Video 076 (Pt2) Socratic interweaves
Use this solution
To help with:
· History taking
· To identify or clarify a negative cognition
· Stuck or looping processing
· Processing to a positive conclusion when time is short
Originator:
Christine Padesky (1993)
Video production
Matthew Davies Media Ltd, Llanidloes, Powys. www.matthewmedia.com
Take-Away Section
What this covers
This video covers the use of Socratic Questioning as a form of cognitive interweave. Socratic questions are mindful, logical questions that get underneath the information being presented. They can bring out knowledge the client holds but isn’t aware of, or focus the client’s attention on specific aspects of their experience.
How long
10.45 minutes
Related videos
See Video 070
Go to ‘Take-away’?
For Aide mémoire to use in a client session. Further information can also be found in Wrap up
+ Aide Mémoire
You can copy and paste this material into a Word document, edit it, and add other information you think may be helpful to you. Socratic questions in the history taking
- Notice when the client is finding it hard to describe what’s going on for them
- Ask questions that focus the client’s attention on the events in current life
- Use the questions to focus attention on the emotion in the present and the body location of that feeling
- Use questions to help the client float back in life to a touchstone event
- Identify the touchstone event and place it on a trauma timeline as part of the history taking.
Socratic questions to access the negative cognition
- Notice when the client is struggling to identify a negative cognition
- Use structured questions to help the client move from an observation about self in the image to a negative belief
- Use questions like ‘What does that say about you?’ ‘What happens when….?’ ‘What does that mean for you?’ until the client has identified the negative belief that lies beneath the events.
Socratic questions to help with processing and desensitization
- Notice when the client becomes stuck or when the processing is looping back through the same material and not becoming more adaptive.
- Try changing the methods of process interweaves such as changing the type or speed of bilateral stimulation or dual attention stimulation before introducing cognitive information
- Notice when the processing hasn’t changed with two consecutive sets of bilateral or dual attention stimulation or the SUDS are failing to drop or when the SUDS drop then return to the original high levels
- Consider which cognitive domain the client is working in
The Socratic or inquiry interweave introduces new perspectives or a new direction by asking a question
Think of a question related to the relevant domain that will help the client’s processing become more adaptive or help the client to overcome the block in their processing
- At the end of a set of bilateral stimulation, introduce the question and ‘go with that’
- It is usual for one interweave to ‘kick start’ processing
- If one interweave doesn’t work, consider the domain and check to see that the negative cognition hasn’t changed
- If there has been a shift in the processing domain, then try with an inquiry interweave in the newly emerging domain.
Inquiry interweave suggestions:
Safety domain • Is the danger happening right now? • Are you in danger right now? • Were you able to keep yourself safe as a very young child? • I’m curious, was it reasonable for your mum to expect you to keep yourself safe as a baby? • Are you safe now?
Choice domain • I’m confused, did the 6 year old have choice? • Did you, as a young child have more power than your dad? • As an adult, can you choose now? • If this was your child, would you expect them to make that choice?
Responsibility domain • What makes you think it’s your fault? • I’m curious about that, how could a 5 year old have done more? • I’m confused, how does that make you a bad person? • What skills would you have needed to be able to do that? • Whose responsibility is that? • If this was your friend …………….? • How much responsibility is yours and how much is his / hers?
Shame domain • How much guilt do you need to hold on to and how much can you let go of? • Was it the child’s fault or the adults’? • If this was your child, what would you expect?
+ Wrap up
Summary of the use of Socratic questions
- Socratic or inquiry interweaves can be useful during the history taking phase to help a client clarify their experience.
- Socratic interweaves help during processing when it has become stuck. Stuckness is identified when the information emerging in processing hasn’t changed for two consecutive sets of bilateral stimulation (Shapiro, 2001)
- The inquiry interweave can also be used when processing does not generalise to other targets despite processing to calmness in the current target or if there is extreme emotional distress
- Socratic questions can be used when there is time pressure and the client has a strong abreaction with no time to process it.
- The most usual phase for using Socratic interweaves is during the desensitisation phase of the EMDR protocol when the processing is stuck or is looping back to the same series of thoughts or responses.
- Socratic questions are not random however. They are carefully crafted to fit with the cognitive domain relevant to the client’s processing. They usually fit into one of four different domains: responsibility, safety, choice or shame. In the aide memoire we give a selection of different inquiry interweaves that can be used in the different domains as a springboard to you finding your own, wider and more creative selection.
- It is helpful to remember that you can think of inquiry interweaves before a session as well as coming up with them during the session. Sometimes a client is prone to blocking or becoming stuck so we can think of possible questions ahead of time or use supervision to discuss interweaves that might help the processing to become more adaptive.
Interweave Steps - Client is looping or stuck.
- Stop bilateral stimulation and ask the client what is happening.
- The client responds.
- You can do one or more of the following: Return to target and check it. Look for blocking beliefs. Look for blocking images. Check for feeder memories. Look for client fears. Look for blocking body sensations. Get oriented in place and time. Check other senses. Talk to the child self (e.g. what does the child need?) Consult the inner advisor or wise self. For example if the client says she was afraid of her stepfather, the blocking belief is "I'm not safe."
- The therapist constructs an interweave. In the above example the therapist might ask the client, "Where is your stepfather now?"
- The client responds to the therapist's inquiry. For example, "He's dead."
- The therapist says, "Go with that," and adds bilateral stimulation.