In Part One (April), I wrote about making a specific decision to change. In Part Two (May), I added more depth to that area of that choice, since change that involves a decision, entails a significant act of the will. Now let me add a final note to this series of change in therapy: Change doesn’t necessarily make life any easier - it can actually add a number of complications

Let me give an example. Many years ago, I worked on a hospital psychiatric ward. We saw many patients come in, and during their time with us they would make significant changes in their thinking and behavior patterns as well as their sense of who they were. The difficulty was that at discharge, they returned to their former world. Using the analogy of a jigsaw puzzle piece, they had made significant changes in their own “shape.” However when they returned to their own world, those people and patterns around them had not changed. In simple terms, each patient had three choices. (1) They could wrestle with everyone around them to make their own shape changes. (2) They could return to their original dysfunctional shapes. (3) They could choose to not return where they came from. Our experience was sadly that option two usually prevailed, at least at first. Making significant change can be a long process - often life-long.

The late poet William Stafford wrote a small book You Must Revise Your Life (1986), with the core message that if you’re going to write poetry, you must be willing to let it change your life, because it will. Otherwise, don’t write. The same is true of good psychotherapy.

Change can involve getting more of what you really want, or having less of how you used to be. Either one involves a change of who you are - a deeper level identity change. That’s the joy and challenge of being a therapist - to work with people who are willing to do whatever it takes - and to be on that journey with them, is an honor. Therapy is not a quick fix activity. However, for many, the hope and desire for a quick fix is what at least gets people in the door to begin making the larger life-giving changes.

When you do change, there are always unanticipated side effects - things you didn’t anticipate. We’ve all heard of “the law of unintended consequences.” Sometimes the decision to change may become a decision to change one’s work, or one’s relationships. That takes courage - so that you can learn to welcome them as they are showing up. The decision to change can open up many more decisions, which in turn open up more decisions, that in turn....

Thirty years ago, a Chicago psychotherapist, Morris R. Schechtman, introduced me to material that I have translated into the following continuum and diagram:

The process of classical psychotherapy involves moving from left to right (like in my April newsletter). The extremes of this continuum reflect, to use a political example, the twin excesses of a police state (absolute security) and anarchy (absolute freedom).

The vertical axis plots the disposition of personal risk - in the pattern of a J curve. Pursuing security reduces the risks of life. To seek freedom increases exponentially the risks of life. With increased risk comes an increase in creativity, or the highs of human experience. But the shadow side is ever present as well, with its increased potential for the lows of human experience - such as grief, anxiety and depression. Of course, these days, we can use medication to limit these “lows” - but it correspondingly limits the potential for creativity and ecstasy as well. To be in charge of our own life, means this kind of decision-making is our own responsibility. The alternative is to live under the control of others. I recall Schechtman commenting that if therapy were truly as effective as its potential, the government would definitely be interested. “Homeland Security” can stand only so much individuation.

There’s always a heroism in taking charge of your own life. Even when there doesn’t seem to be a real choice - I consider that it always is a choice, and will honor it as such. This affects the lives of other people as well. The ripple effect of our decisions and behaviors can be virtually endless. So it’s important that we take responsibility for what we think, what we feel, and what we do. That’s true healthy living. It’s that’s the epitome of mental health. And it involves making changes.

So, until next month, pay attention!