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Lori introduces the five stages of behavior change, according to psychologist James Prochaska: 1) Pre-Contemplation (not yet thinking about change); 2) Contemplation (deliberation, with ambivalent resistance); 3) Preparation (gearing up to take steps); 4) Action (performing change); 5) Maintenance (preserving the change). She uses Charlotte’s drinking as an example. When she started therapy, she thought of herself as a “social drinker,” not connecting her other’s alcoholism with her own. When she had her DUI, she moved into contemplation by recognizing she had a problem, but was unwilling to take steps (“People often start therapy during the contemplation stage” (558)). When she started to cut back on her drinking, she entered the preparation stage, which finally led to action as she started to attend an addiction-treatment program. The final stage implies dealing with occasional setbacks (she had drinks when her father promised to come but cancelled at the last minute).
Lori posits that Charlotte must also deal with her addiction to unsuitable men (notably, the Dude, who is a cheater and avoidant type of personality). Charlotte realizes “he won’t change, so she’ll have to” (565). She reschedules her therapy to avoid meeting him.
Lori relates the story of the Austrian psychiatrist Viktor Frankl, a Holocaust survivor, who wrote about logotherapy (“intersection of psychology and philosophy” (568)). As opposed to Freud’s pleasure principle (we seek pleasure and avoid pain), he believed the primary human drive was “toward finding meaning” (568) in life, and his principle included “Reacting vs. responding = reflexive vs. chosen” (569)—our initial reactions are reflexive but we can choose our responses, and in the choosing lies our freedom.
In therapy, Lori discusses her father who is in poor health, and how they shared a moving moment when he told her how proud of her he was, in case he had not said it or shown it enough before. Lori knows from the internet that Wendell’s father died suddenly at dinner, and she wonders whether Wendell had enough time to communicate with him everything he wanted. When she verbalizes this, Wendell tells her he misses his father every day. Lori admits finally that she googled Wendell, and he surprises her by reacting with equanimity.
Rita’s life has started to change for the better: After Myron’s advance, she has finally met the happy family from across the hall and started giving the two girls art lessons, while their dad helped her open an online store for her works. However, she does not allow herself to feel any pleasure from it. Lori introduces Psychologist Erik Erikson’s eight stages of psychosocial development (“personality development in a social context” (586)), each of which implies a crisis that needs to resolve itself to move forward.
The stages are: Infant, Toddler, Preschooler, School-age child, Adolescent, Young Adult, Middle-aged Adult and Older Adult, and the crises: trust/mistrust, autonomy/shame, initiative/guilt, industry/inferiority, identity/role confusion, intimacy/isolation, generativity/stagnation, and integrity/despair. Rita is in the process of choosing between integrity and despair, based on what she feels she has made of her life. She seems to be suffering from cherophobia (fear of joy), because she feels accustomed to punishing herself, primarily for her children’s unhappiness, which she contributed to by ignoring them and their father’s abusive behavior, but also by envying them the childhood she never had.
Parents often feel unconscious envy of the opportunities their children have, because they compare themselves at that age. Therefore, they sometimes ruin their children’s opportunities. Lori knows Rita’s children will probably never forgive their mother, but that does not exclude their feeling compassion for her, but only if she stops self-punishing.
Lori has lunch with Caroline and admits that she is the one seeing Wendell, which Caroline finds funny, as she knows both well. Next week in therapy, Lori mentions the meeting to Wendell, struggling to find what has been bothering about it, when he asks her if she has a question for him. She realizes that she wants to ask him if he genuinely likes her. She cites humanistic psychologist Carl Rogers who introduced unconditional positive regard to therapy, which implies that the therapist “genuinely believes in the client’s ability to grow” (607). She poses her question and Wendell answers that he likes her neshama (a Hebrew word for spirit or soul). Lori immediately understands what he means because this is what she feels for her patients.
Julie talks about meaningless and sometimes hurtful things people say when they learn of her sickness, things that make themselves feel better and not Julie. She also mentions things that feel right, like simply saying “I’m sorry” or “I love you”—“the best responses I’ve gotten have been from people who were genuine and didn’t edit themselves” (616). Lori has helped Julie work on her obituary, as she reviewed things that mattered the most to her. Finally, she decided she just wanted the obituary to say that she was loved every day of her life, because that is how she feels.
Lori has finally forced herself to finish the book on happiness, and she works hard to get it done. During a break, while talking to her friend Jen, she checks her mail and finds a meaningless, innocuous email from Boyfriend after eight months of silence, about a person they both disliked joining his firm. The pointlessness of the email helps her gain significant clarity: She does not want to finish her book, because it is essentially equally meaningless. She accepts this need to change and sends her publisher a note about canceling her contract.
As Lori arrives for her session with Wendell after a two-week break, she is stunned to find a completely renovated, modern waiting room, instead of the old, chintzy one: “For a moment, I panic, as if in a dream: Where am I?” (628). She has been feeling happy, but now she wonders if she is experiencing a flight to health (when patients persuade themselves they do not need therapy anymore because of the underlying anxiety the process is bringing up).
When Wendell appears, she has another shock, as he has grown a beard and dressed fashionably. She suddenly finds him attractive and questions her transference. His office is also different, same in layout but chic and attractive. Just like Wendell. Lori reflects how she is behaving similarly to John (who calls Lori his mistress, and often makes inappropriate remarks). She relates how last time Wendell told her he trained as a ballet dancer and asked her if she wanted to dance, which she refused, although she knows dance therapy can be useful. Wendell gently insists that she register what she might be feeling towards him, as feeling less does not mean feeling better. Because she has registered Wendell as a man means that her therapy is working and that she can feel attraction again.
In describing Charlotte’s road to understanding her drinking problem and her attachment style (Chapter 39), the author explores the stages of change in behavior according to American psychologist James O. Prochaska, one of the authors of the Transtheoretical model of behavior change. Aside from the stages of change that Lori mentions in the book, the model also deals with processes and levels of change, as well as self-efficacy (a personal assessment of how well a person can deal with situations) and decisional balance (a somewhat controversial method that uses graphs and tables to determine the pros and cons within certain choices).
The model, developed in the late 1970s, has become one of the dominant paradigms of healthy change, although many experts criticize its essential arbitrariness in determining where stages and processes begin and end, as well as the presupposition that all people behave in predictive and rational ways. The consensus seems to be that the model works best when dealing with proactive decision-making behaviors, rather than with deeper psychological behavioral patterns. It is, therefore, logical that Gottlieb uses it in the context of Charlotte’s drinking problem.
In the circumstance of her own search for meaning (first mentioned in Chapter 37), Lori mentions neurologist and psychiatrist Viktor Frankl (Chapter 40). A Holocaust survivor, Frankl spent his career developing his theory of the human need to instill meaning into a life’s events to find fulfillment. However, Frankl did his initial work on this theory while collaborating with the Nazis between the two world wars, which for some critics brings the morality of his work into question. Nevertheless, his term noogenic neurosis (“existential frustration,” which originally implies the state of anxiety during the weekend of those who work a lot over the week) has contributed significantly to the study of the pervasive feelings of meaninglessness in the modern era of digital existence.
Through Rita’s example as an elderly person who struggles to cope with this stage of her life, Gottlieb introduces German-American developmental psychologist Erik Homburger Erikson (Chapter 41). Erikson coined the now widely used term identity crisis (which implies failed development of ego during adolescence, resulting in a state of anxiety in young people striving to discover who they really are psychologically). Gottlieb lists Erikson’s stages of psychosocial development, emphasizing that each stage requires a state of crisis to develop into the next phase (almost like a butterfly developing from a caterpillar).
As opposed to Freud, who believed that the id (subconscious) rules the ego, Erikson theorized that ego plays a more active role in the psychological development of humans. Gottlieb uses Rita’s example to illustrate that, according to Erikson, she belongs to the Older Adult stage (usually people over 65 years of age), which is the time where ego-integrity ensures we accept life and its vicissitudes. Because Rita suffers from a guilty conscience about her life, she struggles to reach ego-integrity and achieve the wisdom that will allow her later years to be happy and fulfilled. Therefore, she finds it hard to enjoy connecting with the family that lives across from her, or to accept Myron’s advances.
While exploring her feelings towards Wendell (wondering if she has entered the stage of transference as a patient) and, more significantly, his feelings towards her, Lori uses the physical changes made to his office and his personal appearance as the starting point to delve deeper into the developing relationship (Chapters 42 and 45). She cites American psychologist and one of the founders of the humanistic approach to psychology, Carl Rogers. The humanistic approach developed during the second part of the 20th century as a response to the prescriptiveness of Freud’s psychoanalysis. It implies every human possesses an urge towards self-actualization.
Gottlieb focuses on Rogers’s thought that while no therapist can ever be completely objective, they can do their best to avoid being judgmental and create an accepting atmosphere for the patient, thereby ensuring a safe space for evacuation of their psychological content. Lori receives this from Wendell, which enables her to share with him the truths she has had difficulty verbalizing (primarily about her procrastination, which hides a fear of a meaningless existence). She supplies the same environment for Julie (Chapter 43) as she helps her work on her own obituary and plan her “funeral party.”
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