4. Symptom prescription:
This is a complementary tactics of reinterpretation. To distinguish between them should pay attention to reinterpretation that is an internal change process and symptom prescription is an external action. Re-interpretation tactics comes to influence the cognition directly and the behavior indirectly. Symptom prescription comes to affect the behavior directly. Here, the therapist is facilitating direct behavior that encourages the client to maintain his symptomatic behavior (the problem, the complaint). The assumption is that the customer uses a symptom as a inefficient solution for specific problems. The idea of change, by symptom prescription, is associated with the thought that it is possible to remove the symptom by developing the ability to control it even if it seems an involuntary phenomenon. The main change is achieved by the customer’s desire to avoid the consequences of behavior or unwanted symptom.
Example: A boy who stutters is complaining that number of boys are harassing him because of stuttering. It turns out that the level of stuttering grows up when he responds angrily to this harassment. The directive given to him was that at the earliest occasion, when he will be harassed, he should stutter at the highest intensity he can generate it. So, perhaps, the boys will be frighten because of the harm they hit him.
The report, given by the boy, turned out to be exaggerating the stuttering so the boys who plagued him panicked and fled from the scene. In terms of guiding the therapists intention was to raise awareness of the boy’s ability to control his stuttering. This, indeed achieved and resulted in reducing the frequency and intensity of stuttering.
Symptom prescription, as a tactic, allows customers to experience a different way of controlling the symptom or the unwanted behavior, especially by expressing curiosity and empathy about the symptom. This can be done by expressing great interest in the symptom, and asking for illustration of how the customer can cause a symptom, as it is done in the case of stuttering. An attempt to illustrate any behavior increases the control of it. Therefore, we should encourage the customer to do so even if he hesitates a little.
When a customer describes what happens to his body, while the symptom appears, it immediately comes to self-recognition. When he will experience again the context, in which the symptom appears, he will be associated and curious about his self-conscious; and it’s very difficult to be curious about what happens in your body, and at the same time deal with it.
Symptom prescription can be used in a very wide variety of problems such as, marital strife, panic attacks, excessive drinking, sleeping problems. People preserve their problem by action designed to block the problem to appear. The therapist can prevent this by getting the customers to design the appearance of unwanted symptom at a planned specific time and place.
At marriage conflicts, for example, the therapist turns to a couple and tells them: “I know that you hope not to fight this week, but it would be rare that you’ll not have fights. So, this week, I want you to promise at least one arguing. On Wednesday evening will it be convenient for you?”.
Sleep difficulties: “There are nights where you sleep for two hours, other nights you sleep no more than four hours. What night it will be at least most comfortable if you sleep less? Friday night? Fine. If so, that night I want you to assure that you will sleep very short time. Do not take pills, drink lots of coffee, go to bed early …”