I recently started a training to learn how to perform EMDR (Eye Movement Desensitization and Reprocessing) therapy which was first developed in 1989 to support those impacted by trauma. I learned about this training from my dear friend and colleague Shayna Lebovic (LMSW) who also practices in New York and New Jersey and specializes in working with children and adolescents. The basic idea of EMDR is that a client revisits a memory that currently causes distress and uses bilateral stimulation, such as eye movements or tapping, while recognizing cognitions associated with the trauma. The person then works toward adopting new beliefs, having identified how the memory makes the person feel and think and what they wish to think about themselves in the future.
Shayna and I attended the training together, and during a little prep session that we had, we discussed what can get in the way of a client benefiting from EMDR: the fear of getting better.
This is a concept often misunderstood; people believe that if someone is suffering, that person must want to get better. Shouldn’t the person wish to end their struggle? Yes and no, readers. Some people who struggle absolutely wish that they can heal and will do whatever it takes to achieve this. The process can be painful, knowing that it can take time and effort. But it feels worthwhile to the individual. Others want to get better, but have difficulty doing so.
“Shouldn’t you want to get better?” or “If you really want it, you’ll do everything you can because it’s worth it.” These ideas are thrown around when describing those engaging in healing or recovery. I call it the myth of motivation; that if you want something enough, you can simply achieve it.
And yet, this ignores the reality of mental health struggles. They are not rational. Sometimes this occurs, yes—people work hard and they heal. But oftentimes, getting better feels tremendously difficult. Not only because getting better is painful; this practice typically involves the individual going against instinct and doing what is uncomfortable or scary. But also because the way of suffering may have formed a habit—especially for those dichotomous (all or nothing) thinkers. Additionally, the person’s healing may lead to a shift in other dynamics. For instance, if the person is the identified sick patient in the family, then the family dynamic will need to shift if there is a recovery. And finally, getting better can be terrifying when the suffering has allowed for secondary gains.
What does all this mean?
1. Change is hard: The idea that someone wants to change and therefore change should be easy implies that one can simply desire a shift and it will come. This is a rational concept, when in reality, human beings are complicated creatures. Someone may want to finish grieving, and yet this does not mean it simply occurs. Instead, efforts must be made and the individual must face what has been lost, what life will look like going forward, how to practically challenge tendencies, etc. To want change does not mean it is easy and to suggest so misses the difficulty the person may experience. Yes, reminding oneself of motivation can be a helpful tool. But it is also helpful to be able to hold the dialectic of wanting change and feeling how arduous this change can be.
2. Habits are tough to break: Many of us appreciate routine. We form habits and connections and these feel safe and predictable. While people suffering may want change, there is also comfort and predictability in suffering and maladaptive behaviors. The person may hate these habits but may also have come to feel safe in these habits. Either way, we must remember that asking someone to change patterns and routines is difficult and takes time and may not be a linear process.
3. Dynamics may shift: If someone has been the identified patient then there may be a fear of changing the system. If a table is missing its fourth leg, people may adjust to this and learn to use the surface, though tilted. Putting in a fourth leg may present as relieving, but also disrupts the system. A family, for instance, may wish for change but then realize that it will require them all to shift and this takes concentrated effort and willingness.
4. Secondary Gains: Secondary gains are the benefits that result without conscious effort. For instance, if an individual must miss school to attend a treatment program, and the person dislikes school, then this has been a secondary benefit—though likely not intended. To get better means that those benefits will also end, and this can be anxiety-provoking. If an individual was to simply say, “I think I need to take time off from work,” others would likely tell them no, or to power through. But if the person was forced to because of a condition, then this desire would be acceptable. For this reason, getting better can be hard—one must let go of the benefits gained that will likely not remain when the healing takes place.
These are among the many reasons that getting better can be difficult. It requires patience and support, reflection and challenge. Instead of saying, “But don’t you want to get better?” one should instead ask, “How does getting better feel? What can I do?”
As we celebrate Chanukah and think about rising up and change—all that came from Hashem—let us remember how we can support our fellow man by not making assumptions, but instead by asking questions and exploring. By garnering the knowledge provided in our community, we can support one another in striving for healing and internal freedom from mental health struggles and “oppressors.” May your Chanukah be about light, gratitude, connecting and healing.
Temimah Zucker, LCSW works in private practice seeing clients virtually in New York and New Jersey. Temimah specializes in working with those struggling with body image, disordered eating, eating disorders and mental health concerns. To learn more or to request a consultation, visit www.temimah.com