Worked with this 45 year old woman on and off for about 5 years. I had not seen her for 6 months and I saw her again last week. She has been a heavy cigarette smoker for many years. She complains about her smoking but has never presented the contract of stopping smoking and I certainly have not suggested it to her.
As with any addiction one needs to find the motive(s) behind the problem use. It never ceases to amaze me that people will use a blanket approach to treating addiction. It seems imperative to find the Child ego state reasons for the use and they can be many and varied. Then of course you ’grasp’ the Child and work with that.
This woman smoked from a rebellious position. Or at least that was one of her major motivators. People and the government were always telling her to stop smoking and she would respond in a rebellious way.
At my office where I work I have a nice garden area outside. With her when we were half way through the session I would suggest we go outside, she could have a smoke and we do the rest of the session in the garden. She of course jumped at the suggestion but was critical of me for encouraging her smoking. I just ignored these comments and went outside with her which was nice to do. We always got on well with lots of joking and fun.
She used to say that I was using reverse psychology on her with her smoking (which I wasn’t). Reverse psychology never works in the long run. The therapist endeavours to transact with the Rebellious Child ego state of the client. If they can do that then the transactions may work. The problem is the long term outcome. The behaviour is a reaction to an outside person and this is the problem. The motivation for the behaviour does not come from within and hence the fragility of the new behaviour. As the diagram shows there is little or no involvement from the Adult and Free Child ego states in the client.
As we know it is the Free Child that is of particular importance in contracting and psychotherapy. Indeed much of therapy is about getting the Free Child into a position where it says
“I don’t want to live like this anymore.”
If a client experiences this then you know the likelihood of long term behaviour change is quite possible. There is quite likely going to be a cessation of the drug use or a significant alteration in problematic drug and alcohol use, the same also applying to weight loss and so forth. The motivation has come from the core of the personality and thus is very different to the transaction in reverse psychology where the behaviour is motived as a reaction to an outside source. It is not what the person wants but simply a reaction to what someone else wants.
When I met her the other day she announced that after the last time I saw her she suddenly stopped smoking and has not smoked since (6 months). She had never done that before in her years of smoking. She again complained that I had encouraged her to smoke. I just ignored the comment and smiled. The cessation of smoking had never been presented by her as a treatment gaol and I was not really interested in it. What I had done was, I like counselling outside in the garden area. She wanted to smoke and could not smoke inside so I suggested we work in the garden area where she could smoke if she wanted to. My transactions to her were Free Child to Free Child. We did the same thing for over 5 years (in total). We had spent half that time in Free Child activity together outside in the garden.
If anything I had stimulated her Free Child into action. She was often locked into the Rebellious Child position. I had refused to engage her RC therapy and instead suggested some Free Child activity we could do. Maybe that had allowed her to at last discover that her Free Child didn’t want to smoke anymore.
This also shows some of the dilemma in working with the teenage client. As I say in my book a core goal of such therapy is to engage with the Free Child of the client. Many teenagers enter therapy due to some kind of rebellion problem. They are rebelling against authority and this has led them to be brought to therapy by parents, teachers, police and so forth.
The problem in such situations is often the goal is for the teenager to comply to authority and that means to move into the conforming Child ego state. Indeed a lot of discipline of teenagers (and children) is about getting the person to move into the Conforming Child ego state. Using loss privileges as a punishment is about that. The problem with it is the Free Child is not involved and Conforming Child behaviour is often quite fragile. It is very easy for the teenager to move back into Rebellious Child ego state.
It is imperative a therapist seek to engage with the Free Child of the teenage client. But many therapist’s forget this and stay focussed only on the Rebellious Child behaviour that is causing the problem which is why they have been brought to therapy in the first place.