May 2, 2022
Last week, you heard the first part of this live therapy session with Anita, a woman struggling with severe social anxiety. David and Dr. Stirling Moorey, from London, are co-therapists. Last week included the T = Testing and E = Empathy portions of the session. Today you will hear the A = Assessment of Resistance, M = Methods, along with end of session Testing and follow-up.
A = Assessment of Resistance
David asked Anita if she was ready to roll up her sleeves and get to work, or if she needed more time to talk and be listened to and supported.
Because she was eager to get to work, David asked the “Miracle Cure Question:” He said, “What would happen in today’s session if it went really great and knocked your socks off?
She said that her negative feelings and self-critical thoughts would be greatly diminished.
David asked the Magic Button Question, and she said she’d press it for sure!
David said he had no Magic Button, but did have some powerful techniques that could be super helpful, but was reluctant to use them. Anita was puzzled, and this led to Positive Reframing. He encouraged Anita to ask the three questions about each Negative Thought and feeling on her Daily Mood Logs:
Although puzzling at first, Anita soon got into the swing of it and came up with the following list of Positives.
David pointed out that there were many positives on the list, and if we had time many more could be added, but asked Anita if the positives were:
She gave enthusiastic “yes” answers to all three questions, and then david asked the Pivot Question: Why in the world would you want to press that Magic button, because if you do all these positives will go down the drain, right along with you negative thoughts and feelings
Anita suddenly didn’t want to press the Magic Button, but agree to use the Magic Dial and lower her goals for each negative feeling, which you can see if you click here.
This concluded this part of the session, which brought us to the M of TEAM.
M = Methods
During the Methods portion of the session, David and Stirling used a number of techniques, including:
And more, using frequent role reversal until she got to “huge” wins, which didn’t take long. Stirling also asked gave Anita how she might test if her fears about the way others saw her were accurate, and they devised some homework to do in the Wednesday training group to find out if other group members had experienced similar doubts about their abilities as therapists. This would involve using:
You can see her final Daily Mood Log if you click here (LINK).
We also jumped in and tried to work with Anita’s conflict with her supervisor, but ran out of time and might pick up that thread again in a future session if she is interested.
I might add that both David and Stirling also used Self-Disclosure and Story-Telling during the session, as well as some spontaneous humor, which can also be viewed as a valuable treatment method, but one that is hard to explain or teach.
You can see Anita's final Daily Mood Log with the outcomes of all of her negative feelings. As you can see, she exceeded her goals in every category, which is not unusual, and was feeling pretty terrific!
She had the homework assignment to listen to the recording of the session and complete her DML, so you will only see a couple of the Positive Thoughts listed.
Final T = Testing
You can see Anita's final BMS here, and her Evaluation of therapy Session here As you can see, there were dramatic reductions in depression and anxiety, but only a modest boost in happiness. It would be interesting to see if the happiness goes up further after her "behavioral experiment" at Wednesday's tuesday group. Her scores on the Empathy and Helpfulness scales were perfect.
Follow-up
This is the email we received from Anita three days later, right after her "behavioral experiment" in Rhonda's Wednesday TEAM-CBT training group::
Hi Stirling, Rhonda, and David,
I did the survey question in Rhonda’s Wednesday training group. Here’s what I said:
“I am so nervous right now. I sometimes feel like I do not have much to say and so I stay silent in the group. I get anxious and think you all are so far ahead of me in your skills, so I miss out on sharing. I was wondering if any of you sometimes feel the same way?”
So many hands shot, so many affirmed my question and thanked me for asking because they get anxious too. I was a little overwhelmed. Loved the experience!
Rhonda I hope I did not take too much time.
Anita
Rhonda, Stirling, Anita, and David