英文原文
The Exception Question: 3 Solution Focused Tips
3 Ways to Ask Exception Questions in Therapy
Help your clients uncover non-problem areas in their lives with this solution focused therapy technique. Exceptions - times when problems don't occur, can often be the first step to a solution.
Jeremy and his partner were trying to start a family, so he had every reason to quit smoking, but was finding it difficult. So he’d sought me out. “Tell me,” I said casually, “do you smoke when you’re asleep?” Looking utterly confused, Jeremy blinked a few times before sputtering, “No, of course not!”
Emotional and psychological problems demand our attention, energy, and focus. But to overcome any problem, we ultimately need to direct our attention to identifying and nurturing the capacity we all have to not have the problem. In most cases, there was a time before the problem started. Jeremy certainly didn’t come out of the womb smoking! But there are also current times when the problem takes a day or even an hour off.
So, being a solution-focused kind of a therapist, as well as asking about the problem I ask clients to tell me in detail about the exceptions – the times they don’t experience the problematic behaviour or feeling. The information they provide starts to form the basis of their escape route.
In addition to not being a sleep-smoker, Jeremy told me he didn’t feel the need to smoke on long-haul flights, when visiting a sick friend in the hospital, around his friends’ young children, and when swimming every other day in his local pool. Although he’d come into my office thinking of himself as a ‘compulsive smoker’, we now had four exception times when the behaviour wasn’t compulsive at all.
When I used hypnosis with him, I would talk about “getting that swimming pool feeling” during the times Jeremy would normally feel triggered to smoke – just before work, with a coffee, after a stressful work-frenzy, and so on. It’s not that he didn’t know how to feel calm without cigarettes, it’s just that he hadn’t been using that resource where he could be using it.
Hypnosis is the perfect vehicle for spreading a resourceful state from where it already exists to other situations in which it will be massively beneficial because your client can hypnotically practice using that resource automatically and naturally in whenever it’s needed. But you first need to identify these resourceful states by asking the right solution focused questions.
Here are 3 ways to ask exception questions:
1. Ask about times when the problem pattern doesn’t happen
What times can you tell me about when you expected to feel embarrassed, but for some reason you just didn’t? Really think about this... You can ask your client about times they expected to feel angry or sad, to blush, or to feel terrified when flying, but the feeling just didn’t show up for some reason – or not to the degree they were expecting.
Diane, who was terrified of the presentation she had to give at work soon, remembered speaking comfortably and without a blush in front of her best friend’s 200-guest wedding. So, I asked, when did she notice that she just wasn’t nervous or embarrassed? “About halfway through my toast, I realized everyone was laughing. Not at me, as I’d dreaded,” she said with a chuckle, “but at a joke about our childhood I hadn’t planned to make. It wasn’t even on the cards I was clutching behind the microphone!” People don’t have exactly the same experience every time, so we can look for the times when it’s naturally been better.
2. Ask what was different
We can then ask What exactly was different about that time? or even How did you do that? What were you doing differently that time? This helps to locate client resources as early as possible. And by asking how they did that, you imply that the improvement was due to their own actions and help them take credit for the good times.
In Diane’s case, she thought about it and said she’d been so nervous beforehand, she’d “over-practiced” for days. She also said it was important to her not to let her friend down on that special day and that she’d wanted the whole crowd to see the couple as she did. Later in the session, we talked about the importance of preparation and ways she could communicate her passion for the topic of her upcoming presentation. But first, I assumed that she not only could but would do that...
3. Use presuppositions to help pinpoint resourceful exceptions
When you enquire about exceptions, it’s great to use presuppositions. A ‘presupposition’ is a masterful way of communicating because it precludes doubt by assuming an occurrence can be ‘taken for granted’. It’s a language construct that’s phrased to indicate that something will, is extremely likely to, or already has occurred.
For example, “When do you feel calmer?” presupposes that there are times when they feel calmer, as well as presupposing a positive identification of such times. In contrast, “Are there ever any times when you feel calmer?” concedes that there may not be such times and readily allows for a negative response.
More examples of presuppositions to glean those precious exemption times include Where are you when you find yourself feeling less depressed? What occasions have you noticed when you expected to feel shy but you actually had a really good time? In what situations would you be least likely to feel like bingeing?
Dr Milton Erickson believed that “therapy should always be designed to fit the client, not the client to fit the therapy.” Jeremy called me up just after the birth of his first child. “It’s funny, Mark, but I never feel the need to smoke anymore. Sometimes I do think about it when I feel a bit stressed, but then I almost hear a splash in my ears and I’m right back to that calm of being underwater after diving into the pool.”
You and I may know all the psychological theory and practice under the sun, but I think we do well to remember that – ultimately – our clients will find the cure from within.
中文翻译
例外提问焦点解决疗法的三大技巧
在治疗中提出例外问题的三种方法
通过这种焦点解决治疗技术，帮助您的客户发现生活中没有问题存在的领域。例外——问题不发生的时候，往往是解决方案的第一步。
杰里米和他的伴侣正试图组建家庭，因此他有充分的理由戒烟，但发现很困难。所以他来找我。“告诉我，”我随意地说，“你睡觉时抽烟吗？”杰里米看起来完全困惑，眨了几下眼睛，结结巴巴地说：“不，当然不！”
情感和心理问题需要我们的关注、精力和焦点。但要克服任何问题，我们最终需要将注意力转向识别和培养我们所有人都拥有的不出现问题的能力。在大多数情况下，问题开始之前有一个时期。杰里米当然不是一出生就抽烟的！但也有当前问题暂时消失一天甚至一小时的时候。
因此，作为一名焦点解决治疗师，除了询问问题，我还要求客户详细告诉我例外情况——他们没有经历问题行为或感受的时候。他们提供的信息开始形成他们逃脱路线的基础。
除了不是睡眠吸烟者，杰里米告诉我，他在长途飞行时、去医院探望生病的朋友时、在朋友年幼的孩子周围时，以及每隔一天在当地游泳池游泳时，都不觉得需要吸烟。尽管他来到我的办公室时认为自己是一个“强迫性吸烟者”，但现在我们有四个例外时间，这种行为根本不是强迫性的。
当我对他使用催眠时，我会谈论在杰里米通常感到触发吸烟的时候“获得那种游泳池的感觉”——比如工作前、喝咖啡时、紧张的工作狂潮后等等。并不是他不知道如何在没有香烟的情况下感到平静，只是他没有在可以使用这种资源的地方使用它。
催眠是将资源状态从已存在的地方传播到其他将大大受益的情况的完美工具，因为您的客户可以在需要时自动自然地催眠练习使用该资源。但您首先需要通过提出正确的焦点解决问题来识别这些资源状态。
以下是提出例外问题的三种方法
1. 询问问题模式不发生的时候
你能告诉我什么时候你预期会感到尴尬，但由于某种原因你却没有？真的想一想……您可以询问您的客户，他们预期会感到愤怒或悲伤、脸红或飞行时感到恐惧，但由于某种原因这种感觉没有出现——或者没有达到他们预期的程度。
黛安对即将在工作中的演讲感到恐惧，她记得在她最好朋友的200位宾客婚礼上舒适地讲话而没有脸红。所以，我问，她什么时候注意到自己并不紧张或尴尬？“大约在祝酒词进行到一半时，我意识到每个人都在笑。不是嘲笑我，正如我所担心的，”她笑着说，“而是因为一个关于我们童年的笑话，我本没打算讲。甚至不在我紧握在麦克风后面的卡片上！”人们每次的经历并不完全相同，所以我们可以寻找自然更好的时候。
2. 询问有什么不同
然后我们可以问那次到底有什么不同？甚至你是怎么做到的？那次你做了什么不同的事情？这有助于尽早定位客户资源。通过询问他们是如何做到的，您暗示改善是由于他们自己的行动，并帮助他们为美好时光获得赞誉。
在黛安的案例中，她想了想，说她之前太紧张了，她“过度练习”了好几天。她还说，在那个特殊的日子里不让朋友失望对她很重要，她希望整个人群都能像她一样看待这对夫妇。在随后的会谈中，我们讨论了准备的重要性以及她可以传达对即将到来的演讲主题的热情的方式。但首先，我假设她不仅能够而且会这样做……
3. 使用预设来帮助定位资源丰富的例外
当您询问例外情况时，使用预设非常好。“预设”是一种高超的沟通方式，因为它通过假设某个事件可以“被视为理所当然”来排除怀疑。这是一种语言结构，措辞表明某事将会、极有可能或已经发生。
例如，“你什么时候感觉更平静？”预设了他们有时感觉更平静，并预设了对这些时间的积极识别。相比之下，“你是否有任何时候感觉更平静？”承认可能没有这样的时间，并容易允许负面回应。
更多用于收集那些宝贵例外时间的预设例子包括你在哪里发现自己感觉不那么沮丧？你注意到什么时候你预期会感到害羞但实际上玩得很开心？在什么情况下你最不可能感到暴食？
米尔顿·埃里克森博士认为“治疗应始终设计以适应客户，而不是让客户适应治疗。”杰里米在他的第一个孩子出生后打电话给我。“真有趣，马克，但我再也不觉得需要吸烟了。有时当我感到有点压力时，我确实会想到它，但然后我几乎听到耳朵里的溅水声，我立刻回到潜入游泳池后在水下的那种平静。”
您和我可能知道世界上所有的心理学理论和实践，但我认为我们最好记住——最终——我们的客户将从内心找到治愈方法。
文章概要
本文介绍了焦点解决疗法中例外提问的三种核心技巧，通过杰里米戒烟和黛安克服演讲恐惧的案例，阐述了如何帮助客户识别问题不发生的时刻。第一种方法是询问问题模式不发生的时间，第二种是探究这些例外时刻的差异因素，第三种是使用预设语言引导客户发现自身资源。文章强调，通过关注例外而非问题本身，客户可以发掘内在能力，从而找到解决方案，体现了焦点解决疗法以客户为中心、聚焦资源和未来可能性的核心理念。
高德明老师的评价
用12岁初中生可以听懂的语音来重复翻译的内容
这篇文章就像教我们玩一个“找不同”的游戏！当有人遇到困难，比如总想抽烟或者害怕上台讲话，我们不去一直问“你为什么这么难”，而是问“有没有什么时候你不想抽烟”或者“有没有一次你讲话不紧张”。就像杰里米发现他游泳时不抽烟，黛安在朋友婚礼上讲话很轻松。这样，我们就能找到他们自己已经做得很好的时候，然后把这些好感觉用到其他需要的地方，就像把游泳池的平静带到工作压力中一样！
焦点解决心理学理论评价
这篇文章精彩地展示了焦点解决短期治疗的核心技术——例外提问。它完美体现了SFBT的核心理念，即问题并非持续存在，总有例外时刻。通过引导客户关注“问题不发生的时候”，治疗师帮助客户从问题导向转向解决导向。杰里米和黛安的案例生动说明了如何将例外时刻转化为资源，这正是焦点解决疗法强调的“客户是自身问题的专家”原则。预设语言的使用更是巧妙地强化了客户的能动性，避免了病理化标签，聚焦于能力和可能性。
在实践上可以应用的领域和可以解决人们的十个问题
例外提问技巧在多个领域具有广泛应用价值，包括创伤后应激障碍干预、焦虑管理、成瘾治疗、情绪调节、人际关系改善、职场压力应对、学习障碍辅导、亲子沟通、自我效能提升和慢性疼痛管理。它可以有效帮助人们解决以下十个问题：1. 创伤记忆的闪回困扰；2. 社交场合的过度紧张；3. 成瘾行为的控制困难；4. 抑郁情绪的持续低落；5. 愤怒情绪的失控爆发；6. 失眠问题的反复出现；7. 自卑感的长期影响；8. 工作压力的累积效应；9. 家庭冲突的循环模式；10. 慢性疾病的情绪负担。通过识别例外时刻，人们能够建立积极的自我认知，增强应对能力，创造更满意的未来生活。