Coping.org:
Tools for Coping
with Life's
Stressors
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The
goal of the challenging techniques in ESBT are to assist clients to have a
better understanding of the unhealthy thinking and emotions underlying their
presenting problems so that they can change them so as to alter their behaviors
and actions. In order for this to happen ESBT therapists must have a thorough
clinical understanding of the presenting problem, which can be obtained by a
clinical interview and supportive homework assignments with assessment
orientation such as the Growing Down Assessment, which are five family
assessment activities, which clients can complete prior to their second
appointment. Once there is better understanding of clients then therapists in
ESBT focus on the presenting problems with a goal to create change in and out of
the sessions.
Challenging
techniques in ESBT are based on a philosophy similar to the ALERT system
developed by Messina (Self-Esteem Seekers Anonymous - The SEA'S Program
Manual).
Clients use the ALERT system when they are confronted with a fear, challenge,
pressure, or crisis, which causes anxiety, panic or stress.
A - Assess
L - Lessen
E - Ease
R - Relax
T - Take Action
A
- Assess
Clients
and their therapists in ESBT must first assess and identify the fear, challenge,
pressure or crisis that is creating their anxiety, panic, or stress. Then they
need to identify the "sick" irrational and unrealistic thoughts and
feelings, which are at the root of the presenting problem, which is causing the
discomfort.
L
- Lessen
Clients
then need to lessen the impact of the "sick" thinking and emotional
response by countering it with new, more rational and reality-based beliefs and
feelings. The clients with the help of their therapists are expected to identify
"healthier" alternative self-scripts, beliefs, attitudes and ideas
about their presenting problem. This enables them to picture their presenting
problems as manageable, workable and potentially fixable.
E
- Ease
Clients
are then expected to ease their anxiety, panic or stress by
"self-talk" based on their new rational and reality based beliefs and
feelings. Clients visualizing themselves handling the current fear, challenge,
pressure or crisis in a successfully healthy way augments these new self-scripts
and self-affirmations.
R
- Relax
Clients
are then expected to relax once they have begun to counter their fear,
challenge, pressure or crisis with healthier, more rational and realistic
thoughts and emotions and self-talk. They are asked to let go of the tension,
tightness and knots in their bodies while attending to a state of calmness,
warmth and relaxation which comes from releasing the stress in their bodies.
T
- Take Action
Once
clients are more relaxed they are ready to take action to confront the fear,
challenge, pressure or crisis with healthier, more rational and realistic
thoughts and emotions. They are expected to take steps to relieve their anxiety,
stress and panic by changing behaviors, response patterns and actions. They are
encouraged to act in a calm, confident, relaxed, less anxious, less panicked and
more rational manner. By taking action on their own to change their presenting
problems they grow in greater self-confidence, self-worth and self-esteem.
Challenging
techniques in ESBT are used to encourage clients to take on their own problems
to resolve and change. The challenge being to prove to themselves that they
indeed are the "light bulbs will to be changed." What follow next are
some ESBT challenging techniques:
1.
Use homework, tasks, practice assignments and prescriptions. Have the clients
prescribe their own assignments or assist them to identify what they need to
complete prior to their next session. Make future sessions contingent on
completion of their assignments. The Tools for Coping Series contains 150
homework chapters or ESBT tools in ten specific categories:
Self-esteem
development (Family Systems: Satir, 1983, 1988)
Life
style of recovery (Reality Therapy: Glasser, 1965, 2000)
Family
of origin behavioral introjected scripts (Gestalt: Perls, 1969) and
irrational beliefs (REBT: Ellis & Harper, 1997),
Handling
loss (Existential: May & Yalom, 1991),
Personal
growth (Behavioral: Lazarus, 1995, 1997; REBT: Ellis & Harper, 1997;
Cognitive: Beck, 1976 & Meichenbaum, 1997),
Handling
relationships (Family Systems: Satir, 1983, 1988),
Communications
(Person Centered: Rogers, 1961),
Anger
work-out (Gestalt: Perls, 1969),
Handling
control issues (Reality Therapy: Glasser, 1965, 2000; Adlerian: Adler, 1930,
1931, 1938 & Dreikurs, 1964),
Healing
the inner child for self healing (Psychodynamic: Freud, 1955; Family
Systems: Bowen, 1978; Haley, 1985; Minuchin, 1974, 1981; & Whitaker,
1976)
These
materials encourage clients to keep a personal journal in which they respond to
the "steps to change" section in each chapter. In their journal they
are also encouraged to record the following:
An
incident or issue that has come up for you today or their week.
How
you dealt with the incident or issue.
What
you’re thinking and feeling at the time of the incident or issue.
What
you would have done differently to handle the incident or issue in a
"healthier" way.
What
your plans are to improve your handling of the same or similar incidents and
issues in the future.
Clients
are encouraged to use their journal and homework writing as a self-healing
experience, opening up emotions and feelings long repressed, suppressed,
ignored, non-identified or unknown. They are encouraged in the "steps to
change" journal work to identify their irrational (Ellis, 1997, 1998),
non-reality-based and unhealthy thinking which has been keeping them stuck and
unproductive. The Tools for Coping journal work becomes an action-planning tool
in which clients write their own books of personal recovery to chart new actions
and behaviors based on healthier and more rational thoughts and emotions.
2.
Have the client envision change. Gibson (1989, p. 35) provides the following
instructions for this vision: "Suppose that some months from now you and
I were to meet and I would show you two one-minute video clips of yourself. One
would come from yesterday, when your problem was bothering you. The other one
would come from a time in the future after you have solved your problem. If
nobody told you which was which, how would you know which one was
"before" and which one was "after"?"
3.
Use novelty, uncommon therapy, do something different with clients, which catch
them off guard and excites them to change, similar to the approach of Whitaker
(1976) in his experiential therapy model.
4.
Use a one-down position, using the "Colombo" technique, recommended by
Cummings (1979), where you let it be known that you do not fully understand or
comprehend the clients’ complaints and need for them to more fully explain
what is going on concerning their presenting problems.
5.
Use humor in treatment. Hoyt (1990) encouraged humor and hyperbole as shown in
this example. He used the following comment with a man about to turn 40. The man
had been complaining that he was feeling old, and that life was rushing by
despite that fact that he was in a "Type A" frenetic fit. He
complained about his inability to make commitments. Hoyt then asked him to be
specific, "What commitment?"
Client:
Well, my girlfriend wants to get married, but I'm not sure.
Therapist:
How long have you been together?
Client:
Eight years.
Therapist:
Oh, I see. Well, you certainly don't want to rush into it. Why don't you
wait to see how she handles menopause and retirement? You certainly don't
want to get stuck with a crotchety
old lady, do you?
The
client laughed, first at Hoyt's gentle mockery, then harder, at himself.
"It is crazy, isn't it?” he said. Hoyt tried to keep a straight face but
added: "Well, I don't know. You can't tell what's going to happen in the
future." Many months later the client telephoned Hoyt to let him know that
he had gotten married and was happy. He offered Hoyt thanks for "bringing
me to my senses." Hoyt told him he was glad to hear that the client was
happy but the credit was his own because "you're the one who got the
joke."
6.
Focus on clients' roles in their past and current family lives. Teach the
clients to do genograms (Bowen, 1978) so that they can have a clearer
understanding of the dynamics of their past and present interpersonal
environments. This helps clients to understand the impact of their families of
origin on their current behaviors. In Laying the Foundation (Messina, 1999-2001)
provides a tool for clients to assess their families and themselves as to the
presence of 9 behavioral patterns or roles developed in dysfunctional families.
These behavioral patterns or roles are: looking Good, Acting Out, Pulling In,
Entertaining, Troubled Person, Enabler, People Pleaser, Rescuer and Non-feeling.
Clients are helped to recognize that the past roles they played in their
families of origin were necessary for survival then but are not adaptive or
functional in their "here and now" adult lives. Once clients have a
good understanding of various roles in family life, have them sculpt (Satir,
1983, 1988) their families of origin and current families to recognize the
feelings and emotions involved in the roles they play so as to motivate their
desire to change out of their unhealthy role scripts.
7.
Utilize metaphor or paradox. An example of extensive use of metaphor is in
Growing Down: Tools for Healing the Inner Child (Messina, 1999-2001). It uses
the metaphor of inner child to mean the "inner part" of clients, their
inner spirit or inner voice, which they have too long neglected, ignored or
forgotten. The metaphor of child opens up clients to begin to re-parent and love
themselves through: letting go of shame and guilt self-forgiveness, getting in
touch with their feelings (Perls, 1969), unconditional self-acceptance,
overcoming invisibility, having fun (Glasser, 2000) and establishing healthy
boundaries (Minuchin, 1974).
8.
Use the Crystal Ball Technique (DeShazer, 1984) to project the clients into a
future through visualization. The four steps of the Crystal Ball Technique are:
Step 1: Have the clients visualize and fully experience an early,
pleasant memory. Have them picture what other people are doing, what they
are doing and then have them return to "where it has been." Goal:
Encourage the idea that forgotten things can be remembered and remembered
things can be forgotten. Repeat several times until clients are trained.
Step 2: Repeat the above
task this time to retrieve a "surprisingly forgotten memory and picture
some success. Goal: To awaken feelings of success.
Step 3: Now have the
clients picture "returning to tell me about your successful resolution
of the problem." Goal: To orient clients to the future and their
success in the future with their presenting problem.
Step 4: Have the clients
remember the manner in which their problems were resolved.
9.
Ask challenging questions of clients (Gibson, 1989).
Ask: Why aren't you worse?
This question prompts clients to take informal inventory of their coping
skills.
Ask: What keeps you from
applying your past solutions to this problem? This question helps clients to
recognize that they can competently handle problems since they have done so
in the past. If they have been successful in the past they can be successful
in the present and future.
10.
Encourage Bibliotherapy. Assigning reading to supplement therapy assist
therapists to validate with clients what is being talked about in sessions.
Getting other perspectives about the same topic from authors helps some clients
to gain trust in the goals and work of their therapy sessions.
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The Tools for Coping
Coping.org
is a Public Service of James J. Messina, Ph.D. & Constance M. Messina, Ph.D.,
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