|Symposium 2012 CE Comments Linda Bacon Clinical Excellence Diets Etienne Wenger Men in Therapy Gender Issues Trauma Couples Ethics The Future of Psychotherapy Mindfulness Mind/Body Community of Excellence Brain Science Wendy Behary Alan Sroufe Great Attachment Debate Clinical Mastery Future of Psychotherapy Attachment Theory William Doherty Challenging Cases David Schnarch Couples Therapy Anxiety Mary Jo Barrett Narcissistic Clients Attachment|
|The Brain's Rules for Change - Page 3|
After the second session, I wrote those words on an index card and handed it to James for daily rereading. He said he was deeply relieved to find that what had seemed so irrational actually made so much sense. The coherence of implicit memory—the fact that the symptom exists because it's in some way part of an emotionally adaptive response—is what we utilize to zero in on the relatively tiny patch of symptom-producing material in the client's vast implicit universe.
At this point, James suddenly felt a further connection between this newly conscious emotional truth and his lack of self-assertion in other contexts, especially his personal relationships. He was struck by a new realization of how pervasive and costly this way of being was for him. After a silence in which he was reflecting on this realization, he uttered, "It's really sort of crippling." James had now retrieved a cluster of personal constructs including memories of Dad, certain emotional meanings, and his own self-protective tactics. All of that symptom-requiring implicit material was now conscious and explicit, so the search for a strongly contradictory experience for step two could proceed.
The contradictory material can be found either in the client's already-existing life experience and knowledge, or in new experiences. A client who's become mindfully aware of his own implicit theme is the best detector of disconfirmations of that material, so I simply asked James to go through day-to-day life with as much awareness as possible of what he'd retrieved. To maximize his new mindfulness I said to him softly, "I'm struck by how clear you are that any degree of self-assertion from you, no matter how small, is utterly potent because it turns you into a tyrant like Dad. For you it's like plutonium: just the tiniest speck of self-assertion is disaster, so absolutely none of it can be allowed. You seem very clear about that." James was silent for a few seconds, and then replied simply, "It is like that." I ended the session by saying, "So you can use the card we prepared together, and when you read it every day, just let it keep you in touch with that, and see how it is to go through the day knowing that."
At his next session two weeks later, James told me, "Something unusual happened. I was in a meeting at work and I thought of a good solution to a problem being discussed. But I went into ÔWhat do I know?' and kept quiet. A moment later, somebody else piped up and suggested the same solution, and he said it pretty confidently. That jolted me. I immediately looked around the room and saw that everybody seemed glad to get this useful solution from this other guy. It was weird, how differently it went from how I was assuming it would go if I'd said it."
My clinical experience has taught me that it's usually a mistake to assume that a disconfirming experience automatically transforms a client's implicit material. Change becomes much more reliable when we take the additional step of creating a juxtaposition experience: guiding the client to attend to both the retrieved material and the disconfirming experience all at once. After all, step two requires concurrent experiences, and that rule of the brain has to be fulfilled thoroughly. In a juxtaposition experience, the client is emotionally in touch with the retrieved material and with a sharply contradictory experience simultaneously. Both feel real, yet both can't possibly be true. It's an experiential form of cognitive dissonance with a unique, peculiar feeling. Both sides need to be emotionally rich and real, not just cognitive insights or talk.
So I invited James to close his eyes and revisit the office scene in imagination and I said, "The moment to revisit is that point right after the jolt: you've already squelched your own good idea to keep from being hated like Dad, and you're looking around the room and it feels weird that folks are fine with hearing the same good idea confidently put forward by the other guy."
That simple "establishing shot" began to focus him on both realities in juxtaposition with each other. Then I again prompted him to feel both at once by simply saying softly, "In your life, you've been convinced that if you say something confidently, you'll always come across like your Dad—like an obnoxious know-it-all whom people will hate. At the same time, here you're seeing that saying something confidently isn't always received that way. And it's quite a surprise to know that."