Reframing as a Therapeutic Skill


Last week I wrote about why words matter. I had an opportunity to speak with several people who had read that blog. Each of them had their own story to share about learning that, indeed, words matter! What they had to share were stories of anger, pain, loss, and frustration. In each case these people shared that they had been trapped in some situation where they felt victimized. They did not have any options except to suffer and endure. They were upset because they were good people who to their thinking had done nothing to deserve the bad luck they were having, but felt helpless to do anything except wait it out and hope for a sunny day. Life was gray and painful for each of them. They felt stuck.

Obviously, these were not first time conversations that I was having with these individuals. One of the things that a counselor needs to learn when they first go into the “business” of counseling is the reality that people move at their own pace. The clients frequently (or usually) spend a lot of time repeating the same litany over and over again. Sometimes it is like listening to a broken record player that plays the same scratchy record until it reaches the place where it is stuck, then resets itself and plays again. So, week after week they come in and repeat the same exact conversation. The therapist can try to guide the conversation, to reframe the perception of the client, to help them focus on skills they can use to challenge these old scripts, but none of this helpfulness will do any good until the client is ready to move. They won’t move and cannot move on your energy or time line. Any movement that happens will have to come from their energy and their time lines. So part of the challenge for developing the skill set of the therapist is to learn to wait and listen patiently, reflectively and probe for the openings. The client seldom knows when the opening appears. They are so busy repeating the litany like a Gregorian chant, that they do not see it. The therapist who has been listening, watching and probing gently and respectfully will think they see an opening and offer an intervention. Many times this will fail because the client is not ready. There are several maxims that we use in therapy. One is, “The only way through it is through it.” Another is, “Clients only move when they are ready.” So our job as a therapist is to ask in creative and energetic ways if they are ready. One way we do this is to re-frame what we are hearing and present it in a new (non-repetitive) way.

If the client is ready, if the opening is there, they will have an epiphany. They will have a flash of insight and a burst of energy and hope. This is the point that interventions can help move them towards change. There is still a problem though, for the entrenched and “should-istic” client who believes that they are victims and that life comes with a script that is already written. They are convinced that they are not allowed to change the script. Everyone in their life and in their relationships will be angry with them and punish them if they write a new script for themselves. They often report that they are angry with all people who just don’t understand that they cannot put themselves in a position where they will “cause” the people in their lives to become angry with them by doing something off script or out of character. This fear of arousing the punitive wrath of the others in their lives keeps them from being able to act freely.

Some clients will not be able to change because they are stuck in rhythms of repetitive self-sabotaging. They will make changes that indicate they are on the path to improvement and growth. Then, just when victory is in sight, they will sabotage their progress by acting out in some way that guarantees that they will fail to get out of the rut in which they have been stuck.

An example would be the young clients who have not learned to manage their money and live on credit cycles. A young couple gets deeply in debt and decides to work hard to discipline themselves and pay off debts and live without credit balances. They budget carefully, do not go out to eat, buy any new toys or anything until they are a month or two from being out of debt and achieving their goal. Usually, at this point, they will decide that they have deprived themselves too long and they have been so good that they deserve some kind of break. So they decide to reward themselves with a vacation that they have richly deserved. They book the vacation, go somewhere glorious for a week or two, live life large and then come home. When the bills come in, they are dismayed to learn that they have returned to the hole they just dug themselves out of. They head back to square one and start to budget again, use discipline again and work hard to get out. Often this leads to another deprivation cycle in the depth of winter when they decide that their children “deserve” to have a good Christmas. Again, they are good people who do no harm. They work hard and they are frugal so they, by God, deserve a good Christmas. Of course the only way they can give the kids what they want is to buy these special Christmas presents on credit. When the season of spending ends, they find themselves deeper in debt. These repetitive self-sabotaging cycles are easy to spot and easy to point out to clients. But, these clients are addicted to a script that resists re-framing. How does one deny her children? Children deserve a good Christmas. How do you deny your family a hard earned vacation when everyone we know gets to go somewhere nice?

These are circular conversations. These people are stuck either by their self-sabotaging script or their victim script. The “shoulds” of their lives limit their options and their freedom of choice. It requires patience from the therapist to wait for the moment of opportunity, and then insert the message of hope and the challenge of new behavioral skills or new cognitive processes. This work is especially difficult when you, as the therapist, have come to care about the client and you see them be stuck over and over again in the same place. It is easy when you are on the outside looking in to make sense out of it and point it out. What is hard is to be on the inside and to be able to hear that there is hope and a chance for change. Making changes requires effort and repetition, just as failure does.

One of the major advantages of going to therapy is to have a therapist who understands and listens and gently reflects back your reality even when you don’t want to hear what they have to say. Clients need and deserve a skilled clinician who will not judge them, but listen, care, attend and work hard at helping them “re-frame” the messages that the clients hear in their heads. These messages can be changed, but it takes time and work. Look at your own life. See if you can notice repetitive cycles of difficulty. Do you keep dating the same wrong type of men? Do you keep having the same money problems? Do you struggle with addictive behaviors that you know put you at risk? Is your weight an ongoing concern and frustration because you feel you are trapped by it?

One of the reasons I talk to my clients about dreaming is to help them dream about adventures and lives that are different than the ones they have lived. I do not believe in the destiny of limited expectations. I believe that we can do anything, go anywhere, be anything we want to be if we just work hard enough and spend enough time looking realistically and honestly at the choices we make and the patterns we have created. Part of the job of the therapist is to help people reality test with honesty. We help them learn the scripts they use and see the payoffs they get from those scripts. We offer the concept of re-framing and re-writing these scripts by making new and different choices. All the while, teaching them to look out for self-sabotaging cycles that will loop them right back to where they started. Therapy works, re-framing works, writing a new script works. Remember that decisions are not one time/forever. They are short steps towards a malleable future. Your ability to go where you want to go and be who you want to be may depend entirely on your skill for looking at reality and then re-framing the way you label it. Then re-write the script you utilize to navigate through life. Good therapy can help you do this.

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