“What changed?” This is a question that any good therapist is going to ask when you first come to therapy. If you can pinpoint it a path for further exploration will appear and the rudiments of a clinical picture will start to take shape. A life change, though not always immediately apparent or in your conscious awareness, is often the cause of the inner turmoil that compels you to seek out therapy.
Most of us fear change, although it’s obviously an unavoidable part of life and there is a positive side to it too. As Thich Nhat Hanh points out, without change you’d never get to see your daughter grow. You’d never get to see the flowers bloom. You could never have been born. But obviously change can also make your life circumstances a lot more bleak and confront you with stressors that seem difficult or impossible to overcome.
Sometimes this change is pretty obvious and clients are well aware of the source of their discomfort. Some common examples are the death of a loved one or a disabling accident. In these cases grief will be a central component and the therapeutic path will be both to help them process and to help them learn everything they can about grief so that they can gain the insight necessary to feel ready to let go, say goodbye to the past, and move on with their lives under new circumstances.
But sometimes a change is not quite as obvious, and all you have to go off of is that something in you has changed, something internal, and you can no longer tolerate the feeling. In these cases you will still usually bring a presenting issue, and you might be pretty sure that it’s the main cause of your troubles, but it’s usually not. There is a cognitive bias that affects all of us, where we seek to pinpoint the causes around us to make sense of the world, called the attribution bias. It’s the power of the word because. Any because will do if it helps to lower anxiety but it doesn’t mean you’re correct. What you often need is more information and a more objective view of the situation, which is what therapy is all about. It’s the search for truth, the search for answers.
If you notice a change in your mentality or a lasting change in your emotional state, instead of ignoring it you want to mindfully embrace the feeling and then see if you can tie it to some external change in your life. Like we said, this change might not be immediately apparent to you but it’s probably out there. It may just be that your conscious awareness has risen about something that you saw one way, only to start to question it, and you are trying to shove that realization back down into your unconscious where it won’t bother you. But it’s going to continue to pester you, to flit at the edge of conscious awareness and cause a lot of discomfort until you face it squarely.
Being aware of what changed is only half the battle though. When Freud started psychoanalysis he believed that simply bringing unconscious material into conscious awareness was enough for therapeutic cure, and this idea has lingered. But it’s a prime example of the emperor not having any clothes; there is little evidence to suggest that insight alone leads to cure. To get relief you don’t just need insight, you need action, you need to do something to shape what you are not satisfied with into something you are satisfied with. You need to change the practice of your life. If something has changed, you have to respond by changing too. But you’ll have no idea where to invest your time and energy unless you figure out first what the true source of your distress is. If you can figure this out, you can start to create an action plan that fits your specific situation.