The gallows transaction raises some quite significant questions about psychotherapy. One could argue there is a gallows transaction in all psychotherapy. It is inherent in the very nature of psychotherapy. Psychotherapy gives people attention for being sick. If one was not sick they would not go to therapy.
Indeed the attention can be quite strong and powerful. With transference the client can imbue the therapist with considerable significance and thus when the therapist attends to the client that can be quite a powerful piece of attention or a stroke. In group therapy the person is getting the attention of a whole group of people and again one does not attend group therapy unless they perceive there to be something wrong with self. The attention most often received is sympathetic and supportive making it ‘nice’ attention which is also appealing.
Attention seeking behaviour?
As Eric Berne stated some time ago, “What you stroke is what you get”. Very true and the research on reinforcement theory is unequivocal. When people receive attention (reinforcement) they will seek that out again. If a behaviour is reinforced humans have a strong desire to do the behaviour again so as to get the attention again. This is a very strong drive in humans.
This implies that therapists automatically stroke or encourage self defeating thoughts, feelings and actions. We give clients attention when they talk about their disquiet and angst. This can be seen as a gallows transaction because we are stroking the problem and hence the problem is encouraged.
In the game of “Poor me” a person repeatedly tells another of their woes and problems and the other person listens sympathetically and gives attention for it. This encourages the first person to continue to tell how ill they are. The problem with poor me, is you have to remain sick to get the attention.
It seems that in this way all psychotherapy is three steps forward and one step back. To deal with and change their difficulties people need to bring them out into the open and discuss them. In doing so a gallows transaction is set up and the problems are indeed encouraged.
Can something be done to lessen the gallows transaction effect implicit in all psychotherapy? I do not know. I do know people like Bob Goulding always said there needs to be a good deal of laughter in therapy. Maybe he was saying this so as to reduce the gallows transaction effect. If there is laughter in therapy then people are also getting attention for the good feelings that come with laughter. I have said before that when treating eating disorders I will only ever spend 50% of the session talking about food, weight and so forth. The other 50% is spent talking about other non food related matters. Maybe this is another way to reduce the gallows transaction effect in psychotherapy.