TIFT #96: The Rules–What Therapy Seeks to Change

In the Howtherapyworks Coaching Community, we have been working on pinpointing the ultimate target for change in therapy. Looking at it from an information standpoint, the specific target of our work is a bit of implicit (unconscious) memory that needs to be rewritten. That critical bit of memory is the key to enduring change without the need for reinforcement. What does it hold? It's the nonverbal logic, the programming, mostly in the amygdala, that measures three critical probabilities: How big is the risk, what is the best strategy, and are the available resources sufficient to prevail? In other words, it is the logic applied to the information the mind has gathered regarding the likelihood that something bad will happen. We have come to call that programming a “rule.” 

Just as the child learns the rules of grammar, its mind comes up with rules for coping with threats. These are meant to improve survival by minimizing negative “limbic emotions,” the all-important nonconscious emotions that trigger healthy and unhealthy responses. When the stakes are high, that is the threat is existential, the rules tend to get frozen in time and protected from change, even decades later. The result is that rules established in early life continue to govern responses, even into adulthood, where they literally cause all sorts of problems.

A clinical example

Jack, the client used in my textbook, Psychotherapy, a Practical Guide, grew up in a dysfunctional household dominated by a ne’er-do-well dad who was both irresponsible himself, and harshly critical of his son. This posed an existential problem for the four-year-old. His first rule was, “If you have needs, you will be yelled at and shamed, so try not to have needs.” But, at that age, needs kept breaking through anyway. He just kept getting in trouble and it didn’t stop.

What we have learned by clinical observation through the lens of recent science, is that Entrenched Maladaptive Patterns, EMPs, the troublesome products of the mind addressable in psychotherapy, arise in layers, where the formation of each new layer of protection is triggered by a prediction of failure of the protective layer below. Thus, as Jack’s deepest layer, the rule against expressing needs, keeps failing, that triggers the development of a new layer of protection. Each layer has its own rule, and Jack’s next one uses a rule based on his recently developed system of values and shame. Shame, at least the limbic version, creates a highly effective deterrent against behaviors that get Jack in trouble. Feelings of shame continue to combat expressions of neediness, even as he becomes an adult. This new type of protective response is common and not easy to change in therapy. Here is more about this layer in Jack's life.

Jack’s internal deterrent goes by many names. We could call it conscience, inner critic, or Freud’s excellent, value-free term, “superego.” Those words describe a system where values, attitudes, ideals, and prohibitions are internalized as standards of judgment to be applied, especially, to the self. The superego now solves Jack’s problem with an internalized rule in the form of a value that says, “You should never express need or rely on anyone else.” Beyond that rule, the superego has an enforcement arm that uses shame as its most dreaded punishment. So now,  Jack, age 5, begins a lifelong practice of building and maintaining self-sufficiency and avoiding dependence on others. Except at rare times, this works out well. When he starts to feel needy, or emotional, the system kicks in and warns him that shame is near. He pulls himself together and soldiers on.

Meanwhile, his mind’s nonconscious problem solver establishes a second value, also using the superego. This one is in reaction to Dad’s irresponsibility. To control his anger at Dad, he vows to follow a new rule, "never to be irresponsible like Dad." Now he has permanently internalized two values, self-sufficiency and responsibility. We can think of this new rule and the one against neediness as “internal electric fences,” using shame to keep him from getting in trouble.

Both values, and the rules that go with them, have a lot of positive benefit. Jack is set up for success in life. His responsibility gets him a good career and upward mobility, while his self-sufficiency makes him appreciated at work. He marries a woman who also admires his responsibility and is only somewhat disappointed that he can’t accept a birthday celebration or lean on her when she could be source of support.

Jack’s successful adaptation to life carries him along well until the day he learns that a baby is on the way and that he is being promoted to a managerial role at work. His wife and friends congratulate him and want to celebrate his moving on in life. But his nonconscious problem solver quickly detects a possible catastrophe. There is a very real probability that the demands of both fatherhood and being a manager will overwhelm him and lead to failure, at least by his standards. 

His two most important values squeeze him like the jaws of a vice. He must show exemplary responsibility, both at work and as a father. Meanwhile, his value of self-sufficiency blocks him from accepting support or help from anyone. Formed when he was very young, these values are rigid and absolute. The demands are black and white. They don’t leave room for extenuating circumstances or shades of gray. His limbic mind evaluates that data and detects, correctly, that he is on course for failure to meet his internal standards, and that will lead to a mountain of shame.

A few days later, “out of the blue,” he has a severe panic attack. His nonconscious problem solver has created yet another layer of protection in response to an impending disaster. It pulls the red emergency cord, the only thing left that might ward off the looming catastrophe. One could call that response a failure of coping, but if we look more carefully, such a response, available from pre-human evolution, works quite effectively to stave off shame. His co-workers take him to the emergency room where he is given no choice but to accept support and relief from the immediate demands of work. This new rule is, “if a catastrophe is impending, get every system ready for an all-out defense.”

Examples of “rules,” held in implicit memory

Let’s look at some of the rules that people store nonverbally to implicit memory. Some belong to the superego and generate shame, but there are other kinds as well. Here are some examples:

• “Missing the primal love I need is too painful, but someday I’ll find a mother who will give it to me.”
• “Being neglected hurts, so I’ll make sure my sick sibling is lavishly taken care of and I won’t feel my pain.”
• “When my self-centered parent finally realizes how wrong he/she has been and apologizes, then my painful anger will evaporate and I won’t have to carry it every day.”
• “I must always be in full control or my world will collapse.”
• “If I control my hunger, that is equivalent to controlling the emotional neediness I hate.”
• “I just need to change the other person and, when they finally give in and do what I need, my painful anger will disappear.”
• “I must be perfect. Only then, will the shaming stop forever.”
• “If I keep thinking about my failures and how bad they are, then I won’t have to close the books and accept that I really am bad.”

As you can see, there are a great variety of rules. Bruce Ecker calls them “implicit learning.” They are the mind’s best solutions to problems of existential weight. They carry the limitations of cognition and experience available at the time, and the degree of peril determines how tightly they are held into the future. 

How rewriting rules is at the center of what therapy does

Looking at the details, these rules are all designed to quiet some painful "limbic emotion." These are the precise bits of programming or logic that therapy needs to change. When the rule is different, then the response to the same inputs will be different. We will have helped our client trade a maladaptive response for a better one. This is where memory reconsolidation is the “queen” of change mechanisms. It is the only known mechanism by which rules can be rewritten permanently.

Interestingly, one of the most common improvements offered by psychotherapy is acceptance of reality. Many problematic rules are designed for avoiding the painful experience of acceptance, accepting life “on life’s terms.” No one wants to accept bad things. As hard as acceptance is, making use of our adult ability to make peace with what can’t be changed leads, at last, to closure and the end of the stress cycle.

 Problem rules often set the person to waiting for something or seeking perpetually to change someone. Giving up on those quests is the ultimate answer, but requires going through the process of grieving that was avoided in early life. Another pattern is repetition of an unsatisfactory experience in the hope of a different ending. Some rules are effective but absolute and need to be softened to fit with adult reality. There are times, in adult trauma, for example, where, as Peter Levine explains, a protective stance is to inhibit action. Perhaps the rule is that “fighting back is too dangerous and must be held in suspension.” That, too, is a rule that can be kept in place for an indefinite time until released by reliving the event in therapy.

When two values collide, as in Jack’s self-sufficiency versus his responsibility, the result is usually compromise, causing damage in one or both directions. For Jack, his level of responsibility was ultimately limited by his inability to accept help. It wasn’t until his promotion and fatherhood that his compromise created a real problem.

In every case, therapy is enhanced by seeking, together with the client, to put the rule into precise words to see if it “resonates.” I suggest first trying together to identify the rule and, only then, checking with what is known historically to see if the facts tend to confirm the hypothesis. The more precise we can be in understanding the rule, the more effective we will be in finding the antidote, the disconfirming information that will allow memory reconsolidation to rewrite the rule so the old pattern of response is changed forever.

Jeffery Smith MD

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Photo credit,  Brian Kostiuk, Unsplash