If you’ve been a therapist and spent any time on an airplane or at a dinner party, you’ve certainly experienced the playing out of a familiar trope: You tell someone what you do for a living and they get a little antsy or awkward, quipping some version of, “Oh no! You’d better not psychoanalyze me!”
It’s usually just a brief eye-roll of an exchange, but there’s something it in fact reveals about the way that most people experience therapists. Perhaps even about the way that therapy has historically operated.
These remarks, always delivered with a laugh, are saying, “You’re going to see something in me that I’d rather you not. I spend a lot of energy cultivating this facade. You’re trained to see all of the cracks.”
And the reality is that the majority of us with conventional mental health training have indeed been trained on the cracks. I see this changing – slowly – in more contemporary models, but most of us were raised to suss out the problems, the deficits, the places that trauma seemed to fracture.
In my view, this stems from mental health’s long-standing worship of the medical model. As in more traditional medicine, we scan for the bleeding, the bruising, the broken. What’s wrong? Where does it hurt?
And then seeing the wound, we believe our job is to immediately stop the bleeding. How else will they be saved?
It’s a tidy little model. Everyone has their role. The patient who arrives impaired or injured – who cannot heal without the other. The doctor who holds the tools and the answers – the one who can fix it.
No wonder our seatmate on the plane gets a little antsy. Who wants to be the one who is broken?
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The point at which this paradigm really shifted for me was while I was sitting in a large classroom in Fitchburg, Wisconsin. I was a trainee in a program for MDMA-assisted psychotherapy, one of the most promising of the recent psychedelic approaches.
In many ways, I was perhaps already primed to have my worldview shift. I had previously trained in EMDR, an approach to trauma treatment that asserted we all have the power to revisit and even rewrite the emotional impact of our memories. I was at the time also learning Internal Family Systems, another modality founded on the idea that there is a ‘Self’ that exists beyond all of the hardships that have influenced us. These approaches shared a thick common thread that veered dramatically from older mental health models: they each believed that we have the capacity for healing within us.
These ideas were all circling inside of me going into my MDMA training, but it wasn’t until witnessing the transformation taking place in these psychedelic-assisted sessions that the plane finally landed. And it was indeed transformation I was seeing. I wasn’t watching people be stitched up or patched over, but fundamentally returned to themselves.
(The word transformation comes from Latin roots, combining trans- (across or through) and formare (shape or form). To transform to is to carry across into another form.)
In the MDMA sessions, patients were given the medicine that softened their defense patterns and long-standing identity structures. Things become more flexible and fluid, and importantly, they become strikingly more compassionate (MDMA and some other psychedelics act as “empathogens” – turning up our empathy toward others and ourselves). Under those conditions, healing started to organically happen.
Whatever the patient needed to address or work through often rose quickly to the surface (often without having to explicitly try to bring it up). The material would come, unbidden, as if the Self knew exactly where the healing needed to happen. Those might be memories, current situations, entrenched beliefs – the stuck points where the hurt resided. Once there and in the person’s awareness, the material was being experienced by the person in a very different way. They would see their difficult memories or the ideas about themselves that had plagued them for years in a new light – often a light of softness, compassion, and new perspective. In these sessions, patients weren’t being “worked on” by a clinician or even striving to “work on” themselves. Work was certainly happening, but it was via another mechanism entirely.
The MAPS researchers, the ones studying and teaching these approaches, called this mechanism the inner healing intelligence. They explain that inner healing intelligence is the fundamental drive that all humans possess toward recovery and actualization. The principle suggests that, given the right conditions, we will all strive toward healing. Given the right conditions, we will all strive toward the very best versions of ourselves.
I realize that to some, that idea might sound like dewy-eyes idealism. It might particularly sound that way to those of us who have spent lifetimes navigating feelings of fundamental brokenness or having come to see others as self-interested or dangerous. But I would suggest that once you start to really consider this framework, it’s impossible not to see the analogs of it everywhere.
When we cut our skin, platelets rush to form a clot and inflammatory cells clean bacteria to prevent infection. When we sleep, our brain clears away metabolic waste. Our bones are living tissue under constant renovation. Our skin, our gut lining, our liver and more are constantly regenerating for us.
In these and countless other ways, our bodies work tirelessly to protect and repair us.
And all of this happens whether we like our bodies or not – whether we approve of them or treat them kindly. Why would we believe our emotional systems wouldn’t do the same?
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Several years ago, I saw it first as a tweet, and it struck me so deeply that I made a little pact with myself that I’d share it on my social media every time it came across my feed. So if you follow me on social, you’ve probably seen it.
It said, “If you’re trying to love yourself, you already do. Where do you think the trying comes from?”
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Dr. Diana Fosha is a Romanian-American psychologist who began working on a new therapy model a little over two decades ago. The model, Accelerated Experiential Dynamic Psychotherapy (AEDP), is another approach that draws on and indeed privileges the ways that we are wired to heal. Within this model, Fosha came up with a name for the seemingly magical process that is our drive to emotionally and relationally heal. She calls it transformance.
Transformance is the neurobiologically-based motivational force that pushes us as humans toward meaning-making and flourishing. It’s rooted in our neuroplasticity – the brain’s ability to continually learn and evolve by creating new neural pathways. Like our other human drives, transformance is not something that we have to learn or obtain. It’s wired into our experience.
The challenge is not in possessing it – it’s in recognizing it in action.
When we look at ways we have felt stuck in our dysfunctional patterns, it could be easy to question the presence of transformance. There are times it certainly doesn’t feel like we have an underlying life force guiding us toward psychological health. But as AEDP explains, transformance is set into action when given the right conditions.
What are those right conditions? First and foremost, transformance thrives on the felt sense of safety and connection. When we get some space from overwhelming emotions, when we feel present and rooted, when we feel that someone else is fully tuned in and affirming… that’s when transformance inevitably emerges.
We could see what’s happening in MDMA therapy as a version of this. In that case, the medicine itself helps someone access a sense of safety and self-compassion, and so transformance drives can take over. Change happens under safety and connection.
I see this all the time (even without medicine) in my work as a therapist. When I am in full attunement and connection with my patient, and when I can help them co-regulate around something that’s been hard or isolating, something profound changes. I don’t mean it just feels good. I mean that something almost tangible emerges. With that emergence, someone can often move through things that would have previously felt impossible, they can feel their own transformance. They witness and feel their own ability to change.
One of my very favorite tasks of being a therapist is being a transformance detector. I actively search for signs of transformance emerging – both in real time in our sessions and in what people describe happening outside of the therapy room. These signs of transformance are glimmers, and they are the signs of life that remind us that even in the most challenging of circumstances, our drive for healing remains.
Far from being some abstract or aspirational idea, glimmers are concrete data. There’s a glimmer in the way my patient took a deep breath and slowed her heart rate before responding to her partner. There’s one in the way another made the difficult decision this time without hours of research. Yes another in the way someone could keep eye contact while talking about the shame she feels, even while a part of her is desperate to look away.
Glimmers can seem so fleeting that they’re easy to miss, which is why we as therapists train in detecting them. But you don’t have to be a therapist to get good at seeing glimmers. It’s simply a matter of orienting yourself to looking for them in yourself.
We can ask ourselves where we showed up with more self-compassion, patience, integrity, slowness, kindness, or self-trust that day. Then, we should take a moment to really feel what it’s like to have done so. This directing of our attention to our own glimmers of transformance is powerful in itself. It tunes us to a new channel – one that reminds us of our relentless capacity to change.
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And then there are the flowers. The ones that sneak up through the cracks in the sidewalks. The ones that say: I know I am existing against the odds, but I’m going to bloom. Here I am, growing.
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We have a bad habit in psychology of looking for the pain points and the deficits. We have a bad habit as humans of doing the same.
Those parts of us need tending, for sure. They need compassion and guidance. But they can tell a false story – one in which we are broken or flawed, irredeemable, something to be overcome. I don’t believe any one of us is any one of those things.
What some of the more recent therapy models – everything from psychedelics to IFS to AEDP – are teaching us is something that has been waiting to be recognized in our society for a very long time. It’s something that, it must be acknowledged, many older and non-western traditions have been reminding us for countless generations. We are being reminded that our very nature is to heal and to grow, that we are entities built to restore.
None of that suggests that we can rest on our laurels or that it’s not possible to get stuck. But it reorients us away from ideas that we will find some fix outside of ourselves and back inward to the places inside of us that want nothing more than for us to be better. It orients us to trusting ourselves, even when that feels very, very hard.
But if you are trying to trust yourself, to trust that you can change in the midst of long-standing patterns or pain or what feels so damn hard, well then you already do. Where do you think the trying comes from?
