I Understand Why I’m Like This. So Why Can’t I Change?
Perhaps you already know why you find it difficult to say no, why criticism affects you more than you would like it to, or why somebody being disappointed with you can occupy your thoughts for hours.
You may know where your perfectionism came from. You might understand why being useful became important to you a long time ago, or recognise your tendency to keep going until you are exhausted, think your way around difficult feelings and make yourself remarkably easy to rely upon.
You can probably identify the pattern while you are doing it, and then find yourself doing it anyway.
For people who have spent a long time reflecting on themselves, this can become deeply frustrating. There is an assumption hidden inside much of our conversation about self-awareness: once we understand ourselves well enough, change ought to follow. When it doesn't, the obvious question becomes: I know why I do this. What do I actually do about it?
Understanding yourself can change a lot. But what if the pattern remains?
Psychological language has travelled a remarkable distance beyond the therapy room. Attachment styles, boundaries, trauma responses, emotional regulation, masking and people-pleasing now appear in ordinary conversation and across social media.
There is plenty to welcome about that. Having language for an experience can make something that once felt confusing considerably easier to recognise. For someone only beginning to make sense of how they think, feel and relate to other people, this can be a significant part of the work.
Connections that seem obvious in hindsight may never have been visible before. You may begin to see a relationship between responsibility and self-worth, for example, or between avoiding conflict and being highly attuned to other people's reactions. A way of coping which makes little sense in your life now may have made considerable sense somewhere else.
Research supports the importance of this kind of insight. Across different forms of psychotherapy, greater understanding of the connections between our past and present experiences, recurring relationship patterns, emotions and current difficulties is associated with better outcomes.[1]
And then there can come a point when the connections are already visible. You understand something of where the pattern came from, what tends to trigger it and even what you would like to do differently. The difficulty is that the pattern remains.
You can know that you have learnt to associate your worth with achievement and still feel uncomfortable on a day when you have accomplished very little. You can understand that other people's feelings are not always your responsibility and still find yourself trying to restore the atmosphere when somebody you love is unhappy. You can know that a boundary is reasonable and still feel selfish for having one.
At that point, another explanation may not be what you are looking for. You want something to actually change.
“Fine. What do I do about it?”
If you have spent much of your life solving difficult things by thinking carefully, making connections and working out what needs to happen next, it makes complete sense to bring the same approach to yourself.
You understand that you take on too much responsibility, so how do you stop? Your standards are exhausting you, so how do you lower them? You know you find it difficult to disappoint people, so what do you need to do differently?
There are times when practical change matters. Therapy can lead to decisions, conversations, boundaries and different behaviour. But emotional and relational patterns do not always respond neatly to instruction, particularly when the person trying to implement the instruction is already accustomed to expecting a great deal from themselves.
The project of changing can begin to acquire exactly the same qualities as everything else. You can become perfectionistic about overcoming perfectionism, judge yourself for not setting boundaries correctly, or recognise yourself trying to keep everybody happy and become frustrated that you are still doing it.
The original pattern remains, with another standard sitting on top of it: I understand this. Why aren't I better at it by now?
Perhaps the difficulty is that the pattern isn't simply something you think.
It is also something you experience.
What happens in the moment before you do what you always do?
Imagine that you know perfectly well that saying no to somebody does not make you selfish.
Then somebody asks something of you. You are tired, you don't want to do it and you have every reasonable justification for declining.
You say no.
Soon afterwards, you begin wondering how your message sounded. Are they annoyed? Were you too abrupt? Perhaps another message would soften it. After enough mental negotiation, saying yes begins to look easier than tolerating what saying no has stirred up.
You haven't forgotten what you know about boundaries. The problem isn't a lack of understanding. Something else has happened between knowing what you believe and experiencing the consequences of acting on it.
You may know that other people are allowed to be disappointed with you while experiencing their disappointment as something you need to put right. You may know that your worth isn't determined by achievement while finding an unproductive day surprisingly difficult to tolerate. You may believe that you are allowed to need other people while still finding needing considerably more exposing than being needed.
Once the pattern is understood, Why am I like this? may no longer be the question that takes us any further. A different question becomes possible: What happens in me at the point where the familiar response begins to feel necessary?
If you don't repair somebody's disappointment, what do you imagine might happen? If you stop working before everything is finished, what does the discomfort seem to say about you? If you tell somebody what you actually think, what are you preparing yourself for in their response?
A pattern can make complete intellectual sense and still contain an emotional expectation: that disappointing somebody threatens connection, that being less useful makes you less valuable, that lowering your standards is dangerous, or that showing more of yourself may change how somebody sees you.
Understanding where an expectation came from does not automatically stop you expecting it.
So where does change actually happen?
This is where the work can move from explaining the pattern to meeting it as it happens.
Knowing that you take responsibility for other people's feelings is valuable. But there is something different about noticing the precise moment another person's disappointment becomes difficult to bear: the tightening in your body, the sudden need to explain, the speed with which their reaction becomes something you need to manage.
Knowing that you struggle to rest tells you something important. Becoming interested in what actually happens when you stop can tell you more. Perhaps rest brings agitation rather than relief. Perhaps an afternoon without achievement leaves you feeling strangely unanchored. Perhaps you discover that work has been doing more than occupying your time: it has been organising your sense of worth, usefulness or identity.
The same is true relationally. You may understand that you make yourself easy to be around, but change becomes possible at another level when you begin to notice yourself doing it: editing what you really want to say, monitoring the other person's face, making your anger more reasonable, withdrawing a need before anybody has had the chance to respond to it.
The point is not simply to catch yourself and perform the ‘healthier’ response instead. That can easily become another demand.
The work is to become more able to remain with what the alternative brings up.
If you don't immediately repair the disappointment, can you stay with the guilt long enough to discover that guilt is not necessarily evidence that you have done something wrong? If you don't soften the disagreement, can you remain present while another person has a different view of you? If you stop before everything is finished, can you become curious about the discomfort rather than immediately obeying it?
Research into emotional change in psychotherapy is relevant here. Across a large body of studies, changes in emotional experiencing and regulation are associated with therapeutic outcome, although no single emotional process explains how all psychotherapy works.[2] Research within Acceptance and Commitment Therapy approaches a related question through psychological flexibility: the capacity to remain in contact with difficult internal experience without that experience automatically determining what happens next.[3]
Different therapeutic traditions describe this differently, but there is an important distinction here. Change does not necessarily require the old feeling to disappear.
You may still feel guilty when you say no. You may still register another person's disappointment intensely. Rest may remain uncomfortable for a while. Criticism may still hurt.
What begins to change is what those experiences require you to do.
Guilt can be present without requiring repair. Discomfort can be present without requiring action. Somebody else's disappointment can remain theirs without becoming evidence that you have failed. An old expectation can make itself known without automatically deciding what happens next.
That is a very different kind of change from finally finding the explanation that makes the pattern disappear.
And this is where the therapeutic relationship matters
Many of the patterns we are talking about were not developed in isolation. They concern how we have learnt to be with other people: what keeps connection secure, what makes us acceptable, what happens when we need something, disappoint somebody, become angry, take up space or stop being useful.
It makes sense, then, that some of these patterns become most visible in relationship.
Someone who understands perfectly well that they are frightened of disappointing people may eventually notice that they are also trying not to disappoint their therapist. Someone who knows they make themselves easy to be around may find themselves arriving with something carefully prepared, worrying that they have nothing important enough to say, apologising for becoming upset or watching closely for signs that the other person has become bored or frustrated.
Someone who has spent years being relied upon may find it surprisingly unfamiliar to be in a relationship where their usefulness is not required.
At that point, therapy is no longer only a conversation about how you relate to other people. There is a real relationship in which the pattern can be noticed as it happens.
You might disagree with your therapist and immediately soften what you have said. Perhaps you notice yourself checking their face. Perhaps you hear yourself explaining why your disagreement is reasonable before anybody has challenged it.
There is a great deal of information in that moment.
Not because the therapist needs to diagnose the behaviour or tell you what it means, but because the two of you can stay close to what has just happened. What became uncomfortable? What did you expect from the other person? What were you trying to prevent when you softened what you said?
And importantly, the relationship continues.
You can disagree and remain in relationship. You can have nothing impressive to say and discover that nothing impressive is required. You can bring anger, uncertainty, contradiction, need or something you find difficult to admit without first turning it into a more acceptable version of yourself.
This does not mean therapy is a carefully engineered series of ‘corrective experiences’, nor that every pattern will conveniently reproduce itself between therapist and client. It means that a relationship offers something an explanation cannot offer on its own: another person is actually there.
The expectation that if I disappoint someone, something bad will happen between us is no longer only an idea to examine. There are opportunities to encounter disappointment, difference, misunderstanding, need and uncertainty within a relationship that has enough steadiness to remain interested in what happens.
Over time, the old expectation is no longer the only experience available.
The relationship is part of the work
The significance of the therapeutic relationship has been studied extensively across psychotherapy approaches. A large meta-analysis involving 295 independent studies and more than 30,000 clients found a consistent association between the quality of the therapeutic alliance and psychotherapy outcome.[4] Subsequent work examining whether that association could be accounted for by client characteristics or other treatment processes continued to find an independent relationship between alliance and outcome.[5]
Research into therapist empathy, positive regard and genuineness has also found associations with therapeutic outcome. None of this reduces psychotherapy to a good relationship, nor does it establish one universal mechanism through which people change. Technique matters, the client matters, life outside therapy matters, and different approaches bring different understandings of what facilitates change.
But it does make the relationship difficult to dismiss as merely the setting in which the ‘real’ therapy takes place.
In relational work, the relationship gives us somewhere to encounter aspects of a pattern that can remain remarkably intact when they exist only as an explanation. A person can know for years that they are allowed to have needs. It is another experience to need something from another person, feel everything that stirs up and discover that they do not have to withdraw the need in order to preserve the relationship.
That is why the relationship is part of the work.
What changes may be your freedom to respond
There is a final complication, particularly when the patterns causing difficulty are tangled up with qualities you genuinely value.
High standards, responsibility, conscientiousness, sensitivity to other people and the ability to keep going are not inherently psychological problems. They may be part of what has made you effective, trusted and successful. Even research into perfectionism distinguishes high personal standards from its more punishing dimensions, such as persistent concerns about mistakes and negative evaluation.[6]
Wanting to do something well isn't the same thing as feeling that you cannot afford to do it badly. Caring about somebody's feelings isn't the same thing as being responsible for them. Being dependable is not something therapy needs to remove from you, and working hard is not automatically avoidance.
The question becomes what happens when these ways of being are difficult to put down, even when they are costing you something.
Therapeutic change may not mean becoming less conscientious, less sensitive or less ambitious. It may mean that these qualities become increasingly available to you rather than compulsory.
You can work hard because something matters to you, without work having to settle the question of whether you are worthwhile. You can care deeply about another person's experience without automatically making yourself responsible for it. You can be dependable without believing that your place in a relationship depends upon how little you need in return.
And you may still feel the old pull.
There may still be guilt after a boundary, anxiety after disagreement, discomfort when you stop, or an immediate impulse to make things better when somebody is unhappy with you.
The difference is that the feeling no longer has to have the final word.
There is a considerable difference between knowing I do this and recognising, in the moment, this is happening now. In that space, however small it is at first, a response that once felt inevitable can begin to become something you have more freedom around.
Perhaps you don't need another explanation
If you have spent years trying to understand yourself, the answer is not that you have been thinking too much. Your capacity for reflection may be one of the reasons you have navigated difficult periods, complicated relationships and significant responsibility as well as you have.
Nor is the answer simply to abandon thought in favour of feeling. We need both.
But there can come a point when another explanation gives diminishing returns. You understand what happens, you know something of its history and you may even recognise the pattern while it is happening.
The work can then become less about discovering the final reason you are this way and more about getting close enough to the familiar response to experience what happens when you don't automatically follow it.
What happens when somebody is disappointed and you don't immediately repair it? When you aren't useful? When another person sees something you would usually edit? When you allow yourself not to know? What happens when you remain in contact with yourself while somebody else remains separate from you, with their own feelings, reactions and expectations?
The old pull may remain. Therapy doesn't promise a life in which you never again overwork, feel guilty for saying no, worry about somebody's reaction or expect too much from yourself.
But those experiences do not necessarily have to organise your life in quite the same way.
For someone who has become exceptionally good at understanding themselves, therapy can take the work beyond another explanation. It offers the possibility of meeting some of those familiar ways of being as they happen, sometimes within the relationship itself, and becoming increasingly able to remain with what you feel without automatically becoming who the pattern has always required you to be.
Perhaps that is where change happens: not in finally becoming someone who never feels the old pull, but in having more freedom to decide what you do when it comes.
If you recognise yourself in this, and you are considering therapy, you are welcome to get in touch to arrange an initial consultation.
References
1. Jennissen, S., Huber, J., Ehrenthal, J. C., Schauenburg, H. & Dinger, U. (2018). Association Between Insight and Outcome of Psychotherapy: Systematic Review and Meta-Analysis. American Journal of Psychiatry, 175(10), 961–969. DOI: 10.1176/appi.ajp.2018.17080847.
2. Sønderland, N. M., Solbakken, O. A., Eilertsen, D. E., Nordmo, M. & Monsen, J. T. (2024). Emotional changes and outcomes in psychotherapy: A systematic review and meta-analysis. Journal of Consulting and Clinical Psychology, 92(9), 654–670. DOI: 10.1037/ccp0000814.
3. Macri, J. A. & Rogge, R. D. (2024). Examining domains of psychological flexibility and inflexibility as treatment mechanisms in acceptance and commitment therapy: A comprehensive systematic and meta-analytic review. Clinical Psychology Review, 110, 102432. DOI: 10.1016/j.cpr.2024.102432.
4. Flückiger, C., Del Re, A. C., Wampold, B. E. & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316–340. DOI: 10.1037/pst0000172.
5. Flückiger, C., Del Re, A. C., Wlodasch, D., Horvath, A. O., Solomonov, N. & Wampold, B. E. (2020). Assessing the alliance-outcome association adjusted for patient characteristics and treatment processes: A meta-analytic summary of direct comparisons. Journal of Counseling Psychology, 67(6), 706–711. DOI: 10.1037/cou0000424.
6. Hill, A. P. & Curran, T. (2016). Multidimensional perfectionism and burnout: A meta-analysis. Personality and Social Psychology Review, 20(3), 269–288. DOI: 10.1177/1088868315596286.
7. Elliott, R., Bohart, A. C., Watson, J. C. & Murphy, D. (2018). Therapist empathy and client outcome: An updated meta-analysis. Psychotherapy, 55(4), 399–410. DOI: 10.1037/pst0000175.
8. Farber, B. A., Suzuki, J. Y. & Lynch, D. A. (2018). Positive regard and psychotherapy outcome: A meta-analytic review. Psychotherapy, 55(4), 411–423. DOI: 10.1037/pst0000171.
9. Kolden, G. G., Wang, C.-C., Austin, S. B., Chang, Y. & Klein, M. H. (2018). Congruence/genuineness: A meta-analysis. Psychotherapy, 55(4), 424–433. DOI: 10.1037/pst0000162.
