challengesThe idea of change in the standard model of health is fairly simplistic. You take a dysfunctional behaviour and replace it with a functional one. Or worse, you take a dysfunctional thought and replace it with a functional, adaptive one. This approach works well if you are fixing cars or washing machines, but with a human being it is bound to fail. And guess who is left feeling a failure each time. The Client is, and another episode in the revolving door called failure is repeated.

If you start to analyse change into smaller steps you can see that there are a number of obstacles in the form of aversive control (R-):

1. Ignorance is Bliss. Thinking that you have a problem is worse that thinking that you do not, thanks to the Lemon effect. Often referred to as denial, we all know that you have to admit that you have a problem before seeking help.
2. Consequences Amnesia. Again more Lemon time comes in. In order to think about change usually it helps to think about the longer term consequences of carrying on as you are. This feels unpleasant so will be avoided.
3. Acceptance Angst. So you recognise the problem and realise that you do not want the consequences. What is the alternative? Surrender, or giving up, produces more angst when the future without the away behaviour is imagined. More Lemons.
4. Letting Go Loss. So you have battled through the first 3 Lemons and now you are ready to let go. Believe it or not letting go of an old friend, like addiction, invokes feelings of loss. You enter the no man’s land of the swamp mourning the loss of your old friend and becoming rapidly engulfed in the uncertainty of carrying on without the comfort of what you know. More Lemons ahead.
5. Trial and Error. Not knowing what the new behaviours are brings up a whole new set of Lemons. A lot of time is spent imagining futures that have not been yet encountered. Inevitable failures in the learning process lead to memories of past failures and doubts about whether you will succeed. Lemons, lemons, lemons…

So the reality of change is a bit harder than the story in the conventional model suggests. And it would be easy to add to this list even more examples of aversive control that are encountered on the road to change. Being honest with our clients at the start sets a more realistic tone, and helps us to validate the pain of change. As I always say to my new clients “I am here to make you feel worse, that’s how we know the therapy is working”.

I saw a book title on this the other day called ‘the obstacle is the way’, click the link if you are interested.


2 Responses to 5 Barriers to Change

  • Lucy says:

    Hi Mark, I love this quote from the book “obstacles on the way”

    “Objective judgment, now at this very moment
    Unselfish action, now at this very moment
    Willing acceptance now at this very moment – of all external events
    Thats all you need”

    Changed my day.

    So thanks for the link.

  • Nick Frye says:

    The idea of simplistic behavior/thought replacement is powerful and compelling but, as you stated, bound to fail. We need more acceptance-based behavioral interventions!

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