Humans are, by nature, creative and productive. We want to explore, build, learn, solve problems and change our environment. It gives us satisfaction to manifest externally what we think or feel, so that we and others can see, hear, taste smell and touch what we have imagined. Creative acts can be anything, from a baby laughing or throwing a toy, to an adult playing the trombone or mowing a lawn. The ability to say “I did that,” and have other people nod and agree, “yes, you did that,” is in our nature.

Most people also want to cooperate, which is why society exists. We are the product of both group and individual selection pressures, evolutionarily speaking.

What humans create is a reflection of the way their minds work. This is true from a micro and macro perspective. The computer, for example, is a machine that does some work our minds might otherwise do. Computers are complicated tools, like engines. They do work for us. We create software for computers, as they are just tools that need instructions to do the work we require of them. We build cars around engines, so we can get from one place to another in comfort, using the power of the engine to move us around.

We create laws and governments, outward manifestations of our internal desire for order, so that we have some structure within which we can cooperate with each other. We investigate what we don’t understand, experimenting to reveal predictability in our environment so that we can manipulate it more effectively. We call this predictability “laws of nature” and record them so that we can build upon the accumulated knowledge.

From the time humans picked up rocks and sticks to use as tools and weapons until present day, we have been driven not only to survive but to effect change around us to make future survival easier.

We do this because it is our nature to do so, and we derive satisfaction from the doing. When our desire to manifest is thwarted, we are dissatisfied.

I’ve listened to many people tell me they “should want” something, or that they “want to want,” which seems oxymoronic but makes sense. They also want to do what they should. Sometimes, they say they need to do what they should, and for that reason, they must do whatever that is.

The process of convincing oneself that a “should” is a “want” is not straightforward. Often, this happens as a result of some external force that changes the equation. For example, many children I’ve seen over the years have shown no interest in doing well in school. Academics have no relevance to them - there is no want or need, only “should.” They often show little interest in personal hygiene, like brushing their teeth or showering. They eat what they want, when they want, despite their parents’ best efforts to offer healthy foods at mealtimes. No matter what is attempted to change their lack of interest and often outright hostility to doing anything they “should” for themselves, they are steadfast in their refusal to cooperate.

Then everything changes. Should becomes want. They put in an effort in school, are more cooperative with teachers, parents and peers, take an interest in their appearance and hygiene, and begin thinking about goals. They want to do well, look good, have friends, and see the point in all of these things. What changed? Not treatment, although they might be more engaged in therapy or find a medication useful for focus without any changes in either of these modalities. What changes is that they care. They care about having friends and looking good for someone to whom they’re attracted or is attracted to them. They see some point in learning, even if there is no immediate relevance. They start to see that eventually, what they are doing now will be relevant, even if only temporarily. They develop their own “why” for doing what they should, and it is because they want to for themselves. It is not because other people told them what they should want or should do. They have known the opinions of others for some time. For real change, as cliche as it might be, they have to want it.

I have seen changes like this happen thousands of times, and have reassured concerned parents that it will happen at some point, and that they must simply do their best and wait for it. That often does not sit well. The same can be said for people of any age, but it is most striking in young people who seem to have no cares or direction and then suddenly do. When asked why this change happened, they usually say “Because I decided.”

-Thor Bergersen M.D.