The person is likely to interrupt you and say, «I don't want to kill my mother!» You can respond «I didn't say to kill your mother. I said to ask the voices.» You need to maintain the dissociation, and then proceed with the standard format of six–step reframing. «Those voices are allies. You don't know that yet, but I'm going to demonstrate that they are. Now, ask them what they are trying to do for you.»

Ben: I'm currently working with a patient who is a chronic schizophrenic. I've discovered that I'm challenging his thirteen–year career as a chronic schizophrenic by working with him. During the last session, he essentially said that he has an investment in maintaining this career. So I applauded his great success at it.

What Ben is saying is really important. He applauds the schizophrenic's thirteen–year–old career. «How well you have done as a schizophrenic for thirteen years.»

Ben: He has the same name as a famous person, and I said that he was as talented at being a career schizophrenic as this person was in his field! He has actually had thirty–two years of treatment, but he has never had adequate family therapy before. In the context of family therapy he told me that he believed his mother would die if he resolved these problems and really became himself.

Was his mother present as he was talking about this belief?

Yes. I explained that she would not die if he got better. In fact, I said she would be pleased. Actually, the mother is somewhat incongruent about wanting him to recover. But I don't know where to go from there. My guess is that I should begin working on the mother.

OK. Ben's been working with a schizophrenic, and now he's going to work on the mother. The next step is the specific way in which he hooks them together. In other words, the mother says to the schizophrenic «I won't die if you get better. Go ahead and get better. In fact, I want you to get better.» (He shakes his head «No.»)

Ben: I didn't read the incongruence that clearly, but I feel that is accurate.

The question is, will the schizophrenic believe that incongruent statement? Definitely not. The schizophrenic is much more sensitive than you and I to those nonverbal signals. He's had a whole lifetime of reading them.

One thing you can do is to get a congruent response from the mother.

You might begin by sorting out the parts of her that do and don't want him to get better. «Ok, pretend that you want him to stay sick. Now tell him all the reasons why it's important that he stay sick.» She says «But I don't," and you say «Well, that will make it easier for you to pretend.» Then later you say «Now pretend you want him to get well.» «Well, I do.» «Of course; that will make it easier to pretend.» The logic of it is flimsy and irrelevant. All that's important is that you make it easy for her to respond. If you want to see something impressive in terms of nonkinesthetic anchors, have the mother alternate between those two behaviors while you watch the schizophrenic. Smoke will come right out of his ears!

Your eventual goal, of course, is to make the schizophrenic independent of whether the mother is congruent or not. In one sense, maturity is reaching a symmetrical relationship that allows a parent to be as incongruent as she wants, and the child can still maintain his own context and momentum in his life.

Whether the schizophrenic believes his mother wants him to stay sick or get well, if you're doing reframing you can say that the purpose the schizophrenic has in staying schizophrenic is to show honor to the mother. His purpose is to demonstrate how much he cares and how concerned he is about her welfare.

This is just standard reframing. I've gone from a piece of behavior, being schizophrenic, to the intent or the purpose of the behavior. I drive a wedge between the behavior «schizophrenia» and the intention or purpose of the behavior, and I validate the outcome. «You're right! Don't you mess around, because you care for your mother and you've got to demonstrate that to her as far as I'm concerned. I care for my mom, too.» Use whatever analogue is appropriate for this particular

guy.

Then you insist that he be schizophrenic until he has tested other ways of showing the respect and caring that his mother deserves and that he wants to give her. You insist that he continue to be schizophrenic until he discovers alternative patterns of behavior that lead to the outcome: showing respect and caring for his mother. «She deserves the best. If schizophrenia is the best, then you need to stay with it. If we can find a better way for you to demonstrate caring and respect for your mother, you'll want to do it that way, because she deserves the best.» By doing this, you operate entirely within his model of the world. At the same time I would also be working with the mother to sort out her behaviors.

Sometimes when someone has come in with aspects of her experience dissociated, we have chosen not to go for an outcome of complete integration. A big Dutch woman who had been in this country for twenty years was brought in by her husband, because she was displaying acute schizophrenic symptoms. She heard voices that were constantly propositioning her sexually, and making lewd and incomprehensible statements. She didn't even understand the meaning of those statements, because she was a «clean woman.»

A number of well–intentioned psychiatrists had attempted to deal with this woman. They explained to her that the voices were really her voices, and were a result of the fact that she was angry with her husband who had been involved with some other woman ten years earlier. This woman was extremely religious, and she had no way of accepting that explanation in her world–model. Her rage was unacceptable to her, so it was projected into auditory hallucinations. If she believed that those voices were hers, it would have shattered her conscious appreciation of herself. The voices were saying things and proposing activities that were abhorrent to her as a good, clean, religious woman. By trying to get the woman to accept this, the well–intentioned psychiatrists were running up against a stone wall.

This woman refused to go to psychiatrists because they were insulting her. So her husband and daughter brought her to us. The problem was getting serious, because she was slugging people who she thought were making indecent proposals to her. She was hitting and slapping waiters in restaurants, and people on the street—and she was a formidable opponent! Consequently, she was about to be locked up. We decided on a fairly limited therapeutic goal. The family was poor, and didn't have any interest in generative change. Mama just wanted to be comfortable, and the rest of the family just wanted Mama to be all right.

She was obviously already very dissociated. In this case it was a representational system dissociation. She had dissociated both the kinesthetics of the rage and the auditory representation of it. We made use of the dissociation, and simply widened it to get an altered state. Then we appealed directly to the part of her that knew what was going on. In the first session we were content with convincing her unconscious of a spurious piece of logic. We told her unconscious that since it had important things to say to her, it should say those things in her language of origin, so that she could completely understand. By doing that, we shifted all the hallucinated voices into Dutch. The consequence of this was that she couldn't beat up anybody here in the U.S., because she was hearing Dutch voices, and she knew that the people around her only spoke English. This was very confusing for her, but it was a good way to prevent her from getting into situations in which she'd actually be arrested or committed.

When she came back, we induced an altered state again, and I had a «revelation» on the spot. God spoke to me, and I reported to her what God said. «God said 'It is right and just and proper that blah, blah, blah.'" This revelation gave her instructions to move all the voices into dreams. So every night this woman would drop off to sleep and have violent dreams about taking revenge on her husband who had stepped out on her. During the day she was perfectly comfortable. We built in safeguards, so that the violent dreams didn't spill over into her behavior during the night, or she might actually have beat up her husband.