I’ve been fascinated with indirect procedures1 ever since Brian McCullough introduced me to F.M. Alexander.
Consider a toddler with a fever. Administering Advil or Tylenol would be a direct approach to treatment. This might tamp down the fever for a few hours but won’t resolve its underlying cause. Moreover, that strategy might prove dangerous if something like meningitis or cancer is the cause of the fever. In contrast, treating an ear infection (driver for fever) with antibiotics resolves the fever indirectly and permanently.
So, too, in mental health and addiction treatment. One can target symptoms and behaviors directly with medications and certain forms of psychotherapy. By and large, however, this doesn’t resolve root causes.
Freud [...] sometimes used a picture postcard of the most ordinary kind for making his point. A picture showed, for instance, a hillbilly in a hotel room trying to blow out the electric light like a candle. Freud explained: "If you attack the symptom directly, you act in the same way as this man. You must look for the switch."2
Do I use direct approaches? Yes — they are often necessary to stabilize patients. But I generally try to shift to indirect procedures that uncover and resolve root causes. ✸
Postscript. In the case of addiction:
Our liquor was but a symptom. So we had to get down to causes and conditions.3
[Y]our problem is not drinking in spite of what anyone has told you or in spite of the conclusion you may have reached yourself. Forget all that stuff. It's a lot of bunk and probably has you so confused you can't look at yourself with any objectivity. I repeat——drinking is not your problem. [...]
Drinking in your case is a symptom of something wrong. If you can make yourself realize this you may be thankful for your drinking at a future date. Why? If it were not for the particular effect that liquor has on you, you might never search for the underlying trouble.4
- Slides 26–39
- Theodor Reik. The Need to Be Loved. New York: Farrar, Straus and Company, 1963, p. 271
- Alcoholics Anonymous, 4th ed. New York: Alcoholics Anonymous World Services, Inc., p. 64
- Charles Clapp, Jr. Drinking’s Not the Problem. New York: Thomas Y. Crowell Company, 1949, p. 17 [emphasis in the original]
Endnote. I contacted the Freud Museum in 2024 to see if it had any postcards in its collection. A research manager replied: “Thank you for your email—what an intriguing question. Good old Theodore Reik! I’ve had a search through and can’t find any postcards matching that description. My guess would be that the postcard that was used for this demonstration wasn’t part of the material that came to London from Vienna—but if you ever are able to track it down—do let me know!”
Series Installments
Find the Switch
Find the Switch — 2
Find the Switch — 3
Find the Switch — 4