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  #1  
Unread January 12th, 2005, 04:30 AM
John Simon John Simon is offline
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Default Therapy as Craft

Mr. Lankton,

I recently began reading your book, Enchantment and Intervention in Family Therapy, and I must admit that the level of detail and distinction that you use during therapy is quite amazing. The other therapists that I have read do not seem to have the same capacity to explain why they used a specific phrase or hand movement etc. in the same level of detail. I was curious about how long it took you to become proficient to the point that every statement or question etc., is developed with the specific client in mind and yet has a matching theoretical context that may or may not fit more than one client (e.g. Gestalt or TA)? Do you think that it is more a function of who you are in terms of a detailed oriented person or simply a lot of practice? As a less seasoned therapist, I always seem to fight the "two minds" in therapy. If I focus on theory, I lose the client, but when I am more present with the client, I sometimes have difficulty figuring out the next move in terms of a plan that is theoretically sound (even in hindsight). In short, when does this career that I like so much get a little easier.
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  #2  
Unread April 12th, 2005, 01:26 PM
Stuart Moore Stuart Moore is offline
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Default Re: Therapy as Craft

My experience as a therapist is that it can be wonderful studying the masters but that most of the interventions that they use should come with a warning label that says, "don't try this at home." The point is that it is so intoxicating to see or experience a great therapist at work that I want to run out and try the technique myself. I've done it often enough to know that it usually falls flat for me, then I feel like a fool and want to say something like "Oh you should have seen Jeff Zieg do it at the workshop last week, believe me it was awesome!" It takes a long time for me to see something that someone else does and make it my own.

Have you ever heard of Luc Longley? Kurt Rambis? Kevin Johnson? Marc Jackson? Unless your an NBA fan, probably not. They were all good basketball players though they weren't Michael Jordon or Magic Johnson. Nor were they all stars.

I'm a pretty good therapist, I think, at least on most days. There's a lot I can't do (the triple pump reverse finger roll for example). There's a lot I'll probably never be able to do. I continue to study and try to improve however, it's typically slow going.

John, you mention that you have two minds (the theory mind and the mind that is present with the client) and you mention that you like your career. Well, it seems to me that those are the three things you need to do good therapy. From my experience it takes time (a lot of time) to balance the two minds, then the engine of your love of doing this work comes in and you take off (at least until you hit a pot hole or have to stop to refuel).

Good luck on your journey, John. There's my two cents worth.
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  #3  
Unread April 15th, 2005, 12:41 AM
Stephen Lankton Stephen Lankton is offline
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Default Re: Therapy as Craft

John,
Thank you for the carefully articulated observation. I do not think what I do is accounted for by attention to detail as a general rule. I seem to be better at overlooking details more often than I desire! I think the idea of a 'single mind' is a good one. I do become absorbed and trust that I will recall (rather than making lots of mental categories as I go). Erickson taught that was should observer, observe, observe. So, if I use a presupposition and the person responds, I watch and listen for that to happen again. Soon, I realize that I may secure a needed resource easily with presupposition syntax. And so on for other interpersonal exchanges. What do I chalk it up to? Two things are important in addition to observation. The first is practice. In a dojo you go over a move repeatedly until it is really 'yours' and you understand when to do it and what effect you are likely to obtain with it. The same is true for all the things you mentioned. The other thing I think was greatly useful to me was memorizing a zillion songs. Yup. Why? I suspect that the way in which my brain learned to store and access songs (in an analogical and random access manner) has to do with how I can jump between theoretical connections and client observations. I don't if this is so, but it is my best serious conjecture. That probably helps with being a bit of a story teller, too. Okay, enough about me. How can you come to do things the way you wish?
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  #4  
Unread April 24th, 2005, 04:54 PM
John Simon John Simon is offline
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Default Re: Therapy as Craft

Mr. Lankton,

The main thing that I have been trying to do when working with clients is to "chunk big" by following a few key principles rather than trying to dissect the client while in the room. The basic principles are to err on the side of empathy and using the client's language before I begin interventions, to help the client prepare for change by developing resources, such as confidence or creativity, through metaphors, and to show the client the positive side of their symptoms and suggest adding to their experience rather than trying to take away their symptoms. Paradoxically, when I work in this way, the interventions (chunking small) begin to come more naturally as if I am finally getting out of my own way. If I can not think of a specific intervention for that client at that time, I will review my options before I meet with the client the following week rather than taking a shot in the dark during the current session.

I agree with Stuart that a Master's intervention that is mistimed by a less seasoned therapist will not produce results. I believe that this ties in with Mr. Lankton's point related to observation. It is difficult to replicate all of the observations that a Master Therapist saw in the room while writing about an intervention in a book. Pulling the intervention out of its context is like trying "the triple pump reverse finger roll" at half court while the baskets have been raised to the rafters for cleaning purposes. It just doesn't work. Therefore, I agree with Stuart that each therapist must integrate an intervention into the flow of therapy rather than just letting it loose on a client because he or she saw it at a workshop. On the other hand, I believe that I have become a much better therapist by watching Mr. Lankton and the other masters than I would have by simple trial and error. Using Stuart's metaphor, if I wanted to learn to play basketball, I would rather watch Magic than Rambis because Magic will help me learn to elevate my game more effectively. I may not be able to always complete the behind the back - no look pass, but I might not have even known that it existed if I ignored this player. I believe that Mr. Lankton has said that he became a much better therapist because of spending time with Erickson. I realize that I will never be Erickson or Lankton but I think that by learning from these masters I will become the best John Simon that I can be, which is why I continue to ask questions.
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  #5  
Unread April 25th, 2005, 01:22 AM
Stephen Lankton Stephen Lankton is offline
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Default Re: Therapy as Craft

How could you not become better with your dedication and open mind? I agree with you. And, it sounds as if your clients' improvement will be the best measure.
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  #6  
Unread May 21st, 2005, 02:58 PM
John Simon John Simon is offline
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Default Re: Therapy as Craft

Mr. Lankton,

Are there any videos or even audio tapes that you would recommend regarding how to set up a metaphor? By set up I mean how to introduce it and how to follow up after telling the story. If a therapist is discussing an attitudinal issue such as a male client not understanding why his wife becomes afraid when he yells (he feels he is just trying to resolve the issue) and then the therapist begins to tell a story about a man who offers a woman tourist his seat on the subway but she thinks he is trying to mug her, will the client bring negative associations about intimidation with him while examining the metaphor? I will try to be more clear: if I am discussing anger with my client and then begin to tell a story about a woman who constantly gets angry and the ramifications, will this client access new associations or simply see it from his normal framework? In the first example, does the therapist need to be more abstract and talk about a large tree that looks like it is providing shade to the other trees so they can grow but really is in danger of toppling over and crushing the other trees because it has gotten so big? Also, how do you deal with the issue of the client constantly wanting to know the meaning of the preceding story? I realize that one could explain that each person has the opportunity to learn something different from the story. However, in my experience that explanation does not always suffice for a client. They might wonder, "why are you wasting my time with a story that you do not even have a reason to tell" or something less hostile like "why did you tell me that story? If you provide an explanation, does it dilute the meaning of the story? Do you sometimes tell a story out of context? For instance, telling a story about a issue that you have not previously discussed in therapy so that the client has to complete a deep internal search to find the meaning of the story? If so, do you tell the person why you told them the story or allow it to remain a mystery? How do you maintain rapport with the clients under these circumstances?

By the way, what is the Ericksonian position on using the one way mirror? Do you ever use it in trainings? I seem to remember someone saying that Erickson did not see most of you conduct hypnosis sessions. Do you find it to be a useful tool to help therapists on a real time basis learn to conduct therapy? Do you provide supervision by watching real client sessions via videotape?

John

Last edited by John Simon; May 22nd, 2005 at 03:09 AM.
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  #7  
Unread May 23rd, 2005, 03:06 AM
Stephen Lankton Stephen Lankton is offline
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Default Re: Therapy as Craft

You have a good deal of questions here. The most important one is perhaps the question about providing a moral at the end. This is rarely done, if ever. The point of being indirect is to let clients create their own meaning.

How do you maintain rapport? You establish it when you first meet clients and thereafter, clients trust you to be relevant and doing therapy for their own good. Take a sincere attitude and expect them to be working as well.

I also expect my clients to be thinking, experiencing, and working by reporting it to me what they are making of what is happening. So, they don't ask me what a story meant.

Perhaps you in need of some training and supervision as you mentioned. I don't know of any tapes on those exact issues you raised. Supervision is available for professionals (check my website for info on that). I usually expect people to have studied with me some minimum amount and read some of my books first so they are familiar with what I'm referring to by the use of terms. Otherwise, supervision sort of becomes expensive private training.

I have worked with one-way mirrors at times. But, more often with live video viewing paired with live ear-phone feedback. These have been in advanced training programs by invitation (that is, when I invite my best students to advanced training groups).

Finally, I don't know why you would need to be indirect with the point you wish to illustrate with the husband. Why not just explain your observation, ask the wife to explain her reaction, etc.? If those were just hypothetical examples, then it seems like either of those brief descriptions you gave could become fine examples of therapeutic interventions when made into stories.
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  #8  
Unread June 12th, 2005, 03:28 PM
John Simon John Simon is offline
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Default Re: Therapy as Craft

Mr. Lankton,

Sorry about the number of questions - my version of a metaphorical brain dump. My examples were only hypothetical and meant to provide a concrete example related to my questions. However, upon further reflection, would it be appropriate to use this metaphor after the husband says something like "my wife overreacts all of the time" when she tries to explain that his behaviors makes her feel uncomfortable? This has happened many times in the past during counseling sessions.

Thanks for the information on training.

John
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  #9  
Unread June 14th, 2005, 01:51 AM
Stephen Lankton Stephen Lankton is offline
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Default Re: Therapy as Craft

You wrote: “would it be appropriate to use this metaphor after the husband says something like ‘my wife overreacts all of the time’ when she tries to explain that his behaviors makes her feel uncomfortable?”

It could be that you have a couple of great skills, one for theorizing as you go and one for noticing small details that may be important for choice in therapy. These are terrific skills. If you have them - keep 'em.

This forum does not involve revealing sufficient client information for supervision of therapy. There are a lot issues to consider to really advise you correctly, and you just can't clarify all of the context of this public forum and this non-real-time interface. Basically, you are seeking training or supervision (whether you realize it or not). It seems that you need to get more training or some supervision to clarify the sorts of things you are trying to learn. So, I would like to not go further in this issue with this set of clients. Make sure that those who train or supervise are qualified and licensed mental health professionals with the proper training in their resumes.


I do not want to discourage you from participating on this forum, however. Please feel free to keep participating. Also, others may wish to address this question, of course.
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  #10  
Unread June 15th, 2005, 03:11 PM
John Simon John Simon is offline
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Default Re: Therapy as Craft

Mr. Lankton,

I think the conversation has gone full circle as I started this link with the topic of asking you about your uncanny ability to notice small details. I will take as my learning that the small things may be the most important and that context is key. Thanks for entertaining my hypothetical example as it has provided many opportunities for deep reflection. I also enjoyed your presupposition language and look forward to learning more.

By the way, I agree with you about supervision and training!

John
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