Question about effectiveness of thinking about the past

[punkedoutriffs]

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A friend and I had a discussion today over whether thinking and reflecting on past events actually make a difference in dictating future behavior. The intuitive answer is yes, but I wondered whether the intuitive answer is misleading in this case.

Examples abound, but let's take AA meetings for one, where members are encouraged to open up about their past, tell their stories, etc. This sends an implicit message (or maybe not so implicit) that one can learn from past and see where they might have erred in the hopes of reducing future error. I mean, the whole rationale for studying macro-history is that we as a society can "learn from the past" so we don't repeat the same mistakes. However, I'm questioning whether this rationale is actually valid.

Therefore, I'm looking for evidence of a direct correlative relationship between time spent thinking/dwelling/reflecting on the past and subsequent changes in behavior. Seeing as how testing this hypothesis cannot happen on a macro level (civilization), it seems the question can only be answered on a more micro-level (a group of people). The implications of the answer might determine whether alcoholics, drug abusers, adulterers, and such should deliberately and consciously think/reflect/dwell on their behavior in a proactive effort to change future behavior. Are we making a difference when we're thinking about the past and suffering the attendant side effects during--guilt, regret, etc.? Maybe we should just not think about it at all...

Let's say we conduct a study with X-amount of people, all with past behavior that they want to change. Let's just say infidelity just to pick something. And let's say these people are all screened for other variables that might upset the validity of the study (income level, educational level, diseases - mental and physical, etc.). And say there's a way to measure how often or how long they spend thinking/reflecting/dwelling on this specific behavior as it occurred in the past(surveys?). Do you guys think there would be an appreciative correlation between the quantity of time they spend thinking on this and subsequent changes in behavior?

I hope it's clear what I'm asking. These thoughts are just forming.

 

[nitemagi]

These are good preliminary thoughts on how to study change and therapy, for someone starting medical school. In my experience, factors more important to change than time thinking about the past are:

-Dissatisfaction with past behaviors (and thus a desire to change) - think of as a continual variable rather than categorical.
-Outside perspective to oneself (or an innate ability to entertain varied points of view rather than a single explanatory model on situations) - as we all rationalize and research does show our natural attempt to justify whatever we do. "Well I was underpaid at work so it seemed right to steal..."
-Introduction of alternative viable models or behaviors that achieve similar ends or better


An even more interesting questions is can change occur in behaviors WITHOUT examining the past. Which is an approach used in many different therapies, including some uses of CBT (more behavioral or immediate examination of cognitive distortions in real time).

I suspect the Amount of time isn't really as relevant as you might think, though I'm sure some psychoanalysts might disagree.

 

[punkedoutriffs]

Hm... interesting.

 

[dl2dp2]

Let's say we conduct a study with X-amount of people, all with past behavior that they want to change. Let's just say infidelity just to pick something. And let's say these people are all screened for other variables that might upset the validity of the study (income level, educational level, diseases - mental and physical, etc.). And say there's a way to measure how often or how long they spend thinking/reflecting/dwelling on this specific behavior as it occurred in the past(surveys?). Do you guys think there would be an appreciative correlation between the quantity of time they spend thinking on this and subsequent changes in behavior?

There are easier ways to study the efficacy of various treatments. For instance, in terms of substance abuse research, you should look up PROJECT MATCH, which is a large multicenter randomized trial comparing 12-step facilitation (i.e. AA), which is more "reflective", and CBT and motivational interviewing, which is "not as reflective". The result is that they are basically equivalent treatments...there are some subtleties, but so far there is no way for the clinician to tell who's going to best respond to "reflective" vs. "here and now" approaches based on evidence alone. However, the MI group had substantially fewer sessions...

So your question is posed in a bit of a simplistic way: rather than asking if "time spent thinking/dwelling/reflecting on the past and subsequent changes in behavior" are correlated, you need to ask FOR WHOM the correlations are the strongest, for WHOM there maybe an INVERSE correlation. This leads to the ideas of personalized medicine, which is at the cutting edge of where the field is going in terms of research and practice.

The other issue is that there is a difference between efficacy and "insight". Strictly approaching a clinical outcome, i.e. cessation of drug use, relief of depression, remission of anxiety, etc. etc. short term CBT with a focus of "here and now" may be as effective or even more than therapeutic approaches that focus on childhood/development and reflection. However, some people are interested in "deeper" things than simply being "symptom free", i.e. what's the point of my life, why am i repeating certain interpersonal patterns, and where am I going with my career. IMHO, a service provided to provide some insight into these more existential questions aren't necessarily part of medical practice and questions would be raised in terms of insurance coverage, but as of right now the ability, if not the desire and financial gain in the end, to do this kind of therapy ("psychodynamic") is part of standard training and repertoire for psychiatrists.

 

[punkedoutriffs]

Thanks for your response.