Clean Language and Leading Questions in therapy


In a therapeutic setting, clean language doesn’t mean not swearing at your client (although in most situations you should probably not do that either), it means avoiding leading questions: those that suggest a specific answer. It’s generally thought of as a good thing, but are there situations when a leading question can be better?

Clean language in therapy

The concept of clean language was developed by therapist David Grove in the 1980s but it's now used in many situations; you will be familiar with it if you watch police or courtroom dramas on TV. ‘Tell me how you killed your wife’ presupposes that you did and would bring the defence leaping to their feet with an objection. Grove developed a very specific set of clean language questions which began by reflecting back whatever the client had said and then adding a non-leading request for more information. Here’s an example.

     Client: The worst moment is when my Dad starts to shout.

     Leading language response
: Is that what makes you anxious?

     Clean language response: And when the worst moment happens, when your Dad starts to shout,
      what happens next?

I hope you can see that the leading language implies we want a certain answer. By asking specifically about anxiety, we indicate what we think the client feels, or what we expect them to feel, instead of letting them tell us about their experiences. If we make a clean language response, then the client might reply ‘I start to feel anxious', or they might say something else. 

Clean language is important in every part of your therapy session, in and out of hypnosis, because it allows the client to tell their own story in their own way. In fact, not using clean language is thought to be the basis of 'false memory syndrome', a term that refers to memories that have been brought about by careless or leading questions. The memories have no foundation in fact, and no evidence to support them, but the client can still come to believe they are true. 

This might seem implausible but think how real a dream, or even your client's peaceful place, can feel. In trance, your client is arguably more than usually open to suggestions, which is pretty much why we use trance in hypnotherapy. An implicit suggestion, particularly during a regression, that an event took place, or that it took place in a particular way, combined with the fact that the unconscious is largely unable to distinguish between reality and imagination, does the rest. 

If you are ever not sure how to respond to something the client says and want a clean language response, questions like 'What happens next?', or ‘Is there anything else about …?', will usually get the conversation going again.

(Technically 'what happened next?' presupposes that something did. But as the client is not still in the situation there must have been something between then and now. And we are not suggesting in any way what that something was.)

  

Therapeutic Leading questions

As we’ve already said, leading questions contain a bias towards a specific response and one place you’ll meet them regularly is in marketing. ‘Would you like the red one or the blue one?’ takes it for granted that you’re going to make one purchase or the other. In other words, it’s a type of suggestion and this is exactly what we use in our hypnotherapy sessions. Look at these examples and see if you already use any of them with your clients.

  • Questions based on assumptions: ‘What will be better when you are a non-smoker?’ assumes that the client will successfully quit, and ‘What changes did you notice since the last session?’ assumes that (a) something changed, and (b) the client is aware of it. 
     
  • Questions based on linked statements and questions: ‘Most of my clients find this better with their eyes closed. What would you like to do?’ We’re hinting we’d like the client to close their eyes.
      
  • Questions inviting the client to reframe an experience or feeling: ‘If you look at that childhood event now, how can you understand it differently?' ‘If you think of your anxiety as protective, how does that change your ideas about it?’
      
  • Questions based on cause-and-effect implications: ‘If you continue to smoke, what will happen to your health?’ The ‘Fork in the road’ metaphor used by so many therapists is an extended version of this. Your descriptions of the options are skewed so that the client chooses the path of change. 
      
  • Questions asking for agreement: ‘Are you ready to be hypnotised now?’

As you can see, asking leading questions can help to move your client forward. In fact, David Grove developed clean language because he noticed that well-known therapists like Virginia Satir and Carl Rogers used their language to subtly shift clients’ experiences and wondered what would happen if therapists took a step back and allowed clients’ internal experiences to be subjected to minimal interference. 

So, there is a well-established tradition of using leading questions to help move the therapy along and no reason at all you can’t move between the two traditions to achieve the best results for your clients.


Advanced Anxiety Management Workshop - click for link to details


References

Loftus, E. F. (1975). Leading questions and eyewitness reports. Cognitive Psychology, 7, 560-572. Leading Questions. [online] Available at: http://changingminds.org/techniques/questioning/leading_questions.htm. [16.4.22]

Tompkins, P and Lawley, J (1997.). Less Is More: The Art of Clean Language, V2. [online] First published in Rapport Issue 35, February 1997 Available at: https://cleanlanguage.co.uk/articles/articles/109/1/Less-Is-More-The-Art-of-Clean-Language/Page1.html. [16.4.22]


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Author: Debbie Waller is an experienced hypnotherapist and hypnotherapy trainer. She is the author of The Hypnotherapist's Companion and Their Worlds, Your Words and a co-writer of the Hypnotherapy Handbook, all of which are available from Amazon.
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