The Five-Step Therapeutic Process


Soil preparation for your psychological garden.


Without question, the most effective form of therapy is behavior therapy. If we can change our behavior with consistency, then we will be able to, at least theoretically, overcome any sort of neurosis if not psychosis.

Behavior therapy of course changes our behavior. And since the mind-body dichotomy is as unscientific as phrenology, it eventually changes our thoughts and emotions too.

Paradoxically, however, the least effective way to get people to change their behavior is by getting them to change their behavior. Likewise, the worst way to change our thoughts and emotions, in the long-term, is to replace our thoughts and emotions with more "helpful” thoughts and more “positive” emotions.

This is the instruction method brought to prominence by the CBT conflagration that is ruining psychology. The satire of this sterilization of the field reached its zenith during an infomercial for Brad Goodman's self-help program in which Troy McClure tells the viewer to "be confident, stupid." 

If this sort of therapy worked then there would be no point of psychology. After all, psychology exists because we cannot bring ourselves to do what we want to do. If we could make ourselves change every behavior through conscious will alone, then psychology would simply be philosophy.

As we prepare soil for a garden, proper therapy involves the submission of the patient to a process through which the cherry tomato of consistent behavior change emerges. We may still need to focus and discipline ourselves to some degree, but this conscientiousness only influences our actions about five percent in the moment, and only when the soil of our psychology is fertile. Whenever someone is able to discipline themselves and focus their effort over a long period of time, it’s only because they have accidentally submitted themselves to the therapeutic process. This is mostly accomplished through healthy family, good relationship with mom and dad, and community support.

So to get the golden egg of consistent, intentioned, abiding behavior, it's helpful to start with the therapeutic process.

1. Education

The first step is to learn how we work—specifically, to learn about emotions, how they work, and what they’re telling us. This is fortunate for me because you, the prospective patient, will not get this education anywhere else. And it's fortunate for you because Providence has, for whatever reason, brought you to my site so you can get an education about psychology.

Without proper education, then the next four steps will be, at best, unhelpful. What could awareness possibly mean if we're not even sure what to be aware of? It’s why cognitive behavioral therapy can only focus on fixing thoughts and behaviors—these therapists simply don’t have the right knowledge.

2. Awareness

To become aware, psychologically, is to first see how our emotions manifest outside of our control. When we’re undisciplined, we no longer see it as a problem with discipline in itself, rather as a problem with anxiety.

When we’re apathetic we understand it’s not a problem with the apathy but the low-grade anxiety that causes the apathy.

When we have trouble sleeping, we know it’s not a sleep problem so much as a symptom of avoided emotions that arise as our consciousness rests.

When we feel like a victim, we no longer chastise ourselves for being a victim; rather we investigate our maladaptive relationship with anxiety that causes us to feel like a victim.

When we feel jealous, we no longer decry the jealousy as irrational; rather we look at our relationship with anger and what needs we can get met in a mature way.

3. Accept

The word acceptance has been co-opted by the fat crowd and their social-constructivist ilk to use it as an excuse from the difficulty of change. Hence we have atrocities like fat people who now believe their disorder is only a problem because society has a problem with it.

Here, I use “acceptance” only as part of the process of change but it’s not the end result.

(Acceptance, furthermore, requires us to accept that which we cannot control, on a metaphysical level. Another's life, for instance, isn't ultimately in our control so if we're trying to change someone else, "acceptance" can be a useful word to consider—preferably as we develop our identity, which would make it more likely for us to focus on our own life instead of someone else's.)

If we’re lost in obsessive thoughts and compulsive behaviors, we may want to shoot right up to confidence by thinking confident thoughts, but this isn’t how our psychology works in the long-term. It's a fact of our nature that anxiety has a deeper cause we must address if we're truly going to transform OCD into capability. 

4. Process emotions

This step comprises talk, meditation, listening, and elucidation, preferably with another person or people and their faces right in front of us. And it’s important to talk about emotions while taking responsibility for them and not seeking consolation.

We’ve perhaps learned it’s not masculine for men to talk about their emotions. But this is only because talking about emotions has been conflated with indulging emotions and seeking solace for them.

However, if we talk about emotions while taking responsibility for them with the intention of making it more okay for other guys to do the same, then it comes off as uber masculine. Think Mickey Rourke doing anything.

A refrain I hear is “I don’t feel like talking,” or “I don’t think this is going to work.” This goes back to awareness and acceptance in that it’s your anxiety coming up with objections because you’re afraid of emotions. It’s okay, simply admit it and talk for the hell of it. Then listen and identify when someone is talking with you. If this is lame then, oh well, psychology is lame I suppose Stallone movies are lame too.

The goal of processing our psychological issues is psychic objectivity. This means we can see other people seeing us. We bring the awareness of others to our inner lives.

5. Act

Once we’ve completed steps one through four, then we have at least a chance of acting with consistency and intention. If we feel like we’re falling off the wagon and regressing and we don’t want to keep taking the actions that we know will master our psychology, it doesn't help to keep beating our head against the wall. The “grit” approach may work for push-ups and algebra problems, but it doesn’t work—not for long, at least—when it comes to emotion. And if we do develop motivation, it’s only going to come, again, from accepting psychology for what it is and using it to our advantage.

Instead of willpower, take a deep breath and go back through steps one through four.

We go back to education and remind ourselves the truth of our psychology and how it works. We look at the direction of the arrows on the map of emotion and don’t try to insert new arrows. We become honest when confronting the omnipotence of our inner lives.

We become aware of how emotions manifest outside of our control and conscious awareness. We accept it without self-criticism. If we are self-critical, then we recognize it as an anxiety and work on that. We talk and write and meditate, even when it feels stupid to do so because we know by doing so we become ever more acclimated to the stress of emotions, which makes it much more likely for us to act with consistency and intention.

The pilot hole

Ever try to drill a screw into a wall, especially mortar? It’s difficult if not impossible. Sure, the goal of the project is to drill a screw in the wall, but we cannot simply focus on getting the screw in the wall since it’s neither the nature of the screw nor the wall.

Instead, we drill a pilot hole. Though it takes more time in the short-term and we may need more tools, it saves us time eventually. This pilot hole is steps one through four of the therapeutic process.

Though, based on our level of neurosis, and the amount of issues we have stowed away in our unconscious, the pilot hole of our psychology keeps closing up. If we cannot get the screw through, we don’t drill harder. Instead, we go back to previous steps, and without referencing the obvious sexual symbolism here, we loosen the hole a little more to make it easier to get the job done.