THE BLOG
05/08/2014 12:20 pm ET Updated Jul 08, 2014

'Why' Is Overrated in Recovery and Relapse Prevention

There was a time in the 1970s when the term "analysis paralysis" was in vogue. Though too young to fully understand what it meant, I now know what therapists as well as the general public were on to.

Having too many good choices can prevent one from taking effective action. Being able to articulate what you know intellectually presents a paradox at times.

I'm not sure who said it first, but becoming a "victim of your own success" is like understanding something in the abstract. "Tragically hip," comes to mind.

In the '50s, psychoanalysis had been all the rage among the literati and intellectuals. Lying on a couch three times a week digging into every nook of our childhoods was a privilege. Frankly, it still is. The age of a more cognitive behavioral approach was on the cusp of being introduced.

Since our last blog post, "Clearing Up Co-dependency," Rose Grakal, MFT, and I discovered we both feel that over-indulgence in "why" can be overrated.

When we have a thought or a feeling, it is processed in our brains that have had a lifetime of feelings and experiences. Past feelings and experiences are a present filter or lens and potentially an opportunity for cognitive distortions. Without intentionally meaning to, we can get in our own way by over-indulging in the trap of mistaking talking for doing.

Many enter therapy with the hope it will be enough to figure out why they think and behave in certain ways. To an extent it is true that knowledge will "cure" the presenting problems of life for having acquired new wisdom. Unfortunately, Rose and I agree, that accurately naming and crying out in your pain has a place in creating positive change in one's life. This must not be confused with the reality check of taking the risk to conduct yourself differently.

The form of therapy best illustrating the point is Cognitive Behavioral Therapy. Aaron Beck, widely regarded as the father of Cognitive Behavioral Therapy, initially devised CBT to help treat depression. CBT is brief, structured therapy "directed towards solving current problems and modifying dysfunctional inaccurate and unhelpful thinking and behavior." In other words, less investigating the past, more identifying "distorted thoughts" we think are valid. More importantly, it's the thinking that informs taking practical actions to solve problems that takes thinking to the next level.

Actions taken, even if imperfectly undertaken, can change one's entire outlook on a situation. Try these even if they seem like ironic directives:

Stop thinking: (or stop thinking so much) though the impulse is to break the rule you set for yourself.

While we agree it's fascinating digging into our pasts, to better understand what version of it we face today, if we let ourselves have the experience of growing pains when we take action, watch what can happen.

An example is people who self-diagnose, which is so easy with Dr. Google these days. If a client comes into therapy frustrated and worried about their over-drinking, a lot of the "whys" are discussed in session and the client's past is combed through, the client feels relieved the truth of their past has been exposed and now they are healed.

What happens soon thereafter is the client comes back several weeks later and is upset that the worrisome drinking and the accompanying anxiety have continued. Shouldn't it have ended when the reasons discussed in therapy they thought were exposed?

When we intellectually understand why something is, have a good cry and an emotionally corrective experience, or so we think, it's as if light bulb goes on and we are "cured." When the same client decides to change their behavior by abstaining from drinking (using whatever tools or support groups work for them), they realize that when the action taken, not the knowledge gained, that caused the change.

Start doing:

Try a behavioral change. Let's take an easy one: If I wake up in a bad mood dreading my job and "pretend" I am in a good mood, excited for work, and take on the day faking my optimism, smiling and engaged, usually by noon that day I am in a good mood. If I am annoyed at my spouse but pretend I am really into him, usually I forget about what was so annoying and like him even more.

Many therapists watch their clients acting "as if" melts away resistance to positive change with remarkable effectiveness. Rose notes that asking anyone to make a behavioral change can be daunting and met with skepticism; certainly that won't work. People who agree to make a behavioral change think they will be pretending and acting "as if" forever and it will become laborious. Often they are challenging the internalized harsh critic who was formed to survive less-than parenting.

The wonder of behavioral changes has to be experienced to be believed. Many recovery models assert the common adage: Bring the body the mind will follow or in the doing is the becoming. The open secret lies in the faking that becomes real. We change our attitude and we have a better experience than initially thought possible.

It can be a hard job, changing one's behavior after years of thinking and behaving in certain rut-filled draining ways. It will most likely require "breathing" though the discomfort then coming out on the other side with a hard won new direction and attitude toward the problem. The goal after all is to feel, do, and live life better!

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