Paying Attention
Bill McDonald’s Website Newsletter
April 2007 - Volume 07, No. 1
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Making a Decision to Change - Part I

Welcome to the first in a monthly series in which I hope to share some threads of News of the Universe, as perceived by the mind of a therapist and the eyes of a life-experienced man. So let’s begin with the topic of “Change.”

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Making a Decision to Change - Part I

Change itself is not the primary reason most people approach a therapist - unless it's to try to get somebody else to change (like your spouse, for example).

No, the real reason most people come into therapy is to relieve pain. When the pain is great enough, you finally seek help. And it’s the pain factor that makes medication so tempting and popular - and for many, for good reason.

Consider a continuum, a line with two halves, like this:


            Human Pain             >                                                 >                                Human Potential
                         [the necessity to change]                                [a decision to change]

The Pain model of therapy involves the task of helping a person get to “zero” (i.e. “normal”). And for many people, this is the best use of therapy – and maybe that all that’s possible for them. I have a great respect for many therapists who do this work. They'll mostly work in agencies or institution, with the severe psychologically hurting of our society. They are the front line soldiers in the trenches of our culture's psychological services. And many of them are saints. Getting a client "up to zero" is sometimes the mark of great clinical and personal success

The Potential model, on the other hand, picks up the task at "zero" and keeps on going. This is where the healing of human pain melds toward a more conscious decision to change.

Here's an overly simple analogy: Compare the person who desperately struggles to get a bully to stop standing on his or her foot, to the person who wants to begin training those same feet to run a high quality footrace.

Those of us in private practice are more the gurus of personal change, of helping people grow toward an increasing level of human potential. We're more cautious about using medication, because while medication can reduce psychic pain, it likewise can reduce creativity and the pursuit of human excellence. Sometimes it’s a difficult trade-off. Often with a new client, I’ll begin with the problem of immediate pain, but in my mind’s eye I always see the person (or couple) in terms of possibility, potential, maturity, and personal fulfillment. I’ll tell my clients that my gift is often to hold for them the vision of a richer fuller life. Whether the client will ultimately choose to work beyond the problem of the moment is always a mystery at first. Curiously, there are no reliable indicators for us at the beginning how far a client will ultimately decide to go in therapy. His or her freedom of decision is always the ultimate determination.

A desire to change may have been lurking in the deep recesses of a person for a long time - perhaps many years. It's the moment when that desire becomes an actual decision that wonders (and some terrors) begin to happen.

Next time I'll discuss getting to that decision, what it's like, and why it's frequently so difficult. Then I'll talk more about the struggles and joys of maintaining that change.

As an additional note, may I suggest you keep in mind the pain/potential continuum I've shared above. I find that many people and groups will hold strong to one side, and exclude the other. The results can become both fuzzy thinking and sometimes dangerous demonizing. Psychologically, socially, personally and politically, we need to hold onto that (often elusive) center which can contain and honor both wings.

Until next month, pay attention!

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Bill McDonald
Fenton, Michigan

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