Evan George thinks about the key question 'how can brief therapy lead to sustainable change?'.
In Time’s Arrow Martin Amis reverses the direction of time. The book starts with the central protagonist dying into life and ends with him being born into non-existence. This structure offers Amis the opportunity to engage and to amuse his readers but in a much more fundamental way to challenge his readers’ core assumptions about the way that life is. From the past to the present to the future, that’s the way that we read life. But more than that, we do not appear just to see a temporal flow, we assume causation. The past we instinctively feel is responsible for shaping and causing the present, and the present and the past will be responsible for the shaping of the future. Given this, it is not surprising that solution focused brief therapists are often challenged for not ‘dealing’ with the past. How can you be sure, if you do not deal with causes, that the problem will not go away just to come back, either the same problem back or another to replace it?
It is of course important first of all to bear in mind that the simple, linear, past towards future through the present construction of time is a simplification. We can relatively easily for instance conceive of the idea that the present is shaped by the future. We are, for example, familiar with the self-fulfilling prophecy. Macbeth is just one instance of this. But in a much more simple way our goals, our preferred futures, where it is that we are trying to get to, will shape what we do today and tomorrow. In this way at least, the future shapes the present. However similarly our past, our history, is shaped by the present and even, to some extent, by the future. Every history represents a selection of material that is thought to be significant. No history contains everything that happened. So during a down, perhaps depressed period in our lives, the history that comes to mind is often the history of what went wrong for us, our history of failures and difficulties. During a subsequent up period our history shifts and what comes to mind is the history of our success. In a similar way an expectation of a future success that has not yet taken place can shape our reading of the past. So clearly the relationship between present, past and future is more complex and subtle than we always choose to realise. St Augustine did attempt to nudge us towards a more complex awareness hundreds of years ago when he pointed out that all we can ever have access to is the present. He pointed out that the past is merely the recollection of past events in the present and that the future is our expectation of future events in the present. This thought perhaps should have been of more use to the therapeutic community than the therapeutic community has, until now, made of it.
The idea that we can ‘deal’ with the past without discussing it seems to many therapists exploring solution focus just instinctively ‘wrong’. However what is generally accepted is that the events of the past cannot change what ever the client may do in relation to them in therapy. So all that can change is the meaning that the events have for the client in the present and the expectation of the meaning that those events will hold for the client in the future. One way to shift that meaning is of course to talk with clients about the events themselves. A simple example of a shift of meaning that many clients have found transformational of their lives can be found in the field of working with survivors of sexual abuse. The shift from the idea that the abuse happened and it was my fault, to the idea that the abuse happened and it was not my fault, has in itself made a major impact on the lives of many clients. However solution focused brief therapy can achieve as dramatic a shift of meaning often without talking about the trauma or difficulty. If we imagine that the client arrives in therapy dominated by the problem. Therapist and client do some work together and the client’s experience of the present changes. The present is now satisfactory. As the client and therapist move forward together the client develops a firm confidence that the future will continue to be satisfactory. In making this shift the meaning of the event, of the trauma, has been changed. It has changed from an event that is minute by minute determinative of the client’s life to an event that happened, one that should not have happened, and yet one which is no longer controlling of the client. Indeed beyond the present the client assumes that the event will no longer be determinative either in relation to the present or the future. In the best possible way the event has been marginalised, it has been de-toxified. A question that will often invite the client in this direction is: ‘How will you know that what happened when you were 10 years old, tough as it was at the time, and disruptive though it has been since, is no longer holding you back in your life? How will you know that you are doing justice to your self and your possibilities despite what was done to you?’ (Iveson)
In 1993 I was invited to lead a Family Therapy course in Slovenia. At the time the civil war in Yugoslavia or struggle for the liberation of Slovenia, depending on your standpoint, was still unresolved and so the course could not start. However immediately after the end of the war the course commenced. During this time and for a period of roughly 2 years, I flew out to Slovenia on a number of occasions using Adria airlines, the Slovenian national carrier. Being an anxious air-traveler I am one of the few people who read not just the in-flight safety instructions but the airline’s in-house magazine as well. When I started travelling the magazine proudly trumpeted that Ljubljana, Slovenia’s capital city, was one of Marshal Tito’s favoured cities because it was the birthplace of his mother, and that he visited the city frequently. By the end of the course the magazine reported the history of Slovenia’s struggle for independence over many hundreds of years and Marshall Tito’s mother and the special relationship between Tito and Slovenia had disappeared. Indeed the relationship was not even ‘just history’. It was gone. In this situation the spin-doctors of history had clearly concluded that the centuries of struggle for independence was the history that best suited the preferred, independent, future of the Slovenian State. E. M. Forster, the English novelist, wrote in his book ‘What is the novel?’ that every story has a beginning, a middle and an end and herein lies for many clients and sometimes for therapy, the problem. Given the linear, causal frame that we tend to apply to events through time, if the past and the present have been highly problematic the implication is that the future will also be so. Thus if the client makes a radical change of direction in her life, perhaps having come to therapy, and a problematic past is transformed into an acceptable present, the danger is that at times that change, from problem to solution, can feel unstable to the client. How long will it last? What if everything goes wrong again? And in such a context a renewed problem can seem to portend the end of the newfound and positive direction in the client’s life. This is particularly the case of course if the client’s past has been problem-dominated and lived in close proximity to professional helpers thereby confirming, at every turn, the client’s ‘problem’ status.
So if the therapist wishes to stabilise an apparent new direction in the client’s life, the therapist can invite the client to construct the history of the solution (Iveson). Very simply the therapist can ask the client: ‘What has it taken to make the changes that you have made in your life?’ When the client responds by identifying personal qualities that she has drawn on the therapist can enquire: ‘When else in the past have you seen yourself drawing on those qualities in a way that is useful to you?’ Beyond this the therapist can invite the client to adopt the wisdom of hindsight: ‘Having made these changes, looking back to the time before the change, what tells you that you always did have the capacity to make these changes?’ And the changes can be rooted into the client’s history through the eyes of supportive others: ‘Of all those who have known you in your past, who would be least surprised by these changes that you have made? And what is it that those people knew that others perhaps did not about you and your possibilities?’ (thanks to Michael White) Thus the change, originally celebrated by client and therapist alike as an exciting and radical shift, can come to be seen as the inevitable flowering of a potential that has long been present, if unseen. Whilst it is perhaps easiest to construct this preferred history following a change in the client’s life, it is not impossible to construct with the client the history that will fit with the future that the client desires even before that future has happened. Linguistically this can seem more awkward. Nonetheless the therapist can ask: ‘Let’s imagine that the miracle that you have just described has happened, that you have got to 10 on your scale, what will you be remembering, looking back, that will say to you ‘I always should have known that I could do it’?’
So it seems time is more complicated than we often suppose and the only way for sure that we can ever know that the past has been dealt with – however much it may or may not have been talked about – is when the present is genuinely satisfactory and the expectation is that this satisfactory state of affairs will persist. Fortunately for the client the Solution Focused approach is particullarly useful for bringing about this change of affairs and is likely to take a great deal less long than talking about the past directly is likely to take.
Evan George thinks about the key question 'how can brief therapy lead to sustainable change?'.