Theory is a word that is used to cover many sins, but is rarely ever truly defined. According to Albert Einstein, as written in his autobiographical notes, a theory has two basic requirements, one internal and one external.
“The first point of view is obvious: the theory must not contradict empirical facts.”
This external requirement has to do with the ability to predict future events and to show evidence that such events take place as predicated. Einstein’s theory of general relativity, for example, predicts that light is affected by gravity and therefore we should expect the light from the stars bend as they go around the sun. It took quite a while to substantiate this prediction, but the bending was ultimately measured by Eddington and others. This has been the case for many of the other predictions made by the theory of general relativity, and therefore, it continues to stand as the most legitimate of theories about how our world works.
“The second point of view is not concerned with the relation to the material of observation but with the premises of the theory itself, with what may briefly but vaguely be characterized as the “naturalness” or “logical simplicity” of the premises (of the basic concepts and the relations between these which are taken as a basis). This point of view, and exact formulation of which meets with great difficulties, has played an important role in the selection and evaluation of theories since time immemorial.”
The second principle has to do with simplicity and beauty – called by most scientist elegance. The theory must have an obvious elegance in the way that it answers questions and must accommodate Occam’s Razor. First expressed in the 1320s by William of Occam. He said, ‘what can be done with fewer assumptions is done in vain with more. Occam’s Razor postulates that if there are two possible propositions that answer all of the questions, it is the simplest which is correct.
However, Einstein goes further to state that “among theories of equally ‘simple’ foundations that one is to be take as superior which most sharply delimits the qualities of systems in the abstract (i.e., contains the most definite claims)”.
Now, it would be helpful if the reader would keep this in mind as s/he considers the elegance of cognitive behavior management theory as opposed to say biomedical or psychodynamic theory. The medical model is consistently contradicting empirical facts. Consider, for example, the fact that people with schizophrenia, despite being classified as a brain disease, which by nature continues to deteriorate, usually get better – and they do so without medication or ‘treatment’. While this is not the only anomaly of the model, it is the only one we will pursue here.
In addition, the medical and psychodynamic models are neither simple nor elegant. The psychodynamic model has no science to it, but is a matter of mere supposition. The medical model is almost without science itself, although it has better credentials. But both models are elaborate schemes which only can be learned through lengthy and tedious study, and yet, neither has anything elegant to say about the reality of atypical behavior.
Cognitive behavior approaches in contrast, embody scientific procedure, make claims that the evidence of empirical testing supports, and is both elegant and simple as the reader will be able to decide.
One reason for this discrepancy may be traced to the origin. The practice of medicine and the practice of psychology have evolved from two different traditions . The practice of medicine evolved as masters passed on to their students various oral traditions about healing treatments and remedies. It didn’t even matter if anyone knew why a treatment worked; all that mattered was that someone could say, “In these circumstances, this treatment seems to work”. If an extract of willow bark relieved a headache, then so be it. Only later would scientific inquiry be utilized both to find new treatments and to validate old ones—such as discovering in willow bark the chemical we now know as aspirin.
Since oral lore decisively linked the illness with the cure, medical treatment then, as now, therefore depends on diagnosis. First the problem is carefully identified, and then the cure – traditionally associated with that particular problem – is applied.
Psychology works on entirely different principles. Unlike medicine with its traditional history of effective remedies, psychology began, more or less, by looking for problems that could be treated with known scientific principles.
Hence the tradition of psychology is to use scientific research to investigate known psychological procedures to determine how effective they might be in treating a particular problem. Essentially, every time someone comes up with a new therapeutic idea, it must be investigated with sound research to determine if it really works. A failure to recognize this fact leads to a massive confusion about the role of diagnosis in clinical psychology.
There is actually no single Cognitive Theory as it applies for the helping services or the management of people. There is however, a basic axiom that we will come to later on. There are actually a series of theories [e.g., social learning, constructivism, attribution, expectancy & motivation, etc.] that together form the basic underpinnings of cognitive behavior approaches. All cognitive theory, however, is focused on the individual’s thoughts as the determining factor of his or her resulting emotions and behaviors and ultimately as shaping the personality or core being.
Part of what should be our concern, however, is to define ‘thoughts’. It is not sufficient to simply think of thoughts in the traditional lay sense. So in order for the reader to understand at least our definition of thought or cognition, we would like introduce the following pragmatic, rather than scholarly discussion.
We are concerned with mental structure and mental processes. Mental structure has nothing to do with the brain, per se, but has to do with that ephemeral concept of ‘mind’ – which leaves us with the conundrum that the definition of mind would include the structure and processes that implement the function of thinking, which is, of course, a function of the brain. But let us proceed to see if we can take anything out of this discussion that is helpful.
Most scientists can agree that all cognition starts with perception. We will define perception as the process of awareness of the qualia of the senses. Understand that there are biological processes that take place, which organize these sensations into qualia. This leads many theorists to define this organizational activity as perception and they certainly have a point, However, this seems to be quite a primitive activity based on epigenetic rules with primarily biological overtones, which probably occurs with many animals, particularly primates. Epigenetic rules are those genetically based predispositions to, for example, notice movement; see light predominantly from the top [children love to make monsters by lighting their faces from the bottom]; and most important for our purposes here, make associations and patterns.
Human beings are pattern makers and it starts biologically and then is furthered cognitively. While most scientists start with the biological, I think it is important to emphasize the cognitive. Once the sensations are grouped into a stimulus that the brain receives, the mind then must interpret that stimulus. This is difficult to do, at least until the person has past experiences, but when they have prior experience, then they are able to compare this new stimuli to past experiences and categorize the experience as fitting somewhere in a scheme of things. Thus we build up over time, schema, or a network of thoughts about a particular interest or domain – which we will return to later.
A biological (neurological) defect can cause these original biological sensations to blocked from awareness. Blindness, for example, limits the qualia of light, color, movement, etc., which make up the stimulus. Whatever the label of this activity is, there is a cognitive process which follows – and that is to interpret these sensations and even the lack of sensation, once experience has taught that other people have sensations and experiences which you do not. In order to demonstrate the power of these interpretations, we can take what is perhaps the most profound of these sensations, pain, and we can demonstrate that until the individual mentally interprets pain as pain, it may not even exist. The easiest example might be the paper cut that you don’t even notice until you see the blood. Once awareness occurs, the interpretation of pain usually as a sting or burning sensation seems to quickly follow. In fact, cognitive interventions regarding pain management help the client address the thoughts about pain as a way of diminishing it.
From a cognitive behavior management perspective, we are concerned about this act of interpretation, for it is here that one creates his/her own personality and lifestyle as well as the reality in which s/he lives. While the qualia are important since they represent a message, we are at the moment, more concerned with the event and the interpreted experiences that go with such an event. We discuss in more detail elsewhere the development of the mental structure, from both from a philosophical theory [Hofstadter] and biological theory [Edleman] perspective. But, to summarize, we create ourselves through the grouping &/or categorization of events predominantly through the ‘cutting edge’ of utility [pleasure/pain]. This is neither an entirely external nor internal process. Since there is no ‘meaning’ to these external events outside of the qualia, the individual child must attempt to give meaning through a process of pattern making. “This is like that and is different than those.”
While the events themselves are random occurrences, we are helped by our epigenetic rules and from the cultural norms presented by those around us to fit them into some organizational pattern. While something may be perceived as ‘painful’, if it is supported positively by those around us, we have a decision to make – is this a good thing or a bad thing? Each of these events, experiences, interpretations, and grouping are represented in the brain as a neural network. Those most used, become semi-hardwired and automatic .
Gradually over many, many experiences and interpretations, this ‘bottom up’ data collection is gradually replaced by a theory driven ‘top down’ process. This process, unlike the prior one, has a bias to confirm our own personal theory of meaning. Thus, we have the ‘lost key’ phenomena – we find our keys in the last place we look – and we can put aside contrary evidence for quite some time until we find supportive evidence – then we stop looking.
This phenomenon of creation of a personal theory of meaning is primarily bounded by the schema [network of beliefs] about self and others. These two pillars lie at the threshold of the personality, the ‘inner logic’ that makes up the reality of the individual. And the lintel across the top of this doorway is expectation – what we expect of our world and ourselves. While these schema are not self-contained thoughts – we bring all thoughts together that impinge upon the domain – so some of our thoughts about others may ‘bleed’ over into our thoughts about ourselves and vice versus. One might think rather of a network of thoughts which are drawn together around a single emotional theme – thus all of the thoughts are ‘colored’ by the thematic theory about oneself or others and if this theme is a positive, pleasant, constructive one our expectations are likely to be high.
However, if we think we are worthless, feel unable to fend for ourselves or helpless, we are likely to feel hopeless about the future. Worth then is a self-value. Helplessness is a self/other or relational value, and Hopelessness is an expectancy value. These are the big three of negative thinking, and in almost all cases can be demonstrated to be wrong, at least as a trait or generalized belief. If this is true, if people walk around with distorted thoughts and therefore, distortions of reality, how does this happen and what can we do about it?
When we consider how we got ourselves into this mess, we must note first – that we have two brains and two nervous systems. The left-brain and the Central Nervous System tend to be logically oriented and language sensitive. The right brain and Automatic (or limbic) Nervous System tend to be intuitive (viscerally) oriented and emotionally sensitive . The original creation of ourselves is first determined, by the right brain.
Please do not assume that this brain is less powerful than the left-brain, for you would be wrong. While our culture is very language and logic oriented, the left side of the brain still has its limits. For example, you can look at a crowd of hundreds of people and see the back of someone who you can identify immediately – but you cannot describe that person sufficiently that anyone else can identify them – unless, of course, you use a right brained picture. So the right brain is quite capable of making visceral decisions about events. These ‘gut reactions’ are categorized into pleasurable and painful experiences – and are, in fact, cognitive groupings even though there is no language to describe them. If that is so, visceral intuitions must be classified as ‘thoughts’, even though we do not normally think of them that way.
The literature indicates that the right brain is predominant in most children up to the age of three and the left brain does not predominate until the age of five [some say seven]. Interestingly, it is around the age of four or five that the personal ‘theory’ of meaning process takes over. What seems to have happened is that the child has created his/her theory viscerally and then later tries to find words [and concepts] to describe it. This is not an overwhelming problem unless the words cannot fully cover the theory – What does it feel like to be humiliated? What exactly is dread? We know what these words mean, but it is hard to describe, other than to say we felt it in our ‘guts’ – in fact, stomach pain might be a part of the experience.
Sometimes, these feelings gain a cognitive label based on experience of self and others – for example, I felt angry. Of course, angry is hard to describe except in your guts as well – oh, the limitations of the left-brain. Some of the literature indicates that anger and sadness are confused [or at least differently defined] in different cultures. Emotions then, are biographical, while sensations, ‘feelings ‘ or affect are biological. It is when a child has experienced and interpreted events that are far beyond the boundaries of primate culture that s/he has ‘feelings’ of worthlessness, hopelessness, &/or helplessness. Such ‘feelings’ may result in differing emotional labels, but the experiences are unsayable and to some extent even unknowable.
Often people will use metaphors to describe these ‘feelings’ and what they feels like …. I am stuck! Clean language is a process of repeating the statement and adding and in order to force the individual to search deeper for a way to get at these ‘feelings’ and experiences. Continued probing on unanswerable questions is one way to identify the visceral intuition – but don’t assume you know what the metaphor means, for then you are simply supplying a way for the person to think about themselves, which may not be helpful. Please understand that these ‘feelings’ are ‘thoughts’ of a quite different quality than what we usually think of as thoughts. They are an unrepresented part of the mental structure that makes us who we are. Thus, when we talk about the mental structure, we are most concerned about the mental schema about self and the mental schema about others. I may be able to tell you what I think [can put into words] about myself and others, but I may ‘feel’ a gnawing certainty that is hard to put into words.
We need another word for these kinds of thoughts, and following the lead of physicists, we will try ‘quirk’ [a match perhaps for quark], in the sense of idiosyncratic, at least for the moment. We have quirks that include visceral intuitions, emotional labels or values, and words. We cognitively create a theory of meaning with these quirks, particularly about the two pillars of mental structure – quirks about the self & others. The lintel or connection across the top of the two pillars contains the expectation or predictions of future prospects. What I believe about myself and what I believe about other people supports my expectations of what will happen in the future. This combined schema [all of the thoughts and quirks that apply] creates an ‘inner logic’ which supports my interpretations of events and my responses.
For example, an event happens – teacher gives an unexpected math quiz. As s/he is passing out the papers, I get a queasy feeling in my stomach. I begin mental processing to appraise this situation in order to make a disposition. So I review all the thoughts and quirks about prior experiences and weigh quirks about self/others in like situations. I reflect that since I am absolutely hopeless in math, and since I believe the teacher knows I am hopeless in math (and that s/he probably doesn’t like me anyway – why else would s/he cause me to feel sick?), I decide that the teacher is purposely trying to humiliate me in front of the class (it has happened before – at least that is what I quirk), and so I categorize this queasiness with pain and I determine that since the teacher’s behavior was deliberate I should be angry and I ‘blow up’.
Since the teacher has a whole different inner logic, s/he may have thought s/he was doing her job and may even have thought that I, as the student, had a good week in math and may be ready to prove my worth. Perhaps, because of this, s/he had planned this quiz as a ‘good’ opportunity for me. This ‘blow up’ with curses and threats is a surprise [how ungrateful I must be when s/he intended something positive] and is threatening [particularly since it is so bizarre (read – not within the teacher’s inner logic) and perhaps causes him/her to feel queasy. So s/he appraises the event (reviewing her own thoughts and quirks about self and others) and decides that I am trying to intimidate him/her and identifies with the anger (anger is quite a contagious emotion), and responds with threats (power assertions) of his/her own.
This reaction confirms for me that the teacher really doesn’t like me and that I am not only helpless in math, but worthless as well, and I get increasing pain in the stomach, I become breathless, my heart starts to pump…. Well, you get the point – this is not going to be a helpful experience for either teacher or student.
This cognitive behavioral cycle of event (stimuli), interpretation (covert behavior), response (overt behavior which becomes a secondary event), interpretation is the epitome of relationship. And how you as a helper, as a parent, teacher, clinician, etc., respond to the secondary event is critical to how the relationships will proceed and what ‘attitudes’ or perspectives of the components of you and the relationships will be developed.
Several questions arise.
First, the teacher has, or should have, a professional schema – this is a conventional [not personal] schema which requires some concentrated or conscious thought about what you believe is a ‘good’ teacher 1. These thoughts about what it means to be an ideal teacher probably does not abide anger (only his/her personal schema [particularly the set of quirks] gets to be angry), so why is s/he responding this way? Are there not more helpful responses?
Second, the student must be having lots of automatic thoughts about this incident. Automatic thoughts are those ‘self talk’ thoughts that go through your mind at all times, but of which we are rarely conscious. In this situation, for example, I may have been thinking something like – “Oh no, not math! I cannot do math! I will make a fool of myself! I will die if I embarrass myself again! I am so stupid! These automatic thoughts are the clues to the ‘inner logic’. Would it be more helpful if the adult could be able to help a student in crisis become aware of his/her automatic thoughts so that they might be changed?
Third, if these automatic thoughts are quirks of the visceral kind, can we help him/her re-experience these so as to change the outcome of the interpretation?
Cognitive Behavior Management answers these questions affirmatively. Biomedical approaches, psychotherapy, and the like, are responses that tend to reinforce the ‘inner logic’ of both the child and the teacher. The child’s “I must be worthless, helpless and hopeless to be unable to help myself”. The teacher’s “This kid is crazy! S/he’s out of control! I need to protect myself! I need to call crisis intervention!”. Think about it – what is the student being told? What messages is the teacher sending, based on the thought that the child is ‘out of control’ and ‘harmful to self and others’, the memes [rhymes with genes – a component of culture] which we are so fond of thinking.
It’s all in the messages sent and received that create and shape the ‘inner logic’. In the final analysis, the cognitive behavior management theory is about communication [sending and decoding] of appropriate messages.
stimuli -> quirks of inner logic -> response which of course is a new stimuli
Or if you prefer the cognitive axiom:
event -> thought -> emotion -> behavior -> reinforcement
Until we [both the helper and the client] understand the quirks of inner logic, we may have no way to understand the other person’s response. If we, the helper, continue to send messages that meet the standards set by the inner logic of the client – we will continue to reinforce the distortion.
Notice that the cognitive approach is still behavioral with its reliance on reinforcement – only before reinforcement is made, the helper is required to gain a better understanding of the covert behavior [cognitions] in order to understand what s/he is reinforcing.
The helper can also reinforce before the event through positive internal antecedent attributions. A good response to a child who is angry and ‘states ” I could kill her!” might be the internal attribution – “You are not that kind of person.”. Before any event takes place, the helper is giving the child an internal meaning for why it cannot and should not happen – ‘because you are not that kind of person’.
If we treat people as they are, we make them worse. If we treat people as they ought to be, we help them become what they are capable of becoming. | Johann Wolfgang von Goethe
The future is not a result of choices among alternative paths offered by the present, but a place that is created – created first in mind and will, created next in activity. The future is not some place we are going to, but one we are creating. The paths to it are not found but made, and the activity of making them changes both the maker and the destination. | John Schaar
As these citations indicate, the helper can make the future better by treating the child as though s/he were not that kind of person, even if the helper thinks s/he might be. The worker helps the client to make choices among alternative paths offered by the present and create a more positive future.
So the terminology – cognitive behavior management – is a play on words. Cognitive stands for the conceptual and intuitive covert (hidden, private) behavior that goes on in the mind. Behavior stands for the overt behavior that goes on in the society. And Management indicates the skill to manage oneself and others covert and overt behavior. But the real factor is the interactive quality of relationships – the communication of messages that have significance and the absorption of messages that connect and detail the other person’s inner logic. The attitudes or perspectives that the other person has on a whole host of conventional domains [restaurants, schools, etc.], and most importantly, the personal domains of self, others and expectation.
This terminology, cognitive behavior management, is a generalization which covers a variety of other labels, including, but not limited to psychosocial rehabilitation, cognitive therapy, cognitive restructuring, cognitive behavior therapy, behavior therapy, brief therapy, etc. All of these have common philosophical and technological underpinnings . There is a concern that some of the people who use them fall into a relationship with the medical model and like the status this relationship endows – for example, therapy, therapist, etc. Cognitive therapy is, after all, much more teaching or training than it is therapy, even though it may be therapeutic. And this insistence on calling one’s clientele ‘patients’, implying that they are ‘sick’ is just untenable and totally and absolutely unproven.
But our society does love the ‘doctor’ and we are a pill-taking bunch, so helpers seek status by calling themselves ‘doctor’, and throwing around diagnosis. If cognitive behavior managers took their own expertise seriously, they would see that they are operating on an entirely different order and that the ‘doctors’ of the helping professions [psychiatrists] are frauds even in calling themselves doctors. There is no pathology, yet their expertise is in medicating a non-disease, reaching for the ‘dead man’ test results of a client who does nothing. These frauds have built their job security through regulation in the public mental health – oops, ‘behavioral health’ as though this new metaphor would make them any more legitimate – and will be difficult to unseat. Our authority is in the fact that their theories make no significant predictions and are certainly not elegant.
What is required to overthrow the status of the ‘doctor’ is not to emulate his/her status, but to create our own. Any reasonable search of the literature demonstrates that it is social learning theory not pathology that is providing solace to people. All of the National Institutes spend almost all of their money on biological research, but advocate cognitive behavior management strategies. And be clear, these two orders are not compatible. You cannot send biological helpless messages and provide social learning help. Schizophrenia [as defined by the inability to focus on reality as we generally know it] exists much more in the community of psychiatrists than in the community of clients, and is profoundly demonstrated by the psychiatrists attempt to use psychiatric as an adjective to describe something other than themselves. It doesn’t, of course, so psychiatric problems are problems of or with a psychiatrist; and psychiatric rehabilitation is rehabilitation of a psychiatrists [although some believe the prognosis for this is very dismal].
But enough of these ‘jerks’ – we are concerned about creating a new order of helpers and, in the process, a new order of clients. There are certain principles that are important considerations. If the client’s problem is a distorted ‘inner logic’ one must find solutions which are compatible with that individual person’s ‘inner logic’ or at least acceptable to it – or help the client modify the inner logic . It follows therefore that the client is the agent of change, and the helper is the enabler of change. Yes, enabling has developed a negative connotation through the substance abuse usage, but it is a very apt word. We use our expertise to enable the client to find his/her own solutions. We provide training on certain cognitive or social skills thus enabling the potential for change and the client chooses to use or not use these skills. Let us not fall back into the arrogance of the psychiatrist to believe that we can do anything more than provide consultation and reinforcement to a change that the client must make on his/her own.
The responsibility for growth and development lies fundamentally with each individual; the responsibility for providing the opportunity for growth and fulfillment lies with society. UNKNOWN
Because it is the client who will make or not make these changes, we must find methods to engage them in a process of considering change. Change is difficult, particularly when it means changing oneself. This is a scary thought even if I am unhappy, unless I feel comfortable that it is my own change.
“It’s so hard when I have to, and so easy when I want to.” | Annie Gottlier
The issue, then for a person who is not sure they want to change and has often been overwhelmed by people who want to change him/her for his/her ‘own good’ – is to increase their motivation and free up their own initiative. This may be a misstatement since our clients are often motivated to change, but either frightened off by the takeover of the medical model approaches or confused about just what and how they want to change. The substance abuse field has discovered the ‘reduction of harm’ entry point with the user who is either pleased by his/her drug use or learned helpless under the influence of drugs. This same concept is valuable with any problem in living. What, if anything, causes harm in the present, and how can we help address that issue and only that issue. The client may love taking heroin, but is afraid of getting a tainted needle and AIDs. If we can help the client reduce the harm, we can a) build trust and b) keep the client involved in service. What usually takes place is the development of a gradual trust that the helper is not going to take over the client’s life, not going to make judgements, but at the same time, can be counted on to provide some good perspectives. As this process ensues, the person is able to find the resources within to make the changes that are necessary to become a more typical member of society.
The only belief that the helper needs to have in the reduction of harm approach is that the thoughts and behaviors are, in fact, harmful and that therefore once freed to look at that issues from a new perspective, the client will want to change. This should not be a very great stretch for the helper. As they used to say in the old University of Pennsylvania School of Social Work – “Trust the process!”.
When a person is actively psychotic, the person is operating out of an ‘inner logic’ that cannot be simply ignored. One cannot debate logical points without understanding the premises upon which the client’s logic is built. Therefore, learning to ask appropriate questions and to listen effectively are also important principles. If a client is hearing voices, denial that the voices exist merely cues the client not to talk about them any more [although they may also consider that the helper is an idiot who doesn’t understand what is going on]. A helping person should want to understand the voices: what do they say, how many are there, who are they, etc.? Once I understand how the client experiences and interprets the voices, I can then begin to help the client question his/her present logic and provide potential alternative ways of interpreting the meaning. You will remember from other articles that there is no meaning ‘out there’ – meaning comes from a cognitive decision built up over time, experience and comparison. Thus, ‘one man’s meat is another man’s poison’ and we see things differently [give different meanings to different experiences].
In fact, Kelly developed a theory of personality based upon the personal constructs one used to organize his/her thoughts. Gregory Bateson defined information as “the difference that makes a difference”, indicating that without knowledge of death, there could be no knowledge of life. To know what heat is, we must know what cold is, etc. All concepts contain differences as a prerequisite for their existence as concepts, either as opposites or as levels on a scale. If there were no differences we would only see light or dark, feel smooth surfaces that never started or ended, hear nothing or a no-sense murmur, and we would not be able to describe any of it.
Kelly took the polar opposites or scalar constructions of individuals as being of significance and created an interview technique both to discover these constructs as well as to see how the individual made decisions about good and bad, etc. For example, you may find that the polar opposites are hot and cold, but you cannot assume which is the positive end of this equation. On the other hand the client may be most comfortable with the polar end of cold, but you cannot assume hot is a negative. When comparing two people in their environment, people make comparisons around these personal constructs. How the construe their personal constructs completes their interpretation of the world. What may seem talkative to you may seem compatible to me.
A third principle would be to remember that this applies to you as well as the client and you should not believe everything you think. Just because you believe that people are not out to get the client and that s/he is paranoid, doesn’t mean that you are right! You made that up – just as s/he made up his/her paranoia. As Hans Vaihinger said in The Philosophy of ‘As If’, “Truth is only the most expedient error”. Understand that you and the client are not seeking the ‘right’ answer – simply a better, more expedient answer or meaning to the experience – and this answer must be compatible with the client’s inner logic to be acceptable to the client.
It is better therefore, if the new meaning can arise from the client and not from you. Solutions focused brief counseling has some wonderful skills at helping the client articulate new constructs from which they might build solutions. The major one, the ‘magic question’ asks the client to describe what would be different if all of the problems they brought with them disappeared. What this essentially does is cause the client to think about what they want to be different – to speculate on how life would be without the problem. To identify solutions of their own making.
Asking unanswerable questions and imagining are two ways of getting at the quirks without articulating them. These techniques allow the person to either create solutions or to give new meaning to past experiences, either of which allows for change to occur. But the major point is that the solution comes from the client and is compatible with or alters his/her inner logic.
There are two ways of finding alternative meanings to experience. We can either help the client find ways of articulating new meanings as described or we can offer new meanings and allow the client to accept or reject them. Part of the concern with providing new meanings is the ‘demand characteristics’ inherent in the suggestion. In research design, the term demand characteristics refer to the sum total of cues that convey an experimental hypothesis to subjects and influence their behavior. In counseling, the term may refer to the sum total of cues that convey the clinician’s wishes, expectations, and worldviews to clients and influence their behavior. Counseling demand, it is thought, may play a role in the client taking on meanings that are not helpful. An exploration of demand characteristics in – cognitive process correction – has indicated that if misused the client can absorb negative meanings. We say, if misused, because the process of analysis and alternative meaning development should appropriately come from the client. However, in the best of circumstances, the client may look to the helper to provide some direction. It is doubtful that the helper, if s/he is truly following a cognitive process correction protocol is likely to provide a ‘demand’ that is uncomfortable. This is unlike the medical approach that gives a diagnosis as a way for a client to identify his/her problems in living. However, the use of the term psychotherapy instead of training, for example, allows the client to think that these problems are much more severe that they are – and we have discussed how people are enamored by the medical status.
Nonetheless, the principle that the client should provide the meaning and solutions is a good one, and when using cognitive process correction, one can dispute evidence or offer analogous meaning, but use caution that the client is not just accepting a label. Of the new technology, ‘clean language’ is probably the least likely to create demand characteristics and the underpinnings of that method should be examined by all practitioners.
‘Clean language’ is a product of David Grove and he intends to never interject a concept or conclusion about the client’s state. He is particularly interested in the metaphors that are used to describe those ‘unsayable’ quirks – such as “I feel like I hit a wall!” or “Its like I’m stuck and can’t get out!”. Because communication is largely a process of ‘filling in the gaps’, we tend to interpret what the person means. Grove never makes or articulates such assumptions. He would repeat the statement using the client’s words and add and – “you feel like you hit a wall” and …. The client then is asked the unanswerable question and needs to fill in the gap. This process leads the client to add more and more explanatory words to the metaphor – it’s a ‘brick’ wall or a ‘wall of mud’, or whatever. Each of these explanatory phrases has meaning for the client in his/her own inner logic and leads the client to find new explanations or at least to open up him/herself to a new understanding of what is going on inside – The counselor actually asks questions on behalf of the information sources, staying strictly within the metaphor or the client’s ‘inner symbolism’ instead of their ‘inner logic’. Thus, this process is not client-centered, it is information-centered. Clean language comes off as almost funny, but Grove assures us that the client’s take it seriously.
The idea that the solution comes from the client is absolutely contrary to the medical or psychodynamic models – these expert models assume that the client will never figure it out, but that the expertise of the counselor must explain to the client what is happening. Reinforcing, or course, the client’s own sense of worthlessness, helplessness and hopelessness.
As Grove points out, the counselor using Metaphor Counseling with Clean Language may not even understand what is going on when the client finds something that has significant meaning to them personally and feels relieved by the new understanding. Again, the counselor is a consultant and an enabler – helping the client to find his or her own solutions.
So we have directly or indirectly talked about the mental structure – pillars of self and others with the expectation lintel across the top, and mental processes – the acts of appraisal, disposition and expectation being the most significant, but we still have not said enough about cognitions [thoughts and quirks]. Raise your hand in the air. How did you do that? In one of the many reversals of cause and effect, we started that process with a cognition. While some studies have indicated that the process of raising the hand started even before you consciously became aware of the fact, the thought was the trigger.
According to Shad Helmstetter …neuroscientists have learned that thoughts are electrical impulses that trigger electrical and chemical switches in the brain. Thoughts are not just psychological in nature, they are physiological – electrochemical triggers that direct and affect the chemical activity. When given an electrical command – a thought – the brain immediately does several things: It responds to the thought by releasing appropriate control chemicals into the body, and it alerts the central nervous system to any required response or action.
It is important to understand that the thought or quirk is the cause of much of your brain activity and functioning. Brain chemistry, for example, can be changed by what you think! This has been demonstrated many times by both tests on biofeedback and meditation. If this is so, the conundrum becomes apparent. Does the chemical imbalance cause the ‘mental illness’; or does the ‘mental illness’ [distorted thinking] cause the chemical imbalance. A common understanding of this can occur by looking at fear. In order to be afraid you must have a quirk [hunch, intuition, ‘gut feeling’, or a thought that something is wrong and dangerous. What happens? Unless you are a Buddhist monk, there is an increase in adrenaline. Does the adrenaline cause the fear? I think not. The adrenaline prepares you to deal with the fear through fight or flight, but occurs after the cognitive occurrence.
Not only that, but thoughts/quirks wire the brain. Because the brain works on an electrochemical basis, the electrical impulse of the cognition flows through the neurons and creates a path. This path if often used becomes semi-hardwired – it becomes the preferred path and the responses happen almost automatically as with habituation. This process can be overcome by rewiring. If the automatic thought and habituating theme is “I’m no good!”, we can habituation another path through constantly thinking and saying “I’m Okay and your Okay!”. When push comes to shove, which path will be used? While the old one will take time to dissipate, people will usually think those thoughts that are most satisfying and gratifying. Which one do you think that will be?
Since this is the case, we should be careful what we think. I should stop thinking and saying that I am no good at math if I want that to change. People, after all, are the sum total of what they think and do not behave differently than they think unless they are acting. Noticing what you think and its impact upon you is called mindfulness, and is an old Buddhist tradition. Mindfulness, thinking about thinking is a major component of changing one’s reality and life.
There is nothing in the science of the medical or psychodynamic models that makes any sense either in terms of hypothesis or outcome. It is a skewed perspective that allows for medication and incarceration to control people with problems in living. It rarely if ever is helpful, and if it is, it is the trust relationship rather than the protocols, techniques and procedures that have helped. Relationships are important, but you can define with cognitive science the elements of a trusting relationship and the trust does not come from a message that “You are not in control” or “Drugs will make everything better”. You have some choices to make about helping and being helped.
You can, of course, go on thinking poor, poor me – no body loves me, everybody hates me, guess I’ll go eat worms – but frankly, I prefer lasagna.