Willingness in Therapy... and life!
Various dictionary definitions of willingness includes “the state of preparedness to do something that is necessary” or “readiness to do something”. Willingness is perhaps one of the most important factors in determining therapeutic progress, and yet it’s not necessarily something that is explicitly discussed unless there is an obvious reluctance to engage. Booking an appointment is certainly demonstrating some level of willingness to seek help or achieve insight…and that is fantastic. Truly! A lot of people don’t have the courage to take that step. If turning up is all you are capable of right now, that’s ok. It is a journey, and you’re doing the best you can. We will support you in that! And at the same time, without a deeper level of willingness moving forward, simply turning up may not be enough to truly bring about the change you desire.
We as psychologists are driven to help our clients. We genuinely care, and at the same time, much as we often find ourselves trying, we cannot do the real work that’s needed to truly change your life. Often clients picture us to be experts that can “fix them” or “fix their issues”, however, therapists are not like mechanics, and people are not like cars. We have training and experience and knowledge of many evidence-based strategies to share with you, and we always strive to create a supportive space where you can reflect and be yourself…but we are not able to change your lives for you. You need to be there for you too!
Willingness as a Therapeutic Aid
CBT
Cognitive Behavioural Therapy requires a willingness to work on changing thoughts or behaviours. For example, exposure therapy to overcome fear or anxiety requires willingness to expose yourself to the things that make you afraid. If a client is not willing, and instead continues to avoid things that make them anxious, it’s likely fear-reduction will be limited. Behavioural activation to conquer depression requires a willingness to do things even when you don’t feel motivated. If a client continues to isolate and withdraw and does not follow through with increasing their activity levels, it is likely that they will continue to feel flat and disinterested in things that used to give them pleasure. CBT also requires a willingness to acknowledge the negative thoughts or beliefs that hold you back, and then a further willingness to actually work towards challenging them. This is really hard if you’ve been thinking them for so long that they feel like facts! Or it may involve working on breathing or relaxation skills to increase your ability to regulate your own physiological arousal so that you feel in control of managing your distress. Without practicing these strategies between sessions, it is unlikely you will feel that confident using them at times they could really help.
DBT
Dialectical Behaviour Therapy explicitly teaches willingness as a skill to be learned and practiced in all areas of life. Willingness is described as a willingness to respond to life’s situations wisely, as needed, voluntarily, and without grudge. Essentially it is to accept each situation as it is and do what is needed to respond effectively. Fully participating in each moment mindfully, wholeheartedly, and without reservation. It is described as the opposite of wilfulness, which is where we refuse to accept facts or reality as they are, try to control events or those around us, sit on our hands doing nothing, or refusing to truly participate in our lives or do what is needed. Often clients say things like “That won’t work” or “I tried it and nothing changed”. Those are often clues that wilfulness has shown up! There is a big difference between grudgingly going through the motions of trying something new, or perhaps trying it once and giving up; versus actually fully committing all the way to doing what is needed. A common metaphor used is that life is like playing a game of cards. The most skilful players are those that play the hand they’ve been given. Not the one they wish they had! If they get dealt a bad hand they don’t throw their cards down and storm off, they don’t give up and just fling any old card down, and they don’t ruminate on the hand before, or worry about being dealt another bad hand afterwards. They willingly and wholeheartedly focus on the hand they have now, and what will be the most effective way to play it! Willingness in DBT is a big component of therapy in the sense that it requires being willing to learn new skills, practice them in session, and then go home and generalise them to other areas of life. However, it is more than that. Willingness is a way of living, of facing every challenge that arises, of accepting the experiences of life, both good and bad, and recognising we each have the capacity to either struggle against reality, give up and do nothing, or instead wisely figure out what to do that is likely to be most effective.
ACT
Acceptance and Commitment Therapy (ACT) frames willingness in two ways. Firstly, as an acceptance of all internal experiences: thoughts, images, feelings, and memories; and secondly, as a willingness to do what it takes to live a rich and meaningful life in accordance with our values. So, with regards to the first one, willingness involves opening up, making room for, or allowing painful or unwanted thoughts or feelings to be there. Truly accepting, rather than just tolerating their presence. Instead of spending everyday trying not to feel anxious, or not to be sad, or trying desperately to avoid or shut down or distract from our painful thoughts or memories, ACT teaches us that living a meaningful life can be done even with these in our life. We can never “get rid of” anxiety, fear, sadness, grief, shame, or guilt because to be alive is to experience a full range of emotions, both painful and joyous. To try to deny those that are painful only leaves us hooked by the very thoughts and feelings we are desperately trying to avoid. The second part of how ACT frames willingness is that to allow these thoughts or feelings does not mean to become fixated on them or controlled by them. It instead means to observe them without judgement as they arise and to make room for them to be there whilst we move forward in valued living. We choose to willingly do things that matter to us, even if it means those painful thoughts and feelings will show up!
Therapy and life in general
Whilst CBT, DBT and ACT are some of the most common evidence-based approaches that we practice, there are many other forms of therapy that do not include components around teaching skills or strategies to practice outside of session. But no matter what therapeutic framework is used, therapeutic change requires willingness in some capacity. Perhaps it’s a willingness to be vulnerable and share with us what is really on your mind. Perhaps it’s a willingness to put scepticism or fear aside and try new things. Perhaps it’s a willingness to reflect upon your life, your experiences, your deepest fears, shame, or guilt. Or perhaps it’s a willingness to let yourself truly be seen. To believe us when we say you don’t need fixing because you are not broken. You are human. And to be human is to be full of complexities, to experience pain, to live in a world where we cannot control the things or people we desperately want to control. These things are hard! It makes sense that not everyone will be ready to engage in therapy in this way immediately. These things require a lot more willingness than simply showing up!
The same is true for life. Living a meaningful life requires more than simply showing up. More than going through the motions and wishing things were different or waiting for things to change. So, take a minute to pause. Really pause, and ask yourself: “Are you willing to give life your best shot?”
