Judge a man by his questions rather than by his answers. – Voltaire
I want to follow up on my previous post Inside the Mind of a Metacognitive Therapist – Part 1 The Basics, in which I describe the most basic elements of metacognitive therapy. In this series of posts, I want to show you what’s going on within the mind of the therapist himself (writing about myself in third person is strange, I know).
Whenever I have a session, I prepare myself by going through the journal that I keep of every client and of every session. In this obligatory journal, I note every aspect of the metacognitive treatment plan and I also note factors that are thought to influence the treatment course, such as social and medical factors. The treatment follows a certain pattern with different treatment elements at different time points and this kind of chronology is kept during the whole treatment course.
The treatment course may appear as a learning curve. When you have noticed and realized a new aspect about your own mind and your situation, we move on to another belief that may keep you stuck. Sometimes, we go back to beliefs that we already looked at, but this is just a part of a normal change proces that we also have to deal with.
It may look like that the therapeutic proces is linear: That the “therapeutic effect” or “recovery” is linearly correlated with “time spent in the sessions”. My experience is that it’s not as linear as my clients tend to believe.
Sometimes a specific belief may change after just ONE conversation with a person (a so-called “aha experience” may occur which is an interesting phenomenon). A change moment like that is likely to happen outside the therapy room as well. Just think about a conversation with a friend that changed you in some way. However, unlike a friendly conversation that may have no other goal than being together, a therapeutic conversation normally has a goal of change.
As a clinical psychologist, I view myself as someone who is trained to ask the right questions at the right time – quetions that have the potential to change you. I “know” what to ask for and in what way I can do it, and I have a clear scientific-based rationale for doing so. The method of questioning in metacognitive therapy is called Socractic Questioning. As a fan of Socrates, I am pleased with this name.
When I emphasize “know” what to ask for, then it’s because conversations can be quite unpredictable, so even though the question may look like a good question in the textbook, I cannot be sure that it has changed anything at all.
The receiver will interpret my questions in ways that I cannot predict. Then I just ask a new question in a different way or leave it alone for a while. Anyway, the point is that all questions are specifically chosen to target and challenge metacognitive beliefs that are related to recovery. Therefore, I care about my questions.
In therapy, I can make things appear very complex by asking complex questions. In the same way, I can make things appear more simple by asking effective questions. For me, I practice questioning every day, and from this experience, I have come to know questions that are more effective than others, at least generally speaking.
In therapy, I will openly and with your consent ask you those questions so that you can engange in a metacognitive change process. Research shows that positive treatment outcomes are related to having a clear rationale and a therapeutic model to guide you throughout the course of treatment.
As a therapist, I call this proces socialization to the model. How well are you socialized to the model? Do we collaborate on the same model? Do you see how the model can help you, and so on…
Effective questions can increase socialization or adherence to a model that is related to positive treatment outcomes. Metacognitive therapy provides specific treatment protocols that have been supported by evidence in so-called Randomized Controlled Trials (sometimes referred to as the gold standard of therapeutic research).
This post is the second part of the series “Inside the Mind of a Metacognitive Therapist” that I am going to write. You might want to catch up on the other parts as well. I hope that you found it useful. See you.