Designing an Ordeal for Insomnia: The Middle of the Night Chore

We approach insomnia as a problem of perverse effort. The client attempts to use their conscious will to command a physiological state that functions only when the will is absent. When you sit with a person who has not slept more than three hours a night for six months, you see a person who has turned their bedroom into a gymnasium for frustration. I once worked with a middle aged accountant who had developed a complex ritual of counting backward from one thousand while tensing his toes. He believed that if he could just find the right sequence of mental actions, sleep would arrive. We know that the more a person tries to sleep, the more they remain awake. This is the paradoxical core of the problem. To resolve it, we do not teach them how to relax. We provide them with a reason to prefer sleep over wakefulness by attaching a price to their insomnia.

You define the ordeal as a requirement that exists only if the symptom occurs. If the client sleeps, they do not perform the chore. If the client lies awake for more than fifteen minutes, the chore begins immediately. This is not a punishment. This is a condition of their existence. I told the accountant that his insomnia was actually a surplus of energy that he was wasting on counting. I instructed him that the next time he found himself awake at two in the morning, he was to get out of bed, go to the kitchen, and wax the linoleum floor until it shone. He was not allowed to stop until the sun rose or until the floor was perfect. He complained that he was tired. I told him that if he was tired, he would sleep. If he was awake, he clearly had the energy to wax the floor.

The ordeal must be more troublesome than the change required. We design a situation where it is easier to give up the symptom than to maintain it. You must get the client to agree to a price before you name the task. You ask them if they are willing to do something to get over their insomnia, even if it is difficult. You wait for a clear, verbal yes. If the client hesitates, we do not proceed. We tell the client they are perhaps not yet miserable enough to change. This creates a challenge to their pride. When they insist they are ready, you ask them to name the household chores they have been procrastinating on for years. You look for a task that is repetitive, lonely, and physically demanding.

The chore must be a task the client hates but knows they should do. It cannot be something they enjoy. If they like reading, you do not let them read. If they enjoy music, you forbid the radio. At three in the morning, the client’s bed is the site of a struggle. When the ordeal is in place, the bed becomes a sanctuary that must be earned. I worked with a woman who had avoided cleaning her attic for a decade. She claimed her insomnia made her too exhausted to manage the clutter. I instructed her that every night she remained awake after midnight, she had to carry three boxes down from the attic, sort every item, and repack them by hand in the cold garage. She had to work in the dim light until she was physically unable to stand. After three nights of sorting through old books and broken decorations in the freezing garage, her brain decided that the pillow was more attractive than the attic. She began sleeping seven hours a night because the alternative was too demanding to endure.

We are utilizing the principle that people will change to avoid a greater discomfort. Jay Haley observed that a symptom is often a way to avoid something else, but we reverse this by making the symptom the gateway to a task that is even more avoided. When you design the ordeal, you are acting as a strategic director. You are not a coach offering suggestions. You are a clinician providing a prescription. If the client says they cannot scrub the floor because their back hurts, you choose a task that does not involve the back, such as hand-writing a boring technical manual for five hours. The task must be productive but miserable. It should be something the client feels they ought to do, which removes their ability to complain about the unfairness of the assignment.

I worked with a successful lawyer who suffered from severe insomnia that left him exhausted during court appearances. He told me he spent his nights pacing the house and worrying about his cases. I made him promise to follow my instructions exactly before I told him what they were. This is a vital step. You must get the client to agree to the price before they know what they are buying. I told him that if he was not asleep by twelve thirty in the morning, he had to go to his basement and sand a large, heavy oak table by hand. He could not use a power sander. He had to use fine-grit sandpaper and work steadily until five in the morning.

We must ensure the ordeal is socially responsible and physically possible, but it must be something the client dislikes. Because the lawyer hated manual labor and found the dust irritating, it was a perfect choice. He returned the next week and reported that he had sanded the table for three nights. On the fourth night, he found himself looking at the bed and then looking at the basement door. He decided that he would rather be asleep than be sanding. His insomnia vanished because the cost of staying awake had become too high.

I worked with a young man who spent his nights playing video games because he said he could not sleep. This was not a symptom, it was a hobby. His insomnia was actually a way to avoid the responsibilities of his day. To design an ordeal for him, I had to take away the pleasure of his wakefulness. I told him that if he was awake at night, he was not allowed to touch his computer or his phone. Instead, he had to stand in the corner of his room and read a thick, difficult book on corporate law that he found incredibly dull. He had to stand up while reading so he could not get comfortable. He found the law book so tedious that his brain chose sleep as a better alternative within three days.

We must be careful not to make the ordeal a punishment in the eyes of the client. You frame it as a way to use the extra time they have been given. You say: Since you are awake anyway, we might as well make that time productive. This reduces the client’s resistance to the instruction. They cannot argue that it is a bad thing to have a clean floor or polished silver. They can only argue that they do not want to do it. When they admit they do not want to do it, you have reached the point of leverage. You tell them that the only way to avoid the chore is to sleep.

The timing of the instruction is essential. You do not introduce the ordeal in the first ten minutes of the session. You spend time understanding the history of the insomnia and the various ways the client has failed to solve it. You wait until they express a high level of frustration. When they say they are desperate, that is when you present the contract. You say: I have a method that works, but it is difficult. I do not know if you are the kind of person who can follow through with it. This challenge to their competence makes them more likely to commit. Once they have committed, you reveal the chore.

You must also prepare the client for the possibility of failure. You tell them that if they do not perform the chore when they are awake, the therapy cannot continue. We do not negotiate on this point. If the client returns and says they stayed awake but did not do the chore, you must take a firm stance. You tell them that they are choosing their insomnia over their recovery. You might even refuse to see them until they have completed the ordeal at least once. This reinforces the idea that the symptom has a real and unavoidable cost.

In the strategic tradition, we are not interested in why the client became an insomniac. We are interested in the current cycle of behavior that maintains the problem. The ordeal disrupts this cycle by introducing a new, unpleasant element. The client’s family may also be involved. If a husband’s insomnia is disturbing his wife, you might design an ordeal that requires him to do something helpful for her while he is awake, such as ironing all her clothes for the week. This changes the social dynamics of the symptom. Instead of the wife being a victim of his insomnia, she becomes the beneficiary of his ordeal. This often leads to a rapid disappearance of the problem because the secondary gains of the symptom are removed.

When you monitor the progress of the ordeal, you look for signs of fatigue and resentment toward the task. These are positive indicators. I once had a client who was so angry about having to pull weeds in his garden at four in the morning that he shouted at me during the session. He told me the task was ridiculous. I asked him if he had slept. He admitted that he had slept soundly for the last two nights just to avoid going back into the garden. I congratulated him on his success. The anger he felt toward me was a small price to pay for his ability to rest. We do not need the client to like us or to like the ordeal. We only need them to change their behavior.

The ordeal must be performed every single time the symptom occurs. There can be no exceptions. If the client wakes up for only thirty minutes, they must still get out of bed and begin the chore. We specify that the chore starts the moment they realize they are not going to fall back to sleep immediately. This prevents the client from lying in bed and ruminating. The bed must be associated only with sleep, and the rest of the house at night must be associated with the chore. By creating this sharp distinction, we allow the body’s natural sleep mechanisms to reclaim the bed.

The effectiveness of this technique relies on the authority of the practitioner. You must speak with the confidence of someone who knows the outcome is inevitable. If you hesitate or present the ordeal as a suggestion, the client will ignore it. You are providing a structural change to their life. I told a woman who suffered from nighttime anxiety and insomnia that her anxiety was a signal that her house was not clean enough. I assigned her the task of scrubbing the tile in her bathroom with a toothbrush every time the anxiety kept her awake. She found the task so exhausting and the position so uncomfortable that her anxiety began to produce a sleep response instead of a wakeful one. Her body learned that the feeling of anxiety would lead to hours of painful scrubbing, and so the anxiety itself began to diminish.

We observe that when the price of a symptom is raised high enough, the symptom becomes a luxury the client can no longer afford. The strategic use of the ordeal takes the symptom out of the category of something that happens to the client and puts it into the category of a choice with a consequence. You are teaching the client that they have the power to sleep, provided they are willing to pay the price of wakefulness. If they are not willing to pay the price of the ordeal, they will find that they are suddenly very capable of sleeping. This is the simplest and most direct way to return the control of the body to the client.

Every ordeal is a custom creation. You must listen to the specific details of the client’s life to find the right chore. It should be something that fits into their environment but remains an intrusion. If they live in an apartment, the chore must be quiet but physically taxing. If they live on a farm, the options are much broader. I worked with a farmer who could not sleep, and I had him move a pile of heavy stones from one side of his barn to the other by hand every night he was awake. He was a strong man, but the repetitive and meaningless nature of the task wore him down. He decided after only two nights that he was tired enough to sleep through any worry. We are not looking for insight or emotional breakthroughs. We are looking for a change in the sequence of events that constitutes the client’s night. When the sequence is interrupted by an ordeal, the old pattern cannot sustain itself. The client’s struggle with sleep is replaced by a struggle with the chore, and in that secondary struggle, the body always wins.

You must individualize the ordeal so that it targets the specific sensibilities and avoids the secret pleasures of your client. We do not assign a generic task because a chore that is a burden to one person is a hobby to another. I once worked with a corporate executive who suffered from chronic insomnia and spent his nights ruminating on his investment portfolio. He viewed traditional exercise as a badge of honor, so I could not assign him pushups or running. Instead, I discovered he possessed a profound distaste for manual domestic labor, specifically the cleaning of baseboards. He considered such tasks beneath his station and physically tedious. I instructed him that if he remained awake for more than fifteen minutes, he was to leave his bed, go to the kitchen, and scrub the baseboards with a small sponge and cold water until the sun rose. He had to perform this task in the dark with only a small flashlight to guide him. This made the task difficult and isolated.

The chore must possess a quality of “good work” that the client has neglected. We select tasks that are objectively productive but personally loathsome. This prevents the client from dismissing the ordeal as a silly game or a waste of time. I worked with a woman who had a closet full of unironed clothes that had sat neglected for six months. She hated ironing more than any other household task. I directed her that if she did not fall asleep within twenty minutes, she must get out of bed, set up her ironing board in the kitchen, and iron every item in that closet. She was not allowed to listen to music or watch television while she worked. She had to focus entirely on the heat of the iron and the removal of every wrinkle. We frame this as a way to make the most of the time that the insomnia provides. You tell the client that since they are going to be awake anyway, they might as well accomplish something they have been avoiding. This framing removes the element of punishment while maintaining the high cost of the symptom.

We must also manage the social environment in which the ordeal takes place. If the client lives with a spouse or a partner, that person can inadvertently support the insomnia by offering sympathy or providing late night conversation. You must bring the spouse into the strategy. I tell the spouse that they are to be a silent observer who never offers help with the chore. If the husband is scrubbing floors, the wife is to remain in bed and ignore him. If she gets up to make him tea or to keep him company, she ruins the ordeal by turning it into a social event. We instruct the spouse that their only job is to ask the next morning if the chore was completed. They are not to provide praise. They are to treat the completion of the chore as a routine matter of fact. This isolates the client with their symptom and their work.

When you deliver the directive, your tone must be matter of fact and devoid of hesitation. You are not asking the client if they think they can do the chore. You are stating the requirements of the cure. If you show any doubt about the client’s ability to complete the task, the client will find a way to avoid it. I once had a client who argued that she was too tired to scrub her kitchen floor at three in the morning. I told her that if she was too tired to scrub the floor, she was certainly tired enough to sleep. I explained that she had a choice between two types of exhaustion. She could be exhausted in bed while worrying about her life, or she could be exhausted on the floor while making it clean. You make it clear that the ordeal is the only alternative to sleep. We do not offer a third option where the client stays in bed and suffers comfortably.

You must prepare for the client to return to the office after the first week and report that they did not do the chore. We call this a failure of compliance, but in strategic therapy, we treat it as information about the client’s secondary gain. If the client says they stayed in bed and suffered instead of getting up to work, you must look them in the eye and wonder aloud if they are truly ready to be over their problem. I tell such a client that perhaps their insomnia is not yet painful enough for them to want to do the work required to fix it. This puts the responsibility back on the client. We do not argue or persuade. We simply state that the price of sleep has been set, and they have chosen not to pay it yet. This usually results in the client performing the ordeal the very next night because they want to prove their commitment to the process.

I worked with a man who was a professional woodworker. He had a piece of furniture in his shop that needed to be sanded by hand with a very fine grit paper. It was a task that required hours of repetitive, boring labor. I told him that if he could not sleep, he was to go to his cold shop and sand that wood by hand, without power tools, until he felt he could no longer stand it. He did this for two nights. On the third night, he found himself standing at his bedroom door, looking toward his shop, and then looking back at his bed. The thought of the cold shop and the tedious sanding was so unappealing that his body chose sleep. This is the goal of the ordeal. We create a situation where the unconscious mind decides that sleep is the lesser of two evils.

We also use the ordeal to break the client’s habit of checking the clock. Most insomniacs are clock watchers who calculate how many hours of sleep they are losing. You instruct the client that they are not to look at the clock to see if fifteen minutes have passed. They are to rely on their own internal sense of time. If they feel they have been awake for a while, they must assume it has been fifteen minutes and get out of bed. This removes the precision that fuels their anxiety. If they get up too early, they simply start the chore sooner. If they get up too late, they have more work to do. Either way, the ordeal is waiting. We make the bed a place for sleep only, and the rest of the house a place for labor.

The first follow up session is where you solidify the change. If the client reports that they slept, you do not congratulate them. We do not want to make sleep a performance for the practitioner. Instead, you ask them if they have kept the ironing board out or if they have kept the cleaning supplies ready. You insist that they must be prepared to do the chore tonight and every night. This prevents the client from relaxing their guard too early. The symptom persists only as long as the cost of maintaining it remains lower than the cost of the cure.

We schedule the first follow-up session exactly seven days after the initial prescription of the ordeal. You must resist the urge to ask the client how they slept when they first enter your office. We do not prioritize the symptom. We prioritize the completion of the task. If you begin the session by asking about sleep, you signal to the client that sleep is still the primary focus of your attention. This reinforces the client’s own obsession with their wakefulness. Instead, you should look the client in the eye and ask to see the evidence of their labor. If the task was to copy a technical manual by hand, you ask to see the notebooks. If the task was to sand a piece of furniture, you ask for a detailed report on the smoothness of the wood grain.

I once worked with a corporate executive who had suffered from insomnia for a decade. He entered the room looking visibly exhausted with dark circles under his eyes. He clearly expected me to offer sympathy or to ask if he felt better. I ignored his fatigue entirely. I asked him if the brass fixtures on his front door were now polished to the mirror finish I had demanded. When he began to tell me about how tired he felt on Tuesday morning, I interrupted him. I told him that his feelings of tiredness were irrelevant to our contract. I insisted that he describe the specific brand of polish he used and the number of minutes he spent on each handle. By focusing on the brass, I maintained the hierarchy of the relationship. I was the director and he was the one who followed instructions.

We use this focus on the chore to redirect the client’s conscious effort away from the autonomic process of sleep. When you emphasize the quality of the work, you are teaching the client that wakefulness is no longer a time for rumination or frustration. It is now a time for demanding labor. If the client reports that they slept through the night for four consecutive days, you should not offer congratulations. We treat sudden success with skepticism. You tell the client that such a rapid change is often temporary and that they must be prepared for the symptom to return. You might even suggest that they should not try to sleep so well during the coming week. I told one woman that her sudden improvement was suspicious and that she should intentionally stay awake for at least two hours on Thursday night to ensure she had not lost her ability to perform the chore.

This technique is known as restraining change. If you encourage the client to sleep, you are joining the struggle that caused the insomnia in the first place. If you tell the client to slow down or warn them against sleeping too much, you are prescribing the very thing they have been afraid of. If they follow your instruction and stay awake, they are being cooperative. If they ignore your instruction and sleep, the symptom has disappeared. In either scenario, the practitioner remains in control of the clinical outcome.

Sometimes a client will return and admit they did not perform the chore. They might say they were too tired or that they simply forgot. We treat this as a breach of the professional contract rather than a psychological resistance to be explored. You must take a firm stance in this moment. You tell the client that because they failed to perform the chore, the sleep they obtained was unearned and unstable. I once told a man who failed to wax his floors that he had cheated the process. I instructed him that for the next three nights, he was to stay awake until three in the morning and wax the floors regardless of how sleepy he felt. This ensures that the ordeal remains a high price that must be paid. If the client learns they can avoid the chore and the insomnia simultaneously, the strategic leverage is lost.

You will encounter clients who attempt to find pleasure in the ordeal. A man might decide he actually enjoys sorting his old tax records or cleaning the garage. If the client finds the task rewarding, it is no longer an ordeal. We define an ordeal by its ability to make the symptom more troublesome than the cure. If the client enjoys the task, you must immediately change it to something tedious and repetitive. I remember a woman who began to enjoy the quiet time she spent knitting in the middle of the night. I told her that knitting was too creative for her recovery. I instructed her to stop knitting and instead spend her wakeful hours standing in the center of her living room with her arms held out at shoulder height. This physical strain removed the pleasure from her wakefulness and replaced it with a direct physical cost.

We also manage the transition back to normal sleep patterns with precision. When the client has slept consistently for several weeks, you do not simply tell them the treatment is over. You tell them that the ordeal must remain in a state of readiness. The bucket of soap and the scrub brush must stay in the middle of the kitchen floor. The sandpaper must remain on the workbench. You inform the client that they are no longer required to perform the chore every night, but if they remain awake for more than fifteen minutes, the chore is there waiting for them. This creates a psychological barrier between the client and their wakefulness. The bed is now for sleep and the rest of the house is for the ordeal.

I worked with a man who had successfully used the chore of cleaning his basement to resolve his insomnia. As we prepared to end our work, he asked if he could finally put his cleaning supplies away in the cupboard. I told him he could not. I insisted that the vacuum cleaner and the boxes of rags remain in the center of the basement floor for at least three more months. I told him that if he moved them, he was telling his body that he was no longer afraid of staying awake. By keeping the tools of the ordeal visible, the client is reminded every day that the price of insomnia is high. The physical presence of the chore serves as a continuous post-hypnotic suggestion that sleep is the more comfortable option.

You must remain the strategic director until the very last minute of the final session. We do not aim for the client to understand why they couldn’t sleep. We aim for the client to sleep. If they leave the office with their insomnia cured but no insight into their childhood, the intervention is a total success. We are not there to be the client’s friend or their confidant. We are there to solve the problem they brought to us. If you allow the relationship to become too warm or too informal, the authority of the ordeal will diminish. The client must feel that you are more committed to the chore than they are.

As the symptoms fade, the client may begin to credit themselves for the change. They might say they finally learned how to relax. We do not correct them, but we also do not agree. You simply remind them that the chore is still waiting if they should ever need it. I often tell my clients that they did not learn to relax, they simply learned that they did not have enough energy to both stay awake and perform the work I assigned. This maintains the focus on the behavioral economy of the symptom. A symptom is a piece of behavior that has become too expensive to maintain, and the practitioner is the one who sets the price.

The ordeal succeeds because it aligns the client’s conscious willpower with the body’s natural need for rest by making the alternative intolerable. You are not asking the client to change their mind. You are requiring them to change their actions. When the cost of the chore exceeds the frustration of the insomnia, the body will choose the path of least resistance. We observe that a person can fight sleep for a long time, but no one can fight sleep and a floor that needs scrubbing at the same time. This is the fundamental reality of the strategic approach. The client’s body always has the final word in the struggle between the chore and the bed.