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Irreversible Change

We don't receive wisdom; we must discover it for ourselves
after a journey that no one can take for us, nor spare us

— Marcel Proust

When you look back on your history do you see recurring patterns of self-sabotage? Perhaps you have gone on a diet, vowed to control your drug/alcohol use, or promised a loved one you would not attack them in the future. If you repeatedly act contrary to your stated intentions, then they are probably losing their credibility.

So we have a puzzle to solve: Why do you act counter to your intentions? To put the puzzle a different way: You have learned the same lesson many times, what can you do to stop making the same mistake?

One explanation of this perverse circumstance is that you were compelled to act counter to your own interests by a disease over which you have no control. This disease model is helpful in guiding treatment when there is an underlying medical cause for the problem. Bipolar Disorder is an example of excessive emotionality that results from an underlying biological disorder. Likewise, individuals with significant neurological impairment resulting from head injury or from the long-term neurological effects of heavy alcohol abuse have such diminished mental capacity that they are indeed powerless to exercise willful influence over their reactions to stress and temptation.

Treatments based on the disease model encourage the patient to admit powerlessness over the disease and seek treatment from an external source of control — for example, follow doctor's orders, take medication, or comply with the norms of a support group. Treatment outcome is more a function of the effectiveness of the change agent than on the intentions of the patient.

Some people don't need a disease to compel them to act counter to their own interests. The cause of their self-sabotage is not their body but their mind. For them the cure involves changing the mind instead of changing to the body.

When the body is not the source of the problem, medication and other medical interventions are not the cure. This is not to say that treating the symptom is less important than treating the cause. Often, as in the case of asthma, it is more important than treating the cause. The point here is that the effects of treating the symptom are reversible. The change produced by the treatment disappears when the treatment ends. The effects of medication disipates as soon as the medication is withdrawn.

So, while external sources of control are often effective at changing behavior, the change tends to last only as long as the source of control exerts its influence. Appetite suppressants do produce weight loss, problem drinkers who attend AA do stop drinking, medication does reduce emotional reactivity. The problem is that the benefits of the treatment tend to be temporary—relapse is the most common outcome of medical treatment for a problem of the psyche.

In contrast to the effects of external change agents (e.g., medication), which are only effective while the source of control is operative, the benefits of changing from within is irreversible. In fact, the longer you practice working with subjective experience, the greater is your ability to act in accord with your interests and principles —even during crises that would motivate you to defect.

Matching the change strategy with the cause of the problem

• When the cause of a recurring pattern of unwanted outcomes is primarily biological, it would be a tragic error for the patient to refuse medical treatment on the grounds that [s]he can achieve good outcome through their own efforts.

• When the cause of a recurring pattern of unwanted outcomes is due to stinking thinking, it would be an error to demand that a person who was capable of cognitive restructuring admit powerlessness and submit to unnecessary medical treatment. This error is especially tragic when self-efficacy [the belief that one is capable of resolving the problem] is precisely what is needed to change one's way of looking at things.

The approach described here is designed for those who are best matched with psychological rather than medical treatment— that is, individuals who have good cognitive abilities and whose problem is not caused by an underlying biological condition. If you are in this group, personal research can satisfy your curiosity about why you act as you do, which is the first step to a greater payoff. The irreversible change that results from understanding what goes on in the space between stimulus and response and knowing how to work mindfully in that space will gives you the power to influence the course of their life. This path of greatest advantage begins with a recommendation made long ago.

 

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