Change and Growth: Not All They Are Cracked Up to Be?

Rethinking the goals of therapy

Posted Aug 27, 2010

As metaphors describing what psychologists do, "change" and "growth" reflect an upbeat, all-American credo: Innovate! Expand! But metaphors can be limited and limiting, particularly if they become fetishes. In a culture and in a profession, there is always the risk of certain terms becoming linguistic celebrities; after a while, no one knows for sure what they actually do and why we should care. Change and growth, it seems to me, have attained such status. Just mumble "change" or "growth" and everyone nods knowingly in respectful appreciation, eyes alight, as if these terms really capture the essence of therapy, or life. They don't.

It is easy to see why "change" became a celebrity. America is, after all, "the new world," a young culture ascended from revolution and steeped in an ethos of striving. In the context of therapy, many patients do seek, ostensibly, changes in their lives--to alleviate pain, resolve a conflict, or learn coping skills; to move from minus to plus, as Alfred Adler would put it.

But change as value in itself can become faddism, an exhausting and ultimately vacant addiction--a futile chase of the New and the More. Change, moreover, is no more necessary and useful than its less sexy siblings, stability and continuity. In fact, to observe individuals and cultures closely is to see an intricate dance of stability and change--tradition and progress. This balancing act is an inherent feature of our internal psychic architecture. The psychologist's task is not to deny one aspect of it and glamorize another, but to illuminate and legitimize the whole structure. Hence, waving the sanctified banner of "change" is an over simplification, necessary perhaps to create a "brand" and bring in costumers, but not to be confused with the real task in the therapy room.

As all psychologists know, the human psychological architecture is resistant to change. Psychological systems are characterized by remarkable stability. Compare, for example, psychology to technology. While technological systems have changed beyond recognition over the centuries, the dynamics of human passion, conflict, and anxiety have stayed essentially the same. While reading Shakespeare can shed no light on the functioning of even the most basic of today's technologies, his insights into the human soul still resonate as strongly as ever. Not much change on that front.

Given our change fetish, we may be inclined to think of this lack of change over the centuries as a problem. It isn't. If change were easy, life would be much more problematic than it is now. A system that accepts change too readily will become unstable and incoherent. A measure of internal consistency and stability allows us to develop a coherent self-narrative--an identity. It makes the constructs "I" and "We" meaningful. Setting the bar for change high allows us to filter out psychological noise and protect the integrity of our experience.

In a still broader perspective, psychologists are by and large agents of the status quo, charged with getting people back to mainstream "normalcy." Like it or not, psychologists are sent to the trenches by society as stabilizers, not agitators; and most of us in the profession, even while advocating individual change in our clients, rarely involve them in revolutionary activity. We feel successful if our clients adapt and adjust.

The "growth" metaphor is another dolled up celeb. In class, I try to show my students that developmental processes encompass both growth and decline. Most students, being young and American, reflexively associate development with sunny visions of expansion and improvement. But all development is development. The fetus develops, but so do your ulcers. The journeys into life (birth) and out of life (death) are both developmental. Sunrise and sunset are equally essential parts of the same cycle.

The "growth" metaphor tugs on the capitalist impulse for what is bigger/better while at the same time emanating a spiritualist, comforting New Age vibe. It's a clever slogan. But as a psychologist I must confess ambivalence about growth. Aren't too many things already overgrown?

When I hear "growth," instead of hearing "personal growth," I just as readily think of a tumor. Growth sounds like buzz and hype to me. And perhaps we psychologists need buzz and hype to frame our product in marketable terms, to "grow our brand," to energize the ground troops by providing a vivid guiding metaphor. But in the therapy room, "growth" means nothing without careful and specific qualifiers. Some patients may not want, need, or understand "growth."

When we psychologists think of ourselves as agents of "change" and "growth," we narrow our horizons needlessly. We are in the business of healing and humanity. One size does not fit all. The appropriate metaphors for each client should be allowed to emerge organically from the therapeutic conversation.

Some patients need help resisting change, maintaining balance. Some need to shed excess, lose some emotional weight, descend the mountain, or accept defeat. We need to remember that surrender, decline, stability and continuity are not dirty words; they represent essential life processes to be understood and addressed.

It may be argued that since change and growth have mostly positive connotations in our culture, we should frame everything in those terms. But a tyranny of benevolent metaphors and user-friendly simplifications is still a tyranny. And if everything is reframed as positive, then the notion of positivity loses its meaning. Such insistence also betrays an unwillingness to confront and contain the whole experience of living. Some things, after all, are negative; the meaning of others may remain unknown until late in the game; some burdens are carried without relief or redemption. Life, we must not forget, is a chronic condition; and it's terminal.

Life is not solely, or even primarily, about change and growth. Human existence is marked by an inherent interplay of opposites: courage and fear, give and take, the note and the pause. These dualities, not one-dimensional slogans, are to be engaged in the world, and in the work of psychotherapy.