Dr. Nathan Cobb
My Theory of Change

On this page I outline my theory of change, or the guiding principles and assumptions that influence my thinking and practice. Here you'll get a sense of how I work in therapy. These ideas focus on my assumptions about the nature of problems and how positive change occurs.

Sometimes the way we think and talk about our lives limits our choices and perspectives. Then something happens to expand our vision so that we see in a new way that opens up possibilities and solutions we hadn’t considered.

I have come to see counseling as partly about helping people to explore the impact of the stories they frequently tell about themselves and their world, and to invite people to reflect on new ways of creating meaning about their lives. One of the rewards of my work is participating with people in this process, celebrating their achievements with them as they gradually start to re-write their own stories.

What are some of the core assumptions that inform your therapy approach?

Assumption One: We are relational beings.

This means that we are best understood within a relational, systemic context. We exist in families and networks of people. Our behavior is often best understood in light of these important relationships. Establishing and maintaining secure, emotional bonds and attachments with others is a central and motivating need in human beings. We yearn to feel accepted and valued by others. We want to know that we matter to those who matter to us.

Assumption Two: We are meaning-making beings.

That is, we constantly form meanings about our experiences and the events that happen to us. For example, we interpret other people's behavior. We make assumptions about the way things are. We adopt core beliefs that we hold to be true about ourselves and others.

I use the term “meaning” broadly, to describe:

1. Our conscious automatic thoughts and internal self-talk,
   
   
2. Our explanations for why events occur the way they do and why people do the things they do, and
   
   
3. Our underlying core beliefs and assumptions about the nature of reality, the world, relationships, others, and ourselves. These core beliefs often lie outside our awareness, yet serve as powerful rules for our decision-making and behavior.

How we make meaning, in turn, guides what we pay attention to, how we think, how we feel, and how we act. Thus, the beliefs and assumptions we hold about the world shape our lives and have significant consequences for our relationships, for others and for ourselves.

Some beliefs help us and our families to experience growth and solutions to our problems. Other beliefs constrain solutions and perpetuate problems. In other words, the “problem” is not always the problem. It is often our belief about the problem that is the problem (Wright, Watson, & Bell, 1996).

Assumption Three: We are agentive beings.

We have the ability to act for ourselves, based on our powers of reflection and choice. We have the ability to reflect on our experience and to consciously choose our response to any given situation. We can choose our thoughts, our attitude, our actions, our words, and our intentions.

It takes work and effort to stand back and reflect, to act consciously, to look for possibilities beyond mere "stimulus-response" behavior. Accepting personal responsibility for the results we are creating in our lives is often the first step toward real, lasting change.

Assumption Four: What we focus on becomes real to us.

Most of what happens around us on a daily basis goes unnoticed or forgotten unless we decide that something is important enough to focus our attention on it. Once we focus on something, it becomes more real to us, no longer just part of the background.

This is what happens, for example, when we buy a new car. Most of us don't usually take the time to count all of the different types of cars we see on the road. But for a while after buying a new car, we become more conscious and aware of other people driving the same car than we ever were before.

In relationships and personal well-being, the same principle applies. Both problems and solutions are heightened and made more real when we focus on them and talk about them with others (Wright, et al., 1996). The more we talk about all of the negatives we see in our life, the more real and pervasive the problems seem to become. Strengths and resources and potential solutions are often present, but we don't notice them because we're too focused on problems. The more we focus on solutions, strengths and successes, the more we can build on possibilities to create positive change.

What is your theory of how problems develop?

While these ideas are not comprehensive, I assume that many problems occur in connection with one or more of the following:

1. Our limiting core beliefs about the nature of things—our assumptions that lie at the heart of the matter—constrain our view of options, solutions, choices and possibilities (Wright, et al., 1996).
   
   
2. Our basic attachment needs for significance and belonging become frustrated or threatened. We often react to this threat, knowingly or unknowingly, with various coping mechanisms that protect ourselves against vulnerability. Sometimes these coping mechanisms create further problems in relationships.
   
   
3. We engage in reciprocal, self-perpetuating, negative interaction patterns with others. As part of these patterns, we interpret each other’s behavior and selectively attend to events in ways that confirm our limiting core beliefs. We subsequently act in ways that further preclude safe, emotional connection and that maintain the negative patterns.
   
   
4. We focus more on problems and limitations in ourselves and each other and less on strengths, resources and solutions such that possibilities and positive changes often go unnoticed or forgotten.

What are your primary tasks as a clinician when working with people to facilitate change?

My primary therapeutic tasks are based on the assumptions and ideas I have already presented. Some of these tasks may apply more than others in particular situations. These tasks include:

1. Drawing forth conversations of affirmation, affection, growth and change, between myself and individual clients and/or between family members (Wright, et al, 1996).
   
   
2. Inviting reflection about more facilitative views on the issues involved, views that create therapeutic possibilities and options.
   
   
3. Promoting stronger emotional connections and attachments between family members through expanding the emotional experience of clients and through subsequent dialogue around that new emotional experience (Johnson, 1996).
   
   
4. Helping individuals address their needs for belonging, acceptance, significance and personal agency.
   
   
5. Helping family members to identify and alter negative interaction patterns through examination of the rules and structure that perpetuates such patterns and to create self-perpetuating positive interaction patterns.
   
   
6. Helping clients focus on solutions, successful outcomes, progress toward goals, efforts to create change, strengths and resources, and personal accountability for change, in order to facilitate further change.
   
   
7. Strengthening each client’s sense of self-efficacy by connecting successes and positive outcomes to their own effort rather than to circumstance or chance.

References

Wright, L. M., Watson, W. L., & Bell, J. M. (1996). Beliefs: The heart of healing in families and illness. New York, NY: Basic Books.

Johnson, S. M. (1996). The practice of emotionally-focused marital therapy: Creating connection. New York: Brunner/Mazel, Publishers.

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