The power of the “Paper Exercise”

In the Developmental Model we use a deceptively simple tool called the Paper Exercise to help assess the developmental level of clients.  Using a “projective” technique, we deliberately set up a conflict between a couple and observe how they deal with it.  Although it’s an artificial situation we set up, it’s usually a pretty good window into what they do in other conflicts (and if not, that tells you something about how they are operating in the therapy process, e.g. putting on a good front). As well as assessment, the tool can be used to intervene and educate clients about dealing with conflict.

Before employing this tool, you may need to reflect on whether it’s okay for you to make your clients uncomfortable.   Some clients find an exercise like this very exposing.  It gives you invaluable information about the way they operate in a very short space of time, so it’s in your client’s interest – it will save them time and money.  However, the therapist has to have a level of Differentiation to tolerate their discomfort with being asked to expose themselves in this way.  Make sure you get their consent to experiment with something different.

It’s a good idea when you do this exercise to warn people that you are going to be giving them some specific instructions and then you’re NOT going to explain any more, so they need to listen carefully.  In the beginning, to help you analyse the exercise, you might want to record the conversation (with your client’s permission).  Makes for great reflection in supervision!

The format

Taking a blank piece of A4 paper you turn to one person, hold up the piece of paper, look them in the eyes and say “This piece of paper represents something important to you. I’d like you to take a minute and think about what this piece of paper represents to you. You can pick anything that’s important to you except for your kids and your relationship.”  That is, you are asking them to imagine that the piece of paper IS the important issue.

Then pause and keep looking at them to give them a moment to process and take in your request.  You can ask “Have you got something?” or “Can you think of something like that?”.  When they have thought of something then you turn to their partner and repeat the exact same process with the exact same words.

Once they both have thought of something that the paper can represent that is important to them, then you ask each of them to hold onto one end of the piece of paper and say  “I’d like you to hold this paper between you and I’m going to give you up to five minutes to decide who gets this paper without ripping or tearing it. You can do it verbally or non-verbally. You can do it any way you like, but at the end of the five minutes, I’d like you to decide who gets the paper without ripping or tearing it.” It’s important to note there is nothing in these instructions preventing people from saying what they want and why.

I will usually also add that I’m going to give them a one minute warning before the five minutes is up and repeat that I’m not going to give them any further instructions or answer questions, that I want to see how they deal with the situation I have set up for them without me interfering further. 

Some people will really try and engage you with questions because you’ve created a projective type of situation that’s unsettling for them and they’re going to want you to structure it for them.  It will undermine the value of the exercise if you give in to the pressure of their anxiety. I keep saying back to them, “You can do it any way you choose and you have up to five minutes to decide who gets the paper without ripping or tearing it.”

Then you sit back and watch what they do.  You can literally move your chair back to indicate they are on their own with this.

After the 5 minutes is up make sure you thank them and give them positive feedback about doing the exercise. Ask them how they are feeling having done it.   It’s always good to ask them if what happened is typical of how they deal with conflict at home.  If it’s not typical, then explore why they behaved differently in this session than they usually do.

The asessment

You will get very different behaviour depending on the developmental level of the couple.  With some very symbiotic people, this is a very quick exercise because they are so panicked at the thought of a conflict one of them immediately gives the other the paper, without any discussion. 

Below are 6 questions you can ask yourself about what your clients did.  Each question points to a different aspect of the developmental stages.

  1. Do the partners self-define?

The first thing is are they able to say what they want?   Very Symbiotic people won’t say or be really vague about what the paper represents to them.  Expect Symbiotic clients to blame you when you point out they didn’t say what they wanted – they will say you implied they shouldn’t say what they wanted (this is part of why sticking to the carefully ambiguous script when introducing the exercise is so important). Others will be very defensive or apologetic about saying what the paper represents.

  • How do they manage boundaries? Are their boundaries rigid or overly permeable?

Once someone defines themselves by saying what they want, what happens?  Do they rigidly defend or collapse & give up easily??  Do they merge (I change what I want to join with what my partner selected)?  Do they look angry or upset that their partner wants something different from them?  It tells us about the level of Differentiation and also will be congruent with the Attachment Style.

  • Do they show awareness that their partner is separate and different from them?

Shown in asking a lot of questions about what the other person picked – why is that important to you? Why does that matter to you?  If you took it could I ever share it back? Those who don’t engage at all tend not to have much awareness that the partner is separate and different from them

  • How do they manage conflict? Is it avoided, escalated or acknowledged and handled?

If one collapses and the other accepts this then they’re both avoiding the conflict.  If they do have the conflict,  how  do they have it.  What is the emotional tone of the conversation – can they stay open, friendly and collaborative or does the presence of conflict make one or both of them closed, hostile, anxious etc?  Are they willing to hang in there even though the time is nearly up or do they foreclose on the conflict. A lot of people who are quite solid in their development won’t be able to resolve the conflict in 5 minutes and this is an indication that they are able to tolerate conflict productively and manage their anxieties.

  • Do they have the capacity to move the conflict forward?

If they avoid it you won’t see this but if they are at the rapprochement stage you would expect them to be exploring options to see if there is a way they can resolve this without either of them giving up what they want.  As a rule of thumb, the more developed, the more creative and collaborative they’ll be in their exporation of potential solutions.

  • Is each partner able to give and/or receive?

Interestingly people who are in the Rapprochement or Synergy stages are likely to end up doing something that Symbiotic people do, with one of them giving up the paper for the other.  However the pacing, tone and meaning of this is VERY different. It’s not done quickly to avoid anxiety, but after lengthy discussion where one of them decides “Hearing what it means to you I’m happy for you to have it”.

It’s a matter of clinical judgement how much of what you observe you feed back to your clients and when.  This exercise can be a good opportunity to explain the notion of Developmental Stages and indicate to each of them where you think they are at and what the developmental tasks are they have in front of them.