Clinicians often use analogies, metaphors, thought experiments, and humor in strategic ways to aid in facilitating therapeutic change.
I would like to share with you a simple analogy I often use with individuals and families. The analogy encapsulates some of the principles that you have already been teaching your patients. They are principles that patients regularly forget to use because, well, life is hard, the world is a stressful place and they are already overwhelmed.
The analogy resonates well, is easy to remember and can serve as a consistent reminder to return to healthy coping. It incorporates a wide range of interventions including the importance of exercise, healthy sleep and diet, staying active, discontinuing hostile and critical communication in the family, decreasing pathological enabling, mindfulness and self-awareness skills, decreasing maladaptive self-talk, self-compassion, acceptance, etc.
The analogy I want to share with you is ‘Bandwidth.”
Think of Bandwidth as the capacity to deal with stress. It is, essentially, a measure of equanimity. Wide Bandwidth reflects our ability to be tolerant, understanding, patient and accepting of our own imperfections as well as the imperfections of others. In short, wider Bandwidth increases the likelihood that we will act more maturely and consistently with our values and goals. Many of our interventions have the implied purpose of increasing Bandwidth.
Narrow Bandwidth indicates decreased capacity to deal with stress. We are less able to tolerate difficult emotions which exacerbates stress and results in more difficult emotions. We act in ways that are driven by impatience, frustration, irritability, anger, anxiety, etc. Effectively, we are acting “less maturely.” Treatment Interfering Behaviors increase. Values-driven behaviors decrease. We are more prone to make strategic errors due to the impact on our ability to carefully deliberate. And the cycle does not end there. Our negative behavior affects others and impacts their Bandwidth. Narrow Bandwidth increases stress in the family. Increased stress narrows Bandwidth. The system becomes mired in a self-reinforcing loop of negative interaction and decreasing Bandwidth for all involved.
Parents can be taught that increased family stress makes it more difficult for their children to engage or succeed in therapy. You can collaborate with parents to develop strategies that can serve to increase their own Bandwidth, and to refrain from behaviors that decrease the Bandwidth of their children (such as criticism, hostility and naïve attempts to force their children into therapy).