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Tuesday 10 September 2013

Therapy and Personal Change Tasks: Significant Versus Do-able

A completely unrelated photo from PsychSalon Farms:
Suspicious damage in the orchard, September 2013.

Sometimes people present for therapy saying that they don’t know where they want to go or what they want to achieve. Therapy becomes a process of generating and winnowing the possibilities.

But often people know exactly what they would like, only the task seems too immense. Find a career. Overcome my fear of heights. Deal with the past trauma. Leave home. Graduate.

Contemplating these enormous goals they feel the energy drain out of them like air from a balloon. Or they feel so overwhelmed that a sense of pointless futility overtakes them.

In therapy, we often try to identify the “Ultimate Goals” – essentially “What would you like, eventually?” And then we break these down to “Immediate Goals.” “What could you do this week that might take you toward one of those Ultimate Goals?”

And here we get stuck. The person can’t think of any Immediate Goals. Or they are dismissive of any ideas that come up. Or the therapist suggests a possibility only to sense the client pulling back and away.

And the culprit, 20 feet away,
anxiously watching the harvest.
In my experience, the most frequent problem is that the person is trying to arrive at an Immediate Goal that meets two criteria:

1. It is small enough that it feels achievable.
2. It is large enough to feel like a significant step.

People are looking for the middle path – the “sweet spot” between something so big it’s overwhelming and so small it feels trivial. They’re trying to find a goal that sits in the gap between the two.

The trouble is, usually there is no gap. No sweet spot. If a goal is big enough to seem significant, it’s too big to accomplish with the person’s existing amount of energy and motivation. If it’s small enough to accomplish, then it’s too small to seem like real progress. This trap often explains why the person has felt stuck – perhaps for months, perhaps years.

The way out is simple and unsatisfying. Pick something small enough to be achievable, knowing that it will seem insignificant and trivial. In other words, keep the first criterion above, and relinquish the second.

So a person who wants to overcome their fear of escalators might go to a shopping mall food court and sit near the escalator to watch it for an hour, forbidden from using it personally. A person who wants to become more social might take a newspaper to a coffee shop to read rather than sitting with it at home. Someone wishing to clean up a neglected house might focus only on the bathroom sink.

There is an emotional cost to doing this. Inevitably, a part of the person’s mind will snort with derision. “This is ridiculous, any idiot should be able to do this. This isn’t getting anything important done, it’s just reminding me of how incapable I am. It’s too small, and I’ll never get to my bigger goal at this rate. And frankly my therapist who is suggesting this is an idiot too.”

This happens sufficiently often that we can propose it as a rule. If we are on the right track, an early goal in personal change should feel trivial, insignificant, foolish, and unsatisfying. If it feels challenging, we’ve chosen something too big.

Ultimate Goals often feel questionable. Will I ever have a partner? Will I really graduate? Will I truly feel comfortable in crowds?

Good Immediate Goals, however, are those that feel completely achievable. “Of course I can step outside my front door for five minutes.” “Yes, I can leave home without unplugging the coffee grinder.” “Okay, I can vacuum the front hall.”

But for a person who has felt stuck, any goal that seems achievable will also seem faintly idiotic. Rather than fighting this sense of idiocy, we can mark it and treasure it.

Idiocy isn’t a barrier. It’s the way out of the trap.

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  1. When I was becoming physically active, one goal was to sit in my car, in the rec-center parking lot, with the car turned off. It was the spark.

  2. Exactly, Anonymous. And was there a small part of you whispering the following in your ear?

    "This is stupid. I look like an idiot just sitting here. I want to drive and reclaim my life, not sit here in a parked car."

    And yet, it was a step. This is what I mean. The path out of anxiety or depression almost always seems to involve at least a few steps that seem nonsensical, childish, or foolish.