MAKING CHANGE

There are two types of pain:  1) imposed suffering – acts of flood, fire, famine – that comes from outside our psyche; and 2) elected suffering – a sense of rejection, shame, guilt, loneliness – that we inflict upon ourselves.  Imposed suffering protects from the elected kind. The despair of the concentration camp crowds out the loneliness of a dateless prom night.

            The patient with cancer illustrates both kinds of suffering. First there is the imposed suffering cancer induces, the pain and sickness the illness renders. The second type of suffering – the elected kind—comes from our own feelings about the cancer.

            Patient and surgeon read from a different book. The surgeon removes the tumor, but fails to relieve the sense of vulnerability the patient feels from the inflicted cancer.

WHY PEOPLE CHANGE

            The Lower Ninth Ward in New Orleans experienced calamitous flooding from Hurricane Katrina in 2005. The storm surge came from the east via flooded Saint Bernard Parish and from the west through two large breaches in the Industrial Canal flood protection system, creating violent currents that smashed homes and tore them from their foundations. The storm became the costliest natural disaster in U.S. history. At least 1,836 people lost their lives in Hurricane Katrina and many more thousands were rendered homeless.

            A College Station resident commiserated with one of the Hurricane evacuees temporarily housed in a local church:

            “That must have been the most terrible thing that ever happened to you. You lost your home. You lost your clothes and all of possessions. You have no money. You can’t get in touch with your relatives. Your friends have been displaced. What a tragedy. How will you ever recover?”

            The evacuee replied:

            “Surely that storm was a terrible thing. I was scared and pretty well knew I was going to die. Then a boat came and they took us to the Superdome, and it was like the devil himself had come down and was torturing us. We were all crowded together and squashed-up. People were yelling and crying. It was hot and dirty. And we all got thirsty and hungry. It smelled bad and it seemed there was no hope for any of us. But somehow, we got rescued and took care of. And now here I am in this nice church. We have food. And water. And air conditioning. And good people are helping us and looking after us.

            Yes, that Hurricane was a horrible thing and I never want to go through nothing like that again. But, you know, that Hurricane—no matter all the bad things that happened—was the best thing that ever happened to me and I am thankful for it.

            I’m not discounting the bad things that happened to so many people and all the dead people and people who never will find their families, but for me that hurricane was good. If it hadn’t been for Katrina, I would have been trapped in the lower ninth ward for life. Before the hurricane, I had nowhere to go. I had no idea how to go. I had no money to go. I was just there and that was my life. But the big wind came and blew me to a better way of looking at things. And now I have a new life, a new start on life. I’ve got possibilities. Yes, thank God for Hurricane Katrina. I’ve got hope.”

THE TRAGIC FAILURE TO CHANGE

            Some people have difficulty changing because they are caught in financial or geographical traps. Let us consider those people, however, who have every opportunity to change, but, nonetheless, continue to engage in self-defeating behavior despite ongoing negative consequences:

Ø    Smoking, obesity, and alcohol abuse can lead to chronic illnesses and premature death. Despite ominous health warnings that are more certain than storm alerts from the National Hurricane Center, surveys by the Centers for Disease Control and Prevention show that very few people are willing to stop their self-destructive unhealthy habits.

Ø    20% of American adults smoke

Ø    More than 30% of Americans are overweight

Ø    15% of Americans are binge drinkers

Ø    People are often noncompliant to medical treatments

Ø    50-65% of Americans fail to follow their doctors’ treatment recommendations

Ø    10% of hospital admissions among older adults result from failure to follow doctors’ directions

Ø    Almost one-third of patients visiting a physician fail to get their prescriptions filled

Ø    A Case Western Reserve University survey showed that 54% of glaucoma patients failed to use their eye drops as directed even though these patients knew they would go blind unless they complied with their doctors’ instructions.

Ø    70% of patients receiving treatment at a community mental health center dropped out of treatment before the third visit.

Ø    Most serious attempts to maintain behavior change are unsuccessful. A University of Scranton study found that only 19% of those who had made a significant change in a problem behavior maintained the change when surveyed two years later.

Ø    People continue to engage in patterns of behavior—anger, violence, nagging, dependency, and jealousy—that are destructive to their relationships and their well being.

REASONS FOR LACK OF CHANGE

            EMOTIONAL AMBIVALENCE. A woman complained vociferously about her husband who controlled her. He wouldn’t let her out of the house alone. He wouldn’t let her drive a car. He wouldn’t let her visit friends. When asked why she didn’t leave her husband, the woman replied, “I love him so much.” When the woman was seen two years later. She had the same complaints about her husband. She remained married.

            CIRCULAR EXCUSES. Common explanations for lack of change become circular arguments. People may blame their resistance to change on stubbornness, an addictive personality, or self-destructiveness. An explanation for refusing to improve a situation may go this way, “Because my situation is hopeless, I can’t change.” The behavior is then used to support the explanation, “I can’t change because my situation is hopeless.”

            REBELLION. Telling someone to change often exacerbates the situation. A highly directive approach causes a person to adamantly resist change. One study showed that the more alcoholics were directed to change the more they drank.

            INERTIA. Systems resist change. Physicists call this resistance to change “inertia.” The first law of motion indicates that people, like objects, tend to keep on moving if they are moving and remain standing still if they are still.

            BLAMING. It is easier to make excuses for our problems than it is to assume responsibility for our own behavior. The statement “If she didn’t nag me so much, I wouldn’t drink,” is an example of blaming others.

            LEARNED HELPLESSNESS. Put an animal in a cage. Apply a mild electrical shock all over the floor of the cage. When the animal discovers that escape is impossible, the animal lies down and passively in the corner of the cage and accepts the shock. Then the electrical shock is applied only to the corner where the animal is lying. The other areas of the cage are shock free. The animal continues to stay in the corner. Humans that are constantly exposed to conditions from which there appear to be no escape will eventually give-up and surrender to the situation.

TWO REASONS PEOPLE CHANGE

1.     Pleasure—realizing that new behavior patterns will produce more pleasure than maladaptive behavior patterns brings change. Believing that we can have a better life engenders different approaches. The power to visualize a successful outcome gives the courage to try new ways of doing things.

2.     Pain—understanding that maladaptive behavior causes intolerable distress stimulates an alternative lifestyle. Drastic environmental consequences may be required before inertia can be overcome. Imprisonment, financial ruin, homelessness, or the treat of death may be necessary before transformation occurs. Allowing a person to suffer may be the best way to generate change.

BENEFITS OF CHANGE

            We, as individuals, feel helpless in a sea of social turmoil where a single life raft offers little expectation for smooth sailing. A harmonious bulwark of social, cultural and spiritual safeguards provide the safest harbor from violent storms. A safe culture would provide:

1.     Children raised by two parents.

2.     A society that discourages a sense of entitlement.

3.     Recognition of individual uniqueness unassociated with power, beauty, and wealth.

4.     A spiritual foundation that offers love, joy, peace, kindness, and generosity.

5.     A culture that encourages and offers a work opportunity for each adult to provide sustenance for themselves and their families.

6.     A society that expects everyone to assume responsibility for his or her own behavior.

7.     More negotiation, less litigation.

8.     A society that recognizes that some people are more talented than others and at the same time a society that appreciates the less talented as much as the gifted.

9.     Respect, concern and the best of care for the mentally

10.  Entertainment that lifts the spirit and lightens the heart, rather than entertainment that celebrates violence and social deviance.

11.  Communities and small groups that regularly meet together to encourage one another and to stimulate loving friendship and good works.

12.   Cultivation of empathy and respect for others.