How can we move from a problem-solving approach to a solution-generating approach?  

When I was in medical practice, someone would come in as a patient with their problem.  And, if I were to do my job as a good doctor, I would ask them, “Tell me about what's happening and when did it start, where is the pain?”  I wanted to know all of the facts, all of the information that I can so then I could make a diagnosis.  Then, having made the diagnosis, comes the treatment.  

If we have a problem with our car, we take it to a car mechanic and he says, “What’s the problem?” He listens to noises, bumps, squeaks, things that are not working.  He gets the information and finds as much as he can so that he can find out what's wrong with the car so that, if something needs replacing or fixing, he can do that.  If something goes wrong with our washing machine or with our computer, we take it to someone who knows how to fix these things and they either ask, “What's happening, what's wrong, what's not working properly?” or they go about testing, in their own way, perhaps with some special equipment, to find out what is wrong, what's not working, what's broken.  And then they fix it, they tighten it, they replace it or they say, “It can't be fixed. Throw it away and get another one.” 

This problem-solving approach is excellent for dealing with physical problems in the human body ,with cars, with computers, with any mechanical object, by finding out what's wrong, making a diagnosis and then fixing it. 

Many contemporary approaches to psychological problems are based on the medical model, as if the body is a machine that needs maintenance and then, if something’s not working, needs to be fixed.  

This idea has percolated across to our thinking and our feeling so that many psychological approaches are mechanistic. We talk about depression, as if something is being pressed down.  We talk about being stressed or being distressed. There's a lot of mechanically informed jargon that finds its way into therapy.  It’s my experience that, although finding techniques to help fix mechanistic processes is wonderful, they are not so good, they don’t work so well when it comes to human dilemmas and psychotherapy.  

Milton Erickson said, “Clients come to therapy not because of their unchangeable past, but because of some discontent in their present and a desire to better their future” so his approach to therapy was not to find out information about the past so that someone could be treated or fixed, but rather to explore what might be helpful for them so that they could move towards their desired future.  

He told me that a woman rang him, saying she wanted some help because she’d been washing her hands obsessively for 12 years.  He said he was very interested to find out what she used to do with her hands 13 years ago.  He was not interested in diagnosing the problem. He was not interested in getting an understanding of what caused it. He was more interested in helping her to reconnect with some personal resource to create the kind of present, the kind of future that she wanted.  

This speaks to the very different approach that Erickson generated and that people who have learnt from him, appreciate. I call this the solution approach. In the solution approach, we are not so much interested in information about causes, but more in gathering information about what resource, what experience that this particular client has become disconnected from, is overlooking, is not making use of or could learn.  

In the problem-solving approach, the whole process is informed by the question, “What’s wrong that needs fixing?”  In the solution approach, it’s informed by the question, “What’s missing?”  What's missing, that, if this client were able to find it, connect with it, access it, learn it, that they would be okay. The whole process in the solution approach, rather than being concerned with fixing, is primarily concerned with connecting.  It’s informed not by what's wrong, but it’s informed by what's missing.  

“What’s missing?” is such a beautiful question that, if we have it in the background, helps to give a direction, helps to give us a format for exploring with each individual client just what it is that’s going to be useful for them, helpful to them to move towards their preferred future.  

There are a couple of marvellous Irish sayings. One is, “If you don’t know where you're going, you might end up in a different place”.  Another variation of that is, “If you don’t know where you're going, any road will take you there”. If we know where we’re going, if we can find the direction that’s going to be useful for the client, then that’s going to be so helpful in giving direction to the whole therapeutic approach.  

To summarise, the problem-solving approach is informed by the question, “What’s wrong that needs fixing?” It involves categorising and treating while the solution approach is informed by the question, “What’s missing?”,  what has the client become disconnected from so that we can assist them to connect, to reconnect or to learn so that they can be enabled to get on with their life, resolve their conflict and have the preferred future that they want.  

Rob