Edit: so please also help me understand this- if a person doesn’t have family and friends to support, sounds like therapy won’t really help this person unless they change their living conditions, or they relapse?
In: 68
All of the answers here are great, but I want to offer more of a neurological perspective.
From the time we’re born, our brains look for patterns and form connections. The more our brain sees a certain pattern, the stronger that connection gets, and the brain will recognize that pattern more easily. The more easily the brain recognizes the pattern, the more frequently it sees the pattern, and the stronger those connections get. It’s a cycle.
For some people, the connections that have become really strong aren’t helpful. These might be connections like, “when I drink, I don’t feel sad” or “if I am not perfect, people will dislike me” or “if I flip the light switch three times, then my family won’t die.” These connections can lead to behaviors that are dangerous, either emotionally or physically.
This is where therapy comes in: therapy can help people break those connections and form new ones. When a person does cognitive behavioral therapy (CBT), they’re asked to identify the dangerous or negative behaviors they’re engaging in. Then, they’re asked to become aware of the beliefs they hold about themselves and about those behaviors- to identify those strong connections that aren’t helpful. Next, they’re asked to identify negative or inaccurate thinking that’s present in those connections- is it actually true that if you’re not perfect, people will dislike you, or is it possible that people can love you even if you’re flawed? This allows the patient to “break” the connections their brain has made. Finally, the patient is asked to replace those old connections with new ones that are more positive or useful- in the example of someone who is struggling with perfectionism, this might be something like, “I am worthy of love even when I mess up”. The more the patient repeats that new connection, the stronger it will get and the weaker the old one will become, until eventually the new connection replaces the old one.
To answer your follow-up question in your post, this process is much easier to do if a person has people around them who are supportive of their therapy process, and if they’re not in an environment that triggers the unhealthy connections they had. For example, if a person has smoked their entire lives, there are lots of things in their environment that might trigger a desire to smoke. Maybe they always smoked while drinking coffee in their kitchen, so now coffee and their kitchen both trigger a desire to smoke- those things are all connected in their mind. Maybe they always smoked with the same person, so now that person triggers a desire to smoke. Maybe that person keeps offering them cigarettes even though they made the decision to quit. Breaking those connections is easier when those triggers aren’t present.
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