General semantics in the practice of a consulting psychologist.

IT IS NOT MY FUNCTION, I feel, to repeat general formulations of neuro-semantics. Rather, I would like to answer the queries of a certain number of professional people interested in applying techniques of general semantics. These people usually say, "I understand these formulations, but how would I apply them in a particular case?" It is this 'how' or methods that I would like to talk about.

The group of people with whom I have found that general semantics techniques work the most rapidly and efficiently and with whom I have been able to rely on general semantics exclusively in therapy, are the people with frank, open conflicts. For instance, the kind of person who comes in and says, "Such and such is bothering me. What am I going to do about it?" With such people I have, of course, used most of the principles and techniques described by Alfred Korzybski in Science and Sanity, relying especially on training in consciousness of abstracting and use of the extensional devices. I believe that this should be done in its entirety whenever there is time. Unfortunately, in life there is generally not time, and I have developed some of the following ways of using the techniques whenever a rapid extensionalization is needed.

A number of people come in with a problem involving a specific 'hurt' and with few other general personality complications.

Case 1:

J.A. reported that he was happily married, had a good job, and enjoyed his social life. In fact, everything in his present situation was very fine, but he worried about his wife's 'past.' His wife's 'past' boiled down to the fact that she had had sexual relations with another man in 1929, several years before he had married her. I asked him to write out how he felt about this. Here is the crux of what he had to say:

   To me a girl who has committed an immoral sex act is incredibly foul
   and unclean. It is a thing once done that can never be atoned for.
   There are no reasons to justify it and no punishment adequate. She
   should be stamped out as one would a horribly repulsive snake ...
   There is this leprous sore on her body which no amount of pretending
   will eradicate.

Because of circumstances, this man was able to see me only two hours a week for four weeks. I spent the opening two hours in explaining to him levels of abstraction and in showing him how to write and talk in lower, more differentiating levels of verbal abstraction. As soon as it was evident that he knew the difference between high inferential levels of abstraction and more differentiated levels, I put him to work on his own problems, re-writing his 'thalamic' outburst about his wife's 'past' in extensional terms of what had actually happened. The strong language he used previously simmered down to "organism X in 1929 had sexual relations with organism Y." With the formulation of the problem in these terms, his 'feelings' were greatly altered, his whole evaluation was changed, and at the end of eight hours, he felt there was no longer any 'hurt' existent. I have seen him ten months later, and he reports no recurrence of the problem.

Case 2:

C.S. could not seem to understand general semantics formulations and exhibited a condition which would ordinarily be labelled "dumbness." I was trying to help her with a severe depression. I asked her to write down for me what she was saying to herself when she got up in the morning feeling depressed. Here is some of what she wrote:

   I am so damned fat I can't move, I feel like a stuffed toad, and look
   worse. My house is positively filthy and I can't stand it. I have to
   go to that crazy party tomorrow and I haven't a decent thing to put
   on. My hair and nails need doing. My car is about to fall apart. I
   doubt if I can make it. Barbara phoned and said her heart is broken.

I was able to show her what is involved in extensionalizing problems on lower levels of verbal abstraction. Here is how she re-wrote the above after this demonstration:

   I weigh one hundred and fifty-five pounds and am five feet three
   inches.
   The house is dirty.
   Tomorrow I am going to a party.
   My hair and nails need doing.
   My car needs washing and the tires checked.
   Holly didn't propose to Barbara.

She reported 'feeling' improved after this re-formulation, and after steady practice in doing this sort of thing, her depression cleared up.

It can be easily seen that the above technique involved the application of very elementary "ABC" knowledge of general semantics. It involves:

a. translating fluid, uncritical, verbalizing into writing--a static medium

b. involving the visual and kinesthetic senses, and

c. putting inner speech into a form where assumptions, inferences, etc., can be verified, and then

d. altering these assumptions and inferences by reducing the levels of abstraction.

Now I am reporting these cases because I presume that a large number of us are interested in general preventive educational procedures and a very small number of us would be interested in deep, complicated cases. A great amount of work in preventing countless maladjustments, verbally produced illnesses, etc., could be accomplished by use of the above described extensional procedure and this could be done by teachers, scout leaders, parents, educational counselors, etc. The only qualification I would make for this is that the case be chosen wisely. The case must not have an anxiety neurosis, be psychotic, be 'dead thalamically,' or be acutely over-verbalized. To use Horney's terminology, he must have a "situation neurosis" and not a "character neurosis." (1)

Another variation of this simple procedure consists in showing the patient how we build up conclusions, generalizations, etc., from first order observations and in making him conscious of the differences between high order inferences, conclusions, generalizations, etc., and first order facts. Then we apply this technique to some obviously faulty generalization of the patient.

Case 3:

D.E. said, "People don't like to hear me stutter." When we broke this down to the underlying observations, it was discovered that an individual, John Smith, had said that it made him feel a little ill at ease to hear D.E. stutter. Upon changing his generalization to fit first order observations, he underwent favorable change in his general orientation toward his speech problem.

Case 4:

C.F. stated with some finality that girls would not go out with a stutterer. Again, I asked him to write down some first order observations.

a. List the girls you've been out with.

b. Make a written report on the question of whether other stutterers at his school dated girls or not.

c. Write up the results of a telephone survey to be conducted by him to determine whether certain specific females would date him.

Needless to say, when these observations were tabulated, he was forced to change his generalization to a more valid and hopeful one.

I generally tell people who appear to be making a large number of questionable inferences, such as the above mentioned cases, to write down the generalization or inference that is giving them trouble. The sheer looking at it quite often causes them embarrassment, etc. They decide to give it up, but with most of them, we have to go further. I tell them to draw a line under the inference, make a heading, "Supporting Observations," and then construct a list. The experience of seeing on paper inferences that are directly contradicted in most cases by observations, is very beneficial and, of course, introduces the correct order of abstracting. This procedure has great applicability in light cases of inferiority feelings, for instance, those we see in great numbers in college populations. Generally you will find at the bottom of the inferiority complex, some such improperly abstracted inference as "People don't like me," "I am socially inferior," etc. And if the case is not too deep, the above procedure carried out on many inferences over a period of time will induce a complete re-evaluation.

Another good extensional procedure is to have the case write his autobiography. This in itself gives insight and furnishes a certain degree of extensionalization. Further extensionalization will be gained by getting the patient to read this autobiography to you. Favorable therapeutic factors here are oral reading with consequent hearing by the patient of his own verbalizations and so evaluations and the situation of having to verbalize them in the presence of a second person. In going over this autobiography, certain 'hurts,' 'shocks,' etc., will be uncovered. The patient in many instances will cry, become tense, get shaky-voiced, etc. You are probably then dealing with a 'hurt' or 'shock' which is still persisting in the nervous system in some repressed form. I have people write about these 'hurts,' sprinkling their writing with dates and indexes and substituting terms with no 'thalamic' associations such as 'organism X' for the names of parents, siblings, etc. I have them do this until they can talk to me and themselves with no noticeable 'thalamic' upset.

Case 5:

G.F. was a manager of a shop which was getting an increasingly educated clientele. This was upsetting because she has a great dislike for 'education.' This turned out to have originated in the year 1909. In that year, she was attending grammar school and liking it very much. Her mother made fun of her for wanting to go to school. There were two particular occasions she remembered very bitterly. Once she had made some drawings at school which were on exhibition. Her mother made fun of them and refused to come to school to see them as the parents of the other children did. On another occasion she was chosen to take part in the school play. Her mother refused to come to see this. G.F. told of these experiences with great affective disturbance; tears, anger, etc. She was instructed to write about them at length using dates, indexes, and differentiating language.

When she came in after doing this, she said she did not feel different and so I asked her to read to me what she had written. She had peppered her writing with dates so that it went something like this:

Ethel[.sub.1909], Father[.sub.1909], Mother[.sub.1909], school[.sub.1909], etc.

When she finished reading this to me, she said, "Now I know what we are trying to get at. I feel like that was a different person to whom all these things happened."

Generally speaking, most cases can be considered over-verbalized, but relatively, there are certain cases with whom you get the impression that an acute over-verbalization constitutes the major symptom. These people talk extremely rapidly, frequently, and for a long time. They are quick, undelayed, and generally 'know all' about 'everything.' In many cases they may have an organic symptom which has been diagnosed as "psychogenic" by a physician and which they have acquired by reacting to an 'idea' instead of sense data.

With such cases I immediately begin to talk about consciousness of abstracting and the correct order of abstracting, and I generally hand them some object on the desk such as an ash tray or letter opener and show them how to investigate it silently, telling them to put it down as soon as they start to form words. In the beginning they will not be able to achieve this at all, or only for a few seconds, and will insist that you cannot investigate without using words; but with steady persistence, the length of time during which they can investigate silently increases and a remarkable change takes place in their semantic reactions. They become quieter, speak less and with frequent qualifications, etc. The writing techniques that I have described above will not work at all with these cases because their problem is over-verbalization, and you must begin below verbalization or their nervous processes will distort what they are doing.

Case 6:

B.R. knew too much about herself for her own good. She 'knew' she did not need therapy, that one or two lectures and a cursory reading of Johnson's Monograph Number 1 had given her all the information there was to have about general semantics. (2) She would drop in for her conferences a month or two apart and spend her time trying to convince me that there was really nothing wrong with her, asking for techniques that would clear her up in a few weeks. During some of these conferences, I told her that she was over-verbal and that she would have to learn to 'shut up.' I did not get an opportunity to go into this mechanism very deeply with her, so she simply repressed and then, when she did talk again she was worse than ever.

Finally, one day I handed her an inkstand to investigate silently. This enraged her, She said, "If I did not know you well, I would leave the office now." But she made an effort to investigate the inkstand. When she tried to investigate, she was still verbalizing inside and her lips moved. I finally got her to the point of investigating for a few seconds without forming words, and this was the turning point in her case. She went home and spent the whole weekend becoming acquainted with her home surroundings on the silent level. On Monday she returned, ready and willing for a long psychotherapy, and from that day on she improved markedly. She became really quiet inside, more delayed in her reactions, less tense, less resistant to analysis of her basic patterns of evaluation.

I want to report a shift that has occurred in 1941 in the kinds of difficulties I see in my work. I do not know whether this shift is due to local or personal factors alone, or whether it is a reflection of the world situation. The facts are that in 1940 'anxiety' cases comprised about eight or ten percent of my total case load; whereas in 1941, more particularly at the present time (July), anxiety neuroses make up ninety-five percent of my total case load. For a full, beautifully detailed picture of this type of disturbance read Karen Horney's The Neurotic Personality of Our Time.

In brief, such people manifest a diffuse, floating, generalized type of anxiety. They have symptoms which apparently have nothing to do with any previous negative conditioning. They are totally unaware of their underlying conflicts and may maintain that they have had a healthy and 'normal' life. But, like one of my cases, they may tremble when they pick up a Coca-Cola glass; or like another, they may go back five times to shut the gas off; or like another, they may tremble in traffic, although they have been driving well for thirty years previously.

I divide these people's therapy into two stages. In the first stage, lasting for about a month, I use a very active form of analysis utilizing autobiographical data, free association, results of the Rorschach test, to help make the case aware of his underlying conflicts. I am still working on methods of speeding up this period, and I shall not report on this stage of therapy because I am still formulating my views as to treatment. However, in trying to reconcile the gap between people's unconscious motivations and their conscious verbalizing, I have found Korzybski's cortico-thalamic formulations to be of immense value. As soon as the individual is actively aware of his basic conflicts, I introduce general semantics formulations with extensional techniques, and then the patient begins to show great progress. At the end of the first stage he is generally upset, tense, greatly disturbed by his self-revelation. I often get from psychoanalysts people who are in such a phase. They have gained excellent insight, they know a tremendous amount about themselves, but they do not know what to do about it. Their answer at this stage is, "So what?" General semantics, I have found, offers the answer to the "so what?"

The following is a summary of the results of my application of general semantics techniques during 1940. They hold essentially for 1941, with the exception I have made above for the anxiety cases.

In the first place, the use of general semantics in therapy, since the remedial techniques are built on a knowledge of invariant relations in the activity of the human nervous system, must apply to wide combinations of neuro-linguistic and neurosemantic patternings. During 1940 I have found general semantics techniques highly workable when they were applied to cases involving the following problems: homosexuality, mild manic-depressive psychosis, 'simple' schizophrenia, severe migraine headache, alcoholism, impotency, frigidity, severe anxiety, neurosis, insomnia, mild depression, extreme infantilism, stuttering, parental involvement, marital conflict, severe phobia, and cases involving extremely undelayed mechanisms.

Secondly, it has been my experience that the use of general semantics techniques cuts down the duration of therapy to one-half or one-fourth the usual time. I can hardly believe my own statistics on the length of treatment. They show the median number of hours in 1940 was eighteen. This tallies with the experience of other clinicians who apply general semantics procedures. It must be realized that in many cases the patient abandoned his therapy prematurely with a spurious sense of recovery, and, as pointed out above, there are a small percentage of cases that do not respond rapidly to any therapy. However, it must also be observed that many significant alterations in patients' behavior were effected in a very short time. Summarizing the results of the treatment of fifty cases seen for a period of ten hours or more during the past year, I have only three cases to report in which general semantics was not useful. In three other cases the benefits seemed extremely small. In other words, the use of general semantics produced conspicuous alterations in the behavior of eighty-eight percent of the cases.

The third advantage I have noticed in the use of general semantics techniques arises logically from the second. The possibility of rapid alteration of psychopathological disorders means that the expense of psychotherapy can be greatly reduced. Since people with poor or modest incomes comprise the majority of the population, psychotherapy has now become more accessible to a new numerically vast income group. The median income of my patients treated with general semantics techniques during 1940 was one hundred-fifty dollars a month.

The fourth advantage is that general semantics methods are highly teachable. This fact alters the role of the psychotherapist. He is now more like a science teacher than a father confessor.

A final advantage is its simplicity. To understand why we use general semantics techniques you must have a grasp of all the sciences relating to man, but many clinical disorders can be alleviated without the patients' knowing this background at all. They simply must learn in an automatic way to apply the devices. This requires little formal education. I have had little difficulty in teaching general semantics devices to housewives with sixth grade education, airplane mechanics, household servants, etc. Of the patients successfully treated during 1940, eighty percent had no college education. In fact, I have found college education quite often a barrier to progress because it so frequently produces an over-verbalized person who is quite incapable of applying his verbal knowledge to life.

To conclude, it may be repeated that general semantics procedures appear to be unusually effective in the treatment of a wide variety of maladjustments. Aside from this basic consideration, the main advantages of these procedures are that they are economical as to time; they are, consequently, less expensive to the patient than most other psychotherapeutic methods; the procedures are highly teachable; and they are relatively simple.

REFERENCES

1. Karen Horney, The Neurotic Personality of Our Time (New York: Norton and Co., Inc., 1937).

2. Wendell Johnson, Language and Speech Hygiene: An Application of General Semantics, General Semantics Monographs, No. 1 (Chicago: Institute of General Semantics, 1939).

HARTWELL E. SCARBROUGH, PH.D.

From Papers from the Second American Congress for General Semantics, August 1-2, 1941, Denver, Colorado. Dr. Scarbrough was a Consulting Psychologist in Los Angeles, California.