When I have a headache I just want to get rid of it. I do not care (or I may not wish to consider) whether it is caused by a cold or a hangover. I know that two aspirins will fix it, quickly. That is good enough for me.
So where can you get a quick fix for misery? You do not care why you are miserable. You cannot spare the time, or the money, to spend years visiting an analyst several times a week. You just want to feel better, to get back in control, as quickly as possible. Where can you go for help?
The answer, according to Richard Gollner, is to a Solution Focused Therapist. Gollner is well qualified to comment on the difference between solution-focused therapy, (also known as brief therapy), and psychodynamic therapies like those of Freud and Jung which seek to resolve a problem by digging its causes out of the unconscious mind. He used to be a psychodynamic therapist but now he prefers the solution-focused approach.
“Therapy is about being stuck” he says. “If you really want to understand why you are stuck you need analysis, which can take years but if you just want to get unstuck you can do it in two or three sessions.” Brief therapy is based on the assumption that whatever may have caused your problem, you are the one that has its solution. This assumption might well be shared by psychodynamic therapists, but they look for the solution by analysing the causes of the problem, which can take a long time.
The brief therapist sidesteps the issue of what caused the problem. He is seeking a short cut that leads directly to a solution. He does this by trying to help you identify hints of the solution in what you already do and know and to help you build up the confidence to put them into practice.
At the heart of the brief therapist’s strategy there are two questions that he asks. They are known as “the miracle question” and “scaling”. The miracle question was devised by Steve de Shazer of the Brief Family therapy Center in Milwaukee who, with his wife Insoo Kim Berg developed brief therapy. It goes like this: “Imagine that while you are asleep one night a miracle happens and your problem disappears; when you wake up, what will be the signs that a miracle has happened?”
The miracle question helps the you identify parts of the solution to your problem. The scaling question helps you to put them into practice. It has two parts. First you have to say how your problem is on a scale from 0-10. 0 is the worst it has ever been, and 10 is the morning after the miracle. Scaling is used to help you identify the things that keep you off the bottom of the scale and things that you could try to do that would move you up the scale – even if only by half a point.
By identifying what you can do yourself – in between sessions – you get a double benefit. You get better but you also get more confident because you have made the improvements yourself and you can work out how to bring about further improvements. This makes progress very rapid. According to Chris Iveson of the brief Therapy Practice in London, every session is treated as if it could be the last one. The client decides when, and whether, to come back for another session. On average people work up to an acceptable point on their scale within four sessions spread over about six months.
The individual sessions tend to cost slightly more than sessions with a psychodynamic therapist. But many therapy groups have low-cost and no-cost schemes for clients with low incomes. It is now being used in settings ranging from psychiatric hospitals to social work teams, to treat problems from stress at work to persistent criminal offending.
Of course by solving a problem without addressing the underlying cause brief therapy may allow the problem to return. But some causes cannot be cured even when you know what they are. Iveson has a client whom he has been treating on and off for 12 years. “Every couple of years she needs to come back for another few sessions.” But even over 12 years this patient has had fewer sessions than she would in her first six months in psychodynamic therapy.
Even though brief therapy is regarded as cheap, effective and easy to learn. “you can learn how to do it in four days” Gollner says, he identifies one drawback for the therapist: “It works so quickly that it’s hard to make a living just by doing therapy.”
The Brief Therapy Practice
Tel 0208 968 0070
Fax 0208 964 4192
Bill O’Hanlon’s Possibility Land
tel 505 983 2843
fax 505 983 2761
Brief family Therapy Center (Where it began!)
tel 414 785 9001
fax 414 785 9008