Alex Polizzi and Gordon Ramsay: progressive problem shifting exemplars?

Neither Alex Polizzi nor Gordon Ramsay are known as cognitive behavioural therapists nor advocates of ‘the talking cures’. And yet anyone who has watched Alex Polizzi in her role as The Fixer on TV’s BBC 2 or Gordon Ramsay in his role as a ‘restaurant fixer’ on TV’s Channel 4 Ramsay’s Kitchen Nightmares USA cannot fail to be impressed by their successes in helping individuals (often as family members) turn failing businesses into successful ones.

While many factors contribute to their successes, including the fact that in all cases the participants sought help from an expert and were prepared for the ‘treatment’ to be televised, there are four overriding lessons to be learnt by all those interested in ‘behaviour change interventions’.

The first is that Polizzi and Ramsay are actively involved as participant observers and committed to the success of those they are helping. There is clearly mutual benefit since their ‘clients’ success enhances their own reputations.

The second is that in every case I’ve watched the change in behaviour has not occurred without emotional trauma at some stage. The general task confronting both experts has been called a ‘boot-strapping’ problem: how to convince clients to see their world differently when to do so they must be able to grasp emotionally and mentally what they are told and shown. But if they are emotionally and mentally capable of comprehending this why have they not been able to effect the necessary changes themselves?

In every programme I have watched clients experience the type of emotional crisis that makes both Polizzi and Ramsay despair of effecting necessary changes.  It is clear that rational argument alone was not sufficient to induce the required changes, for if it were, change would have been effected immediately after the first rational exposition about what the clients should be doing differently and how they should be doing it.

The third lesson is that in every case Polizzi and Ramsay had to handle the interactions resulting from the often conflicting thoughts and feelings between themselves and their clients and amongst clients and their family members and / or members of staff. Establishing the common ground was not achieved merely by talking about the need to establish a common ground.

The fourth lesson is that if there is a simple explanation for their respective successes it is that Polizzi and Ramsay interact in a progressive problem shifting manner. They also accept that profound change does not occur without a lot of blood, sweat and tears. There is little evidence that any of these attributes feature in ‘the talking therapies’. They effect change, to quote Pepper, because they themselves are engaged in the doing, enduring and enjoying with their clients.

About petermathews

Member of the Royal Society of Medicine
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