“… All I did was give him a look of confident expectation. An infant learning to walk, you know he can learn to walk, but the infant doesn’t know. You give the infant the confident support of your expectation.”
– Dr Milton Erickson
Ever heard of a double blind drug trial? This is where new drugs, before coming to market, get tested against placebos to see how much of their effect is produced by expectation in the patient’s mind (which can be extremely powerful) as opposed to the actual psychoactive chemical impact of the drug itself.
Of course, drug manufacturers hope that the difference between the placebo and chemical response will be significant!
Anyway, the reason the trials are called ‘double blind’ is because neither the subject on the trial nor the doctor dishing out the pills knows whether what the patient receives is the real drug or the sugar pill placebo.
What’s the point in hiding this from the doctor?
Expectations are powerful
Double blind drug trials exist because if the doctor knows which is the drug and which is the placebo, their own expectations about the effect may be unconsciously transmitted to the trial subject – and influence how they respond.
People are tremendously sensitive to what ‘the doctor’ seems to expect. So a doctor’s attitudes and beliefs are an important factor in the success of a treatment. Or a trial.
This same principle can be applied to your therapy room.
I don’t know about you, but I’ve treated plenty of clients over the years who don’t really believe they will ever get better and will be ‘stuck’ with their problems until they die. Depressed clients in particular can have this attitude because of the black-and-white thinking trance depression has put them in.
As a therapist your attitude could make all the difference to how your client progresses in overcoming their ‘problem’. So what’s the best way to communicate to your clients your confidence that their therapy will be successful – making that outcome far more likely?
3 psychotherapy techniques that help your client believe in their recovery
1. Remember – human beings strive for progress
The human race pulled itself up by its boot straps before boot straps were invented. Naked as every other animal, how likely was it that we could (or would) come up with farming, technology, literature, great feats of architecture, an understanding of our place in the universe?
My point is that, unlikely as all this might have seemed from our grazing grounds on the savannah two million years ago, barely distinguishable from the other primates, nonetheless it came to be.
Reflecting on this with clients, simply weaving it naturally into the conversation, will allow them to both consciously and unconsciously register the expectation that things will change and improve – because that’s how we are.
2. Visualize your client’s future success
No matter what sort of difficulty a client may be struggling with, I like to define what the measures of success will be in their therapy. I then ‘internalize’ those measures for myself through self-hypnosis, and vividly visualize what those successes will look like.
In this way I can feel as if I have already ‘glimpsed’ their future success before it happens. And so I will more naturally feel the confidence I want to convey to them.
3. Mind your language
Presuppositions are powerful. So use them.
Talk in terms of
when things improve…
as things start to get better…
while you’re recuperating, you’ll also notice…
rather than using more tentative expressions like ‘if’ or ‘whether’.
A presupposition contains within it the assumption that progress will occur. A presupposition does not crassly draw attention to the assumption on which it is based. This would risk it being rejected.
For example, rather than saying:
You will get better!
(a statement that a severely depressed person might bluntly reject) we might more effectively embed the idea of getting better within a wider framework:
As you start to feel better in the coming weeks, I wonder what kinds of things your family will notice changing? What sort of things will they be able to tell about you that let them know you’re feeling happier?
Here we have covertly delivered the ‘sense of progress’, while apparently focusing on what friends and family will notice.
Never underestimate the power of the ‘confident support of your expectation’.
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