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Change the Name and You Change the Game
Jay S. Efran and Kerry P. Hepner
Department of Psychology,
Temple University
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CONTENTS
ABSTRACT
Structure determinism emphasizes the central role
of language in shaping human affairs. It has implications for understanding the
addictive experience and the work of the psychotherapist. Language makes complex
social interaction possible, but also generates the possibility of hypocrisy in
social endeavors. People — especially addicts — confuse themselves and others by
telling lies and half-truths about the nature of their engagements. Mental
health workers may actually contribute to the confusion through their use of
terms such as "addiction," "habit," "alcoholism," "denial," and "disease."
Therapy, as we understand it, is fundamentally an opportunity to sort through
the implications of semantic falsehoods.
"Please don't ask me what the score is — I'm not
even
sure what game we're playing."
Ashleigh Brilliant (1933- )
"We save our lives many times over through
hypocrisy."
Humberto Maturana (1928- )
"To fall into a habit is to cease to be."
Miguel de Unamuno (1864-1936)
In an earlier article (Efran, Heffner, & Lukens, 1987) we discussed how the
theory of "structure determinism" (Maturana & Varela, 1987) might be applied to
the realm of alcoholism and other addictions. Structure determinism provides a
systematic, inclusive perspective about how living systems operate. It
emphasizes both the self-producing nature of living organisms and the central
role of language processes in shaping human affairs (Efran, Lukens, & Lukens,
1988, 1990). In this paper, rather than reviewing the theory's basic tenets, we
will amplify our previous discussion of how addiction and psychotherapy appear
when viewed from the perspective the theory affords.
From our point of view, therapy isn't about
directly trying to change people. Instead, it is the provision of a context in
which people can state more clearly who they are and what they are doing. Under
those circumstances, changes tend to occur naturally. Because of the importance
of language in forming the social fabric of people's lives, the words they use
to describe their actions determine, to a large degree, the outcomes of those
actions. Therefore, the heart of the therapy process, as we construe it, is a
close examination of the language people use in talking about (and to)
themselves.
Language as Friend and Foe
The role of language in human activity cannot be
overestimated. Language allows us to differentiate and label objects, to know
who we are, to compare and evaluate ourselves and others, to generate and
exchange meanings, and to entertain hypothetical scenarios. “Shoulds” and
“mights” exist only in language, and so do all those “problems”
— mental and
physical — to which people devote their conceptual attention. A problem always
consists of someone — using language — having made something of some thing.
According to structure determinism, “languaging” — which includes the use of
both words and symbols — is an essential element in the coordination of human
social performances. Although members of other species may coordinate behaviors
in rudimentary ways, only people, using language, are able to develop the far
more elaborate “second order” action patterns that characterize human
interaction. Language requires people not only to dance together, but also to
describe, discuss, plan, and analyze the nature of their dances. Thus, people
create and perform a series of life minuets, labeling these enactments as they
go along. Unfortunately, they may also delude themselves and each other by
assigning and accepting false labels for the activities in which they are
engaged. Language is not just epiphenomenal — it is an integral part of action
processes. Therefore, as the title of our article implies, when a game is
inaccurately named, it affects the nature of the game itself.
Behaviors that may seem roughly equivalent in
appearance can lead to entirely different outcomes when carried out under
different linguistic “banners.” For example, two individuals may go to the same
AA meeting, and both may appear to be listening intently to the proceedings. To
an observer, both seem to be engaged in similar tasks. Yet, it could be said
that they are actually attending quite "different" meetings and are involved in
different processes. One person may be “proving” to himself or herself that AA
has little to offer, while the other may be actively seeking an opportunity for
personal “surrender.” Notice that although AA provides the meeting place, it
does not exert control over the nature of the games that are played at that
meeting. The first person in our example is playing something that might be
labeled “being right,” although he or she is likely to call it something else,
such as “seeing what AA has to offer.” The second is “being helped.”
Researchers almost invariably want to objectively
evaluate the effectiveness of AA and other procedures, formats, or treatments.
From our point of view, it might be more profitable to study instead the effects
of the varied games that people choose to pursue in such settings. Figuratively
and literally, that is “where the action is.”
Stories, Lies, and
Hypocrisies
Even a cursory examination of daily living
reveals how often people say one thing when they mean something else. Secrets,
lies, deceptions, cover-ups, bluffs, diversions, and subterfuges are prominent
features of all human enterprises, including international diplomacy, economics,
labor negotiations, religious practice, family interaction, and even scientific
and educational endeavors. According to the classical legend, Diogenes failed in
his quest to locate one honest man in ancient Greece. It is unlikely that he
would have been any more successful if he had set about his mission in
contemporary times. Whether we are talking stocks, sports, sex, or sales,
hypocrisy — saying one thing while doing another — seems to be more the rule
than the exception. To put the matter bluntly, all of us — addicts and therapists
included — are inveterate liars, and our unrecognized and unacknowledged lies
have the potential to corrupt and undermine the very endeavors we pursue.
Fooling Oneself
and Others
Given the self-reflexive nature of language, it
is not difficult to comprehend the mechanisms by which people sell themselves
and others a bill of goods about who they are, what they are doing, and the
factors that are presumably “making” them do it. Since the dawn of civilization,
people have found ways to attribute their less admirable qualities to factors
outside themselves, such as the actions of gods and devils, “extenuating
circumstances,” the exigencies of heredity and environment, and various elements
of luck, chance, and fate.
Moreover, in explaining themselves, people rarely “play fair.” They take
personal credit for laudable performances and successful outcomes but at the
same time insist on ducking direct responsibility for perceived failures and
limitations. They develop and promulgate a “sad tale” (Goffman, 1961) that
accounts for predicaments and personal characteristics that might otherwise seem
less than ennobling. As essayist C.S. Lewis once noted, “It is only our bad
temper that we put down to being tired or worried or hungry; we put our good
temper down to ourselves.”
In other words, people, as living systems
operating in language, continually “argue” for themselves. Even when people
appear to be more willing to openly admit to negative characteristics, a
moment's consideration usually reveals that they have not changed their overall
policy of trying to look good — they have simply switched tactics. For instance,
they have decided that on this particular occasion “discretion is the better
part of valor,” or they have given up head-on competition and are instead
angling for the sympathy vote. They may be distracting attention from still more
grievous transgressions that have not yet come to light, or they may have
decided to cut their losses by an act of self-derogation that will beat others
to the punch. Perhaps, as Szasz (1973) has suggested, they have discovered that
it is better to be wanted for murder than not to be wanted at all.
At the same time that people are attempting to
look good, they are busy devising ways to avoid recognizing the duplicity
involved in constructing and promulgating such self-justificational tales (Goffman,
1959). As Bateson (1972) pointed out, a person's belief system will become
partially self-validating, regardless of its ultimate truth or falsity. As
social beings, people tend to enact and reenact their own stories so often that
the line between spontaneous happenings and dramatized performances — between
reality and invention — is easily blurred.
One of the authors remembers his days as an
inexperienced therapist, when he felt compelled to pretend that he knew exactly
what he was doing even at moments when he was feeling totally lost. After a
while, as his “therapist act” became more practiced and polished, he began to
acquire increased faith in his abilities. He was, so to speak, taken in by the
success of his own performance. He thus felt more natural in a role he had
initially been play-acting. Similarly, individuals who receive doctoral degrees,
as they get used to the new title, may convince themselves that they really do
know a lot (Kelly, 1969).
Parties, weddings, graduations, funerals and
similar social occasions usually represent peculiar admixtures of staged
performances and spontaneous happenings. Often the central participants of such
events — such as the bride and groom at a wedding — cannot easily separate out,
in their own experience, the “real” from the fabricated. Similarly, cheerleaders
may buoy their own spirits as they reenact a preplanned and carefully rehearsed
routine.
Even when a person is in a room completely alone,
peering into a mirror, he or she engages in a calculated act of impression
management based on one of a number of recognizable social scripts. For example,
a man may attempt to adduce from the image in the mirror evidence that he looks
attractive, mature, suave, slim, and so on. He may simultaneously be aware, at
least dimly, of the posturing and stage management that goes into making this
performance persuasive — for example, that he is actively holding his stomach in
or favoring one profile over another. If, however, he becomes too self-conscious
about the bias of the performance, it may fail to convince him and he will have
to modify it or reenact it later. People will sometimes walk away from the
mirror and then return to it several times in order to get “a fresh view.”
(Teenagers have a well-deserved reputation for working at such mirror routines
for hours on end.)
Keeping Our
Stories in Order
All of us have, as a primary life obligation, the
task of bringing conceptual order to our narrative world. This requires a
continual process of invention, editing, and self-negotiation. A fuss has been
made about the “denial” behavior of the problem drinker or addict. However, such
drinkers are only doing what comes naturally. We all engage in lengthy
conversations with ourselves and others about where we stand in life. In those
self-dialogues, we attempt to portray ourselves in very particular ways.
However, despite all our efforts to create and
maintain a viable and consistent self, our narratives tend to remain precarious.
In an unpublished study performed a number of years ago at the University of
Rochester, it took investigators only a few minutes to puncture large (and
potentially disturbing) holes in the narratives of undergraduate students,
chosen at random. It was an easy matter to find and point to inconsistencies,
for example, between their stated values and goals and their prior records of
activity and accomplishment. Fortunately, our personal stories are rarely
subjected to that kind of direct scrutiny. Usually, others are quite forgiving
of gaps in our “yarns” and, reciprocally, we are willing to accept their
presentations at face value. When a person is in conflict with others, however,
the rules change. There is then a tendency to focus on the gaps and
inconsistencies and to seek special explanations for them. Ordinary hypocrisy is
gradually converted to “pathology.”
Pathologizing the Obvious
Many members of the helping professions tend to
underestimate the degree to which people in general (and clients in particular)
are inclined to lie, cheat, and steal to get what they want. This leaves them
with a lot of “pathology” to explain. For instance, they may talk about the
“denial” of the problem drinker as if it were a primary and serious symptom of a
“disease.” This construction ignores the extent to which each of us — mentally
healthy or mentally ill —“languages” our situation in self-serving ways. When we
are in a jam, we may become even more extreme in our attempts to portray our
actions in favorable terms. In the social world, there are small and large acts
of “denial” all around us. For instance, virtually all accident survivors —
regardless of bow many bones they may have broken and how miserable they may be
feeling — are encouraged by their friends and relatives to consider themselves
“lucky,” given what might have happened to them. That is surely a form of
denial. Why isn't it just as plausible for a person to consider himself or
herself quite unlucky, given what did, in fact, happen?
The Computer
Comparison
The tendency to pathologize has unfortunate
ramifications. Unless used with extreme caution, the language of psychopathology
is a language of defamation — what Szasz has called the “language of loathing”
(1973, p. 27). In the mental health field, “symptoms” are rarely described in
neutral or complimentary terms. These terms serve to emphasize distinctions
between people rather than similarities. Yet most of what problem drinkers and
other addicted individuals do is perfectly ordinary and does not require
invoking mental health jargon or fancy explanatory schemes. At the level of
organism operations, the behavior in question is perfectly functional and
understandable (e.g., Steinglass, Bennett, Wolin, & Reiss, 1987).
Only in language, from the viewpoint of a
hypothetical outside observer who applies artificially high standards of
rationality and consistency, does such behavior appear “sick” — self-defeating,
and dysfunctional. The mental health worker often takes exactly that
perspective, and so does the drinker himself or herself (often in between
drinks). Such observers, confusing semantic abstractions and actual system
operations, create for themselves a need to posit special explanations for the
presumably “odd” behavior they believe they are witnessing. They therefore focus
on peculiarities in the person's developmental history or attribute what they
see to deviant genetic and biochemical processes.
This sensed need for an extraordinary explanation
is heightened by the false belief in the rationality of people. This belief,
although widespread, is essentially a cultural myth based on very dubious
assumptions. People are not at all like computers that calculate the odds and
behave accordingly (cf. Gazzaniga, 1988). In fact, they frequently insist on
engaging in high-risk or self-defeating behavior in which the odds are clearly
stacked against them. Human beings, unlike computers, often spite their noses to
save their faces and act in a multitude of other ways that might seem foolhardy
to a dispassionate observer.
For example, people are often reluctant to take a
moment to buckle their seatbelts, even though that act might save their lives.
They do not necessarily cut their consumption of fried foods, despite the risk
of coronary disease, nor do they stay out of the sun to avoid skin cancer. When
the jackpot increases, they make a mad rush to buy lottery tickets, even though
the odds haven't shifted, and the difference in payoff amounts is hardly
consequential to the average individual. Moreover, people's decisions concerning
jobs, marriage, and large purchases are often based more on sheer caprice than
actual facts.
The Primacy of
Preferences
From a biological perspective, a strong case can
be made that we are fundamentally arational (i.e., not rational) creatures. In
fact, Maturana and Varela assert that all our systems of thinking and logic are
based on arational starting preferences. Thus, for human beings, preferences are
primary and logic is secondary — not vice versa. However, using language, people
quickly paste a veneer of justification on top of whatever they happen to be
doing. In this way, their choices can often be made to appear to be sensible.
People draw up lists of considerations, but when the list doesn't tally with
their hunches, they add or subtract items until it comes out right. Even actions
that are patently contradictory are made to sound consistent and reasonable. As
we pointed out earlier, this facade of consistency, created through the use of
language, rarely holds up under close scrutiny. The accounts people give of
their actions — their “stories” — seem plausible only when viewed at a certain
aesthetic distance, from which glaring discrepancies are ignored,
underemphasized, or successfully explained away.
At various times, even the clever use of language
or an appeal to common sense cannot mask the basic arationality of our
operations. For example, when normal individuals, are made uncomfortable by any
number of factors, such as a foul smell, a rise in temperature, or physical
stress, they may automatically become irritated and angry at targets that —
logically speaking — have nothing whatsoever to do with the source of their
discomfort (Berkowitz, 1990). They may even realize that they are being totally
unreasonable, but they may be powerless to do anything about it. A person in the
midst of a “pout” may recognize that he or she is playing a losing game, and
perhaps even acknowledge that the initial premise was farfetched or entirely
erroneous. However, the person may find it difficult to “reverse engines,” and
helplessly hears himself or herself making pronouncements and taking positions
that border on the preposterous. These primitive mechanisms are commonplace, not
psychopathological. They characterize the life of the therapist as well as the
client.
There are many other circumstances that occur on
a routine basis in which people do not act “as advertised.” For example, rarely
in real-life situations do we maximize rewards in the way we might expect from
learning-laboratory experiments. In situations involving "distributed choice" —
where current decisions recursively influence later reinforcement values —
people routinely pick alternatives that actually serve to limit rather than
maximize their overall profit margin (Herrnstein, 1990). Furthermore, it is
well-known that people are swayed by immediate and short-term contingencies,
often to the detriment of their long-term goals and interests. A person may walk
away with the model that's on the shelf rather than wait for the one that both
customer and salesperson recognize as being more suitable. Someone may decide
how much to “budget” for a particular purchase but will often exceed that figure
several times over on the basis of momentary whim or impulse. The costly
purchase will then be defended on the basis of one or more newly invoked
principles, such as “penny wise and pound foolish,” “you only live once,” or
“I've worked hard and deserve it.” Somehow, when the budget was being planned,
such principles were not considered worthy of being taken into account.
The principles embodied in our cultural folk sayings cover all bases. For
example, people can argue that they should “never put off until tomorrow what
can be done today.” On the other hand, they can point out that “tomorrow is
another day” and that “all work and no play makes Jack a dull boy.” When accused
of “chasing rainbows,” they can cite the advisability of “hitching your wagon to
a star.” A steadfast or stubborn man can be said to be “sticking to his guns”
and “avoiding switching horses midstream,” although if and when he is ready to
give up a position, he can argue that it is pointless to “beat a dead horse.”
Does “absence make the heart grow fonder” or is it “out of sight, out of mind”?
Do “birds of a feather flock together” or do “opposites attract”? Should a
person “leave no stone unturned” or should he or she avoid “rocking the boat”
and “let sleeping dogs lie”?
Before a behavior is labeled “pathological,” it should be evaluated against this
background of ordinary inconsistency and arationality. Theorists and
practitioners who want to understand why people gamble, eat, drink, work, or
love “to excess” might be advised to attend to the relatively mundane rules of
distributed choice, partial reinforcement, and the potency of immediate
consequences. Fancier explanations may be unnecessary. The very same operating
principles that control addictive states probably also apply to the coffee
fiend, the sports fanatic, the inveterate pack rat, the perennial
procrastinator, the video junkie, the compulsive doodler, the cleaning fanatic,
the computer nerd, the arcade freak, and so on. However, most of these patterns
are either too common or insufficiently upsetting to others to qualify as bona
fide addictions.
In fact, over time, several such behaviors that
used to represent merely bad judgment have now been reclassified as “genuine”
addictions (e.g., gambling, overeating, working hard, and sexual indulgence).
Almost all of these now have their own 12-step programs, and some have the usual
array of adjunct programs for friends and relatives. If the trend continues much
longer, virtually every individual in the civilized world will have at least
some support group to join. A person may someday be able to find a local chapter
of “Bookworms Anonymous” (for those who find themselves reading prodigiously) or
“Punctuality Anonymous” (for those compelled to arrive at work on time).
Researchers will periodically announce breakthroughs in finding the
neurological, genetic, and family-history correlates of these exceptional
patterns — and there will actually be some. Any occurrence — good or bad — can
always be connected to aspects of a person's developmental history or
biochemical colorations. We are, after all, little more than the sum total of
our bodies and our histories.
The Drift of Living
and the Semantic Domain
According to Maturana and Varela, life is simply
a “natural drift” — an essentially purposeless journey of an organism through a
medium. It is a kind of random walk, with each step paving the way for a new set
of choices. Every step is as important as any other, since it connects the past
with the future. As the person drifts, his or her structure continually changes,
as does the structure of the medium. Therefore, the person and the environment
co-evolve a suitable “fit” much the way a foot and a shoe accommodate to one
another through continued wear. When the fit becomes insufficient for the
individual's structure to remain intact, disintegration occurs — the person
dies.
On the biological scale, then, an individual life
is simply a series of mutual accommodations that end when a destructive
interaction comes along. Meanings — purposes, goals, intentions — are all added
to this “drift” by a human observer, who uses words and symbols to create,
distinguish, describe, and label familiar or recurrent action sequences or
patterns. The observer delineates boundaries, assigns causes, narrates stories,
and breaks up the ongoing flow into a series of cognitively manageable events
and units. It is there — in the cognitive domains of observers — that terms such
as “addiction,” “mental health,” “habit,” or “therapy” have their currency.
Such concepts are, of course, consequential. It
matters how we divide up the world of our experience and what we decide to call
things. As we already suggested, different words and symbols can lead to
different outcomes. For example, people who claim that they drink too much
because of a special habit, a biological abnormality, or a particular family
background (rather than on the basis of preference) dictate a distinctive form
of interaction with others. If people allude to their “drinking habit,” they
invite others to interact with them as “minimal selves.” They are not in charge
— the habit is. As de Unamuno notes in the opening epigram, a person who claims
to be operating out of “habit” disappears from view.
Terms like “habit” are used mainly as part of social negotiations, but they are
not applied to all behaviors for which they might be deemed appropriate. For
example, we rarely call behaviors we admire “habitual,” even if these are
performed repetitively and sustained over long periods. In other words, people
are apt to describe their smoking as a habit, but not their toothbrushing. A man
who, contrary to custom, decides one morning to remain in his pajamas until
after breakfast does not lament the need to first “break” a very long-standing
“dressing habit.” However, moments later, when his spouse suggests that he give
up gambling, he will almost surely argue that making that kind of change would
be practically impossible, given the number of years he has played cards.
Other explanatory schemes can also be milked for
their “political” advantages. Following recent news reports of possible advances
in genetic research pertaining to alcoholism (Blum et al., 1990), one client
told his case-worker, “Don't argue with me, argue with my genes” (R.J. Leffel,
personal communication, May 26, 1990).
Reductionism
and Reification
Explanations in terms of brain chemistry often
seem more “real” to us than those that focus on, say, patterns of communal
living, reinforcement schedules, or personal gain. This is, of course, the
reductionistic error to which our culture is prone. Virtually any pattern of
human activity — from falling in love to falling down the back stairs — can
legitimately (and sometimes usefully) be described in the language of
biochemistry. However, positing an explanation in one linguistic domain — the
biochemical — does not replace nor invalidate explanations proffered in other
domains, such as the sociological, psychological, religious, economic, and so
on.
Structure determinism cautions us to avoid this sort of reductionism and
reification. Explanations never replace the phenomena they seek to explain.
Lightning is still lightning, even though it can be described in terms of ion
exchange. Similarly, although one person's body is not like the next one's (and
ingested substances obviously have different effects on differently constructed
systems), it does not follow that biochemical descriptions are inevitably and
always the best tools for understanding and describing drinking patterns or
other activities that take place within a social matrix.
The ways we go about living together — including
how and when we gamble, drink, take drugs, commit infidelities, and so on —
remain matters to be examined through all of our “knowledge lenses.” These
include the linguistic domains of philosophy, ethics, mathematics, learning
theory, cultural anthropology, political science, aesthetics, and education.
Moreover, it is crucial to note that these “lenses” are languages — not
variables or factors. Therefore, a particular behavioral pattern or event, such
as hanging around bars, should not be said to be “caused” by economics,
biochemistry, religion, or what have you. Similarly, it is inappropriate to
claim that hanging out at a bar is 20 percent sociological, 40 percent family
history, and 40 percent heredity. Such statements confound the phenomenon being
explained with the sets of descriptive terms people use to talk about it. The
description may be “sociological” or “medical” or “religious,” but the event
itself isn't. The map is not the territory — the explanation is not the
phenomenon to be explained (Korzybski, 1941).
Two important — and sometimes neglected —
corollaries of this general principle are that (a) it is permissible to
intervene non-chemically in patterns of activity that have been described in
chemical terms, and (b) it is permissible to intervene chemically in those
patterns that were originally explained in non-chemical terms. That is, an event
— such as problem drinking — does not become the exclusive “property” of any
given discipline, no matter how much research has been done within that domain.
Thus, it is fully legitimate to prescribe ibuprofen for a headache that seems
intimately connected with a precipitous drop in the Dow Jones average; it is
also legitimate to prescribe Marx Brothers films or relaxation exercises for
someone attempting to slow the growth of a tumor or pass a kidney stone (e.g.,
Cousins, 1979). On the one hand, the stock market can figure into medical
practice, and, on the other, cancer can be addressed by the entertainment
industry.
The discovery of biochemical sensitivities or
genetic predispositions does not restrict the range of social action
possibilities available to a given individual. Religious figures have regularly
renounced sexual activity, despite the fact that humans are strongly primed to
respond to reproductive urges. Equally impressive are the large numbers of
individuals who have initiated hunger strikes (sometimes resulting in death) or
set themselves afire in order to make a political point. The kamikaze pilots of
World War II aimed their planes toward enemy targets and certain death, in
defiance of ordinary survival instincts. In accomplishing such feats, people
have demonstrated time and time again that social-linguistic arrangements are
not trivial — even in domains of activity that are usually described
biochemically. In slightly less heroic fashion, individuals with allergies,
diabetes, hypoglycemia, or dozens of other ailments — including addictive
patterns — regularly demonstrate the ability of people to adopt entirely new
lifestyles, modifying or giving up favorite foods (including salt, sugar, meat,
or dairy products) as well as a wide variety of cherished activities and
routines.
In the face of all this evidence of human malleability, it is nonsense to assert
that any single set of biological or historical "factors" forces an individual
to remain imprisoned within just one or two life options. Researchers and
clinicians have noted that in the case of hand-washing compulsives, people do
not literally need to perform a given compulsion at a set time — they may want
to wash, and be uncomfortable in postponing the act, but they are indeed capable
of doing so (e.g., Foa, Steketee, Grayson, &. Doppelt, 1983). Even chronic
alcoholics are able to control their drinking when it is worth their while
(Chase, Salzberg, & Palotai, 1984; Miller, 1983).
In this context, it may also be useful to remind
ourselves that experienced drinkers are able to act and feel intoxicated even
when the placebo drinks they have been served are devoid of alcohol content
(e.g. Marlatt & Rohsenow, 1980). In other words, such individuals can “do a
drunk” on just tonic or soda-pop — they do not need much direct chemical
assistance. Moreover, they may be as convinced as anyone else of the validity of
their performances. Here, again, people demonstrate more latitude in designing
their social selves than we usually acknowledge.
The Power
of Acknowledgement
From our perspective, the traditional “denial” of
the addict is not necessarily a denial of illness — it is a denial of
responsibility. The addict's claim, “I can stop whenever I want,” may be valid
after all. Equally valid is the unspoken second pan of that statement — “I don't
want to.” Rather than acknowledging this, however, the person is invited by
society to espouse the opposite position: “I want to quit, but I can't.” As a
result, the addicted individual is subtly given permission to be irresponsible —
to blame others, to make half-hearted “attempts” to curb consumption, to relapse
frequently, and to explain his or her “illogical” behavior through allusions to
hereditary factors and past life circumstances, including the addictive behavior
of parents and close relatives. As we have argued elsewhere (e.g., Efran,
Heffner, & Lukens, 1987; Efran & Lukens, 1985), this leads to a series of
paradoxical injunctions that get in the person's way. For example, in the
typical 12-step program, one is required to simultaneously admit being powerless
over the addictive substance and to somehow refrain from consuming it.
We submit that any strategy that first requires
that the person construe himself or herself as “addicted” has disadvantageous
elements. That is, it concedes in advance that the individual is operating at
the effect of a particular substance or activity. Such a concession reifies an
organism's behavioral choices or preferences into “afflictions” — a stance that
diminishes the role being assigned to the self. This linguistic maneuver
justifies and potentially amplifies personal helplessness. It can easily set the
stage for repeated failures at making alternative choices, or even convince the
person that there are no other choices. It also demands that the person
subscribe to a claim that is probably not true — that he or she really wants to
quit. Like the author who said, “I hate to write but love to have written,” most
addicted individuals may wish to have the effects of having quit but that does
not necessarily mean that they intend to quit at the moment.
As the existentialists have noted, a person is
his or her choices — now. Therefore, it is a hazardous policy to require that
individuals lie about what they are actually doing or demean their current set
of choices. “Reform” movements, which always sound so noble on the surface,
almost invariably have a hidden “down side” — they require that the individuals
involved renounce their current achievements and choices. Promising to reform
says to the world, “Will you accept me if I agree to be someone other than who I
now am?” This establishes a context of self-abrogation — of enforced distance
from the self. Changes that derive from that kind of negating context, motivated
by fear and threats of disapproval, are often short-lived. The moment the threat
is reduced, people tend to revert to their previous behavior. It is far better
for people to fully acknowledge who they are and where they have been, so that
they can operate from a position of strength rather than weakness.
Acknowledgements of this kind, which fully endorse the self, transcend the
domains of right and wrong, good and bad. They more solidly set the stage for
responsible action. Therapy can provide a context in which these distinctions
can be made.
Candor and
Psychotherapy
Hypocrisy is not only an important feature of
everyday social life — the grease that helps keep social interaction running
smoothly — it is also a central, defining component of client-therapist
interaction. Construed in this way, therapy must begin with a “lie” on the part
of the client.1 We have given a common example above
— the addicted individual asserts that he or she wants to quit, when this isn't
exactly true, and that he or she cannot quit, when that isn't really the case
either.
A person who has a problem expressed in
psychological terms is spinning a yarn in which there is a lie — a crucial
element has been omitted, underplayed, overdramatized, or altered (Efran, Germer,
& Lukens, 1986). The description the client offers of his or her plight is
intended to mislead listeners — including, perhaps, the person who is telling
the story. Consider, for example, the client who begins an initial therapy
session by claiming that “circumstances are hopeless.” Obviously, if that were
literally so, the person would not have appeared at the therapist's door. Thus,
his or her presence suggests that the statement is not to be taken at face value
— it is hyperbole.
Clients, as heroes or heroines of the exaggerated
tales they tell, frequently like to portray themselves as “innocents” struggling
against nearly impossible odds to win a battle against powerful external and
internal forces. The situations with which they have been confronted are
described as not being of their own making. They may admit to having committed
some minor infraction or having made an understandable error of judgment along
the way. They may even acknowledge having had to operate under certain
limitations of personal equipment or experience. Nevertheless, the heart of
their “argument” is that their basic faults (and therefore their current
predicaments) are not actually their fault (Brilliant, 1988).
The “sad tale” each client brings to therapy —
and which he or she sometimes refines and embellishes while there — is a mixed
blessing. The personal “innocence” it purchases carries a high price tag. It
requires the sacrifice of self-respect and self-satisfaction. It ensnares the
person in the role of victim — a role from which it becomes increasingly
difficult to escape. It is impossible to be an “innocent” and an autonomous,
responsible adult at the same time.
People who are willing and able to be totally clear about their situation —
taking credit (and blame) where these are due — rarely need the services of a
therapist. Such individuals have not made a mystery of their lives. Therapy is
the treatment of choice only for problems that hinge on self-deception. In those
arenas, therapy provides an opportunity for a client to “come clean” — to tell
the truth about his or her experience. Basic assumptive structures can be
examined; pockets of self-deception, which in other social settings may go
unnoticed or may even be actively encouraged, can be revealed. Therapy, at its
best, breaks up the little — but highly consequential — conspiracies of everyday
life (Rabkin, 1970). That is why it is so crucial that therapists and other
“helpers” not become a party to the ordinary social conspiracies, even under the
headings of “being supportive,” or “joining with the client.”
The smallest linguistic details in the client's
narrative may warrant therapeutic attention. For example, when a person says, “I
need to find another job,” instead of “I want to find another job,” a little
piece of the self is subtly being given away — and might usefully be restored if
the proper client-therapist dialogue takes place. Although the content of the
two sentences is virtually identical, the speaker presents himself or herself as
“smaller” in the first formulation — the self is being disclaimed (Schafer,
1976). Similarly, a person who “needs” a drink or a fix is less potent than a
person who merely “wants” one — even if he or she wants it “badly.” Just as the
research has shown that hand-washing compulsives can resist the urge to wash, so
too can alcoholics resist the urge to drink.
Two Real-Life
Examples
Throughout our presentation, we have emphasized
the importance of language. In the therapy we do, we are continually interested
in what things are being called, since that determines what they are apt to
become. We attend to snippets of language, continually asking ourselves and our
clients, “What is being acknowledged or disclaimed?” “What are the hidden
assumptions about self and others that are being taken for granted?”
We have learned, over the years, that when a
person claims to be unable to make a particular decision, the core issue is
generally not contained in the dilemma as the person is posing it. We recall
someone who was conflicted about whether or not to take a new job. He went back
and forth, describing the advantages of the offer and the related risks of
trying something new. However, in all this discussion he neglected to highlight
how strongly he felt about leaving his friends and relocating in another city.
He had been taught that “smart” people do not allow friendships to interfere
with their careers. “You can always make new friends” was a familiar slogan in
his family. Thus, he wanted to stay in town, but did not have his own permission
to turn down an attractive offer on the basis of attachments to friends. The
dilemma was resolved when he acknowledged that at this stage of his life,
friends were as important to him as career advancement. He coined a new slogan:
“You can always find another job.”
A 25-year-old single woman complained not only
about drinking to excess on a regular basis but also of being involved in an
ongoing relationship of several years without being able to decide whether to
marry her boyfriend or to look elsewhere. Neither her drinking patterns per se
nor the decision to ditch her boyfriend were critical. What was more central was
a conflict over the meaning of success and accomplishment in life. Members of
her family expected her to marry, settle down, raise children. To them, that —
and only that — constituted success and fulfillment. But this woman, who had
been moderately successful as an art student, entertained the notion that making
a mark in the world of art was as meaningful as starting a family. However, she
didn't have the courage of her convictions. Since a noteworthy career in art was
far from a certainty, it was especially risky to give up the immediate prospect
of family life.
The existence of a boyfriend allowed her to keep
her options open and to fend off potentially embarrassing questions from her
family. However, she doubted that she actually loved him, and she had the
guilt-provoking suspicion that she was just “stringing him along” for her own
convenience. When she drank, all of this made less of a difference, and she was
even able to convince herself that perhaps she did love him after all. They had
some good times together, and he was an understanding and reasonable person.
“Can anyone really be certain what love is?” she would argue.
In resolving some of these issues, it was
necessary for her to speak more clearly about the truth of her experience: Her
family and boyfriend would need to know that she intended to define herself as
an artist first, even if this meant facing critical failure and postponing the
start of a family. She liked — but didn't love — him, and they were not, in
fact, headed toward matrimony. The pathway she was choosing was risky but
honest. Nothing was being promised that wasn't being delivered. (To be
satisfied, one needs to be true to self, until or unless that “self” changes.)
After she made her position clear to her family
and boyfriend, her drinking disappeared as a major concern — not because she had
made a self-conscious decision to go on the wagon, but because she felt less
alienated from her pattern of choices and activities. There were fewer times
when she experienced a desire to “take the edge off.” Because, in this case,
drinking ceased to be seen as a problem, some readers might want to argue that
she was never an “alcoholic” in the first place. We would agree. However, it may
be that the term “alcoholism” is an appellation that does very few of us any
good. It is a term that has been reified and given an undeserved life of its own
(Fingarette, 1988; Peele, 1989).
Summary
Structure determinism emphasizes the central role
of language in shaping human affairs. “Languaging” is the essential element in
the construction of complex social performances. Using language, people not only
engage in a series of “life dances” but are also impelled to tell stories to
each other about the nature of these engagements. However, our language tools
spawn hypocrisy in social living. There isn't always truth in labeling, and when
the games people play are falsely labeled, the players find themselves
diminished — their enterprises may take unexpected turns and lead to outcomes
that fail to satisfy the participants.
From our perspective, therapy is a place in which individuals can reexamine the
implications of the tales they tell to themselves and others. As Rabkin (1970)
suggested, therapy is as much about candor as it is about change. During the
course of therapy, clients frequently discover that they have been sabotaging
their own efforts. They have sought to dodge responsibility for their
preferences, but the innocence they have protected has been purchased at
enormous cost. They portray themselves as pawns of history, biochemistry, and
fateful events. In this helpless role, they find themselves unwilling or unable
to create new and useful opportunities for themselves. Only by reclaiming
responsibility for their preferences — even those that now seem like mistakes —
can clients regain a sense of mastery over their lives.
To aid in this process of repossessing disclaimed
action, therapists must take a number of steps: They must avoid entering into
the social collusion that enables individuals to skirt responsibility for their
actions. They must pay more attention to the intricacies and inconsistencies in
the client's personal narrative. They must be judicious in applying the language
of psychopathology to the patterns of addicts and others, most of whose behavior
is, given the situations in which they operate, quite ordinary. They must resist
the temptation to reify biochemical and learning theory explanations of
addictive behavior — most of which are little more than technical restatements
of the obvious. It would be also useful if they avoided confusing semantic
descriptions — terms such as “addiction,” “habit,” “alcoholism,” “denial,” and
“disease” — with operational realities. Under these conditions, therapists will
be in a better position to help clients clarify the actual game being played,
and to see why the labels they previously attached to those games have caused
such frustration.
Footnote
1The therapist also usually begins
with the lie that he or she has a “treatment” to offer, but that's a point
outside the scope of the present paper. The interested reader can find a
discussion of the “lies” of psychotherapy in Efran, Lukens, & Lukens (1990).
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