Dinner for One

“Dinner for One” illustrates how memories, momentary experiences and future expectations influence each other, and how concentrating on negative memories can have a particularly negative effect on future expectations and the very nature of the future. It encourages the listener to distinguish between memories which should continue to be used as a basis for expectations, and those which should be ignored when developing a personal vision of the future.

Last Sunday, while sitting in my consultation room, I thought to myself, “I need to see a therapist.” “But you are a therapist,” said my inner voice, “and this is your consultation room.” “Well, if you say so…” Three glasses were standing next to a half-full bottle of apple juice. I filled up the glasses, and invited everyone to attend a family therapy session; the I of memory, the I of momentary experience and the I of expectation. All three took their seats, and I asked for their permission to drink from each of the glasses in turn on their behalf. I led the conversation. To begin with the three almost got into an argument, because Expectation I believed that no one was taking any notice of him and that Memory I – who had nothing positive to say – was getting all the attention. I asked Expectation I how the situation could be improved, and I asked Momentary Experience I to give his opinion on the relationship between Expectation I and Memory I. I also asked Memory I for his opinion on what had been said, remaining neutral and acting like a good family therapist should. Each of the three had some good ideas. They suggested that a distinction should be made between pleasant and unpleasant memories, and that only the pleasant memories should be used as a basis for developing new and more heartfelt expectations. When everyone was happy and the bottle of apple juice was empty, I thanked them, dismissed them and ended the session. This therapy session had a long-lasting effect on me, and put me in a very optimistic mood…

Life as a Sinus Curve

A life is described as happy or otherwise not primarily because of the actual events which occur during it, but because of the way they are arranged in the individual’s memory. Many life stories stop at an unhappy ending rather than continuing to the subsequent happy ending. In order to achieve a “happy” biography, the stories told by a person about his or her life must end with events which were experienced as positive, and also start with such events if possible. Like the following stories, “Life as a Sinus Curve” encourages the listener to structure biographical stories in such a way that they end with positive experiences of this kind.

If we imagine that life’s ups and downs resemble a sinus curve, we can draw this curve in two different ways. We can start the curve at its highest point, trace it down through its lowest point and then return to its highest point – or we can do the opposite, and draw the curve from its lowest point, through its highest point and back to its lowest point. In mathematical terms, it is exactly the same curve.

The People of Lensland

Like the previous story, the metaphorical story “The People of Lensland” can be used for patients suffering from body dysmorphia, in particular anorexia. It can however also be used in relation to hypochondria and the exaggeration (or downplaying) of illness in order to help the unconscious set a more realistic benchmark for the assessment of symptoms.

The people of Lensland are born with binoculars in front of their eyes. Most of them are born with binoculars which are the wrong way round, and everything they see looks very small. Whenever they meet someone, they might think, “Aren’t they a long way away!” “Aren’t they small!” or “Aren’t they thin!” However a few people are born with binoculars which are the right way round. Whenever they look down at themselves, they might think, “Aren’t I long and wide!” The people of Lensland find it very hard to agree amongst themselves. Yet once upon a time a woman living there made an incredible discovery…

The Fat Woman and the Thin Woman

The story “The Fat Woman and the Thin Woman” was developed while working with anorexic patients, and takes as its starting point the idea that even patients suffering from anorexia have a part of their personality which knows that they are underweight and which can engage in a conversation with the other part of their personality. The story is also based on the idea that the therapist should avoid representing the viewpoint “you are too thin”, and should instead represent the ambivalence between the outer world, which assumes that the patient is “too thin”, and the client’s inner world, which assumes that she is “too fat”. The task pursued in therapy is to initiate an inner dialogue between both viewpoints and parts of the personality, with the ultimate aim of negotiating a middle road and a “third way”.

There is not just one world, but two different worlds. This must be the case, because we are not talking about the same world. We are talking about different worlds.

The fat woman lives in the inner world. The fat woman is not very popular. Everyone in the inner world despises her, and everyone in the outer world refuses to believe that she exists. The thin woman lives in the outer world. The thin woman is also not very popular, because everyone in the outer world worries about her, and no one in the inner world believes in her. The fat woman from the inner world does not believe in the thin woman from the outer world. She can’t work out why the people she meets claim to meet the thin woman every day. The thin woman from the outer world does not believe in the fat woman from the inner world either, and she can’t work out why the person most affected by all of this claims to see the fat woman every day. Who is right? Those who believe in the fat woman, or those who believe in the thin woman?

Both the thin woman and the fat woman live in people’s heads – but in different worlds. They live on different planets. Now that we have entered the age of technology, visiting other planets is simply a question of deciding on a means of transport. I can imagine boarding a special capsule which would take me out of the inner world and over to the outer world for a limited period of time. That might be quite pleasant, since I’d get rid of the fat woman on the way there, and I’ve needed a break from her for a long time. The price I’d have to pay when visiting the outer world is that I might meet the thin woman, even though I don’t believe in her and perhaps don’t want to believe in her. And apparently she doesn’t look too great, but who knows. I can also imagine that at the same time as me, in exchange so to speak, a second spaceship would launch off from the outer world and fly to the inner world for a holiday in the fat women’s world. Then they’d know what it was like living with her day after day, and would no longer deny her existence. I wouldn’t go on this journey very often – why bother? Later I will send the fat woman herself on a journey to the thin woman, so that they can exchange experiences and learn from each other. I want the fat woman to learn from the thin woman, and the others want the thin woman to learn from the fat woman. I’ll stay at home and take a break from the fat woman.

How to Handle Sexual Assault…

The case study “How to Handle Sexual Assault…” discusses the possibility of protecting oneself against sexual harassment.

A colleague recently called me for some advice. A female friend of hers was being sexually harassed on a regular basis by a neighbour who engaged in exhibitionistic behaviours towards her while he was in his garden, and sometimes also made lewd comments on her figure and her clothes.

We discussed possible solutions together, and decided that the police would probably not be much help in a case like this. In my colleague’s opinion, the next time it happened her friend should look over and comment wearily, “Not exactly well endowed, are you?” I for my part thought that the woman should keep a pile of water bombs made from balloons filled with tomato juice ready in her garden. Alternatively, a blowpipe filled with cherry pits should also do the trick – simply aim at his manhood, and one hard puff! A friend who was listening in on the conversation suggested that the woman should carry a digital camera around with her and take a photo the next time it happened. Even if the photo didn’t show much, the neighbour would be in a very awkward position as soon as the flash had gone off – not only because it might be shown to the police, but also because he would have to live in permanent fear from that moment onwards that the offending image might be posted on the Internet, “liked” by friends and neighbours and go viral. “You’d be better off with a video,” suggested someone else. “Then you’d have sound too!”

My only fear is that these brilliant ideas were never used; once the woman had these tricks up her sleeve, her behaviour would have altered and the neighbour would probably have intuitively stopped the harassment.

Snail Race

The story “Snail Race” can be used with patients suffering from various sexual dysfunctions, although it is recommended that the text be adapted to the relevant situation. The accumulation of suggestions through semantic field associations and ambiguity is unmistakable.

The snails are having a race. A group of birds who are watching are open-mouthed – or rather open-beaked – at the length of time taken by these moist creatures to make progress, and how slowly they expel slime as they moisten the ground over which they glide. They make steady progress, but it takes them a very long time to reach their goal. Yet a snail race is enormous fun for those who know how to take their time. There’s a lot to see; how the snails strain forward to make progress! How they straighten their smooth, solid feelers, and stretch them out towards their goal! How the sides of their body move with a wave-like motion in order to push them onwards! Someone once said that if only we could learn to experience slowness, we would see how snails really lean into the corners. And it’s true; anyone who wants the snails to go faster can simply experience everything more slowly. Then a snail race will be just the right place for him, and he will see how fast they are. When the snails race each other, they are full of movement. From their feelers to their slime glands and from their mouth to their tail, everything moves forward. They are experts at rationing their strength. And when the time comes, they accelerate for one final spurt on the home stretch until they finally cross the finishing line, panting with exertion.

Snoring

Recently I stayed at a friend’s house. “You snored all night long. It woke me up and I couldn’t get back to sleep for over an hour,” she told me the following morning. “Wake me up if it happens again tonight,” I said. “Did I snore last night?” I asked the morning after, although I had slept all night without being woken. “No, not at all. I don’t understand why,” she answered. “I told myself not to lie on my back at any point during the night, and instead only to move from my left side to my right side.”

Alarm Clock with a Snooze Button

The story “Alarm Clock with a Snooze Button” represents a basic intervention for handing over control of sleep from the conscious to the unconscious, and for suggesting that it is safe to do so because the unconscious knows that it can easily handle the task. The alarm clock story can be used for patients who find it difficult to fall asleep or stay asleep, for patients who repeatedly oversleep and for patients who are worried about waking up too early from an anaesthetic or not waking up at all. It can also be used for all sleep disorders which can be prevented by waking up in time, such as bedwetting, sleep apnoea and snoring, as well as for nightmares. The story embodies the basic suggestion that control is retained even during sleep, and can therefore be used to make it clear to patients with a compulsive and controlling personality that they can stay relaxed while remaining fully in control.

“My body has an internal alarm clock,” one friend said to another. “Before going to sleep, I tell myself; ‘Tomorrow morning I’ll wake up at ten past six.’ And then the next morning I’ll wake up at exactly ten past six. Yet recently I woke up at ten past six and did not get straight out of bed. I went back to sleep again and overslept.” “That could never happen to me,” answered his friend. “My internal alarm clock has a snooze button. Before going to sleep, I tell myself; ‘Tomorrow morning I’ll wake up at ten past six, and then I’ll wake up every five minutes after that.’”

Soiled Underwear Again

The case study “Soiled Underwear Again” demonstrates a symptom prescription in the form of homework to carry out a ritual. This paradoxical intervention follows the Milan tradition of systemic family therapy.

Paul was six years old. Almost every day he waited until he was alone, found a quiet spot in the house where he could hide in peace and take his time, and then soiled his underwear. His excuses were many and varied, and often he had none at all. He only used the toilet reluctantly and under protest. None of the doctors who had examined him had found any problems. His mother had tried both being patient and being strict.

When I met Paul and his mother, I asked him whether he thought he could deliberately soil himself on a particular day. He responded in the affirmative, both to this question and to the question of whether he could deliberately not soil himself on a particular day. So I came to an agreement with Paul and his mother that he should deliberately soil himself, today if possible, and that his mother should allow him to do so. Tomorrow could then be the day when he deliberately did the opposite. Or he could soil himself today and tomorrow, with his mother’s express permission; what mattered was that he had soiled himself at least once before our next meeting. He could tell his mother beforehand or afterwards, or simply let her work it out for herself. And I discussed the details with Paul; on how many days of the following week he would soil himself, and on how many he would not. His mother offered to note down every time when he soiled himself on the calendar so that I could see whether he had done his job properly. The young boy protested that he would never soil himself again. I made a point of telling him that it was much too early to be thinking about that. I implored him to try and soil himself at least one more time