How did you learn that?

O this learning, what a thing it is!—Shakespeare

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In medical school we learn this saying “see one, do one, teach one”. This is a mantra about learning and mastery in learning procedures in medical school that really doesn’t make any sense in the world of psychiatry and psychotherapy. I suppose the idea plays off our tendency to want to know everything at an instant. I saw a news story online recently that promised to teach me a foreign language in just 15 minutes a day. We are constantly bombarded with quick weight loss schemes. Everywhere we look, we are told that we can have everything with little or no effort.

In psychotherapy learning takes time. My patients often feel disheartened when they come to grips with the fact that real lasting change is going to take a long time. Sometimes it takes years. I’ve noticed in myself that there is quite a difference between an intellectual knowledge or learning, and an emotional learning or knowledge. What I mean by that is this. Before medical school and residency I was a musician. I played the piano. When I was in the process of learning a piece of music there was a period when it seemed like a kind of intellectual exercise. Like I was able to think about the notes, get my fingers in the right place on the keyboard and so on, but it would take time before the piece seemed to flow in an automatic way. Kind of like the change and learning seemed to have to “sink in”. That process takes a lot of time.

In my acting I’ve seen a similar thing happen when working on lines for a character. Getting “off book” is just the first part of learning. It takes time for the nature of the character to sink and and for the words to seem to “become a part of me”. My acting coach calls that the “click”. That is a moment when the character seems to be coming through me as an actor, and the words feel more like what the character has to say as opposed to just something I’ve memorized.

I have a patient I’m seeing once a week and have been seeing them for over a year now. It is only now becoming apparent to the two of use what is exactly going on with their relationship with family by understanding what is going on in our relationship in the therapeutic space. This kind of learning can only be done over time. There is no short cut for this. This is the learning that will provide lasting change. The same lasting change we long for when we are trying to loose weight, or learn a language. It has to sink in. We need the “click” my coach talks about. It takes time.


Stephen M. Taylor, MD

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