In therapy there are certain elements which will always be present. Other things can be involved, but they are not necessary. Secondary gain will always be evident in every therapeutic change somewhere along the line. Manipulation of parts will also be evident in every therapeutic change. You are either going to change a part's behavior, or create one, or negotiate between them. And there will also always be some kind of alteration in the process of generalization. A generalization will either be made or broken, or a pair of them will be combined, or one of them will be split into two. Those three processes—secondary gain, manipulation of parts, and an alteration in generalization—will always be at work in every change.

Reframing Systems: Couples, Families, Organizations

The heart of reframing is the recognition that behavior can become detached from the outcome it is supposed to achieve. Psychologists recognized this years ago, and invented the term «functional autonomy» to describe behaviors that continued long after they had any useful function for the person. Psychologists didn't know what to do about this, but they did recognize it. They didn't realize that they could directly identify outcomes, and then select or design other behaviors, which they could tie to those outcomes.

The other aspect of reframing that makes it work so easily is that it is explicitly ecological. We make sure that the new behaviors don't interfere with any other aspects of the person's functioning. Any objecting parts become allies in selecting the new behaviors, so that the new behaviors fit in harmoniously with all the person's other needs and behaviors.

This takes care of the person's internal ecology, but it doesn't directly take care of the ecology of the interpersonal system that the person lives in. Sometimes when you change a person, she is fine individually, but the rest of her family suddenly develops problems. When you do reframing, parts will often object because they recognize that certain new behaviors will impact on people around them in ways that are undesirable. However, that presupposes that the person has parts which are able to notice how other people respond to her, and that isn't always true.

The only way to be really sure you are dealing appropriately with the ecology of the larger system is to be able to observe it. This is one of the values of doing couple therapy or family therapy instead of individual therapy. What we want to do next is demonstrate the application of reframing to situations in which you can observe the system that the person is in, and explicitly deal with the ecology of the whole system. Changes that are great for an individual are sometimes disastrous for the family or business organization in which she exists.

One of our students taught the Meta–Model to the nursing staff of a hospital. The immediate result was the patients got well faster, and the average hospital stay was reduced by a little over a day. However, the job of the hospital administration is to keep the hospital as full as possible to maximize income. Soon they had empty beds, and then an empty ward.

When the administration started proposing staffing cuts, the nurses saw the handwriting on the wall, and the average hospital stay went back to what it had been before. The change that was good for the patients was not good for the hospital system as a whole. In order to make it ecological for the hospital, there would have to be some way to maintain the economics of the hospital—generate more patients to fill the empty beds, or slowly reduce the staff by attrition, etc.

Many people go to therapy, start changing, and end up getting divorced. Usually that's because the changes they make don't take their spouses into account. Of course, afterwards you can say that they «outgrew their marriage» or that their spouses «weren't willing to change» if you want to cover up your incompetence. But if you can use reframing with the whole family system, you can do really clean work. It will be much easier to do and it will last longer, because other parts of the family system won't try to undo what you're trying to accomplish.

In order to successfully reframe a system, you have to take into account the needs and wishes of all members of the system. This is the basis for what we have often called «outcome therapy.» I think you can do everything you need to do in couple therapy, family therapy, or conference work just using this one pattern. The first thing you do is notice any message that elicits a negative response in someone else— whether in a couple or family interaction, or during a corporate conference or consultation. Then you simply find out from the sender of the message if the response that he managed to elicit was in fact a response that he intended to elicit. In other words, it's the old formula «Message intended is not necessarily message received.»

Let me demonstrate one example of «outcome therapy» — what we call couple reframing. Beth and Tom, would you come up please? I'd like to have you role–play a couple. I'm going to arbitrarily ask you to interact in the following way: Beth, you say or do anything, and then Tom, you act depressed.

Beth: Hello, Tom, how are you today?

Tom: Oh, I don't know. (He starts to slump and talk in a monotone.)

OK. I don't know exactly what portion of Beth's behavior Tom is reacting to, but whatever it is, I can see that it is getting a response that isn't useful, so I interrupt the interaction and anchor Tom's response. If Beth had asked me that question, I would just answer it, but it seems to have a really profound and over–determined impact on Tom, so I know something important is going on.

My next step is to turn to Tom and say, «Are these feelings familiar?» as I press the anchor I set up a moment ago.

Tom: Oh, yeah.

What's the name of the message you get from Beth when she says «Hello, Tom, how are you today?» in that way? Tom: «Go away.»

«Go away.» OK, now hold on a minute here. Beth, was it your intent to give him the message, «Go away»?

Beth: No.

What were you intending? Beth: I just want to know how he is feeling. OK. So it was just a straight question. You are interested in finding out how he is.

Now I turn to Tom and say «Did you hear what Beth just said?» Tom: Yes.

Now, I understand that you got a different message than the one she intended. Do you understand that she didn't intend the one that you

got?

Tom: Yes.

OK. Now, Beth, are you really committed to getting across the message that you intended? Beth: Yes.

This commitment step is really necessary. I'm setting up the leverage that I may need later on if she objects to changing her behavior in order to get the response she wants.

Now I ask Beth, «Have you ever been able to approach this man and ask him how he feels without having that profoundly depressive effect on him?» (Yes.) «Go back into your personal history and recall what you did in the past that worked to get the response you wanted.»

If Beth can find an example of when she was successful in getting her intended message across in the past, then I will ask her to do it here, and notice whether or not it works.

Beth reaches out and touches Tom gently as she says softly «How's it going?» Tom responds positively.

In this case it worked fine. If she can't find an example in her own personal history that works, I can have her think of a woman she respects, and ask her how that woman does it. She can use that woman as a model and try that behavior.

If I can't find a new response easily in Beth's experience, then I'll get it from Tom. I'll turn to Tom and say «Have you ever gotten the message 'Hey, how are you?' and understood it simply as a message of interest and concern?»