The Rule

THE RULE

The first principle of NCP (Hoover calls the therapist 'a technician' -oops!) is to:

• seek to understand the client's point-of-view fully AND make every effort to ensure 'it is not altered' (p. 62).

Although this procedure seems counter-intuitive to normal therapy practice it's in accord with what Russ Hoover has argued to this point. Psychotherapy is not about fixing up what's inside people's heads for them; it's first about 'holding all relevant environmental and intrapsychic features constant as treatment systematically ensues' (p. 62).

When the above is not done, therapists are moving into the realm of desensitisation and defence mechanisms, just schooling clients in 'crafty sorts of minimisation and denial' (p. 62).

Interestingly (and I applaud him for this) he accepts that sometimes, in emergency situations, psychotherapy has to be put to one side because a person's life may be in danger.

Hoover gives an illustrative example: Judy has separated from her husband. The husband is very distressed that she has left. He is ringing her regularly, crying over the phone and saying he will do anything to get her back. She has come to psychotherapy to try to cope with the situation.

From my examination of the dialogue which I can't obviously reproduce in this post, his responses to the client initially could be described as paraphrasing. This stage enables him to fully understand what situation she is in. But next he also goes to an empathic level: where the emotional and cognitive elements implicit in the client's words are made explicit by the therapist. The latter is no mean ability and calls for either natural talent and/or tutored experience.

The gist of the first part of the session with Judy is that she keeps saying that she doesn't understand why she is having this tortured reaction (of guilt?) about his ringing her up crying and distressed. The therapist points out that his suffering matters to her--it's an adversity, already defined as something that matters to the client--otherwise she wouldn't be concerned about it. (We only get concerned or upset about things that matter to us. We cannot distress ourselves about things that don't matter to us unless we are actors and have vivid imaginations which enable us to go into a make-believe 'world'.)

Although the NCPst may think her husband is a 'loser' from earlier reports from Judy the therapist does not initiate any effort to get her to leave him. To do so would be to break the basic rule above and in any case, NCP is not interested in meddling in people's lives.

NCP resists any procedure that involves convincing clients that they are irrational to be upset and to change the presumed thoughts they have that are upsetting. Hoover says insightfully,

[I]s Judy really being irrational or rationally recognizing something the likes of which quite logically activates her alarm? . . . Is it not within the realm of feasibility that George really cares about her and that maybe she still cares about him? And one could ask, moreover, is it not at least conceivable she is to some degree the cause of his suffering (p. 65)?

The therapist's main focus is the adversity-alarm-emotional/mood reaction complex and his knowledge that people cannot get alarmed by what is completely okay with them. To blind oneself to this fact is to encourage the client to use defence mechanisms that in the long-term will not benefit the client. Defence mechanisms defectively reduce people's sensitivity to their environments.

His second illustrative case under the Rule heading involves an 11-year old girl, Deb, diagnosed as 'schizophrenic' who is afraid to be alone after attending the funeral of her uncle. The plot thickens when we realise that Deb believes that spirits are in her bedroom. The spirits she says can follow her anywhere but trouble her mainly at night.

Therapist identifies her scaredness and then says tellingly, 'I can [understand what you are saying]. But could it ever be possible for you to be among these spirits; to know they might be lurking about, and not be afraid?' (p.66).

She says well she would be okay if she knew they weren't going to do anything to her.

He says but if you didn't know that for sure, what then? 'Well I'd be scared she says'. She is quite sure that she can't live with the uncertainty about what they might/might not do to her without being scared.

Then he proposes not being scared coupled with this state of uncertainty as their therapeutic goal.

He makes sure that the denial and suppression paths are not used. He doesn't want to convince her that no spirits are in her room because he believes it is 'not therapeutic' to destroy her belief even if it's mistaken. (The RULE at work.) Moreover, he tells her that if there are spirits sneaking about it would be strange not to be a little bothered.

'But what if [---to restate the point--what if] we designated . . . our therapeutic goal, the queer thing of not being scared knowing all the while they might do something to us?' (p. 67).

Her response is fully understandable: 'Yeah, but I don't see how you could do that' (p. 67).

I hope you are eager to know how the therapist deals with Deb! I was. We all have to be a patient because although Hoover does take up the case again. It's in PART THREE, page 132! This PART gives many practical examples of how NCP works.