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From Issue Sixteen, November 2011 « Previous Article

Redirect: The Surprising New Science of Psychological Change

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Police officers Gary Felice and Prince Jones were the first to respond to a house fire on De Leon Street in Tampa, Florida. When they arrived, they heard what every emergency worker dreads—screams for help from inside a house engulfed in flames. Through a window, they could barely make out the silhouette of a man stumbling and falling, just short of escape. Felice and Jones frantically tried to break down the door, which was secured with burglar bars. It took five minutes of tugging, pulling, and smashing before the door finally gave way, but by then it was too late. The man was “curled up like a baby in his mother’s womb,” said Jones. “That’s what someone burned to death looks like.”

The next day Gary Felice saw a picture of the victim in the paper and realized, to his horror, that he had known him—it was Tommy Schuppel, forty-​two, a popular X‑ray technician at a local hospital. The fact that Felice had seen his friend die haunted the officer, so much so that he had trouble eating and sleeping. His bosses sympathized and wanted to help, so they did what many police departments do: they scheduled a Critical Incident Stress Debriefing (CISD) session for Felice.

The premise of CISD is that when people have experienced a traumatic event they should air their feelings as soon as possible, so that they don’t bottle up these feelings and develop post-​traumatic stress disorder. In a typical CISD session, which lasts three to four hours, participants are asked to describe the traumatic event from their own perspective, express their thoughts and feelings about the event, and relate any physical or psychological symptoms they are experiencing. A facilitator emphasizes that it is normal to have stressful reactions to traumatic events, gives stress management advice, answers questions, and assesses whether participants need any additional services. Numerous fire and police departments have made CISD the treatment of choice for officers who, like Gary Felice, witness horrific events; indeed, some departments require it. It is also widely used with civilians who undergo traumatic experiences. Following the September 11, 2001, terrorist attacks, more than nine thousand counselors rushed to New York City to help survivors deal with the trauma and prevent post-​traumatic stress disorder, and many of these counselors employed psychological debriefing techniques.

Psychological debriefing sounds like an effective intervention, doesn’t it? An ounce of prevention is worth a pound of cure, and surely getting people to talk about their feelings instead of bottling them up is a good thing. Or is it?

Let’s put CISD aside for a moment and consider another approach. Instead of asking Officer Felice to relive the trauma of Tommy Schuppel’s death, suppose we let a few weeks go by and see if he is still traumatized by the tragic event. If so, we could ask him to complete, on four consecutive nights, a simple exercise in which he writes down his deepest thoughts and emotions about the experience and how it relates to the rest of his life. That’s it—no meetings with trained facilitators, no stress management advice—just a writing exercise that Felice does on his own four nights in a row.

Which approach do you think would be more effective—CISD, in which people express their thoughts and feelings right after a traumatic event with the help of a trained facilitator, or the writing technique [pioneered by social psychologist James Pennebaker], which people do in private weeks after the event? If you are like me (and the hundreds of police and fire departments that use it), you would put your money on CISD. Surely early interventions are better than later ones, and offering people the services of a trained professional is better than asking them to sit and write by themselves. But we would be wrong.

It took research psychologists a while to test CISD properly, in part because it seemed so obvious that it was beneficial. When they did, they found something unexpected: not only is CISD ineffective, it may cause psychological problems. In one study, people who had been severely burned in a fire were randomly assigned either to receive CISD or not. Over the next several months, participants completed a battery of measures of psychological adjustment and were interviewed at home by a researcher who was unaware whether they had received CISD. Thirteen months after the intervention, people in the CISD group had a significantly higher incidence of post-traumatic stress disorder, were more anxious and depressed, and were less content with their lives. Similar results have been found in studies testing the effectiveness of CISD among emergency workers. It turns out that making people undergo CISD right after a trauma impedes the natural healing process and might even freeze memories of the event. (This may have been the case with Gary Felice—according to a journalist who interviewed him four years after the fire, Felice seemed unable to get rid of the mental image of Tommy Schuppel lying dead on the floor.)

Through Your Eyes Only

Why does CISD fail to work, and why is the writing exercise so powerful? It has to do with people’s interpretations of what happens to them—as we will see shortly, the writing exercise helps people redirect those interpretations in healthier ways than CISD does. But first, some words about the importance of personal interpretations.

For centuries, philosophers have recognized that it is not the objective world that influences us but how we represent and interpret the world. Social psychologists have added the important proviso that these subjective interpretations are formed quickly and unconsciously. When something happens to us, our brains kick into gear and try to make sense of it as best we can—so rapidly that we don’t even know that we are interpreting rather than observing the world.

Suppose that, after a staff meeting, your boss tells Jack, a longtime employee, to take the rest of the afternoon off. What do you make of this? Maybe your boss is rewarding Jack for his hard work—he has been putting in long hours of late. Or maybe she has decided to fire him and is interviewing his replacement that afternoon. The reasons why people do what they do are often mysterious, and we have to fill in the blanks. The interpretation we come up with matters because it dictates how we feel and act (e.g., whether we are envious of Jack or feel sorry for him).

Our interpretations are rooted in personal narratives about ourselves, and these narratives aren’t always so positive, as is the case with teenagers who feel like rebels without a cause, college students who are convinced they were admissions errors, and adults who always seem to assume the worst about their relationships. [P]eople have core narratives about relationships that are rooted in their early interactions with their primary caregivers, and these narratives act as filters, influencing interpretations of their adult relationships—sometimes in unhealthy ways. Our interpretations are [also] rooted in the narratives we construct about ourselves and the social world.

[T]his is hardly news. Of course some people have maladaptive ways of thinking about themselves and the social world, and of course it would help to get them to construct better stories. Further, there is a well-​known form of psychotherapy designed to do just that, namely, cognitive behavioral therapy (CBT). CBT assumes that maladaptive interpretations—negative thought patterns—are responsible for many mental health problems and that the best way to treat those problems is to make people aware of their thought patterns and learn how to change them. The student who immediately assumes the worst about one bad grade, for example, is at risk for depression and might benefit from cognitive behavioral therapy, in which he would learn to recognize and change his negative assumptions about himself.

Psychotherapy is great for people who need it, especially those with serious problems such as depression or debilitating anxiety. But there is a new way to redirect people’s personal interpretations that is quick, does not require one-on-one sessions, and can address a wide array of personal and social problems. It can help people like Gary Felice who have witnessed traumatic events, people who assume the worst about their abilities, teenagers experiencing problems of adolescence, and people like you and me who want to find ways to be a little happier.

Story Editing

The new approach began with the theorizing of Kurt Lewin, who helped found the field of social psychology in the 1930s and 1940s. Lewin championed the subjectivist view that in order to understand why people do what they do, we have to view the world through their eyes and understand how they make sense of things. But he had a more radical insight: not only do we need to view a problem through other people’s eyes, we can also change the way they view it with relatively simple interventions. True, people’s self-​views are often embedded in years of family dynamics, personal relationships, and cultural forces, and we can’t always expect people to revise these views overnight. If a teenager is a rebel without a cause, it doesn’t do much good for his parents to implore, “Please change your view of yourself,” any more than it would to say, “I would appreciate it if you would lay off the crystal meth, lose the lip piercing, and take flute lessons.” Narratives are often like an oil painting to which we add a little daub each day. Revising that narrative would mean scraping away layers of paint and starting over again with a fresh canvas—a daunting task, to say the least.

But, as Lewin noted, sometimes it is possible to change people’s interpretations fairly easily if we find just the right approach. During World War II, Lewin demonstrated this by getting people to change what seemed like an intractable food preference—namely, an aversion to organ meats (e.g., kidneys and hearts), which were in greater supply at the time than traditional cuts of meat. Simply lecturing people about the importance of this alternative food source didn’t work. Instead, Lewin convened groups of homemakers to discuss the issue. During the meetings, a trained leader skillfully steered the conversation to the ways in which obstacles to serving organ meats could be overcome (e.g., how to deal with complaints from one’s family). Women who took part in these groups were much more likely to serve organ meats, in the following week, than were those who simply listened to the lecture. Since then, new generations of social psychologists have refined Lewin’s idea into an approach that I call story editing, which is a set of techniques designed to redirect people’s narratives about themselves and the social world in a way that leads to lasting changes in behavior.

The term story editing implies that we are targeting long-​standing personal narratives that people have constructed about themselves and the social world, and, indeed, we often are. But at other times, we are targeting people’s quick, initial spin on events. Editing people’s initial interpretations of events is an important way of redirecting their narratives, just as altering a few key details at the beginning of a novel changes the story yet to come.

How does story editing work? One way is to get people to redirect their own narratives, as they do in the Pennebaker writing exercise [described above]. This approach is most useful for people who have failed to come up with a coherent interpretation of an important event in their lives. Something has happened that doesn’t make sense and is unpleasant to think about. They try to put it out of their minds, which makes it even less likely that they will succeed in explaining or coming to terms with it. The writing exercise, it turns out, is an effective way to get people to reinterpret such episodes. The traumas that cause prolonged stress are usually the ones that we can’t make sense of; they are profoundly troubling because they seem like meaningless, random acts that don’t fit into our view of the world as a predictable, safe place. Furthermore, we often spend a lot of psychic energy trying to banish the events from our minds, rather than taking the time to dissect the events and find some meaning in them. This is exactly what the writing exercise does—it allows us to take a step back and reframe what happened. In fact, the people who benefit the most from the exercise are those who begin by writing a jumbled, incoherent account of the traumatic event but in the end tell a coherent story that explains the event and gives it meaning. At this point, the event is less likely to intrude into people’s thoughts, and they don’t have to spend psychic energy trying to suppress it.

This is story editing in its simplest form: inducing people to make sense of an event that has gotten under their skin. As Susan Sontag said in her journal, “I write to define myself—an act of self-​creation—part of [the] process of becoming.” To be sure, the writing technique is not a magic cure for all psychological problems. Sometimes we can’t construct a coherent narrative on our own, and in such cases psychotherapy can be a big help. [C]ognitive ​behavioral therapy is specifically designed to teach people how to turn negative thinking patterns into healthier ones. But the writing technique has proved to be remarkably beneficial for people with a wide range of traumatic experiences.

Why doesn’t CISD accomplish the same thing? One reason is the timing. As anyone who has ever been unexpectedly left by a lover knows, the worst moment to work through the loss is right after we find the Dear John note taped to the bathroom mirror. Time does indeed heal at least some wounds; once we are done throwing furniture or sobbing into our pillows, we can take a step back and put as good a spin as we can on what happened. (“We were never really suited for each other, and besides, it’s great to have more closet space.”) If time goes by and we are still bothered by a traumatic event, we probably haven’t succeeded in making sense of it, and we might need the extra boost the writing exercise can give us. In short, one reason CISD fails is that it makes it harder for people to take that step back and gain some perspective on what happened. Forcing people to talk about the traumatic event right after it happened can even solidify memories of it, which makes it harder for people to reinterpret the event as time goes by.

Sometimes, though, people need more of a nudge than simply writing about their problems. They may be barreling down a particularly destructive narrative track, [and] like a railroad worker operating a switch, we need to redirect them onto a healthier track. One way to do this is to spoon-​feed people a better interpretation of their behavior. [T]his works particularly well with children. Labeling kids as “helpful people,” for example, encourages them to internalize this view of themselves. We have to be more subtle with adults; rather than simply giving them a label for their behavior, we need to get them to reach that conclusion themselves. I call this approach story prompting, because it involves redirecting people down a particular narrative path with subtle prompts.

[A] colleague and I conducted the following experiment. We targeted first-​year college students who seemed to be caught in a self-​defeating cycle—those who were not doing as well as they wanted and were worried about their grades. The students came in for what they thought was a survey of first-​year students’ attitudes toward college life. We told them that they would see some of the results from our previous surveys of upper-​class students, so that they could get an idea of the kinds of questions we would be asking. We then showed them survey results indicating that many students have academic problems in their first year but that these problems get better as time goes by. For example, participants read that “67 percent [of the upper-​class students] said their freshman grades were lower than they had anticipated; 62 percent of the students said their GPA had improved significantly from the first semester of their freshman year to their upper-​class years.” (These data were from an actual survey we had conducted earlier.) To make this message more concrete, we showed participants videotaped interviews of four upper-​class students who conveyed the same message about grade improvement. These students answered questions about their major, career plans, hometown, and leisure-​time activities, and then conveyed some key information: their GPAs for the first semester of their freshman year, the second semester of their freshman year, and the semester they had just completed. All students reported a steady increase; for example, one student reported getting a 2.0, a 2.6, and then a 3.2.

That was all there was to it—a thirty-​minute session in which students learned that lots of people struggle academically at first but then improve their grades. We made no attempt to delve into participants’ academic history, inquire about their study habits, or counsel them on how to manage stress. In fact, participants didn’t even know that the purpose of the study was to help them improve their academic performance. We figured that the simple message that lots of people struggle at first but do better later might make a light bulb go off in the students’ heads, triggering the thought, Maybe I’m not an admissions error who should have gone to community college—I just need to learn the ropes and try harder, like those students I heard about.

Thus far we have seen two forms of the story-​editing approach: the writing exercise, in which people reinterpret a problem by writing about it, and story prompting, in which people are directed down a particular narrative path with the hope that it will bump them out of a self-​defeating thinking pattern. A third technique, called the do-good, be-good approach, involves changing people’s behavior first. This idea goes back as far as Aristotle, who suggested that people acquire virtues “by first having them put into action . . . we become just by the practice of just actions, self-​controlling by exercising self-​control, and courageous by performing acts of courage.” In other words, people’s behavior shapes the personal narratives they develop. If they act kindly toward others, they begin to see themselves as having kind dispositions, and the more they view themselves as kind, the more likely they are to help others—thereby strengthening their new narrative.

Excerpted and abridged from Redirect: The Surprising New Science of Psychological Change, © 2011 by Timothy D. Wilson. With permission from Little, Brown and Company; New York.

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  • Anonymous Icon

    Infinite Nov 29, 2011

    If you believe you are, you will be that belief. As The Untethered Soul points out, if you make a commitment to be happy you automatically start searching for everything that makes you happy.Just the thought makes me smile. Gail Howell

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