Psychotherapy, Solution Focused Therapy

Making the unconscious conscious

Until you make the unconscious conscious it will direct your life and you will call it fate.

Carl Jung

I stumbled across this quote from Carl Jung, which beautifully encapsulates so much of the the approach I use that I couldn’t help but write a blog about it.

Here, Jung highlights the significance of our subconscious mind for effecting any positive changes we would like to make. Totalling 90% of our brain functioning, our subconscious mind is nevertheless consistently underrated, underestimated, and under-utilised in getting us to where we want to go. When used alongside talking therapy, hypnosis is an incredibly useful and versatile tool, in bringing your whole brain onboard in achieving your goals, whether they are to feel more confident, or feel less pain.

Jung also points to the importance of understanding our own brains and putting words to tho unconscious processes that impact our thoughts, emotions and behaviours. Using neuroeducation within psychotherapy can be an extremely useful way of lifting the lid on our own brain functioning. We start to gain conscious awareness of the neurophsyiological processes that accompany our every thought, action, and interaction. We learn ways in which we can influence these processes. In doing so, we take back a level of direction over our inner and outer lives.

Jung further alludes to the unconscious thought patterns that dictate our thoughts and behaviour. Lines of thought left unexplored and unchallenged because we never asked, or were asked, the right questions. Using solution focused questioning techniques in talking therapy can open doors in our thinking so that our answers can do the rest. This can be an incredibly effective way of bringing those unconscious thought patterns into the conscious where they can be explored, challenged and perceived from a different angle. In doing so, we gain back direction over our thought patterns, our stories, and our lives.

Psychotherapy, Solution Focused Therapy

First-order dependency in SFBT: what is it and why is it so important?

In his recent lecture – A Review of the Salamanca Studies, Director of Research and Training at The Solution Focused Universe, Adam Froerer discussed research (Beyerbach & Escudero, 1997 in Beyerbach, 2014), which found that Solution Focused Brief Therapy is statistically characterised by first-order dependency.

This means that, in Solution Focused Brief Therapy, what the therapist says is more likely to be related to whatever the client just said, and vice versa.

For example, the therapist asks “What are your best hopes?” And the client responds “I want to sleep better. I’m so tired. It’s making my job impossible. I want to feel productive again.” Statistically, a Solution Focused Brief Therapist would be more likely to develop their next question in response to the client’s last utterance: “I want to feel productive again.”

But what does this mean? And how does it help us to better understand the solution focused approach?

As Adam Froerer points out, solution focused conversation is a co-construction, built one utterance at a time. Each and every word spoken has value in creating a conversation that can affect positive change. By responding to what the client has just said, in the moments before they chose to pause, we value not only their last spoken words, but also their decision to pause after them.

There is no judgement, so each and every utterance holds value. As Froerer says when we use the client’s last utterance for the basis of our next question, “the client feels heard, the client feels understood, the client feels valued, and that’s what creates a good therapeutic alliance.”

According to the research, the client is also more likely in Solution Focused Brief Therapy to respond to what the therapist has just said. Both parties on the same journey, both following one step with the next. Perhaps when one party takes this co-constructive approach to conversation the other follows suit, though the research is yet to confirm this.

Much as a wall is constructed, we are encouraged that each communication in Solution Focused Brief Therapy rest directly on the last, brick by brick. We may come back to strengthen the wall with additional lines of conversation, pulling together threads from resources the clients have mentioned to support the construction. But we tend towards building rather than digging, forwards rather than backwards. As Froerer says, “We listen to what the client just said we develop the question we ask based on this.”

Or, as As Global Leader in Solution Focused Brief Therapy, Elliot Connie says, “Just keep asking asking the next question.”

Beyerbach, M. (2014). Change Factors in Solution-Focused Brief Therapy: A Review of the Salamanca Studies. Journal of Systemic Therapies 33(1), pp. 62-67

Froerer, A. (February 3, 2021). Review of the Salamanca Studies – The Evidence of Greatness Episode 4. Retrieved from https://thesfu.com/a-review-of-the-salamanca-studies-the-evidence-of-greatness-episode-4/

Image by Waldemar Brandt on Unsplash.

Psychotherapy, Solution Focused Therapy

Beyond the solution

In his award winning book Atomic Habits, bestselling author James Clear describes three layers of behaviour change. 1) Outcomes, or goals, such as losing weight, winning a competition, securing a promotion. 2) Processes, or habits and systems, such as getting up earlier, eating fruit for breakfast, writing a journal. And 3) Identity, or beliefs and judgements about yourself, others and the wider world.

When we try to build up outcome-based habits, we focus on what we want to achieve. I want to be thinner. I want to quit smoking. In contrast, when we focus on identity-based habits, we focus on who we wish to become. I believe that I am a non-smoker, I believe that I can lose weight.

Focus on outcome-based habits only at your peril, warns Clear, because unless you shift how you look at yourself, your old sense of identity will sabotage the best of intentions.

There is a common misunderstanding about Solution Focused Therapy, largely borne out of the unfortunate name, Solution focused, that the focus of change is solely on the outcome, not on processes and not on identity. This is simply not true.

Whilst we may start the first session with a client by establishing a preferred outcome, asking “What are your best hopes?”, our work with clients does not end there. Understanding what our client hopes for is, rather, a starting point, because, as the Global Leaders in Solution Focused Therapy teach, if you don’t know where your client wants to get to, you can’t begin to be able to support them to get there.

In the early days of Solution Focused Brief Therapy, much more airtime was given to goals, defining them and working towards them. These days, many of the big names in SFBT shudder at the use of the term “goals”, and steer well clear of tying a client to any goal they might mention.

The goals themselves are less important. Best hopes established, the questions we then ask support our clients to focus on describing the life in which those best hopes exist. In a sense, we ask our clients to pick out the detail of the atomic habits, the systems and processes that form a part of their preferred future.

Other questions we ask support our clients to explore how progress they have already made towards their goals impacts their sense of identity. What have they learned? What did it take to get themselves to that point? How does the way in which they have coped change what they believe about themselves?

So, contrary to what the name suggests, Solution Focused Therapy reaches far beyond the solution to the bigger picture beyond. We ask questions so that our client can shade in the parts of that picture that already exist and we ask questions so that our clients can sketch out the details in which the solution resides.

Psychotherapy, Solution Focused Therapy

You lead the way

In the Solution Focused approach, the client takes the lead. Each session is shaped by what the client brings to it, their hopes, their strengths, their focus, their ideas. The client chooses  what they would like to achieve and how they would like to achieve it. The more a client takes ownership of their progress, the better we have done our job. 

Expressing how then, as solution focused therapists, we can help guide the client along this process of positive change, is tricky. Guiding seems to suggest leading. So how do we guide while following? The answer ‘we ask questions’, is too vague a statement to really convey the essence of the solution focused therapist. 

In a recent lecture, Solution Focused Brief Therapist Adam Froerer provided a metaphor that captures perfectly the essence of solution focused therapy. 

We stand in a room shoulder to shoulder with the client

The room is pitch black.

The client holds the only source of light – a torch.

They shine the light where they choose.

We ask the client what they can see.

The client answers: “A wall”

“What does the wall look like?” we ask?

“Is it coming from the right or the left?”

“How tall is it?”

Our questions help the client to move the torch, to adjust their focus and get clarity on their thoughts. Clarity that can inform their next step forward. Clarity that had been otherwise sat undiscovered, hidden by the dark. 

Psychotherapy, Solution Focused Therapy

The power of believing

“I believe in you.”

How many times have you heard this in your life? When did you hear it? What difference did it make to you?

In moments of sincerity when we reach for the words I believe in you, we are digging deep into our emotions and our instincts, so deep that it can feel like this feeling of belief is spoken from beyond our consciousness, far beyond our thinking – this is the feeling we’re trying to explain when we use the expression speaking from the heart. We are digging so deep that this feeling of belief can feel like it is spoken from our whole self – this is the feeling we’re trying to explain when we use the expression I’m fully behind you. These metaphorical expressions are our attempts, bound by the limitation of language itself, to convey that feeling that we believe.

In solution focused therapy, we believe in the client:

  • so we ask questions that help them to develop and rediscover their belief in themselves; 
  • so we value and make time to listen to and understand their perspectives and tailor the therapy to them;
  • and so we trust them to choose what it is they need to work on and what it is that works for them at a level of engagement that is right for them.

But, crucially, we also believe in the process itself: 

  • so we transfer our confidence to the client;
  • so we stick to the structure and questions that we know will ultimately support the client to open doors to a new way of thinking;
  • and so that we can sit beside, rather than before, the client on their journey, as a discrete guide, trusting that the process will take the client where they want to go.
Psychotherapy, Solution Focused Therapy

The most important assumption a solution focused therapist makes…

One of the fundamental differences that holds Solution Focused Brief Therapy apart from many other psychotherapeutic approaches, is a basic assumption that we, as therapists, make.

We assume that our client is there, not because they have a problem, but because they want to find a solution.

We make this assumption of all of our clients, regardless of what brings them to us. For the purposes of our work together, it doesn’t matter if the person sitting across from us is mourning the loss of a loved one, coming to terms with a terminal diagnosis, or hasn’t slept a full night in years. Global Leader in Solution Focused Brief Therapy, Elliott Connie, often refers to entire sessions he has with clients without ever knowing a whisper of the problem that ails them.

This may sound like we don’t have patience for our client’s problems. We absolutely do. We sit and listen to our clients tell us about their problems (if they wish to – not everyone does!) because we trust that they know their talking about their problems is a necessary part of their journey towards the solution.

So we are interested in the problem (to the extent our client is anyway). It’s simply that we are particularly interested in a specific dimension of the problem: how our client has managed to cope with it? What strategies has our client come up with to get through it? What resources have they noticed that have helped them along the way?

The very fact that they are sitting across from us is in itself a strength that warrants exploration. How did they recognise that they wanted to find a solution and that this might help? How did they manage to turn up for the appointment at all?

Session time is precious and short, and so we choose to spend it exploring our client’s strengths and resources. Not only does this support our clients to open up doors in their thinking in session; the priority that we give to exploring strengths and resources over problems also opens up for the client a whole new approach to thinking, in which their strengths are in the spotlight. Rediscovered, reinforced, acknowledged, celebrated.

Mindfulness, Psychotherapy, Solution Focused Therapy

The power of choice

As the majority of the UK picks its way through yet another lockdown, shuffling past a Christmas that many would rather forget, the wise words of psychologist, best-selling author and Holocaust survivor Dr Edith Eger may offer some solace against the stubborn backdrop of uncertainty.

“The most damaging prison is in our mind, and the key is in our pocket.”

In her #1 New York Times bestselling book “The Choice”, and “The Gift” Eger recounts her journey from imprisonment at Auschwitz to liberation and then on towards her own mental freedom. In spite of the horror she and millions of others suffered, Edith nonetheless describes our minds as our biggest prisons, to which we already hold the key. It is liberation from our own negative, self-destructive incapacitating thoughts that brings us true freedom:

“When we escape our mental prisons, we not only become free from what has held us back, but free to exercise our own free will.”

We have the power of choice, and we can choose freedom, writes Eger. We can choose how we look upon what has happened to us. We can choose how we will respond. 

We can focus on the usefulness of our experiences. How have they been helpful to us? How have they nourished us? In the solution focused approach, we encourage our clients to focus on the nuggets of usefulness from their everyday experiences, with questions such as ‘What’s been better?’

And, writes Eger, if there is no such usefulness to be found when we look out, we can look within. In the solution focused approach, we encourage our clients to do so with questions such as ‘Given what you have been through, how have you manage to cope?’ ‘What strengths have you drawn on to keep going?’

As Eger points out, “It’s not what happens to us that matters most, it’s what we do with our experiences.”

When we are deep, deep down; our neurochemistry flatlined, the top – where all the mental freedom and inner peace hangs out – can seem a long way up. 

Likewise, when we are flying so high, so fast, too fast to think; too busy to check-in with ourselves – cortisol and adrenalin fuelling our way forward and blocking out everything (and everyone) else – inner peace and mental freedom might as well reside on another planet.

And yet, there is always choice. We can choose to look up, to stop, to breathe, to make a cup of tea, to practice gratitude, and to remember how strong we really are.

Eger, E. (2018). The Choice. Penguin Books

Eger, E. (2020). The Gift. Penguin Books

Psychotherapy, Solution Focused Therapy

Clients: competent, capable, motivated

In Solution Focused Brief Therapy, we need to do everything we can to see our clients as competent, capable, and motivated.

To see them as anything else would make our jobs as therapists infinitely harder. Then we would start to distrust and lecture. We would lose faith in our clients, blinded by our belief in our own expertise.

Our clients are experts. They know more about their lives than we will ever know. Somewhere, in between the lines of everything they have experienced, said, felt, heard, noticed, touched; somewhere between the lines of every struggle and every success, is the beginning of a way forward that works for them.

Our job is to be experts of our questions, the process by which we can support our clients to reach deep within their own thinking to find their way.

Allowing our clients to own their journey recognises their individuality and allows them to own their success. We don’t prescribe what our clients must do, should do, ought to do. We simply create a space where they can describe what they are doing, in the future that contains their best hopes.

Mindfulness, Psychotherapy, Solution Focused Therapy

Ending and beginning

This month has been one of endings and beginnings for me. I achieved my qualification in Solution Focused Hypnotherapy with Clifton Hypnotherapy Practice Training, having gathered the most awesome group of friends I could have hoped for. Set against the backdrop of coronavirus and uncertainty, CPHT gifted me a year of learning and growing together – supporting each other to help others. From that nest of support, Choice Therapies was born, and it continues to grow into a nurturing community for practitioners from all walks as therapy, as they learn and grow and strive to do their best by their clients.

This month I also had a big push on my Masters thesis, exploring the use of Solution Focused Hypnotherapy for the management of chronic pain conditions. For a few weeks I was wholly submerged in data analysis and write-ups, and thanks to the incredible support of my supervisor, not to mention my family, I’m returning to the surface, as a finalised report takes shape.

And yesterday, I waved goodbye (over Zoom) to a lovely bunch of solution focused practitioners from across the globe who I had learned so much with and from over the last four months, on the Intensive Solution Focused Brief Therapy course with BRIEF International. Discussing the intricacies of this transformative approach with the solution focused greats, Adam Forever, Chris Iveson, Elliott Connie, and Evan George, was an absolute joy, and has shaped how I work with clients for the better.

So here I am, winding down, taking a moment, taking a breath. Looking back down the mountain to admire the view. These moments are important. We take stock, we process, we gain perspective on where we are right now, in this moment, and nudge the tiller if needs be to help us along the path ahead.

There’s so much to look forwards to; collaborations, projects, research, learning. Choice Therapies continues to grow into a wonderful community. My own practice continues to allow me the opportunity and privilege of watching my clients grow in strength and confidence, finding ways to manage their challenges that work for them. Many of the ventures I am fortunate to be a part of, are in their infancy. The future is full and exciting.

But for now, in this moment, I am pressing pause. Reconnecting, celebrating, and feeling grateful.

Psychotherapy

Accepting our inner selves: using the Internal Family Systems (IFS) model in Solution Focused Hypnotherapy

This week I attended a training seminar led by founder of the Whole Health Medicine Institute, Lissa Rankin, MD, and founder of the Internal Family Systems model Richard Schwartz, PHD.

Firstly, a huge thank you to Lissa and Richard for running the seminar, which, as someone relatively new to IFS, I found really accessible and informative, and very useful for therapists like myself working with those impacted in some way by COVID-19. 

The seminar got me thinking about the value of the IFS model for use in Solution Focused Hypnotherapy. 

The analytical side of IFS can often draw clients towards childhood experiences as they follow the trailhead back from their present thoughts and behaviour, and this contrasts with the SFH focus on the future, not the past. However, there do seem to be many areas in which Solution Focus Hypnotherapy, and Internal Family Systems align. 

  1. Both IFS and SFH share the same positive assumption that we all essentially have the capacity to draw on our inner resources in identifying where we want to get to and getting there. As Richard Schwarz explains, in IFS, “Everyone has an essence or state amid the terror, the Self in each of us is always there—the “I” in the storm, the calm depth beneath the roiling waves.” (Rankin, 2020). The positive suggestions in SFH encourage both self acceptance and a focus on our strengths and successes. Similarly, IFS aims to bring the exiles – the parts of ourselves that we don’t like – into acceptance, in doing so accessing the inherent strengths. 

  1. Both SFH and IFS work with the subconscious mind, using rewinding and reframing techniques to help us achieve positive change, although the use of rewind in SFH is usually restricted to specific phobias.  Equally, both SFH and IFS use solution focused questioning to assist this process.

  1. The multiplicity of our minds is a key focus in both SFH and IFS. In SFH we draw on neuroscientific understanding about the brain to recognise the role of its multiple parts in how we feel and behave, while in IFS the multiplicity is through the metaphysical understanding of how our personalities are comprised of multiple sub personalities, or parts.

  1. Both SFH and IFS aim to work with, rather than against, all parts of our mind. In SFH we talk about the primitive mind as an essential part of us. Our intention is to utilise the creative strength of the subconscious mind through meditative practice, while consciously thinking, acting, and interacting in a positive way to avoid operating from our primitive mind in times of stress. The anger, anxiety and depression we resort to when we operate out of our primitive mind are often unwelcome in today’s society, but 100,000 years ago would likely have saved our life. Even now, the speed at which our subconscious mind can react to danger saves lives every day. In the same way, according to the IFS model all of our personality ‘parts’ are essentially good, although how they are expressed sometimes when we are under pressure can cause us trouble. Progress comes in accepting all of our parts, and nurturing rather than rejecting the parts of us we don’t like or fear.

The value of the IFS model for SFH is in the precision it can bring to identifying our inner resources through solution focused questioning (Adams, 2018). The SFH approach provides a meditative platform through which to employ the IFS technique of focusing on one thought, belief or sensation at a time and using it to get back to the part of us it comes from (Schwartz, 2020). In turn the IFS model gives SFH a useful understanding of our personalities that lends itself to exploration through hypnosis. The visual metaphor of our multiple inner selves is something we can use in SFH to encourage a positive inner dialogue, within which we can draw on our stronger parts to nurture the parts of ourselves we wish to grow.

References

Rankin, L. (2020). The viral wake-up call. An IFS perspective. Retrieved from https://lissarankin.com/the-viral-wake-up-call-an-ifs-perspective-by-dick-schwartz/

Adams, J. The Situated Self as a Motivational Resource. Journal of Systemic Therapies 37 (3), 29-41, 2018. Retrieved from https://guilfordjournals.com/doi/pdf/10.1521/jsyt.2018.37.3.29