Understanding Therapy

Story

Spring was warming into summer, and David and his wife Mia were planning a day hike north of town to celebrate. 

“You’re right,” Mia said on Monday. “The trail up Blackrock Butte is always lovely, but my girlfriends told me about a trail we haven’t ever tried! Don’t you think it would be fun to see Mackerel Falls? It’s only two miles out of town, and apparently the wildflowers there are something else this time of year.” She smiled invitingly.

But David snapped. “You always want to do what you want! It’s like my preferences don’t matter at all!” he shouted. 

Mia jumped, and her smile crumpled. “David, it’s just one hike. We can do something else too. I thought you’d like this one.”

But to David, it wasn’t just about the hike; it felt like a pattern. He shook his head grimly, grunted, and retreated to his study.

The next day, at therapy, David explained, “I don’t know why I overreacted, but Mia can be so infuriating! She always has to get her way. We never do things the way I want. Sometimes I think she only cares about power.”

Dr. Adams nodded, a knowing look in her eyes. “That sounds like all-or-nothing thinking, David. It’s when you see situations as if there’s no room for compromise.”

“But if she doesn’t choose what I want, it feels like she doesn’t care,” David replied. Saying that out loud made David feel he was being a bit unreasonable.

Dr. Adams leaned forward. “I understand. But consider this: Just because Mia suggested a trail you didn’t like doesn’t mean she doesn’t value your preferences. There can be room for complexity. It’s possible for her to want something different and still care deeply about what you enjoy.”

Analysis

By naming a cognitive distortion (“all-or-nothing thinking”) Dr. Adams is engaging in a kind of Cognitive Behavioral Therapy (CBT). Dr. Adams does not mean to attack David for thinking in this way. Nor is the goal for Dr. Adams’ will or rationality to “overpower” David’s will or rationality. Instead, the point is to give David a chance to question his own Default Human Range of Stressors (DHRS) narrative about social rejection – thinking that “if she doesn’t choose what I want … she doesn’t care.”

Reasoning is a Default Human Range (DHR) activity that can provide reliable, net positive pleasure, as hunter gatherers needed to reason about social organization and about survival activities. (Just because they didn’t have advanced math or propositional logic doesn’t mean they couldn’t reason in the informal way that non-logicians do!) In this case, David’s reason is able to reinterpret or reframe the situation, getting away from this harmful narrative. By proposing an alternative interpretation (“that’s all-or-nothing thinking”), David can literally breath a sigh of relief, recognizing that his DHRS narrative is “just a narrative.” This only works if David is on board with the “all-or-nothing” label for this interaction. If the therapist finds that David doesn’t agree with the label after some discussion, she might have to try something else.

In this story, the point of Nexus State Theory is to help David understand the purpose of the therapy. David should understand that he is the consumer of the therapy and, as such, his Reason arrow (not Dr. Adams’ Reason arrow) determines what works for him.

David should also understand that his DHRS narrative may be unhelpful – a realization that he has to come to intuitively. Ultimately, Reason cannot “prove” that his narrative is “wrong” in the manner of proving a math theorem. Instead, David’s brain can decide that for itself by entering a DHR state. If CBT doesn’t help David in this case, he could try a more Mystery-oriented or Awareness of Emotions-oriented narrative instead – options which we will discuss later.

Empowered by Nexus State Theory, David will be better able to discuss what he wants with his therapist and to understand what his therapist is telling him in return. He will be more likely to comply with his therapist’s requests (when it’s working for him) or to explain what isn’t working (when it isn’t working for him).

Without Nexus State Theory or a similar understanding of therapy, David may be hindered from adopting therapeutic approaches because he doesn’t understand what’s supposed to happen and how to assess whether it’s worked.  For example, mindfulness meditation could invite David to close his eyes and attending to his breath.  What’s supposed to happen?  Is the idea that by blanking his mind, David will feel better in that moment?  Is he supposed to feel a blissful mental emptiness – and if he doesn’t, does that mean he is “bad at meditation”?  Nexus State Theory frames what’s going on as building mental and emotional connections to a nexus state – by entering an autonomous DHR state that involves breathing and resting. Thus, the connections are “Awareness of Breath arrows.” From this state, David will be more relaxed and have more self-control.

Building these connections takes time, so David can’t expect it to work right away – any more than physical exercise works right away. Like David’s Reason approach which questions the all-or-nothing narrative, the Awareness of Breath approach can help him to denarrativize his DHRS state by letting go of thoughts.

Cognitive behavioral therapy (CBT) asks David to reason about his concerns, building his connection with a nexus state via a Reason arrow.  What happens if the reasons don’t make any sense to David?  Will the CBT still work?  I’d argue that since his Reason arrow is in his own mind, David can enter the DHR state only if the reasons make sense to David and not just to his therapist. 

My point is that if David can understand how therapy works, he will be empowered and motivated to make it work for him.  He will be better informed about the kinds of therapeutic approaches that exist and better able to know if they are going well for him.

Vocabulary

  • Cognitive Behavioral Therapy (CBT): A common approach to therapy.
  • Cognitive distortion: in the theory of CBT, an unhelpful narrative – a way of interpreting a situation that is not useful to the client. This is often a DHRS or LL narrative.
  • Reason arrow: a connection to a nexus state state of high self-control or agency. The connection (“arrow”) is powered by one’s rational mind, since reason is a DHR faculty that provides net positive pleasure. This is one of many possible arrows. Later, I will address the Mystery arrow, the Awareness of Emotion arrow, and many others.

Next page: Effort Timing Strategy