8. “If t’were done, t’were best done quickly”: The benefits of working briefly
Working brief or long-term is a choice. Brief seems like the ethical and moral choice to me.
I had an enjoyable and thought-provoking visit to Edinburgh’s Lyceum theatre at the weekend to see writer/director Zinnie Harris’ MacBeth (An Undoing). It’s a reworking of the Shakespeare classic which sees Lady MacBeth at the heart of the action from start to finish, with her husband suffering the nervous breakdown and attempting to wish his hands continuously in his sleep. It’s an audacious piece of theatre with new twists, re-sequenced dialogue, buckets of blood, fourth-wall breaking and an outstanding central performance by Nicole Cooper as Lady MacBeth.
One of the classic lines from the original, and present here too, is when plotting with her husband to kill King Duncan, Lady MacBeth utters the now-famous phrase:
“If twere done, twere best done quickly.”
The brief therapy tradition
This got me onto thinking about working briefly and the benefits of making early progress. Solutions Focus has strong roots in the brief therapy tradition which dates back to the 1960s at the Mental Research Institute, Palo Alto. Building on the work of Gregory Bateson who saw mental illness not in Freudian terms as some kind of inner disorder of repressed experience but rather the result of dysfunctional communication, the Brief Therapy Center members (John Weakland, Paul Watzlawick and Dick Fisch) started to work with individuals on this basis. (They had already laid the groundwork for family therapy in the previous decade.) One key presupposition is that however stuck things might look, there is something in the here-and-now that can start progress towards something better.
This is in stark contrast to the prevailing wisdom of the time, based on the psychodynamic model developed by Sigmund Freud and others, that progress was only possible after a prolonged period of painful exploration of childhood experiences, repressed emotions, hidden memories and other things outwith the conscious experience of the patient. This meant, of course, that the client’s own conscious experience could not be trusted. The therapist took charge of the process with their own ‘deep’ interpretations of the client’s statements, decided what was ‘really’ important and pressed on knowing that this would all take a long time. They even evolved a term, ‘flight to health’, for the times when the client started to say they were getting better too soon, making the assumption that the client was not really getting better but seeking to escape from the treatment!
The psychodynamic approach fails both of my tests for Steps To A Humanity Of Organisation; not only is it inhumane to spend months or years undermining people’s own judgements, it is ineffective too. This is not to say that people don’t feel they are ultimately helped - they can be. But to voluntarily set off on such a long, hard and painful journey when a much shorter, energising and potentially easier route is available beggars belief. It’s like a guide saying that the only way from London to Edinburgh is an accompanied barefoot walk, all the while directing attention away from the railway station behind them.
The brief therapy tradition offers ways of working which suffer from neither of these (to me) terminal drawbacks. We always take peoples’ own lived experiences very seriously indeed from the outset. This is both affirming and acknowledging for them, and puts us into a mode of listening very hard not to what may be (but probably isn’t) ‘beneath the surface’ but instead to what is being said, right here right now, in the room. Add in a keen interest in what the client wants in their lives (and not what murky experience may be getting in the way) and the scene is set for a productive conversation.
Can it really be effective?
Of course, any measure of success depends on the productive brief conversation being effective. Brief practitioners tend to define success as the client feeling they can go on with their lives without further professional help. People tend to come seeking help when life seems to be, as Winston Churchill put it, “the same damn thing over and over”. Something is consistently and irreparably getting in the way. Something is making life intolerable. Despite all efforts, it’s still there and seems unshiftable. When after some dialogue they feel at least able to carry, that things are at least getting better, that there is a way forward – that’s our cue to step back. That doesn’t mean that we throw them out and never see them again; there’s a common practice to allow people to keep a session or two ‘in the bank’ if they ever feel they need it. Most don’t.
Putting the criteria of success in the hands of the client is a major revolution. The psychodynamic world, taking their cue from medicine, insists that the client can’t know when their troubles are really over; that’s the role of the professional. In the medical field I’m quite happy to take the doctor’s word as to whether a cancerous growth has been removed or continues to spread. That’s a matter of molecules, which is usually a cue for a factual exploration. The kinds of situation we are asked to help with are usually about meanings rather than molecules; there is no consistent physical cause or correlate for a feeling of anxiety, let alone a relationship in crisis, a team working well below potential, or an organisation adrift.
“No pain, no gain” – not always true
I guess it’s natural for the proponents of long-term treatments to think that theirs is the only way. My SF colleague Evan George of BRIEF in London, writing in his weekly Facebook piece this week, tells of a woman who came to him clearly expecting that the therapy process would be long, painful and exhausting. She had even brought a friend to help her get home. Evan, by contrast, set out expecting that she would leave in a better place than she arrived on the day. He goes on to write:
Over the years BRIEF has worked with many clients who have lived through truly awful experiences, including abuse, torture, trauma, loss, bereavement and separation. We have worked with people who have attempted suicide, who self-harm, who struggle with eating, who drink and use drugs in ways that are problematic for them and what we know is that therapy does not have to involve ‘tears’, it does not have to be ‘draining’ and does not have to ‘exhaust’ our clients…
…clients very often appear to enjoy sessions and even when clients have lived through really tough experiences there is often a great deal of laughter. Children not infrequently look forward to sessions. So distress is optional as a part of a change process, it is not inevitable or necessary. Distress in the change process is a result of the therapist’s chosen assumptions about problems and change; indeed there appear to be some therapists who take the view that distress is evidence that the client is confronting rigid structures in a way that is associated with progress. Distress, in their view, may be regarded as a good thing, a true marker of ‘deep’ work going on.
Another good way in organisational work to make things longer and more painful is to carry out an extensive ‘where are we now’ survey without any thought of where we want to move towards. When I was in the nuclear industry at headquarters, someone thought we should communicate better. Not a bad idea, if highly abstract. So those in authority commissioned big-six consultants to help us. I won’t embarrass them by naming them here, but they managed to convince our leaders that before any progress could be made they had to conduct a survey about who communicated with whom to start with! This took months, wasted a lot of managers time and, in the end, went unused as other priorities took over. It also cost a lot of money – not a problem for the consultants, of course. I have met partners at big consultancies who are open that their first objective is to sell more work to their existing clients.
The benefits of brevity
Once we have established that there are choices for the practitioner here, to work in a brief and energising way or to assume that pain and distress are necessary and indeed a good sign, it’s time to look at why people (practitioners or clients) may choose one route or the other.
The benefits of helping people in a few sessions, or a single focused team workshop, as opposed to spending many months sweating away in pursuit of some invisible yet apparently critical barrier, may seem obvious. But let’s spell them out here anyway.
The clients get back to being able to live their lives quickly. Life turns from ‘the same damn thing over and over’ to ‘one damn thing after another’. That’s normal. We have no cure for life’s challenges and ups-and-downs. (And you should mistrust anyone who claims that they do.) But being rid of an overbearing debilitating pain, frustration or block is a good thing. If things can move on quickly and encouragingly, so much the better.
Other things can then ensue by a ripple effect. Once the big thing recedes, we find that other more useful things can develop including in areas of life a long way from the original concern. A person trapped in their house and scared to go outside may begin to walk to the shops, then go on the bus, then discover a men’s shed club in town and get interested in bicycle maintenance. A team trapped in conflict with their manager may find ways to work better together, become more productive, build better relations inside and outside, and end up merging with a supplier team to form a new business.
Waits and delays are reduced or eliminated. Imagine being in distress and being told that you can be helped, but there is a nine month waiting list. So you are now effectively sentenced to nine months distress waiting. Of course you might accidentally get better during the wait – but the incentives are not to take this possibility seriously. After all, you’d look silly going along without a problem in nine months. Working briefly means that practitioners can help more people and eliminate waiting lists.
The practitioner can help more people. The effect above is not only a benefit to those not having to wait. Practitioners take less time (on average – see below) to help people. Of course this means fewer sessions and less time, which for those paid by the hour seems on the face of it to mean less income. However, there is no shortage of folk seeking help, particularly rapid and effective help.
You end up working with people, not against them. The long-term route usually means taking control of the process and extending it (sometime painfully) until you think enough is enough. Working briefly, control of the process is with the clients (unless there is an overwhelming concern for their safety, or the safety of those around them). And when you work with people, things get easier, more productive and, yes, more humane and effective.
And it costs less. Obviously. This is a great benefit to the clients. And not so much a benefit to practitioners who enjoy having a long list of captive clients who can be relied upon to turn up every month (or even every week). In times of constrained budgets, it’s hard to see why brief practices are not more popular.
Briefly is not always quickly
Rapid effectiveness is, quite rightly, a prime concern of the Solution Focused or brief practitioner. But that’s not always the same as quick results. In the early days of brief practice the practitioners gave themselves a time limit for their work – initially ten sessions, then six, just to set some parameters for themselves. (It can be seen how this can spill over to the clients too. Being told that there are ten sessions is tantamount to being given permission to mess around for the first five, in my view).
These days our view is that there is no time limit, but every session or workshop should be approached as if it was the last. Nobody knows where things will be at the end, and the choice about when and how to proceed (if at all) is with the clients. This means not setting out a time-limited frame at the start but rather approaching each meeting seeking changes of perspective and behaviour that will move the client’s priorities along. So we expect useful progress in a few sessions or in a good workshop.
If there is no progress to be found in a reasonably brief time, our focus is not that ‘this will take years, you have little choice but to persist’, but rather to seek to try new things including new ways to tackle the issue, redefining the said issue or, heaven forfend, seeking to refer the clients on to someone else who may find better traction. ‘If it’s not working, stop it and do something different’ is a key piece of brief practice wisdom.
Of course acting quickly didn’t work out in the end for the MacBeths, at least in the long run. They were both dead, an inevitability pointed out centuries later by economist John Maynard Keynes. But our work is not a guarantee the everything will (or even could) be rosy for ever. Neither are we usually doing a job for the organisation, as opposed to helping it along. “I can’t get started on building my house” we can help with. “Please build my house for me” we can’t – for that you need a builder. SF work is often about crystallising a new direction of travel and setting out on the journey. That’s a humane and effective way to organise.
I talk about brevity as one of the five key elements in my paper Solution Focused Work As An Aesthetic from InterAction, 2019 (free download). You’ll have to read it to discover the other four elements.
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Dates and mates
Evan George and his colleagues Chris Iveson and Harvey Ratner have been at the SF game even longer than I have! Their website is packed with great insights and their Summer Schools come very highly recommended. This year’s is online from 18-20 July 2023.
Starting 21 March 2023 for four weeks: My Hosting Generative Change online course.
12-13 June 2023: The Host Leadership Gathering 2023 in Vienna, Austria. I’ll be there and leading a workshop on Blue work/red work works both ways: Co-participation by host leaders and teams builds more than you think. Full details and registration at https://sinnvoll-fuehren.com/hostleadershipgathering2023/.
I want to mention that these steps are so good and I have come back to them several times in the past few weeks. 🙏They give a lot of thought and at the same time contribute to comprehensibility and to me trying to bring together the different parts of my work that I deal with. (Which was one of my hopes when I started following Steps to a humanity of organization) I am involved in Genuine Contact https://genuinecontact.net and in that context we have just now talked a lot about magic and miracles. And it got me thinking about the issue of miracles in SF that I have sometimes over the years paid more attention to and that I have sometimes (if not ignored or passed over) then at least reformulated or sometimes excused. I would like to start using the miracle question more again. Anyone who has any thoughts about the return of the miracle question, it would be interesting to hear.