Sabotage (ˈsa-bə-ˌtäzh) is the act of doing deliberate damage to the therapy. To prevent the Therapist from achieving the positive end goal, or to protest about something; the act of deliberately spoiling something in order to prevent it from being successful. The deliberate action aimed at weakening another entity through subversion, obstruction, disruption, or destruction.
What has stopped you from changing so far?
By asking the Patient to identify the things that have stopped them from making the changes they require you will in effect be asking the Patient to go on an inner search through the past strategies that have sabotaged their attempts to change their behaviour. It may seem strange to think of Patients actually trying to sabotage getting better, but it a real phenomena that has to be appreciated and dealt with.
Patients are not used to identifying the things that stop them from achieving. They are usually more familiar with just not being able to achieve. By asking them to go back one step, you are helping them to see the cause and effect relationship between their problem (symptom) and the possible cause. In addition to this you are also identifying potential situations or behaviours in the future that might prevent the person from changing.
When you ask “What has stopped you from changing so far?” the answer is rarely available at the conscious level. This is because answers of this nature are not in the Patients conscious frames of reference. If they were already able to identify what has stopped them from changing so far they would have already made use of that information and started to change by themselves. The therapist’s role is to tease out the unconscious processes that lie behind the problem and then re-model the strategy or “problem maintaining pattern” so that it no longer occurs.
I had a Patient who wanted to be a little healthier and work out at the gym but who just couldn’t get motivated. I asked him what had stopped him from going to the gym in the past and he thought hard but couldn’t answer the question. So later when he was in trance I asked him the same question again and then he said “Oh I tell myself that I will never make it as a body builder”.
So, although on the surface (at the conscious level) he was telling himself that he ought to work out. At the unconscious level he really saw himself as Mr Universe but knew that he would never make it. So he had sabotaged his visits to the gym every time by finding some “very urgent work” that needed doing instead.
Sometimes the effort of having to get better is too much for some Patients. They feel that it is easier to hang on to their problem than to go through the anticipated effort or pain of trying to change (many Patients think that therapeutic change has to be painful, this is not the case). These Patients lack motivation and even though they present themselves for therapy they find all kinds of devious ways of getting out of actually having to do something that will help them. You have to be very artful with these kinds of Patients. You have to be more artful than they are. Usually they are not aware of their patterns of sabotage so direct confrontation is often of no use because they usually go on the defensive if you confront them with your observations.
There are two ways you can get these Patients to change. One is to work with them indirectly over many sessions Re-framing all of their yes-buts with indirect suggestion and metaphor to slowly chip away at their old belief system and then ease them off of their backsides and guide them into action. Or you can motivate them from inside by creating a context that will ideally catapult them out of their chair and into action. The later is a faster process but carries more risks. To get a Patient to sit up and really take notice you might have to be quite provocative but not confrontational (unless that is your usual successful style). You should be careful to maintain rapport even if you are challenging them.
Near where I had a practice in the South of England there is a famous stretch of white cliffs called Beachy Head. It’s quite a drop to the sea below. Sometimes if I had a really stubborn Patient who sabotaged all my re-frames I would say to them, “If I were to take you to Beachy Head now and stand you on the edge and give you a choice of either working together with me on your problem or you going over the edge what would you choose.” This usually puts things into perspective for them.
There was a frog hopping down the road and he came across another frog caught in a rut. So he tried to help him get out of the rut. Somehow the harder he tried the more tired the trapped frog became and just couldn’t get out. Then the trapped frog said “I have an idea, why don’t you hop down here and then I can climb on your back and get out”. “I don’t like that idea much,” said the other frog, “because then I will be trapped and I have far too many things to do today, so I will leave you to find some way out yourself”. Well, the frog went off on his way and when he was about 50 metres further down the road he heard the other frog close behind him. “Hev how did you get out! I did everything I could to help you but you just couldn’t get out. What happened?” Well, said the frog. “there was a truck coming.”
It is important to remember that there always comes a time in therapy when Patients should get off their backsides and do something different. Good Hypnotherapy is not about talking about change it is about changing. Even so, you may still find that some of your Patients are only window shopping. If they really don’t want to change you may have to let them go. Milton Erickson even admitted that he had to refer some of his Patients on because they were just not willing to change.