Years more therapy, or one conversation?
Why do we accept that emotional issues take years to resolve?
It took too long to outgrow the worst of my anxiety. Afterward, I wondered, “How could this have been 10x easier?” This was my guiding light as I began helping others resolve their anxiety issues.
Clients of mine have largely freed themselves from lifelong, therapy-resistant issues after approximately one conversation. I call these cases “one-shots.” A few examples:
Anxiety resistant to talk therapy, CBT, and IFS
First attempt was with a man I met at a CFAR reunion. He was struggling with lifelong anxiety resistant to talk therapy, CBT, and IFS. He asked to talk. One year later:
I used to get triggered by very small things that some of the people surrounding me would say or do… These things would incapacitate me for 48 hours, I would have to shut myself in my room. Now I just laugh…
This ultimately wasn’t a strict one-shot — he needed two short calls at nine months — but pretty good for a first attempt. I’ve since diagnosed and resolved the issue in the protocol.
UPDATE 18 months later: He says all is good and he continues to grow because of the work.
Anxiety resistant to 8 years of talk therapy
A man I met at a prediction market conference set a bounty on reducing his lifelong social anxiety. He had already tried eight years of talk therapy for it.
In our one conversation, he got unblocked and, in his words, learned how to “turn anxiety into excitement”. He continued the practice on his own. Six months later, he reported:
Every week I had some new ridiculous, fun, stupid project that I had others rallied around. It's exactly the stuff I kind of pictured doing but never really did.
Other people started describing him differently:
One of my new friends said, “You're so adventurous.” That shocked me…
Detailed interview. Bounty claimed.
UPDATE 12 months later: He says he’s doing great.
Multi-decade porn addiction
A man set a bounty on resolving his multi-decade porn addiction. In one conversation, he learned a skill that he has applied in times of need ever since.
UPDATE 7 months later: He says he doesn’t have urges anymore. Bounty claiming.
Approach anxiety resistant to years of IFS therapy and meditation
A tech founder in SF placed a bounty for asking out crushes, something he had been unable to do despite hundreds of hours of IFS therapy and meditation over many years. After our first conversation, he went home, immediately went to sleep, woke up with muscle soreness, and within two weeks had easily asked out multiple crushes.
Detailed interview. Bounty claimed.
UPDATE 11 months later: He’s in a happy relationship. He asked her out in person.
How do one-shots happen?
One-shots can happen regardless of prior attempts to resolve their issue. I’ve mostly focusd on cases resistant to years of previous therapy, meditation, and other attempts.
My main model for how one-shots happen: first they got unblocked on introspection, then they learned how to coach themselves and followed through. They must also meet certain prerequisites, such as feeling their feelings and not being overly constrained by life circumstances. This model fits the first three cases above.
Another model how some one-shots happen: all of the incentives for the client’s issue were detected and integrated in the session. In these more rare cases, like the fourth example above, self-coaching is unnecessary because all necessary updates occurred live.
Limitations: First of all, not every case should be one-shot: see “Flaky breakthroughs” pervade coaching — but no one tracks them for discussion on long-term integration. Secondly, not every case is ready for a one-shot — a future post on bottlenecks expands on this. Finally, issues with clear emotional components, like anxiety, tend to one-shot more readily than pure avoidance patterns, like numbness and (often) procrastination. One-shots usually aren’t learning, they’re unlearning. It’s faster to delete “lines of code” from the mind than to add and integrate new code.z
I’ve had some “one-off” successes like this too (sometimes in as little as 30 minutes, though this was in an environment where we had a lot of shared context). A lot of your intuitions about this match mine, and I hadn’t actually made the “anxious vs avoidant” heuristic explicit to myself until I read your account of it, so thank you! Also love the “bounty” idea, and will think about how I might be able to implement it in my own practice.
This was a pleasure to read, I have been surprised on a few occasions when I have been told that something I said was transformative, I use metaphors very often and sometimes they really hit home for people.
One was talking about loss/grief, and I talked about what it's like to close a book and hold it in your hands, and the impact that it had even several months later surprised me immensely.