Earlier I my life I lived and worked in Japan. I taught English to a group of young men at one of Honda’s subsidiaries, Keihin Seiki, where they produced Honda’s carburetors. It was from these young factory workers that I gained an understanding of how change is slowly and incrementally effected from the bottom up in Japan, a concept called kaizen. By the time a policy or idea gets to the board room, it is at a place of acceptance among the workers, and the decision that is made in the board room is but a formality. This takes time. It is also one of the key reasons Japanese made cars have such a strong reputation for reliability.

When people come to therapy, it is typically because they have tried everything they can think of and are at a point of desperation. They come wanting relief from their emotional pain, and the depression or anxiety caused by their dilemma. And they want that relief now, not later, even if it took years to reach this point. They have talked to their friends and their family. They may have missed work due to the problem, turned to various forms of addiction, and damaged relationships in the process, sometimes irreparably.


Their pain is palpable, and it is completely understandable that they want it to stop, but is it reasonable to think it will happen without effort and time on their part? This is when they need to hear about kaizen, the process I described above wherein lasting, effective change occurs incrementally. This is where persistence is key.

The good news is that often learning coping techniques as initial tools to manage depression and anxiety will reduce the pain you feel fairly quickly, often in as little as a month or two, but sometimes making lasting change takes longer. While I don’t advocate months of therapy, you need to keep both feet in long enough to keep the change momentum going.

Learning to walk as a toddler is a typical example of putting together a whole bunch of complicated new motor skills that suddenly combine into that first step. It can be that way in therapy. One week you may suddenly get it, or behavioral experiments you have been trying click, and you see results that make it worth the continued effort. Perhaps the concept of kaizen explains why taking a series of ‘baby steps’ really is the path to desired change.

One of the therapy models I use, cognitive therapy, tends to get fairly fast results, particularly for anxiety. But I still believe that it is the safety of the therapeutic relationship that contributes to your growth and change, plus the trust we build together, that lets you try things you might not have considered.

This trust helps you to build hope and maintain your persistence–they key to successful, long lasting change.

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