08 Jun

Is Change Possible?

Arguably the most common question I have been asked in over thirty years of practicing psychotherapy and psychoanalysis is whether change is really possible.You may think that this question is born out of the frustration over endless failed attempts at change. Or you may think it is born out of the inevitable sense of hopelessness that comes with depression and despair. Or out of the fear of becoming hopeful, only to be disappointed again. Depending on the individual, the doubt about change can emanate from any and all of these circumstances.

What many people fail to understand is that the pursuit of change, no matter how much it is desired and needed, comes with its own set of fears. From my experience, even the people who hate themselves the most do not really want to become someone else. It is something we are constitutionally unable to imagine, or really desire. So, to paraphrase Freud, every ardent wish is accompanied by some degree of fear, and so it is for change. None of us can really imagine being someone else. This is basic to our core identity. Homeostasis, the natural process by which an organism returns to its dynamically stable state after responding to external disturbances of its equilibrium (As defined by the Oxford English Dictionary), rules every aspect of our existence. Studies show this return to a stable self is true for people who win the lottery (they are momentarily happy, then return to the emotional state that preceded their win), and even more surprisingly, it is equally true of people who have been severely injured (war veterans who have lost limbs). Their level of satisfaction and ability to cope with the world usually returns to what it was prior to even the most powerful positive or negative life events.

This return to homeostasis also explains why self-help efforts rarely last more than a few weeks, no matter how inspiring the source. And why brief therapies can also fail to address underlying issues, with new symptoms developing down the road. Our personalities are formed very early in life as a result of both genetic makeup and environment. Significant changes in the stable sense of self, even if the person is unhappy, are limited in scope and require effort and time. Neuroscientists have confirmed that such change requires the laying down of new neural pathways in the brain, which is accomplished through many repetitions of expressing emotion, achieving insight about those feelings, and learning to regulate them constructively. Even when these new neural pathways are laid down, the old ones still remain, and can be reactivated under duress.

I explain to my patients that real change takes time, that they will have to be highly aware of their emotional responses to life, learn to manage their emotions better, express them more, and gain insight about how the past and the present intersect in their daily lives. What I don’t have to tell them is that this necessitates the experience of emotional pain. Those who come for symptom relief, which I am fine with providing, can feel better within a few months and leave therapy. But those who know that something deeper needs to happen for them also intuitively sense the pain and vulnerability involved in such an undertaking. They know that change naturally requires grieving—the grieving of what was longed for and will never be, and the grieving of what was and was lost. Through this surrender to one’s own emotions, there is a sense of losing not the core self, but the armored overlay of self who has defended against this very vulnerability. This part of us that keeps the more authentic self from emerging must recede into the background. French writer Anatole France (1881) more poignantly phrased it as:

“All changes, even the most longed for, have their melancholy; for what we leave behind us is a part of ourselves; we must die to one life before we can enter another.”

Many of my patients have said, “I am here for therapy because of pain in my life, and now you are telling me that the only way to move past this pain is to grieve what I have lost or what I have never had and never will. It seems so unfair that the path to change requires even more pain.” I am sympathetic to their frustration and sense of unfairness, yet know, as they do, that there is no other choice.

Change is possible, if individuals are willing to give up the notion of quick fixes and take a hard look at themselves and those around them. (And understand that certain aspects of the core self are not changeable, such as sexual orientation.) No one need worry about becoming a different person. When we talk about deep change, it refers to confronting internal conflicts, like both loving and hating the same person. Or difficulties in expressing emotion like being too restrained or emotionally out of control. The focus is on emotion, not basic traits. The truth is that even though deep change is possible, and takes time, it does not change the character, basic values, or will of the person who comes for therapy.

I tell my patients that it is the good news and the bad news that the changes that do occur will be small, incremental and will hopefully build into something that is life-changing. Changing a life and changing the core self are not the same thing. I like to use the example of someone who is depressed, lonely, without a relationship and thinks of suicide every day. To ultimately reach the point of still being prone to depression but not experiencing it on a daily basis, being capable of joy, having a significant other, and barely remembering any desire to die or hurt oneself—is an example of creating a dramatically different life experience. Yet it does not, and cannot, be accomplished through creating a different person.

Change is a more a function of accepting who we are, becoming more emotionally honest and expressive, and embracing both our flaws and our strengths. For anyone with the courage and motivation to face these challenges, which focus on achieving greater authenticity and self-acceptance, change is indeed possible.

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