Saturday, June 23, 2012

Escaping the Waiting Place

In his guide to life, "Oh, The Places You'll Go," the sage Dr. Seuss warns readers about:
"a most useless place. The Waiting Place...for people just waiting. Waiting for a train to go, or a bus to come, or a plane to go, or the mail to come, or the rain to go, or the phone to ring, or the snow to snow, or waiting around for a Yes or a No, or waiting for their hair to grow. Everyone is just waiting. Waiting for the fish to bite, or waiting for wind to fly a kite, or waiting around for Friday night, or waiting, perhaps, for their Uncle Jake, or a pot to boil, or a Better Break,
or a string of pearls, or a pair of pants, or a wig with curls, or Another Chance. Everyone is just waiting."

Most of us can probably relate. I think most people find themselves, at various points in our lives, feel like we have to put everything else on hold while we're waiting for...whatever it is we're waiting for. We wait to grow up, to go to college, to finish college, to get the perfect job, to buy the perfect house, to find a spouse, to have a family, for our kids to walk, start school, finish school...etc. We can spend most of our lives waiting for some future point to really live!

The same pattern can play out in therapy. All too often, clients say they "aren't ready" to change their behavior, or talk about/work on something sensitive, or take whatever risk they need to take to reach their life goals. They want to wait - until it stops hurting, or they stop having distorted thoughts, or completely resolve the last little bit of ambivalence, or stop feeling depressed (angry, anxious, whatever), or "get over" their grief, or forgive someone, etc., etc., etc.

Dr. Seuss does not happen to offer any sage advice on escaping the Waiting Place (he writes only: "Somehow you'll escape all that waiting and staying. You'll find the bright places where Boom Bands are playing"). However, barring a boom band showing up in our offices, therapists are challenged to find creative ways to help our clients break out of their "waiting."

I think it starts with psychoeducation. At its heart, waiting is the result of inaccurate or distorted thoughts or beliefs about the nature of feelings, thoughts, and actions. For example, people often operate on the assumption that feelings are an accurate basis for, or inevitable determinant of behavior. Based on this assumption, people who are depressed often say that they'll get up, shower, get dressed, socialize, etc, once they "feel better." However, research suggests that people begin to "feel better" once they start getting up, showering, socializing, etc. (an approach called Behavioral Activation). Identifying, and providing education to counter, the inaccurate assumptions impeding the client from taking necessary action is an important first step.

Even with this foundation, clients may still be stuck in the Waiting Place. Here's the hang up: we judge the veracity of new information based on how it fits with our experience. Without taking action, clients have no new information to test out the accuracy of what we want them to believe. But, they don't want to take action until they believe the new information. We have a few options in this sort of stalemate. We can continue trying to "talk them into" believing the new information. We can facilitate "vicarious learning" by pointing to others whose experiences provide support for the new information. Or, we can encourage clients to test it themselves in a small experiment. Instead of committing to sustained effort or change, they can just try it for a limited time or in a limited frequency, and self-monitor for any changes in how they feel (the experiment should be long enough to provide accurate information, however!). Finally, we can reach for any past experiences the client may have had that provide supporting evidence.

What other strategies do you have for helping clients (or yourself) escape the Waiting Place?

1 comment:

  1. It's such a fine balance between encouraging and pushing someone. It's helping people to find the motivation and curiosity to want to do it for themselves, rather than convincing them to give it a try for the purpose of therapy.