Over a decade ago, when I was in college, I was at the mechanic getting the brakes fixed on my car. It was a specialized mechanic that only worked on brakes, and Mito the mechanic was the best in the area because he specialized (remind you of anyone? *wink*). Anyway, he had a sign in his waiting room that I will never forget. You can find some variation of this sign floating around the internet:
We offer 3 kinds of service: Good, fast, or cheap...but you can only pick two
Good service Fast won't be Cheap
Good service Cheap won't be Fast
Cheap service Fast won't be Good
That last line was burned into my memory. Although I saw this sign at a mechanic's office, I can't help but feel like it fits in perfectly in almost every service area. How often do we see mistakes made by rushed work? Think about this: if your house is being built, do you want the construction team to take their time and do the work carefully, or do you want them to rush? I'm guessing you'd want them to be accurate, but quick. But I think we can still agree with that last line: cheap service that is fast won't be good.
Getting to the root cause often takes time
I am about to express what is a very unpopular opinion among most insurance companies (and some schools of thought in mental health): good psychotherapy takes time. This is not to take away from the very real pain that often requires a sense of urgency. However, In my experience, the symptoms are often just the tip of the iceberg, and in no world have I felt comfortable digging into someone's soul during the first session of therapy...or even the second. Sure, I can ask hard questions, like "do you have a history of trauma?" But it's more likely that I'm going to wait after we've gotten more comfortable with one another before I get to the root of said trauma. After all, sharing deeply personal information is an act of trust.
But Dr. Stephanie, I don't have trauma!!!
Cool...many of us don't. That doesn't mean there's no root cause, no problematic pattern at the heart of the symptom itself. We can and will address the symptoms (e.g., "You feel scattered, let's take a few deep breaths together…") but part of my work is to support you in building a future in which that symptom doesn't control your life (remember the house?). As I've said to parents before: I'm not just interested in reducing your family's discomfort in the short term, I'm interested in who you will be as a family 1, 5, even 10 years down the road.
Changes that happen gradually may be more likely to stand the test of time
Many people are familiar with the effects of quick, fad diets, right? To be clear, I'm talking about anecdotal evidence, not empirical studies. How many times do we see cases of rapid weight loss from a fad diet that end up resulting in the person careening back to where they started? And sadly, how many times do we see a rebound that is even worse?
We see plenty more examples of people making micro changes (e.g., a fifteen minute walk in the morning; reducing the sugar in their coffee) and building on those changes over time as they form into habits (e.g., a morning jog; a low sugar diet). Taking the time to be present in therapy is largely about finding meaning in the micro changes that will help relieve the psychological distress. It can start with micro changes (e.g., pay attention to the tension in your face when you talk to your child; notice what time you cut the electronics before bed) that build into meaningful habits (e.g., taking a deep, mindful breath before responding to your child's tantrum; cutting electronics two hours before bed).
These changes rarely happen overnight and they often require some degree of accountability and support (from...say...your kid's therapist *wink*). And if implementing these changes doesn't become habitual, it's time for us to have some of the harder conversations that get to the root. A therapist does not exist simply for the sake of erasing symptoms, but of helping the clients discover the patterns behind the psychological distress.
So the motto of my practice became the final line of that sign at Mito's Brakes in Hialeah, FL:
Cheap service fast won't be good. Slow down. Reject the urge for a quick fix.
This concept of slowing down to improve outcomes isn't new. Psychologist Dr. Daniel Kahneman has entire bodies of work related to the differences between quick, impulsive thinking and slower intentional thinking.
Feel free to check out what other experts have to say about the benefits of being slow and steady:
Note: This blog post was originally published on September 11, 2020 and republished with some revisions on May 14, 2021.