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Cognitive Behavior Technique #32

Cognitive Behavior Technique #32 The Pathological Critic Compiled by Jerome R. Gardner 2002 – First Edition This technique is an adaption of the material in the book Self-Esteem, New Harbinger Publications, Inc, 1992 by Matthew Mckay & Patrick Fanning. cognitivebehavior. com Technique # 32 INTRODUCTION Definition THE PATHOLOGICAL CRITIC The pathological critic is a term coined by psychologist Eugene Sagan to describe the negative inner voice that attacks and judges you. Everyone has a critical inner voice. But those people with negative self appraisal tend to have a more viscious and vocal pathological critic.

The Critic blames you for things that go wrong. The critic compares you to others – to their achievements and abilities – and finds you wanting. The critic sets impossible standards of perfection and then criticizes you for the smallest infractions. The Critic keeps a record of failures, but ignores strengths and accomplishments. The Critic calls you names – stupid, incompetent, ugly, selfish, weak – and makes you believe that all of them are true. The Critic reads your friends’ minds and convinces you that they are bored, turned off, disappointed or disgusted by you.

The Critic always exaggerates your weaknesses by insisting that you ‘always say stupid things’, or ‘always screw up’, or ‘never finish anything on time’. The Critic’s voice is so insidious, so woven into the fabric of your thought, that you never notice the effects. No matter how distorted and false the attacks may be, the Critic is almost always believed. A loud, negative Critic is enormously toxic. The Critic speaks in a kind of shorthand. S/he might only scream the word ‘lazy’, but those two syllables contain the memory of the hundreds of imes a child manager [mother, father, teacher] complained about laziness, attacked your laziness, or said how s/he hated laziness. Sometimes the critic uses submodalities [images or pictures from the past] to undermine your sense of self worth. Through a process called chaining, the Critic may show you a past failure, 1 cognitivebehavior. com which reminds you of another and another in a long string of painful associations. And though you try to turn the Critic off, you keep being reminded of yet another mistake, another rejection, another embarrassment. The Critic has many weapons.

Among the most effective are the values and rules of living that you grew up with. The Critic has a way of turning your ‘shoulds’ against you. The Critic compares the way you are with the way you ‘ought’ to be and judges you inadequate or wrong. Origin Although the Critic seems to have a will of his/her own, this independence is an illusion. The Critic was born during your earliest experiences of socialization by your parents. All through childhood your parents teach you which behaviors are acceptable, which are dangerous, which are morally wrong, which are lovable and which are annoying.

They do this by hugging and praising you for appropriate behavior and teaching or punishing you for dangerous, wrong or annoying behavior. It is impossible to grow up without having experienced a great number of punishing events. Harry Stack Sullivan called these punishing events forbidding gestures. By design, forbidding gesture are frightening and rejecting. A child who is spanked or scolded feels the withdrawal of parental approval very acutely. S/he is, for a while, a bad person – or at least this is how s/he tends to interpret this account.

Parental approval is a matter of life and death to a child. The experience of being separated from this approval can be very deeply felt. All children grow up with emotional residues from the forbidding gestures. They retain conscious and unconscious memories of all those times when they felt wrong or bad. Their interpretation of these experiences is coded in these memories as well. The child may have received ‘mixed messages’ from his/her parents: ‘laughing’ at inappropriate behavior sometimes, punishing others. The child identifies a pattern to the forbidding gestures, since this is what we do.

The tendency to impute order to ambiguous stimuli is simply built into the 2 cognitivebehavior. com cognitive machinery we use to comprehend the world. This predisposition is what leads to discovery and advance. The problem, however, is that the tendency is so strong and so automatic that we sometimes detect coherence even when it does not exist. Many times we treat the products of this tendency not as hypotheses, but as established facts. [Gilovitch] While negative self affirmation may be the result of abuse and neglect on the part of the parents, this is not necessarily so.

Neither is it true that all children who are abused and neglected end up with a highly toxic Pathological Critic. Hypotheses that are formed on the basis of one set of results are often considered to have been proven by those very same results. By retrospectively and selectively perusing the data in this way, people tend to make too much of apparent anomalies and too often end up detecting order where none exists. [Gilovitch] But whether the interpretation was realistic or not1 , the child ends up with a very negative image of self and the Pathological Critic maintains that perspective.

There are five main factors that determine the strength of these not-okay feelings: 1) the degree to which issues of taste, personal needs, safety or good judgment were mislabeled [or misunderstood] as moral imperatives. In some families when a parent wants things quiet, the child is made to feel morally wrong if s/he is noisy. Other families seem to make a low grade in school into a sin. When the issue is really a matter of taste, failure to perform a task, or poor judgment, and the parent does something which makes the child feel morally wrong, they are laying the foundation for a self affirmation problem. Please remember that when we use examples of parental mistakes that this is a mechanism for simplicity. The process itself, since it is interactive requiring a message and a reception of that communication – is not that simple. We do not want to imply that because a child has a problem with negative self affirmation that the fault is the parents’ alone – even though we may ask the parents to address and change some child management practices that can easily cause misinterpretation. 3 cognitivebehavior. com 2) the degree to which parents fail to differentiate between behavior and identify

Often the parents indicate that the child is bad, not that the behavior is unacceptable. A child who hears a stern warning about the dangers of running in the street will likely have a better self affirmation than a child who hears only that s/he is a ‘bad’/boy or girl. Of course, parents don’t tend to understand these fine distinctions, and often when the child runs into the street the parents are so distraught they simply want to make this behavior stop. So they beat the child out of their own fear of what could have happened.

There is no logic to beating a child you saved from injury, but young parents operating out of fear will often do illogical things. 3) the frequency of the forbidding gestures If school teachers provide five negative responses to every positive one, imagine the ratio for parents of toddlers. Of course, the number of forbidding gestures will increase if you have an active, curious child who ‘gets into everything’. Nonetheless, the more often you hear something the more true it becomes. Not only that but repetition is habituating, which contains two components. First, it becomes nonconscious.

We no longer are even aware that it is occurring. Second, we become desensitized. Once we hit a child, the child fears being hit less. If the child is hit often, hitting will no longer suffice. This can cause an escalation in the level of physical punishment if the child manager believes s/he needs to ‘get control’ over an ‘incorrigible’ child. • the consistency of the forbidden gestures Suppose the child’s parent did not like a specific word. The child may think the prohibition rather stuffy, but at least the parents are consistent. Suppose, however, they let the child say the word sometimes and blew up when /he said it at other times. And suppose they were equally inconsistent about other rules. At first, the child would be confused, but the randomness of the attacks could eventually lead to a very painful conclusion [I. e. , It wasn’t what you (the child) did – it was you (the child). Children who have experienced inconsistent child management often feel an inexpressible feeling of guilt. They feel as if they have done something 4 cognitivebehavior. com wrong, but because they can never get the rules straight, they have no idea what it was that was wrong. the frequency with which forbidding gestures were tied to parental anger or withdrawal If the criticism is accompanied by parental anger or withdrawal [threatened or actual], it has enormous potency. Anger and withdrawal give a clear message: ‘you are bad and I am rejecting you! ’. Since this is the most terrifying thing a child [particularly a young child] can hear, s/he is certain to remember it. Function You listen to the Critic because it is very rewarding to do so. To understand the function of the critic is to recognize that everyone has certain basic needs.

Everyone needs to feel: • • • • secure and unafraid effective and competent accepted by parents and significant others a sense of worth and OKness in most situations If you have a degree of confidence in yourself, you keep yourself secure by confronting and eliminating things that frighten you. You solve problems instead of worrying about them. If you have negative expectations, you rely on the Critic to help you cope with feelings of anxiety, helplessness, rejection and inadequacy. Paradoxically, while the Critic is beating you up, s/he is also making you feel better.

Positive reinforcement occurs when a rewarding event follows a particular behavior and results in an increase in the future likelihood of that behavior. Obsessing about the misfortunes of someone you dislike can be reinforced by feelings of pleasure or vindication. Negative reinforcement can only occur when you are in physical or psychological pain. Any behavior that succeeds in stopping the pain is 5 cognitivebehavior. com reinforced, and is therefore more likely to occur when you feel similar pain in the future. Negative reinforcement is basically a problem solving process.

You’re in pain. You want to feel better. You keep searching for some action or thought that is analgesic. Continuous reinforcement means that particular thought or behavior is always reinforced. Continuous reinforcement can lead very quickly to extinction if the thought or behavior stops being reinforced. Variable ratio reinforcement on the other hand happens in a random fashion. Since you never know w h e n you will be reinforced, you tend to continue the behavior because reinforcement could occur. The Critic’s statements can be both positively and negatively reinforced.

Every time the critical self statement agrees with your parents’ judgements, you are reinforced by feeling close to them. By identifying with their point of view, you may paradoxically feel safer, more accepted and more loved. On the other hand the critic obligingly helps you deal with guilt by providing punishment. Taking control To gain control of the Critic, you have to first be able to hear him/her. Every conscious moment of your life, you are engaging in an inner monologue. You are interpreting experiences, problem solving, speculating about the future, reviewing past events.

For the child to catch these thoughts, s/he will need to make a commitment. S/he will need to first make a list of problematic situations. These are the situations in which s/he will need to monitor self talk very closely. The list should include statements such as: • • • Whenever I have a math test. When my father tells me I can’t do something. When I have to play basketball in gym. Each statement should represent a specific situation in which the child has in the past experienced problems and heard about it from his/her Critic. 6 cognitivebehavior. om In order to attend to these thoughts, s/he will then need to record them in a journal [See CBT#01 – Perceiving Reflex Thoughts]. The journal can be organized in any manner that is convenient, but here is one way: # 1 2. Time 8:15 8:40 Critical Statement The teacher must be sick of my getting here late. No homework – boy, I’m lazy. The more of these attacks the child can identify and write down the better. Congratulate the child if s/he catches at least ten negative self statements a day. For Home Work, you will want the child to complete an addition task with the Journal Material. On a piece of paper, draw a line down the middle.

And set up as follows: # 1 2 Motivated to develop better work habits. Helps Me To Feel Or Do Helps Me To Avoid Feeling Be surprised and hurt if s/he calls me on my tardiness What you are helping the child to do is to identify the reinforcement that occurs with the criticism. On the occasions when s/he finally meets one of these high standards, she has a feeling of self acceptance. The problem is that the standards are usually unrealistically high. In the DOING section of CBP#08 – Self Appraisal protocol, you will be helping the child set attainable standards in a developmental way for personal mastery.

Disarming the Critic Before you can disarm the Critic, you have to really know him/her. Secrecy is the Critic’s greatest strength. So if the child can get really good at hearing and identifying the Critic’s voice, s/he will have won a major victory. 7 cognitivebehavior. com The child will need to know when s/he should be particularly vigilant, I. e. , those problematic times that were listed – times when s/he has made a mistake, been criticized or dealt with people who might be disapproving; those times of performance trials: tests, public speaking, etc. times when s/he will be judged by others as well as him/herself. Even the anticipation of these performance tests can make the child feel helpless and down. S/he will need to know how to relax and be at his/her best for these occasions. The changeworker should use CBT#04 Relaxation and/or CBT#26 – The Calm Technique for support in this area. It is also helpful to the child to recognize the themes of the Critic. As you and the child analyze the critical thoughts, determining what they help the child feel or help the child avoid feeling, s/he can begin to see a pattern to the attacks.

When you become aware of the theme or themes the Critic uses, you are ready to begin a three step process for disarming. 1. Unmasking the Critic’s Purpose There are few things more effective for winning an argument than to suddenly unmask your opponent’s ulterior motive. When you unmask the Critic, you expose the true purpose and functions. Getting clear about the function makes everything said less believable. Remember the Critic attacks because the voice is in some way being reinforced. What does the Critic help you feel/do or avoid?

Help the child make specific statements for all criticisms. 2. Talking back The idea of talking back to his/her own critical voice may seem strange to the child. But the truth is that talking back – learning to refute and reject the old negative programming is what this technique is all about. Externalizing the Critic through personalization is a common procedure in metaperception. The process of using metaperceptions [visualization, imagining] for the purposes of helping people change is not new. Cognitive clinicians have 8 cognitivebehavior. com been doing this for years.

However, over time, we have expanded the dimensions considerably. We can, for example perceive ourselves in regard to time as 1) in the present, 2) in the past, or 3) in the future. We can also change not only the time, but the place and the circumstances in which we find ourselves. In addition, we can perceive ourselves in what are called positions, we can view ourselves in the first position as actually the one experiencing the event, in the second position, as the other person in the experience, or the third position, as a by-stander watching the event occur from the outside.

The movement to these different positions changes the emotional content of the experience as it modifies the degree of association or dissociation with the experience. Thus, we can view ourselves as a movie, experiencing a phobic reaction to a stimulus, without feeling the emotional fear in the process. Or, conversely, we can view that same experience from the first position, as a process of desensitizing ourselves to the emotional feelings caused by the stimulus through imagined exposure. We can even perceive ourselves in a different time and place.

How many different perceptions of ourselves perceiving ourselves that can occur in a single person is open to question. With practice, such metaperceptions can probably be expanded. Cognitive clinicians have used the personalization and the externalization of a part of the self quite successfully, for example, in OCD techniques. By making this part of him/herself separate, the child can dissociate him/herself from the critic and treat it as a separate entity. In this way, s/he can reframe both the process and content of the Critic’s harassment. There are at least three procedures for talking back.

Properly delivered, they will render the Critic speechless. The child should experiment with each of them; trying them singley and in combination. Find out which ones work best. Procedure: The Howitzer Mantra A mantra can be a word or phrase repeated to aid our memory. When we repeat it over and over we remember it. In fact, based on the rules of repetition and habituation, the mantra itself can become a nonconscious 9 cognitivebehavior. com comment. The construct of the Howitzer Mantra is that the selected words and phrases are designed to hit the Critic like a cannon blast, stunning him/her into silence.

Here are some examples: This is poison. Stop It! These are lies! No more put downs! Shut up! Get off my back! Stop this garbage! The Howitzer Mantra combines habituation with thought stopping. Thought stopping is one of the oldest cognitive techniques still commonly practiced. Introduced by Bain in 1928 in his book Thought Control in Everyday Life, it was adapted by Joseph Wolpe and other behavioral scientists in the late 1950s for obsessive and phobic thoughts. Thought stopping involves concentrating on an unwanted thought for a short time, then suddenly stopping it and emptying your mind.

The internal command ‘Stop! ’ or snapping a rubber band on the wrist is generally used to interrupt the unpleasant thought. Since the child needs to catch the Critic’s criticism, this requires that s/he concentrate on it for a moment. Choose a mantra that helps the child feel angry. It is good to get mad. Note the exclamation marks after each Howitzer Mantra. This means that it is shouted in the mind explosively. Mentally, the child should scream at the Critic to drown him/her out with indignation. If the Critic continues despite this, s/he can add the rubber band to snap.

The child screams internally and simultaneously snaps the rubber band, emphasizing the ‘stop’ command and making successful thought interruption more likely. The sharp stinging sensation breaks the chain of negative cognition and acts as a punisher so the Critic is less likely to attack in the near future. The important thing is to catch the Critic just as s/he starts, before s/he does much damage. If the child snaps the rubber band and internally screams the mantra whenever s/he hears the Critic’s voice, the frequency of the attacks will greatly diminish. 0 cognitivebehavior. com Procedure: Asking the Price One of the best ways to disarm the Critic is to think about the price the child pays for the attacks. What does listening to the Critic cost the child? It is time for the child to evaluate the cost. Help the child make a list of the ways in which his/her self affirmation has been affected in terms of relationships with others, academic achievement and level of well being. When s/he has completed the list, combine the most important items into a summary statement that can be used when the Critic attacks.

The child can then fight back by telling the Critic, “I can’t afford what you cost me! ”. The list might include such statements as: • • I blow up when someone else criticizes me and this loses friends and gets me in trouble. I am afraid to be assertive even when I think I know the answer and I diminish my grades. Affirmation of Worth Procedure: This procedure is often hard to practice – especially if the child has a deeply held belief that there is something wrong with him/her. But the child must learn to affirm him/herself if s/he is to fully disarm the Critic.

The first two procedures of talking back are important, but they are not enough. The child will not be able to permanently turn off the Critic by calling names and insisting that s/he is too costly. When the Critic has been silenced, the child will have to replace that voice with a realistic mantra about his/her own worth. Affirming your worth is no easy task. The Critic would have you believe that there is no intrinsic value to your life, only a potential for doing something worthwhile, something important.

The truth is that your intrinsic value is your consciousness, your ability to perceive and experience. The value of a human life is that it exists. The child does not need to prove this value. Thus, the child will need to develop affirmations on two levels. The first, is a statement of intrinsic value, which can be as simple as “I am worthwhile 11 cognitivebehavior. com because I live and am aware”. The other affirmation is based on the potential for doing – the potential for continuous quality improvement of personal performance.

This affirmation should be tied to the DOING section of the CBP#08 – Self Affirmation protocol. It is important that you and the child work together to develop these mantras. It is helpful if you can identify affirmations that the child believes. But, even if s/he doesn’t believe the affirmation, the rules of repetition and habituation apply. One of the procedures that you will want to do at this point is the Accurate Self Assessment. What is important is that s/he state these affirmations to him/herself on a regular basis. The changeworker can help schedule them.

For example, the intrinsic mantra could be said every morning as soon as the child wakes up, when s/he is going into a performance test, or when s/he is going to bed. The potential mantra can be stated whenever the specific potential is being tested. For example, if the potential mantra is “I can make ten foul shots in a row! ”, it can be said every time the foul shooting practice takes place. Perhaps the only rule is that the child must be comfortable with the mantra(s) selected, and not feel foolish saying them even to him/herself. Procedure: Accurate Self Appraisal

This procedure starts with a Self Concept Inventory. The child is asked to write down [or record on tape] as many words or phrases as s/he can to describe him/her self in the following areas: • Physical appearance: Include descriptions of height, weight, facial appearance, quality of skin, hair, style of dress, as well as specific body areas such as neck, chest, waist and legs. How you relate to others: Include description of strengths and weaknesses in intimate relations and in relationships to friends, family and co-students/workers, as well as how you relate to strangers.

Personality: Describe positive and negative personality traits. 12 • • cognitivebehavior. com • • • How other people see you: Describe the strengths and weaknesses that your friends and family see. Performance at school or on the job: Include descriptions of the way you handle the major tasks of work &/or school. Performance of the daily tasks of life: Should include such areas as hygiene, health, maintenance of your living environment, food preparations, chores and any other ways that you take care of personal or family needs.

Mental functioning: Include an assessment of how well you reason and solve problems, your capacity for learning and creativity, your general fund of knowledge, your areas of special knowledge, wisdom you have acquired, insight, etc. Sexuality: How you see and feel about yourself in relation to the opposite sex. • • After finishing the inventory, have the child go back and put a plus (+) by items that represent a strength and a minus (-) by items s/he considers a weakness or would like to change about him/herself. Don’t mark items that are neutral, factual observations. Now have the child divide a sheet of paper into two columns.

On the left write down each item marked with a minus, leaving three lines between each to write on. Help the child revise the language of these concerns following these rules: • Use non-pejorative language: Change such words as stupid, fat, ugly, etc. • Use accurate language: Don’t exaggerate and don’t embellish. Make the items purely descriptive. Confine to the facts. • Use language that is specific rather than general: Eliminate words like everything, always, never, completely, etc. • Find exceptions or corresponding strengths: An essential step for those items that the child really feels bad about. Each weakness should be revised.

The next step is to acknowledge strengths. As a result of cultural and parental conditioning, the child may find it anxiety provoking to give him/herself credit. Be audacious. On a fresh sheet – have him/her write down all of the pluses. Seek corresponding strengths on the revised 13 cognitivebehavior. com weakness page. Try to add other special qualities not remembered. Exercise: for a few moments have the child think about the people s/he most admires or cares for. What qualities make this so? Jot them down. It is now time to meld the child’s strengths and weakness into a new selfdescription that is accurate, fair and supportive.

It must be the truth, acknowledging weaknesses that s/he might like to change, but it will also include personal assets. The new description should cover all eight areas of the Self Concept Inventory. Indoctrination The new self description should be read by the child out loud, slowly and carefully, twice a day for four weeks. This is the minimum length of time for him/her to begin changing the ways s/he spontaneously thinks about him/herself. Celebrate Strengths: Ensure that the child remembers strengths in times of distress. The child should remind him/herself verbally.

Three methods to help develop a system to remind about affirmation: • Daily affirmations: This is a one sentence realistically positive statement, which typically begins with ‘I’, and is repeated at intervals throughout the day • Reminder signs: Write a brief affirmation in large letters on a three by five card. Place this on your mirror, by the refrigerator or on your night stand, where you will see it. • Active ingredients: Recall specific examples and times when you clearly demonstrated your strengths. Each day, select three strengths and look into the past for situations that show those qualities.

Self Change For those items in the Self Concept Inventory marked with a minus, the child will want to develop a goal and an implementation plan to address those s/he wishes to change. [See CBT#27 – Motivation & Goal Setting] 14 cognitivebehavior. com Additional Procedures What follows are a series of other procedures that can be used to challenge the Critic and can be used based upon the needs and progress of the child. Compassion The essence of positive self affirmation is compassion for yourself. When you have compassion for yourself, you understand and accept yourself. If you make a mistake, you forgive yourself.

You have reasonable expectations, set attainable goals and tend to see yourself as basically good. The Pathological Critic cannot stand compassion and therefore, compassion is one of the most potent weapons you can have. Compassion is not an unchanging character trait. Compassion is a skill and it can be learned and improved. Compassion is also not something that you only feel for others. There are three basic components to understanding, acceptance and forgiving. Understanding An attempt to understand is the first step toward a compassionate relationship to self and others.

Understanding the nature of the problems doe not mean that you have to come up with solutions for them. It merely means that you have figured out how you operate. It means you have a sense of how you came to be the person you are. Understanding others is mostly a matter of listening to them instead of listening to your own self talk about them. Acceptance Acceptance is perhaps the most difficult aspect of is an acknowledgement of the facts, with suspended. You neither approve nor disapprove of others involves acknowledging the facts about judgements. compassion. Acceptance all value judgements you accept.

Acceptance them without the usual the skill of compassion: 15 cognitivebehavior. com Forgiveness Forgiveness flows out of understanding and acceptance. Like those two traits, it doesn’t mean approval. It means letting go of the past, reaffirming self respect in the present and looking toward a better future. True forgiveness of others means that the accounts are balanced. The person who harmed you no longer owes you anything. S/he is no longer in a one down position to you regarding what happened. To develop a compassionate mind, you must make a commitment to a different way of thinking.

The old way was to judge and then reject. The new way requires that you suspend judgment for a few moments. Procedure: The Compassionate Response The compassionate response begins with three questions you will always ask yourself to promote an understanding of the problematic behavior. 1. 2. 3. What need was s/he trying to meet with that behavior? What beliefs or awareness influenced the behavior? What pain, hurt or other feelings influenced the behavior? Next come three statements to remind yourself that you can accept a person without blame or judgment, no matter how unfortunate his/her choices have been. 4. 5. 6.

I wish ____________ hadn’t happened, but it was merely an attempt to meet his/her needs. I accept him/her without judgment or feeling of wrongness for that attempt. No matter how unfortunate his/her decision, I accept the person who did it as someone who is, like all of us, trying to survive. Finally, two statements suggest that the slate can be wiped clean, that it is time to forgive and let go of it. 7. 8. It is over, I can let go of it. Nothing is owed for this mistake. 16 cognitivebehavior. com The worker should memorize this sequence and teach the child to memorize it as well. The sequence applies to the self as well as to others.

The sequence should be used to review situations in which the child became upset with him/herself or others as a means of slowing down the self depreciation style. Learning compassion skills helps the child to contact a sense of his/her own self worth. The Problem of Worth The difficulty negative self but on what them reframe of determining human worth is a struggle of those with affirmation. They have decided, that they are worthless grounds? Part of restoring them to affirmation is to help the problem of worth. Many criteria for human worth have been devised throughout history. Every culture has its own definition.

Buying into these cultural concepts of worth can be deadly. It may help a little to remind the child that every criterion ever devised for measuring human worth is dependent upon cultural context. The Zen Monk of great virtue is worthless in Wall Street. The most ‘obvious’ and ‘reasonable’ cultural criteria for worth can often be confounded by observation. Some people have solved the problem of personal worth and some haven’t regardless of the outside influence. When you conclude that the solution must lie outside of the culturally determined criteria, that leaves four [04] ways you can approach the concept of worth. . The first way to deal with the problem of worth is to throw it out the window. Accept that human worth is an abstract concept that, upon examination, turns out to have an extremely fragile basis in reality. The second way to deal with the problem of worth is to realize that worth exists, but that it is equally distributed and immutable. Everyone at birth has one unit of human worth, no matter what you do or is done to you, your worth cannot be diminished. 2. It is interesting to notice that these two options are functionally the same, while being essentially different.

The first is a kind of practical agnosticism, while the second is more in line with traditional western 17 cognitivebehavior. com religious teaching. For the purpose of fostering positive self affirmation, you can choose either option and succeed. 3. The third choice is different from the first two without negating either of them. In this option you acknowledge your own internal experience of human worth. Recall the time when you felt good about yourself and own it. The point is to admit that your personal worth exists, as evidenced by your own internal experience, however brief and occasional it has been. . The fourth way to deal with the problem of worth is to take a good look at yourself through the lens of compassion. You carry on, in the face of all pain, past and to come, you continue to struggle to improve. Compassion for others The child may find it easier to understand, accept and forgive others than him/herself or the other way around. Fortunately, this imbalance is self correcting. Feeling increased compassion for others will eventually make it easier to feel compassion for him/herself and vice versa. Sometimes a more convenient term than compassion is empathy.

Empathy is not feeling the same way as someone else feels. That is sympathy. Empathy is also not acting in a tender, understanding manner. That is support. Empathy is not agreement or approval either. Empathy operates outside of and prior to sympathy, support, agreement and approval. There are four [04] procedures that may help the child learn compassion. You can use them in any order that seems easiest. Procedure: Video Encounter This is a safe, nonthreatening way to practice empathy. Have the child watch a television show s/he hates – one s/he normally wouldn’t be caught dead watching.

Have him/her watch and listen carefully. Every time s/he feels irritated, disgusted, bored or embarrassed, have him/her 18 cognitivebehavior. com set these feelings aside and refocus attention. Have the child say to him/herself “I notice I’m feeling very irritated by this. That’s OK, but it is not what I’m interested in right now. I can set the irritation aside and just observe for a while, without judging. When s/he arrives at an empathetic understanding, have him/her switch to another kind of show and try again.

Remind the child that s/he doesn’t have to approve of what s/he sees – just see it clearly and understand its attraction to others. The purpose is to provide a safe, nonthreatening situation in which s/he can practice setting aside snap judgments and gain insight into a point of view s/he would ordinarily dismiss out of hand. The child can expand upon this purpose by watching a show his/her parents enjoy, but which s/he doesn’t like. The dual response of carefully listening and watching, along with observing the parent and determining what the parent likes about the show can give insight.

Obviously, we are not suggesting that the child watch shows that are xrated or inappropriate. Procedure: With a friend As homework, have the child choose a close friend s/he trusts. If no friend can be identified, perhaps an adult relative. Or finally, if no one else, s/he can practice with you. If done with someone other than you – have the child tape the conversation – with permission of the other person. Teach the child beforehand the important aspects of active listening: keeping a beginner’s mind, careful listening, probing for thoughts and feelings, paraphrasing.

Ask the friend to tell a story about something that is important to his/her life: a traumatic experience, an important childhood memory, or a hope for the future. As the friend talks, the child’s job is to listen carefully and ask questions about any part that s/he doesn’t understand. Ask the friend to clarify or expand. Dig beneath the facts by asking for information on thoughts and feelings. Paraphrase what the friend has said – “wait, let me see if I understand: you thought that …. Paraphrasing is an important 19 Active Listening cognitivebehavior. com part of listening with empathy because it keeps you on track.

It helps to remove your own false interpretations and clarify the meaning. Review the tape with the child and help the child identify when and where s/he was judging and where s/he was actively listening. Once you are certain that the child understands and is able to use active listening, go on to the next exercise. With an acquaintance Now, as homework, have the child choose people s/he doesn’t know as well and practice the active listening skills without informing them what s/he is doing. Paraphrasing is even more important with people you don’t know well. Have the child report back on his/her experience.

The child should be able to identify when s/he was judgmental and when not. Ask about the experience in general, what was the child’s feelings about the experience? With strangers Ultimately, you want the child to learn how to communicate with people through active listening, working both on his/her compassion skills as well as the interpersonal relationship aspects. A homework ask him/her to engage a stranger in conversation and use the active listening skills to really try to comprehend what the person has to say. After each homework event, have the child go through the Compassionate Response sequence.

Procedure: Compassion for things past This is a visualization exercise that can be done over and over again to develop skills in understanding, acceptance and forgiveness. The first time should be done with the changeworker and the worker should question the child and focus the child. This then can be given as homework either on the same past event or on different ones. In the case of homework, the child should be supplied with a tape recorder so 20 cognitivebehavior. com that s/he can comment on the experience just as s/he does here. First, have the child select an event from the past, one that the Critic has used to make attacks.

Have the child get into a comfortable position [See CBT#04 – Relaxation]. Closing his/her eyes and taking deep breaths, have the child scan his/her body for tension and stretch or relax any tight areas. At this point, let the child begin drifting into the past. Go back to that time when the selected event was unfolding. Ask the child to see him/herself doing whatever it was s/he now regrets. Have the child describe how s/he was dressed, the room and the environment. Have her report any conversation that is taking place. Have the child notice how s/he feels [physically or emotionally]. Ask the child: “What need were you trying to meet? Was s/he trying to feel more secure, more in control, less anxious, less guilty? Ask the child: “What were you thinking at the time? ” What were his/her beliefs about the situation? How was s/he interpreting things? What did s/he assume to be true? Ask the child: “What kind of pain for feeling was influencing you? ” Give the child time to think about these questions and to respond thoughtfully. When the child has answered the questions, have the child stay focused on being in the event and say to the person s/he was [in that time]: I wish this hadn’t happened, but I was trying to meet my needs.

I accept myself without judgement for my attempt. I accept myself at that moment as trying to survive. I owe no debt for this mistake. 21 cognitivebehavior. com It is over, I can forgive myself. If the child is comfortable with this exercise, it should be repeated both with you and as homework for both depth and breadth over past issues. Procedure: Compassion Meditation This procedure has three parts: visualizing and feeling compassion for someone who has hurt the child, for someone the child has hurt, and for the child.

Have the child sit or lie on his/her back with hands and arms uncrossed and legs stretched out side by side and take deep breaths, scanning the body for tension. Again you may want to use CBT#04 Relaxation as preparation for this procedure. Someone who has hurt the child It may be important to start with a hurt that the child can forgive more easily than the severe hurt that will need to be addressed later. The worker should read this to the child and/or tape it for homework use. Imagine there is a chair in front of you. Someone is sitting in the chair, someone you know who has hurt you in some way.

Imagine that person who has hurt you sitting silently in the chair. Notice all the details: how big or small the person is, the clothes, the colors, the posture. The person who has hurt you is looking calmly, expectantly at you. Say to the person: You are a human being like me. You are tying to do your best. When you hurt me, you were trying to maintain yourself. You do your best, given your limitations and your understanding of the situation at the time. I can understand your motivations, your fears, your hopes. I share them because I am human too. I may not like what you did, but I can understand it. I accept the fact that you hurt me.

I do not like it. Nothing now can change what happened. I forgive you. I may not approve or agree, but I can forgive. I can let go of the past and wipe the slate clean. I know better 22 cognitivebehavior. com than to expect atonement. I let go of revenge and resentment. Our differences are in the past. I am in control of the present. I can leave my anger behind. Have the child continue looking at the person who hurt him/her. Gradually s/he should open him/herself to the other. Let anger and resentment fade out. If it is difficult for the child to empathize or let go of his/her anger, take a moment and then say “I forgive you” one more time.

Let the image of the person fade. This may be very difficult for the child, depending on the hurt s/he has chosen to address. What is important to remember is that anger and hate is a self deteriorating experience. It is important that the child let go of it. Someone the child has hurt Following the same preparations, now have the child imagine the person in the chair to be someone whom s/he has hurt. Someone from whom s/he wants understanding, acceptance and forgiveness. Remind the child to see all the details of clothing and appearance, making the vision as real as s/he can. The person s/he has hurt is looking at im/her calmly, expectantly. Say to the person: I am a human being, worthy but imperfect. I am like you. We are both just trying to do our best. When I hurt you, I was just trying to do what seemed best for me at the time. If I had then the awareness I do now, I would have chosen differently. But at the time, I could only do what I did. I understand that I hurt you and I want you to know that hurting you was not my goal. Please accept the fact that I hurt you and nothing can change that. I would undo it if I could. You would undo it if you could. But we can’t. Nothing now can change the past.

Please forgive me. I don’t ask you to approve of what I did, or agree with me, but I do ask you to forgive me. I want to put 23 cognitivebehavior. com our differences in the past, wipe the slate clean and start fresh. As the child looks at the person, s/he should see that person slowly smile. Know that s/he is understood, accepted and forgiven. Let the image of the person fade away. For him/herself As the final segment of this meditation, the child should imaging him/herself sitting in the chair. Again, see all the details. Have the child imagine that the image of herself is saying: I am a human being.

I am worthwhile just because I exist and try to improve. I take care of myself. I take myself seriously. I correctly take myself into consideration first in all matters. I have legitimate needs and wants. I can choose what I need and want without having to justify it to others. I make choices and I take responsibility for them. I always do my best. Each thought and action is the best I am capable of at the time. Because I am human, I make mistakes. I accept my mistakes without blame or judgement. When I make a mistake, I learn from it. I am imperfect, but continue to improve. I know that others are equally worthy, equally imperfect.

I have compassion for them because they are engaged in the same struggle for improvement that I am. Now have the child imagine the figure of him/herself get up from the chair, come over to the child and merging with him/her. Have the child relax and rest. S/he is at peace with him/herself and others. When s/he is ready, s/he can open her eyes and move on. This procedure should be done at least five [05] times over the following 24 cognitivebehavior. com two weeks. CONCLUSION This technique is particularly oriented to the process of Self Affirmation, There are other techniques which can be used to challenge the Critic. 25

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