The Curse of 'A Christmas Carol'

Lasting change isn't that simple.

Posted Dec 22, 2017

A Christmas Carol is one of my all-time favorite stories. Who could not be moved by such a brilliantly crafted tale of redemption? The story of a cold and cynical heart turned compassionate and kind is nothing short of a blessing of literature, an inspiration of hope, and a curse on realistic expectations of change. 

Unfortunately, we’re conditioned to think of meaningful change in terms of life-altering experience, like being visited by three ghosts who push us through deep tunnels of loss and calamitous life-choices to the brink of lonely death, to dramatize what is really important in life. We love stories about driven or self-obsessed folks who suddenly become appreciative and warm-hearted. We want to believe that if some people would just “hit bottom” and feel badly enough about their terrible behavior, they would start to behave well, as if the devalued self were less likely to fail, abuse, or offend than the valued self.

These myths of transformation, though moving and seductive, distort the truth about lasting change. Falling in love doesn’t make us appreciate other people; appreciating other people makes it more likely that we’ll fall in love. (Appreciation can be practiced and conditioned; love cannot, at least not directly.) We don’t change our bad behavior by feeling bad about it; in fact, we can fully understand the effects of errant behavior only after we’ve changed enough to achieve a more enlightened perspective. (That’s why we can now easily give up denial of the foolish things we did as adolescents.) Except for saints and literary characters, enduring change rarely happens by falling off a horse on the way to Damascus. Perdurable change is gradual and mundane. It occurs by extending, supplementing, and altering the habits that shape perspectives and drive behavior.

I began clinical practice four decades ago, firmly committed to what might be called "A Christmas Carol therapy." Although I didn’t make the conscious connection back then, I searched with each client for the opportunity of a transformative session that would change the course his or her life. And I usually found what I sought. Ghosts of the past (childhood, early relationships, salient choices) illuminated ghosts of the present (dysfunctional patterns of behavior) and foreshadowed the ghost of an ominous future, all of which inspired rapid change in highly emotional sessions. With few exceptions, my clients left therapy transformed.

Because my Ph.D. training instilled the need for empirical verification of practice effectiveness, I dutifully sent each of my clients a series of questionnaires that measured symptoms, relationship satisfaction, and overall well-being a year after treatment termination. To my great shock, the clients who had made the most dramatic transformations in therapy did the poorest a year later. A few were worse off than before treatment. It had to be the fault of the questionnaires! So I tried different ones and persisted in A Christmas Carol therapy for another 10 months. But the results at one-year follow-ups remained consistent: The clients who discovered the most insight and achieved the greatest emotionally-wrought transformation in therapy did the poorest one year later.

For starters, my practice of A Christmas Carol therapy did not account for what psychologists refer to as state-dependent and context-dependent learning and recall — i.e., information learned in one mental state and social context is most likely to be recalled when in that emotional state and social context and unlikely to be recalled in other states and contexts. Yet I fully expected Mr. Hyde to remember what Dr. Jekyll learned in therapy.

Habits Rule

Highly reinforced neural connections are experienced as habits. The brain loves habits because they conserve energy. It stores numerous assumptions about its environment, based on experience, which it uses as processing filters to make tacit judgments and behavior choices. If there is no obvious environmental exception to the string of assumptions underlying a given behavioral impulse, it’s enacted automatically, without conscious thought, emotion, or perception. Researchers describe habits as a series of conditioned responses. By adulthood, most emotional responses and behavioral impulses are conditioned; we think, feel, and behave more or less the same in the same states and social contexts over and over. Both habits and the conditioned responses that comprise them are processed in the brain in milliseconds, thousands of times faster than conscious attention. More recent research suggests that many, if not most of our decisions are made prior to conscious awareness. That’s one of the reasons diets ultimately fail. Before you know you’re hungry, much less that you want a hot fudge sundae, you’re already motivated to consume one.

Once a habit is entrenched, there is no evidence that it can be unlearned. Old rats put in a maze they had not seen since they were pups are able to negotiate its twists and turns, and they can actually do it more efficiently under stress, as conscious decision-making breaks down. Habits rule under stress.

Blue Collar Therapy

Compared to A Christmas Carol therapy, extending old habits and developing new ones is repetitious and sometimes tedious stuff. I call it "blue-collar therapy," due to its factory-like repetitiveness. When it’s been featured on TV shows, the editors had to go through hours of recordings to find the kind of tearful drama they like to show on the air. Oprah Winfrey introduced it the first time she featured my work with clients on her show as, “30 hours of intensive, soul-searching therapy.” It would have been more accurate to say, “Three hours of intensive soul-searching and 27 of repetitious practice.” (Her editors had to work so hard to meld together dramatic footage that I was surprised when she asked me to do another show with different clients.) The “drama” that TV shows like to feature is more about how clients fall into a hole and how bad they feel about being in it, while healing and growth are about getting out of the hole. Blue-collar therapy is developing skills to climb out of the hole and habits to stay out of it.

The most effective way to change our lives is by continually developing new habits and skills, while sharpening whatever old ones we deem beneficial. That can be in athletics, scholarship, appreciation of nature or the arts, or doing psychotherapy. Learning sometimes means rejecting the familiar but more often requires going beyond it. Learning to make big therapeutic changes that will endure over time means going beyond A Christmas Carol type of miracle transformation to focus instead on our smaller habits. Ghosts and catharsis don’t make us compassionate and loving partners and parents. Daily practice of behavior that supports our deepest values does.