The assumptions one makes drive all thinking – behavior, perceptions, expectations both within the individual and in relationships. Beliefs and values also become part of the process. Work systems are also driven by all of the above. In human service systems, there are often legal mandates as well that drive the entire process (e.g. Child Protection Services).
Given these forces, is it possible for any degree of clarity or will one’s reality be governed by all the external parties’ assumptions and subjectivity?
Flip Wilson, a comedian of the 1960’s recorded a monologue on Queen Isabella sending Christopher Columbus to America to discover Ray Charles. Upon arriving on the shore of America, he was met by a band of Indians. Columbus informed the Indians that he had come to “discover” them. The Indians responded, “How are you going to discover someone who doesn’t want to be discovered? You had better discover your … away from here.”
Clinical relationships certainly reflect major assumptions, both from the therapist and from one seeking something from the therapist. Defining one’s clinical responsibility in the process is critical, yet the assumptions about responsibility are seldom clarified or examined, which will result in a situation that keeps both parties “stuck.”
Dr. Bowen’s letter of November 28, 1966 is a response to a letter written by a patient (not his) who is “stuck” and is seeking his advice about directions she might pursue. His clarity focuses on her assumptions and his. Again, principles drive his response.
November 28, 1966
Dear Mrs.
In your letter you wondered if I could advise a course of action for you. That is easy. All your life you have had all kinds of different advices. Your problem is in finding a course of action that works for you, and if you are realistic, I think you have to be prepared for the possibility that you many never find a really successful course of action. In support of this is the long term fixed nature of your life pattern. On the other side of the coin is your long experience in finding out what does not work. From that you should be able to derive a lot of clues in knowing what does not work.
You speak of no one understanding you. I do not believe it is ever possible for one person to ever “understand” another. At least I gave up that effort a long time ago. Many years ago I worked at that. It is possible to break one’s neck trying to “understand” only to have the other person say “you don’t understand!” One’s success at such an effort is completely dependent on the other person’s mood. So I gave up trying to “understand”. Instead I began communicating “I hear you”, which means that I hear what the other says, but it makes no promise beyond that.
Long ago I discarded the concept of “sickness” with emotional problems. I also never use the concept “patient” nor do I make “diagnoses” except when dealing with the rest of the medical profession. So, I would not agree that you are “sick”. I would agree that you are in some kind of state of dysfunction. If one uses the concept “sickness” it implies that the person is a victim of some kind of malevolent force, and it makes recovery or “cure” the responsibility of the therapist or healer. If one is to recover from a state of emotional dysfunction, it has to come from within oneself. Another may suggest or counsel but that is the most another person can do.
One brief story from days before I started working with families, will communicate an idea about the “sickness” thing. This had to do with an experience from Menninger days. A hospitalized young man was permitted to go to town alone. As he started to board the bus to return he began hearing voices that told him “No”. He was detaining the bus and other people who wanted to get on. The bus company called to complain about permitting such “sick” people out alone. Now it was up to me to discuss the incident with him. The usual way would be to tell him that he was “too sick” to go to town alone and he could not go again until he was “well enough”. What could he do about that? Rest in his bed until the “sickness” went away? Instead of calling it “sickness”, I called it “misbehavior”. I told him that he had “misbehaved” and he could not go to town again until he could behave in a way that did not call attention to himself nor interfere with others. Now he had an assignment that he could do something about. He could change his irresponsible behavior. He practiced for hours and days on learning to behave responsible in spite of the voices that said “No”. He asked to go to town again. It worked. He was soon out of the hospital and back at his job, functioning normally in spite of voices that cut in when he was tense. The voices disappeared a few months later when his total life situation improved.
You asked for advice. There are a dozen projects I could outline, and any single one could take years of hard work. No one ever achieves perfection on any of them. Anyone can achieve something on all of them. You feel sorry for yourself and you have the capacity to get others to feeling sorry for you too. Maybe you can never get it to the point that others do not feel sorry for you, but perhaps you can make some progress on not feeling sorry for yourself. If you wait for symptoms to disappear before you can begin to function, you will never make the grade. If you can find some way to function in spite of the fears and anxiety, then maybe you can make a little progress. If anxiety is too great for you to function in spite of the anxiety, then you are stuck. Tranquilizers, in my opinion, are as much of a trap as they are a boon for mankind. The person who waits for tranquilizers to make him feel better automatically loses motivation to do something about his own life. You could make a project out of your own self centeredness, and perhaps achieve something on that, or you could make a choice to do nothing. When you say that no one knows how you suffered, you are accurate but also extremely self centered. Implied in that is your own lack of awareness of the plight and problems of others. You might “feel” that you have the worst of all problems but if you are objective, you know very well that the “feeling” is inaccurate You could also make a project out of being aware of the difference between “feelings” and “beliefs” or “principles”. You tend to act on what “feels” right and when one consistently acts on “feelings” one increases the depth of the dilemma. There are times when feelings and principles are contradictory. Unless one can act on principle, and take a stand against feelings that cry out in opposite direction, then one is stuck.
In the above paragraph I have outlined just a few “do it yourself” projects. Success on any one will pay dividends. The problem with all “do it yourself” projects is that you never know when you are digging the hole deeper with your own efforts. Most people require some outside help in order to “see” when they are immersed in the “feeling” morass. Lacking outside help, can you devise a way to estimate objectivity for yourself? It takes a lot of doing to make a project out of objectivity.
Finally I would ask whether or not the “pain” of working out of your dilemma might not be greater than you would be willing to invest. Personally, I think the short term acute stress of working out a dilemma is more than the long term chronic less severe pain of staying in it. Any problem can be brought to some kind of reasonably successful solution. I do not accept the thesis that problems cannot be solved. However if someone tells me that they have rather live with the problem than go through the pain of changing, I can accept that as a valid decision.
I go into much more detail here than I ever expected when I started this. It is not often that I have time for this kind of an exposition but your letter just happened to come along at the right time. You are in one of mankind’s old dilemmas of wanting your cake and eating it too, which you well know is not possible. There are millions of people caught up in your same dilemma. You have been bogged down in your morass for so long that it might make more sense to accept it, and find a way to live with it, than to try to change it. You have a comfortable place to live and essential needs are met. Maybe you can find a way to join the millions of others and to enjoy it as much as possible. If you decide not to make the effort, maybe you can find a way to stop fretting about it so much. If you make a decision to do something about the situation and you are up to the stress and are willing to take the chances involved, then you would have my moral support and any possible reality support that is possible.
Best wishes to you in whatever you decide to do.
Sincerely,