Leading questions in psychotherapy

I was asked this question the other day in supervision. The client started to cry and the trainee therapist said, “What are you sad about?”. The trainee then asked if this was OK as she was asking a leading question.

Leading questions obviously happen when the person is lead by he questioner. For example

Person is crying

Non leading question – Tell me about the crying, what are you feeling?

Leading question – Why are you sad?

In this case the person has been lead by the therapist by the use of the word ‘sad’. The therapist has led the client’s thinking to the concept of sad rather than letting the client discover it for them self. The client may not have been feeling sad and the crying may be related to some other emotion.

swimmer

In many cases this does not matter all that much but if you have a client who is highly adapted and has a strong Please me driver or is in a particularly strong transference with the therapist then this can be a problem. In these cases the client can think,

“The therapist has recognised it as sadness therefore it must be, so I am feeling sad.”

If the client wasn’t crying because she was feeling sad then you have created a problem. The client now mis identifies some of her feelings as sadness when in fact they are not.

In recent times there has been research into interrogative suggestibility and pathological compliance.  This research originally began with people who under pressure in police interrogations confessed to crimes they did not commit or were particularly susceptible to pressure from peers to commit crimes they would never normally do.

Some psychological characteristics of these people have been found to include

Low self esteem

High character anxiety

Eagerness to please

Avoidance of conflict and confrontation

Often has a history of childhood neglect and/or abuse

Has low levels of resilience (with the process being Neglect/abuse > impaired resilience > pathological compliance).

Has a freeze response to stress

Uses regression as a way to cope

One hears therapists report from time to time, “Lots of my clients seem to be angry (or sad or scared.”). If that’s happening one would need to look at the possibility of leading questioning. In this case the therapist may be projecting onto the client. That is, the therapist has their own sense of sadness and hence they see sadness in the client when it is not there and they can express that in leading questioning to some of the clients. They adapt to that and start to report feelings of sadness.

 

This can go further where one gets to false memories. This is a more extreme version the client adapting to the therapist. With leading questions the client can adapt to the therapist interpretation when it is wrong. In most cases their unconscious (at least) will realise the interpretation is incorrect and they are not really feeling sad and eventually they realise this and identify the correct feeling. That may happen after they have left therapy.

Some do not do this and take on the therapist’s incorrect interpretation as a fact. They convince self to such a degree they experience it is a factual thing that happened in their life. It is a fact they were sad and that becomes a normal memory like all the other memories people have about things in their life. The only problem is, it never actually happened. This is what is known as pathological compliance.

Leading questions can also have a positive. When a person is in a highly emotional state they are said to be regressed and more suggestible. One way to change how you think feel and behave is to have hypnotic suggestion. A man who denies his sad feelings may begin to cry a bit. The therapist can then do a leading question and say, “What are you sad about?” or “Tell me about the sadness.”

Because he is in a suggestible state he is more likely to accept the therapist’s suggestion (you are sad) than if he was in a non emotional thinking state (his Adult ego state was more in control). The denial of his sadness is more likely to be broken by the leading question if he accepts the suggestion that he is sad. Hence leading questions can be used as a type of hypnotic suggestion to assist the client. BUT the therapist has to be sure their interpretation of the client is accurate.

Share it if you like it...
Share on FacebookTweet about this on TwitterPin on PinterestEmail this to someoneShare on StumbleUponBuffer this pageDigg thisShare on RedditShare on TumblrShare on LinkedInShare on Google+Flattr the author

Leave A Comment...

*