The client was a 55 year old male from a non-English speaking country. His English was imperfect, with a strong accent. The most striking thing about him was his facial tics. His face was in constant motion, muscles jerking on both sides of his face, like a gargoyle, twisting and pulling his mouth, his cheeks, his eyes, the whole face seemed to have a life of its own. A new tremor erupted every few seconds.
But that wasn't what he came to therapy for. He told a very colourful life story with an astonishing history of serious personal injuries from childhood right up to the present. He had broken everything you could break. He had been in more than ten significant car crashes including being knocked down in the street outside the hospital where he had just spent several weeks as the result of being in a car crash. He had a pronounced limp from being shot by government forces during a coup. He was a political fugitive in several countries. He was proud of his wealthy landed family who had produced generations of colonial governors in his home country.
He first presented wanting to 'explore his spirituality' which turned out to mean investigating past lives. He had spent his life trying to understand his life. For example he had spent six months living in a meditation centre in India several years earlier, seeking spiritual harmony, unsuccessfully. He had fallen on hard times, but was intelligent, amusing and courteous, and seemed totally bewildered by his endless series of woes and by his current inability to take the opportunities available to him.
In the first session I tried hypnosis, but the induction failed because every time he relaxed for a moment the incessant movement of his facial muscles would jerk him out of trance. He was initially unable to relax at all and even attempting to utilise the tics as part of the induction process was unsuccessful.
In three further sessions he gradually gave out more of his life story and admitted that his real problems were gambling and alcohol and a vague but permanent feeling of frustration. He had recently migrated to this country, had married and now had a baby daughter, but something prevented him enjoying his new life. The three sessions with guided imagery gave him some benefits and he began to relax physically, but mentally he could not give up control enough to go into trance.
During each session I had listened closely to his language patterns. He did not use many overt metaphors in normal speech and had no clear NLP-type representational style. I did not consider him a good candidate for Metaphor Modelling but resorted to it for want of a better option.
The following pages give an annotated transcript of the session.
This is an interesting case because it illustrates several salient aspects of using metaphor modelling in the therapeutic situation:
The client initially offers the metaphor of a prison, but then abruptly switches to a different metaphor, and talks about a fence for the rest of the session. I find this happens in most MM sessions.
The balance of speaking changes as the session progresses. At first it is mostly the client, then mostly the therapist and finally the client takes over again once the blockage is cleared.
It shows how Metaphor Modelling can be incorporated into other therapeutic modalities. In this case the therapist is a primarily a hypnotist and uses standard hypnotherapy constructions along with the symbolic modelling, for example starting with a 'yes set' and ending with a long series of direct suggestion and positive reframings to cement in the change.
The client does not at first accept the idea of modelling the metaphor, and the objections need to be overcome. The transcript also shows later on that the client objects to the solution being developed, and how that is overcome.
The development of the metaphor in several places shows the use of the hypnotherapeutic technique of suggesting that very small changes are possible - one nail - and then building on that initial acceptance in getting movement towards a larger change.
It shows how persistent you sometimes have to be to get a metaphor at all from some clients. In this case it took eleven tries to get the first metaphor.
It shows how important it is to test and test again for acceptance of all aspects of the client's problems by repeatedly seeking buy-in and how the client will let you know when they have fully accepted the change by spontaneously suggesting new behaviour.
It demonstrates that the idea that all mental problems arise from childhood trauma is mistaken. In this case the source of the limiting mental construct clearly dates from events in adult life.
The case also very neatly illustrates how the metaphor directly mirrored the client's view of reality. The client was in serious financial strife, was being hunted by authorities and found physical and financial safety on an oil platform, perched high above the sea, with a fence all round and the only way in and out by helicopter.
It does not need a double or triple bind to cause severe problems for clients. The situation that the client was in led to debilitating problems in his life, but the controlling metaphor was a simple one level mental construct. Never the less, it still took considerable work to uncover and disarm the metaphor.
The case is memorable for another reason, too. It shows how clearing one problem can often clear a whole class of problems. The client wanted release from his frustrations and to be open to new opportunities in his new life. He got that. But he also got something neither of us expected. When I led him to the door to say goodbye, I was startled by another change - his face was perfectly still. The entire apparatus of tics and grimaces had totally vanished.