This particular video begins to do a job that we think is more important than ever: to build a community of colleagues who know and understand that the theoretical frameworks with which we’ve become so enamoured over the years are more the philosophical wonderings of protected “gurus” than actual evidence-based protocols.
We’ve had a little feedback objecting to the title on a couple of grounds, one being that it’s similar to a book title, and the other that it’s too violent or brutal. So we need to explain.
The original quotation “If you meet the Buddha on the road, kill him” was the much-quoted advice of a 9th Century Buddhist monk, attempting to get across the idea that enlightenment couldn’t be “endowed” by an external source, but had to be worked for and and formulated by the seeker. The moral is, if you come across someone presenting themselves as a guru, at least remain skeptical. Some people were concerned we might open ourselves to a copyright action, but formal legal advice is that this is not the case for various reasons. We don’t recommend reading the book because deliberate ignorance of science, and blind trust in our own flawed perceptions is not an answer either.
So we apologise if the perceived brutality is objectionable. Sometimes fierce language is required and we think this case is one of them, since so many dud therapies continue to infect the therapeutic landscape and appear to be increasing rather than being weeded out.
In this webinar we discuss:
- When to do what you already do and when to up the ante
- When to bring people in who need to be there but are resistant (including a simple and pretty failsafe way to bring in reluctant partners)
- Why you should entirely separate yourself from the gurus
- Innovative ways to use strategic therapy to get past blocks, with real-life examples
- When to develop insight and when to just send them out with a task
- What to do if the client insists on insight
- How therapy can be completely mundane
The full transcript is below because we appreciate that some people read and comprehend a lot faster than the speed of speech. There will soon be a community for questions and contributions right here, but in the meantime we encourage everyone to join us on Substack, which is basically where we’ll be engaging and also advising of the next in the series. You’ll find James HERE and Christine HERE.
If for some reason the video doesn’t load well for you, there’s a copy on Youtube HERE.
Title of Webinar: If you see the Buddha on the road, kill him
Transcript
00:00:07 Christine Sutherland
So we’re welcoming everybody to our webinar: “If you see the Buddha on the road, kill him”. This is the first of a series of webinars that we’re really looking forward to sharing. This one and the two following will be free and they’ll be on Substack.
We really encourage you to go ahead, watch, join the discussion, make commentary. If you’re already doing strategic therapy, you might like to share some of what you’re doing. If you’re not and would like to introduce it or to be doing it more skillfully, please join in the discussions. We’re really looking forward to having those chats with you.
So we’re very fortunate today to have Professor James Coyne with us. James has a remarkable history. He is a walking, talking encyclopaedia of psychology and one of the things that really thrills me about James is that all of the textbooks I’ve ever read, and the seminal writers and developers in psychology, James has pretty much worked with all of them, so that’s rather mind boggling. But James rose from a welfare and public housing (situation) to emeritus professor of psychology and psychiatry at Penn, where he was Co-director of cancer prevention and control and senior fellow at the Leonard Davis Institute and Centre for Clinical Epidemiology and Biostatistics. He held faculty positions at Berkeley and Michigan, visiting professorships at Rutgers, Groningen and Australian National University, and Carnegie Centenary visiting professorship at Stirling University. He’s written over 400 papers and is designated amongst the 200 most eminent psychologists of the late 20th century. He’s one of the most cited researchers that we have, so very, very pleased to have James, and really looking forward to his discussions. His work with strategic therapy and depression goes way, way back to his roots with the Brief Therapy Team at MRI. And so what I’d like to open with is asking you, James, why your approach to depression is so different to most other people’s.
00:02:23 James Coyne
Well I got an offer to go to Michigan and one thing led to another and I found myself tenured in the Department of Family Medicine and the Department of Psychiatry at University of Michigan, which was considered a rather prestigious place.
And I was there to do research, but the two department chairs would allow me to see eight patients a week. That was more of a favour, because I said I needed to keep in touch with clinical work, than anything special. And I became quite well known for accepting referrals from staff whom other therapists preferred not to see in therapy.
They had a specialty mood disorders inpatient unit that attracted severely depressed people who hadn’t been benefiting from any treatment. The patients had typically been on multiple medications, they’d be very, very depressed and they would take them on an inpatient unit and take them off all their medications and then rebuild the medications.
And when they got discharged to outpatient treatment, often their life was in ruins because they had been chronically depressed. And so I was supposed to do something to get them going.
Many referring physicians did not believe that I was treating depression. They believed that I was helping people readjust after having been depressed.
00:03:48 Christine Sutherland
Because they didn’t believe these people had depression (now)?
00:03:52 James Coyne
Well, they believed they had depression, but they didn’t have anything that would be treated with psychotherapy. A lot of the staff believed the patients had a medical condition that ruined their life and they needed help by a therapist. If you wanted to call that therapy, fine, it is billable. And so I adapted what I was doing in Palo Alto.
And not all these patients initially said they wanted to bring their spouse in. Sometimes the spouse was reluctant to come in. I started saying, giving my usual rap, that sometimes you don’t have to be part of the problem to be part of the solution.
No one’s blaming you. There’s a lot of blame to go around. There’s a lot of disappointment, hurt and frustration, but the point is that by coming in, you’re making a commitment to be part of the solution.
I was very non blaming and spouses who came in were relieved. But I assumed back then that men have a bias against believing that they will benefit from psychotherapy. They worry somewhat that it makes them seem as weak.
Some of them do, but some just feel that they’re problem solvers, they don’t need talk, they need action. And so I had to appeal to that and so basically I found myself surrounded by people coming in to see me, who didn’t want to be there. They were very sceptical I’d be able to do anything for them.
So I adapted to that new environment and all of a sudden I realised I was doing something nobody else was doing.
And this became a sensation among the residents who felt inadequate as therapists. And they started saying you can take my patient because I’m a failure. But I really would like to watch what you’re doing. So really the situation where there’d be a team watching.
But the residents were too intimidated to suggest to tell me what to do. And you know, we were stuck in a hierarchy. So legends formed built on what people saw, and often it was exaggerated. But eventually, I don’t know how, but a women’s magazine, Good Housekeeping, gave me the award declaring me to be the depression therapist to see in the State of Michigan.
And so I started getting referrals from people who had read about being in a women’s magazines, and that just seemed all the more bizarre.
00:06:32 Christine Sutherland
That’s when you put your price up, James.
00:06:35 James Coyne
Yeah. Yeah, exactly. Yeah. But see, I was working in a system where I did not want to do that. My pay didn’t depend on it.
And so I try unconventional things if I could defend them.
Like I felt sometimes that 15 minutes into a therapy session, you accomplish what you wanted to do. If you kept talking another 35 minutes, then you might ruin it because you’ll undo it and so I would say, OK, I’m only going to bill you for 15 minutes and the secretary would say, how can you do that. I said that the psychiatrists do that all the time. Sometimes you know, it takes 15 minutes to check meds. I was just checking their relationships.
00:07:28 Christine Sutherland
Yep, yeah. And they’re moving. They’re moving on. And James, you’ve got a terrific story about getting a very reluctant husband into therapy, haven’t you? With his sweet wife. Would you share that story?
00:07:40 James Coyne
Yeah, it kind of got a thing where I was particularly interested because I come from my teen years on welfare, below a working class background. I felt I could relate better sometimes, to the practically-minded working class patients than the more intellectual patients from, say, from the academic community.
And I remember one case in particular. The wife’s complaint was that she was terrorised by her husband throwing things and screaming. And she was very clear that she believed that the rageful behaviour was never aimed at her. It just seemed a bit of frustration. [OMG]
And so what you do in strategic therapy is you start asking for details. You want to be able to imagine a videotape of what was actually going on behaviorally. And she described that they would be disagreeing and he would raise his voice, a big guy. And she would get more quiet and intimidated.
And sometimes she just froze and stared at him. And he would be furious because he felt she had castrated him. That he was this big, powerful guy and he was laid low by her not speaking at all.
And he felt that she should be fixed in therapy. That was her problem. He didn’t want to come in. And so in the third session I said to her, “why don’t you tell your husband that I’m so confused why such a nice, calm, loving woman could drive a man crazy. There must be some part of the story I’m missing.” Could he come and set the record straight and we could have a man to man talk. You can introduce him.
But I added that I should be able to see him behind closed doors because he might be able to tell me something about you that I did not know. I recall her laughing. She said, you know what’s what about me. I said of course. But your husband is sceptical. And he won’t buy into this, he may not buy into it all unless he can be heard out.
So he came in and he described exactly a scary one where he got upset with her and there was something on TV he didn’t like. And so he threw things at the TV. And he damaged the TV with an object.
And I said, well, that’d be terrifying. He said, well, it’s not like I broke her jaw, I broke the TV. (I felt I was on my way of having a customer, even if not someone who was gleeful about spending a lot of time with me.)
And so then I said, you know when I think of your wife, I think of her like a doe, like a deer.
He said, you think of her like a doe? She ruins my life.
I said, well, maybe. I said, do you hunt? He said yeah when deer hunting season comes.
I said, well I know some of you guys out there, where you live, that you sometimes use lights, bright lights to freeze the deer. Did you ever see a deer freeze up?
He said, well, I didn’t do that on purpose, but once I was out in the truck and saw the deer in the headlights and he froze, and I hit him. I couldn’t avoid hitting him, and so we took it and we ate him.
I said some people do that, it’s illegal. But he said I didn’t do it illegal. It was an accident. OK.
I asked “do you ever think or imagine that deer staring into your truck as you ploughed into him? And that maybe your dear was frozen? Like your wife freezes.
He said, that’s the stupidest thing I’ve ever heard. I said, well, I don’t know. We’ve run out of time. I think you should come back. He said, I’m not sure I want to come back, I hope I set you straight.
I said OK, but the next time that this happens, could you imagine the deer? In fact, if you could have something like that happen before the next session it’d be good, because I’d have something to talk to. If you have a good week, I won’t have anything to talk to.
And so I sent them out and she came back next week and said my husband thought you were a jerk. But you’re very nice. And I said, what about the freezing thing? I don’t know. We didn’t get around to it. Well, why not? She said that she didn’t know. “We’d have a disagreement and we would just talk a bit about it and he would listen, but we still didn’t agree, but I didn’t feel so intimidated.”
And so we have a few more sessions. She said, you know, I came in because I was freezing up, but I’m not doing that now, and you’ve been very helpful. But I don’t see any reason to see you anymore.
I said, well, that’s fine because you had 10 sessions and you used 7. And so you’ve got three in the bank if you ever need them. So if you feel things are out of control then just say I’ll just call Doctor Coyne next week. And so I did a follow up with her but she never came back. She said oh, hi, Doctor Coyne, there were times when I thought I should see you, but I figured I didn’t want to waste the sessions. So we just dealt with it and he’s not perfect but he’s a good provider and he really isn’t violent toward me and I guess it’s not what you’d want for your sister or daughter, but it’s a marriage that works for me.
00:13:56 Christine Sutherland
So, James, can we unpack that because that in fact was a really brief intervention, wasn’t it? You gave him the visceral experience of smacking into that deer and having the blood all over the windscreen, etcetera. And he was repelled by that. He thought you were a jerk (for suggesting it).
And you’d already asked him to think of his wife as the doe, you’d described her as the doe, so it would be very difficult for him, now in those situations to not see the blood and see her as the doe. You stopped him in his tracks, didn’t you?
00:14:36 James Coyne
Absolutely. So I come with a very uneducated background and when I went to college, I felt I had to learn everything that people knew, that I didn’t know. And of all things, I started reading poetry. And I read Ezra Pound, who had a theory of objective correlative. That sounds like fancy thing, but basically he felt his poetry should evoke an emotion with a graphic image.
And so I felt it was very important with this command to give him something graphic that would keep his attention. And so it had to be bloodied.
And to get there, I didn’t go in there with the idea that that’s what I would do. I felt I needed to get a response out of him. So I just listened to him and asked for a lot of details that first puzzled him that I’d be interested in, and I certainly didn’t jump on the fact of their pickup truck with a gun rack, but I see it. That’s one thing different that you might want to talk about. And I knew that people who did that were uncomfortable shooting deer that way. It’s illegal. They could be arrested.
00:15: 56 Christine Sutherland
You explored that beautifully and then you really knitted the metaphors together perfectly and he got the reaction there right in front of you. So you knew it hit (home).
00:16:12 James Coyne
But the problem that, if say there was a resident watching them, a psychiatric resident and some of them, frankly, they become psychiatrists because they don’t like talking to patients. They like giving out the meds.
00:16:28 Christine Sutherland
Yeah, they might be prescriptive.
00:16:29 James Coyne
Yes, and so they might go to the next patient that the woman is intimidated or has fears about domestic violence and give the assignment to imagine she’s the deer and the guy doesn’t hunt or he thinks it’s silly and so there’s a whole art to reeling the person in by asking them questions.
Now there was something I believed at the time, I don’t know if it was true, but it was very helpful. I watched Watzlawick hypnotise patients and I saw that he would often develop a cadence. In fact, sometimes even tap and what he would do is he would start talking about the weather and the surf and California or something. But the thing was to say things that people agreed with. And so there would be nodding.
And the whole body thing was they were participating in the conversation and agreeing. Only then would he throw in an intervention. And when they’re caught up in being compliant.
00:17:38 Christine Sutherland
And they’re kind of entranced by that point because …
00:17:40 James Coyne
Right. And so you don’t jump in and say I’m hypnotising, you go do this.
And I remember I sat in on a session I with Paul (Watzlawick) where he yawned and he asked me to go out and get him a cup of coffee. And he asked the woman, who was supposedly in trance, did she want a coffee too? And so they both had coffee. And at the end I said, Paul, I said you broke the trance. He said, what trance, you believe in trances?
I said I don’t know. I mean, I’m learning hypnosis from you. It’s very confusing. And he said well, I don’t believe in trances, and I believe that I needed her attention. We were both tired. So we needed coffee.
And they (the residents) said, well, that’s common sense, but it’s not common sense. And so a lot of things I did were radical common sense, but it sounds strange.
Yeah. And one phrase I learned from the team, confusion is our most important product. And that doesn’t mean what it meant back then. Back then, Ronnie Reagan was going to eventually be president of the United States, used to be selling stuff for GE or Westinghouse and it always come on the commercials and say you’re buying a product, but progress is our most important product and so it was just banter based on that.
So, you know, I started working on ideas and it was very much a, you know, kind of a whole body thing. We think about things in terms of bodily involvement and emotion. And it was nowhere near as complicated as the way some people came in later. It was anti analytic. It was anti insight. It was just how do you persuade people to do something that they say they can’t do what they want.
00:20:03 Christine Sutherland
Yeah. And where are the Patients’ resources? Where are the resources within the person? And you can’t put an arbitrary framework on that. It’s exploration, isn’t it?
00:20:08 James Coyne
Yeah. And the belief is there’s a reality out there and you can’t change it but you can reframe it, might have different outcomes. So I was very uncomfortable that I didn’t fully understand what I was doing, so I started reading about things. I started reading about social construction and things like that.
There’s a power to reframing, but you can’t get people to believe anything you want them to believe because it has to feel real for them. And so I was, for instance, like not very many other therapists at the time, I didn’t believe in magic. I didn’t believe in fantasy. I didn’t believe that you could sell people a bill of bum goods, but you might be able to get them to experiment in their own life and discover things weren’t as bad as they thought.
00:21:06 Christine Sutherland
Yeah. And experiment in a way that made sense to them and met their worldview. It wasn’t some guru’s world view being foisted upon them. There weren’t any theoretical explanations.
So there’s another interesting case you talked about, James, which is where you were explaining that sometimes what’s needed is not therapy at all, but just a way to get unstuck. And there was the lady who was, I think an amputee? So would you explain that one as an illustration of what’s often needed is not therapy.
00:21:52 James Coyne
She and her husband were bikers, and she had stopped using drugs because she discovered she was pregnant. And they were out riding on her bike, on his motorcycle, and she went into labour. And for some reason, I don’t know if that’s something to do with the bike ride or whatever, but she started hemorrhaging during the delivery. And in the panic, this was not a planned delivery. It was, you know, it wasn’t on schedule.
00:22:26 Christine Sutherland
A traumatic delivery.
00:22:30 James Coyne
And so in the confusion they introduced infection. And in a very short time she developed, she became septic and developed gangrene, and lost her legs. And so this was horrendous thing for them and the physicians made a referral to MRI. And by the time they got to see me, she had been expressing thoughts of suicide for a while, but then they told her she had a referral to MRI. And people begin to hope and believe that they can deal with this sort of thing. And so she actually got a bit better by the time she came in.
So one of the things you always do in strategic therapy, one of the details you always collect, is why are you coming in now rather than waiting for a few months, or before? She said, before I was just as devastated, as when my father molested me.
And I thought oh my God, the analysts would say, now we’re going to talk about molestation. We’re going to talk about things that happened 20 years ago and we can’t solve the problem at hand. And I was sitting there, I could see all the metal from the prosthetic devices in her jeans, so it it’s a constant reminder. And I said, well, what do you think the next task is?
And she says, I really want to go back to work. And I may not look like it, but I’m a good accountant, and when I go back to work, it’s OK that I don’t have my legs.
And I said, well then how is it a problem? And she said, well, my husband has started to smoke dope again and I don’t feel like I can leave him with the baby. And so I said that’s the problem, that your husband smokes dope. And she said, yeah.
And I said, well, you know, you mentioned about your father molesting you. She said, yeah, I said. How did you get through that? She’s, I don’t know. I just did what I had to do. I coped. I said, well, whatever you have, I wish we could bottle it because there are a lot of people can’t get past those kind of things. She laughed. She said, yeah, that’d be great.
And so I saw him (the husband) and I asked him, he described being a construction worker, and cutting concrete, the particular task he had. And he mentioned that he smoked dope to mellow out but that she was pestering him to stop smoking, and that sometimes irritated him, and he needed to smoke when that happened.
And so I said to the wife, for next session, why don’t you start telling him about not smoking dope and you say he’s stoned and he can’t function, and according to the script, he says he’s not stoned. You’ve got to guess whether he smokes afterwards and you keep track of each time. That you have that task. Did he, did he actually get out of it so he couldn’t work with the babies?
And so it turns out that what happened was that he got the message he can’t smoke dope right now. He had to be responsible. And it was kind of silly thing to talk about. And I said, well, how did you solve it? He said. I don’t know. I just coped. I wish I could tell you.
I said, well, maybe you could have a whole line of products. There’s a men’s coping and a woman coping because it does what? What works for men doesn’t work for women. You know, you don’t use your wife’s perfume for deodorant, then go to work, do you? So that was the last I saw them because they had a real task ahead. But they knew what they needed to do and they had a vague confidence that it would work out.
The emphasis on being vague. Because if I said do this and you get better, then patients are set up to have a failure experience, but if you leave it vague and confusing, then maybe they’ll never explain it, but they know how to get it back is to play the game again, yeah.
00:27:18 Christine Sutherland
Yeah, they have to. They have to wonder about how this is going to work out, not how this is not going to work out (meaning not thinking they’ve got an answer and then experiencing failure of something they hoped would “work”. Also this is an exercise for the unconscious mind, not an exercise for the intellect).
00:27:28 James Coyne
Right. And sometimes I don’t believe that people cope like they do when you read psychology books. According to textbook accounts, hey are stopping and thinking “what should I do next?” and their cognitions are all working in there somewhere. I think now sometimes people just are more primitive than that. They just do something automatic. And so you do that. You want to get the automatic.
00:27:52 Christine Sutherland
Yeah, yeah, that’s the bit you need on side (meaning the automatic, unconscious behaviour of the client).
00:27:54 James Coyne
Absolutely. And Christine, that’s where my work coincides with yours. You work very differently. Like most therapists work very differently than me, but we both judge what we do by behaviour.
And I remember in a bar at an AABT conference that I was giving a talk and people were asked me afterwards. And I came up with it after a second drink. I said to a cognitive therapist, “you fix what’s in the head, and I fix what the head is in.”
00:28:00 Christine Sutherland
Some people say there isn’t such a thing really as depression. How should we think of depression? What is depression?
00:28:08 James Coyne
Well, it’s different things to different people. If you ask people, what bothers you most about your life, sometimes they’ll say my depression, sometimes not.
When I was at the outpatient clinic at Michigan receiving a referral from the inpatient unit, “depression” would almost certainly be what they would say, if you ask one of these women. “Well, my depression has kept me laid low for so long, I can’t remember what it was like to be normal. And my big issue is getting that out of my life.”
On the other hand, somebody whose problems were more tied to their marriage might say my marriage is the problem. It’s depressing to be in this marriage. And so I would leave it up to the patient and the spouse to decide what they wanted to focus on, their depression or their marriage. But because I was on a biologically oriented unit, I was much more aware of what they call the phenomenology of depression and the psychiatrists used that word different than psychologists. Psychologists use phenomenology like existential, like Frankel, you know Victor Frankl or something like that. Phenomenology for a traditionally trained psychiatrist, old style, in the nature of the report that people give.
00:29:44 Christine Sutherland
And the symptom or symptomatology?
00:29:46 James Coyne
And so what I learned practically speaking, so people would say I’m just really exhausted. And so I ask how do you feel exhaustion. And what was interesting is that a lot of people when they’re exhausted say, oh, I’m just, I’m just worn out. I can’t think straight. I’m in a fog. But certain depressed people would say, it’s in my limbs. It’s my arms and legs. I can’t lift them. They’re so heavy.
00:31:26 James Coyne
But I’m so exhausted that I have to squirm all the time to stay awake during the day and. And so I realised that there were different descriptions of being exhausted.
And I would realise that some of them didn’t sound like they’d respond to just exercise. I would ask and they would generally agree. Yeah, because some of my patients, in fact when they start to recover they’d resume their exercise because they could follow routine. But when they started to relapse, that warning sign was they couldn’t force themselves to exercise and so I got much more aware that depression is in a context, and relationships matter, but depression’s a real bummer that may be so strange to someone who’s not depressed. They can’t understand.
And so that validated and reinforced my idea that some people are dealing with something different and I don’t know what’s going on. I’ll depend on them. But coming back to my simple assumption, regardless of what is happening, renegotiating the relationships might be really important.
00:31:46 Christine Sutherland
Their relationships. Yeah. And you talked about how important it was, you know, not to be overly positive with these particular clients, not to dispute their negativity, you know, by trying to get them to think or speak more logically, not taking their side.
Because when they feel better, you know, if you’ve taken their side against others around them, when they when they feel better, they’re gonna hold that against you.
00:32:14 James Coyne
Oh, I learned that from hard knocks because I came in to therapy thinking I was going to engineer stuff. And I would cheer them up because they seem demoralised and I felt that was like a football coach. Do it for Gipper, you know, like that Reagan movie with the football team, you know, the coach is dying, but go out there and win for him, you know. And the people (in therapy) wouldn’t find that was persuasive.
And often they felt they had defend themselves, that things were really that bad. Yeah, so I found that if I reversed the dance then I would really say your life is really horrible. How could I possibly help you? What little thing would give you a ray of hope? Because we can’t be overcome them. I say, I don’t want to be overwhelmed with therapeutic enthusiasm for being a help to you, because that would be my following my view, not yours. So I’ll defer to you. What little thing, bare thing, would convince you it’s not totally hopeless. So you think small, not big.
00:33:30 Christine Sutherland
The way I think about you, you’re kind of like the Columbo of psychotherapy.
00:33:34 James Coyne
He was my hero. Yeah. I like the idea that he’d interview people and he wouldn’t be making too much sense and then get out and walk towards the door. There was always the moment when he’d turn around and say one more question, and that’s when he would catch people off guard.
I was squeamish about the threat to confidentiality, but I found that if I walked people out the clinic door, rather than just letting them leave my office, we often had conversations along the way that they disclose things they wouldn’t say in the room. And I’d sometimes do a parting shot with them and say that I just don’t know.
I remember an extreme case. We had a broken coffee percolater, a little glass thing, the old fashioned coffee machines, and it was sitting there and I grabbed this little glass thing and I gave it to the patient and said this is for you. And they said, well thank you, what should I do with it. I said, I don’t know. Come back and tell me what you did with it. Maybe it’s like a rabbit’s foot.
So the idea is that you’re being very directive (by maybe giving a task), but you’re not telling the person what to do, so they can’t argue with you.
00:35:04 Christine Sutherland
(So in a way it’s asking a question that they have to answer, they have to fill in the blanks from their own imagination, their own head).
00:35:06 James Coyne
So if a person wants to discuss dreams, I say, you know, I really don’t do dreams. I’m not good at that. And they said, well, I’d like to do dreams. OK. And so I’ll say, well why don’t you have a dream this week. Maybe it’ll be a nightmare and you feel you can let go, or maybe it’ll be a happy dream. Or maybe it’s just a dream in colour. I don’t know the difference, but at some point you’ll have a dream this week and you know you’ve been changed.
00:35:40 Christine Sutherland
Sounds so Ericksonian.
00:35:42 James Coyne
It can be, but what was missing about Ericksonian to me, what I found offensive about Erickson is he really believed that he was a guru.
00:35:54 Christine Sutherland
Oh, he did. His ego was gigantic.
00:35:56 James Coyne
And my thing is, hey, I’m just a therapist. I’m dyslexic. I can’t remember names. Oh, that was a problem. My disability is, the strength of my ADHD or neural difference is that if I’m only seeing 8 patients a week, I can think about each one of them. And I can usually have a good episodic memory. If I ask for details, I’ll remember the details. I just can’t remember names.
And so it gets to be awkward where I’m trying to get people in a situation where they’ll say their names, so I can recall. But the nightmare situation I got into was dealing with a couple where the man had left his wife because he was going to have a trial separation. And he got involved with his secretary, and that was a horrible experience. So he came back. But he was gone for a while.
It was a trial separation. Now I say a trial separation is the trial divorce. Yeah, but, you know, if people do that anyway, fine. So he came back and he was obsessed with the fact that his wife had had a date. And he was jealous. He didn’t believe her when she said nothing really happened. And so when he’d get comfortable having returned home (they tried to get on with their lives) he would start obsessing about what actually happened between them, and ask if she enjoyed him more (the guy on the date rather than the husband).
Well, caught up in this conversation trying to get into the details, I made the mistake of calling him the other guy’s name and he got really angry. I said wait a minute. I said, why did I make that mistake? He says I don’t know, maybe you’ve got a problem. I said maybe you have a problem. Your wife was so confused that she thought she was with the old you, not the guy that was cheating, and she didn’t really cheat on you. If you believe her. I don’t know if you can believe her.
(He said) Well, I do believe her, right, but then I start worrying. I said, well, I’ve a way to put a stop to that. But it’s so crude and ugly you probably don’t want to do it. He says “I’ll do it. I’ll do it.” Well, the problem is, I know people say you’ll do what I say. And the one thing they won’t do is what they need to do. So I have to build some trust with you before I tell you what my idea is. He says, look, this is ruining our lives, I’ll do whatever. OK, what you’ll do is rather than waiting for you to get comfortable and then tense, you can get tense, and then get comfortable.
So that when this all works out, won’t you feel better? She said. Yeah, yeah, I feel better, but we can’t go through the same. I said OK. I’m going to give her a script and you should follow it carefully. She should write it down. And whatever you feel you want to ask her, what was he like? And you should do it at least a couple times at the beginning of the week, so you’ve done it for the week and you don’t have to keep doing it.
So you should say what was he like, and she would say, you know, Doug and Doug is your name, not his name. We got that right. She’ll say, Doug, I don’t know what he did, but I saw he was so “little.” But it was amazing.
He said, it’s disgusting, she didn’t do anything with him. I said, that’s not the point. We both agreed that she probably didn’t do anything with this guy, but that’s not the problem. The problem is that you keep being curious.
This cat will kill your curiosity (about the previous situation).
00:40:18 Christine Sutherland
Yeah. So, James, this is strategic therapy and you could talk to that example specifically. It is quite manipulative of the client. It’s getting the client to do what the client needs to do in order to resolve whatever’s going on. So what do you say to claims that this is a manipulative approach to doing psychotherapy?
00:40:42 James Coyne
Well, I hope so because people come to therapy because they want change and often they just get talk. I think they get cheated. You know, it’s interesting because people used to compare me to Carl Rogers and I thought that’s the furthest thing in the world that I am. I’m more like Albert Ellis, I think.
And you know, they have these movies back then that compare the two, the …… same patient. In some ways I am empathic and interested in a way that other therapists aren’t. I just want the details of their everyday life, and I don’t want to let my theory get too much in the way.
00:41:26 Christine Sutherland
Yeah, yeah, yeah. You’re intensely curious.
00:41:28 James Coyne
And so in fact, sometimes when I felt really guilty, and I had struggled doing this therapy at first. I stopped thinking I was a bad therapist because I now was doing something I was comfortable with, but it did feel manipulative and some of my colleagues criticised that.
So I would say to patients, you know we could talk for 10 sessions or we could talk as long as we needed to do for a lot less. And then I could get you to do something. I feel guilty if you would feel manipulated. Would you feel manipulated if you felt better? No, I’m here to feel better. I don’t want to talk.
So, yeah, yeah, whatever. (What) I was drawing on is that sometimes telling the people the truth is very disarming. If you say I’m gonna manipulate, you, is it OK? Oh, no, I don’t want to be manipulated. I just want to spend 20 sessions with you. They don’t say that. They say, I’m here to change. So I do informed consent.
But then I realised people didn’t do that well. I’ve been doing videotapes. That was always very complicated back then, whether it was ethical to videotape people. They were more concerned about the ethics of showing a videotape and someone saying something that would reveal who they were.
And so they have a standard consent within, say, there’s no guarantee. What they want to say is there’s no guarantee that if you have a pink poodle with three legs that it’s mentioned in the therapy, people will realise there’s only one person in California that has a pink poodle with three legs and you’ll be exposed, no guarantee.
So that was our concern, confidentiality.
00:43:36 Christine Sutherland
Yeah. So what about the client? Who you know, maybe has read a lot of psychology and comes along deeply desiring insight into some issue that they have. What’s your view on insight in psychotherapy?
00:43:56 James Coyne
Well, I think insight is rather arbitrary. So that if I’m a Jungian therapist, God forbid, but if I were a Jungian therapist, people would talk my language and they would have these experiences that were, you know, of the collective unconscious or all of that spacey stuff. But if I was Freudian and they dream of penises, or at least the therapist would convince them that they were really dreaming of penises and butts.
You know, anal or oral, and so I think insight is rather arbitrary. I’d rather have people create their own insights. I’d rather send them out confused and they come back with an original thought about what’s happened, which I won’t argue with.
00:44:56 Christine Sutherland
Yeah, because it comes from their own psyche. It’s not the psyche of the guru who made up a whole world of explanations. It’s their (own) answer.
00:45:02 James Coyne
Yeah, I mean I’m not like a Fritz Perls and that he was real “in” back then, you know, he’d get naked and at SLN and he’d be a guru and all that. And you know, I don’t like getting naked with patients and. But they did, and always talk about inner stuff being inside.
And I talked about people being inside, but they don’t know until they talk about it. So when I write a paper, I don’t know the paper in my head. I write bad, mediocre stuff on my computer, and I correct it. And (then) I say, that’s what I wanted to say.
So you develop insights from engaging the world and discovering what was really going on.
00:45:48 Christine Sutherland
It’s afterwards, isn’t it, in review?
00:45:50 James Coyne
Yeah, it was an expression that’s really stuck with me at the time. In Siberia the indigenous people would feed their dogs thawed woolly mammoth. Whatever. But your past is not frozen in your head.
And so I would say that if something in your past is still involving (or bothering) you, it’s because you’re interacting in your everyday life (right now). So sometimes the way to deal with the past is to confront it in the present, and if you’re not finding it, then good riddance.
In fact, there’s some severely traumatised people like the woman who had had been sexually abused and had lost her legs, that it’s better to pave over all that. You don’t want to feel that you’re suppressing it. You’re just making it irrelevant.
00:47:08 Christine Sutherland
Exactly. You don’t need to go back, and you don’t need to dwell and try to resolve all of that, because in fact, it might not really exist in the here and now. So why would you go back and retraumatise a person (with it)? It makes no sense.
00:45:25 James Coyne
Absolutely. Yeah. Now, I know I’m talking to you and I’m talking to the audience, most of whom aren’t strategic. And most of them are not inclined to do what I’m saying to do.
And so I would say (to therapists), fine, if you don’t need to do it, just do what you’re doing if you’re content. But every now and then you may get stuck, and feel desperate to try something different. Or better, sometimes therapy is going so well, is so uneventful that you feel you can experiment a little with this developed insight with homework tasks rather than just sitting around talking in the room.
So wait till you’re desperate or wait till you’re comfortable. Otherwise, don’t listen to me.
00:48:24 Christine Sutherland
So James, this is really interesting. I’m thinking of our (upcoming) discussions online with listeners, people who are interested in learning more about strategic therapy and how they might implement it in their clinics. How would you feel about doing case studies or doing a live session with a therapist who’s interested in applying this with a particular client.
00:48:50 James Coyne
Well, one thing I don’t know about the legality of doing this across borders, but you know, I gave up my licence because I didn’t want to take continuing ED courses. It costs money and I wouldn’t be seeing patients, I was just doing research and writing. So I can’t provide supervision towards licensure. But if someone wants the consultation, I can train.
What people could do is they could give me a report about their patient, we can follow a template.
00:49:30 Christine Sutherland
Yeah. And some patients may be very willing to be videoed in the interests of progress.
00:49:34 James Coyne
Well, that’s fine. I found that a lot of people thrive on that. And the idea. But what I used to do, (was) a weird thing that worked out real well. I was giving a workshop in Toronto. And the 250 people in the audience had patients who wanted to be seen. So what I did is I pulled the curtains. And we had the videotape running behind the curtains so they (the patient) couldn’t see the audience. But the audience could see them. And then what I would do is say, you know, I’ve got 250 therapists here. I can’t imagine you ever getting the chance for 250 therapists to ever give you advice on a case again. So this is very special. I’m going to see you 20 minutes and then you can go and have some soft drinks in the back, or some coffee.
I’ll go out onstage and get a consultation (with the audience) and then I’ll convene, the curtains will still be closed, and we’ll talk just you and me, about what these 250 people have to say. And maybe I’ll give them (the audience) some feedback, or if you feel really comfortable, it might not happen, but you might want to just walk out and thank them and give them some feedback.
And if they tell you something (that’s) wrong, you’re free to go out there and tell them they did something wrong. They’re paying good money to come and tell me to tell them that they did something wrong, so you can do it for me.
And it got to be a thing that it got very attractive to some patients that say Coyne’s coming to town. Can we go be seen behind the curtain?
00:51:30 Christine Sutherland
Yeah, fabulous. And such value for the audience. Absolutely great value.
I guess we need to wrap up now, but I wonder, we’ve got like, a million different schools of theory, and the proliferation of modalities doesn’t seem like stopping anytime soon. They just keep coming and coming. You know, we’ve got especially CBT and its multitude of derivations, DBT, etcetera, there’s ACT, acceptance and commitment, there’s mindfulness, there’s family systems, it just goes on and on and on. All of these, without exception, are birthed by gurus. So what does a sane aware therapist do, who seriously wants to provide the best science based therapy that they can. How do they approach this?
00:52:24 James Coyne
Well, they should first eat some humility. They’re not a guru, and if they think that they are, they’re at risk of putting their patient in trouble because they’re going to stop listening to the patient. My thing is if you don’t know what to do, you don’t draw on your theory, you ask your patient and if you still don’t know you didn’t ask your patient enough.
Think of Colombo. He has theories about what’s going on, but he has to get the patient to say them. And so it’s being willing to be an anti guru, where you just go and put yourself at the mercy of what occurs in the conversation. And to be honest, an awful lot of strategic therapy is pretty boring to watch once you know what’s going on, because you’re not trying to magic people into getting upset and they’re not talking to empty chairs. They’re not role playing. They’re just.
00:55:00 Christine Sutherland
It’s not fancy.
00:55:12 James Coyne
Talking to you..
00:53:34 Christine Sutherland
They’re not learning about their parts.
00:53:35 James Coyne
Yeah, and. And a lot of people just love the attention (that strategic therapy requires). You know the problem with psychoanalysis, is the therapists never talk to you. You know, they don’t even look at you. They’re the traditional analyst. You know, you can’t see them. They’re sitting in the back of the couch. And this (strategic therapy) is the opposite. I talk a lot.
00:54:00 Christine Sutherland
Yeah. (You have) this intense curiosity about what’s actually happening in the client’s head and the client’s world. Without judgement, without preconceived theories about why. Along with the humility to know that what you’ve learned may not apply right here.
00:54:18 James Coyne
Well you can’t be too curious. If you’re (indiscriminately) curious what goes on in people’s minds, you get a Netflix subscription. You don’t want to depend too much on clients’ meeting your needs. Being a professional means if someone said, oh, I saw an old girlfriend just after I broke up with my current one, I don’t get curious about what that girlfriend looked like or whatever, unless it’s relevant. And so you’ve got to be careful about being a voyeur in people’s lives. You know, too curiosity is a mixed bag.
You know the traditional (saying) curiosity killed the cat. There are things that the monks felt it was a vice to be too curious about, things that were forbidden. And so I feel I’m only at my best if I’m only interested in the facts that fit, or that it made the person comfortable talking about them because they need to.
00:55:38 Christine Sutherland
Yeah. So again like Colombo, you’re hot on the trail of something in your curiosity. So your curiosity, what’s the best way of putting this? It’s targeted curiosity.
00:55:50 James Coyne
It’s targeted as it deliberately takes the attitude of not knowing, you know, I may know from my theory. I may know from 15 patients that I have seen just like this one. This is probably what’s going to happen, but I suspend that confidence. And I act like I don’t know. And I need them to tell me.
00:56:13 Christine Sutherland
I’ve enjoyed this very much James and I hope that those watching might like to put aside the guru therapies that they maybe have become very emotionally attached to, to take this more open, directed, curious approach to their clients and discover from the client what the client needs in order to get the outcomes that the client says they want.
00:56:46 James Coyne
I couldn’t put it better.
00:56:48 Christine Sutherland
So if we see the Buddha on the road, we will happily kill him.
00:56:54 James Coyne
We can because he’s not the Buddha.
00:56:58 Christine Sutherland
So we’ll put this video up. Once it’s edited, we’ll put this video up on Substack and invite people to comment and engage with us on the points raised maybe on some of the stories that were reported here, and I think watch this space for some live interaction with therapists, potentially with clients, using this strategic approach. So I look forward to collaborating on that as well.
00:57:30 James Coyne
And so we should offer people (because) they’re doing us a favour by bringing clientele, we will do them the favour of allowing them to tell us what happened and we’ll give them feedback. So we won’t throw them out the door and never to see them again. But we’ll make it a learning experience because they go out and do their assignment and they come back just like clients do with me.
00:58:00 Christine Sutherland
Sounds great. I can’t wait. I think it’s going to be a lot of fun, very exciting. Look forward to all the great conversations. James, thank you for today. It’s been marvellous and we’ll talk soon.