October 1st, 2011

Serenity prayer for psychologists

You don’t have to work very long in the mental health field before you encounter the serenity prayer: God, grant me the serenity to accept the things I cannot change, /Courage to change the things I can, /And wisdom to know the difference. For many of us, our introduction to these lines may have come in connection with addictions work since the prayer has been a part of the AA literature ever since a member brought it to the attention of AA co-founder, William Wilson, in 1941.

The serenity prayer is generally attributed to the theologian, Reinhold Niebuhr, who may have written a similar version as early as 1937. To psychologists, it is readily apparent that the ideas expressed in the serenity prayer are consistent with a key tenet of cognitive behavior therapy. When you’re faced with a stressful situation, you can either change the situation or change the way you think about it. So how do we apply these principles in the daily routines of our professional lives?

Accepting the things we
cannot change:
I have my list and I’m sure you have yours. The items range from the mundane and trivial to weighty matters that seem to define the nature of our professional and perhaps even personal identities. But let’s get one thing straight from the beginning – if we are willing to accept the consequences, we can change almost anything. I would like a shorter commute to work and more courteous motorists with whom to share the road. I would also like to arrive at my office without driving up a hill that takes 45 minutes to climb in icy or snowy conditions. Work crews have been busy all summer along the margin of the road so, if they add another lane, I might be able to cross this wish off my list. Of course, that still leaves a building that admits sunlight and has more than two temperature settings of freezing and sweltering, but that’s just being picky. After all, we are moving into a new building next year, so things are bound to be better or at least different.

I suspect we could all easily ignore those little annoyances related to our commute and physical environment as long as we could see real results from our psychological work. This is where it is even harder to accept things that cannot change. We would all like a one hundred percent success rate, whatever that means, from our efforts to help people make the kinds of changes that lead to safer, more secure, and fulfilling lives. Perfection is unrealistic but there are days when even adequacy seems like a stretch. If falling short frustrates us as treatment providers, we have only to listen to our patients’ stories of frustration and discouragement and recall our own to know the true measure of despair.

When you sit with someone who has murdered a loved one, you can help them understand how their mental illness diminished their responsibility and you may even be able to help them find a new and perhaps redemptive meaning to their own lives. But their loved ones are still gone.

Changing the things we can: As psychologists, we are always trying to become more effective instruments of change. This is why we read the literature, attend conferences, and take continuing education classes. This process of continual self-evaluation requires dedication and hard work. It also requires courage. We need the courage to question our familiar and comfortable ways of doing things, to discard practices that have not been effective, and to modify others with the new knowledge coming to light daily in our evolving field. We do all this to help our patients make the changes they desire in their lives. But that takes courage too – the courage to let go of a troubled but familiar present for the hope of a better future, only dimly glimpsed and a long way from being realized.

The next time you wonder why a patient did not respond to your brilliant intervention, remember your own struggle to make a major change in your life and you will have a better idea of what you are up against as a therapist. Shifting the lens of change from the individual to the larger system, we realize that sometimes we will also need the courage to go up against the status quo or the established order. Saints and visionaries are especially good at this on a grand scale but the rest of us have the same obligation to use our influence to improve conditions in our own little corners of the world.

Knowing the difference: Without wisdom, we are left with a choice between nihilism and grandiosity. I can change nothing or I can change everything. Wisdom supplies the middle ground so obviously lacking in this all-or-nothing way of viewing the world. The facts of our individual and personal histories are immutable. We were each born at one place and time and not another into one particular family in a world that was going long before we arrived. We suffered the loss of loved ones and welcomed new people into our lives even as others have invited us into theirs. We can’t change the past but what we make of it will shape our future. It would not be wise to call this wisdom but maybe it’s a good place to start.  n

Alan Bodnar, Ph.D. is a psychologist at Worcester State Hospital and a consultant in the field of leadership development.

By Alan Bodnar Ph.D.

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