Absent but Implicit

People seek therapy for a number of reasons, but often people find these reasons are obscured from themselves. For example, a person may visit a therapist with anger issues. It might seem natural to focus on the anger, but the anger itself is an effect – something else is the cause. If a counsellor helps you to deal with your anger specifically, it might provide some temporary relief, but the underlying cause still exists.

Behind the emotions are thoughts and beliefs that drive the emotions. If you believe that life is unfair to you and this makes you angry, using techniques to manage your anger won’t address your views about a world that seems unjust to you. Sometimes suppressing the anger can lead to another emotional outlet – like depression – as the underlying problem hasn’t been addressed and the person can no longer cope with the feelings through angry outbursts.

In Narrative Therapy, we look at the stories that drive our lives. The angry person in our example is enveloped in stories – stories s/he has told self, stories told from early childhood by family and significant others, and wider cultural stories. The person who feels that life is unjust is constantly maintaining and developing stories that feed into this belief. The founder of Narrative Therapy referred to these stories as absent but implicit.

Anger is driven by expectations. What are the expectations in this example? How have they been developed? How are they maintained? As noted, the causes of the presenting problems in therapy may be unknown to the client. A therapist who only focuses on the anger (or pain) can be further embedding these feelings and potentially re-traumatising the client.

It is normal for us to focus on our emotions and – especially when we are in distress – it can be difficult to understand what is driving our pain. Understanding the thoughts and beliefs that drive us can help us to modify these to better fit our lives and to help us grow and thrive.

Vertical Descent

This technique in Cognitive Therapy involves the therapist attempting to determine with the client what the client’s core beliefs, fears and concerns might be. It involves the therapist asking about the relevance of content and drilling down into this content for further meaning.

For example, Beth doesn’t want to go to a school reunion because she says that “People will ignore me!” Beth thinks that this fear is what is driving her to avoid the reunion. Vertical descent into the meaning Beth places in rejection could go something like this:

Beth: I don’t want to go to the reunion!

Therapist: Why?

Beth: People will ignore me!

Therapist: People ignoring you will be significant because?

Beth: I will feel isolated!

Therapist: Feeling isolated would make you feel . . . ?

Beth: Like I am not worth being around.

Therapist: And?

Beth: I was never as good as those people!

Beth moves here from a fear of being rejected to a belief that she has held since school – that she is not as good as her former classmates. Notice the present tense – “is not as good”! Therapy is always about the present. Discussing further, we find that Beth has always believed herself to be inferior to these others and if she goes to the reunion and is rejected, the rejection will confirm her belief. So, the issue is not simply rejection, but a long-term belief that needs to be considered. Vertical descent allows the client and therapist to delve into the ideas and beliefs behind immediate concerns.