TIFT #111: Arrested Development

I’ve been writing a lot about memory reconsolidation, but perhaps half of the work in my practice is helping people restart psychological development where it was left off. Development doesn’t necessarily involve my favorite change mechanism, memory reconsolidation, because growth is about creating something new. The difference is that memory reconsolidation is for modifying existing maladaptive patterns, while work with development is about growing new capabilities. Looking at the literature, there is a lot about methods for skill building but not much about being ready to grow or about the process.

Motivation

A good starting point is motivation. The late Jaak Panksepp describes motivation as centered in the SEEKING system, a dopamine fueled pipeline to keep us on track for achieving whatever our brain has set its mind on. It is susceptible to genetics and brain chemistry, but, of particular interest to us therapists, it is profoundly affected by the influence of emotional factors. Two things are particularly important, the likelihood or possibility of success (otherwise known as hope), and the influence of personal values.

Hope is like the carrot in front of the donkey. If the likelihood of success is certain, motivation is modest. If the carrot is too far ahead, motivation goes down. In between it is at its maximum. On the other hand, values have a big impact. We invest in long shots if they represent things we truly cherish. One young woman had no hope about her own life, but valued being a good dog mother. She knew she could do that and it kept her going. Dreams are important, too. Humans are profoundly motivated by inner, and often unconscious, dreams and fantasies. When motivation is present, but not understandable, it is wise to suspect some deep wish or dream.

Both hope and what we value are areas where we are subject to influence. Coaches tell us, “You can do it.” From early in life, parents hopefully do that, too. Not only do they say we can do it, but they often give us an idea of who we are and what we can or should achieve. When support is missing, development is likely to stop. Especially in the face of clear abuse, some children become their own parents and are determined to succeed. When the abuse is mixed or covert, that's much harder. Older siblings are examples of what can be done, so younger ones may strive for more than they otherwise would. As the individual grows, community and culture also influence hope. They set expectations and show examples, positive, neutral, and negative.

The role of values

Values are critical in determining what is worth striving for. Their internalization is driven by the need to stay connected with those we need. In trauma, identification with the aggressor leads to internalizing the negative attitudes of the abuser, driven by a deep instinct to avoid being alone (TIFT #4). Positive, healthy values support hope and motivation, while negative ones cause humans to internalize low self esteem and feelings of guilt and unworthiness. Personal values, including internalized self esteem bring out feelings of shame or pride, which act like reinforcers. The anticipation of feeling pride drives positive motivation, while the expectation of shame creates a powerful force for avoidance of the risks that come with practicing new behaviors.

What is growth?

With the background described so far, we have a picture of growth sustained by pride and hope. Growth and development are actually very simple. They happen as a result of trying and practicing new, previously unfamiliar behaviors. As we have all experienced, taking on new challenges is rarely without some trepidation. It often entails discomfort. Failure may be a real possibility and that generates anxiety. Whether it is simply a lack of familiarity or the realistic likelihood of failure, trying new behaviors takes courage. Some people are fearless, even shameless, and ready to try new things with little hesitation. That is to their advantage in gaining skills. Others are more cautious and risk averse, either due to an inborn bias or from past experience. Both seem to have important roles. What is most important from a clinical standpoint is that anyone can do the work of trying and practicing new skills and experiences. As long as the balance is positive between the likelihood of good feelings versus the anticipation of pain, then the individual is likely to take the risk of trying the new. A leaning toward growth is built in and tends to keep us moving forward. Only when there are internal or external sources of discouragement is it natural for this process to become arrested. I like to call this positive bias, “paddling downstream,” taking advantage of the natural current.

Development is not monolithic

Many accounts of development focus on “phases” and see the process as an overall progression from one stage to the next. The clinical reality is that arrested development commonly affects only one area, while others are spared. How common it is for students to stop progressing in a certain area of study, while doing well overall? What is taken for a lack of aptitude may really be early discouragement leading to avoiding further effort in a particular direction. Parents and, to an extent, therapists need to support natural strengths and to be quite tentative about pushing areas that don’t come naturally to the client. Since we so often encounter clients who have become profoundly demoralized, we need to encourage “easy wins,” efforts with a high likelihood of success.

Hyper-development

Another distortion of overall development is to gain extra strength and skills in an area that compensates for or denies some perceived weakness. Men of small stature are classically susceptible to over-achievement in other areas. Those who have not learned to negotiate may learn to manipulate, that is, to bypass the other person’s free will and apply power or pressure instead. Often hyper-development brings some rewards in the world. A realistic clinical stance here is to value the positive skills and use them to help the client gain traction in the neglected areas.

The role of the therapist

The most important point to make is that helping people grow and develop requires an engaged, positive attitude on the part of the therapist. This is a place where passivity and “neutrality” tend to be unhelpful. The work is more like coaching or cheerleading than when an old pattern needs to be modified or let go. Our role is to enhance motivation by active encouragement as much as is possible. There are limits, as described below in relation to ambivalence.

Sometimes the client has never experienced the benefits of growth. Realizing this, we may need to help them see or even experience what success looks and feels like. Often it is more powerful to gain hope from others who have gone through the same process and can demonstrate a positive outcome. 

Handling ambivalence

There can be a limit to support. When we are, as we should be, invested in the client’s success, there is a risk of what we might call “splitting the ambivalence.” When a client is ambivalent about moving forward, they may transfer responsibility for the new, positive behavior to the supporter. It can become the therapist’s goal, rather than the client’s, while the client becomes passive or even resistant. The client retains the negative side of the ambivalence. They are now responsible for the negative behavior, while the therapist has become responsible for the positive. That’s the opposite of what it should be. Which side wins? Obviously the negative. 

If and when we sense that positive goals are not being shared, we need to back off and make sure the client is supplying the motivation to move forward. A therapist might say, “I’m feeling like this is more for me, not you. Maybe it's too early. Unless you are ready, we don’t have to continue this effort.” In this regard, parents are like the king and queen in chess. They carry extra weight. For that reason, with adult children, their wishes feel more like commands. Parents need to take that into account and be scrupulous in respecting the younger person’s boundaries and lowering the volume on anything that can be interpreted as pressure.

Restarting development

A remarkable principle is that arrested development can be picked up wherever it stopped. This can be a source of hope for those who dare to face what they are lacking. To repeat, with regard to arrested growth and development, we are paddling downstream due to the natural rewards of pleasure and pride accompanying new skills, capabilities, and maturity.

Jeffery Smith MD

Photo credit,  Cara Fuller, Unsplash