How Therapy Works: The Importance of Skill Building | Psychology Today

Source: How Therapy Works: The Importance of Skill Building | Psychology Today

We can only do well what we know how to do well.

Posted Feb 09, 2021

Imagine yourself a therapist. The client across from you is a young man with a fear of driving. Once in his car, he experiences disorienting panic, which causes him much distress and limits his ability to enjoy his life. Your background assessment has shown that he is not physically handicapped (i.e., blind, deaf) or mentally handicapped (i.e., low intelligence; psychosis). What would you guess is the source of his problem? What questions would you ask him in order to figure it out?

Perhaps you’d start by inquiring about his personality traits. Is he an anxious, neurotic person, lacking in overall confidence? If so, that could help explain things. His fear of driving is but one manifestation for his overall personality style.

Perhaps you’d inquire too about the condition of his car, or the road conditions where he lives. If his car is old and unreliable, or if he lives in a shattered war zone, then that may explain his fear.

IconTrack for Wikimedia Commons
Source: IconTrack for Wikimedia Commons

Perhaps you’d want to inquire about his life history. Did he experience or witness a car accident as a child, thus developing a lifelong aversion? Was he involved in a recent accident, after which the symptoms emerged?

Perhaps you’d inquire too about his relationships with his parents. Perhaps his abusive father was a truck driver, and the client’s fear of driving manifests his unconscious resentment of his father.

All the above are good questions, and may yield important data. But the most important question you’d want to ask first is altogether different, simpler, and potentially more useful: Is he a good driver?

Owing much to the legacy of Sigmund Freud and his followers, therapy in the popular imagination is often viewed as a deep dive into the dark, convoluted mysteries of the unconscious, unearthing clients’ traumatic experiences, tangled relationships histories, and personality quirks.

In the real world, however, clients’ difficulties often relate more to skill deficits than to deep, obscure, or complicated motives. Most meaningful life projects—relationship, work, love, sex, parenting, health, money—require a measure of skill. At the end of the day, we can only do what we know how to do, and we do it only as well as we know how.

Your personality traits, environmental conditions, and past experiences are important, and a big reason why is that they often relate to your skill level. But these are not one and the same and should not be confused. Traits are behavioral tendencies. Skills are behavioral abilities. Environmental conditions and early experiences create (and limit) opportunities for skill development, but they are not sufficient to produce skill. Having a piano at home is not the same thing as knowing how to play the piano.

Still, our traits, circumstances, and early experiences may help us to develop some skills over others. An extraverted person, who grew up in a socially open and safe environment will likely end up with better social skills than an introverted, isolated, timid individual.

Alas, the fact that your personality, circumstances, and early experiences have conspired to deprive you of certain life skills doesn’t render those skills less important; quite the opposite, in fact. Money doesn’t cease to matter because you were born poor. It matters more.

To wit: If I’m an introverted child growing up with timid parents and used to being ignored at school, then my self-assertion skills will remain underdeveloped. Such underdevelopment may underlie my current problems in finding intimacy and advancing at work. The solution is not to rage against my history or try to alter my biological makeup, but to acquire the missing skill.

Skill acquisition is effortful and may often require us to bump up against our temperamental tendencies, our experience, or our environmental conditions. If you’re an inhibited, introverted individual by personality, then you are less inclined to put yourself in situations of social interaction. This may over time lead to deteriorated social skills, and thus higher social anxiety and more social avoidance—a self-perpetuating vicious cycle.

To gain adequate skill, you’ll need to reverse the cycle, accept the discomfort, and move counter to your tendency. This is difficult, but worthwhile, because, as the work of psychologist Gilbert Gottlieb has shown, just as biological temperament may drive behavior, so behavior may drive biology. To evolve teeth, a species has to start biting first. Likewise, over time, skills may evolve into traits (if what you learned how to do becomes what you tend to do), re-shaping character, affecting experience (doing something well feels different than doing it poorly or not at all) and environmental conditions (improved skills lead to improved circumstances: social, financial, occupational etc.).

Once we agree that skills are important for mental health, the question arises: what are the most important mental health skills? A new article in Psychological Science attempts to answer this question. In the piece, authors Christopher Soto of Colby College and colleagues argue that in addition to the effects of personality, experience, intelligence, etc., “success in life is influenced by … social, emotional, and behavioral skills (SEB skills): a person’s capacities to maintain social relationships, regulate emotions, and manage goal- and learning-directed behaviors.” Summarizing a large body of research on such skills, they go on to propose “an integrative model that defines SEB skills as capacities (what someone is capable of doing) rather than personality traits (what someone tends to do).”

Noting that personality traits and skills are often correlated, the authors then organize these life skills by five major domains that parallel the Big Five personality traits, as follows:

Social Engagement skills (linked to the personality trait of extraversion): Capacities used to actively engage with other people, including leadership (asserting one’s views and speak in a group) and conversational skill (initiating and maintaining social interactions)

Cooperation Skills (linked to agreeableness): Capacities used to maintain positive social relationships, including perspective-taking (understanding other people’s thoughts and feelings) and social warmth (evoking positive social responses from other people).

Self Management Skills (linked to conscientiousness): Capacities used to effectively pursue goals and complete tasks, including goal regulation: (setting clear and ambitious goals), and task management (working persistently to complete tasks and achieve goals).

Emotional Resilience Skills (parallel to low Neuroticism): Capacities used to regulate emotions and moods, including stress regulation (regulating stress, anxiety, and fear), and anger management (regulating anger and irritation).

Innovation Skills (openness to experience): Capacities used to engage with novel ideas and experiences, including abstract thinking (engaging with abstract ideas) and artistic skill (creating and appreciating art).

The authors argue that while many SEB skills likely relate to personality traits and measured intelligence, they remain distinct enough to capture unique information.

A focus on skills is also useful because we cannot yet control our genes, early experience, and early environment, and we often have limited ability to control our current circumstances. Our skill level, however, is to a considerable extent under our control. We can get better at stuff, and one place in which to do this is in therapy.

Indeed, much evidence has accumulated in recent decades to show that life skills of the kind discussed by the authors can and do improve with therapy, as clients learn how to regulate emotions, set appropriate goals, manage stressinteract usefully with others, increase empathy, and appreciate abstraction.

Thus, the goal of therapy—and the hard work of it—is often for clients to find which important life skills are underdeveloped, and to develop them adequately.

Often, the way to eliminate your fear of driving is to become a better driver.