How to Win Friends & Influence People

A seventy year old sales manual is not an obvious first choice for a therapist’s bookshelf, but this is no ordinary sales manual. How to Win Friends & Influence People offers ways to make people like you, win people to your way of thinking & change people without giving offence or arousing resentment, achievements as useful to therapists and our clients as to salespeople.

Written in 1936 by Dale Carnegie, a public speaking coach, the book summarises twenty years of training courses and advice for salespeople and their managers. The language of the book is very much of its time, as are the examples Carnegie uses to illustrate his points (you will learn more about US presidents and 1930’s gangsters than you ever wanted to know!), but the core messages are timeless.

Carnegie argues that successful outcomes arise from positive relationships, much as Carl Rogers (father of counselling) believed that unconditional positive regard for the client was an essential part of effective therapy.

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Change occurs outwith therapy

Therapeutic change is due more to factors outwith therapy than any one aspect of therapy. Factors outwith the session are at least as important as our rapport with our clients…and much more important than our years of experience or the technique we’re using.

The myth of therapy is that it is done by therapists to patients and that the outcome is a measure of the therapist or of the technique employed, not of the client (unless, of course, the client is “resistant” or “non-compliant”, in which case the outcome is very definitely attributed to them!).

The myth of therapy is perpetuated by research focusing upon the outcome of a given intervention on a given condition, where the therapist is merely a vessel for delivery of the treatment and the client is an interchangeable recipent of said treatment.

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How will you know you’re a better therapist?

Solution-Oriented therapists ask clients how they will know when they are better. Therapists often wish to be better in their role, but few ask the Miracle Question of themselves.

Solution-Oriented therapists often ask clients the Miracle Question:

Suppose that one night, while you were asleep, there was a miracle and this problem was solved. How would you know? What would be different? (de Shazer, 1988)

Stressed therapists might be asked a similar question:

Suppose that tonight, while you are asleep, there is a miracle and you become a better therapist. How will you know that this has happened? What will you notice has changed about the way you’re working?

I’ve asked this question many times, of my self and of others. The answers tend to be much the same.

  • Every intervention I make in therapy will work
  • My clients will never try to manipulate me
  • I will always be available for my clients whenever they want me
  • Nothing I say will ever upset my clients
  • All my clients will get better all the time
  • My clients will be grateful for the help I’ve given them
  • My clients will co-operate with my therapeutic strategies
  • If I see a problem, I will be able to address it and solve it
  • I will always know what to do in any situation arising in therapy
  • I will not feel frustrated, angry or anxious during therapy sessions

If our clients gave such unrealistic answers, we would renegotiate more practical, achievable goals. How will you know when you’re a better therapist?

Disclosure is promoted by permission not to speak

Giving clients permission not to speak encourages disclosure. Explicitly granting the freedom to subvert our power frees the client to tell us what they need.

The first time is to check out the therapist, the second is to tell you the real problem.

I was given this advice in training and for years it seemed to be true. Now, in my practice at least, it is the exception rather than the rule.

The balance of power in therapy lies with the therapist. We decide when, where and for how long is each appointment. We set the boundaries and grant exceptions. The client must work within our framework.

Clients can exercise control by withholding information or themselves. Failure to attend is the ultimate means of regaining control of therapy. More subtly, the client can, without overtly challenging the therapist, keep back important facts for as long as they choose.

Full disclosure can occur in the first appointment if the client has permission to withhold. I tell clients “if there are any questions you don’t feel comfortable answering, that’s OK”. It is now rare for clients to surprise me in the second appointment (unless I forget my line).

The underlying process may be that, having been given permission to withhold, the client can now exercise control by disobeying you…and telling all. This appears manipulative but this accusation would be genuine only if the permission to withhold were false, given only to manoeuvre the client rather than arising from a genuine respect for their privacy.

Eye contact tells you when to speak

Steady eye contact from a client is your prompt to speak. Attending to eye contact helps us to minimise interruptions of the client’s train of thought and to be more comfortable with silences.

In 1:1 conversation we spend 50% of our time looking at the other person. It is important to remember that this is an average across two distinct roles: speaker and listener.

When listening, we look for 50–90% of the time. We can see expressions and gestures, the non-verbal modulators of the spoken word. More importantly, we can see if the other person shows signs of finishing, so that we can have our turn.

When speaking, we look from 10–50% of the time. We need to know that the other person is listening, but we can reassure ourselves of this with a quick glance. When we have the floor, it is more useful to look away from the other person, minimising distractions from our train of thought.

It is difficult to be sure when someone has finished speaking. A pause may be for reflection or may be the signal that you have the floor. In ordinary conversation between equals, interruptions are inconsequential, easily remedied in the to & fro of the chat.

Interruption by a therapist can discourage a disclosure. A client who has stopped speaking may be awaiting a response or marshalling their thoughts. Speaking just as the client is about to can distract at best; at worst, it can be taken to mean that the forthcoming disclosure was unwelcome or irrelevant.

You will know it is your turn to speak when they look steadily at you. A quick glance need only be to check that you are still listening. A steady gaze indicates that a reply is now expected.

Relaxed Therapists make better therapists

Relaxation improves our performance, benefitting us and our clients. We promote relaxation in our clients but we rarely apply our approaches and techniques to ourselves.

Both physical and psychological therapists promote relaxation as a way of decreasing disease and distress. Relaxation improves balance, coordination, digestion & sleep. Relaxation also improves concentration, memory, decision making & self control.

Sports coaches and life coaches recommend relaxation as a way of improving performance. A colleague once said that he knew his clients were getting better when their golf game improved. I know my clients are recovering when they don’t need me to repeat the date of their next appointment.

Physiotherapists are usually fit and speech therapists enunciate clearly, but relaxed therapists are rare. Therapists are typically pressured by excessive demand, inadequate resources, wide responsibilities and the need to balance personal & professional life. Not only do we need to practice what we preach, any gains will be experienced both by us and by our clients.

The pressures on novice therapists are primarily related to competence: the fear that this client will be the one who uncovers your inadequacies.

The pressures on experienced therapists are related more to the burden of success: the demands that follow from from having demonstrated your competence and being sought for it.

The pressures on senior therapists are usually related to being pulled away from therapy by the responsibilities of seniority: consultation, supervision, management & service development.

At each stage of our career, we evolve strategies to support us, sometimes effective and sometimes not. These strategies are mostly personal and rarely passed on to anyone other than our trainees and closest associates. This site is an attempt to promote sharing of such strategies across disciplines, across professions and across the world.

We know how to help others relax. By making our own relaxation an explicit goal, we can improve our performance and our services.