The King's Speech: A Model for Effective Psychotherapy
Effective and non-traditional methods of psychotherapy
Posted Dec 31, 2010
"The greatest weapon against stress is our abilty to choose one thought over another." - William James
On the surface, The King's Speech is a film about how Prince Albert, (Colin Firth), hamstrung with a lifelong affliction of stuttering, inherits the fateful role of spokesperson for the free world. His eccentric elocutionist, Lionel Logue (Geoffrey Rush), unflinchingly takes on the challenge of treating the soon to be King George VI. The stakes couldn't be higher: Britain braces itself for war with Hitler who seems to have an amazing bent for speaking his mind. By raising the ante on the huge screen (i.e., effective treatment of the monarch vs. Nazi victory) the secrets of effective psychotherapy are vividly revealed. Viewers discover how skilled practitioners can dramatically reduce the sting from problems faced by nearly all - psychological barriers to communication, fears of failure and residual harm from familial intimidation.
At first things seem hopeless. Before taking on Lionel Logue as a last ditch effort to help him address the public, the soon-to-be king experienced only abject failure. A bevy of highly credentialed quacks prescribed everything from smoking cigarettes to filling his mouth with marbles. Logue's insistence on conducting treatment at his bohemian office ("I'm sorry, my game, my rules, my turf.") and relating on a first name basis ("Lionel" and "Bertie" - Albert's royal nickname) threatens to unseat any starting point for collaboration. So, how does a self-taught speech teacher, would be actor, even a commoner from Australia, turn things around - for the client, the monarchy, the British Empire and possibly the entire free world? What unfolds is a story of gold-standard psychotherapy.
First of all, throw pomp and ceremony aside. Effective treatment is not predicated on kowtowing to titles or credentials. It depends foremost on the emergence of a trusting alliance between a caring therapist and motivated client. Research shows high success rates among practitioners who possess empathy and unconditional positive regard for their clients, independent of their formal training or preferred model of treatment. Logue facilitates the therapeutic bond in several ways: He establishes a trusting and collaborative relationship, engenders optimism by citing prior cases of success, exudes unwavering confidence in his client's ability to change, avoids personalizing or buying into his client's resistance, and uses non-traditional, multi-sensory approaches to enhance interest and involvement in therapeutic activities.
Dismiss the Freudian presumption that treatment success depends on professionally mediated resolution of deeply rooted unconscious conflict. Knowing that delving into personal matters was abhorred by the royal family, Logue proceeds under a pretense that the causes of the stammer might well be mechanical, not mental. The problem was framed as faulty breathing, and the remedy rested on dedicated practice of tedious speech and breathing exercises; a fine example of meeting clients where they are at and taking them where they may not want to go.
Incursions into traumatic childhood memories were not the primary ingredients of change, rather steadfast work on skills to cope with present obstacles to satisfying life experiences. Effective therapists no longer assume authoritarian roles as heir doctor; rather they model respect and appreciation for the client's life and work. They serve their clients as coaches, orchestrating opportunities to practice increasingly proficient skills for dealing with life's inevitable challenges.
Logue uses non-traditional means to capitalize upon Bertie's many strengths and available resources. His wife Elizabeth is drawn into the treatment by having to sit on the King's chest during a breathing exercise. The King's proclivity to express anger is redirected into a humorous exploration of expressive freedom. Using a mélange of innovative techniques Lionel has Bertie rolling on the floor, noisily jiggling his cheeks, and dancing around the office while singing his thoughts to the tune of "Swanee River." Spontaneous eruptions of profanity are rewarded as unimpeded phrases, reflecting progress in his goal for competent public speaking. In the course of experiencing newfound expressive freedom, Bertie steps out of his isolation and discovers the empowerment afforded by Lionel's friendship.
Another atypical, yet highly effective psychotherapy tool is the use of an intermediate object to catalyze the therapy process. In the midst of an episode of severe stammering, Bertie picks up an unfinished model airplane. Lionel recognizes his subject's keen interest and his therapeutic acumen comes shining through. If Bertie would agree to speak about matters from his childhood, Lionel would permit him to glue the missing wing in place. By anchoring Bertie's concentration to an object of interest, his speech becomes more fluid and it becomes possible to discuss emotionally stressful material. Like Lionel, I have found irrefutable evidence for the deployment of a host of mediating devises - ranging from painting, drumming, dancing, singing and acting -- to offset the anxiety provoking demands of traditional talk therapy.
Finally, Logue uses Socratic means to re-shape Bertie's long-term irrational core beliefs: Stuttering is irreversible; I am weak of character; I am defective; I cannot be a competent king. In the course of working with his coach, King George VI discovers that he has far more strength of character than his older brother; that he is able to meet the challenge of war with Germany; that being left-handed and knock kneed as a child are not signs of inferiority or defect. Perhaps the biggest revelation is that in contrast to remaining brow-beaten by the words and teachings of his pompous and hypercritical father, and intimidated by his inept and insecure brother, the new monarch, King George VI, reshapes his personal narrative and discovers his own inspirational voice.
Pathways to Self Discovery and Change (PSDC), by Milkman, H. & Wanberg, K. (Sage Publications, Inc., 2005) is the backbone of criminal conduct and substance abuse treatment for youth in custodial settings in Colorado, Kansas, Montana, Oregon, & Texas. The program has been successful in using non-traditional means, such as comic strip narratives, humor, interactive exercises, role plays and worksheets to teach pro-social coping skills to teenagers who were formerly resistant to most types of intervention services.