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Change and motivation

In research about what factors determine success in therapy, one of the most important factors is "client motivation". In other words, therapy is most successful with the clients who are most motivated.

This is not surprising. However, my experience says that a client's motivation has to be of a particular kind. Specifically, the client has to be willing and able to do try doing things differently than he is used to.

I have observed for quite a while that most people are motivated to change when the pain or discomfort they are currently experiencing is greater than the pain or discomfort they expect the change to cause. Human beings tend to fear big changes because the nature of most change is that you don't know what it will really feel like until it happens. It is the unknown, and most of us have a fear of the unknown. It is so easy to focus on the worst case scenario: that a big change will end up being a change for the worse.

Making any significant change requires taking this leap of faith, risking putting yourself through the potential pain and discomfort the change may cause without knowing for sure that the result will be worth it. Our society doesn't teach us that this is normal. Our cultural mythology says that this requires an unusual kind of courage, and that progress is making such courage unnecessary.

For example, obesity is increasingly common, with the corresponding increase in obesity-related illness. But people who are obese often go to a doctor because of these illnesses, fully expecting the doctor to fix the illness with a pill or other medical approach. They may know that the doctor will urge them to lose weight, but he'll still give them treatment to try to reduce their blood pressure or fend off diabetes, whether they lose weight or not. And they expect the doctor to succeed, even if they can't or won't change their lifestyle to help themselves.

As a psychotherapist, I don't have a similar option. There's no pill to make you attracted to healthy relationships instead of abusive ones, or to make you stop telling yourself you are a hopeless loser. As a therapist I can help you understand why you are doing things the way you are, I can make suggestions about changes to try that are most likely to be helpful, and I can cheer you on through the good times and bad times of the process. But if you want something to change, sooner or later you are going to have to take a leap of faith and try doing something different.

This is scary. In order to make real change, you have to let go of your old ways before you know that the new ways are going to work, or how. There is going to be a period of limbo, when it feels like you have no solid ground to stand on. This is a normal experience when making big changes. It's like the experience of a child taking her first steps — it feels scary and precarious, and there is no way for her to know whether it's going to work out or not. If she never takes that chance, she will never learn to walk.

Of course, one reason that you come to therapy is to get help determining productive changes to try. A good therapist is kind of like a good jungle guide in unexplored territory: they can't carry you to your destination, but they can show you the most promising trails, point out the edible fruit, and warn you about likely dangers. It may still be a challenging journey, but it will be quicker and easier — and less lonely — than trying to figure it out alone.

One thing to remember about this process is that ultimately you are in control of it. You can slow it down or stop it at any time. Some people find there is a point of no return, where you start to really understand how much pain their old ways of doing things are causing them, but usually by that time they are far enough along that they wouldn't go back if they could. Until that point happens you can always decide that this is too hard or too scary and go back to the old, familiar patterns. As a therapist I can't stop you, and I wouldn't if I could. It's your life, and your choice.

But you can bet that if you decide to keep trying, I'm going to be cheering you on. And I'll be betting that you, like many people I've helped in the past, are way more courageous than you know.

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