Can I Really Change? How Do I?

Born to Grow

Happiness and well-being, then, are realized to be skills to acquire and a path to take, rather than an inviolable nature. Misery is not our destiny.”

If I’ve heard it once over my 25 years of professional practice (give or take), I’ve heard it a thousand times: “I can’t change; that’s just who I am.”

But is there any scientific validity to it?

Therapeutic Example: “Mark”

His name has been changed but the story of the first patient I ever used the mindfulness-based cognitive therapy approach with (before there was a mindfulness based CT approach formally identified, anyway) has much to say here. Let’s call him “Mark.”

I had recently accepted a position at a small private college approximately 1 hour and 20 minutes away from my home. To get away from the job I was in (and poorly suited for) I would have gladly driven twice that distance so I jumped at the opportunity. Since I tend to be on the geeky side, I wanted to use the time to learn some cool neuroscience stuff so I began listening to a series of CDs from the Mind and Life Institute titled “Getting Rid of Destructive Emotions.”

The Mind and Life Institute consists of eminent scientists of nearly every stripe, as well as clinical professionals all in dialogue with the Dalai Lama and other mediation practitioners. I also have a masters in religion. Bingo! Geek heaven for me!

What does science have to do with the Dalai Lama?

I had to find out. And the science was astounding.

Mark came to me at the small private college I was working with, complaining of serious depressive and anxious symptoms including suicidal thoughts. He also had developed trichotillomania — he pulled hair out of his head and eyebrows, leaving unsightly bare spots. He colored in his eyebrows and wore baseball caps to cover up the damage.

Although Mark was very intelligent he was unable to concentrate, remember and learn, so he could not get his grade point average to go above a 2.7 to save his life. He was not a partier then, and is not now. He studied assiduously. Moreover, he reported having suffered with anxiety and depression since about age 10. The family dynamics for this adopted son and his sister were not terrible, but they were not optimal either. Issues are as issues are, and he had them.

The severity of his symptoms concerned me, and I said, “With all these symptoms I think I’m going to have to refer you to our nurse practitioner for some med… .” But before I could get the word “medications” out, he said firmly: “I don’t want any medications!”

At that moment, my scientifically oriented brain shifted into gear, and before I realized it, I said: “Cool! You want to do an experiment with me?” He said, “Sure!”

Oh, no … . Quickly, I realized my mistake. Suicidal thoughts had to be taken into consideration.

So I quickly offered him my services under three conditions:

1. He had to promise me he would guarantee his safety
2. He would see me twice weekly
3. And, if he was not feeling any better by 4 weeks, he would reconsider the idea of medications

I began to teach him what I was learning about mindfulness, and he began to apply a few practices. As I learned, I showed him how to do this everywhere he went. When this happened, he was off like a shot!

Therapy is not about continuing to rehearse what we have always done in order to remain as we always perceive ourselves to have been.”

He practiced 30 minutes per day sitting still. He practiced when he ate meals, when he walked to class, when he drove, when he showered and in the classroom.

The results astounded us both.

His grade point average was 3.2 that semester, 3.5 the next, 3.75 the next, and 4.0 the next. His last semester at college it was a calamitous 3.75. We had seen each other all along, but formal therapy had been relatively brief.

He learned, I learned. He practiced, I practiced. We did so separately and together. And he came to me after it was all said and done and said, “Things with my family are still messed up, but I’m not depressed about it anymore, I’m not anxious like I was and I hardly ever pull a hair out of my head.”

Pardon my language here but I thought to myself: “Holy crap! What have I found.”

All of this prompted me to fly to Harvard Medical Schools’ conference on mindfulness the next spring. I heard presentations form some of the best scientists and practitioners about the research and promise of mindfulness, and I have been sold ever since. This was about 9 years ago. The research studies now are in the tens of thousands, with much more needing to be done.

The Myth of the “Fixed” Self

Usually, we hear that if mental disorders begin in early childhood, they are likely to continue throughout life — requiring medication to keep symptoms under control. And many have said that once personality is developed, say by age 6, it is “fixed.” Is this the case?

The buzz word in neuroscience over the last 40 or so years, as you may know, is neuroplasticity. And this concept states that the brain/neurology changes throughout life with new information and, especially, practices. “The neurons that fire together wire together” and the more frequent the firing the more powerful the action potential. Habits are habits because of this process, and habits also change because of this process.

So just what is this “I” my initial quotation refers to? What constitutes the “self?” Is there something that makes me what I am permanently? These and other questions are not completely understood by science. Religion and philosophy have many answers to them, but none are scientifically validated.

So what does science say now?

An intriguing view comes from the work of a group of scientists involved in the relatively new field of interpersonal neurobiology — and the story of their deliberations on the subjects is fascinating — but here is their current understanding. It can be summarized by a metaphor for “self” I first read in the writings of Stephen Hayes, Ph.D, — the originator of acceptance and commitment therapy. I do not know how he presents this in therapy sessions (but I have my take on it), so with apologies to Dr. Hayes — here goes.

The “self” is like a chessboard.

There are dark colored squares and pieces and light colored squares and pieces, which can move about and create nearly innumerable patterns (and the brain is incredibly complex).

Our brains have 1 trillion cells and 80-90 billion neurons with trillions of synapses. Each of these neurons fire between 5 and 50 times per second — even while sleeping — so these “chess pieces” are continuously moving about.

So on our personal chessboard of the “self,” these pieces and the possibilities of thoughts, feelings, sensations, images and behaviors are truly innumerable. At times, when the dark pieces are “winning” the moment, we may feel uncomfortable. When the light colored pieces are in ascendance, we feel comfortable. But no feeling lasts forever, and with the movement of a single pawn the whole chemistry changes.

The truth is (whether we consciously change anything or not), the chess pieces move; feelings and sensation and thoughts change moment to moment. We can learn to move pieces about to develop in any number of directions. Depressed folks generally and automatically practice depression. Anxious folks usually practice anxiety in an equally automatic way.

Further Defining the Self

The “self” is, as Daniel Siegel writes, the “place of possibilities” with no one single set of behaviors defining the personality any more than another can — within the generally unknown limits of a person’s genetic expression, that is. It is dynamic, fluid and malleable, and this is good news indeed.

Happiness and well-being, then, are realized to be skills to acquire and a path to take, rather than an inviolable nature. Misery is not our destiny.

Therapy is not about continuing to rehearse what we have always done in order to remain as we always perceive ourselves to have been. These perceptions are always skewed anyway and limited by themselves. If this was the case we would continue to feel much as we always have and why bother with therapy or psychiatrists. This old deterministic view does not square well with science. Therapy is about becoming aware of how our minds, our “self”, our chessboard operates so we may accept it as it is, with all of its possibilities, and learn to direct the flow.

Sustained Progress

What about Mark you might ask? Well, I had lunch with him in December 2014 and he reported that his progress has continued. No depression. No trichotillomania.

And he was reading Jon Kabat-Zinn’s “Wherever You Go, There You Are.”

Interested in learning more about mindfulness-based cognitive therapy? Leave a comment below, and lets start a conversation!

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