3 mismatches for transformational change in therapy

Mismatch experiences are the key to transformational change. These are the moments whereby old expectations are disconfirmed. The client has an experience of prediction error. In the surprise of that anomaly, there is the opportunity to update old learning for new.

But how do we know what mismatch experiences to set up? What exactly needs to be mismatched?

In this article, I will look at three key mismatch possibilities:

  • Beliefs
  • Feelings
  • Unmet Needs

By the end of the article, you will be able to use these categories in order to identify mismatch possibilities in your work with clients.

Beliefs

When the client brings a problem it will also have a useful function. It makes sense that the problem is showing up. By repurposing Motivational Interviewing questions, we can quickly discover the belief.

This explores the benefits of the status quo and the price of change. From the client’s answers, we can get to a single sentence that describes how it makes sense that the problem is present.

I call this The Single Sentence Technique. It looks like this:

If I allow myself the change I want
Then bad consequences would occur
So I keep reproducing the problem
Even though I long to change
Because anything is better than those consequences

To illustrate, let’s say that Pamela feels a burden to everyone and she’d like to live life in a carefree manner. Her sentence may look like this:

If I allow myself to be carefree
Then my parents would only resent me
So I edit myself and apologise for my existence
Even though I long to enjoy life carefree
Because anything is better than being disliked by Mum and Dad

Pamela has made a decision to act in a way that shows contrition for her very existence. It’s not a fun way to live, but the alternative of being disliked by her parents seemed much worse to her.

Digging into this sentence further we can see that it is supported by a core belief: My parents will dislike me if I enjoy life.

Out in the world, this may easily be translated more generally to: People will dislike me if I enjoy life.

If Pamela suddenly had a realisation that this belief was not true, the prediction of “If I allow myself to be carefree then my parents would resent me and dislike me” falls apart.

Setting up mismatch experiences to help disconfirm this belief is the job of the therapist. It starts the process of memory reconsolidation which produces permanent change.

For instance, exception questions can discover information from the client’s life that offers evidence to the contrary. You may have come across exception questions before. They feature in a range of therapy approaches, such as Solution Focused Therapy, Narrative Therapy and Coherence Therapy.

“Tell me a time when you did feel more carefree and people seemed happy with you.”

As you discover the evidence, you can join the dots. The key is to invite the client to hold both ideas in mind at once.

“How is it to have this old belief that to be carefree means people won’t like you, and on the other hand to remember when you were very carefree and your friend said she loves this side of you?”

After all, they can’t both be true. If the juxtaposition lands, the brain will be open to updating the old learning. Repeating the invite to hold both ideas at once will complete the rewrite.

Now, without the fear that reproduces her original problem, Pamela will find it easy to live carefree.

Naturally, Pamela may not enter therapy with a conscious sense of this belief. The exploration of The Single Sentence Technique will bring it into their awareness – and yours.

You now have the core belief that needs to be updated through mismatching.

There are many ways to notice or create belief mismatches. For instance, The Lefkoe Method invites clients to identify a scene where they might have learned the belief. Then he would invite the client to brainstorm alternative meanings for it, and revisualise the scene with each of those meanings applied.

Likewise, depending on your modality, there are many ways to identify core beliefs. So you don’t have to adopt the example discovery methods in this article. The point is to understand that mismatching core beliefs can lead to transformational change.

Feelings

Another option is to choose to mismatch feelings. When triggering memory reconsolidation, it is implicit memory that is updated. Implicit memory, amongst other things, includes emotions and autonomic nervous system response.

A client can be guided to notice what is happening in the body. The nervous system will produce a range of possible sensations – such as going red, increased heart rate, butterflies in the stomach and nausea.

Connecting to bodily sensations and getting curious about them can provide a way into imaginal work. When we identify how the body is reacting by asking where in the body these reactions occur, it can remind us of other times in our lives when these feelings were there. It can lead us to useful scenes for imaginal reenactment.

During imaginal work, we can design a new scene that goes in our client’s favour. This way, the old expected autonomic responses are mismatched with the new, desired responses.

As well as bodily sensations brought up by the autonomic nervous system, we can investigate other feelings too such as emotions.

Likewise, the client’s sense of things. These are not bodily sensations or emotions, but impressions of the situation. For example, the client might say “I felt trapped.”

In imaginal work, we can create a list of opposite feelings that the client would like to feel instead. When we devise the reenactment scene, we can ensure that it is designed to generate these opposite feelings and so create a mismatch.

Unmet needs

When a person undergoes a traumatic experience, it is common that needs went unmet. In childhood trauma of the kind that is repeated – for instance, neglect or abuse – these needs are especially hungered for in adult life.

A person who seeks acknowledgement or validation will feel great pain each time those needs are missed today.

Providing experiences that meet those needs can be an important mismatch. It may well be one of the reasons why research often points to the importance of the therapeutic relationship itself.

Imaginal scenes can provide this mismatch too. Daniel Brown’s Ideal Parent Figure Protocol is an example of visualisation work that seeks to give the client an experience of core needs being met. It covers safety, being seen and known, soothing, inherent worth, and unconditional support.

Other interventions such as Matrix Reprinting guides the client into being with their younger self and discovering what they need.

Some needs involve a need for release. This covers those that were suppressed at the time, either because it wasn’t safe or wasn’t permitted. In a scary situation, they may have wanted to move yet were unable to do so, either because they were physically restrained or because the consequences were too frightening. The natural fight or flight was squashed into shut down.

Likewise, they may have suppressed a need to speak out and make their voice heard as it was not safe to do so. The consequences would likely have made a bad situation worse so they kept understandably quiet despite their feelings.

Many also learn that certain emotions are not welcome. So the need to cry is stifled, or replaced by another emotion like anger.

These stifled impulses can often result in a person feeling helpless. Creating experiences that meet these needs for movement, speech and authentic emotion provides a powerful mismatch for that helplessness.

Feelings of simultaneous scare and safety produce an important mismatch too. The old memory was scary, yet this feels safe. Such dual focus can be achieved in various ways, and many therapies incorporate it.

Summary

When working with a client, it helps to know what kind of mismatches are possible. Rather than it being a jumble of possibilities, thinking of three makes it clearer to work in this way:

  • Beliefs
  • Feelings
  • Unmet needs

Note that you are not restricted to only one. Indeed, some interventions will naturally create mismatch experiences that covers more than one category at the same time.

Creating mismatches opens the door to memory reconsolidation. To see the steps of memory reconsolidation and appreciate the wide range of approaches possible, check out this post.

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