Copyright © New Therapist
By Tim Barry
For some time my colleagues and I have been experimenting with, failing with and enjoying the use of video playback with clients. This technique started off as a clumsy attempt to both offer the client more objective information about themselves and democratize some aspects of the therapy relationship. With time, we have tried to use it as an adjunct to helping clients challenge some of the dominant ideas about themselves as they move between the performative and observing systems. This allows for a type of double description. In his well-known illustration involving binocular vision, Bateson (1979) describes double description as the exponential information (depth perception) that arises when our brain integrates different left and right retinal images. He emphasizes that the resultant information is greater than just adding the two images or allowing the one to take precedence. In a similar manner, video playback allows for the news of difference between "how I appear" versus "how I thought I would appear". This has a number of potentially useful consequences and possibilities for both the client and the therapist.
In itself, video feedback is of little value, and the times that I have used it because I believed that it had some independent merit, it has invariably added little value or, in some cases, it has been detrimental to the therapy relationship. However, when embedded within an established relationship and used in a negotiated manner, it allows for some creative and powerful ways of enhancing therapy. As Duncan (1997) points out:
"Positive change is only modestly correlated with technical wizardry... it is far more heavily influenced by what clients bring into the room and the relationship that is created there" (p. 28).
This technique can be used from a number of approaches, but the somewhat contrived nature of the process seems to lend itself to what O'Hanlon refers to as "fourth wave" therapy. He suggests that these types of therapy share a post-modern emphasis and focus on opening up ways for the client to be other than who they are deemed to "really" be. This constructed nature of personality and change is captured well in De Shazer's (1993) definition of therapy. For him, therapy is:
"concerned in inventing, 'discovering' and applying solutions and/or results; a mutual, cooperative conversation between two or more experts" (p.89).
Video feedback can be used to illuminate some of these aspects of his definition of therapy. Because client and therapist can be their own reflecting team, they can ask questions of themselves in a way that:
1. illuminates "preferred ways of being" (White and Epston, 1990);
2. allows for the client's expertise to emerge; and
3. invites the client and therapist into a mutual exploration of the therapy relationship.
My partners and I have typically used this way of working in a particular sequence that has naturally emerged. We have introduced the concept of video feedback as a comment on the liminal quality of our lives. 'Liminal' has been a useful way of condensing the inventive/ authoring nature of personality. The term refers to being in a doorway, not out of one room and not in the other. We are not who we used to be, but not quite who we are becoming, and the uncertainty of being in the doorway offers some power to choose what furniture we want to leave behind and how we wish to decorate the new room. The disorientation of being "in between" seems to be a powerful engine that encourages a sense of agency and urgency in clients.
Who we appear to be vs. who we thought we were: Video playback as double description
White and Epston's (1990) technique of externalization has been very useful in invoking a functional dissonance in clients. They are asked to firstly personify their difficulties while being videotaped and are then asked to predict how these problems will affect them when they see themselves later on video (often there has been an established dialogue about naming and attributing malicious intent to the problems prior to the first video session). The kinds of questions that we have found useful are:
• Given how X has disrupted your life, how do you anticipate its effect on you when we look at the tape just now?
• How do you think it is affecting you now in terms of your confidence (poise, ability to engage with me, presence etc.)?
• Do you think you are going to identify how X is lying to you right now?
• How do you think it will affect how you perceive yourself as a woman (man, teenager, manager, lecturer etc.)?
• Despite X's influence, do you think that you will notice any competencies in the person you are about to see?
Once the first video session has been completed (it is often as short as seven minutes), there are a number of questions that have been useful during the playback:
• Given your expectations of how X would affect you, what strikes you as you watch this?
• What does this tell us about some of the more convincing lies that X tells you?
• In what other ways is this person different from your expectations?
• If you met this person for the first time, what history would you expect them to have behind them?
• What does this tell us about some of the less convincing lies that X has been trying to make you believe?
• Would you trust this person to attempt some of the things that you have been avoiding?
• Given this evidence, what unexplored competencies come to light?
(Note: it has been useful to start to talk about the recorded self as "this person" because it may allow the client distance from the self and freedom to be more supportive/critical)