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The person has a degree of certainty about the meta-response. “I know this is scary.” This is a meta-response about a meta-response (a meta-meta-response, with corresponding meta-meta-state). We could call this “third-order reality,” which is even more distant from sensory experience than second-order reality, and even more troublesome and dangerous. Plenty of problems (and solutions) also occur at this level.
Many people who come for therapy appear to suffer from uncertainty: “I don't know what to do.” “I'm not sure if this is the right thing to do.” “Life has no meaning.” But you can also think of this as resulting from other certainties. “I know that wouldn't work,” “I know she hates me,” “I know I can't succeed,” etc. Since these certainties will make it difficult for the person to consider other understandings at level 2, it can often be very useful to reduce certainty.
Someone who is phobic of airplanes, and someone who is not, may be making exactly the same images of flaming death and destruction. The difference is that the images of the non-phobic include some representation of the small probability of the crash, as well as its possibility. This could be either a certainty of its unlikeliness, or a very great uncertainty about its happening. However, a phobic person is experientially certain that it will happen, no matter what s/he says “intellectually.”
What makes it difficult to work with a paranoid is not just that s/he thinks that others are plotting against him/her, but that s/he is certain that this is occuring, and is unwilling to question it and consider other possibilities.
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