The Switch Approach Explained
Understand the theoretical reasoning behind our approach
To understand the Switch Approach
We must first understand the backdrop of mental health treatment.
A brief history of mental health treatment
The way we have approached and provided support for people with psychological problems has changed dramatically over the last 100 years or so. From the writings of Freud to the current research in neuroscience, we have come a long way in our knowledge. However, in spite of our advances in science and understanding, people still continue to suffer with mental health problems.
At the turn of the 20th century psychological inquiry and treatment was dominated by the two towers of psychoanalysis and behaviourism - the psychoanalysis community, spearheaded by the writings of Sigmund Freud proposed that psychological disturbance arose from internal conflict primarily between the animalistic id (meaning IT), the ego (I) and the superego (above I). Beast-like desires are said to have raged within the unconscious mind, and the self and social self (ego/superego) would venomously defend itself against this tirade of drives and impulses (the libido). According to the theory, as the person aged, they would go through the so-called psycho-sexual stages of development, and if they did not successfully complete, or resolve these stages, they would encounter psychological difficulties. Difficulties that could only be resolved with the assistance of a professionally trained psychoanalyst; often at a frequency of three times plus per week and lasting sometimes many years. Most psychoanalysts were trained medical Doctors who were men, and many of their patients were women who were in Freud’s view, hysterical and neurotic.
Running alongside this were the behaviourists, recognised by their characteristic white lab coats, these experimental psychologists focused primarily on the behaviours of animals with a view to explaining human behaviour. Experiments such as “little Albert” and “Pavlov’s dog” are well known in popular culture.
Behaviourists tended to believe more in environmental factors; the behaviourist J B Watson famously stated that given a number of infants (including his own son), he would be able to sculpt them into any specialist he would choose, be it lawyer, policeman or politician. These were the guys who would prod about at things to see what happened.
This was in great contrast to Freud’s Internal dynamic model, and although it is easy to level criticism at Freud, his work did result in more humane treatment and moved the profession away from the asylums. You could say that he spawned the concept of talking therapies, and without him, barbaric practices such as electroshock treatment and lobotomies may have continued for much, much longer.
Now don’t be fooled into thinking that Freud’s work is redundant, he’s still a heavy hitter in the psychological world, with some countries, France for example, and many parts of the United States, continue in using psychodynamic therapy as the preferred model for psychological treatment. Same goes for the behaviourists, cognitive behavioural therapy (CBT), the most widely used psychological treatment in the NHS, is directly linked to the work of the behaviourists.
So, throughout the first half of the 20th century, the Freudians and the behaviourists battled it out, with their theories branching out to form other schools of inquiry; transactional analysis, cognitive therapy, attachment theory, REBT and object relations to name but a few.
Then, after the second world war, another movement started to gain momentum, led most notably by an American psychologist from Illinois, named Carl Rogers.
Rogers and other like-minded scholars such as Abraham Maslow, spear-headed a movement that is so influential that if you have ever had any dealings with any Government agency, or any form of psychological treatment, been in formal education or received any counselling, you would have come into contact with it. This school of inquiry is known as the Humanistic movement, and it underpins almost every counselling school in the UK.
This school of thought, with many of the forerunners themselves disillusioned psychoanalysts or behaviourists, moved away from the Doctor/patient model of psychoanalysis and the experimentational distance of behaviourism, and began to allow the person to tell their own story, in their own way, putting the client’s experience at the centre of the work.
The humanist model is still the preferred model for counselling to this day. In fact, counselling is the humanistic model in practice, with Carl Rogers’ work at the centre.
So, moving forward we saw the emergence of Cognitive Behavioural Therapy (CBT), which has well over 200 therapeutic models within it!
CBT is preferred by the medical fraternity as it can be relatively easily modified into manual based platforms due to its linear style – if you’ve ever been treated by the IAPT service through the NHS, then you’ve experienced a form of CBT.
Government agencies like the NHS prefer CBT because it is good at providing outcomes – and the medical profession really like outcomes! However, evidencing therapeutic work is often very difficult as it relies mostly on the subjective report from the patient, and in British culture, people really like to please their health professionals. Sure, we can use behavioural outcomes such as using less drugs or being less violent, but unless a person is being observed 24 hours a day, it’s really difficult to know the truth – what people do behind closed doors, often stays behind closed doors.
CBT attempts to use a sort of cause and effect type model, and in general, the process is as follows - a thought, followed by a feeling, followed by a behaviour. This seemingly predictable, linear process sits nicely with the medical model of causation and symptom, with the cause being the faulty or irrational thought and the symptom being the feeling and/or behaviour. So, fix the thought and you’ve solved the problem.
This view is often challenged, as we can measure with the assistance of fMRI scanners, the activation of different brain regions – the lower brain (where emotions are said to be activated) can be stimulated in 12 milliseconds, whereas the higher cortices (where the thinking brain is said to reside) takes up to twice that amount of time (24 m/s). Obviously, this is not always the case, and in some circumstances (reflection or considering the future for example) we can absolutely think before we feel, but not always, and especially not with things like psychological trauma.
I guess what we are learning is that all these theorists/schools of thought have value in some way but not necessarily in others. Trouble is the majority of them were written by men, and unfortunately, historically men tend to have a need to be completely right, especially if they’re kind of right about something.
In more recent times we have seen the emergence of another form of CBT, again robustly evidenced, but this time, coming from a completely different perspective. Put simply, the opposite of classical CBT. This is known as 3rd wave, or mindfulness CBT – Acceptance & Commitment Therapy (ACT) Dialectical Behavioural Therapy (DBT) are examples of this method.
ACT differs from classical CBT in that rather than work to change the thoughts and feelings, it looks to accept and view “experiential avoidance” as the core property of mental disturbance. In other words, stop trying to avoid your feelings, however unpleasant, and learn to be with them (that’s where the mindfulness comes in), which according to the model strengthens resilience and promotes authenticity – being in touch with your core personal values is also a key principle of this approach. With regards to the potential effectiveness of Mindfulness CBT, such as ACT, the results are promising. The model looks towards long-lasting change with techniques that can be learnt and applied after the therapy itself has been concluded. Celebrities including Dr Phill and Ruby Wax are great advocates of this approach.
Ok, so through our very brief journey through the history of psychological theories and treatment approaches, we have learnt that there is some value in all of them to some degree and they can be useful in one way or another.
So, let’s sum up what seems to be effective; well for sure the development of a positive therapeutic relationship based upon authenticity, empathy and a non-judgemental attitude is pretty hard to argue against, and most health professionals will promote this, including us here at Switch.
The techniques from CBT can be effective for sure, and it seems true that by looking at the situation from a different perspective, does appear to change how we feel about it. Also, an aspect of the Switch model.
However, one of the seemingly most impactful in therapeutic approaches comes from the mindfulness CBT method of ACT – the research and the outcomes are difficult to dispute; psychological flexibility appears crucial in terms of addressing psychological and emotional distress. Further, ACT is what is known as a “contextual therapy” meaning that in order to really make sense of something, you need to understand the context. In short, the human mind makes meaning in context, and without context, there is no meaning. Therefore, the Switch approach is, unsurprisingly, a contextual approach with psychological flexibility as one of its primary objectives.
Ok, so I hope this is all making sense so far. However, this is far from the complete picture, for now we move with gusto into the 21st century, where new theoretical concepts in neuroscience begin to allow for workable therapeutic tools and approaches.
Neuroscience made Workable
Neuroscience has historically sought to understand the functions of the brain, with this pursuit, it has attempted to correlate certain brain regions with certain aspects of human experience, for example, the experience of emotion. It is common to hear statements such as ‘anxiety lives in the amygdala” or the “conscious mind lives in the Medial Prefrontal cortex”, or “emotions live in the limbic system”, or “cortisol is a stress hormone”. People are often amazed and seduced by these apparent findings and dare not challenge them through fear of ridicule and shame – for how could someone possibly argue with a brain scientist about the brain! However, we might ask, how useful are these ideas and theories in terms of application to alleviating mental distress? So, neuroscience, although interesting, has not been, let’s say, workable.
However, in more recent times, big players in the neuroscientific field has begun to challenge some of these ideas which has led to the emergence of digestible theoretical concepts, that can be applied to working with people with psychological problems (click the “Further Reading” button on this page for more info).
In short, there is absolutely zero evidence that anything lives anywhere in the brain! Yes, the amygdala does have something to do with anxiety, but so do many other brain regions, and the amygdala is also responsible for countless other tasks. To the best of our knowledge, it appears that no one brain part or region is alone responsible for one thing, and it’s much more likely that the brain works as a whole system. All brain regions are in some way responsible for everything. Of course, some regions might have more influence than others, but the brain seems to work as a whole – it’s more than the sum of its parts. What seems to be the case is that the brain “generates” your experience, and it takes pretty much the whole thing to complete the task.
So in short, emotions and memories for example, do not reside anywhere in the brain, they are generated on the spot every single time. This is why a memory becomes more unreliable as time goes by. The brain has to regenerate the image every single time, and every time it is regenerated, it is slightly changed. Which is why in a court of law, we tend to rely more on a witness statement given immediately after the event. If we could just draw upon a pool of memory, the memory would be the same every time, and that just is not the case.
So, a sensible person might ask, why are the scientific community so obsessed with finding the “place” or “cause” of things?
So, when attempting to answer this question, we need to understand how we approach scientific investigation itself. Science is, the investigation of nature, and this is approached by means of “reductionism”; meaning that the pursuit of science is to reduce something down to its basic units, in order to see what it is made of. In physics for example, we take a piece of wood and reduce it down to a carbon molecule, that is then reduced down to an atom, then to subatomic particles and so on. This is how science works, and this approach works extremely well with the physical body.
The medical model is also reductionist, so a pain in the leg is caused by a break, the symptom of this break is pain. Reduce it down to the causation (the break), fix the break and the pain goes away, and it does. This approach works really well! We can write manuals and teach anyone to do it. So, it seems sensible that if it works with the body, it will work with the mind, right?
Wrong, the mind is not physical, it’s abstract, and it does not behave in the same way as the body. The mind works in context, and the brain is plastic. Which means it has plasticity – the ability to change and reconfigure over time, which is why many different brain regions can take up similar tasks and functions.
Social Construction
So as you sit here, reading this text, you’re probably blissfully unaware that your real-time experience is an amalgamation of things that are “real”, meaning you can touch, weigh and measure them, like computers, trees or settees, and things that are “abstract”, or are not in the real world, things that can’t be weighed, measured or touched, things like the value of money, mathematics, laws, political correctness, mental health, or even your emotions and thoughts. Thing is, these social constructs, have as much power, and are often more influence in our minds as “real” touchable things.
They’re called social constructs because in order for them to become real, they need lots of people to agree that they exist. Let me explain, did you ever find it curious, that when reporting our emotional state, most people will usually come up with the same types of words; anxious, depressed, angry, lonely etc. If you were asked say, 200 years ago about how you felt, I almost guarantee that you would not have said “I’m anxious”, but we absolutely know that the experience that we call “anxiety” would have existed 200 years ago, because in that time, the architecture of the brain hasn’t really changed. However, the term anxious was not used in popular culture. It’s not that the emotions themselves are social constructs (although some scholars would say that they are) but more so the names we ascribe to them.
So, we can see that the way we describe our experience is determined by certain factors; what time in history you are saying it, what part of the world you live in, your immediate social influences, and from where you source your information from.
However, social constructs are much more powerful than that; us humans make things “real” in two ways. We see or touch something in the world, and because we can all see it, and touch it, we give it a name, so when we say the name we all know what we’re talking about, even if the object we are talking about isn’t there ( language is extremely important in the way that we socially construct the world), or we can give something a name, and as long as enough people agree to it, it becomes real, even if we can’t touch it, see it, hear it or taste it. This is social construction, and it probably is the most single important aspect of our mental health and wellbeing.
The way we socially construct the word is an intrinsic aspect of the Switch approach.
Psychiatric illness and mental health diagnosis
Here it might be useful to mention briefly the field of Psychiatry. Psychiatry is curious as it is rooted in the medical model, which we now know is reductionist, but relies upon socially constructed categories to diagnose patients. The main texts on mental health disorders, the Diagnostic and Statistical Manual of Mental Disorders (the DSM) now on its 5th edition, and the World Health Organisation’s International Classification of Diseases (the ICD), which is now on its 10th edition, both apply a reductionist framework.
The DSM deals with psychiatric problems exclusively, whereas the ICD addresses health problems in general - The DSM is usually the main text referred to when making a clinical psychiatric diagnosis by a psychiatrist, who will usually be a formally trained medical Doctor before taking additional training in psychiatry.
Mental health disorders are social constructions, meaning they do not exist in the real world. They are created by committee and are adapted due to political influences and cultural frameworks. For example, not so long ago, homosexuality was a mental health disorder that was considered a treatable condition – if you’ve ever read about Alan Turing and his abhorrent treatment to cure him of his homosexuality, then you’ll know what I’m talking about. Turing, who had one of the most brilliant minds produced by the human race was chemically castrated, which arguably led to his suicide at the age of 41. By the way, if you’re thinking of disputing his brilliance, then consider that if it wasn’t for him, the machine that you are reading this on, would probably not exist!
Homosexuality was removed from the DSM only in 1973. If a mental health diagnosis was “real”, like heart disease, or diabetes, then you couldn’t just “erase it” when societal views changed.
The function of mental health disorders and categorisation is to identify the cause of the psychiatric problem based upon the symptoms reported by the patient, so that the psychiatrist can prescribe the correct medication. The problem with this approach is that many symptoms are the same for different disorders – it is not uncommon for a person suffering with psychological trauma to be diagnosed with up to 5 different psychiatric disorders, and to be medicated in line with those disorders, before the trauma is identified and the person is signposted to the correct type of support.
Here, it might be useful to define the difference between mental illness and mental health; illnesses such as schizophrenia, psychosis or bi-polar are illnesses, meaning that are not curable, and although they can be better managed by means of therapy and/or medications, they exist independently of environmental factors - although environmental factors can be influential in terms of exacerbation and the person’s experience of the illness. This is different to mental health which exists on a spectrum and if often influenced by environmental factors. For example, the person is depressed because he is in prison, the person is schizophrenic whether he is in prison or not.
One problem we are facing in modern times is the popularisation of psychiatric terminology in everyday life; phrases such as “I’m OCD”, “I’m depressed”, or “that triggers my anxiety”. Now, that is not to say that the person is not experiencing compulsions or depression or anxiety, we all do from time-to-time, but the inclination to self-diagnose is perpetuated by popular culture and social media. If we remember the cause and symptom model; the pain being the symptom of the broken leg, then we are saying that the anxiety, or depression is the cause, and with a psychiatric illness it might be, but in most cases it’s a symptom, and looking at it as the cause actually prevents us from addressing the cause of the problem itself. Causes like debt, dissatisfaction in life, a divorce, or a bereavement, feeling ugly or unhealthy lifestyle choices, which in most cases, are workable and treatable, without the need for medication or psychiatric diagnosis. Humans appear wired to avoid displeasure, on this point Freud was correct, and unfortunately, grabbing a mental health diagnosis can aid in this avoidance, and although this might give us temporary relief, it may ultimately prevent the problem being addressed and result in continued suffering, negatively affect our relationships, and generally be detrimental to our overall quality of life. Further, a mental health label, whether self or professionally diagnosed, often results in learned helplessness (remember, misdiagnoses is common, with some reports stating that over 70% of diagnoses for depression are incorrect). Due to the power of the medical model in our cultural framework, the person believes that there is nothing they can do and resign themselves to their diagnosis. This often prevents exploration and curiosity, which can be confounded by addiction to prescribed drugs or self-medications like drugs and alcohol and can prevent our minds from being flexible enough to re-perceive the problem, and to ultimately find a way out.
Predictive Brain Theory & Affective Science
As you’re reading this section, I’d encourage you to keep in mind the earlier segment on social construction; remember, our ideas on psychology and mental health are largely based upon social construction and mental experiencing and are not “real” in the true sense of the word. It is often argued that psychology is not a “real science” as many of its experiments cannot be replicated – a key aspect of research in empirical science. However, psychology attempts to work with human experience, which is in itself, not a “real” phenomenon like chemistry and biology. So, we probably need to give psychology a bit of a break on this score, it is after all, trying its best.
The psychological paradigm both historically and currently looks something like this – the world happens, and you react to it, if you like, cause and effect. There you go, simple. Sounds about right and feels very intuitive. Do we not hear a loud bang (cause) then jump (effect), or see an image of an adorable cat (cause) and become compelled to cuddle it (effect)? Well, that’s what it certainly feels like. However, what we’re learning is that the way the mind and brain work is not intuitive at all!
So, what if we challenge this idea of cause and effect? Well, certain writers, most prominently from the neuroscientific field have done exactly that. These writers have been committed to following the research itself, rather than being influenced by their cultural and academic expectations, or their personal experience. This has led to some fascinating and exciting discoveries, which appear to be applicable to working therapeutically with people with mental health problems.
Believe it or not it takes a lot of courage to break from the norm in the scientific and academic community, as they do like to do things in the traditionally correct way. For example, until very recently, and still in many educational institutions, it is still considered preposterous to study a phenomenon such as the conscious mind, and If you spoke of doing such a thing you would probably be laughed off campus before lunchtime. Although history tells us that some of our greatest achievements were by people who dared to think and do things differently!
OK, so the brain is probably the most efficient piece of organic or mechanical machinery we know about. It completes functions at a mind-boggling rate; for an adult brain, approximately one thousand trillion functions per second (the number 10 followed by 15 zeros!). Now we are starting to develop computers that can get somewhere close to this processing power. However, these computers can take up somewhere around 2000 square metres of floor space and consume somewhere in the region of 15 million watts of power, compared with the brain, which weighs only around 1.5 kilograms, is the size of your two fists put together, and uses only about 15 watts of power – it’s is a scientific mystery how a formula 1 driver manages to keep his brain cool sitting in a cockpit at 200 kilometres an hour, wearing a helmet and fire resistant suit, while computing all the things necessary to keep him on the track.
It therefore is not surprising that many of the workings of the brain do not breach the level of our awareness, and we are on a “need -to-know basis”. It is estimated that of all the processes occurring within your brain, you are aware of around 40!
Your conscious mind is a summary of what has occurred before it in your biological brain matter, and it seems that what is happing in that time is a series of competing predictions, with your experience being the winning prediction. I know this might sound strange and counter-intuitive but allow me to say a little more.
In very basic terms, your brain is locked away inside a very dark place called your skull. From there it knows nothing, and it is completely reliant upon the information it receives through the things we call our senses; our smell, taste, hearing seeing and touch. From this information it generates concepts, and concepts are predictions.
Your brain recognises shapes and patterns in the world and basically fills in the gaps for you.
For example, if you’ve ever played tennis, it feels like you see your opponent hit the ball, you see the ball move through the air and you return it. In fact, this doesn’t happen at all! You do see the opponent hit the ball; however, the rest is pure guess work; your brain, based upon previous experiences of playing tennis, predicts where the ball will be and actually gives you the sensation of seeing the ball – it imagines the ball, but to you, the movement of the ball is real; you actually believe you are seeing it even though you are not. The more you play tennis, the better your predictions get, and the more often return the ball in the way that you would like, becoming more accurate, the more you practice. Which is why if you’ve never played before, you might not even hit it at all.
This is one example of how your brain predicts the world around it, and your emotions are just another way of doing it.
If I imagine harm coming to someone I care about, then I don’t need to experience it in order to know what it might feel like. The imagined feeling alone is enough to drive me to keep safe the things I love. If we had to actually experience the loss of a loved one before we knew what it felt like, our species probably wouldn’t have survived very long.
The only real difference between imagining an event and that event being real is the sensory feedback my brain receives; when I look at a windowsill with the sun beating down upon it, my brain predicts what this will feel like. So, when I touch the windowsill and it’s warm like my brain predicted, this reaffirms that my brain’s prediction is correct.
My brain has been matching its predictions, and correcting prediction errors with the sensory feedback it receives since day one, and it’s extremely good at it. This is why I trust my sight and touch over probably anything else, and gives rise to statements such as, “I’ll believe it when I see it.
Surprisingly, the imagined negative emotional state is often more severe than it would be in if it actually happened. This is not accidental, however it can result in the idea that we will not be able to cope with certain situations or events if they occur. It is extremely common for a person who has experienced an extremely stressful, or anxiety promoting event to be surprised at how well they actually coped with the situation. They often report that ‘it wasn’t as bad as I thought it was going to be”.
As predictions are equal to concepts that are primarily built upon generations within our mind, this gives scope for movement and adaptation.
“The deconstruction and reconstruction of concepts are the way in which we nurture psychological flexibility in the Switch approach.”
Emotions & Affect
When we talk about emotions, what are we actually talking about? Well, let’s review this so we’re all on the same page.
There are a continual flow of emotions passing through your system all of the time. Thing is, most of them will go unnoticed; rather like a small cut I received while I was doing the garden the other day, but wasn’t aware of it at the time, and only noticed it when drying off after my shower, 3 hours later.
When an emotion attains the energy to breach the threshold of your awareness, you notice it, and the moment this happens, you’re experiencing a feeling. In other words, you feel the emotion.
So that’s what emotions are and how they’re different from feelings, but why do we have them?
Well. One thing we do know is that emotions have been around a very long time; we have kept hold of them throughout our evolution. So, it seems fair to assume they must be important and useful to us in some way.
Different theories have sought to explain the nature and purpose of emotions throughout the ages and have characteristically attempted to reduce them down to their root function and basis.
However, after reviewing many theories from many different schools of thought, it appears that there are many types of emotions, and they have many different functions; for example, they glue the world together and give substance to our experiences, they tell us about the world around us, in the present, the past and the future, they serve as units of communication between our body and our minds, they’re extremely influential in how we make decisions, and they help us understand the emotional states of other people and help us communicate our own internal states to others. In short, emotions are an intrinsic aspect of being human.
Emotions are also flexible and transient in nature, and our experience of them may change due to cultural and social frameworks and the way our cognition (thinking & language) interacts with them.
Currently, in our society, happiness is seen as the preferred emotional state to be sought, with governments promoting this state of mind; the government’s NHS talking therapies programme was commissioned in its current form largely due to the influence of a paper written about happiness by Richard Layard. However, somewhere around 300 years ago, the governments of the time promoted the experience of pain and suffering; the thinking was that pain and suffering were common aspects of life, and if you learnt to tolerate these sorts of emotions, you wouldn’t suffer as much. This idea is interestingly very close to ideas put forward by the mindfulness CBT community.
One model of the brain and the emotions within it has been a staple of the psychological community for some time; this so-called Taurine Brain model proposes that your brain is made up of three evolved parts and looks something like this –beginning with a reptilian brain (Basal Ganglia), we then developed the mammalian brain (the limbic system – the place where emotions are said to reside), and fast forwarding a couple hundred thousand years we developed the higher cortices (the neocortex - the conscious mind and thinking brain). This idea is again attractive due to its intuitive style, and it infers that emotions are an old and archaic aspect of the brain. However, many scholars dispute this and challenge advocates of the model to present the research to support it.
So, where do emotions come from? Well, if we remember earlier the idea of feeling the emotion, we could say that the emotions originate in the body and they are felt in the mind. Then you might ask, where in the body?
This is where we have a brief introduction into an aspect of the human system called “affect”.
Many of the processes that keep your body functioning, and ultimately keep you alive, such as blood pressure, heart rate, temperature regulation, pupil dilation, digestion, cell mitosis, and countless other functions, are happening on a continuous basis mostly without your knowledge – remember the “need-know-know basis”. In fact, you only really get wind of these processes if something is going wrong and you experience a symptom such as pain or discomfort. However, many medical health problems are asymptomatic, meaning that they have no symptoms at all, high blood pressure for example.
In sum, your body is continually working to keep your internal state regulated and in balance; the physical system likes balance and when things get out of control it is not good for our health in general. An Illness such as cancer is an example of what happens when the body loses control is its regulation and things get out of control.
There are a number of bodily systems involved with these processes such as the immune system and nervous system, and they all need to be working well and in cohesion with each other for optimum health and performance; this is why an Olympic athlete for example will have a very specific diet, sleep and behavioural regime – ask any boxer about the frustration he or she feels when having to abstain for sex during the period before a big fight, and you’ll get an idea of the commitment necessary in order to have the body perform at its optimum rate.
Homeostasis is the usual term used to describe the body’s function of internal regulation. However, as usual, we’re going to find again that things may not be quite that straight forward.
The term Homeostasis is based on the idea of the body’s regulation of itself through reaction. As previously mentioned, if we are working within a predictive framework, the concept of homeostasis may not be an appropriate fit for the model. However, there is another phrase that would be more appropriate in a predictive brain framework; that phrase is called allostasis.
Your brain needs to assess what recourses are required throughout the whole of your bodily systems; it need to deploy energy recourses to different body parts in relation to what it most probably expected to occur. This fine balancing act of internal regulation is called allostasis.
Apart from the well known five senses of sight, hearing, taste, smell and touch, we also have another sense, and although lesser known it is rigorously researched and documented, this is the sense of interoception – so little known that it is actually not known in MS word, and is flagged up as an incorrect spelling! Interoception is a term to basically describe your minds sensing of your internal state, and it can be quite subtle in comparison the very noticeable feelings of say, anger, fear and anxiety. If you like, you might experience this as your background mood, or general emotional state; I like to call it, your background noise; a bit like the fuzzy dots on a tv screen when it’s not tuned into a specific channel.
Your background noise (interoception) is a by-product, or if you like, the sensing of your allostasis process – your affect, and we can view affect in the following way.
If we imagine that all emotional states are made up of two things; arousal - the state of the affect in terms of it energy; high or low (according to the science of physics, everything is fundamentally made of some sort of energy), and valence, meaning pleasure (in both a positive and negative sense) - An illustrative model describing this is called the circumplex (a link is provided on the “further reading” page).
For example, if I have a high arousal (high energy), and high valence (high pleasure) affective state, I may experience excitement, exuberance or joy. If it is high arousal (high energy) but low valence (low pleasure), I might feel anxious. Other examples are; low energy + high pleasure = satisfaction or relaxation; low energy + low pleasure = depression etc.
Remember that this affect is a biological process that in determined by a variety of different factors that are always not always easily identifiable; things like diet, sleep patterns, exercise regimes and interpersonal relationships can all impact upon our affect, which is why these all are elements that may need attendance in the management of our health wellbeing.
I like to view in this way; imagine that you’re busy; the kids are being kids, work is stressful, you’re eating on the run and spending lots of your time sitting at a desk. This might cause a shift in your affective state and through interoception, you might feel meh; a low energy state that is not very pleasurable. Now imagine after work, you’re supposed to do some course work or go to the gym. Are you going to feel like it, hell no; your body is probably going to crave high carbohydrate foods because it lacks energy, which you’ll probably take on in the form of a pizza or something like that, this will make you feel sluggish as the energy recourses will be taken to your digestive system to break down the food, this will make you want to just sit down and do nothing but watch tv, you’ll feel bad that you haven’t done the thing you were supposed to do, and probably eat some high sugar food, like chocolate, or drink some alcohol so make you feel better – sound familiar? The next morning you wake up un a high energy, low pleasure state because your body is still firing the energy form last night’s carb and sugar binge, which you still feel pretty crappy about. However, today you need to do that presentation at work, you know, the one that could see you get that promotion that you’ve worked so hard for. So, what do you think might happen if your affect is already in an anxious state and you have an event upcoming that your system predicts will require additional energy to keep you alert and on your toes – yep you guessed it, even more anxious. Now, your body isn’t making you anxious, it’s just that the energy being deployed to assist you with the task is resulting in your experiencing of anxiety, for the above-mentioned reasons.
Now imagine that the body’s affect is in balance because you didn’t have the pizza last night, and you did go to the gym, and you don’t feel guilty about the fact that you watched you tube or tv all night till 1am. That energy recourse will be experienced in a completely different way, and most probably can be used as an asset rather than being a hinderance, and you will have the energy recourses to manage the things that are important for you like being alert for the questions following the presentation, or aligning your attitude to one that is conducive to getting what you want. People spend too much time and energy managing the anxiety relating task, which takes away recourses to be used doing the task itself.
Trouble is, the above scenario is usually not a one-off, and it’s quite likely that situations like it happen quite often. This can cause habitual behaviours and adaptations that can become systemically imbedded. Everyone knows they’re better of going to the gym, or practicing for the presentation, not eating fast food for drinking too much alcohol, but if it were just a simple as knowing what we’re doing wrong and choosing to do some different, we’d all just do that wouldn’t we? And life would be oh so simple, but it’s not, and it isn’t because it isn’t that simple. So, let take a look at why it’s just isn’t that straight forward.
So, you know who you are, right? Ok, but have you ever asked the question of, “why am I who I am” and “where does my identity come from and how is it formed?”. Well allow me to try and briefly begin to answer those questions.
So, we might start with that idea from CBT we mentioned earlier of thought, feeling, behaviour, or the idea of the ego from Freud’s writings on psychosexual development, or the idea of the self-concept from the humanistic school built upon messages and interactions with people throughout early years. But where is our identity? Is it an amalgamation of memories, events and relationships which create an autobiographical narrative? Maybe, sounds reasonable. However, how workable is that, and is there any real evidence that by investing a lot of time, money and energy in these pursuits it will be fruitful? I know people who swear by these sorts of methods, people who I have worked with and respect, and I meet people who have gained much through exploring these areas, so maybe it’s useful, and I would not disregard them.
However, when we’re speaking specifically about our identity, who we are, then these ideas appear to me to be conflated, blurred and difficult to grasp, and I want something simpler, something I can get hold of, something workable – the switch method is about workability; it’s about taking complex and multi-layered phenomena and simplifying it in order to make it tangible, understandable and ultimately, workable. So, let’s do just that.
I want you to imagine that you’re at a wedding, you’ve been assigned to a table through a seating arrangement that you’ve had no influence in constructing. You find yourself sitting with a group of people; some you know, some you know a little, some you’ve never met. So curious animals that we are, you want to know who you’re going to spend the next three to four hours with; you want to know who they are, and they want to know who you are. So, to get an answer to this question, do you ask; who are you? No, you ask the first question anyone asks in this sort of scenario, you ask; what do you do? And depending on the answer to that question you generate a concept on the person in your mind – and along with that concept a prediction of how they might behave and what you may have in common. You also generate ideas about how they live their life. For example, imagine the response to that question is “I work in a warehouse”, or “I’m a pilot”, or “accountant”, from that two word response your system will generate a whole host of different concepts about their financial security, the type of places they frequent, their pastimes, where they go on holiday, what car they might drive or where they live, where they do there weekly shop, how they treat their wife or husband, or partner, how much they drink, they’re credit rating, they’re political viewpoint; the list goes on and on. The answer to that question will also cause a change in your affect; am I going to get on with this person? Am I good enough? Will they bore me? Are they unpredictable? will they get drunk and become aggressive?
Obviously, the words spoken by the other person will be aligned with your sensing of them; you will pick up subtle behavioural cues that will either reaffirm your expectations or dispute them, and the more you interact with them, the more your predictions of them will be corrected and aligned with the sensory feedback you receive. So simply put, your identity is based upon how you behave; you are what you do. But that not the whole story as we’re going to see that what you do, is not exactly what you want, or what you choose.
So, what do I mean by, “you don’t really choose your behaviour”? Well, if you did completely choose what you did then why would make choices that are bad for us? Wouldn’t we all just drink moderately, eat less fat and sugar, do more exercise, be perfect parents, all of the time? But we don’t and we’re not, and that’s not because we’re bad people – I’ve worked in the criminal justice system in one way or another for somewhere in the region of 25 years and I can honestly say that in that time, I’ve never, not once, met a “bad” person. If fact, more often then not, people are pretty much ok.
So, let’s take for example, a leopard in a zoo. The zookeeper or anyone who chooses to study the animal for a meaningful length of time, will probably be able to predict its behaviour to a pretty good degree of accuracy. This is because the leopard’s environment is so static and unchanging. Of course, the leopard may be capable of some variance in its behaviour, but to what point is he able to really choose, and how do we describe the phenomena of free will and choice?
There is an abundance of experiments that have been carried out that suggest that free will is a type of illusion, and that the choices we make have in fact been decided by our brains before our minds are brought online. In short, your brain makes the choice before you even know the choice has been made; your brain chooses, not you, it just feels like you do.
This is a little disconcerting, and has some obvious implications, so we prefer to go with our intuitive feelings and believe that we are all free-thinking, independent creatures making choices based on free will and autonomy. However, it’s not quite that simple.
If I were to ask you, for example, what your favourite movie is, you’d probably think about it for a little while and then respond with your preferred choice. But let’s have a closer look at what is actually happening here. When asked the question “what is your favourite movie”? You don’t get access to every single movie you have ever seen, or do you just get one movie come into mind. If you observe the process, it’s more likely that your brain throws you a limited number of options for you to choose from; probable somewhere around 3-6, and from these available options you choose one. Now, there can be a multitude of reasons that the brain is giving you these options; what movie you last saw, your mood at the time, something you saw or heard on tv that morning. However, the point is that you do not get all the options, and your choice is limited. This process is called functional autonomy and is happening all of the time and with every decision you make, and often, you do not get nearly as many as 3-8 options.
Our environment, our emotions, and the way we construct our social world are all huge influences in how and why we make certain choices. We could sum this up as, environmental systems (which include social constructs about the world around you), make us behave, and our behaviour forms our identity. In basic terms, you are what you do.
“This is why committed behaviour is a fundamental aspect of the Switch approach.”