|Sponsored by the HealthcareTrainingInstitute.org providing Quality Education since 1979|
Ethics - Doing
is this more evident than in our own field where we have learned that the following
opposite polarities can coexist:
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 Einsteins most famous theory.
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:
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 oppositesitting quietly. This time the client volunteers useful information.
Ethics - Fabian
Tactics: Doing the Unexpected
The strategy of General Fabius against Hannibal was not simply to evade battle or stall for time; it was designed to destroy the enemys 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.
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:
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 Hannibals 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, Marshalls 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 hereI think thats a great ideabut 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, thats 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.
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,
Reflection Exercise #6
Ethics CEU QUESTION 12
Others who bought this Boundaries Course
CEU Continuing Education for
Psychologist CEUs, Counselor CEUs, Social Worker CEUs, MFT CEUs