We also treat alcoholism as a psychosomatic process—like allergies or headaches or phantom-limb pain. The alcohol is an anchor, just as any other drug is. What an alcoholic is saying to you by being an alcoholic is essentially "The only way I can get to certain kinds of experiences which are important and positive for me as a human being—camaraderie, escape from certain kinds of conscious process, or whatever it is—is this anchor called alcohol." Until the secondary gain is taken care of by some other behavior, they will continue to go back to that as an anchor. So there are two steps in the treatment of alcoholism. One is making sure the secondary gain gets picked up by some other activity: they can have camaraderie but they don't have to get drunk in order to get it. You have to find out what their specific need is, because it's different for everyone.
Once you have taught them effective ways to get that secondary gain for themselves without the necessity of alcohol, then you anchor something else to take the place of the alcohol stimulus so they don't have to go through the alcohol state to get to the experiences that they want and need. We've done single sessions with alcoholics that stick really well, as long as we make sure that those two steps are always involved.
Man: Do you make the basic assumption that an individual is consciously able to tell you what the secondary gain is?
Never! We make the assumption that they can't.
Reframing in the six-step format we did here has certain advantages that we talked about. For example, this format builds in a program which the person can use by themselves later to make change in any area of their life.
You can also do this behaviorally. In fact, this is a strategy and outline for behavioral therapy as well as what we've been doing here. In the more usual therapeutic relationship, the therapist takes responsibility for using all his verbal and non-verbal behavior to elicit responses, to get access to resources in parts of the person directly, and to communicate with those parts. The client in the normal therapeutic process will, in turn, become those parts. S/he will cry, become angry, delighted, ecstatic, etc. S/he will display with all output channels that s/he has altered consciousness and has become the part that I want to communicate with.
In reframing we take a step back in that process and ask that s/he create a part that will have the responsibility for maintaining an efficient, effective internal communication system between parts. However, the same six-step format can be used as an organizing principle for doing more usual kinds of therapeutic work. Step one, identifying the pattern, is equivalent in a normal therapeutic context to saying "What specific change would you like today?" and getting a congruent response.
In usual therapeutic work there are a lot of ways of establishing communication with a part, as long as you are flexible. There's playing polarity, for instance. Suppose that I'm with someone who is really depressed. One way for me to contact the part in him that is really depressed is to talk directly to him. If I want to contact the part that doesn't want him to be depressed, I can say "Boy, you are depressing! You are one of the most depressing—I'll bet you've been depressed your whole life. You've never had any experience other than being depressed, never at all."
"Well, not my whole life, but for the past—"
"Oh no, I'll bet it's been your whole life."
"No, not my whole life, last week I felt pretty good for about an hour...."
In other words, by exaggerating the position that is offered to you, you get a polarity response if you do it congruently. And as soon as the person accesses the polarity, you can anchor it.
Woman: I have a client who will say "This is ridiculous! I don't want to do it."
Fine. So what?
Woman: Do you laugh at that point? Or do you, you know ...
No. Well, first of all, I've never had anybody tell me that. And I think that's because I do a lot of "set-ups" before I get into this. I do a lot of pacing, matching, mirroring. So you might take this as a comment that you didn't set up this person sufficiently well.
Or you might take it as a signal that you just accessed the part that you need to communicate with. Their behavior gives one set of messages and the verbalization gives another. If you recognize that the part which is now active and just told you that this is ridiculous is the part you need to communicate with anyway, then you don't do it in the six-step format. You immediately move into the usual therapeutic format. You've already established communication with the part. Reach over and anchor it in the same way we were talking about earlier. That will always give you access to that part whenever you need it. That response is a successful response in the usual therapeutic format.
Whether you do it in the six-step format or in the format of more normal therapeutic encounters, such as I just talked about, you now have established a communication channel. The important thing here is to accept only reports—not interpretations from the person's conscious mind. If you accept interpretations, you're going to fall into the same difficulties that they are already in: the communication between their conscious understanding and the unconscious intent is at variance. If you take sides you are going to lose—unless you take sides with the unconscious, because the unconscious always wins anyway.
If your client refuses to have anything to do with exploring unconscious parts, you can say "Look, let me guarantee that the part of you that you are attacking consciously, the part of you that keeps you doing X, is doing something useful for you. I'm going to side with it against your conscious mind until I am satisfied that this unconscious part of you has found patterns of behavior that are more effective than what you are presently doing." Now, with that it's very hard to get any resistance. That's been my experience.
Step three of reframing is the major component of what most people do when they do family therapy. Let's say that you have a father who loses his temper a lot. Virginia Satir waits until he has expressed quite a bit of anger. Then she says "I want to tell you that in my years of doing family therapy I have seen a lot of people who are angry, and a lot of people could express it. I think it's important for every human being to be able to express what they feel in their guts, whether its happiness, or anger like you just felt. I want to compliment you, and I hope all the other members of this family have that choice." Now, that's pacing: "accept, accept, accept." And then she gets in real close to the father and says "And would you be willing to tell me about those feelings of loneliness and hurt underneath that anger?"
Another form of behavioral reframing is to say "Do you yell at everyone like that? You don't yell at the paper boy? You don't yell at your mechanic? Well, are you trying to tell her that you care about what she does? Is that what this anger is about? I mean, I notice you don't do it with people you don't care about. This must be a caring message. Did you know that this was his way of expressing that he cares what you do?"
"Well, how do you feel about knowing that now?" How many of you have heard Virginia Satir say that? That's a weird sentence; it doesn't actually have any meaning. But it works! That's another example of behavioral reframing. It's the same principle, but it involves content. That's the only difference.
Carl Whittaker has one nice reframing pattern that is apparently uniquely his. The husband complains "And for the last ten years nobody has ever taken care of me. I've had to do everything for myself and I've had to develop this ability to take care of myself. Nobody ever is solicitous toward me." Carl Whittaker says "Thank God you learned to stand on your own feet. I really appreciate a man who can do that. Aren't you glad you've done that?" That's a behavioral reframe. If a client says "Well, you know, I guess I'm just not the perfect husband," he says "Thank God! I'm so relieved! I've had three perfect husbands already this week and they are so dull." What he does is to reverse the presupposition of the communication he's receiving.