The Key to Change
Photo by Jagoda Kondratiuk
I bet if we gathered a dozen psychologists together in a room and asked them about the key to change, they would come up with many compelling, but very different, perspectives. Some might suggest knowledge and insight; others, cognitive and behavioral modification. One might emphasize methodology; another, the healing interactions with a deliberate and caring therapist. There is no question that certain modalities are better suited to tackle specific issues. However, we know for a fact that progress can be made through every modality. So clearly, there must be other intangible factors that also play a role. Let’s look at some of them.
First, the therapist. Whether the therapist is competent and knowledgeable is important. But how the therapist facilitates discussions and interacts with the patient may prove to be critical. If the therapist is perceived as judgmental or aloof, the patient may choose to withhold or disengage. If the therapist is seen as emotional or anxious, the patient may lose confidence and trust. In a setting where the patient divulges secrets and shares vulnerabilities, any nuance observed in the therapist can be potentially misinterpreted. Unless the therapist is cognizant of the ebb and flow and poised to address any misconceptions, the therapeutic rapport may be compromised.
Second, the timing. Whether or not therapy can unfold, gain traction, and generate momentum depends on the circumstances. These might include, for example, current stressors, available resources, or priorities. Let’s say an individual suffering from PTSD requires trauma work, but is in constant crisis — homelessness, legal battles, etc. In that case, it is probably not an ideal time to launch into trauma work. This does not mean that trauma work will necessarily do harm. Rather, it is simply taking into consideration the likelihood that treatment could be interrupted or terminated prematurely due to external circumstances. Having continuity is crucial. Because it is through trauma work that difficult memories previously suppressed or repressed are now viable for therapeutic interpretation. Stopping the work abruptly may leave the individual in a precarious state, with just enough awareness but not enough confidence to commit to the new understanding. So, in this case, timing has the potential to affect the outcome in a significant way.
Last but not least, the patient. Whether the patient is ready for therapy can make all the difference in the world. You might think anyone who enters into therapy is ready to work. (I wish.) But the reality is that many people do so for a whole host of other reasons. When the patient is not ready, therapy is slow to take on momentum. It could even make therapy feel tedious or contrived. How do we know if someone is ready? Motivation. After all….
How many psychologists does it take to change a light bulb?
Only one, but the light bulb has to want to change.