Yesterday I was getting dressed in the locker room at the YMCA after swimming. I overheard a conversation taking place between two guys who obviously knew each other. One was upset with his son-in-law.
He’s been complaining, on and on and on, about the fact that the school next to their house has put up a new playground right next to them, and of course there’s a lot of noise, you know, kids playing and yelling. But he doesn’t do anything about it. He’s just pissed off about the school doing that. He just complains. So I say, ‘what do you expect, it’s a school? When you moved next to a school, didn’t you think this might happen?’
The other guy echoed the first guy’s attitude.
Yeah, that’s what schools do. They have children, and lots of noise. Why doesn’t your son-in-law talk to the school, see if anything can be done? Maybe they can put a wall up or some hedges or bushes or something?
Then the first guy, with exasperation, continued:
Yeah, I’ve told him things like that. But it seems like he’s more interested in complaining than in doing anything about it. So I just told him, ‘suck it up,’ ‘accept it,’ ‘let it go,’ ‘live with it.’ ‘It is as it is.’ Sometimes you can’t do anything about it.
I just sat there listening to this wonderful and rather typical episode of “locker room therapy.” One guy shares a problem of daily life with another guy, who typically agrees and validates it. The first guy gets to vent, receives a hearing, and maybe they do a little problem solving together. The wisdom of locker room conversations. They usually don’t go very deep (though sometimes they really do!), but they represent one way to get some help with emotion regulation in daily life. And they are guided by the same principles that guide the DBT therapist. It goes on all the time; in locker rooms, barber shops, at the dump where you take your trash, at a diner in the morning, at a bar at night. A lot of men get help this way.
In this conversation, the father-in-law laid out the problem faced by the angry, complaining son-in-law. The other guy immediately went after solutions to the problem, suggesting that the son-in-law could push the school for a solution, perhaps put up a barrier to block the sound. It wasn’t a bad direction to consider, but as it goes with locker room therapy, it was dropped in the next statement. The father-in-law quickly pivoted toward the Acceptance Paradigm, going down the road of “suck it up,’ ‘let it go,’ and ‘live with it.’ Of course that can be incredibly helpful, not easy to do, worthy of consideration, but naturally it too was dropped in the next comment. They weren’t really trying to come up with solutions for the son-in-law. The more immediate function of the conversation was to connect interpersonally within the locker room space, and for the one guy to express his frustration and receive some validation from the other guy. Time limits these therapeutic conversations as both guys needed to get to work. But had they taken the third direction laid out within DBT, the Dialectical Paradigm, they might have noted that 1) the son-in-law’s frustration and anger were understandable, that 2) the school’s construction of a playground was understandable, that 3) there was an understandable collision between the two, and 4) perhaps a creative synthesis could be found that includes both agendas, includes acceptance and change, and that involves ongoing movement toward a resolution.
What if the two guys wanted to seriously come up with a solution for the son-in-law, using Change, Acceptance, and/or Dialectics; i.e., whatever it would take? That’s where it comes in handy to know the five principles, or guidelines, of each. Today I will lay out the five principles of the Change Paradigm. In my next blog I’ll do the same with the the Acceptance Paradigm, and following that, the Dialectical Paradigm. In future blogs after these, we will consider one dead end situation of life after another, bringing with us the three paradigms and fifteen principles.
Change Principles (derived from Cognitive-Behavioral Therapy)
- Direction
- Force
- Perseverance
- Intelligence
- Technique
Direction
Sometimes we get lucky, and a problem is solved for us, almost without effort. But most stubborn problems need to become the focus of our deliberate attention. We decide to change things. To do so, it helps to start out by stating the problem, and envisioning a positive outcome. Maybe the problem is intolerable conflict in the family; the positive outcome would be a family atmosphere that is safe and trusting, with greater harmony, where each person can thrive. We start at point “A” and we try to envision our destination, point “B.” We “lock in” on the destination, the way a guided missile locks on to the target.
We spell out the obstacles on the way to the destination. Those are the problems to be solved. Each one requires attention and focus in its own right. In short, there are usually multiple objectives, or targets, on the way to the ultimate destination, and we take them on, one at a time, in some sensible order of priority. We can’t just convert our conflict-ridden family to harmony, we have to tackle one piece at a time, perhaps starting with creating more harmony and trust between the two parents (if there are two), or with the oldest child, and then move on to building some agreement between everyone. Much as we “lock on” to the ultimate destination, we need to “lock on” to each objective as we go, until we solve it. Some problems with problem solving can be traced to the lack of a specified destination to aim for, a vague definition of the objectives along the way, or the failure to devote 100% focus to each objective.
The nature of the destination, and the objectives, matters. These aims should be compelling, should be defined with as much specificity as possible. “We want a happier family” is nice, but breaking it down to specified objectives is a better way to solve it. “I want my husband to respect me” is a good place to start. To specify just what it means, behaviorally, for him to respect his wife, is more productive in solving the problem. And we want the destination and the objectives to be collaborative, among those involved, including any individual who is trying to help. It is most powerful if everyone involved “owns” the efforts. And finally, the destination and the objectives need to be realistic. Maybe I want to be able to jump higher. If my maximal effort to date has been to clear four feet, and I set my goal to be seven feet, all the problem solving in the world is likely to fall short. On the other hand, we want to reach for the stars (those stars that might conceivably be within reach).
Force
Having determined a direction, we cannot bring about change in a stubborn situation without requisite force. The failure to solve a problem often results from a failure to generate sufficient initial force toward solving it. We typically need 100% devotion and determination to get to the destination, and so solve each obstacle along the way. Even 90% might be insufficient. How to generate that force varies from person to person and from situation to situation. Within the practice of DBT, when trying to generate sufficient force, or commitment, from the client, we turn to several factors that are relevant to any problem solving. First, the person has to see that the specified change is in his/her best interest, or even necessary to one’s well being. Second, making a public declaration of one’s intent to change, made to a person or people who matter to the individual, can help. Third, being attached to someone who cares about the change can matter, which may require strengthening that attachment. Fourth, understanding the “rules’ of life—why this particular change will lead to more desirable outcomes and the failure to change will lead to negative outcomes—can help to generate force.
Within DBT there are several formal “commitment strategies” used by the therapist to strengthen the client’s commitment. These can be adapted to help any of us strengthen our commitments. We can weigh the pros and cons of making a change. We can recognize each step in the right direction, even mini-steps, and find ways to reinforce ourselves for those steps (e.g., stars on a calendar). We can try to make a huge leap, going beyond what anyone thinks we can do, or we can decide to take baby steps, succeeding at each one and getting some momentum. We can keep reminding ourselves of our original commitment to a destination or objective, or we can remember other things in our lives that have required a lot or force and that we have successfully accomplished. And finally, we can challenge ourselves by playing the devil’s advocate: e.g., “c’mon, Charlie, you know you can’t do that, don’t even try,” which if done with the right balance might increase motivation.
Obviously, the point is that, no matter how you do it, you generate force, devotion, determination, passion, commitment. You go for 100%, not 90%. You decide to “do it” rather than settling for “I’ll give it a try.’” Failing to attend deliberately to the magnitude of force or commitment can be just as damning to the effort to solve stubborn problems as it is to have a poorly defined direction.
Perseverance
Establishing one’s direction, and generating sufficient force at the outset, has to be followed, in most cases, by momentum, endurance, and often “blood, sweat, and tears” shed over time. Without attending to this, we may have a great start which then dissolves as the battle continues. We get distracted, or frustrated, impatient or demoralized. Perseverance can’t be taken for granted; we have to build it, and often to resurrect it. We need to build in whatever structure and support is needed to enhance perseverance. We may benefit from some kind of system of ongoing accountability where we keep track of our progress, review it, and make adjustments. Having a person who plays the role of helping us stay on target, an “accountability partner,” can help. We should assume from the start that we will drift, we will fade from our initial efforts if they don’t produce quick success, and have a plan to address it. Within DBT’s treatment program, this is accomplished by: 1) having regularly scheduled weekly meeting with a therapist who serves as an “accountability partner,” 2) filling out a “diary card” every night on which we record our target-related behaviors of that day, and 3) sharing that diary card with the therapist every week to begin the session. In our lives, we need equivalent supports and mechanisms to keep us on track and maintain our momentum. We might need to keep a diary, to keep track of our efforts on a calendar, and to establish an “accountability partner” of some kind. Like a marathon runner or someone trying to keep up an exercise regimen, we need periodic recognition, reinforcement, and cheerleading from someone outside ourselves. We know the term “self starter.” We need as much focus on being a “self-continuer.”
Intelligence
Direction, force, and perseverance are necessary but not sufficient to solve stubborn problems. Brute determination and force are typically not enough. Obstacles arise every time we try to change a stubborn behavioral pattern of our own, of someone else, of a system. We can count on it. Actions elicit opposite reactions. Things get complicated. We have to proceed strategically, with intelligence. Specifically, this means we need a system to assess the obstacles, a way to convert the assessment into a formulation, and have the kind of formulation that leads to interventions. Within the practice of DBT, we repeatedly engage the patient in a process of behavioral chain analysis as an assessment tool, from which we develop a behavioral case conceptualization, and from this we derive a treatment plan.
There isn’t one formula for this, but we do need some way to step back, to consider the obstacles, to evaluate our failures, and to come up with intelligent ways to proceed. It will most likely be a trial-and-error process, in which we try this, try that, modify this or that, and eventually figure out what works. If we don’t have a “road map,” where we can map out where we are going, what gets in the way, and where we can see the other ways to get where we want to go, we are stuck. Without it, we are shooting in the dark, relying on sheer force, luck, and prayer. We might get lucky, but usually not. The parent concerned about her drug-using teenager will have a destination, may have objectives along the way, is driven with maximal force and perseverance by the attachment and the pain, but after multiple appeals, demands, inspirational talks, and limit-setting doesn’t work, the parent needs a road map of possibilities. He or she has to bring together knowledge of that child, an informed understanding of the process of addiction, and perhaps an understanding of the family system and of the child’s peer culture. So often, the failure to achieve one’s destination can be traced to the paralyzing experience of running out of ideas, running out of a bigger way to think about the problem, and thereby running out of alternative pathways.
Technique
The individual that engages with intelligence arrives at hypotheses, solutions, and interventions to implement the solutions. But this then requires the fifth change principle: Technique. We have to have the know-how, have the skills within our repertoire to carry out the indicated plans. In treatment, this means that the therapist has to master the treatment strategies and intimately understand the skills. In “real life” it is the same: we need to have the capabilities to carry out what is needed, and the more we understand what is required and how to do them, the better. There are strategies and skills associated with problem solving—with changing interpersonal situations and changing our emotional responses—and we might need them. We might need the skills associated with acceptance—how to “let go,” to be in the present moment, and to embrace what is rather than always pushing for what could be. Some of us self-sufficient types might need to learn to ask for help rather than to go it alone. I am reminded of a very capable woman whose beloved son decided to transition to being female. After the initial shock and pain, she began to study, and to attend courses, about the transgender process and community, and she took on the task of learning to relate to her daughter in ways that would facilitate their ongoing relationship. Perfectly defined direction, maximally engaged force, extraordinary perseverance, and applied intelligence, will fall short in the face of a stubborn predicament if the needed technique isn’t brought to bear. We usually need all five principles in action.
In the next blog we will take up the Acceptance Paradigm, which is extraordinarily helpful in augmenting and balancing the Change Paradigm, especially when problem-solving alone is insufficient to solve the problem.