If you’ve been trained in mindfulness-acceptance or 3rd wave therapies like acceptance and commitment therapy (ACT), you may have heard at some point that asking “why” to your clients is not a good therapeutic move. Ever bitten your tongue when catching yourself saying these three letters in session, or apologized to your supervisor while showing your tapes (“I know, I’m not supposed to ask why!”)? If that sounds familiar, I’d like to offer a perspective that you will probably find more flexible.
First, let’s clarify an important point. For functional contextual approaches like ACT, what you should say and not say in the clinical conversation is all a matter of goal (function) in a given set of circumstances (context). For this reason, rules that prescribe or proscribe verbal moves regardless of the context are pretty hard to find in these kinds of therapies. In other words, whether it’s a good idea to ask “why” depends on your therapeutic goal. So, why would you (not) ask why?
Perhaps the urge to ask “why” is a reminiscence of the way we express curiosity as children. If you are parents, you know what I mean. Kids are so curious about the world that they want to hear explanations about everything (“Why is the sun yellow?” “Why can’t we fly like birds?”). After all, curiosity and openness are two of the corner stones of the therapeutic stance in 3rd wave approaches. So, maybe it makes sense to ask “why” in therapy?
Kids also ask “why” to challenge rules they find constraining and arbitrary (“Why should I brush my teeth?” “Why should I go to school if I want to play instead?”). One of the primary goals of 3rd wave therapies grounded in humanism like ACT is to free clients from arbitrary rules. So, perhaps we want to ask our clients “why” when they seem constrained by arbitrary rules?
Did you notice that these two ways of using “why” actually reflect two kinds of goals? One goal is to understand how the world works, and the other is to clarify the purpose of an action. In 3rd wave therapies, both are important but clearly distinct goals.
Understanding how things work in a clinical context generally targets validation, normalization, and compassion. Therapists encourage their clients to consider the past and current circumstances that lead them to feel and act in painful and problematic, but also totally understandable way.
Clarifying the purpose of clients’ actions is meant to shape their tracking skills – their ability to notice the consequences of what they do and to assess if these consequences match their goals. Therapists help clients take a more pragmatic perspective on their lives, in order for them to engage in actions bringing satisfaction, rather than repeating the same patterns over and over again.
These two goals are at the core of 3rd wave therapies. On one hand, we want clients to approach their psychological experiences as part of human life (yes, even the painful and bizarre stuff); and on the other hand, we want clients to identify and do what works to live the life they want. So, in theory, you could ask “why” all the time!
But the thing is, using a single word that carries such different meanings can be confusing and sometimes take the therapeutic process to unhelpful directions. In particular, asking “why” can get the client even more stuck in stories that may be true but distract from solutions that could actually make a difference. By the way, this is why 3rd wave therapy trainers sometimes warn against asking “why”. There is a risk of over-analyzing and ruminating about things that can’t be changed anyway, or that we don’t need to analyze in that particular context (you know the saying, don’t approach a sunset like a math problem if you are looking for contemplation –unless you’re a geek).
So, how can you avoid the traps of “why” and still help your clients develop compassion and pragmatic thinking? Here are a couple of tips you can immediately apply to your clinical conversation:
#1 Be clear about what you actually want to achieve with your client in this moment. Is it normalization? Is it shaping of tracking skills? Don’t just ask why because you want to know why; know why you’re asking why.
#2 Consider replacing “why” with other, less ambiguous terms that reflect the exact message you want to convey. For example, if you want to clarify the purpose of an action, ask “For what purpose?” “What for?” “What do you hope for while doing _____” or “What is your intention while doing _____?” If you are aiming for understanding and normalization, ask “what do you think might be influencing you to do _____?” “If you took a compassionate perspective, how would you make sense of how you’re feeling right now?” or “Are their things in your life right now or in your history that make it hard for you to do what you want?”
#3 In any case, choose the words that feel right to you given your intention and conversational style, and watch for the client’s response in order to assess if your verbal moves are effective. For example, a question focusing on purpose should orient the client’s attention to the goals and consequences of her actions. This may seem obvious but the content of the clinical conversation is often so rich that can we lose track of what is going on at the process level!
— Matthieu Villatte, PhD