Strategic Therapy Mr. Bond?

By Stephen Bray

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Every age constructs a unique model of life based within a specific social context.[i]-[ii] In a recent James Bond film the villain asks Bond, “Is not dying chasing a dream the best way to go?"  Bond replies unconcernedly, “I’d rather not go at all.”[iii]

Ian Fleming created Bond in the early 1950s, just when the cold war between East and West was emerging. Fleming’s Bond is a ruthless assassin and under no illusions about matters of life and death. When Fleming created Bond the world had just experienced a bloody war. His Bond could never have made such a retort Indeed the early Bond sometimes speculated that he would die an anonymous death.[iv] Today’s Bond really expresses the concern of a coming age, which is not how to live or pursue immediate dreams, but how to live forever. This important distinction is changing the nature of Brief Therapy.

Let it be understood that therapy is a process in which two parties, a therapist and client, or a team and family unite in order to resolve difficulties. Although this process was known to the ancients only during the last 100, or so years has psychotherapy and counselling become established as a profession.[v] The man most commonly held responsible for this development is Sigmund Freud, the founder of psychoanalysis. Incredibly it seems that the average length of an analysis in Freud’s day was around 18 months, today analytical treatment may last for years.[vi]

Psychoanalysis was ‘invented’ for a clientele composed of the relatively wealthy middle classes of Vienna. Although it enjoyed some popularity in Europe, it was really its adoption by America’s medical profession that swelled the numbers of its practitioners helping to make it, and psychotherapy in general, a worldwide phenomenon.[vii] Freud held that:

“We resolve to think of the consciousness or unconsciousness of a mental process as merely one of its qualities and not necessarily definitive . . . Each single process belongs in the first place to the unconscious psychical system, from the system it can in certain conditions proceed further into the conscious system . . . Every time we meet with a symptom we may conclude that definite unconscious activities which contain the meaning of the symptom are present in the patient’s mind.”[viii]

In some ways Freud’s influence eclipsed some of America’s own talent in the field of medical psychology. This it may be argued has resulted in tragic consequences for humankind, since one of those so obscured is William James, who is generally acknowledged as America’s first modern psychologist. James’ writing style is dated but his concepts could be interpreted as those of today’s quantum psychology:

    “Let him begin with a perceptual experience, the 'presentation,' so called, of a physical object, his actual field of vision, the room he sits in, with the book he is reading as its centre; and let him for the present treat this complex object in the commonsense way as being 'really' what it seems to be, namely, a collection of physical things cut out from an environing world of other physical things with which these physical things have actual or potential relations. Now at the same time it is just those self-same things which his mind, as we say, perceives; and the whole philosophy of perception from Democritus's time downwards has been just one long wrangle over the paradox that what is evidently one reality should be in two places at once, both in outer space and in a person's mind. 'Representative' theories of perception avoid the logical paradox, but on the other hand they violate the reader's sense of life, which knows no intervening mental image but seems to see the room and the book immediately just as they physically exist.

The puzzle of how the one identical room can be in two places is at bottom just the puzzle of how one identical point can be on two lines. It can, if it be situated at their intersection; and similarly, if the 'pure experience' of the room were a place of intersection of two processes, which connected it with different groups of associates respectively, it could be counted twice over, as belonging to either group, and spoken of loosely as existing in two places, although it would remain all the time a numerically single thing.”[ix]

So James realizes that subject and object are representative of a greater Self, whilst Freud holds that behaviours are predicated upon a meaning and processes locked within an individual’s mind. Clearly James operates from a philosophy of monastic idealism[x], whereas Freud speculates in terms of psychic determinism.[xi]

A major influence upon the development of Brief Therapy is Dr. Milton H. Erickson. Almost alone between 1935 and 1956 he pioneered the concept of the families being treated as a system of relationships operating within specific social contexts. Erickson studied both medicine and psychology at the University of Wisconsin and the great American functionalist Clark F. Hull influenced some of his ideas.[xii]

By the mid 1950s when the ‘Cold War’ between East and West was emerging Erickson’s work started to become highly regarded. The meeting of Erickson’s ideas with ‘Cold War’ interpretation resulted in one of the earliest forms of formalized Brief Therapy to be developed outside of a psychoanalytic paradigm. One interpretation was developed by a communications analyst Jay Haley and initially called ‘Directive Therapy’, but after the publication of his book Strategies of Psychotherapy[xiii] the approach came to be known as Strategic Therapy.

According to Haley:  “Therapy may be called strategic if the clinician initiates what happens during therapy and designs a particular approach for each problem.”[xiv]

The implication of the approach then is that the process may not only be directive, but may also be open to abuse. This coupled with its unfortunate title has drawn criticism from all corners of the globe, and particularly from Family Therapists[xv] and Philosophers of Social Work Ethics[xvi] in the United Kingdom. The problem with strategic thinking is that one finds oneself concerned with power relationships, as was the preoccupation between East and West during the cold war years.

The result of this stance may be that some therapists cease to communicate as people with people, but rather seek to manipulate their communication with others, from what they perceive as a ‘superior or enlightened’ position. Take for example Haley’s evaluation of psychoanalysis:

“The patient enters analysis in the one –down posture by asking for help and promptly ties to put the therapist one down by building him up . . . the patient compliments the therapist by how wonderful he is . . . the skilled analyst is not taken in by these manoeuvres. When the patient finds himself continually put one-down he changes tactics. He becomes mean, insulting, threatens to quit analysis, and casts doubt upon the sanity of the analyst . . . They meet an impassive, impersonal wall as the analyst remains silent or handles the insults with a simple statement like, “Have you noticed this is the second Tuesday afternoon you’ve made such a comment? . . . You seem to be reacting to me as if I’m someone else.” Frustrated in his aggressive behaviour, the patient capitulates and ostensibly hands control of the situation back to the analyst. Again building the analyst up, he leans on him, hangs on his every word, insists how helpless he is, and how strong the analyst, and waits for the moment that he will lead the analyst along far enough to devastate him with a clever ploy. The skilled analyst handles this nicely with a series of “condescending” ploys, pointing out that the patient must help himself and not expect anyone to solve anything for him . . .”[xvii]

This kind of selective interpretation led to a generation of ‘helpers’, many not as well educated or skilled as Haley, ‘intervening’ with ‘patients’ in ways that were not suspected.

But according to these excerpts from the standard British textbook Family and Marital Psychotherapy, printed in 1979, some people’s condition improved as a result of Strategic Therapy

    “A man sought help, having found himself increasingly unable to maintain an erection. This was causing him considerable distress and creating some tension in his relationship with his girlfriend. They were seen conjointly and the man told he needed to learn to control the behaviour of his penis more effectively. As the first stage towards his learning this control, the girl was asked that night, to try all she could to make him excited. He was instructed to try and prevent his penis becoming or staying erect. He failed.”[xviii]

    “A woman sought help for what she described as “shop phobia”. For some time she had been unable to remain in the smallest of shops for more than a few moments before being sick or fainting . . . . I told her that I must see exactly what happened when she went into a shop . . . As we drew nearer to the door I told her that she should be experiencing the humming noises in her ears by now and that her skin would start to feel clammy. She was not to try to avoid these feelings. Once inside the shop I directed her to the less crowded part so that she would be able to faint without being stepped on. Although anxious, the woman reported that she had not experienced any of her usual symptoms . . . The woman was seen two years after. She was Christmas shopping alone in the crowded toy department of a large department store.”[xix]

One root of Strategic Therapy comes from the Mental Health Institute of Palo Alto, California. A group of specialists from there worked closely with Erickson and Haley in developing the early Brief Therapy models.  One of the team, Paul Watzlawick frequently contributed examples of miscommunication drawn from intelligence work into Communication Theory,[xx] and Family Therapy.[xxi] In one anecdote in a Family Therapy textbook Watzlawick even gives an account of John and Robert Kennedy’s negotiations with, and the strategies used by them to mislead, Nikita Khrushchev during the Cuban missile crisis.[xxii]

Today we may imagine that therapies owe little to the pioneers of Brief Strategic Therapy. But Watzlawick was one of the first to recognise and illustrate today’s post-modern idea that reality is a construction.[xxiii] In rural Scandinavia a team of therapists have developed a unique form of narrative therapy in which cultures are understood as sets of interpenetrating actions and ideas shaped by as well as shaping their practitioners.[xxiv] One of their concepts is that of the ‘saga-space’, which is a reintroduction of the Nordic verbal storytelling tradition. Within saga-space each of us lives our dream, and may die a hero’s death.

But does not the modern Bond have something in preferring not to die at all? MRI’s Strategic Therapy first introduced us to the idea of first and second order change.[xxv]

“When we have a nightmare we may do many things in our dream. We may run, hide, fight, scream, jump off a cliff, (indeed we may create our very own James Bond scenario.) But no change from any one of these behaviours will terminate the nightmare. This kind of variation we all know, it’s called first order change. Second order change occurs when we awaken from our dream. Waking is not a part of the dream, but a change to a completely different state!”[xxvi]