Milton H. Erickson Foundation Newsletter
Case Report, Vol. 24, No. 3

Think Small
By Annette Poizner, Ed.D., RSW

It was a stressful moment.  A young woman sat before me trying to tell me why she had come in, a matter of vital concern to me.  I was a new intern at the counseling center and had to document each client's presenting issue. In this case, though, I was stymied. After 30 minutes, I had absolutely nothing to write. This woman was clearly grappling with a need to maintain a secret.  Every sentence was unintelligible, lacked a noun or verb, and relayed virtually no information. I was getting anxious wondering what my supervisor would think about a chart note that lacked the most basic information.

Fortunately, an intervention of Erickson's came to mind.  I interrupted the woman's stream of words, which had been both continuous and halting at the same time.  I said, "You know, there are probably 20 things you wouldn't dream of telling me right now.  Highly personal parts of your life story. Who could expect you to share these things?"  Silently, she nodded.

I continued, "The top of that list has three things that you wouldn't tell me now; you wouldn't tell me 20 years from now. Those secrets are yours and yours alone to keep."She nodded. Down from there, “Icontinued, "there are probably three more secrets that maybe you would tell someone after you knew them many years. That’s five to seven years. But I'm only here for a year. We couldn't expect it would ever beappropriate for us to discuss these matters." She nodded.

My list continued until, of course I got to the bottom of the 20, the one topic that was quite private but the least so of her collection. I asked, "Do you think you could tell me that little thing, the bottom of the 20?" She said, "I'm having trouble with my boyfriend." Bingo!

The Chinese have an expression, which says, "If you want to move a mountain, start with the first pebble. "As therapists, we know how much can be achieved by scaling down. Solutions-oriented therapy has clients continually identifying the 'next small step,' as in "What would be the next small step which would move you toward your goal around...weight loss, anger management or whatever?"  How often people harbor galloping ambitions that hunger for dramatic and immediate outcomes. These bloated agendas often, ironically enough, push success off into the very distant future... when there is bound to be more time, energy and Resources available to achieve the whole thing in one go. Not.

Feminist Gloria Steinem recognized the power of small-scale change. In the 1970's she would end hr social activism lectures by extracting a promise from the thousands of people in her audience. She would say something like this:  I'm going to ask you each to make me a promise and I will make the same promise to all of you: that in the next 24 hours we all perform one small act, perhaps an act of kindness, perhaps an assertion of that which is fair and right, all in the interests of making this world a better place. And if each one of us sees through the commitment, in 24 hours the world truly will be different.

We can't specifically know the effect of this exchange of vows, but I can tell you the effect of thinking small with my client. I do believe we reached the top item on her list, with a disclosure that seemed to liberate her. The following week she came to therapy and for the first time casually took off her hat, seemingly unaware that she had never
removed it in our sessions before. I pointed it out and we laughed. She didn't need to keep things "under her hat" any longer!

The moral of the story: though glamorous it is not, small is beautiful. It is not that less is more.  Less heralds the way for more. All this being just one more argument for thinking small.

"When the diagnosis is correct, the healing begins."
Carl Jung, M.D.
"I think that true psychotherapy is knowing that each patient is an individual, unique and different."
Milton H. Erickson, M.D.
"The cure is to let the individuality come out and flower in all its particular genius."
Ernest Rossi,
Ph. D.
BRIEF THERAPY
"Being under sentence of termination doth most marvelously concentrate the material."
David Malan after Samual Johnson