Click here to read Part 1.
In my first post, I talked about what to expect from therapy, which included a focus on change. I am devoting extra time to this in Part 2 because change is so important and yet so misunderstood.
Recently a nine-year-old girl, whom I've been seeing twice a month for a while, came into the room and started by saying she was having a really hard day. This was somewhat unlike her because she had been putting on such a brave face for most of our time together. She then described the compulsions she had engaged in, and how it caused a big problem. She didn't think that her OCD was part of why we were there until that day, when she admitted that the behaviors actually can and do get her into trouble.
I thought, Finally, we're having a breakthrough! My mind momentarily raced to all the new work we could start: we can talk about the compulsions and gain understanding, we can talk about all the positives from change and gain motivation. . . But no sooner did I think of these things than she slumped into her chair and, with all the stubborn sullenness a nine-year-old can muster, said, "And the worst thing is it's never going to be better because it's my brain that makes me do it and my brain can't change!"
Even though I could hear her using words that were a bit beyond her, like she was repeating someone else's explanation, I knew this idea was etched deeply in her mind: if the problem is my brain, then I can't change it. There's a big piece missing from this theory, but I get where it came from. There is a biological reflection of each mental health disorder within the body, especially in the brain. So often, mental health disorders have been stigmatized and treated with the flippant disregard of the (possibly) well-meaning friend or relative who says something like, "Get over it." A logical response is to point out that there is a physical component that anyone, were they looking inside your brain, could physically see. While I understand that the "get over it" point of view is to say that some mental toughness is needed, just pulling yourself up by your bootstraps is not going to cut it when it comes to mental health disorders. They are called disorders because they cause an impairment in function, i.e. in one's ability to "just get over it."
There's no denying that a mental health disorder can be reflected in the brain. But what I want to add to that is: this does not mean there is nothing you can do to about it. In fact, we do something about it all the time.
It's called neuroplasticity: neuro meaning "of the brain" and plasticity meaning "the quality of being easily shaped or molded." In biology and specifically evolution, plasticity refers to the ability of an organism (plant, animal, bacteria, human) to change and adapt to their environment. Have you ever heard the saying, "Use it or lose it," when it comes to people's ability to use their brains as they age? This is because of neuroplasticity. When you learn something, your brain makes new physical connections, connecting pathways to other pathways. When you practice that thing over and over again, you're making those connections stronger and deeper. If you don't practice, they become like a path through a grassy field that no longer gets used: the once clear path starts to grow over with grass and weeds. It may all but disappear. Neuroplasticity is lifelong. That's why they say: use it, or lose it. It goes for a 90-year-old as much as a 9-year-old. In the case of my 9-year-old, she has repeated certain behaviors over and over, strengthening and clearing the pathways, which makes them more obvious, deep and strong. The result she now feels is a compulsion. It isn't going to be obvious that she can change it, because the pathways that exist now are already so obvious that it will seem like she must follow them. But it only seems that way. She wasn't so keen to believe me that day, but I taught her the word neuroplasticity, and she liked knowing that. Knowledge and observation of this is where we can start. Later, we'll move on to the next stages of change.
Stages of Change is a model that was first introduced and applied within the field of addiction by DiClemente and Prochaska. It is also called the transtheoretical model of change. We know now that these stages can be applied to anyone with a problem that can be changed. Sometimes you'll see the stages listed as such:
Learning about how we change, and then accepting and expecting the phases of change, helps people feel empowered. I've seen it happen. It normalizes change. It illustrates the path. And it can do this for you, too.
Change is a vital part of life. We are doing it whether we know it or not, and we can use the available knowledge and research about change in order to empower the process of change for ourselves. Expect it if you're going (or considering going) to therapy.
Change can be good. You can do it!
And you already are.
I am Lisa and I believe we create our reality. I hope to help empower people to create more mindfully, be kind to oneself and others including animals and the environment, and just generally feel better.