International Handbook of Clinical Hypnosis - E-Lib FK UWKS

92 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
Many therapists have dif®culty working with couples in these sometimes
explosive, symmetric relationships since the clinician essentially encounters a
couple who bicker incessantly. Any suggestions that a couple are involved in a
power struggle usually falls on deaf ears. One of the pair might respond with
`Power struggle? I'm not involved in a power struggle. She he) may be in a power
struggle, but not me!' Subsequently, the therapist might become embroiled in an
escalating symmetrical relationship with one of the partners.
INTERVENTION STRATEGIES
Madanes 1984) has demonstrated that strategic therapy that modi®es disturbed
family hierarchies can remove symptoms. Straightforward discussions are usually
of little value in changing relational power dynamics, primarily because the duel
does not occur on the conscious, verbal level, but on an extraverbal level. People do
not say to each other, `Well, in this situation, I'm going to be one-up or one-down.'
Nonverbal behavior such as demeanor, tone and posture signal these roles within
the ®rst fewseconds of an encounter.
As a result, psychotherapy should be effected at the level of experience at which
the problem is generated. If a problem is generated at a verbal level, it may be
solved through discussions. If the problem is generated at extraverbal levels,
therapy should be directed extraverbally. Because most problems are generated at
the level of preconscious associations, `right hemisphere' methods such as tasks
and metaphors which pattern new associations and disconnect old rigid sets are
the most effective psychotherapeutic techniques in cases with disturbed power
balances.
Consider the case in Uncommon Therapy Haley, 1973) of the couple who were
involved in a rigid complementarity. The wife complained bitterly that her husband
was incompetent, forcing her to tend to both the family and the family business.
Erickson offered the wife a directive. He commented that she deserved some rest, a
statement with which she would likely agree. Then he suggested that she could
arrive at work 30 minutes late, indicating that her husband `could not possibly do
much damage in 30 minutes.' The wife arrived at the instructed later time and
discovered that the husband had done a competent job without her presence. Over
time, she went to the business later and later, and the relationship improved. The
use of directive tasks to rearrange problematic hierarchies has been elaborated by
Madanes 1984).
Erickson was acutely attuned to styles of complementarity and symmetry and he
used strategic tasks, jokes and confusion techniques to disrupt in¯exible patterns of
behavior. Erickson also was consistently one-up in his relationships with patients
because he held that it was essential for the clinician to be in control of the
therapeutic relationship.