I have gotten some pretty good feedback on an exercise I’ve recently put together and have used in groups. It’s one of those things I imagine someone has already thought of and used but I never came across it. The “pieces” to it come from well-established theories and interventions (EMDR, Psychodynamic Theory and Cognitive Behavioral Therapy). So much of this is not new, but I think how the exercise is packaged and implemented here may be.
Whether it’s new or not, I’m posting it on here because the folks I have used it with have reported pretty significant shifts in their thinking as a result. It appeared most helpful to individuals who experienced trauma or were raised in highly critical and abusive family systems. Please understand that me saying “this was helpful” is based purely on anecdotal data. It worked for the folks I used it with; it may not work for everyone. Also, when I use this in groups “Step Six” is something group members help the individual with-there is something powerful about other people validating your experience.
Before proceeding with this exercise please place a priority on safety. This article is mainly intended as a resource for therapists to use in session. This exercise is something that should be done within a therapy session. You really, really, really shouldn’t do this on your own if you are triggered by negative memories, negative thoughts or negative feelings into:
- Suicidal thinking
- Dissociative states
- Relapse (alcohol, other substances)
or if you struggle with
- Trauma and Loss
Step One- Worst Image
Think about the most recent event that you feel really captures the problem. For example, some folks with depression may identify the following:
“Last weekend when I was invited to a party put I spent the entire day in bed staring at the ceiling”
Someone with anxiety may say:
“Three days ago when I started having a panic attack at a meeting at work.”
An individual with significant life changes might say:
“When I told my wife I lost my job”
Someone with PTSD may say:
“When I woke up screaming and terrified”
Step Two-Identifying the Negative Cognitions
Watch the “movie” of the event in your mind and hit the pause button on the part of it that brings up the most intense negative feeling and/or thinking. You may have to watch the movie a couple of times to identify that part of it.
Once you’ve identified the worst image, sit with it. Notice your thoughts and feelings as you sit with it. Notice and identify the negative beliefs that appear to come up for you and list ALL of them. Examples of negative beliefs include:
“I’m not safe”
“I’m not in control”
“I’m a failure”
“I am dirty”
“I am used”
“I am broken”
Step Three-Identifying the source
After identifying the negative belief, scan your life history to find your earliest memory of hearing this about yourself. Was this something you learned from the perpetrator(s), your parents, teachers, or coaches? Was there an early experience when you felt like you failed or let people down?
Step Four-Checking source credibility
Ask yourself; is this a reliable source of data? Is it reasonable or fair to form a firm conclusion about yourself or anyone based on these sources?
If your loved one, friend or even someone you did not know shared a similar experience, would you draw the same conclusion about them? Would you call them “stupid”, “inadequate” a “failure”?
Now imagine this friend or loved one at the same age as you were when this happened to you. Would you call that person or child “stupid”, a “failure”; would you hold them as accountable for the things that happened to them or their family at that point in time? Would your view of them be so black and white? No? Why not?
What kind of person would call a child or even another person “a failure”, “stupid” or “inadequate”? What would that say about their credibility in forming conclusions about others? Is this the kind of person you would rely on for information about another person?
Step Five- Broadening the Memory
Scan your life again. All of it. Over and over. And look for the evidence that contradicts the negative cognition and the source of it. What evidence exists that demonstrates you are not what your negative cognition says you are? Write everything that comes up for you on another list. Some examples might include:
“I spend time with my kids and they tell me that they love me”
“I may have failed at times but I have also succeeded, I had great jobs that I chose to leave in order to pursue other opportunities”
“I graduated college or high school”
“People tell me I’m a great friend, that they can trust me”
“I lost my job but I’m surviving it”
“My house couldn’t function without me; I know this after I come home after being away for a while”
“I know my family needs me, because they worry about me when I’m in my symptoms”
“Although being raped affects me, I can still function- I work and manage my household, I haven’t stopped living”
“Although I was abused, I don’t allow it to affect the relationship with my kids. Children are safe with me. I can be and am trusted.”
Step 6- Evidence based cognitions
Allow yourself to examine the list of evidence that contradicts the negative cognition; observe each of those events in your mind. After doing so bring your attention back to the source of the negative cognition (step three) and answer this question:
“How would you describe someone who was made to believe that they were [“stupid”, “a failure”, “inadequate”, “dirty”] who was then was able to [“survive the trauma”, “survive that childhood”, “maintain a great relationship with their kids”, “graduate high school or college”, “be a great friend”, “get a job”, “survive losing a job”]? What would you say about that person? List all the evidence based characteristics and qualities that come to mind. A list may look something like this:
Step 7-Examine the evidence and make your choice
Look at the evidence in front of you mindfully. Which list seems more credible to you? Coming from a place of reason, what evidence would be most appropriate to act from, live in, and be attentive to?
Take the list of evidence based cognitions, put it somewhere convenient (maybe on your phone, purse, or wallet) and carry it with you. Make an active decision to refer to it when you’re thinking, emotion or behavior seems to be straying from who you really are- a survivor.
This exercise can elicit strong feelings and it’s important to take a break from it if they become overwhelming. It is not unusual to engage in a breathing exercise or mindfulness activity throughout different points as a way of bringing a person “back”. Other therapists that work from a different modality can use the emotions that come up in ways they feel makes sense for their work.