HOW WE MIGHT USE DEMAMAPS IN COUNSELING.

GARDNER GATELEY [*]

COUNSELING AND PSYCHOTHERAPY often involve changing a client's demamaps. Demamaps are decision-making maps, (MacNeal, 1997). (See also Gateley, 1999 for extended discussion of demamaps.) Goal-directed decision-making maps, such as desire for happiness, contentment, etc., may motivate us to seek help from our clinicians. A typical client request might go like this (Watts, 1975):

"If I want to be a happier and more productive person, I have to eat less, drink less, talk better, etc., and I cannot do it. Will you help me do this?"

Once therapy begins, clinicians elicit patients' demamaps, strengthen productive ones, and create new demamaps that will help patients reach or modify their goals. Among the many techniques available for overhauling demamaps, the following are often used (usually without awareness of demamap construction):

* normalization, refraining, and redefinition (Goffman, Havens, Johnson)

* disapproval (Snyder)

* appeals to reason (Ellis)

* symptom prescription and utilization (Van Riper, Adler, Haley, Erickson)

* gestalt responsibility training (Perls)

* paradoxical intention (Frankl)

* contacting the present (Perls, Watts)

* elimination of the aggressive use of symptoms (Adler, Low)

* strengthening inhibitions (Dollard and Miller)

* assertiveness training (Salter, Alberti and Emmons)

* interpretations of behavior (Snyder, Werner).

Combined awareness of how demamaps function and the above techniques could help us develop new treatment strategies. The following eleven suggestions to clients for reducing or eliminating worry illustrate how we might do this. For example, a client could learn a new responsive demamap, such as, "When you find yourself worrying, think of it as normal."

1. Ask what your doctor says about your case. If you have a real problem with worry, you need to check with your physician. If he cannot help you, he will refer you to someone who can.

2. Accept that it is normal to worry sometimes. Don't give yourself the additional problem of worrying about worry. Everybody worries occasionally.

3. Note that too much worry is a dangerous practice. It may result in significant problems, from insomnia to ulcers.

4. Recognize that worry accomplishes little. We cannot prevent bad things happening by worrying about them. We may come to believe we can, if we make this post hoc error in logic -- we worry about a possible tragedy that in fact does not occur, then assume unconsciously that our worry prevented it. (Some psychologists maintain that we can use emotions and feelings as proof that we are right. When you think of bad things that might occur, you naturally feel some anxiety. From this you could conclude that your worry is realistic and therefore worry even more!)

5. Use common sense. Take the advice of the Dalai Lama: It is useless to worry about what you cannot control. If you can do something, do it. Don't complicate matters by telling yourself that you should be able to do something about everything.

6. Make worry a friend. Use worry to understand yourself. What you worry about can reveal your values to you, and become a friendly guide to self-insight. You might even feel proud of some of your worries. Certain worries are signs that a loving and caring person dwells inside the skin of the worrier.

7. Let your worries become triggers to productivity. We can use worry as a stimulus to trigger doing important tasks we might otherwise put off. When you find yourself about to engage in a round of self-torture, spring into action: finish the report, do those exercises, write those thank-you notes, vacuum the living room, do something for someone else, etc.

8. Remind yourself that you cannot be responsible for others. The word "responsible" means "capable of responding." As much as we might like to be responsible for others, we cannot. Gestalt psychotherapist Frederick Pens often made this important point in his lectures and writings. We can influence others, but not respond for them.

9. Recognize that to learn to live with worry or eliminate it, you have to have it. To overcome your fear of thunder, you need a thunderstorm. To overcome your fear of snakes, you must have a snake. Paradoxically, you need worry to overcome worry. When you are feeling calm and relaxed, think up a worry and deal with it! You might be surprised at the results of trying to worry!

10. Differentiate between the "here and now" and the "then and there." What you did or what happened in the past cannot in most cases affect you in the present without your cooperation. What is commonly called a "traumatic event" is often nothing more than a "dramatic event," a point that the rational-emotive psychologists make to "traumatized" clients. As Dr. Albert Ellis has long taught, we are not disturbed by events but by our evaluations of them.

11. Don't use your worries to disturb others. We can get attention by dominating and worrying listeners with detailed accounts of our problems. But ask yourself, is this a form of aggressive behavior? Many listeners feel uncomfortable listening to your tales of woe. Everybody has problems. Would it be better to keep most of yours to yourself?

Some Points to Consider

These suggestions may or may not help chronic worriers, even though the techniques used by competent clinicians to treat a variety of problems are embedded in them. As a speech pathologist and teacher, I am no expert in managing worry problems per se, but by analogy, treating patients who worry (anxiety, stress, self-torture) seems to be very similar to treating some speech disorders, stuttering in particular.

We can view such treatment of confirmed stutterers as a process of changing speech through changing the speaker's demamaps. I can illustrate this by summarizing a current popular method of treating stuttering known as "symptom modification therapy." A well-known promoter of this therapy, Dr. Charles Van Riper, (1973, p.205) described his four-phrase system as follows:

1. An identification phase in which the stutterer explores, analyzes and classifies the overt behaviors and covert experiences that characterize his particular kind of stuttering.

2. A desensitization phase devoted to decreasing speech anxieties and the other negative emotions connected with the disorder. We seek to "toughen" the stutterer as he confronts his fear and his experience of fluency failure.

3. A modification phase involving first the varying and then the unlearning of habitual avoidance and struggle responses, and also the learning through counter-conditioning of a new, more fluent, less abnormal way of stuttering.

4. A stabilization phase in which we help the stutterer to consolidate his gains, to create generalized sets that will make the new fluent form of stuttering automatic, and to develop proprioceptive monitoring of his normal speech.

Interestingly, during all of these stages, stuttering must be present for the client to make progress. In order to proceed, however, new demamaps must replace old demamaps. The client's old demamap, "When I expect to stutter, I should try to suppress it" is replaced by a new demamap "When I expect to stutter, I should do x, y, or z." (Let the stuttering out, and analyze it or cancel/correct it.)

During the stabilization stage, when many clients have little trouble speaking fluently, especially in the clinical setting, we discourage them from developing the demamap, "When I am having no trouble, I should enjoy my fluency."

Instead, we encourage the demamap, "When I have no trouble, that is a time to do some deliberate stuttering and practice my techniques, so I can keep my fear under control and stabilize my gains."

Notice that the final product is a "new form of fluent stuttering." The only "failure" that clients receiving treatment can have is "speaking fluently."

This system makes extensive use of symptom prescription and utilization. Van Riper's therapy for stuttering can be viewed as a system for demamap overhaul. However, one cannot use the system unless one has an in-depth understanding of the processes involved in the production of both normal and abnormal speech.

Although he did not use the term demamap, clinician Dr. Joseph Sheehan maintained that a change in one specific goal-directed demamap would lay the stuttering problem to rest for any confirmed stutterer! He asserted, "If you want to become a fluent speaker, don't try to hide it by pretending to be a normal speaker [old demamap]; instead, be yourself, be a stutterer" [new demamap]. Sheehan called his stuttering therapy Role-Taking Psychotherapy and was a living example of the effectiveness of the method.

Are there dangers in using the above techniques for treating worrying, even though they are useful in helping stutterers reduce or eliminate speech anxiety? Our purpose is to transform problematic or dangerous worry into useful and helpful worry, thereby making worry a "friend." (Wendell Johnson (1946) suggested similar techniques for dealing with useless or dangerous selfishness.) Might we focus too intensely on our goal-directed demamaps, and ignore unforeseen side effects?

It is possible that suggesting a client worry more for therapeutic purposes might produce more unwanted worry outside of therapy. However, if a client is receiving regularly scheduled counseling, such a complaint could help the therapist because the therapist can then take responsibility for it. A common complaint of stutterers receiving symptom prescription therapy (symptom "modification" therapy) for stuttering is that "Since starting my therapy, my stuttering has gotten worse." This might frighten an inexperienced therapist. Van Riper, however, used this complaint to strengthen the client's confidence in the clinician and increase the assertiveness of the client.

Van Riper would say something like, "And I am the dirty rat who did that to you."

Then he would say, "I'm glad that this is happening, for you need stuttering in order to learn how to do it in a better way."

Clients with a worry problem might fool themselves into believing that they are not doing the worrying. If worriers can deliberately increase their worrying, they may learn a useful lesson. For example, a significant insight that stutterers can get from increasing their stuttering is that "I, not the stuttering, am doing the stuttering."

Worriers who use worry to avoid work can turn this around and use worry as a trigger to start doing their work. Some workers use concern about personal problems as excuses for non-productivity. Prescribing worry as a trigger for getting work done might make it easier for them to become aware of this.

On the surface, telling a person who is sick from anxiety that her worry is "normal" appears foolish indeed, and that would be true if we use the statistical definition of "normal." The engineering concept of "normal" elaborated by Wendell Johnson, however, justifies this use. Given personality x, everything that x does is "normal" for her. Johnson used this concept quite effectively in his counseling of mothers who had interpreted various hesitancies in their children's speech as "stuttering." Johnson believed that some mothers' attempts to help often did the reverse, and reinforced speech hesitancies, a practice that could lead to real stuttering. When Johnson normalized their children's speech, he eliminated parental concerns and reduced the reinforcement. I should add, however, that Johnson was convinced that the misdiagnosis of children's normal speech hesitancies by others was the cause of stuttering. He based this theory on a statistical model of normal.

The deliberate increasing of fear of worrying by pointing out its dangers to a worrying client might seem a case of "preaching to the choir!" Yet, as a Sunday-school teacher, I once spoke to a group of elderly people about the uselessness and possible dangers of worry. After the talk, a lady stopped me and said, "You are exactly right. My doctor told me that if I did not get hold of myself and stop worrying, I might just get sicker and pass on. I came home, thought about what he said, and stopped that foolishness."

Conclusion

Because understanding other people consists largely of discovering their decision-making maps (demamaps), it is not remarkable that working with demamaps is a significant part of counseling. When students come to me with problems, we can usually resolve them by using demamaps analysis. The fact that they come for counseling reveals a positive responsive demamap: "When you have a problem you cannot solve, ask for help."

If they are in conflict about where they want to go to graduate school, for example, and have several schools in mind, I have used the scorecard demamap to help them reach a conclusion. We list the positives and negatives of each possible choice, and they usually are able to make a decision they can live with.

What I like about using demamaps in speech therapy and student counseling is that I don't have to learn a lot of new techniques. Awareness of demamaps makes it easier for me to apply those I already have available.

(*.) Professor of Communications Sciences and Disorders, Baylor University, Waco, Texas. Dr. Gateley holds the Certificate of Clinical Competence issued by the American Speech-Language and Hearing Association (ASHA), and the Certificate of Specialty Recognition in Fluency Disorders awarded by the ASHA Specialty Commission on Fluency Disorders.

REFERENCES AND FURTHER READING SUGGESTIONS

Adler, Alfred. Understanding Human Nature. New York: Greenberg, 1946.

Alberti, Robed E., Ph.D., and Michael L. Emmons, Ph.D. Your Perfect Right: A Guide to Assertive Behavior. San Luis Obispo, CA: Impact, 1974.

Dalai Lama. His Holiness the Dalai Lama and Howard C. Cutler, M.D. The Art of Happiness. New York: Riverhead Books, 1998.

Dollard, John and Neal E. Miller. Personality and Psychotherapy: An Analysis in Terms of Learning, Thinking, and Culture. New York: McGraw-Hill, 1950.

Ellis, Albert. A Guide to Rational Living in an Irrational World. Englewood Cliffs, NJ: Prentice-Hall, 1961.

Erickson, Milton H. Conversation with Milton H. Erickson, M.D., Edited by Jay Haley. New York: Triangle Press: Distributed by W. W. Norton, 1985.

Frankl, Viktor E. Man's Search for Meaning: An Introduction to Logotherapy. Boston: Beacon Press, 1959.

Gateley, Gardner. "Rational Behavior as Correcting Demamaps," ETC, Fall, 1999.

Goffman, Erving. Frame Analysis: An Essay On the Organization of Experience. New York: Harper and Row, 1974.

Haley, Jay. Strategies in Psychotherapy. New York: Grune & Stratton, 1963.

Havens, Leston. Making Contact: Uses of Language in Psychotherapy. Cambridge, MA: Harvard University Press, 1986.

Johnson, Wendell. People in Quandaries. New York: Harper & Brothers, 1946. Now available from the International Society for General Semantics, Concord, California.

Low, Abraham A. Mental Health through Will Training. Winnetka, IL: Willett Publishing Co., 1950.

MacNeal, Edward. MacNeal's Master Atlas of Decision Making. Concord CA: International Society for General Semantics, 1997.

Perls, Frederick S., M.D., Ph.D. Gestalt Therapy Verbatim. New York: Bantam Books, 1959.

Postman, Neil and Charles Weingartner. Teaching as a Subversive Activity. New York: Dell Publishing Co., Inc., 1969.

Sheehan, Joseph G. Stuttering: Research and Therapy, by Joseph G. Sheehan and Others [Under Advisory Editorship of J. Jeffery Auer]. New York: Harper and Row, 1970.

Snyder, William U. Dependency in Psychotherapy; A Casebook. New York: Macmillan, 1963.

Van Riper, Charles. The Treatment of Stuttering. Englewood Cliffs, NJ: Prentice-Hall, 1973.

Watts, Alan. Psychotherapy East and West. New York: Vintage Books, 1975.

Weiner, Irving B. Principles of Psychotherapy. New York: John Wiley and Sons, 1975.