Patient & Therapist
bridging the gap between points of view
you see yourself as addicted, while i see you as at an early stage of behaviour change
you want a miracle, while i see a learning process
you think less bad habits, while i think more good ones
a novice painter has a weak brush stroke, but it is not by avoiding weak brush strokes that a better stroke emerges…it is by conceiving of a better brush stroke and attempting to reproduce it, practicing and improving it with trial and error — the teacher demonstrates the proper method and provides feedback on the novice’s attempts
a yoga practitioner starts out with the idea to learn a sequence of postures and other practices, knowing that he can do very little of it right now…but the possibility of improvement is there in the stories of others, and seeing others at higher levels of mastery…with practice specific improvements in the posture occur, and the person is able to discern more of the underlying principles and mechanisms of the postures and the practice as a whole — some of this is taught explicitly but most of it is acquired gradually with practice — it is common knowledge that only practice can bring improvement, and the method of practice and the ability to judge incremental progress is clear
in relation to weight management, the individual often mistakenly focuses too much on what not to do, with a less clear idea of what to do more of — the individual is reacting similarly to many people (patients and professional helpers) in the weight management field as a whole, which has been dominated by the idea that to lose weight you need to eat less than you want (apply restraint) — even those who explicitly oppose this approach only propose its opposite (the letting go of restraint), but no viable alternative. To help people move beyond the guilt and ineffectiveness of self-denial we need to map out a path for moving towards greater mastery of moderation. The problem is that dieters are saying “help me be less bad” and don't yet see the importance of practicing a fundamentally different approach
for the depressed patient, the question for patient and therapist is initially how to be less depressed — that quickly shifts to how to feel better — by increasing the frequency, duration and intensity of positive feelings the overall feeling is of being less depressed. Something needs to get this process started, to shift the person bit by bit away from the goal of feeling “less bad” to the goal of feeling “better,” creating an approach rather than an avoidance orientation
no matter what the problem or issue is, we need to identify and work towards the behaviour and outcomes we want — this is a continuous process, and the goal keeps moving — patient and therapist need to negotiate this process together
Patient and therapist talk, looking for understanding and a way forward.
Every therapy story is about seeing what is and deciding how to move ahead, about getting started and keeping it going.
It is about finding a way to bridge perspectives and work as a team.
Stephen Stotland, Ph.D. is a psychologist, therapist, teacher and researcher
