By Dr Mark McKergow
sfwork - The Centre for Solutions Focus at Work
29 March 2006
I first met Steve in 1994 at the Interaction View conference in Palo Alto, California. Although I did not know it at the time, this was a milestone event in the development of interactional and systemic ideas - one of the few times where the Mental Research Institute group (Paul Watzlawick, John Weakland and Dick Fisch amongst them) came together with the Solution Focused therapy crowd led by Steve de Shazer and Insoo Kim Berg.
Steve and Insoo had trained at MRI two decades earlier, and had introduced new subtleties and simplicity into the MRI model - improvements, as they saw it. However, the link between the two centres was maintained by Steve's relationship with John Weakland, his supervisor and mentor.
I next met Steve in London. My colleague Harry Norman had approached him for an interview, which we finally managed to do in London in 1995. I only discovered later that he was noted for not giving interviews, and that this was a great privilege. Steve was a keen brewer and beer drinker, and Harry had managed to interest him in sampling some 'medieval beer', brewed in tiny quantities to authentic recipes. This may have been the key to our success!
In the week before the interview Steve was leading a training in Solution Focused Therapy, with a large audience (well over 100 people). Steve ambled onto the stage with a microphone, exhaled deeply as he always did before starting, and said... "So.. you'd better ask me some questions". A shiver went around the room. Surely he was the expert, and we wanted to be told what to do. Yet here he was, refusing to tell us. There was a silence.
"Does it work with alcoholics?", came a question from the floor. "I don't know. Next question." "Does it work with personality disorders?" "I don't know. Next question." Several more diagnoses were mentioned, and each time the answer was the same - "I don't know".
I was amazed and disturbed. Here I was, keen to find out more about this fantastic approach to change, and the star performer was telling me he didn't know if it worked with alcoholics. What was going on? My discomfort was clearly shared by other audience members - after a while, some started to leave.
"Can I see you ask the Miracle Question?" asked someone. Steve brightened up visibly. "Ah! Yes, I'm sure I can do that. Thanks for asking." We relaxed a little - at least he was going to do something.
As the session went on, I reflected on Steve's remarks of "I don't know". Surely this approach did work with many kinds of patient? Were there not studies to prove it? I came to realise that Steve, of course, knew all this perfectly well. Actually, he was showing us how to do Solution Focused therapy in that moment, engaging what I have to come call his 'different kind of cleverness'.
In order to answer the apparently simple question "Does it work with alcoholics?", one must accept two presuppositions. Firstly, there is such a thing as an alcoholic. And secondly, that it (the treatment in question) is replicable by anyone who applies it.
Let's look at the first one first - is there such a thing as an alcoholic? Clearly the word is used as if there was, but SF work is not based on diagnosis - the client's complaint is not relevant in determining what they want (the 'solution' in Solution Focus) and times when that happens already. Steve's work was part of the tradition that questions the value of diagnosis in any case, and even if an accurate assessment of the condition could be made, each one would want something different - leading to a course for treatment which would vary in each case. There was therefore no value in even considering whether the client was an 'alcoholic' or not. Part of his 'I don't know' was a rejection of this as a relevant term in his work.
The other presupposition is in the 'Does it work' element. 'Does it work?' implies that 'it' is working, rather than someone is acting skilfully to make something happen. We might say of a piano, 'Does it work?' - meaning that if someone hits the notes, then the relevant sounds will emerge. It doesn't matter who is hitting the notes, the sounds will emerge. In SF work, solutions are constructed in conversation, which is an art as well as a science. To ask if SF therapy works is therefore to ask not if the piano works, but instead to ask if piano-playing 'works'. This is not a sensible question - pianos can be made to sound beautiful with skill, but someone without the skill could scarcely claim that playing the piano didn't work - just that they were not yet individually skilful enough.
A question which may have had a better reaction from Steve was "Have you got successful outcomes with clients who want to drink less?" In this case, the question is about his own experience, and related to a client group defined in terms of what they wanted. The distinctions between this and 'Does it work with alcoholics?' are, for me, at the heart of SF practice. Maybe Steve's legacy to us is to stop trying to answer big questions and focus instead on the tiny micro-construction of conversations which build solutions.
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29 days ago