Change a Life
Christian Jonathan Haverkampf, M.D.
Psychotherapy should aim at changing a person’s life, so that values, needs and aspirations can be fulfilled, and more happiness be achieved. Unfortunately, many psychotherapeutic approaches do not try to reach this goal, but are aimed at functioning, which reduces the humanity, individuality and autonomy of a patient.
Change begins with an understanding that goes beyond a model that focuses on simplistic stimulus-reaction interactions. ‘Issues’ are what leads to change, and it is important to understand them in the context of the individual basic parameters, such as values, needs and aspirations. Using communication to shed light on these issues and help the patient separate the own issues from those of others is an important process in psychotherapy.
Resolving issues means overcoming own fears, integrating pieces into a life story, being true to one’s values, interests and aspirations, and developing a healthy sense of the past and the future. Communication is the instrument that can accomplish this.
Keywords: change, psychotherapy
Many people feel quite helpless when they have a sense that they have to resolve ‘issues’, and it never fails to amaze how long some people suffer their ‘issues’ before they finally get some help. Often, there have been great personal sacrifices, including losses of relationships and jobs, as a consequence of these unresolved issues.
Many people live their lives driven by their issues rather than by things they truly value, want and need in life. This leads to unhappiness and not being able to reach one’s potential. However, issues are not necessarily bad. They can be the beginning of a journey that leads to change. Thinking things through and emotionally connecting with oneself usually helps in bringing about and completing personal change.
Change is the result of something being communicated to the person where changes happen. It can happen from a meaningful message received internally or externally. An internal change is when the person develops an awareness or insight which did not exist before. This requires that new associations are made which is linking some existing information to another, but at the same time the result of some relevant information which led to the link. If there is no new information nothing changes. Thus, whether we are looking at internal or external communication, the communication of meaningful messages, message which appear relevant and can induce change, is required for change. Furthering communication within and without oneself is thus an important mechanism to bring about change.
To continue life requires information that is meaningful, and which helps the organism to adapt to the environment, fulfill its needs and wants, and change in novel ways. Life thus involves change all the time. At the same time, it is important that change is selective, while not changing what works. This is what information is needed for, to enable the organism to select what to retain and what to change.
The transmission of information is thus something organisms engage all the time to survive. Single cell organisms are inconstant communication with their environment, as well as connecting their cell components internally through communication processes. But communication is a process for the exchange of meaningful messages. Whether it is a mother returning a baby’s smile, a touch with the hand or information on a new business innovation, all this can only make sense and lead to meaning if it is communicated. Information makes things both stable and open for change, but it is communication which makes new information possible and maintains life.
An ‘issue’ is something that needs to be looked at. When a patient talks about an issue that means it is something that gives rise to discomfort and requires some communication about it, whether internally, in the sense of thinking about it, or externally by communicating with others about it. Often, when something has become an issue, a patient may doubt that he or she can resolve it quickly. This means there is some perceived barrier or hindrance to an easy solution. One reason is that communication is no longer viewed as effective, which should be a primary target in therapy. Helping the patient to feel more efficacious in the use of communication internally and externally can bring about significant change.
The presence of an issue also means there is a conflict. Emotional conflicts and conflicts with a basic value, needs, interest or aspiration can lead to greater issues. If we live in a mythical happy place, where we can pursue what we truly want and need, we would not have any ‘issues’. On the other hand, it would probably be a dull and boring place, because having issues is a by-product of the capability for change. The objective of therapy is therefore not to eliminate all conflict, but to help individuals identify and work with conflicts, which can then lead to change. Psychotherapeutic models, on the other hand, which do not help patients solve conflicts may be less likely to bring about change.(Haverkampf, 2017)
As we grow older, many of our earlier strategies that seemed to work in getting what we need and want in the past no longer seem to work. We need new strategies, which might include anything from the way we interact with others to how we identify what we ourselves truly value and want in the world. Often, we might think that we know what we want, only to find on deeper reflection that we are trying to please someone else. Living with other people means humans are not disconnected from the wishes and expectations of others, particularly when we feel that we are dependent on them for something we need. However, people often misinterpret the expectations and wishes of others. It is easy to project one’s own wishes, expectations, needs and aspirations into other people. Unless one can mind read, one does not know what another person wants. Often, even the people themselves do not know what they want, so how could one know this about them. This does not mean that different individuals do not have several values, expectations and needs in common. Communication with oneself and others helps to get insight into these, which then makes it possible to develop strategies that work for oneself and avoid major conflict with others.
Strategies that really work mean exploring those basic parameters of oneself and others at greater depth. For example, if a partner gets upset because the other partner is meeting others on a social occasion, it usually does not help if the other partner promises to no longer attend social gatherings. This could lead to considerable unhappiness and resentment. However, talking about the real issues, such that one partner has fears of being abandoned, can help find solutions that help both. Of course, some work with a therapist could be helpful if those feelings are unrelated to the relationship. Ultimately, it is communication with the partner, another person or a therapist which resolves the situation and helps the individual with the feelings of abandonment resolve them.
Strategies that play a direct role in allowing an individual to bring about change internally and in the world are communication strategies. (Haverkampf, 2010a, 2010b, 2010c) Thus, working with communication, whether in a therapeutic setting or in any other area of life, can lead to profound change. Important is to become aware of communication patterns, their use, and the reasons for using them. This insight allows to bring about change.
Everyone has ‘issues’. Realizing that it is not just oneself who has them, but everyone else as well, is an important first step towards a better interaction with the world. It is a feature of life that things are probably never fully ‘in sync’. Since people and their environments are changing and evolving all the time, there are adjustments needed everywhere to adapt to the new reality. Mostly these are learning processes triggered by signals that one has to learn something. Having an ‘issue’ is such a signal. However. For some reason it does not lead to a learning process, but things get stuck. Everyone has a resistance to change in some areas, which is necessary for a certain degree of stability and continuity. However, if an ‘sue’ is interfering with life in a significant way, and possibly also with the life of others, there is an increased pressure for change. If this pressure is resisted because of fears or anxiety the pressure goes up further and symptoms of anxiety or depression, for example, can be the result.
Since humans are receptive to how another person feels, one will pick up the frustration, anxiety, anger, hopeless ness and so on of a person who is feeling these emotions because of an unresolved issue. Since one only perceives the emotion, but it is more difficult to see and understand the issue, the brain fills the gap by seeing itself as the source of these emotions. The consequence is that one feels the emotions associated with an ‘issue’, and one feels one has an issue. However, since this is not the own issue, there is no way it can be resolved by oneself. So, it is interesting to see how the easier communication of emotions than of thoughts can lead to another person experiencing to have an issue. Emotions very easily transferred because the repertoire is limited and largely hardwired. One does not have to talk about emotions to be able to experience them.
Feeling sad or angry when talking to another person may mean that unpleasant experiences from one’s own past are triggered, but it could also be the case that the other person experiences these emotions, which are then felt by anyone he or she talks to. Being able to separate one’s own emotions from someone else’s is an important step in regaining a connection with oneself and the own emotions. Understanding the sources of information is an important skill towards mental health. AN individual suffering from schizophrenia, for example, cannot distinguish between the outside and the inside world anymore. Information is misattributed and one hears voices which are own thoughts or feels external events are inside events. Even in stress, boundaries between oneself and others can break down
Unfortunately, in many interactions, especially fights and confrontations, most people do not really talk about the underlying emotions, such as ‘hurt’ and ‘disappointment’, but about the issues on the surface. “You are wrong about how to select our kid’s school” “No, you are” etc. The underlying issues may actually be the hurt experienced from bullying at school in one parent’s past experience and the anger from never being good enough for one’s father in the other parent’s pas experience. Only when talking about the underlying ‘issues’ is a real resolution possible, which may require a third person observer, such as a therapist or a very good friend.
Quite frequently, a psychological issue creates that life will improve if a simple ‘solution’ is found – even if the path there leads to misery for oneself and others. ‘Dealing’ with it in a constructive way, on the other hand, would mean excepting the event and seeing it as something that happened in an interconnected world. One may not want to reevaluate one’s own counter-productive behaviors and actions because that may mean having to face the bad experiences and bad treatment one has suffered in the past.
An important realization is that people are hurtful mostly because of their issues and not because one has done something wrong. Victims of crime often feel responsible or guilty and wonder if they could have done something different. Arguably the best and at the same time least satisfying explanation why one became the victim of a crime is that one was in the wrong place at the wrong time, and there was no way of knowing the right place and the right time. Individuals who commit some of the most severe crimes, such as rape or murder, unless they are suffering from hallucinations or other serious mental health conditions, mostly have defects which lower their ability to read another person’s emotions and the pain they are causing. A true sociopath, for example, may seem to be empathic, but one realizes after a while that it is mostly learned behavior. Fortunately, these individuals are very rare, and most people with issues have the ability to be empathic and connect with themselves and another person emotionally. A partial disconnect often results from a combination of stress, feeling overwhelmed and helpless, which cause a withdrawal from oneself and other people.
It is impossible to force someone to face up and deal with their issues. However, dealing with one’s own issues and feeling better and happier has in many instances provided a friend of partner to do the same. Clearly separating between one’s own and someone else’s issue also makes it easier to suggest to that person to get help and do something about it, because is pointing at an unresolved issue and not saying the other is a bad person.
Many people are afraid to deal with their issues. We all see our issues – on some level. Many people are not aware how their past life experiences are still controlling their actions and interactions today. Unfortunately, the exclusive focus in many places on cognitive behavioral therapy models leaves out what we learned from psychodynamic psychotherapy. The past matters to the extent that it has emotional significance to us because our brain associates situational memories with emotions. It makes sense for the brain to have this process built in, because it protects one from getting repeatedly into situations which are hurtful or harmful. However, this works best for normal everyday situations and situations that do not require complex understanding. For very traumatic rare events or situations that have a high degree of complexity, it may not work. In these cases, one needs to use conscious thought processes to provide information to the emotional centers of the brain which can then escape the vicious cycles of anxiety and other stressful emotions.
Awareness of the past is important to see and feel the differences between the experience in a situation or place in the present and an experience in this past. It is not necessary to retraumatize oneself or re-live an event, which is impossible in any case. However, it I impossible to remember what made someone happy in the past, and what the values, dreams and aspirations were. Just getting in touch with that side of oneself and connecting with the thoughts and things that could induce happiness and contentment is often a major relief to a patient and brings about a major change, because it means plugging into something positive which is at the same time close to the experience of the self and stable over time. The next step is dissociating what happened from the self not in a pathological but constructive way. This requires seeing that the other person has an issue or some defect, not in the form of an excuse, but to draw a firm line between oneself and the other.
A past trauma can also be a mental health condition, such as episodes of depression or the often long and tortuous journey through untreated bipolar disorder or borderline personality disorder. In these cases, it is also helpful to connect with one’s emotions and thinking more fully, especially when mood disturbances cause negative feelings to seem more relevant and negative thoughts become more prominent in ruminations.
Humans need the sense of wholeness about the story of their lives. ‘Things have to make sense in the greater scheme of things’, and especially so does one’s life. However, this also requires that we integrate our life experiences into our mental representation of our life’s narrative. We can do this by talking about our life with someone else, such as a therapist, who can provide feedback on our story making process.
Having an explanation for one’s life gives a sense of security and we feel connected with life and other people. Purpose and meaning connect us with other people. When communicating with other people a purpose connects us with them and ourselves. Having a purpose means never feeling alone, because there is always something that connects us with the rest of the world. Thus, not only is meaning gained from communicating with others, communication is easier when there is meaning. Giving meaning to something thus makes it more connected.
The self itself has no specific attributes, but one can have a sense of meaningful when experiencing oneself. This connects the self with the world and life in general, which can bring more happiness. Since Narcissism is essentially a partial disconnect with oneself and others and a perceived lack of meaning in the life story, reconnecting can be helpful in a case of Narcissism.
Real change means it fits into the dynamics of one’s life over time. If change does not fit with one’s basic values and aspirations, it will not last long. However, identifying one’s values and genuine interests requires accepting all facets of one’s past life because it is also in the more difficult moments where they shine and become apparent.
Values, interests and aspirations make the sense of self also more valuable because one feels more of a sense of purpose in them. These basic parameters set some of the basic building blocks as perceived by the individual. When they are communicated they can shape some personality traits, while these personality traits can also have an effect how individual see themselves. Values, needs and aspirations are relatively stable. Linking in with them can stabilise the world on the inside and as a result on the outside.
It is important that these central parameters do not need to change. What often needs to change is how on communicates with oneself and others and how they are acted upon. The first step is to identify the basic parameters. They usually can be identified by a closer look at how an individual communicates with oneself and others. This can happen in therapeutic settings or in other types of meaningful exchanges. In another step, which can run in parallel, it is helpful to use this information to also explore and improve the own communication patterns and styles.
The past is the past and the future has not happened yet. Dealing with one’s issue should not retraumatize or make someone feel worse. Rather, it is about taking a more reflective look at what happened. If others do not treat us well, we often tend to start with ourselves, asking if we did something wrong. Children see the world as a magical place with themselves at the centre and equipped with magical powers. This often translates into adult life as seeing oneself as the cause for the emotional states of others. However, in reality a far better explanation is that we all are individuals with ‘issues’, the other person and ourselves included, and that we only have some direct control over our own emotions. A human being who deals with her or his own issues achieves greater happiness and makes the world a better place for all of us.
Different approaches in psychotherapy focus on different places on the timeline. Psychodynamic psychotherapy puts a greater emphasis on the entire timeline than cognitive behavioural therapy (CBT), for example. Communication-focused therapy (CFT), as developed by the author, emphasizes internal and external communication processes in the present and past, and regards time as more secondary. Change does not depend as strongly on the timeline as one might think. For example, a trauma that was experienced many years ago may become reactivated with strong emotional states by something minor experienced in the present. As long-term memory can be quite immune to time lags, time in itself is a weak predictor for how strong a particular symptom is, and there also are no specific cut-off values for time.
Resolving ‘issues’ brings about the opportunity for change in how one interacts with oneself and the world. This can lead to changes in many different areas of life, including material changes, relationship changes, and so on. Changes, particularly the larger ones, can cause their own issues, but any time an intrapsychic issue is resolved, awareness and insight is generated, which brings about positive changes in perspective, approach, strategy and so forth. This leads to real change in the life of the individual.
Change, if it benefits the individual, should be lasting. Changes in perspective, for example, have a lasting effect, if they bestow a benefit. It is impossible to forget a new viewpoint, and one will usually not shift it as long as it is useful. The same applies to patterns of interacting with the environment and oneself. Only if something works even better is there usually a change in one’s communication behaviour and styles.
Since communication is how humans satisfy their needs, interests and aspirations, focusing on it in a therapeutic session can be helpful in getting results more quickly. Psychotherapy was developed as the ‘talking cure’ and that is what it still is. However, communication happens via many different channels, verbal and non-verbal, where the latter ones make up a major part of the information flow, and it is important to include them all in the work with the patient.
Dr Jonathan Haverkampf, M.D. MLA (Harvard) LL.M. trained in medicine, psychiatry and psychotherapy and works in private practice for psychotherapy, counselling and psychiatric medication in Dublin, Ireland. The author can be reached by email at jo****************@gm***.com or on the website www.jonathanhaverkampf.ie.
Haverkampf, C. J. (2010a). A Primer on Interpersonal Communication (3rd ed.). Dublin: Psychiatry Psychotherapy Communication Publishing Ltd.
Haverkampf, C. J. (2010b). Communication and Therapy (3rd ed.). Dublin: Psychiatry Psychotherapy Communication Publishing Ltd.
Haverkampf, C. J. (2010c). The Lonely Society (3rd ed.). Dublin: Psychiatry Psychotherapy Communication Publishing Ltd.
Haverkampf, C. J. (2017). CBT and Psychodynamic Psychotherapy – A Comparison. J Psychiatry Psychotherapy Communication, 6(2), 61–68.
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