Why Does Therapy Take So Long?: Examining the Difficulty of Overcoming Unhealthy Habits of Thinking

In the documentary Most Likely to Succeed, which follows several high-achieving, college students throughout their collegiate careers, Peter, the brilliant introvert, struggles with self-esteem as he learns to accept a new self-concept. His best-friend during filming, who happened to be a girl he had a crush on, noted that his romantic issues stemmed from an outdated self-image. She argued that, like most boys in his predicament, he couldn’t accept himself as being attractive because he was “ugly” in middle school, shining a light on the version of cognitive dissonance, in this case the conflict between new information and his core belief about himself, he experienced.

In therapy, some of my clients get upset with themselves for not having come far enough, believing that using cognitive tools should have already somehow fixed them. The thinking goes, “If I already know this stuff, how come I still struggle with spotting distorted thinking?” And the answer is cognitive dissonance, the tension that the brain automatically attempts to preclude through various maneuvers, as described by Frantz Fanon:

“Sometimes people hold a core belief that is very strong. When they are presented with evidence that works against that belief, the new evidence cannot be accepted. It would create a feeling that is extremely uncomfortable, called cognitive dissonance. And because it is so important to protect the core belief, they will rationalize, ignore and even deny anything that doesn’t fit in with the core belief.”

Thus, to prevent confusion and anxiety (and, sometimes, even shame for the mistaken judgment), unless we’re vigilant (and, sometimes, not even then), our brains foster assumptions that fit with how we already see ourselves. And since we’re so used to thinking the way we do (in addition to an innate desire to be right), it can be difficult to spot and examine distorted assumptions.

So, even though a client and I can have a productive set of sessions, wherein they accept, in those moments, that there’s more to them than being a failure, if they fail in the real world, they’ll still likely globalize the failure and might even fail to acknowledge it as a potential distorted thought. Changing habits, of which patterned thinking is one, is a difficult undertaking; our brains simply prefer our familiar ways of thinking. When Peter approached a girl he was interested in, his brain told him to run away, and this happened repeatedly. Additionally, he likely misinterpreted signals to indicate disinterest, and believed that every rejection implied his inherent unattractiveness. Essentially, the evidence was aligned with the way in which he conceived of himself, strengthening his core belief. And, none of us are immune from returning to our prior habitual, thinking patterns.

Daniel Kahneman, the psychologist who differentiated System 1 and System 2 Thinking, was asked on a podcast if he had overcome forming biased conclusions; his answer was a resounding, “No!” Kahneman noted that the most he could hope for was to spot the distorted assumptions when they arose. And therapy follows the same trajectory. People often ask, “Why does therapy take so long?” Because synthesizing your core beliefs with new, and apparently conflicting, information is hard (think about a kid progressing toward more nuanced thinking, away from the black and white version) and constantly reminding yourself of your newly formed beliefs is even harder.

In my own thinking, my brain often forms assumptions that it doesn’t believe need challenging; automatically, I have a tendency to just think I’m right and stick with that notion. So, sometimes, I need someone else to point out a flawed conclusion. This occurred recently on our podcast when I fell into black and white thinking while discussing Kate Manne’s interpretations of sexism and misogyny, having to be corrected by our guest; I mistakenly noted that her conceptions were sociological rather than psychological when they were both. And even though I’m fully aware of dichotomous thinking as a distortion, my mind can still, sometimes, be enamored by its “brilliant” conclusions.

In forming healthier beliefs, we have to accept a healthier understanding of therapy and ourselves in it. Our goals will never be fully met; like Kahneman, we’ll continuously fall into the traps of our biased tendencies. The point is to reduce their impact as we become better at spotting them. We don’t have to feel ashamed of being wrong; if Kahneman’s reasoning isn’t perfect, can ours ever be?

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