One class of stories that my parents told used to drive me crazy. Some character would be walking along through the forest one day and suddenly he would meet a magical creature whose beard had gotten caught in a fallen tree. I could never figure out what kind of a magical creature would be stupid enough to get his beard caught in a fallen tree! The main character would save the magical creature, and the magical creature would say «You now have three wishes.» The person would always blow it. He'd immediately say «I want to be immensely wealthy.» Then the entire countryside would be destroyed and in ruins, and his family would be wiped out, because everything would be covered with gold.
That kind of story is a good metaphor about the need for the ecological protections we build into reframing. The character doesn't think about the secondary effects of his wish. He doesn't specify context or procedure; he just names a goal. Reaching the goal is much more disastrous than not having reached it at all. Consequently, the character always uses the second wish to reverse the ill effects of the first one. Then he says something like «I wish I had never met this creature.» And that uses up his third wish. So he blows all three wishes and ends up back at zero.
Often people's conscious requests in therapy are a lot like that. People ask for things without any appreciation of their own personal context, or the larger family context in which they are embedded. So one of the ways in which I might proceed in your position, would be to act naive. I might act as if I am taking his request seriously, and arrange for him to go back and recall just a few things.
First I would set up a strong amnesia anchor. Then I would induce a trance in which I was guaranteed that I could create amnesia if I requested it. Then I would have him stay dissociated so he could view things from his past externally, and not be kinesthetically involved. Then I would ask his unconscious to pick three incidents from his personal history; one pleasant, one not so pleasant, and one disastrous, to give him some idea of the range of experiences in his personal history. After he has observed those, I would arouse him, and ask him for his response. If he wanted to continue, then I could. If he didn't want to continue, I would re–induce the trance, create amnesia for those recovered pieces of information, and then proceed to setting new goals.
Once a therapist brought in a trainee who wanted me to use hypnosis to discover something about her past. She believed that her older brother and a friend had raped her when she was eleven years old. She wasn't certain this had actually happened, and she wanted to know whether it was true. My response was «What difference would it make to you if you knew?» She had no answer to that question—it had never occurred to her. You might consider asking your client that.
Janet: Well, I have asked him, and he says he wants to remember so that he doesn't have to feel so funny when he runs into somebody that he used to know and doesn't remember. I feel like he's set up a task that is impossible for himself, because he doesn't really want to know.
That would be my first guess, too. He has consciously asked to recover a memory, so that's the goal, but he also has good reasons not to remember.
Janet: He was also in a VA hospital for awhile. He's very proud that they used sodium pentathol on him and got nothing! They also used hypnosis on him and it was unsuccessful in helping him recover the past. All he can remember are very precise details of the day that he woke up looking into the barrel of the shotgun.
I would probably go for his meta–goals then. «You want to recover memory. For what purpose?» «So that when I meet people from my past I would know how to treat them.» «Oh, so what you really want is not to recover memory. You want a way of gracefully dealing with the situation of meeting people who claim to be from your past.» One way to get that outcome for him would be to teach him a little «fluff.» «Gosh, it's been so long! Where was it?» It's quite easy to teach him «fillers» that will gracefully elicit all the information he needs to respond appropriately.
Whenever there is a direct conflict on any level, you just jump up to the next level. You ask for the meta–outcome. «What will you gain from this? What purpose will this achieve for you?» Once you know this, you can offer alternatives that are much more elegant. He will soon give up his original request, because recovering his history will have no function for him anymore.
Janet: As far as I can tell, his family situation continues to be horrendous. I tried saying «Well, you can't remember anything, so why don't I just have your family tell you the good things that happened in your life?» His family couldn't come up with anything!
Another alternative would be to make him a good hypnotic subject, with the goal of creating a new personal history for him. Get him to agree to using hypnosis, not for recovery of his memories, but for building him a new personal history. If you got a bad one the first time around, go back and make yourself a better one. Everybody really ought to have several histories.
Janet: How would you do that?
Directly. You can say «Look, you're a talented guy, but you don't know where you came from. Where would you like to have come
from?»
Janet: This is an unsophisticated farmer.
That makes it easier. The toughest of all clients to deal with are sophisticated psychotherapists, because they think they have to know every step of what you are doing. They have nosy conscious minds.
In the book Uncommon Therapy a case is described in which Milton Erickson built a set of past experiences for a woman. He created a history for her in which he appeared periodically as the «February Man.» That case is an excellent source for studying the structure of creating alternate personal histories.
Fred: Is schizophrenia another example of sequential incongruity and dissociation?
People diagnosed as schizophrenic usually have certain aspects of themselves which are severely dissociated. However, the dissociation is generally simultaneous. For example, a schizophrenic may hear voices and think the voices come from outside of himself. The voices are dissociated, but both «parts» of the person are present at the same time.
Fred: OK. I have been working with schizophrenics for a long time. I have been using some of your techniques, but not as efficiently or precisely as I would like. What particular adjustments would you suggest with so–called schizophrenics?
From the way you phrased your question, I take it you've noticed that some people who are classified schizophrenic don't manifest the symptoms which other people with that label have. There are two ways in which working with a schizophrenic is different from working with any of the people here in this room.
One is that people labeled schizophrenic live in a different reality than the one most of us agree upon. The schizophrenic's reality is different enough that it requires a lot of flexibility on the part of the communicator to enter and pace it. That reality differs rather radically from the one that psychotherapists normally operate out of. So the issue of approach and rapport is the first difference between dealing with the so–called schizophrenic, and someone who doesn't have that label. To gain rapport with a schizophrenic you have to use all the techniques of body mirroring and cross–over mirroring, appreciating the metaphors the schizophrenic offers to explain his situation, and noticing his unique nonverbal behavior. That is a very demanding task for any professional communicator.
The second difference is that schizophrenics—particularly those who are institutionalized—are usually medicated. This is really the most difficult difference to deal with, because it's the same situation as trying to work with an alcoholic when he's drunk. There's a direct contradiction between the needs of psychiatric ward management and the needs of psychotherapy. Medication is typically used as a device for ward management. As a precondition to being effective in reframing, I need access to precisely the parts of the person that are responsible for the behaviors I'm attempting to change. Until I engage those parts' assistance in making alterations in behavior, I'm spinning my wheels— I'm talking to the wrong part of the person. The symptoms express the part of the person that I need to work with. However, the medications considered appropriate in a ward situation are just the medications which remove the symptoms and prevent access to that part of the person.