Charles Dickens’s A Christmas Carol is one of my all-time favorite stories, as it’s been for millions of others since it was written in 1843. Who doesn’t start sniffling when reading this classic tearjerker about Ebenezer Scrooge, a cold, bitter old man dragged—by the ghosts of his past, present, and potential future—on a terrifying midnight journey of self-discovery, from which he emerges transformed and redeemed? Most people love movies about driven, selfish people who, struck by the life-altering experience of sudden love or near loss, eventually see the light and blossom into life-affirming mensches. Miraculous conversion stories appeal to the wishful thinker in all of us. We want to believe that hitting bottom—being forced into genuine awareness of one’s bad behavior and experiencing true remorse about it—is the key to transformational change, a comforting daydream shared by many therapists.
However appealing this view of human transformation may be, the reality is that it distorts what we now know about the foundation of lasting change. Falling in love, for example, doesn’t make us appreciate other people; appreciating other people makes it likelier that we’ll fall in love. Appreciation can be practiced and conditioned; love cannot, at least not directly. We don’t change our bad behavior by feeling bad about it. In fact, we usually don’t feel bad about it—much less understand its effects on ourselves and others—until after we’ve changed enough to achieve a more enlightened perspective. (That’s why it’s usually not until we become adults that we can transcend denial about the foolish things we did as adolescents.) Except for saints and literary characters, enduring change rarely happens as the result of being knocked off our feet by a spiritual or psychological whack upside the head. Perdurable change is gradual and mundane. It occurs by extending, supplementing, and altering the habits that shape perspectives and drive behavior. First comes the hard work; then comes the epiphany.
I began clinical practice some 25 years ago, firmly committed to what might be called Christmas Carol therapy. Although I didn’t make the conscious connection back then, I secretly believed that change for every client was always a transformational session away. I can recall many highly emotional sessions that did, in fact, shake many clients to their core; most left therapy changed forever, or so it seemed to me at the time. But the follow-up questionnaires I regularly sent clients a year after treatment told a different story. To my dismay, the clients who’d had the most dramatic experiences in therapy did the poorest a year later. A few were even worse off than before treatment. It had to be the fault of the questionnaires! So I tried different ones, and persisted with my version of Christmas Carol therapy—until I met Mattie.
Mattie showed up for an appointment that was actually intended for her husband, Patrick, who’d completed therapy with me five months earlier. Before coming to therapy, Patrick had been convicted of misdemeanor domestic violence for pushing Mattie into a wall and court-ordered into a batterer’s intervention program, after which he was referred to me by the group leader.
In therapy, Patrick relived his ghosts of times past, including when he’d witnessed traumatic scenes of his drunken father battering his mother. On the mornings following these beatings, while his mother’s face was bruised and swollen, Patrick would be smothered in affection by his now sober and remorseful father. The ghost of Patrick’s present soon became obvious: Mattie’s unhappiness reminded him of his mother and his own failure, as a boy, to protect her, as well as the guilt he felt for hating a father who, when sober, was loving. But rather than elicit a deep need to redo the past and protect Mattie from harm, he blamed her for making him feel bad. The slightest hint that she was unhappy, even a complaint that he wasn’t doing enough around the house, would scrape the old wound and prompt an eruption of anger. Although the incident that landed him in court had been the worst of his violent attacks, he frequently raised his voice, laced with contempt and disgust, bullying his diminutive wife. Through our work together, Patrick came to see the ghost of the future—divorce, isolation, desolation—and seemed to make some important discoveries about himself.
With honesty and sincere emotion, he mournfully recalled his childhood feelings of fear, guilt, shame, and helplessness. More importantly, he became aware that Mattie, then pregnant with their second child, was not a symbol of his failure, but his beloved wife, with a right to her own thoughts, feelings, and desires. He left therapy a new man, confident that he could use the fruits of our work, along with the safety plans learned in his domestic violence class, to give Mattie the kind of relationship she wanted and deserved.
When Patrick called for a follow-up appointment five months after our therapy had terminated, I looked forward to seeing him again, but when I stepped into my waiting room and saw Mattie, one feature of her appearance shocked me: fading but still ugly bruises on her cheeks and around one eye. Patrick had beaten her up and was now sitting in jail. When I invited her in, she described the stress they were under with their new baby and the threat of downsizing at Patrick’s job. “He really has changed,” she added. “Therapy really did him good. He’s a much nicer guy . . . most of the time.” This beaten young woman was trying to reassure me.