Monday, September 12, 2005

The Physics of Psychotherapy

The Physics of Psychotherapy

I sucked at physics, both in high school and college, and what I remember about the science of physics is vague. The fact that Copernicus’s elegant explanation of the earth and other planets and their movement in the sky challenged my then-atheist brain …how could something so ordered exist without a supreme intelligence?  The laws of thermodynamics.  Words like “vector”, “fusion”,  “quark”.  

Ergo Kelly the psychotherapist, not Kelly the rocket scientist or engineer.  Today I found myself thinking about some of the principles in therapy that I have learned while being a psychotherapist, while doing crisis intervention , while interacting with the residents and medical students who work with us, giving them tips and helping my department function as a training environment.  And  I was reminded that I use a lot of physics dicti in my mental health work.

     Every Action Has an Equal and Opposite Reaction

There are so many therapeutic hours wasted because either the therapist, the client, or a parent doesn’t expect people to act the way they act when something is said or done.  I have literally heard parents say (more than once):  “But he doesn’t like it when I punish him,” or even worse, “He won’t let me punish him.”  Despite media suggestions to the contrary,  you don’t need your child’s permission to do what’s best for him.  And a child  whom a parent simply watches tear the limbs off the cat or purposely break a Mingh vase,  saying simply, “Oh, Johnny, please don’t do that.  Mommy doesn’t want you to do that” will not only keep on doing it, they will do it harder.   I know, this sounds simplistic, but there are otherwise bright and talented people who can’t understand why they cannot reason with a three year old, or thirteen year old.  

The teenage years provide a great laboratory for testing the above maxim.  When I was doing family therapy,  I joked  that I was going to write a book about parenting adolescents.  It would be very short.  It would read, “All parents should sit down their thirteen year old children in the living room and tell them solemnly, ‘Alright, things are going to be a little different around here.  I want you to go out there right now and do every drug on the street, drink as much alcohol as you can, and have sex with everyone in your class.  And I don’t want to see you back in the house on weeknights until 3:30 a.m.  Is that clear?’”  Because then the teenager, insistent that he or she was being completely independent in thinking, would strive every day to do the opposite.

Tongue in cheek, obviously; and not all children do exactly the opposite of what their parents say.  Some are bright enough to realize that such a tactic puts them firmly under their parents’ control,  obliging them to wait until they know what their parents think to decide what to do.  And some are the kind of kids that don’t tend to end up in therapy, who catch on quickly what’s good for them and what’s not.  

     The Universe Tends Toward Disorder

That reassuring notion that reminds us that we’re all headed for hell in a handbasket, barring a miracle . 

From the tiniest organism to the largest galaxy, everything is pretty much falling apart.  Our bodies begin falling apart shortly after they’ve grown to their full potential….around age 25, decay sets in. 

For families, the above maxim has obvious implications.  Once again, you cannot expect children to parent themselves.  Just as it takes work to reverse disorder in any system, it takes work to discipline.  It is going to be hard for you.  This is another thing young parents sometimes have a hard time accepting.  

One of the saddest scenes to happen in a family (and I’ve seen it happen more than once) is to see an adoptive family reject, or to be kinder, give up on the child they’ve adopted.  “We bit off more than we could chew,” “He’s not happy here, so he must not belong”, “We’ve done everything for her and she hates us anyway,” are things I’ve actually heard (keep in mind that, by virtue of working in crisis settings, I would not see the majority of adoptive families who do very well).   All of these notions stem from a total lack of knowledge about the Law of Entropy, or at least its application on human beings.  

You bit off more than you could chew, did you?  This gem, said right in front of the adoptee, came from someone who specifically chose a handicapped child to adopt.  Not only were they frustrated with the amount of time and attention he needed, they were also na├»ve enough to believe that he  would immediately bond with them, although he’d lived in an institution for seven years.  They were incensed that he missed his lifelong friends.  They were incensed when he misbehaved—not out of righteous desire for him to do better, but because they considered it a personal attack.  “He’s not grateful.”  Newsflash: in the words of Rosalie Sorrells, author of The Hostile Baby Rocking Song, “[Children] don’t care what you say.  They don’t listen to you.  They will not listen to you until they are 35.”   (Which is why reasoning with kids instead of doing parenting ---loving them, disciplining them,  reinforcing the behavior you want and extinguishing the behavior you don’t want—doesn’t work).

“He’s not happy”.  Give him a chance!  You’ve only had him two weeks.  He’s just gone through a pretty big change.  Another news flash:  kids from troubled environments aren’t happy all the time.

“She hates us.”  See Rosalie Sorrells quote above.  So what???  Were your parents your favorite people when you were fifteen?  Is it possible the word “hate” may have cropped across your mind, if not your lips, if  your mom insisted on going shopping with you and your friends?  Told you you could not date the neighborhood hoodlum?  Actually, for once, followed through on her threat to get rid of the TV if your grade fell?  

The universe tends toward disorder.  Babies do not come into this world the innocent beings Rousseau painted; they have their own personalities, traits and will.  And without loving behavioral shaping….as well as parents who don’t expect them to be saints right out of the box…..they too tend toward disorder. No doubt this is hard work for the parent.  But it’s not the kid’s job to make it easy.

     You can’t create something out of nothing, and you cannot turn something into a different thing.

Matter is matter.  You can rearrange it, you can melt it or freeze it, you can shoot it up into space. You can mix it with other things to make a third thing. But you, with your limited human abilities, cannot create more of it or less of it, or give it a different composition.  If you have a certain number of molecules of gorp, that number of molecules will always be the same, even if they are mixed with something else or in five different places after you’ve worked your magic on it. You simply cannot make more gorp.  

This has a lot of implications for therapy.  If you phrase it, “You can’t do the same thing over and over and expect different results”, it applies to professionals who are sabotaging their own career through bad habits; to substance abusers who insist they can “handle” their drug of choice; or to codependents who are sure that if they yell loud enough or plead sweetly enough a substance abuser will stop using.  Sometimes when I’m sitting with someone who is truly in anguish in one of our interview rooms at the ER, I’ll get a picture in my mind of him or her as a little kid with a big top hat, bow tie, and wand, frantically waving the latter to get something to change into something else.  As a clinician, my job is to get them to put the wand away and figure out how the “trick” is actually done.  In other words, they’re going to have to work, and they’re going to have to learn something different.  

A lot of depression results from frustration at trying to thwart this physical maxim.  Seligman’s “Learned Helplessness Theory” postulates that we begin to feel helpless when we receive “punishment”, or painful results, over and over again as a result of a repeated behavior.  Since helplessness and a feeling of hopelessness are classic symptoms of clinical depression, there are theories that postulate depression sometimes comes from learned helplessness.  

There are probably many other things in physics that parallel human behavior.  But it’s late, and I get up early.

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