Stop It

Posted on May 16, 2013

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In a sketch from Mad TV, Bob Newhart plays a therapist that has a rather unique approach to brief therapy.  His solution to every problem presented is to yell, “Stop it” at the client.  Go watch the video, then come back and we can talk.  http://www.youtube.com/watch?v=Ow0lr63y4Mw

For the record I am not endorsing Bob’s approach to therapy.  Phobias, eating disorders, and destructive relationship are not funny and can be quite damaging to one’s health, both mental and physical.  Where the humor lies is in the absurdity of the approach.  Anyone who has ever had to cope with any of these issues knows how difficult stopping the behavior or controlling the intrusive thoughts can be.  Many who experience these issues have been yelling “stop it” at themselves for years (metaphorically speaking).

Therapy on such presenting problems can follow one or more of three approaches: 1) insight, 2) behavior modification, 3) reprocessing.  Each of these approaches has its strengths and its limitations.  Traditional therapy operates on the assumption that gaining insight into one’s thoughts and actions is the key to change and gaining relief from the presenting problem.  Most talk therapy follows this approach.  The intent is to understand the unconscious thought processes that drive the behavior.  Second, is behavior modification which assumes that the goal is to be free of the behavior, and therefore, changing the behavior should be the focus of therapy.  Both of these are useful approaches, but for this post I would like to focus on the third approach.

Human beings have this wonderful pre-frontal cortex in the front of our brains.  It does our higher thinking for us and performs executive functions for us.  We also have an amygdala that is a bit more primitive part of our brains.  It has a role in our emotional reactions.  The amygdala is also susceptible to trauma.  In a sense it is adaptive that the amygdala can record a disturbing event, note the relevant stimuli that are associated with the event, and then alert us to any future events that contain those stimuli.  The fear helps us avoid similar situations in the future and adrenaline rush prepares us to escape the danger.  However, when that event is particularly traumatic, the amygdala can be continually reacting to cues that are not indicative of any real danger.  Hence, we get phobias, post-traumatic stress disorder, and other anxiety.

That great philosopher, Jim Morrison, once observed that “no one here gets out alive.”  I would assert that no one gets through life without some amount of trauma.  Some people are exposed to the “Big T” traumas.  These are life threatening or extremely distressing situations.  Everyone gets some “Little T” traumas.  These are the incidents in one’s life that we remember as disturbing.  There are moments in our lives that we remember everything clearly.  We remember the sights, the sounds, the smells, the emotions, our thoughts, and the feelings in our bodies when the incident occurred.  Certain triggers can take us right back to the event, even if it happened during childhood.  Sometimes these triggers don’t bring the event into consciousness, but cause the same emotional and physiological reactions that were associated with the original incident.

Talk therapy is effective when we are seeking insight.  Talk therapy is communicating with the higher thinking area of the brain.  When the problem has its origin in trauma, we need a means of talking to the amygdala.  An effective treatment modality for doing this is Eye Movement Desensitization and Reprocessing (aka EMDR).  EMDR is a treatment utilizing eye movements, audible tones, or tapping to provide bilateral stimulation that gives the brain the opportunity to do its own healing from the trauma.  Often current anxiety and phobias have their root in earlier memories.  Through the treatment, both the current fear and the traumatic memories can be robbed of their power over life in the present and future.  The memories are still there, but without the extreme emotional reaction.

It works way better than, “Stop it.”

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