What You Can Change and What You Can't

1. Change is possible, but not all aspects of ourselves are equally changeable

"What can we succeed in changing about ourselves? What can we not?"

Depth of change. The author proposes a theory of "depth" to explain why some aspects of ourselves are more changeable than others. Deeper traits, such as sexual identity and orientation, are rooted in biology and early development, making them extremely difficult or impossible to change. Surface-level traits, like specific phobias or sexual dysfunctions, are more amenable to change through therapy or medication.

Factors affecting changeability:

• Biological underpinnings (e.g., genetic factors, brain structure)
• Evidence for or against beliefs underlying the problem
• Power of the belief in explaining multiple aspects of life

Understanding the depth of a trait or behavior can help individuals focus their efforts on areas where change is more likely to be successful, rather than struggling with deeply ingrained aspects of themselves.

2. Biological factors play a significant role in shaping our behavior and personality

"To understand and undo such malevolent effects, we must face the human beast."

Nature vs. nurture. The book challenges the long-held belief that our personalities and behaviors are primarily shaped by our environment and experiences. Instead, it argues for a more balanced view that acknowledges the significant role of biological factors, including genetics and evolutionary history.

Key points:

• Many personality traits have a strong genetic component
• Evolutionary history has shaped our predispositions and tendencies
• Biological factors can influence our susceptibility to certain disorders or behaviors

This understanding doesn't negate the importance of environmental factors but suggests that some aspects of ourselves may be more resistant to change due to their biological roots. Recognizing this can help individuals and therapists set realistic expectations for change and focus on strategies that work with, rather than against, our biological predispositions.

3. Childhood experiences have less impact on adult personality than commonly believed

"If you want to blame your parents for your own adult problems, you are entitled to blame the genes they gave you, but you are not entitled—by any facts I know—to blame the way they treated you."

Debunking myths. The author challenges the popular notion that childhood experiences, particularly traumatic ones, have a lasting and deterministic impact on adult personality. He argues that the evidence for such long-term effects is weak and often confounded by genetic factors.

Key points:

• Identical twins raised apart are more similar in personality than fraternal twins raised together
• Adopted children's personalities are more similar to their biological parents than their adoptive parents
• Many childhood traumas have surprisingly little effect on adult personality

This perspective doesn't deny that childhood experiences can be important, but it suggests that their impact is often overstated. The author argues for a more nuanced understanding of personality development that considers both genetic and environmental factors, without giving undue weight to childhood experiences.

4. Cognitive therapy can effectively treat many psychological disorders

"Changing the gloom of conscious thought should cure depression."

Power of thought. Cognitive therapy, which focuses on changing patterns of thinking and beliefs, has been shown to be highly effective in treating various psychological disorders, particularly depression, anxiety, and panic disorders.

Key elements of cognitive therapy:

• Identifying and challenging negative thought patterns
• Learning to reframe situations and experiences
• Developing coping strategies for managing symptoms

Research has shown that cognitive therapy can be as effective as medication for many disorders, and in some cases, more effective in preventing relapse. This approach empowers individuals to take an active role in their mental health by learning to recognize and change maladaptive thought patterns.

5. Addiction and substance abuse are complex issues with biological and psychological components

"Being a way of life does not make something right or good or benign."

Multifaceted problem. The book presents addiction, particularly alcoholism, as a complex issue that involves both biological predispositions and learned behaviors. It challenges both the purely biological model of addiction as a disease and the notion that addiction is simply a matter of willpower.

Key points:

• Genetic factors can influence susceptibility to addiction
• Addiction often becomes a "way of life" that is difficult to change
• Treatment approaches should address both biological and psychological aspects

The author suggests that while individual efforts are important in overcoming addiction, societal approaches may also be necessary to address the widespread nature of substance abuse problems.

6. Dieting often fails due to biological and psychological factors

"Dieting doesn't work."

Weight struggles. The book presents a critical view of dieting, arguing that most attempts at long-term weight loss are doomed to failure due to powerful biological and psychological factors.

Reasons diets fail:

• Body defends its "natural weight" through various mechanisms
• Yo-yo dieting can lead to even greater weight gain
• Psychological factors, such as the "thin ideal," contribute to unhealthy relationships with food

Instead of focusing on weight loss, the author suggests emphasizing overall health and fitness, and accepting a wider range of body types as normal and healthy.

7. Anger management requires understanding and specific techniques

"Anger is the emotion that fuels violence."

Controlling rage. While anger can serve important functions, uncontrolled anger can be destructive to relationships and health. The book offers insights into the nature of anger and techniques for managing it effectively.

Anger management techniques:

• Recognizing triggers and early signs of anger
• Using relaxation and breathing techniques
• Cognitive restructuring to change anger-provoking thoughts
• Developing better communication and problem-solving skills

The author emphasizes that while expressing anger can sometimes feel cathartic, it often reinforces aggressive behavior and doesn't lead to long-term solutions.

8. Post-traumatic stress disorder (PTSD) is challenging to treat but not impossible

"Do they believe it ruined their lives?"

Healing trauma. PTSD is presented as one of the most difficult psychological disorders to treat, with symptoms often persisting for years after the traumatic event. However, the book offers hope through various treatment approaches.

Treatment approaches for PTSD:

• Prolonged exposure therapy
• Cognitive processing therapy
• Eye Movement Desensitization and Reprocessing (EMDR)
• Medication in combination with psychotherapy

While complete cure may not always be possible, these treatments can significantly reduce symptoms and improve quality of life for many individuals with PTSD.

9. Sexual identity and orientation are deeply rooted and difficult to change

"Sexual identity is the core layer of sexuality, and perhaps the very core of all of human personality."

Layers of sexuality. The book presents a model of sexuality with multiple layers, from the deeply ingrained (sexual identity and orientation) to the more changeable (sexual preferences and performance).

Layers of sexuality (from deepest to most changeable):

1. Sexual identity
2. Sexual orientation
3. Sexual preferences
4. Sex role
5. Sexual performance

Understanding this model can help individuals and therapists focus on areas where change is more likely to be successful, rather than attempting to alter deeply rooted aspects of sexuality.

10. Everyday anxiety can be managed through various techniques

"Anxiety is your mental tongue."

Taming worry. The book acknowledges that some level of anxiety is normal and even adaptive, but offers strategies for managing excessive or disruptive anxiety.

Anxiety management techniques:

• Progressive relaxation
• Meditation
• Cognitive restructuring to challenge anxious thoughts
• Regular exercise
• Time management and problem-solving skills

By understanding anxiety as a normal part of life and learning to manage it effectively, individuals can reduce its negative impact on their daily lives and overall well-being.

Last updated: March 11, 2025