The first thing I assume about all my clients is this: You are doing the best you can, in and out of therapy. You are already trying hard, and you want to improve.
You may not have caused all your problems, but you have to solve them anyway. What a freeing truth this is! Let’s start solving and quit the useless shame.
You and I will have a real relationship between equals. I am a consultant to your behavioral change and the most caring thing I can do is to help you change in ways that bring you closer to your goals.
Even though I truly believe you are doing your best, at the same time I believe you have to do better, try harder and be more motivated to change. Being motivated comes from behaviors, and not much from willpower. If you’ve been trying to willpower your way through your problems, you’re probably exhausted. There’s a better way.
These positive assumptions about treatment are part of any Dialectical Behavior Therapist’s outlook. You’ve heard enough criticism and it just isn’t helpful. The first reason I believe all these assumptions is because they are the truth – for almost everyone. The second reason I believe them is that change is made possible in the context of positive thinking.
I’m not talking about faking a positive attitude. Anyone who’s seriously tried to change knows that faking happiness only goes so far. What I’m talking about is finding the positive elements that exist in your life, and using effective behavioral principles to build on these positive elements.
Here’s an example of you doing the best you can AND needing to try more: Let’s say you are having trouble sleeping and this has been going on for about ten years. You and I sit down and do a behavioral analysis of what underlies the sleeping trouble. Through this analysis, we identify four different things:
1) You got used to a chaotic bedtime about twelve years ago when you were in college. You started thinking of 10:30 as “the night is still young” and you still think in those terms. You find yourself working on your laptop right up until you can’t keep your eyes open any longer. On the nights you can’t stand to work, you’re watching television, hoping that you’ll get tired enough to drop into sleep without much effort. That usually happens but it’s around 2 am instead of 11.
2) You don’t get home until about 7 three nights per week, so you’ve gotten in the habit of eating late – around 8:30. This doesn’t even feel late to you anymore.
3) When you can’t sleep, you worry about being tired the next day. You try to do all the things you’re supposed to do like keep the room cool and dark, etc., but you still end up frustrated and even more awake than when you started.
4) You are so tired that you end up falling asleep around 5:30 in the afternoon on your days off. You can’t help it. You sleep for a few hours, and then you are wide awake for so long you’re afraid to even look at the clock.
Sound familiar? Here’s the positive:
a) You really are doing the best you know how to do right now. Remember how tired you are? It’s awfully hard to think clearly when your whole life is one big wish for more sleep. So you are doing the best you can a a tired person. Really, if you knew what to do to fix this problem, you’d do that thing, wouldn’t you? Without that knowledge, you are doing the best you can.
b) You learned some good things about “sleep hygiene” and you are trying to use them (cool dark room, for example).
c) You are asking for help! This is a very effective move, and one that indicates readiness to change.
d) You are willing to find out some new information. This indicates courage and the ability to think outside the box you have been living in.
Doing great so far. Now it’s time to find out what you don’t know yet, and figure out how to make those changes.
See how that works? You are doing the best you can. At the same time you need to change and do more. You don’t know what that is yet – but we can work together to identify the most effective next steps.