From Both Sides of the Couch

A therapist reflects on her time with patients, and her time as a patient.

Change: Why Is It So Difficult?

A therapist speaks to why change has to be so hard.

     Change is hard. Small changes are hard and big changes are even more difficult. In the past, I was terrified of change. Giving up all of my self-destructive behaviors; changing them for more productive ones set off my inner alarm. I was sure nothing would be as effective as cutting, as starving, as my addiction to drugs — they were all used to numb myself.
     The first change I had to make was to allow myself to feel. In my early twenties, when I had just begun psychotherapy, my therapist asked me what I was feeling and I replied, "Feeling, what's a feeling?" I had grown up in a household where feelings weren't allowed.
     Instead I began cutting instead of feeling and because I was so afraid (Aha — a feeling!) of changing, I hid that behavior from my therapist. The cutting (which took many years to give up) was followed by the anorexia. I found starving, being able to count my ribs and admire my protruding collarbones and hipbones a great distraction from my feelings. Constant, gnawing hunger is not a feeling, but focusing on that pain in my belly meant I didn't have to acknowledge my growing depression and anxiety, and the fact that I was slowly killing myself.
      Any suggestion that I eat something, anything sent me into a tailspin. I was in love with my many rituals which centered around food, eating, mirrors, exercise and other aspects of my anorexic life. My day consisted of back-to-back rituals performed with precision in order to keep me safe. Any hint of change shook my world.
     Only through writing, a profession which requires concentration, creativity and brain power - which starving drained me of — was I slowly, reluctantly able to loosen the grip that anorexia had on me. I started my first essay which detailed my struggle with this illness early in 2007, while I was a patient on an eating disorder unit, and it was published in an anthology with the theme of illness and healing later that same year.
     Still, change was slow to come and I was stubborn. There were times that I relapsed back into anorexia, obstinately believing that I could starve myself and write as well. I wanted both to be thin and to be a writer so badly that I tried again and again, restricting and with time my ability to string together words to make rhythmic sentences that flowed, disappeared. As the numbers on the scale decreased, so did my facility to make music with words. I was not ready to acknowledge that writing and restricting were contradictory in nature.
     The concept that change is terrifying is hammered home when I see my patients struggling to change. As I did, they cling to self-destructive and negative behaviors because the actions are so familiar and safe to them. It's hard to convince them that their lives will be improved if and when they find something, some alternate way of behaving that they feel passionate about to take the place of their rituals.
     My patients tend to hang on to old behaviors simply because that is the way they always did them. Eschewing new approaches of proceeding with tasks in their lives, they often choose not to try, to hide in the past. Again, it is hard to persuade my patients to endeavor to make an adjustment in the way they live.
     "The key word is process," I often tell them. "Nothing worthwhile happens overnight." I try to prepare them. "Change is hard because change is scary, even change for the better. Varying your routine can be frightening, but we'll do it in baby steps, together."
     Some of the patients begin to take those baby steps, some of them shrink back even further, alarmed by my words. I find myself feeling sad for these men and women. They remain paralyzed by their fear and for right now, no amount of coaxing can encourage them to peek out of the hideout they have created for themselves. Perhaps at some point in the future there will be something alluring enough that will entice them out of their shell.
     Still working on changing, I continue to have my favorite (read that "safe") foods, but my list is expanding. I recently had a slice of chocolate cake in celebration of my birthday. I gave up the scale that took up a lot of space in my bathroom, but once a week or so I walk up one flight of stairs to the gym in my building and weigh myself — just to keep an eye on things. But still that's better than hopping on and off the scale ten times a day.
     Change is hard but good. I never want to stop changing, transforming, striving for a metamorphosis.

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Gerri Luce is a licensed clinical social worker who publishes under a pseudonym.

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