A.I.M.

"The greatest revolution of our generation is the discovery that human beings, by changing the inner attitudes of their minds, can change the outer aspects of their lives.” (William James, 1842—1910)

Towards the last years of my practice, I began to conceptualize a theory of psychotherapy, a distillation of what I believed to be the most important components of therapy. AIM was the result, AIM standing for Attitude, Involvement, and Meaning.

ATTITUDE is a word easily tossed around, but a concept little examined. Attitude is the manner in which we face the challenges of the world. It is not a cognition or belief, but it influences our thinking. It is not a behavior, but it gives direction to our behavior. It is not an emotion, but it has an emotional valence, good or bad. Psychotherapist Viktor Frankl called attitude the last of our freedoms, the freedom to choose the attitude with which we face the circumstances of our lives.

Patients enter into therapy with a variety of attitudes. Some enter unwillingly, others eagerly.  Some enter with doubt, others with optimism.  Some come emotionally detached, others fully engaged. Some come close-minded, others open to change. The work of therapy begins with recognition and acknowledgement of one’s attitude, whatever it may be. Then, on the premise that attitude is a choice, patients can consider their options, and determine what attitude best serves their particular goals both in therapy and outside of the therapy.

INVOLVEMENT is participation in important and gratifying activity. It happens with immersion in creativity or spirituality. It happens in interaction with nature or involvement in community. It happens in close friendships and in relationships.

To understand involvement, we can look at what stands in contrast:  detachment, avoidance, escapism, self-absorption. Involvement stands in contrast to otherwise trivial pursuits.

Engagement with life is essential for healing and for health. The talking and the exploration that occurs in context of therapy sessions is valuable, but it is not enough. An important goal for those in therapy is to get involved.

MEANING stands in contrast to nihilistic despair. Viktor Frankl believed that humans are inherently meaning seeking. “Why am I here? For what purpose?”  Life’s difficulties can be better endured if life is lived with identified purpose and meaning. Friedrich Nietzsche famously said that those who have a why can bear almost any how.

To ask, “What is the meaning of life?”, may be unanswerable.  But we can instead ask, “What do I want from life?”  “Who do I want to be?”  “How do I triumph in the face of life’s hardships and challenges?” “What will be my legacy?”

The answers to those questions of Meaning emerge when circling back to Attitude and Involvement.  With the right attitude, and involvement in important and gratifying pursuits, one may subsequently discover that life can be filled with meaning.

A good acronym is easily remembered and seems to confer some degree of credibility and gravitas. There is CBT, cognitive behavioral therapy; DBT, dialectical behavioral therapy; and ACT, acceptance and commitment therapy.  Now there is AIM.  “AIM for your mental health,” or if you prefer, “Ready . . . AIM . . . Bullseye!” I think it has some potential.