years ago i read a study about an experiment was done where they had 2 groups of people and they gave them 2 separates of words to read, one set of words were associated with health and longevity and the other set of words were associate with disease, what they did after that was time the group of people walking to the elevator to leave, the conclusion was the people who read the words associated with health and longevity made it to the elevator faster and the ones that read about disease and old age took longer to get there.
The conclusion drawn was everything affects us in the environment. Another study was done based on is you hold a cold or warm object in your hands can they change your decisions.
As a therapist I sit in a room talking to people and I watch where their eyes go when they are talking to me and they dark major places. Once I saw that, I went onto word and I wrote messages I wanted them to see then I printed them out and I taped them exactly where I saw their eyes dark.
Use everything to your advantage.
When you are working with clients what you really are doing is you are making predictions. You want to look for being proven right and where you are proven wrong. Because based on every response you will be building a picture in your mind of what the situation looks like. The predictions themselves don't actually matter that you make. The response back that you get make all the difference in the world because that's how you are going to construct the image of what you're dealing with.
So if I were to ask you what your office looks like. And I ask you questions and have you describe it to me in detail. What I'm looking for is isomorphic relationships and I'm also looking for where i'm wrong. Because that will always happen, you're always going to be right about some things and you are always going to be wrong about some things. It's very rare that you will be wrong about everything and it's very rare that you will be right about everything so you control for that. And act on the idea that what you will get some things right and some things wrong.
The exercise is describe to me your office, and I will describe to you the inside of your house. That's the exercise.
When I did the exercise with someone else it alerted me to some details, they asked me about the ground in my office and if it had carpet, my bedroom has carpet, if they had asked do I have things on my floor, in my office I have pieces of paper from where I shred medical records, pieces of paper on my carpet, the analogy he could of made is if I let small shreds stay there then I allow stuff to remain on my bedroom carpet as well, that would be true, i keep alot of stuff on the ground in my bedroom.
You are looking for an error in prediction as quickly as possible. Pictures on the wall, i'll give another analogy, I had a client come into me they work on an air line, they are very organized and very much to the book, they sent me a picture of the airplance they are working, everyone is in their seats in alignment and in rows.
And isopmorphic relationship.
Clean in personal life, clean in professional life, people act in patterns and they repeat.
That's what you're looking for. when you are asking for what their office looks like to predict what their house looks like from the inside what you're looking for is what seems the same in one situation and what would naturally carry over if you did the same thing somewhere else. To the degree you can see it, it will look very specific
You're looking for patterns that look the same to you and you have to assume they will do it in other contexts.
Hannibal Lecter was a shitty therapy because he cast doubt on people’s abilities, their judgment, he cast doubt on their ability to make decisions, also him eating people was pretty bad.
As a therapist your job is to cast doubt on peoples judgments of their failings, your job is to call into question all the times they give themselves a hard time, you bring their attention to the things they do well, you look for and consider things the client has never thought of that they do well. You job as a therapist is to see the problem in a way so that their problem is a gift.
There’s tons of bad things that happens to people in life, giantism, a miscarriage, murder, depression, anxiety, agrophobia, trauma episodes, major traum, eating disorders, everything bad comes your way, your job is to show the client how this is actually good for them because it reminds them they have to make a change in their life in their behavior for the better.
Giantism, reality is not what we would like to be, and every problem is different, and embrace life because it’s a hell of a ride, miscarriage, it’s super painful and I’ll never know that pain and I’m sorry, but you have to keep going, it’s painful but you have to keep going, depression you have to make yourself get out of bed and be apart of the world, you have to be more active in the world, that’s the only way your problems get solved unless it’s organic, then otherwise you have to do everything you can do, anxiety, ramp up your anxiety to the worst and lay down and let it happen, do it enough, you can handle it, major trauman,you gotta break it down into separate parts, then deal with it, eating disorders, well you gotta break that down also into smaller parts.
Sometimes in life you have overwhelming problems to deal with, so the way you deal with them is you slice them in half, and then you slice them in half again and you keep breaking them down into smaller problems until eventually their small enough that you now what to do.
If a problem is too hard for you , you always break it down into smaller and smaller pieces.
One day a client came into me and told me he would throw himself off the stratosphere unless I helped him. He was male, and gay and because I wasn’t he felt I couldn’t understand his problems so I wasn’t good enough, though the clinical administrator she was there and she was able to de-escalate him to the point that he was willing to allow the paramedics to come pick him up and take him for observation for his safety and he willingly went with the paramedics for observation.
The next day I went to the stratosphere. They have a bungee jump experience. I paid to go on it. And I ran through all the safety checks. The stratosphere crew put all the harnesses on me. I walked on to the plank of the stratosphere jump I felt the wind whipping my face both ways, and I put myself in the clients position, I imagine what it would be like to be suicidal and wanting to jump… my first thoughts was this is scary, and before I ever get to this point, I better exhaust every other possibility to resolve my problem because anythings gotta be better than this.
Taking a jump without a bungee cord and a safety harness looks painful. I don’t think jumping from a building is cowardly, it think it’s courageous, and to be frank if you have that much courage to jump then certainly you have enough courage to figure a better solution out.
After that thought experiment. I went and spent 4 hours riding the rides on the top of the stratosphere practicing breathing exercises to keep myself calm. It was interesting.
The night of the mandalay shooting I was in my bedroom shooting whiskey. I saw social media going nuts. I started to figure out something was wrong. But I didn’t know how bad things really were. The next day a woman I was trying to patch things up with contacted me telling me the victims of the shooting needed help and asked me what we should do, I still trying to impress her told her we should help, as the hang over went through all my body, I got up showered and caught an uber over to circus circus by then I was sober.
I started to realize how chaotic a crisis makes organizations. I got a contact from the girl she told me as she entered the circus circus ballroom they are turning people back she asked me what she should do, I said go forward always make them tell you to their face that they don’t need. You.
When I arrived to the circus circus, I went for the ballrooms and the same guy was standing there telling people no one was needed anymore to turn back, so I kept going to the heart of the ballrooms, the president of harmony healthcare was there with a laptop saying loudly where are my therapists why is there no one here as he was staring at a laptop.
The girl I was looking for she was there, I was there, we were assigned to different sites to provide crisis response. I saw in the course of 4 days over 200 people.
I didn’t take it seriously coming in because I was sobering up but then as I kept going I kept seeing so many people and they were suffering so I cleared my entire case load for the week.
Therapists they know how to do therapy, they don’t know how to do crisis response. Crisis response is different than therapy. Crisis response is being there and giving people a sense of certainty and letting people the world is not falling apart, giving them a sense of stabilization so they can regain their bearings. In most cases when you do that people can re-establish themselves and thrive and because not everyone is the same and things effect us all differently after 7-10 days if they are still having problems then let’s talk it out.
Let’s figure it out. When I came back home from every day I became aware of 2 things, 1. How much the stress affected me every day, my body ached, all my muscles and all my joints even my feet hurt to walk on and all i did was sit in a chair and listen to problems and then respond.
The second thing that happened was that after listening to all the stories I would when there was a moment of silence and no one was around I would cry.
I remember one time after a session during the crisis I went to subway to get food, I went to order a sandwich, I was about to break down and cry so I ordered my sandwich then i asked for the bathroom because I was breaking down, I went into the bathroom and set a timer for 10 minutes. I was allowed to cry for as much as I wanted for 10 minutes but then after that was done, I had to move on with my life, so I did that.
After the week was over dealing with all those clients, I started having flashbacks from my military training, so naturally I drank a bottle of whiskey and texted messaged the girl I was trying to impress and I fucked it up. That’s what I remember from the mandalay shooting. Helping people, fucking up a relationship and getting flashbacks. Honestly, I’m glad I could be there for those people, I’m not sure I was always a resource because I was making it up as I went. But i’m glad I could do that for them.
A colleague one asked me why I don’t try to achieve more titles,I told them because I don’t care about what people think of me. I know I’m good because of the results. I also don’t open myself up to feedback because most things I do people would disagree with they are decisions they wouldn’t do, they aren’t illegal or unethical, those are boundaries I believe in yielding to. I believe in yielding to the courts and the board of examiners I know they have a job to do and I respect their authority and I yield to their authority and at the same time you have to think about what is in the best interest of the client and make sure what you do is right, and you need to be able to explain yourself to the courts or the Board if you are ever called to the carpet because we are always accountable for our actions as we should be and I yield to the authority of the board or the courts.
With that said, a colleague asked me why I don’t care about titles I told them because l know I’m good based on the results that I create with my clients, it’s not like a phd where you write one paper and your title is forever established, I know I’m good based on the results I create with a client at the time sometimes i’m really good sometimes i’m not really good. Sometimes I ask myself what I am doing in this profession.
When I first started out being a therapist, I spent my time trying to become fully prepared for every session. I would look at the symptoms the potential diagnosis and then I would look at the evidence based treatment plan. As I spent more and more money I started to realize evidence based work had not figured everything out or at least they hadn’t found a way to organize it into a course that they could charge me for.
Years ago, I spoke to Robert Dilts and I asked him about modeling Milton Erickson, he told me. When I went to model Milton Erickson, I was there with other people we asked him all sorts of questions, Dr. Erickson, I have a client with this type of problem and these types of symptoms how would you treat them, Dr. Erickson, I have a client with this type of problem and this type of problems, how would you treat them, and they kept going. Every time Dr. Erickson kept replying I don’t know, I don’t know, I don’t know.
Robert Dilts told me at the end of the day they had pages filled with questions, and all the answers to them were, I don’t know.
At the end of the day a student asked him one final question. Dr. Erickson, I have a client with this problem and these symptoms what would you do? He said I don’t know, but I’m curious to find out.
And that is the solution to the problem. When clients come to you then tell you their problems the first thing you start to do is make a picture in your mind of what their life will look like without their problems, then your work from there is moving them from their problem to what you think is right.
The reason why you can’t give a one size fits all is because no one is alike.
When clients tell you their problems the first thing you do is build a picture in your mind of what their life will look like without their problem
You create the image first then you go from there.
The skill of Calibration
I’ve decided I’m going to consider writing again. The skill of calibration is a complex skill and it’s always a work in progress. I will attempt through the course of multiple posts to break it down in many different ways. When it comes to mastering skills sets the thing a person wants to do is to create exercises for themselves for improvement. The difference between a student and a master is not one of giving up practicing. The student has the exercises for improvement handed to them. The master makes them up for themselves. There’s different types of calibration, I by no means claim to be an expert. I’m merely a student who creates their own exercises for themselves. So let’s talk about basics. There’s a concept in geometry of congruency and incongruency. Something can be said to be congruent or incongruent. Congruent can be thought of as coinciding. Incongruent can be thought of as not coinciding.
There’s two time of incongruencies/congruences that you look for. Let’s remember first we are all walking contradictions. Life is too complex to be totally consistent. It’s too complex. There’s sequential and simultaneous congruities and incongruities.
A sequential is when someone says or does 1 thing at one point in time and at another point in time they either do the same thing or something different. Say so I say that I believe in honest and that people should not lie. I say that today. Tomorrow I say I believe lying is okay. That’s a sequential incongruity. In one sequence I say/do 1 thing, at another point in time I do/say something different. Or I say lying is a great thing and it’s useful, and then tomorrow I tell a lie. That would be a sequential congruity.
A simultaneous congruity is when I say that I like you, and at the same time my body language and the actions I engage in are the type of behaviors that match what people might typically do when they like someone. A simultaneous incongruity is when I say I like you and I give you a finger or I screw you over. There’s a mismatch. Verbally I say one thing and my actions indicate otherwise.
If you have to choose between verbal and nonverbal (actions specifically), if you have to try to decide which response to pick to make decisions based on, you always privilege actions over words and let them prove with their behaviors, make them prove you wrong by DOing something else. Always privilege actions/behaviors over words.
Mischaracterized Nature of (Hypnotic) Amnesia:
Anyone that has had the experience of hypnotizing an individuals for any great length of time will be familiar with the scenario of inducing a trance, deepening it, giving suggestions, emerging the subject from the trance state and them having ‘amnesia’ for all that occurred during the session. Recently I was reading an article by Milton Erickson (Clinical and Experimental Observations on Hypnotic Amnesia: Introduction to an Unpublished Paper) where he was speaking of various distinctions that he had made regarding ordinary forgetting and hypnotic amnesia.
The first couple of pages of the article is him speaking about the challenges in experimental design in testing various assumptions and being able to differentiate between the two phenomena. Towards the end of the paper though Erickson relates an interesting example of something that most people would mischaracterize as Amnesia one that I am sure in varying forms most of us can identify with.
“This example relates to the teaching of a series of tricks to the family dog. By force of circumstances this teaching and all performances of the tricks occurred in a basement room, although the dog had the run of the entire house. One day, long after the dog had not only learned the tricks well but would perform them spontaneously in anticipation of a food reward, visitors asked for a demonstration. The dog was called into the living room, a crust of bread was offered, and the usual commands were given. The dog gave every evidence of wanting the bread but seemed to have no understanding of the commands or of what was wanted, despite patient, repeated efforts. When everyone went down to the basement, the sight of the bread crust was sufficient to elicit repeated spontaneous performances of all her tricks without commands being given. Even after having eaten the bread, she performed readily upon commands from anybody without further reward. Upon return to the living room the dog again seemed unable to understand commands, nor did the offer of food do more than elicit restless, hungry behavior. Giving her small morsels didn’t help, but another trip to the basement resulted in an adequate performance. Finally, after repeated commands and offering of food and much restless puzzled behavior by the dog, she finally began to understand the familiar command of “roll over.” She responded by racing to the basement, performing the task, and then racing back for the food reward, repeating this behavior at every new command.”
Erickson does go on in the next paragraph to say, “While this behavior cannot legitimately be called an amnesia, certain of the results were comparable to those that would derive from an amnesia.” This observation by Erickson seems to fall in line with the research presented in Gabriel Radvansky’s book, Memory P.125 where he speaks of, “Context being an important memory cue.” There is a phenomena that is referred to as Encoding Specificity. An example of this would be seminar amnesia as many of us like to call it. We teach students how to do amazing and wonderful skills or we see people pull off amazing things in seminars but then once they walk outside the seminar room doors all that they just had is no longer available to them. It’s almost as if it never happened.
Radvansky cited an example of encoding specificity, “Having lived most of his life in St. Louis, Missouri, except for 2 years at the University of Texas at Austin, and 4 years in the military service during the Second World War, my father returned to Texas after 42 long years of forgetting. Although previously certain that he could recall only a few disembodied fragments of memories of his college days, he became increasingly amazed, upon his return, at the freshness and detail of his newly remembered experiences. Strolling along the streets of Austin, my father suddenly stopped and animatedly described the house in which he lived in a location now occupied by a parking lot. He recalled in vivid detail, for example, how an armadillo had climbed up the drainpipe one night and became his pet, and how the woman who had cooked for the residents of his house had informed them of the attack on Pearl Harbor, abruptly ending his college career. Not until he returned to the setting in which those long-past events had occurred had my father thought or spoken of them.” (Radvansky, 2010)
Radvansky further goes on to speak of a study in which scuba divers learned lists of words. Some divers learned the words on land other learned them underwater. The divers were then tested in both contexts. It was found that divers that learned on land recalled better on land than underwater and that divers that learned underwater recalled better underwater than on land. The implication of all this research appears to me that if a person wants to have information available in multiple contexts then they should learn it there or use it there so that there is a generalizing effect.
This all got me thinking. Many times what is really a situation of something NOT generalizing we mischaracterize it as amnesia or forgetting. At the most we could consider this non-generalizing a form of amnesia or forgetting but then even that might be stretching it. The applicability of this information to me seems two fold 1.) we begin getting closer to describing the varying phenomena that is all lumped together as ‘Amnesia’ or ‘Forgetting’ 2.) as we break down these various phenomena we discover fairly simple ways to deal with them.