By David S. Prescott, LCSW, LICSW
“I know it sounds funny, but I changed that night when I got arrested. Nobody would ever believe it, but when I was in the back of the cop car… That was it. I knew I would never hurt anyone again. That’s when I really changed.” Many professionals will hear these words and assume that this individual was engaging in impression management, putting himself into the best light he could under the circumstances.
In fact, this person (whose progress in treatment I was asked to assess) went on to describe how everyone assumed that he needed treatment in order to change (meaning to manage risks and lead a better life). His perspective was that although he had already changed, he needed treatment to help make those changes solid and durable. He also appreciated the opportunity to reflect on his life with therapists and group members.
It was an interesting way to look at the treatment process, one that our field rarely discusses. From the perspective of treatment planning, he sought to demonstrate in his actions who he had become in his identity. It was certainly a different pathway to completing treatment, although the end game was the same: the development of a lifestyle incompatible with harming others. What helped this client move forward, however, was that by viewing himself as a different person he could more easily maintain a better outlook on his future.
Another client was asked to reflect on what made him get himself together and participate meaningfully in treatment. He had made a sudden turn for the better in every respect, surprising everyone in his multidisciplinary team. He resided in one of two treatment programs located on the same campus. One night, a client into his program became highly aggressive, to the point where he overcame a staff person. The other staff member shouted out for help, telling the client to run and get help from the program next door. While many will recognize this as reflecting several problems with program staffing, the client did what he was told.
He later recalled, “When I saw the look on the staff’s face in the doorway as I told her they needed help next door, that’s when it all made sense. I did not want to spend the rest of my life in places where all this could happen. I knew I had to do something different.” He did; he went on to make meaningful changes in his life and returned to living independently in the community. Arguably, his life changed quickly, with treatment being a means to become in his life who he now was in his heart. The clients in these cases went on to live successfully, all things considered.
How is it that these sudden insights so infrequently receive attention? We tend to structure treatment programs in a stepwise fashion to help clients change their lives slowly, and for good reason. Living one’s life differently is a lot of work. Often, our attempts to reduce risk don’t easily mesh with many clients’ progress, which can proceed in fits and starts. Nonetheless, whether we call them sudden insights, quantum changes, or epiphanies, they do happen and can be cause for celebration. They also illustrate how no one treatment plan or program is a perfect fit for every individual.
Perhaps
one reason these sudden changes don’t garner more discussion is that
professionals so often have a wait-and-see attitude. There was a conference
presenter who observed with sarcasm that, “I’ve seen more people suddenly find
God in the back seat of a police cruiser than in any chapel.” Many have seen
some variation of this observations in their own practice. With that kind of attitude,
it is e no surprise that professionals
are very cautious. On the other hand, if we remain too skeptical, we may miss
the opportunity to help clients consolidate their motivations to change and
weather the storms of generalizing treatment insights into daily behaviors. As
always, change can be messy and sporadic, and therapists need to work hard to
make sure that they hear, understand, and respect their clients as fellow human
beings.
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