Making Ideas Stick

Sand slipping through my patient’s hand, is how I often think about ideas which we discuss, but for powerful unconscious reasons, never seem to materialize into action. Or, as my colleague says, “people pay us money, not to take our advice.” The key here is to penetrate the patient’s brain, so the new way of seeing the world, is not merely cognitive, but also visceral. Without this visceral component, people tend to relapse into their old habits, their old defenses. Milly, for example, thirty-six, continually has relationships which ultimately make her feel used and worthless. All of the men in her life have ended their relationship by having an affair, which upon revelation, was lasting for most of their time together. This pattern, Milly sees, is a result of her not acting on her deep suspicion that the men she chooses to be with, are disloyal and sensing Milly’s desperation for a relationship. Although she understands this dynamic, she feels powerless to change it. We discuss the repetition in her mates, and how it reminds her of how she was treated by her mother, dismissed and overlooked. Yet, to her frustration, she continues this pattern. “You must need to continue this routine, perhaps with the wish that you will finally get a better outcome.” I say, highlighting that within the repetition is a wish. Milly begins to see that if the wish were more conscious, then she could see that instead of wishing that these men would take a different course, it is she who has to change. Still, even with that insight, the pattern continues. The depth of her initial pain lives on in the persistent repetition. As we spiral inside her unconscious, there is hope for relief from that pain, freeing her to use better judgment for her suitor. The deeper we go, the more likely it is that Milly will break the cycle of degradation.