These are exciting times for the mental health field as neuroscience is rapidly evolving to help guide therapeutic interventions. As our understanding of brain development and how such things as trauma impact the entire central nervous system expands, treatment modalities can be developed that more effectively target problematic behaviors.
I recently read an article on the topic of memory reconsolidation, which suggested a template for successful teen therapy. I was quite excited as I read the article, for two reasons. The first reason was my recognition that what the article describes as effective therapy is being carried out on a daily basis at Greenbrier Academy. My second reason, probably connected to my logical brain, was my awareness that what constitutes a complete therapeutic process could be expressed in a formula that provides the clinician with a sense of direction within the “maze” that therapy sometimes resembles.
A Therapeutic Formula Explained
The formula is as follows; I ===> E x NB
I wouldn’t expect anybody to decipher this equation, allow me to elaborate. The I represents implicit memory, which must be brought into consciousness for successful problem resolution. The E stands for explicit memory, defined as conscious recall. The NB stands for new behaviors, which must be practiced an unknown number of times before they become inculcated.
Let me illustrate through the work of a student at Greenbrier Academy. As is the case with roughly 30% of our girls, Susan (not her real name) was adopted. She has been in therapy since around the age of seven, and always steadfastly maintained that adoption was not an issue. Certainly an aspect of actualizing the formula is the skill of the therapist in being able to operationalize the various factors in a way that is meaningful for the troubled teen. Remember that the “I” stands for implicit memories, which are unconscious memories that are generally formed early in life.
Beliefs Elicit Behavior
Once formed, they then tend to be then “acted out”, outside of the troubled teen’s conscious awareness. Rarely does a cognitive or literal intervention dissuade someone who is operating out of their unconscious beliefs. ( try telling an alcoholic to stop drinking, while good advice, it is doomed for failure ) Instead, the clinician must be skilled at helping track the ways that a person’s present behaviors and feelings provide clues to where they may have originated in the dim remembrances of the past.
When I first met with Susan, she was attempting to convince me that none of the other girls at our school liked her. As we began to explore this further, I gently suggested that she close her eyes and then began a guided imagery process to track how long that feeling of being unlikable had been present. Around an hour into our time together, as I was simply asking her to allow her thoughts and feelings to come to the surface, she began to softly cry. She opened her eyes and told me that she had experienced a vision of being handed away as a newborn, and as a result has always had a feeling that she wasn’t wanted or likable. It should be noted that I was not this young woman’s primary therapist, and accordingly, had not even been aware that she was adopted. I had simply been present when she was upset about her perceptions regarding being liked, but as described, the therapeutic intervention ended up being much more significant and deeper than what she had initially thought. In this way her implicit memories were brought into her explicit awareness.
She had a powerful quote at the conclusion of our work, where she stated, ” I have never been able to remember what happened, but at the same time I’ve never been able to forget it”.
Her developing awareness of the origins of many of her self-doubts was helpful. However, insight alone will not create resolution, any more than knowing the language spoken in a foreign country will allow you to suddenly start speaking it! That is where the second part of the formula, new behaviors, practiced many times, is necessary to truly create a new identity.
New Behaviors Become Internalized
At Greenbrier, we provide many of these experiences, and the majority of the time the girls are not told, “we want you to try this new experience to contradict your old belief system”. The conscious mind resists interventions, related to the intractable nature of implicit memories. Therefore, we have found it is best to place students in situations that will challenge the old limiting beliefs, while doing so in a manner where they don’t feel they are artificially being praised or rewarded.
A powerful example that illustrates a new behavior becoming internalized occurred recently when our African drumming performance group presented at a Martin Luther King Day celebration. One of our drummers came back and was speaking to the community, describing how she felt inspired being part of something greater than herself while she drummed for the audience. This was a young woman who had attempted suicide and has done work on her implicit memory of feeling unimportant and not good enough.
As she fed off the energy of the crowd, she became aware of her own smile, and further noticed that as she smiled, her perception was that everyone in the audience was smiling back at her. She excitedly shared the story with the GBA community, beaming the entire time, and almost incidentally adding how she cannot even remember her old feelings of depression and despair.
According to the formula, I would suggest that she has done the work that allowed her unconscious, or implicit memories to surface, and she has now had many experiences that provide a contradiction to her feeling “invisible”.
Creating Lasting Transformation
It is extremely exciting to be a part of this kind of transformation. You can literally see changes in the student’s physiology, as they begin smiling more, standing taller and looking people directly in the eye, as a result of changing these unconscious perceptual distortions. In future articles, we will discuss specific means of actualizing the formula, through methods and modalities that bring implicit memories to the surface, and how to skillfully provide contradictory experiences to help form a new identity.