Maya’s tears were falling fast from the first moments of our work together. She was from Argentina, slight with dark curly hair. Her voice was slight too, almost like a bird song. When she’d made the appointment, she’d told me that work as an art director at a big advertising firm was hard and she wanted to talk about handling the stress. Once in my office, she’d barely sat down before she was sobbing, her breath caught in chokes in her throat.
“Can you tell me something about what’s happening right now?” I asked gently. “When you called, you said you wanted to talk to someone about job stress. I’m open to us going a different direction. What’s happening behind the tears and overwhelm, Maya?” I hoped my voice was both welcoming and tentative enough to allow her space to show up however she needed to in that moment.
“I’m a disaster,” she wept. “There’s pressure from every direction at work, and I feel like I’m always—I mean, I never let this out at work, or with my girlfriend, or I try not to—but I can’t seem to—.” She paused repeatedly. “I’ve been to therapy before, and I don’t think it helped. Maybe I’m unhealable.”
“When you feel overwhelmed, how do you talk to yourself, Maya?” I asked gently.
“It’s terrible in my head, even when I’m not overwhelmed,” she replied.
I took a breath, letting myself feel the seat under me as Maya went on to describe a vicious self-critic who berated her from the moment she woke in the morning to the moment she fell asleep. She walked through the world with a continual sense of dread, aware that anything she did, or didn’t do, could lead to an intense bout of self-hatred, in which she’d feel awash in shame, her stomach knotted up with nausea. She was walking on eggshells in her own mind.
This self-hatred, I noted to myself, is the sticky symptom. Because sticky symptoms are inextricably tied to the subconscious mind, they stay put and feel unmovable even with big interventions focused solely on shifting them. I tag this as a sticky symptom so that I remember to help us discover how this symptom makes sense to her inner landscape but not to make it the focus of the work. With clients, I try to home in on the subconscious emotional learnings that keep the symptom stuck.
For the past 10 years, I’ve studied, taught, and applied in my therapeutic work something neuroscientists have termed memory reconsolidation, a process in which long-term patterns in the implicit memory system shift so clients can unlearn old information and take in new understandings. It’s the process by which the subcortical brain changes its mind about what to expect in the world.
For years, scientists and therapists believed that the implicit memory system couldn’t be changed. Recently, however, neuroscientists discovered that old learnings and understandings can indeed be updated, provided a specific set of circumstances can occur. First, the original learning (emotional knowing) is active. We can recognize when this happens in the therapy room because clients will feel the “truth” of it in their bodies. Second, another emotional knowing is also active, one that mismatches the original emotional knowing. Third, the brain is regulated enough to catch the mismatch, which causes a prediction error. Then, once the prediction error has happened, the new learning occurs again.
Many therapies, such as Coherence Therapy, Internal Family Systems, EMDR, AEDP, Somatic Experiencing, and Sensorimotor Psychotherapy, set up processes in which this is a likely occurrence, some with awareness of the memory reconsolidation research and others without any conscious or overt reference to this natural phenomenon. Once therapists understand the necessary components of this unlearning process, they can use these, or other modalities in which they’re already trained, to create spaces that will help clients update the implicit memory system with more clarity and depth, which ultimately helps sticky symptoms resolve.
The implicit memory system is a layer of subconsciousness made up of neural networks that intertwine to create what I call your psychological floor. I call it this because you walk on it, trusting without question that it’s true. In fact, it holds all sorts of “truths” for you, from how the world works, like gravity (on this planet, stuff falls), to what to do when you’re thirsty (drink water), to who you are (good at solving problems, not so good at relationships), to how to keep yourself safe (make as little eye contact as possible). Notice that some of these “truths” are really true and others are things we only believe to be true.
What does this look like in the therapy room? As I work with clients, I listen for what they’ve learned the world is like, for what they’ve learned about who they are, and for what they do to protect themselves from feeling too hurt or scared. I think of the things they do to protect themselves (like making as little eye contact as possible) as symptoms. And I think of the things they expect about the world or themselves (like I’m not good at relationships) as the emotional knowing. I care about the differences because the “emotional knowings,” not the symptoms that often feel too sticky to budge, are the target of unlearning work.
Maya’s sticky symptom—her inner-critic voice—was loud and scathing, and it often left her feeling empty and twisted in the center of her diaphragm. Although she fights this voice when possible, it’s always there, telling her how she’s messed up again or warning her that she’ll make a mistake soon because she’s too dumb not to. She could sometimes keep this voice in the background, but other times the voice would overwhelm her, causing her to spend days between projects in bed, where she distracted herself by binge-watching Netflix.
Maya came to me wanting some sort of skill with which to combat her inner critic and make it go away. “I’m good at hard work. If there’s some sort of practice I can do, I can commit to that,” she told me earnestly.
I’m an integrative therapist and often pull from the many modalities in which I’m trained. So, while I waited for her emotional knowings to emerge, I offered her some mindfulness techniques to try, as well as some self-compassion exercises that help build curiosity around the inner experience. Still, my sense was that there had to be a really good reason why her inner critic was so loud—and until we could address it, it wasn’t likely to change.
Finding the Original Emotional Knowing
For Maya’s subconscious mind to make a really big, potentially costly change, it had to feel there was a really big benefit. Because the implicit memory system talks to us in body-based feelings and sensations more than in thoughts and words, I wanted to talk to her subconscious mind through an experiential exercise I learned from my mentor, Bruce Ecker.
“Maya, can we imagine something?” I asked in our next session.
“Okay,” she said.
“Picture yourself walking into your office late for the weekly staff meeting.”
“Oh, God,” Maya muttered, her voice stressed.
“It’s not a pleasant situation. Still, if you can, stay with me. Imagine this happened yesterday.”
“Okay,” she replied.
“It was hot and super sunny yesterday. See yourself there and feel the heat as you begin walking away from your car.” As Maya closed her eyes, her face looked troubled. “Good work,” I told her. “Now imagine you drop your keys, and they fall under the car, so you’re gonna have to get down on the ground to pick them up. The critical voice usually gets really loud when stuff goes wrong. It tells you how you mess things up, how you won’t be good at anything.”
“I can hear it,” she scowled.
“I get how hard this is, Maya. You’re doing a good job. Now, imagine that all of a sudden, the voice is gone. It’s blank and quiet in your mind.”
“I can’t. I mean, that’s impossible. The voice never goes quiet,” Maya said, her eyes still shut.
“Just for a moment imagine it’s gone, and then tell me what sensations are in your heart and belly when you even try to think of your mind going blank.”
“It’s super hot, like my chest is on fire.”
“Good tracking,” I told her. “See if you can be with that super-hot feeling; let everything else go. Keep the hot feeling in your awareness but let go of the office and the lateness and the keys and everything else. Just be with the heat in your chest. Can you ask the super-hot feeling how old it thinks you are?”
Maya paused. “That’s crazy.”
“What’s crazy, Maya?” I asked.
“My mind flashed up a picture of me on the stairs at my old house. I think it must have been when I was 11.”
“Can you tell me about what happened when you were around that age?”
Maya told me that her parents had separated by then, and she was often left alone with her older brother, who bullied, teased, and sometimes pushed and hit her. Around that time, she said, her friend group rejected her. They’d write terrible lies about her on pieces of paper—about the way she looked or smelled—and shove them in her locker. In the many months that this went on, Maya had felt tortured and deeply alone.
“Did you feel like this was somehow your fault?” I asked her.
“Not exactly,” she said. “But I knew I was smart, smarter than most, and I thought I should’ve seen all this coming and figured out a way to prevent it. I mean, my brother—I should’ve been smart enough to get ahead of him and escape before he’d start on me. I should’ve been able to stop my parents’ separation. And those girls, I guess I didn’t feel like I caused the bullying, more like I should’ve been able to get ahead of it and stop it from happening.”
“And the moment on the stairs?” I asked.
“That was the moment I promised myself I’d do everything I could to prevent bad things from happening to me,” Maya told me, her eyes wide. Then she paused. “That’s so weird—right now the critic is saying, ‘Stop looking at that girl. She’s stupid—and so are you!’”
“I see,” I said. “Sounds like your inner critic has a really important job. The girl on the stairs tries to prevent every bad thing from happening, and your inner critic wants to make sure you don’t see what she’s doing?”
“But what’s so bad about trying to prevent every bad thing?” Maya asked. “Why would my inner critic want to stop me from seeing that?”
“I think trying to prevent bad things from happening makes you good at your job,” I told her. “But I wonder if there’s a downside to trying to get ahead of everything. Can you go inside again and ask the 11-year-old on the stairs what she thinks will happen if this strategy doesn’t work?”
There was a long pause as Maya went inside, trying to hear what the 11-year-old knew. She was tearful when she came back to our shared space, and spoke so quietly that I could barely hear her. “I tried to kill myself. I mean, I took a bunch of Tylenol, because that’s what we had, and then I made myself throw it up. I never told anyone. On the stairs, that was right after I threw up. I was saying it again and again, rocking: ‘I will stop every bad thing.’”
“That sounds so scary and hard, Maya,” I said. “It sounds like your inner critic is afraid that if the 11-year-old fails, you might die.”
“It’s true,” Maya said. “It’s like if I fail at an impossible task, like stopping every bad thing, then I have to end this life. Or I will die because I can’t actually stop every bad thing.”
“Right,” I nodded, encouraging her growing understanding of the complex psychological floor we’d discovered. “So your critic keeps you distracted from that task, from noticing if anything goes wrong with it, so you don’t kill yourself.”
“In that moment on the stairs, it felt like the only way to say yes to living was to stop all the bad stuff before it happened,” Maya said.
“It was your bargain with life in that moment,” I reflected. “Like the only way I stay on this planet is if I can stop all the bad things.”
“Yeah,” said Maya, “and another part of me must know that’s crazy, that I won’t win at that game, so it keeps trying to get me to stop playing by keeping me away from that promise I made to myself.”
We’d come a long way. We now understood her inner critic had the important job of keeping her alive. And with our new awareness of what her psychological floor was holding, we could focus on the possibility of her discovering that the original learning—“the only way to say yes to this life is if I stop every bad thing”—which felt emotionally true for her, was not actually true.
Finding the Mismatch
In the next session, I asked Maya if it would be all right to focus back on the 11-year-old and the promise she made to herself.
“I’ve been thinking about that all week,” she told me.
“Could you go back to that moment on the stairs, like you’re with her and embodying her at once? So you really feel her alive within you, but also see her from the vantage point of your adult mind. Can you do that?”
“I can,” she said with her eyes closed. I noticed her rocking a bit, just like she’d described her 11-year-old self doing on the stairs. “I won’t have to die as long as I can figure out how to stop all the hurt before it happens. And I’m smart enough to do it. I can get ahead of it. I’m faster than life. My brain is faster than life. Ha!” Suddenly, she started laughing out loud.
“What’s happening now?” I asked her.
Her laughter continued for a while. “What’s really crazy,” she said, “is that there is no code!”
This is the moment I’m always looking out for in therapy—when the implicit mind compares the old learning and another subjectively true learning and finds that the new learning disconfirms the original one. When this juxtaposition happens, the most common response is surprise. Sometimes surprise comes with exclamations like, “Whoa, whoa, whoa!” Other times it comes with a pullback in the neck and a widening of the eyes. Occasionally, profound confusion occurs as the surprise settles in. But many times, as with Maya, the surprise is expressed with laughter.
That’s the moment when the old neural network becomes labile (a fancy word for flexible and open to new learning). When that occurs, I know I have a four-to-five-hour window to help the old network take in the new learning. So, I go to work right away, toggling between the original way of seeing things and the new truth my client just discovered.
“Maya, you just said there is no code?”
“Yeah,” she said, still laughing. “That 11-year-old thought if she worked hard enough, she’d find a code, a secret formula to get ahead of life, to win the game. She thought she could crack the code and never be hurt like that again.” She was still giggling. “But, of course, there is no code: that doesn’t exist.” She was smiling widely now.
“I think I’m following you,” I told her. “She was sure there was a code to avoid that kind of hurt, and she was gonna find it and crack it—and if she did, she was okay to go on living.”
“Yeah,” Maya said. “And she promised herself that if she failed, she’d go ahead and choose not to live anymore. But the thing is, there is no code.”
“Say it again, Maya,” I suggested. “She knew what, but the truth is there is no code.”
“She knew there was a way to beat life and end the pain, but the truth is there is no code. Actually, I’m not so bad at being in pain. I can do hard feelings. I’m pretty together.”
“You didn’t crack a code to get together like you are,” I reflected.
“Well, I couldn’t because there is no code,” she giggled, wiping tears from her eyes. “I don’t know why I think that’s so funny, but it is. It just tickles me. There is no code.”
The next week, Maya reported that her inner critic was significantly less active—not gone, but quieter and less insistent.
“Can you try to picture the 11-year-old?” I asked her.
“I can,” Maya said, “but she’s not on the stairs anymore. She’s petting Ruffles, the cat, and smiling.”
“That sounds like a big change,” I said. “Can you just try to think the thought I have to beat life, to beat every bad thing?”
“She’s shaking her head and laughing and petting Ruffles. She’s totally different.”
“And the inner critic? How is she with this change?” I asked.
“She still calls me stupid, but now it doesn’t bother me as much, and she’s not so sure she’s right anymore, either.”
“Do you think your inner critic likes her job?” I asked.
“God no! She wants the hell out of it,” Maya asserted. There was a pause. Then she looked at me and said, “So what now? There’s gotta be other ways she wants to help me, right?”
“I bet that’s right. Wanna find out?” I asked.
“Yes,” she said.
Moments like the one I experienced with Maya, where old learnings are updated and sticky symptoms decrease, aren’t unique to people who understand and intentionally practice memory reconsolidation, or who use the language associated with it to describe what they’re doing. Most therapies are already geared toward shifting long-term patterns in implicit memory so new understandings can replace outdated learnings. But pulling back the curtain on the mysterious and often misunderstood memory reconsolidation process, shedding light on its basic components, offers us a simple, clear scientific explanation for what occurs in the subcortical areas of the brain in breakthrough moments of therapy.
When we’re clearer about what’s happening in these moments, we bring greater precision and depth to our interventions.
Illustration Source Pedro Scassa
Juliane Taylor Shore
Juliane Taylor Shore, LMFT, LPC, SEP, is a therapist specializing in trauma recovery and couple therapy in Austin, Texas. In addition to her work with clients, she teaches therapists how to integrate neurobiological discoveries into their clinical work. Visit her website at julianetaylorshore.com.