Blog Posts Tagged "Self Esteem".

This article contains a very basic version of the instructions for a Cognitive Behavioural Therapy (CBT) technique called “Situation Exposure”

I’m going to use an example of how I used this in my own life last week (Additional examples included at the end). The reason for offering my example is to show that these techniques aren’t just useful for “disorders” – anyone can use them.

My Goal: Becoming More Comfortable with Sleeping in a Tent

What I Did (I’ve already briefly mentioned doing this on Facebook):

Step 1: Got all the tent parts out of the stuff sack and set up the tent on the lawn with help.

Step 2: Set up the tent on the lawn on my own x 2 (one day and then the next day).

Step 3: Set up the tent in the lounge and slept in it for 3 nights.

Step 4: Slept in the tent in the garden.

How it Works

I repeated each step until doing that action no longer triggered more than 2/3 out of 10 anxiety/uncomfortableness, and then moved on to the next step. Repeating a small behavior until it no longer triggers significant anxiety is called “habituation.” What’s great about this procedure is that it doesn’t involve becoming overwhelmed.

Results: I’m now far more comfortable about tenting than I’d be if I’d just gone out and tried sleeping at a camp ground or in the woods.
Thought change:
Before = “I don’t think I’ll be able to get a good night’s sleep in the tent” or “I think I’ll be scared by noises”
After = I did get a good night’s sleep and I wasn’t scared of bumps in the night.

Why parents tend to be good at this

The skill involved in this technique is in breaking something down into small enough chunks.

Parents can often do this for their kids but don’t think about doing it themselves. For example, if a child is having a hard time with multiplication tables, parents don’t say “Don’t worry about multiplication.” They say – “Let’s break this down into easier bits and practice the first bit. Let’s not worry about the hard bits until we’ve done the first bit”. (Parents also typically recognize that harsh criticism isn’t likely to help their child make progress, but might use harsh criticism or self flagellation to try to motivate themselves. If that was going to work for you, it would’ve worked already).

How Therapy Clients Use This

This technique is very flexible.

All of the following examples are things that more than one client has decided to include in their situation exposure plans.

- Sending coffee back and asking for it to be hotter.

- Potentially mildly annoying someone e.g., asking for 200g of ham at the deli and then changing mind and asking for only 100g when the person has already started weighing out 200g.

- Making a phone call without rehearsing.

- Doing a task without double or triple checking.

- Asking a question when the answer might be No.

- Asking for something special e.g., the McChicken Sauce on a Big Mac.

- Asking a question in class.

- Doing something less than perfectly (e.g., leaving a typo in a doc)

- Someone with an eating disorder practicing eating forbidden food (e.g., eating 7 grapes if their rule is 6 grapes)

Several of these are designed to show the person that even if something negative happens, they’re able to cope with it. Actually HAVING the experience of that tends to be more helpful for starting to believe it vs. just talking about it.

Which Therapy Techniques Give the “Best Bangs for Your Effort Bucks”

As a VERY general rule of thumb (with exceptions), research has shown that therapies that include exposure techniques work and therapies that don’t include exposure techniques don’t work as well.

This example is of “Situation Exposure” but there are other types such as “Interoceptive Exposure” and “Imagery Exposure.” Sometimes exposure is also called “Behavioural Experiments.” Usually more than one type of exposure is used in therapy.

Exposure techniques work because they impact the big four of: Behaviour, Thoughts, Emotions, and Physical Responses (such as physical spikes of anxiety in response to triggers).

Research has shown that these techniques tend to be more effect in changing thoughts than writing or talking about thoughts.

If you’d like help coming up with a situation exposure plan, you can just give someone a call and let them know that’s what you’d like. Most CBT-trained clinical psychologists should be able to easily help with this as it’s a core technique.

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Yesterday I wrote about how people do avoidant coping to avoid difficult thoughts and emotions getting triggered, or to escape from them once they are already occurring.

I wrote that the first step to overcoming avoidant coping is nutting out the function of the avoidance i.e., which specific thoughts and emotions the avoidant coping is helping you avoid.

Procrastination is a very common type of avoidant coping. A simple way you can figure out the function of your procrastination is to pick your most-procrastinated activity (e.g., some type of paperwork), and commit to doing that activity for a short period of time. Let’s say 30 minutes. During that 30 minutes, take a piece of paper and note down what difficult thoughts and feelings arrive while you are doing the task. Just very briefly note down the thoughts and emotions on paper as they arrive, and then return to doing the procrastinated activity until the 30 mins is up.

Examples Of What You Might Find:

- You might uncover that doing the procrastinated activity leads you to experience more thoughts about other activities that you need to do, and that causes you anxiety.
- You might feel overwhelmed.
- You might have self-criticism related thoughts. Note what the specific thoughts are e.g., “My self-critical thoughts are that I should’ve done this ages ago. I have no self-discipline, I’m such a loser.”
- You might have self-doubt. Note the specific self-doubt related thoughts.
- You might have negative thoughts about the future e.g. “I’m never going to be a success” or “It’s impossible for me to ever do a good job at this.”
- You might feel irritated/annoyed. (If this is the case, try to figure out the thoughts behind the feelings of anger).
- You might thoughts of being unsupported.
- You might have thoughts like “It’s not fair that I have to do this”.
- You might have thoughts of worthlessness or powerlessness.
- You might find that doing the procrastinated task brings up seemingly unrelated worries (e.g., you start worrying about your relationship or your health). Note these down.

You have lots of great options for what you can do once you identified what thoughts and feelings are being avoided, such as using self-compassion therapy techniques to learn how to cope with self-critical thoughts without avoidant coping.

The trap of avoidant coping is that it might work in decreasing difficult thoughts and emotions temporarily, but it typically increases your problems with the avoided thoughts and emotions overall. It makes you more scared of those thoughts and emotions, and increases the size of your reaction when those thoughts and emotions do get triggered. Avoidant coping also tends to be “stress generating” which means that avoidant coping tends to create more real problems in your life (e.g., you avoid something about your finances and end up with a bigger problem).

A tip: Emotions/feelings are the specific emotions words like anxious, angry etc., and thoughts are pretty much everything else. Try to understand the emotions caused by your thoughts, and the thoughts behind your emotions.

Doing your most-procrastinated activity might trigger happier, calmer feelings & thoughts too, but you’re likely to find you have a mixture of positive and negative thoughts/feelings, and the negative thoughts/feelings will help you determine why you are avoidant coping.

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I thought I’d do something I haven’t done before – open a post up for comments.

This is my version of an exercise from Dr Kristin Neff’s book.

The exercise is for helping you reduce the extent to which your feelings of self worth are contingent on being superior to others. Or, as Kristin puts it, helping you “Opt out of the self esteem game.”

If, to have self-worth, we have to be better than average in all important domains, then our feelings of self-worth will be shaky and we’re likely to be defensive.

There are 3 questions.
- What are 5 important skills you’re better than average at?
- What are 5 important skills you’re average at?
- What are 5 important skills you’re worse than average at?

Your answers for all 3 questions should be skills that are generally considered important in our society and that are important to you personally. In other words, you’d really like to be better than average at the skill.

This shouldn’t be like when people go to a job interview and get asked their worst quality and they say they’re a perfectionist because they think it will help them get hired.

I’m going to share my examples and if you want to share your examples, chime in in the comments. You might find that sharing publicly (even just using your first name), might help reduce your feelings of shame about the important skills you’re average or worse than average at, and correspondingly help with defensiveness and avoidance. This is the principle of Opposite Action.

My examples

What are 5 things you’re better than average at?

1. Finding information.
2. Synthesizing vast quantities of information.
3. Incorporating new information into my ways of working (e.g., when I read new studies, new technologies emerge, or clients say “Could we do more of this and less of that?”) (provided the information is presented clearly).
4. Nutting out difficult problems (from how to do something on the computer, to how to help clients overcome their problems).
5. Being a romantic partner.

What are 5 things you’re average at?

1. Being a family member.
2. Writing.
3. Being organized.
4. Self-discipline.
5. Cooking.

What are 5 things you worse than average at?

1. Networking.
2. Sharing.
3. Being a friend.
4. Being in a group.
5. Driving.

If you want to contribute your examples, I would LOVE that. This was a hard exercise to share without giving into the temptation to be self-presentational rather than honest, so you might find that this aspect is hard for you too.

Tips: keep your focus on skills rather than traits, and keep the comments to sharing your own information. I like my back and forth conversations to be in person, so I don’t get into back and forth discussions on the internet, and if you want personal help…. people pay me for that ;-)

Can you see the flaw in self worth being contingent on being better than average?
It means that, in any domain, at least half of people are either going to be very defended against admitting being average/less than average, or feel bad.

If you don’t see the existing comments followed by a comment box, click on the blog post title “Self Worth” to go to the permalink page. Its there.

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