Therapy and Swiss Cheese

We are a nation of counseling, support groups, and a process called therapy. As Karl Menninger wrote, “what was once a sin became a crime and is an issue or problem.” And now a disease. Alcoholics Anonymous (AA) is a good example of how support groups work. Basic principles of AA are acceptance, regular meetings, the idea of one day at a time, and a sponsor to guide one through the 12 steps. The step program has expanded into overeating, sex, love, and gambling, etc. Perhaps the plethora of groups has developed to fill in for church communities, diminished extended families, or the lack of close friendships. As Kurt Vonnegut noted: “women need someone to talk with, and guys need someone to pal around with.” I rarely see anyone for an extended period of time who has a really good friend unless a major mental illness is the cause.

Therapy has evolved, and the person with problems has changed identities from patient to client to “consumer.” This represents a change in “therapist” from MDs, PhDs, social workers at the Masters level, and counselors who bring some educational requirements plus the experience of having been, for example, an alcoholic or drug addict. Psychiatry has evolved from description and classification of mental problems to attempts to understand the genetic and epigenetic experiences behind the symptoms. A multitude of chemical interventions have emerged.

Dr. Albert Ellis introduced a simple but effective treatment several decades ago. Think of it as an ABC method.

A) Dedicated amateur golfer makes a bad shot.
C) Throws his golf club

What happened at B?

Typically a variety of self-defeating, critical messages occurred after the shot and these are usually in the “you” voice. Pick your own list; be creative, expansive, and negative as possible. The list is endless. The thought process is lightening fast and typically has a “you” voice inferred.

1) You blew it again
2) You’re never gonna get it right or good enough
3) You are stupid, dumb, lame, etc., etc.

Now translate this scenario into an endless list of daily disappointments, unfulfilled expectations, and impossible comparisons; Comparison to an idealized self or to Tiger Woods. There is a simple response – Next time I will practice and do better.

Write down your list in the “you” voice.
What percentage, this moment, do you believe your shit list?
Rewrite the laundry list in the “I” voice. Is there any difference in percentage of belief this moment?

As an extreme example, read Lame by Joe. Joe (not his name) was 27, very depressed, and his “you” voice had become a habit therefore an identity. Please do not try to outdo Joe. After years of therapy, counseling, overeaters anonymous, and impossible expectations form childhood, he had become a real expert.

Lame

You are a fucking retarded moron.
Who told you you could think?
Why do you think you can?
Why would you know anything?
You can’t even save yourself?

You are a complete fucking loser.
You will never be great
You will never be mediocre
You are nothing.
You always have been, you always will be.

You are an ugly piece of dog shit.
Who could ever love you?
Why would they lower themselves? Who would take you in?
You’re a fat fucking fraud.

You are a stupid, pathetic fucking loser.
Because you can’t get your shit together.
You believed the lies.
You let yourself dream.
You know you are a fake.
You know you are lame.

At the moment of writing he believed his Lame 100%. Rewritten in the “I” voice, fifteen of his responses remained at 100%; the other four ranged from 50 to 80%. We looked at this as a “window of opportunity” and he gradually improved. His “never” and “always be this way” and “what if I do the same thing;” (with practice) gradually changed. Looking back is “if only”; looking forward is “what if.” How about “next time, I will, in that brief moment before the mental roll of toilet paper unfolds, practice and do better – next time. Again, please do not attempt to outdo Joe; he was outstanding and lame.

With practice, changing the “you” to the “I” voice helps. As noted on other pages of this website, the “you” voice is learned at toddler age by imitation. The “I” voice cannot be learned by imitation, so it is fragile or excessively rigid. I think of the “I” voice as similar to Swiss cheese. Swiss cheese has holes in it which occur at irregular intervals. Once in the hole, sing, kick, swing or jump your way out. If looking for the next hole, you are already in it. Digging around in the hole, the hole gets wider and deeper. And, as with Swiss cheese, we get moldy, dry out, shrivel, lose some of our body parts and with a little help from our friends and families, gain acceptance, understanding, and integrity.

Yes, holes happen. Acceptance leads to hope for another day, another opportunity. Next time. An improvement over “shit happens?” Perhaps.