Трансформирующие пресуппозиции оценки путём счёта/ шкалирования

Some therapeutic approaches make regular use of “scaling” as a way to monitor changes in the intensity of a client’s feeling response, in order to track the usefulness of interventions. This is particularly true in Solution Focused Therapy, and in EMDR where the scale is known as a SUDS scale, an acronym for “subjective units of distress.” Scaling is most often used for unpleasant responses, but it can also be used for feedback about progress toward a positive outcome. “On a scale of 0-10, where 10 is the happiest you have ever been, how would you rate the way you feel right now?”

What’s not widely recognized is that scaling isn’t just a way to get feedback about interventions. It is actually a substantial intervention in itself, because scaling elicits a number of specific predictable changes in the client’s experience.

Many clients start out focusing exclusively on their present feelings without reference to other times and places, creating a kind of “tunnel vision,” in which their problem state occupies all their attention. This narrow focus often leads them to think of their problems in absolute digital terms, as something they are in—a “depression,” a “trap,” a “stuck state,” etc. that they would like to be out of.

When an experience is thought of as being a digital either/or, that implies that it would be very difficult to make the huge change to the opposite polarity, for instance from depression to happiness. When the problem experience is located on an analog scale, it is easier to think about making smaller changes along that scale, say from a 10 to a 9.

A conversational way to reply to a client who is thinking about their situation in a digital way is to say sincerely, “OK, how depressed (or trapped or stuck, etc.) are you right now?” The word “how” changes the absolute either/or into a comparison with other similar experiences, creating an analog continuum that presupposes different degrees of depression (or being trapped or stuck). The same thing happens when a client is asked to locate their present feeling somewhere on a scale of 0-10. Even if they rate it as a 10 at the end of the scale, that places it in relation to other experiences on the analog scale, creating a more balanced perspective.

A scale also requires the client to make simultaneous comparisons between different experiences. “Well this one was bad, but this other one was worse, and this other one wasn’t quite as bad.” While it is possible to make a simultaneous comparison in the auditory or kinesthetic modalities, it is much easier to do this with visual images. So even when the scale is not explicitly described visually as a horizontal scale or a vertical ladder, there is a strong likelihood that a client will spontaneously represent their kinesthetic feeling state as a visual image. When a kinesthetic feeling is represented as a visual image, that reduces the felt emotional response, making it less overwhelming, and easier to change.

When you visualize two (or more) experiences on a scale simultaneously, you become an observer of both, making it even harder to be immersed in either one. This creates some distance between the client and the problem state, sometimes called “self-distancing,” “externalization,” or “becoming more objective.” (NLP has traditionally called this “dissociation” but that term has many troublesome connotations in psychiatry, so I have turned to other more descriptive words.)

Seeing two images at the same time also usually reduces the size of the mental image of the present state, because generally the two images have to fit into the same space as a single image. This smaller size further reduces the emotional response, and this makes the problem appear easier to resolve.

Scaling can also be used as a basis for adjusting the location of a problem on the scale. “If you were to be at a 5, rather than a 6, how would your experience be different?” “What would it take for you to change from a 10 to a 9?” Scaling is particularly useful in something like pain control, or physical tension, in which the goal is simply to reduce a troublesome sensation.

So to summarize, what seems like a simple question for gathering information is actually a substantial intervention that changes a client’s experience in a number of ways, and sets the stage for further interventions.

This morning was chilly, with a beautiful fresh snowfall. My wife said, “It’s 7:45,” using a time scale. But she could as easily have said, “It’s 66” if she was commenting on the temperature, or “4” to indicate the depth of the snow in inches. Each of these responses can be useful, depending on the context. The time might be most important if we have a morning appointment, the temperature if I need to build a fire, the depth of snow if we’re concerned about driving somewhere. Whenever we quantify one aspect of an experience, that reduces it to a number on a single continuum, a huge oversimplification that ignores all the other aspects. Numbers are great for allocating people to airplane seats, but that inevitably ignores all their individual differences, and this can create problems.

In therapy, focusing on a “scale of 0 to 10” for a given feeling directs attention to its intensity, and away from qualitative aspects that may be more important. For instance the forgiveness pattern does result in resentment being reduced. However that’s not all it does. Much more significant is that it replaces resentment with a completely different feeling response, forgiveness. Using scaling for resentment continues to focus the client’s attention on the resentment, diverting attention from the possibility of having a qualitatively different response. While this may not prevent a client from benefitting from the forgiveness process, it certainly doesn’t support the change. Ideally every aspect of our interventions support each other in reaching an outcome.

Conclusion

If your goal is to simply elicit an analog change in the intensity of a response, as with pain, stress or tension, then it’s useful and appropriate to use scaling, which presupposes that a change in intensity is what matters.

But if your goal is to elicit a digital change in response—such as from anger to forgiveness, anxiety to confidence, grief/loss to a sense of presence, etc.—then scaling is not appropriate, and could even interfere with the process you are using.

If you’re not sure whether a quantitative or qualitative change is appropriate for a particular problem or outcome, you can combine these two approaches, which is what Connirae and I did many years ago when we were developing the Eye Movement Integration process. We asked clients to report any difference in the intensity of a feeling, and also asked them to report any qualitative changes in the content of the image, the submodality process elements (color, brightness, distance, etc.) or any changes in the kind of feeling.