[Editor: This is one of the last pieces of my father’s writings]
[Editor: HyperLinks added]
[Pillars of Madness]
This revolution revealed to those who cared to look that every successful method of corrective counseling owed its success, not to the factor guessed at by its inventor, but to the unintentional “prescription of the symptom.” Logical investigation of successful methods invariably led to the same conclusion: each useful method in its own way entails “symptom prescription” as practiced by Milton Erickson. It was clear to those who studied Erickson’s method of encouraging clients to practice their symptoms under his supervision that Rogers’s reflection, Kelly’s role assignment, Stampfl’s implosion, Wolpe’s reciprocal inhibition, Ellis’s insane sentencing, Moreno’s role directing, Adler’s logical consequences, Berne’s permission, Glasser’s bite-sized assignments, Skinner’s rewards, Eglash’s restitution, and even Freud’s free association, each contained an inadvertent ingredient of symptom prescription.
The word ‘symptom’ takes on a special meaning in the context of social field theory. Physical disabilities are said to be “diagnosed” if and when their physical “symptoms” are detected. Distracting tactics are “diagnosed,” which is to say inferred, when their disconcerting symptoms are detected, the diagnostic task being that of determining what distracting tactics an “identified patient”—a client—is deploying when under threat of being found out as unworthy of care. Each client has a repertoire of distracting tactics for self defense—
▪ Idealists depersonalize self [flutter, swoon, sunder, sacrifice] to gain alienation
▪ Guardians demobilize self [complain, dawdle, moan, sigh] to gain exemption
▪ Artisans beguile self [defile, deprive, risk, disgrace] to gain deception
▪ Rationals besiege self [repeat, horrify, avoid, blank] to gain cancellation
It’s not too difficult to tell the difference between these tactics. Once we determine which is being deployed, then we can take over that tactic by prescribing it. So instead of prescribing the symptom prescribe the tactic.
But with a twist. Just as our clients must continue to twist family conventions, so must we encourage them to do so, not for their covert objective, but for our overt objective. Also, and equally imperative, not involuntarily. but deliberately.
The crux of the matter, then, is to take over purposeless-spontaneous behavior and reframe it into purposeful-deliberate behavior. But why? What is gained by this takeover and reframing of our client’s distracting tactics? The reason is that deploying tactics deliberately and purposefully cannot be in the service of the hidden aim of shame concealment, cannot, that is, serve as a defense. Nor can our clients’ claim that they can’t help doing what we told them to do. After all they agreed to and were therefore obligated to continue twisting whatever family convention they were in the habit of twisting. When a distracting tactic doesn’t work it is simply forgotten. That is, if it does not provoke a negative response on the part of family members, then it is of no further use. If using the label affixed to them by an official as a substitute for a confession to their hidden offense—unworthiness—no longer affords them an excuse to put off facing the tasks of living (no excuse needed since they’re required to act that way), then repeating the confession is no longer of any use to them. Both tactics, provocative twisting and substitute confessing, have been co-opted and thereby rendered useless.
Now, this is not to say that tactical takeovers and reframing are easy to do. They are not, even after long practice and careful redesign of takeover and reframing procedures. Moreover, we cannot rest our case with having taken over our client’s distracting tactics. Something else must be done, especially in severe and enduring cases. What that is, is that we must arrange for our clients to make a positive contribution somewhere in their own social field, a contribution that can serve as a platform, however narrow, from whence to start building positive self-regard, remembering as we should that it is negative self-regard that got our clients into a demoralized state in the first place.
Milton Erickson, William Glasser, and George Kelly, each in his own way, developed methods for encouraging clients to take small steps toward doing something worthwhile, such as to gradually make them worthwhile in their own eyes. To acquire this sort of technology the reader is advised to study the methods these men have devised, especially those found in the case reports of Milton Erickson.