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Jesse Whittle-Utter, LMFT

The Four Doors of Change


Image of Door - Oakland Therapist EMDR

I remember in graduate school, it was in a relatively inconsequential class that I learned one of the most valuable guiding principles about therapy and human change. I can’t even remember now what the class topic was. But I remember the professor posing the following question to us:

“Imagine that your client has three doors in front of them, and each one leads to a pathway of change. The first door is labeled Thought. The second is marked Feelings. And the third reads, Action. How do you decide which door is right for them?”

At the time, it was a confounding question. It seemed like another question designed to make us sharpen our individual theoretical orientations, to draw lines in the sand about where we stand on How People Change. A hesitant debate was allowed for a few minutes before the professor said:

“You choose the door that they are most willing to walk through.”

This stuck with me. Because human beings are so complex, the field of psychotherapy has generated dozens if not hundreds of ways to work with them. Some of these focus on thinking, some on action, some on feeling and still more on the body, on unconscious processes, or on catharsis. (And really, the Body should be a fourth door in the original example, and Intuition might be a fifth).

Many practitioners swear by their chosen method. Some incorporate several different methods, and or languish in indecision about how they want to work. Some types of therapy have been evaluated, while for others, the evidence of efficacy is anecdotal. But many therapists believe theirs is the best, and engage in turf wars in the territories of funding, legitimacy, and marketing.

I think what this situation fails to acknowledge is that each person seeking therapy has their own particular constellation of needs, defenses, strengths, and hidden potentials. Each person’s psyche is unique. So how could a therapy that focuses on, for example, behavior change, work equally well for everyone? The answer is that it can’t.

Whether you are a therapist or a client, you can benefit from thinking about which door you are most willing to walk through, and which door you most need to walk though. Here are some guidelines for figuring it out.

Door 1: Thought / Thinking

Because we live in a patriarchal culture, reason, logic, analysis and other cognitive processes are celebrated above all others. Many people come to therapy because they have not been able to think their way out of a problem, but want to keep trying. Questions of meaning are bound up in thinking. Wanting to “figure out” a problem, to insist on a clear or “right” answer, and to chart cause and effect are all hallmarks of utilizing thinking as a means of changing an unwanted symptom or circumstance.

Thinking is prone to all sorts of corruptions, often known as thought distortions. If thinking is your dominant mode of engaging in your life, or the door you’re most willing to walk through, it’s important to take stock of where your thinking goes awry, and work with a therapist on starting a course correction.

Door 2: Feeling / Emotion

Being thinking-oriented, however, might actually mean that Thought is NOT the door to walk through, however comfortable and familiar it may seem. This is because becoming analytical is so often a defense against feeling. If you have too many thoughts but can’t access your feelings, you may want to work with someone who will help you explore more emotional territory. It may not be the most comfortable, but if you’re stuck in your head, it’s almost certainly where you need to go.

Humans are extraordinarily emotional creatures. Our emotions secretly influence thoughts and decisions that we consciously believe to be purely rational. Feelings become buried if they are unfelt or unexpressed – they cannot just be eradicated by will or reason. Fully feeling anger, sadness, fear, and loss – those emotions we instinctively try to avoid – is what allows them to pass, to resolve. Ignoring them makes them fester and sap us of energy and clarity. It’s equally deadening to stop yourself from feeling love and joy which, for many of us, were at some point in our lives not safe to feel.

None of us may ever achieve 100% awareness of our feelings 100% of the time, but the more mindful we become, the more easily we’ll be able to move through the inevitable ups and downs of daily life.

Door 3: Action / Behavior

You might be someone who knows from experience that taking action, particularly something that feels risky or uncomfortable or breaks a longstanding pattern, can often cause a cascade of changes in your thoughts and feelings as well. You may think very clearly and feel your feelings fully, and know exactly what you need to do, but have trouble with motivation or follow through – or perhaps you feel frightened of taking risks. If you find yourself circling the same thoughts and feelings again and again, and feel guilty and avoidant when it comes to shaking things up in your routine, you’re a good candidate for Door 3.

Door 4: The Body

When I took that class in graduate school, the field of somatic psychology was in its infancy. Outside of the emerging field of trauma research, where insights into neuroscience and physiology were beginning to upend much of the conventional wisdom about trauma treatment, there wasn’t much mention of engaging the body as a means of change.

Of course, the body is where so much of our psychology resides: our stress, tension, anxiety, depression, joy, trauma, and even memories. Feelings can be understood and felt as traceable sensations in the body, with movement, intensity, temperature, pressure, weight, texture, and sharpness. How often do you track your experience in this way?

Following how thoughts, feelings and memories manifest in your body can lead to unexpected, emergent wisdom. Feelings can be felt fully and released; persistent negative thoughts can dissolve or lose their grip, while newer insights can spring into being. These shifts are common in somatic therapy and EMDR.

If you feel like your body is just a machine that keeps your head safe, or if you don’t have a strong sense of what is happening in your body at any given time, you’ll likely benefit from Door 4.

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Of course, any transformational change will necessarily reverberate through all of these domains of being, and any effective process will have to address each along the way to some extent. But knowing how to orient – by either what’s most comfortable to you or what’s least comfortable – will help you get started.

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