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You may be familiar with the old joke that goes, “How many psychologists does it take to change a light bulb?” Answer: “Just one, but the light bulb has to want to change.”
They say that every joke has a kernel of truth, but a closer look at the message hidden in this old cut up clunker is entirely un-illuminating. Got a problem? See a therapist, the joke suggests, and it's out with the old you and in with a new...but if you’re still struggling around in the dark, well, you know who to blame, right?
Phooey!
Let’s flip the script and find a little enlightenment in three bright ideas about motivation and change.
Bright idea #1: The desire to change is not an on/off switch.
Have you ever had the thought that something you were about to do wasn’t the brightest idea, or that some action you took wasn’t the “right thing” to do, and you went ahead and did it anyway? How could such a thing happen? Did your brain shut off? Did you fry a circuit?
No! Our brain is made of massively complicated circuitry and our wants/needs/desires aren’t all tied to a single on/off switch. Instead, our minds work more like those great big light boards full of buttons, sliders, and knobs that you find in the back of a theater auditorium or running the show at a rock concert.
Sure, at any given moment you might be able to dial up the slider that lights on the idea about wanting a nice long workout at the gym, but there are probably dozens of others turning up the thought that a nice hot bath sounds pretty good, or how about a chocolate bar, or maybe check out that new episode of Mad Men on the DVR, or even the one spotlights the thought that’s it been a long day and you’re just too tired to do anything? Our minds have too many channels for anyone to possibly pay attention to all the time and when it comes to the intensity of thoughts about things we feel bad about or don’t want to do, well, those amps go up to eleven.
This kind of interference of thoughts, feelings, and desires, is perfectly normal. We call it ambivalence. Elite performers don’t worry about shutting off or turning down all these conflicting knobs and sliders…they don’t have the time! Think LeBron James has never considered giving up basketball and just hanging out with friends? Doubtful. Can you imagine President Obama entertaining the idea of making a throw-down rage-out phone call to Fox News anchors on a rough day? He's probably given it a thought...maybe more than one!
Unless IBM has come up with some new super-computer artificial intelligence that I don’t know about, we’re all human and you can’t just “shut off” all these conflicting wants and “turn on” some key desire for success. Instead, adaptive change happens when we acknowledge and accept these conflicting noises as an essential part of existence and instead focus our energies on spotlighting our cherished values, personal strengths, and rewarding priorities. Sure, there are a zillion reasons and obstacles getting in the way of going to the gym, though when I actively focus on how I care about my health and vitality, how I want to continue to be with my friends and family for the long run, or on the idea of how good it feels to ‘get in the zone’ while jamming out to the latest Fun. song or Taylor Swift tune (don’t judge), the act of lacing up my running shoes doesn’t seem so far off.
Bright idea #2: You are not a broken bulb to be fixed.
Plenty of people come to my office feeling burned out, shut off, and struggling to shine. Many are fused with an identification of feeling “damaged”, “dysfunctional”, or “defective”. Some worry about being seen as “crazy” or preface their thoughts with phrases like “this is terrible, but…”
I can assure you though that the people I see at work every day are not busted, broken, or bad. And I can further assure you that I have never heard anything following the phrase “you’re probably going to think this is weird, but…” to be odd, unusual, or out of this world (sometimes something surprising or unexpected, but never bizarre!)
What I do see is people struggling against pain and discomfort, stuck spinning their wheels, lost and looking for a way, or caught up in the same old complicated and familiar pattern webs.
For example, one time I was boarding a plane with a slightly overstuffed carry-on bag (not unusual for me, the ever procrastinating overpacker). It should have been readily apparent that the suitcase was clearly not able to fit into the overhead bin without some David Copperfield-esque feat of physics-defying distortion. However, not knowing what else to do and feeling completely exposed to the critical judgments of all those other passengers waiting so urgently to get wherever we were going, I could think of nothing else but to persist in repeatedly trying to jam the bag into the overhead compartment. I was completely stuck in set, like a mindless Roomba vacuum robot endlessly bumping into a tricky wall corner. Only after the flight attendant broke in with a polite, but firm, “Sir, please don’t break our airplane,” was I able to snap out of it and into more effective action. It’s not that I wasn’t capable of finding an alternative or choosing a different plan of attack. I didn’t need someone to step in with advice or to tell me what you do with a suitcase, I just needed someone’s presence to gently disrupt and redirect my attention so I could see my ineffective pattern and try something different.
In the same way, therapy is rarely ever about the therapist solving someone’s problems, doling out shallow advice, or directing people in what to do. Sure, there are times and situations in therapy when providing some specific information can be helpful (such as offering information about sleep apnea or the symptoms of PTSD) or directing someone to resources they might otherwise not know about, but these moments are rarely the transformative treatment experiences. So people who come to me dead set on finding some kind of “answers”, new “solutions”, and things to be “fixed” are probably going to end up feeling some frustration and disappointment. After all, who am I to come up with some sort of new and unique “answers” to all of life’s various problems and obstacles? No therapist should want to be seen as a know-it-all or try to have a corner the snake oil market.
So if therapy isn’t about fixing out a broken light bulb, what good is it anyway?
Bright idea #3: Therapy can help you re-connect with your power to shine.
I’ve written before of the demonstrated value of good dynamic-interpersonal psychotherapy. Practicing from this framework, I’ve experienced confidence in helping people see patterns and repetitions in key interpersonal attachments and relationship experiences across their lives. Dynamic approaches facilitate opening up to difficult, uncomfortable, avoided, and unfamiliar emotional experiences so people can promote emotional flexibility in experiencing and expressing joy, sadness, anger, grief, pride, and connectedness. Also, a good dynamic eye can us try to see our own and others’ unique masks of self-deception or presentational biases which we put up to protect ourselves from shame or to keep others at a comfortable distance.
But a common and frustrating experience I keep running up against is the expression “yeah, sure, I see all that and it helps to understand it, but what am I actually supposed to do about it”. It is a common fallacy that contemporary dynamic psychotherapy is only about gaining “insight” into your problems. [Maybe that belief is true of more traditional psychoanalysis, which is a highly specialized method that often bears slight resemblance to most approaches known as psychotherapy today and which I have almost no practical experience with]. A good dynamic-interpersonal therapy should encourage people to consider and try out new ways of expressing affect or relating to others and breaking out of problematic interpersonal habits.
However, I have continued to struggle with this aspect of targeting and motivating behavior change, the language to describe it, and the tools to facilitate it. And this is the point where I’ve become increasingly drawn to integrating concepts and strategies from motivational interviewing, positive psychotherapy, and “third wave” behavioral therapy approaches such as acceptance and commitment therapy (ACT). ACT shares a psychodynamic value of greater awareness, embrace, and acceptance of feelings through enhancing mindfulness and mentalization skills. ACT and positive psychotherapy highlight the rewards of identifying and focusing attention toward values and meaningful virtues, aspirations, and goals. ACT and motivational interviewing offer techniques for enhancing motivation to committed action and adaptive change.
Working in an academic medical setting, I’ve been frequently surprised at the casual and flowing prescriptive statements to patients to “take your medications”, “show up at all these appointments”, “lose weight”, “stop smoking” and the frustrations of physicians and staff who can feel that their patients just won’t listen or just don’t want to change.
The problem is that we have a health care system built around the old light bulb joke of human behavior: we have the tools to fix what’s broken about you, but only if you want to change. But here is exactly where psychotherapy can offer a unique bright spot and a different beacon of hope. Good psychotherapy doesn’t treat you like a broken light bulb with a simplistic on/off switch. When you’re stuck struggling around in the dark, a good therapist can go there with you, develop your skills to accept and adjust to your surroundings as they are, encourage you in energizing your strengths and inner resources, guide you away from blindly bumping into the same old corners and obstacles, and support your resolve and exploration to re-connect with those power sources which help you shine your best and brightest.
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Jared DeFife, Ph.D.
