What Doesn’t Work in Psychotherapy?

Finger Traps and “Stop It”!

Posted May 18, 2019

All of us get trapped in our tried and true solutions. True resolution typically involves stepping outside of what we know as true and following a path that doesn’t always make sense. Resolving psychological problems by doing more of the same is pure folly, as we can see in the children's finger trap and in Bob Newhart’s hilarious sketch, “Stop It”.

The Child’s Finger Trap

iStock-104473519 Finger Trap Photo, open source
The Child's Finger Trap
Source: iStock-104473519 Finger Trap Photo, open source

The finger trap is a small cylinder made of woven hemp strips. The cylinder is not firm but flexible. One child asks another to put the index finger of each hand into each end and then try to escape these “handcuffs” by pulling their fingers out. As you might remember, simply pulling your fingers out only causes the fibers of the finger trap to bind more closely to your fingers. The more you pull, the tighter the finger trap becomes. It is only by giving up the logical solution of pulling out, and instead of pushing in, that the trap finally releases and your fingers may be gently removed. Pushing in to get out is a counterintuitive change. Getting to that illogical solution is what often creates the fun.

We might ask why problem-solvers try pulling out of the trap as their logical solution. The instinct to pull out is universal; virtually all children initially try to solve the puzzle in this manner. Most children then get stuck in the cycle of trying this method over and again. A closer look will shed some light on the hidden complexities of the finger trap and the paradox of change.

How Logical Solutions Evolve

As they grow, children learn many fundamental lessons about life. An important lesson involves solving certain challenges in daily living by “pulling out” of them.

If a child places her hand on an object that is too hot or cold she instinctively pulls her hand away. She learns to pull her feet out of her socks; the same procedure is used for taking off her shoes. If she steps in a mud puddle and her foot becomes stuck in the mud, she pulls her stuck foot out. When she grows older, she learns more complex variations on the same theme; to find your way after getting lost, you retrace your steps.

In other words, you find your way out of a challenging situation by going in the opposite direction from the way that you entered it. A child’s mind thoroughly understands this rule. Upon seeing the finger trap for the first time, the child’s mind immediately reads the problem, determines the problem-solving level, and goes into action.

This process occurs so fast that it is almost instantaneous. There is only one problem. The finger trap represents an exception to the rule of pulling out. It cannot be solved that way.

The Paradox of Change

This is an elementary example of the paradox of change. The logical solutions of pulling one’s fingers directly out only further traps the fingers. The harder one pulls, the tighter the trap becomes. More of the same solution breeds more of the same results. This is the now the familiar vicious cycle. The solution makes sense to the child, but it makes the problem worse. The resolution is a classic counterintuitive change. The resolution is a reversal of the tried-and-true prior solution. Pushing the fingers together releases the trap and allows the child to gently slide free.

This resolution is based upon viewing the dilemma differently. It is a product of using a different level of logic. The child solves the problem by doing less of the same instead of more of the same. The resolution is paradoxical and counterintuitive to most children. It usually results in cascades of laughter after discovering the “trick” of the trap.

How Psychotherapy Doesn’t Work

This leads to the question of what works and what doesn’t work in psychotherapy. If we keep it simple, most “problem solvers” find themselves trapped in their own finger trap or in their own nine-dot problem as we discussed in the last post. Problem resolution involves stepping out of our assumptions and escaping our own “neurotic boxes”. As we can see in the finger trap, this is easier said than done. Most solutions appear paradoxical or counterintuitive from within the logic of our own view of the world and the dilemmas at hand.

Effective Psychotherapy

Effective psychotherapies all help us make these paradoxical steps outside our problems by helping to make the counterintuitive “make sense”. Each effective approach offers a fitting explanation of the problem at hand along with a related rationale explaining the steps to resolution.

Offering simple, direct advice in line with the assumptions and typical solutions of clients plays right into the same vicious cycles of their problems. The goal is to break those cycles, as in the title of these blog posts—Breaking the Cycle.

Stop It!

This is the comic genius of Bob Newhart’s depiction of a psychotherapist using his tried-and-true two-word solution, “Stop It”! Visiting the clip below should not only prove fun but also drive home the point of what doesn’t work in psychotherapy.

Bob Newhart's "Stop It" intervention is so funny because it obviously is unlikely to work. The reason? Because it is most likely the same as what this woman has already tried. She is caught in the finger trap.  Most all of us try to solve our personal or interpersonal distress with solutions based upon what we know as true.  We then trap ourselves in vicious cycles of repeating variations on the same failed themes.

The Golden Thread

Solutions to many psychological problems--what I have called "the golden thread" that runs through all effective psychotherapies (Fraser & Solovey, 2007)--reflect a counterintuitive or paradoxical type of change. Such effective change doesn't make sense from our current struggles with our problems. What doesn't work in therapy is any approach that is too close to our own failed patterns. Effective solutions, the same as effective psychotherapy, help us to make sense of doing the counterintuitive--pushing in on the finger trap to get out--or literally thinking outside our own neurotic boxes as we saw in the nine dot problems.

So, What is Effective?

Our next step is to visit what we now know is true of most organized psychotherapies, and that is, on the whole, psychotherapy is effective. But how? Furthermore, how come there are so many versions of psychotherapy now determined to be effective? Which approach might be best for me? My next posts will step into these questions.

References

Fraser, J. S. & Solovey, A. D. (2007). Second-order change in psychotherapy: The golden thread that unifies effective treatments. Washington, DC: APA Press.