I read Feeling Good some time ago and think it is excellent. For those not familiar, it was written by Dr David D Burns who worked with Aaron Beck. However I’d since assumed that CBT was a’ finished work ‘. While the list of cognitive aberrations haven’t changed, I’ve lately detected got a couple of techniques that( to me) seem like useful additional approaches to consider.
The first is in Dr Chris Williams’ Living Life to the Full volumes( also available as an inexpensive programme through the website of the same name, some of the booklets are free ). He describes’ five areas’ – the specific situation, responded to with altered reasoning, which leads to altered impression, altered behaviour and finally to altered physical symptoms. His phase is that a positive change in any of these five areas may aid recovery. So an anti-depressant may lift the physical( chemical) symptoms of depression, but so may alter behaviour. CBT always seemed to me to be heavily about the “C” – Cognitive and not about initiating changes in other areas of our lives. Patently in someone who is depressed, an SSRI may be the only treatment which they have energy to comply with, but given an early warning that a depressive episode is coming on, boosting behaviour alone may be enough, especially if it’s previously worked to lift mood( and we remember this ). He describes this approach as reversing/ spinning the circle.
The second technique is described by David D Burns himself in a recent situate of( free) podcasts, relating to TEAM therapy. The Test – Empathy – Agenda-Setting – Method approach is covered in seven of them. While he presents this as new, it seems to me it’s an enhancement of CBT and one that is particularly useful with treatment-resistant people. The agenda-setting proportion is organized around more than “What shall we cover today” and is about role-playing a paradoxical version of the individual’s situation to help them to see that what they are defending – their faulty reasoning – may be the root cause of the problem. He lists four various kinds of distress – relationships, depression, anxiety, craving – and says that for each there are two forms of resistance – outcome resistance and process resistance
A simple instance is when someone tells “I should get slim” – there are always reasons that that outcome is resisted, from “I would have to buy more clothes” to “My wife would be more jealous”. I think most people would agree the process resistance is “I would have to eat less and exercise more”
I’d be interested in hearing if anyone else can identify outcome and process resistance to change in their own lives. I’d like to build some changes myself and want to feel I’m not alone out here!
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