Ua

I go to bed, I just don’t sleep

Working with every-day language

The following annotated transcript is our twelfth published demonstration of Clean Language and Symbolic Modelling with a client from a group Ukrainian psychologists and psychotherapists. The group want to use Clean approaches to support themselves and their clients during the ongoing trauma of war.

The aim of the session was simply to demonstrate Symbolic Modelling ‘live’. The annotation gives some idea of what we take into account in deciding which Clean Language question to ask, and when.

Over two years the sessions have evolved into a mixture of training, supervision of client cases and live facilitation of participants.

This session illustrates a number of features:

  • The session mostly involved everyday language with only a few metaphors.
  • How we responded to a client who brings in lots of material in to the session that is important to her, but does not appear to have direct relevance to her desired Outcome. (See rows 4C, 10C, 12C, 16C, 22C)
  • How we repeatedly invited the client to consider how she would like her life to be (See rows 1F, 13F, 21F, 41F, 45F)
  • How we acknowledge the difficult and painful aspects of a client’s experience while at the same time retaining her desired Outcome as a point of reference (signpost) for the whole session – both for her and for us.

The above approach is particularly important for this client who is living under very difficult circumstances and tells us she has a long-standing ability to distract herself from the realities of life.  Symbolic Modelling provides an opportunity for the client to maintain two perspectives at the same time: The reality of now, and a desire to improve her life – without diminishing either.

The annotation describes our reasoning when deciding which Clean Language question to ask.

Transcripts of other demonstrations with this group are available at:

List of transcripts with Ukrainian therapists

Notes:

C = Client, F = Penny or James.

The client’s responses and our questions were translated by Anna Stativka.

The format of the Clean Language questions is highlighted in bold to make it easier to see their structure.

We have underlined the client’s words we selected to incorporate in our Clean Language question (as you’ll see we do not always ask a question based on the client’s last response).

When ‘Problem’, ‘Remedy’ and desired ‘Outcome’ are capitalised they refer to definitions in our PRO model:

Coaching for P.R.O.’s

The translation slows everything down by at least half. And although this session lasted for 40 minutes, it was probably equivalent to 15 or 20 minutes of the beginning of a session.

Row

Transcript

Annotation 

1F

And what would you like to have happen? Invites client to identify a desired Outcome.

2C

I would like, I would like to stop my insomnia. I don’t understand why I have this insomnia because I’m always sleepy. I want to sleep all day long. But then I go to sleep in the evening and I can’t sleep, and I can’t understand that. “I would like to stop my insomnia” is is a proposed Remedy to “stop” a Problem (according to the PRO model definitions).

3F

And how long has this been going on? The length of time a problem has existed is usually important, e.g. there’s a significant difference between acute (recent onset) and chronic (long-standing) problems.

4C

Several months. It started when I started to work with a request from one of my clients about her insomnia. “Several months” indicates the problem is becoming a pattern.

5F

Okay, and what you’d like is to stop your insomnia. And when you do stop your insomnia, then what happens? Standard PRO model response to a Remedy.

6C

I think that maybe I am more – when my insomnia stops I become more adequate. I stop living in some chaotic state. A mixture of desired Outcome,  Remedy and Problem.

7F

So when you become more adequate and stop living in chaos then what happens? Continue inviting a desired Outcome.

8C

It’s getting easier. My life becomes easier. Closer to a desired Outcome although “easier” means it is still linked to the current Problem.

9F

And what kind of easier is that life? Invites client to start developing the form of her desired Outcome.

10C

A life that is bearable. And I don’t want to – to make suicide. If the client sleeps better and her life is easier, it is likely that thinking about “make suicide” will reduce …

11F

So this life that is bearable, and you don’t want to make suicide. [C: Yeah.] Anything else about a bearable life like that? … and therefore we do not attend to it but continue to invite her to attend her desired Outcome.

12C

This is like a double bind, maybe, because a bearable life can be only if my daughter will die. And I understand that only her death will, to sort of say, ‘make me free’. And although  I [do not] want my daughter to die – it is absolutely not possible to think like that – but sometimes I’m thinking like that. And when in this situationI have insomnia it makes my life really unbearable, because I’m not young. I’m [nearly] 70 and I have a shadow when I don’t sleep because I have to take care of my daughter, and if [as well as] all of that I have insomnia, it’s really terrible. The client is in a very difficult situation related to her daughter’s ongoing illness. Given her insomnia has only been going on for “some months” it implies insomnia is a compounding but separate issue from her relationship with her daughter.

13F

So when that is the situation, what would you like to have happen when that is the way that it is? Continue to use the PRO model to acknowledge the reality of the client’s life and invite a desired Outcome given “the situation”. It gives the client an opportunity to define the scope of the session.

14C

What I would like to have happen, at a minimum I would like to sleep when I can, when I have an opportunity to sleep. A clear desired Outcome related to the initial presenting issue, insomnia.

15F

And so what happens when you try to sleep when you have an opportunity to? Invites client to start self-modelling the current pattern.

16C

When I’m trying to sleep I go to bed, but I just don’t sleep.  And now, when I’m talking about that, now I have a headache. And it started when I started talking about it. I’ve begun to –  I’m, I’m having it. We wonder: Is the headache directly relevant to the client’s desired Outcome, or is it simply a sign that this is difficult material for the client?

17F

You try to go to sleep and it doesn’t happen, so what does happen then, when you try? We decide not to address the headache at this moment but rather to continue with modelling and wait and see what happens.

18C

There can be two variants. First, if I’m more or less okay, I’m just lying quietly and reading a book. And the second variant, if I’m very, very tired, I’m lying down and I feel as if I’m in some mental fog.

19F

Okay, and so when you’re very very tired and lying down, how would you like to feel? Inviting client to identify a desired Outcome for “the second variant”

20C

I would like to be able to, if not sleep, to be able to calm down and read a book – instead of being in this mental fog that is very unpleasant. Client says she would like the “first variant”. However, this answer is still not about sleeping when she has an opportunity to (see row C14).

21F

So that would be to calm down and read a book. And how would you like to feel when you have an opportunity to sleep? Repeat question, this time specifying it is within the context of the desired Outcome of the session “when you have an opportunity to sleep”.

22C

I would like to feel that I want to sleep, because when I read a book at some moment I feel that I’m sleepy. And then I put the book away and sleep. Reading is one of my main coping strategies from my childhood – to distract myself from life, from reality, from my inner states. The comment about her “childhood” suggests her ability to “distract myself from life” is a long-standing pattern but not necessarily something that will prevent her from sleeping. Therefore …

23F

And what you’d like is to feel that you want to sleep, and feel that you’re sleepy, and then go to sleep. And so what happens just before you go to sleep? … we decide not to follow the client’s attention into her childhood but to continue to facilitate her to self-model how she would like to be.

24C

This is a kind of normal classical feeling that I’m getting to sleep. The I’m becoming – that I’m starting to, to fall asleep. It’s like heaviness in my body, and my eyes close, and I feel that I’m falling asleep. Client drops into metaphor.

25F

And when there is that heaviness in your body, where is that heaviness? Continue developing the metaphor.

26C

In my head, maybe. In my head.

27F

And whereabouts in your head, is that heaviness?

28C

[Pause] Somewhere inside my head. It’s like a fluid inside my head. It’s not any special point. It’s like a fluid that is inside all my head.

29F

What kind of fluid is that fluid inside your head?

30C

Lke fog. We wonder: Is this the same or different “fog” metaphor to 18C?

31F

Anything else about that fog?

32C

Yes, this fog makes my head not foggy, but, just the opposite. It makes it light. Easy. Light. It seems this “fog” is a Resource.

33F

Light. And so that fog makes your head light. What kind of light is the light of that head?

34C

Like forgetting-ness. Like forgetting.

35F

So it’s a light head that’s a forgetting, that’s a fluid fog in your head, that a heaviness. And your eyes close. Just before you fall  asleep. And so where could a fluid fog like that, come from? Invites client to identify the sourceof the Resource.

36C

I don’t know. [pause] This fog comes from life.

37F

From life. And a fog that comes from life. Anything else about a fog that comes from life?

38C

Yeah, my insomnia. It just works like that, that I am beginning to fall asleep. And then, in some moment, it stops and I cannot continue to fall asleep. This process of falling asleep stops. “Some moment” indicates a choice point is nearby.

39F

At some moment the process of falling asleep stops. So what happens just before that moment? Invites client to identify the choice point in the current pattern.

40C

What happens just before, is that something distracts me. I feel cold, for example. Or I begin to feel I need to take my medicine for my nose because my breathing is not good. I need some medicine to take to breath, and maybe I forgot to take this medicine. Or I feel cold. Or my daughter is crying. Or something else distracts me from the process of falling asleep. And this one moment, when it happens, when I’m distracted like that, I just cannot continue to fall asleep.

41F

And so what would you like to have happen at the moment? Invites client to identify a desired Outcome at the choice point.

42C

I would like other things not to distract me. I want all these things not distract me. Of course, however, …

43F

And can other things not distract you? … is this Remedy possible?

44C

These kind of distractions I’ve had them for several years and my observation is that when all these things distract me then I cannot sleep. So I think that’s it’s not possible that these things would not distract me. The reality is: “it’s not possible”.

45F

Not possible. And so when it’s not possible that those things would not distract you, what would you like to have happen when they do distract you – while you’re falling asleep? Continues to attend to a desired Outcome at the choice point.

46C

What I’m thinking about now, I’m thinking that this distraction is not a problem. My problem is that I cannot go to bed in time. And that I don’t use the time that is possible to use for sleep. Even this time that is possible for me to use for sleep I don’t use. My daughter, she’s sick and she needs somebody to always be beside her. And when it’s my husband, we divide the night – half of night he’s beside her, and half of night me. And because of that, my usual time when I go to sleep – because of this situation with my daughter – it is like 3am.  But even when I go to bed at 3am I don’t sleep immediately. I begin to read something to [pause] It’s the only, the one time in my day when I can be by myself, and have this time just for myself. And what I think is that maybe I need to stop doing that. And maybe I need to, when I go to sleep at 3am, just to discipline myself and to go to sleep instead of reading or doing something else. I think that for now there is only one solution for my insomnia, to discipline myself and to have a special order of things that I do after I go to bed. Client redefines the Problem from “insomnia” to  “I don’t use the time that is possible to use for sleep”. The “solution” is a necessary condition for sleeping at “the time that it is possible to use for sleep”.

47F

And so what needs to happen for you to discipline yourself like that? Continues to invite the client to specify the conditions necessary to experience her desired Outcome.

48C

I know what has to happen for me to discipline myself, but I don’t think that it’s possible because all my life I’m very bad with discipline! I think that maybe our conversation today would motivate me to do this, because in our conversation now I begin to have more awareness about how I do this insomnia problem to myself. The client considers that the “more awareness about how I do this insomnia problem to myself” may be the beginning of a change.

49F

And is there anything else you need right now in relation to sleeping? Bringing session to a close.

50C

I think that it’s enough for now, because now I better understand my situation with my sleep. And this new level of awareness will help me to do better, maybe.

51F

Okay, we’ll leave it there then. Thank you. We’ll find out what happens next month. We’ll find out how much sleep you’re able to get and whether you can discipline yourself to fall asleep. Let’s see what happens now the client has this new awareness. We call this ‘trial and feedback’.

52C

Yes, I feel better now. Thank you.

Discussion

James: Okay, we’ll open it up to the group for questions about our approach.

Participant A: I am now reading your book in Ukrainian. And now I am interested in the chain of why you asked this question and then this question, how it was in this case – how the sequence of questions works.

Penny: Every question is a result of the client’s last answer. We are modelling the client’s words, the structure of their thinking and this influences the next question we ask.

James: At the beginning we’re seeking for the client to state a desired outcome. So that we have a contract of where we are heading. In this case, there wasn’t a desired outcome that was forthcoming for quite a while.

And also, extra factors kept coming in to make the situation more and more complicated. And then, when we’re given a desired outcome [at row 14C], we look for the place within the structure where something needs to shift.

We’ve worked with a lot of people around insomnia. It seems to us falling to sleep is a natural phenomena and so if the person is not falling asleep something must be happening (in the words of this client) to “stop” them falling asleep. And we wonder what happens at the moment when the natural process is interrupted? This is likely to be a very important place and that’s why we asked quite a lot of questions about what the client was experiencing at those moments.

We’re not trying to hypothesise, nor are we trying to find a solution. We’re trying to facilitate the client to model their own structures, their own way of being in the world. And to find out which pieces are most important [to their process of change].

Participant B: And one more thing that I noticed during our session that from time to time, the client was doing this movement, back and forth, back and forth, and if I would be therapist, I would ask what does it mean?

Participant C: When the client started to talk about her problem with insomnia, her physical state became worse with a headache. And she says it did because that her coping strategy is to block off body sensations usually.

Penny: I think it was important in this piece of work when James asked “what happened just before the process of falling asleep stops?”

The client said “something distracts me.” And he asked: “And what would you like to have happen in that moment that something stops you.”

The client said “I would like other things not to distract.” And a key question we asked was : “And can other things not distract you?”

And the client got quiet. She went inside to think. And then she said “I think it is not possible things would not distract me.”. She’s been telling herself all this time that she can’t sleep because things distract her, now she says it’s not possible for things not to distract her.

James said: “And when it’s not possible, what would you like to have happen when they do distract you while you’re falling asleep?”

The client went quiet again. And she said: “Now I’m thinking the distractions are not a problem. My problem is that I cannot go to bed in time.” And she started describing what she needed to do.

I’m repeating all this because it’s important to get a sense of how the process works.

Also, to come back to what [participant A] was asking about the sequence of questions. We follow the logic of the clients metaphor landscape. Those questions are always relating to the client’s information, the client’s logic, their answers, that’s what we’re responding to – the reality of her life. Those questions were all about the reality of her life as she knows it to be.

We are not trying to change the reality of a person’s life. We’re facilitating them to find new perspectives, new choices, have other ways of being in the world while they have that reality

Participant D: I have an insight. I was thinking during this work, what are we doing? What do we create? We create a space for the client to become more aware about how his system functions – right here right now, without any other [input].

Penny: And to learn from that. For the client to learn from themselves.

Participant E: Ah yes, the client learns how to use his or her own system.

James: Exactly. Because the one thing that they can’t get out of is themselves. The way nature works is it evolves from what it has. We can only change from where we are. And a lot of people have not spent much time understanding, as you say, how their system works. And secondly, how do we prevent ourselves from understanding? How we, as the client said, distract ourself from life, from reality, from our feelings; how we stop thinking about things; how we do all these things other than go ‘this is the reality of my life, right now’.

Participant F: I just have an observation. I noticed a lot of pauses between questions, pauses and silence. And I like it because for me, these pauses give the clients a chance to go deep into himself or herself and to have this inner process.

Penny: Yes. And if the client is processing quickly, and something is happening in their metaphor, say something’s running or moving quickly, then those questions might come a little faster. The pace of our question is in relation to the client’s metaphor

Participant G: Sometimes I work with clients, and we are going to the direction to the desired outcome. And we are developing metaphors. And in some point, something happens, like in our session today that the client suddenly has a headache or some other physical symptoms. In this situations I pay attention to these symptoms. I leave the desired outcome and begin to pay attention and ask questions about these symptoms. Do I understand it right now that even if client has symptoms, physical symptoms, we continue to move towards a desired outcome, not developing this new symptoms, is that right?

James: No, it’s a choice. If you feel that it’s important for the client to develop the symptoms, then facilitate them to develop the symptoms.

In this case, we chose not to, but it’s not a rule. You have to make a decision about what’s the most valuable for the client, given their desired outcome.. And if you’re not sure, then ask the client. So if they say they’re having a headache, you could ask: And when you’re having a headache, what would you like to have happen next? We give them the choice.

What we don’t want to do is encourage the symptoms to get worse through our questions. If they’re in terrible pain, that they’re not going to be very creative and resourceful. If they’re suffering we want to be careful that our questions don’t make it worse for the client.

The client I would like to add, when I had a headache and the not-pleasant physical state, we were talking a lot about how you fall asleep, and what is going on before this is a pleasant process. And the more we were talking about this falling asleep topic, the better and then more resourceful I felt myself so this was very helpful because the resourceful topic about falling asleep makes me feel better.

James: If there’s someone who is new to the group that hasn’t spoken I’d be interested to hear what you learned from observing the demonstration.

Participant H: For me very useful to hear that we work with therapeutic contract. We don’t touch topics that clients haven’t requested.

James: In the demonstration the client started talking about her childhood. That wasn’t part of what she asked for. So we didn’t go there. And the client talked about her relationship with her daughter who’s very ill, and that didn’t seem to be part of her desired outcome, so we didn’t go there either. If the client had indicated that it was important to go into those experiences to achieve their desired outcome, then we would have done so, but we don’t take the decision on behalf of the client.

Participant I: I understand English, I don’t speak, but I understand. And when I was observing how you work in English, I had an impression that in English, clean language questions sound more natural than in Ukrainian, right? In Ukrainian it’s a bit of a different story because in Ukrainian it’s like they create a different space. Whereas in English, it sounds very natural. And for me, it was important because it helps me to better understand the method.

Penny: I wonder if part of that is that is because we’re repeating back the client’s words exactly and naturally incorporate them into our questions.

James: It’s an interesting observation. Maybe you can see if there are other ways to ask these questions. Because the important thing is not the translation of the question the important thing is the translation of the function of the question – what they invite the client to do with their mind and body.

And we’ve been doing the work for 25 years so maybe that helps!

Participant J: What is very valuable for me when I see how you work, I begin to think that the most important thing is not just to formulate the questions exactly word by word. The most important is to develop a landscape, to develop metaphors and help the client to follow his self-modelling process.

Penny: Absolutely!

Participant K: After a second module of of symbolic modelling [with Anna S]. I had a conversation with a friend and he was complaining about something and complaining and complaining and I just automatically asked him, ‘What do you would like to have happen?’ And he said that what he would like to have happen was so and so. I then asked him and when so and so happens, what happens then? And he said like, I never was thinking about that. And I then I thought of you two!

Penny: Thank you. Lovely to meet the new people.

One month later the client reported:

What was most important was the session gave me the awareness about the whole situation, more awareness than what I had before.

My sleeping is much better now. Although several nights in this month I had insomnia, but in general it’s getting better.

At first the intention and impulse to do something to create a special regime for going to bed at the proper time was very strong. After some time it became not so strong because these conditions were fulfilled.

It was a very strange feeling be so aware how this situation was created, the roots of this situation and the mechanics. And also it was so strange to have an intention to do something with that, and this intention was just natural. Not like pushing yourself, but just natural.

body * { color: inherit !important; }