TIFT #90: Directive or Nondirective?

Announcment: Before going into the subject of this 90th post, we are pleased to let readers know that our Psychotherapy Coaching Community is up and running and accepting new members. More information is at the end of this post.

The issue of directive vs. nondirective is relevant in so many relationships where one with more knowledge or experience helps another with less. Today’s trend is towards the nondirective, but that isn’t always the best answer. The post is primarily about learning positive skills and patterns, as opposed to cognitive learning, though I’ll mention the latter briefly. Let’s consider the issue of directiveness as it relates to:

• Psychotherapy clients with maladaptive patterns
• Those suffering from compulsive behaviors
• Athletes and other performers
• Coaching clients
• Students and trainees
• Children developing new skills

Searching for wisdom on this subject, I ran across a research paper on counseling people for weight loss (Gabrielle et al. 2011). One group was counseled in a nondirective way and the others were directed. Guess who did better? The group that was counseled directively! In my own experience with addictions, I, too, have found that the neutrality I had learned in my psychodynamic training was not appropriate. The traditional approach of interpreting the person’s dysfunction and waiting for change was simply ineffective with addiction. Wilhelm Reich talked about “character armor” and the need for a more forceful stance, but the taboo on telling people what to do has been deeply internalized by generations of psychodynamic therapists. The point here, is that “it depends.” There isn’t one rule for every situation. How, then, can we untangle this question?

Child development

As so often happens, the best starting point is child development. Two dimensions are relevant. Directiveness in the context of parenting is about influencing the child in a particular direction vs. waiting for the child to find his or her own direction. Directiveness also carries the dimension of how hard to push. Does the parent push the child to engage with a challenge or not? And how much?

In both dimensions, direction and drive, parents must make judgments about what is optimal at a unique point in the child’s development. Optimal means giving direction unless the child is ready to explore on their own, but ready is a tricky call. Parents constantly estimate their child’s readiness to find their own way and ability to take on hew challenges. What child development clarifies for therapists, coaches, teachers, supervisors, etc. is that development involves both helping clients discover their direction and helping them deal with mixed feelings about new challenges.

Being seen

The degree of accuracy of the helper’s judgment has profound impact. A helper who is on target gives a sense of security. The client feels seen as they are, as an individual. On the other hand, random errors give a sense of not being seen. When the errors follow a pattern, it raises the question of why? What personal agenda is driving the helper’s decisions? In both cases inaccuracy erodes trust, whether acknowledged or unconsciously felt.

On the positive side, having someone recognize us as we are brings strong positive feelings. When a helper recognizes strengths, it gives the client a sense of ownership of those strengths and encourages making use of them. It may even be reassuring to have an outsider recognize weaknesses, giving a sense connection along with being seen. Accurate assessment helps with self-acceptance, too.

In yet another way, when the more experienced person “believes in” the other (and is not wrong,) the result is “en-courage-ment.” The child, trainee, etc. feels energized to try harder. Why is this? The human mind is an organ of prediction. Well placed encouragement supports hope, which can be defined as prediction of a positive outcome. Anticipation of success is a strong motivator for doing hard work. (I have also seen false hope as a reason for resisting change. Ask me and I’ll explain.)

Pride and shame

Early interaction with primary caregivers naturally leads to internalizing their values. In most cases, we judge ourselves by those internalized values. When we fail or fall short, we feel shame, and when we succeed we glow with pride. Sometimes values are a source of trouble, such as perfectionism or placing a high value on being self-sufficient when interdependence is healthier. Early in life, we internalize the value of “being grown up.” That motivates us to master new skills and situations, which is the essence of growth and development. The anticipation of pride helps overcome reluctance to do hard work and risk failure. On the other hand, anticipating failure in relation to unrealistic standards leads to shame and is a deterrent to growth. Changing values is challenging, but starts with helping clients recognize the need and supporting healthy behavior in spite of waves of shame.

When good things are hard

If growth and learning required only exposure to new information, there would be little need for teachers and coaches, or even parents and therapists. Much of what we do is to help clients overcome barriers to acquiring new abilities or trading in old ones. Why is development hard? Evolution has taught us to conserve energy. That’s probably why it takes a lot of will to overcome a natural resistance to doing hard work. That applies to mental work, as well. It is worth noting that, at rest, the brain consumes the most energy per gram of any organ in the body. We all know that a first day at a new job or activity is exhausting. Much of that comes from the mental work it takes to do things for the first time. When we follow well established habit patterns, it often seem effortless. The computational efficiency of doing the same thing over again presumably saves energy.

What that means is that much of growth and development is experienced as work, especially when not matched with anticipated reward. Add to that the risk of possible failure, shame, and social pain from disappointing those who believe in us. Taken together, forces against change can be formidable.

Let’s add a factor that is central to psychotherapy, but visible in other kinds of performance when individuals defeat themselves. Entrenched maladaptive patterns, the problems that psychotherapy aims to change, are generated for a reason. As I have written elsewhere, they are products of the nonconscious mind’s mission to protect us. They are entrenched because the mind naturally resists efforts to take away it’s cherished protective strategies and weapons. In addition, the mind’s self-protection is often achieved by shielding the self from problematic awareness. Many entrenched maladaptive patterns embody strategies to block awareness. That can include knowledge that could give hope and positive motivation. For example, the belief that others won’t want to support or help an individual might lead to missing out on available support. Another example is addiction, where early use of a substance may mean never having experienced the satisfactions of sober life. Without a taste of past pleasure, there is little motivation to do the work.

So what are we therapists, coaches, and teachers to do?

I hope I have made a case for close attunement, not rigid policies. If we are to maximize our effectiveness, we need to do what parents do, practice seeing our clients as accurately as possible and being in touch with their experiences of discovering their direction and facing their challenges. Fortunately, as helping professionals, clients come to us with the expectation that we want them to make progress in directions they value. We have a built-in mandate to side with positive goals of healing and growth. In favoring health, we are not imposing our values, but doing our job. In the end, having accurate expectations and believing in our clients’ desire to heal and grow are basic and vitally important, even when some parts of the mind may see otherwise.

Trust

Neutrality may be safe, but it is not effective. Being an actively supportive therapist does incur risk, but it’s more than made up for in benefits. Most of the problems that arise from being an active therapist or helper are due to difficulty with trust. Trustworthiness is essential, but transference can add an additional layer of difficulty. Clients may expect us to fail them just as others have done before. This makes them especially attuned to hints that we are “just like them.” Even without such negative expectations, clients are highly sensitive to indicators of inauthenticity or lack of caring. Similarly, when helpers’ needs intrude on the relationship, trust is eroded. When clients don’t trust that we really want them to succeed, the alliance loses one of its most important success factors. Therapists who try to disguise their feelings, are, fortunately, doomed to fail. Their clients pick up the clues anyway. In the end, research shows unequivocally that a positive alliance leads to better results.

Discovering one’s personal direction

In coaching as well as therapy, the job often hinges on the client discovering a direction that resonates with their deep limbic self. As advertisers know, that part of the self, sensitive to colors, music, and smiles, is the most powerful seat of motivation. For better or worse, success in life usually requires engaging that deep motivation, yet it is often hidden and undiscovered. Finding how it connects with the individual’s environment often requires trial and error. Simple lack of experience may make this impossible to determine at first. People are asked what is their “passion?” Many, especially those whose minds have been preoccupied with survival, have no idea. They must go through a process of discovery.

That is where nondirective comes into its own. It is one more way that we need to be accurate in recognizing to what extent our client must go through their own process of discovery. Some clients need help and others need to be left to discover for themselves. Some want help but use it to avoid facing the unknown. Others who need help may push it away. We need to recognize that our own ideas or influence can either facilitate or distort the process. One reason teens keep things from their parents because the parents carry too much weight. Their opinions can prevent the young person from accurately feeling out their unique deep motivations. We helpers can have a similarly exaggerated weight of influence.

Further complicating the situation, especially for young people, not all deep motivations lead in directions rewarded by the outside world. We presume that early learning teaches humans the rewards of giving others what they value. That is a formula for success in the world but not every client works that way. Young people are constantly exposed to internet millionaires and pop stars who promise that following one’s own inner genius will bring success. That is not always true. Super success grows out of a peerfect match between inner motivation and what the public happens to desire at that moment.

In the end, seeing our client and understanding these factors with precision are what should guide us in supporting our client’s discovery of their direction and in knowing whether to push and how hard. Meanwhile, accuracy and honesty in knowing ourselves are requirements for seeing others as they are. Despite the best of both honesty and accuracy, we will often get it wrong. Then we need to be ready to acknowledge our mistakes. Failure to do so is to impose our own ego on a vulnerable client and undermine the outcome we seek.

Learning and retention

I hope it is apparent that directive and nondirective have subtle effects on emotion. It is increasingly clear that a moderate level of emotion, including negative emotions and confusion, increases learning and retention of experiences and new material. Nondirective can heighten emotion, where directive can lead to clients tuning out when information is boring or "dry," that is, lacking in emotional content. The subject is beyond the scope of this post, so I’ll cite an excellent review (Tyng et al, 2017).

What kind of therapy, coaching, teaching, etc. 

The last point I want to make is that the distinction between “supportive therapy” and “uncovering therapy” is forcing a binary choice upon a nuanced scale. Not only do clients occupy an infinite matrix of possibilities, their precise position on the scale depends on the issue of the moment and evolves over time. There is really only one kind of therapy, as there is coaching, teaching, parenting, etc. In all these endeavors our efforts are aimed at creating the conditions for positive change. Given that change is hard, our own personal influence may be the most critical element in determining the outcome.

Jeffery Smith MD

References

Gabriele JM, Carpenter BD, Tate DF, Fisher EB. Directive and nondirective e-coach support for weight loss in overweight adults. Ann Behav Med. 2011 Apr;41(2):252-63. 

Tyng CM, Amin HU, Saad MNM, Malik AS. The Influences of Emotion on Learning and Memory. Front Psychol. 2017 Aug 24;8:1454.

Photo credit,  Vidar Nordli Mathisen, Unsplash