‘Normalising’: an old but useful idea
In Putting Difference to Work (1991) Steve de Shazer, writing about a case, says ‘since the client accepted this new name for her complaint, the therapist focused the conversation around the difficulties with getting to sleep and emphasized the fact that some sleep disturbance now and then was quite normal. (It is, of course, easier to develop a solution to a “normal difficulty” than it is to develop a solution to a “very pathological problem that has roots deep in my infancy.”) (p66)
There is a lot one could take issue with about this, not least the notion of giving a ‘new name’ to a complaint and that we might be in the business of developing solutions for particular problems. What interests me today is that the therapist might emphasize a problem as being ‘now and then…quite normal’.
This intervention is known by the rather ugly term ‘normalising’. I am always quoting Bill O’Hanlon’s advice for us to ensure that our clients feel ‘acknowledged’ by us for their difficulties and he added that they should also feel ‘validated’. This means that in addition to saying something like ‘I hear you saying you’ve been having a tough time’, we might add ‘and given your situation that is quite normal’. He writes in his A Field Guide to Possibility Land that ’normalising is one way to validate and give permission’.
This practice might seem antithetical to Solution Focused Practice. Who are we to tell a client something is ‘normal’? Yet I know for myself that I do this quite a lot. If a client is going through bereavement or relationship break up, I might normalize their feelings of numbness, confusion, anger etc. If they have had a traumatic reaction to an event I might say, for example, ‘in my experience it’s quite normal for someone who has been through your sort of experience to have flashbacks’.
It is well known that many people see benefit in being given a diagnosis. Several young people I’ve seen this year have wanted to know whether they have ADD and have been relieved when told (not by me – I’m not qualified!) they ‘have’ it. This is not the place to discuss the politics of medical diagnoses but just to acknowledge how much this can mean to the client – ‘it’s not me, it’s my condition’.
There’s a further aspect to this process. In the late 1980s de Shazer’s team wrote about what they called ‘flagging the minefield’. When a client was making progress and nearing the end of the work, they would be asked what might be possible future hazards they could encounter; the idea was of course to examine these and have ideas in place as to how to deal with them. I recall that in 1990 de Shazer was in our observation team one day and the client I was seeing had made huge ‘pre-treatment change’ (as de Shazer’s team called it) and I asked him if I should ‘flag the minefield’. ‘We no longer do that’, he replied; later on he explained that they feared this was simply putting ideas into the client’s head about how things could go wrong.
Well, de Shazer will be turning in his grave at how often I now ask clients what might be potential ‘humps in the road’. I’m not concerned about ‘giving clients ideas’. I think they know only too well how life can trip them up, and I believe they find it useful to examine possible pitfalls in the future. For example, the other day a student told me that ‘humps’ for him might include how the behaviour of other students (‘being silly’) could bother him and also how he would have to continue to resist the urge to make people laugh. We had a valuable discussion about how he would manage such ‘normal’ eventualities, building on skills he had already developed.
de Shazer, Steve (1991) Putting Difference to Work. New York: Norton.
Harvey Ratner
London
10 July 2022
