... ↑
metanymous в посте Metapractice (оригинал в ЖЖ)
I want to respond to a number of points that have been raised in the comments to date.
Several people proposed using a scale of 1-10 rather than 0-10. A 1-10 scale implies that the lowest point on the scale is 10% of the highest point on the scale, making it difficult to scale a zero response. When I asked one woman why she used 1-10, she replied that the physicians who refer to her insisted on her using that scale in reporting progress, and that their reason was that, “There was no possibility of a complete absence of an issue” (precluding any possibility of a digital shift).
I responded that I thought it would be fairly easy to think of counterexamples to that particular limiting belief, such as asking the physician, “Do you ever seriously think about wearing women’s clothes to your office, or taking up wing suit flying?”—or some other similar unlikely possibility. And then ask him if he would scale that “issue” as a 1 or a 0, with 10 indicating, “Yes, I’m planning to do that tomorrow!” However, in her position I thought it would probably be best to just use 0-10 in her work with clients, and translate a 0 into a 1 when reporting to a physician.
Since we usually assume that a higher number indicates more of something, Bob’s suggestion to assign a 1 to the “most resentful” seemed counterintuitive to me. When I try doing that, I get a little confused, so I asked myself, “OK, When might it be useful to introduce a little confusion or uncertainty?” Many clients suffer from an excess of certainty, so it would be interesting to try that with a few of them, and find out if it is useful in loosening up the present state. Bob and I are corresponding about this, but haven’t yet reached a resolution to share.
Bob’s third comment was, “ ‘Physical’ scaling works too. I have clients work with ‘projects’ on a time-line facing into the future: ‘Hey, that looks a bit big, just to make it easier here, how about we shrink it down so that you can clearly see all of it?’ accompanied with a downward movement of both hands to allow the client to look down at the project in front of them.” That kind of intervention can be very useful, but it is somewhat different from asking an overt scaling question, so I won’t comment further on now.
I like both Bob and Nick’s suggestion of going off the scale that has been established. “What would an 11 (or a -1) be like?” This ought to be especially useful for a client whose experience is mired in the mid-range of what is possible for them, and who could usefully expand that range—something that is probably true for all of us.
Finally, Rob Voyle’s excellent post clarifies a very important additional situation. A client’s problem, described with a very general word like “distress,” “resentment,” or “bad feeling” may appear to be analog, but may actually be a combination of two (or more) distinct digital components. When one of these components is resolved, the overall intensity of distress is reduced, so it may appear to be an analog change, but full resolution requires a digital change in the one(s) remaining. This will often be true in PTSD, because the client’s bad feeling may be a mix of guilt, shame, grief, resentment, etc. in addition to the core phobic experience. Resolution of one of these digital components may actually be successful, but appear to have failed because of the remaining components.
The original question about when scaling is appropriate led first to the distinction between analog and digital change, and then to quite a number of additional understandings, which has certainly refined how I think of change. Again thanks to all who participated in this exploration.