“Tell him what happened,” the mom said to her son.

“Tell him what happened,” the mom said to her son.

My client shrugged. “My brother made me mad,” he said, “so I hit him. I'm bipolar. That's what I do.”

In therapy, we try to understand what clients do and why they do it. However, I learned a valuable lesson early in my training from my family therapy mentor, Dr. Gil Greene, who said, “Insight is a poor agent for change.” Knowing why we do things doesn't always inspire us to make changes; often, it becomes the rationale for doing it.

Negative behaviors—driven by a true disorder or not—often shape how families work. A family system is neither good nor bad; it's simply functional. And if the unit needs to accommodate a behavior to function, the system develops to maintain the very problems the family wants to avoid.

That's why insight about what's happening often doesn't lead to change. Sometimes, it just leads to, “Yeah, but …”

Ask any therapist about the “Yeah, but …” client, and his head will start to spin. We all have these clients, well-meaning people so afraid of upsetting the status quo that they accept things they know don't work. That's because positive change is the scariest kind.

Let's repeat that for emphasis: Positive change is scary. People are comfortable with the status quo—dance with the devil you know instead of the devil you don't—because at least it's predictable. And if things get worse? Well, they thought that would happen anyway. When things change for the better, people get nervous. They like the changes but worry it's just a temporary tease.

When I worked at Nationwide Children's Hospital, a fellow clinician and I ran 12-week parenting groups based on the Incredible Years approach, and we quickly saw a pattern. By week three, parents would start sharing success stories, followed by more the next week. Then it was just a matter of time until the first person would say, “Things are going so well that I'm waiting for the other shoe to fall.”

When things get better, anxiety temporarily increases. You like the changes, and you start imagining a life where you're not limited by the previous problem. But you start dreading the disappointment that would set in if things fell apart again, dragging you back to the old way of doing things. It seems easier to just do what you did before, even though you know the new approach is what you really want.

My favorite example of this was a client who worked for several months to learn to process emotions instead of burying them inside. One week, she demanded, “Put me back the way I was!” I stayed quiet and let that sink in, and she started to chuckle. “Never mind,” she said. “I don't want to go back to that. I was a mess.”

Insight before, insight after—it doesn't matter when it comes. Often, we simply create change, and the insight follows.

—Carl Grody, LISW-S, is a licensed independent social worker who works with families at Grody Family Counseling in Worthington.