\\We tend to think of therapy as a place we go to discover what we need to change about ourselves to return to the way we were before symptoms first arose. But what if therapy is actually a way to accommodate a process of change that has already begun? What if we are looking for the permission to surrender to change?
In pursuit of change
In most cases, we come to therapy because we are anxious or depressed, or otherwise distressed. An emotional or behavioral disturbance of some kind has arisen. Naturally, we tend to believe that the distress is evidence that we need to change something. We feel that “something” has interrupted or interfered with the normal functioning of the status quo, and we hope to work with the therapist to identify that “something” and hence re-establish the old order. And so, we engage the therapist to help us identify what we need to change about ourselves in order to quell the disturbance.
The permission to surrender to change
Ironically, we tend to overlook that our emotional disturbance is evidence that a process of psychological change has already begun—and that it began well before we thought to seek help. At the start of treatment, we are usually unaware that we are not looking to summon the will to begin a process of change, so much as we are looking for permission to stop resisting a process of change.
The role of cognitive dissonance
In certain situations, psychological symptoms, such as anxiety, might be the products of something called cognitive dissonance. Glenn Perry (2021) writes about the connection between cognitive dissonance and psychological symptoms: “[A] lack of internal consistency between behaviors and beliefs is…referred to as ‘cognitive dissonance.’ And dissonance is experienced as anxiety. More broadly, cognitive dissonance is the subjectively felt discrepancy (1) between two incompatible cognitions, (2) between a behavior and a cognition, and (3) between an experience and a cognition.”
He continues, “Cognitive dissonance leads to attempts to resolve the dissonance (or anxiety) by (1) changing or eliminating a cognition, (2) changing one’s behavior to conform to one’s cognitions, or (3) changing cognitions to conform to experience.” To sum up, anxiety often arises when a new “cognition” (i.e., thought, idea, or belief) arises to challenge an established one for dominance or supremacy within the psyche. Since the two ideas or beliefs contradict one another they cannot co-exist without generating the psychological equivalent of “static”. Until the discrepancy is successfully resolved, anxiety tends to persist.
The role of pathogenic beliefs
Certain well-grooved, long-established cognitions fall into the category of what cognitive–behavior therapists might call “negative core beliefs,” or of what control–mastery therapists might call “pathogenic beliefs.” Simply put, pathogenic beliefs are frightening, inhibiting, and/or depressing thoughts, ideas, or beliefs about the self, and about how worthy or deserving the self is of having its basic needs met. Pathogenic beliefs are psychological artifacts of childhood impingements, dilemmas, or traumas. While ultimately self-limiting or self-undermining, such beliefs are initially conceived to protect us from the possibility of retraumatization.
Typically, anxiety arises when a pathogenic belief is challenged by an experience that suggests we have underestimated our worth. For example, a patient who believes herself to be unworthy of success may become anxious or otherwise distressed upon receiving a promotion. This is because such an experience contradicts a long-standing (albeit self-limiting) belief about herself. Another patient who believes he is unworthy of a mutually rewarding intimate partnership may become highly distressed upon coupling with a thoroughly decent, considerate, and generous partner because such an experience violates a long-standing (albeit self-limiting) belief about himself.
As fresh experiences give rise to new, healthier, and more accurate cognitions about the self, anxiety may increase as incompatible cognitions duke it out for dominance within the psyche. From the outside, it appears that the patient’s condition is deteriorating. The “inside story,” of course, is that the ironclad grip of pathogenic beliefs upon the psyche has begun to loosen as new, salutogenic beliefs take hold.
A somatic metaphor
When we have fallen ill with an infectious disease, the immune system revs up and begins to fight the infection. We often experience the body’s “fight” as a cluster of symptoms, including fever. And while fever may be difficult or uncomfortable to endure, we understand it is a byproduct of the body’s bid for health. It is a similar situation with regard to mental health. In some situations, symptoms such as anxiety are the psychological equivalents of fever. They are uncomfortable and perhaps unwanted, but nonetheless a sign of work being done.
Why we resist and how to learn to let go
It is understandable why we would resist this process. No one gives up a long-held and strongly felt belief in a blithe, casual, or nonchalant manner. This is doubly true if the belief in question is believed to protect us from perceived dangers. When we come to therapy, we are often looking for permission (from the therapist perhaps at first, but ultimately from ourselves) to surrender to change. We wish to no longer do anything to interfere with the natural falling away of the old, painful stories we have been telling ourselves for many long years.
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I strive to create a safe, comfortable, and supportive environment for individuals who are confronting issues related to adjustment, anxiety, depression, grief, stress, relationships, and trauma. I specialize in helping individuals who find themselves caught in repetitive patterns of less-than-effective coping and bewildering self-defeat, and those with LGBTQ+ concerns. Call or message today to schedule your free phone consultation or arrange your first appointment.