Often one has to feel worse before you can be better:

Dear Dr. Brilliant Cliché;

Do you think it is possible for people who have messed up coping skills and negative behavior patterns to change on their own?

My cousin was a chain smoking, coffee swilling, abrasive butthead and no one could tell him anything. His way of coping with people who annoyed him was to haul off and slap them.

Then he had a heart attack. He actually died on the operating table during a triple bypass and they brought him back after several minutes. When I asked him about the experience later,

he said that he met up with his mother (who’d died over 10 years ago) and had a long talk with her.

Since he’s been back from the hospital, he is a completely changed man. He only drinks green tea, has quit smoking, alcohol, and eating bacon. He takes vitamins and is nice to small children and old ladies. I’ve had a number of pleasant conversations with him and I’m starting to really like the guy.

My brother was in therapy for years and it did him no good at all. But my cousin’s heart attack seems to have given him a brain transplant overnight. What gives?

Curious George


Dear Curious,

Your cousin didn’t change on his own. He had an intense epiphany, much like meeting the Ghost of Christmas Future.  Studies show that this type of spiritual catharsis can permanently change behaviors. However, catharsis in therapy has not been shown to make any long term difference.

High emotion can work to either cement positive memories…or negative ones. If your therapist was like the doctor in Steven King’s Quitters who’d cut off your finger if you had a relapse it might indeed make permanent life altering changes. But in typical therapy today we try to make the patient comfortable; this decreases the likelihood of permanent change. An interesting fact– the intent of old style Freudian therapy was exactly the opposite. You weren’t allowed to look at your therapist; the treatment was all about agitating you.

Feeling better and being better are not the same thing. Often you have to feel worse before you can be better. This fact has been lost in most modern treatments but is still understood by organizations such as Alcoholic Anonymous- that’s why they have a higher behavioral change rate than nearly any other form of treatment.    Working the 12 steps is painful.

Dr. Brilliant Cliché


Granny says: I would have loved to have been a fly on the celestial walls for that conversation your cousin had with his dead mother.

I believe that the reason most people can’t change is because they keep falling asleep. They go to therapy, talk, talk, talk, have some ideas… and then go back to the mind-numbing demands and routines of their daily lives. People fall back asleep and into old habits because they just can’t maintain the necessary awareness to change.

When you die, or have some other similar drastic supernatural experience, it wakes you up in a way that a trip to the therapist just doesn’t. You stay awake for quite a while afterwards. Sadly, many people eventually fall back asleep again and return to the status quo. About 6 months is the average.

Ironically, most of the negative habits we have are designed specifically to keep us asleep. This is one of the reasons that when we are awakened by an extraordinary event, it can be so much easier to quit bad habits- when one is truly awake, one seldom feels an overwhelming desire to go back to bed, just as one seldom wants a nap in the middle of an exciting football game. But in our usual state of rote induced lethargy, we long to return to the comfortably numb fog of sleep. It seems a natural progression from the lethargy.

It would be great if therapists could scare people into changing, but I doubt if that would really work. People need a genuine scare, not a contrived one, to wake them up. Generally, such events can’t be planned. We have to wait for such moments… and when they arrive, we should try not to spoil them by bitching about the inconvenience. It makes a great deal more sense to see them as possibly our last great chance to find true happiness.



About Dr. Brilliant Cliché

Dr. Brilliant Cliché and the Granny Dr. are a fictional web presence and advice blog. Together we offer a joint perspective that is deep but not academic, entertaining but not fluff, and educated yet street smart. By joining the internet community we hope to share thoughts and stimulate insightful conversation around pressing issues that affect us all. Looking forward to hearing your thoughts. (This is not a site for therapy nor does it intend to replace medical or other professional care. ) You can leave comments here or email The Dr. at dr.brilliantcliche@yahoo.com and don’t forget to like us on facebook. Our facebook page is Dr. Brilliant Cliche
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One Response to Often one has to feel worse before you can be better:


    The field of Behavioral Economics talks of this. They don’t call it sleep but instead explain that takes a great deal of brain energy (glucose) to pay attention. Most of human existence is on automatic because we are unable to sustain active attention for long. Crisis causes us to pay attention; that’s why people often crash once the crisis is over and safety is re-established.

    Dr. B.C

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