Ericksonian Family Therapy with a Problem Child
Case Report by Jeffrey K. Zeig, Ph.D.
Harold called me because he was concerned about his ten-year-old son, Bob, who was phobic about gravel roads. Bob’s phobia had generalized to the extent that he had become reticent about leaving his home. I told Harold that I would be willing to provide a one-hour consultation, if he would bring his wife, June, and his son.
Bob was the most hyperactive child I have ever seen in my private practice. Based on the phone call, I had no idea that ADHD was part of the constellation. Bob couldn’t stop fidgeting. As he entered my office, he poignantly announced, “I’m the crazy person.” My heart went out to him.
I did not want Bob to assume a negative self-definition. I gave him a difficult wooden puzzle consisting of two pieces that fit together to make a pyramid. Bob struggled but could not solve the puzzle. I told him that I could not solve the puzzle when I first got it. I called the friend who sent me the puzzle and asked, “Where’s the third piece?” There was no third piece.
I took Bob out of the office into the waiting room. I showed him how to solve the two-piece pyramid puzzle. I then instructed him to give the puzzle to his mother and father. Smiling, he strolled back into the office. Then Bob and I watched as his mother and father struggled to put the puzzle together. They could not easily do something that he knew how to do. Now Bob was one-up.
Building on the situation, I said to Bob and his parents, “I’m an expert at helping families solve puzzles.” I wanted to define the solution as existing within the family.
Harold told me how Bob’s problem began. The family was driving on a gravel road when suddenly a mechanical failure caused the car to spin out of control. A very good driver, Harold brought the car to a safe stop, but Grandmother, who was in the back seat with Bob, completely panicked. Then Bob panicked and subsequently refused to get into a car. Eventually he refused to be in any place where there was a gravel road. When Bob went on to say that he was afraid of being out of control, Harold had a new insight. He had not previously understood that aspect of his son’s problem.
I remembered a dictum from Gestalt therapy: “If you’re in terror, play out the terrorizer.” If I can get the fearful person to play the part of the fear monger, it may breed a solution. Continuing my redefinition of their familial problem, I said, “Mr. Fear has attacked this family.” I then asked Bob to show me, Mr. Fear. Bob went to the far corner of the office and became Mr. Fear, attacking his family.
I knew from experience that analogies can generate a solution, so I inquired, “Tell me, what is Mr. Fear like?” Bob asked me if I watched Power Rangers, which I knew only vaguely. “Mr. Fear is Drilla Monster,” he continued.”Be Drilla Monster and attack your family.” So Bob pantomimed being Drilla Monster attacking his family.
Next, I thought about the Ericksonian principle of eliciting resources. I knew that there must be a resource in this family to deal with Bob’s fears. Since Bob had offered the metaphor of Power Rangers, I asked him, “What power do you have?” “I know karate,” Bob replied. “Show me how you can use karate to fight off Drilla Monster,” I said. Bob successfully fought back the imaginary Drilla Monster, pushing him out of the consulting room.
Next, I explained the therapy. Whenever Mr. Fear, Drilla Monster, attacked the family, they were to stop and convene a meeting of all the Power Rangers who would decide together how to use their powers to defeat Drilla Monster. I then added, “I have two other therapies that I would like you to practice.” Because June seemed exhausted and overwhelmed, I directed the tasks to the father and son. Harold was bright-eyed and seemed to have a lot of energy to devote to Bob. I explained that each morning for a week, Harold and Bob should practice being out of control. Bob would go into the backyard and play being out of control and Harold would coach him about being better at being out of control. Then Harold would act out of control and Bob would coach him about being out of control. My covert design was to turn a problem component into a game. They agreed to the therapy.
Then I offered, “I have an another therapy for Bob. I want you to write your name in my driveway.” I live in Phoenix, Arizona, in the desert. My driveway is made of gravel. I told him that I did not even allow my daughter to write in the gravel, but that I would like him to leave his mark there showing that he had been at my home office. My technique was a symbolic desensitization. Bob would have to slide on my driveway as he shuffled his shoes around to put his name in the gravel. I would have him violate his phobia about gravel. Adequate psychotherapy with a phobia can be achieved when one gets the patient to violate the phobic pattern, even on a symbolic level.
In the one session therapy, I had a series of heuristics that could generate solutions. In this case, the most important heuristic was faith. There were three components of this faith: One, I had faith in my ability to utilize whatever they brought me. Most of my professional contributions in print during the past ten years have been explications of Milton H. Erickson”s utilization method. I have made utilization of a center point of my therapy. The second aspect of faith also came from what I learned from Erickson. I had faith in the family. I had faith that they had a resource in their system that would be adequate for solving the problem. The job of the psychotherapy would be to help them access that resource experientially. Finally the third part of this faith was in myself. I knew that I had surmounted similar problems. I also had used methods to cure myself similar to those I prescribed for them. If I could do it, I knew they could, too.
Jeffrey Zeig, Ph.D. will present at the December 2005 Evolution of Psychotherapy Conference, www.evolutionofpsychotherapy.com