Problem Remedy Outcome

[Ned]

There was a thread on the previous version of this forum that was unfortunately lost when the site was hacked. Seeing Penny & James’ excellent article “Coaching for PROs” has prompted me to put my thoughts here again.

I believe that Problem Remedy Outcome could be usefully stated using four categories:
Problem, Desire, Remedy, Outcome.

Problem: Client seems hypnotised by the problem, describing how they are ‘stuck’ in it. Can seem that they are justifying themselves for not ‘moving on’
Facilitator response: And when [problem], what would you like to have happen?

Desire for change: Client indicates that they want the problem state to end (stop, put behind, disappear, go away etc.)
Facilitator response: And when [problem end], then what happens?

Proposed remedy: Client indicates how they want to move from the problem state to their outcome. This may or may not be the client’s optimum method to achieve their desired outcome. The fact that they want coaching/therapy probably means that their remedy is ‘defective’ in some way
Facilitator response: And when [remedy], then what happens?

Desired outcome: Client indicates what they want to experience without limiting themselves to how this could be achieved. (This allows for alternative, new remedies to be explored).
Facilitator response: Develop the outcome

Developing the example in the article differently for illustration:
Problem: “I am getting terribly wet”
Desire for change: “I want to stop getting wet”
Remedy “I want an umbrella”
Outcome “I want to keep myself dry”
Higher level outcome: “I want to be comfortable”

In Penny & James article they describe “I want to stop getting wet” as a remedy but I believe that it only signals the desire to change and does not describe any sort of remedial methodology.

In Box 3 of their article they also describe the Outcome as “a desire for a new ‘something’ to exist” and I don’t think this is sufficient to define it. E.g “I want an umbrella” could be an outcome for someone like Eddie Izzard but it is much more likely to be a remedy. I have tried to come up with a better test for an outcome but have had to settle for “a desire for a new ‘something’ to exist that is not in itself a remedial process”

Exploring higher level outcomes (And when [outcome], then what happens?) opens up more options for remedies, if this is necessary, but there is a danger of getting too high (E.g. “I want to be happy”) and trying to solve everything when all that is needed now is an umbrella! However, asking the question can be informative.

Any views from others?

Ned

[JamesLawley]

Thanks for raising these points Ned. For such a simple model the underlying philosophy of PRO needs some careful teasing out and I hope this discussion will help. You said:

"I believe that Problem Remedy Outcome could be usefully stated using four categories: Problem, Desire, Remedy, Outcome."

Despite our article, Penny and I also think there are four categories. And so does Phil Swallow, but we each have a different 4th category!

Our vote is that the 4th category is 'Resource'. That is, any description of the client's EXISTING experience that they do not describe as a problem. Thus is our new and improved PRRO model there are two CURRENT States: Problem and Resource; and two DESIRED States: A Remedy and a (Desired) Outcome.

Phil, how about describing your 4th category and we'll be able to compare all three "new and improved" versions?

I shall add my comments about the other points from your post later.

[JamesLawley]

Now for my second post on Ned's thoughtful comments on the current PRO model.

The PRO model made sense to me when I realised it is purely and simply a linguistic model. It takes as its input a client's language and gives as its output the facilitator's language. It is an algorithm for deconstructing the content of a client statement and generating a facilitator reply (NB. with the desired outcome of the facilitator somewhat pre-given.) It says nothing about what a client may actually be experiencing.

Let's take the sentence you suggest:
"I want an umbrella."
According to the PRO model this statement is to be taken as a desired Outcome because is has an explicit desire ("want") for a something to exist ("an umbrella"). We have no evidence to suggest this is a Remedy because, taking this statement on it's own, there is no linguistic evidence that the client is attempting to counteract or eliminate a Problem. Maybe the speaker collects umbrellas. Or maybe they just like them in their cocktails.

Also, linguistically there is no difference between the above statement and the other statement you suggest is a desired Outcome (which I agree with):
"I want to be comfortable."
They are both of the form "I want x" and without other evidence I am suggesting that (in terms of creating a consistent model) we have to treat them both the same.

In a real-life situation you are likely to have more than just linguistic evidence. You may be able to see that it is raining. This may lead you to believe that the speaker's desire for an umbrella was a Remedy, and you would respond appropriately by not saying "And then what happens?"

However, it is worth remembering that David Grove originated the whole notion of 'clean' when he was working in the symbolic realm of a client's experience. Ten years of working in the land of metaphor has taught me that I cannot trust my everyday intuition because stranger than strange things happen in a Metaphor Landscape - where a perceiver may want an umbrella for a thousand reasons.

So, as always, context matters.

Now to your second point:
"In Penny & James article they describe “I want to stop getting wet” as a remedy but I believe that it only signals the desire to change and does not describe any sort of remedial methodology."
I agree that “I want to stop getting wet” expresses a desire for change, and what part of the sentence does that? As soon as the word "want" appears in the sentence we can presuppose that the speaker is talking about a desire for the future to be different to the present. The "stop getting wet" is, at this stage of the deconstruction, irrelevant. Penny and I maintain that both a Remedy and a desired Outcome statement contain a word that expresses desire - by definition.

And we maintain that "stopping" is a remedial methodology. It may not be explicit about how the stopping should occur but the metaphor gives clues, and is certainly different from:
"not get wet"
"prevent myself getting wet"
"keep from getting wet"
"refrain from getting wet"
etc.
All of which suggest different remedial methodologies. From a linguistic point of view, whether the Remedy is specific or general is outside the scope of the model.

In conclusion, I can't see how a 4th category of 'desire for change' gives the facilitator an extra distinction especially when your suggested facilitator response is the same as for a Remedy.

I also have an intuition that our differences may in part stem from a difference of focus. I think you may be focussing more on the noun aspect of a remedy (i.e. "a pill" or in this case, "an umbrella") while I am conceiving a remedy as a process (i.e. "stop getting").

What I am sure of is that there is more to uncover.

[phil]

As James points out these categories are lingusitic distinctions and say more about how we are experiencing what we notice happening in the client than how it might actually be for them. The words are, as ever, our best shot at representing our experience - and, like any metaphor, only fit where they touch. However there are some fairly universal aspects to the perception of problems and desires that make this breakdown useful, in my view.

I think of the 'desire-ability' aspect of this as running through or underpinning the whole model, rather than being separable into a category. Without the perception of a desire, a liking or a wanting (or the lack of same), there would be no perceived Problems or Desired Outcomes. Experiences would come and go and be neutral: "Oh, it's raining... oh, now it's sunny". Bland, insipid, anodyne* - we'd stand around like cows in a field, letting it all wash over us as the seasons come and go... hang on, that sounds quite pleasant really... very Tao!

The interest in PRO for me is not about the categories as such but the movement through the categories, the shifting of attention from 'what we have and don't like' (Problem) towards 'what we don't have and would like' (Desired Outcome). I think of the PRO categories as snapshots of that attention as it shifts.

So my feel for a 4th category is about capturing that shifting in 'higher resolution' as it happens. My take on PRO is to split the Remedy category into Remedy and Solution. In my mind it runs something like this:

"Oh no, it's raining, I'm getting wet! I hate it when that happens! Oh, yuck, this is horrible, woe is me, alack-a-day, etc" = Problem

"I really need to get out of the rain - ah, here's an umbrella - just let me get under it - ah, that's better! Phew, it's tipping it down out there" = Remedy

"Okay, I got out of the rain but it's still raining and I'm having to hold this umbrella which, useful though it is, cramps my style - I'm not getting so wet but I can't play the violin, juggle flaming torches or fold napkins. In a way I'm attached by my umbrella to the rain. I want something else, perhaps something that will fix this in the long-term, so I can let go of the umbrella. Maybe I'll look around, 'raise mine eyes unto the hills whence cometh my help' [Resources?]" = Solution

"HAving looked I've realised that the ideas I've had to solve this long term are just better versions of the umbrella - they are still within a world of rain. And stepping back a little, is it the rain or 'getting wet' that I don't like? Hmm. What could not liking getting wet tell me about what I do like? Maybe I want to be dry. Where could I go to be dry? Or even better where could I go or what could I do such that being wet or dry is not something I am even paying attention to. I mean, rain happens, so does drought, but what was I doing before I got distracted by not liking getting wet? What am I aiming for? Hold on, what do I really want? " = Desired Outcome

I like Ned's bringing in of a higher level outcome because it aids someone to widen their perspective from the narrowness of the Problem to take in more of the available information.

Phil

I looked up 'anodyne' to check the meaning (see below) and found this rather nice description of someone seeking a remedy:


An avid fisherman himself, McGarr shares Nellie's philosophy: "I do not merely fish for fish," she would say, "I fish for doubt's anodyne and care's surcease (http://dictionary.reference.com/wordoftheday/archive/2000/03/21.html)."
-- Marilyn Stasio, "Crime", New York Times (http://www.nytimes.com/), September 19, 1993


It also seems that my sense of anodyne as meaning 'bland' is secondary to the original meaning of relieving pain or suffering which would be a Remedy in our terms.

I think the 'bland' meaning derives from the 'relief' meaning - is the result of applying a Remedy pain reduction but also blandness, numbness and loss of sensation. I would liken that to what happens when people drink (or whatever) to blot out psychological pain - it may work (partially) but at the price of losing sensitivity to other pleasureable aspects of life.

So I think at best a Remedy neutralises Problem - without a focus on Desired Outcome there can be no further development in that situation.

[Ned]

Thank you James & Phil, as usual you get my brain into the gym.

I realise that I do a lot of cognitive/conceptual modelling, which will affect how I see this issue, and I realise that it can be less easy to ‘know where the client is’ in symbolic modelling.

James, I also see remedies as mechanisms/processes rather than pills. The remedy is the client’s desired path to their outcome.

Just to review my current beliefs:
The reason I use my four categories is that I don’t want just a linguistic tool; I want to be able to assess ‘where’ the client is on the spectrum of:

1. Stuck
2. I want anywhere but here
3. I think I have a solution but…
4. I want to experience this!

The “I want to experience this!” provides the motivation for necessary changes and I want the coaching to be in the context of that resource state. I do not believe the remedy (3) always provides this and sometimes the client has not even considered the consequences of their remedy so I want them to experience that; to check whether it is what they really want.

I understand your reasoning James, how “I want to stop getting wet” can be a remedy and this just proves to me the need to develop these categories further. I believe there is a fundamental difference between a remedy of
1. “I want anywhere but here” and
2. “I have a solution that results in me experiencing what I want”.
In the first, there is no indicated direction to a desired outcome whereas in the second there is a direct indication towards an outcome. To put it another way: the first only uses ‘away-from’ motivation and the second uses ‘away-from’ AND ‘towards’ motivation. However, because the second may not be an effective solution, I still want the client to identify what it is that they really want (as we all do!) so I can help them explore other possibilities

It is interesting that Phil also wants to split the remedy category but we seem to have slightly different ways of doing this
My attempted summary of Phil’s is:
1. Problem + desire for change
2. Quick fix
3. Ecological fix
4. Desired outcome
5. (Higher level outcome)
I like Phil’s description that he is interested in the “movement through the categories” rather than “the categories as such” (me too)

I see the benefit of having my fourth category “desire for change” as giving the facilitator better distinctions for evaluating ‘where’ the client is in relationship to their issue/outcome. The current tests (your article James) for an outcome in PRO are whether it
• Has not yet happened.
• Contains a desire, want, need or would like, for a new situation, state or behaviour.
• Does not contain any reference to a problem (even though you may think you can guess what the problem is).

And as I said previously, this test can result in labelling a remedy (“I have a solution that results in me experiencing what I want”.) as an outcome. It is often quoted that “the solution is the problem” and this test could result in modelling the client’s binds rather than their outcome. I may choose to do that but I want, if possible, to be clear when I am doing it.

Ned