Do you ever feel stuck with a client? Are you working hard on what the client wants to change but find that the suffering continues much the same?

Clients suffer from something they want to change. Your job, as the therapist, is to be able to find the target of change. The target and presenting issue are not necessarily the same thing. So focusing on the “symptom” often won’t help.

For instance, I may have a bucket full of water, but the real target of any change work is my leaky roof.

In order to help the client to discover the target of change, you need to:

• clarify the task of the therapist
• have a reliable process you can follow
• know how to make sense of the data

The task of the therapist

If there wasn’t a good reason for what your client brought to therapy, they’d have changed without you. Their “symptoms” aren’t symptoms at all. They are defences that protect them from a feared bad consequence.

The job of the therapist is to discover and target the client’s feared consequence. An essential step of memory reconsolidation is to identify the target learning that is to be changed.

But how to do that? How can we quickly help the client (and yourself) to understand what is producing their problem?

Given that the feared consequence is often out of awareness, how can we help them to discover it?

A quick, reliable process

There is, of course, no single way to do this. Therapists are often skilled at this anyhow and use a range of insight-producing interventions.

Yet the process below gets to the target learning much faster than any other way I use.

The client finds it an engaging exercise. It privileges the client’s experience and viewpoint. The therapist brings the process or framework, but the client fills in the details.

The steps below are borrowed from Motivational Interviewing. You may have encountered them before. Later, I will show you how to use the results of this process specifically for the job of memory reconsolidation.

Step 1: ask what are the positives with things just staying as they are. How might staying how things are serve them? There are always benefits and positives, even in bad situations. So despite wanting to change, what are some of the upsides of staying the same?

Step 2: What are the costs of staying the same?

Step 3: What are the costs of changing? How will life get worse once they change? What other downsides or losses do they face from changing?

Step 4: What are the benefits of changing? How will life get better? What differences will the change make for them?

Make notes as they brainstorm some answers. Take your time. Recap aloud often to give time for reflection. Ask “what else?” until they have run out. Feel free to explore some of their answers to better understand what they mean.

Make sense of the data

You will now have a lot of information from the client. They have told you what benefits the current problem brings, as well how it gets in the way. They have told you the costs of making the change they want, and the benefits that await them when they do.

How do we make sense of this information in order to identify the real target of your work with the client.

Look only at the answers given in Steps 1 and 3. They contain the good reason why the client is deciding not to change yet.

Explore which of the things on the list feel heaviest or scariest. Together you’ll reach some understanding about why it feels hard to change.

Formulate it as: If I get the change I want then I’ll get this bad thing, and I’d rather stay how it is than have that bad thing.

You can check it out with the client to see if it resonates. Offer them a hypothetical deal. They can have the change but they get the feared consequence too. Or they can stay as they are without the feared consequence.

If they decide to stay as they are, you have found the target of change. Now you both understand why they won’t permit themself the change they long for.

You have identified the target of change that will become the focus of your memory reconsolidation work. Once overcome, they no longer have a reason not to change, and the change happens naturally.

Summary

Let’s recap. We saw that you need to

• clarify the task of the therapist
• have a reliable process you can follow
• know how to make sense of the data

The task of the therapist is to discover the client’s feared consequence of change. This is the true target of change. Without this, the client can change effortlessly.

The process borrowed from Motivational Interviewing allows the client to share the benefits of things staying the same and their concerns about the risks of changing.

Using their answers can help you formulate an understanding that looks like: If I get the change I want then I’ll get this bad thing, and I’d rather stay how it is than have that bad thing. You can then test it out by offering the client a deal that, if you’ve identified it correctly, they will reject.

Memory reconsolidation requires that you have the correct target when working through your imaginal scene later. This process helps you to discover that with speed and reliability.

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