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Ethics & Boundaries: The Power Dynamic in the Therapeutic Relationship
Ethics Boundaries continuing education psychology CEUs

Section 12
Using Fabian Militant Power Interventions

CEU Question 12 | Ethics CEU Answer Booklet | Table of Contents | Boundaries
Psychologist CEs, Counselor CEUs, Social Worker CEUs, MFT CEUs

Ethics - Doing the Opposite
The essence of creative problem-solving, according to Rothenberg in his study of Nobel Laureates, is the resolution of polarities or the blending of opposites. So often, he observes, new discoveries in science, art, or philosophy are the opposite of previously held ideas. “Even more surprising is this: not only is the opposite true, but both the opposite and the previously held idea are operative and true.”

Nowhere is this more evident than in our own field where we have learned that the following opposite polarities can coexist:
1. Nurturing clients facilitates change, but so does confronting them; blending the two techniques is even better.
2. Dealing with unexpressed feelings promotes insight, as does exploring underlying thought processes; combining the two strategies is ideal.
3. Seeing clients in individual sessions is quite effective, as is working with them in groups or families; sometimes a combination approach is even more powerful.
4. Dealing with the past promotes changes in the present; looking at present behavior helps explain the past; both approaches combined make for a more productive future.

Some practitioners employ insight as their principal tool; others prefer to ignore self-understanding altogether and concentrate on action strategies. Some clinicians stay objective and detached in the therapeutic relationship; others present themselves as authentic and genuine. It is apparent, therefore, that our whole profession is grounded in polarities that contradict one another and that reconciling opposites is a requirement of the practitioner.

Creative professionals tend to think in the language of opposites! When administered a free association test, Nobel prize winners are more likely to respond to a stimulus word by supplying its opposite. Rothenberg cites several examples of how this Janusian Process (from Janus, the Roman god of beginnings who faces in opposite directions at the same time) operates in problem-solving. Albert Einstein had been greatly perplexed as to how he could develop an all-encompassing general theory of relativity similar to his special theory of relativity applied to light. He was convinced that there was some underlying order to the physical world, that “God does not play dice with the universe.” The idea came to him that if a man was falling from a building he would be in motion and yet at rest relative to an object falling from his pocket. The reconciliation of this paradox led to Einstein’s most famous theory.

I believe this same process underlies our most creative work in therapy. When we are stymied with a difficult case, it is usually because we are trying the same things over and over again. Therefore, the simplest prescription for practitioners who feel stuck is to apply the strategic dictum of doing the opposite of what has already been tried. This could involve several strategies mentioned by Dolan:
1. If talking doesn’t work, become silent; if silence doesn’t work, try talking.
2. If you feel stuck while sitting, start moving; if you feel stuck while moving, try sitting immobile.
3. If the mood is impersonal, soften it; if the situation is emotional, shift to a more objective tone.
4. If you feel anxious, take a few deep breaths to relax; if you feel bored, do something to heighten the intensity.

The formula for becoming unstuck in any situation is to identify your pattern of ineffective responses and then to alter something in a systematic way — whether it is the style, the content, the context, the direction, the pace, the intensity, the frequency, the force of impact, the speed of action, the amount of pressure, or the degree of investment in the outcome. Tinkering with individual variables might be plotted something like this: the therapist asks the client pointed questions about her history and background, after which she becomes evasive. The therapist then tries using more open-ended inquiries, but the client begins to ramble and drift off track. Finally, the therapist stops asking questions altogether and tries the opposite—sitting quietly. This time the client volunteers useful information.

Ethics - Fabian Tactics: Doing the Unexpected
The strategy of confusing an opponent in an adversarial position by adopting an unexpected series of moves is described by Goldberg as Fabian Tactics. Named for the Roman general Quintus Fabius Maximus, who was able to out-maneuver Hannibal during the Punic Wars, this approach seeks to avoid direct confrontation in those situations where one is clearly overmatched. Throughout history, other military leaders have defeated vastly superior forces by using tactics designed to delay, harass, and confuse. Thomas J. (Stonewall) Jackson during the Civil War, Francis Marion (the Swamp Fox) during the Revolutionary War, and Erwin Rommel (the Desert Fox) during the North African campaign of World War II were able to throw opponents off balance with completely unpredictable and incongruous behaviors.

The strategy of General Fabius against Hannibal was not simply to evade battle or stall for time; it was designed to destroy the enemy’s will to fight, to so thoroughly demoralize and frustrate him that he would give up and go home. This was also the strategy of the Viet Cong that proved so effective during the Vietnam War.

Difficult clients are hardly “enemies” or “opponents,” even if they sometimes see us in that role. Yet the principle of avoiding direct confrontation and employing indirect interventions with an entrenched and resistant client was a particular favorite of Milton Erickson. Many of his hypnotic induction procedures that proved potent, even with those most determined to resist, were based on Fabian Tactics of doing the unexpected.

When Marshall enters the office and demands that I accommodate every one of his detailed requests before he will agree to work with me, he is expecting me to turn him down so he has an excuse to fire me. He tells me that in order for us to proceed further (Marshall is an attorney), I will have to agree to the following:
1. Schedule appointments on a week-by-week basis with his secretary.
2. Bill his office once a month and wait for payment until he has received insurance reimbursement.
3. Agree not to schedule anyone else immediately before or after him so he will not be seen entering or leaving my office.
4. Allow him to bring his portable telephone into the session in case anything from the office needs his immediate attention.
5. Permit him to sit in my chair because it has maximum support for his back problem.
6. Stick to his agenda of matters he would like to address. If he does not wish to talk about something, I will agree not to push him.
7. Keep on hand for his exclusive use his brand of herbal tea, which he will supply.

I was so stunned by the sheer audacity (not to mention volume) of his demands that at first, I did nothing except stare at him openmouthed. While Marshall adjusted his posture in my chair (that had been his first request to which I had innocently acquiesced), I considered my options. If I told him what I really thought— that I would not stand for his manipulative, controlling behavior, nor would I tolerate his games to undermine my position— then it seemed clear that therapy with Marshall was over. I must say that idea appealed to me tremendously. Next, I considered what would happen if I tried to negotiate with him. I mean, this man was a professional litigator. He chews people up and spits them out for a living. He even carries a telephone with him so he can intimidate someone whenever the mood strikes him! And I think I am going to go up against this guy and get him to back down? I felt like General Fabius facing Hannibal’s hordes astride their elephants.

I therefore considered my third option: give in to his demands, but with a few conditions of my own. This I reasoned, might disarm him completely and we could stop with the jousting.

“Sure,” I said. “What you are asking sounds perfectly reasonable to me. I have no objection to anything you ask. In fact, I like a person who states what he needs. That is why I will accept your conditions if you will accept mine.”

Wary now, Marshall’s initial signs of triumph evaporated. “What do you have in mind?” he asked in his silkiest, lawyerlike voice. “Nothing much. Just a few modifications of your requests. First, if you are going to sit in my chair, I ask you not to lean back, as sometimes it tips over. Second, you are more than welcome to keep your tea here—I think that’s a great idea—but you will also need to bring your own cups, sugar, spoons. Oh yes, and a teapot. I think it would be best if you made your tea with your own things. As for your portable phone, that’s fine. But if you are going to take calls during the session, I would like to do the same thing. And the scheduling arrangement, I would be happy to arrange things with your secretary— that is, if you will remind me the day before I am supposed to call her.”

I continued no further as his laugh interrupted my “negotiations.” (I was just warming up, too!) He moved out of my chair with the exasperated remark that he did not know shrinks were so temperamental about where they sat. But now we had an understanding, even an alliance of sorts. I am not saying this guy did not continue to be a challenge to deal with, but I found that whenever he did resort to similar controlling tactics, I could best neutralize them through indirect, unexpected means.
Jeffrey A. Kottler, “Compassionate Therapy”

The article above contains foundational information. Articles below contain optional updates.

Personal Reflection Exercise #6
The preceding section contained information on using Fabian militant power interventions. Write three case study examples regarding how you might use the content of this section of the Manual in your practice.

Ethics CEU QUESTION 12
When a client enters your office and demands that you accommodate every one of his or her detailed requests before he or she will agree to work with you, what are they probably expecting and why? To select and enter your answer go to Ethics CEU Answer Booklet.

 
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The article above contains foundational information. Articles below contain optional updates.
Ethics Alive! Respect in Social Work Advocacy
We explore the nature of respect in social work advocacy. Social workers demonstrate respect to individual clients by honoring their right to self-determination. Advocacy often involves persuason and trying to change beliefs and behaviors of others.
Ethics Alive! To Record or Not To Record: The Ethics of Documentation
How much and what should social workers document? Allan Barsky outlines the ethics of social work documentation.
Ethics Alive! Coping With Multiple Codes of Ethics as a Social Worker
Which codes “must” social workers abide by? Which codes “should” social workers abide by? And if there are conflicts between two or more codes by which you are abiding, which code takes “precedence”?
Respect: Ethical Imperative or Skills for Success?
Many of us think about respect in terms of how we engage with clients. Honoring clients’ dignity is not the whole story, however, with social work codes of ethics also highlighting the importance of showing respect to colleagues.
Ethics Alive! Social Work With Client Friends and Family: Avoiding Collateral Damage
The first standard in the NASW Code of Ethics advises social workers that their primary ethical obligation is to clients. The Code is silent on what obligations, if any, social workers owe to clients’ family members, friends, and other collaterals.

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