6) Symptom Enabling - Symptom Enabling encourages the client to practice, improve or exaggerate a given symptom – This, of course, highlights the absurd nature of paradoxical interventions. It would seem that active encouragement to practice, improve, or exaggerate disruptive behavior is the last thing a clinician would want to do. Clearly, the intervention lacks ‘face validity’ as it is antithetical to the goals of treatment. On the surface it would seem that by ‘enabling’ the client is likely strengthen and promote the problem. However, as with other paradoxical interventions, that when done correctly, it affirms the importance of ‘joining’ and strengthening the alliance.
From the client’s perspective, he may view himself as a ‘rebellious spirit’, and believe that his disruptive behaviors demonstrate his ‘spontaneous nature’. For the clinician to suggest that he ‘practice or improve’ his disruptive pattern places the client a quandary. The intervention conveys that his behavior is more in the realm of a ‘performance’ rather than ‘spontaneous expression’. The clinician can allude to the fact that just as Olympic athletes are scored for their performance, the clinician, staff and/or family will be ‘scoring the performance’ of the client’s disruptive behavior. In a non-confrontational fashion the intervention facilitates the client to feel ‘noticed and included’ as he experiences that his actions are being scrutinized.
The advantage of ‘enabling’ is that the clinician imposes his presence in a way that does not rely on the client’s ‘voluntary participation.’ By the clinician making his ‘helpful suggestions’, the client is usually left in an awkward position that highlights the obvious habitual nature of his behavior. When done correctly, the client has no way to avoid or ‘defend against’ this intervention. As a result (contrary to linear logic), the net effect is that targeted behavior simply fades away without planning or forethought.
By instructing him to ‘practice, improve or exaggerate’ the clinician establishes his presence / ‘shadow’ in a way that the client ‘can not escape’. As with all paradoxical interventions, a key factor is that it diminishes the client’s status-quo assumption that he is alone-in-the-world. The intervention is particularly useful in addressing non-criminogenic behaviors such as cursing, yelling, lying, etc.
Ultimately, ‘symptom enabling’ demonstrates that while words and ideas are important, it is the underlying dynamic of the therapeutic alliance that has the dominant impact on treatment. As with other paradoxical interventions, ‘symptom enabling’ (when done correctly), emphasizes the primary importance that ‘joining’ is the core ‘active ingredient’ in successful treatment.
7) Colluding - Colluding can be viewed as an extension of ‘symptom enabling’. In colluding the clinician gives his advice on how best to broaden and expand the client’s ‘business model’. A ‘colluding’ intervention may suggest new people and places that the client can bring his style of disruptive behavior. While ‘conventional wisdom’ is adamant that ‘enabling’ and ‘colluding’ have no place in treatment, within the goal of promoting the therapeutic alliance, these methods offer a distinct advantage.
‘Enabling and colluding’ indicate the clinician’s ‘close personal knowledge’ of the client. In so doing these interventions allow the clinician to ‘crowd’ the client’s comfort zone, The benefit is that the ‘supportive nature’ of the intervention completely undermines the client’s expectation for an ensuing ‘power struggle’.
Within the process of ‘colluding’, the clinician takes note of the client’s ‘style and direction’ and offers ideas in how to expand his ‘business model’. However, in the words of Alfred Alder, the intervention is akin to “spitting in one’s soup”. Once the clinician has made ‘helpful suggestions’ the client can no longer claim these ideas as his own. The consequence of ‘colluding’ is that the clinician establishes a strong ‘shadow’ presence that follows the client through his daily activities. The clinician therefore conveys (to the client’s surprise!) the ‘close relationship’ between them and how much they are ‘on the same wavelength’.
The advantage of ‘enabling’ and ‘colluding’ is that the clinician imposes his suggestions and presence in a way that does not rely on the client’s ‘voluntary participation.’ By the clinician making his ‘helpful suggestions’, the client is usually left in an awkward position that highlights the obvious habitual nature of his behavior. When done correctly, the client has no way to avoid or ‘defend against’ this type intervention. As a result, the net effect is that targeted behavior dissipates without effort, forethought, or planning.