Years back, I led a therapy group in a day treatment program for individuals who all had extensive histories in the mental health system. This was an open group, so new participants were always coming and old ones leaving. Over time, I began to wonder about one specific issue: Why did participants in the group consistently resist changes in their lives that seemed so obviously positive? I repeatedly asked the participants this question over the span of years. No matter who was attending these groups, their responses were remarkably the same. I documented these responses, calling them “The Ten Reasons not to Change.”  The Ten Reasons not to Change capture, what I call, “dialectics of disappointment”: how a person who has experience considerable setback, might become afraid of the very thing that motivates most of us: hope.

 

1. Raising one’s own expectations about change. When a person enacts change she raises her own expectation about her ability to change further. For someone who has experienced multiple disappointments, acts of competence are thus threatening because they mean the potential of failing to meet the expectations generated by change. Keeping one’s expectations low about success is a central means of avoiding this threat. If one does not have high expectations about oneself, then there is little possibility of disappointment. However, one can only keep her expectations low by resisting change.
2. Raising the expectations of others. To make a positive change in ones life, a person not only raises his own expectations. He inevitably raises the expectations of others. Doing so, he risks that others will witness him failing from the new, more positive status he has achieved. For someone who has experienced a series of disappointments, the risk of failing in the eyes of others is that his failure in one project will confirm for them his failure at life.
3. Facing where you are in life. Progressive change requires that individuals assess what they need to change, and thus confront the current state of lives that they have authored. That confrontation is particularly difficult for an individual who believes her life is an awful disappointment. For her, evaluating her life is synonymous with evaluating life as disappointing.
4. 4. Taking “small steps”. To change his circumstance an individual is not merely required to face the status of his life momentarily, but to do so repetitively, as he takes the incremental steps towards a goal. Thus, when one forges into change, he is potentially confronted by his current predicament each step of the way. For an individual who sees his life as a series of disappointments, these incremental steps towards change feel injurious; each one reflecting his status. He sees that he has many small steps to take to reach his goals, and is thus confronted with his lack of accomplishment each step of the way.
5. Being accountable for “what’s next.” Each change she makes raises the expectations that she is accountable for the life that lays ahead. The more she changes, the more the outcome of her life is seen as within her hands. For someone overwhelmed by a sense of disappointment, positive change is like stepping into an abyss of accountability in which there is no return to a previous life shielded from expectations regarding autonomy and personal agency.
6. Facing the unknown. Enacting change in his life, a person faces the unknown possibilities of a life created by his own free actions. He must contend, not only with an inherently capricious world, but with the unpredictability of the future created in part by his own actions. Someone confronted with serious disappointments sees little information in his past to predict a successful future. For him, facing the unknown, means facing a menagerie of possible failures.
7. Existential Aloneness. The challenges of change are markedly temporal, existing on a continuum of cognitions about the past (the person’s accountability for previous decisions and actions), the present (the person’s responsibility for who she is in the moment) and the future (with its unpredictability and potential for disappointment). At the axis to these challenges is her existential aloneness. Enacting change, a person recognizes that she is the author of her life, the originator of what she has made happen in the past, what she is making happen now, and what she will happen to do in the future. A person overwhelmed by disappointments correlates her agency with failure. She thus finds singularly unbearable this recognition of her life-authorship. Anxieties about existential aloneness invade all of the seven “Reasons not Change”. Each reasons is a quagmire formed by these anxieties.
8. Losing a Network of Treaters. Therapy aims towards change and the amelioration of symptoms. Thus, when a person makes positive changes in his therapy, he inevitably forges the path that leads out of this therapy. For a person who has been injured by repeated disappointments, who is also well entrenched in treatment, this polarity between change and loss is threatening. For him, losing therapy means losing vital social psychological resources.

The daily activities and the types of relationships that comprise the social lives of individuals engaged in the mental health system provide a full prescription of psychological supports that actually mimicking basic social, familial and community supports: intimacy and quasi-friendship found in relationships with therapists, day programs and hospital staffs; and an extended family of providers recognizing and discussing the patient, keeping track of him or her, and responding to his or her requests for help. Two such resources are the guarantee that someone is paying attention and the promise to her wish to be understood as comprehensively damaged; the loss of which one client in my group called “destroying the negatives”.

9. Losing the Guarantee that someone is Paying Attention. To approach life securely, every individual needs a sense that they play a part in the consciousness of someone else; that, while alone, they “matter” to others. Therapy, and especially therapeutic communities provide this sense. With their charts, their tendency to “begin where we left off,” their propensity to remember and remark on the progress of each client’s life, they pay attention to individuals contiguously. Therapists and therapeutic communities offer an enduring recognition to those they treat, providing their clients the important sense that they exist in the mind’s eyes of someone else even when they are out of physical site. As we will see further, they often provide this contiguous attention, without the pressures of expectations regarding accountability.
10. Destroying the Negatives. Therapy is partly a process of co-memorating in the present; a sharing of the daily memory of the daily life of people. It is also a process of commemorating the past; of recognizing an individual’s former hardships. For someone overwhelmed by a sense of disappointment, the need for others to recognize past damage is often insatiable. For this individual, the therapist’s recognition of his difficult history is not only therapeutically empathic, but a means to a life narrative imbued with themes of external forces and individual passivity.

For a person overwhelmed by disappointment, acts of independence are signs to others that the past was not as bad as they portray it.   Independent functioning signals that past events may have been painful, even traumatic, but not so oppressive to destroy the individual’s ability to survive.  As one of my clients describes it, change is “like destroying the negatives” to her past (a remarkable term, for it can mean both “destroying the memory of negative experiences” and, more metaphorically, “destroying the snap-shot record that they occurred”). Becoming better, for her, means partially obliterating the proof of her hardships. Therapy, and belonging to a therapeutic community, on the other hand offer the (albeit a somewhat false) hope that someday, someone will merge with her in her pain, and endorse her narrative of total passivity.

The Ten Reasons Not to Change show a powerful dynamic between changing and staying the same. It is a tension between two forces we all face in our lives. But for someone traumatized by repeated disappointment, this tension becomes a powerful force, something she consistently faces on a daily basis. Her life as a psychiatric patient is forever marked by issues of change; getting better, improving, recovering. Thus, the issue of change, and the pressure to change, are forever on her mind. Feeling this pressure a person might see sameness and refusing to change as her only sanctuary.

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