PCT/MOL version of an old joke and the role of the therapist

[David Goldstein (2009.06.29.18:02)]

Question: How many Psychologists does it take to change a light bulb?

Answer: One! However, that is true only if the light bulb wants to change.

PCT/MOL version: How many Psychologists does it take to change a light bulb?

PCT/MOL answer: Zero! The light bulb changes itself if it wants to and the Psychologist doesn’t get in the way.

Then, what is the role of the therapist? Today my colleague Dr. Gary Padover coined the phrase “reorganizer facilitator” or RF.

The therapist can help the person to self-explore in a way that the patient might not do on his/her own.

Research by Sache shows that the therapist’s comments or questions can have the result of the patient going up, staying the same or going down levels.

If I ask you: How many words did I misspell in this email, you would have to go down a level.

If I ask you: Do you think the PCT/MOL version of the old joke is funny?, you would go up a level.

So, while the therapist can’t cause the patient to change in any specific way, the therapist can help the patient make changes by the questions and comments and nonverbal actions which he/she asks, especially if the patient is focusing on areas of life which are not satisfactory.

PCT/MOL version: How many
Psychologists does it take to change a light bulb?

PCT/MOL answer: Zero! The light bulb changes itself if it wants to and
the Psychologist doesn’t get in the way.
[From Bill Powers (2009.06.30.0647 MDT)]

David Goldstein (2009.06.29.18:02)

···

Then, what is the role of the
therapist? Today my colleague Dr. Gary Padover coined the phrase
“reorganizer facilitator” or RF.

The therapist can help the person to
self-explore in a way that the patient might not do on his/her own.

Let’s make that “Facilitator of reorganization,” since it’s
still the client who does the reorganizing.

Research by Sache shows that the
therapist’s comments or questions can have the result of the patient
going up, staying the same or going down levels.

Yes, that was an interesting article (you showed it to me) and it rings
true with what happens in MOL sessions. Another way to see this is that
it must be the patient who leads up or down levels while the therapist
follows; if the therapist leads too much, he will fail to see where the
patient wants to go and will drag the patient in the wrong direction. I
suppose that a really experienced MOL patient will stop the therapist and
say, “No, not that way, THIS way.” But a really experienced MOL
patient probably doesn’t need the therapist any more.

If I ask you: How many words did I
misspell in this email, you would have to go down a level.

If I ask you: Do you think the
PCT/MOL version of the old joke is funny?, you would go up a level.

Nice.

So, while the therapist can’t cause
the patient to change in any specific way, the therapist can help the
patient make changes by the questions and comments and nonverbal actions
which he/she asks, especially if the patient is focusing on areas of life
which are not satisfactory.

Very clear. How about comparing this approach with more traditional ways
of doing therapy? What do traditional therapists think they are doing
that will help the patient? Is there any theory behind such
methods?

Best,

Bill P.

bill. thanks for the fine tuning on the term facilitator of reorganization. It makes sense conceptually and in application. also appreciate your recent comments with davids clarifications and support i am beginning to understand the big picture of pct and mol. all the best.gary p.

[From Rick Marken (2009.06.30.0920)]

Bill Powers (2009.06.30.0647 MDT)--

David Goldstein (2009.06.29.18:02) --

If I ask you: How many words did I misspell in this email, you would
have to go down a level.

If I ask you: Do you think the PCT/MOL version of the old joke is
funny?, you would go up a level.

Nice.

I agree. Very nice David.

So, while the therapist can't cause the patient to change in any specific
way, the therapist can help the patient make changes by the questions and
comments and nonverbal actions which he/she asks, especially if the patient
is focusing on areas of life which are not satisfactory.

Very clear. How about comparing this approach with more traditional ways of
doing therapy? What do traditional therapists think they are doing that will
help the patient? Is there any theory behind such methods?

Again, I agree completely. Nicely put David. And I would also like to
hear what traditional therapists think they are doing and what theory
informs their doings.

Best

Rick

···

--
Richard S. Marken PhD
rsmarken@gmail.com

[From Bill Powers (2009.06.30.1416 MDT)]

bill. thanks for the fine tuning on the term facilitator of reorganization. It makes sense conceptually and in application. also appreciate your recent comments with davids clarifications and support i am beginning to understand the big picture of pct and mol.

Excellent. We need you Big Picture guys. When you're ready, how about writing us a piece on PCT, MOL, and psychodynamics? There are obviously going to be differences, and we need the view of people who have been insiders in other approaches, yet who are "getting it" with respect to PCT. What are the similarities and differences? What does PCT (or MOL) add, if anything? What can we say to analysts that might help them see the big picture, too? Have you had any thoughts about writing about PCT for publication?

Best,

Bill P.

···

At 09:35 AM 6/30/2009 -0400, Gary Padover wrote:

Bill. You must be reading my purposeful mind. As dr. david goldstein knows my interest is in applying pct and mol priniciples and applications to family therapy. As you know despite the fact that a family biologically is not an organism i define a family as a self correcting closed feedback loop system with homeostatic and rheostatic properties. also i define client centered and humanistic existential principles as compatible with mol applications and in both the psychologist is a facilitator of reorganization. Families have error signals and disturbances usually verbalized by the parents in my experience as a psychologist. Look forward to your feedback. All the best. Gary p.

[From Bill Powers (2009.07.01.0835 MDT)]

GP: As you know despite the fact that a family biologically is not an organism i define a family as a self correcting closed feedback loop system with homeostatic and rheostatic properties. also i define client centered and humanistic existential principles as compatible with mol applications and in both the psychologist is a facilitator of reorganization. Families have error signals and disturbances usually verbalized by the parents in my experience as a psychologist. Look forward to your feedback.

BP: Let's be careful about metaphors; they can be misleading. The family may act as a single control system sometimes, but that's when everything is working well. What happens when the husband's concept of "wife" is different from the wife's concept? Does the family self-correct errors of that kind? If so, whose reference level determines the definition of zero error? When a family has an error signal, is it the same error signal in every member of the family? When the parents agree that a teenager's staying out all night constitutes an error signal for them, does the teenager agree?

It seems probable to me that family difficulties can arise when the members have different perceptions and different reference levels, which can lead to conflict between the members. And resolving such interpersonal conflicts may require looking into the internal conflicts each person has, such as "I love my dad and want him to approve of me so I won't do anything to hurt him, but I have to have my freedom and self-respect so I don't want him controlling me."

This may look much like an individual's kind of problem, except that each individual has to reorganize for separate reasons. But perhaps you have gone further into this than I have done (wouldn't be surprised!), so what's your view?

Best,

Bill P.

···

At 05:03 PM 6/30/2009 -0400, Gary Padover wrote:

Bill. You have restated the dynamics consistently with the way i have come to understand pct mol and systems family therapy. I think an article describing these phenomena is a good place to begin. I also think that the family has a perceptual range and tolerance for disturbances and error signals as well as individual family members. Hence the gestalt notion of the whole being greater than the sum of its parts applies to families and their capacities for reorganization. The psychologist becomes the facilitator of reorganization for the family perception which has its own error signals and disturbances which are greater than the sum of the individual family members error signals and disturbances. Hence each family member has both an individual and family reorganization process which takes place very much like our biology. Our human anatomy reorganizes at hierarchical levels with the organs reorganizing as well as the biological systems. Best always and i welcome your feedback. Thx bill. gary p.

[From Bill Powers (2009.07.01.2143 MDT)]

Bill. You have restated the dynamics consistently with the way i have come to understand pct mol and systems family therapy. I think an article describing these phenomena is a good place to begin. I also think that the family has a perceptual range and tolerance for disturbances and error signals as well as individual family members. Hence the gestalt notion of the whole being greater than the sum of its parts applies to families and their capacities for reorganization.

My problem with this is that it's metaphorically true, but not literally true. A family of N members consists of N interacting but otherwise totally independent control systems, all with the same number of potential or actual levels of organization, and no one person being able to adjust the reference signals or experience the perceptions inside another member of the family. For one member to influence another requires communicating through the lowest level of perception or directly, physically, interacting.

This may not agree with your way of looking at it. So say more! How can there be a control hierarchy that is actually shared by different members of a family (if that's what you propose)?

Best,

Bill P.

···

At 01:35 PM 7/1/2009 -0400, Gary Padover wrote:

bill,

your feedback on this point is well taken. literally, it is quite accurate to say that each family member has individual error signals and disturbances independent of each other. while you note that the perceptual range of error signals and disturbances of a family may metaphorically be greater than the sum of its parts, it is not logically or literally possible for one member to speak for the error signals and disturbances of any other family member.

It then follows logically that one member cannot reorganize for the family; but only can reorganize within the context of his or her independent homeostatic self correcting negative feedback loop. Yet, as you noted in an earlier email on this topic, some of the principles of psychodynamic psychotherapy may be applicable and translatable here into pct and mol terms and have significant relevance.

For example, even freud referred to anxiety as an error signal and disturbance which signifies to us that an inhibition can no longer be controlled for and the function of the symptom or anxiety, is to let the person know, there is a need which is requiring satisfaction.

Moreover, family systems therapists, most notably murray bowen have described families as having their own anxieties. As a culture, as you know from engineering principles, stress has mistakenly been identified as the culprit rather than adaptive; even hans selye, the founder of the term and concept of stress, wrote of stress without “distress”.

Our culture, erroneously wants to believe that anxiety is harmful, as well as stress. Rollo May, a prominent existential psychiatrist wrote of the meaning of anxiety and noted we live despite anxiety, not without anxiety. Social learning and motivational studies know the importance of some level of anxiety as required for optimal performance. Even psycholgists know that an unmotivated client in treatment is a client with flat affect, few error signals and disturbances defined by them (not by their parents or spouses) and absent minimal anxiety for growth.

Again, the organism, as you are aware, depends on stress as a kind of error signal and disturbance with reference to a comparator, as in the pct model you have founded and taught to so many. Another way, therefore, to look at families is to say that families purposively seek out those members it can to identify as the sources of stress (which subjectively may be defined as “distress”). I say subjectively as there is a perceptual range of family disturbance beyond which is intolerable and becomes identified by a family member(s) and then becomes the family problem with a designated family member as the symptom.

Families scapegoat to reduce each member’s own sense of guilt, anxiety, and responsibility. Systems scapegoat (institutions, governments, corporations, schools), as any real analysis of how systems function would indicate. In psychodynamic terms, we know individuals displace their frustration. For example, at the residential center here in vineland where i consult and where dr. david goldstein is clinical director, residents may be disappointed they cannot get home visits, so they fight with other residents. Individuals project qualities onto others of which they are ashamed in themselves. As humans, functioning in a social context, errors and disturbances, or in psychodynamic terms anxiety are perceived and externalized onto others.

In the 1950’s -1980’s it was the zeitgeist to refer to the chosen or designated family error and disturbance as the “scapegoated” or “index patient”. So, in the context of all families having their unique anxieties, there is, to my way of understanding families, a perceptual range of tolerable error signals and disturbances, beyond which a designated family member becomes the “symptom” or “disturbance”.

Families enter counseling when their perceptual range is “out of whack” and the error signals and disturbances are beyond the perceptual range which is tolerable. Hence, a mother will seek counseling for a 14 year old son who does not listen and stays out too late; a father or mother will seek counseling for an 11th grade high school son or daughter who is failing high school; a mother wants to bring her 9 year old son in to counseling because all he wants to do is play video games. According to one or more family members (typically a parent) the family’s homeostasis is thrown off balance. Yet, the referral is individual in nature. “My son has an anger problem.” “My daughter is not listening to me.” “My husband and I disagree on how to discipline our 15 year old daughter.”

I like to metaphorically refer to the “see saw” or “teeter totter” of the family as severely out of alignment. Its homeostasis needs adjustment. It is self correcting, by definition, when the family reorganizes around NOT making the designated family “error” member the “symptom”.

At that point, the family therapist, in my experience the psychologist becomes the facilitator of reorganization, so the family can reorganize and the family once again comes within the perceptual range of manageable error signals and disturbances or in psychodynamic terms manages its anxiety without making an individual family member an error, disturbance, or symptom. There is a family realignment and reorganization with new definitions of purpose in each family member and the family system.

If in a family, as so often occurs in our culture, parents have to learn how to set limits and appropriately, without violence, enforce rules, hierarchical issues of parenting require reorganization. This was the approach of structural family therapists, of whom salvador minuchin was the most prominent.

What happens in effective family therapy and explored is the perception of each individual family member and how it contributes to the family perception. In reality, the family perception, which as you noted bill can only exist metaphorically, controls the family’s behaviors, which is designed to “scapegoat” in its search for the cause of the family disturbance and distress.

the facilitator of reorganization, in my experience the psychologist, is mindful how the family uses the symptom to justify its error signals and disturbances. To understand family therapy in pct and mol terms then, requires the question be asked “what is the function of the disturbance?” In family therapy terms the question is “what is the function of the symptom?” Hence, disturbance (pct) = symptom (family therapy). Moreover, in family therapy, typically, the family focuses on attributing the disturbance to one member as the causal agent or the designated or scapegoated family member.

In other words, which family member is the carrier of the error signal, disturbance, and family anxiety? What is the 9 year old son doing to upset mom? How is the 15 year old son or daughter failing high school causing distress in mom and dad? Are their behaviors, which cause such distress in their parents, purposeful?

Here is where the purposeful behavior of each individual family member needs to be understood as a self correcting closed negative feedback loop. Hence, family therapy is really about the perceptions of each N as an independent, individual family member and N.1…N2…N3…N4… or the family perception. Is it a metaphor or does a family perception exist? If it does exist, what is its purpose?

What is the purposeful behavior, moreover, of the “victimized” family member (ie. child or parent)? Are they looking for error signals and disturbances? Are they creating error signals and disturbances and attributing the disturbance to another individual family member, eventually impacting that member’s perceptual experience, altering that individual family member’s purposeful behaviors? What about the error signal of a deprived, neglected or abused child? Who speaks for the child’s error signals and disturbances? Where is a child’s comparator and referent? How is the concept “blaming the victim” translated into pct and mol terms?

The therapeutic question asked in strategic family therapy, for example, jay haley’s contributions as well as milton erickson is what is the function of the symptom? The question i would add, however, is not only what is the function of the symptom, but what is the purpose behind choosing the particular independent family member as the bearer of that disturbance or symptom.

that’s how i see families functioning bill. i welcome this discussion with you and appreciate your feedback and comments. as dr. david goldstein has been aware for a while, this is my real area of interest in psychology and i do want to write and publish on the conceptual bridge between pct, mol, psychodynamic, and family therapy.

all the best bill. gary p.

···

Make your summer sizzle with fast and easy recipes for the grill.

[From David Goldstein (2009.07.03.10:51 EDT)]

[About Gary Padover (2009.07.02.02:23 EDT)]

Family Therapy from a PCT/MOL Viewpoint

Perhaps talking about an actual case would be useful.

This case involved a 12-year-old boy who lives with his single mother and maternal grandmother. Before he came to me, he had been diagnosed as ADHD and was taking a lot of medication to address this. Typically, I speak to him individually and then call in the mother for a family session. The grandmother has never attended a session. The mother is a blue collar worker and has been out of work for a while until recently, which is why they were living with the grandmother. The boy has blond hair, a slender build, wears glasses, has braces, and has a mild articulation problem. He is funny and intelligent and reminds me in looks of Dennis the Menace on TV. He is doing pretty will in school in terms of grades.

In the beginning of our sessions, the mother identified the problem as ‘his room’. It was messy, had left over food items in it, and had clothes strewn around the room. The mother was receiving a lot of grief from the grandmother, who she described as ‘emotionally abusive’ when she was growing up, and who keeps on asking “When will you two be leaving?”

The messy room was not a problem for the boy. However, he did want “peace in the house” and was willing to work on it. It took several weeks, but the boy has discovered some strategies to help him keep the room in an acceptable state. This issue seems to have moved into the background.

A new identified problem area became “his disrespectful” attitude when a friend was over the house. He was unaware that his mother perceived it this way. He doesn’t want to be disrespectful to his mother who expresses her love for him and does a lot for him. Example: He and a friend were having a catch next to the house. The mother then started talking to a neighbor woman and the boys had to stop for a while because she was standing in their ‘ballfield.’ He said some things to her which embarrassed her. The purpose of his comments was to hurry her up. The boys were becoming inpatient. I am not sure about the status of this problem at the current moment.

Now the latest problem is ‘his lying’. He lies about “stupid stuff” in his words. For example, his grandmother gave him the directive that he should “Eat only snacks that were open.” He went into the garage, opened a snack and brought it into the house. The grandmother caught him, accused him of disobeying, and then yelled at him. He lied about doing it. He says it is “an old habit” and is “like a reflex.” His mother reports that it has been a problem from about the age of 6. The problem of “lying” seems to be his way of coping with being caught at disobeying his grandmother and mother. He wants something and then takes action without thinking about the consequences. He becomes tearful when he becomes criticized for lying and disobeying. He does think that his mother and grandmother are over-controlling.

The problems in this case were identified by the mother, who was being given grief by the grandmother. There is interpersonal conflict between the mother and grandmother, between the mother and boy and between the boy and his grandmother. The boy is the one who is being asked to change by the mother and grandmother. However, the mother is also being encouraged to change by the therapist in specific ways (for example, providing more direct help and guidance with his room; setting up a system for eating snacks, looking for their own place to live). The PCT approach is recognizing that the ‘misbehaviors’ are purposeful. Then the therapist attempts to help the family resolve the interpersonal conflicts. It seems like a good idea to have individual therapy with the ‘identified’ patient, using the MOL Therapy, approach prior to the Family Therapy. This helps to identify the purpose of the boys ‘misbehavior.’

David

···

Perhaps talking about an actual
case would be useful.
[From Bill Powers (2009.07.03.0943 MDT)]

David Goldstein (2009.07.03.10:51
EDT) –

This case involved a 12-year-old boy
who lives with his single mother and maternal grandmother. Before he came
to me, he had been diagnosed as ADHD and was taking a lot of
medication to address this. Typically, I speak to him individually and
then call in the mother for a family session. The grandmother has never
attended a session. The mother is a blue collar worker and has been out
of work for a while until recently, which is why they were living with
the grandmother. The boy has blond hair, a slender build, wears glasses,
has braces, and has a mild articulation problem. He is funny and
intelligent and reminds me in looks of Dennis the Menace on TV. He is
doing pretty will in school in terms of grades.

In the beginning of our sessions, the
mother identified the problem as ‘his room’. It was messy, had left over
food items in it, and had clothes strewn around the room. The mother was
receiving a lot of grief from the grandmother, who she described as
‘emotionally abusive’ when she was growing up, and who keeps on asking
“When will you two be leaving?”

The messy room was not a problem for
the boy. However, he did want “peace in the house” and was willing to
work on it. It took several weeks, but the boy has discovered some
strategies to help him keep the room in an acceptable state. This issue
seems to have moved into the background.

I’m not clear as to whose problems were being addressed here (though
later you say the mother defined them). Were these therapy sessions aimed
at helping the people learn to cope better in general, or were you acting
more as a referee or advisor trying to help settle disputes among the
participants? What you describe are details of the disputes, but nothing
is said about how the individuals were trying to solve them, or what they
would consider a solution to be. What lies behind saying that the boy
“was willing to work on it?” That sounds as if someone were
trying to get a committment from the boy to keep his room neater, and
managed to get the boy to agree. Is that what the boy saw as the problem,
and its solution? Or was the boy’s agreement sought mainly as a way of
addressing the mother’s problem?

When you “typically” speak to the boy individually, what is the
objective of the dialogue? Is it to make the boy’s behavior more
acceptable to his mother or grandmother, more “socially”
acceptable? What did the boy say the problem was that he wanted to see
solved?

A new identified problem area became
“his disrespectful” attitude when a friend was over the house. He was
unaware that his mother perceived it this way. He doesn’t want to be
disrespectful to his mother who expresses her love for him and does a lot
for him. Example: He and a friend were having a catch next to the house.
The mother then started talking to a neighbor woman and the boys had to
stop for a while because she was standing in their ‘ballfield.’ He said
some things to her which embarrassed her. The purpose of his comments was
to hurry her up. The boys were becoming inpatient. I am not sure about
the status of this problem at the current moment.

That sounds much like the way an adult would describe the adult’s problem
with the boy’s behavior or attitude. Did the adult in question say
anything about why this was a problem? What does being
“respectful” imply? Did the mother see anything disrespectful
about interrupting the boys’ ball playing to speak to her neighbor? Did
that have anything to do with what the boy said to her that embarrassed
her? What conflict was behind the embarrassment?

The problem with these case descriptions is that they tend to report only
superficial appearances, while often revealing social or cultural biases
of which the people involved, and the reporter, are unconscious. Is there
anything unusual, in terms of MOL, about accepting the mother’s
definition of the boy’s problem? Is it always the child who is called on
to conform or change behavior? What reason does the grandmother give for
wanting her daughter and grandson to move out?

Now the latest problem is ‘his
lying’… His mother reports that it has been a problem from about the
age of 6. The problem of “lying” seems to be his way of coping with being
caught at disobeying his grandmother and mother.

You describe the mother’s problem, but again, not the boy’s. His choice
seems to be between obeying and being yelled at; how does he describe his
reason for lying? What does the lying accomplish, when it works?

He wants something and then
takes action without thinking about the consequences. He becomes tearful
when he becomes criticized for lying and disobeying. He does think that
his mother and grandmother are over-controlling.

Is that what they do? Does he really not think about the consequences, or
does he think about them and hope he can avoid them? Does he wish he
didn’t have to lie? If so, why? Do you think the boy shouldn’t lie? Is it
OK that the adults yell at him for disobeying? Do you think the boy
should always obey?

The problems in this case were
identified by the mother, who was being given grief by the
grandmother.

Does that mean you accepted the identification?

There is interpersonal conflict
between the mother and grandmother, between the mother and boy and
between the boy and his grandmother. The boy is the one who is being
asked to change by the mother and grandmother. However, the mother
is also being encouraged to change by the therapist in specific ways (for
example, providing more direct help and guidance with his room; setting
up a system for eating snacks, looking for their own place to live). The
PCT approach is recognizing that the ‘misbehaviors’ are purposeful. Then
the therapist attempts to help the family resolve the interpersonal
conflicts. It seems like a good idea to have individual therapy with the
‘identified’ patient, using the MOL Therapy, approach prior to the Family
Therapy. This helps to identify the purpose of the boys
‘misbehavior.’

But doesn’t it also endorse the idea that it is misbehavior? Perhaps the
one who needs MOL more is the mother, or the grandmother.

I think that trying to help a family resolve interpersonal conflicts
inevitably drives the therapist into a position of taking sides,
especially when everyone is involved is making one family member the
scapegoat for the failings of others (as Gary Padover would put it). The
therapist then simply joins in the scapegoating.

What I see in the above case description is a myriad of internal
conflicts. The grandmother, I’m sure, loves having her family with her,
and hates it at the same time (and possibly can’t afford it). The mother
wants her mother to love her but thinks she is abused instead. The boy
wants peace in the family, but not at any price. Each person needs to
resolve these conflicts (or whatever they really are, which has to be
explored) and figure out how to live with the others even if the others
don’t change. When each person resolves the inner conflicts, the external
conflicts will take care of themselves. The solutions are too obvious
even to be interesting. The only real question is why the people involved
haven’t already found solutions. And the answer is not in any solution,
but in the fact that all the participants are stuck in private
conflicts.

With MOL we would ignore most of the details in the case description, and
go directly for the conflicts that need to be resolved. It doesn’t matter
what they are about; that’s essentially irrelevant. What’s important is
to find and examine the internal conflicts that keep each person locked
in conflict with the others.

Best,

Bill P.

[David Goldstein (2009.07.03.16:22 EDT)]

[About Bill Powers (2009.07.03.0943 MDT)]

The therapist has to ‘join the family’, be accepted. If I tried to disagree too much with the goals that the mother chose, she would have likely ended the therapy as not being relevant. I did say that the boy accepted that he was being asked to make some changes. I also said that I was encouraging the mother to make some changes too. I am sure that this is different than she had in mind. Her expectation was that I ‘would fix her son so that he would be more obedient.’

The boy’s basic conflict is: he wants, and doesn’t want, to listen to his mother and grandmother. Not such a surpising conflict for someone transitioning between being a child and being a teenager.

The mother’s conflict is: she wants to leave, and not leave her mother’s house.

I don’t know the grandmother well enough to say what her internal conflict is.

I gave some details just so that you would get a better picture of the case. Sorry if it bored you.

David

bill,

once again, good to review your comments; this time on a case dr. david goldstein has posted, which he and i also discussed briefly.

i agree that often the interpersonal conflicts require the parents and, in this case, the grandparent to look at the conflicts intergenerationally, as well as take a good look at their error signals, disturbances, comparators, and references.

i agree mol is a likely method to work on interpersonal conlicts in individual sessions. in fact, as i recently indicated to dr. david goldstein, i am working more these days with individual teenagers and approaching treatment with more of the “mol attitude”.

after doing this kind of work for over 30 years bill, my seasoning, mindfulness, and verbal clarifications have helped me to avoid “colluding” in the family’s scapegoating, for reasons to which you have referred. moreover, i do not believe collusion in “scapegoating” by the psychologist necessarily has to occur.

in fact, while carl whitaker, a prominent existential family therapist with a medical orientation would have observed, while the psychologist joins the family, i believe he too would have defined the psychologist, in my experience, as the “facilitator of reorganization” without colluding in the family’s “pathos”. as my last post indicated, i would look at the function of the “scapegoating” by the family. usually, there are underlying interpersonal conflicts among spouses and siblings, for which the “scapegoating” is simply a kind of avoidance.

although david has suggested working individually, initially, with the youngster, i prefer to gain a contextual understanding of the interpersonal conflicts, so i usually refrain from any hardfast rule of necessarily working with the “index” patient first, although initial intake assessments require me to focus on the referral reasons, again referred to in my earlier post, as parent driven, and usually involving the “index” patient as the problem.

occasionally, youngsters will ask their parents to take them to counseling to talk about something bothering them. while that is less frequent, in my experience, it does occur, and as i noted on an earlier post, a good indicator that there is motivation for treatment and/or the youngster may have insight into him or herself as well as the interpersonal family conflicts. sometimes, these referrals want to grow up and become psychologists.

btw, an informal clinical observation over the years has led me to the conclusion that the “index” patient, when siblings are involved, may very well be the child the parent has chosen to bring into counseling either due to a very powerful bond the referring parent has with the "index’ patient, despite the conflict, and/or again because paradoxically the “index” patient may be less resistant, despite all their identified problems, then another sibling may be. The maxim i have learned in providing treatment is “things aren’t always what they may appear to be.”

i do structure, however, later entry of siblings into the session with the parents and “index” patient with the permission of the parents and with a discussion with the parents and the “index” patient of how entry into the therapy by siblings will help everyone (ie. the family and the psychologist) better understand the family conflicts and, in effect, actually does take the “index” patient off the “hotseat”, which the “index” patient eventually comes to appreciate.

looking forward to continuing this discussion on the “mol attitude” and family therapy, as well as the conceptualization and application of pct and mol principles, theories, and practice to family therapy.

have a good holiday weekend bill and, as always, wish you the best and look forward to your comments and feedback.

gary p.

···

Make your summer sizzle with fast and easy recipes for the grill.

[From Bill Powers (2009.07.03.1709)]

GP: once again, good to review your comments; this time on a case dr.
david goldstein has posted, which he and i also discussed briefly.

i agree that often the interpersonal conflicts require the parents and,
in this case, the grandparent to look at the conflicts
intergenerationally, as well as take a good look at their error signals,
disturbances, comparators, and references.

i agree mol is a likely method to work on interpersonal conlicts in
individual sessions. in fact, as i recently indicated to dr. david
goldstein, i am working more these days with individual teenagers and
approaching treatment with more of the “mol
attitude”.

after doing this kind of work for over 30 years bill, my seasoning,
mindfulness, and verbal clarifications have helped me to avoid
“colluding” in the family’s scapegoating, for reasons to which
you have referred. moreover, i do not believe collusion in
“scapegoating” by the psychologist necessarily has to
occur.

BP: I agree, it doesn’t. But I think it’s much less likely to occur if
the therapist doesn’t involve himself in solving the family’s problems,
which inevitably requires walking a tightrope between the
conflicting interests of the various participants. In MOL the emphasis is
not on resolving the conflicts or solving the problems, but on enabling
the participants to find out what aspects of the problems are important
to each of them, and to encourage dwelling on those aspects while
reorganizing. It should not matter to the therapist what solution is
found. And if the participants do their own reorganizing instead of
following recommendations from someone else (however wise and
experienced), they are likely to find the results more satisfying and
permanent.

David, it’s not that the process is boring, it’s that the particular
problem and its solution is never very complicated or unique (except for
trivial details). If a child’s messy room offends the mother, an
effective solution is for the child to clean up the room. That doesn’t
take a brain surgeon to figure out. The hardest part is for the child to
work through issues of pride and culture to figure out how to give in and
clean up the room, and/or for the uptight mother to admit that perfect
order in a 12-year-old’s room is a pretty unrealistic demand. The whole
problem is not the possible solutions, which are all pretty obvious, but
how to get each person into a position where the obvious can be accepted.
And that is why we have to investigate conflicts, not solve problems. The
answer to the question, “Why not do the obvious?” (once the
person honestly looks for an answer to ‘why not’ and finds it) takes you
into the core of the problem where changing something can fix it. It
solves itself.

in fact, while carl whitaker, a
prominent existential family therapist with a medical orientation would
have observed, while the psychologist joins the family, i believe he too
would have defined the psychologist, in my experience, as the
“facilitator of reorganization” without colluding in the
family’s “pathos”. as my last post indicated, i would
look at the function of the “scapegoating” by the family.
usually, there are underlying interpersonal conflicts among spouses and
siblings, for which the “scapegoating” is simply a kind
of avoidance.

Yes, I agree. But my agreement is irrelevant, since the important thing
is for the participants to find their own understanding of what is going
on, and resolve their own private conflicts about what to do about it.
Notice that I don’t say “find their own solutions.” Every
solution will be a little different even if the problems look similar,
and the only solutions that will stick are those invented by the
partcipants. Which they will do, oh ye of little faith, if you just give
them the chance to do it.

although david has suggested working
individually, initially, with the youngster, i prefer to gain a
contextual understanding of the interpersonal conflicts, so i usually
refrain from any hardfast rule of necessarily working with the
“index” patient first, although initial intake assessments
require me to focus on the referral reasons, again referred to in my
earlier post, as parent driven, and usually involving the
“index” patient as the problem.

I agree that no hard and fast rule can work. Each person is going to see
the others are part of the problem, so unless the parents gang up on a
child, there will be no agreement on what the problem is, much less a
solution. This is why each person has to reorganize, perhaps while
contemplating questions from the therapist like, “What if grandma
never changes? Does that mean you can never be happy?”

occasionally, youngsters will ask
their parents to take them to counseling to talk about something
bothering them. while that is less frequent, in my experience, it does
occur, and as i noted on an earlier post, a good indicator that there is
motivation for treatment and/or the youngster may have insight into him
or herself as well as the interpersonal family conflicts. sometimes,
these referrals want to grow up and become
psychologists.

If your experiences are like those of other therapists I have known, and
like mine, the presenting problem is mostly likely to be someone else’s
bad habits, not one’s own. But the changes needed to resolve one person’s
problems do not take place inside another person. They represent changes
in perceptions, goals, and methods of one’s own.

btw, an informal clinical observation over the years has led me to the
conclusion that the “index” patient, when siblings are
involved, may very well be the child the parent has chosen to bring into
counseling either due to a very powerful bond the referring parent has
with the "index’ patient, despite the conflict, and/or again because
paradoxically the “index” patient may be less resistant,
despite all their identified problems, then another sibling may be. The
maxim i have learned in providing treatment is “things aren’t always
what they may appear to be.”

An excellent principle, which I cast in the form of advice to the
therapist: don’t be afraid to ask a dumb question. The mother says,
“He just drops his clothes anywhere and never puts anything away,
and lives like a pig.” The wise therapist asks, “What is it
about this that bothers you?”

looking forward to continuing this
discussion on the “mol attitude” and family therapy, as well as
the

conceptualization and application of
pct and mol principles, theories, and practice to family
therapy.

I hope you don’t mind my speaking as if I had years of experience as a
therapist. But my thoughts are based on sonme experiencem, and what
I believe is a sound theoretical basis, and are consistent with only a
few basic principles like the idea that only the person with a problem
can do the necessary reorganizing. If I don’t sound too presumptuous for
your taste, I like these discussions, too.

Best,

Bill P.

···

At 05:06 PM 7/3/2009 -0400, Gary Padover wrote:

bill,

thanks for your timely and very helpful comments as i “reorganize” around the practice of family psychology now, evermore mindful of pct and mol concepts.

each time you elaborate, i review these discussions initially and then more carefully, while integrating and reorganizing my thoughts around my style of working with families.

i also am glad dr. david goldstein, who, as you know, along with you, has opened my eyes to pct and mol, as you both have enhanced my understanding, was able to post a real life case. david and i had reviewed this case together after he wrote it up. i felt it was a very realistic and well written representation of what i also see in my practice.

you may or may not know bill that i like to think of myself as always seeking to learn more about the field of psychology. as david is aware, my focus is more experiential and less hard data based than he is. in my attending of conferences and readings of professional articles and journals, besides the csgnet and the works of the practicing psychologists doing mol in australia, david, to my knowledge is the only psychologist in this country doing actual data based n=1 research and publications in mol therapy.

both david and i have had much of the discussion which has been posted on this csgnet site the past few days on family therapy. in fact, i recall the conversation with david when he told me the neo revisionist light bulb joke, whereby, according to the principles and practice of mol no psychologist would be needed to “change the light bulb”, as you consistently have indicated bill, most recently, in this posting.

btw, (ATT. dr. david goldstein) david, i found an interview online with dr. lorna benjamin about her interpersonal reconstructive therapy and work with personality disorders. i believe this is the psychologist you told me about the other day. she did her dissertation with harry harlow on thumb sucking in the psychoanalytic context (i certainly can relate to that).

interestingly dr. lorna benjamin was supervised while at univ. of wisconsin by carl rogers for a half a year of supervision. moreover, carl whitaker, who was at the univ. of wisconsin in the dept. of psychiatry was a colleague of lorna benjamin’s.

i continually am fascinated by carl whitaker’s approach since i was introduced initially to his style and by a friend and teacher, joe horvat, recently deceased, of whom i have spoken to you about on several occasions david. when i studied at family insti. of phila. i was able to view lots of taped therapy sessions by carl whitaker.

i believe the postings over the past few days have really helped me. i guess my light bulb really wanted to change.

many thanks to you, bill, the csgnet group, and david, who has been a support to me for the past 12 years.

enjoy the 4th.

look forward to more discussions of this nature.

best,

gary p.

···

Make your summer sizzle with fast and easy recipes for the grill.

[From Rick Marken (2009.07.03.1820)]

Bill Powers (2009.07.03.1709)--

David, it's not that the process is boring, it's that the particular problem
and its solution is never very complicated or unique (except for trivial
details). If a child's messy room offends the mother, an effective solution
is for the child to clean up the room. That doesn't take a brain surgeon to
figure out. The hardest part is for the child to work through issues of
pride and culture to figure out how to give in and clean up the room, and/or
for the uptight mother to admit that perfect order in a 12-year-old's room
is a pretty unrealistic demand. The whole problem is not the possible
solutions, which are all pretty obvious, but how to get each person into a
position where the obvious can be accepted. And that is why we have to
investigate conflicts, not solve problems. The answer to the question, "Why
not do the obvious?" (once the person honestly looks for an answer to 'why
not' and finds it) takes you into the core of the problem where changing
something can fix it. It solves itself.

For some reason, this simple little paragraph helped enormously. I
think I've understood the basic idea of MOL for some time but I also
think I tended to "over-complexitize" how conflict-resolution actually
works. This little paragraph really made it clear (and also cleared up
all the problems in my life, so thanks for that, too;-)

If I don't sound too presumptuous for your taste, I like these
discussions, too.

Me too.

Best

Rick

···

--
Richard S. Marken PhD
rsmarken@gmail.com

glad you have also benefitted from this discussion rick. as you have been noting, for the past decade, at least, i have been trying to factor a “pct and mol attitude” into family therapy. have a good holiday weekend and enjoy vince scully and “dodgertown.” gary p.

···

Make your summer sizzle with fast and easy recipes for the grill.

[From David Goldstein (2009.07.04.04:31 EDT)]

[About Bill Powers (2009.07.03.0943 MDT)]

I think that patients have an expectation that the therapist will see solutions to the problem that they did not see.They expect the therapist to be an active problem solving agent. In addition, not all patients want to ‘self-explore’. They just want their problems to be fixed.

By making a concrete suggestion, one often facilitates the reorganization of the patient to come up with an approach that works for them.

Take the snack problem. I suggested that the mother let the boy choose snacks, which she said would be OK with her if the boy had during the day, and put them in a box or place that the boy could go to, without asking permission. At first the mother resisted. She wanted the boy to ask her permission all the time, which he refused to do. She modified my suggestion to be ‘three snacks’ and said that if he wanted another one that he would have to ask her. The boy agreed to the mother’s proposal. In the course of the discussion, the mother explained her reasons for not wanting him to eat too many snacks. I commented that there seem to be a lot of snacks in the house. I didn’t say it, but observed that the mother was a tall, big woman, who must not be a stranger to eating snacks.

I don’t know how well this is going to work. They came up with the final solution, I didn’t. Why they didn’t come up with a solution, I don’t know. The mother probably didn’t have a model of a parent who could talk to her child in a problem solving way.

It is interesting to me that the messey room problem seems to have faded into the background (seems reorganized).

I have made suggestions, or taken points of view, that patients did not like. There is also a danger that they will end therapy. One case involved two teenage boys who were not doing their school assignments and were not doing well in school because of this. The mother, who was a social worker, and who viewed the boys’ actions as a failure in parenting, did not like the idea of negotiating with the boys. She was the power in the family. She stopped therapy. I was the second therapist that this family left because the mother did not like the approach. The first therapist had a more laissez-faire approach. The mother had tried her more autocratic approach, and it failed. I would like to hear what happened to this family and how they eventually reorganized.

In short, there is a danger that a patient will end therapy if the therapist does too little (in the patient’s experience) or too much. The MOL attitude can be interpreted as ‘doing too little’. Making some suggestions, even if not accepted, is a way that a therapist can walk this tightrope of doing too little or too much.

David

From:
Bill Powers

To: CSGNET@LISTSERV.ILLINOIS.EDU

Sent: Friday, July 03, 2009 12:50 PM

Subject: Re: PCT/MOL version of an old joke and the role of the therapist

Perhaps talking about an actual case would be useful.

[From Bill Powers (2009.07.03.0943 MDT)]

David Goldstein (2009.07.03.10:51 EDT) –

This case involved a 12-year-old boy who lives with his single mother and maternal grandmother. Before he came to me,  he had been diagnosed as ADHD and was taking a lot of medication to address this. Typically, I speak to him individually and then call in the mother for a family session. The grandmother has never attended a session. The mother is a blue collar worker and has been out of work for a while until recently, which is why they were living with the grandmother. The boy has blond hair, a slender build, wears glasses, has braces, and has a mild articulation problem. He is funny and intelligent and reminds me in looks of Dennis the Menace on TV. He is doing pretty will in school in terms of grades.

In the beginning of our sessions, the mother identified the problem as ‘his room’. It was messy, had left over food items in it, and had clothes strewn around the room. The mother was receiving a lot of grief from the grandmother, who she described as ‘emotionally abusive’ when she was growing up, and who keeps on asking “When will you two be leaving?”
The messy room was not a problem for the boy. However, he did want “peace in the house” and was willing to work on it. It took several weeks, but the boy has discovered some strategies to help him keep the room in an acceptable state. This issue seems to have moved into the background.

I’m not clear as to whose problems were being addressed here (though later you say the mother defined them). Were these therapy sessions aimed at helping the people learn to cope better in general, or were you acting more as a referee or advisor trying to help settle disputes among the participants? What you describe are details of the disputes, but nothing is said about how the individuals were trying to solve them, or what they would consider a solution to be. What lies behind saying that the boy “was willing to work on it?” That sounds as if someone were trying to get a committment from the boy to keep his room neater, and managed to get the boy to agree. Is that what the boy saw as the problem, and its solution? Or was the boy’s agreement sought mainly as a way of addressing the mother’s problem?

When you “typically” speak to the boy individually, what is the objective of the dialogue? Is it to make the boy’s behavior more acceptable to his mother or grandmother, more “socially” acceptable? What did the boy say the problem was that he wanted to see solved?

A new identified problem area became “his disrespectful” attitude when a friend was over the house. He was unaware that his mother perceived it this way. He doesn’t want to be disrespectful to his mother who expresses her love for him and does a lot for him. Example: He and a friend were having a catch next to the house. The mother then started talking to a neighbor woman and the boys had to stop for a while because she was standing in their ‘ballfield.’ He said some things to her which embarrassed her. The purpose of his comments was to hurry her up. The boys were becoming inpatient. I am not sure about the status of this problem at the current moment.

That sounds much like the way an adult would describe the adult’s problem with the boy’s behavior or attitude. Did the adult in question say anything about why this was a problem? What does being “respectful” imply? Did the mother see anything disrespectful about interrupting the boys’ ball playing to speak to her neighbor? Did that have anything to do with what the boy said to her that embarrassed her? What conflict was behind the embarrassment?

The problem with these case descriptions is that they tend to report only superficial appearances, while often revealing social or cultural biases of which the people involved, and the reporter, are unconscious. Is there anything unusual, in terms of MOL, about accepting the mother’s definition of the boy’s problem? Is it always the child who is called on to conform or change behavior? What reason does the grandmother give for wanting her daughter and grandson to move out?

Now the latest problem is ‘his lying’.... His mother reports that it has been a problem from about the age of 6. The problem of “lying” seems to be his way of coping with being caught at disobeying his grandmother and mother.

You describe the mother’s problem, but again, not the boy’s. His choice seems to be between obeying and being yelled at; how does he describe his reason for lying? What does the lying accomplish, when it works?

 He wants something and then takes action without thinking about the consequences. He becomes tearful when he becomes criticized for lying and disobeying. He does think that his mother and grandmother are over-controlling.  

Is that what they do? Does he really not think about the consequences, or does he think about them and hope he can avoid them? Does he wish he didn’t have to lie? If so, why? Do you think the boy shouldn’t lie? Is it OK that the adults yell at him for disobeying? Do you think the boy should always obey?

The problems in this case were identified by the mother, who was being given grief by the grandmother.

Does that mean you accepted the identification?

 There is interpersonal conflict between the mother and grandmother, between the mother and boy and between the boy and his grandmother. The boy is the one who is being asked to change by the mother and grandmother. However,  the mother is also being encouraged to change by the therapist in specific ways (for example, providing more direct help and guidance with his room; setting up a system for eating snacks, looking for their own place to live). The PCT approach is recognizing that the ‘misbehaviors’ are purposeful. Then the therapist attempts to help the family resolve the interpersonal conflicts. It seems like a good idea to have individual therapy with the ‘identified’ patient, using the MOL Therapy, approach prior to the Family Therapy. This helps to identify the purpose of the boys ‘misbehavior.’

But doesn’t it also endorse the idea that it is misbehavior? Perhaps the one who needs MOL more is the mother, or the grandmother.

I think that trying to help a family resolve interpersonal conflicts inevitably drives the therapist into a position of taking sides, especially when everyone is involved is making one family member the scapegoat for the failings of others (as Gary Padover would put it). The therapist then simply joins in the scapegoating.

What I see in the above case description is a myriad of internal conflicts. The grandmother, I’m sure, loves having her family with her, and hates it at the same time (and possibly can’t afford it). The mother wants her mother to love her but thinks she is abused instead. The boy wants peace in the family, but not at any price. Each person needs to resolve these conflicts (or whatever they really are, which has to be explored) and figure out how to live with the others even if the others don’t change. When each person resolves the inner conflicts, the external conflicts will take care of themselves. The solutions are too obvious even to be interesting. The only real question is why the people involved haven’t already found solutions. And the answer is not in any solution, but in the fact that all the participants are stuck in private conflicts.

With MOL we would ignore most of the details in the case description, and go directly for the conflicts that need to be resolved. It doesn’t matter what they are about; that’s essentially irrelevant. What’s important is to find and examine the internal conflicts that keep each person locked in conflict with the others.

Best,

Bill P.

···

----- Original Message -----

[From Fred Nickols (2009.07.04.0713 EDT)]

I agree with Rick; a remarkably helpful paragraph. In a way, it also points to Kurt Lewin's force-field theory and the change strategy of under-cutting restraining forces instead of increasing the driving forces. Thus, as Bill says of the problem, it solves itself.

It also happens to be the case in business that consultants are often hired who then do little more than point to the obvious (which the clients knew all along) and the client proceeds to do the obvious. Perhaps introducing a consultant is a means of resolving the conflicts that kept the client from doing the obvious.

···

--
Regards,

Fred Nickols
Managing Partner
Distance Consulting, LLC
nickols@att.net
www.nickols.us

"Assistance at A Distance"
  
-------------- Original message ----------------------
From: Richard Marken <rsmarken@GMAIL.COM>

[From Rick Marken (2009.07.03.1820)]

> Bill Powers (2009.07.03.1709)--

> David, it's not that the process is boring, it's that the particular problem
> and its solution is never very complicated or unique (except for trivial
> details). If a child's messy room offends the mother, an effective solution
> is for the child to clean up the room. That doesn't take a brain surgeon to
> figure out. The hardest part is for the child to work through issues of
> pride and culture to figure out how to give in and clean up the room, and/or
> for the uptight mother to admit that perfect order in a 12-year-old's room
> is a pretty unrealistic demand. The whole problem is not the possible
> solutions, which are all pretty obvious, but how to get each person into a
> position where the obvious can be accepted. And that is why we have to
> investigate conflicts, not solve problems. The answer to the question, "Why
> not do the obvious?" (once the person honestly looks for an answer to 'why
> not' and finds it) takes you into the core of the problem where changing
> something can fix it. It solves itself.

For some reason, this simple little paragraph helped enormously. I
think I've understood the basic idea of MOL for some time but I also
think I tended to "over-complexitize" how conflict-resolution actually
works. This little paragraph really made it clear (and also cleared up
all the problems in my life, so thanks for that, too;-)

> If I don't sound too presumptuous for your taste, I like these
> discussions, too.

Me too.

Best

Rick
--
Richard S. Marken PhD
rsmarken@gmail.com