful distinctions!
L. Michael Hall
21|Mar|2016 12Steve — an excellent article on scaling with your many refined distinctions about the value of scaling for a person. I learned to do that originally from the works in Brief Psychotherapy and then in NLP. 15 years ago we began doing this for the skills of coaching. That lead to the book on “Benchmarking: Measuring the Intangible” (2009). And now we are doing the same for all of the competencies of NLP Prac. and Master Prac.
Anneke Meijer
21|Mar|2016 13In another group this topic is discussed as well and Peter Schultz mentioned to ask a hand to show the scaling… That is very helpful I remember. Body speaks louder than words as an Aikido master once said to me, I find hands talking often very clear compared to all the words.
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