Character Clinic: Scott Byron Aylward

Today I've got Katherine's murder mystery character on my couch. Scott is a very effective detective. He's married to a surgical nurse, and at home, he's messy, disorganized, and unfocused. A girl in his hometown is murdered, and Scott often feels compulsion to seek justice for victims. Lately, he's been a mess. He's starting to drink and forget to eat, running compulsively, and spending his own time hunting down leads on the home-town girl's murder. His wife recently left him, getting tired of waiting for him to "grow up."

Katherine wants to know: Scott is in therapy, but doesn't see that he needs to learn to be happy with or without his wife. Nor does he see that winning his wife back is an unrealistic goal. What would you as a therapist tell him to do? What exercises would you suggest for him to follow to gain focus?

Oooh! I true therapy question. I must say that if you ask twelve therapists, you'd get twelve different answers, but I'm honored you chose me. :)

Many times clients come in with unrealistic goals. It's not for me to tell them that the goal isn't feasible, but for them to come to that realization on their own. I might start out with a discussion about what things in their life they have control over, and what things they don't. I break out a chart like the one below to give structure to this activity.

 

I then have the client list all the things that they would like to see change. As the person lists everything (and usually it is a litany), I plug each item into the right box.

So Scott wants to his wife to come back. This would fall in Box 4, since it isn't something he can do himself (she has to come back) and it isn't a change that happens internally for her. It's a physical, external change of location/marital status. If he said he wanted to "grow up" and take more responsibility in his life in order to get his wife back, this would fall in Box 1, because it happens internally, and only he can make this change.

What clients usually see is that the only thing they have 100% control over is Box 1. In fact, control slips further and further away as you go to Boxes 2, 3, & 4. I usually will play devil's advocate and ask questions that help the client arrive at this conclusion.

Therapy is about internal change affecting external change. At least it is to me. There are lots of things you can do to get immediate external relief, but unless you change internally, the external change doesn't usually stick. It's a lot of work, so I hope to help clients not worry about what other people are doing, and focus on themselves. Perhaps this exercise will help Scott do that.

I'm open to answering additional questions about this method if you have any. I think it could make a compelling scene with him in therapy coming to this conclusion.

Treatment Tuesday - Strong Heroes, Even Stronger Motivations

[You have until Friday for a chance to win Deborah Vogts' Snow Melts in Spring! Click here!]

This week's assessment is from Jaime. She's writing in a second time about her historical suspense to tap the psychology well about her hero, Seth.*

Seth is a strong, silent, brooding man haunted by past war crimes he committed alongside his nemesis. Seth, whose background is the US Calvary, confessed to his crimes and took his nemesis down with him. He still feels like he owes penance, though, so when a new crime is committed by the bad guy, Seth turns himself in to appease his guilt (and thwart the bad guy by pulling such an unexpected card). He's currently on the run from the nemesis, but when the bag guy threatens the woman he loves, he decides to face his past.

* Names have already been changed to protect the fictional. Gotta love that!

Jaime wants to know: Is there a different psychology behind Seth's "guilt factor" that could bring a different spin to Seth's reaction? Why would a military man consumed by guilt not just face his opponent and end it rather than continue to run away and then take the blame for something he didn't do? How do I make Seth look strong while not losing my entire story?

Reading your sketch brings up some questions for me, not just as a therapist but as a reader. You wrote that you have a hard time believing yourself that he wouldn't just face his nemesis, fight him, and get it over with. You even wrote that turning himself in for a new crime he didn't commit almost seems weak to you, which makes you like him less as a hero.

I say you need to stick with that reaction! If you, as the author, aren't so keen on his behavior--and ultimately his character--then you have two options:

1) Change the behavior (easier way out)
2) Change his motivation (harder, but will pack more psychological punch)

If you change the behavior, you have him fight the guy, win, and then have what might be a very run-of-the-mill novel. Good guys fighting bad guys. Not a bad formulaic equation, but nothing special, either.

If you change the motivation, then you give a new twist that old plot line. My brain started turning as soon as you said the good guy "turned himself in" to thwart the bag guy. (Yes, yes, you also said to appease his guilt...but the thwarting is much more interesting. Guilt is a powerful motivator, sure, but the type guilt he's carrying around is more of a deficit in his Esteem Needs, which is pretty high up on the Heirarchy of Needs pyramid.)

I'd consider a lower needs deficit for his motivation, probably Social Needs. Why on earth would Seth turn himself in for the bad guy? This question led me to the next, more important question: What is the relationship between Seth and the bad guy? Is it simple (i.e., good guy v. bad guy) or is it more complex (i.e., good guy v. former best friend or half-brother)?

I don't think you need to change Seth's character so much as you need to layer it more (which is the psychological punch I was talking about). Characters usually tell us how they want to be written. You've got the strong, silent type who likes to brood. He's former military, so we can all imagine he's a muscular, "git-r-done" kind of guy. So make his motivation for steering clear of the conflict greater than his desire to even the score or fight.

What would keep him away, keep him running? It doesn't have to be a weak, pansy reaction for him to have. Could the bad guy be holding something over him, like a terrible secret? What if Seth doesn't want the girl he loves to find out, and only when the bad guy threatens her--and the secret might come out and "ruin" his life--does he feel the need to stand up and fight (that, and he loves her).

As your sketch reads right now, it's pretty vague why he's not wanting to stand up to Bad Guy. Could he not want to go after the bad guy because to kill him would be to kill the only family he's got left--or even knew he had? (Seriously leaning toward something like this personally. Man....think about the possibilities!) Then he'd be running to protect the guy from himself, from his guilt-infused anger, possibly? What if running was the more noble thing to do? No reader alive would think him weak if you made the motivation for his behavior more solid and something people can relate to.

These are just a few of the brainstorming ideas I had while thinking about Seth and his behavior. It makes sense for him to stand up to Bad Guy when Bad Guy starts threatening the woman he loves. If you give him a great motivation prior to this juncture in the novel, then the showdown will be just that: a showdown! Pitting his motivation to run with his motivation to protect the heroine....good stuff, Jaime. Good stuff.

Hope this helps. As always, if I'm totally off or have misunderstood in some way, please comment! I love running "sessions" between authors and me (and others!). :)

T3 - Therapy Basics: Treatment Plans

Therapy isn't therapy without a treatment plan. This goes for fictional therapists and their clients, too. Contrary to how it's conveyed in popular shows like Frasier and In Treatment when the audience is privy to the talking but not the behind-the-scenes, therapy isn't just about the talking.

The conversational direction--i.e., the "talking"--should be towards an end that's already been specified between the therapist and the client. That's what a treatment plan is for.

Treatment plans look different depending on which therapist you go to. Here's the elements mine incorporates and the reason behind it.

1) Goals

Developing goals sounds much easier in theory than it actually is in practice. The reason? To make this worthwhile, the goals have to be specific, observable and quantifiable. So a therapist shouldn't just write down, "To decrease depressive symptoms." Yikes! This could be a legal nightmare were my file on that client to be subpoenaed.

So instead, a better way to put this goal would be: "Decrease depressive symptoms (as evidenced by crying, oversleeping and overeating) from 8-9 times a day to 1-2 times a day, as reported by client and her husband."

Now I've managed to convey how many times the symptom is happening and I've made the goal a measurable one by indicating how many times a day we would like the client to not be exhibiting depressive symptoms. It's often unrealistic to go from a certain number to zero, so I strive for reality in my goal-setting with clients.

Typical treatment plans have room for 2-3 goals.

2) Interventions

Then of course the therapist will want to spell out exactly what's in his or her bag of tricks that she will pull out to address the each specific goal. Interventions are as plentiful as goals, but to give you an idea of what I use frequently, say, with children:

art therapy, play therapy, bibliotherapy (reading books with messages/morals), role playing, modeling appropriate behavior, positive reinforcement, relaxation/anger management techniques, assertiveness training (to combat aggressiveness and teach the different), and so on.

3) Duration of Interventions

For sure we have to have a date we're working toward, if for no other reason than to revisit the goals at that time to see if we're on track. This can be 3 or 6 months from when the goals were initially discussed. Treatment plans expire after one year, so for sure a review needs to happen before then.

4) Termination Dates

Treatment plans expire after one year, so for sure a review needs to happen before then. If at the time of any review, it is determined that the goals have been met, then treatment is terminated, and this date is added to the treatment plan as evidence of the acknowledgment of both ther therapist and the client that treatment was satisfactorily concluded.

5) Changes to Treatment Plan

Sometimes changes are made to a specific goal during one of the reviews. In our example above, say the client's depressive symptoms swung mainly toward overeating. We might want to add as an intervention that the therapist referred the client to a nutritionist and exercise consultant (both of which would make the client hopefully feel better about herself and get her on the right track). I would note the date that this addition was made to the treatment plan and have the client initial it, as well.

This can be a hard one for therapists to remember. I know I did when I started out. But now, I just think of the client. Anything pertinent to their treatment should be noted not only for my own safeguard, but for theirs. A change in a goal or an added intervention is definitely pertinent.

6) Signatures

Signatures should be pretty self-explanatory, but sometimes even this can be complicated. Everyone privy to the treatment goals and interventions signs. So if I'm seeing a married woman, who on occasion brings in her husband, he would need to sign, too. If there are family therapy goals, then the family signs. i'f I'm seeing a minor or dependent adult, then the guardian would need to sign, as well. And every time there is a change, EVERYONE signs, which can be a major pain, just so you know. :)

Now we've covered treatment plans...next week we'll focus on session notes and you can once again enter the inner sanctum of a therapist's world.

Q4U: What are some topics you'd be interested seeing posted for Thursday Therapeutic Thoughts? I'm nearing the end of my Therapy Basics series and want to post what will help you the most. Thanks!