Healing from the Top-Down and Bottom-Up

How do we create and sustain change?

Top-down and Bottom-Up. That’s how.

Let’s say you want to start an exercise program to get fit.

You need to join a gym. Hire a trainer. Maybe get a journal or download an app to track your progress. You need to get the right shoes and of course, the latest Lululemon workout tights. You need to learn the proper techniques of your exercise of choice which includes warming-up and cooling-down. In other words, you need the “how do I change?” You need to get educated on the specific techniques and tools to bring change into your life. We call that the “Top Down.” It’s conscious, cognitive and skill-focused.

But without the “Bottom Up,” you are wasting your time and your money. That fancy boutique workout gear will either sit in your closet or adorn the not-yet-paid-for-and-never-used treadmill.

Skills are not enough. We need our friend “Bottom-Up.”

The “Bottom-Up” is the unconscious emotional terrain of your being. It is the “why should I?” It consists of all the unearthed reasons why you are the way you are, the unconscious story of how you ended up unfit and out-of-shape in the first place. Maybe you don’t love yourself enough to be healthy. Maybe you want to remain unattractive and unavailable. Maybe you fear success. Maybe lying on the couch and devouring chocolate doughnuts is a desired slow suicide. Or at least lives up to Mom or Dad’s version of “you will never amount to anything.” Whatever the multitude of options, without your unconscious’s agreement, you cannot maintain change. You will find a way to sabotage success so that your way of living matches your internal landscape. (Hint: this is where therapy can be helpful.)

However, if you only focus on the “Bottom Up,” you will become emotionally in tune but you will be stuck. Because, insight and two dollars only can buy you a cup of coffee. Once your internal world is on board and ready, you will then need the knowledge and know-how – and of course the right outfit – for real change to occur.

Thus, growth happens when we work both ends – the top and the bottom. Like two matching bookends, both are necessary for behavior to shift. One without the other will not only fail, but perhaps discourage from ever trying again. And that would be a sad ending to a potentially good story … yours.

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