test for the CV continued

CSGnet Archive CSG1999
1

Q: The business at hand is helping the client discover what he is
controlling for - or the two incompatible things he is trying to control
for - and while disturbing what appears to be one of them is something some
therapists seem to think is useful, MOL suggests that it is not. Or so I
concluded from the 3-day MOL workshop in Vancouver this summer.

the MOL with different sorts of people. As far as I know, we have some case
studies on a very few people.

I agree that it is a mistake to continuously say or do things which are
designed to upset a person. We don't want to traumatize a person. I don't
think I do this. However, the occasional use of the test for the controlled
variable can be useful. In fact, I think it is unavoidable. The example I
gave was a surprise in the delay of the corrective action. I do think the
man learned something from it along the lines of the quote.

ยทยทยท

From: David M. Goldstein, Ph.D.
Subject: Re: test for the CV continued
Date: 9/10/99

Re.: [Mary Powers (9909010)]

Q: I realize that the diagnosis is something you have to do for the
insurance company, but does it have a place in the therapy session?

A: With all its limitations, I have found that the diagnosis is helpful and
does have a place in therapy sessions.

Actually, this man is following an avoidance and distancing strategy as a
way of handling any further hurt and disappointments. My statement was a
verbalization of this avoidance stategy.

Qs: You are looking at this man as self-centered. Is that good or bad? Is
it your role to shake him up a bit, get him out of this unhealthy
narcissism? I'm saying these things because I think that an MOL therapist
tries to avoid being judgemental, and keeps his opinions and advice to
himself.

As: I was looking at his self-centeredness as a fact about the man. He seems
to accept this fact about himself. Good and bad outcomes can follow from
this fact. One such outcome is that he has chronic problems in people
relationships.

I find that most people don't enjoy going to a therapist who plays such a
neutral, detached role. They want a real human being, opinions and all. In
fact, being neutral/nonjudgemental may be a disturbance to some people who
can misinterpret it, even after an explanation of what is being done.

Q: You "think he learned" that "I don't want to die with noone there to say
good-bye to me". Did he tell you that or did you just think it?

A: Mary, the reason I put it in quotes was because he said it.

A: Mary, I don't think we can say that we really know the best way of doing

2

[from Mary Powers (9909010)

David G. (990908)

You say that because of MOL you are much more sensitive to self-reflective
remarks by your patients than you used to be...but detecting up-level
remarks isn't all there is to MOL.

You said, about your statement to your client that maybe he'd be better off
if he didn't have a committed relationship: "I did it on purpose...I wasn't
sure if this idea would appeal to him or not" - and handed the guy, macho
black belt scuba diving boxer that he is - an idea that panicked him. An
idea that came not from him, apparently, but from your diagnosis of him as
a self-centered person with "Narcissistic Personality Disorder" who just
might be happier if he didn't think he had to be in a long-term committed
relationship.

I realize that the diagnosis is something you have to do for the insurance
company, but does it have a place in the therapy session? You are looking
at this man as self-centered. Is that good or bad? Is it your role to
shake him up a bit, get him out of this unhealthy narcissism? I'm saying
these things because I think that an MOL therapist tries to avoid being
judgemental, and keeps his opinions and advice to himself. His main focus
is on what the client has to say, listening for that shift in level and
articulating it when it comes. This can be very difficult - the therapist's
training and experience probably leads him to correct answers to the
client's problem - but, ironically, for the therapist to tell the client
the answers, to take the lead in the process, is just what should not
happen. The client must do it himself for it to be real to him, and the
therapist is there only to facilitate. It is probably a more self-effacing
role for the therapist than most envision. It is also quite demanding and
requires sensitivity and skill.

So, detecting "self-reflection" is only part of the story. But so is going
up a level.

Before going up a level, the conflict has to be recognized - again, by the
client. Usually one side of it is well-hidden. But the therapist has to be
careful to let the client be the one to discover the other side. For the
client you are talking about, I'm not so sure that "I feel that I am
trapped by my anger" is going up a level - after all, his presenting
problem was "I am unwilling to let go of my anger and it is dominating my
life". The one sounds like a restatement of the other. You "think he
learned" that "I don't want to die with noone there to say good-bye to me".
Did he tell you that or did you just think it? If he did actually tell you
that, he has found the other side of his conflict, and helping him to
contemplate the contradiction - when he brings it up again - may help him
go up a level. If you drew that conclusion from his panic, but he has not
come up with it or anything like it himself, then slow down, he's not
ready. What he needs, I think, is to hear someone say "Tell me about
feeling trapped", or "What would happen if you let go of your anger?" But
only when he makes a statement about it again. You don't have to worry
about missing the opportunity - if that's what's on his mind, it will come
up again.

I don't think a therapy session is a good place to fool around with
disturbing a controlled variable. The business at hand is helping the
client discover what he is controlling for - or the two incompatible things
he is trying to control for - and while disturbing what appears to be one
of them is something some therapists seem to think is useful, MOL suggests
that it is not.

Or so I concluded from the 3-day MOL workshop in Vancouver this summer.

Mary P.

3

[From Tim Carey (990911.08400]

[from Mary Powers (9909010)

Great post Mary. I really liked your explanation of MOL. Thanks.

I don't think a therapy session is a good place to fool around with
disturbing a controlled variable.

I'm glad you made this point. I agree completely. In fact, if a client is in
conflict doesn't that mean that _aren't_ controlling those particular
perceptions effectively? I'm not certain what disturbing one side of a
conflict would do.

Thanks again,

Tim