Why some problems keep coming back
You know someone — probably yourself — who has been wrestling with the same theme for years. It’s been thought about. Talked about. Books read, coaches consulted, maybe even therapy done. There have been moments of insight, moments of “now I get it”. And yet it returns, in a new shape, in a new relationship, in a new job — slightly different, but unmistakably the same thing.
That is the domain of what Andrew T. Austin in IEMT calls patterns of chronicity or chronicity patterns. It’s one of the most distinguishing concepts in IEMT methodology, and it’s why people sometimes find movement after years of therapy in something else — not because the previous therapists were poor, but because the pattern that held the problem in place wasn’t directly addressed.
This article is a full explanation of the six patterns: five primary plus one secondary. Each pattern gets an example from practice as I encounter it with managers and professionals. At the end there’s a reference to the self-scan that makes visible in five minutes which pattern is most active for you right now.
What chronicity patterns are (and aren’t)
Let me first clear out what they are not.
Chronicity patterns are not character weaknesses. They’re not signs of a lack of discipline, insight, or resilience. They’re not diagnoses. They’re not personality traits you just have to learn to live with.
What they are: behaviour and language structures that unconsciously protect a problem against change. They are patterns of thinking, feeling, reacting, and speaking that have become so ingrained they automatically keep the problem in place — even when you’re consciously trying to get rid of it. They were useful in the past, often as protection or a survival mechanism. And they continue now, in situations where they no longer serve.
Austin developed this concept from long clinical observation of clients whose problems persisted despite repeated therapy. The patterns are so stubborn that, when active, they deflect therapy itself — regardless of modality. That’s a hard claim, and it’s exactly what makes the concept distinctive: the method isn’t failing, the pattern is blocking the method.
They’re often invisible to the bearer. Most people who come to me can’t immediately name the pattern — they only know the feeling that something keeps coming back. Only when the pattern is recognised does it become workable. Naming the pattern is the first shift. Working on it is the second.
The diagnostic question that belongs to this thinking sounds different from most therapy traditions. Not: “what happened?” Not: “how intense is the complaint?” But: “What prevents this from changing?” That question, developed by Austin as the core of the IEMT approach, exposes the pattern that other questions look past.
In the IEMT methodology there are five primary patterns plus one secondary pattern. The names below are the plain-language variants as used in the self-scan; in brackets is the IEMT term as Austin briefly names them. The formal Austin names are longer and more descriptive (for example “Three-Stage Over-Reaction” for pattern 1); those who want to read further in IEMT literature will find them there.
Pattern 1 — Reactions that escalate (three-stage over-reaction)
The core. When something touches you and the other person doesn’t respond the way you’d hoped, you notice something in you growing stronger. Sometimes you go quieter and heavier; sometimes sharper or more direct. It often happens before you consciously decide anything. After an outburst you feel brief relief — but the situation that triggered it comes back.
Example from practice. A manager notices that in meetings his voice keeps getting louder to be heard. He sees for himself that it doesn’t help — his team withdraws, decisions get deferred. And still it happens every time, before he’s aware of it. At home something similar: if his partner doesn’t respond the way he’d hoped, he becomes irritable until the atmosphere grows heavy enough for her to ask about it. The escalation is a form of calling for help that sabotages itself.
Why it stays stuck. Underneath the reaction sits an unspoken question: “Do you see me now?” The escalation is a way of forcing that. Because it sometimes works — briefly — the pattern is maintained. More thinking about the reaction doesn’t help; the pattern plays out on a layer beneath thinking.
Pattern 2 — It happens to me (at-effect)
The core. You often feel that things happen to you and that you have little influence on them. Others make you angry, sad, or uncertain. You look for someone who will solve it for you — a partner, expert, therapist, boss. If that solution doesn’t come, it feels like there’s nothing you can do.
Example from practice. A young professional tells me that a comment from a colleague threw her whole day off. Not because the comment was that bad — cognitively she sees that too — but she can’t get out of it. It happens to her. In another conversation this same pattern shows up around her employer: promotion keeps being delayed, she feels passed over, and waits for “them” to notice her. She doesn’t ask, because the solution feels like it should come from someone else.
Why it stays stuck. The pattern protects against the weight of responsibility. If things happen to you, you don’t have to make them. That gives relief in the short term, but keeps your keys with others. Change begins with the feeling that you can do something — and that’s exactly the feeling this pattern keeps out.
Pattern 3 — What if… (what-if)
The core. Your thoughts often search for what might go wrong. One unlikely scenario weighs heavier than ten realistic ones that would work. The “what if” questions feed themselves: one leads to the next, and back again. Reassurance from others doesn’t land — immediately a new “what if” appears.
Example from practice. A professional is considering a different job. Within a minute he can name ten things that might go wrong if he makes the move. His wife, friends and coach all provide solid counter-arguments. Each argument is briefly weighed, and then a new “what if” surfaces. What sits underneath the questions is not a real risk problem — it’s an unspoken question about himself: “Am I actually good enough for this?”
Why it stays stuck. The “what if” scenarios are not thoughts — they’re automated reactions dressed up as thoughts. Working on the content (“is this scenario accurate?”) doesn’t bring a shift, because the question sits below the scenarios. Only when that underlying layer is touched does the scenario production stop.
Pattern 4 — Rather not decide yet (maybe-man)
The core. Deciding feels heavier to you than to most people. You often answer “maybe” or “we’ll see” when others want something definite. Small choices you keep weighing back and forth. Big ones you defer to keep all options open. Staying vague protects against the risk of doing something wrong — and at the same time prevents the action that would move something.
Example from practice. A senior manager has weighed three job offers. None feels quite right, so she stays where she is — not because that feels good, but because choosing seems risky. At home the same: her partner asks what she wants to eat, she says “doesn’t matter”, and afterwards it turns out it did. She starts projects without finishing them. When someone asks what she actually wants, her answer is vague — even to herself.
Why it stays stuck. This pattern often has a background where deciding wasn’t safe earlier — a parent who reacted critically to choices, a situation where mistakes were punished harshly. Now it’s usually safe, but the habit of deferring continues. Deciding consciously doesn’t help, because the freeze sits lower. The body responds as if it were dangerous.
Pattern 5 — Is it still there? (testing)
The core. You regularly check whether your complaint, feeling, or pattern is still there. When you encounter a piece of it, it feels as if all of it is back. You look at what’s still there, not at what has changed. After a good phase you think: when will it come back? You scan yourself for signals to know how you are.
Example from practice. Someone I’ve coached for stress complaints notices after six sessions that it’s become noticeably quieter. Then he has three days with slightly less energy — perhaps a mild flu, perhaps normal fluctuations — and he concludes: “It’s still there, just hidden.” The three calm weeks beforehand don’t register. He’s looking for the 1% that can still be found, and misses the 99% that has changed.
Why it stays stuck. The scanning is itself the carrier of the problem — it’s how something stays active. If you keep searching for your anxiety, you keep your anxiety alive. 99% improvement doesn’t feel like progress as long as that 1% is still detectable. You’re not keeping the problem active because you want to, but because checking feels safer than not checking.
Pattern 6 (secondary) — This or that (either-or)
The core. You often see situations as “this or that”, as if there are only two options. The third path, the both-and, or the neither-of-both stays out of view. This makes commitment difficult — every choice seems to exclude something else. When choosing, you get stuck, because neither option feels good.
Example from practice. A director wrestles with a reorganisation. The framing is: “we need to cut back or we need to grow”. Every month both options sit in the same meeting waiting for a decision that doesn’t come. Only when in a session the framing itself is questioned — “is it possible neither is the right one?” — does space open for a third route that was previously invisible.
Why it’s secondary. This pattern plays out differently from the five primary ones. It’s more a thinking structure than an ingrained reaction. It often works together with one or more primary patterns — someone carrying “Rather not decide yet” more often gets tangled in “This or that” frames. For some people it’s the dominant pattern, for others barely present.
How the patterns behave
A few things are important to understand about how these patterns manifest in a life.
They rarely come alone. Most people have one or two patterns that are strongly active, with some influence from the others. The self-scan gives percentages per pattern — a combination like “strong What if… plus moderate Is it still there?” is common.
They move through someone’s life. A pattern that is strongly active in one role may rest in another. Self-scan results are a snapshot; over time they shift. That’s why taking the self-scan again after a year is useful.
They hold themselves in place. That’s precisely why they’re called “chronicity” patterns. Each pattern has an internal logic that keeps it working — Pattern 1 through the brief relief after escalation, Pattern 5 through the perceived safety of checking. Breaking through requires working on that internal logic itself, not on the symptom.
They arose in context. Patterns are not innate. They’re learned, often in a period when they did serve. What was once smart adaptation is now ingrained automatism. The pattern has served you — it’s just no longer useful.
Why this matters for therapy and coaching
The idea of chronicity patterns has a concrete implication for therapeutic and coaching work: without addressing these patterns, any modality gets stuck. You can have the best talk therapist, follow the best method, receive the best instructions — if a pattern is active that holds the problem in place, the work spins in circles. That’s not the fault of the therapist or the method; it’s the nature of the pattern.
IEMT is explicitly designed to address these patterns first, as a foundational step before (or parallel with) work on the actual theme. That distinguishes IEMT from many other modalities, which can be effective on their own domain but get stuck where a problem holds itself in place. Read more in what is IEMT and when does it work.
What this means for you
If you read this and recognise something — one pattern, or several — that’s information, not judgement. Most people carry at least one pattern. They don’t exist to be suppressed, but to become workable.
There are two practical steps.
First step: self-scan. In five minutes you’ll get a view of which pattern is most active for you right now. Not a diagnosis, but a mirror. All answers stay in your browser — nothing is stored or shared.
Second step: if a pattern is recognisable, a conversation. In an introductory call (twenty minutes, free) we see whether your pattern fits the IEMT methodology. If it doesn’t — for example because clinical care is needed, or because another modality would fit better — I’ll say so and think with you about what would work.
An honest caveat
A coach who claims they can solve every pattern for every client is a warning sign. Some patterns yield after three sessions; others require a longer and layered approach. Some people find movement in IEMT; others don’t, and for them something else fits. That’s not a flaw in the method — it’s the reality of work at this layer. Being honest about this is part of how I work.
If this touches something you see in yourself, get in touch. Then we can look together at whether the route fits.