By: Kevin Clouthier
An ancient Chinese saying asks that people be blessed to "live in interesting times."  We have been so blessed.  An amazing shift occurred within therapy with the genesis of the Brief Therapy age.  When Watzlawick, Weakland and Fisch published "Change," they ushered in a new way of conceptualizing both problems and the creation of solutions to those problems.  Anyone seeking evidence of the significance of the movement that grew from this seminal work from the Mental Research Institute needs only review the proliferation of theorist/therapists who have built the tradition of brief therapies over the past 25 or so years.  Notable contributors whose names would appear on such a list would include the likes of Steve de Shazer, Michael White, Insoo Kim Berg, Harry Goolishian and Harlene Anderson.  Of course, legions of others have furthered the "state of the art" of therapy.  Through their research and writing regarding the application of post-modern therapies, they too would have realistically expected to have their names included.  Through their collective effort, a momentum built as theory began to shift from therapist expertise that was applied "to" a client.  They advocated the dissolution of the hierarchy of power within the therapeutic system.  The therapist as part of the therapeutic system was conceptualized and the face of therapy changed.  These notable contributors in our field of endeavour drew upon the  philosophical writings of Wittgenstein and Foucault regarding linguistics and power to build a foundation from which our current therapies have emerged.    Clearly oversimplifying the process, post-modern therapies regard problem formation and change as being grounded within the linguistic and meaning systems upon which they are based.  The transformations of meanings that emerge through collaborative therapeutic conversations facilitate conditions that are conductive to change.  Meaning, experience and language are regarded as being the same.  Collectively, these therapeutic practices represent a profound departure from earlier modernist models of change that honoured the expertise held by the therapist.
The Chinese blessing has not been limited to the field of therapy, however.  While the changes that catapulted therapy from a modernist to post-modernist undertaking were emerging, a parallel revolution was emerging within other fields.   Scientist inquiries were challenging Newtonian physics that describes a linear and mechanistic view of the organization of the universe as an adequate paradigm to understand and explain the universe.  Fields as diverse  as economics, organizational development, computer science, mathematics, biology, physics and other natural sciences, in a shift similar to that of therapy, have been recasting the rules by which these fields are organized.  The notion of Newtonian scientific knowledge is, as a result, gradually giving way to the emergence of nonlinear dynamics.  In its place, Complexity Science represents the growing body of knowledge revealing the development of descriptions of the properties and behaviour of dynamic systems that are capable of change. 
At first blush, it may be a stretch to draw a connection between computer science, mathematics, physics and therapy.  However, the study of the process of change clearly does not reside exclusively within the therapeutic domain.  Complexity science is adding to our collective understanding of how the world operates, and the processes of change within it.  Advances within the field of complexity science have facilitated growing appreciation of the manner in which nonlinear change occurs within complex adaptive systems.  Complex Adaptive Systems (CAS) are defined by Paul Plsek as:
A collection of individual agents, who have freedom to act in ways that are not always totally predictable, and whose actions are interconnected such that one agent's actions changes the context for other agents.
That sounds a lot like human systems.  Through work conducted to date, some interesting information has become known about the characteristics of change within nonlinear dynamic systems:
I.Change can occur without it being imposed; in fact imposing change can lead to adaptations that are undesirable.
II.complex changes can emerge from only a few simple rules; a "good enough vision" of the correct direction is desirable to initiate change and the process will be adjusted through time.
III.consistent with non-linearity, small changes can lead to large outcomes
IV.Introducing a new agent to the system incorporates the new agent into the system with a similar level of influence upon the system as other agents; a new agent cannot remain objective and detached.
V.complex systems performance is heightened when there is a modicum of both stability and chaos
VI.As a system moves toward, but not into chaos, there is greater probability for change.
VII.Resistance does not exist; dynamics of complex systems move in the direction of attractors
Reading the characteristics of Complex Adaptive Systems noted above within the therapeutic context reveal that there is a significant convergence of thinking between Brief Therapy and Complexity Science.
Single Session Consultation represents one form of brief therapy or as some have suggested, represents ultra-brief therapy.  It is a therapeutic practice that has been demonstrated to successfully create change with clients from one conversation.  The key developers of this method of working with people, Talmon, Hoyt and Rosenthal have explored the model from the perspective of brief therapy.  They have collectively and individually recommended therapeutic activities that have drawn from solution focused therapy, narrative therapy and problem focused therapy.  In the final analysis, they recommend a very pragmatic intervention strategy that will support change through whatever means that makes sense.  When looked at from a theoretical perspective, to great extent single session therapy recommends therapeutic process as a condensed version of longer brief therapies.
Conducting single session consultation as a souped-up model of brief therapy can lead a therapist into some difficult challenges.  Not the least of these is to require follow-up sessions beyond the first one to further develop the therapeutic process.  The practice of single session therapy that is organized from the perspective of complexity science offers insights into how a therapist can create conditions that are beneficial for the client.  Appreciating that there are dynamics at work within any physical and social system guides the conversation in such a way that it produces results as a therapeutic process.  Single session consultation as a therapeutic process that establishes an initial condition that provides "good enough vision" based upon attractor patterns for the client to proceed with the work beyond the consultative conversation capitalizes upon the inherent forces of the universe to process change.
 In Volume 1(2) of The Brief Therapy Network News, Allan Kay described the influence of brief therapy upon his marketing consulting practice and the impact that it has had upon the Glasgow Group's relationship with their clients.  Kay suggests that application of brief therapy principles to a business context aids organizations to move toward a described preferred future without agonizing through the review of what has been sub-optimizing the performance of that organization. 
The suggestion in this short essay is that therapists can enhance their work with clients by applying the learning that is occurring within complexity science. Business consultants turning to brief therapy to develop maps to work with their clients.  Therapists looking to physics to gain greater appreciation of the process of change within complex adaptive systems.  Perhaps the greatest blessing of our "interesting times" lies in the increasing convergence of knowledge within what have until now been regarded as largely disparate bodies of knowledge and practice.  END.

• The element of surprise. Many of my clients say that they start therapy feeling anxious and worried, expecting to start digging into the problem and excavate their past. They are pleased to learn that instead I like to find out what it is they wish to achieve, and rather than dwelling on their problem, we start building solutions.
  

• Miracle Question. Most clients know exactly what they want to STOP doing, but have not formulated what they would rather do instead. When asked: "What will be the first thing that tells you a miracle has happened?" they commonly reply: "I won't be thinking about food". My next question is: "Ok, so what will you think about instead?" The MQ helps to draw them away from the problem and towards their preferred future. A helpful 'task' is to invite clients to look out for tiny parts of the miracle and report those when we next meet.
  
• Exceptions. A black-and-white viewpoint is common among my client group and looking for Exceptions helps to challenge these. If they say: "I'm always vomiting" I wonder: "What? Always? Even while you take a shower? Even when drive your car?"  "I can never stop eating" gets challenged by: "How come you're not eating at this moment?" These questions are empowering. They give evidence that something positive is already happening, and this forms the basis for further change.
  
• Externalizing the problem. This is an intervention borrowed from Narrative Therapy. I invite clients to buy into the idea that they are not the problem, in fact they are perfectly lovely and precious human beings which have been unfortunate in that a slimy monster (the eating disorder) has attached itself to their shoulder, and now it is brainwashing them with eating disordered thoughts and behaviour. Once clients get used to this idea they can stop fighting themselves ('I'm useless, I'm disgusting, I should be able to snap out of this') and fight against the eating disorder (slimy monster) instead. They become assertive and are able to make constructive choices. Instead of listening to their monster which tries to persuade them to eat/not eat/vomit etc, they say: "No, I don't want to do that, so instead I will do something that does my body justice, such as phone a friend, have a bath, read a book etc.
  
• Teaching It is useful to raise awareness of related problems such as tooth decay, osteoporosis and infertility. Many clients are simply not aware of the ravaging and far reaching effects of an eating disorder. I appreciate that some therapists never get involved in educating/advice giving but as my clients clearly identify this to be helpful I continue to do this when it appears appropriate.
  
• Turning negatives into positives. Clients are often stuck in negative thought patterns. With little or no self-esteem, their metabolism is disrupted and they feel a physical wreck living in isolation and often shame, with a sense of loss of control.  Characteristically, recovery follows a pattern of peaks and troughs. Some people say they feel like they've taken one step forward and then several back! This is normalized in therapy. The larger picture generally reveals that they have slipped, but either they have not gone as low down as they were before or they have not dwelled in the pit as long as they did previously. We are not interested in the whys and wherefores of a dip. Instead we look at how they managed to dust themselves down and decided to climb up again. In other words, we prioritize the ups rather than the downs.
  
• Breaking rigid routines. Eating disorders of the restricting kind tend to seduce people into the 'safety' of rigid routines. We challenge what is offered by the eating disorder and begin to move towards being able to move towards being more spontaneous around food. The therapist leads from behind and is guided by the client in this process. Small achievable goals are set and these are expanded as the client feels ready. In cases of extreme low weight the input from a nutritionist is sought.

 From a clinician's point of view I value the fact that SFT allows me to be spontaneous and creative. The client is treated with utmost respect and the work is collaborative: clients are considered to be experts of their lives and this knowledge is dovetailed into the expertise of the therapist. Together we work on devising strategies to bring about positive change.
I do not follow standard assessment protocols such as 'EATS' or 'SCOFF', I get most of the information I need from the client's problem description. I am more interested in knowing what they wish to achieve and getting a clear description of what we are working towards. We can then go forward in small, achievable steps. This is often quite a learning curve as many clients have a sense of perfectionism and their eating disorder tells them they should be at 10 after one session! This is a good opportunity to explore the benefits of living in the 'good enough' range.
The 'not knowing' stance also appeals to me. It does away with the potential hierarchical aspect of therapy (therapist is expert, client is victim) and allows the problem to be challenged. Working with a scale from 0-10 enables me to get a quick and clear overview of any (lack of) progress.
I think the combination of physical and psychological problems sets eating disorders a bit apart from other ailments. It pays to have some knowledge of the potential physical harm that can be done by not eating, over-eating and selective eating, or through compensating by vomiting/laxative or diuretic abuse and over-exercising. It is essential to work within safe boundaries and therefore I ask for help from a nutritionist/dietician or a doctor when appropriate.
I hope this small snippet of my work has given a bit of insight into the way SFT can be applied to the recovery from eating disorders and wish everyone who has the privilege to work with this client group much enjoyment in their work.
FJ.